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Biomedical subjects

A Lee

Publications and source records attributed to A Lee.

841 records · Page 47Linked to original sources
PubMedDate not supplied

Efficacy and tolerability of lumiracoxib versus placebo in patients with osteoarthritis of the hand.

OBJECTIVE: This multicentre, randomized, double-blind, placebo-controlled parallel-group study was undertaken to investigate the efficacy, safety and tolerability of lumiracoxib (Prexige), a cyclooxygenase-2 selective inhibitor, in patients with primary osteoarthritis (OA) of the hand. METHODS: The study randomized 594 patients aged > or = 18 years with symptomatic OA of the hand. Patients underwent a 3 to 7-day washout for previous nonsteroidal anti-inflammatory drugs and those with pain intensity > or = 40 mm on a 100 mm Visual Analogue Scale (VAS) in the target hand during the 24 hours prior to baseline and an increase in pain intensity of either > or = 20% or > or = 10 mm VAS since screening (whichever was greater) were randomized to lumiracoxib 200 mg once daily (od) (n=205), lumiracoxib 400 mg od (n=193) or placebo (n=196). The primary efficacy variable was overall OA pain intensity (VAS mm) in the target hand after 4 weeks of treatment. Safety and tolerability assessments were performed. RESULTS: After 4 weeks of treatment, overall OA pain intensity in the target hand was significantly lower for patients treated with lumiracoxib compared with patients treated with placebo (both doses p<0.001). There was no significant difference between lumiracoxib doses in terms of the reduction in overall OA pain intensity. Lumiracoxib was well tolerated. The incidence of adverse events was similar for active treatment groups and placebo. CONCLUSIONS: Lumiracoxib 200 and 400 mg od were effective and well tolerated treatments for OA of the hand. Lumiracoxib significantly improved overall OA pain intensity in the target hand versus placebo, with a tolerability profile similar to placebo.

Aged↗
PubMedDate not supplied

Cardiac events after heart transplantation: incidence and predictive value of coronary arteriography.

Cardiac events from graft arteriopathy, including myocardial infarction, heart failure resulting from previous myocardial infarction, and sudden death, may limit long-term survival after heart transplantation. To determine the incidence of cardiac events and the use of coronary arteriography in predicting these events, the long-term results (mean follow-up, 3.5 years; standard deviation +/- 2.0) of heart transplantation in 427 patients were reviewed. Cardiac events included 19 cases of myocardial infarction, 13 cases of sudden death, and 10 cases of congestive heart failure. All these events occurred after the first year except for three cases of sudden death and one case of myocardial infarction. Cumulative incidence of cardiac events per patient year was 0.9% within the first year, increasing to 1.9% by 5 years. Cardiac events accounted for 3.8% of the deaths by the end of the first year, rising to 18% of total mortality by 7 years after heart transplantation. In patients dying after the first year of transplantation, deaths from sequelae of coronary artery disease occurred in 36% (20/55). The relative risk ("odds ratio") of any cardiac event was 3.44 (p less than 0.05) in patients with angiographic evidence of obstructive disease compared with those without evidence of disease, risk of cardiac death 4.6 (p less than 0.05) and risk of sudden death, 2.4 (not significant). Of the 13 patients who died suddenly, five seen at autopsy were found to have had a recent myocardial infarction. Of all patients who died of heart disease, recent myocardial infarction was detected in nine who were seen at autopsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Posttransplantation diabetes mellitus in heart transplant recipients.

This study was undertaken to investigate the impact of diabetes, which develops after heart transplantation, on infection and patient survival. Nondiabetic patients (366) underwent heart transplantation at our institution between June 1, 1980 and January 12, 1988. Of these patients, 29 (8%) developed posttransplantation diabetes (PTD), defined as a continued need for hypoglycemic agents. The PTD group did not differ significantly from the nondiabetic recipients in age, sex, or human leukocyte antigen type. The average age in the PTD group was 49 years. Average length of follow-up was 21 months (range 4 to 46 months). Eighteen patients are maintained on insulin. Eight patients are on oral hypoglycemic agents. Three patients died while on insulin. The average prednisone dosage in this group is 0.23 mg/kg/day. There have been 18 minor infections and four potentially serious nonlethal infections in the 27 PTD recipients. One lethal infection occurred 33 months after heart transplantation. The only other fatality was related to metastatic bladder cancer. This lethal infection rate of 3% compares with a rate of 11% in all nondiabetic recipients who have follow-up for 21 months. The 3-year actuarial survival of the PTD group is 75%, which compares favorably with the survival of nondiabetic patients. PTD cannot be predicted by sex, age, or human leukocyte type before transplantation, and it does not significantly increase the incidence of mortality or serious infection.

Coronary Angiography↗
PubMedDate not supplied

Management of cyclosporine toxicity by reduced dosage and azathioprine.

