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Biomedical subjects

M Lazzaroni

Publications and source records attributed to M Lazzaroni.

At least 73 records · Page 4Linked to original sources
PubMed1989

The effect of an oral morning dose of nizatidine and ranitidine on gastric acid secretion in duodenal ulcer patients.

The aim of this study was to compare the inhibitory effect and duration of action of a new H2-antagonist, nizatidine (150 mg per os), with ranitidine (150 mg per os) in a group of 10 patients with healed duodenal ulcer. The total inhibitory effect on acid output observed under basal conditions (30 min), during pentagastrin stimulation (120 min) and after stimulation (60 min), is overlapping. However, nizatidine showed a more rapid inhibitory activity -80%, and 31% higher than ranitidine with regard to basal acid output and maximum acid output, during the first hour of stimulation. On the other hand, ranitidine has a more prolonged antisecretory action--more than 27% and 54%, respectively, with regard to maximum acid output during the second hour and the period after hormonal stimulation. Also, variations in pepsin and acid output resulted in overlapping. In conclusion, these results, explainable by the pharmacodynamic property of the two drugs, confirmed the excellent inhibitory capacity of nizatidine, and furnish another reason for its use in clinical practice.

Adult↗
PubMed1989

Comparison of qid and bd administration of De-Nol in the short term treatment of duodenal ulcer.

One hundred and twelve patients (80 males, 32 females) with endoscopically proven gastroduodenal ulcer participated in a clinical trial to compare the ulcer-healing effect of colloidal bismuth subcitrate (CBS) at standard dosage, administered either twice daily (Group A) or four times a day (Group B). Endoscopic control was programmed at Week 4 and Week 8, in case of delayed healing. With an 'intention to treat' analysis, the healing percentage at four weeks was 69.6 for Group A and 82.1 for Group B (IC95 of percentage difference: -0.049 to 2.29). At Week 8, the healing percentage for Groups A and B was 87.5 and 94.6 per cent respectively (IC95: -0.05 to 0.19). The mean steady-state values of bismuth levels in plasma were well below the threshold value of 50 micrograms/l. The data confirm the efficacy and acceptability of CBS swallowing formulation tablets and suggest that administration twice daily is an acceptable alternative to the qid schedule.

Adult↗
PubMed1988

Effect of mifentidine on peptone meal-stimulated gastric acid secretion and plasma gastrin levels in duodenal ulcer patients.

Mifentidine is a new H2-receptor antagonist with distinct characteristics of potency and long plasma half-life. The aim of this study was to evaluate the effects of mifentidine on peptone meal-stimulated gastric acid secretion. Nine duodenal ulcer patients in remission were enrolled in the study and given in double-blind and at random, on two different occasions, a single tablet of 10 or 20 mg mifentidine or placebo according to an incomplete balanced block design. Ninety min after ingestion of the drug, basal gastric secretion was collected for 30 min and volume, pH and acid output determined. Thereafter, the acid output following peptone meal-stimulation was measured for 2 h by a modified version of the intragastric titration method of Thompson and Swierczek. Plasma samples were collected for gastrin and mifentidine determinations. Basal acid output was strongly inhibited by both the low dose (-78%) and the high dose (-98%) (p less than 0.01). The peptone meal-stimulated acid output was reduced in a dose-dependent manner (-45% by 10 mg and -90% by 20 mg). The drug did not affect the fasting serum gastrin levels but increased, although not significantly, the gastrin response to food. The log of the area under the mifentidine plasma levels correlated linearly with total acid output (p less than 0.01). The results of this study indicate that mifentidine dose-dependently suppresses basal acid secretion and reduces peptone-stimulated gastric acid secretion in duodenal ulcer patients.

Adult↗
PubMed1988

Tripotassium dicitrate bismuthate and ranitidine in duodenal ulcer. Healing and influence on recurrence.

