Phase I chemoprevention study of piroxicam and alpha-difluoromethylornithine

A two-step Phase I study of piroxicam (PXM) and a-difluoromethylornithine (DFMO) alone and in combination was initiated to assess toxicity and the impact of these drugs on several biological markers. In step 1, 12 subjects with a history of skin cancers were assigned to receive PXM 10 mg every day (q.d.) or 10 mg every other day (q.o.d.). The dosage of PXM 10 mg q.o.d. was tolerated. No changes were seen in 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced ornithine decarboxylase (ODC) or urinary polyamine levels. Steady-state serum levels of PXM were consistent with the oral dose level. In step 2, 31 subjects with stage 0 or I nonmelanoma skin cancers, stage A or B prostate or colon cancer, or stage I breast cancer or who had a family history of cancer were randomized to receive DFMO 0.5 g/m2, PXM 10 mg q.o.d., or the combination of DFMO and PXM. In addition to the biological markers of TPA-induced ODC activity in skin biopsies and urinary polyamine levels, we measured urinary 11-dehydrothromboxane B2, a specific metabolite of thromboxane A2. Of the 12 subjects on DFMO/PXM, 2 dropped out for non-drug-related reasons. Three developed grade-2 drug-related toxicities. One subject developed dyspnea that resolved and was able to continue on the study for 6 months. One subject who developed diarrhea that resolved after 5 days was also able to restart the drug without a recurrence. A third subject described intermittent episodes of tinnitus starting 4 h after taking PXM that lasted only 5 s and did not progress on treatment. Comparing the 6-month measurements with pretreatment, DFMO/PXM or DFMO significantly reduced TPA-induced ODC levels (Ps, 0.03 and 0.05). Urinary polyamine levels of spermidine decreased slightly with the DFMO/PXM or DFMO alone, whereas putrescine decreased with PXM alone. Levels of 11-dehydrothromboxane B2 were depressed by PXM and PXM/DFMO. The doses of DFMO/PXM determined in step 2 are potential starting dosages for Phase IIa and IIb chemoprevention trials.     

Comparative study to assess the efficacy and adverse effects of amlodipine and nifedipine retard in patients with stable exertional angina and hypertension

The purpose of the study was to compare the antianginal and hypotensive efficacy and tolerability of 8 weeks of treatment with amlodipine taken once daily and nifedipine taken twice daily in patients with stable exertional angina pectoris and mild-to-moderate hypertension. Following a 2-week placebo run-in-period 13 patients were randomized to receive amlodipine (5 to 10 mg once daily) and 8 patients to receive nifedipine (20 or 40 mg twice daily) in an 8-week treatment phase. Antianginal efficacy was assessed with angina diares, investigators, and patients global evaluations and with treadmill exercise test during placebo run-in-period and after 8 weeks of the therapy. Amlodipine significantly reduced both weekly anginal attacks and consumption of glyceryl trinitrate tablets. This effect was more pronounced compared to efficacy of nifedipine. Exercise tolerance was also improved more markedly after amlodipine than after nifedipine treatment. Amlodipine treatment resulted in significant increase in total exercise time, increase the exercise time to angina onset, increase time to ST segment depression, decrease in ST segment depression, decrease in total duration of ST segment depression and decrease in duration of pain. In patients treated with nifedipine only favourable effect was significant decrease in total duration of ST segment depression, without significant changes of other examined parameters. Both drugs decreased blood pressure with no significant change in heart rate. No serious adverse events occurred in any patients during therapy with amlodipine as well as with nifedipine. The results of the study demonstrate that amlodipine has markedly better anti-anginal efficacy than nifedipine with respect to the most of the parameters examined. However both drugs showed comparable antihypertensive action and both were well tolerated by angina patients. The good anti-anginal and hypotensive efficacy and safety of amiodipine with once daily dosage regimen makes this drug an excellent choice of treatment for hypertensive patients with severe coronary artery disease.     

