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Biomedical subjects

L Barbara

Publications and source records attributed to L Barbara.

At least 217 records · Page 12Linked to original sources

Effects of short- and long-term administrations of famotidine and ranitidine on some pituitary, sexual and thyroid hormones.

The endocrine effects of short-term (4 weeks) and long-term (6 months) oral administration of famotidine (40 and 20 mg nocte, respectively) and ranitidine (300 and 150 mg nocte, respectively), were investigated in 20 male patients with duodenal ulcers. Basal PRL, LH, FSH and TSH serum levels were evaluated and their response to specific releasing factors, and basal blood levels of some sexual (E2, P, T) and thyroid (T3, T4) hormones. None of the treatments modified basal and RH-stimulated levels of PRL, LH, FSH and TSH, nor basal levels of sexual hormones. Regarding the thyroid hormones, no effect was observed during the administration of famotidine. On the contrary, short-term treatment with ranitidine induced a significant decrease in thyroxine serum levels, while no effect was observed during maintenance treatment.

Adult↗

Short-term treatment of reflux oesophagitis with ranitidine 300 mg nocte. Italian multicentre study.

A multicentre study involving 9 Italian institutions was carried out to compare the efficacy and safety of ranitidine 150 mg b.i.d. and ranitidine 300 mg nocte in the treatment of reflux oesophagitis. 117 patients with histologically proven oesophagitis were randomly allocated to two comparable treatment groups. Efficacy and reliability were evaluated by clinical and laboratory tests at the beginning of the study, and at 3 and 6 weeks; endoscopy and biopsies were performed at the beginning and at 6 weeks. Treatment with ranitidine for 6 weeks led to total disappearance of gastro-oesophageal reflux symptoms in 60% of patients, with percentages of partial improvement varying between 85% and 95% of cases. Improvement in the results of endoscopic examination was 85%, of which 55% were cured. Microscopic examination revealed an improvement of 36% and 44%, with a cure rate of 18% and 26% respectively. With regard neither to the regression of symptoms nor to the macroscopic and microscopic inflammation of the oesophageal mucosa did statistical examination show significant differences in the therapeutic efficacy of ranitidine 150 mg b.i.d. or 300 mg nocte for treatment of reflux oesophagitis.

Adult↗

Omeprazole vs. ranitidine in the short-term treatment of duodenal ulcer: an Italian multicenter study.

A double-blind, double-dummy, randomized Italian multicenter trial was carried out to compare the efficacy and safety of omeprazole 20 mg in the morning and ranitidine 150 mg b.i.d. in short-term treatment of acute duodenal ulcer. One hundred and twenty-one patients (61 in the omeprazole and 60 in the ranitidine group) with endoscopically proven active duodenal ulcer, completed the study. The healing rates after 2, 4 and 6 weeks were 66, 97 and 100%, respectively, with omeprazole and 53, 85 and 92%, respectively, with ranitidine. The difference was statistically significant (p less than 0.05) at weeks 4 and 6. Night and day pain were markedly reduced during both treatments, as also antacid consumption. Both drugs were well tolerated, and the adverse events were infrequent and moderate. In our experience, omeprazole 20 mg once daily seems to be superior to ranitidine 150 mg b.i.d. in the short-term treatment of duodenal ulcer.

Adult↗

Protective effect of sulglycotide on human gastric mucosa exposed to taurocholic acid.

Sulglycotide is a non-systemic drug used in the treatment of peptic ulcer. It seems also to possess cytoprotective action. A double-blind cross-over study on the influence of oral sulglycotide on gastric mucosal cell loss induced by taurocholic acid (20 mM + HCl 7mM in 100 ml normal saline) was carried out in sixteen healthy volunteers by means of the DNA-loss technique. Each subject received either sulglycotide (400 mg thrice daily) or a placebo in random order on the basis of a double-blind cross-over design. Sulglycotide appeared to reduce the gastric cell loss induced by taurocholic acid. These results can explain the therapeutic effect of sulglycotide in peptic disease.

