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Biomedical subjects

A J Miller

Publications and source records attributed to A J Miller.

At least 109 records · Page 6Linked to original sources
PubMed1991

A comparison of a single occasion treatment of head louse infestation with phenothrin liquid shampoo or a carbaryl lotion.

Fifty subjects with head louse infestation were recruited into a controlled trial to compare a phenothrin liquid shampoo with a carbaryl lotion. Twenty-seven subjects were treated with phenothrin and 23 with carbaryl, each formulation being applied only on a single occasion. Subjects were inspected for evidence of live lice and eggs at 24 hours and 3 to 4 weeks after application of treatment. The results showed that both the phenothrin liquid shampoo and the carbaryl lotion were effective in killing adult lice and viable eggs. No statistically significant difference in treatment efficacy was observed between the two groups. Fewer side-effects, however, were observed with the phenothrin liquid shampoo than with the carbaryl lotion. These results indicate that, when applied as a single treatment, a phenothrin liquid shampoo was as effective as a carbaryl lotion in eradicating head lice and eggs.

Adolescent↗
PubMed1991

The efficacy and tolerability of enteric and non-enteric coated naproxen tablets: a double-blind study in patients with osteoarthritis.

A double-blind, crossover study was undertaken to compare the efficacy and tolerability of a novel enteric coated 500 mg naproxen tablet with normal release 500 mg naproxen in patients with osteoarthritis. Eighty-eight patients were randomly allocated to receive enteric coated naproxen as a single daily dose of 2 tablets at night or 1 normal release naproxen tablet twice daily for a period of 3 weeks, followed by the alternative treatment for a further period of 3 weeks. The results of patient and doctor assessments showed that both treatments were increasingly efficacious, with a significant period effect found in the measures for pain on passive movement and duration of morning stiffness. No significant treatment differences were seen in any of the measures of efficacy and tolerability, although there were more withdrawals on normal release than on enteric coated naproxen (p = 0.07). It was concluded that enteric coated naproxen given as a single 1 g dose at night and normal release 500 mg naproxen given twice daily are equally efficacious and well tolerated.

Adult↗
PubMed1991

Morphine at gramme doses: kinetics, dynamics and clinical need.

The MS Contin tablet 200 mg (controlled release morphine sulphate) provides an equivalent rate and extent of absorption to two MS Contin tablets 100 mg. The characteristics of controlled release from this higher strength formulation are also consistent with those of the 100 mg tablet. The level of analgesia provided during the early post-dosing period, at the end of the dosing period and overall over the twelve hour interval were also equivalent between the preparations. The addition of the MS Contin tablet 200 mg to the existing range will facilitate oral dosing in patients requiring large doses of morphine. This extension to the range will increase the choice available to the clinician and provide a natural progression for those patients requiring a step-up in the dose titration procedure.

Adult↗
PubMed1991

A comparison of controlled release metoclopramide and domperidone in the treatment of nausea and vomiting.

Dopamine antagonists are effective anti-emetics. Domperidone does not readily cross the blood-brain barrier and is less likely to cause central nervous system side-effects than metoclopramide. However, a direct comparison of the safety and efficacy of the two drugs has not hitherto been made. Ninety-five patients, with symptoms of nausea and vomiting due to a variety of oesophageal or gastric disorders, were recruited into a randomised, double-blind, three-part, parallel-group comparative study of controlled release metoclopramide 15 mg (Gastrobid Continus tablets, Napp Laboratories) given twice daily, and domperidone 10 mg or 20 mg given three times daily. Assessments for nausea, vomiting, reflux symptoms and adverse events were made on entry to the study. Patients were randomly allocated to one of the three treatment regimes for a period of seven days, throughout which daily symptomatology and use of escape medication were recorded on a diary card. At the end of the treatment period, nausea, vomiting and reflux symptoms, adverse events and a global assessment of patients' symptom control were recorded by the investigator. Both controlled release metoclopramide and high and low dose domperidone significantly reduced symptoms of belching, flatulence, distension, heartburn, regurgitation, reflux, nausea and vomiting compared to baseline. There were no significant differences between the three treatments in efficacy or in the number and severity of side-effects.

