Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038358 (gastric ulcer)
 5,179 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied omeprazole and ranitidine in promoting duodenal ulcer healing in a multicentre trial by comparing the proportion of healed ulcers after two, four, and eight weeks of treatment. Altogether, 194 patients (143 men) were randomly allocated according to a prearranged treatment schedule to either drug and were treated double blind. Each received 40 mg omeprazole in the morning and a ranitidine placebo morning and evening or 150 mg ranitidine morning and evening with an omeprazole placebo in the morning. A total of 188 patients (94 taking omeprazole, 94 taking ranitidine) completed the trial. Sixty four (68%) omeprazole treated and 45 (48%) ranitidine treated patients had healed ulcers at two weeks, 91 (99%) omeprazole treated and 79 (88%) ranitidine treated had healed ulcers by four weeks, and 91 (100%) omeprazole treated and 86 (97%) ranitidine treated patients had healed ulcers by eight weeks. The overall difference in healing rates was significant (p = 0.0008, Mantel-Haenszel test). The differences were significant also at two weeks (20%, 95% confidence interval 5.6 to 34.4, p less than 0.01) and at four weeks (11%, 95% CI 3.7 to 17.3, p less than 0.01), but not at eight weeks (3%, 95% CI -0.5 to + 7.3, p = 0.25), using the chi 2 statistic, the study having a power to detect a 20% difference on 90% of occasions. After two weeks of treatment complete symptom relief was observed in 70 (74%) patients receiving omeprazole and in 58 (62%) receiving ranitidine. Diary cards showed a significantly lower percentage of days with pain in the omeprazole treated group (7.4% v 21.4%, p < 0.02) when assessed over either the first two weeks or over weeks three and four treatment. A total of 144 patients with healed duodenal ulcer were followed up, with no treatment, for six months. At the end of this period 19 (26%) of 74 patients healed with omeprazole and 17 (24%) of 70 patients healed with ranitidine were still in remission. A similar protocol was used for 46 patients (25 men) with gastric ulcer who were randomly allocated to treatment with omeprazole or ranitidine as described above. Forty patients (16 omeprazole, 24 ranitidine) completed trial. Thirteen (81%) omeprazole treated and 14 (58%) ranitidine treated patients had healed ulcers at four weeks; at eight weeks 14 (93%) omeprazole treated and 20 (87%) ranitidine treated patients had healed ulcers. These differences were not significant at four weeks (p = 0.25) or eight weeks (p = 0.96). Twenty seven gastric ulcer patients were followed up for six months and seven (58%) of the 12 omeprazole healed and five (33%) of the 15 ranitidine healed patients were in remission at six months. Unwanted adverse events were trivial except for one fatality in a 67 year old women, who died from bronchopneumonia and myocardial ischaemia while receiving treatment with omeprazole, which was judged to be unrelated to her death.
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PMID:Double blind comparative study of omeprazole and ranitidine in patients with duodenal or gastric ulcer: a multicentre trial. Cooperative study group. 206 Aug 85

The trial was carried out in a large Hungarian 2000 sow "farrow-to-finish" production unit. Out of a total number of 15,841 evaluated growing/finishing pigs, 1319 pigs died or were emergency-culled and were post-mortem routinely examined. For the purpose of this study the emergency-culling and mortality were recorded into the same category. The average annual emergency-culling/mortality rate was unusual high (8.62%). Five body condition related categories were registered. The majority of the mortality comprised animals of body condition "below average", representing 891 pigs (67.56%) and "average" (407 pigs = 30.85%). The rest of the examined animals comprised 17 pigs (1.29%) "emitted", 2 pigs "kachexia" (stunted pig) or "fat" (0.15% each). The overall study showed that gastrointestinal tract disorders (395 animals = 29.95%) were the most frequently recorded cause of emergency-culling or mortality. Both inflammatory disorders (7.66%) and rectal stricture (7.51%) were in this category the most frequent diagnosis followed by rectal prolapse (5.92%). Gastric ulcers comprised 4.55% of the necropsied animals. Torsion of abdominal organs and miscellaneous cases represented slightly more than 2% of the post-mortem examined pigs. Lesions which involved the respiratory system, comprised 14.85% of the necropsied pigs. Bronchopneumonia due to Mycoplasma hyopneumoniae occurred in 5.61%, embolic suppurative or necrotic pneumonia in 4.78% and pleuropneumonia due to Actinobacillus pleuropneumoniae in 3.1% of the cases. Diseases involving the urinary system were diagnosed in 21 cases (1.59%). Five cases of skin disorders were registered (0.38%). Cardiovascular disorders were represented by congestive heart failure (31 pigs = 2.35%), pericarditis (22 animals = 1.66%) or endocarditis (21 pigs = 1.60%). Cardiomyopathy was found in 15 (1.2%) animals. Lesions involved the locomotor system ranked second of all cases (15.92%). Claw lesions accounted 13.72%, arthritis 2.13% of the animals and luxation or fracture was diagnosed only in one case (0.07%). Systemic infections were reported in 96 cases (7.28%) including polyserositis (4.09%), erysipelas, edema disease or miscellaneous causes (each category slightly more than 1%). Genetic problems were involved in 8.19% of the fatal cases and social stress or cannibalism related culling or mortality comprised 37 animals (2.81%). In 161 cases (12.20%) of the mortality the causes of death were not established. Two or more lesions related to culling or mortality were found in 320 pigs (24.26%, p < 0.001). The most common diagnosed pathologic changes in association with other lesions were Mycoplasma hyopneumoniae caused bronchopneumonia (4.09%), embolic suppurative or necrotic pneumonia (4.55%), followed by inflammatory gastrointestinal problems (3.10%), gastric ulcer (2.35%), claw lesions (2.19%) and arthritis (1.14%). It appears from the presented study that a routine post-mortem examination of all emergency-culled or dead pigs over a long period of time gives a clear picture of causes of mortality enabling the management to plan management strategies as vaccination programs, genetic improvements and optimising environmental conditions.
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PMID:Emergency-culling and mortality in growing/fattening pigs in a large Hungarian "farrow-to-finish" production unit. 1183 93

Management of the pancreatic stump following pancreaticoduodenectomy (PD) has always been a main source of concern among pancreatic surgeons. The present pilot study describes the reconstructive technique of anterior transgastric pancreaticogastrostomy (PG) after pylorus-preserving PD. Outcome in 50 patients with "soft" residual parenchyma treated with this technique is also reported. The average duration of the intervention was 351 minutes (range, 240-360); only two patients needed intraoperative transfusion with 2 units of blood. The postoperative period involved complications in 15 cases (30%). In particular, four patients developed pancreatic fistulas (8%), which were grade C in three cases (6%) and grade B in one patient (2%). Two patients (4%) presented with enteric fistula from erosion from a drain. Two patients experienced perianastomotic fluid collections associated with delayed gastric emptying (4%) and a clinically silent 5-cm abdominal collection was observed in an additional case. Bleeding of a gastric ulcer was treated in one case and four patients developed bronchopneumonia. None of the complications required a second surgical intervention and there were no deaths. One patient with a symptomatic fluid collection was treated by ultrasound-guided cutaneous drainage. The mean hospitalization time was 11.1 days (range, 8-25 days). The results obtained in this pilot study appear encouraging and merit further analysis in a randomized comparative trial.
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PMID:Open pancreaticogastrostomy after pancreaticoduodenectomy: a pilot study. 1698 93