Biomedical subjects

H Bethge

Publications and source records attributed to H Bethge.

At least 19 recordsLinked to original sources

PubMed1998

[The thiazolidinones--a new therapeutic agent for type 2 diabetes].

Both, impaired beta-cell function and insulin resistance, predominantly of the skeletal muscle, are considered to be the key factors in the pathogenesis of type-2 diabetes (non-insulin-dependent diabetes; NIDDM). In the early stage of the disease, impaired insulin-mediated glucose disposal is accompanied by increased insulin secretion and hyperinsulinaemia. The thiazolidinediones (e.g. troglitazone), by improving insulin sensitivity of target tissues, appear to be a novel pathophysiologically interesting approach for the treatment of patients with NIDDM or impaired glucose tolerance. Troglitazone mainly elicits the following actions: Enhancement of insulin-mediated glucose disposal in patients with insulin resistance, impaired glucose tolerance and NIDDM, reduction of hyperglycaemia (blood glucose; HbA1c) and concomitant hyperinsulinaemia, improvement of dyslipidaemia in NIDDM. These actions are attained with monotherapy (200-600 mg once daily; plasma concentrations 0.3-3.0 micrograms/ml) or, with increased effects, when troglitazone is added to previously insufficient treatment with sulfonylureas or insulin. Potentially therapeutic actions with clinical relevance include (a) improvement of insulin resistance-associated hyperglycaemia-independent states of dyslipidaemia, (b) inhibition of LDL-oxidation and (c) amelioration of function and/or protection of beta-cells, an effect indicating to a beneficial modulation of the second pathogenetic relevant factor of NIDDM. Troglitazone appears to be well tolerated by the majority of patients. Post-marketing reports of partly severe liver injury including deaths from liver failure among Japanese and U.S. patients taking troglitazone require a critical evaluation of the benefit to risk ratio of the drug and a careful monitoring of the patients.

Animals↗

PubMed1991

Fidus.1903.

Explore the source record for details and available documents.

Gender Identity↗

PubMed1990

Sucralfate in the treatment and prevention of gastric ulcer: multicentre double blind placebo controlled study.

A randomised controlled multicentre trial was performed in 160 patients with gastric ulcer, proved by endoscopy and biopsy, to compare ulcer healing with sucralfate and ranitidine (double blind double dummy design) and to assess the effect of maintenance treatment with sucralfate on ulcer recurrence (double blind placebo controlled design). The healing rates were similar with 4 g sucralfate suspension per day and 300 mg ranitidine per day (82% and 88% after 12 weeks, respectively). Of the 109 patients with healed ulcers, 92 were entered into the maintenance trial and treated with sucralfate tablets (2 g per day) or placebo tablets. Maintenance treatment with sucralfate delayed symptoms of gastric ulcer recurrence. Lifetable analysis showed significant differences between sucralfate and placebo, both after six months (p = 0.018) and after 12 months (p = 0.044). The rates of symptom recurrences were 13% and 34% after six months and 34% and 55% after 12 months for sucralfate and placebo, respectively. The rate of asymptomatic recurrences after 12 months was similar in the two groups (9% and 10%, respectively). The recurrence rate was higher in patients who had never taken non-steroidal anti-inflammatory drugs than in those who had but had stopped on admission to the study. It was also higher in patients with recurrent ulcer and in those with scarring deformation and narrowing of the pylorus. Maintenance treatment with sucralfate slowed the appearance of symptom recurrences of gastric ulcer.

Adult↗

PubMed1989

[The 24-hour-effect of bisoprolol on blood pressure at rest and during stress].

In a multi-center study, 188 patients with mild to moderate essential hypertension were treated with the beta-1 selective beta blocker bisoprolol. Treatment was started with 5 mg bisoprolol once a day; if the aim of therapy, namely normalising (less than or equal to 90 mmHg) the diastolic blood pressure at rest (DBP-R) 24 hours after drug intake was not achieved, the dose was increased every two weeks to a maximum of 20 mg. With the individual dose established in this way, the patients were admitted to long-term treatment that was scheduled to last one year. Prior to and during bisoprolol therapy, bicycle ergometry studies were carried out up to a maximum of 100 watts. After only two weeks on 5 mg bisoprolol, both resting and exercise blood pressures were clearly reduced. By means of success-related dose increments, normalisation of the DBP-R was achieved in 79% of the patients by the end of the 6th week. The percentage of patients manifesting load-positive blood pressure reactions during exercise was reduced from 63 to 18%. On conclusion of one year of treatment, 33%, 56% and 11% of the patients were receiving 5 mg, 10 mg and 20 mg bisoprolol, respectively. On the basis of subjective and objective parameters, including laboratory examinations, bisoprolol was seen to be well tolerated even over the long term.

Adolescent↗

PubMed1987

Exercise blood pressure and heart rate reduction 24 and 3 hours after drug intake in hypertensive patients following 4 weeks of treatment with bisoprolol and metoprolol: a randomized multicentre double-blind study (BISOMET).