Inhibitory effect of the non-steroidal anti-inflammatory drugs, indomethacin and piroxicam on 2-acetylaminofluorene-induced hepatocarcinogenesis in male ACI/N rats

The modifying effects of the non-steroidal anti-inflammatory drugs, indomethacin (IMC) and piroxicam (PC) on hepatocarcinogenesis induced by 2-acetylaminofluorene (AAF) were investigated in male ACI/N rats. Rats were divided into 6 groups: group 1 was fed a diet containing 200 ppm AAF for 16 weeks, starting at 6 weeks of age; group 2 was fed an AAF together with 130 ppm PC-containing diet; group 3 received an AAF diet and IMC (10 ppm) in their drinking water; group 4 was fed a PC diet alone; group 5 was given IMC alone; and group 6 served as controls. The PC diet, or the drinking water containing IMC, was given to the rats starting at 5 weeks of age until 1 week after the carcinogen exposure. At termination of the experiment (week 36), the incidences of iron-excluding altered liver cell foci (24.2 +/- 5.2/cm2) and liver cell tumors (1/10, 10%), and the tumor multiplicity (0.10/rat) in rats of group 2 were significantly smaller than those of group 1 (foci incidence, 42.6 +/- 6.7/cm2; tumor incidence, 10/10, 100%; and multiplicity, 4.00/rat) (P < 0.05). Similarly, the incidence of iron-excluding hepatocellular foci (27.4 < 1.2/cm2) and liver cell tumors (1/10, 10%) and the tumor multiplicity (0.10/rat) in rats of group 3 were significantly lower than those of group 1 (P < 0.05). There were no liver cell lesions (foci and neoplasms) in rats of groups 4, 5 and 6. Thus, PC and IMC inhibited the hepatocarcinogenesis induced by AAF when administered concurrently with the carcinogen and the results may indicate possible involvement of altered arachidonic metabolism in the initiation phase of AAF-induced liver carcinogenesis.     

Comparative effect of tiaprofenic acid and piroxicam alone and as adjuvants to praziquantel in Schistosoma mansoni infected mice

A simple, rapid and sensitive two column-switching high-performance liquid chromatographic (HPLC) method with ultraviolet detection at 210 nm has been developed for the determination of N-(trans-4-isopropylcyclohexanecarbonyl)-D-phenylalanine (AY4166, I) and its seven metabolites in human plasma and urine. Measurements of I and its metabolites were carried out by two column-switching HPLC, because metabolites were classified into two groups according to their retention times. After purification of plasma samples using solid-phase extraction and direct dilution of urinary samples, I and each metabolite were injected into HPLC. The calibration graphs for plasma and urinary samples were linear in the ranges 0.1 to 10 microg ml(-1) and 0.5 to 50 microg ml(-1), respectively. Recoveries of I and its seven metabolites were over 88% by the standard addition method and the relative standard deviations of I and its metabolites were 1-6%.     

The topical anti-inflammatory effects of piroxicam in rodents

Piroxicam is a structurally novel, long-acting anti-inflammatory drug with potent activity following oral administration in animal models of inflammation and in human inflammatory diseases. The present studies, performed in rats, demostrate that topically applied piroxicam is a potent inhibitor of inflammation induced by either carrageenin or complete Freund's adjuvant. Comparable potencies (ED50 approximately 1--5 mg/kg) were obtained for topically and orally administered piroxicam in these models of inflammation. The potency of topical piroxicam exceeds that of topically applied bufexamac or phenylbutazone in the rat adjuvant arthritis model.     

Pharmacokinetic profile of piroxicam beta-cyclodextrin, in rat plasma and lymph

1. The absorption of piroxicam into the blood of rats is significantly slower after oral administration of piroxicam beta-cyclodextrin than of free piroxicam. 2. The pharmacokinetic profiles of piroxicam in rat lymph were very similar in both groups. 3. Bioavailability of piroxicam in plasma is higher after treatment with the inclusion product than with free piroxicam. On the other hand, bioavailability in lymph is higher when free piroxicam is administered.     

英汉詈词对比分析

骂詈是人们表达情感的需要,因此詈词无处不在.讨论英汉两种语言文化对詈词的影响,从中了解詈词研究长时间受阻的原因.通过对比分析英汉詈词,反映英汉两种文化的相似点和区别.     

