This clinical, double-blind, multicentre trial evaluates the long-term effect of ranitidine in patients dilated for peptic oesophageal strictures. Seventy-one consecutive outpatients were dilated with hydrostatic balloons to a diameter of 18-20 mm and randomized to a 1-year treatment with 300 mg ranitidine in the evening or with placebo. Endoscopies with measurement of the stricture size were performed before the initial dilatation, after 6 and 12 months, and in between when necessary. Symptoms and use of antacids were registered at inclusion and after 3, 6, 9, and 12 months. Thirteen patients were withdrawn before study end point. Fifteen of 30 (50%) in the ranitidine group and 11 of 28 (39.3%) in the placebo group were redilated. The difference in disfavour of ranitidine was 10.7% (95% confidence interval, -14.9; 36.2%). Nor were there any statistically significant differences between the treatment groups with regard to stricture size at end point, symptoms, or use of antacids. In conclusion, there is no evidence of any clinically significant effect of a 1-year treatment with 300 mg ranitidine once daily after dilatation of peptic oesophageal strictures.
The study analyzes the natural esophageal restricturing process after dilatation of peptic esophageal strictures. Fifty patients (male/female: 30/20) with median age 71 years (range 20-87) with peptic esophageal strictures were dilated with hydrostatic balloons to 20 mm and followed up for 12 months. Stricture size was measured with a 'balloon pull-through' technique before the dilatations, and at follow-ups after 6 and 12 months. The restricturing rate was defined as the difference in stricture diameter at two measurements divided by the time interval. The mean restricturing rate during the first and last 6 month periods were 0.99 and 0.02 mm/month respectively (P < 0.001), and during the first 6 months the restricturing rates were 1.98 and 0.69 mm/month in patients redilated and not redilated respectively (P < 0.001). A tight stricture at the initial dilatation, a long history of reflux symptoms and a short history of dysphagia were all significantly related to a high restricturing during the first 6 months (P < 0.001).
Preoperative paralysis of the facial nerve was found in 145 of 1,029 patients with malignant parotid tumours (14%) treated at nine university clinics in Scandinavia. The incidence of facial paralysis varied between the different clinics. A parallelism between the incidence of the facial paralysis and the impairment of the prognosis of the different tumour types is shown. The presence of preoperative facial nerve paralysis in malignant parotid tumours implies a very poor prognosis but the situation is not as hopeless as has been suggested and therefore one must rely on very radical surgery.
Among 145 children with severe hearing loss 35 had a characteristic retinopathy. Only few of these had additional malformations. Most of these children (28) were born during the months September through February. Rubella antibodies were present more frequently than in matched controls. No such difference was found for cytomegalovirus and herpesvirus hominis.
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