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K. G. Wormsley - One of the best experts on this subject based on the ideXlab platform.
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Long-term Maintenance Treatment of gastric ulcers with ranitidine.
Alimentary pharmacology & therapeutics, 2007Co-Authors: J. G. Penston, K. G. WormsleyAbstract:One hundred and twenty patients with gastric ulcer disease, who had been receiving Maintenance Treatment with ranitidine (150 or 300 mg/day) for periods up to 7 years, were studied retrospectively. The proportion of patients remaining free from symptomatic recurrence of ulcer during Maintenance Treatment was 97% after 1 year; 90% after 3 years; and 79% after 5 years. No patient developed haemorrhage or perforation during Maintenance Treatment. None of the demographic features was shown to be associated with a significantly increased risk of ulcer recurrence during Maintenance Treatment. Comparison of the recurrence rates during Maintenance Treatment with those during periods without active anti-ulcer therapy, using life table and incidence density analysis, showed a significant difference in favour of Maintenance Treatment. We conclude that Maintenance Treatment with ranitidine for 5 years significantly reduces the risk of symptomatic ulcer recurrence in patients with gastric ulcer.
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Asymptomatic duodenal ulcers occurring during Maintenance Treatment with ranitidine.
Alimentary pharmacology & therapeutics, 2007Co-Authors: J. G. Penston, K. G. WormsleyAbstract:Fifty-seven patients who developed asymptomatic recurrence of duodenal ulceration during Maintenance Treatment with ranitidine were followed up to assess the risk of developing symptoms or complications of ulcer disease. The risk of development of symptomatic ulcer recurrence was 4% in the first year of follow-up during continuous Maintenance Treatment, irrespective of whether or not the asymptomatic ulcer had been actively treated (by doubling the dose of ranitidine used for Maintenance therapy). The asymptomatic duodenal ulceration during Maintenance Treatment did not predispose to complications such as haemorrhage or perforation. It seems, therefore, that patients receiving Maintenance Treatment for duodenal ulceration do not require endoscopic re-examination unless symptoms have recurred, because the asymptomatic recurrences of duodenal ulceration occurring during Maintenance Treatment are clinically benign, usually heal spontaneously if Maintenance Treatment is continued, and do not require active medical intervention.
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Ranitidine Maintenance Treatment of non-steroidal anti-inflammatory drug-induced duodenal ulceration.
Alimentary pharmacology & therapeutics, 2007Co-Authors: J. G. Penston, K. G. WormsleyAbstract:SUMMARY Fifty-six patients who presented with non-steroidal anti-inflammatory drug-associated duodenal ulcers received Maintenance Treatment with ranitidine. Forty-eight of these patients stopped Treatment with nonsteroidal anti-inflammatory drugs. The cumulative symptomatic remission at the end of 5 years of Maintenance Treatment was 97.7%. While half the patients had presented with haemorrhage from the ulcer, only one patient bled during Maintenance Treatment, giving a cumulative risk of 2.3% in 5 years of Maintenance Treatment. We conclude that Maintenance Treatment with ranitidine effectively and safely keeps patients with non-steroidal anti-inflammatory drugassociated ulcers symptom- and risk-free.
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Nine years of Maintenance Treatment with ranitidine for patients with duodenal ulcer disease.
