bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Hepatocellular Regeneration in CCl4 Autoprotection
Authors: Thakore Kashyap N. , Mehendale Harihara M.
Published: January 2017

The destruction of liver microsomal cytochromes P450 by a previously administered low dose of CCl4 has been widely accepted as the mechanism of CCl4 autoprotection. However, circumstantial evidence suggests that this mechanism cannot completely explain the phenomenon of autoprotection. The protective effect of a low dose of CCl4 (0.3 ml/kg, po) on the lethal effect of a subsequently administered high dose (5 ml/kg, po) was established in male Sprague Dawley rats. The protective dose permitted 100% survival, whereas only 15% survival was observed without it. Hepatotoxicity, measured by serum enzyme elevations (aspartate transaminase, alanine transaminase, and sorbitol dehydrogenase) and histopathological changes 24 hr after the treatment with high dose, was similar in both the groups, even though the protective dose had significantly decreased liver microsomal cytochromes P450 (to 62% of normal) and associated enzymes, aminopyrine demethylase and aniline hydroxylase. Rats pretreated with CoCl2 to decrease hepatic microsomal cytochrome P450 to 44% of normal levels did not show a significant protection from the hepatotoxicity of high dose of CCl4. Previous studies have established that hepatocellular regeneration is stimulated within 6 hr after the administration of a low dose of CCl4. Based on this observation, a premise that autoprotection results from augmented recovery from injury rather than decreased injury appears likely. Hence, the role of hepatocellular regeneration was evaluated by following 3H-thymidine incorporation in hepatocellular nuclear DNA, labelling index by autoradiography, and by morphometric estimation of mitotic index. After administration of the protective dose of CCl4, stimulated nuclear DNA synthesis measured by 3H-thymidine incorporation into nuclear DNA was increased and this remained high even after subsequent administration of high dose of CCl4. Forty-eight hr after the administration of a lethal dose of CCl4 alone (5 ml/kg, po), labelling index was slightly increased, but mitotic index was not increased. In the surviving rats (15%), both labelling index and mitotic index were significantly elevated after an additional 24 hr. In rats receiving the protective dose, a significantly greater elevation of labelling index as well as mitotic index occurred 48 hr after the administration of the same lethal dose of CCl4. These results suggest that hepatocellular regeneration stimulated by the protective dose, as a biological response recruited to overcome the accompanying limited injury, may augment and sustain tissue repair processes to permit tissue restoration even after the massive liver injury elicited by the subsequent large dose of CCl4.
Preneoplastic and Neoplastic Lesions in the Pancreas of Rats Fed Choline-Devoid or Choline-Supplemented Diets
Authors: Longnecker Daniel S. , Chandar Nalini , Sheahan Daniel G. , Janosky Janine E. , Lombardi Benito
Published: January 2017

Groups of male Fischer 344 rats were chronically fed semipurified choline-devoid or choline-supplemented diets, high in fat (15%), and containing or not containing 0.06% phenobarbital. Atypical acinar cell nodules were observed in the pancreas of the rats, irrespective of the diet fed, with incidences varying from 38% to 100% in the various groups. No consistent differential effects of the dietary treatments on the incidence and growth of the nodules were evident, even though the diameter of the nodules tended to be greater in some of the groups fed the basal choline-devoid diet. The vast majority of the nodules were of the acidophilic type. More advanced pancreatic acinar cell lesions were observed in a few of the rats. Since the rats were not exposed to a chemical carcinogen(s), development of the nodules and of the more advanced lesions, even in rats fed the control diets, was most likely due to evolution of endogenous (spontaneous) initiated pancreatic cells, promoted primarily by the feeding of semipurified diets with a high fat content.
Benchmarking Information and Learning Resources
Authors: Ettinger Andrew
Published: January 2017

Andrew Ettinger joined Ashridge in 1985 and is the Manager of Learning Resources. He is responsible for Ashridge's unique multi-media Learning Resource Centre. He also organises and lectures on courses for several professional bodies in the UK and abroad and is an external lecturer at library schools. He has also completed consultancy projects in India and Poland.

After graduating from London University, he completed a post-graduate diploma in Information Studies and then worked at the North East London Polytechnic before moving to the London Business School.

He is particularly interested in managers' use of information and how they learn and is currently researching quality information services.
Market Research in the US - Part 3: data from the US Economic Census
Authors: Pagell Ruth A
Published: January 2017

The US Bureau of the Census conducts the Economic Census and the Census of Population and Housing, which form the basis for much of the demographic data available in the US. This article examines the Economic Census. It explains how the Census is organized, highlights those reports that are relevant to marketing and describes how to access the data.
Evaluation of Compression under an Elastic Tubular Bandage Utilised as an Introduction to Compression Therapy in the Treatment of Venous Leg Ulcers
Authors: Melhuish J. M. , Wertheim D. , Llewellyn M. , Williams R. , Harding K. G.
Published: January 2017

Objective:

To investigate the physical parameters of an elasticated tubular bandage (Tubigrip) on the leg and in durability studies.

Design and setting:

Cohort studies.

Participants:

Six healthy volunteers and 16 patients.

Main outcome measure:

Sub-bandage pressure.

