Enprostil and ranitidine: comparative efficacy and safety in patients with duodenal ulcer.

This randomised, double-blind, double-dummy, multiclinic study of duodenal ulcer healing compared the efficacy and safety of enprostil with ranitidine. The six week trial admitted 164 patients with endoscopically demonstrated duodenal ulcer. Ratings of symptoms and adverse events were collated from patients' daily diaries, and endoscopy was repeated to verify healing after four weeks and, if appropriate, after six weeks. Medication used was enprostil (35 micrograms capsule) or ranitidine hydrochloride (150 mg tablet) with matching placebos twice daily. After six weeks, 81% of patients treated with enprostil and 95% of those treated with ranitidine had healed ulcers, a statistically significant difference (p = 0.007). There were no differences between treatment groups for the number of days until the daytime ulcer pain completely ceased. Night-time ulcer pain ceased significantly earlier in the group receiving ranitidine (p = 0.019) and was less severe during the week before the last visit (p = 0.001); daytime pain for ranitidine users was also less severe (p = 0.020) during this week. Mild to moderate adverse experiences were reported by 44% of enprostil and 35% of ranitidine patients. There were no severe adverse events. In conclusion, both enprostil and ranitidine were found to be safe and effective in the treatment of duodenal ulcer. However, the ranitidine regimen used in this trial produced better results than the enprostil regimen.

Takayasu's disease associated with generalised amyloidosis.

A case of Takayasu's disease in a young Caucasian female is described. The major complications which developed over the ten year course of the disease include nephrotic syndrome, severe refractory hypertension, aortic valve regurgitation associated with aneurysmal dilatation of the ascending aorta, and recurrent congestive heart failure. Amyloid deposits have been demonstrated in the aorta, atrial appendage, aortic valve, and renal cortex. The association of amyloidosis and Takayasu's disease is discussed.

Acute oesophagitis due to emepronium bromide.

Six cases of endoscopically documented acute oesophagitis during therapy with emepronium bromide (Cetiprin) for urinary symptoms are described. The oesophagitis was associated with acute severe retrosternal pain and dysphagia which resolved spontaneously on stopping medication. The potential of this drug to induce severe oesophageal inflammation and ulceration should be emphasised.

Porphyria cutanea tarda and the pill: case report.

A patient is described who developed porphyria cutanea tarda in association with the use of a contraceptive pill. The relationship to porphyrin metabolism as at present understood, as well as the significance of abdominal pain and change in psyche, is discussed. Stopping the pill has been associated with a remission.

Serum vitamin B 12 levels and vitamin B 12 binding capacity in pregnant and non-pregnant Europeans and West Indians.

The vitamin B(12) level and the capacity of serum to bind B(12) are higher in the West Indian population living in Great Britain than in Europeans. The B(12) level fell during pregnancy in both groups but remained higher in the West Indians. West Indians had higher levels of IgG.