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Control of endotoxinemia in liver disease by lactulose and paromomycin.

Through the use of the Limulus test research has been carried out on gram-negative endotoxin in patients with hepatic cirrhosis, chronic hepatitis, acute hepatitis, and in a control group. The positivity of this test in patients with cirrhosis and chronic hepatitis was 93.3% and in cases of acute hepatitis it was 90.9%. The effect of the combined administration of lactulose and paromomycin on endotoxin blood levels has been evaluated in a group of 9 patients with acute hepatitis, 8 with cirrhosis, 1 in hepatic coma, and 1 patient with chronic persistent hepatitis: in 18 of the 19 patients the Limulus test became negative. The results have been discussed in relation to clinical and laboratory data, and to recent data concerning the interaction between intestinal bacterial flora, endotoxin, and liver. Hypotheses have been proposed regarding the hepatocellular c-AMP mediated mechanism of endotoxin action.

Chronic Disease

[Use of lactulose in the treatment of chronic renal failure].

The effectiveness and tolerance of lactulose were studied in 15 patients suffereing from terminal chronic renal insufficiency under conservative treatment with hypoproteic diet. The drug was administered in doses such that 2-4 soft faeces discharges were obtained daily and in most cases led to an increase in the feeling of wellbeing, a reduction in arterial pressure, a reduction in potassiaemia and frequently in azotaemia, with no change in residual renal function.

Adolescent