摘要:

SUMMARYUp to 20–30% of patients treated with sulphasalazine experience a variety of adverse effects, principally due to the carrier moiety sulphapyridine. In the last decade there has been a major drive to develop a new generation of 5‐aminosalicylic acid (5‐ASA) and 5‐ASA‐related drugs which not only have a high efficacy but are also devoid of the unwanted side‐effects of sulphapyridine. Various forms of 5‐ASA have been evaluated in ulcerative colitis and appear to be effective orally in preventing relapse and topically in the treatment of active distal colitis. More recently, topical 4‐ASA has been found to be useful for the treatment of distal colitis with the advantage of better stability and lower cost compared with 5‐ASA. In the foreseeable future it seems likely that these new aminosalicylic acid derivatives will become the drugs of choice in the treatment of inflammatory bowel disease and largely repla

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00699.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYAlthough enterochromaffin‐like (ECL) cells form the major endocrine cell population of the non‐antral stomach, they have been largely overlooked in the study of gastric disease. In the human, their product and functions are unknown, but they are associated with histamine secretion in rodents. The cells are controlled by neural and hormonal factors, the most significant of the latter being gastrin. Interest in ECL cells has been stimulated by the observation that hyperplasia of these cells, sometimes leading to formation of gastric carcinoid tumours, occurs in conditions of persistent hypergastrinaemia — for example, in response to the achlorhydria of individuals with pernicious anaemia. The advent of new highly potent inhibitors of gastric acid secretion is allowing more information to be obtained on the physiology and functions of the ECL cell. However, there is clearly a great deal more to be discovered about this enigmatic endocrine cell

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00700.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYData from several sources are used to quantify the expected direct medical costs of a recently healed duodenal ulcer patient prescribed an H2‐antagonist (famotidine) for a 6‐month period. These costs are compared to the expected direct medical costs associated with not using maintenance therapy.Our results indicate that the estimated direct cost of patients prescribed a 6‐month regimen of an H2‐antagonist (famotidine) is 30.3% lower than patients who receive no H2‐antagonist therapy. Most of the savings result from a reduced risk of hospitalization and surgery. The results of the sensitivity analysis of four varying scenarios indicate that H2‐antagonist maintenance therapy remains less costly even when the assumptions underlying the model are varied enormously. We conclude that the decision to withhold maintenance therapy with H2‐antagonists should not be based

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00701.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYBacterialN‐formyl‐methionyl oligopeptides are spasmogenic for guineapig ileumin vitrobut the mechanism of this effect is not understood. To investigate this phenomenon further, we have determined pA2values (the negative logarithm of the concentration of an antagonist reducing a double‐dose agonist response to a single‐dose response) for a number of potential antagonists ofN‐formyl‐met‐leu‐phe (F‐met‐leu‐phe) using histamine, acetylcholine, 5HT and substance P as control agonists. Atropine, pirenzepine and tetrodotoxin were potent inhibitors of F‐met‐leu‐phe induced contraction (pA2's 8.4, 8.0 and 7.9, respectively) suggesting involvement of neural and cholinergic pathways in the response. Sulphasalazine, known to block the F‐met‐leu‐phe receptor on neutrophil leucocytes, was also a potent inhibitor. Tachyphylaxis induced by either 5HT, or substance P, did not diminish the response to F‐met‐leu‐phe, suggesting that these potential mediators were not involved. These studies indicate that bacterially synthesized formyl—methionyl oligopeptides bind to cells bearing receptors in guinea‐pig ileum and produce muscle contraction v

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00702.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYIn a double‐blind placebo‐controlled study in nine healthy volunteers, the effects of single doses of oral enprostil (8.75, 17.5, 35 and 70 μg), taken before a standard breakfast, were assessed on the post‐prandial release of gastrin into the plasma. All doses of enprostil caused a significant dose‐related decrease in median post‐prandial plasma gastrin concentration (range from — 29 to — 44%). In the same subjects, two doses of 25 mg indomethacin caused a significant (38%) increase in median post‐prandial plasma gastr

