Biomedical subjects
C Caulin
Publications and source records attributed to C Caulin.
Persistent gastric-protective effect of antacid evaluated by measurement of transmucosal gastric potential difference.
The aim of this study was to determine the effect of 1 week of antacid dosing on the aspirin-induced potential differences (PDs) across the gastric mucosa. The study design was double blind and randomized with crossover. Ten healthy subjects received aluminum hydroxide gel, 8 gm t.i.d., or placebo for 1 week. They then received 1 gm aspirin after an overnight fast and the PD across the mucosa was measured. Baseline potentials were the same before both treatment periods. Antacids reduced the aspirin-induced PDs. The mean (+/- SD) maximal PD was 27.4 +/- 1.7 mV with placebo vs. 10.7 +/- 2.2 mV with antacids (p less than 0.001). Recovery time was 65.5 +/- 5.2 minutes with placebo vs. 29.0 +/- 6.7 minutes with antacids (p less than 0.001). These results suggest the effect is due to a longer-term cytoprotective property of antacids rather than to acid-neutralizing activity.
[What is the duration of the gastric cytoprotection. Measurement of the gastric potential difference after ingestion of boehmite].
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Does informed consent influence therapeutic outcome? A clinical trial of the hypnotic activity of placebo in patients admitted to hospital.
To examine whether written informed consent might influence the results of clinical trials the effect of placebo when given with or without informed consent to patients suffering from insomnia was studied. The study was a single blind observer blinded trial, and patients were paired according to sex, age, and hospital environment. Randomisation assigned the first patient of each pair to the control group (without informed consent) or the group to give informed consent. Of the 56 patients, 26 refused to give informed consent, and the age and sex distribution of these differed significantly (p less than 0.02) from the 30 pairs of patients ultimately enrolled into the study. In this "biased" sample, the hypnotic activity of placebo was significantly higher in the control group (p less than 0.05). It is concluded that the informed consent procedure biases the results of clinical trials and might affect their general applicability.
Histamine H2 antagonists in acute upper gastrointestinal hemorrhage.
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Prevention of deep vein thrombosis in elderly medical in-patients by a low molecular weight heparin: a randomized double-blind trial.
Two hundred and seventy patients over 65 years were included in a placebo-controlled randomized double-blind trial to determine whether a small dose of a low molecular weight (LMW) heparin prevents the occurrence of deep vein leg thrombosis (DVT) diagnosed by 125I fibrinogen scanning. LMW heparin (60 mg daily) significantly reduced the frequency of DVT from 9 to 3 percent (p = 0.03). Adverse drug reactions did not differ significantly between the 2 groups, except for the injection site hematomas that were more frequent in the LMW heparin group. In conclusion, LMW heparin appears of value in preventing the occurrence of DVT in an unselected elderly in-patient population.
Clinical trials with C 1740, an immunomodulator compound proposed for prevention of acute infectious exacerbations in chronic bronchitis.
C 1740 is an immunmodulating agent of biological origin proposed for the prevention of infectious exacerbations in chronic bronchopathy. The first placebo-controlled double-blind randomized clinical trials have led to opposite conclusions regarding the utility of C 1740. The rate of infectious exacerbations in the placebo group and a large Type II error could explain the "negative clinical trials". However, two out of four "positive clinical trials" were associated with high risk of falsely positive results. The activity of C 1740 is discussed here.
[Hospitalization of the elderly in a department of internal medicine. Predictive elements of risk and benefit].
One hundred and thirty patients over 70 years have been examined in a prospective way, so as to determine pernicious and benefic effects of hospitalization in elderly people. Deaths appear to be more frequent in old male patients, with a high cultural level on one hand, and a "reduced" independence, on the other hand (according to the "Sandoz clinical assessment of geriatrics scale"). Benefic effects appear to be essentially dependent on primary diagnosis, and on the entourage, as well as on the previous medical care, though less important.
[Choice of a statistical test in a clinical or therapeutic study].
The results of clinical trials are only valid if the right statistical test for the type of study performed is applied. The authors suggest a method, accessible to all physicians, that should facilitate the choice between various tests and enable the readers of clinical trial papers to detect errors in the presentation of the results. Starting from an answer to four questions (what kind of data is investigated, how many samples are studied and are they independent, and what is the purpose of the study?) the mental process is developed in the form of a flow chart, each terminal branch of which leads to the correct statistical test or tests.
Gastric emptying of solid radiopaque markers in diabetic patients.
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[Gastric potential difference: effects of non-steroidal anti-inflammatory agents in the healthy volunteer].
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Effect of diltiazem on plasma glucose, insulin and glucagon during an oral glucose tolerance test in healthy volunteers.
The effect of the calcium antagonist, diltiazem, on glycoregulation was investigated in 12 healthy volunteers using a standard glucose tolerance test. No significant change was observed in plasma glucose, insulin or glucagon levels after oral treatment for B days with diltiazem 180 mg/day.
[Effect of smectite on the changes in gastric potential difference induced by aspirin in man].
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[Angiodysplasias of the colon and small intestine: a not uncommon cause of gastrointestinal hemorrhage. 3 cases].
Three cases of bowel angiodysplasia with digestive bleeding were reported. In all cases, diagnosis was confirmed by arteriographic and/or histological data. Angiodysplasia of the colon was the most often an acquired and degenerative disease, and most commonly affecting patients after the seventh decade of life. This condition was a frequent and misinterpreted cause of bleeding per rectum in patients after fifty years. Selective superior mesenteric angiography, after colonoscopy (except during major bleeding) was the best investigation, showing pathognomonic images and specifing the site, often located in the caecum and/or ascending colon. Treatment was surgical, but endoscopic methods provided encouraging results.
[The choice of an antacid in therapy: use of in vivo methods].
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[Radiotelemetric study of the effects of antacids and cimetidine on intragastric pH (author's transl)].
Radiotelemetric measurement of intragastric pH constitutes a simple method for assessing the activity of surface antacids and antisecretory agents in man. The time during which the intragastric pH is maintained at 3.5 or above is the bet criterion of therapeutic effectiveness. One hundred and fifty-two measurements were performed to evaluate the effects of six antacids administered in the usual doses and of cimetidine, milk (250 ml) and a standard continental breakfast. The results showed that the effects of antacids were extremely brief (less than 30 minutes). The delay in onset of cimetidine activity (more than 45 minutes) and the time it maintained intragastric pH above 3.5 were determined. These in vivo results correlated positively with in vitro measurements. The authors suggest that the dosage of surface antacids should be expressed in anti-acid mEq, knowing that 50 mEq produce as therapeutic effect lasting approximately 30 minutes. The data provided by radiotelemetry could be used to adjust the anti-acid treatment to the diet and the time of the day. The method also seems to be applicable to the study of new antacids and antisecretory drugs.
[Current role of biochemical tests in hepatology].
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[Dangerous drugs in hepatic insufficiency].
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