Delayed-Action Preparations↗
PubMed1991

Ticlopidine: a new antiplatelet agent for cerebrovascular disease.

Ticlopidine is a new prototype antiplatelet drug chemically unrelated to currently available agents. It causes an alteration in platelet membrane reactivity to a variety of aggregating stimuli and a marked prolongation of bleeding time, the mechanism of which remains unclear. Two major phase III multicenter trials, the ticlopidine-aspirin stroke study (TASS) and the Canadian-American ticlopidine study (CATS) reported that the agent may reduce the occurrence of stroke, myocardial infarction, or vascular death in patients of both sexes who have had recent cerebral ischemia. Ticlopidine has been well tolerated in preliminary studies, with the most commonly described adverse effects being rash and gastrointestinal complaints. The most important adverse effect is neutropenia, which was reported in both TASS and CATS, approximating a frequency of 0.9% and 0.8%, respectively. Ticlopidine holds considerable promise as adjunctive therapy in selected patients.

Cerebrovascular Disorders↗
PubMed1991

Blood transfusion in total hip replacement: is it always necessary?

Routine blood transfusion was prospectively withheld from 10 patients undergoing routine elective total hip arthroplasty who fulfilled specific criteria. A standard anaesthetic regimen was used. The mean perioperative fall in haemoglobin concentration was 1.9 g/dl, and only one patient required a postoperative blood transfusion. There were no postoperative complications. The need for routine peroperative blood transfusion of patients undergoing total hip arthroplasty is questioned.

Blood Transfusion↗
PubMed1990

The long-term treatment of stable angina pectoris with verapamil.

In a double-blind 16-week crossover study, the effectiveness of verapamil therapy for chronic stable angina was evaluated in 19 patients (Phase I). Twelve of these patients were then followed for 38 to 58 months of open-label treatment (Phase II). Clinical responses were assessed with traditional indices, treadmill exercise tests, and a newly developed Performance Index (PI). During Phase I, verapamil resulted in a 50% mean reduction in the number of patients developing effort angina on treadmill exercise, a 15% mean increase in treadmill exercise time, and an 18% mean improvement in the PI. In eight of ten patients, diastolic blood pressure rises during exercise were significantly lowered during verapamil treatment in Phase I. In a limited population of patients followed for long periods of time, our data show that verapamil remains acceptably effective in the treatment of angina pectoris. Though diastolic blood pressure rises were decreased during Phase I, we could not confirm that effect over longer periods of time. Functional capacity as determined by the PI was sustained in Phase II.

Angina Pectoris↗
PubMed1990

Patterns of mandibular movements in subjects with craniomandibular disorders.

Mandibular movements were evaluated for border and functional movements in 24 adult normal subjects and 26 adult patients with muscle pain associated with a craniomandibular disorder. The mandibular incisor position was tracked with an electromagnetic system in three planes by use of either a Myotronic Kinesiograph or a Siemens Sirognathograph instrument while the subject sat in an upright position. In the normal subjects, the maximum movements of the mandible in lateral, protrusive, and vertical directions were compared with the envelope of movement during speech and mastication. The range of the rest position was 1 to 5 mm in relation to the intercuspal position; the range of maximum excursion during speech was 30% to 36% of maximum opening; the vertical extent of excursion during mastication was 18% to 90% of the maximum vertical opening dependent on the bolus. Protrusive movements were straight forward, dividing the angle evenly between left and right laterotrusion. Laterotrusive movements were of equal length and similar to the length of protrusion. Twenty-six patients with muscle pain, in many instances, demonstrated asymmetry in the length of laterotrusive movements. Different pathways for moving the mandible away from the intercuspal position and returning to this position could be seen during laterotrusion. Unequal laterotrusive excursions and asymmetrical, nonparallel movement patterns for mandibular protrusion and retrusion were often observed. In contrast, the extent of the speech envelope and the envelope of mastication were similar to that of the controls.

Adolescent↗
PubMed1990

Adaptation of craniofacial muscles in subjects with craniomandibular disorders.