Alimentary pharmacology & therapeutics, 2007Co-Authors: J. G. Penston, K. G. WormsleyAbstract:Four hundred and sixty-four patients with duodenal ulcer disease received continuous Maintenance Treatment with ranitidine for up to 9 years. Treatment failure was defined as either the first symptomatic recurrence of ulcer or the first ulcer recurrence accompanied by haemorrhage. Life tables were constructed using the Kaplan-Meier product-limit method; comparisons of survival curves were performed using the log-rank test; and multivariate analysis was carried out using the Cox proportional hazards model. Results. The proportion of patients remaining free from symptomatic recurrence of ulcer during Maintenance Treatment with either 150 mg/day or 300 mg/day ranitidine was: 95% at 1 year; 88% at 3 years; 86% at 5 years; and 81% at 7 and 9 years (95% C.I. 76-86%). Young age and the absence of exposure to non-steroidal anti-inflammatory drugs (NSAIDs) at the time of diagnosis of ulcer were shown to increase the likelihood of developing ulcer recurrence. The rate of ulcer recurrence after 9 years of Maintenance Treatment (17%) was significantly less than that after 5 years without active anti-ulcer therapy (80%), P = 0.0001. The proportion of patients who remained free from ulcer haemorrhage during Maintenance Treatment was: 99.1% at 1 year and 98.1% at 5 and 9 years (95% C.I. 96.7-99.6%). The risk of haemorrhage was significantly greater in patients who were not receiving active Treatment (12.4% at 5 years) than in patients receiving Maintenance Treatment (less than 2% at 9 years), P = 0.0001 (log-rank test). Patients who had originally presented with haemorrhage had an increased risk of further ulcer bleeding compared with patients who presented with pain (P = 0.0013). A significantly greater proportion of patients with NSAID-associated duodenal ulcers remained free from ulcer recurrence during Maintenance Treatment compared with patients suffering from 'idiopathic' ulcers (P = 0.0238), although there was no difference between the two groups in respect of haemorrhage during Maintenance Treatment. Conclusions. (a) Continuous Maintenance Treatment with ranitidine for up to nine years successfully prevents ulcer recurrence in more than 80% of patients with duodenal ulcer disease. (b) Young age increases the risk of ulcer recurrence during Maintenance Treatment with ranitidine. Ulcers associated with NSAID-intake at the time of diagnosis have a lesser risk of recurrence during Maintenance Treatment. (c) The risk of haemorrhage in patients with ulcer disease receiving Maintenance Treatment with ranitidine for nine years was less than 2% compared with greater than 12% in untreated patients observed for 5 years.(ABSTRACT TRUNCATED AT 400 WORDS)
Wayne Hall - One of the best experts on this subject based on the ideXlab platform.
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Role of Maintenance Treatment in opioid dependence
Lancet (London England), 1999Co-Authors: Jeff Ward, Wayne Hall, Richard P MattickAbstract:Methadone Maintenance Treatment (MMT) involves the daily administration of the oral opioid agonist methadone as a Treatment for opioid dependence-a persistent disorder with a substantial risk of premature death. MMT improves health and reduces illicit heroin use, infectious-disease transmission, and overdose death. However, its effectiveness is compromised if low Maintenance doses of methadone (
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role of Maintenance Treatment in opioid dependence
The Lancet, 1999Co-Authors: Jeff Ward, Wayne Hall, Richard P MattickAbstract:Methadone Maintenance Treatment (MMT) involves the daily administration of the oral opioid agonist methadone as a Treatment for opioid dependence-a persistent disorder with a substantial risk of premature death. MMT improves health and reduces illicit heroin use, infectious-disease transmission, and overdose death. However, its effectiveness is compromised if low Maintenance doses of methadone (<60 mg) are used and patients are pressured to become prematurely abstinent from methadone. Pregnancy and psychiatric comorbidity are not contraindications for MMT. As an alternative to MMT, other oral opioid agents (eg, naltrexone, buprenorphine) may increase patient choice and avoid some of the more unpleasant aspects of MMT. The public-health challenge for the future is to develop and continue to deliver safe and effective forms of opioid Maintenance Treatment to as many opioid-dependent individuals as can benefit from them.
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Methadone Maintenance Treatment reduces heroin injection in New South Wales prisons
Drug and Alcohol Review, 1998Co-Authors: Kate Dolan, Alex Wodak, Wayne HallAbstract:The purpose of this study was to examine whether methadone Maintenance Treatment reduces injecting risk behaviour (and therefore transmission of blood-borne viral infections) among prisoners in New South Wales (NSW), using comparison of retrospective reports of drug use in prisons for people who received standard drug Treatment, time-limited methadone Treatment and methadone Maintenance Treatment. The setting for the study was the NSW prison system. One hundred and eighty-five injecting drug users who had been recently released from NSW prisons were recruited in 1993. Self-reported drug use and injecting risk behaviour were compared in inmates who received standard drug Treatment (counselling), time-limited methadone Treatment and methadone Maintenance Treatment. HIV status was determined by serology. Intervention comprised high and low dose methadone Treatment and counselling. The groups were similar in terms of most basic demographic characteristics but subjects who had been maintained on methadone repo...
