Humans ; Child ; Neurofibromatosis 1/drug therapy* ; Benzimidazoles/therapeutic use*

BACKGROUND/AIMS: Reflux esophagitis is a recurring condition for which many patients require maintenance therapy. This comparative, randomized multicenter study was designed to evaluate the effect of long-term maintenance treatment comparing proton pump inhibitor, rabeprazole and H2 receptor antagonist, ranitidine. METHODS: Eighty four patients with healed reflux esophagitis confirmed by endoscopy were randomly allocated to receive maintenance treatment with either rabeprazole 10 mg once daily or ranitidine 300 mg once daily for 32 weeks. Patients were seen every 8 weeks or at symptomatic relapse. RESULTS: Of 84 initially treated patients, 73 entered the maintenance study. The percentage of asymptomatic patients after 90-day and 210-day treatment were 97% and 81.5%, for rabeprazole and 74.3% and 62.3%, for ranitidine, respectively. After 32 weeks, the relapse rates of esophagitis were 21.3% in the rabeprazole group and 62.9% in the ranitidine group (RR: 0.405, 95% CI: 0.215-0.766). CONCLUSIONS: Maintenance treatment with rabeprazole (10 mg once daily) is superior to ranitidine (300 mg once daily) in keeping the patients with reflux esophagitis in remission over a 32 week period.
2-Pyridinylmethylsulfinylbenzimidazoles ; Adult ; Anti-Ulcer Agents/*therapeutic use ; Benzimidazoles/*therapeutic use ; Esophagitis, Peptic/*drug therapy ; Female ; Humans ; Male ; Middle Aged ; Omeprazole/*analogs & derivatives/therapeutic use ; Ranitidine/*therapeutic use

Adult ; Benzimidazoles ; therapeutic use ; Echinococcosis, Pulmonary ; diagnosis ; drug therapy ; Female ; Humans

INTRODUCTIONNovel oral anticoagulants (NOACs) have at least equivalent efficacy compared to standard anticoagulants with similar bleeding risk. Optimal management strategies for bleeding complications associated with NOACs are currently unestablished.

MATERIALS AND METHODSA working group comprising haematologists and vascular medicine specialists representing the major institutions in Singapore was convened to produce this consensus recommendation. A Medline and EMBASE search was conducted for articles related to the 3 available NOACs (dabigatran, rivaroxaban, apixaban), bleeding and its management. Additional information was obtained from the product monographs and bibliographic search of articles identified.

RESULTSThe NOACs still has substantial interactions with a number of drugs for which concomitant administration should best be avoided. As they are renally excreted, albeit to different degrees, NOACs should not be prescribed to patients with creatinine clearance of <30 mLs/min. Meticulous consideration of risk versus benefits should be exercised before starting a patient on a NOAC. In patients presenting with bleeding, risk stratification of the severity of bleeding as well as identification of the source of bleeding should be performed. In life-threatening bleeds, recombinant activated factor VIIa and prothrombin complex may be considered although their effectiveness is currently unsupported by firm clinical evidence. The NOACs have varying effect on the prothrombin time and activated partial thromboplastin time which has to be interpreted with caution. Routine monitoring of drug level is not usually required.

CONCLUSIONNOACs are an important advancement in antithrombotic management and careful patient selection and monitoring will permit optimisation of their potential and limit bleeding events.

Administration, Oral ; Anticoagulants ; therapeutic use ; Benzimidazoles ; Consensus ; Dabigatran ; Hemorrhage ; prevention & control ; Humans ; Singapore ; Thiophenes

OBJECTIVETo study the effects and the possible mechanism of Tangshenling (TSL) combined with telmisartan on early diabetic nephropathy (DN). Methods Eighty-one patients with early DN were randomly assigned into the control group (n=40) treated by telmisartan alone and the treated group (n=41) treated by TSL combined with telmisartan, and the conventional western therapy was given to all patients in both groups. Changes before and after treatment in symptoms and levels of urine albumin excretion rate (UAER), urine transforming growth factor beta1 (TGF-beta1), retinol binding protein (RBP) and beta2-microglobulin (beta2-MG), fasting blood glucose (FBG), serum creatinine (SCr), blood lipids, plasma atrial natriuretic peptide (ANP), serum collagen type IV (Col-IV) and TGF-beta1 were observed.

