Markers of slow-healing peptic ulcer in the elderly. A study on 1,052 ranitidine-treated patients.

Little is known about ulcer outcome in the elderly. The aims of the present paper were to establish whether risk factors of slow-healing peptic ulcer can be demonstrated in the elderly and whether clinical differences exist between ulcer patients whose age of onset of the disease was before or after 65 years old. The short-term, open study, involving 1052 elderly patients (over 65 years) in 37 gastroenterology centers throughout Italy aimed to compare two schedules of ranitidine treatment: 150 mg twice daily versus 300 mg at bedtime. As nonsignificant differences were found between these two schedules, the sample was considered as a whole. It included 319 gastric ulcer (GU) patients, 699 duodenal ulcer (DU) patients, and 34 concomitant GU and DU cases. Ninety-three patients dropped out of the trial; 79/294 GU, 138/635 DU, and 10/30 GU+DU were found still unhealed after four weeks and 20 GU, 15 DU, and 1 GU+DU remained so after eight weeks. Statistical analysis was performed using likelihood-ratio and Pearson's chi-squared tests and Cox's models. Univariate analysis showed that the indicators of slow-healing GU were ulcer size (P = 0.002) and persisting ulcer symptoms (P = 0.0001); indicators of slow-healing DU were ulcer size (P = 0.0001), persisting ulcer symptoms (P = 0.0001), alcohol (P = 0.0003), and NSAID (P = 0.0088) consumption. DU patients taking antiplatelet drugs have significantly better results after four weeks and worse results after eight weeks (P = 0.0352).(ABSTRACT TRUNCATED AT 250 WORDS)

[Bipolar disorder: clinical trials with fluoxetine]. / Disturbo bipolare: esperienze cliniche con fluoxetina.

Sixty patients (39 females and 21 males) aged between 20 and 65 (average 48.5) with bipolar disorder in the depressive phase, according to the DSM III-R diagnostic criteria, were treated with fluoxetine (20-60 mg/die) for 8 weeks. Evaluation of therapeutical efficacy was performed at 0 time and after 14, 28, 42, and 56 days, using the following psychometric tests; HAM-D, SCL-90, CGI. At the end of treatment 42 patients (70%) showed a reduction of the HAM-D score over 50%. Clinical results suggest that fluoxetine is affective in bipolar disorder. Tolerability was judged good and very good in 76% of patients. Side effects were very mild and in any case of rapid regression.

[Efficacy and tolerance of aniracetam in elderly patients with primary or secondary mental deterioration]. / Efficacia e tollerabilità dell'aniracetam in pazienti anziani affetti da deterioramento mentale primitivo e secondario.

The study was carried out on 60 patients (mean age 69.9 +/- 10.3 years) suffering from slight-moderate brain pathology primary or secondary to vascular forms. Patients were treated with 1500 mg/day per os of Aniracetam or placebo. Drug efficiency evaluation was performed utilizing the following psychometric tests: Blessed Scale, figures repetition test, Benton test, Corsi test, Rey test, Pieron test, phrases construction test, verbal fluency test. They were carried out during basal visit after two and four month treatment. In Aniracetam treated group the score showed a significant improving during the first and second control. In placebo treated group no change statistically considerable happened in any test. Aniracetam has proved to be a useful drug in slight-moderate brain decay treatment of the elderly.