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Biomedical subjects

S Zaterka

Publications and source records attributed to S Zaterka.

At least 19 recordsLinked to original sources
PubMed2000

Pantoprazole versus ranitidine in the treatment of duodenal ulcer: a multicenter study in Brazil.

OBJECTIVE: The aim of this study was to compare the effectiveness and tolerance of pantoprazole versus ranitidine in the treatment of duodenal ulcers in the Brazilian population. METHODS: A total of 222 patients with active duodenal ulcers (DU) were randomly allocated to a double dummy blind treatment, either with ranitidine (RAN) 300 mg (111, aged from 20-68 yr old, 56 female) or with pantoprazole (PANT) 40 mg (111 patients, 18-70 yr old, 45 female). After a 2-wk course of treatment, each patient was clinically and endoscopically assessed for ulcer healing. Failure to heal required a further 2-wk course of treatment and a new evaluation thereafter. RESULTS: In all, 77 of the 103 patients in the PANT group (74.8%) and 42 of the 94 patients in the RAN group (44.7%) who completed the study had ulcer healing after one 2-wk treatment course, and an additional 23 in the PANT group (22.3%) and 28 in the RAN group (29.8%) after the second 2-wk treatment course, totaling 100 (97.1%) and 70 (74.5%), respectively. Therapeutic gain in favor of pantoprazole was significant both at the end of the first and the second 2-wk treatment course (p<0.001). At 2 wk, symptoms remission was significantly higher in the PANT group (97.6%) than with the RAN group (77.5%) (p<0.001). The Intention-to-treat analysis showed results statistically similar to those observed in the per-protocol analysis. Minor adverse events were reported by four patients in the PANT group and three in the RAN group. No relevant laboratory abnormalities were seen. No patient withdrew from the study due to adverse events. CONCLUSIONS: Our results show that pantoprazole is more effective than ranitidine in the treatment of duodenal ulcer providing faster ulcer healing in most patients (97.1%), in 4 wk. Adverse events were rare and were similar in both groups, and had no influence on the therapeutic outcome.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1999

Hansen's disease and the digestive system: clinical symptoms and gastric secretory profile at baseline conditions and following maximum stimulation with pentagastrin.

The incidence of digestive symptoms in 100 patients with Hansen's disease was evaluated in this study, following a standardized questionnaire. A correlation between the frequency of symptoms, the form of the disease, and the length of treatment was investigated. Digestive symptoms were found in 31 patients (31%). No statistically significant difference was found between the presence of symptoms and the length of the disease or between the multibacillary and the paucibacillary form of the disease. However, a positive correlation between digestive symptoms and Hansen's disease was found in the multibacillary form of the disease only for patients treated for more than 12 months. Baseline and pentagastrin-stimulated gastric acid secretion was studied in 30 Hansen's disease patients and in 10 controls. A Iower basal acid output was observed in patients with Hansen's disease, but no statistical difference was found. Pentagastrin-stimulated gastric acid secretion was statistically different in Hansen's disease patients, as compared to controls. A Iower pentagastrin-stimulated acid secretion was found in Hansen's disease patients under treatment, as compared to untreated patients, but the difference was not statistically significant.

Adolescent↗
PubMed1994

Helicobacter pylori and refractory duodenal ulcers: cross-over comparison of continued cimetidine with cimetidine plus antimicrobials.

OBJECTIVES: To determine the distribution of Helicobacter pylori in the antral and duodenal mucosa of patients with duodenal ulcers refractory to 12 wk of treatment with cimetidine and to evaluate the effect of adding antimicrobial agents to cimetidine on the healing of refractory duodenal ulcers. METHODS: A randomized crossover comparison of continued 800 mg of cimetidine at night for 4 wk with cimetidine plus 500 mg of amoxycillin three times a day for the first 2 wk and 250 mg of metronidazole three times a day for the second 2 wk. H. pylori status in the gastric antral and duodenal mucosa was evaluated by histology and bacterial culture before and at the end of each treatment period. RESULTS: Forty-eight patients were studied. Upon entry to the study, all patients had antral colonization with H. pylori. In the duodenum, active chronic duodenitis was present in 66%, duodenal gastric metaplasia in 33%, and H. pylori in 50%, similar proportions to patients with nonrefractory duodenal ulcers. Healing occurred in 70% (30 of 43) of patients during treatment with cimetidine plus antimicrobials but in only 21% (6 of 28) during treatment with cimetidine alone (p = 0.0003). In patients who received antimicrobials, neither clearance of H. pylori from the antrum (58% of patients) or duodenum (71% of colonized patients) nor eradication of H. pylori (33%) was significantly correlated with ulcer healing. CONCLUSIONS: The distribution of H. pylori in refractory duodenal ulcers is similar to nonrefractory ulcers, and the combination of amoxycillin and metronidazole with cimetidine increases the proportion of refractory duodenal ulcers, which heals.