Results:

Median pressures recorded under the Tubigrip bandage system at the lower, middle and upper calf muscle in 6 healthy volunteers, while sitting were 26, 25 and 12.5 mmHg, and for standing were 32, 40 and 16 mmHg. The median pressures recorded at the lower, middle and upper calf muscle in 16 venous leg ulcer patients while sitting were 18, 20 and 14 mmHg, and for standing were 32.5, 29.5 and 18 mmHg. Tubigrip durability studies demonstrated no decrease in sub-bandage compression over 8 days when applied to a model leg and volunteer leg. However, sub-bandage pressure decreased by more than 29% when the bandage was subjected to four wash-dry cycles.

Conclusions:

The pressures measured under Tubigrip were consistent with the ranges seen in other compression therapies. Laundering reduced the applied sub-bandage pressure.
Deep Vein Thrombosis Prophylaxis: Audit of Practice in General Surgical Patients in a Teaching Hospital
Authors: Agu O. , Handa A. , Hamilton G , Baker D. M.
Published: January 2017

Objective:

To audit the prescription and implementation of deep vein thrombosis (DVT) prophylaxis in general surgical patients in a teaching hospital.

Methods:

All inpatients on three general surgical wards were audited for adequacy of prescription and implementation prophylaxis (audit A). A repeat audit 3 months later (audit B) closed the loop. The groups were compared using the chi-square test.

Results:

In audit A 50 patients participated. Prophylaxis was correctly prescribed in 36 (72%) and implemented in 30 (60%) patients. Eighteen patients at moderate or high risk (45%) received inadequate prophylaxis. Emergency admission, pre-operative stay and inadequate risk assignment were associated with poor implementation of protocol. In audit B 51 patients participated. Prescription was appropriate in 45 (88%) and implementation in 40 (78%) patients (p< 0.05). Eleven patients at moderate or high risk received inadequate prophylaxis. Seven of 11 high-risk patients in audit A (64%) received adequate prophylaxis, in contrast to all high-risk patients in audit B. The decision not to administer prophylaxis was deemed appropriate in 5 of 15 (30%) in audit A compared with 6 of 10 (60%) in audit B.

Conclusion:

Increased awareness, adequate risk assessment, updating of protocols and consistent reminders to staff and patients may improve implementation of DVT prophylaxis.
Compression Treatment of Chronic Venous Ulceration: A Review
Authors: Moneta G. L. , Nicoloff A. D. , Porter J. M.
Published: January 2017

Objective:

To review the recent medical literature with regard to the use of compressive therapy in healing and preventing the recurrence of venous ulceration.

Methods:

Searches of Medline and Embase medical literature databases. Appropriate non-indexed journals and textbooks were also reviewed.

Synthesis:

Elastic compression therapy is regarded as the ‘gold standard’ treatment for venous ulceration. The benefits of elastic compression therapy in the treatment of venous ulceration may be mediated through favourable alterations in venous haemodynamics, micro-circulatory haemodynamics and/or improvement in subcutaneous Starling forces. Available data indicate compressive therapy is highly effective in healing of the large majority of venous ulcers. Elastic compression stockings, Unna boots, as well as multi-layer elastic wraps, have all been noted to achieve excellent healing rates for venous ulcers. In compliant patients it appears that approximately 75% of venous ulcers can be healed by 6 months, and up to 90% by 1 year. Non-healing of venous ulcers is associated with lack of patient compliance with treatment, large and long-standing venous ulceration and the coexistence of arterial insufficiency. Recurrence of venous ulceration is, however, a significant problem after healing with compressive therapy, even in compliant patients; approximately 20-30% of venous ulcers will recur by 2 years.

Conclusions:

Compressive therapy is capable of achieving high rates of healing of venous ulceration in compliant patients. Various forms of compression, including elastic, rigid and multi-layer dressings, are available depending on physician preference, the clinical situation and the needs of the individual patient. Compressive therapy, while effective, remains far from ideal. The future goals are to achieve faster healing of venous ulceration, less painful healing and freedom from ulcer recurrence.
Peroperative Venography in Sapheno-Popliteal Ligation: Still a Useful Technique
Authors: Cheatle T. R. , Hassan S. A. , Fox J. A.
Published: January 2017

Objective:

To establish the efficacy of peroperative venography in identifying the use of the sapheno-popliteal junction during varicose vein surgery.

Design:

Single patient group.

Setting:

District General Hospital, Edgware, Middlesex, UK.

Patients:

Forty-one patients undergoing sapheno-popliteal ligation for varicose veins of the lower limb.

Interventions:

Surgical exploration and ligation of the sapheno-popliteal junction.

Main outcome measures:

Peroperative venographic demonstration of the short saphenous vein and sapheno-popliteal junction.

Results:

Thirty-four sapheno-popliteal junctions (85%) lay at a site approachable by a conventional incision. Five junctions lay higher than this and one lower.

Conclusions:

On-table venography is an efficient, quick and reliable way of demonstrating the anatomical site of the sapheno-popliteal junction.
Comparison of Clinical and Photoplethysmographic Assessment of Venous Insufficiency
Authors: Kurgan A. , Lerenbuch L. B. , Gertz S. D. , Shapiro J. , Ofek B. , Shemesh D. , Abramowitz H. B.
Published: January 2017

Objective:

To assess the concordance between clinical and photoplethysmographic evaluation of venous insufficiency.

Design:

Comparison of two methods of evaluation of venous insufficiency in randomly selected patients.

Setting:

The Vascular Institute, Shaare Zedek Hospital, Jerusalem, Israel.

Patients:

Four hundred patients selected at random from a pool of 3000 patients referred to the vascular institute for suspected venous insufficiency.