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Methadone Maintenance Treatment as a crime control measure. by Wayne Hall
BOCSAR NSW Crime and Justice Bulletins, 1996Co-Authors: Wayne HallAbstract:tag=1 data=Methadone Maintenance Treatment as a crime control measure. by Wayne Hall tag=2 data=Hall, Wayne tag=3 data=Crime and Justice Bulletin, tag=5 data=29 tag=6 data=June 1996 tag=7 data=1-12. tag=8 data=DRUGS tag=9 data=METHADONE Maintenance Treatment tag=10 data=This bulletin reviews research that is relevant to answering the question: should the number of persons enrolled in methadone Maintenance Treatment be expanded as part of a larger strategy to reduce drug and property crime among opioid-dependent offenders. tag=11 data=1997/3/3 tag=12 data=97/0084 tag=13 data=CAB
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Methadone Maintenance Treatment in prisons: The new South Wales experience
Psychiatry Psychology and Law, 1994Co-Authors: Wayne Hall, Jeff Ward, Richard P MattickAbstract:This paper uses the New South Wales experience with methadone Maintenance Treatment in prison to address the question: should methadone Maintenance Treatment be provided in Australian prisons for opioid‐dependent prisoners? First, it outlines three rationales for providing drug dependence Treatment in prisons: as a way of giving prisoners access to community‐based forms of drug Treatment in the prison‐setting; as a measure to reduce recidivism in opioid‐dependent prisoners; and as a measure to prevent the transmission of HIV and other infectious diseases within prisons, and to the sexual partners of prisoners on their release. Second, it reviews the kind of research evidence that supports the effectiveness of community‐based methadone Maintenance Treatment in Australia. Third, the effectiveness of the New South Wales Prison Methadone Program, one of the few prison‐based methadone programs in the world, is evaluated in the light of the available research evidence.
J. G. Penston - One of the best experts on this subject based on the ideXlab platform.
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Long-term Maintenance Treatment of gastric ulcers with ranitidine.
Alimentary pharmacology & therapeutics, 2007Co-Authors: J. G. Penston, K. G. WormsleyAbstract:One hundred and twenty patients with gastric ulcer disease, who had been receiving Maintenance Treatment with ranitidine (150 or 300 mg/day) for periods up to 7 years, were studied retrospectively. The proportion of patients remaining free from symptomatic recurrence of ulcer during Maintenance Treatment was 97% after 1 year; 90% after 3 years; and 79% after 5 years. No patient developed haemorrhage or perforation during Maintenance Treatment. None of the demographic features was shown to be associated with a significantly increased risk of ulcer recurrence during Maintenance Treatment. Comparison of the recurrence rates during Maintenance Treatment with those during periods without active anti-ulcer therapy, using life table and incidence density analysis, showed a significant difference in favour of Maintenance Treatment. We conclude that Maintenance Treatment with ranitidine for 5 years significantly reduces the risk of symptomatic ulcer recurrence in patients with gastric ulcer.
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Asymptomatic duodenal ulcers occurring during Maintenance Treatment with ranitidine.
Alimentary pharmacology & therapeutics, 2007Co-Authors: J. G. Penston, K. G. WormsleyAbstract:Fifty-seven patients who developed asymptomatic recurrence of duodenal ulceration during Maintenance Treatment with ranitidine were followed up to assess the risk of developing symptoms or complications of ulcer disease. The risk of development of symptomatic ulcer recurrence was 4% in the first year of follow-up during continuous Maintenance Treatment, irrespective of whether or not the asymptomatic ulcer had been actively treated (by doubling the dose of ranitidine used for Maintenance therapy). The asymptomatic duodenal ulceration during Maintenance Treatment did not predispose to complications such as haemorrhage or perforation. It seems, therefore, that patients receiving Maintenance Treatment for duodenal ulceration do not require endoscopic re-examination unless symptoms have recurred, because the asymptomatic recurrences of duodenal ulceration occurring during Maintenance Treatment are clinically benign, usually heal spontaneously if Maintenance Treatment is continued, and do not require active medical intervention.
