Subject(s)
Communication , Continuity of Patient Care , Medical Staff, Hospital/psychology , Patient Care Team , Humans , MoraleABSTRACT
In a double-blind, multicentre study 77 patients with benign gastric ulcer were randomly allocated to treatment with either enprostil 35 micrograms bd or pirenzepine 50 mg bd. After four weeks of treatment 13/26 (50 per cent) of evaluable enprostil-treated patients and 9/30 (30 per cent) of evaluable pirenzepine-treated patients were healed. Corresponding healing figures after eight weeks were 20/25 (80 per cent) and 25/31 (81 per cent). Both drugs rapidly reduced the severity of ulcer pain and the need for antacid use. No statistically significant differences were detected between the treatments with respect to healing rate or symptom control. Adverse events were reported by eight patients taking enprostil and by 17 patients taking pirenzepine. Two patients withdrew from each treatment group because of adverse events. None of these was serious. In conclusion, enprostil and pirenzepine were equally effective in healing gastric ulcers and no statistically significant differences in safety and efficacy were detected. There was a tendency for earlier healing and fewer side effects in the enprostil-treated patients.
Subject(s)
Pirenzepine/therapeutic use , Prostaglandins E, Synthetic/therapeutic use , Stomach Ulcer/drug therapy , Adolescent , Adult , Aged , Double-Blind Method , Enprostil , Female , Humans , Male , Middle Aged , Multicenter Studies as Topic , Pirenzepine/adverse effects , Prostaglandins E, Synthetic/adverse effects , Randomized Controlled Trials as TopicABSTRACT
Sixty patients with nonulcer dyspepsia took cimetidine 1 g daily or a placebo for 5 weeks in a double-blind trial. Thirty-four men and 26 women with normal double-contrast barium meals were included. Five percent had the endoscopic appearances of duodenitis. Symptoms improved during treatment in 62% of those taking cimetidine and in 54% of the placebo group (NS, p = 0.5). We suggest that significant duodenitis is uncommon in the absence of active or quiescent duodenal ulcer disease. From this study there is no evidence that cimetidine benefits those patients with normal double-contrast barium meals and no duodenitis endoscopically who nonetheless have symptoms similar to those of peptic ulcer disease.
Subject(s)
Cimetidine/therapeutic use , Dyspepsia/drug therapy , Adult , Clinical Trials as Topic , Double-Blind Method , Duodenitis/drug therapy , Female , Humans , Male , Prospective StudiesABSTRACT
Information obtained from 3 questionnaires circulated to British gastrointestinal endoscopists has been used to trace the development of endoscopy services during the 1970s. Oesophagogastro-duodenoscopy became available in most hospitals; colonoscopy services were slower to develop and endoscopic retrograde cholangio-pancreatography was performed in under 50% of hospitals. Various therapeutic techniques followed the diagnostic procedures and by the end of the decade constituted one of the major areas of growth. The impact of gastrointestinal endoscopy on other disciplines, diagnostic radiology, surgery, pathology and general practice is reviewed. Organizational aspects of endoscopy services with emphasis on staff, premises, instrumentation and finance are discussed. Analysis of the trends during the 70s has allowed some predictions of the likely developments in the 1980s.
