摘要:

SUMMARYOver the past 3 years there has been a renewed interest in bile acid therapy not only because of the promising results obtained by combining this therapy with extracorporeal shock‐wave lithotripsy for rapid gallstone dissolution, but also because of its novel use as a treatment for primary biliary cirrhosis. This article reviews the use of bile acids for both these indication

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00444.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYWe have investigated the relationship between the suppression of acidity by antisecretory drugs for the treatment of benign gastric ulcer and their corresponding ulcer‐healing rates. For a variety of antisecretory drug regimens, there was a significant correlation between suppression of 24‐h intragastric acidity and ulcer healing rates after 2, 4 and 8 weeks of treatment. There was a lesser degree of correlation between healing and suppression of nocturnal acidity and the association between suppression of acidity and gastric‐ulcer healing rates was less marked than that previously described for duodenal

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00445.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYFifty patients who underwent diagnostic upper gastrointestinal endoscopy after midazolam sedation were randomized to receive (after completion of the examination) either the benzodiazepine receptor antagonist flumazenil or an identical‐looking placebo. The speed of recovery from sedation was assessed by reaction time testing, measurement of critical flicker fusion frequency, and the semi‐quantitative SOCA scoring system. Measurements were made up to 6 h post examination in all subjects, and at 12 and 24 h in all in‐patients (n= 20). Flumazenil‐treated patients were significantly more alert than those who received placebo at 10 min, 30 min, 1 h and 2 h (P<0.001 in all instances). Thereafter the two groups were similar. There was no evidence of recurrence of sedation in flumazenil‐treated patients, nor did this drug adversely affect the period of anterograde amnesia between the administration of midazolam and f

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00446.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYOne hundred patients for endoscopy, aged, between 18 and 74 years were randomly allocated to two equal groups. Group A received 10 mg diazepam intravenously rapidly over 2–4 s; Group B received diazepam intravenously over 1–2 min, titrated to provide a satisfactory level of sedation (mean dose 15.9 mg).Patient co‐operation during endoscopy was similar in both groups, but one patient in Group A developed respiratory depression. Tests of psychomotor function after endoscopy showed greater impairment 30 min following injection for Group B, compared with Group A (P<0.02).Total or partial amnesia for endoscopy was present in 62% of Group A, and 90% in Group B (P<0.005). However, postal follow‐up showed that endoscopy was acceptable to 96% of Group A and 98% of Group B. Delayed sedation later in the day was reported by 26% of Group A compared with 48% of

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00447.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYSixty consecutive patients with endoscopically proven duodenal ulcers were given colloidal bismuth subcitrate tablets either as 120 mg q.d.s. or 240 mg b.d., in a randomized single‐blind study. The efficacy of each regimen was determined by endoscopic examination and antral biopsy at 4 weeks; if the ulcer remained unhealed, treatment was continued and endoscopy repeated at 8 weeks. The ulcer‐healing efficacy of the two regimens was identical; however, in the four times daily group only 27% remainedCampylobacter pyloripositive after 8 weeks of treatment compared with 58% of the twice‐daily group. Similarly, only 21% of twice daily patients were free of histological gastritis compared with 42% of the four times daily pat

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00448.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYA randomized, double‐blind, placebo‐controlled multicentre study was undertaken to evaluate the safety and efficacy of coated, oral 5‐aminosalicylic acid (Mesasal/Claversal; 5‐ASA) in maintaining remission of inactive Crohn's disease for up to 12 months. A total of 248 patients were entered from eight countries, of which 206 adhered to the protocol and were included in the analysis. The patients had Crohn's disease for an average of 5 years, with their disease clinically inactive for at least 1 month prior to entry into the study, and for an average of over 12 months previously. Thirty per cent of patients had had a previous resection, 16% of patients had been treated with sulphasalazine, while none of those analysed received glucocorticosteroids. Treatment consisted of 500 mg 5‐ASA t.d.s. or placebo. ‘Relapse’was defined as the first occurrence of Best's Crohn's Disease Activity Index>150, which had increased 60 points from the pre‐trial index. The cumulative life‐table relapse estimate was lower in 5‐ASA patients compared to placebo (22.4% us 36.2%, respectively, Log rank test P = 0.0395). The 12‐month relapse estimate in the 5‐ASA group was also lower in patients with ileal disease (8.3% for 5‐ASA and 31.0% for placebo, P = 0.0535) and in patients with previous bowel resections (14.2% us 47.0%, P = 0.0436). The incidence of side‐effects was similar in both treatment groups. It is concluded that 5‐ASA was significantly superior to placebo in preventing relapse of Crohn's disease; this effect was most apparent in patients with disease restricted to the ileum and in patients with previous bowel resection. 5‐ASA was well‐tolerated, as demonstrated by

