PubMed Health⌕ Search

Biomedical subjects

M Dreyer

Publications and source records attributed to M Dreyer.

At least 55 records · Page 3Linked to original sources
PubMed1989

[Lowering of the plasma lipid concentration with lovastatin. A clinical study in patients with primary hypercholesterolemia].

A study of 27 patients (18 males and 9 females; median age 57 [35-70] years) with hypercholesterolaemia examined the lipid-reducing effect, clinical reliability and tolerance of lovastatin, an HMG-CoA-reductase inhibitor, given in a single evening dose. After a four-week period on placebo and a lipid-reducing diet the patients received 20 mg lovastatin for four weeks. If, at the end of this period, total cholesterol levels were still above 200 mg/dl, the dose was increased to 40 mg, after a further four weeks to 80 mg. After a three-month treatment period total cholesterol concentration in lovastatin-treated patients was 28% lower than in the placebo group (289.4 +/- 42.2 vs 208.0 +/- 39.9 mg/dl; P less than 0.0001). LDL-cholesterol concentration had fallen by 40% (215.1 +/- 44.4 vs 130.1 +/- 24.7 mg/dl; P less than 0.0001), while plasma triglyceride concentrations had fallen by 15% (166.3 +/- 71.8 vs 141.8 +/- 69.8 mg/dl; P less than 0.01). At the same time, HDL-cholesterol levels had risen by 12% (42.9 +/- 12.4 vs 47.9 +/- 18.2 mg/dl; P less than 0.01). These results confirm the marked lipid-reducing effect of lovastatin.

Adult↗
PubMed1989

[Inhibition of 24-hour acidity by nizatidine].

In a randomized, double-blind, placebo-controlled, comparative cross-over study, we studied the effect of four H2-receptor antagonists on intragastric 24-hour acidity, nocturnal volume and acid output. Ten healthy male volunteers were administered 300 mg or 150 mg nizatidine, 800 mg cimetidine, 300 mg ranitidine, 40 mg famotidine, or placebo on several days, in each case at 9:000 PM. Nocturnal intragastric H+ concentration (mmol/l) (11:00 PM to 7:00 AM) was significantly reduced by all H2 blockers compared with placebo. We obtained the following inhibition rates: Cimetidine 67%; ranitidine 95%; famotidine 89%; nizatidine 80% (300 mg) and 69% (150 mg). Nocturnal acid (mmol/l) and volume output (ml/h) were also significantly (compared with placebo) inhibited by all four H2-receptor antagonists. Inhibition of nocturnal acid secretion was almost identical on nizatidine 300 mg nocte, ranitidine 300 mg nocte, famotidine 40 mg nocte, and cimetidine 800 mg nocte. Nizatidine 300 mg nocte and 150 mg nocte exclusively reduced acid secretion at night, without an aftereffect into the following day (8:00 AM to 6:00 PM). These results suggest that the clinical efficacy of these H2-receptor antagonists is identical with respect to healing peptic ulcer disease and providing freedom from pain. It is generally accepted today that gastric acid inhibitors used in the treatment of peptic ulcer disease should interfere with daytime gastric acid secretion as little as possible, particularly since the acid protects the stomach from bacteria ingested with the food during the day.

Cimetidine↗
PubMed1989

A new familial syndrome with impaired function of three related peptide growth factors.

We describe a new familial syndrome in three siblings; it is biochemically characterized by a combined defect of the action of the three related peptides insulin, insulin-like growth factor I (IGF I) and epidermal growth factor (EGF). Clinically, the disease has features of Werner syndrome with lipodystrophy, scleroderma-like alterations of the skin, alterations of the skeleton and contractures of joints. In addition, one of the patients has an insulin-resistant diabetes mellitus. Studies with cultured fibroblasts obtained from skin biopsies show a markedly reduced stimulation of RNA synthesis by the three growth factors and a decreased insulin stimulation of 2-deoxy-D-glucose uptake as compared with normal controls. Receptor binding of the three peptides occurred with normal capacity and affinity. We conclude that the signal transfer of different growth factors has a common denominator at the postreceptor level.

Adult↗
PubMed1989

Rioprostil in the acute and long-term treatment of peptic ulcers: a review.

The new prostaglandin E1 analogue, rioprostil, significantly accelerates healing and the elimination of pain in cases of peptic ulcer. The anti-ulcerous potency of this prostaglandin is equivalent to that of cimetidine. In comparison with ranitidine, there is a positive trend in favour of the H2-receptor antagonist, ranitidine, which has a more pronounced antisecretory effect than rioprostil. The differences in the healing rates during treatment with rioprostil and ranitidine are statistically significant in some cases, whereas those relating to pain alleviation are not. In contrast, the therapeutic efficacy of the two substances is almost identical in cases of Ulcus ventriculi. Rioprostil can be used with much the same success as ranitidine for preventing the recurrence of duodenal ulcers. The frequency of diarrhoea during rioprostil treatment, 300 micrograms b.d. and 600 micrograms nocte, is approximately 10%. In only about 1% of the patients does the rioprostil treatment have to be discontinued because of this adverse reaction.

