An evaluation of increasing doses of ranitidine for treatment of heartburn

BACKGROUND: This was a randomized, double-blind, placebo-controlled, multicentre, parallel group, dose-ranging trial of ranitidine tablets for relief of episodic heartburn. Adult out-patients who reported heartburn relieved by antacids at least seven times per week were eligible. METHODS: Patients who successfully completed a 1-week single-blind placebo run-in phase and who did not achieve adequate relief in more than 50% of heartburn episodes were randomized to a 1-week, double-blind treatment phase during which they received ranitidine doses of 25, 75 or 125 mg, or placebo. RESULTS: Of 577 patients randomized, 566 had at least one evaluable heartburn episode and were included in the intention-to-treat analysis. All three ranitidine doses were statistically significantly superior to placebo in providing overall episodic heartburn relief for the first episode (P < 0.002), last episode (P相似文献   

A double-blind, placebo-controlled study of the efficacy and safety of non-prescription ranitidine 75 mg in the prevention of meal-induced heartburn

BACKGROUND: Ranitidine 75 mg (Zantac 75) has been shown to be effective for the treatment of pre-existing heartburn symptoms. AIM: To compare the efficacy of dosing ranitidine 75 mg or placebo 30 min prior to a proven heartburn-provoking meal in completely preventing or reducing subsequent heartburn symptoms. METHODS: A randomized, double-blind, parallel methodology was used at nine investigative centres. Following a screening visit, patients ate a standard test meal consisting of chili, chips and a soft drink on two occasions. On the first occasion, patients received single-blind placebo 30 min before the meal. This meal was used to qualify patients and to ensure the onset of a minimum level of heartburn. Patients who qualified were randomized (n = 284) to receive double-blind ranitidine 75 mg or placebo 30 min before a second test meal administered 4-14 days later at the treatment visit. Patients recorded whether heartburn was present and rated heartburn severity by completing visual analogue scales at 15-min intervals over the 4. 5 h meal evaluation periods. RESULTS: Statistically significant differences favouring ranitidine 75 mg were determined for complete prevention of heartburn (P < 0.006), heartburn severity area under the curve (P < 0.001), a clinical success end-point (P < 0.001), and all other end-points (P < 0.001). CONCLUSIONS: These data clearly demonstrate that ranitidine 75 mg is effective in completely preventing or decreasing heartburn when administered 30 min prior to a provocative meal.     

Fever and evoked potentials in multiple sclerosis

Summary The somatosensory evoked potentials (SEPs) and visual evoked potentials (VEPs) were studied in 19 patients with multiple sclerosis; 17 controls were studied during fever (38.0°–39.7°C) and 2–3 days following return to normal temperature. The latencies of components N₂₀ and P₁₁₄ were measured and specified as abnormal when their value exceeded the standard deviation of the controls by 2.5 times. The corresponding criterion for the evaluation of the amplitude of components N₂₀ and P₁₁₄ was a reduction in amplitude of more than 50%. In the controls fever did not cause significant changes in evoked potentials. On the other hand, patients with multiple sclerosis showed abnormalities in evoked potentials during fever in a greater number of recordings (26 of SEPs and 33 of VEBs) than after return to normal temperature (19 and 27 respectively). In addition, the average latency of components N₂₀ and P₁₁₄ was clearly greater in the patients during fever (N₂₀=29.5±5.2 ms and P₁₁₄=143±18.1 ms) than after return to normal temperature (N₂₀=6.6±3.5 ms and P₁₁₄=134±16 ms). The amplitude of components N₂₀ and P₁₁₄ in patients during fever was clearly smaller than after return to normal temperature. These differences were statistically significant. Finally, in two patients, a decrease was found, during fever, in the conduction velocity of the peripheral somatosensory pathway from the median nerve to the wrist at Erb's point.

