Depressed outpatients (n = 107, age 26-75 years) were treated with either a 50 mg single morning dose of diclofensine (n = 54) or 75-100 mg nomifensine given in two divided doses (n = 53) over a period of three weeks. The baseline mean values of the Depression Status Inventory (DSI index) of Zung corresponded to those of a mildly depressed population, as given by Zung. At the end of the treatment the mean DSI and Anxiety Status Inventory (ASI-index) values of both groups dropped to the levels of a normal population. The side-effect profile of the two treatments was similar. There were no side-effects indicating sedation. Adverse effects of the anticholinergic type were rare. It can be concluded that both diclofensine and nomifensine are beneficial for the treatment of depressed outpatients and that in a dose relation of 2:3 (diclofensine:nomifensine) they lead to a similar improvement in depressive outpatients.

Adult↗

PubMed1986

Experimental clinical studies on the effect of eburnamonine in cerebrovascular disorders.

Two double-blind, placebo-controlled studies were performed successively to demonstrate the efficacy of Eburnamonine. In the first study, the efficacy of 12 weeks of administration of 3 X 60 mg Eburnamonine per day (n = 25) was investigated in 49 inpatients with cerebrovascular disorders. In the second, the effect of 12 weeks of therapy with 1 X 60 mg Eburnamonine per day (n = 25) was investigated in 50 patients of the same diagnostic category. Results related to the efficacy were analyzed on the basis of the physician's global rating of therapeutic effect, and evaluated by the x2-test. Global therapeutic effect was confirmed and illustrated by effects on specific variables (List of Cerebral Symptoms, function test, NOSIE) evaluated by analysis of covariance. Under the influence of both dosages, therapeutic improvement was observed more frequently than under placebo. The incidence of gastrointestinal side effects was higher under the dose of 3 X 60 mg than under placebo. No effects were observed with respect to parameters of clinical chemistry. In the quasi-experimental comparison of 3 X 60 mg and 1 X 60 mg Eburnamonine, the higher dose was found to yield more therapeutic improvement, but also more frequent side effects than the lower dose, which, in this respect, did not differ from placebo.

Aged↗

PubMed1986

Production of "Asao toxin" by Aeromonas strains isolated from feces and drinking water.

Cultures of Aeromonas species were tested for production of a toxin recently purified by Asao et al. (T. Asao, Y. Kinoshita, S. Kozaki, T. Uemura, and G. Sukaguchi, Infect. Immun. 46:122-127, 1984) and described as a hemolysin with enterotoxic and cytotoxic activity. The toxin was produced by only 63% of Aeromonas sobria strains and by 93% of Aeromonas hydrophila strains. Also, 54% of A. hydrophila strains produced another cytotoxic entity.

Aeromonas↗

PubMed1985

The treatment of senile dementia associated with cerebrovascular insufficiency: a comparative study of buflomedil and dihydrogenated ergot alkaloids.

Seventy-six patients took part in a randomized, comparative study of the efficacy of buflomedil hydrochloride and dihydrogenated ergot alkaloids in the treatment of senile dementia associated with cerebrovascular insufficiency. Efficacy was assessed by the patients' performance in four psychometric tests. The results showed that a trend in favour of the buflomedil group in three of the tests became statistically significant in the fourth. Both drugs appeared to be safe, causing no marked adverse reactions. In conclusion, buflomedil is as effective or more effective than dihydrogenated ergot alkaloids in the treatment of senile dementia associated with cerebrovascular insufficiency and could prove a valuable addition to long-term therapy if further studies support the trend shown in this study.

Aged↗

PubMed1985

Long-term effect of etilefrine pivalate on blood pressure in man.

An open and a placebo-controlled double-blind trial were carried out to measure the effect of a long-term treatment (2-6 months) with etilefrine pivalate (K 30 052, Ep) on blood pressure of 60 patients suffering from orthostatic dysregulation. Oral administration of the agent took place once daily, each dose containing 20 mg. While the acute response to a single dose was comparatively weak, long-term administration had a marked and long-lasting effect both on systolic blood pressure (+40.3 mmHg) and blood pressure amplitude (+37.5 mmHg) (p less than 0.01). Steady state values were reached only when duration of therapy was approaching 6 months. The increase in blood pressure amplitude points to an augmentation of stroke volume, whereas heart rate was virtually unaltered. Peripheral resistance appears not to be increased since diastolic pressure was unchanged. The elevation in blood pressure amplitude was fully reversible within 9 weeks of wash-out, thus hinting at functional rather than structural (sclerotic) changes in the cardiovascular system.

