Scandinavian journal of gastroenterology
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Scand. J. Gastroenterol. · Jan 1985
Clinical Trial Controlled Clinical TrialThe effect of cimetidine in non-ulcer dyspepsia. Experience with a multi-cross-over model.
The symptomatic effect of cimetidine was examined in 27 patients with non-ulcer dyspepsia (NUD) by means of a multi-cross-over model (MCO model) for testing the symptomatic effect of drugs in individual patients. None of the patients showed an ulcer at the time, but 20 patients had evidence of previous peptic ulcer disease. The variant of the MCO model used included six treatment periods and three regular interchanges between cimetidine and placebo. ⋯ The chance of getting an X score of 5 when cimetidine is not better than placebo is about 9%. Accordingly, the risk of being wrong when defining these five patients as cimetidine responders is 9%. The present study confirms that the MCO model may identify individual cimetidine responders among patients with NUD.
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Scand. J. Gastroenterol. · Jan 1985
Bleeding pattern before admission as guideline for emergency endoscopy.
In a prospective study of 539 patients admitted because of hematemesis and melena the bleeding pattern before admission was compared with the findings obtained on emergency endoscopy and the subsequent clinical course. Ranked in order of prognostic importance, red hematemesis with melena, black hematemesis with melena, and red hematemesis alone increased the probability of massive hemorrhage. Moreover, black hematemesis with melena was the superior predictor of bleeding ulcer, the commonest lesion carrying the risk of massive hemorrhage. ⋯ The order of prognostic importance was supported by the transfusion requirement. In screening for a potentially life-threatening ulcer hemorrhage, emergency endoscopy is recommended in patients with black hematemesis with melena or with red hematemesis with or without melena. In patients presenting with black hematemesis or melena alone endoscopy may be postponed to the next convenient daytime.
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Subjects with upper abdominal pain without any demonstrable organic basis are often met with the attitude that the pain is "not real'. Twenty-five patients with long-standing upper abdominal pain but with normal findings on X-ray examination, gastroduodenoscopy, and relevant blood analyses were examined with pain-measuring techniques. ⋯ A methodological study of the submaximal effort tourniquet technique was performed on the healthy volunteers. The method was found to be suitable for use in pain studies, since the pain produced gradually increased as a linear function of time.