A comparative study of frusemide-amiloride and cyclopenthiazide-potassium chloride in the treatment of congestive cardiac failure in general practice.

Forty-seven patients entered this comparison of frusemide-amiloride and cyclopenthiazide-potassium chloride in the treatment of congestive cardiac failure in general practice. Frusemide-amiloride was 'very satisfactory' in 92% of the patients compared to only 55% who took cyclopenthiazide-potassium chloride. Significantly more patients were free of paroxysmal nocturnal dyspnoea and orthopnoea after taking frusemide-amiloride.

A double-blind comparison of two lormetazepam doses in elderly insomniacs.

The relative efficacy and tolerability of two lormetazepam doses, 0.5 mg and 1.0 mg, were compared in 145 elderly insomniacs in a double-blind, multi-centre study. On entry, data were recorded on the patient characteristics and sleep pattern, and patients were allocated at random to receive treatment with either 0.5 mg or 1.0 lormetazepam per night for 7 nights. Details were recorded daily in a diary by patients on sleep latency, the number of night-time awakenings, time of morning awakening, and whether they awoke refreshed. A record was also kept of any adverse effects of treatment. At the end of the study period, an overall assessment was made by the physician of the patients' response to treatment. The results showed that patients in both dose groups improved significantly (p = 0.001) in the three principal efficacy measures, but there were no apparent trends in the time when patients awakened in the morning. The only evidence of a difference in response to the two doses was that significantly (p less than 0.01) more patients on the larger dose were given a global rating of 'much improved' by the physician. Five patients withdrew from the study; 2 because of lack of efficacy, 2 because of side-effects, and 1 because of a suspected myocardial infarction not related to therapy. Only 6% of patients (4 on each dosage) reported adverse effects, most frequently related to carry-over sedation, i.e. drowsiness, sleepiness, muzzy head. (ABSTRACT TRUNCATED AT 250 WORDS)

A long-term open study of a frusemide/amiloride combination ('Frumil') in elderly patients with congestive cardiac failure.

Twenty-seven patients (mean age 72 years) with symptoms of congestive cardiac failure who had been controlled by treatment with 1 to 2 tablets per day of a combination preparation of frusemide (40 mg) and amiloride (5 mg) for at least 12 weeks were studied. The study was designed to assess the efficacy and tolerability of continuing treatment with the combination for a further 9 months, i.e. a total period of 12 months. Assessments of disease status and laboratory data were made every 3 months. Reasonable control of symptoms was achieved over the 12-month period although the majority of patients did not show a clinically important change. Some overall trends towards increasing oedema, dyspnoea and orthopnoea were observed as the study progressed, but these changes were not regarded as unusual considering the patients' age group. Significant increases in pulse rate and decreases in blood pressure were demonstrated, suggesting that diuresis was maintained. The combination preparation was well tolerated without any reports of side-effects.

Frusemide/amiloride combination ('Frumil') in heart failure: an open, multi-centre study in general practice.

A total of 95 patients seen in general practice with oedema associated with heart failure took part in an open study of the efficacy and tolerability of a combination tablet containing 40 mg frusemide and 5 mg amiloride. The study was of 3-months' duration and patients received a dosage of 1 to 2 tablets once daily. Efficacy was assessed by physicians' scores for ankle, leg and lumbosacral oedema and pulmonary crepitations, body weight and physicians' global clinical impression. In addition, patients recorded their symptom severity in study diaries during the first 7 days of therapy, and the day before each trial visit. On the basis of the physicians' overall impression of response to therapy, 89 (93.7%) of the patients were graded as 'excellent', 'good' or 'adequate' responders. Improvement in severity scores for oedema, crepitations and body weight also followed this pattern, although certain symptoms were mild or absent in some patients at recruitment. Nine patients were withdrawn from the study, 4 due to drug-related adverse effects. There was no evidence of any consistent change in serum potassium levels or other clinical chemistry, liver function tests or haematology during the study.

Comparative efficacy of 3-day and 7-day chemotherapy with twice-daily pivmecillinam in urinary tract infections seen in general practice.

In a multi-centre general practice study, 183 females suffering from symptoms of acute urinary tract infection were randomly assigned to receive 400 mg pivmecillinam twice-daily for either 3 or 7 days. The clinical response was equally good in both treatment groups with a mean reduction in symptom scores of 88%. Positive pre-treatment bacteriological cultures were obtained from 48 (36%) of the 134 patients for whom data were complete. Bacteriological cure was achieved in all these patients except for 1 in the 3-day treatment group. Pivmecillinam was well tolerated, with side-effects reported by 7 (7%) patients in the 3-day group and 12 (13%) patients in the 7-day group. One patient in the 3-day group and 2 patients in the 7-day group stopped treatment prematurely due to side-effects.

Adenosylhomocysteine hydrolase. Crystallization of the purified enzyme and its properties.

Adenosylhomocysteine hydrolase (EC 3.3.1.1) from calf liver was purified to homogeneity by crystallization. The purified enzyme exhibited one single component in polyacrylamide gel electrophoresis. But by Ampholine gel electrophoresis, two isoelectric focusing variants were observed, with pI values at 5.8 and 6.0. when subjected to polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate, one major subunit with a molecular weight of 60,000 was found; five other minor subunit variants were also observed, with molecular weights ranging between 50,000 and 57,000. These minor subunit variants comprised approximately 15% of the total protein applied. The molecular weight of the native enzyme was estimated to be 237,500 by gradient gel electrophoresis. The native enzyme is probably composed of four subunits, each with a molecular weight of not more than 60,000. Amino acid analyses of the purified enzyme revealed the presence of 1.2 residues of glucosamine/mol of enzyme, in addition to all of the common amino acids. The presence of enzyme-bound NAD was confirmed, probably 1 NAD molecule bound/enzyme subunit. In addition to adenosine, 3-deazaadenosine was found to be an effective substrate as well in the direction of synthesis.