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Biomedical subjects

W Reichel

Publications and source records attributed to W Reichel.

At least 37 records · Page 2Linked to original sources

Nizatidine versus ranitidine in the prevention of duodenal ulcer relapse. Six-month interim results of a European multicentre study.

Nizatidine, a new H2-receptor antagonist, was compared with ranitidine in a double-blind, randomized, multicentre trial for the prevention of duodenal ulcer relapse. This is the interim analysis of 197 patients admitted to the study by 1 September 1985, having finished a 6-month treatment period by 1 March 1986. At night, 96 and 101 patients received 150 mg nizatidine and 150 mg ranitidine, respectively. Both groups were well matched for demographic data, duration and severity of ulcer disease. Calculating cumulative relapse rates by the life-table method of Cutler and Ederer, 18% on nizatidine and 13% on ranitidine had experienced a symptomatic or asymptomatic recurrence. The difference is not statistically significant. The symptomatic response was identical in both groups, 3/4 of the patients in both groups being free of any symptom over all 6 months. During maintenance treatment, 24% of the patients on nizatidine and 32% of those on ranitidine reported new symptoms, listed as 'adverse events'. However, none of these events was likely to be drug related. There was no difference between the two groups concerning the percentage change of laboratory variables from baseline to endpoint.

Adult↗

Effects of low and high dose oral cimetidine on hormone serum levels in patients with peptic ulcers.

Luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (hPRL) and testosterone (T) were assayed in a total of 131 patients with peptic ulcer. Initial oral treatment was performed with 1000 mg cimetidine per day for 6 to 12 weeks. After healing was confirmed endoscopically, the patients were switched to a maintenance dose of 400 mg per day cimetidine for 3 years. Serum hormone levels before and during the two regimens were estimated in 48 male, 22 postmenopausal and 5 premenopausal subjects. Comparison between the two cimetidine doses was possible in 76 male, 44 postmenopausal and 6 premenopausal patients. In all patients hormone parameters assayed before therapy were within the normal ranges. FSH was noted to increase significantly in all but the premenopausal group but remained within the normal range. In contrast, hPRL declined significantly in all groups of subjects except for premenopausal females during cimetidine treatment. LH and T did not change during treatment and no differences of hormone serum levels were noted between the two regimens. Present data combine to suggest that an initial treatment with 1000 mg of cimetidine per day did not provoke hyperprolactinemia, and a switch from an initial high dose to a maintenance dose of 400 mg per day did not cause further changes in hormone serum levels. Changes of LH, FSH, hPRL and T recorded in the present study are too small to be considered responsible for possible endocrine disorders observed during cimetidine therapy.

Administration, Oral↗

The stabilizing effect of synovectomy on the synovial membrane in arthritic rabbit knees.

An inflammatory arthritis was induced in rabbit knees by intra-articular injection of human IgG complex in immunized animals. A increased invasion of large plasma proteins into the arthritic knee could be measured by electrophoretic separation of synovial extract and autoradiographic detection of 125I-labeled proteins. Synovectomy resulted in a reduced invasion of plasma proteins compared with the preoperatively arthritic knees. This protective effect was lost, however, following repeated intra-articular IgG injections. Fibrosis and decreased vascularization of the synovectomized knee, the excision of inflammatory cells, and mediators of inflammation are discussed as possible explanations.

Animals↗

Survey research guiding public policy making in Maryland: the case of Alzheimer's disease and related disorders.

The Maryland Governor's Task Force on Alzheimer's Disease and Related Disorders conducted a comprehensive 18-month assessment of the extent of dementing illness in Maryland, the needs of Maryland dementia victims and their families, and the availability of resources to meet these needs. A major tool in this assessment was a series of 16 specially designed surveys which were sent to physicians, family caregivers, nursing homes, geriatric aide training programs, and other populations. The survey findings, along with hearing testimony, provided the basis for the Task Force's 18 principal and 35 further recommendations, published in the Maryland Report on Alzheimer's Disease and Related Disorders (Governor's Task Force, 1985). These recommendations have become the basis of public policy discussion for services to dementia victims and their families in Maryland.