The purpose of this study was to examine muscle function in subjects with muscle pain. Forty-three subjects with pain in the craniomandibular muscles, clinically determined by manual palpation, were studied for alteration in recruitment of temporalis, masseter, and suprahyoid muscles during a series of phasic movements. Seventeen normal subjects were used as controls. The subjects with muscle pain were divided into three subgroups: (1) those with pain in both mandibular and neck muscles; (2) those with pain in these two muscle groups with joint degeneration; and (3) those subjects with pain only in mandibular muscles. Surface electromyographic (EMG) recordings were taken as each subject performed 16 different responses in which mandibular incisor movement was tracked simultaneously. The results show that the subjects with muscle pain use their anterior temporalis muscles with less frequency (i.e., probability) and with less intensity in several responses than normal subjects. These responses include rapid vertical closing movements, retrusion, ipsilateral laterotrusion, and natural as well as contralateral mastication. The masseter muscle is impaired much less in its function, and the recruitment of the suprahyoid muscles is not affected in the patients with muscle pain. Comparison of the bilateral activity in the anterior temporalis muscles during intercuspal clenching shows that the subjects with muscle pain often demonstrate a more severe asymmetrical recruitment of these muscles than the more symmetrical recruitment seen in normal subjects. Similar observations were made for the masseter muscle. These studies demonstrate that subjects with muscle pain in craniomandibular muscles alter the recruitment of their jaw muscles, thus supporting the concept that the neuromuscular system is altered in patients with craniomandibular disorders.

Adult↗
PubMed1990

Cytosolic calcium homeostasis in fungi: roles of plasma membrane transport and intracellular sequestration of calcium.

Cytosolic free calcium ([Ca2+]c) has been measured in the mycelial fungus Neurospora crassa with Ca2(+)-selective microelectrodes. The mean value of [Ca2+]c is 92 +/- 15 nM and it is insensitive to external pH values between 5.8 and 8.4. Simultaneous measurement of membrane potential enables the electrochemical potential difference for Ca2+ across the plasma membrane to be estimated as about -60 kJ.mol-1-a value that cannot be sustained either by a simple Ca2(+)-ATPase, or, in alkaline conditions, by straightforward H+/Ca2+ exchange with a stoichiometric ratio of less than 5 H+/Ca2+. We propose that the most likely alternative mechanism of Ca2+ efflux is ATP-driven H+/Ca2+. In accord with this proposal, depletion of the ATP level from 2.5 to 0.5 mM by CN- elicits an increase in [Ca2+]c, but only in alkaline conditions in which the putative H+/Ca2(+)-ATPase would be selectively stalled. The insensitivity of Ca2+ homeostasis to CN- in more acid conditions implies that the Km (ATP) of the transport system is 100 microM or less. The increase in [Ca2+]c in the presence of CN- at pH 8.4 (50 nM.min-1) is compared with 45Ca2+ influx (0.62 mM.min-1) under the same conditions. The proportion of entering Ca2+ remaining free in the cytosol is only 8 x 10(-5), and since the concentration of available chelation sites on Ca2(+)-binding proteins is unlikely to exceed 100 microM, a major role for the fungal vacuole in short-term Ca2+ homeostasis is indicated. This notion is supported by the observation that cytosolic Ca2+ homeostasis is disrupted by a protonophore, which rapidly abolishes the driving force (a transmembrane pH difference) for Ca2+ uptake into fungal vacuoles.

Adenosine Triphosphate↗
PubMed1990

Controlled-release indomethacin and sustained-release diclofenac sodium in the treatment of osteoarthritis: a comparative controlled clinical trial in general practice.

A double-blind, crossover study was undertaken in general practice to compare the efficacy and tolerability of a new controlled-release indomethacin with sustained-release diclofenac sodium in patients with osteoarthritis. Eighty-four patients were randomly allocated to receive controlled-release indomethacin tablets (75 mg) or sustained-release diclofenac sodium tablets (100 mg) at night for a period of 4 weeks before being crossed-over to receive the alternative treatment for a further 4 weeks. Pain scores for day and night, duration of morning stiffness, requirement for escape analgesia, and treatment preference were similar for both treatments. There was no significant difference between treatments for incidence and severity of side-effects. It was concluded that controlled-release indomethacin tablets (75 mg) given as a single night-time dose were as efficacious and well tolerated as sustained-release diclofenac sodium (100 mg).