Aged↗

PubMed1985

Comparison of the oral effectiveness of etilefrine pivalate and etilefrine in a long-term trial in man.

The influence of equimolar oral doses of etilefrine pivalate (K 30 052, Ep) and etilefrine on blood pressure of patients suffering from orthostatic dysregulation was compared. Both drugs augmented the systolic blood pressure in both, the upright and horizontal body posture. Diastolic blood pressure was not influenced. The resulting increase in blood pressure amplitude points to an augmentation of cardiac stroke volume. Ep in equimolar doses was nearly twice as active as etilefrine. This result is in line with the hypothesis that acylation of etilefrine with pivalinic acid inhibits the first-pass inactivation nearly completely.

Aged↗

PubMed1985

[Correlation of roentgen picture and lung function testing within the scope of silicosis evaluation].

The chest roentgenograms codified according to the 1980 ILO classification and the lung function tests of 100 persons with silicosis have been compared with each other. The results show that, with a higher degree of dissemination and a growing size of nodes, there is a statistically significant tendency to increasing gravity of pathological results of resistance and the arterial blood gas analysis. A correlation between the degree of dissemination and the size of nodes to other lung function parameters (vital capacity, intrathoracic gas volume) cannot be finally established. Furthermore, neither coding as category B nor the employment of the symbols em (emphysema) and tb (tuberculosis) allow conclusions to be drawn about the results of lung function tests. The poor correlation is caused on one hand by the insufficient description of the morphological parameters important for function, due to the restricted classification. On the other hand there is little correlation between chest roentgenogram and lung function, as lung function in anthracosis is essentially influenced by obstructive bronchitis, which has only a loose connection with silicosis.--Lung function must be the central point in the process of forming an opinion. Chest roentgenograms are important for clarifying the causes of pathological changes and allow a simple observation of progress.

Airway Resistance↗

PubMed1984

[Endocardial cardioversion--a new method for treating recurrent ventricular tachycardia].

The effect of endocardial cardioversion was investigated in 17 patients (aged 26-76 years), ten of them with ventricular tachycardia, either spontaneous or initiated by programmable stimulation. During a total of 14 days of observation there were 33 episodes of spontaneous or induced ventricular tachycardia. A special cardioverter catheter had been placed into the right ventricle and endocardial microshocks were given ranging from 0.05-2.0 J. All patients could feel the shock, but in most instances it was mild to moderate, in only one painful. The tachycardia was slowed in 20% of all microshocks, moderate acceleration occurred in 6%, while in 71% the tachycardia rate remained unchanged. In 7 out of 65 microshocks sinus rhythm occurred spontaneously, after an interval in which the tachycardia slowed. Atrial fibrillation was induced in 6% of cases, but there was no instance of ventricular fibrillation. Reversion directly to sinus rhythm after endocardial cardioversion occurred in 26 of 33 episodes of ventricular tachycardia, while in 7 episodes the tachycardia rate slowed. In no case was it necessary to use external DC cardioversion to terminate a ventricular tachycardia. Threshold values for successful cardioversion of ventricular tachycardia averaged 0.77 (+/- 0.63) J. In one patient, atrial flutter with a relatively high A-V conduction rate was converted into atrial fibrillation by an intra-atrial microshock of 5.0 J. Thus endocardial cardioversion proved effective and safe in terminating ventricular tachycardia, even in patients in whom anti-tachycardic ventricular pacemaker stimulation had failed. The method is apparently not suitable for the conversion of supraventricular tachy-arrhythmias to sinus rhythm.

Adult↗

PubMed1984

[Effect of nitroglycerin plasters on hemodynamics and stress tolerance of patients with coronary heart disease].

The haemodynamic and antianginous efficacy of percutaneous nitroglycerin was evaluated in 24 patients with coronary heart disease. Groups of 8 patients each received one, two or four patches (nitroglycerin liberation 5 mg per patch within 24 hours). Prior to application and after 1 and 2 hours cardiac frequency, arterial and pulmonary arterial pressures and exercise tolerance were assessed. Cardiac frequency and arterial pressure showed no relevant changes after application of patches. The mean pulmonary arterial pressure decreased after application of one or two plasters by 18.5 and 22.2% at rest and by 12.7 and 21.1%, respectively, during exercise. The working capacity showed a trend towards improvement only. With four nitroglycerin patches the mean pulmonary arterial pressure at rest was lower by 26.2% and during exercise by 39.1%. The working capacity rose significantly by 48.7%. Comparison of these effects with oral single dosage of 20 mg 5-isosorbide mononitrate (ISMN) showed that two simultaneously administered plasters did not achieve efficacy of 20 mg 5-ISMN, four plasters, however, were more effective.

