In a double-blind, randomized, multicenter trial in 80 consecutive outpatients with endoscopically verified duodenal ulcer, we have tested the ulcer-healing efficacy of a quite low dose of antacids, given only four times daily. The patients received one chewable aluminum-magnesium-antacid tablet (buffering capacity, 30 mmol/tablet) or placebo 1 h after meals and at bedtime. Re-endoscopy after 4 weeks of treatment showed healed ulcer in 28 of 38 patients (74%) in the antacid group, compared with 11 of 38 patients (29%) in the placebo group (p less than 0.001). The number of days and nights with ulcer pain was significantly less in the antacid group than in the placebo group during the treatment period. Thus, only four antacid tablets a day, with a total buffering capacity of 120 mmol/day, significantly promote duodenal ulcer healing and pain relief.
THE rapid increase in the use of serum, plasma and universal donor blood for transfusion has renewed interest in the possible dangers of high-titre iso-agglutinins. !I'he view is widely held that such agglutinins are dangerous. Witebsky et al. (1940), in a recent review of the literature, conclude that the transfusion of 0 blood into A and B patients causes a larger percentage of reactions than the use of homologous blood, these additional reactions being attributed to the effect of the anti-A and anti-B iso-agglutinins. Hesse (1935), who has investigated the problem of reactions from 0 blood, states that a high agglutinin titre may sometimes be responsible. He takes the rather extreme view that over 30 per cent. of group 0 donors have dangerously high titres. Wiener (1939, pp. 49 and 92) and Riddell (1939, p. 53) advise against the use of group 0 donors with high iso-agglutinin titres. Some writers, however, think that the strength of the iso-agglutinins in the plasma of donors can safely be ignored. Tatum et al. (1939) state that plasma can be transfused without typing or cross-agglutinating. Brines and Manning (1941 a and b )report a considerable number of transfusions of plasma, in 50 per cent. of which the plasma contained iso-agglutinins for agglutinogens in the recipient's red cells, without a single reaction. They consider that the agglutinin titre is of no practical importance. These references, which are by no means exhaustive, serve to show the diversity of views held.
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