Efficacy and tolerability of 20 mg pantoprazole versus 300 mg ranitidine in patients with mild reflux-oesophagitis: a randomized, double-blind, parallel, and multicentre study.

BACKGROUND AND AIM: The aim of this study was to compare the efficacy and tolerability of low dose pantoprazole (20 mg) (a gastric proton pump inhibitor) with standard dose ranitidine (300 mg) (a histamine-receptor antagonist), in their ability to relieve symptoms and heal oesophageal lesions associated with gastrooesophageal reflux disease (GORD). METHODS: Patients with endoscopically established mild GORD (stage I, modified Savary-Miller classification) were enrolled into a multicentre, randomized, double-blind, parallel-group comparison study (intention-to-treat population, n = 201; age range, 18-82 years). Patients took either oral pantoprazole 20 mg in the morning (n = 101) or ranitidine 300 mg in the evening (n = 100) once daily for 4 weeks or, if the healing was not complete, 8 weeks. Relief from key symptoms (heartburn, acid regurgitation, pain on swallowing) was assessed after 2, 4, and if applicable, 8 weeks. Healing of lesions was confirmed endoscopically after 4 and, if applicable, 8 weeks. RESULTS: Complete relief from key symptoms was noted after 2 weeks in 70/88 (80%) patients treated with pantoprazole vs 45/89 (51%) patients treated with ranitidine ('per-protocol and key-point available' populations, P < 0.001); the corresponding results after 4 weeks were 77/88 (88%) vs 51/88 (58%) (P < 0.001). Complete healing of lesions after 4 weeks of treatment was seen in 74/88 (84%) vs 49/89 (55%) in the pantoprazole and ranitidine group, respectively (P < 0.001, per-protocol); by week 8 the cumulative healing rates were 84/88 (95%) vs 69/89 (78%) in the pantoprazole and ranitidine group, respectively (P < 0.001). For the intention-to-treat populations, the corresponding values for healing after 4 and 8 weeks were 73% vs 49% (P < 0.001) and 83% vs 69% (P < 0.05), respectively. Both study medications were well tolerated. CONCLUSION: Compared to ranitidine 300 mg, the regimen with pantoprazole 20 mg provides faster relief from symptoms and is significantly more effective in healing of oesophageal lesions in patients with mild reflux-oesophagitis. Thus, the low dose of pantoprazole offers a treatment approach which minimizes drug exposure and costs while retaining high efficacy.

Electrocardiographic and biochemical studies on marathon runners.

The electrocardiographic findings and certain biochemical observations in 48 male runners before and after participation in the Comrades Marathon race are presented. In 21 of the 48 runners electrocardiographic changes consistent with early ischaemic heart disease could be demonstrated before the race. In 2 runners who had normal tracings before the race, abnormalities could be shown after the race. The total serum creatine kinase activity was markedly elevated after the race in the majority of the 23 runners in whom this was measured. In 11 of these subjects, the Marsh-Bender (MB) fraction could be demonstrated after the race. It is concluded that an elevated MB fraction is probably not a reliable index of myocardial damage after strenuous exercise.

[Smokers on Bloemfontein schools: profile and standpoint]. / Rokers in Bloemfonteinse skole: profiele en standpunte.

Primary prevention is now the first priority of research on smoking. A study was made of 1 505 children of 12 high schools situated in a conservative Afrikaans-speaking community in an attempt to determine the characteristics of the smoking and non-smoking groups. Of the total group 16% were smokers. The male/female ratio was 3:1. The mean age at which smoking commenced was 15,5 years. A positive relationship was found between the smoking habits of the smokers and those of their parents and best friends. The majority of pupils think that smoking is addictive. In addition, they believe that it is unhealthy and leads to poor sporting achievements. The great majority of smokers and non-smokers agree that non-smokers do better at school. Fathers of both smokers and non-smokers do not favour the habit. Ninety per cent of the boys and 83% of the girls started smoking between 12 and 18 years of age. The critical age for a preventive programme is thus 11 years.

[Cycling, fitness and the prevention of ischemic heart disease]. / Fietsry, Fiksheid en die voorkoming van iskemiese hartsiekts.

A short review of the prevalence of ischaemic heart disease in South African Whites is given, and primary prevention, which entails an alteration in life style, is emphasised. The role of increased physical activity in primary prevention is discussed. Any programme to increase the fitness status of a population based on activities that must be performed outside the daily routine, willhave limited impact. The possible role of cycling is discussed and it is shown that ordinary cycling to work probably causes sufficient stimulation of the cardiovascular system to produce an acceptable standard of physical fitness.