Aging↗

Effect of cimetidine treatment in the prevention of gastric ulcer relapse: a one year double blind multicentre study.

One hundred and forty six gastric ulcer patients were given open treatment using 1 g cimetidine daily to heal their ulcers. Of 130 who completed the acute treatment period of eight weeks, 112 (86%) had healed ulcers. Of these 112 patients with healed ulcers, 108 entered a one year double blind study to compare the effect of cimetidine maintenance therapy (400 mg at night) with placebo. Of the 84 patients available for assessment at the end of one year, 86% in the cimetidine treated group were in remission compared with 45% in the placebo treated group (chi 2 = 15.03; p less than 0.001). There were similar losses from non-compliance and drop out in both groups. The incidence of untoward effects and significant drug related laboratory abnormalities was low. The results indicate that cimetidine heals nearly 90% of acute gastric ulcers within eight weeks and that subsequent low dose maintenance treatment at night offers a considerable benefit over placebo therapy.

Adult↗

Geriatric medical education: developments since the American Geriatrics Society Conferences on Geriatric Education, 1976-77.

This is a Report presented to and endorsed by the Board of Directors of the American Geriatrics Society (AGS). It deals with developments since the AGS Conferences on Geriatric Education, 1976-77. Summarized is the position adopted by various medical organizations and associations, including the Institute of Medicine, Federated Council for Internal Medicine, American Society of Internal Medicine, and the American Academy of Family Physicians. Their stances essentially agree with that described in the Proceedings of the 1976-77 Conferences (JAGS, November 1977). The consensus arising from discussions by organized medical groups is that creation of a new practice specialty is unnecessary, although development and maintenance of an academic cadre of teachers and researchers is essential. Called for is greater commitment at the medical school level to incorporate geriatrics into the curriculum. The Report also deals with the question of merited recognition for those with special competency or expanded training in geriatrics. Finally, the Report provides support for the Medical Director concept, and looks to the Society's new Section for Long-Term Care Physicians to provide leadership in emphasizing the role of the physician in long-term care. The AGS intends, through future reports, publications, conferences, and liaison relationships with other organizations, to continue this advance, seeking solutions designed to improve and extend the health care of the aging population.

Curriculum↗

Hormone serum levels during oral cimetidine treatment of patients with peptic ulcers.

Radioimmunoassayable basal serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (hPRL), 17 beta-estradiol (E2) and testosterone (T) were estimated in a total of 68 patients, who were treated because of peptic ulcer with 1 g cimetidine per day. 37 patients were male and 31 were female subjects, respectively. Hormone serum levels were assayed before and 4 to 6 weeks after start of therapy. A significant increase of LH serum levels (p less than 0.025) and a significant decrease of hPRL (p less than 0.025) was noted in the male subjects during therapy. Similarly, a decrease of hPRL serum levels (p less than 0.001) was registered in the female subjects during treatment with 1 g cimetidine per day. All other hormone serum levels in both female and male subjects remained unchanged. The present data combine to suggest that 1 g cimetidine per day does not provoke hyperprolactinemia. In addition, cimetidine at the dose used does not interfere with other hormones of the hypothalamus-pituitary-gonadal axis and therefore, cannot be considered, responsible for endocrine disorders during treatment with cimetidine.

Administration, Oral↗

[Endoscopic papillotomy in Austria].

In 5 gastroenterologic centres in Austria 383 EPT were performed at a total of 10031 ERCP until July 1980. In 350 cases this procedure was successful (91.3%). The most frequent indication was a choledocholithiasis in 300 cases (85.7%). Complete disappearance of gall stones was achieved in 94%. Complications happened in 14 patients (4%), in 4 patients (12%) surgical procedures were necessary consequently. The death rate was 0.6% (2 patients). These favorable results and the low rates of complications and letality of this procedure encourage for the more frequent use of this method for the treatment of choledocholithiasis also in Austria in capable and experienced hands. In view of reducing complications the limitation of the EPT to few specialised centres is demanded.

Ampulla of Vater↗