摘要:

SUMMARYIn a pilot study six patients with active ulcerative colitis and six healthy controls were given fish oil (MaxEPA) containing 3–4 g of eicosapentaenoic acid daily for a period of 12 weeks. There was a significant improvement in the patients' symptoms and histological appearance of the rectal mucosa by the end of the treatment period. There was a significant fall in neutrophil chemiluminescence during treatment in patients, whereas no change was observed in the control group. Neutrophil leukotriene B4levels fell significantly during treatment. Serum from patients receiving fish oil was significantly less chemotactic for neutrophils compared with control serum. Eicosapentaenoic acid inhibited neutrophil chemotaxis and chemiluminescencein vitro. The omega‐3 fatty acids, which occur naturally in fish oils, may exert a beneficial effect by decreasing the production of inflammatory mediat

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00232.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYDrugs that inhibit gastric acid secretion heal duodenal ulcers at a rate that correlates with the ability of individual treatment regimens to decrease 24‐h intragastric acidity. As current therapeutic regimens of ranitidine decrease 24‐h intragastric acidity submaximally, higher dosages may expedite duodenal ulcer healing. To test this hypothesis a randomized, double‐blind clinical trial was conducted in 245 patients with duodenal ulcer to compare the effects of standard dose (300 mg nocte) and highdose (300 mg q.d.s.) ranitidine. Patients were assessed after 2 weeks of treatment and, if unhealed, after a further 2 weeks of therapy. The therapeutic gain in ulcer healing at the 2‐week endoscopy of the higher dose over the lower dose of ranitidine was 22% (68%vs46%,P<0.001). The cumulative ulcer healing rates at the 4‐week endoscopy were 88% and 92% for the standard and high‐dose ranitidine groups, respectively (N.S.). By 2 weeks, 61% of patients treated with standard ranitidine therapy and 79% of those receiving 300 mg ranitidine q.d.s. were pain‐free (P<0.01). A further 2 weeks of therapy enabled 88% and 97% of patients (N.S.) to become pain‐free on these two regimens, respectively. The drug regimens were equally well tolerated. Thus higher‐dose ranitidine can significantly accelerate the healing of duodenal ulcer with improveme

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00233.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYStudies were carried out on 16 healthy male volunteers to investigate whether intravenous administration of the α2‐adrenoreceptor antagonist, idazoxan, could affect fasting antroduodenal motility with and without administration of the agonist, clonidine. Contractile activity was recorded using an oral tube with perfused side holes positioned in the stomach and duodenum.Clonidine decreased antral contractile activity, an effect that idazoxan did not restore. Idazoxan alone did not affect antral motility. In the duodenum, clonidine decreased the number of contractions significantly and idazoxan restored them. Idazoxan alone did not increase duodenal motility but clonidine induced phase‐III activity within the first 15 min after administration.The observations indicate that regulation of antroduodenal motility is influenced by α2‐adrenoreceptor drugs. Idazoxan may have potential as a motility restoring drug, for example, in postoperativ

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00234.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYThe object of this double‐blind, multicentre study was to compare duodenal ulcer healing rates after 2 and 4 weeks of treatment with either 20 mg omeprazole o.m. or 150 mg ranitidine b.d. One hundred and eighty‐one patients were randomized: 91 received omeprazole and 90 received ranitidine.In a per protocol analysis at 2 weeks, 63% of the patients were healed on omeprazole and 65% of the patients were healed on ranitidine (N.S.); at 4 weeks 91% were healed in the omeprazole group and 96% were healed in the ranitidine group. There were no differences in ulcer symptom relief between the two groups. There were no significant changes in laboratory values in either of the groups. Adverse events were few and mainly mild and transient.We conclude that both omeprazole (20 mg o.m.) and ranitidine (150 mg b.d.) result in rapid, ulcer healing ra

