[Multicenter controlled clinical studies on the effectiveness of pirenzepin in the treatment of peptic ulcer].
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Biomedical subjects
Publications and source records attributed to A Nowak.
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Fifty patients with peptic ulcer disease were followed up to 1 to 5 years. Panendoscopy was repeated on the average of 5.6 times a year, also in patients who were actually well. The pattern of changes during on calendar year was a substantial comparative unit. The incidence and intensity of pain, erosions, and ulcers were registered in yearly charts, and the results were calculated per month from 100 yearly cycles. Pain appeared to be the most frequent symptom, being reported in 50% to 100% of visits in particular months. Its decrease in springtime and in August was significant at the level of p less than 0.5, whereas the increase in early autumn was more significant, with p less than 0.01, as was also the next decrease in December. Although pain appeared more often than ulcer niches, and although 4% of patients never felt pain, the only positive correlation found (p less than 0.05) was that between incidence of pain and of ulcer. Erosions occurring in 10% to 30% seemed to be the most constant feature in these cases, whereas the appearance of ulcers ranged from 15% to 60%. The lower ulcer incidence in August and in December was highly significant (in both, p less than 0.001).
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One hundred and seventy seven duodenal ulcer and eighty-one gastric ulcer patients were treated with either ranitidine or placebo in a prospective double-blind study. Groups treated with active drug and placebo were comparable and ulcer healing was assessed by weekly endoscopic examinations. Ranitidine was shown to accelerate the rate of spontaneous ulcer healing in both duodenal and gastric ulcer. This acceleration is significant after one week of treatment in duodenal ulcer and from three weeks onwards in gastric ulcer. The ulcer healing rate after three weeks treatment with ranitidine was 85.5% in duodenal ulcer, and 72.5% in gastric ulcer which was significantly higher than in the placebo group where it was 51.7% and 41.5% respectively (P less than 0.005 and P less than 0.01). Treatment with ranitidine for a maximum of six weeks healed 97.1% of duodenal ulcer patients (172 out of 177) and 96.5% of gastric ulcer patients (77 out of 81). Out of total of 258 patients only 9 failed to heal. No adverse events were seen with ranitidine and it would appear free of the side effects that have been seen with cimetidine. In addition there were no significant changes in blood haematology or clinical chemistry parameters. Ranitidine is also given in a more convenient regimen, 150 mg daily as compared to 200 mg three times daily and 400 mg nocte with cimetidine.
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The study was carried out in 168 patients treated in 5 Departments of Gastroenterology according to a standardized design. All were diagnosed and followed-up by panendoscopy: they were give similar diet and antacids ad libitum, and were urged not to smoke. Such basic therapy in our studies resulted in 30-40% of gastric, and about 50% of duodenal ulcers coded packages of the tested drug. Tablets contained wither 150 mg of Ranitidine or placebo They were taken twice a day. Spontaneous healing under such conditions occurred in the present study in 37% of gastric, and 45% of duodenal, ulcers, while in patients taking Ranitidine 62% of gastric (P less than 0.05) and 82% of duodenal ulcers (p less than 0.01) were cicatrized after 3 weeks. There were no drop-outs, and no undesired effects were observed.
50 patients with acute gastrointestinal bleeding (GIB) were randomly allocated to treatment with i.v. Ranitidine 50 mg b.d., or to a standard conservative therapy. When possible i.v. administration was replaced by oral ranitidine 150 mg b.d. for a total of up to 10 days. Three subgroups included gastric ulcer, duodenal ulcer and haemorrhagic gastritis. The criteria were: the need for blood replacement, comparison of the endoscopic appearance before and after therapy, and the final outcome of treatment, including the need for surgery. Ranitidine appeared to be superior to the standard treatment, the advantages being due largely to the gastric ulcer cases.
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Separately and simultaneously occurring disorders in thyroid and adrenal functional circuits were recorded from 218 land race pigs, 01 line, in several experiments, in the GDR. No detrimental impact on post mortem pork quality was found to have been caused by disorders in each one of the two circuits separately, but measurable defects were established, following malfunction of both circuits. Also studied were consequences of disorders on the hormonal and cardiovascular systems as well as on fattening and slaughter performance.
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A long prevesical ureteral defect was bridged by a somewhat modified Boari's operation. The bladder flap appeared too narrow and thick and was therefore unsuitable for the creation of a tube. It was therefore turned upwards and left in the wound as a buried strip with the upper ureteral stump submucosally implanted in the upper end of the flap. During several weeks a tube developed spontaneously from the flap. The late result was satisfactory.
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