Showing papers in "Journal of International Medical Research in 1988"
TL;DR: It is shown that tizanidine/ibuprofen is more effective in the treatment of moderate or severe acute low-back pain than placebo and ib uprofen alone.
Abstract: This study reports on 105 patients with acute low-back pain given tizanidine (4 mg three times daily) plus ibuprofen (400 mg three times daily) or placebo plus ibuprofen (400 mg three times daily). Patients assessed their pain using visual analogue scales in a daily diary and the doctor assessed their condition at baseline and on days 3 and 7. Both groups were treated effectively, but earlier improvement occurred in patients given tizanidine/ibuprofen, particularly regarding pain at night and at rest. Doctors assessed the helpfulness of treatment: tizanidine/ibuprofen was significantly better than placebo/ibuprofen at day 3 (P = 0.05). Significant differences between treatments in favour of tizanidine/ibuprofen occurred in patients with moderate and severe pain at night (P less than 0.05), at rest (P less than 0.05) and those with moderate or severe sciatica (P less than 0.05). Significantly more patients given placebo/ibuprofen had gastro-intestinal side-effects compared with tizanidine/ibuprofen (P = 0.002). This supports previous work in animals showing that tizanidine mediates gastric mucosal protection against anti-inflammatory drugs. More patients given tizanidine/ibuprofen suffered drowsiness and other central nervous system effects (P = 0.025). In patients with severe acute low-back pain, however, some sedation and bed rest is advantageous. This study shows that tizanidine/ibuprofen is more effective in the treatment of moderate or severe acute low-back pain than placebo and ibuprofen alone.
112 citations
TL;DR: Results for pain at rest, pain at night, restriction of movement and pain on movement suggest that tizanidine may give greater improvement, earlier, in patients with severe acute low-back pain, and sedation, analgesia and bed rest might be beneficial and desired.
Abstract: Patients (112) with acute low-back pain of recent onset were recruited to this double-blind, randomized, placebo-controlled parallel group study in general practice to evaluate the efficacy and tolerability of the muscle relaxant, tizanidine They were treated for 7 days with tizanidine (4 mg three times daily) or matching placebo Aspirin tablets (300 mg) were taken as required as 'rescue' medication Symptoms were assessed by the patient and doctor before treatment, and after 3 and 7 days Patients recorded pain and aspirin consumption in a daily diary Both treatments were effective In patients who had taken no medication prior to entry, aspirin consumption was almost halved in the first 3 days of taking tizanidine compared with placebo (P = 0037) Results for pain at rest, pain at night, restriction of movement and pain on movement suggest that tizanidine may give greater improvement, earlier No serious drug-related adverse events or abnormal biochemistry or haematology were observed in either group Drowsiness occurred in 22% of patients taking tizanidine although, in patients with severe acute low-back pain, sedation, analgesia and bed rest might be beneficial and desired Considerably more patients given aspirin/placebo had gastro-intestinal side-effects (P = 0018) In conclusion, tizanidine may reduce the need for analgesics and be useful in the treatment of acute low-back pain
83 citations
TL;DR: This study showed that a non-absorbable derivative of rifamycin, rifaximin, has a satisfactory therapeutic efficacy in contaminated small bowel syndrome and is free of side-effects.
Abstract: In twelve patients affected by small bowel bacterial overgrowth, diagnosed by means of the lactulose hydrogen breath test, the therapeutic efficacy of a non-absorbable derivative of rifamycin, rifaximin, was evaluated. This study showed that this drug has a satisfactory therapeutic efficacy in contaminated small bowel syndrome and, at the doses tested, is free of side-effects.
65 citations
TL;DR: The results suggest that patients with rheumatoid arthritis may experience an increase in pain symptoms due to an alteration of mood, and therapy with tricyclic anti-depressants, such as dothiepin, may determine an improvement of pain indexes besides having an anti-Depressant effect.
Abstract: The effectiveness of dothiepin (a tricyclic anti-depressant) at a dose of 75 mg given orally at night was compared with placebo for 4 weeks in alleviating pain in 60 patients with classical or definite active rheumatoid arthritis. Patients were classified as either 'depressed' or 'not depressed'. The week before, during and 2 weeks after the study, 600 mg ibuprofen was given orally three times daily to all patients. Compared with placebo, dothiepin produced a significant reduction in daytime pain by the end of the treatment period. The Hamilton rating scale in 'depressed' patients was significantly improved in patients given dothiepin. The Cassano-Castrogiovanni self-evaluation rating scale in both 'depressed' and 'not depressed' patients showed a tendency (not significant) to be improved following dothiepin treatment compared with placebo. These results suggest that patients with rheumatoid arthritis may experience an increase in pain symptoms due to an alteration of mood. Therapy with tricyclic anti-depressants, such as dothiepin, therefore, may determine an improvement of pain indexes besides having an anti-depressant effect.