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00703.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYGastric aspiration was performed continuously overnight and at hourly intervals during the daytime in 20 healthy male volunteers. Medications used included enisoprost 100, 200 or 400 μg, misoprostol 200 μg and placebo, given at bedtime. Each dose of enisoprost markedly inhibited nocturnal mean acid output, hydrogen ion activity, pH and peptic activity. The duration of these effects was up to 10 h. Misoprostol, given at bedtime, also decreased acid secretion, but the effect was significantly less than that observed with any of the doses of enisoprost. A dose—response effect for enisoprost was found for the mean nocturnal hydrogen ion activity and pH, as well as for maximum pH attained. Although enisoprost, given at bedtime, had a marked inhibitory effect on acid and pepsin secretion for the overnight interval, this did not result in rebound hyperacidity or a rise in serum total gastrin concentration. The results of this study suggest that enisoprost should be tested by clinical trial for the treatment of peptic ulcer dise

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00704.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYA 57‐year‐old woman presented with a 3‐week history of dysphagia for solids, 6 months after starting treatment with nifedipine. Endoscopy demonstrated oesophagitis and a benign oesophageal stricture. Twenty‐four‐hour ambulatory pH monitoring demonstrated decreased acid reflux 8 weeks after withdrawal of nifedipine, with coincidental symptomatic and endoscopic improvement. Nifedipine may induce, or aggravate, pre‐existing, gastro‐oesop

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00705.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYOn the basis of the report that benzimidazoles bind to and inhibit the hepatic cytochrome P‐450 enzyme system, the effect of mebendazole and albendazole on theophylline disposition was studied in 12 volunteers. Mebendazole at a dose of 100 mg b.d. for 3 days did not significantly alter the theophylline half‐life, volume of distribution or clearance in a group of six. In another group of six adult volunteers, albendazole (400 mg) pretreatment did not alter the same parameters. However, in this second group, pretreatment with cimetidine (400 mg t.d.s. for 5 days) significantly increased theophylline half life from 7.7 to 9.8 ± 1.5 h (P<0.001) and reduced its clearance from 0.8 to 0.60 ± 0.1 ml min−1kg−1(P<0.005). The volume of distribution was not altered significantly.It is concluded that at therapeutic doses it is unlikely that mebendazole or albendazole will induce theophylline toxicity if co‐administered with the bronchodilator. Cimetidine‐induced impairment of theophylline metabolism is such that toxicity will be more likely in individuals with initial high theophyll

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00706.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYFourteen patients with chronic diarrhoea, but no evidence of active organic disease, completed a double‐blind crossover comparison of the anti‐diarrhoeal effects of loperamide, placebo and the clonidine analogue, lidamidine. Failure of diarrhoea control led to early withdrawals from seven placebo‐ and six lidamidine‐treatment periods, but there was only one early withdrawal during treatment with loperamide. Loperamide was found to be superior to lidamidine or placebo for the control of stool consistency in patients with chronic di

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00707.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

SUMMARYIn a multicentre trial, 120 patients with endoscopically diagnosed duodenal ulcer were randomly allocated to treatment with either 35 μg enprostil b.d. or 400 mg cimetidine b.d. for up to 6 weeks on a double‐blind basis. After 6 weeks, 82% (42/51) of enprostil‐treated patients and 92% (44/48) of cimetidine‐treated patients were healed. Corresponding healing figures on an intention‐to‐treat basis were 70% and 76%. No significant differences were detected between treatments with respect to healing rates or symptom control at any time. Side‐effects were reported by 14 patients taking enprostil and 17 patients taking cimetidine; none were serious but they resulted in withdrawal of one and two patients respectively. Enprostil was found to be similar in efficacy and tolerance t

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1988.tb00708.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY