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Biomedical subjects

L Witzel

Publications and source records attributed to L Witzel.

At least 37 records · Page 2Linked to original sources
PubMed1987

Comparison of ranitidine 300 mg twice daily, 300 mg at night and placebo on 24-hour intragastric acidity of duodenal ulcer patients.

Continuous measurement of 24-hour intragastric acidity was performed in 12 duodenal ulcer patients in remission during treatment with placebo, ranitidine 300 mg nocte and ranitidine 300 mg b.d. Median 24-hour acidity was 79.4 mmol litre-1 during placebo treatment; it decreased to 28.2 mmol litre-1 during treatment with ranitidine 300 mg nocte and to 3.6 mmol litre-1 during treatment with ranitidine 300 mg b.d. The two regimens decreased intragastric acidity to a similar degree during the night, but significantly greater inhibition of daytime and 24-hour acidity followed use of ranitidine 300 mg b.d.

Adult↗
PubMed1987

Single dose treatment with H2 receptor antagonists: is bedtime administration too late?

Using ambulatory ph-metry, intragastric acidity was measured over three separate 24 hour periods in each of 12 healthy volunteers receiving either (a) placebo (1800 h and 2200 h), (b) 300 mg ranitidine (1800 h) and placebo (2200 h), or (c) placebo (1800 h) and 300 mg ranitidine (2200 h). Ranitidine was significantly more effective in decreasing 24 h median intragastric acidity when the drug was administered at 1800 h rather than at 2200 h. Median pH (and interquartile range) was 1.45 (1.4-1.7) on placebo, 2.55 (2.05-3.2) on ranitidine given at 2200 h and 3.35 (2.5-3.85) on ranitidine given at 1800 h (p less than 0.004). The total duration of highly acidic electrode readings (pH less than 1.5) over a 24 h period was reduced significantly by administering the H2-receptor antagonist at 1800 h compared with the later administration. It is suggested that treatment of duodenal ulcers by single administration of ranitidine in the early evening should be evaluated by clinical trial.

Adult↗
PubMed1986

[Different healing tendencies of reflux esophagitis following omeprazole and ranitidine. Results of a German-Austrian-Swiss multicenter study].

The effectiveness of a single, morning oral dose of 40 mg omeprazole or a twice daily oral dose of 150 mg ranitidine was compared in a randomized endoscopically controlled double-blind trial at 37 clinics in Austria, Germany and Switzerland. A total of 178 out-patients in stages I-IVa (after Savary and Miller) were entered into the trial: 78 in stage I, 60 in stage II, 27 in stage III, and in 13 in stage IVa. As early as at the end of the third treatment week there was a significantly higher rate of complete healing or reduction into a lower stage with omeprazole than ranitidine (85% vs 67%; P less than 0.02). After six treatment weeks, healing tendency after omeprazole compared with ranitidine was 85% vs 45% (P less than 0.04). Omeprazole also brought earlier improvement in symptoms. The difference was statistically significant for heartburn (pyrosis): P less than 0.01. Both drugs were equally well tolerated and there were no clinically significant side-effects. This is the first demonstration that the ATPase inhibitor omeprazole is superior to the H2-receptor antagonist ranitidine in the treatment of reflux oesophagitis.

Administration, Oral↗
PubMed1985

[Healing rates following omeprazole and ranitidine treatment of gastric ulcer. Results of a German multicenter study].

The effectiveness of omeprazole (20 mg orally each morning) or ranitidine (150 mg orally twice daily) in the treatment of gastric ulcer was compared in 184 out-patient in a randomized, endoscopically controlled multi-centre double-blind ("double dummy") trial. Healing rates with omeprazole after two, four and eight weeks were 43, 81 and 95%, respectively, those with ranitidine were 45, 80 and 90%, a statistically not significant difference. Independently of medication, small ulcers (less than 8 mm diameter) healed more quickly than larger ones. Ulcers in the body of the stomach responded poorest to both drugs. Smoking had no statistically significant effect on healing rate. Omeprazole and ranitidine had similarly favourable effects on symptoms. Neither side effects nor changes in biochemical parameters could be ascribed to omeprazole. Both drugs had equivalent effects on the healing of gastric ulcers in the stated dosages.