Adult↗
PubMed1993

Treatment of duodenal ulcer with omeprazole or ranitidine in a Brazilian population: a multicenter double-blind, parallel group study.

Two hundred and forty-one patients with at least one ulcer at stage A1 or A2, measuring at least 5 mm in its larger diameter, were included in this Brazilian double-blind randomized study. Patients received omeprazole 20 mg in the morning (n = 120) or ranitidine 300 mg at night (n = 121) for 2 wk; unhealed ulcers were treated for an additional 2 wk. At the end of 4 wk, unhealed ulcers were treated openly with omeprazole 20 mg o.m. for 4 wk. Healing rates at 2 and 4 wk were 67.3% and 92.9% for omeprazole and 39.8% and 82.0% for ranitidine (per protocol analysis). Results were similar when analyzed as intention to treat (p significant in favor of omeprazole). Epigastric day-time pain was the most common of all symptoms (89.2%), but only heartburn at day 15 showed a significantly better response to omeprazole than to ranitidine. A multivariate analysis (logit analysis) showed that the odds in favor of healing were greater for small ulcers, nonsmokers, and omeprazole treatment.

Adult↗
PubMed1991

Very-low dose antacid in treatment of duodenal ulcer. Comparison with cimetidine.

Antacid (AA) in a very low dose (88 mmol/day) was compared to the standard 800-mg dose of cimetidine in healing duodenal ulcers. The influence of sex, age, symptom duration at entry, night pain, smoking, coffee consumption, and alcohol on ulcer healing was studied. The antacid was given in two different schedules: group I--20 ml 1 hr after breakfast and at bedtime; group II--10 ml 1 hr after breakfast and lunch and 20 ml at bedtime. Cimetidine (group III) was given in two divided doses: 400 mg 1 hr after breakfast and 400 mg at bedtime. Endoscopic control was performed after four weeks and, if necessary, after eight weeks of treatment. The healing rate after four weeks of treatment was, respectively, for groups I, II, and III, 45.5%, 55.8%, and 69.4% (group I = group II, and group III different from groups I and II). After eight weeks of treatment the healing rate was 61.5%, 80.8%, and 88.0% for groups I, II, and III, respectively (group II = group III, and group I different from groups II and III). Except for group I, smoking did not influence healing rate. Age, sex, symptoms at entry, night pain, and coffee consumption did not influence the treatment results. The authors concluded that the very low dose of magaldrate (88 mmol/day), when administered in three divided doses (10 ml after breakfast and lunch and 20 ml at bedtime) for eight weeks was as effective as 800 mg of cimetidine (400 mg twice a day) in healing duodenal ulcer.

Adult↗
PubMed1989

Coffee drinking in patients with duodenal ulcer and a control population.

The ingestion of plain coffee was compared in 150 duodenal ulcer patients (DU) and 100 control subjects without digestive complaints (C). The DU and C groups were registered in accordance with their daily consumption of coffee: none, 1-100 ml, 101-300 ml, 301-500 ml, and more than 500 ml. Fifty millilitres of coffee as prepared in Brazil contain around 50 mg of a caffeine, which is 2.8 times more than in an equal volume of coffee in the United States. Patients with DU stopped drinking coffee or reduced the volume significantly after symptoms started. There was a significant change in coffee intake at all volume levels except at 1-100 ml. The main reason for the reduction of coffee ingestion was the relationship observed by the patients between the consumption of coffee and dyspeptic complaints. Our results suggest a close correlation between the ulcer-like symptoms and the amount of coffee ingested by patients with duodenal ulcer.

Adolescent↗
PubMed1988

Famotidine in the short and long-term treatment of duodenal ulcer.

Famotidine was compared to ranitidine in a short-term study on the treatment of duodenal ulcer. Famotidine 20 mg. b.i.d., 40 mg. b.i.d. and 40 mg. nocte heal as many ulcer as ranitidine (90.9%, 91.7%, 83.3% and 100% respectively). A single 20 mg. bedtime dose shows to be effective on preventing ulcer recurrence for as long as 48 weeks; the 38% recurrence rate observed with famotidine was statistically different from the 78% observed with placebo. Diarrhoea was the most common complain observed during the short-term trial, followed by sleepiness and headache. The few and small biochemical alterations during the long-term treatment (increase in transaminases, alkaline phosphatase, glucose, BUN) could in no instance be directly related to the substances on use.