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00235.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYIn this preliminary study, we examined the effects of acarbose and placebo together with a standardized breakfast on blood glucose levels, on breath hydrogen excretion and on plasma insulin and glucagon levels, in addition, the effects on fasting blood levels of metabolites were studied following an evening meal with acarbose or placebo. Acarbose significantly reduced blood glucose levels in 10 patients with alcoholic cirrhosis following a meal containing 100 g of carbohydrate. There were no significant changes in plasma insulin after breakfast but glucagon levels were increased at 1 h after the meal. Breath hydrogen excretion did not change significantly. Acarbose given with a late evening snack reduced fasting β‐hydroxybutyrate levels the next morning in these cirrhotic patien

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00236.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYTwo hundred and eight patients with benign gastric ulcers seen on endoscopy were recruited by 13 hospitals in the United Kingdom and Ireland into this double‐blind study. Patients were assigned by prerandomized schedule to 8 weeks of treatment with either 40 mg famotidine at night or 150 mg ranitidine b.d. Repeat endoscopy confirmed complete ulcer healing in 62 of 77 evaluable patients in the famotidine group (81%) and 58 of 71 in the ranitidine group (82%). The treatments were equally effective in promptly relieving day and night pain. Adverse events were uncommon; dizziness and headaches were the most frequently reported in both groups. In conclusion, night‐time famotidine is as effective as twice daily ranitidine in healing benign gastric ulcers and provides similarly rapid symptomatic rel

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00237.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYWe compared the effects of fasting and feeding on the antisecretory actions of ranitidine in 19 patients whose duodenal ulcers remained unhealed or relapsed despite treatment with the drug. Nine of the patients received, and continued with, 150 mg ranitidine b.d. and 10 took 300 mg ranitidine b.d. In all patients, gastric secretion was inhibited during the night, with near‐neutral pH and acid output less than an average of 2 mmol in 8 h. Gastric secretion was not inhibited during the day by either of the therapeutic regimens. However, on the day when the patients fasted, gastric acidity was, on average, 20–50 mmol/L less than on the day when food was consumed. Food‐induced interference with the therapeutic inhibition of gastric secretion produced by H2‐receptor antagonists may be responsible for the unsatisfactory clinical response of some patients with duodenal ulcers. Prolonged fasting can improve the control of gastric secretion and may allow resistant ulcers

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00238.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYThe nature and time‐course of acute piroxicam‐induced gastric mucosal injury was determined in ten healthy volunteers treated with 10 mg piroxicam twice daily by mouth for 21 days. Mucosal injury was measured endoscopically by visual analogue scales and by the method of Lanza, and luminal blood loss by haemoglobin measurements in gastric washings, 10 h after the first drug dose and then after 5, 10 and 21 days.Acute mucosal injury, consisting mainly of haemorrhagic lesions in the gastric body, developed to a maximum extent within 10 h of the first dose of piroxicam, and did not increase thereafter. By contrast intraluminal bleeding increased little for 10 days and then rose significantly at 21 days, when plasma piroxicam levels reached values likely to affect platelet function.We conclude that gastric mucosal injury and bleeding may be dissociated and may constitute different targets for prophylaxis. Gastric mucosal injury is probably exerted topically as it is maximal at low plasma drug concentrations, whereas bleeding may arise because of interference with platelet‐dependent mecha

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00239.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYEnprostil, a prostaglandin E2analogue, is effective in healing acute duodenal ulcer but its value in preventing recurrence, when given daily for maintenance therapy, is uncertain. In this three‐centre study we compared enprostil and ranitidine maintenance therapy; the latter is known to reduce duodenal ulcer relapse rates. Patients whose duodenal ulcers had been healed by treatment with an H2‐receptor antagonist were randomized to receive single‐blind treatment with either 35 μg enprostil (n = 64) or 150 mg ranitidine (n = 64) at bedtime for periods of up to 1 year. Endoscopy was routinely performed at 3 months at one centre, and at 6 and 12 months at all three centres, or whenever ulcer symptoms recurred. Clinical assessment and laboratory investigations were performed every 3 months. Relapse, defined as recurrent ulcer with or without pain, or erosions with pain, was significantly greater in patients on enprostil, the comparative rates at 3, 6 and 12 months were: enprostil 23, 31 and 36% ranitidine 6, 12 and 17% (P= 0.013;P= 0.03 andP= 0.03, respect

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00240.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

SUMMARYFifty‐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

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1989.tb00241.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY