Sucralfate effervescent tablet: treatment of peptic ulcer disease and change in serum aluminium concentration.

In a single-centre randomised clinical trial, a new effervescent formulation of sucralfate was compared with the granular formulation of the drug in the treatment of peptic ulcer. The effervescent tablet had not been previously administered to human subjects. Fifty patients with endoscopically verified duodenal (40) and gastric (10) ulcers were treated with 2.0 g sucralfate twice daily, given either as a granular formulation or effervescent tablet. Control endoscopies were performed at weeks 4 and 8 and again at week 12 if gastric ulcers had not healed earlier. The healing rates in the effervescent tablet group were 71% (15/21) and 86% (18/21) after 4 and 8 weeks. In this group one gastric ulcer had to be treated for a further 4 weeks and had not healed at week 12. The corresponding rates in the sucralfate granulate group were 95% (18/19) after 4 and 8 weeks. Serum aluminium concentrations were measured simultaneously before and after treatment. The aluminium concentration almost doubled in both treatment groups during dosing with sucralfate. This effect has not been described previously in the course of therapy with sucralfate in patients with peptic ulcer disease and should be borne in mind when considering treatment with this drug.

Effect of exogenous ATP and physical stimulation on ciliary function impaired by bacterial endotoxin.

The effects of exogenous ATP and physical stimulation on ciliary beat depressed by lipopolysaccharide from Pseudomonas aeruginosa were studied in cell culture. Both the ciliary beat frequency (CBF) and the amplitude (CBA) of human respiratory cells in monolayer cell cultures were studied by using a differential interference microscope equipped with a high speed video. Both the ATP and the physiol stimulation stimulated temporarily the depressed CBF and CBA. In both groups the CBF and CBA increased in 1 min to the initial level and then gradually decreased to the level before the stimulation. The duration of the ATP stimulation on the CBF (10.1 +/- 1.8 min) and CBA (10.1 +/- 2.3 min) were significantly better than the duration of physical stimulation on CBF (8.0 +/- 1.8 min) and CBA (6.8 +/- 1.6 min). However, the areas under the CBF/CBA curves (from the beginning of stimulation until the initial level of CBF or CBA was reached again) did not differ significantly. After the removal of the bacterial toxin the CBF was restored to the initial level. In the present study the adenosine receptor antagonist could not prevent the ciliostimulative effect of exogenous ATP combined with the physical stimulation. Both exogenous ATP and physical stimulation have a clear but temporary stimulative effect on the ciliary beat depressed by bacterial toxin, ATP being slightly more effective. It seems that the effects of ATP are not mediated by adenosine receptors.

Lathosterol and other noncholesterol sterols during treatment of hypercholesterolemia with lovastatin alone and with cholestyramine or guar gum.

Sixty-two patients aged 19-64 years with primary hypercholesterolemia (mean level of total cholesterol, 10.8 mmol/l) were treated with 80 mg/day lovastatin (L) alone for 18 weeks and, after randomization to either L + 20 g/day guar gum (L + GG) or L + 16 g/day cholestyramine (L + C) treatments, for an additional 18 weeks. The total cholesterol level declined from baseline by 34% during L and by 44% and 48% during L + GG and L + C, respectively. In terms of micromoles per millimole of cholesterol, serum levels of the cholesterol synthesis precursors cholestenol, desmosterol, and lathosterol were decreased and those of the plant sterols campesterol and sitosterol were increased by treatment with L. The serum contents of cholesterol precursors were increased markedly after the combination of either GG or C with L, but the increase was greater after the addition of C (e.g., the lathosterol to cholesterol ratio was 51% versus 212% for L + GG and L + C, respectively; p less than 0.001). Thus, a higher rate of removal of bile acids by C than by GG reduced more effectively the low density lipoprotein cholesterol level but simultaneously stimulated cholesterol synthesis compensatorily to a higher level even under concurrent treatment with L. The serum sitosterol to cholesterol ratio declined by 13% during L + GG but increased by 49% during L + C compared with the value under L alone, suggesting different effects of GG and C on the metabolism of plant sterols.

Combination therapy with lovastatin and guar gum versus lovastatin and cholestyramine in treatment of hypercholesterolemia.