Anti-Ulcer Agents↗
PubMed1989

A single evening dose of rioprostil, 600 micrograms, in the treatment of acute duodenal ulcers.

When administered as 300 micrograms b.d. or as 600 micrograms once in the evening, the new prostaglandin E1 analogue, rioprostil, is capable of reducing nocturnal H+ activity (1200 h to 0800 h) by 52% and 74%, respectively (p less than 0.01). Diurnal acidity (0900 h to 1800 h), on the other hand, is only reduced by 33% and 15% (not significant). A single evening dose of rioprostil, 600 micrograms, is used successfully on 208 patients suffering from acute duodenal ulcer. After 2 weeks and 4 weeks of treatment, the healing rates are comparable to the high values obtained with ranitidine, 300 mg nocte (rioprostil, 600 micrograms nocte: 54.1% and 84.1%; ranitidine, 300 mg nocte: 54.4% and 89.9%). There are also no significant differences between the groups as regards symptomatic improvement. Severe diarrhoea and abdominal complaints do not occur with rioprostil, 600 micrograms nocte.

Adult↗
PubMed1989

[Single evening administration of a new antimuscarinic agent telenzepine in therapy of acute duodenal ulcer. Results of a randomized double-blind comparative study versus pirenzepine].

A multicenter, double-blind, randomized controlled study was conducted in 314 duodenal ulcer patients to compare the efficacy and safety of the antimuscarinics telenzepine and pirenzepine in the treatment of duodenal ulcer. Patients received telenzepine 3 mg (156) once-daily at bedtime or 50 mg pirenzepine (158) two times daily for 2 weeks. If ulcerous lesions persisted treatment was extended to 4 weeks. Efficacy was assessed by relief of ulcer pain and endoscopic findings of ulcer healing. Safety was determined on the basis of side effects and results of laboratory tests. The 2- and 4-week healing rates achieved with telenzepine were 21.1 and 67.3%, respectively, and with pirenzepine they were 20.0 an 69.0%, respectively; the differences in healing rates for the two drugs were not statistically significant. Similarly both drugs provided satisfactory relief of pain. The incidence of untoward effects was 24.5% with telenzepine and 29.7% with pirenzepine, dryness of mouth being most prominent (20.4 vs. 19.3%). With telenzepine blurred vision was reported in a significantly lower rate compared to pirenzepine (0.7 vs. 4.2%, p less than 0.05). Clinically relevant abnormal laboratory tests were not observed. The present study shows for the first time that the newly developed antimuscarinic drug telenzepine is in a single nocturnal dosage regimen (3 mg nocte) as effective as pirenzepine (50 mg bid) in the treatment of duodenal ulcer.

Adult↗
PubMed1989

[Childhood obesity as a symptom of genetic syndromes].

The authors describe on examples from the practice of a genetic clinic seven different genetic syndromes associated with obesity: Laurence-Moon-Biedl, Alström, Weiss, Cohen, Carpenter, Prader-Willi and syndrome of insulin resistance. The autosomal recessive determination of the majority of these syndromes emphasizes their genetic impact with a high risk of repeated occurrence in the family. Visual and hearing defects increase clinical and social importance of these syndromes. When evaluating the genetic prognosis of risk families, the authors consider the possibility of prenatal diagnosis and its forms and the risk of implementation of a preventive method. In some instances obesity is a manifestation of a disorder of insulin receptors.

Abnormalities, Multiple↗
PubMed1988

Optimal reduction of gastric acid secretion in the treatment of peptic ulceration.

Pronounced and sustained inhibition of acid secretion is currently the therapeutic principle most frequently applied in the treatment of peptic ulcer disease. Since theoretically short term risks of complete inhibition of acid secretion cannot be totally ruled out, anti-secretory anti-ulcer drugs should interfere as little as possible in the physiology of gastric acid secretion. This concept is presently best achieved through the single bedtime dose of H2-blockers, which has been shown to be as effective as a twice daily dosage regimen in peptic ulcer disease. This reduces only nocturnal acid secretion, while daytime acidity remains unaffected. But there is a close correlation between the extent of the reduction of nocturnal acid secretion, healing rates and pain relief. Additionally, large clinical trials with peptic ulcer patients have shown that after 14 days' treatment with H2-blockers 30 to 50% of patients still complain about ulcer pain and about 20 to 40% of patients take supplementary antacids. As a result of this there is undoubtedly a need for an additional medication that produces a more pronounced reduction of acidity than current treatment with H2-receptor antagonists as a single evening dose. Obviously this dosage regimen does not always fulfil the therapeutic requirements (i.e. pain relief) of the individual patient. Therefore a more flexible form of application should be introduced. In general clinical use it is not feasible to identify patients with a higher treatment requirement by acid secretion analysis. However, what is feasible is the recommendation to increase the dose and frequency of administration of H2-blockers in relation to the symptoms of pain.

