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  • 1
    Electronic Resource
    Electronic Resource
    Cisapride in the treatment of post-operative ileus (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 5 (1991), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The effect of cisapride on duration of post-operative ileus after surgery was investigated in a randomized, double-blind, placebo-controlled study. Patients undergoing elective upper gastrointestinal (n= 47) or colonic (n= 22) surgery were pre-operatively randomly allocated to treatment with either cisapride 30 mg t.d.s., by rectal administration, or placebo. Treatment started exactly 48 h after surgery if the patient at this time had not passed stool. Time to passage of first stool after surgery was estimated.Mean time to passage of stool was 85 (32) h (s.d.) for cisapridetreated and 91 (43) h for placebo-treated patients. No difference between the treatment groups was noted.Treatment with cisapride did not shorten the duration of postoperative ileus after either upper gastrointestinal or colonic surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1991.tb00519.x
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  • 2
    Electronic Resource
    Electronic Resource
    The role of the gut flora in health and disease, and its modification as therapy (2002)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 16 (2002), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The gut flora is a vast interior ecosystem whose nature is only beginning to be unravelled, due to the emergence of sophisticated molecular tools. Techniques such as 16S ribosomal RNA analysis, polymerase chain reaction amplification and the use of DNA microarrays now facilitate rapid identification and characterization of species resistant to conventional culture and possibly unknown species. Life-long cross-talk between the host and the gut flora determines whether health is maintained or disease intervenes. An understanding of these bacteria–bacteria and bacteria–host immune and epithelial cell interactions is likely to lead to a greater insight into disease pathogenesis. Studies of single organism–epithelial interactions have revealed the large range of metabolic processes that gut bacteria may influence. In inflammatory bowel diseases, bacteria drive the inflammatory process, and genetic predisposition to disease identified to date, such as the recently described NOD2/CARD15 gene variants, may relate to altered bacterial recognition. Extra-intestinal disorders, such as atopy and arthritis, may also have an altered gut milieu as their basis. Clinical evidence is emerging that the modification of this internal environment, using either antibiotics or probiotic bacteria, is beneficial in preventing and treating disease. This natural and apparently safe approach holds great appeal.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2002.01310.x
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  • 3
    Electronic Resource
    Electronic Resource
    Measurement of the impact of heartburn and dyspepsia on quality of life (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Alimentary pharmacology & therapeutics 11 (1997), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The interest in heartburn in endoscopy-negative patients and in functional dyspepsia has increased in recent years. This necessitates new methods of disease evaluation due to the lack of objective markers. In this paper basic data are presented from the application of two widely used quality of life questionnaires - the Psychological General Well-Being Index and the Gastrointestinal Symptoms Rating Scale - in patients with upper gastrointestinal symptoms without treatment and in healthy controls. From the reference population, it can be concluded that gender, as well as age, influences the outcome of both indices. In patients with untreated reflux oesophagitis, peptic ulcer or dyspepsia quality of life was low. The severity of symptoms also correlated well with both the Psychological General Well-Being Index and the Gastrointestinal Symptom Rating Scale scores in patients with heartburn. In patients with upper gastrointestinal complaints, an evaluation of quality of life is helpful in patient evaluation, particularly in the absence of objective clinical markers of disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.1997.tb00796.x
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  • 4
    Electronic Resource
    Electronic Resource