43 citations
TL;DR: It is concluded that cadexomer iodine significantly accelerates the healing of chronic, infected, treatment-resistant, venous ulcers in hospitalized patients.
Abstract: A total of 67 patients with treatment resistant chronic venous ulcers were admitted to hospital for 6 weeks of bed rest and daily dressings. The patients came from a rural area in Poland with poor socioeconomic conditions. They were randomized to treatment with either standard dressings or with cadexomer iodine. After 6 weeks all but four patients had shown a clear reduction of ulcer area; the mean reduction was 54% within the former group and 71% with cadexomer iodine. The latter treatment was significantly more effective than the standard hospital dressings in debriding the ulcer, accelerating healing and reducing pain. Elevation of serum concentrations of protein-bound iodine occurred after treatment with cadexomer iodine in patients with large ulcers, but tests of thyroid function showed no changes associated with the use of cadexomer iodine. It is concluded that cadexomer iodine significantly accelerates the healing of chronic, infected, treatment-resistant, venous ulcers in hospitalized patients.
37 citations
TL;DR: A randomized, double blind, double-dummy crossover study was carried out to compare the single dose effects of salbutamol administered from the widely used metered dose inhaler and a breath operated system (Diskhaler®).
Abstract: A randomized, double-blind, double-dummy crossover study on 42 asthmatics was carried out to compare the single dose effects of salbutamol administered from the widely used metered dose inhaler and a breath operated system (Diskhalers'). The bronchodilator response (change in forced expiratory volume in the first second) was almost identical for the two systems. The Diskhaler'" system however, since it is breath operated, obviates the need for hand- breath coordination.
34 citations
TL;DR: A mathematical model has been developed, however, to evaluate the speed, intensity and duration of the analgesic effect and provides data which significantly favour flupirtine maleate in the treatment of patients with post-operative pain.
Abstract: A controlled, parallel group study of the analgesic efficacy of flupirtine maleate, was compared against diclofenac sodium in 40 orthopaedic patients with post-operative pain. Clinically, both drugs were of equal analgesic efficacy. A mathematical model has been developed, however, to evaluate the speed, intensity and duration of the analgesic effect and provides data which significantly favour flupirtine maleate in the treatment of these patients.
33 citations
TL;DR: Both the single and the multiple doses of ketorolac tromethamine (10 mg) alleviated moderate to severe pain after gynaecological surgery as safely and efficaciously as paracetamol (1000 mg)/codeine (60 mg).
Abstract: In a randomized, double-blind, multiple-dose, parallel study of 107 patients, the safety and analgesic efficacy of single and multiple doses of orally administered ketorolac tromethamine (10–40 mg/...
31 citations
TL;DR: The diurnal variation in peak expiratory flow rate was reduced in the nedocromil sodium treated patients and there were no serious adverse reactions and no treatment related changes in haematological findings, blood biochemistry or urinalysis.
Abstract: A 3-month double-blind group comparative trial of nedocromil sodium (4 mg twice daily) and placebo was carried out in 30 adult asthmatic patients maintained on bronchodilator therapy. Fifteen patients received each treatment. Subjective (asthma symptoms and severity) and objective (lung function and use of concomitant medication) variables were measured to monitor the response to trial treatments. Significant differences in favour of nedocromil sodium for night-time asthma, daytime asthma, cough, daytime bronchodilator use and clinic assessment of forced expiratory volume during the first second of expiration were observed by week 4 of the trial. The diurnal variation in peak expiratory flow rate was reduced in the nedocromil sodium treated patients. There were no serious adverse reactions and no treatment related changes in haematological findings, blood biochemistry or urinalysis.
29 citations
TL;DR: Recent evidence indicates that flavoxate hydrochloride exhibits only weak anticholinergic activity on receptors involved in the control of the lower urinary tract.