One hundred patients were entered into a double-blind, double-dummy comparison of tripotassium dicitrate bismuthate (TDB) versus ranitidine, to evaluate short-term healing rates, and successfully healed patients were then entered into a follow-up phase to observe relapse rates. At 4 weeks 84% of patients treated with TDB and 68% of those treated with ranitidine had healed. At 8 weeks these figures had risen to 96% and 90%, respectively (p = NS). After a year's follow-up study 84% of patients healed initially with ranitidine had relapsed, whereas in the case of patients healed initially with TDB the relapse rate was 67% (p less than 0.05). The results confirm that in the short term, TDB is as effective as ranitidine, whereas the significantly better protection against relapse offered by TDB compared with ranitidine underlines the importance of restoring mucosal defence, an approach that to date has been somewhat overlooked.

Adult↗
PubMed1988

Gastric acid and pepsin secretion after single oral doses of mifentidine in healthy subjects.

Mifentidine represents a potential improvement in the class of H2-receptor antagonists because of its long plasma half-life (10 h). The aim of this study was to evaluate the effects of mifentidine on pentagastrin-induced gastric pepsin and acid secretion in man. Nine healthy subjects participated in two separate sessions in which they were given randomly either a single oral dose of placebo or 10 or 20 mg of mifentidine, in accordance with an incomplete balanced block design. Basal secretion was measured 30 min before the administration of the drug, and 90 min later unstimulated gastric secretion was collected through a nasogastric tube for an additional 30 min. Then, 2 micrograms/kg/h pentagastrin were infused intravenously for 2 h, and gastric juice collected again in 15-min aliquots. Acid output was almost completely blocked by both doses of mifentidine during the unstimulated period (-99%). Pentagastrin infusion induced 10 times as much acid output as in the unstimulated phase. This dramatic increase was reduced by 32% with the low dose of mifentidine and to a major extent (-86%) with the high dose. The pepsin output was significantly inhibited by both doses of mifentidine during unstimulated (-83% and -82%) and stimulated (-49% and -71%) phases. Acid output correlated with the area under the mifentidine plasma levels (r = -0.69, p less than 0.05). It is concluded that mifentidine is a potent inhibitor of both acid and pepsin secretion in man.

Adult↗
PubMed1987

Cerebrospinal fluid and peripheral blood T-lymphocyte subsets in multiple sclerosis: monoclonal antibody analysis and correlations with clinical activity.

Enumeration of cerebrospinal fluid and peripheral blood T-lymphocyte subsets (T-total, T-helper and T-suppressor) was performed by monoclonal antibody technique in 18 patients with Multiple Sclerosis and in 4 patients with non-inflammatory neurological diseases. While no differences were observed in peripheral blood subsets among the various phases of the disease, a marked rise in cerebrospinal fluid helper-suppressor ratio was seen in acute relapses. The results give further support to the concept of a strict compartimentalization in immune response abnormalities in Multiple Sclerosis patients.

Cerebrospinal Fluid↗
PubMed1987

Action of mifentidine on the secretory response to sham feeding and pentagastrin and on serum gastrin in duodenal ulcer patients.

A study has been done in 10 duodenal ulcer patients of the effect of a single oral dose of 10 mg mifentidine on the acid and pepsin responses to sham feeding after 1 h 30 min and to pentagastrin after 4 h 15 min. The study followed a double-blind, randomized, placebo-controlled, cross-over design. Gastric juice was collected for 5 h 15 min after treatment. Blood was sampled for up to 3 h 30 min to determine the effects of mifentidine on serum gastrin. Mifentidine suppressed basal acid output by 77% and sham feeding-stimulated acid output by 71% vs the placebo values. Pentagastrin-stimulated acid output was inhibited by 30% throughout the pentagastrin infusion. The suppressant effect of the drug on pepsin output was not as marked as on acid secretion. Mifentidine did not affect the serum gastrin level during the basal and sham feeding phases. No untoward effects were reported by the patients. The results show that 10 mg mifentidine p.o. produced a large reduction in the acid output in response to sham feeding and pentagastrin without affecting the serum gastrin responses.