Adult↗
PubMed1985

Prophylactic endoscopic sclerotherapy of oesophageal varices. A prospective controlled study.

Of 109 patients with cirrhosis and endoscopically demonstrated oesophageal varices who had not bled, 56 were treated by sclerotherapy and 53 were treated conservatively. Patients were assigned to one of three categories according to varix size and Child's classification of severity of liver disease. Severity of liver disease increased with varix size. Frequency of haemorrhage in the control group also increased with varix size: haemorrhage occurred from small varices in 35% of patients, from medium varices in 53%, and from large varices in 83%. Prophylactic sclerotherapy diminished the frequency of variceal bleeding and overall mortality: over 25 months, frequency of bleeding was 9% in the therapy group and 57% in the controls, with mortality rates of 23% and 55%, respectively.

Adult↗
PubMed1985

[Short-term therapy of duodenal ulcer with omeprazole and ranitidine. Results of a German multicenter study].

In a randomized, endoscopically controlled double-blind trial the effectiveness of a single oral, morning dose of 40 mg omeprazole was compared with a twice daily oral dose of 150 mg ranitidine given to 334 ambulatory patients with duodenal ulcers. Under omeprazole 105 of 146 duodenal ulcers were demonstrated to have healed within 14 days (72%), compared with 95 of 160 (59%) on ranitidine. The difference is statistically significant (P = 0.0121). After 14 days smaller ulcers healed more quickly than large ones, regardless of the drug used: 80 of 110 with diameter 3-5 mm (73%); 48 of 90 with diameter more than 8 mm (53%). Smoking delayed healing [healing rate among non-smokers, 87 of 117 (74%); among smokers, 113 of 189 (60%)]. Healing rates among smokers receiving omeprazole and non-smokers receiving ranitidine were nearly identical. After 4 weeks, at 96 and 92% respectively, there was no difference in regard to healing rate. Both drugs had a similar influence on the symptoms. Thus, for the first time it has been demonstrated that omeprazole is superior to ranitidine after 14-day treatment of duodenal ulcer.

Adolescent↗
PubMed1985

Omeprazole heals duodenal, but not gastric ulcers more rapidly than ranitidine. Results of two German multicentre trials.

In two double-blind, randomized German multicentre trials the effects of omeprazole 20 mg mane and ranitidine 150 mg b.i.d. were compared for the first time in 334 outpatients with duodenal ulcer and 184 outpatients with gastric ulcer. In patients with duodenal ulcer endoscopically controlled healing rates after two weeks were 72% with omeprazole and 59% with ranitidine (p = 0.012); after 4 weeks 96 and 92%, resp. were healed (n.s.). In patients with gastric ulcer the healing rates after two, four, and eight weeks were 43, 81, and 95%, respectively, with omeprazole and 45, 80, and 90%, respectively, with ranitidine (n.s.). Smoking impaired healing in duodenal, but not in gastric ulcer. Symptom relief was comparable with both drugs. Serious side effects or clinically relevant changes in laboratory screening results were not detected. - Our results demonstrate for the first time that omeprazole 20 mg mane is superior to ranitidine 150 mg b.i.d. in the short-term treatment of duodenal, but not gastric ulcer.

Adolescent↗
PubMed1984

[Prospective controlled study of para- and intravariceal sclerosing therapy of esophageal varices].