Effects of amlodipine and nifedipine retard on autonomic nerve activity in hypertensive patients

1. The effects of 1,4-dihydropyridine calcium antagonists with different biological half-lives, amlodipine and nifedipine retard on 24 h blood pressure (BP), heart rate (HR) and autonomic nerve activity in patients with essential hypertension were compared. 2. Twenty patients (six men and 14 women; mean (+/- SEM) age 63 +/- 2 years) with essential hypertension were enrolled in the present study. Their ambulatory BP and electrocardiograms were monitored for 24 h at intervals of 30 min with a portable recorder after a 4 week drug-free period, after a 4 week treatment period with amlodipine (2.5 or 5 mg once daily) and after a 4 week treatment period with nifedipine retard (10 or 20 mg twice daily). The order of the three periods was randomized. Autonomic nerve activity was evaluated by power spectral analysis of HR variability, using the high frequency (HF) component as an index of parasympathetic activity and the ratio of the low frequency (LF) to the HF component as an index of sympathovagal balance. 3. Amlodipine and nifedipine retard significantly lowered the 24 h BP to a similar extent (amlodipine: -12.7 +/- 2.6/-5.6 +/- 1.4 mmHg, P < 0.01/P < 0.01; nifedipine retard: -15.1 +/- 2.1/-6.9 +/- 1.5 mmHg, P < 0.01/P < 0.01). Amlodipine did not change the 24 h average HR, while nifedipine retard significantly increased it (+3.3 +/- 1.2 b.p.m., P < 0.05). Amlodipine also did not change the HF component or the ratio of the LF to the HF component. However, nifedipine retard significantly decreased the HF component (P < 0.01) and increased the ratio of the LF to the HF component (P < 0.05). 4. These results suggest that nifedipine retard caused a decrease in parasympathetic activity and an increase in sympathetic activity with reflex tachycardia in these patients with essential hypertension, while amlodipine did not produce such effects on the autonomic nervous system.     

Comparative study of astrocytes in human and rabbit retinae

Immunohistochemical location of Glial Fibrillary Acidic Protein (GFAP) was used to compare the morphology of astrocytes in vascularized and partially vascularized retinae (human and rabbit, respectively). Astrocytes in human and rabbit retinae were found in the same regions as the blood vessels. These cells in partially vascularized retinae differed from those in vascularized retina in several respects. Firstly, there were six morphological types in rabbit retina and only two in human retina. Secondly, in rabbit retinae there were astrocytes only related to blood vessels called "perivascular astrocytes" which were absent in human retinae. Thirdly, the astrocytes were located in the nerve fiber layer and ganglion cell layer in both types of retinae, but in human retinae these cells could also be seen in the internal nuclear layer. These observations demonstrate that there are many differences between astrocytes in human and rabbit retina, suggesting that rabbit retina could be used with caution as an experimental model in comparative studies with human retina.     

Pharmacokinetics of indomethacin and indomethacin metabolites administered continuously to patients with healthy or damaged kidneys

After oral administration of 75 mg Indomethacin dlimination half-life of the unchanged drug is not altered in patients with severely impaired renal function. In patients with renal insufficiency half-life of Indomethacin plus metabolites is twice that of the normal value. Repeated daily administration of 75 mg for 8 days does not influence Indomethacin kinetics. In the control group and in patients with moderate by impaired renal function Indomethacin half-life does not change during chronic administration.     

Bioavailability of morphine after oral administration as retard tablets

The oral bioavailability of morphine following administration of a single dose of 30 mg morphine hydrochloride as Vendal retard film tablets (Lannacher Heilmittel) was investigated and compared with the bioavailability of morphine following administration of 30 mg morphine sulphate as Mundidol retard film tablets (Mundipharma). A randomized crossover study was conducted in 24 male, healthy volunteers. In 6 of them a pilot study with formulations containing 60 mg was conducted. Morphine and its metabolites were quantitated with an immunofluorimetric solid-phase assay (DELFIA). With regard to the following parameters the novel controlled-release formulation was statistically different from the reference formulation: area under the concentration-time curve, time to maximum and half value duration. After a single dose of the test formulation analgesic serum levels were maintained over a longer lasting period of time than after administration of the reference formulation. The maximal levels in serum and the elimination half life were not different. From the improved pharmacokinetic parameters of the novel controlled-release formulation an improved clinical efficacy can be expected.     

A case of paracetamol retard poisoning with fatal outcome

A case of fatal paracetamol (acetaminophen) poisoning in a 26-year-old woman who developed liver necrosis is described. The patient reported having ingested 11 g of a slow-release paracetamol preparation and a certain amount of alcohol and benzodiazepine. An unknown dose of phenobarbital (phenemal) had been ingested 24 hours previously, leading to a serum phenobarbital concentration of 0.195 mmol/l at the time of admission. The patient was initially treated with N-acetylcysteine intravenously. This treatment was discontinued after five hours due to a serum paracetamol concentration of 0.49 mmol/l, well below the "treatment line" paracetamol concentration of 0.8 mmol/l six hours after ingestion. Possible aggravating factors are discussed, including sustained high serum concentration of paracetamol due to the slow-release preparation and enzyme induction caused from concomitant phenobarbital and alcohol intake, as well as benzodiazepines displacing paracetamol from liver enzymes. These factors make serum paracetamol concentrations undependable; the importance of continuing N-acetylcysteine treatment in spite of "safe" serum concentrations in the above cases is stressed.     