RESULTSBefore treatment, no significant difference was shown in all these indexes between the treated group and the control group. After 8 weeks of treatment, the effective rates in symptoms improvement were higher in the treated group than those in the control group (P < 0.05 or P < 0.01); UAER, urine RBP, beta2-MG and TGF-beta1, serum TC, TG, Col-IV and TGF-beta1, and blood pressure were significantly lowered in both groups after treatment (P < 0.05 or P < 0.01); and the treated group showed a better effect than the control group in improving all the above-mentioned indexes except the blood pressure (P < 0.05); but there was no significant difference in the changes of FBG, SCr and blood pressure between the 2 groups (P > 0.05); after treatment, plasma ANP significantly lowered in the treated group (P < 0.01), while there was no significant change of that in the control group (P > 0.05). Conclusion Combination of TSL and telmisartan has a better effect than telmisartan on DN in early stage. Its mechanism might be related to the decrease of ANP and TGF-beta1 and improvement of lipids metabolism and renal tubular interstitial pathological changes.

Adult ; Aged ; Benzimidazoles ; therapeutic use ; Benzoates ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

Objective To evaluate the clinical effectiveness of JianpiQinghua decoction in treating stage 3 chronic kidney disease (CKD3) with syndrome type of dampness-heat due to spleen deficiency. Methods A multicenter, randomized, controlled, prospective, double-blind, and double-simulation study was undertaken. A total of 270 CKD3 patients with syndrome type of dampness-heat due to spleen deficiency from the outpatient departments of six general hospitals were randomly divided into telmisartan+analog traditional Chinese medicine (TA) group, traditional Chinese medicine+analog telmisartan (TCMA) group, and telmisartan+traditional Chinese medicine (TTCM) group, in which the corresponding treatment was applied in addition to basic treatment. Six months later, changes in the traditional Chinese medicine (TCM) clinical symptom scores and renal functions before and after treatment were compared among these three groups. Results Of these 270 CKD3 patients who had been enrolled in this study, 30 cases lost to follow-up. The baseline data were comparable among these three groups. After treatment, the TCM clinical symptom scores of both syndrome of spleen-qi deficiency and dampness-heat in TA group were significantly higher than those in TCMA group and TTCM group (P<0.001). With the treatment time prolonged, the TCM clinical symptom scores showed similar descending trends in TCMA group and TTCM group but were different from that in TA group. After treatment, abnormal creatinine rate decreased (P=0.003), and these three treatments and their interactions with each visit had no effect on serum urea nitrogen value (P=0.270, P=0.520); with prolonged treatment, the estimated glomerular filtration rates in three groups tended to be relatively stable after the first rise. The liver function and abnormal serum potassium rate were not statistically significant before and after treatment (P>0.05). Conclusions JianpiQinghua decoction can improve clinical symptoms of TCM in CKD3 patients with syndrome type of dampness-heat due to spleen deficiency and thus improve the quality of life and prognosis. The clinical efficacy of JianpiQinghua decoction alone or combined with telmisartan is superior to telmisartan monotherapy.
Benzimidazoles ; therapeutic use ; Benzoates ; therapeutic use ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Prospective Studies ; Quality of Life ; Renal Insufficiency, Chronic ; drug therapy

OBJECTIVETo observe triclabendazole effect on Paragonimus skrjabini in experimentally infected rats,and to develop a new drug for treating paragonimiasis.

METHODSMetacercariae of Paragonimus skrjabini were isolated from crabs (Sinopotamon) collected from endemic area. Wistar rats were infected intraperitoneally. One and two months after infection, they were treated with triclabendazole at the dosage of 300 mg.kg(-1).2 d(-1), 450 mg.kg(-1).3 d(-1) and 600 mg.kg(-1).3 d(-1) respectively. Five patients with Paragonimus skrjabini were treated, with Triclabendazole dosage of 10 mg/kg bid x 3 days.

RESULTSThe worm reduction rates were 50.3%, 80.8% and 86.7% respectively one month after completion of treatment. Dead worms of sesame size recovered from muscles, liver, abdominal cavity, chest cavity and lung were greatly diminished in size and weight in comparison with that of the control group. Many large (about 1 cm) black-colored distended worm cysts were found in the lungs of the control rats. Usually there were two adult worms pairs with numerous eggs in each worm cyst. Most worm cysts in the treated groups of rats were changed into hemorrhagic-necrotic patches. All five patients were cured.

CONCLUSIONTriclabendazole was highly active against Paragonimus skrjabini in rats experimentally infected and patients.