Adult↗
PubMed1987

Tripotassium dicitrato bismuthate (TDB) versus two different dosages of cimetidine in the treatment of resistant duodenal ulcers.

The use of tripotassium dicitrato bismuthate (TDB) has been suggested recently for cimetidine resistant duodenal ulcers. This study compares the efficacy of TDB with two different cimetidine dosages in the treatment of duodenal ulcer patients who failed to respond to an eight week therapy with H2-blockers. Fifty two patients (40 men, 12 women) were randomly allocated to one of the following three oral regimens: (1) TDB 120 mg quid, (2) cimetidine 400 mg tid, (3) cimetidine 400 mg with meals plus 800 mg at bedtime. Endoscopy was carried out after four weeks; if the ulcer had not healed patients continued with the same treatment for a further four week period when they were endoscopically reassessed. After four weeks similar percentages of ulcer healing were registered in the two cimetidine schedules (39% with 1.2 g and 44% with 2 g), whereas TDB resulted in a significantly higher healing rate (82%) compared with cimetidine 1.2 g (p = 0.01) and with cimetidine 2 g (p = 0.025). After eight weeks the cumulative percentages of healing were 65% on cimetidine 1.2 g, 75% on cimetidine 2 g, and 94% on TDB (TDB v cimetidine 1.2 p = 0.042). These results confirm previous data that resistant duodenal ulcers are more responsive to an agent which strengthens the mucosal defences than to antisecretory compounds.

Adult↗
PubMed1987

Effect of cisapride on gastric emptying and ileal transit time of balanced liquid meal in healthy subjects.

Cisapride is a new prokinetic gastrointestinal agent which has been shown to be able to increase gastric emptying and intestinal transit time in experimental animals and in patients with preexisting motility alterations. Up to now, however, clinical research evaluating the activity of the drug in healthy subjects is very limited. We have therefore undertaken a placebo-controlled study to simultaneously investigate the effect of cisapride (20 mg p.o.) on gastric emptying and intestinal transit time of a balanced liquid meal in 9 healthy volunteers. Median gastric half-time was 60 min after cisapride, as compared to 73 min after placebo (p less than 0.05). Intestinal transit time was similar after cisapride (75 min) or after placebo (105 min). These data confirm that cisapride significantly increases the speed of gastric emptying also in normal subjects. The lack of effect on intestinal transit could be explained by the interindividual variation observed in our experiments.

Adult↗
PubMed1987

Maintenance therapy with colloidal bismuth subcitrate in duodenal ulcer disease.

Various investigators have reported that relapses after healing of duodenal ulcers with colloidal bismuth subcitrate (CBS, De-Nol) occur less frequently than after healing with H2-antagonists. To date, treatment with CBS has been limited to 8 weeks. After a volunteer study showed that prolonged administration of CBS did not cause safety problems, a trial was undertaken in which the effects of additional maintenance CBS treatment with 120 mg of CBS daily is compared with placebo. Interim results showed that after 6 months endoscopically confirmed relapse occurred in 5 (38.5%) of the 13 patients as compared to 12 (80%) of the 15 placebo-treated patients (p = 0.05). Besides 3 cases of transient constipation, no side effects, neurological, biochemical or hematological changes were observed.

Adult↗
PubMed1987

Effect of mifentidine, a new H2-antagonist, on pentagastrin-stimulated acid secretion in healthy subjects.

The purpose of this study is to investigate the effects of a single oral dose of 10 mg of mifentidine, a new H2-receptor antagonist, on unstimulated and pentagastrin-stimulated gastric acid secretion in healthy subjects. The study was carried out in a double-blind randomized, placebo controlled, cross-over design. Ten subjects were given both placebo and active drug, with a wash-out period of at least 3 days. Unstimulated acid secretion was measured in the period between 1 and 1.5 h after drug administration. Immediately thereafter, 2 micrograms/kg/h of pentagastrin was infused intravenously and pentagastrin-stimulated gastric acid secretion was determined for two subsequent hours. The volume of gastric secretion was significantly less after mifentidine than after placebo during the pentagastrin-stimulated period. Acid output was inhibited during unstimulated and pentagastrin-stimulated secretion by mifentidine by 45% and 39% of the placebo values, respectively. No adverse clinical or laboratory effects were noted during the study. The results of this study indicate that mifentidine, given as a single oral dose of 10 mg, inhibits effectively unstimulated and pentagastrin-stimulated acid secretion in healthy subjects.

