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Biomedical subjects

A Berstad

Publications and source records attributed to A Berstad.

At least 199 records · Page 11Linked to original sources
PubMed1984

Treatment of gastric ulcer with ranitidine.

Forty-eight patients with endoscopically proven gastric ulcer were treated either with ranitidine tablets, 150 mg twice daily, or with placebo tablets under double-blind conditions. Three patients were for various reasons excluded from the study. After 6 weeks' treatment a second endoscopy was performed. The ulcer had healed in 22 (88%) of the 25 patients who had received ranitidine tablets and in 4 (20%) of the 20 patients who had received placebo tablets. The difference was statistically significant (p less than 0.002). The number of days and nights with pain attacks and the number of antacid tablets consumed were significantly (p less than 0.002) lower in the patient group treated with ranitidine. The 3 patients with non-healed ulcer after treatment with ranitidine had their ulcers healed after a further 6 weeks' treatment with ranitidine, and of the 16 patients with non-healed ulcer after treatment with placebo tablets, 13 had their ulcers healed after 6 weeks' open treatment with ranitidine, 150 mg twice daily. No serious side effects that could be ascribed to treatment occurred during the study.

Antacids↗
PubMed1984

Prolonged influence of a meal on the effect of ranitidine.

Ten healthy volunteers received 150 mg ranitidine or placebo. Eight hours after drug administration they were served a standard meal or continued fasting. Four hours later the gastric acid and pepsin secretion and gastrin and ranitidine levels in blood were recorded for a further 2 h. At the time when secretion was measured, the meal neither stimulated acid or pepsin secretion nor altered the circulating plasma levels of ranitidine or gastrin. In spite of that, the meal significantly reduced the acid-inhibitory effect of ranitidine from 63% to 39% (p less than 0.01). Pepsin secretion was not affected by the meal or the administration of ranitidine. The results indicate that a meal may decrease the acid-inhibitory effect of the H2-receptor antagonist longer than it stimulates acid secretion.

Adult↗
PubMed1984

Dopaminergic and adrenergic influence on gastric acid and pepsin secretion stimulated by food. The role of vagal innervation.

Dopaminergic and adrenergic mechanisms were studied in a dog model which made possible physiological stimulation by food and comparison of vagally innervated and denervated acid and pepsin response at the same time. Five dogs were equipped with two pouches separated from the stomach, and stimulation was done by a standard meal - a mixture of liver, heart and bonemeal , 10 g/kg. The meal was combined with different doses of dopamine 0.1 - 2.0 - 20.0 - 40.0 micrograms/kg/min and with single doses of phentolamine, propranolol and sulpiride separately and combined with dopamine. Acid and pepsin secretion were inhibited in dose-response manner by dopamine in innervated mucosa, but all other effects of the compounds were different in parietal cells and chief cells and in vagally innervated and denervated mucosa.

Animals↗
PubMed1984

The effect of physical stress on gastric secretion and pancreatic polypeptide levels in man.

Twelve healthy subjects were exposed to a 4-day period of hard physical exercise, calorie supply deficiency, and severe sleep deprivation. The basal acid output (BAO), the sham-feeding-induced acid output (MAOsh), and the pentagastrin-stimulated acid output (MAOpg) were measured immediately after this stress period and in a control experiment performed several weeks later. The stress induced a threefold increase in the median BAO and an increase (p less than 0.05) in the MAOsh, which, however, was not significantly elevated when basal-subtracted. MAOpg was unchanged. In contrast to acid, pepsin output was not influenced by stress. The human pancreatic polypeptide (hPP) level in serum increased twofold after the stress. The integrated hPP response induced by modified sham feeding was higher (p = 0.02) after the stress than in the control experiment. The results show that physical stress has separate influence on the gastric secretion of acid and pepsin.

Adult↗
PubMed1983

Effect of cimetidine and oxmetidine on 24-h gastric acid and pepsin in patients.

