A RANDOMISED,DOUBLE-BLIND,PARALLEL-GROUP COMPARISON OF VENLAFAXINE AND DOTHIEPIN IN GERIATRIC PATIENTS WITH MAJOR DEPRESSION

This randomised, double-blind study conducted at nine sites in the UK and the Netherlands compared the safety and antidepressant efficacy of venlafaxine and dothiepin. Ninety-two geriatric patients (aged 64-87 years) with major depression were randomly assigned to receive either venlafaxine or dothiepin for up to 43 days. The dose of venlafaxine or dothiepin was titrated up to a maximum of 150 mg per day for the first 15 days, and thereafter could range from 50 to 150 mg per day. Adjusted mean scores on the MADRS and the HAM-D decreased significantly (p 0.05) from baseline to the end of the study in both groups. A response to therapy was observed in 60% of patients in the venlafaxine group and 53% of patients in the dothiepin group on the MADRS, and in 60% of patients in both groups on the HAM-D. Suicidal ideation scores on the MADRS were significantly (p=0.042) lower in the venlafaxine group at week 6. Treatment-emergent study events were the primary reason for withdrawal in only 7% of venlafaxine-treated patients and 8% of dothiepin-treated patients. The results confirm the efficacy and tolerability of venlafaxine for treating major depression in the elderly.     

FLUVOXAMINE IN THE TREATMENT OF DEPRESSIVE ILLNESS. A SERIES OF DOUBLE-BUND HOSPITAL BASED COMPARATIVE STUDIES CARRIED OUT IN THE UK

A series of double-blind hospital based studies comparing fluvoxamine with other antidepressants in depressed patients is reviewed. Overall there were no significant differences in terms of efficacy between fluvoxamine and the comparators (amitriptyline, dothiepin, lofepramine and mianserin). Fluvoxamine was shown to be associated with a low incidence of anticholinergic, cardiovascular or sedative effects. This profile of activity, together with low toxicity in overdosage, has established the place of fluvoxamine in the treatment of depressive illness.     

Sumatriptan治疗偏头痛的双盲研究

应用Ｓｕｍａｔｒｉｐｔａｎ与安慰剂口服随机双盲试验，治疗符合参试标准的偏头痛４６例。Ｓｕｍａｔｒｉｐｔａｎ组２２例，安慰剂组２４例。两组性别、年龄、病程、体重及身高等一般情况，经统计学处理均无明显差异。治疗结果显示：Ｓｕｍａｔｒｉｐｔａｎ组头痛消失１１列（５０％），进步７例（３２％），总有效率８２％，无效４例（１８％），而安慰剂组头痛消失９例（３７．５％），进步３（１３．５％），总有效率５０％，无     

TREATMENT OF MAJOR DEPRESSION IN GENERAL PRACTICE: A DOUBLE-BLIND COMPARISON OF PAROXETINE AND LOFEPRAMINE

SUMMARY A six-week, double-blind, randomised study was used to compare the efficacy, tolerability, safety and effect on cognitive function of paroxetine with that of lofepramine in the treatment of 138 patients with major depression in general practice. Efficacy was assessed using the Montgomery and Asberg Depression Rating Scale (MADRS) and Clinical Global Impression (CGI) scale. Effect on cognitive function was assessed using the paired associate learning test and the serial ‘E’ cancellation test. The results showed that the antidepressant efficacy of paroxetine was comparable to that of lofepramine in the treatment of depressed patients. Similar improvements in mean total MADRS scores were observed in both treatment groups, but a significantly greater improvement was seen in the CGI with paroxetine at weeks 2 and 4. The effect of treatment on cognitive function did not differ significantly across the two treatment groups, nor did the number of adverse events reported nor the overall tolerability.     

A COMPARATIVE STUDY OF THE EFFICACY AND TOXICITY OF ETODOLAC AND NAPROXEN IN THE TREATMENT OF OSTEOARTHRITIS

SUMMARY In a two-period, double-blind, crossover study, patients with osteoarthritis of the knee and/or hip received etodolac 300 mg twice daily for 4 weeks and naproxen 500 mg twice daily for 4 weeks in random order. The assessment of efficacy showed that naproxen and etodolac were equally effective in the management of pain and stiffness in osteoarthritis. However, a significantly higher proportion of patients preferred naproxen to etodolac for the relief of pain intensity. The incidence of adverse events caused by either drug was the same.     