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00449.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYTo determine the effect of three times daily dosing with intravenous omeprazole on intragastric acidity, 24 h intragastric pH was measured continuously with a monocrystalline antimony electrode system in 11 patients with inactive duodenal ulceration during fasting conditions. After a baseline investigation, two different dosage regimens of intravenous omeprazole were compared in a double‐blind crossover study, with regard to their ability to keep the pH ≥ 4 for as long as possible. Success in the individual patient was defined as pH ≥ 4 for at least 90% over the 24‐h period. Two doses of omeprazole [40 mg t.d.s. (120 mg) and 80 mg + 40 mg + 40 mg (160 mg)] were compared.Omeprazole (120 mg) increased the median of individual median intragastric 24‐h pH from 1.49 to 6.67. The pH was ± 4 for ≥ 90% of the 24 h in three of the 11 patients. With omeprazole, 160 mg (a loading dose of 80 mg), the median of individual median intragastric 24‐h pH increased to 7.33. The pH was ≥ 4 for ≥ 90% of the 24 h in seven of the 11 patients. Median time to reach pH 4 was 39 min after 40 mg and 20 min after 80 mg omeprazole.An initial loading dose of 80 mg omeprazole seems preferable to 40 mg to achieve a fast and sustained increase in intragastric pH to above 4 in t

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00450.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYMotor changes could be involved in the pathogenesis of diarrhoea that complicates the treatment of ulcer disease by prostaglandins. Our aim was to assess the effect of enprostil, a synthetic analogue of PGE2, on duodeno‐jejunal motility. During this randomized double‐blind crossover study, two manometric recordings, each lasting 20 h (12.00‐08.00 hours), were carried out during dosing with 35 μg enprostil b.d. or placebo (eight volunteers: part 1), or during dosing with 35 or 70 μg enprostil b.d. (nine volunteers: part 2). Subjects were only allowed a standard dinner at 18.00 hours.During fasting, in part 1, the number of phase 3 activity patterns (PIIIs) was higher with enprostil than with placebo (P<0.01), without any difference in their characteristics; the overall duration of phase 1 activity was longer with enprostil than with placebo (P<0.01). In part 2, during fasting the number and characteristics of the PIIIs were not different, but there was a dose‐related increase in PI, and decrease in PII activity. Fed motor patterns did not differ between the two doses of

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00451.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYThe pharmacokinetics of famotidine were studied in seven healthy control subjects and in 14 patients with cirrhosis, following single oral and intravenous 20‐mg dose administration, and after seven daily doses of 40 mg.Following intravenous (i.v.) administration, the mean (range) total plasma clearance values were not significantly different in the patients with compensated cirrhosis (n= 7), 337 (241–576) ml/min or in the patients with decompensated cirrhosis (n= 7), 270 (120–408) ml/min compared with the control group, 370 (154–612) ml/min. The mean halflife in the compensated cirrhotics, 2.86 (1.87–4.98) h, was similar to that in the control group 2.91 (1.86–6.03) h, but it was insignificantly prolonged in the decompensated cirrhotics 3.35 (2.00–5.77) h.The mean, maximum, plasma famotidine concentrations after single oral doses were comparable between the groups but there was considerable inter‐subject variability, with individual values ranging from 17 to 139 ng/ml. Peak plasma concentrations were reached within 2–3 h, although more variability was observed among patients with decompensated cirrhosis. The mean systemic availability of the drug, estimated from urinary recovery, was 0.39 (0.15‐0.64) in the healthy controls, 0.35 (0.14‐0.51) in the patients with compensated cirrhosis and 0.38 (0.13‐0.77) in the patients with decompensated cirrhosis.No significant increases were observed in plasma trough famotidine concentrations following multiple oral dosing in any of the subjects, and the kinetic variables after the seventh dose were not significantly different from those following the single oral dose. in control subjects or in patients between the pre‐study day and day seven of the multiple oral dose phase.No significant changes were observed i

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00452.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYSeventy‐seven patients with endoscopically verified duodenal ulcers were randomized to treatment with either 2 g sucralfate daily at bedtime or 1 g sucralfate q.d.s. in a controlled double‐blind comparative study. After a 4‐week treatment period, the healing rate was 68% for the former and 69% for the latter trea

ISSN:0269-2813    

DOI:10.1111/j.1365-2036.1990.tb00453.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY