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Biomedical subjects

A Rubin

Publications and source records attributed to A Rubin.

At least 109 records · Page 6Linked to original sources
PubMed1987

Misoprostol in the treatment of duodenal ulcer refractory to H2-blocker therapy. A placebo-controlled, multicenter, double-blind, randomized trial.

A multicenter, double-blind, randomized study compared 200 micrograms of misoprostol and placebo four times daily for four weeks in the treatment of 225 patients with duodenal ulcer (0.7 cm to 2.0 cm in size) persisting after at least four weeks of adequate, conventional therapy with cimetidine or ranitidine. Misoprostol was significantly superior to placebo in healing duodenal ulcers (achieving a healing rate of 37 percent versus 22 percent in the placebo group [p = 0.02], and in relieving ulcer pain [p = 0.01]). Healing also occurred more frequently with misoprostol than with placebo in patients with subgroups of particularly resistant ulcers. In the treatment of ulcers refractory to at least eight weeks of histamine H2-blocker therapy, misoprostol achieved a healing rate of 42 percent versus 20 percent with placebo. In the treatment of pyloric channel ulcers, 28 percent of patients in the misoprostol group showed healing as compared with 20 percent in the placebo group. Diarrhea was reported by 15.4 percent and 3.4 percent of patients receiving misoprostol and placebo, respectively, and was usually mild and transient. Misoprostol is safe and effective therapy for duodenal ulcers that have not healed during the course of H2-blocker therapy.

Adolescent↗
PubMed1987

Coexistent Meige's syndrome and myasthenia gravis. A relationship between blinking and extraocular muscle fatigue?

We studied five patients with a combination of Meige's syndrome (blepharospasm-oromandibular dystonia) and myasthenia gravis. The coexistence of two disorders impairing eyelid opening led to diagnostic confusion and delayed appropriate therapy. Detailed oculographic monitoring of one patient indicated that eye position drifting due to myasthenic oculomotor fatigue was corrected by eye blinks, and that blinks tended to occur with slower saccades. Our observations suggest that fatigue of extraocular muscles may lead to synkinetic blinking and perhaps eventually to autonomous blepharospasm.

Aged↗
PubMed1987

Nizatidine, and H2-receptor antagonist: disposition and safety in the elderly.

Nizatidine is an orally active H2-receptor blocker. Its disposition and safety in eight young and 12 elderly volunteers were investigated. Single oral doses of nizatidine were administered: from 100 mg to 300 mg in the elderly, and from 100 mg to 350 mg in the young. The nizatidine AUC was directly proportional to dose for both groups. Calculated pharmacokinetic variables in the elderly vs. the young were t1/2 = 1.9 vs. 1.6 hr; CLp/f = 32 vs. 40 L/hr, and Vd beta/f = 1.2 vs. 1.3 L/kg. The impaired renal function of some elderly volunteers prolonged nizatidine elimination and lowered its clearance. Renal impairment rather than advanced age per se was the predominant factor in decreasing the nizatidine elimination rate. Because Clcr correlated directly with nizatidine renal clearance, Clcr values may be used to estimate nizatidine dosage reductions in renal insufficiency. During the trial, no serious adverse effects occurred.

Aged↗
PubMed1987

Absorption studies of the H2-blocker nizatidine.

The absolute and relative bioavailability of nizatidine, an H2-blocker, was studied in healthy male volunteers. The absolute oral bioavailability, relative to that after intravenous administration, was 98% +/- 14%. The bioavailability of single and multiple oral doses of 150 mg nizatidine was unaffected by concurrent food ingestion; nizatidine may be administered either with or without food. The relative bioavailability of nizatidine was compared when given simultaneously with placebo or Gelusil, 30 minutes after propantheline, or 60 minutes before activated charcoal. Gelusil reduced the amount of nizatidine absorbed by about 10%, charcoal reduced it by about 30%, and propantheline did not affect it.

Absorption↗
PubMed1987

A pharmacokinetic profile of nizatidine in man.

In this report, the pharmacokinetic, pharmacodynamic, and hormonal effects of nizatidine are reviewed in healthy volunteers and in patients with renal or hepatic impairment. The absolute oral bioavailability of nizatidine exceeded 90%; the half-life (t1/2), plasma clearance (Clp), and volume of distribution (Vd) of iv nizatidine were 1.3 h, 461/h, and 1.21/kg, respectively. Within 16 h of dosing volunteers with nizatidine, more than 90% of the administered dose was recovered in urine as parent drug and metabolites; unchanged nizatidine accounted for 65 and 75% of the recovered substances, after oral and intravenous administration, respectively. Renal impairment decreased the elimination of nizatidine and dosage reductions are recommended for patients with creatinine clearance (Clcr) less than 50 ml/min/m2. Nizatidine suppressed gastric acid secretion produced by sham meals, protein meals, or pentagastrin; its antisecretory activity was dose and concentration dependent. Nizatidine was three times more potent than cimetidine. Nizatidine, after oral or iv administration, did not alter hormone concentrations in plasma.

Adult↗
PubMed1985

Stereoselective inversion of (R)-fenoprofen to (S)-fenoprofen in humans.