Anti-Ulcer Agents↗
PubMed1981

Acid secretion in patients with Chagas' disease.

In order to evaluate the acid secretory pattern in patients with Chagas' Disease when compared to control subjects, the following tests were performed; a) Basal Secretion, b) Acid output after increasing doses of I.V. Pentagastrin (1, 2, 4 and 8 micrograms/Kg-h); c) I.V. Pentagastrin (P) plus a background of subthreshold doses of Urecholine (U) (40 micrograms/Kg-h); d) Calcium infusion test (4 mg of Ca++/Kg-h). The histological aspects of the antral and fundic mucosa was studied on 11 CD patients through samples obtained during gastroscopy. Basal, Pentagastrin stimulated acid secretion and Ca++ stimulated secretion were statistically lower in CD patients when compared to controls. Association of P + U resulted in a higher acid response in 4 out of 8 CD patients but, the mean result of the group was not statistically significant. These results suggest that the lower basal and stimulated acid response of CD patients is related to a decreased sensitivity of the parietal cell. This lower sensitivity is probably dependent on vagal blockage as a consequence of the intramural nerve destruction. The possibility of a smaller stomach and consequently small parietal cell population could not be ruled out in this investigation. However this possibility seems very unprobable to the authors.

Adolescent↗
PubMed1981

Long-term treatment of gastric ulcer with cimetidine.

Twenty patients with gastric ulcer received treatment with cimetidine. Patients were studied endoscopically before initiation of treatment and after three and six weeks of treatment. Cimetidine was administered at an initial dose of 1 gm/day. At the end of the third week, patients who had a reduction of less than 50% in the size of their ulcers were given 1.6 gm/day of cimetidine for the next three weeks, while the other patients remained on the initial dosage schedule for three more weeks. The 16 patients whose ulcers healed received either cimetidine or placebo (one tablet after lunch and one at bedtime) for an additional 12-week period in a double-blind, randomized study. At the end of this period, patients underwent endoscopic follow-up examination. One of nine patients given cimetidine and one of seven patients given placebo had recurrence of ulcer at the end of the trial. The four patients whose ulcers did not heal by the end of six weeks of treatment were smokers.

Adolescent↗
PubMed1977

Acid secretion and serum gastrin at graded intragasric pressures in man.

In 16 healthy subjects, gastric distention was produced by infusion of 5% mannitol solution, pH 5.5. Constant intragastric pressure was maintained by use of a barostat. Over successive 1-hr periods the head of pressure was raised in 5-cm increments from an arbitrary zero point to 15 cm. Gastric acid secretion was measured by constant intragastric titration. Blood samples were obtained throughout the study for measurement of serum gastrin concentrations. When intragastric pressure was raised from zero to 5 cm H2O, gastric acid secretion increased significantly (24% of peak acid response to pentagastrin). Acid responses at 10 and 15 cm pressure were lower. Serum gastrin concentrations increased slightly at 15 cm pressure but not at 5 or 10 cm. There was no correlation between increments in serum gastrin and acid secretory rates. We conclude that gastric distention at low pressures stimulated acid secretion by a mechanism and did not involve increases in circulating gastrin concentrations. Slight increases in serum gastrin observed at the highest distending pressure were not associated with further increases in acid secretion.

Adolescent↗
PubMed1977

Chronic gastritis and peptic ulcer.

The relationship between chronic gastritis and peptic ulcer was studied in 97 patients, 51 with duodenal ulcer and 46 with gastric ulcer. Six biopsies (three from the antrum and three from the body) were obtained under direct vision by means of an Olympus panendoscope. Chronic gastritis was classified according to the grade of inflammation (slight or moderate and intense), and to its location (antritis or pangastritis). In gastric ulcer the relationship between frequency of chronic gastritis and the site of the ulcer (antrapyloric, at the angulus, body of the stomach) was also established. Antritis was just as frequently observed in duodenal ulcer (94%) as in gastric patients (96%), but severe inflammation of the antrum was higher in G.U. (43%) than in D.U. (17%). Chronic gastritis of the gastric body was always accompanied by antritis, both in G.U. and in D.U. and was observed in 63% of the former group and 37% of the latter. Severe inflammation of the glandular portion of the stomach occurred in only one patient with D.U (2%) and in 7 with G. U (15%). In the present investigation, no relationship between between the site of gastric ulcer and the frequency of chronic gastritis was observed.

Adolescent↗