RESUMO
Six asymptomatic, non-smoking men with endoscopically proven duodenal ulcer disease received single nocturnal doses of placebo, 40 mg famotidine and 300 mg ranitidine each for 1 week prior to serial measurement of pH, peptic activity and serum gastrin concentrations over 24 h and of acid output. The intragastric pH fluctuated between 1.53 and 5.07 when subjects were given placebo but within 2 h of taking famotidine or ranitidine it rose to 5.57 or higher; the effect lasted for 12 h from midnight. Peptic activity fell during famotidine and ranitidine treatment and the decline was somewhat greater 8-15 h after using famotidine. Serum gastrin levels did not change materially with any treatment. The study shows the equivalent effect of standard bed-time doses of famotidine and ranitidine on intragastric pH, acid output and serum gastrin concentrations in asymptomatic men with duodenal ulcer disease.
Assuntos
Úlcera Duodenal/tratamento farmacológico , Famotidina/uso terapêutico , Ácido Gástrico/metabolismo , Ranitidina/uso terapêutico , Adulto , Método Duplo-Cego , Úlcera Duodenal/fisiopatologia , Determinação da Acidez Gástrica , Suco Gástrico/efeitos dos fármacos , Suco Gástrico/metabolismo , Gastrinas/sangue , Humanos , Concentração de Íons de Hidrogênio , Masculino , Pepsina A/metabolismoRESUMO
The Medical Record departments of the five teaching hospitals in Edmonton, plus the 37 community hospitals in the eight census districts of the northern half of the province of Alberta, Canada, were contacted, and a search was made of all patients with a discharge diagnosis of Crohn's disease or ulcerative colitis. Also, the patient records of all Edmonton gastroenterologists were reviewed to discover patients with Crohn's disease or ulcerative colitis who had never been hospitalized within these census areas. From January 1, 1977, to December 31, 1981 (which was the prevalence date), the population was 1,295,360. Of the 2,419 patients with inflammatory bowel disease, 48.5% had definite Crohn's disease and 33% had definite ulcerative colitis. There were 1,716 (70.9%) patients analyzed in this study. The factorial analysis of disease prevalence per 10(5) population revealed that significant differences were found for location of residence, sex, and age. The prevalence of Crohn's disease was higher in urban than in rural areas and in females than in males, whereas the prevalence of ulcerative colitis was unaffected by these variables. The peak prevalence of Crohn's disease was below age 29 in males and females, and the prevalence in young women at this age was approximately twice that in males. The highest prevalence of Crohn's disease was in urban females aged 20-39 (greater than 234 cases/10(5) population), with similar prevalence rates in urban males and rural females, and with the lowest prevalence rates in rural males. The incidence of Crohn's disease was greater than for ulcerative colitis, began to increase in about 1965, and reached a plateau in the late 1970s. In conclusion, the demonstration of an age, location of residence, or effect of sex on the prevalence of inflammatory bowel disease requires multiple factorial analyses. When the sample is extrapolated to the total diseased population of the region, a prevalence value of 330/10(5) was derived for young female urban individuals residing in this northern area.
Assuntos
Colite Ulcerativa/epidemiologia , Doença de Crohn/epidemiologia , Fatores Etários , Alberta , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Prontuários Médicos , População Rural , Fatores Sexuais , População UrbanaRESUMO
In view of in vitro tests suggesting good performance of an experimental tablet formulation of an aluminum hydroxide-magnesium hydroxide antacid, a study was conducted to evaluate the efficacy in vivo. Twenty-three healthy men and women were enrolled in the study, which was carried out in two parts: fasting and postprandial. Eight of the volunteers failed to qualify because of repeated baseline pH greater than 2.5. In the 15 participants who qualified, the intragastric pH was monitored for up to 240 minutes after the administration of one or two experimental tablets, 5 or 10 ml of a commercially available liquid antacid, or placebo. In the fasting subjects (n = 10), the antacids rapidly increased the mean pH. One antacid tablet and 5 ml of liquid antacid yielded similar results, with mean peak pH values of 5.2 and 4.8 and durations above pH 3.5 of 25 and 40 minutes, respectively. When the doses were doubled, 10 ml of liquid produced a peak pH of 6.7 and maintained the pH above 3.5 for 40 minutes, whereas two tablets produced a peak pH of 4.8 and maintained pH above 3.5 for 15 minutes. In the fed subjects (n = 10), neither antacid formulation at either dose significantly raised intragastric pH. Further studies are needed to establish the optimal time for postprandial administration of antacids.