Adult↗

[Effect of tiropramide on solid gastric emptying time in man].

The influence of Thyropramide, a recently developed spasmolytic on the gastric emptying times of a solid meal was assessed in 10 healthy subjects aged 23-54. Thyropramide (300 mg per diem for 3 days per os) does not significantly modify gastric emptying time compared to the placebo though a slight average increase in T 1/2 was noted. No side effects were noted during the study. Thyropramide therefore appears to have a spasmolytic effect on the large intestine without in any way influence the stomach either proximally or distally.

Adult↗

The sonographic appearance of the normal gastric wall: an in vitro study.

In order to evaluate the real number and anatomical correspondence of the ultrasonographically recognizable layers within the gastric wall, we used a high frequency (7.5 MHz) rotating transducer to examine five surgical specimens of the stomach suspended in a water bath. Five layers were always clearly distinguishable within the gastric wall, whose thickness was 3-6 mm. Fine needles and lancets were localized at the level of the 3rd hyperechoic layer when inserted in the submucosa and in the 4th hypoechoic layer when inserted in the muscolaris propria. Thin echogenic bands were always displayed on both sides of other homogeneous tissues (spleen, myometrium) suspended in water. On the basis of these findings and also taking in account the physical laws of ultrasound interactions with tissues, we conclude that the 1st and the 5th hyperechoic layers are partially generated by ultrasound reflection at the interface liquid/wall. The 2nd hypoechoic layer corresponds to the deepest part of the mucosa; the 3rd hyperechoic to the submucosa and the submucosa/muscularis propria interface and the 4th hypoechoic layer to the muscularis propria.

Gastroscopy↗

The evolution of anti-ulcer therapy with cimetidine. Is a single large nocturnal dose of cimetidine the right therapy for duodenal ulcer?

Peptic ulcer results from the prevalence of agents causing endoluminal lesions over the defence mechanisms of the mucosa of the upper GI tract. Particularly, in the case of duodenal ulcer, the pathogenetic relevance of non-buffered acid secretion of the early nighttime period has been emphasized. This is indeed confirmed by the fact that a single night dose of 800 mg cimetidine has apparently been proved able--in numerous controlled clinical trials--to provide results that are similar to those obtained with the classic dose of 1 g daily or 400 mg twice daily. Our centre carried out a crossover double-blind controlled trial aimed at evaluating titrable acidity and pH during the 24-h period in seven patients with active duodenal ulcer. The single nighttime dose of cimetidine resulted in a significant and long-lasting inhibition of acid secretion during the entire night. During the day, secretory values returned to levels similar to those obtained with placebo, hence allowing normal digestive functions.

Administration, Oral↗

The role of colloidal bismuth subcitrate in the short-term treatment of duodenal ulcer.

Colloidal bismuth subcitrate (CBS) is a drug used in the treatment of duodenal ulcer; it acts mainly by increasing mucosal resistance against endoluminal aggressive agents, without inhibiting gastric secretion. In previous clinical trials, CBS solution induced healing rates significantly higher than placebo and similar to those observed with cimetidine. In spite of these promising results, the drug has never been widely employed, mainly because of its unpleasant taste, which greatly reduced patient compliance. For this reason, chewing tablets have been introduced. CBS tablets have been reported to induce healing rates significantly higher than placebo and similar to those obtained with CBS solution, cimetidine, and ranitidine. CBS may therefore represent an important alternative to antisecretory drugs in the therapy of duodenal ulcer patients.

Bismuth↗

A double-blind controlled trial of ranitidine 300 mg nocte and ranitidine 150 mg b.i.d. in the short-term treatment of gastric ulcer.

