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Changes in blood pressure, serum potassium and electrolytes with a combination of triamterene and a low dose of chlorthalidone.

A controlled study was carried out in patients with mild to moderate hypertension to compare the efficacy and tolerability of chlorthalidone alone and chlorthalidone combined with the potassium-sparing diuretic triamterene. After a 4-week period on placebo, 129 patients were allocated at random to receive 1 tablet daily of either 25 mg chlorthalidone (67 patients) or 25 mg chlorthalidone plus 50 mg triamterene (62 patients) for 10 weeks. Ninety-one patients (48 who had received chlorthalidone alone and 43 the combination) entered the third part of the study. During this 6-week period there was a partial crossover, approximately half continuing with their existing medication and the other half with the alternative treatment. All patients were then treated for a final 2 weeks with placebo. The placebo periods were single-blind, the active treatment periods were double-blind. Patients were seen at regular intervals throughout the trial. At each visit, measurements were taken of blood pressure and pulse rate and routine haematological and biochemical tests made. The results showed that both treatments produced similar, clinically significant reductions in blood pressure within the first 4 weeks of active medication and by the end of the 10-week period 51% of those on chlorthalidone alone and 57% on the combination showed a decrease of at least 10 mmHg or to less than 90 mmHg in standing diastolic pressure. Serum potassium decreased with both therapies but was less with the combination than with chlorthalidone alone, and the incidence of a serum potassium less than 3.5 mmol/l was significantly less with the combination. After crossover, blood pressure control was maintained but serum potassium decreased in patients changed from the combination to chlorthalidone alone and increased in those changed from chlorthalidone alone to the combination. Few adverse effects were reported and were generally mild and similar in frequency with the two therapies.

Adult↗

Effect of glucagon on the diagnostic accuracy of double-contrast barium enema examinations.

The effect of glucagon-induced hypotonicity on the diagnostic accuracy of double-contrast barium enema examinations was determined in 133 consecutive patients in a double-blind crossover study. All patients underwent colonoscopy and served as their own controls by undergoing a double-contrast study after intravenous injection of 1 mg of glucagon and another after intravenous injection of 1 ml of saline placebo, in randomized order. The frequencies of good/excellent hypotonicity and quality of examinations after first doses of glucagon (55.3% and 80.8%) were not significantly different from the frequencies of good/excellent results after first doses of saline (51.3% and 86.5%). The sensitivity was 72.6% after glucagon and 64.5% after placebo; the specificity was 88.7% after glucagon and 77.9% after placebo; and the respective accuracies were 81.2% and 71.9%. These percentages should be used only to compare results with and without glucagon and, by study design, do not represent results of a complete double-contrast study. The variation among these percentages was not statistically significant, but diverticulitis was more accurately diagnosed after glucagon. It was concluded that glucagon does not significantly improve the sensitivity and specificity of the double-contrast barium enema examination and should be used only in selected instances.

Adult↗

Effects of Hydrogen-Rich Water Supplementation on Exercise Performance, Autonomic Nervous System Recovery, and Blood Lactate Concentration During Repeated Sprint Exercise in Male University Athletes.

Hydrogen-rich water (HRW) supplementation has been proposed to exert anti-fatigue effects during exercise; however, its impact on exercise performance and autonomic nervous system (ANS) function during repeated sprinting remains unclear. The aim of this study was to examine the effects of acute pre-exercise HRW ingestion on repeated sprint performance, ANS regulation, and blood lactate concentration. This randomized, single-blind, placebo-controlled crossover study included 13 male university athletes (23.9 ± 2.0 years). Each participant completed two sessions of 7×6-second all-out cycling sprints interspersed with 30-second recovery intervals, with a one-week washout period between sessions. Critical flicker fusion frequency, heart rate, heart rate variability (HRV), and blood lactate were assessed at baseline, during exercise, and at 0-5 min and 10 min post-exercise. Compared to the placebo trial, the HRW trial demonstrated significantly higher average power output (d = 0.61) and significantly lower total work decrement and fatigue index (d = 0.62; d = 0.64). Post-exercise HRV recovery was significantly accelerated in the HRW trial, including RMSSD (d = 0.62), LF/HF ratio (d = 0.82), SampEn (d = 0.79), and DFAα1 (d = 0.79). Blood lactate at 3 min post-exercise was approximately 1 mmol/L lower in the HRW trial (d = 0.64). These findings suggest that acute HRW ingestion attenuates the decline in power output, accelerates ANS recovery, and enhances lactate clearance following repeated sprint exercise.