Comparative study of institutionalized and non-institutionalized nonagenarians

BACKGROUND: The 1992 census showed that 10,470 people over 90 years old lived in Santiago and we do not have information about their general medical status. AIM: To evaluate and compare quality of life and functional status of free living and institutionalized nonagenarians in Santiago. SUBJECTS AND METHODS: During 24 months, 241 people of 90 years or older were interviewed. One hundred twenty seven (96 female) lived in their own homes and 114 (108 female) lived in institutions. The geriatric evaluation scale, validated in previous studies, was used as the assessment instrument. RESULTS: Mean age of subjects was 94 years old (range 90 to 106). Eight percent of subjects were bedridden. No differences in general condition, fecal or urinary continence, nutritional status, blood pressure, cognition, sight and hearing acuity, were observed between free living and institutionalized subjects. Free living elders had a significantly higher number of brothers or offspring and 90% were happy with the place where they lived. CONCLUSIONS: Most nonagenarians in Santiago are in good general medical conditions. Probably, the decision to become institutionalized depends more on lack of family support than on worse medical, functional or mental conditions.     

Efficacy of mononitrate retard therapy in patients with advanced congestive heart failure

To determine the efficacy of mononitrate retard therapy in congestive heart failure 54 pts (42 males and 12 females, aged 67.2 +/- 8.7 yrs.) with NYHA functional class 1-3 and left ventricular ejection fraction less than 40% were investigated. Clinical examination, exercise treadmill test (ETT), ecg holter monitoring and echocardiography (echo-2D) were performed before and after 4 weeks of therapy with Olicard 40 mg Retard. 4 weeks treatment with mononitrate improved clinical parameters. The shift to lower functional NYHA class was observed in 12 cases (p < 0.01). Number of anginal pains per week was reduced from average 3.15 to 1.55 (p < 0.01). Mononitrate therapy improved exercise tolerance during ETT. Exercise time increased from 424 +/- 168 to 568 +/- 143 sec. (p < 0.001) as well as total workload in METS (3.6 +/- 1.4 vs. 4.9 +/- 1.9, p < 0.001). The time to 0.1 mV ischemic ST segment depression was extended from 215 +/- 149 to 357 +/- 173 sec. (p < 0.01). Holter monitoring revealed moderate increase in heart rate and significant reduction of ventricular arrhythmia (p < 0.05). No changes in systolic and diastolic echo-2D parameters were observed.     

Interactions of indomethacin with lysosomes and proteins

The stabilizing action of indomethacin on lysosomes and protein in vivtro was studied. The magnitude of the stabilizing action on lysosomes was greater than that of aspirin or oxyphenbutazone, similar to that of phenylbutazone, but less than that of prednisolone. The stabilizing action of indomethacin on lysosomes possibly may contribute to its anti-inflammatory properties.     

An observer-blind randomised parallel group study comparing the efficacy and tolerability of tenoxicam and piroxicam in the treatment of post-operative pain after oral surgery

Tenoxicam and piroxicam were compared for analgesic efficacy in 58 patients undergoing removal of bilateral impacted third molar teeth, under general anaesthesia. Pain intensity was assessed over a 7 day period by the patient using verbal and visual analogue scales. The patients received one hour pre-operatively dormicum 7.5 mg orally and either tenoxicam 40 mg or piroxicam 40 mg rectally. This was followed by tenoxicam 20 mg daily in effervescent form, or piroxicam 20 mg daily in despersible tablet form for 7 days. Surgical and anaesthetic techniques were standardized for all patients. Therapeutic gain was assessed by comparing hourly pain levels 4 hours post-operatively and then twice daily for 7 days. Trismus was evaluated pre-operatively, at one hour, 24 hours and 7 days post-operatively. Analysis of the results showed a statistical significant difference between the treatment groups only 4 hours post-operatively, patients in the tenoxicam group experiencing less pain than those in the piroxicam group (p = < 0.05).