Journal of International Medical Research

The effect of acute bleeding on catecholamine synthesis in the dog adrenal medulla has been investigated. This study showed that haemorrhage was associated with an increase in the synthesis of catecholamine. The increase in the synthesis was found to be about 66 % when compared with the catecholamine content of the left adrenal, the control gland.

Labour was induced in 91 patients by means of low amniotomy and an escalating dose of oral prostaglandin E ₂ tablets* up to a maximum dose of 1.5 mg hourly. This regime led to vaginal delivery in 91.2% of patients. The induction delivery interval was 11.2 ± 4.9 and 7.5 ± 4.5 hours for primiparous and multiparous patients respectively. The incidence of gastrointestinal side-effects was 15.4%, with 6 patients being unable to tolerate the regime. It is suggested that a higher hourly dose is necessary for primiparous patients with a low Bishop score.

One hundred and fifteen patients suffering from acute exacerbations of chronic bronchitis took part in a double-blind, multicentre, clinical trial designed to compare the therapeutic efficacy and tolerability of ampicillin and minocycline hydrochloride, a new, long-acting, semi-synthetic tetracycline.

Both antibiotics were equally successful in treatment, there being no statistically significant difference between the two in any of the parameters studied.

Side-effects were few and far between. Only one patient out of the 57 who took minocycline, complained of dizziness.

Thirty-one patients suffering from typhoid and paratyphoid have been treated with amoxycillin. Success was achieved in 86.6% of cases. Fever settled within 24 hours in 36.6% and within 5 days in all the remainder except 2 in whom normal temperature was delayed until the 8th day. The relapse rate of 3.2% is lower than that normally seen with chloramphenicol. One patient developed a hypersensitivity reaction to amoxycillin which settled on withdrawal of the drug.

The therapeutic efficacy of tinidazole administered over a two-day period was assessed in a group of patients with amoebic rectocolitis and compared to the activity of metronidazole administered to a test group, with the same condition, over the same period of time at equivalent dosage. Twenty patients participated in the study and were randomly assigned to two groups of ten. The therapeutic efficacy of both drugs was similar at equivalent doses, however tinidazole was quicker in healing the distal and proximal colonic lesions caused by the vegetative forms of the parasite.

The anabolic effect of Formebolone on the retention of nitrogen, phosphorus and calcium in adult male volunteers was evaluated over a period of 21 days. The study was divided into a pre-dosc period to establish baseline data, a period where the drug was given daily followed by a third period after treatment had ceased to investigate whether the effects were in any way prolonged. Formebolone was well tolerated and showed a positive effect on nitrogen balance and bodyweight change in all subjects. The effects on calcium and phosphorus balance were less clear-cut but indicated increased retention of both elements.

Pyritinol, a drug which is capable of increasing cerebral glucose uptake, has been used in the treatment of 15 alcoholic patients, in conjunction with routine measures. The results of treatment assessed by liver function tests as well as by subjective response, showed that the addition of pyritinol to the routine therapy of such patients increased the rate of recovery.

Preclinical data suggesting potential advantages for mazindol prompted the design of a double-blind comparative trial with 60 obese patients. In it, mazindol, 2 mg once a day, was compared for 12 weeks to placebo. Weight loss was significantly greater with mazindol than placebo throughout the trial. After the 12 weeks, the mazindol patients had lost an average of 18.5 lbs compared to 2.4 lbs with placebo.

Constant efficacy at the fixed once-daily dosage was obtained with no signs of tolerance. No significant adverse effects or other signs of toxicity to mazindol were encountered. Extensive clinical evaluation of this drug in relation to the established anorectics is strongly recommended.

The ^99m Tc uptake by the proximal interphalangeal joints (2nd, 3rd, 4th, 5th fingers of both hands) was measured by external directional counting in 24 patients (three groups of eight patients each) affected by rheumatoid arthritis, before and after five days of treatment with acetylsalicylic acid (3 gm/day), indomethacin (200 mg/day), and diftalone (1000 mg the first day and 750 mg/day subsequently).

A significant decrease in the articular uptake was found only in the group of patients treated with diftalone. The differences relative to diftalone were also statistically significant when the results were analyzed comparatively.

In an open study of alprenolol for hypertension in 100 patients and involving 29 practitioners, the drug was found to he capable of controlling blood pressure to a level of 120 mm Hg mean blood pressure in 79 patients, either alone or in combination with other drugs, at an average dose of 359 mg daily. The average systolic blood pressure fell from 186 to 157 mm Hg, and the average diastolic pressure fell from 112 to 95 mm Hg over 8-12 weeks.

Three patients had to withdraw from treatment due to side-effects. Thirteen patients had side-effects of tolerable nature, and 16 patients with side-effects of similar severity on previous treatment suffered less or not at all when switched to alprenolol.

These results are very similar to other studies of the same type using other beta-blockers, but the side-effect frequency seems to be lower with alprenolol. This is corroborated by comparative official side-effect reporting over seven years for different beta-blockers.

The influence of Anafranil® on the symptomatology of depression has been evaluated in an open trial in 30 patients suffering from various types of depression. All the patients were hospitalized in the geriatric department of a psychiatric centre for the whole duration of the trial.

Within one week a marked decrease in the depressive symptoms was observed. This improvement reached its maximum after 3 weeks and remained at this level during the 4th week of treatment.

At a daily dose of 30 to 50 mg of Anafranil (mean: 40 mg) the results were good in 19 and moderate in 8 patients, whereas in 3 patients there was no change in their depressive state.

Anafranil was well tolerated; no abnormalities were observed in the laboratory investigations.

Sixty patients whose head injuries had occurred 2-6 months previously were examined in a double-blind trial to demonstrate the effect of piracetam (UCB-6215) upon late symptoms. A significantly better result of treatment of vertigo was established in the piracetam group compared to the placebo group. The disappearance of symptoms of vertigo could also be objectively established by diminished spontaneous and positional nystagmus as well as diminished pendel deviations with eyes closed. No significant change during the period of treatment could be established with respect to the caloric test.

Three familiar commercial nasal decongestants were compared in a doubleblind trial using patients suffering from acute rhinitic conditions. Variables measured were quantity of medication used within a given period of time, onset of action, frequency of application and duration of action.

It was shown that in a given period of time the use of one trial product was significantly lower than that of the two other products with regard to establishing and maintaining free nasal breathing. There were indications that special biopharmaceutical factors in a product could control patients' self-dosage of the preparation thereby improving the risk/benefit relation considerably.

Another important conclusion was that the patient himself could handle a medicine reasonably and responsibly thereby providing valuable additional data for evaluation of a product under trial (consumer orientated research).