    Is it possible to predict treatment response to a proton pump inhibitor in functional dyspepsia? (2003)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 18 (2003), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The efficacy of proton pump inhibitors in functional dyspepsia is modest and the prognostic factors are almost unknown.Methods: Data were pooled on patients (n = 826) with a diagnosis of functional dyspepsia from two placebo-controlled trials who were treated with omeprazole, 10 or 20 mg once daily, for 4 weeks. Self-administered questionnaires for the assessment of symptoms and health-related quality of life were completed before entry, and epigastric pain/discomfort was recorded on diary cards. Treatment success was defined as the complete absence of epigastric pain/discomfort on each of the last 3 days of week 4. Prognostic factors were identified by multiple logistic regression analysis.Results: The most discriminating predictor of treatment success (P 〈 0.0001) was the number of days with epigastric pain/discomfort during the first week of treatment. Fewer days with symptoms during the first week led to higher response rates at 4 weeks. In addition, age 〉 40 years, bothersome heartburn, low scores for bloating, epigastric pain and diarrhoea, history of symptoms for 〈 3 months and low impairment of vitality at baseline were identified as positive predictors of outcome.Conclusions: Early response to treatment with a proton pump inhibitor, during the first week, seems to predict the outcome after 4 weeks in patients with functional dyspepsia.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2003.01651.x
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  • 5
    Electronic Resource
    Electronic Resource
    Laparoscopic antireflux surgery for gastroesophageal reflux disease (GERD) (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 413 -426 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Consensus development conferences — Laparoscopic antireflux operations — Outcome assessment
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic antireflux surgery is currently a growing field in endoscopic surgery. The purpose of the Consensus Development Conference was to summarize the state of the art of laparoscopic antireflux operations in June 1996. Methods: Thirteen internationally known experts in gastroesophageal reflux disease were contacted by the conference organization team and asked to participate in a Consensus Development Conference. Selection of the experts was based on clinical expertise, academic activity, community influence, and geographical location. According to the criteria for technology assessment, the experts had to weigh the current evidence on the basis of published results in the literature. A preconsensus document was prepared and distributed by the conference organization team. During the E.A.E.S. conference, a consensus document was prepared in three phases: closed discussion in the expert group, public discussion during the conference, and final closed discussion by the experts. Results: Consensus statements were achieved on various aspects of gastroesophageal reflux disease and current laparoscopic treatment with respect to indication for operation, technical details of laparoscopic procedures, failure of operative treatment, and complete postoperative follow-up evaluation. The strength of evidence in favor of laparoscopic antireflux procedures was based mainly on type II studies. A majority of the experts (6/10) concluded in an overall assessment that laparoscopic antireflux procedures were better than open procedures. Conclusions: Further detailed studies in the future with careful outcome assessment are necessary to underline the consensus that laparoscopic antireflux operations can be recommended.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900382
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  • 6
    Electronic Resource
    Electronic Resource
    Laparoscopic Rosetti fundoplication (1994)
    Springer
    Surgical endoscopy and other interventional techniques 8 (1994), S. 1417-1422 
    Details
    ISSN: 1432-2218
    Keywords: Esophagitis ; Fundoplication ; Gastroesophageal reflux ; General well being ; Laparoscopy ; Quality of life
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Early experiences with laparoscopic fundoplication using the Rosetti technique are presented and compared with retrospective results from conventional fundoplication procedures. A 360° floppy fundoplication was laparoscopically constructed without division of short gastric vessels. We have performed 60 consecutive procedures. Conversion to open surgery was done in seven cases due to anatomical reasons and in two due to progressive subcutaneous emphysema and CO2-retention. The complication rate was low. The range of postoperative hospital stay is 1–4 days for non-converted patients. Symptomatic follow up has hitherto been performed in 41 patients with a follow-up time of 3–9 months. Regurgitation and heartburn had disappeared in all but one patient. The follow-up results do not differ from those achieved in patients operated upon with the conventional open Nissen (N=41), Toupét (N=9) or Rosetti (N=36) technique. Pre and postoperative control of 24h pH and lower esophageal sphincter pressure (LESP) in 19 laparoscopically treated patients showed normalisation of LESP in all cases and postoperative 24h pH〈4 ranging between 0 and 3%. Assessment of quality of life showed postoperative results in accordance with normal population for all treated groups.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00187348
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  • 7
    Electronic Resource
    Electronic Resource
    Quality-of-life assessments in evaluation of laparoscopic Rosetti fundoplication (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 183-189 
    Details
    ISSN: 1432-2218
    Keywords: Esophagitis ; Fundoplication ; Gastroesophageal reflux ; General well-being ; Laparoscopy ; Quality of life