Sixty-two patients (34 men and 28 women) aged 19-64 years, half of whom had familial hypercholesterolemia, treated initially for 18 weeks with lovastatin alone were randomly allocated either to lovastatin (L) and cholestyramine (16 g/day) or lovastatin and guar gum (L + GG 20 g/day) treatment for 18 additional weeks to compare the hypocholesterolemic effects of these two combination therapies. The patients were selected for this study from a larger study of patients (n = 120) with severe hypercholesterolemia [serum total cholesterol (serum Chol) 6.5-16.3 mM before treatment], and only those patients in whom serum Chol after lovastatin alone (dose 80 mg/day) remained greater than or equal to 5.2 mM were eligible for evaluation of combination therapies. Serum Chol decreased from 10.6 +/- 1.6 to 5.9 +/- 1.3 mM (mean +/- SD) (p less than 0.001) and low-density lipoprotein cholesterol (LDL Chol) from 8.5 +/- 1.8 to 4.1 +/- 1 mM (p less than 0.001) in patients treated with L + GG (values before the beginning of lovastatin and at the end of the combination therapy). The respective changes were from 10.9 +/- 2.2 to 5.5 +/- 1.2 mM (p less than 0.001) and from 8.7 +/- 2.3 to 3.5 +/- 1.2 mM (p less than 0.001) in patients treated with lovastatin and cholestyramine (L + C). At the end of the study, both serum Chol (p less than 0.005) and LDL Chol (p less than 0.01) were significantly lower with L + C than with L + GG.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of a chlorhexidine-fluoride-strontium rinsing program on caries, gingivitis and some salivary bacteria among Finnish schoolchildren.

In order to find out if it is possible to prevent caries and gingivitis by periodical use of chlorhexidine-fluoride mouthrinses with or without strontium, and to find out what effects they have on salivary mutans streptococci and lactobacilli counts, a total of 243 schoolchildren aged 11 yr with high DMFS scores were randomly divided into four groups. One group (C) served as a basic control. Subjects in the second group (CXF) rinsed their mouths twice a day every third week with a rinsing solution containing 0.05% chlorhexidine gluconate and 0.04% NaF. In the third group (CXFS) the rinsing solution contained 500 ppm Sr during the first and second year and 15 ppm during the last 6 months, in addition to chlorhexidine and fluoride. In the fourth group (CX) the solution contained only 0.05% chlorhexidine gluconate. All the rinsing solutions had pH 5.8 buffered with succinic acid-NaOH buffer. After 2 yr and 9 months, the mean DMFS (SD) increments in the C, CXF, CXFS, and CX groups were 3.8 (5.7), 2.5 (3.2), 3.5 (4.8), and 3.4 (5.5), respectively. The percentage of subjects with bleeding gingival units had decreased from initial to final values as follows: C, 81-38; CXF, 88-42; CXFS, 89-56; CX, 89-37. The number of lactobacilli and mutans streptococci in saliva remained virtually unchanged throughout the study. For caries increment and gingival bleeding, the differences between groups were not statistically significant. The chlorhexidine-fluoride combination tended to prevent caries, but the effect on gingival bleeding and salivary counts of mutans streptococci and lactobacilli was negligible.

A new method for studying the effect of glass ionomer on plaque in vivo.

In order to study the amount of fluoride originating from glass ionomer, a test appliance was constructed and set on upper molars of sixteen volunteers using glass ionomer. The control appliance was set on the contralateral tooth using composite. Six weeks after the setting of appliances, plaque samples were taken and analysed. Mean amounts of protein corresponding to the amounts of plaque were equal in the test and the control groups. The mean fluoride/protein ratio in plaque was 80 times higher in the glass ionomer group than in the composite group. With this sampling method it is possible to collect sufficient amounts of plaque for quantification of plaque fluoride.

Pharmacokinetic comparison of a dextromethorphan-salbutamol combination tablet and a plain dextromethorphan tablet.

We compared in this double-blind crossover study the bioavailability of dextromethorphan from a dextromethorphan-salbutamol combination tablet (Redol comp) and from a plain dextromethorphan tablet (Extuson) by determining dextrorphan concentrations after single-dose oral administration in 10 healthy volunteers. The absorption of salbutamol from the combined preparation was also determined. The absorption of dextromethorphan was slightly faster from the plain dextromethorphan preparation. The peak concentration of dextrorphan was achieved at 1.5 h after Extuson and at 2 h after Redol comp (1,053.0 +/- 366.5 ng/ml and 901.5 +/- 210.9 ng/ml, NS). AUC0-12 values of dextrorphan were 4,315.6 +/- 295.0 (ng/ml)h after Extuson and 3,983.8 +/- 205.6 (ng/ml)h after Redol comp (p less than 0.05). Salbutamol was well absorbed from the combined preparation and the peak concentration was achieved at 3 h (6.57 +/- 2.95 ng/ml). Four subjects reported side-effects typical for salbutamol after the combination tablet. No side-effects were reported after the plain dextromethorphan tablet. On the basis of the present study, we conclude that the absorption of dextromethorphan from the preparations tested is almost equal and the dextromethorphan-salbutamol combination can be administered in tablet form for the treatment of cough.

Metabolic studies on the hypolipidaemic effect of guar gum.