Abstract: This article provides a review of the use of flavoxate hydrochloride in the treatment of urge incontinence. It outlines the pharmacology, mode of action, toxicology and pharmacokinetic studies which have been carried out, and then reviews the clinical studies, including those involving patients with benign prostatic hypertrophy. The effects of dosages of 600-1200 mg/day are compared, particularly regarding safety and tolerability factors. Finally, alternative therapies to flavoxate hydrochloride (alpha-adrenergic receptor blockers, oxybutinin chloride, terodiline hydrochloride, emepronium bromide and imipramine) are summarized. The article is written in the knowledge of recent evidence which indicates that flavoxate hydrochloride exhibits only weak anticholinergic activity on receptors involved in the control of the lower urinary tract.
28 citations
TL;DR: The pharmacokinetics of loratadine, a non-sedating anti-histamine, were studied in normal geriatric volunteers and inter-individual variation within each age group appears greater than any age effect.
Abstract: The pharmacokinetics of loratadine, a non-sedating anti-histamine, were studied in 12 normal geriatric volunteers. In an open label fashion, each volunteer received one 40 mg loratadine capsule. Blood was collected prior to and at specified times (up to 120 h) after dosing. Plasma loratadine concentrations were determined by a specific radioimmunoassay and those of an active metabolite, descarboethoxyloratadine, by high performance liquid chromatography. Concentrations of loratadine in the disposition phase were fitted to a biexponential equation and those of descarboethoxyloratadine to either a monoexponential or biexponential equation for pharmacokinetic analysis. Loratadine was rapidly absorbed, reaching a maximum plasma concentration of 50.5 ng/ml at 1.5 h after dosing. The disposition half-lives of loratadine in the distribution and elimination phases were 1.5 and 18.2 h, respectively. The area under the plasma concentration-time curve, was 146.7 h.ng/ml. Descarboethoxyloratadine had a maximum plasma concentration of 28.0 ng/ml at 2.9 h post-dose and an area under the concentration-time curve of 394.9 h.ng/ml. Its disposition half-lives in the distribution and elimination phases were 2.8 and 17.4 h, respectively. Comparison of these data with those from a previous study of loratadine in young adults showed no clear differences in the disposition half-lives between the two groups. The clearance of loratadine tends to be lower in the elderly, but inter-individual variation within each age group appears greater than any age effect.
TL;DR: An infectious aetiology, possibly a sub-clinical endometrial or ovarian infection, behind certain cases of pre-menstrual syndrome is postulated.
Abstract: Thirty patients with well-defined symptoms of pre-menstrual syndrome were randomly treated with the antibiotic doxycycline or placebo. The antibiotic-treated group showed a highly significant reduction of symptoms. Subsequent antibiotic treatment of the original placebo group similarly diminished the symptoms in this group. A 6-month follow-up demonstrated that the improvement in symptom scores was permanent and independent from the presence of the antibiotic. Luteal phase endometrial biopsies showed a high incidence of out-of-phase endometrium. An unexpectedly high percentage of endometrial biopsy cultures yielded positive findings for mycoplasma, Chlamydia trachomatis and anaerobic bacteria. There were no characteristic hormonal changes in this study group. An infectious aetiology, possibly a sub-clinical endometrial or ovarian infection, behind certain cases of pre-menstrual syndrome is postulated.
TL;DR: The anti-thrombotic effect of low molecular weight heparin was greater than for calcium hepar in patients with deep vein thrombosis and low molecular Weight Heparin improved maximum venous outflow in approximately half of the patients.
Abstract: This open controlled study compared the effects of subcutaneous administration of two types of heparin in two groups of 40 patients each with deep vein thrombosis. One group received calcium heparin and the other received low molecular weight heparin for 40 days in each case. Patients receiving low molecular weight heparin showed a greater increase in inhibition of activated factor X than those receiving calcium heparin. Both drugs slightly reduced activated partial thromboplastin time. No patient experienced pulmonary embolism during the study. At the end of the study, maximum venous outflow was significantly higher in patients given low molecular weight heparin than in those given calcium heparin. No major side-effects were observed. This study showed that: (a) the anti-thrombotic effect of low molecular weight heparin was greater than for calcium heparin; and (b) low molecular weight heparin improved maximum venous outflow in approximately half of the patients, possibly by promoting or accelerating recanalization of the vessel.
ALFA1
TL;DR: Compared with the control group, those who used low molecular weight heparin showed a significant increase of activated factor X inhibition and smaller increases in activated partial thromboplastin times.