Adult↗
PubMed1987

Gastric antisecretory and cytoprotective activity of MDL 646, a 16-methyl-16-methoxy prostaglandin E1 analog in man.

MDL 646 is a 16-methyl-16-methoxy PGE analog with gastric antisecretory and cytoprotective activity in rats following oral administration. The efficacy of MDL 646 in inhibiting pentagastrin-stimulated acid secretion in man was investigated in a pilot crossover study in 10 male subjects given single oral doses of 500-1,000 mcg of the compound or placebo in randomized order. The doses showing consistent antisecretory effects in all subjects were 800 and 1,000 mcg, which caused a reduction in acid output of at least 25% over the whole test period (2.5 h), with greater inhibition in the first hour. The cytoprotective activity of MDL 646 was investigated by measuring the ability of single oral doses of 500 mcg of compound to prevent the drop in gastric potential difference (PD) induced by aspirin. The study was carried out in 8 male subjects given MDL 646 or placebo in randomized order in accordance with a single-blind crossover design. MDL 646 prevented the aspirin-induced drop in PD: No adverse reactions or changes in bowel habits were reported in either study. The compound is worth investigating further as a potential anti-ulcer agent.

Administration, Oral↗
PubMed1986

Medium-dose antacids versus cimetidine in the short-term treatment of duodenal ulcer.

Seventy-eight patients with endoscopically proven duodenal ulcer were randomly allocated to be treated with a medium dose of liquid aluminum-magnesium antacid (75 ml in five daily doses) or cimetidine (400 mg twice daily) for 4 weeks in a prospective double-blind, double-dummy study. Healing rates at completion of trial were 66.7% in the cimetidine-treated group and 71.8% in the antacid group (p, ns). Both treatments were equally effective in relieving ulcer symptoms. Among the patient variables considered, only cigarette smoking was found to have a significant negative effect on ulcer healing. These results indicate that medium doses of antacids are as effective as cimetidine in the short-term treatment of duodenal ulcer.

Adult↗
PubMed1986

A comparison of two different doses of omeprazole versus ranitidine in treatment of duodenal ulcers.

In a study involving three centers, 105 patients with duodenal ulcer proven by endoscopy were randomly assigned to treatment with either the H+, K+, ATPase inhibitor omeprazole (20 mg or 40 mg taken as a single morning dose), or ranitidine (150 mg morning and night). It was a double-blind study using a double-dummy technique. Clinical assessment and laboratory investigations were carried out at 2, 4, and 8 weeks; endoscopy was done at 2 weeks, and if not healed, at 4 and 8 weeks. The patients in the three treatment groups were well matched. Significantly more patients treated with omeprazole healed compared with ranitidine at 2 weeks (p = 0.007) and at 4 weeks (p = 0.007), but there was no statistically significant difference between the two omeprazole groups. Pain was of similar severity at the start in all groups, but patients treated with omeprazole had fewer days with pain (median values being omeprazole 20 mg: 2 days; omeprazole 40 mg: 1 day; ranitidine: 7 days). The difference between the combined omeprazole groups and ranitidine was significant (p less than 0.02). There was also a tendency towards less severe daytime pain on omeprazole during the first week. The difference was statistically significant between omeprazole (40 mg) and ranitidine for days 2-7 (p less than 0.01). No change in laboratory screen attributable to drug treatment occurred. After healing, 79 patients entered a 6-month follow-up study with endoscopy at 3 and 6 months or whenever symptoms occurred. After 6 months relapses occurred in 14/24, 19/23, and 15/25 after 20 mg omeprazole, 40 mg omeprazole, and ranitidine, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