曲唑酮治疗持续性疼痛性躯体形式障碍的双盲对照研究

目的:观察曲唑酮与止痛剂对持续性疼痛性躯体形式障碍的疗效与副反应。方法:140例患者随机分为2组进行双盲对照(每组70例),分别以曲唑酮或去痛剂布洛芬治疗4周。其疗效和副反应分别用汉密顿抑郁量表(HAMD)和临床疗效评定标准和副反应量表(TESS)评定。结果:曲唑酮的有效率大于布洛芬,分别是92.85％和62.85%(P<0.01);副反应发生率也大于布洛芬(P<0.01),但均较轻。结论:曲唑酮对持续性疼痛性躯体形式障碍疗效肯定,副反应轻。     

EFFICACY AND SAFETY OF ORAL SILDENAFIL IN THE TREATMENT OF ERECTILE DYSFUNCTION: A DOUBLE-BLIND,PLACEBO-CONTROLLED STUDY OF 329 PATIENTS

SUMMARY The efficacy and safety of oral sildenafil citrate for the treatment of erectile dysfunction (ED) were assessed in a 12-week placebo-controlled study. Men with ED of organic, psychogenic, or mixed aetiology were randomised to placebo (n=166) or 50 mg sildenafil (n=163), with adjustment to 100 mg or 25 mg based on efficacy and tolerability. Efficacy assessments included a global efficacy question, event log data, and an optional partner questionnaire. At the end of the study, improved erections were reported by 74% of patients receiving sildenafil versus 16% for placebo (p<0.0001). In the final 4 weeks of treatment, 65% of all attempts at sexual intercourse were successful for all patients (responders and non-responders) receiving sildenafil versus 20% for placebo (p<0.001).The mean number of successful attempts per month was 5.9 for patients receiving sildenafil versus 1.5 for those receiving placebo (p<0.0001). The most common adverse events – headache, flushing, and dyspepsia – were generally mild to moderate in nature and rarely (<1%) a reason for discontinuation of treatment. Oral sildenafil is an effective, reliable and well-tolerated treatment for ED of organic, psychogenic or mixed aetiology.     

A DOUBLE-BUND,RANDOMISED COMPARISON OF FLUVOXAMINE WITH DOTHIEPIN IN THE TREATMENT OF DEPRESSION IN ELDERLY PATIENTS

SUMMARY The efficacy and tolerability of the selective 5-HT reuptake inhibitor fluvoxamine were compared with the tricyclic dothiepin in 52 elderly (age > 64 years) hospital patients in a multi-centre double-blind randomised trial. Patients met DSM-III criteria for ‘major depressive episode’ and scored > 29 on the Montgomery Asberg Depression Rating Scale (MADRS) after a one-week placebo baseline. Active treatment was for six weeks. The dosage of both drugs was 50 mg nocte for three days, 100 mg nocte for the remainder of the first week, thereafter increasing to a maximum of 200 mg/day according to response/tolerance. MADRS scores improved by 63.5% with fluvoxamine and 60.0% with dothiepin; there were no significant differences between treatments at any assessment. Nausea, dizziness, headache, somnolence and constipation in both groups, plus dry mouth and asthenia in the dothiepin group were more frequent than single reports. Two patients in each group discontinued treatment owing to unwanted effects. There were no clinically significant changes in haematological, biochemical or cardiovascular parameters.     

阿霉素与庆大霉素治疗三叉神经痛的早期疗效对比研究

目的：比较不同浓度阿霉素及庆大霉素用于三叉神经痛的治疗效果。方法：50例三叉神经痛患者随机分为3组，分别用0．2％、0．5％阿霉素及庆大霉素行外周神经阻滞。观察治疗前、治疗后1天、3天、1周、2周、1月、2月、3月时的疼痛缓解情况及治疗过程中出现的不良反应。结果：0．2％阿霉素组除治疗后第1天外其余各时间点数字评分(NRS)均较治疗前降低，而其它两组治疗后各时间点NRS均明显下降。0.5％阿霉素组在治疗后1天、2周、1月、2月、3月时的NRS值明显低于0．2％阿霉素组，治疗后1月、2月时明显低于庆大霉素组。0．5％阿霉素组有效率明显高于0．2％阿霉素及庆大霉素组。结论：0.5％阿霉素对三叉神经痛的治疗效果较好，庆大霉素可用于病情不太严重的患者。     

