[Stomach ulcer. Treatment with nocturnal doses of 300 mg ranitidine].
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Clinical Trials as Topic↗
Biomedical subjects
R Jorde
Publications and source records attributed to R Jorde.
Asymptomatic gastric ulcer: a follow-up study in patients with previous gastric ulcer disease.
40 patients with their first gastric ulcer diagnosed gastroscopically 4-8 years ago and who have not since undergone surgery for their ulcer disease or been on medical treatment for active ulcer were reexamined with endoscopy. In 22 patients one or more gastric ulcers were found. At the follow-up endoscopy, 14 of these patients were without dyspeptic complaints, 4 had minimal symptoms and did not need antacids, and 4 were taking antacids for the relief of dyspepsia. A high frequency of asymptomatic gastric ulcer in patients with previous symptomatic disease has not been reported before, and the natural course of gastric ulcer disease should be re-evaluated by long-term prospective studies.
Adult↗
Plasma vasoactive intestinal polypeptide, insulin, gastric inhibitory polypeptide, and blood glucose in late pregnancy and during and after delivery.
The plasma levels of the gastrointestinal regulatory peptides vasoactive intestinal polypeptide, insulin, and gastric inhibitory polypeptide, as well as blood glucose, were measured in six healthy women before, during, and after normal parturition at term. Plasma levels of vasoactive intestinal polypeptide increased significantly (p less than 0.05) during delivery and remained significantly elevated for 15 minutes post partum. Plasma insulin levels rose significantly (p less than 0.05) within 5 minutes after delivery and stayed three-fold and significantly elevated for 120 minutes post partum. Plasma levels of gastric inhibitory polypeptide decreased significantly (p less than 0.05) between 5 and 30 minutes after delivery. Blood glucose levels were significantly (p less than 0.05) increased during labor, delivery, and the early postpartum period compared to late pregnancy. These findings suggest a mediating role for vasoactive intestinal polypeptide, insulin, and gastric inhibitory polypeptide in the physiologic adaptations to normal pregnancy, delivery, and the postpartum period.
Adolescent↗
A follow-up study of 68 patients with anti-mitochondrial antibodies (AMA).
During the period 1976-83, anti-mitochondrial antibodies (AMA) were detected in 68 patients out of about 48 000 sera (0.14%) analyzed for a repertoire of autoantibodies at the Department of Immunology, University Hospital of Tromsø. Fifty-five of these patients were women, and only 10 had unequivocal primary biliary cirrhosis (PBC). At follow-up in 1984, 48 out of these 68 patients were accessible for complementary testing. The AMA test became negative in 17 of these 48 patients during the observation period. Eleven of these 17 had originally a titer of 50. Seven of the 31 patients with persistent AMA were without detectable liver pathology. One patient had antibodies against smooth muscle, one against cell nucleus, whereas 35 had an increased serum IgM level. In conclusion, most patients with AMA do not have obvious PBC, a low AMA titer is likely to be transient, and there is a strong association between AMA and an increased serum IgM level.
Adult↗
Gut peptides in lactation.
The circulating levels of prolactin (PRL), vasoactive intestinal polypeptide (VIP), somatostatin (SRIH), cholecystokinin (CCK), pancreatic polypeptide (PP), insulin, motilin and blood glucose were measured in nine nursing women 27-40 days after delivery to establish the possible role of some gastrointestinal regulatory peptides in human breast feeding. During the last 20 min of suckling a significant (P less than 0.05) increase in serum PRL was observed concomitantly with a significant decrease in plasma SRIH levels (P less than 0.05 at 20 min and P less than 0.01 at 30 min). There was a highly significant inverse correlation between mean PRL and SRIH levels during the first 30 min of breast feeding (r = -0.996, P less than 0.001). Pancreatic polypeptide (pp) also increased significantly (P less than 0.01) during nursing, while there were no changes in the plasma levels of the other gastrointestinal regulatory peptides studied.
Adult↗
A single night time dose of ranitidine in the acute treatment of gastric ulcer: a European multicentre trial.
Four hundred and twenty eight patients with endoscopically diagnosed gastric ulcers, randomly allocated to treatment with ranitidine 300 mg at night or ranitidine 150 mg twice daily, were evaluated in a double blind multicentre trial conducted in 10 European countries. After four weeks, complete ulcer healing was observed in 138 of 211 patients (65%) treated with ranitidine 300 mg nocte and in 155 of 217 patients (71%) receiving 150 mg bd. Cumulative healing rates at eight weeks were 90% and 93%, respectively. There was no statistically significant difference between the healing rates at either four or eight weeks. The treatment regimens were equally effective at rapidly reducing the incidence of ulcer related symptoms. Adverse events reported were minor and equally distributed between the two groups. The results of this trial show that 300 mg of ranitidine administered at night is an effective and safe alternative to the current twice daily regimen for the short term treatment of gastric ulcer.
Administration, Oral↗
Plasma concentrations of motilin, somatostatin and pancreatic polypeptide before, during and after parturition.