Humans↗

[Evaluation of antiemetic effect of clonazepam, metoclopramide, dexamethasone and diphenhydramine for prevention of cisplatin-induced vomiting].

In prospective alternative crossover test, we confirmed significant superiority of a three-drug combination of clonazepam (C) lorazepam (L) and dexamethasone (D) to (L) and (D) to control vomiting induced by 50 mg/m CDDP containing chemotherapy for gynecological malignancies (p less than 0.001). Vomiting frequency in initial 24 hours was 2.28 +/- 2.21 and 6.00 +/- 3.80 times a day respectively. According to this result, clonazepam, dexamethasone, metoclopramide and diphenhydramine (B) were used as a second regimen to control the vomiting in 80 mg/m CDDP containing chemotherapy for ovarian cancer patients. Clonazepam (2 mg 2 times p.o. -4 and 0 hrs before CDDP drip), dexamethasone (8 mg 5 times iv from -3 hrs each 3 hrs), metoclopramide (2.5 mg/kg iv loading from -2 hrs with 0.4 mg/kg/hr continuous infusion for 9 hrs) and diphenhydramine (30 mg/body 2 times im -2.6 hrs) were chosen to control CDDP-induced nausea and vomiting. These four drugs (C+L+D+B) prominently inhibited the chemo-induced vomiting up to 0.44 +/- 1.50 times a day, and 87.5% of courses was completely satisfactory.

Adult↗

Amlodipine in angina pectoris: effect on maximal and submaximal exercise performance.

Amlodipine, a dihydropyridine calcium antagonist, was compared with placebo in a double-blind cross-over study in 16 patients with angina. After a 2-week single-blind placebo period, patients entered a double-blind crossover phase alternating between 4 weeks of placebo and 4 weeks of amlodipine, 10 mg once daily. The two 4-week periods were separated by a 1-week single-blind placebo washout period. The efficacy of drug therapy was measured using frequency of angina, nitroglycerin consumption, peak oxygen consumption during a maximal treadmill exercise test, and endurance time during a separate submaximal exercise test performed at 70% of the peak work capacity that had been determined before randomization. Compared with single-blind placebo there was a reduction in angina frequency during double-blind placebo and amlodipine, whereas nitroglycerin consumption was significantly reduced only by amlodipine. Amlodipine produced a significant increase in peak oxygen consumption and endurance time during the submaximal exercise test when compared with single-blind and double-blind placebo periods. Patients tolerated both placebo and amlodipine without clinically significant side effects.

Aged↗

[Epidemiological study of fertility in adolescents in the Autonomous Community of Madrid].

OBJECTIVE: The purpose of this study was to research the frequency and distribution of fertility in adolescence and, in looking at different environments within the Autonomous Community of Madrid (ACM), to evaluate the relationship of fertility rates to determined variables of a socio-economic, educational and demographic nature. DESIGN: An observational crossover study was carried out. SETTING: Autonomous Community of Madrid. PATIENTS AND OTHERS PARTICIPANTS: In this study, the specific rate of fertility in adolescents (SRFA) was calculated and the correlation between the SRFA and variables of a socioeconomic, educational and demographic nature were analysed by means of the multiple linear regression method. MEASUREMENTS AND MAIN RESULTS: We found important differences in the distribution of fertility within the ACM. There was also a positive correlation (p < 0.05) between the SRFA and those variables which expressed the percentages of illiteracy, industrial workers and with the synthetic youth index. A negative correlation (p < 0.05) was found for the percentages of graduates, professionals and technicians, managers and directors and with the synthetic ageing index. We found no correlation with the unemployment index. On applying the multivariant model, the variable that weighed most on fertility was the level of education, which was in our case measured by the percentage of illiteracy. CONCLUSIONS: We found an uneven spread of adolescents' fertility rates in the Autonomous Community of Madrid. The fertility rates were higher in those boroughs where there was more illiteracy.

Adolescent↗

[The allocation of the pharmacy budget to health centers].