In a prospective randomized controlled clinical trial, prevention of hemorrhage from oesophageal varices by repeated peri- and intravariceal injections of 20 ml Aethoxysclerol 1% were compared with medical management alone. The study involved 126 patients with cirrhosis and recent variceal bleeding confirmed by endoscopy. Injection sclerotherapy was carried out using a fiberoptic gastroscope under 10-20 mg intravenous diazepam and 20 mg hyoscin -N-butyl-bromide. Injections were given at monthly intervals. During the first five sessions the agent was given by perivariceal injections followed by five sessions with intravariceal injections. After the 10 months of injection therapy the patients were followed up for 16 months. During the perivariceal injection period 37% of the patients in the sclerotherapy group had further bleeding compared with 39% of the control group. During intravariceal injections 12% of the sclerotherapy group and 38% of the control group had further bleeding (p less than 0.05). During the follow-up of 16 months after sclerotherapy, 16% of the sclerotherapy group and 56% of the control group had further bleeding (p less than 0.05), 35% of the sclerotherapy group and 61% of the control group died in these 26 months of investigation (p less than 0.05). Intravariceal injection sclerotherapy significantly decreased the incidence of further bleeding and mortality in patients with cirrhosis and oesophageal varices. Perivariceal injections did not appear to be effective.

Adult↗
PubMed1983

[Treatment of reflux esophagitis with sucralfat].

In a multi-centre placebo-controlled double-blind study, the therapeutic effectiveness of sucralfate (aluminium sucrose sulphate, four times 1 g daily) was tested on 66 out-patients with endoscopically confirmed reflux oesophagitis. After 12 weeks of treatment complete healing occurred in 72% of the sucralfate group, and in a further 14% there was improvement. In the placebo group the healing rate was 40%, with improvement in a further 20%. Serious side-effects did not occur. Sucralfate treatment was especially effective in patients with signs of high-grade inflammation (stage III of Savary and Miller) unsuccessfully treated with other drugs. Contrary to previously available drugs, sucralfate is effective also in lesions caused by alkaline reflux and is thus a useful addition to the hitherto unsatisfactory means of treatment.

Alginates↗
PubMed1981

[The effect of salmon calcitonin on pancreatic enzymes and hormones before and after retrograde cholangiopancreatography].

The effect of salmon calcitonin (SMC) on pancreatic enzymes and hormones was investigated following retrograde choledocho-pancreatography (ERCP). 40 patients were randomly divided in two groups and 2.5 micrograms/h SMC or sodium chloride was infused intravenously for 28 hours. Infusion was started 4 hours before endoscopic procedure and amylase, lipase, glucose, insulin, glucagon and gastrin plasma concentrations were measured before and 2, 12 and 24 hours after the end of the ERCP. According to the radiological findings of pancreatography two additional groups were formed: group 1 with visualization of the main duct and its branches and group 2 with additional visualization of the pancreatic parenchyma. No change in glucose, insulin, glucagon and gastrin was found in any of the groups analyzed. Amylase and lipase showed a significant increase after 2 hours and 24 hours later, values were reached which were not significantly different to baseline levels. The time course of the plasma concentrations was identical in the patients treated by SMC or sodium chloride and showed no significant difference at the various time intervals. Therefore, inhibition of the known increase in pancreatic enzymes following ERCP was not found with SMC treatment.

Amylases↗
PubMed1981

Dissolution of retained duct stones by perfusion with monooctanoin via a Teflon catheter introduced endoscopically.

Retained bile duct stones in patients who have undergone prior cholecystectomy are removed by operation or endoscopic sphincterotomy. We achieved dissolution of cholesterol duct stones by perfusion with monooctanoin, a commercially available mixture of medium chain glycerides. Sixteen patients were treated in whom endoscopic sphincterotomy was impossible or unsuccessful. In 12 patients, 16 stones were dissolved within 6 to 25 days (mean, 15.6 days). In all successfully treated patients elevated serum liver enzymes became normal during therapy.

Aged↗
PubMed1981

Treatment of achalasia with a pneumatic dilator attached to a gastroscope.

A pneumatic dilator for the treatment of achalasia of the esophagus is described. An inflatable polyurethane balloon assembly is attached to a small-caliber forward-viewing fiber-optic gastroscope. The balloon is introduced and dilatation carried out under endoscopic visual control. The described method greatly increases the safety and accuracy of the dilatation procedure, even in patients with an extreme degree of megaesophagus. 39 patients have been successfully treated with the dilator with no complications.

Dilatation↗