Interventions:

Each of the 800 legs was evaluated clinically, by Trendelenburg testing, and by venous reflux photoplethysmography (VPPG).

Results:

Of 230 legs without clinical evidence of venous insufficiency (including Trendelenburg testing), 214 (93%) were also normal by VPPG. However, of 359 legs with clinical evidence of venous insufficiency, only 178 (50%) were so confirmed by VPPG. Of 135 legs considered to have insufficiency of the deep venous system (DVI) by clinical criteria alone, only 31 (23%) were confirmed to have DVI by VPPG, and 49 (36%) were found by VPPG to have insufficiency of only the superficial system.

Conclusions:

Reliance upon clinical assessment alone is inadequate for distinguishing between insufficiency of the deep and superficial or perforating venous systems. Assessment by VPPG may identify many patients with dermatologic changes “typical of DVI” who may benefit from superficial venous surgery.
Venous Reflux Localization: Comparative Study of Venography and Duplex Scanning
Authors: Valentín L. I. , Valentín W. H. , Mercado S. , Rosado C. J.
Published: January 2017

Objective:

To compare the results obtained by duplex ultrasound imaging and ascending and descending phlebography in patients with chronic venous insufficiency.

Design:

Prospective comparison between venography and duplex ultrasound imaging in a single patient group with chronic venous insufficiency.

Setting:

Private vascular clinic in Puerto Rico.

Patients:

Twenty-one patients presenting with clinical evidence of venous disease of the lower limb.

Main outcome measures:

Presence of valvular incompetence in deep and superficial veins as indicated by duplex ultrasound imaging and ascending and descending phlebography.

Results:

Duplex ultrasound imaging showed twice as many patients with popliteal vein incompetence (eight veins compared with four veins) and twice as many incompetent long saphenous veins (14 detected by duplex, eight detected by venography). In the proximal venous system, 13 common femoral veins were thought incompetent on venography, but only seven on duplex scanning; in the superficial femoral vein, 11 were incompetent on venography and three on duplex scanning.

Conclusion:

Duplex ultrasound scanning provides greater sensitivity for detection of valvular incompetence in distal veins compared with venography. Descending phlebography is poor in demonstrating distal venous valvular incompetence.
Lower Limb Volume Measurements: Standardization and Reproducibility of an Adapted Optical Leg Volume Meter
Authors: Hebeda C. L. , de Boer E. M. , Verburgh C. A. , Krijnen R. M. A. , Nieboer C. , Bezemer P. D.
Published: January 2017

Objective:

To investigate the reproducibility of an adapted optical leg volume meter and to determine intraindividual volume changes of the lower legs on separate days and in the course of a working day in healthy volunteers.

Design:

Adaptation of a standard optical leg volume meter, ‘volometer’, and calibration on an artificial leg and on volunteers. Study of the behaviour of lower leg volume in volunteers.

Setting:

Free University Hospital, Amsterdam.

Participants:

Thirty-six healthy volunteers, workers in the hospital.

Intervention:

The lower leg volume was measured on five or six different days at the beginning and end of a full working day.

Main outcome measures:

Reproducibility of the adapted volometer, and volume changes of the lower legs at different times.

Results:

Adaptation of the volometer resulted in a reproducibility of 0.07% in an artificial leg and of 0.46% in volunteers. A significant increase ( p<0.0001) in the volume of the lower legs in the course of the day was observed.

Conclusion:

Adaptation of the optical leg volume meter resulted in reproducible recordings of the volume of lower legs. In the course of the day an increase in volume occurs.
Potential Psychotropic Activity of Phlebotropic Drugs: Weak Interactions with Brain Benzodiazepine Receptors
Authors: Blätter W. , Schoch P.
Published: January 2017

Background:

Epidemiological and psychometric studies have provided evidence that some symptoms of venous disease might reflect a psychosomatic rather than organic disorder. Traditionally, plant extracts are prescribed to alleviate such symptoms. Since benzodiazepines (BZ) and BZ-like compounds are present in various plants, we studied potential interactions of ‘phlebotropic’ drugs with BZ receptors.

Methods:

Six drug preparations used in phlebology and extracts of hop and valerian were tested for neuronal and mitochondrial BZ receptor binding activity in vitro. In addition, plasma samples of volunteers who ingested phlebotropic drugs for 3 weeks were assayed for the presence of BZ-like activity.

Results:

All phlebotropic drug preparations interacted weakly with central and/or peripheral BZ receptors in vitro. Their diazepam-equivalent concentrations were, however, too low to be of pharmacological relevance. No binding activity was recovered in the blood of volunteers pretreated with phlebotropic drugs.

Conclusion:

The positive influence of so-called ‘phlebotropic’ drugs on the subjective symptoms of venous disease is not mediated through BZ receptors.
Injury to the Common Peroneal Nerve during Surgery of the Lesser Saphenous Vein
Authors: Lucertini G. , Viacava A. , Grana A. , Belardi P.
Published: January 2017

Objective:

To evaluate the incidence and associated problems of common peroneal nerve (CPN) injury, which can occur during short saphenous vein (SSV) surgery.

Design:

A retrospective cohort study.

Setting:

Section of Vascular Surgery in a University Hospital.

Patients:

In a consecutive series of 88 patients (31 male, 57 female, ages ranging from 35 to 68 years, mean 49), 104 lower extremities were operated on for SSV insufficiency.

Interventions:

Each patient was assessed by clinical examination, duplex scanning and in some cases by venography (ascending venography and/or varicography). Surgery was carried out via a longitudinal or transverse approach in the popliteal region or the posterior aspect of the thigh.

