RESUMO
Thirty-seven patients with chronic duodenal ulceration were entered into an endoscopically controlled trial of cimetidine (Tagamet) versus tri-potassium di-citrato bismuthate (De-Nol). At six weeks, 83% of patients taking cimetidine showed complete ulcer healing compared with 74% of patients taking tri-potassium di-citrato bismuthate. By ten weeks, the corresponding figures were 89% and 84% respectively. Symptomatic relief was similar in both treatment groups and, despite advice to the contrary, continued smoking and alcohol consumption did not appear to adversely affect healing. Both drugs appear to be equally effective in healing chronic duodenal ulcers.
Assuntos
Antiulcerosos/uso terapêutico , Bismuto/uso terapêutico , Cimetidina/uso terapêutico , Úlcera Duodenal/tratamento farmacológico , Guanidinas/uso terapêutico , Compostos Organometálicos , Adulto , Idoso , Consumo de Bebidas Alcoólicas , Doença Crônica , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , FumarRESUMO
The association of chronic liver disease with long-standing arsenic ingestion is well documented, although the spectrum and incidence of liver disease due to arsenic remain uncertain. We report two patients with chronic liver disease and arsenical skin changes that followed previous chronic arsenic ingestion. One patient developed macronodular cirrhosis and the other non-cirrhotic portal hypertension with perisinusoidal fibrosis. The latter patient developed a primary liver cell cancer. There is only one previously reported case of malignant hepatoma in a non-cirrhotic liver complicating chronic arsenicism. Lack of awareness of this uncommon but well described cause of chronic liver disease may account for a small proportion of patients with "cryptogenic" liver disease. Previous arsenic administration should be considered as a cause of chronic liver disease, especially when typical skin changes or internal neoplasia develop.