Adult↗

PubMed1984

Surgical aspects of radiation enteritis of the small bowel.

Injury to the small bowel is one of the tragic complications of radiotherapy. We performed a retrospective analysis of patients operated upon for stenosis, perforation, fistulization, and chronic blood loss of the small bowel after radiotherapy for multiple malignant diseases. In the period 1970 to 1982 in the Department of General Surgery of the St. Radboud University Hospital, Nijmegen, and the Department of Surgical Oncology of the State University, Groningen, 27 patients were treated surgically. Twenty patients presented with obstruction. In 17 patients a side-to-side ileotransversostomy was performed; in three the injured bowel was resected. Of the five patients with fistulization, three underwent a bypass procedure; in two cases the affected bowel was resected. In one patient with perforation, a resection was performed, as in a patient with chronic blood loss. Two of the 20 patients (10 per cent) in whom the diseased bowel was bypassed died postoperatively. Of the seven patients whose affected bowel was resected four (57 per cent) died of intra-abdominal sepsis. Management of the patient with chronic radiation enteritis is discussed. We conclude, on the basis of our experience, that in patients with obstruction and fistulization, a bypass procedure of the affected bowel is a safe method of treatment. In case of resection, the anastomosis should be performed during a second operation.

Adult↗

PubMed1984

[Computed tomographic findings in mitral valve disease].

In 38 patients suffering from mitral valve disease the findings of cardiac CT scans were compared to the results of echocardiographic, standard roentgenographic, and cineangiocardiographic studies as well as to intraoperative and histological findings. CT proved to be superior to the other imaging modalities in detecting mitral calcifications and in demonstrating the morphological changes, but cannot replace cardiac catheterization as it does not yield haemodynamic data. The indication for CT in mitral valve disease therefore is restricted to cases with extremely enlarged left atria in which the other methods do not provide satisfactory visualization, and to patients with suspected intracavitary thrombus or tumor.

Adolescent↗

PubMed1984

Netilmicin versus tobramycin in multi-centre studies.

In two prospective, randomized studies conducted in West Germany and involving 80 patients, netilmicin-ticarcillin was compared to tobramycin-ticarcillin in the treatment of serious systemic infections. Both regimens were essentially identical with respect to the clinical and bacteriological results they produced. The netilmicin group developed significantly less nephrotoxicity than the tobramycin group (0% versus 15%, P = 0.03). Ototoxicity also occurred less frequently in the netilmicin-treated patients (3% versus 10%, P = 0.4). In a large collaborative study involving 15 centres, 254 patients were enrolled. Clinical and bacteriological responses were excellent, with netilmicin and tobramycin equally effective, but the incidences of nephrotoxicity and ototoxicity were lower in patients treated with netilmicin than those receiving tobramycin.

Acute Kidney Injury↗

PubMed1984

C3 and haptoglobin polymorphism in dementia of the Alzheimer type.

The C3 and haptoglobin phenotype distribution was studied in 60 patients with dementia of the Alzheimer type. In contrast with earlier reports we did not find any significant association between dementia of the Alzheimer type and certain C3 or haptoglobin phenotypes.

Aged↗

PubMed1984

Nomifensine in geriatric inpatients: a placebo-controlled study.

In a double-blind randomized group design, nomifensine (100 mg single daily dose) was compared to placebo in 100 geriatric inpatients (average age = 75 years). Patients in each group were categorized as depressed (Feighner criteria for primary depressive disorder and Hamilton Depression Rating Scale scores greater than or equal to 18) or non-depressed (no psychopathologic disorders and HDRS scores less than or equal to 7). Outcome measures included the HDRS and various tests of cognitive function. The nomifensine-treated depressed patients showed significant improvement over the placebo depressed patients early in and throughout treatment. Depressed patients also showed significant improvement on several cognitive tests with nomifensine treatment. Nomifensine was well tolerated in both depressed and nondepressed patients.

Aged↗