Adult↗
PubMed1990

Controlled-release indomethacin and sustained-release diclofenac sodium in the treatment of rheumatoid arthritis: a comparative controlled clinical trial.

The efficacy and tolerability of a new, controlled-release indomethacin (75 mg) tablet was compared to that of a sustained-release diclofenac sodium (100 mg) tablet in 84 patients with rheumatoid arthritis. The study was designed as a double-blind, double-dummy crossover trial, patients being allocated at random to receive 1 active tablet and 1 placebo tablet of the alternative medication at night for 4 weeks before being crossed over to the alternative treatment for a further 4 weeks. Patient and clinical assessments on entry and at the end of each treatment period showed that pain scores for day and night, duration of morning stiffness, requirement for escape analgesia (paracetamol) and treatment preference were similar for both treatments. Both preparations also significantly improved the degree of joint tenderness compared to baseline (p less than 0.001), as measured by a modified Ritchie Articular Index. Incidence and severity of side-effects were comparable, with a significant improvement in degree of constipation reported for both treatments compared to baseline (p less than 0.05). The incidence and severity of headache was statistically significantly worse (p less than 0.05) for controlled-release indomethacin; however, there was no difference in any other parameter of tolerability. It was concluded that controlled-release indomethacin tablets (75 mg) given as a single night-time dose were as efficacious and well tolerated as sustained-release diclofenac sodium (100 mg).

Adult↗
PubMed1989

Changes in facial morphology in Macaca mulatta: a cephalometric study from 1.5 to 5 years of age.

A cross-sectional and longitudinal (3.5 years) study on the craniofacial growth of 10 male rhesus monkeys, using metallic implants and a radiographic cephalometric technique based mainly on angular measurements, led to the following observations. (1) Maxilla and mandible were displaced in a forward and downward direction during growth, the sagittal changes being predominant over the vertical changes. (2) Maxillary and mandibular prognathism increased continuously during the whole time span. This increase was twice as great for the maxilla as for the mandible. (3) The inclination of the palatal plane and the mandibular plane changed very little over time. (4) Mandibular form remained constant, but the cranial base showed a significant flattening between approximately 1.5 and approximately 3 years of age. (5) Upper and lower occlusal plane angles changed little over time. (6) The interincisal angle decreased significantly until approximately 3 years of age in relation to the increase in proclination of the permanent incisors in the maxilla and mandible. The intermolar angle remained fairly constant. Changes in some of the variables reported (maxillary and mandibular prognathism, sagittal jaw relationship, mandibular length, interincisal angle, proclination of the upper and lower incisors, and opening of the cranial base angle) occurred as a function of age. The use of angular measurements allowed us to develop a series of templates that will provide a useful tool for a quick check of normal craniofacial morphology at three representative time points.

Aging↗
PubMed1989

Normal maxillary and mandibular growth and dentoalveolar development in Macaca mulatta. A longitudinal cephalometric study from 2 to 5 years of age.

Normal maxillary and mandibular growth and dentoalveolar development were examined in a longitudinal study of 10 male Macaca mulatta monkeys. Metallic implants were placed in the jaws of the monkeys as markers, and head films were taken semiannually from 2 to 5 years of age. The results showed that maxillary and mandibular growth is associated with rotational changes that are mostly in an anterior direction and are about twice as great in the mandible (9.4 degrees) as in the maxilla (4.2 degrees). These rotations are largely masked--about 75% in the maxilla and 90% in the mandible--by modeling within the jaws. Similarly, differential vertical dentoalveolar development almost completely masked the rotation of the occlusal plane that results from the rotation of the jaws, which created the impression that the occlusal plane is stable during growth. Peak growth velocity was reached on average at 3 years of age in the maxilla and mandible, with some individual variation. No major growth changes occurred after 3.5 to 4 years of age.

Aging↗