The hypolipidaemic effect of guar gum (30 g/day) was examined in a double blind placebo-controlled crossover study in 9 patients with primary hyperlipidaemia. The treatment periods were of six weeks duration. Cholesterol levels in low density lipoprotein (LDL) were decreased by 11.5% and in intermediate density lipoprotein (IDL) by 10.7%. Plasma cholesterol levels were reduced by 9.6% (P less than 0.05). Kinetic studies using autologous 125I-labelled LDL showed a decrease of 21.6% in plasma LDL apo B pool size (P less than 0.05) that resulted from a 39.1% increase in its fractional rate of catabolism. The kinetic effects of guar gum on LDL metabolism appear similar to that of bile acid binding resins in that LDL apo B fractional catabolism is greatly increased while there is a slight increase in production rate.

Level of airborne bovine epithelial antigen in Finnish cowsheds.

Samples of airborne particulate material were collected from 18 Finnish cowsheds both at stationary sites and in breathing zones. The concentrations of bovine epithelial antigen (BEA) in samples were analyzed by the immunochemical enzyme-linked immunosorbent assay (ELISA) inhibition test. For total dust and BEA measurements the range of results among cowsheds was wide. In the breathing zone the mean concentration of total dust was 2.4 +/- 1.5 mg/m3 and of BEA 460 +/- 300 ng/m3. The concentrations of total dust and BEA were significantly lower at stationary sites than in breathing zones. Correlation analyses of total dust and BEA concentrations revealed that only moderate correlations existed, and they were not statistically significant (P greater than 0.05). Correlations between BEA concentrations in feeding passage or manure passage and breathing zone were at most only moderate (rs 0.29, P = 0.12 and rs 0.42, P = 0.02, respectively). The correlation of BEA concentrations between the two stationary sites was relatively strong and significant (rs 0.71, P = 0.004), suggesting that the variation in BEA concentrations between cowsheds is real. The effects of brushing and number of animals on total dust and BEA concentrations were studied statistically in samples from the breathing zone. No high or significant correlations were observed.

Interdependence of associations of physical activity, smoking, and alcohol and coffee consumption with serum high-density lipoprotein and non-high-density lipoprotein cholesterol--a population study in eastern Finland.

The interdependence of the associations of physical activity, smoking, and consumption of alcohol and coffee with serum high-density lipoprotein and non-high-density lipoprotein cholesterol concentrations was studied in 9,347 persons ages 25-64 years from east and southwest Finland. In covariance analyses with corrections for age, body mass index, saturated fat index, and fasting time, the mean adjusted serum high-density lipoprotein to non-high-density lipoprotein cholesterol ratio was high among physically active male non-smokers but not among smokers (P = 0.024 for two-way interaction). The cholesterol ratio was lower among both men (P = 0.010 for two-way interaction) and women (P = 0.030 for two-way interaction) reporting no or very little use of alcohol, and this association was stronger among smokers and women with high coffee consumption (P less than 0.001 for two-way interaction). Our data suggest that the elevating effect of regular physical exercise on serum high-density lipoprotein cholesterol may be absent in smokers, whereas that of alcohol is greater in smokers than nonsmokers. High coffee consumption associates with decreased serum high-density lipoprotein cholesterol levels in smokers but increased levels in non-smokers.

Coffee consumption is correlated with serum cholesterol in middle-aged Finnish men and women.

The association between coffee consumption and serum cholesterol was studied in a cross-sectional epidemiological study in Finland where the annual per capita consumption of coffee (13.0 kg) is the highest in the world. Coffee consumption was assessed by a questionnaire in a representative population sample of 4744 men and 4495 women aged 25 to 64 years. Serum total cholesterol and HDL-cholesterol concentrations were determined in fresh sera by the enzymatic method. Data on a large number of potential confounding variables were also collected. In the age group 25 to 44 years, the level of serum total cholesterol increased linearly with increasing coffee consumption in both sexes, but in people aged 45 to 64 the peak level of serum cholesterol was found in those who consumed 4 to 6 cups of coffee per day. In the analysis of covariance controlling for age, body mass index, intake of fat, sugar, and alcohol, smoking, physical activity, and fasting time, the mean level of serum cholesterol of men was lower (p less than 0.001) in those who drank no coffee (5.9 mmol/l) than in those who drank 1 to 3 cups (6.1 mmol/l) or 4 or more cups (6.2 mmol/l) per day. In women, the corresponding mean serum cholesterol values were 5.8 mmol/l, 6.1 mmol/l, and 6.1 mmol/l (p less than 0.05). Serum HDL-cholesterol levels did not vary significantly with coffee consumption. There was a slight inverse association between tea drinking and serum total cholesterol in men (p less than 0.05) but not in women. Although our results suggest a positive association, the impact of coffee drinking on serum cholesterol seems to be minimal. The results also indicate that the possible mechanisms do not include caffeine.