Main outcome measures:

Haemodynamic criteria, cosmetic outcome and complications of the surgical procedures due to SSV insufficiency were considered. In particular, we focused on neurological complications.

Results:

Abnormality of foot dorsiflexion was observed in two out of 104 (2%) cases. This complication was caused by injury to the CPN. Recovery had occurred 1 year later.

Conclusions:

Two factors seem to be essential in preventing this neurological complication: (a) good knowledge of surgical anatomy and (b) a cautious, accurate surgical technique. The incidence of this complication has been underestimated, but its importance and medico-legal implications must be emphasised.
Venous Haemodynamics and Morphology in Relation to Recanalisation and Thrombus Resolution in Patients with Proximal Deep Venous Thrombosis
Authors: Rosfors S. , Norén A.
Published: January 2017

Objective:

Follow-up studies of deep venous thrombosis (DVT) are needed to gain increased knowledge of the process of recanalisation over time. In this study modern diagnostic techniques were used to analyse changes in venous circulation during the process of recanalisation and thrombus resolution.

Design and setting:

Prospective follow-up study of patients with symptomatic DVT referred to a vascular diagnostic laboratory. The patients were evaluated by repeated examinations with colour duplex ultrasound and computerised strain-gauge plethysmography.

Patients:

Eighteen consecutive patients with acute DVT occluding the calf veins and femoropopliteal vein segments.

Main outcome measures:

Ultrasonographic assessment of thrombus resolution and flow patterns in deep and superficial veins. Plethysmographic determination of venous volume and venous outflow capacity.

Results:

At 3 months' and 6 months' follow-up, 33% and 56%, respectively, were recanalised but almost all limbs still had some degree of functional outflow obstruction. Duplex evaluation further demonstrated a complex pattern of recanalisation with thrombus resolution from above, from below or both. Computerised strain-gauge plethysmography showed a progressive time-related increase in venous outflow capacity and venous volume over 6 months, but volumetric variables could not be used to distinguish between limbs with patent veins and those with still-occluded veins. None of the limbs had completely compressible femoropopliteal venous segments at the end of the follow-up.

Conclusion:

The combination of these two modern diagnostic techniques, suitable for repeated studies, can provide detailed information on morphological and haemodynamic changes occurring during the process of recanalisation and thrombus resolution.
The Impact of Duplex Scanning for the Diagnosis of Deep Vein Thrombosis on Workload in a District General Hospital
Authors: Sudhindran S. , Rosser S. , Pilbrow W. J. , Sissons G. R. J. , de Cossart L. M.
Published: January 2017

Objective:

To assess the impact of changing from ascending phlebography to colour flow duplex (CFD) scanning for the investigation of deep vein thrombosis (DVT) in a District General Hospital and to determine the role of light reflection rheology (LRR) as a Preliminary screening tool for DVT.

Design:

Retrospective audit.

Setting:

Vascular Laboratory and Department of Radiology of the Countess of Chester Hospital, Chester, UK.

Patients and methods:

Audit and review of the all venograms done during the years 1989 to 1991 was undertaken. All the LRR and CFD scans done from 1991 (year of introduction in this hospital) to 1996 were audited and analysed.

Outcome measures:

Total number of various investigations done for suspected DVT in this hospital from 1989 to 1996 and their detailed analysis.

Results:

Four hundred and ninety-four venograms were performed between 1989 and 1991, of which 44% confirmed DVT. The least number of venograms was performed in 1991 ( n = 127), after the introduction of LRR. From 1991 through to 1996, the number of LRR scans increased from 90 to 697 and the CFD scans increased from 97 to 786.

Conclusion:

The audit revealed a 6-fold increase in demand for the examination of limbs for suspected DVT after the introduction of non-invasive tests. LRR continues to be a useful screening tool, reducing the number of CFD scans by 23%.
Dissociation of the Hypocalcaemic Effect of Sheep Pituitary Extract from its Lipolytic Action
Authors: Zileli M S , Adalar N
Published: January 2017

The relation between the calcium-lowering and lipid mobilizing effects of crude sheep pituitary extract given intravenously was investigated in rabbits. Pituitary extract produced hypocalcaemia and free fatty acid elevation in rabbits. The hypocalcaemic effect was not related to the lipolytic effect of the extract, since infusion of dextrose in water prevented the lipolytic effect without altering the hypocalcaemic effect of the pituitary extract.
Clinical Experience with Visken, (Prindolol) in Essential Hypertension: Its Special Comparative Action to Aldomet (Methyldopa)
Authors: Van Coller P E
Published: January 2017

There is sound statistical evidence that Visken in thirty randomly selected cases was on the average more effective than Aldomet. The results also show that Visken is an excellent drug to lower both systolic and diastolic pressures without a marked effect on posture. Higher systolic and diastolic pressures are lowered more effectively than the lower pressures. The fact also emerges that there is no sound statistical evidence that Visken is more effective for either of the sexes or that efficacy of therapy shows predeliction for a specific age group.

Visken was well tolerated and showed no significant side-effects.
A Clinical Trial of a New Anti-Inflammatory/Analgesic Compound in Rheumatoid Arthritis – GP 45 840
Authors: Ghazi S A , Fowler P D
Published: January 2017

GP 45 840, N-( 2-6-dichlorophenyl)-o-aminophenylacetic acid, sodium salt, has been shown pharmacologically to have good analgesic and anti-inflammatory properties.