OBJECTIVE: To design a mathematical model which permits pharmacy budgets to be assigned to Health Centres (HC), examining the social and demographic variables and health service usage which explain the variability of the pharmaceutical expenditure (PE) of the HCs. DESIGN: A descriptive, crossover study. SETTING: 17 HC of the Insitut Català de la Salut (Catalan Health Service) in the city of Barcelona during 1994. MEASUREMENTS AND MAIN RESULTS: Relationships among the following variables at the 17 HCs were studied: pharmaceutical expenditure per inhabitant (PEi), frequency of attendance (FRA), care pressure (CP), percentage of the population 65 or over (P65), percentage of the population with medical records (PPR), index of family economic capacity (IFEC), ratio of comparative mortality (RCM) and ratio of potential years of life lost (RPYLL). In the bivariant analysis, those variables with a statistically significant linear correlation with PEi were FRA (r = 0.67; p < 0.01), PPR (r = 0.56; p <0.01), IFEC (r = -0.68; p < 0.01), RCM (r = 0.61; p < 0.01) and RPYLL (r = 0.62; p <0.01). In the multivariant analysis, IFEC, P65 and FRA enabled 94% of the PEi variability to be explained (r2 = 0.94; p < 0.001). Through multiple regression a mathematical formula for calculating the PE of HCs was obtained. CONCLUSION: The model presented enables pharmacy budgets to be assigned to the HCs if the IFEC, P65 and FRA of the population attended is known.

Budgets↗

[Non-steroid anti-inflammatory agents and gastrointestinal protection: adequate prescription in primary care?].

OBJECTIVES: To find the frequency of prescription of gastro-intestinal protectors (GIP) at the same time as non-steroidal anti-inflammatory drugs (NSAID). To find certain characteristics linked to their use in primary care. To evaluate how correctly they are prescribed. DESIGN: A crossover descriptive study. SETTING: A base urban health area. PATIENTS: Patients over 14, who attended in 1994, who had a medical history and were treated with NSAID. MEASUREMENTS AND INTERVENTIONS: 1,115 medical histories were obtained by simple randomised sampling, of whom 205 were under treatment with NSAID. A questionnaire was used to evaluate: age, sex, NSAID treatment, GIP, history of peptic ulcer, corticoid or acenocoumarol treatment, tobacco, alcohol and related pathology. After a complete bibliographic review, some criteria were fixed for when it is correct to give GIP-NSAID. RESULTS: The prevalence of NSAID prescription was 18.39%. 34 patients treated with NSAID received GIP at the same time. Aceclophenac was the most widely prescribed NSAID; and H2 antihistamines, the drugs most commonly used as GIP.

Anti-Inflammatory Agents, Non-Steroidal↗

Comparison of high-frequency chest wall oscillation and oscillating positive expiratory pressure in the home management of cystic fibrosis: a pilot study.

Enhanced airway clearance is thought to result in better-maintained pulmonary function in cystic fibrosis (CF). Postural drainage, percussion, and vibration (PDPV) have been the primary airway clearance technique (ACT) employed in CF for over 40 years. Two new airway clearance modalities are high-frequency chest wall oscillation (HFCWO) and oscillating positive expiratory pressure (OPEP). This pilot study was undertaken to evaluate the efficacy of these techniques during home use, assess patient satisfaction with them as compared to PDPV, and assess the feasibility of performing a definitive comparative trial. The prospective, randomized, multicenter crossover trial was conducted at three urban academic CF Care Centers. Twenty-nine CF patients, 9-39 years of age, participated. Subjects performed 4 weeks each of HFCWO and OPEP following 2-week lead-in/washout periods. Spirometry, lung volumes, National Institutes of Health and Petty Scores, and a satisfaction survey were performed at baseline and after each treatment period. An ACT preference survey was completed at the conclusion of the study. Twenty-four subjects completed both therapies. There were no statistically significant differences between therapies for spirometry, lung volumes, or clinical scores. No significant safety issues arose during the study period. Compliance between therapies was similar. Significant differences among therapies existed in patient satisfaction. Given a choice of therapy, 50% of subjects chose HFCWO, 37% OPEP, and 13% PDPV. This study suggests that HFCWO and OPEP are safe and as effective as patients' routine therapies when used for airway clearance in a home setting. Patient satisfaction and preference differ among ACTs and should be considered when prescribing home therapy. A definitive, multi-center, comparative study evaluating long-term efficacy of these techniques is feasible.

Adolescent↗

Controlled trial of aerobic exercise in hypertension.

