A double-blind comparison of two different treatments for acute enteritis in adults.
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Biomedical subjects
Publications and source records attributed to E Camarri.
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Daily administration of 900 mg dihydroxydibutylether (DHBE) produced a significant reduction of lithogenic index in patients with cholesterol gallstones. After treatment with placebo, in the same subjects the lithogenic index rises significantly. The activity of DHBE is not casual.
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Diagnostic and prognostic significance of total bile acids concentrations has been evaluated in 26 patients with acute viral hepatitis. The levels of fasting and post-prandial blood cholates have been compared with the values found in normal subjects, in 20 patients with extrahepatic pathology and in 10 cases of non-viral icteric diseases. A remarkable rise in serum bile acids concentration has been showed in acute stage of hepatitis; the level of cholates is significantly higher in cholangitic jaundice, but difference is not found in respect of patients with extrahepatic cholestasis. The improvement of disease decreases the serum bile acids concentration; the decrease going on at the same rate of serum transaminases lowering but preceding the serum bilirubin one. No difference was found between fasting and post-prandial blood cholates. In conclusion, serum bile acids concentration has no diagnostic value in hepatitis, nevertheless it seems an useful test for monitoring the course of the hepatitic disease.
Oral administration of 900 mg daily of dihydroxydibutylether to patients with cholesterol stones in the gall-bladder, reduced the lithogenic index of the bile, whose mean value shifted from 1.64 to 1.03 (p less than 0.01) after 20 days of treatment. Reduction of lithogenic index must be ascribed exclusively to the reduced biliary concentration of cholesterol.
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Administration of 500 mg/day chenodeoxycholic acid for 60 days in a series of 44 patients with type IV dyslipidaemia led to gradual normalisation of triglycerides by the end of the treatment. Falls were greater in subjects with initially higher values, but were independent of age, sex, weight and type of diet. Further falls were obtained by repeating the treatment in some cases when prebetalipoproteins rose again. Decreases were already evident by the 5th day (about 24%) and could be obtained with only 4 mg/Kg/day. The rapid effect of the acid and its specific action on prebetalipoproteins were demonstrated by examination of lipid curves after a glyco-lipid load with and without pretreatment with chenic acid. Encouragement of the shunt of triacylglycerols towards the phosphoglycerides during hepatic synthesis of triglycerides is put forward as the most likely mechanism of action in endogenous hyper-triglyceridaemia. The chemical composition of bile is interfered with, which may explain why cholesterol lithiasis is significantly more common in type IV dyslipidaemia than in other forms and in controls, as shown by statistical analysis.
The effect of chenodeoxycholic acid on the fasting serum triglycerides was studied in 30 patients with type IV hyperlipemia and in 20 patients with primary gout and associated endogenous hypertriglyceridemia, the triglycerides being determined before treatment and at monthly intervals for three months. Chenodeoxycholic acid treatment resulted in a significant lowering of the serum triglycerides in both groups of patients. The drug was well tolerated and there were no undesirable side-effects. Although the mechanism of action is still not known, the drug is thought to reduce triglyceride synthesis in the liver. Chenodeoxycholic acid appears to be electively indicated in type IV hyperlipemia treatment.
Administration of chenodeoxycholic acid (CDCA) to patients with primary hypertriglyceridemia caused the diminution of serum triglyceride concentrations of 54.31% and 46.04% at dosages of 500 mg/day and of 250 mg/day, respectively. Results after 1 month of treatment with 250 mg/day are not statistically different from those obtained with 500 mg/day. Administration of CDCA did not change the serum cholesterol, SGOT, SGPT, total bilirubin, gammaGT or alkaline phosphatase levels.
Administration of chenodeoxycholic acid (CDCA), 200 mg/day, for 5 days to patients with primary hypertriglyceridemia reduced by 34% the serum triglycerides concentration. Reduction after CDCA is statistically significant vs. the placebo. Even after a short time of CDCA administration, the pharmacological effect is clearly evident.
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