GP 45 840 in progressively increasing dosage from 50 to 150 mg per day was compared with a placebo in a double-blind cross-over trial in thirteen patients with rheumatoid arthritis, GP 45 840 and placebo each being given for one week.

GP 45 840 produced no more intolerance than did placebo therapy. The rather high mean white cell count of the placebo period was lower during treatment with GP 45 840 but n ever below the normal range. GP 45 840 had no effect on weight, erythrocyte sedimentation rate, renal and liver function tests or other haematological tests.

The following features were assessed twice weekly; pain, morning stiffness, grip strength, swelling, tenderness, and range of certain joints, requirements of supplementary analgesics and drug intolerance.

An improvement, independent of the effects of GP 45 840 was observed in several of the features assessed, including decrease in potentially reversible joint swelling, but GP 45 840 resulted in a further significant reduction in pain and requirements of supplementary analgesics. An anti-inflammatory effect on early synovitis of the p.i.p joints was demonstrated though not conclusively proved.

The trial procedures were sufficiently sensitive to demonstrate significant improvement in many symptoms and signs of rheumotoid arthritis due to overall in-patient treatment during a two week period.

A new method of analysis of p.i.p size was used. Joints were graded clinically into four categories of joint swelling. Although overall measurements showed no significant change, a significant decrease in joint size was demonstrable in joints graded as having ‘definite’ synovial inflammatory changes.
A Clinical Trial of Opipramol in the Treatment of Symptoms of the Female Climacteric
Authors: Kagan G , Beaumont G
Published: January 2017

Thirty patients suffering from symptoms of the female climacteric were admitted to an open clinical trial. Twenty-seven completed eight weeks treatment with opipramol. A better response was obtained after eight weeks than after four weeks. Twenty-six of the twenty-seven patients were found moderately or much improved at the end of the trial. Better results were obtained in mild cases than in severe cases as assessed by the rating scale and in those patients who had ceased to menstruate. Of the target symptoms assessed vasomotor disturbances showed the best response, hot flushes being improved by 86% and sweating by 80% after eight weeks treatment.
Anti-Hypertensive Effect of Timolol, a New Beta-Blocking Agent (Double-Blind Study)
Authors: Alcocer Luis , Aspe Julio , Gomez Enrique Arce
Published: January 2017

The anti-hypertensive effect of timolol maleate (MK-950) was evaluated in patients with mild or moderate hypertension, in a double-blind, randomized, placebo controlled clinical trial.

The study was divided into a baseline placebo period, that lasted 9 weeks, during which documentation was made of the patient's untreated diastolic blood pressure. A 9 week titration period followed the placebo period, at which time patients were randomly assigned to an MK-950 or matching placebo group; the titration period was devoted to finding out the optimal dose of MK-950 or its matching placebo. The titration period was followed by a 6 week maintenance period during which patients were maintained on their optimal MK-950 or placebo dose.

Timolol is an effective anti-hypertensive drug and significantly reduces diastolic blood pressure. Its effect becomes apparent at the first week of treatment, and reaches maximum effectiveness at 4 weeks of treatment. The diastolic blood pressure in the timolol group remained consistently below 90 mm Hg and at the end of the study, the average diastolic blood pressure was: 88·57 ± 8·6 mm Hg (p > 0·001 in comparison with placebo). The average daily dose of timolol maleate was 31·10 ± 1·80 mg.

MK-950 has a strong negative chronotropic effect, capable of reducing the resting heart rate by an average of 28·50 beats/min. No correlation could be established between heart rate and blood pressure lowering effect. Other than bradycardia, no important side-effects were observed.
A Comparative Trial of Minocin (Minocycline Hydrochloride) and Ampicillin in the Treatment of Acute Exacerbations of Chronic Bronchitis
Authors: Burrow G R F , Fox A S , Daniel R J E
Published: January 2017

One hundred and fifteen patients suffering from acute exacerbations of chronic bronchitis took part in a double-blind, multicentre, clinical trial designed to compare the therapeutic efficacy and tolerability of ampicillin and minocycline hydrochloride, a new, long-acting, semi-synthetic tetracycline.

Both antibiotics were equally successful in treatment, there being no statistically significant difference between the two in any of the parameters studied.

Side-effects were few and far between. Only one patient out of the 57 who took minocycline, complained of dizziness.
A Controlled Clinical Comparison of Nasal Decongestants in Acute Rhinitis
Authors: Meurman O H
Published: January 2017

Three familiar commercial nasal decongestants were compared in a doubleblind trial using patients suffering from acute rhinitic conditions. Variables measured were quantity of medication used within a given period of time, onset of action, frequency of application and duration of action.

It was shown that in a given period of time the use of one trial product was significantly lower than that of the two other products with regard to establishing and maintaining free nasal breathing. There were indications that special biopharmaceutical factors in a product could control patients' self-dosage of the preparation thereby improving the risk/benefit relation considerably.