The 24-h intragastric pH, titrated hydrogen ion concentration, and pepsin concentration were studied in nine peptic ulcer patients during administration of placebo and of 800 mg cimetidine given as two or four equal doses. Cimetidine, 400 mg twice daily, was more effective in reducing acidity during morning (p less than 0.05) and overnight (p less than 0.01) than cimetidine, 200 mg four times daily, which, however, was the most effective regimen during the afternoon (p less than 0.05-0.01). During the 24-h period pH values equal to or above 5 were observed for less than 1 h with placebo treatment, for 1.8 h with cimetidine, 200 mg four times daily, and for 4.7 h with cimetidine, 400 mg twice daily. A new histamine H2-receptor antagonist, oxmetidine, was studied in six other patients, also during a 24-h period. Both 400 mg twice daily and 200 mg four times daily of oxmetidine were superior to placebo (p less than 0.05) in reducing intragastric acidity during the entire 24-h period.

Adult↗
PubMed1983

Effect of verapamil on gastric secretion in man.

To elucidate the role of calcium as a second messenger in gastric acid secretion, the effect of the calcium antagonist verapamil was studied in healthy subjects. Verapamil had no inhibitory effect on acid and pepsin secretion, stimulated with histamine, 6.4 micrograms X kg-1h-1 (no. = 6); pentagastrin, 0.10 micrograms X kg-1h-1 (no. = 9); or modified sham feeding (no. = 7). The results do not exclude the possibility that influx of calcium through channels in the parietal cell membrane could be of importance in the stimulus-secretion coupling of acid secretion. The results suggest, however, that these channels are not blocked by verapamil.

Adult↗
PubMed1983

Effect of pirenzepine and antacids on postprandial intragastric pH.

Peptic ulcer treatment with high dose regimens of antacids may be inconvenient and unpleasant, and the risk of side effects should not be neglected. Anticholinergics are claimed to accentuate and prolong the effect of antacids on intragastric acidity. In the study the effect on postprandial intragastric pH of a moderate dose of antacids in combination with pirenzepine was compared with that of a double dose of antacids in six healthy subjects, to see whether the dose of antacids could be reduced when given in combination with an antimuscarinic compound. Doubling the dose of antacids caused higher pH peaks while adding pirenzepine caused a more sustained pH elevation. The curves showing the percentage of pH readings greater than or equal to each pH level were almost identical up to pH 4. The results support the rationale of using antacids and pirenzepine in combination.

Antacids↗
PubMed1982

Relationship between ranitidine plasma levels and reduction of postprandial intragastric acidity in healthy man.

Intragastric acidity was measured for 20 min before and 6 h 40 min after a steak meal by aspiration of small aliquots of the gastric content every 10 min in 11 healty volunteers. Administration of ranitidine hydrochloride (100 mg) at the beginning of the meal reduced postprandial acidity markedly throughout the test, but there was no correlation between the percentage reduction of acidity and the concentration of ranitidine in plasma. The effect of the drug lasted much longer than would be expected from the plasma values. The results suggest that ranitidine is cleared more rapidly from the blood than from the H2-receptors of the parietal cells, and the reduction of postprandial acidity by ranitidine cannot be deduced from the plasma values of the drug.

Eating↗
PubMed1982

Controlled clinical trial of duodenal ulcer healing with antacid tablets.

The effect of an antacid tablet regimen (total acid-neutralizing capacity, 280 mmol/day) and placebo was studied in 75 patients with duodenal ulcer in a double-blind 4-week trial. The ulcer healed in 30 out of 37 (81%) patients treated with antacids as compared with 9 out of 38 (24%) patients treated with placebo (p less than 0.001). Ulcer symptoms in the antacid- and the placebo-treated groups did not differ significantly until the last week of treatment (p less than 0.01). Both constipation and diarrhoea were slightly more common in antacid- than in placebo-treated patients (NS). Serum concentration of aluminium increased significantly (p = 0.01), whereas serum concentrations of calcium, phosphorus, magnesium, iron, and total iron-binding capacity did not change during treatment. No other side effects of antacids were recorded. Thirty-eight patients with unhealed ulcer after cessation of the antacid/placebo treatment were treated openly with 150 mg ranitidine twice daily. The ulcer healed in 31 out of 37 (83%) patients (one drop-out) after 4 weeks' treatment, and only one patient remained with unhealed ulcer after 6 weeks' ranitidine treatment. No side effects due to ranitidine were recorded.

Adult↗
PubMed1982

Antacid therapy of duodenal ulcer. Effects of smaller doses.

