ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Consecutive patients coming as an emergency with chest pain due to myocardial ischemia or esophageal disease were interviewed on admission to the hospital, before they had been fully investigated. Classical features of angina pectoris were equally common in both groups and “crescendo angina” was often found in patients with esophageal disease. Features that helped to distinguish esophageal from cardiac pain were: 1) an atypical response to exercise, 2) pain that continued as a background ache, 3) retrosternal pain without lateral radiation, 4) pain that disturbed sleep, and 5) the presence of certain esophageal symptoms. A positive diagnosis will be made more often in cases of suspected but unsubstantiated coronary disease by clinicians who are aware that esophageal pain and angina may be indistinguishable.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Patients with recently healed duodenal ulcers were enrolled at 14 participating centers in a 12-month study comparing the effectiveness of ranitidine and cimetidine, two H2-receptor blockers, for maintenance therapy. Patients were randomly assigned to take bedtime doses of 150 mg of ranitidine (n=60) or 400 mg of cimetidine (n=66). Endoscopic examinations were scheduled at baseline and after 4, 8, and 12 months of therapy, or when symptoms compatible with active ulcer disease developed. Life-table analysis indicated a relapse rate of 16% for the ranitidine subjects and 43% for the cimetidine subjects during the 12-month period (p=0.01). Therapy was discontinued in one ranitidine subject and two cimetidine subjects for adverse events considered drug-related. There were no drug-related laboratory abnormalities in either treatment group. No significant drug-related adverse effects were seen with either drug during this 1-year trial. At the doses prescribed, ranitidine was superior to cimetidine as maintenance therapy in duodenal ulcer disease.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Because of its widespread availability and the generally increasing economic pressure, endoscopy needs critical scrutiny to establish appropriate clinical guidelines. We carried out a prospective evaluation of 200 consecutive upper gastrointestinal (GI) endoscopies to ascertain the frequency of abnormal findings when specific indications were the impetus to endoscopy. Those indications were esophageal complaints, upper GI bleeding, abdominal discomfort, known premalignant disorders and abnormal findings on barium meal. The overall frequency of abnormal findings for all indications was 66%. Abnormal endoscopic findings were most often present when upper GI bleeding or premalignant conditions (88 and 87%, respectively) were reasons for endoscopy. Endoscopic confirmation of lesions seen on barium meal was 64%. Only 37% of patients endoscoped for abdominal discomfort had abnormal findings. Moreover, as symptoms resolved in 70% of such patients within 1 to 9 weeks, the low yield of endoscopy suggests that our current threshold for endoscopy in this setting may be too low. Refinement of the indications for and reassessment of the timing of endoscopy are needed.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

A review of 93 patients with ulcerative colitis revealed that in 47 (50.5%) symptoms first appeared between 21 and 30 years of age—“early-onset”—and in 26 (27.9%) at the age of 51 years or above—“late-onset.” Proctocolitis was more common in late-onset patients (p=0.077) and in males of both age groups (p=0.002). Extensive colitis was significantly more common in females (p=0.002). Patients with late-onset proctocolitis had more bowel movements/day and liver involvement than patients with early-onset disease. The first episode of proctocolitis was more protracted and the ensuing remission of shorter duration in late-onset patients. Most patients with earlyonset disease improved on steroid enemas, whereas most patients with late-onset disease required systemic corticosteroid therapy (p=0.0028). Female patients with earlyonset proctocolitis tended to be more severely afflicted than males, with an increased incidence of weight loss, leukocytosis, increased erythrocyte sedimentation rate (ESR), and need for systemic corticosteroid therapy. We conclude that late-onset uicerative colitis is distinct from early-onset disease in its relative refractoriness to therapy and its predilection for distal colonic involvement.

ISSN:0192-0790    

出版商:OVID    

年代:1985

数据来源: OVID