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract It has recently been suggested that quality-of-life investigations should be included in the evaluation of new medical and surgical regimens. We present the quality-of-life evaluations for the first 40 consecutive patients undergoing laparoscopic antireflux surgery at our department. Two well-established and validated questionnaires, the Psychological General Well Being (PGWB) Index, and the Gastrointestinal Symptom Rating Scale (GSRS), were used. The PGWB gives a general measure of patients' well-being while the GSRS concentrates on gastrointestinal complaints. In untreated reflux esophagitis patients, the PGWB score is very low. We found normal PBWB scores preoperatively during optimal medical treatment with potent acid inhibition. The average score became significantly better (than on medical treatment, P〈0.05) 1 month postoperatively, after which it fell off to normal values 3 and 8–12 months after operation. The GSRS scores were good in all subgroups postoperatively, especially regarding reflux syndrome, where scores were significantly (P〈0.05) better than on medical treatment. In conclusion: After laparoscopic antireflux surgery, patients had good quality-of-life scores, better than untreated patients and as good as or better than on optimal medical treatment. Different treatment regimens could be discriminated by adding the patients' view of the treatment effect. We suggest that quality-of-life effects should be included when evaluating new regimens in laparoscopic surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00191963
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  • 8
    Electronic Resource
    Electronic Resource
    Laparoscopic suture closure of perforated peptic ulcer (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 656-658 
    Details
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Peptic ulcer ; Suture ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Laparoscopic vs open suture in the surgical treatment of perforated peptic ulcer were compared in a retrospective study. Methods: The outcome of 10 patients having the laparoscopic procedure was compared with the outcome of 17 patients treated with suture via laparotomy during the same time period. Results: The mortality rate and the complication rate were comparable. The laparoscopic procedure was more time consuming; hospital stay did not differ. Conclusions: The results indicate that surgery for perforated peptic ulcer can be performed with the laparoscopic technique with an outcome comparable to open surgery. No obvious advantages to the patient were noted with the laparoscopic method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00188522
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  • 9
    Electronic Resource
    Electronic Resource
    Thoracic herniation and intrathoracic gastric perforation after laparoscopic fundoplication (1995)
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 917-918 
    Details
    ISSN: 1432-2218
    Keywords: Laparoscopy ; Fundoplication ; Complication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This case report describes a serious complication after laparoscopic Rosetti fundoplication. Two days postoperatively the proximal part of the stomach herniated into the thoracic cavity where a gastric perforation caused leakage. The patient was reoperated and a new fundoplication was constructed. Postoperatively the patient recovered. Possible mechanisms are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00768893
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  • 10
    Electronic Resource
    Electronic Resource
    Short-term treatment of prepyloric ulcer (1987)
    Springer
    Digestive diseases and sciences 32 (1987), S. 225-231 
    Details
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A double-blind, randomized, multicenter study was performed to compare the effect of sucralfate (1 g qid) and cimetidine (400 mg bid) in the treatment of prepyloric ulcer. Altogether 142 patients (68 in the sucralfate and 74 in the cimetidine group) with endoscopically confirmed ulcer within 2 cm of the pylorus completed the study. Endoscopic follow up was performed after four weeks and, if the ulcer was not healed, after eight weeks of treatment. After four weeks, 65% of the ulcers in the sucralfate group were healed, compared to 70% in the cimetidine group. There was no significant difference between sucralfate and cimetidine at either time point. The 95% confidence interval for the difference in ulcer healing with sucralfate or cimetidine ranged from +4 to −19% at eight weeks. Said another way, with an observed difference of 7% (83% vs 90%), the 95% confidence limit ranged from 4% in favor of sucralfate to 19% in favor of cimetidine. Symptomatic relief, antacid intake, and side effects did not differ significantly between the two groups. The healing rate of prepyloric ulcer in this study is similar to that reported for duodenal ulcer after four and eight weeks when treated with sucralfate or cimetidine. Sucralfate is safe and as effective as cimetidine in the short-term treatment of prepyloric ulcer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01297045
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