A multi-center study was carried out to compare the healing rates of ranitidine 300 mg nocte and 150 mg b.i.d. in the short-term treatment of gastric ulcers and to assess the side-effect liability of ranitidine 300 mg given in a single daily dose. Forty-five outpatients suffering from endoscopically and bioptically proven uncomplicated benign gastric ulcer were selected for the study. The patients were treated, for 4 weeks, on the basis of a double-blind randomized design. An endoscopic examination was repeated within 4 days after the end of the treatments. The patients who did not demonstrate complete healing were treated for an additional 4-week period. Clinical controls were performed to evaluate symptoms, antacid consumption, compliance with trial tablet consumption; hematological and biochemical tests were also carried out at the end of the 4 and 8-week periods. No differences were observed between the healing rate induced by 300 mg nocte and 150 mg b.i.d., after 4 weeks of treatment (76% and 79% respectively) and after 8 weeks (100% in both groups). Similar results were obtained as far as symptoms, antacid consumption and compliance are concerned. Neither treatment regimen induced appreciable side-effects.

Adult↗

Comparison between two different posologies of ranitidine on 24-hour gastric acidity in duodenal ulcer patients.

Eight outpatients with active duodenal ulcer, endoscopically proven, entered a controlled double-dummy cross-over study aimed at comparing the effects of ranitidine 150 mg b.i.d. and 300 mg nocte on 24-h intragastric titratable acidity and pH. Both treatments markedly inhibited (p less than 0.01) gastric acid secretion when the mean 24-h results were compared. When the effects of two posologies on nocturnal and diurnal periods were considered separately, 300 mg appeared to control nocturnal acid secretion more actively, while during the day 150 mg b.i.d. seemed to be the more active. Since nocturnal hypersecretion can be considered an important determinant of duodenal ulcer, a large bedtime dose of ranitidine seems to represent a valid therapeutic approach to this disease.

Adult↗

[Accelerated healing of ulcus ventriculi by a single evening dose of famotidine. Results of an Austrian-German-Italian multicenter study].

An 8 week, double-blind randomized, placebo-controlled multicenter trial was conducted in Austria, Germany and Italy to determine whether famotidine would speed healing and relief of symptoms in patients with benign gastric ulcer. Of the 131 patients who completed the trial, 66 received 40 mg famotidine in the evening and 65 placebo. At 4, 6, and 8 weeks after entry, ulcers had healed in a higher percentage of patients treated with famotidine than of those treated with placebo (47%, 70%, 91% vs 32%, 49%, 61%). In the famotidine group healing had occurred significantly more often after 6 and 8 weeks (p less than 0.05 and p less than 0.01 respectively). Famotidine was superior to placebo in relieving ulcer symptoms. The proportion of patients receiving additional antacid therapy was significantly lower in the famotidine group. The findings suggest that the new H2-receptor antagonist famotidine significantly speeds the healing of benign gastric ulcers in a single evening dose.

Adolescent↗

Candida albicans infection of gastric ulcer frequency and correlation with medical treatment. Results of a multicenter study.

This paper reports the results of a multicenter prospective study of 188 consecutive patients affected by gastric ulcer, verified by endoscopy, in whom the frequency of a mycotic infection of the lesion was evaluated as well as the eventual influence of such pathology on the efficiency of medical treatment, the healing rate, and the healing time. A mycotic infection, defined as penetration of the periulcerous mucosa by the fungi, was found in only 13 patients (6.9%). No significant differences were found in the healing rate and healing time among these patients treated with H2-receptor antagonists and a control group of 43 matched gastric ulcer patients treated in the same period with the same therapy. It would appear from the data that mycotic infections of the gastric ulcer do not modify the efficiency of medical treatment.

Candida↗

Value of serum determinations for prediction of increased ursodeoxycholic and chenodeoxycholic levels in bile.

