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Biomedical subjects

W R Burnham

Publications and source records attributed to W R Burnham.

At least 55 records · Page 3Linked to original sources
PubMed1986

HLA-A and -B antigens in inflammatory bowel disease.

We examined all available data on HLA-A and -B antigen distributions in patients with Crohn's disease and ulcerative colitis. The risk of Crohn's disease was significantly increased in individuals with HLA-A2, having a relative risk of 1.25, in 730 pooled Caucasoid patients compared with 10 863 pooled controls, and decreased in individuals with HLA-A11, having a relative risk of 0.62. The risk of ulcerative colitis was also significantly increased in individuals with HLA-B27 and -Bw35, having a relative risk of 1.81 and 1.41 respectively, in 560 pooled Caucasoid patients compared with 6151 pooled controls, whilst in 144 pooled Japanese patients who were compared with 442 pooled controls, the risk of colitis was increased in individuals with HLA-B5 with a relative risk of 2.79. All differences remained significant after correction for the number of antigens examined. The bases for these genetic associations are unclear.

Colitis, Ulcerative↗
PubMed1985

Use of adjuvants for enhancement of rectal absorption of cefoxitin in humans.

The biological availability of cefoxitin administered rectally in the form of suppositories was examined in six human subjects by a cross-over design. Four different suppository systems containing adjuvants expected to enhance the absorption of the drug were studied. The presence of sodium salicylate and a nonionic surface-active agent, Brij 35, gave increased bioavailability as high as 20% compared with 3% for a system without adjuvants. The quantity of sodium salicylate was found to have an influence on the quantity of cefoxitin absorbed, and the salicylate was absorbed over an extended period of time from the rectum. The suppositories were well tolerated, and there were no adverse effects on bowel flora.

Biological Availability↗
PubMed1984

The microbial flora of the rectal mucosa and faeces of patients with Crohn's disease before and during antimicrobial chemotherapy.

The faecal flora and mucosa-associated flora (MAF) of rectal biopsy material from 12 patients with active Crohn's disease were studied before and during treatment with a combination of metronidazole and cotrimoxazole given orally for at least 2 weeks. The total faecal flora was greater than the MAF although the proportions of bacterial groups were similar. The changes observed during treatment were: obligate anaerobes such as Bacteroides spp. decreased in faeces (p less than 0.05) and in MAF (p less than 0.02); the total count of facultative bacteria increased in the faeces (p less than 0.002) but not in the MAF. Streptococci, predominantly enterococci, increased significantly in faeces (p less than 0.001) and in MAF (p less than 0.02) such that they became predominant components of these florae. Facultative gram-negative bacilli were unaltered in faeces but significantly reduced in the MAF (p less than 0.05). Sporing clostridia were infrequently isolated from the MAF but were significantly reduced in the faeces (p less than 0.01). During the treatment period, eight of the 12 patients showed clinical improvement, but this could not be related to the site or extent of disease or to specific changes in faecal flora or MAF. This combination of antibacterial agents causes profound alterations to the bacterial flora of mucosa and faeces and these changes may help to define the role of bacteria in the pathogenesis of Crohn's disease.

Adult↗
PubMed1983

Simplified intravenous nutrition using Intralipid-based mixtures in patients with serious gastrointestinal disease.

An Intralipid-based intravenous feeding mixture has been given to 20 patients with serious gastrointestinal disease who required parenteral nutritional support (mean duration 13.75 days). In half of the patients, only peripheral veins were used for infusion (mean duration 12 days), the infusion site being changed every 24-48 hr. Positive nitrogen balance was maintained in all but one individual and other parameters of nutrition improved. No serious complications due to intravenous feeding were encountered, although some patients did develop abnormal liver function tests and mild phlebitis at the peripheral vein infusion site. No abnormalities of pulmonary gas exchange attributable to the infusion were noted. We conclude that this mixture is safe, relatively simple to use and effective. Consequently, it may be especially appropriate for patients in general medical and surgical wards as well as those in specialist units.

Adult↗
PubMed1980

Cimetidine and ranitidine in duodenal ulcer.

Two histamine H2 antagonists, cimetidine and ranitidine, given in doses of 1 g daily and 200 mg daily to 18 and 20 patients respectively proved equivalent in promoting healing of duodenal ulcer. No adverse effects occurred during the trial, though serum urea and creatinine concentrations tended to rise slightly during treatment with cimetidine but not ranitidine. Choice between the two drugs is likely to be influenced by overall patterns of adverse effects rather than considerations of individual potency.

Adult↗
PubMed1979

Oral BCG vaccine in Crohn's disease.

In a randomised double-blind trial over one year oral BCG has been compared with a control preparation in the treatment of chronic Crohn's disease. Overall assessment scores deteriorated in nine of 22 patients taking BCG, and 11 of 26 in the control group (P = 0.25); this deterioration was great enough to be regarded as a clinical relapse in three patients taking BCG and in seven taking the control preparation (P greater than 0.1). No significant benefit from oral BCG treatment has been demonstrated.

Adolescent↗
PubMed1978

Mycobacteria as a possible cause of inflammatory bowel disease.

Mesenteric lymph-nodes from 27 patients with Crohn's disease, 13 with ulcerative colitis, and 11 without inflammatory bowel disease were cultured for mycobacteria. A node from a patient with Crohn's disease yielded a strain of Mycobacterium kansasii. Cultures from 22 other patients with Crohn's disease, 7 with ulcerative colitis, and 1 control subject yielded pleomorphic organisms with the electron-microscopic appearances of cell-wall-deficient organisms. Further culture and characterisation of these organisms has so far proved unsuccesful. Skin tests with tuberculin were positive in a smaller proportion of patients with Crohn's disease than in healthy control subjects. Conversely, the patients gave a higher proportion of positive reactions to a reagent prepared from the strain of M. kansasii isolated. No differences in the proportion of positive test were found between patients and controls with reagents prepared from 16 other mycobacteria. Cell-wall-deficient mycobacteria are a possible causative agent of inflammatory bowel disease.

Adolescent↗
PubMed1977

Sexual problems among married ileostomists. Survey conducted by The Ileostomy Association of Great Britain and Ireland.

The Ileostomy Association of Great Britain and Ireland has conducted a survey to assess the incidence and nature of sexual problems among a one in 10 sample of its membership. The analysis was restricted to married ileostomists; of those aged up to 45 years at the time of operation 16% had married and 23% had had children after the operation. The majority had adapted well to the ileostomy, and this appeared true also for the spouse. However, 12% of those who replied ascribed marital tension, unhappiness, or even separation, to the presence of the stoma. There was no evidence of sexual dysfunction from the construction of an ileostomy without rectal excision. After rectal excision nearly one-third of men reported sexual dysfunction, the frequency and severity of which was related to the age at operation. Up to the age of 45, one of 88 men developed complete erectile impotence and 17 partial dysfunction; over this age five of 30 men developed complete and 11 partial erectile impotence. One-third of women reported some dyspareunia after rectal excision.

Adolescent↗