Another important conclusion was that the patient himself could handle a medicine reasonably and responsibly thereby providing valuable additional data for evaluation of a product under trial (consumer orientated research).
Combination Therapy of Extrapyramidal Disease with Trihexyphenidyl and L-Dopa
Authors: Hökendorf H
Published: January 2017

An electromyographic method was used to study the effect of combination therapy with L-dopa and trihexyphenidyl on tremor in thirty patients suffering from extrapyramidal motor system disease. In this method tremor activity was measured and documented so that the course of the disease could be followed objectively. L-dopa alone was slightly more effective against tremor than was trihexyphenidyl alone. The combination of the two drugs was more effective than either drug used alone, and its side-effects were mild and definitely fewer than had been reported with L-dopa combined with a decarboxylase inhibitor. Good control of tremor with L-dopa and trihexyphenidyl was obtained clinically and verified electromyographically.
Aldactone and Acebutolol in Treatment of Hypertension
Authors: Leary W P , Asmal A C , Williams P C , Marwick B
Published: January 2017

Twenty-one essential hypertensives were randomly treated with Aldactone, acebutolol or a combination of the two drugs. Statistically significant falls in systolic and diastolic pressures were demonstrated during treatment with Aldactone 100 mg daily, also when acebutolol and Aldactone 200 mg daily were administered. When the combination of Aldactone and acebutolol was given, diastolic pressures were lowered to a greater degree than seen with individual treatments.
A Comparison of Indoprofen and Indomethacin in the Supportive Treatment of Soft-Tissue Injuries in Football Players: A Pilot Study
Authors: Chiapuzzo A
Published: January 2017

Twenty-four professional footballers suffering from recent soft-tissue injuries were included in a double-blind pilot trial comparing the efficacy and tolerability of indoprofen 800 mg/day and indomethacin 80 mg/day. Twelve subjects were allocated at random to each of the two drugs. Mean reduction of pain and swelling by the 3rd day of treatment was greater in the indoprofen group, as was the rate of disappearance of these symptoms, calculated in terms of t ½. A statistically significant (p<0.05) superiority of indoprofen versus indomethacin was, however, reached only for pain elicited by active movement. No adverse reactions were recorded with either drug.
Clinical Trial of Xipamide in the Treatment of Hypertension
Authors: Lentini Sirio , Antonelli S , Leone G , Paoletti V
Published: January 2017

Nine patients with hypertension were given xipamide 40 mg orally as monotherapy on alternate days. An additional seventeen patients had xipamide added to an existing treatment regime of clonidine 450 micrograms per day. Xipamide alone produced a significant fall in blood pressure comparable to that obtained with clonldine alone. However, a significant further reduction was obtained when xipamide was added to the existing clonldine regime.
The Use of Timolol/Bendrofluazide (Prestim) in the Treatment of Hypertensive Patients Failing to Respond to other Antihypertensives
Authors: Ellis R , Wood S J T
Published: January 2017

This study was designed to assess the effectiveness of a timolol/bendrofluazide combination (Prestim®) in mild to moderate essential hypertension in patients not achieving control of blood pressure on a variety of drugs used alone or in combination (methyldopa, diuretics, beta-blockers, etc.). Normotension (diastolic blood pressure <95 mm Hg) was achieved in sixty-eight out of eighty-four (81%) patients with a mean daily dose of 1·9 tablets. Seven patients stopped therapy because of adverse reactions and eight patients did not respond to the maximum dose of four tablets daily. One other patient, initially controlled on two tablets daily, was uncontrolled at the final assessment. The change-over from previous therapy to Prestim was easily managed and no reports of metabolic disturbance were received. Prestim proved an effective alternative in patients not responding satisfactorily to other antihypertensive therapies.
Topical Tioconazole versus Systemic Ketoconazole Treatment of Vaginal Candidiasis
Authors: Rohde-Wemer Heidrun
Published: January 2017

A total of forty patients participated in an open, randomized study to compare the efficacy and toleration of a single dose of topical tioconazole 6% vaginal ointment with 5 days treatment of systemic ketoconazole (400 mg/day) in patients with symptomatic vaginal candidal infection. Disease in patients of both treatment groups was effectively eradicated after 5 weeks of therapy. Symptoms of patients receiving topical therapy responded more quickly than those of patients receiving oral therapy. Side-effects were more prevalent with ketoconazole systemic therapy. Overall, topical therapy with tioconazole was preferred over systemic ketoconazole therapy for these women with symptomatic vulvovaginitis due to Candida albicans.
Double-Blind Crossover Study of the Efficacy and Acceptability of Oxazepam Expidet® Tablets Compared to Placebo in Patients Undergoing Gynaecological Surgery
Authors: Brampton W J , Plantevin O M
Published: January 2017

In a double-blind crossover trial, the hypnotic efficacy and acceptability of oxazepam Expidet®, a fast-dissolving tablet, was compared to placebo in patients undergoing minor gynaecological surgery. Patients received 30 mg oxazepam Expidet® or placebo the night before their operation and the alternate medication the night after. A sleep questionnaire was completed the morning after both nights and acceptability was assessed the morning after the second night. Data were available for analysis on seventy-two patients aged 18–50 years. There was a significant improvement In sleep onset and quality and less awakenings after oxazepam compared to placebo (p ≤ 0·01). There was no significant difference in the occurrence or type of dreams, or morning-after symptoms. There was a significant preference for oxazepam compared to placebo and for the fast-dissolving Expidet® form compared to conventional tablets or capsules (p ≤ 0·01). There were no adverse reactions in the oxazepam group. It was concluded that oxazepam Expidet® was an effective and acceptable hypnotic in this group of patients.
Controlled Trial of Pyridoxine in the Premenstrual Syndrome
Authors: Williams Melanie J , Harris Raymond I , Dean Bernard C
Published: January 2017