To determine the antihypertensive efficacy of aerobic exercise training in mild essential hypertension, a prospective randomized controlled trial was conducted comparing an aerobic exercise regimen to a placebo exercise regimen, with a crossover replication of the aerobic regimen in the placebo exercise group. The study took place in an outpatient research clinic in a university-affiliated Veterans Administration medical center. Twenty-seven men with untreated diastolic blood pressure (DBP) of 90-104 mm Hg were randomized to the two exercise regimens. Ten patients completed the aerobic regimen. Nine patients completed the control regimen, seven of whom subsequently entered and completed the aerobic regimen. The aerobic regimen consisted of walking, jogging, stationary bicycling, or any combination of these activities for 30 minutes, four times a week, at 65-80% maximal heart rate. The control regimen consisted of slow calisthenics and stretching for the same duration and frequency but maintaining less than 60% maximal heart rate. DBP decreased 9.6 +/- 4.7 mm Hg in the aerobic exercise group but increased 0.8 +/- 6.2 mm Hg in the placebo control exercise group (p = 0.02). Systolic blood pressure (SBP) decreased 6.4 +/- 9.1 mm Hg in the aerobic group and increased 0.9 +/- 9.7 mm Hg in the control group (p = 0.11). Subsequently, seven of the nine controls entered a treatment crossover and completed the aerobic regimen with significant reductions in both DBP (-6.1 +/- 3.2 mm Hg, p less than 0.01) and SBP (-8.1 +/- 5.7 mm Hg, p less than 0.01). BP changes were not associated with any significant changes in weight, body fat, urinary electrolytes, or resting heart rate. This randomized controlled trial provides evidence for the independent BP lowering effect of aerobic exercise in unmedicated mildly hypertensive men.

Adult↗

A quantitative theory of transfection in B. subtilis.

A theory of transfection is developed which describes three different types of experiments in transfection: The concentration dependence of transfection, transfection with marker rescue, and the mapping function in transfection crosses. The theory is applicable to transfection systems exhibiting quadratic or higher order dose response (APP1, AP50, SP82). It pictures the essential process in transfection as follows: transfecting DNA molecules, having suffered inactivating events during uptake or intracellularly, have to recombine prior to replication under elimination of these lesions. The probability for recombination, successful in this sense, is calculated as a function of the number of DNA molecules within the competent cell, the mean number of inactivating events per DNA molecule, and the crossover probability per nucleotide. Under the assumption of random distribution of inactivating events over the population of DNA molecules and homogeneous crossover probabilities the theory explains on a quantitative basis a number of experimental observations in transfection, as for instance the relative efficiencies of different helper phage in transfection with marker rescue, the third order concentration dependence in SP50 transfection, and the high recombination frequencies observed in transfection crosses.

Bacillus subtilis↗

Short-term effects of omega-3 fatty acids on exercise stress test parameters, angina and lipoproteins.

The short-term effects of omega-3 fatty acids on exercise test parameters in patients with known coronary artery disease are poorly defined. Therefore, we administered a preparation containing 5.4 g of eicosapentaenoic acid and 3.6 g docosahexaenoic acid to 8 patients in a random order, double-blind, crossover design. The patients were given either fish oil or a vegetable oil control for 6 wk and then crossed over to the other treatment for a second 6-wk period, after a 2-wk wash-out interval. Exercise test parameters, angina frequency, and lipoprotein composition were measured at baseline and at the end of each trial phase. No significant changes were found in resting or peak exercise heart rate or double product, exercise duration or ischemic electrocardiographic changes at peak exercise. Angina frequency and sublingual nitroglycerin usage did not change during either the fish oil or the control oil phase. Plasma triglyceride levels decreased significantly with fish oil treatment and HDL cholesterol levels rose slightly. Total and LDL cholesterol levels were unchanged. We conclude that relatively high dose, short-term administration of omega-3 fatty acids does not alter exercise test parameters.

Adult↗

Low settings of the ventricular pacing output in patients dependent on a pacemaker: are they really safe?