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Ranitidine Maintenance Treatment of non-steroidal anti-inflammatory drug-induced duodenal ulceration.
Alimentary pharmacology & therapeutics, 2007Co-Authors: J. G. Penston, K. G. WormsleyAbstract:SUMMARY Fifty-six patients who presented with non-steroidal anti-inflammatory drug-associated duodenal ulcers received Maintenance Treatment with ranitidine. Forty-eight of these patients stopped Treatment with nonsteroidal anti-inflammatory drugs. The cumulative symptomatic remission at the end of 5 years of Maintenance Treatment was 97.7%. While half the patients had presented with haemorrhage from the ulcer, only one patient bled during Maintenance Treatment, giving a cumulative risk of 2.3% in 5 years of Maintenance Treatment. We conclude that Maintenance Treatment with ranitidine effectively and safely keeps patients with non-steroidal anti-inflammatory drugassociated ulcers symptom- and risk-free.
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Nine years of Maintenance Treatment with ranitidine for patients with duodenal ulcer disease.
Alimentary pharmacology & therapeutics, 2007Co-Authors: J. G. Penston, K. G. WormsleyAbstract:Four hundred and sixty-four patients with duodenal ulcer disease received continuous Maintenance Treatment with ranitidine for up to 9 years. Treatment failure was defined as either the first symptomatic recurrence of ulcer or the first ulcer recurrence accompanied by haemorrhage. Life tables were constructed using the Kaplan-Meier product-limit method; comparisons of survival curves were performed using the log-rank test; and multivariate analysis was carried out using the Cox proportional hazards model. Results. The proportion of patients remaining free from symptomatic recurrence of ulcer during Maintenance Treatment with either 150 mg/day or 300 mg/day ranitidine was: 95% at 1 year; 88% at 3 years; 86% at 5 years; and 81% at 7 and 9 years (95% C.I. 76-86%). Young age and the absence of exposure to non-steroidal anti-inflammatory drugs (NSAIDs) at the time of diagnosis of ulcer were shown to increase the likelihood of developing ulcer recurrence. The rate of ulcer recurrence after 9 years of Maintenance Treatment (17%) was significantly less than that after 5 years without active anti-ulcer therapy (80%), P = 0.0001. The proportion of patients who remained free from ulcer haemorrhage during Maintenance Treatment was: 99.1% at 1 year and 98.1% at 5 and 9 years (95% C.I. 96.7-99.6%). The risk of haemorrhage was significantly greater in patients who were not receiving active Treatment (12.4% at 5 years) than in patients receiving Maintenance Treatment (less than 2% at 9 years), P = 0.0001 (log-rank test). Patients who had originally presented with haemorrhage had an increased risk of further ulcer bleeding compared with patients who presented with pain (P = 0.0013). A significantly greater proportion of patients with NSAID-associated duodenal ulcers remained free from ulcer recurrence during Maintenance Treatment compared with patients suffering from 'idiopathic' ulcers (P = 0.0238), although there was no difference between the two groups in respect of haemorrhage during Maintenance Treatment. Conclusions. (a) Continuous Maintenance Treatment with ranitidine for up to nine years successfully prevents ulcer recurrence in more than 80% of patients with duodenal ulcer disease. (b) Young age increases the risk of ulcer recurrence during Maintenance Treatment with ranitidine. Ulcers associated with NSAID-intake at the time of diagnosis have a lesser risk of recurrence during Maintenance Treatment. (c) The risk of haemorrhage in patients with ulcer disease receiving Maintenance Treatment with ranitidine for nine years was less than 2% compared with greater than 12% in untreated patients observed for 5 years.(ABSTRACT TRUNCATED AT 400 WORDS)
Richard P Mattick - One of the best experts on this subject based on the ideXlab platform.