In a previous study, antacids in a dose consuming 480 mmol of acid per day were administered in combination with small doses of trimipramine or cimetidine. The healing rate of duodenal ulcer after 6 weeks' treatment was 85%. In a subsequent study, the dose of antacids was reduced further and antacid tablets were given instead of liquid antacids. In this study, antacids were given alone and the daily dose consumed only 280 mmol of acid. The healing rate of duodenal ulcer after 4 weeks' treatment was 81%, but the symptomatic effect was weak. The effect of this dose of antacid tablets on intragastric postprandial pH was much less than the effect of a therapeutic dose of ranitidine. The high efficacy of smaller doses of antacids on ulcer healing, in spite of a weak effect on acidity, suggests the possibility that, in duodenal ulcer, antacids may act via other mechanisms than neutralization of hydrochloric acid.

Aluminum Hydroxide↗
PubMed1982

Management of acute upper gastrointestinal bleeding.

The medical management of patients with acute upper gastrointestinal bleeding includes both diagnostic and therapeutic procedures. Emergency or early endoscopy has greatly improved the diagnosis, but it has not yet changed the therapeutic approach very much. The main emphasis is still on close observation of the patients in order to give blood transfusions when necessary and to identify those who need urgent operation. Most patients stop bleeding spontaneously, but the frequency of rebleeding is high. Patients with continuous bleeding or rebleeding are candidates for emergency operation. Much effort has been made to prevent rebleeding because, if the patients can be operated on electively, the frequency of complications is lower and vagotomy may be preferable to resection. Several medical treatments including antacids, H2-receptor antagonists, pepsin inhibitors and specific antifibrinolytic agents have been tried, but their value is still sub judice. Curiously, methods of treatment that are clearly effective in healing peptic ulcers seem less effective in preventing rebleeding from eroded vessels within such ulcerations.

Antacids↗
PubMed1982

Effect of peroral antacid treatment in patients with acute upper gastrointestinal haemorrhage: a randomized controlled trial.

During recent years, it has been reported that antacids have a beneficial prophylactic effect in critically ill patients regarding upper gastrointestinal bleeding. In these trials rather complicated treatment schedules and high doses of antacids were used. The present study was designed to investigate the therapeutic efficacy of a more practical antacid treatment regimen in patients with haematemesis and/or melaena. Ninety patients, hospitalized for haematemesis and/or melaena within the past 24 hours, were included to double-blind treatment with antacids or placebo for 7 days. The dose, 20 ml liquid antacid (Balancid) with a neutralizing capacity of 105 mmol, was administered each second hour during waking hours. The groups were comparable regarding incidence of ulcer disease, age, sex, acid secretion, and usage of aspirin. Continuous bleeding or rebleeding was recorded in 15 of the 43 patients in the antacid group (34.9%), compared to 19 of the 47 patients in the placebo group (40.4%), the difference not being statistically significant. Furthermore, the requirement of blood transfusions was not significantly different in the two groups. In conclusion, the haemostatic effect of the antacid treatment regimen used in the present study was not significantly superior to placebo in patients with endoscopically verified acute upper gastrointestinal haemorrhage.

Adult↗
PubMed1982

Nocturnal gastric secretion following treatment with trimipramine (Surmontil).

The study was conducted double blind in 12 healthy volunteers, average age 30 years (23-48). On separate days they were allocated at random to either two tablets of Trimipramine, 25 mg each, or two tablets of Placebo, one and a half hours before introduction of a Levine tube into the stomach. The volunteers had on the day of starting the experiment performed their normal duties, and consumed the last meal, the dinner, at 5 pm. The gastric juice was collected continuously in half hour samples from 11 pm until 7 am the next morning. The average recovery was 87% in 4 tested experiments. The volume of gastric juice was 448 ml/8 h for the series receiving Placebo compared to 418 ml/8 h for those treated with Trimipramine (Table 1). During the first half hour a relative high volume was aspirated, whereas in the following 3 half hours portions the volume decreased to a fairly stable level of about 15-23 ml. A significant lower volume was observed in the Trimipramine treated series in some of the morning portions. A significant lower concentration and output of HCl was found during the middle of the night and in some morning portions in the subjects given Trimipramine. Similarly the concentration and output of pepsin were lower in the Trimipramine series than in the Placebo treated subjects.

Adult↗