Validity of high-dose ranitidine treatment (300 mg b.i.d.) in clinical practice: an open study in 68 consecutive cases of severe peptic disease.

Ranitidine, at doses of 300 mg b.i.d., brings about a pronounced inhibition of both daytime and nocturnal acid secretion. The aim of the present open study, conducted in 68 patients with peptic lesions of the upper gastrointestinal tract, was to assess whether or not ranitidine at 300 mg b.i.d. for 4 weeks was capable of healing these lesions, which had failed to respond to treatment with H2-antagonists at standard doses, even when administered over fairly lengthy periods (greater than 8 weeks). The results obtained show that the 300 mg b.i.d. regimen yields a marked gain in terms of healing of lesions and relief of symptoms (achieved in roughly 80% of cases), accompanied by excellent tolerance. It is concluded that a double dose of ranitidine is clinically justified in particular cases.

Effect of exogenous gastrointestinal peptides containing the C-terminal tetrapeptide of gastrin on calcium, calcitonin and parathormone serum levels in man.

Gastrointestinal hormones containing the C-terminal tetrapeptide of gastrin are involved in calcium homeostasis. The aim of this study was to investigate: 1) the effect of a standard meal (schedule a) and of a duodenal infusion of 5% aminoacid solution (schedule b) on calcium, CT and PTH serum levels in man; 2) the behaviour of these parameters during I.V. infusions of pentagastrin (mcg 1.5/Kg-hour), sincalide (mcg 0.04/Kg-hour) and caerulein (ng 75/Kg-hour) (schedule c). In order to avoid any possible interference by endogenous secretin release, schedule c was performed in 5 patients previously submitted to total gastrectomy. Schedule a and b were studied in 5 healthy volunteers. After a standard meal a slight increase of CT and PTH was measured. Duodenal infusion of aminoacid was followed by hypocalcaemia and slight but constant rise of CT levels, without significant variations of circulating PTH. Pentagastrin, sincalide and caerulein induced a slight but significant hypocalcaemia and a rise of serum CT levels, together with a significant increase of serum PTH. These findings suggest that peptides containing the C-terminal tetrapeptide of gastrin directly affect calcium homeostasis in the absence of secretin release.

[Sulfobromophthalein clearance and survival of cirrhotics after an elective porto-systemic shunt]. / Clearance della bromosulfonftaleina (B.S.F.) e sopravvivenza dei cirrotici dopo uno shunt porto-sistemico di elezione.

Preoperative clearance of a single dose of BSP was assessed in 72 candidates for porto-systemic shunt in cirrhosis of the liver. Comparison between those who had died (24) and those who had survived (48) several years later showed statistically significant differences with regard to equivalent liver volume, first uncorrected exponential (Ki), absolute clearance, and 45' retention. A certain degree of differentiation could be made out among the survivors, whereas those who had died could not be distinguished from the series as a whole, nor could correlations be established with the length of survival. No practical advantage was displayed by the more complex, computer-processed parameters as opposed to those that were more immediately available.