A total of 617 patients diagnosed by their general practitioner, according to set criteria, as having premenstrual symptoms were treated in general practice for three menstrual cycles with either pyridoxine or placebo. Treatment was randomized and administered blind. In the 434 patients analyzed, an improvement was found in 7 of the 9 symptoms assessed for both treatments, but the differences between treatments did not reach conventional significance levels. However, improvement as measured by global assessment after three cycles was significantly greater in the patients treated with pyridoxine (p < 0·02).
A Comparative Study of Adsorbed Tetanus Vaccine
Authors: Mayer A D , McMahon M J , Telford D R , Balfour A H , Harford J
Published: January 2017

A study is reported in which 197 volunteers were given adsorbed tetanus vaccine from two different sources. Using an ELISA system all pre-vaccination sera were screened. Both pre- and post-vaccination sera from volunteers with an initial antibody level of < 1 iu/ml were then titrated and the antibody response analyzed. The results confirm that both vaccines produced an excellent antibody response with little difference in reactogenicity.
Antianxiety Properties of Lormetazepam. A Double-Blind Crossover Trial versus Diazepam
Authors: de Leo Diego , Ceccarelli Giovanni
Published: January 2017

A double-blind crossover trial was carried out to compare the anxiolytic activity of lormetazepam vs diazepam. After 1 week of placebo, the drugs were administered for 4 weeks (10 drops twice daily) to 10 subjects with anxiety disorders. Each patient received either lormetazepam or diazepam and modifications of symptoms were evaluated through a series of tests at various intervals (days 0, 8, 16, 24, 32 and 40 of the study). Both drugs proved to be effective and significantly superior to placebo. They were both well tolerated.
The Role of Prenylamine in the Prevention of Adriamycin-Induced Cardiotoxicity. A Review of Experimental and Clinical Findings
Authors: Milei J. , Vazquez A. , Boveris A. , Llesuy S. , Molina H. A. , Storino R. , Marantz A.
Published: January 2017

Experimental and clinical trials to determine the potential of prenylamine in the prevention of adriamycin-related cardiotoxicity are reviewed. In mice given 4 mg/kg body weight adriamycin, the incidence of myocardial damage after 19 days' treatment was lower than in those given adriamycin and placebo. Rabbits were given adriamycin (total dose 10.8 mg/kg body weight), adriamycin plus prenylamine (1.5 mg/kg body weight), and adriamycin plus vitamins A (250 IU) and E (40 mg) for 9–11 weeks. Adriamycin-induced electrocardiogram changes were observed to a lesser extent in animals also receiving prenylamine. Heart homogenates from adriamycintreated animals showed enhanced hydroperoxide-initiated chemiluminescence which was not affected by the simultaneous administration of prenylamine. The extent of adriamycin-induced myocytolysis and the degree of alterations observed on electron microscopy were markedly reduced by prenylamine. In a double-blind clinical trial with 26 oncological patients, no cardiomyopathy, arrhythmia or adverse reactions were observed in the group given adriamycin plus prenylamine. In those given adriamycin plus placebo, two patients developed congestive cardiopathy and another showed severe supraventricular arrhythmias together with hypotension and dyspnoea. The mechanisms of adriamycin-related cardiotoxicity, the effects of prenylamine and the benefit from combined treatment are discussed.
Treatment of Small Intestine Bacterial Overgrowth with Rifaximin, a Non-Absorbable Rifamycin
Authors: Corazza G. R. , Ventrucci M. , Strocchi A. , Sorge M. , Pranzo L. , Pezzilli R. , Gasbarrini G.
Published: January 2017

In twelve patients affected by small bowel bacterial overgrowth, diagnosed by means of the lactulose hydrogen breath test, the therapeutic efficacy of a non-absorbable derivative of rifamycin, rifaximin, was evaluated. This study showed that this drug has a satisfactory therapeutic efficacy in contaminated small bowel syndrome and, at the doses tested, is free of side-effects.
Salsalate in the Treatment of Rheumatoid Arthritis: A Double-Blind Clinical and Gastroscopic Trial versus Piroxicam. II – Endoscopic Evaluation
Authors: Porro G. Bianchi , Petrillo M. , Ardizzone S.
Published: January 2017

A double-blind, double-dummy controlled study to compare the clinical efficacy and gastric tolerability of salsalate and piroxicam in the treatment of rheumatoid arthritis was performed. A total of 23 patients were treated with 1.5 g salsalate twice daily and 20 with 20 mg piroxicam (after the evening meal) for 4 weeks. Patients were submitted to gastroscopy at the start and end of treatment; only patients who presented a normal baseline gastroscopy were admitted to the trial. At the end of the planned treatment period, a statistically significant improvement of all clinical variables was observed in both treatment groups, the difference between the two drugs not being statistically significant. Five of 20 (25%) piroxicam treated patients and only 2/19 (11%) salsalate treated patients showed gastric lesions at final endoscopy. No relationship was found between dyspeptic symptoms and endoscopic lesions. The results show that salsalate and piroxicam have equal efficacy in relieving arthritic symptoms, but salsalate causes fewer gastric lesions.
Comparison of Single Administration with an Ovule of 600 mg Fenticonazole versus a 500 mg Clotrimazole Vaginal Pessary in the Treatment of Vaginal Candidiasis
Authors: Wiest W. , Azzollini E. , Ruffmann R. , Colli Enrico
Published: January 2017