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role of Maintenance Treatment in opioid dependence
The Lancet, 1999Co-Authors: Jeff Ward, Wayne Hall, Richard P MattickAbstract:Methadone Maintenance Treatment (MMT) involves the daily administration of the oral opioid agonist methadone as a Treatment for opioid dependence-a persistent disorder with a substantial risk of premature death. MMT improves health and reduces illicit heroin use, infectious-disease transmission, and overdose death. However, its effectiveness is compromised if low Maintenance doses of methadone (<60 mg) are used and patients are pressured to become prematurely abstinent from methadone. Pregnancy and psychiatric comorbidity are not contraindications for MMT. As an alternative to MMT, other oral opioid agents (eg, naltrexone, buprenorphine) may increase patient choice and avoid some of the more unpleasant aspects of MMT. The public-health challenge for the future is to develop and continue to deliver safe and effective forms of opioid Maintenance Treatment to as many opioid-dependent individuals as can benefit from them.
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Role of Maintenance Treatment in opioid dependence
Lancet (London England), 1999Co-Authors: Jeff Ward, Wayne Hall, Richard P MattickAbstract:Methadone Maintenance Treatment (MMT) involves the daily administration of the oral opioid agonist methadone as a Treatment for opioid dependence-a persistent disorder with a substantial risk of premature death. MMT improves health and reduces illicit heroin use, infectious-disease transmission, and overdose death. However, its effectiveness is compromised if low Maintenance doses of methadone (
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Methadone Maintenance Treatment in prisons: The new South Wales experience
Psychiatry Psychology and Law, 1994Co-Authors: Wayne Hall, Jeff Ward, Richard P MattickAbstract:This paper uses the New South Wales experience with methadone Maintenance Treatment in prison to address the question: should methadone Maintenance Treatment be provided in Australian prisons for opioid‐dependent prisoners? First, it outlines three rationales for providing drug dependence Treatment in prisons: as a way of giving prisoners access to community‐based forms of drug Treatment in the prison‐setting; as a measure to reduce recidivism in opioid‐dependent prisoners; and as a measure to prevent the transmission of HIV and other infectious diseases within prisons, and to the sexual partners of prisoners on their release. Second, it reviews the kind of research evidence that supports the effectiveness of community‐based methadone Maintenance Treatment in Australia. Third, the effectiveness of the New South Wales Prison Methadone Program, one of the few prison‐based methadone programs in the world, is evaluated in the light of the available research evidence.
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Methadone Maintenance Treatment in prisons: The New South Wales Experience
Drug and Alcohol Review, 1993Co-Authors: Wayne Hall, Jeff Ward, Richard P MattickAbstract:This paper uses the New South Wales experience with methadone Maintenance Treatment in prison to address the question: should methadone Maintenance Treatment be provided in Australian prisons for opioid-dependent prisoners? First, it outlines three rationales for providing drug dependence Treatment in prisons: as a way of giving prisoners access to community-based forms of drug Treatment in the prison setting; as a measure to reduce recidivism in opioid-dependent prisoners; and as a measure to prevent the transmission of HIV and other infectious diseases within prisons, and to the sexual partners of prisoners on their release. Secondly, it reviews the kind of research evidence that supports the effectiveness of community-based methadone Maintenance Treatment in Australia. Thirdly, the effectiveness of the New South Wales Prison Methadone Programme, one of the few prison-based methadone programmes in the world, is evaluated in the light of the available research evidence.
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Key issues in methadone Maintenance Treatment
1992Co-Authors: Jeff Ward, Richard P Mattick, Wayne HallAbstract:A report of an investigation, funded by the Drug and Alcohol Directorate of the New South Wales Department of Health, into the effectiveness of methadone Maintenance Treatment. The investigators present a major review of the scientific literature on the subject and augment this with comments from Australian experts on the literature and clinical practice surrounding the Treatment.
