SUMMARY Sixty patients with gastric ulcers were treated for four weeks with either 1 g cimetidine per day or with identical tablets containing lactose. The healing rate, assessed by endoscopy, was 23 out of 35 (66%) in the patients given cimetidine and 13 out of 25 (52%) in those given placebo. The difference between the groups is not significant. During each of the four weeks of the study the cimetidine group experienced significantly fewer attacks of pain and consumed less antacids than the placebo treated patients.The effectiveness of the histamine H2 antagonist cimetidine in duodenal ulcer is now well known. Its value in gastric ulcer has yet to be established. We report the results of a double blind trial of four weeks' treatment with cimetidine 1 g daily in the management of gastric ulcer.
MethodPatients admitted to the trial were ambulant and had been shown to have a gastric ulcer by fibreoptic gastroscopy within the previous four days. None had previously received cimetidine. At the beginning only patients considered unsuitable for treatment with carbenoxolone were included. These were either aged over 60 years, had a history of cardiovascular disease, or had already been unsuccessfully treated with carbenoxolone. After encouraging preliminary results, however, with 80 % healing of the first ulcers studied (Ciclitira et al., 1976), it was decided to include patients who previously would have been treated with carbenoxolone. Any ulcer proximal to the pylorus was included in the study and all were brushed and biopsied to exclude malignancy.Patients were allocated at random to receive either cimetidine 200 mg tds and 400 mg at night for four weeks, or identical tablets containing lactose. Both groups were supplied with unlabelled antacid tablets whose buffering capacity is 15-1 mmol per tablet (Rennies, Nicholas Laboratories), to be taken whenever necessary for relief of ulcer pain. All other 'Drummond Research Fellow 1977-79. "Present address: Wellcome Research Fellow, Department of Gastroenterology, St Bartholomew's Hospital, London EC1. Received for publication 12 February 1979 therapy was forbidden. Symptoms in the week before entering the trial were assessed by asking the patient to recall how many attacks of pain he had suffered. Subsequently all patients recorded on diary cards the number of attacks of pain suffered and the number of antacid tablets consumed. A return tablet count was made at each clinical visit to check that treatment had been correctly taken.The patients were seen in outpatients after two weeks and at the end of the four week trial period. At these visits haemoglobin, white cell count, liver function tests, urea and electrolytes estimations were performed. At the end of the trial the endoscopy was repeated.
ResultsSeventy patients entered the trial. Ten had to be withdrawn for various reasons including the subsequent discovery of malignancy in the biopsy (six) or default (two). In two cases (both on placebo) haemorrhage occurred within 48 hours of entry to the trial. These case...
Background
There are no antiviral therapies for Parainfluenza virus (PIV) infections. DAS181, a sialidase fusion protein, has demonstrated activity in in vitro and in animal models of PIV.
Methods
Adult immunocompromised patients diagnosed with PIV lower respiratory tract infection (LRTI) who required oxygen supplementation were randomized 2:1 to nebulized DAS181 (4.5 mg/day) or matching placebo for up to 10 days. Randomization was stratified by need for mechanical ventilation (MV) or supplemental oxygen (SO). The primary endpoint was the proportion of patients reaching clinical stability survival (CSS) defined as returning to breathing room air (RTRA), normalization of vital signs for at least 24 hours, and survival up to day 45 from enrollment.
Results
A total of 111 patients were randomized to DAS181 (n=74) or placebo (n=37). CSS was achieved by 45.0% DAS181 treated patients in the SO stratum compared with 31.0% for placebo (p=0.15), while patients on MV had no benefit from DAS181. The proportion of patients achieving RTRA was numerically higher for SO stratum DAS181 patients (51.7%) compared with Placebo (34.5%) at Day 28 (p=0.17). In a post-hoc analysis of solid organ transplant, hematopoietic cell transplantation within one year, or chemotherapy within one year, more SO stratum patients achieved RTRA on DAS181 (51.8%) when compared to placebo (15.8%) by day 28 (p=0.012).
Conclusion
The primary endpoint was not met, but post-hoc analysis of the RTRA component suggests DAS181 may have clinical activity in improving oxygenation in select severely immunocompromised patients with PIV LRTI who are not on mechanical ventilation.
Background: To investigate whether Transversus Abdominis Plane (TAP) block using either 0.5% or 0.25% bupivacaine confers additional analgesia for Cesarean section patients when compared to placebo.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.