Abstract: The prophylactic antithrombotic efficacy of a low molecular weight heparin was compared with a traditional unfractionated calcium heparin after orthopaedic surgery in 140 patients. Deep vein thromboses were detected in legs either by Doppler sonography or [125I]fibrinogen uptake tests in five (7.1%) and seven (10%) patients, respectively. The capacity of both drugs to prevent deep vein thrombosis was demonstrated. Compared with the control group, those who used low molecular weight heparin showed a significant increase of activated factor X inhibition and smaller increases in activated partial thromboplastin times. Tolerability of both drugs was good, with a low incidence of local side-effects.
TL;DR: The mechanisms of adriamycin-related cardiotoxicity, the effects of prenylamine and the benefit from combined treatment are discussed.
Abstract: Experimental and clinical trials to determine the potential of prenylamine in the prevention of adriamycin-related cardiotoxicity are reviewed. In mice given 4 mg/kg body weight adriamycin, the incidence of myocardial damage after 19 days' treatment was lower than in those given adriamycin and placebo. Rabbits were given adriamycin (total dose 10.8 mg/kg body weight), adriamycin plus prenylamine (1.5 mg/kg body weight), and adriamycin plus vitamins A (250 IU) and E (40 mg) for 9-11 weeks. Adriamycin-induced electrocardiogram changes were observed to a lesser extent in animals also receiving prenylamine. Heart homogenates from adriamycin-treated animals showed enhanced hydroperoxide-initiated chemiluminescence which was not affected by the simultaneous administration of prenylamine. The extent of adriamycin-induced myocytolysis and the degree of alterations observed on electron microscopy were markedly reduced by prenylamine. In a double-blind clinical trial with 26 oncological patients, no cardiomyopathy, arrhythmia or adverse reactions were observed in the group given adriamycin plus prenylamine. In those given adriamycin plus placebo, two patients developed congestive cardiopathy and another showed severe supraventricular arrhythmias together with hypotension and dyspnoea. The mechanisms of adriamycin-related cardiotoxicity, the effects of prenylamine and the benefit from combined treatment are discussed.
TL;DR: The main differences between this survey and other published data relate to the comparison of sleep reports from men with those from women, the sleep of nightshift and dayshift workers and the effects of caffeine and alcohol.
Abstract: A total of 2714 people, aged 20-45 years from the Brighton area who completed a questionnaire were interviewed on their sleep patterns and complaints, medication, behavioural aids, and consumption of caffeine and alcohol. Analysis showed that 24% had delayed sleep onset, 23% awakened frequently, 19% awakened early, 21% were dissatisfied with sleep, and 8% took medication to aid sleep. Of those on night shifts, 29% awakened frequently and 25% awakened early. There were 648 responses describing behavioural sleeping aids. The moderate consumption of caffeine and alcohol had no significant effect on sleep. The main differences between this survey and other published data relate to the comparison of sleep reports from men with those from women, the sleep of nightshift and dayshift workers and the effects of caffeine and alcohol. These differences may arise from sampling characteristics and the form of the questionnaire.
Journal Article•
TL;DR: It is confirmed that antihypertensive treatment with beta-blockers does not reduce left ventricular mass in patients with a left ventricle of normal size, as well as differences in the systemic and regional haemodynamic effects of the two drugs.
Abstract: The antihypertensive efficacy of a new beta-blocker, celiprolol, was compared with that of a well established antihypertensive drug, metoprolol. Systemic and forearm haemodynamic effects were investigated using echocardiography and two-dimensional pulsed Doppler flowmetry, respectively. Twenty hypertensive patients completed the double-blind crossover randomized study. Each 6-week active treatment period was both preceded and followed by 2 weeks of placebo treatment such that the total duration of the study was 18 weeks. Despite comparable efficacy in reducing systolic and diastolic blood pressures by approximately 10% of the basal value, the two drugs differed in their systemic and haemodynamic effects. Celiprolol significantly decreased forearm peripheral resistance and total peripheral resistance. Cardiac output remained unchanged and forearm blood flow was increased. Metoprolol reduced cardiac output through a reduction in heart rate, but stroke volume was unaltered. Neither drug significantly modified cardiac performance, as evaluated by left ventricular circumferential fibre shortening and left ventricular ejection fraction. Differences in the systemic and regional haemodynamic effects of the two drugs could account for the different blood pressure response seen in some patients. There was no observable change in left ventricular wall thickness or left ventricular mass. These results confirm previous reports which demonstrate that antihypertensive treatment with beta-blockers does not reduce left ventricular mass in patients with a left ventricle of normal size. It is generally accepted, however, that the ability of beta-blockers to reverse left ventricular hypertrophy is unrelated to the individual pharmacological characteristics of each agent.