Depression, Chemical↗
PubMed1987

What are the current possibilities in treating peptic ulcer disease?

There are two major principles of ulcer therapy. Today, the most widely accepted drugs are those which substantially reduce aggressive factors (i.c. acid and pepsin), namely histamine H2-receptor antagonists, antimuscarinics and antacids. Less frequently applied are mucoprotective agents like colloidal bismuth compounds and sucralfate. Prostaglandins both reduce acid secretion substantially and are believed to enhance mucosal resistance. Their anti-ulcer efficacy, however, is solely explicable by their antisecretory activity. Although mucosa-strengthening agents and H2-receptor blockers have nearly identical healing rates, mucosa-strengthening agents have inconvenient dosage regimens (four times or twice daily) and are probably less effective in relieving pain. The same holds true for antacids. Prostaglandins, antimuscarinics and antacids have dose related side effects. In contrast, H2-receptor blockers are characterized by a clear mechanism of action, convenient dosage regimens, good tolerance and a low incidence of side-effects. H2-receptor antagonists are the most effective anti-ulcer drugs presently available.

Anti-Ulcer Agents↗
PubMed1987

[H2 receptor antagonists in the therapy of peptic ulcer disease].

Today histamine-H2-receptor antagonists are the most intensively investigated drugs in the therapy of acid related diseases. They are characterized by a clear mechanism of action, a convenient application form, a high tolerability, a low incidence of side effects, and a large therapeutic window. The single nocturnal dosage regimen of H2-blockers follows the concept to reduce substantially night time acidity only, which is believed to play a decisive pathogenetic role in peptic ulcer disease, while during day time physiological acid secretion remains unaffected. The clinical efficacy of this application form has been well documented in the healing and symptomatic relief of acute peptic ulcers. However, about 30% of patients still suffer from ulcer pain after a 2 weeks treatment period. A more flexible dosage regimen, which is more adapted to the ulcer symptoms of the patient will probably lead to even better clinical results.

Anti-Ulcer Agents↗
PubMed1986

Prolonged plasma half-life of insulin in patients with a genetic defect of high affinity binding sites.

Plasma clearance of endogenous and intravenously administered insulin was studied in three sibs with severe insulin resistance secondary to an affinity defect of their insulin receptors, and in five healthy controls. Intravenous infusion of somatostatin was used to inhibit the insulin secretion. 0.3 U of insulin/kg body weight was administered as an intravenous bolus. Plasma glucose, immunoreactive insulin and C-peptide were determined subsequently at constant intervals. We found a prolonged plasma half-life of insulin in the three patients, being 33.5 +/- 11.8 min vs 8.2 +/- 2.2 min in controls, P less than 0.002, but a normal half-life of C-peptide. The result indicates, that the plasma insulin clearance is predominantly mediated by intact insulin receptors. We conclude, that insulin has a prolonged half-life in all patients with insulin resistance secondary to an impaired receptor function.

Adult↗
PubMed1986

Nocturnal acid suppression with a new H2 receptor antagonist--nizatidine.

To determine the potential efficacy of bedtime doses of the new furan H2 receptor antagonist nizatidine in the suppression of nocturnal acid secretion, this randomized, crossover, single-blind study was performed in 10 healthy male subjects. The actions of a single bedtime (21:00 hour) dose of the H2 receptor antagonists nizatidine (150 mg and 300 mg), ranitidine (300 mg) and cimetidine (800 mg), as well as placebo on nocturnal gastric acid and volume secretion (01:00 to 07:00 hours, and on overall 24 hour H+ ion concentration were studied. Compared with placebo, night-time (23:00 to 07:00 hours) H+ ion concentration was reduced by 70, 79, 95, and 76% (p less than 0.05-p less than 0.01). Nocturnal acid secretion, too, was significantly lower for the H2 blockers than for placebo (p less than 0.05-p less than 0.01). A significant reduction in night-time gastric volume secretion was observed in the hourly intervals from 04:00 to 07:00 hours and in total volume in the whole 6 hours period (p less than 0.05-p less than 0.01). Nizatidine 300 mg nocte, ranitidine and cimetidine significantly decreased H+ concentration for only 1 hour (08:00 to 09:00 hours, p less than 0.05-p less than 0.01) during the subsequent daytime period (08:00 to 13:00 hours). Since no significant pharmacodynamic differences between nizatidine 300 mg nocte, cimetidine 800 mg nocte and ranitidine 300 mg nocte were observed, it may be concluded that at the doses employed, these three H2-blockers will all be similarly effective in the acute therapy of peptic ulcer disease.

Adult↗