RESUMEN
Silymarin, the active principle of the milk thistle Silybum marianum, protects experimental animals against various hepatotoxic substances. To determine the effect of silymarin on the outcome of patients with cirrhosis, a double blind, prospective, randomized study was performed in 170 patients with cirrhosis. 87 patients (alcoholic 46, non-alcoholic 41; 61 male, 26 female; Child A, 47; B, 37; C, 3; mean age 57) received 140 mg silymarin three times daily. 83 patients (alcoholic 45, non-alcoholic 38; 62 male, 21 female; Child A, 42; B, 32; C, 9: mean age 58) received a placebo. Non-compliant patients and patients who failed to come to a control were considered as 'drop outs' and were withdrawn from the study. All patients received the same treatment until the last patient entered had finished 2-years of treatment. The mean observation period was 41 months. There were 10 drop outs in the placebo group and 14 in the treatment group. In the placebo group, 37 (+2 drop outs) patients had died, and in 31 of these, death was related to liver disease. In the treatment group, 24 (+4 drop outs) had died, and in 18 of these, death was related to liver disease. The 4-year survival rate was 58 +/- 9% (S.E.) in silymarin-treated patients and 39 +/- 9% in the placebo group (P = 0.036). Analysis of subgroups indicated that treatment was effective in patients with alcoholic cirrhosis (P = 0.01) and in patients initially rated 'Child A' (P = 0.03). No side effects of drug treatment were observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Flavonoides/uso terapéutico , Cirrosis Hepática/tratamiento farmacológico , Silimarina/uso terapéutico , Adulto , Causas de Muerte , Ensayos Clínicos como Asunto , Método Doble Ciego , Femenino , Humanos , Cirrosis Hepática Alcohólica/tratamiento farmacológico , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Distribución AleatoriaRESUMEN
A randomized double-blind study about the therapy of the cirrhosis of the liver shows a significant higher surviving rate of the alcoholic cirrhosis in the group treated with Silymarin. This result can be well explained by the protective influence of this substance against toxic injuries. The etiology of many chronic liver diseases is uncertain and therefore it is advisable to try the therapy also in other cases. The conditions of the study are exactly reported. The influence on the clinic of the disease and on the laboratory data obtained in many controls will be published later, because the statistical analysis needs some more time.
Asunto(s)
Flavonoides/uso terapéutico , Cirrosis Hepática/tratamiento farmacológico , Silimarina/uso terapéutico , Ensayos Clínicos como Asunto , Método Doble Ciego , Humanos , Cirrosis Hepática/mortalidad , Cirrosis Hepática Alcohólica/tratamiento farmacológico , Cirrosis Hepática Alcohólica/mortalidad , Distribución AleatoriaRESUMEN
Gitoformat, a new derivate of Gitoxin, was tested with 50, mainly geriatic patients with a manifested cardiac insufficiency. The initial treatment as well as a changeover from the usual glycosid-treatment after a renewed decompensation was without any problems. With a rate of success of 95 per cent the efficiency of this new glycosid can be classified as excellent. Side effects or incompatibility were consequences of overdosage. It is remarkable that also patients with a reduced renal function did not need a reduction in dose. At 10 patients the recompensation with Gitoformat continued after discharge over an observation period of 6 months. The maintenance dose had not to be changed, incompatibility or overdosage reactions didn't appear.
Asunto(s)
Glicósidos Cardíacos/uso terapéutico , Insuficiencia Cardíaca/tratamiento farmacológico , Anciano , Glicósidos Cardíacos/efectos adversos , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A multicentre study of cases of acute myocardial infarction was undertaken at 27 departments at teaching and non-teaching hospitals throughout Austria over a period of three years. Altogether 3397 patients were investigated. On classification of the patients according to the number of shock indicators, two comparable groups (B and C) of "mild" infarction with 0, 1 or 2 signs of shock were obtained. These low-risk groups comprised 728 patients. The mortality in group C ("mild" infarction, no streptokinase) was 17.3%, significantly higher (p less than 0.01) than the corresponding figure of 10.5% in group B ("mild" infarct, streptokinase therapy). The decrease in mortality by streptokinase therapy applied both to monitored patients as well as to those who were not monitored. Haemorrhage was a very rare complication, but somewhat more frequent in the streptokinase-treated cases, as expected. The incidence of complications such as stereocardia, asystole, and cardiac insufficiency, as well as the conversion of "mild" cases into a "severe" symptomatology was markedly reduced in the streptokinase-treated group.
Asunto(s)
Infarto del Miocardio/tratamiento farmacológico , Estreptoquinasa/uso terapéutico , Enfermedad Aguda , Austria , Ensayos Clínicos como Asunto , Evaluación de Medicamentos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Fisiológico , Infarto del Miocardio/clasificaciónRESUMEN
The decrease in blood viscosity induced by streptokinase (SK) in the present investigation in proportional to the streptokinase concentration up to a concentration of 2000 IE/ml blood. A maximum decrease in viscosity is attained with a dosage of between 200 and 300 IE/ml blood. The decrease in viscosity is already clearly detectable at 10 minutes at all investigated doses and is completed after 20 to 30 minutes. An increase in SK resistance delays the decrease in viscosity. Prevention of the decrease, however, only seems to occur with a very high SK resistance and a very low SK dosage (50 IE/ml blood). The optimum dosage of SK to achieve a maximum decrease in viscosity is 200 IE/ml blood.