Jeff Ward - One of the best experts on this subject based on the ideXlab platform.
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role of Maintenance Treatment in opioid dependence
The Lancet, 1999Co-Authors: Jeff Ward, Wayne Hall, Richard P MattickAbstract:Methadone Maintenance Treatment (MMT) involves the daily administration of the oral opioid agonist methadone as a Treatment for opioid dependence-a persistent disorder with a substantial risk of premature death. MMT improves health and reduces illicit heroin use, infectious-disease transmission, and overdose death. However, its effectiveness is compromised if low Maintenance doses of methadone (<60 mg) are used and patients are pressured to become prematurely abstinent from methadone. Pregnancy and psychiatric comorbidity are not contraindications for MMT. As an alternative to MMT, other oral opioid agents (eg, naltrexone, buprenorphine) may increase patient choice and avoid some of the more unpleasant aspects of MMT. The public-health challenge for the future is to develop and continue to deliver safe and effective forms of opioid Maintenance Treatment to as many opioid-dependent individuals as can benefit from them.
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Role of Maintenance Treatment in opioid dependence
Lancet (London England), 1999Co-Authors: Jeff Ward, Wayne Hall, Richard P MattickAbstract:Methadone Maintenance Treatment (MMT) involves the daily administration of the oral opioid agonist methadone as a Treatment for opioid dependence-a persistent disorder with a substantial risk of premature death. MMT improves health and reduces illicit heroin use, infectious-disease transmission, and overdose death. However, its effectiveness is compromised if low Maintenance doses of methadone (
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Methadone Maintenance Treatment in prisons: The new South Wales experience
Psychiatry Psychology and Law, 1994Co-Authors: Wayne Hall, Jeff Ward, Richard P MattickAbstract:This paper uses the New South Wales experience with methadone Maintenance Treatment in prison to address the question: should methadone Maintenance Treatment be provided in Australian prisons for opioid‐dependent prisoners? First, it outlines three rationales for providing drug dependence Treatment in prisons: as a way of giving prisoners access to community‐based forms of drug Treatment in the prison‐setting; as a measure to reduce recidivism in opioid‐dependent prisoners; and as a measure to prevent the transmission of HIV and other infectious diseases within prisons, and to the sexual partners of prisoners on their release. Second, it reviews the kind of research evidence that supports the effectiveness of community‐based methadone Maintenance Treatment in Australia. Third, the effectiveness of the New South Wales Prison Methadone Program, one of the few prison‐based methadone programs in the world, is evaluated in the light of the available research evidence.
-
Methadone Maintenance Treatment in prisons: The New South Wales Experience
Drug and Alcohol Review, 1993Co-Authors: Wayne Hall, Jeff Ward, Richard P MattickAbstract:This paper uses the New South Wales experience with methadone Maintenance Treatment in prison to address the question: should methadone Maintenance Treatment be provided in Australian prisons for opioid-dependent prisoners? First, it outlines three rationales for providing drug dependence Treatment in prisons: as a way of giving prisoners access to community-based forms of drug Treatment in the prison setting; as a measure to reduce recidivism in opioid-dependent prisoners; and as a measure to prevent the transmission of HIV and other infectious diseases within prisons, and to the sexual partners of prisoners on their release. Secondly, it reviews the kind of research evidence that supports the effectiveness of community-based methadone Maintenance Treatment in Australia. Thirdly, the effectiveness of the New South Wales Prison Methadone Programme, one of the few prison-based methadone programmes in the world, is evaluated in the light of the available research evidence.
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Key issues in methadone Maintenance Treatment
1992Co-Authors: Jeff Ward, Richard P Mattick, Wayne HallAbstract:A report of an investigation, funded by the Drug and Alcohol Directorate of the New South Wales Department of Health, into the effectiveness of methadone Maintenance Treatment. The investigators present a major review of the scientific literature on the subject and augment this with comments from Australian experts on the literature and clinical practice surrounding the Treatment.