BACKGROUND: It is generally acknowledged that pacemaker output must be adjusted with a 100% voltage safety margin above the pacing threshold to avoid ineffective pacing, especially in patients dependent on pacemakers. AIMS: The aim of this prospective crossover study was to assess the beat-to-beat safety of low outputs in patients who are dependent on a pacemaker between 2 follow-up examinations. METHODS: The study included 12 patients who had received a DDD pacemaker with an automatic beat-to-beat capture verification function. The ventricular output at 0.4 milliseconds pulse duration was programmed independently of the actual pacing threshold in a crossover randomization to 1.0 V, 1.5 V, and 2.5 V for 6 weeks each. At each follow-up, the diagnostic counters were interrogated and the pacing threshold at 0.4 milliseconds was determined in 0.1-V steps. The diagnostic pacemaker counters depict the frequency of back-up pulses delivered because of a loss of capture. During the randomization to 1.0-V output, we evaluated whether the adjustment of the output under consideration of the >100% voltage safety margin reduced the frequency of back-up pulses. RESULTS: Pacing thresholds at the randomization to 1.0-V, 1.5-V, and 2.5-V output were not significantly different, with 0.7 +/- 0.3 V at 2.5-V output, 0.6 +/- 0.2 V at 1.5-V output, and 0.6 +/- 0.2 V at 1.0-V output. The frequency of back-up pulses was similar at 2.5-V and 1.5-V output, 2.2% +/- 1.9% and 2.0% +/- 2.0%, respectively. The frequency of back-up pulses significantly increased at 1.0-V output to 5.8% +/- 6.4% (P <.05). Back-up pulses >5% of the time between the 2 follow-ups were observed in no patient at 2.5 V, in 1 patient at 1.5 V, and in 5 patients at 1.0 V. At the randomization to the 1.0-V output, 6 patients had pacing thresholds of 0.5 V or less, and 6 patients had pacing thresholds >0.5 V. The frequency of back-up pulses in the 2 groups was not significantly different, 6.4% +/- 8.6% and 5.7% +/- 2.6%. CONCLUSIONS: The frequency of back-up pulses was significantly higher at 1.0-V output than at 1.5-V and 2.5-V output. This also applied to patients with pacing thresholds of < or =0.5 V. Fixed low outputs seem not to be absolutely safe between 2 follow-ups in patients who are dependent on a pacemaker, even when the output has a 100% voltage safety margin above the pacing threshold. When patients with pacemakers programmed to a low ventricular output have symptoms of ineffective pacing, an intermittent increase of the pacing threshold should be carefully ruled out.

Aged↗

Extended HLA/complement allele haplotypes: evidence for T/t-like complex in man.

The chromosomal distribution of alleles for HLA-A,-B,-C, and -DR and the serum complement protein alleles of factor B and C2 and C4 was studied in normal Caucasian families. Eight combinations of HLA-B, DR, BF, C2, C4A, and C4B markers were found to occur in haplotypes at frequencies significantly higher than expected. In these combinations, which were defined as extended major histocompatibility complex haplotypes, HLA-A showed limited variation. A possible mechanism for the maintenance of extended haplotypes are human analogs of murine t mutants which are characterized by crossover suppression and male transmission bias. One human 6p haplotype, HLA-B8, DR3, SCO1, GLO 2, was found to be transmitted from males to 83% of their offspring. The same haplotype with GLO 1 had no transmission bias. It is suggested that this GLO 2-marked chromosome is a human analog of a murine t mutant.

Alleles↗

An examination of the effects of double-strand breaks on extrachromosomal recombination in mammalian cells.

We studied the effects of double-strand breaks on intramolecular extrachromosomal homologous recombination in mammalian cells. Pairs of defective herpes thymidine kinase (tk) sequences were introduced into mouse Ltk- cells on a DNA molecule that also contained a neo gene under control of the SV40 early promoter/enhancer. With the majority of the constructs used, gene conversions or double crossovers, but not single crossovers, were recoverable. DNA was linearized with various restriction enzymes prior to transfection. Recombination events producing a functional tk gene were monitored by selecting for tk-positive colonies. For double-strand breaks placed outside of the region of homology, maximal recombination frequencies were measured when a break placed the two tk sequences downstream from the SV40 early promoter/enhancer. We observed no relationship between recombination frequency and either the distance between a break and the tk sequences or the distance between the tk sequences. The quantitative effects of the breaks appeared to depend on the degree of homology between the tk sequences. We also observed that inverted repeats recombined as efficiently as direct repeats. The data indicated that the breaks influenced recombination indirectly, perhaps by affecting the binding of a factor(s) to the SV40 promoter region which in turn stimulated or inhibited recombination of the tk sequences. Taken together, we believe that our results provide strong evidence for the existence of a pathway for extrachromosomal homologous recombination in mammalian cells that is distinct from single-strand annealing. We discuss the possibility that intrachromosomal and extrachromosomal recombination have mechanisms in common.