While cyclosporine immunosuppression has improved the results of heart transplantation, nephrotoxicity and hypertension occurred in a large percentage of surviving patients. The potential irreversibility of these toxicities was noted in patients chronically exposed to cyclosporine. The immunosuppressive protocol was modified in those patients with a serum creatinine greater than 2.5 mg/100 mL. Azathioprine was added to the immunosuppressive regimen, and the dose of cyclosporine was steadily decreased until the creatinine was lowered. The combination of low-dose cyclosporine and azathioprine provided effective immunosuppression and was associated with a significant decrease in serum creatinine level, in systolic and diastolic blood pressures. Although it is premature to assess the long-term results of this immunosuppressive protocol, the early results are encouraging.

Azathioprine↗
PubMedDate not supplied

The effects of surgery on the circadian rhythms of cortisol.

The circadian rhythms of plasma cortisol levels are studied extensively. Frequent sampling techniques are used to examine the effects of surgical trauma on the circadian pattern of plasma cortisol in man. Five patients were studied, 48 hours before and 48 hours after major surgery. The normal preoperative cortisol rhythms of these patients did not disappear after surgical trauma but they were significantly phase-shifted. In addition, the mean cortisol concentrations were significantly elevated and the intracircadian cycles suffered complex changes in the postoperative period.

Adult↗
PubMedDate not supplied

Ambulatory blood pressure recorder.

A 24-hour, 3.5-lb., fully automatic, indirect blood pressure monitoring device has been developed that permits up to 40 programmed and manual readings each hour during normal daily activities. A study comparing the automatic ambulatory device with standard conventional sphygmomanometry revealed mean absolute differences of blood pressure measurement of less than 5 mmHg and mean pairwise differences of 2 mmHg for both systolic and diastolic pressures.

Adult↗
PubMedDate not supplied

Infiltrating lobular breast carcinoma: detection of occult regional lymph node metastasis by immunohistochemistry.

Twenty-two patients primarily operated for infiltrating lobular breast carcinoma (ILC) stage T2 with negative axillary lymph nodes in routine histology were investigated in order to detect occult metastasis in the nodes by immunohistochemistry. After testing a panel of monoclonal antibodies against cytokeratins, AE1/AE3 as the most sensitive marker for ILC cells was selected for the study. The immunohistochemical investigation of the 226 regional lymph nodes showed one case of a tumor cell embolus in the subcapsular sinus. Despite the fact that our routine examination included serial sections of the lymph nodes, an occult micrometastasis could be detected by immunohistochemistry only. As so far no significant prognostic value of micrometastasis to axillary lymph nodes of ILC has been shown, at the moment the clinical impact of the detection of micrometastasis is limited. Immunohistochemical methods do not appear to be an improvement for clinical decisions if careful histological examination of serial sections of lymph nodes in ILC is carried out.

Antibodies, Monoclonal↗
PubMedDate not supplied

[Morbidity and mortality of retarded and normal weight premature infants].

Differences of fetal outcome between appropriate for gestational age (AGA) and small for gestational age (SGA) preterm newborns with birth weight below 2500 g and gestational age ranging from 27 to 36 weeks have been evaluated. As described by Rohrer SGA have been divided into symmetrical retarded and asymmetrical retarded newborns using ponderal index. Therefore distribution of ponderal index on our local population has been analysed. SGA more often had an Apgar score below 6 five minutes post partum (p = 0.01) and their mothers more often announced abuse of nicotine during pregnancy. AGA have been on respiratory ventilation significantly longer than SGA (p = 0.001) and photo therapy because of hyperbilirubinaemia more often had to be performed on AGA (p = 0.02). AGA have spent a longer time at the neonatal intensive care unit than SGA (p = 0.0006). No differences could be found in mortality between AGA and SGA. Preterms with low ponderal index had no different outcome than SGA with normal ponderal index.

Apgar Score↗
PubMedDate not supplied

Priapism associated with psychotropic drugs.

Priapism, a rare, potentially dangerous but largely preventable condition, remains associated with the use of drugs, many of which are of the psychotropic variety. This article reviews various aspects of this condition, with a view to increasing awareness and understanding of the condition among clinicians.

Adult↗
PubMedDate not supplied

Metastases to meningioma.

We describe a patient with metastatic disease to an intracranial meningioma in which MR images showed multiple foci of intense enhancement within a background of moderate enhancement. The discrete foci proved to be metastatic disease from the patient's known breast carcinoma.

Aged↗
PubMedDate not supplied

Sputum cells from lung tumor patients carry a cell surface marker not found in normal sputum.

Cells were collected from sites of known lung tumours and corresponding control areas of these lungs. Fluorescent staining demonstrated that the tumour cells and epithelial cells (cytologically these cells appeared normal) both possessed a receptor for these fluorescent probes. Fluorescent labelling of sputum cells from these tumour patients also resulted in fluorescent labelling of these "cyto logically normal" epithelial cells. No such fluorescent epithelial cells were observed in sputum samples collected from control subjects or in cells collected from the control areas of the tumour patients' lungs. We conclude that a cell surface protein receptor is expressed in lung tumour-associated epithelial cells but is absent from control sputum epithelial cells.

Biomarkers, Tumor↗