Adult ; Animals ; Anthelmintics ; therapeutic use ; Benzimidazoles ; therapeutic use ; Child ; Female ; Humans ; Male ; Paragonimiasis ; drug therapy ; Parasite Egg Count ; Rats ; Rats, Wistar

No abstract available.
Antiviral Agents/*therapeutic use ; Benzimidazoles/*therapeutic use ; Female ; Fluorenes/*therapeutic use ; Hepacivirus/*classification ; Hepatitis C, Chronic/*drug therapy ; Humans ; Liver Cirrhosis/*drug therapy ; Male ; Ribavirin/*therapeutic use ; Uridine Monophosphate/*analogs & derivatives

OBJECTIVETo observe the effect of Shenshuaining Granule (SG) combined telmisartan on serum creatinine (SCr) levels and urinary albumin contents in diabetic nephropathy (DN) patients, and to explore its efficacy.

METHODSTotally 204 DN patients were recruited, and further assigned to 3 groups, i.e., the early DN group, the clinical stage of DN with normal renal function group, the clinical stage of DN with insufficient renal function group. Patients in the same group were randomly allocated to the telmisartan treatment group, the SG treatment group, and the combination of SG and telmisartan treatment group, 68 in each group. Patients in the telmisartan treatment group took telmisartan tablet, 80 mg per day, once daily. Those in the SG treatment group took SG, 5 g each time, 3 times per day. Those in the combination of SG and telmisartan treatment group took telmisartan tablet (80 mg per day, once daily) and SG (5 g each time, 3 times per day). The therapeutic course for all was 3 successive months. SCr levels, serum urea nitrogen (BUN),24 h urine microalbumin (24 h U-MA) were detected before and after treatment. Results In three different treatment groups, 24 h U-MA decreased after treatment in the telmisartan treatment group; SCr and BUN decreased after treatment in the SG treatment group; and 24 h U-MA, SCr and BUN decreased after treatment in the combination of SG and telmisartan treatment group (P<0.05). In the clinical stage of DN with insufficient renal function group, SCr obviously increased after treatment in the telmisartan treatment group (P <0. 05). In the 3 DN stages, SCr and 24 h U-MA obviously decreased in the combination of SG and telmisartan treatment group, when compared with the telmisartan treatment group and the SG treatment group (P<0.05). Compared with the telmisartan treatment group, SCr and BUN obviously decreased in the SG treatment group, but 24 h U-MA quantitation obviously increased (P<0.05). BUN obviously decreased in the combination of SG and telmisartan treatment group (P<0. 05).

CONCLUSIONThe combination of SG and telmisartan could decrease urinary albumin, and stabilize SCr levels.

Adult ; Albumins ; metabolism ; Antihypertensive Agents ; therapeutic use ; Benzimidazoles ; therapeutic use ; Benzoates ; therapeutic use ; Diabetic Nephropathies ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Tablets

The functional mutation of c-kit and platelet-derived growth factor receptor α (PDGFRA) which encode proto-oncogene receptor tyrosine kinase are the crucial pathogeneses of gastrointestinal stromal tumors(GISTs). 80%-85% c-kit gene mutation including exon 11,exon 9,exon 13,exon 17 and 5%-10% PDGFRA gene mutation such as exon 18, exon 12 are examined in GISTs. Neither of c-kit or PDGFRA gene mutation are called wide type GISTs. The pathogeneses of wild type GISTs are not clear. The deficiency of succinate dehydrogenase B(SDHB)-related insulin-like growth factor 1(IGF-1R) activation, BRAF gene mutation and neurofibromatosis type 1 may be related to progression of wild type GISTs. More than half of metastatic GISTs patients receiving imatinib treatment can develop to c-kit secondary mutations, which are responsible for secondary resistance. However, the reasons of imatinib resistance in GISTs without c-kit secondary mutation need to be explored. At present, many clinical trials are ongoing to evaluate new drugs in GISTs treatment, including nilotinib, masitinib, pazopanib, dovitinib, ponatinib, dasatinib, crenolanib, linsitinib and immunotherapy, which may bring resistance GISTs treatment to new hope. Next generation sequencing (NGS) and liquid biopsy will be very important in GISTs research and clinical practice.
Benzimidazoles ; therapeutic use ; Exons ; Gastrointestinal Stromal Tumors ; drug therapy ; genetics ; High-Throughput Nucleotide Sequencing ; Humans ; Imatinib Mesylate ; Mutation ; Piperidines ; Protein Kinase Inhibitors ; therapeutic use ; Proto-Oncogene Proteins c-kit ; genetics ; Pyrimidines ; therapeutic use ; Quinolones ; therapeutic use ; Succinate Dehydrogenase ; genetics ; Sulfonamides