Prevalence of latent portasystemic encephalopathy in an unselected population of patients with liver cirrhosis in general practice.

To evaluate the prevalence of latent PSE in unselected ambulatory patients with liver cirrhosis practicing physicians were asked to perform two non instrumental psychometric tests (number connection test and line tracing test) on patients with clinical signs of liver cirrhosis and portal hypertension. Tests were repeated after 8 weeks of treatment with Lactulose in those patients considered to have latent PSE at the initial evaluation. 296 physicians tested a total of 783 patients, 771 of these could be evaluated. 551 patients (71.5%) were considered to have latent PSE. There was a significant correlation between psychometric test results and biochemical parameters related to liver function. Repeat testing after 8 weeks treatment with Lactulose revealed definite improvement of psychometric test results in 88% of the patients. At the final evaluation only about 30% of the patients fulfilled the criteria of latent PSE. There was a statistically significant albeit weak correlation between changes in biochemical parameters and psychometric improvement. Psychometric testing with simple non instrumental tests proved to be practicable in the office setting.

A double-blind comparative study of doxazosin and nitrendipine in patients with mild-to-moderate essential hypertension.

The antihypertensive efficacy and safety of doxazosin, a selective alpha 1-inhibitor, were compared with nitrendipine. Seventy-two hypertensive patients were entered into the 18-week, double-blind parallel group study, which involved three phases: a 4-week baseline period, a 10-week period in which patients received 1 to 8 mg of doxazosin or 10 and 20 mg of nitrendipine once daily, and a 4-week maintenance period. For all patients, the mean final daily doses were 2.5 mg for doxazosin and 13.9 mg for nitrendipine. In efficacy evaluable patients the percentages of therapy successes (standing diastolic blood pressure less than or equal to 90 mm Hg with greater than or equal to 5 mm Hg reduction or greater than or equal to 10 mm Hg decrease) were comparable for doxazosin (94%) and nitrendipine (91%), as was the proportion in whom blood pressure was "normalized" (standing diastolic blood pressure less than or equal to 90 mm Hg), 91% and 85, respectively. Blood pressures (diastolic and systolic in supine and standing positions) were significantly reduced (p less than 0.05) at all visits in both treatment groups. Ten patients (28%) in each treatment group experienced at least one adverse event. No clinically significant laboratory changes were apparent in either the doxazosin or nitrendipine groups, and no trends were observed with regard to organ systems or correlations with dose or duration of treatments. The investigators' global assessment of efficacy was rated excellent or good for all doxazosin-treated patients and excellent or good for 32 and fair for four in the nitrendipine group.(ABSTRACT TRUNCATED AT 250 WORDS)