Fenticonazole is an imidazole derivative with a broad spectrum of antimycotic activity. The therapeutic activity and tolerability of 600 mg fenticonazole versus 500 mg clotrimazole were evaluated in an investigator-blind trial in 80 patients with mycologically confirmed vaginal candidiasis. Fenticonazole was administered as an ovule and clotrimazole as a vaginal pessary, both in a single administration. Therapeutic efficacy was assessed by microbiological and clinical criteria 7 days after the start of treatment. Patients cured at the end of the trial were rechecked 4–5 weeks after the start of therapy in order to identify and evaluate possible relapse. Both treatments resulted in a statistically significant reduction in vaginal symptoms (erythema, itching, discharge and oedema) and in elimination of Candida albicans in about 90% of patients. The tolerance of both treatments was excellent since no local or systemic signs or symptoms of toxicity were reported. An equally high efficacy and safety for both drugs in the elimination of symptoms and objective evidence of vaginal candidiasis was indicated.
Oral Bioavailability of Atenolol
Authors: Vergin H. , Nitsche V.
Published: January 2017

The bioavailability of two formulations of atenolol was compared in an open, randomized crossover study. Each film-coated tablet contained 100 mg of active drug. The plasma concentrations of atenolol were determined using a newly developed and specific high-performance liquid chromatography procedure. The areas under the concentration – time curves (AUC) were calculated, as were pair differences and ratios for individual AUC values and for maximum plasma levels. The latter were determined (Cmax.(c)) and calculated (Cmax.(c)) at the corresponding time values ( tmax.) for test and reference formulations, and were then tested for statistical significance. The 95% confidence limits for both test and reference preparations, taken according to Westlake or Wilcoxon, were found to be 80.0 − 114.7% for AUC, 80.2 − 119.9% for Cmax. and 74.5 − 132.8% for tmax. In terms of pharmacokinetic target criteria, therefore, it can be seen that there were no substantial differences between the two film-coated tablets. The two atenolol preparations, therefore, may be classified as bioequivalent.
A Multicentre Trial to Evaluate the Efficacy and Tolerability of α-Glycerylphosphorylcholine versus Cytosine Diphosphocholine in Patients with Vascular Dementia
Authors: Perri R. Di , Coppola G. , Ambrosio L.A. , Grasso A. , Puca F.M. , Rizzo M.
Published: January 2017

An open clinical trial was carried out to compare the efficacy and the tolerability of 1 g/day α-glycerylphosphorylcholine (α-GPC) with 1 g/day cytosine diphosphocholine (CDP) both given intramuscularly for 90 days in 120 patients with mild to moderate vascular dementia. The clinical evaluation, carried out at the start as well as halfway through (45 days) and at the end of treatment (90 days), was expressed by psychometric tests (modified Parkside behaviour rating scale, Sandoz clinical assessment geriatric scale, word fluency test, Hamilton's rating scale of depression, narration subtest of Wechsler memory scale). Both treatments produced a definite symptomatic improvement and showed a very good tolerability. The results suggest that in most tests α-GPC possessed a statistical higher efficacy and an overall more satisfactory activity assessed by both patients and investigators compared with CDP.

E’ stato effettuato uno studio clinico in aperto per confrontare l'efficacia e la tollerabilità di α-glicerilfosforilcolina (α-GFC) alla dose di 1 g al giorno verso citosina difosfocolina (CDP) sempre alla dose di 1 g al giorno, somminístrate entrambe per via intramuscolare per 90 giorni in 120 pazienti affetti da demenza vascolare di grado da lieve a medio. La valutazione clinica, effettuata all'inizio, a metà (45 giorni) e al termine del trattamento (90 giorni), è stata effettuata con test psicometrici (modified Parkside behaviour rating scale, Sandoz clinical assessment geriatric scale, word fluency test, Hamilton rating scale per la depressione ed subtest del racconto della Wechsler memory scale). Entrambi i trattamenti hanno indotto un miglioramento della sintomatologia e hanno presentato una buona tollerabilità. I risultati mostrano che, nella maggior parte dei test, α-GFC ha presentato una più elevata efficacia, a confronto con CDP, come confermato anche dalle valutazioni soggettive espresse dai pazienti e dagli esaminatori.
Pharmacokinetics of Rheumatic Fever Prophylaxis Regimens
Authors: Thamlikitkul V , Kobwanthanakun S , Pruksachatvuthi S , Lertluknithi R
Published: January 2017

The pharmacokinetics of benzathine penicillin G (1200000 IU given intramuscularly), penicillin V (250 mg given orally twice daily), erythromycin stearate (250 mg given orally twice daily) and roxithromycin (150 mg given orally once daily) were investigated. The drugs were given prophylactically to prevent the recurrence of rheumatic fever to 20 patients attending a rheumatic fever clinic in a study of crossover design. Serum antibiotic concentrations were determined by microbiological assay at intervals of up to 28 days after intramuscular injection and immediately before and 1–2 h after the fifth oral dose. The concentrations of penicillin G in all serum samples obtained on day 28 after parenteral benzathine penicillin G administration were greater than 0.01 mg/dl. Most patients had no detectable penicillin V or erythromycin in blood samples drawn immediately before the fifth dose. The concentration of roxithromycin at 24 h after the dose was greater than 1.2 mg/dl in all patients. Based on the pharmacokinetic profiles, it is suggested that 1200000 IU benzathine penicillin G given every 4 weeks is an appropriate regimen for preventing the recurrence of rheumatic fever in Thai adults. Roxithromycin had much better pharmacokinetics than penicillin V and erythromycin stearate, and is probably the best alternative regimen to intramuscular penicillin G.