Animals↗

Plasma phytoestrogens are not altered by probiotic consumption in postmenopausal women with and without a history of breast cancer.

Soy phytoestrogens were suggested to reduce the risk of a number of diseases including breast cancer. Given that these compounds are metabolized by bacteria, alteration of intestinal bacteria and enzymes may affect phytoestrogen metabolism. We hypothesized that probiotics, when consumed with soy protein, would increase plasma isoflavones, as well as equol producer frequency, in postmenopausal women. We further hypothesized that these effects would differ between women who have had breast cancer and women who have not. To test these hypotheses, 20 breast cancer survivors and 20 controls completed four 6-wk treatments in a randomized, crossover design: supplementation with soy protein (S) (26.6 +/- 4.5 g protein, 44.4 +/- 7.5 mg isoflavones/d); soy + probiotics (S+P) (10(9) colony-forming units Lactobacillus acidophilus DDS+1 and Bifidobacterium longum, 15-30 mg fructooligosaccharide/d); milk protein (M) (26.6 +/- 4.5 g protein/d); and milk + probiotics (M+P). Plasma phytoestrogen concentrations did not differ between controls and survivors, although genistein tended to be lower in survivors at baseline (P = 0.15), and during soy (P = 0.16) and milk protein (P = 0.16) consumption. As expected, soy consumption increased plasma phytoestrogen concentrations (P < 0.0001). Plasma phytoestrogen concentrations and the number of equol producers did not differ between the S and S+P diets. At the same time, plasma equol concentrations as well as urinary equol excretion in 2 subjects were more than 7-fold different between the 2 diets. These results indicate that this particular probiotic supplement does not generally affect plasma isoflavones, although the large differences between plasma and urinary equol in some subjects suggest that equol producer status may be modifiable in some individuals.

Biological Availability↗

Does oxybutynin add to the effectiveness of prompted voiding for urinary incontinence among nursing home residents? A placebo-controlled trial.

OBJECTIVE: To determine if oxybutynin, a bladder relaxant medication, adds to the effectiveness of prompted voiding (PV) in the management of urinary incontinence among nursing home residents. DESIGN: Randomized, placebo-controlled, double-blinded, dose-adjusted, crossover trial of oxybutynin added along with PV. SETTING: Seven nursing homes in Los Angeles County, California. PARTICIPANTS: Seventy-five nursing home residents with predominantly urge incontinence, whose incontinence did not respond well to a trial of PV. MAIN OUTCOME MEASURES: The frequency of incontinence, measured as the percentage of hourly (7 AM to 7 PM) physical checks over a 3-day period at which the resident was found wet. RESULTS: Sixty-three (84%) of the residents completed the study. Among those completing the trial, the percent of checks wet went from 26.5% to 23.7% on placebo to 20.2% on active drug. These changes were statistically significant but not clinically meaningful. A clinically significant decrease in the frequency of incontinence, which we defined as a relative reduction in the percent of checks wet of > 33%, occurred in 20 subjects (32%) while on active drug and in 12 subjects (19%) while on placebo (P = .48 by chi-square). Twenty-five subjects (40%) met our "continence criteria" of an average of one or less wet per day while on active drug, and 11 subjects (18%) achieved this goal on placebo (P = .005 by chi-square). CONCLUSION: Oxybutynin does not add to the clinical effectiveness of PV in the majority of nursing home residents with urge type urinary incontinence. Selected residents may, however, become more responsive to PV while on oxybutynin. Our data are consistent with other studies of bladder relaxant medications in functionally impaired populations. New drugs and/or other interventions are needed for the large number of incontinent nursing home residents who do not respond well to PV.

Aged↗

Comparison of the effect of acetazolamide tablets and sustets on diurnal intraocular pressure in patients with chronic simple glaucoma.

Twenty patients with primary open-angle glaucoma uncontrolled on single topical therapy completed a double dummy crossover study to compare acetazolamide tablets with a sustained release formulation (Sustet). The two preparations were equally effective, but no direct relationship was found between the intraocular pressure and the plasma concentration of acetazolamide. No difference between the formulations was found in the frequency or severity of side effects.

Acetazolamide↗