西酞普兰治疗持续性躯体形式疼痛障碍对照研究

目的：观察西酞普兰治疗持续性躯体形式疼痛障碍的疗效。方法：将持续性躯体形式疼痛障碍门诊患者64例随机分为治疗组和对照组，两组分别给予西酞普兰（31人）和阿米替林（33人）治疗，总疗程6周。分别于治疗前及治疗后第2、4、6周评定疗效，阿米替林组有2例脱漏，最后完成疗程每组各31人。结果：治疗组和对照组完全缓解分别为9例和8例，明显缓解分别为10例和8例，轻度缓解分别为7例和9例，无效分别为5例和6例；有效率分别为83．87％，80．65％；两组间差异无显著性（P〉0．05）。但治疗组口干、便秘、视物模糊、心动过速、嗜睡等不良反应明显比对照组少（P〈0．01）。结论：西酞普兰对持续性躯体形式疼痛障碍与阿米替林疗效相当，但不良反应小。     

A STUDY TO INVESTIGATE THE COMPARATIVE EFFICACY AND TOLERABILITY OF NISOLDIPINE COAT-CORE AND ATENOLOL IN THE TREATMENT OF MILD TO MODERATE HYPERTENSION

SUMMARY The efficacy and tolerability of nisoldipine coat-core (nisoldipine CC 10, 20, 40 mg) and atenolol (50, 100 mg) were compared in 230 patients with mild to moderate essential hypertension. Treatment was titrated at two-weekly intervals as necessary to control blood pressure. After eight weeks of active therapy, the two treatments proved to be equally effective in reducing sitting diastolic blood pressure (13.7 ± 8.3 mmHg and 14.2 ± 9.1 mmHg for nisoldipine CC and atenolol, respectively), and provided equivalent reduction in systolic blood pressure and identical response rates (69%). Heart rate was reduced from baseline in the atenolol group but remained unchanged in the nisoldipine CC group (p < 0.001 difference between the two groups). Both nisoldipine CC and atenolol were well tolerated and had no detectable metabolic effects. Adverse events were minor and of the type commonly associated with drugs of these classes.     

A COMPARATIVE STUDY OF CERTAIN ACTIONS OF ADRENALIN IN THE CAT AND THE RABBIT

The present investigation brought out the facts that the pupil of the cat is little affected by instillation of adrenalin, but shows, nevertheless, a greater responsiveness to adrenalin when given intravenously than does that of the rabbit, and that the duration of the dilatation effected by intravenous injection is, on the contrary, longer in the rabbit. In regard to the vasoconstricting effect of adrenalin when administered intravenously, it was found that the intensity as well as the duration of the rise of blood pressure was greater in the rabbit than in the cat.     

A COMPARATIVE STUDY OF THE GROWTH, NUTRITION, AND METABOLISM OF THE PRIMARY AND THE TRANSFORMED HUMAN CELLS IN VITRO

The growth characteristics, nutritional requirements, and metabolic activities of primary explants (chiefly amnion) and transformed human cells (derived from amnion, conjunctiva, and cervical cancer) were compared. Major differences observed are as follows: 1. Five types of human tissue when freshly explanted in vitro were found to have varying but limited growth potential in contrast to the autonomous and apparently unlimited growth of the transformed cell. 2. A requirement for an external source of inositol or glutamine could not be demonstrated for the slowly multiplying primary amnions in contrast to the rapidly growing transformed cells which degenerated in the absence of either metabolite. 3. Unlike the transformed cells, the primary amnion cells fixed an insignificant amount of CO₂; when infected by the Coxsackie virus, however, a requirement for CO₂ in the formation of more virus became readily demonstrable. 4. The biggest difference in the incorporation of various C¹⁴ substrates occurred in the nucleic acid fractions. 5. The difference in the incorporation of glycine into the protein fraction was very small. 6. The utilization of glucose, ribose, and xylose as well as the oxidation of lactic acid into CO₂ by the primary amnion cells occurred at a rate much lower than that of the transformed cells. 7. The cytotoxic dose of 5-fluorodeoxyuridine for the primary amnion was at least 100 times that of the transformed cells although growth inhibition was readily demonstrated at 0.1 µg. per ml. for both types of cells. Based on these observations, several hypotheses are put forth for consideration.     