TL;DR: Clinical tolerability of doxofylline proved to be good since no signs of local or general side-effects were observed in any of the patients treated and one out of 10 patients given placebo had improved clinically according to the patients' own opinion.
Abstract: This double-blind, randomized, placebo-controlled study investigated the therapeutic effects of a single dose of doxofylline, a methylxanthine derivative, in 10 patients aged 26–79 years. All patie...
TL;DR: It is suggested that ibuprofen may be administered routinely to patients receiving thiazides or propranolol without loss of control of the anti-hypertensive action of these drugs but it is recommended that individuals are monitored for possible weight gain or an increase in diastolic blood pressure.
Abstract: The effect of 1600 mg/day ibuprofen in two groups of patients with hypertension controlled by either propranolol or bendrofluazide was studied in a double-blind, double-placebo, randomized crossover trial. No significant difference in blood pressure was found at the end of the crossover period in either group, suggesting that the routine co-administration of ibuprofen does not attenuate the anti-hypertensive effect of thiazide diuretics or propranolol. Significant weight gain, attributable to fluid retention, had occurred in the bendrofluazide-treatment group by the end of the drug-free washout period. No significant change in mean weight occurred in the crossover stages in either group, although substantial weight gain was noted during ibuprofen treatment in two patients given bendrofluazide and one given propranolol. Biochemical variables were unaffected by ibuprofen throughout the crossover period. This study suggests that ibuprofen may be administered routinely to patients receiving thiazides or propranolol without loss of control of the anti-hypertensive action of these drugs but it is recommended that individuals are monitored for possible weight gain or an increase in diastolic blood pressure.
TL;DR: Results show that Brufen is superior to either Burana or Ibumetin when considering both the rate and extent of absorption, which is clinically interesting since a high and early plasma concentration of ibuprofen seems to be related to increased analgesic efficacy.
Abstract: The pharmacokinetic variables of ibuprofen 600 mg were investigated after administration of Brufen and compared to administration of Burana and Ibumetin. The investigation was carried out as a randomized single-dose crossover study in 17 healthy volunteers. The mean maximum plasma concentrations of ibuprofen were 58, 45 and 54 micrograms/ml after administration of Brufen, Burana and Ibumetin, respectively, the time to reach this being 1.4, 2.1 and 1.6 h, respectively, after administration. The differences between Brufen and Burana were significant. The relative bioavailability was very similar between Brufen and Burana but about 8% lower for Ibumetin and this difference between Brufen and Ibumetin was significant. Thus, different brands of ibuprofen may not be pharmacokinetically interchangeable and the results show that Brufen is superior to either Burana or Ibumetin when considering both the rate and extent of absorption. These findings are clinically interesting since a high and early plasma concentration of ibuprofen seems to be related to increased analgesic efficacy.
TL;DR: A randomized double-blind trial comparing 600 and 1200 mg/day flavoxate hydrochloride is currently underway, the results of which will be reported in due course.
Abstract: This preliminary communication reports on a non-randomized pilot type trial of 34 females with urgency after pelvic radiotherapy who were treated with flavoxate hydrochloride for 4 weeks. A dosage of 600 mg/day was given to 21 patients and 1200 mg/day to 13 patients. Clinically, both regimens achieved comparable results. Urodynamically (first desire volume, bladder capacity and pressure at capacity) treatment with 1200 mg/day was significantly superior to 600 mg/day. Both schedules were equally well tolerated by patients and no treatment interruption occurred. A randomized double-blind trial comparing 600 and 1200 mg/day flavoxate hydrochloride is currently underway the results of which will be reported in due course.
TL;DR: Aspirin–mefenamic acid in combination was more effective than both drugs alone, and aspirin and mefenamic acid alone were equally effective for most of the analgesic variables.
Abstract: A double-blind randomized single dose study of the analgesic effects of 650 mg aspirin, 250 mg mefenamic acid, the combination of 650 mg aspirin and 250 mg mefenamic acid and placebo on 120 patients with pain following oral surgery was conducted. Patients evaluated their pain intensity and extent of pain relief at 1, 2, 3 and 4 h after drug administration. For most parameters, including the sum of the pain intensity differences and the sum of the hourly pain relief scores, each of the drugs was more effective than placebo. Aspirin-mefenamic acid in combination was more effective than both drugs alone, and aspirin and mefenamic acid alone were equally effective for most of the analgesic variables.