The concentrations of the (R)- and (S)-enantiomers of fenoprofen (alpha-methyl-3-phenoxy-benzeneacetic acid) were measured in plasma and urine of volunteers after oral administration of the (R,S)-racemate. In addition, urinary concentrations of the (R)- and (S)-4'-hydroxy metabolite of fenoprofen, the major metabolite, were measured. The (R)-enantiomer of fenoprofen was stereoselectively inverted to (S)-fenoprofen, which was the major isomeric form found in plasma and urine. A potency comparison of the enantiomers in vitro showed the (S)-isomer to be 35 times more active than the (R)-isomer in inhibiting the fatty acid cyclo-oxygenase pathway from human platelets. In vivo, the similar pharmacological potency of the two enantiomers previously observed in experimental animals may have been due to the rapid inversion of the (R)- to (S)-isomer.

Biotransformation↗
PubMed1985

Advanced extra-uterine pregnancy.

Forty-three cases of advanced extra-uterine pregnancy of more than 34 weeks' gestation, seen and treated at Baragwanath Hospital between 1966 and 1978, are reviewed. The incidence in our unit was 1 per 6 389 deliveries. Abdominal pain and vaginal bleeding were the most common complaints. Simple vaginal examination is of great help in establishing the diagnosis, while the abdominal signs are found to be disappointing in this respect. The oxytocin test is a helpful diagnostic aid and various radiographic methods, such as plain X-ray abdomen, hysterosalpingography and ultrasonography have their merits. The placenta, although attached to rather critical areas in the majority of patients, was removed safely without damage to neighboring structures in 93% of the cases. Four patients, however, required hysterectomy. There were two maternal deaths. Of the 18 babies born alive, only 8 survived. All the surviving infants had congenital anomalies but only 5 had problematic defects.

Adolescent↗
PubMed1985

Relationship between plasma and stimulated-saliva concentrations of theophylline in asthmatic children.

The trough steady-state concentration of theophylline in plasma and stimulated saliva of 12 asthmatic children receiving an oral slow-release theophylline preparation was determined after 1 week of treatment. Plasma theophylline concentration ranged from 3.6 to 10.8 microgram/ml and saliva concentration ranged from 3.2 to 7.0 microgram/ml. There was an excellent linear relationship between theophylline concentration in plasma and stimulated saliva (r=0.89, p is less than 0.001). These observations suggest that theophylline therapy could be monitored routinely using stimulated saliva. This may be a convenient, painless and non-invasive alternative for routine monitoring of theophylline levels in asthmatic children.

Asthma↗
PubMed1984

Caffeine as an analgesic adjuvant.

Thirty clinical studies involving more than 10,000 patients conducted during the last 20 years have been analyzed to assess the value of caffeine as an analgesic adjuvant. Although most studies included patients with postpartum uterine cramping or episiotomy pain, some involved patients with pain from oral surgery or headache. In 21 of 26 studies, the relative potency estimates of an analgesic with caffeine to an analgesic without caffeine is greater than one. The pooled relative potency estimates in each of several major categories of combination analgesics are significantly greater than one. The overall pooled relative potency estimate is 1.41, with 95% confidence limits of 1.23 to 1.63; that is, to obtain the same amount of response from an analgesic without caffeine requires a dose that is approximately 40% greater than one with caffeine.

Acetaminophen↗
PubMed1984

Community-based care of the mentally ill: a research review.

A review designed to assess the state of the art of social work research in mental health discovered that a number of important studies have built knowledge cumulatively on community-based care of the chronically mentally ill. This article highlights the major findings of the studies, as well as their methodological strengths and weaknesses.

Community Mental Health Services↗
PubMed1984

A double-blind randomized study of an aspirin/caffeine combination versus acetaminophen/aspirin combination versus acetaminophen versus placebo in patients with moderate to severe post-partum pain.

In a double-blind, randomized controlled trial among 500 post-partum patients experiencing moderate to severe pain, a single oral dose of an aspirin/caffeine combination (800 mg aspirin, 65 mg caffeine) provided significantly more pain relief at 2 hours than did a higher dose of an acetaminophen/aspirin combination (648 mg acetaminophen, 648 mg aspirin) and a higher dose of acetaminophen alone (1000 mg acetaminophen). At 3 and 4 hours, the acetaminophen/aspirin combination as well as the aspirin/caffeine combination were significantly superior to acetaminophen alone. At all times, all three drugs were significantly superior to placebo. There were no clinically significant adverse reactions. These results provide evidence of a potentiating effect of caffeine on aspirin's analgesic potency.

Acetaminophen↗
PubMed1984

Vestibular compensation and nystagmus.

In healthy young subjects barbiturate induced vestibular nystagmus was sequentially studied with repeated electronystagmographic recordings. The analysed data together with our earlier studies indicated that, except for vertical nystagmus, spontaneous and different types of positional nystagmus by themselves are not diagnostic of site of lesion. The transition from spontaneous to positional to paroxysmal nystagmus observed in follow up studies of several of these cases indicates that these various types of vestibular nystagmus are likely a measure and reflection of different degrees of vestibular decompensation.

Adult↗
PubMed1984

Continual postoperative antibiotic peritoneal lavage in diffuse peritonitis complicating cesarean section.

Nine women treated surgically for diffuse peritonitis complicating cesarean section underwent continual postoperative antibiotic peritoneal lavage as an adjunct to surgery. In all the patients the indication for surgery was failure to respond to standard medical therapy. Seven patients treated with hysterectomy recovered without evidence of continuing peritonitis or intraabdominal abscess formation. One of two patients in whom uterine conservation was attempted required an emergency hysterectomy three days later. In this series, continual postoperative antibiotic peritoneal lavage appeared to be an effective adjunctive treatment in the prevention of continuing peritonitis and abscess formation provided that hysterectomy was performed at the initial operation.

Adult↗