The correlation between biliary and serum levels of ursodeoxycholic and chenodeoxycholic acids was studied in a double-blind controlled manner in 39 patients before and during treatment with ursodeoxycholic acid, 800 mg/day; ursodeoxycholic acid, 400 mg/day; chenodeoxycholic acid, 750 mg/day; chenodeoxycholic acid, 375 mg/day; and placebo, respectively. On a total of 74 occasions, fasting duodenal bile and venous blood samples were obtained simultaneously. Biliary bile acid composition was determined by gas-liquid chromatography and serum ursodeoxycholic and chenodeoxycholic acid concentrations by radioimmunoassays. There was a much closer correlation between the biliary and serum levels of ursodeoxycholic acid (r = 0.8184, P less than 0.001) than between those of chenodeoxycholic acid (r = 0.4707, P less than 0.01). In contrast to serum chenodeoxycholic, which showed many overlaps between pre- and posttreatment values, serum ursodeoxycholic acid proved to be a very sensitive, specific, and convenient means of predicting the presence of increased levels of ursodeoxycholic acid in the enterohepatic cycle.

Bile↗

Oesophageal motor events at the occurrence of acid reflux and during endogenous acid exposure in healthy subjects and in patients with oesophagitis.

In order to assess the oesophageal motor events associated with the occurrence of gastro-oesophageal acid reflux and those during endogenous acid exposure, we studied six healthy subjects and nine patients with symptoms and lesions of reflux oesophagitis. In the case of each subject simultaneous pressure and pH measurements of the distal oesophagus were taken both in fasting conditions and after a standardised balanced meal. Reflux episodes occurred in the absence of a lower oesophageal sphincter relaxation (34.3%, 17.7%) or in the presence of a relaxation associated (34.2%, 30.8%) or unassociated (31.5%, 51.5%) with a peristaltic sequence, in the controls and patients respectively. No significant differences were found between the two groups. During endogenous acid perfusion the distal oesophagus showed mainly a peristaltic motor activity, but the mean hourly number of peristaltic sequences was significantly lower in the patients than in the controls (33.5 +/- 27.2 vs 81.5 +/- 3.2, p less than 0.01). Our results show that the mechanisms of reflux are similar in controls and in patients, while the peristaltic frequency is reduced in the latter. This motor failure may be responsible for the increased reflux duration observed in patients with oesophagitis.

Adult↗

Famotidine in the management of duodenal ulcer: experience in Italy.

A multicenter study that involved 15 Italian institutions was carried out to compare the efficacy and safety of famotidine 40 mg at bedtime, famotidine 20 mg b.i.d., famotidine 40 mg b.i.d., and ranitidine 150 mg b.i.d. in promoting the healing of acute duodenal ulcer. Two hundred and twenty-four patients with endoscopically proven duodenal ulcer were randomly allocated into four treatment groups. Efficacy results for the four groups were similar at weeks 2, 4, and 8 of therapy. At week 8, the percentage of patients healed in each group was as follows: 92% in the famotidine 40-mg bedtime group, 97% with 20 mg b.i.d., 93% with 40 mg b.i.d., and 90% with ranitidine 150 mg b.i.d. Day pain and night pain were markedly reduced in all four groups, antacid consumption fell considerably, and therapy was generally well tolerated. The adverse experiences evaluated by the investigator as possibly, probably, or definitely related to test medication were rare and moderate.

Adult↗

Famotidine (MK-208) in the treatment of gastric ulcer. Results of a multicenter double-blind controlled study.

The aim of the present investigation was to study the efficacy and safety of famotidine (MK-208), a new, potent, histamine H2 receptor antagonist, in promoting the healing of active gastric ulcer when compared to placebo. Of the 71 patients who took part in this multicenter double-blind study in Italy, 37 were administered famotidine 40 mg once daily and 34 placebo. Treatment duration was for up to 8 weeks, and endoscopic and clinical studies were performed at onset and week 4 and, if necessary, at weeks 6 and 8. All patients were carefully evaluated at regular intervals for adverse drug reactions by clinical and laboratory examinations. By the end of the study, 97% of the ulcers were healed in the famotidine group compared to 66% in the placebo group (p less than 0.01). Day and night pain decreased significantly more in the famotidine group than in the placebo group. Both treatments were well tolerated, and no alterations in laboratory tests were observed. Famotidine, therefore, proved effective in the treatment of gastric ulcer and was well tolerated on a short-term basis.

Adolescent↗