In a 4-week randomized, double-blind study, 87 patients with essential hypertension received either 10 mg bisoprolol (B) or 100 mg metoprolol (M) once daily (o.d.). The effects of the beta blockers on systolic blood pressure, heart rate and rate-pressure product during exercise, 24 h (E2) and 3 h (E3) after administration (p.a.) were compared with the values obtained in the baseline exercise test (E1). 24 hours p.a. the effects of B were significantly stronger than of M (E1-E2: B vs M; P less than 0.01) whereas 3 h p.a. no significant differences were detectable between B and M. The residual effects 24 h p.a. in relation to the effects 3 h p.a. (E1-E2/E1-E3) were significantly greater with B (86-93%) than with M (53-66%). In contrast to the findings with 100 mg M o.d., 10 mg bisoprolol o.d. guarantees a persistent reduction in exercise blood pressure and heart rate throughout the entire dosage interval of 24 h.

Adolescent↗

PubMed1986

Effects of single oral doses of bisoprolol and atenolol on airway function in nonasthmatic chronic obstructive lung disease and angina pectoris.

A randomized, placebo-controlled, double-blind crossover investigation in 12 patients with non-asthmatic chronic obstructive lung disease and co-existing stable angina pectoris was done to compare two beta 1-selective adrenoceptor blocking agents, atenolol 100 mg and bisoprolol 20 mg. Systolic and diastolic blood pressures (SBP, DBP), heart rate (HR) as well as airway resistance (AWR, and less frequently forced expiratory volume in 1 s (FEV1) and intrathoracic gas volume (ITGV) were measured in the sitting position before and at various times up to 24 h after drug intake. During the first 4 h both beta-blockers produced a significant reduction in HR in comparison to placebo (p less than 0.01). Atenolol 100 mg significantly increased AWR relative to placebo and bisoprolol (p less than 0.05). After 24 h, a significant reduction in HR (p less than 0.01) could only be demonstrated after bisoprolol, whereas atenolol alone led to a significant elevation in AWR relative to placebo and bisoprolol (p less than 0.05) at that time. It is concluded that bisoprolol appears to have a high degree of beta 1-selectivity, thus providing a wide split between beta 1- and beta 2-adrenoceptor blockade. Bisoprolol in its therapeutic dose range is expected to be relatively safe as regards bronchoconstriction in patients suffering both from hypertension and/or angina pectoris and chronic obstructive lung disease.

Adrenergic beta-Antagonists↗

PubMed1984

[Tolerance of nitrefazole in alcoholics with liver disease. A 4-week placebo-controlled double-blind study].

Liver damage is one of the most common organ manifestations of chronic alcoholism. The recovery process following abstinence should not be impaired by therapy with alcohol sensitizing drugs. In a double-blind multicentre-study (controlled against placebo) the liver tolerance of Nitrefazole which is indicated as an alcohol sensitizing agent for therapy of alcoholics, was tested during the first four weeks of a planned longterm therapy. A total of 62 patients with alcoholic liver disease--demonstrated clinically and in the laboratory--were tested. The patients received 800 mg of Nitrefazole (4 capsules a 200 mg), respectively 4 placebo capsules of identical appearance, once a week in the presence of the doctor. In both treatment groups there was a significant (p less than or equal to 0.01) decline of the previously pathologically altered laboratory values, especially concerning gamma-GT, GPT, GOT. The physical and mental condition which was additionally evaluated by the doctor improved within both treatment groups. The improvement of the liver functions due to abstinence is not delayed or impaired by Nitrefazole .

Adult↗

PubMed1983

Effect of sucralfate on peptic ulcer recurrence: a controlled double-blind multicenter study.

We entered 174 patients with healed duodenal ulcer and 77 with healed gastric ulcer into a double-blind, placebo-controlled, 6-month trial to investigate the efficacy of 1 g sucralfate twice daily in preventing ulcer recurrence. Endoscopy was performed after 6 months or earlier for symptoms compatible with ulcer disease. The relapse rate in the 126 patients with duodenal ulcer who could be evaluated for efficacy was 14/66 (21.2%) under sucralfate and 30/60 (50%) under placebo treatment (p less than 0.01). No significant difference in relapse rate was found in the 55 gastric ulcer patients who could be evaluated; 11 of 30 (37%) relapsed on sucralfate and 11 of 25 (44%) relapsed on placebo. Among the duodenal ulcer patients in the placebo group, those who had been treated initially with H2-receptor blockers for acute ulcer had significantly more relapses than patients who had been treated with other drugs. The recurrence rate was independent of prior treatment in the sucralfate group. Duodenal ulcer patients with a history of multiple episodes of active ulcer disease had a significantly higher rate of relapse than patients with only a few previous episodes. Both treatments were well tolerated. Two patients in each treatment group complained of nausea and epigastric pain immediately after drug intake. No other drug-related symptoms were observed. We conclude that sucralfate is effective in the prophylaxis of duodenal ulcer. No significant effect was found in the prevention of gastric ulcer recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum↗

PubMed1980