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Zusammenfassung Wir studierten die somatosensorisch evozierten Potentiale (SSEP) sowie die visuell evozierten Potentiale (VEP) bei 19 Patienten mit Multipler Sklerose und 17 Kontrollpersonen. Die somatosensorisch und visuell evozierten Potentiale wurden in beiden Gruppen unter dem Einfluß von Fieber als auch zwei bis drei Tage nach dem Abklingen des Fiebers untersucht.Die Latenzzeit der Komponenten N₂₀ und P₁₁₄ wurde als pathologisch bewertet, wenn ihre Werte 2,5 Standardabweichungen über dem Mittelwert von Normalpersonen lagen.Der entsprechende Maßstab für die Bewertung der Höhe der Komponenten N₂₀ und P₁₁₄ war eine Höheminderung über 50%.Wir fanden, daß Fieber bei den Kontrollpersonen keinen wesentlichen Einfluß auf SSEP und VEP hatte. Bei den MS-Patienten haben wir wesentlich mehr Abnormitäten der SSEP und VEP während des Fiebers (26 SSEP und 33 VEP) als nach dem Abklingen des Fiebers (19 SSEP und 27 VEP).Darüber hinaus war der Mittelwert der Latenzzeit der Komponenten N₂₀ und P₁₁₄ bei den MS-Patienten während des Fiebers höher (N₂₀=29,5±5,2 ms; P₁₁₄=143±18,1 ms) als nach dessen Abklingen (N₂₀=26,6±3,5 ms; P₁₁₄=134±16,8 ms).Abgesehen davon war die Höhe der Komponenten N₂₀ und P₁₁₄ während des Fiebers wesentlich kleiner als nach dem Abklingen des Fiebers.Diese Unterschiede sind statistisch signifikant.Ferner fanden wir während des Fiebers bei zwei Patienten eine Verminderung der Erregungsleitungsgeschwindigkeit im N. medianus zwischen Handgelenk und Erbschen Punkt.

     

Chelators controlling metal metabolism and toxicity pathways: applications in cancer prevention, diagnosis and treatment

Chelating drugs and chelator metal complexes are used for the prevention, diagnosis and treatment of cancer. Cancer cells and normal cells require essential metal ions such as iron, copper and zinc for growth and proliferation. Chelators can target the metabolic pathways of cancer cells through the control of proteins involved in the regulation of these metals and also of other molecules involved in cell cycle control, angiogenesis and metastatic suppression. Other targets include the inhibition of specific proteins such as ribonucleotide reductase involved in DNA synthesis, the inhibition of free radical damage on DNA caused by iron and copper catalytic centers, the inhibition of microbial growth in immuno compromised cancer patients and the decorporation of radioactive and other toxic metals causing cancer. Chelating drugs and metal ions can affect the metabolism, efficacy and toxicity of anti-cancer drugs such as doxorubicin, mitozantrone, bleiomycin and hydroxyurea (HU). Although many experimental chelators have been shown to be effective as anti-cancer agents, only a few, e.g., dexrazoxane, deferoxamine (DFO) and triapine, have reached the stage of clinical testing or application. In many experimental models, deferiprone (L1) has been shown to be effective in cancer prevention and treatment, and in the inhibition of doxorubicin-induced cardiotoxicity. New anti-cancer drugs could be developed using chelators and chelator complexes with platinum and other metals, and also new protocols of combinations of chelators with known anti-cancer drugs.     

Efficacy of intravenous immunoglobulin in the treatment of thrombotic thrombocytopaenic purpura. A study of 44 cases

Thrombotic thrombocytopaenic purpura (TTP) is characterised by platelet aggregation in the capillaries, thrombocytopaenia and microangiopathic haemolytic anaemia that result in organ ischaemia, mainly of the CNS and kidneys. Since the institution of plasma exchange therapy no further treatments have been proved to improve the survival and the relapse rate of TTP patients. In this retrospective study, we evaluated the efficacy of normal human immunoglobulin treatment in 44 patients suffering from TTP. Patients were divided into two groups that either did not receive (group A: 15 patients) or received (group B: 29 patients) 400 mg/kg of human normal immunoglobulin intravenously (ivIgG) for 5 days. All patients received treatment with corticosteroids, anti-platelet agents and plasma exchange. The results clearly showed that there was no statistically significant difference between the two groups in either remission rate or time to relapse following remission. In conclusion, this study did not prove any beneficial effect of ivIgG in the treatment of TTP patients.     

Post‒cataract surgery endophthalmitis outbreak caused by multidrug-resistant Pseudomonas aeruginosa

In June 2010, a severe outbreak of 13 cases of post-cataract surgery endophthalmitis caused by multidrug-resistant Pseudomonas aeruginosa occurred. Pulse-field gel electrophoresis in eye isolates found 95% genetic similarity; however, extensive environmental and carriage investigation revealed no source of infection.