COMPARING THE EFFICACY OF CISAPRIDE AND RANITIDINE IN OESOPHAGITIS: A DOUBLE-BLIND,PARALLEL GROUP STUDY IN GENERAL PRACTICE

SUMMARY Patients with endoscopically confirmed oesophagitis (n=49) were treated for 8 weeks with either cisapride (10 mg four times a day) or ranitidine (150 mg twice a day) in a double-blind study in general practice. Mean overall symptom scores fell from 10.8 to 4.5 in the cisapride group and from 9.9 to 4.4 in the ranitidine group over the course of the study. The proportion of patients reporting improvements in individual symptoms in the two treatment groups (cisapride and ranitidine respectively) were: heartburn, 66% and 55%; acid regurgitation, 53% and 47%; epigastric pain, 60% and 52%; satiety, 57% and 47%; bloating, 69% and 71%; belching, 65% and 72%; nausea, 62% and 85%; vomiting, 77% and 66%; poor appetite, 50% and 75%. Improvement in the endoscopic grade of oesophagitis was observed in 66% of patients receiving cisapride and 63% of those receiving ranitidine. It was concluded that cisapride is as effective as ranitidine in relieving the symptoms of oesophagitis and in healing oesophageal erosions.     

通迪胶囊与芬必得胶囊镇痛疗效对照研究

目的：将通迪胶囊与芬必得胶囊用于急慢性疼痛性疾病的镇痛疗效进行对照研究。方法：选择100例急慢性颈、肩、腰、腿痛和骨性膝关节炎患者，随机分为通迪组和对照组，每组为50例患者。通迪组口服通迪0．92g／次，3次／日；对照组口服芬必得0．3g／次，2次／日，分别记录治疗前、治疗4天后、治疗8天后的VAS评分。结果：两组治疗后各时点VAS评分与治疗前比较有显著差异，两组间治疗前、治疗后各时点VAS评分无差异。结论：通迪胶囊用于急慢性颈、肩、腰、腿痛和骨性膝关节炎的镇痛治疗有明显疗效，与芬必得胶囊镇痛作用相似，副作用少，是一种安全、有效的镇痛药物。     

COMPARATIVE EFFICACY AND TOLERABILITY OF TWO DICLOFENAC FORMULATIONS IN THE TREATMENT OF PAINFUL OSTEOARTHRITIS

SUMMARY The efficacy and tolerability of a new resinate formulation of diclofenac 75mg taken once or twice daily were compared with that of conventional enteric-coated diclofenac sodium 50mg tablets given two or three times daily in a double-blind, randomised, between-patient, 12-week trial in 216 adult patients suffering from painful osteoarthritis of the hip and/or knee. Similar and clinically significant reductions in the mean intensity scores of pain at rest or on activity were observed after treatment with either formulation. Global evaluations showed the overall response rate to range between 60% and 75%. A significant analgesic effect was obtained within two weeks of treatment with 150mg diclofenac daily; this improvement was maintained on reduction of the dosage to 75-100mg over the next ten weeks. One or more drug-related adverse events, predominantly gastrointestinal adverse events, were reported by 40% and 38% of patients in the diclofenac resinate and diclofenac sodium groups, respectively.     

A DOUBLE-BLIND CROSSOVER STUDY TO COMPARE LYSINE ACETYL SALICYLATE (ASPERGESIC) WITH IBUPROFEN IN THE TREATMENT OF RHEUMATOID ARTHRITIS

Lysine acetyl salicylate [1.8 g t.d.s. (Aspergesic 1,000 sachet)] has been compared to 400-mg ibuprofen tablets t.d.s. in a randomized double-blind trial in patients with rheumatoid arthritis using double-dummy technique. Both drugs proved effective in relieving symptoms. Three patients experienced drug-related side-effects with Aspergesic, and one patient with ibuprofen, that necessitated early discontinuation of treatment. Aspergesic was associated with a greater number of haemoglobin values falling below the normal range than ibuprofen. At the end of the study, eight out of 10 patients who expressed a preference selected Aspergesic for improving mobility whilst 15/24 selected Aspergesic for improving pain.     

ASSESSMENT OF PATIENTS' KNOWLEDGE ABOUT THEIR ILLNESS AND TREATMENT

One hundred and twenty two patients over the age of 65 were questioned about their knowledge of their illness and treatment. They were unaware of a quarter of both their illnesses and medications. There was a considerable lack of knowledge about certain groups of diseases and medications, while patients were much better informed about others. The possible reasons for this discrepancy are briefly discussed and some practical suggestions are put forward.