The plasma concentrations of the gastrointestinal regulatory peptides motilin, somatostatin and pancreatic polypeptide were measured in 6 pregnant women, 17-35 years old. Plasma samples were drawn 2-3 weeks before, during, and immediately after labor, and 24 h as well as 1 year after delivery. Plasma motilin levels did not change during labor, but peaked non-significantly upon delivery, and were thereafter significantly elevated 24 h post partum (p less than 0.05). Plasma motilin concentrations measured one year after delivery were almost identical with the pre-term values. Plasma somatostatin rose non-significantly during labor and peaked transiently upon delivery (p less than 0.05), whereas plasma pancreatic polypeptide increased significantly during the second stage of labor (p less than 0.05). The plasma motilin increase may be part of a compensatory mechanism leading to augmented gastrointestinal motility after delivery.
Adolescent↗
Evidence of somatostatin as a humoral modulator of motilin release in man. A study of plasma motilin and somatostatin during intravenous infusion of somatostatin, secretin, cholecystokinin, and gastric inhibitory polypeptide.
In six healthy persons receiving graded intravenous infusions of synthetic somatostatin the plasma motilin concentrations decreased significantly (p less than 0.05) already with doses giving physiological plasma somatostatin levels, and a rebound of plasma motilin was observed after cessation of infusion of pharmacological somatostatin doses. After an intravenous secretin infusion (280 pmol/kg-h) producing pharmacological plasma secretin concentrations, a comparable plasma somatostatin increase was observed together with a substantial decrease in plasma motilin (p less than 0.05). Infusion of cholecystokinin in a pharmacological dose and of gastric inhibitory polypeptide (GIP) in doses giving plasma GIP levels in the physiological range had no effect on plasma somatostatin or motilin. Circulating plasma somatostatin may be a physiological modulator of the motilin release, and the plasma motilin fall seen during infusion of pharmacological doses of secretin may possibly be explained by the secretin-induced somatostatin release occurring simultaneously.
Adult↗
Morbid obesity treated with gastric partitioning and gastrogastrostomy.
Between April 1981 and July 1983, 30 patients were operated on for morbid obesity with gastric partitioning and a gastrogastrostomy (GP). The patients were checked 3, 6, 9, 12, and 24 months postoperatively. Radiological investigations were performed on the 5th postoperative day and after 2-32 months. All patients lost weight postoperatively, ranging from 14 to 45 kg after 9 months, but thereafter a slight increase in weight was noted. The weight loss was not correlated with radiologically measured stoma size or volume of the upper gastric pouch. Thus, in contrast studies combined with Gastroluft (sodium bicarbonate, tartaric acid, and dimethicone), pouch distention does not yield prognostic information on anticipated weight loss. More reliable methods for measuring stoma and pouch size are needed, but other factors like patient motivation and a careful postoperative follow-up study with dietetic advice are probably more important for a satisfactory outcome.
Adult↗
A single-centre study of gastric ulcer healing with 300 mg ranitidine at night versus 150 mg ranitidine twice daily.
In a single-centre study 59 patients with gastric ulcer were treated either with 300 mg ranitidine at night or with 150 mg ranitidine twice daily. After 4 and 8 weeks 73% and 97%, respectively, of those treated with 300 mg at night and 59% and 86% of those treated with 150 mg twice daily had complete ulcer healing. These differences between the two groups were not statistically significant. No serious side effects were seen. Ranitidine, 300 mg at night, appears to be at least as effective as the standard 150 mg twice daily regimen in the treatment of gastric ulcer.
Adult↗
The priming effect of glucose on the gastric inhibitory polypeptide-induced insulin release.
Six healthy subjects were given a 15-min intravenous infusion of gastric inhibitory polypeptide (GIP) in a dose of 1.0 microgram X kg-1 X h-1 at a mean blood glucose level of 4.9 mmol/l after a priming infusion with glucose. A significant insulin release was seen during the GIP infusion, an effect that could not be demonstrated without the priming glucose infusion.
Adult↗
[Lipid deposits in the ventricle].
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Aged↗
Haemodynamic effects of high doses of insulin during acute left ventricular failure in dogs.
Haemodynamic effects of pharmacological doses of insulin during acute ischaemic heart failure were studied in 8 dogs. Severe depression of left ventricular function was induced by the injection of 50 micron plastic microspheres into the left main coronary artery. This was demonstrated by a significant increase in left ventricular end-diastolic pressure and a significant decrease in the maximum rate of left ventricular pressure rise (LVdP/dtmax), stroke volume and cardiac output. Eighty-five minutes after the embolization procedure, 300 IU of insulin free of glucagon and calcium was injected as a bolus. This was followed by infusion of glucose and potassium to maintain physiological levels of these factors. Five minutes after insulin administration, there was a significant improvement in left ventricular performance as shown by decreased left ventricular end-diastolic pressure (P less than 0.01) and increased LVdP/dtmax (P less than 0.01), stroke volume (P less than 0.05) and cardiac output (P less than 0.05). A significant reduction in heart rate occurred. A non-significant increase in mean aortic blood pressure and reduction in total peripheral resistance were seen. In conclusion, pharmacological doses of insulin significantly improve cardiac pump function during acute ischaemic left ventricular failure in dogs.
