A multicenter, controlled trial of ursodiol for the treatment of primary biliary cirrhosis

Article Abstract:

Bile acids are produced in the liver and are passed into the small intestine by the gall bladder where they contribute to the emulsification and absorption of dietary fat. If the flow of bile from the gall bladder is obstructed, these bile acids build up and begin to damage the liver. This is what happens in primary biliary cirrhosis, in which cellular damage in the bile duct impedes the bile flow. The disease progresses and the liver eventually may become cirrhotic due to the toxic effects of the bile acids. The cause of the disease is not known, nor is it understood why the disease progression may vary widely among patients. Preliminary research has suggested that this toxic build-up of bile acids may be treated with ursodeoxycholic acid, also called ursodiol, a bile acid that is not toxic to the liver. This finding has been confirmed in a major two-year study involving 146 patients with biliary cirrhosis. Half the patients were randomly assigned to receive daily doses of ursodiol, while the remainder received placebo treatment only. During the course of the study, six patients treated with ursodiol and 13 patients treated with placebo progressed to the terminal phase of the disease. A series of different chemical analyses of blood samples were used to monitor liver function. In the group treated with placebo, the blood specimens revealed liver abnormalities that were either getting worse or not changing. The only improvements that were observed were among the patients taking the ursodiol. Examination of liver biopsy specimens under the microscope showed improvement in 13 patients treated with placebo only and in 28 patients treated with ursodiol. Conversely, 22 of the placebo patients who were biopsied showed signs of deterioration compared with 10 of the patients treated with ursodiol. Ursodiol is a safe drug, and these results indicate that it should become the standard treatment for primary biliary cirrhosis. The mechanism by which ursodiol produces these beneficial effects is not certain, but several factors might be at work. Ursodiol probably reduces the uptake of the toxic bile acids from the small intestine; furthermore, ursodiol may replace some of the more toxic bile acids that accumulate within the liver cells themselves. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Low dosage and long treatment duration of beta-lactam: risk factors for carriage of penicillin-resistant Streptococcus pneumoniae

Article Abstract:

Long-term use of beta-lactam antibiotics at lower than normal doses appears to be linked to the development of penicillin-resistance in the bacterium Streptococcus (S.) pneumoniae. This bacterium is a major cause of pneumonia, meningitis and otitis media. The occurrence of penicillin-resistant S. pneumoniae (PRSp) in the nasal passages of 941 children was compared to the use of antibiotics in these children. Overall use of antibiotics was not linked to PRSp but the use of beta-lactams such as penicillin, amoxicillin and some cephalosporins was linked to PRSp.

Health aspects, Risk factors, Drug resistance in microorganisms, Microbial drug resistance, Streptococcus pneumoniae, Beta lactam antibiotics

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Ursodeoxycholic acid for the treatment of primary biliary cirrhosis

Article Abstract:

The article analyzes primary biliary cirrhosis through a case study and suggests treatment methods such as ursodeoxycholic acid and recommendations for use.

United States, Dosage and administration, Ursodiol, Case study

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