[Placebo: Problem and practical consecutions].
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Humans↗
Biomedical subjects
M Felder
Publications and source records attributed to M Felder.
Study of parotid and mixed saliva in the diagnosis of chronic pancreatitis.
A study on the diagnostic value of the parotid and mixed saliva assay after stimulation with 1% pilocarpine hydrochloride was carried out in 36 controls and 26 patients affected with chronic pancreatitis. No statistical difference between the two groups was found as far as saliva volume, bicarbonate and amylase (concentration and output) are concerned. No correlation was found between the results of the saliva test and those of the secretin-pancreozymin test or endoscopic retrograde pancreatography. These data excluded any diagnostic role of the saliva test in chronic pancreatitis.
Amylases↗
[Duodenal ulcer therapy with cimetidine. A clinical endoscopic study in 76 patients (author's transl)].
34 patients were treated with cimetidine and placebo in a double blind trial and 42 were treated with cimetidine alone. Criteria investigated were the pain response, consumption of antacids when required and especially the endoscopically demonstrated scarring of the duodenal ulcer. Compared with placebo, cimetidine is capable of soothing pain and also reducing the consumption of antacids more quickly and to a greater extent. The differences are statistically significant. Complete anatomical healing of the ulcer was established in the double blind study in 80% of the patients in the cimetidine group and in 40% of the placebo group. Similar results were also shown in the group which received cimetidine alone.
Cimetidine↗
Vinblastine: influence on nerve conduction and synaptic transmission.
Vinblastine injected into the eyes of pigeons had a detrimental effect on the amplitude of the postsynaptic evoked potential in the optic tectum; impulse conduction of the optic nerve was not influenced. The depression of the postsynaptic evoked potential was dependent on the dosage. Only 20 and 100 mug vinblastine had an influence; no influence was observed with 10 mug vinblastine. The reversible depression was seen from the third day after injection to between the 21st and the 28th day after injection, and in that period it remained constant. The latency of the response was not influenced by vinblastine.
Animals↗
Randomised trial of nadolol alone or with isosorbide mononitrate for primary prophylaxis of variceal bleeding in cirrhosis. Gruppo-Triveneto per L'ipertensione portale (GTIP)
BACKGROUND: The risk of having a first cirrhosis-associated variceal bleed is lowered by about 50% by beta-blockers. Use of beta-blockers is currently recommended for patients with cirrhosis and oesophageal varices that are at risk of bleeding. We aimed to test the effectiveness of isosorbide mononitrate as an adjunct to the beta-blocker nadolol in the prophylaxis of first variceal bleeding in these patients. METHODS: We did a randomised multicentre study to compare the non-selective beta-blocker, nadolol, with nadolol plus isosorbide mononitrate in 146 relatively well (Child-Pugh score < or = 11) patients who had oesophageal varices at risk of bleeding. Patients on nadolol alone received a single oral 40 mg daily dose. Every second day the dose was titrated to achieve 20-25% decrease in resting heart rate (maximum dose 160 mg daily). Patients receiving both drugs received nadolol as above then isosorbide mononitrate was added starting with 10 mg orally twice daily, which was increased to 20 mg unless hypotension or severe headache occurred. The main endpoint was the occurrence of variceal bleeding of any severity. Patients were followed up for up to 40 months. FINDINGS: During the study period 11 of 74 patients from the nadolol alone group and four of 72 from the nadolol plus isosorbide mononitrate group had variceal bleeding (log-rank test p = 0.03). Cumulative risk of variceal bleeding was 18% in the nadolol group and 7.5% in the combined treatment group (95% CI for difference 1-25%). Two patients in each group had a non-variceal bleed related to portal hypertension. 14 patients from the nadolol only group and eight from the combined treatment group died during the study period (log-rank test p = 0.09). Four and eight patients, respectively, had to discontinue one of the drugs because of side-effects. INTERPRETATION: Nadolol plus isosorbide mononitrate is significantly more effective than nadolol alone in the primary prophylaxis of variceal bleeding in relatively well patients with cirrhosis, and has few side-effects.
Administration, Oral↗
A bioethical compass.
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Community Networks↗
Microvascular dynamics at the nailfold in rheumatoid arthritis.
Conventional and fluorescence videomicroscopy using Na-fluorescein as tracer was performed in 13 patients with rheumatoid arthritis (RA) and Waaler Rose titers less than 1: 112, 10 patients with titers greater than or equal to 1: 112 and 11 patients with osteoarthritis (OA) (control group). At the nailfold different microvascular diameters, capillary flow pattern, red blood cell velocity and transcapillary diffusion of Na-fluorescein were determined. Mean red blood cell velocity was significantly (p less than 0.02) decreased in patients with RA and high titers (0.23 +/- 0.21 0.21 mm/s) when compared to OA patients (0.59 +/- 0.20 mm/s). Abnormal flow patterns, in 2 cases even a reversal of flow direction, were only observed in RA patients and not in controls. Mean transcapillary and interstitial diffusion of Na-fluorescein was not enhanced at the nailfold in RA-patients. These findings do not exclude increased microvascular permeability in synovial membranes or in RA patients with vasculitis.
Adult↗
[Cryoglobulins in arthritis].
During the years 1984-1986 we saw 22 patients with cryoglobulinemia, 8 of whom had rheumatoid arthritis, 1 psoriasis arthritis, 2 Sjögren syndrome, 1 progressive systemic sclerosis, 5 different arthralgias, 1 soft tissue rheumatism, 2 vasculitis and arthralgias and 2 purpura-arthralgia-nephritis syndrome. The measurement of cryoglobulins is done only in special cases of diagnostic importance. The prognostic outlook in patients with nephritis is bad. A monoclonal cryoglobulinemia is always suspicious for a lymphoproliferative syndrome.
Adult↗
Temporal arteritis in polymyalgia rheumatica: immune complex deposits and the role of the leukocyte elastase in the pathogenesis.
Immunohistochemical studies were performed on the temporal artery of 34 patients with clinically established polymyalgia rheumatica (PR) or temporal arteritis, 6 patients with vasculitis, and 25 patients with various diseases. The combined immunofluorescence and peroxidase-anti-Peroxidase Methode zeigte Immunoglobulin- und C3-Ablagerunin histologically affected and to some degree also in unaffected arteries of patients with PR and in all patients with temporal arteritis. The deposits were found both inter- and intracellularly, and contained IgA and to a lesser extend IgG, IgM, and C3. Linear deposits of leukocyte elastase were found along the fragmented internal lamina, and decaying polymorphonuclear (PMN) leukocytes surrounded by elastase-containing inclusions were found in the neighborhood of zones rich in elastic material. These findings suggest that immune complex deposition is a prominent feature of temporal arteritis and that the PMN elastase is probably involved in the destruction of elastic fibers. The combined immunohistochemical investigation appears to increase the diagnostic value of temporal artery biopsy.
Aged↗
[Appearance of giant cell arteritis 6 years after the 1st manifestation of polymyalgia rheumatica].
A case of polymyalgia rheumatica in a 70 year old woman is described. The patient was treated for 6 years with corticosteroids. Seven months after withdrawal of treatment, a severe relapse of polymyalgia rheumatica appeared which was connected with a histologically and immunohistochemically proved temporal arteritis. The problem of the duration of steroid treatment and the need for continued clinical as well as laboratory follow-up after withdrawal of therapy are discussed.
Aged↗