Acute Disease↗
Release of gastrointestinal hormones in cardiodepressive shock.
In previous studies increased plasma levels of vasoactive intestinal polypeptide (VIP), somatostatin and pancreatic polypeptide (PP) were demonstrated in a porcine endotoxin shock model. Unchanged levels of gastric inhibitory polypeptide (GIP) and secretin point to a specific shock reaction of peptide release and not to a diffuse mucosal leakage. A porcine model of cardiodepressive shock was developed to enable discrimination to be made between a general low-flow state and endotoxin reaction. Infusion of the tricyclic antidepressive agent nortriptyline 15 mg/kg bodyweight resulted in a grave shock state. Increased plasma levels of somatostatin, PP and insulin were found. No increase in VIP levels could be demonstrated. Endotoxin given after nortriptyline administration resulted in the increase of VIP levels regularly seen during endotoxinaemia. VIP release during endotoxin shock is related to endotoxin and not to a general low flow state.
Animals↗
Haemodynamic effects of low and high doses of insulin during beta receptor blockade in dogs.
Haemodynamic effects of small and high doses of insulin during beta receptor blockade were studied in nine dogs. Beta receptor blockade was induced by 0.5 mg/kg propranolol and caused depression of cardiac performance with a significant increase in left ventricular end-diastolic pressure (LVEDP) and a significant decrease in heart rate; maximum rate of left ventricular (LV) pressure rise (LVdP/dtmax), stroke volume and cardiac output. At 15 min, after beta receptor blockade, a bolus injection of 0.5 IU/kg of insulin, free of glucagon and calcium, was given followed by a continuous infusion of 0.5 IU/kg/h. After 30 min another bolus dose of 300 IU insulin was injected. Glucose and potassium were given to maintain physiological levels of these factors. Five minutes after a low dose of insulin there was a significant decrease in LVEDP (P less than 0.01), and a significant increase in LVdP/dtmax (P less than 0.01), in stroke volume (P less than 0.01) and in cardiac output (P less than 0.01). The other haemodynamic variables were not significantly changed. Administration of a high dose of insulin further, significantly, improved performance of the beta receptor blocked heart and caused a significant reduction in total peripheral resistance. In conclusion, insulin exerts inotropic and vasodilator effects which are dose-dependent and not related to adrenergic mechanisms.
Animals↗
Protein-binding of secretin in human plasma.
Protein-binding of endogenous plasma secretin and of 125I-labelled secretin incubated with charcoal-treated plasma examined by gel filtration on a Sephacryl S-200 Superfine column (16 X 980 mm) showed that secretin in plasma appears both to be bound to at least two different plasma proteins where albumin appears to be the major binding protein, and also to occur as a free molecular form. In addition, protein-binding studied by incubating 125I-labelled secretin with charcoal-treated plasma under various conditions followed by charcoal separation of bound from free label indicated the presence of more specific secretin-binding sites on the plasma proteins with an avidity comparable to that otherwise reported for albumin as a binding protein. The protein-binding of 125I-labelled secretin was optimal or reached equilibrium after 2 days incubation at 20 degrees C and first after 8 days incubation at 4 degrees C. Also, the protein-binding of 125I-labelled secretin was higher at an incubation temperature of 20 than of 4 degrees C; was optimal at pH 7.4; increased with increasing amounts of charcoal-treated plasma up to an amount of 800 microliters in our assay system before levelling off; and increased in a constant and predictable manner with increasing amounts of 125I-labelled secretin at least with the amounts of labelled secretin examined here.
Blood Proteins↗
Pharmacological effects of gastric inhibitory polypeptide, cholecystokinin, and somatostatin on the serum levels of cationic trypsin-like immunoreactivity in man.
In six healthy volunteers there were no significant changes during a 300-min control period, whereas gastric inhibitory polypeptide in pharmacological doses first caused a transient and non-significant decrease and then a significant increase in the serum cationic trypsin-like immunoreactivity (CTLI). In another two groups of six healthy subjects, pharmacological doses of cholecystokinin elicited a non-significant increase, whereas somatostatin in pharmacological doses first caused a significant decrease and then a rebound effect with significantly higher levels of serum CTLI.
Adult↗
Release of gastrointestinal regulatory peptides after a soap enema.
A 1-l soap enema given to nine healthy volunteers elicited significantly elevated plasma levels of vasoactive intestinal polypeptide (VIP) and cholecystokinin (CCK), together with a transient somatostatin peak. These rises coincided with significant rises both in systolic and diastolic blood pressure, whereas plasma levels of motilin and pancreatic polypeptide remained unchanged. It is suggested that the peptide releases are of colonic origin and that VIP and CCK may play mediatory roles in the enema-induced defecation.
Adolescent↗