A double-blind study of misoprostol (SC-29333) in the healing of duodenal ulcer

In a double-blind randomized placebo controlled trial, 50 patients with endoscopically confirmed duodenal ulcer were treated with either misoprostol 200 micrograms or placebo in q.i.d. doses for 4-8 weeks. Of 25 patients in the placebo group, four defaulted and two were withdrawn due to worsening of symptoms. Of 25 misoprostol-treated cases, 17 cases (68%) and 21 cases (84%) healed at 4 and 8 weeks respectively, compared with three (14%) and five (24%) of the 21 placebo-treated cases (P less than 0.001). Except for diarrhoea in 2 patients in each group and itching in one with misoprostol, no serious side effects were noted.     

Effect of thiamine on glucose utilization in hepatic cirrhosis

Thiamine, an essential co-enzyme, improves glucose utilization. Thiamine hydrochloride (50 mg per capita per day for 30 days), given to 25 patients with liver cirrhosis who had hyperglycaemia, produced a significant reduction (P less than 0.001) in blood glucose levels. It is therefore suggested that thiamine supplements be given to cirrhotics with hyperglycaemia, to improve glucose utilization.     

Acute Lymphoblastic Leukaemia in Adults in the Northern Region of England - A Study of 75 Cases

Over a ten-year period we have studied 75 cases of adult acutelymphoblastic leukaemia (ALL) Sixty of the cases were seen from1979 to 1984 and represent an unselected series of all knowncases in a region of 3 000 000 people. Study of these patientshas given further insight into the heterogeneous, clinical andcytological nature of adult ALL. Three protocols have been usedand results are presented indicating that conventional approachesto treatment in this disease are unsatisfactory. Not all patientscould be entered on protocols but these patients are includedto give the overall perspective of this disease in clinicalpractice. A new strategy is proposed which envisages abandoningtraditional maintenance chemotherapy in favour of either allogeneicmarrow transplant or autologous transplant in first remissionin the post-consolidation phase. Preliminary results of thisflexible approach are given.     

Lithium-Induced Nephrotoxicity in Rats following Subcutaneous Multiple Injections and Infusion Using Mini-osmotic Pumps

The nephrotoxicity of the anti-manic-depressive drug lithium(Li) is well recognized but the effects of fluctuation in plasmalevels from different Li dosage regimens are not. Experimentswere done to compare the nephrotoxicity of Li in rats treatedeither with subcutaneous multiple injections (SMI) or by infusionusing mini-osmotic pumps (MOP) vs concurrent controls. A doseof 2 meq/kg/day of LiCl dissolved in saline was given for 8consecutive days. During treatment, the animals were kept inindividual metabolism cages and their plasma Li levels, waterintake, urine volume, pH, and osmotality were monitored daily.In the SMI group, average daily plasma Li levels, 30 mm postinjectionand just prior to the next injection, were 2.6 and 0.34 meq/liter,respectively. The daily mean plasma Li level in the MOP groupwas 0.39 meq/liter. While both Li treatment groups showed evidenceof toxicity not seen in the respective controls, overall differencesin the nephrotoxic response between the Li regimens emergedon Days 6 to 8. Thus water consumption and urine volume wereboth raised with SMI and by Day 8 the urine osmolality was reduced(all p < 0.05). The results indicate that after administeringequivalent amounts of Li, SMI treatment produced a higher degreeof nephrotoxicity than the MOP treatment.