TL;DR: A prospective randomized study was carried out to evaluate the efficacy of clavulanate-potentiated amoxycillin with that of cefotaxime as prophylactic agents for the prevention of sepsis following elective cholecystectomy.
Abstract: A prospective randomized study was carried out to evaluate the efficacy of c1avulanate-potentiated amoxycillin with that of cefotaxime as prophylactic agents for the prevention of sepsis following elective cholecystectomy. One hundred patients were randomized into two treatment groups. In the first group, each patient received a single intravenous dose (1200 mg) of c1avulanate potentiated amoxycillin 2 h before surgery. In the second group, patients were given intravenous cefotaxime, in three doses (2 g each) during surgery, and 6 and 12 h after their operation. No case of serious post-operative sepsis occurred in either group. Superficial wound infection occurred in 2% of patients receiving a single pre-operative dose of c1avulanate-potentiated amoxycillin and in 6% of those given cefotaxime according to the three-dose regimen.
TL;DR: The combination of aspirin and dipyridamole resulted in a significant decrease in platelet uptake and a nonsignificant trend towards prolongation of platelet half-life, suggesting that this combined therapy may be of benefit in the treatment of atherosclerosis in man.
Abstract: Eighteen patients with ischaemic peripheral vascular disease were treated for a 5-week period with either 20 mg aspirin daily, 75 mg dipyridamole three times daily or a combination of these two treatments. Before and after 4 weeks' treatment autologous platelet labelling with 111In was carried out and sites of active vascular platelet uptake monitored, and platelet half-life measured. Neither aspirin nor dipyridamole alone had any effect on platelet uptake or on platelet half-life. The combination of aspirin and dipyridamole resulted in a significant decrease in platelet uptake and a nonsignificant trend towards prolongation of platelet half-life. These findings suggest that this combined therapy may be of benefit in the treatment of atherosclerosis in man.
TL;DR: Flavoxate hydrochloride at a daily dosage of 600 mg was compared to adaily dosage of 1200 mg for the treatment of unstable bladder in a double-blind, randomized, parallel-group trial.
Abstract: Flavoxate hydrochloride at a daily dosage of 600 mg was compared to a daily dosage of 1200 mg for the treatment of unstable bladder. Twenty-seven patients were treated for 4 weeks in a double-blind, randomized, parallel-group trial. Clinically, both schedules were equally successful. In urodynamic terms, however, particularly with respect to uninhibited detrusor contractions, 1200 mg/day was significantly superior to 600 mg/day. Tolerability was excellent for both regimens. The side-effect free treatment of urgency and urge incontinence is of paramount importance for a patient's quality of life.
Journal Article•
TL;DR: C celiprolol and enalapril are both effective once-a-day antihypertensive agents, but celiprool provides a longer lasting protection from hypertensive peaks caused by exercise.
Abstract: Muscular exercise is the most common stress imposed on the cardiovascular system and, in hypertensive patients, it causes an exaggerated increase in the already elevated blood pressure. The evaluation of any antihypertensive drug must, therefore, include an investigation of its effects on the haemodynamic response to exercise. For this reason the effects of celiprolol and enalapril were studied in hypertensive patients, both at rest and during an exercise stress test performed on a bicycle ergometer. The haemodynamic changes observed were very similar at rest: both drugs consistently reduced blood pressure without impairing either myocardial geometry or function. The only between drug difference found at rest was slight bradycardia with celiprolol, whereas heart rate was unaffected by enalapril. By contrast, there was a marked difference in the effect on the blood pressure increase caused by muscular exercise: 24 h after dosing, celiprolol continued to attenuate the hypertensive response to exercise while enalapril failed to show any significant antihypertensive effect possibly because after this time there was a reduction in angiotensin converting enzyme inhibiting activity. Thus, celiprolol and enalapril are both effective once-a-day antihypertensive agents, but celiprolol provides a longer lasting protection from hypertensive peaks caused by exercise.
TL;DR: An ampicillin suppository was compared with amoxycillin suspension in the treatment of acute otitis media in children as discussed by the authors, and the overall clinical outcome was satisfactory (cured plus improved) in 89% of the patients given the suppository and in 86% given the suspension.
