Pantoprazole 20 mg is effective for relief of symptoms and healing of lesions in mild reflux oesophagitis.

AIM: To investigate the efficacy of a low dose of pantoprazole, a gastric proton pump inhibitor, for the relief of symptoms and healing of lesions in mild gastro-oesophageal reflux disease (GERD), and to compare it with the efficacy of ranitidine. METHODS: Patients with endoscopically established GERD (Stage I, Savary-Miller classification) were enrolled into a randomized, double-blind, parallel-group and multicentre study (intention-to-treat n = 209, age range 19-82 years). They were treated once daily with oral pantoprazole 20 mg or ranitidine 300 mg, for up to 8 weeks. End-point parameters included relief of symptoms (heartburn, acid regurgitation, pain on swallowing) and the healing of GERD lesions. Relief from symptoms was assessed after 2 and 4 weeks, and endoscopically confirmed healing of lesions after 4 and 8 weeks. RESULTS: The proportion of patients reporting complete relief from symptoms after 2 weeks was greater in the pantoprazole than in the ranitidine group (69 vs. 48%, P < 0.01), with further improvements seen in the pantoprazole group after 4 weeks (80 vs. 65%, P < 0.05, Cochran-Mantel/Haenszel test). Healing of lesions was confirmed in 70/87 (80%) patients after 4 weeks (pantoprazole group), as compared with 55/86 (64%) patients (ranitidine group) (P < 0.05, per protocol population); after 8 weeks the respective results were 78/87 (90%) and 63/86 (73%) patients (P < 0.01). Both study medications were well tolerated. CONCLUSION: Low-dose pantoprazole (20 mg) is clinically superior to ranitidine (300 mg) in providing fast relief from symptoms and healing of lesions in patients with mild GERD.

[Gastroduodenal motility in chronic dyspepsia. 1. Interdigestive motility]. / Die gastroduodenale Motilität bei chronischer Dyspepsie. Teil 1. Die interdigestive Motilität.

The interdigestive gastroduodenal motility was studied in 28 patients suffering from chronic dyspepsia and in 15 healthy controls. The pressure activity was recorded using a four-lumen manometric probe positioned in the gastric antrum, the proximal and distal duodenum as well. - The mean cycle duration of the interdigestive myoelectric complex lasted 108 +/- 36 min. in dyspepsia and 81 +/- 30 min. in controls (p less than 0.05). In the antrum this prolongation resulted from a longer duration of phase 1. 7 dyspeptic patients had no activity fronts in the stomach. Both examined groups showed little differences in duodenal motility patterns, except for a significant increase of tonic pressure component during phase 3 activity in dyspepsia. Between gastric emptying time and interdigestive motility no correlation were established.

[Disturbances of consciousness of old people from internal view (author's transl)]. / Bewusstseinsstörungen alter Menschen aus internistischer Sicht

Any unconsciousness and especially that of old people refers to direct danger to life and requires immediate medical intervening. A diagnostic plan will not be adequate in association to the multifariour etiological factors and can delay in a special case the beginning of an aimed therapy. The unconscious patient must have a clinical treatment. The author describes the diagnostic of the most important comatose states in the age.