Abstract: An ampicillin suppository was compared with amoxycillin suspension in the treatment of acute otitis media in children. Both antibiotics were given three times daily for 5 days in a daily dose of 25 - 50 mg/kg body weight. Safety was evaluated in 454 patients in the group given suppository and in 229 given the suspension, and 421 and 229 patients, respectively, were evaluable for efficacy. Ampicillin was rapidly absorbed and produced plasma concentrations well above the minimum inhibitory concentration for common respiratory pathogens. The overall clinical outcome was satisfactory (cured plus improved) in 89% of the patients given the suppository and in 86% given the suspension. Gastro-intestinal disturbances occurred in 28.4% of the patients given the suppository compared with 14.4% of those given the suspension. Perianal irritation was recorded in 12.1 % of the patients given the suppository and in 5.2% of those given the suspension. Treatment was interrupted in 9.8% of patients given the suppository and in 0.9% of those given the suspension. In spite of these discomforts rectally administered ampicillin is considered to be a good alternative in children when oral medication is not feasible.
TL;DR: The results confirmed the therapeutical efficacy of miocamycin and amoxycillin in the oral therapy of bronchopneumonia and acute bronchitis in paediatric patients and the natural killer cell activity of patients treated with mioc amycin was increased on days 7 and 10 of therapy compared with baseline.
Abstract: The clinical efficacies of 50 mg/kg.day miocamycin and 60 mg/kg.day amoxycillin were studied in 23 patients aged 3-11.5 years with presumed bacterial infection of the lower respiratory tract (bronchopneumonia and acute bronchitis). During the therapy, which continued for 10 days, non-specific immune function, represented by natural killer cell activity, was monitored by measurement of the rate of lysis induced on target K-562 51Cr-labelled tumour cells. The results confirmed the therapeutical efficacy of miocamycin and amoxycillin in the oral therapy of bronchopneumonia and acute bronchitis in paediatric patients. The natural killer cell activity of patients treated with miocamycin was increased on days 7 and 10 of therapy compared with baseline. This finding did not occur in patients treated with amoxycillin.
TL;DR: No significant benefit could be demonstrated for giving ketotifen in this group of patients and a double-blind placebo-controlled trial was carried out to assess the efficacy of ketotIFen in the pre-school asthmatic.
Abstract: A double-blind placebo-controlled trial was carried out to assess the efficacy of ketotifen in the pre-school asthmatic. The trial period consisted of a I-month run-in period followed by a 4-month treatment period. Symptom scores for asthma, rhinitis, eczema and, where possible, twice daily peak flow measurements (24 cases) were recorded on diary cards by the parents. All concomitant medication used in addition to the trial drug was noted. The only medication not allowed was disodium cromoglycate. A total of 37 children, 23 boys and 14 girls, mean age 4.1 years (range 1.3-5.9 years) completed the trial. They comprised 19 given ketotifen and 18 given placebo. All were atopic and had allergic rhinitis and 15 had eczema. Ketotifen dosage was 1 mg twice daily in the under 5-year-olds (23 cases) and 2 mg twice daily in the remainder. On analysing the results no significant benefit could be demonstrated for giving ketotifen in this group of patients.
TL;DR: Oxaprozin is a promising therapeutic agent for ankylosing spondylitis and shows significant improvement in spontaneous pain of the vertebral spine and in morning stiffness after 6 weeks' treatment.
Abstract: The efficacy and tolerance of 1200 mg/day oxaprozin and 100 mg/day diclofenac sodium were compared in 40 patients with ankylosing spondylitis in a 6-week open study. Overall improvement was seen in the patients in both treatment groups. Oxaprozin-treated patients showed significant improvement in spontaneous pain of the vertebral spine and in morning stiffness after 6 weeks' treatment. There were no statistically significant differences between the treatment groups. Therapy was discontinued in 10 patients; five treated with oxaprozin (three because of intolerance and two because of worsening of symptoms) and five taking diclofenac sodium (four because of intolerance and one because of worsening of symptoms). Five (25%) oxaprozin-treated patients and six (30%) diclofenac sodium-treated patients had side-effects, with gastro-intestinal disturbances and dizziness reported most frequently. There were no statistically significant differences between the groups in the frequency of side effects. These results indicate that oxaprozin is a promising therapeutic agent for ankylosing spondylitis.