Search PubMed⌕ Search

Biomedical subjects

B Bloom

Publications and source records attributed to B Bloom.

At least 55 records · Page 3Linked to original sources
PubMed1980

Expectation and patient preference -- does it matter?

Admission to clinical trials is often based on the assumption of homogeneity of the population. A group of 60 patients, all with pain in the neck or shoulder of at least 3 months duration, were studied. Expectation was graded before treatments were started by sharing out 100 points between freedom from side effects, pain relief, depression relief, improved mobility, improved sleep and speed of action. A double-blind crossover study of two established anti-inflammatory analgesics and placebo was carried out. Using analogue scales, patients were asked to grade their response. Side effects were recorded, and preference was established at the end of the study.Although all the patients were in sufficient pain to require medical attention, some rated relief of depression, improvement in sleep or lack of side effects as more important than pain relief. Differences between drug and placebo were most clearly demonstrated in those patients whose main concern was improved mobility. In our view it is important to select patients who are in need of a dominant property of a drug for a trial of this property and this may have ramifications across the medical spectrum.

Apazone↗
PubMed1980

Clinical study comparing acupuncture, physiotherapy, injection and oral anti-inflammatory therapy in shoulder-cuff lesions.

In a single-blind trial, five treatments for painful stiff shoulder were compared for a 4-week assessment period in 60 patients. The treatments were acupuncture, steroid injection with placebo and with active tolmetin sodium, physiotherapy in the form of ultrasound and 'placebo' physiotherapy with placebo tolmetin sodium. Objective assessment was gained by use of goniometer readings to monitor shoulder abduction. Pain was measured by visual analogue scales and by a 4-point scale. Comparative assessment was also recorded and at the end of the study a success or failure was recorded for each patient's treatment. With very few exceptions all patients improved markedly, both in terms of the subjective and objective parameters. No differences between the treatments were detected. The incidence and severity of side-effects was low. It is suggested that the results show that the painful stiff shoulder may be a self-limiting condition and that any beneficial effect was really due to natural recovery. This is an important consideration because patients do not always receive immediate attention when referred to an out-patient department and the use of physiotherapy and acupuncture in such cases, perhaps, should be critically examined.

Acupuncture Therapy↗
PubMed1980

Dose-range studies of benoxaprofen compared with placebo in patients with active rheumatoid arthritis.

The new nonsteroidal antiinflammatory drug benoxaprofen was compared with placebo in separate double-blind crossover studies in patients with active rheumatoid arthritis given 400 mg, 600 mg, or 800 mg a day. Benoxaprofen was significantly better than placebo at all doses studied. The 800 mg dose was the most effective but there were slightly more gastrointestinal side effects with this dose. The 600 mg dose was more effective than the 400 mg dose with an acceptably low incidence of side effects at both these doses. For most patients, 600 mg once daily will probably be the usual dose of the drug, but some will need the higher dose to 800 mg, while the condition of others may be satisfactorily controlled with just 400 mg daily.

Adolescent↗
PubMed1978

Macrophage proteases and rheumatic diseases: regulation of plasminogen activator by thymus-derived lymphocytes.

Macrophages in culture secrete a variety of products including neutral protease activities such as plasminogen activator(s) (P.A.), collagenase and elastase. These products are not made by unstimulated macrophages, but only after induction by inflammatory stimuli, phagocytosis and lymphokines. Phagocytosis induces the prompt release of high levels of P.A. by endotoxin-primed macrophages and prolonged secretion follows uptake of non-degradable particles. Stimulation of lymphocytes results in the release of a supernatant product which enhances P.A. secretion by unstimulated mouse macrophages up to 5-fold. The production of the P.A. inducer (P.A.I.) is immunologically specific and is found in allogeneic mixed leukocyte culture (MLC) reactions, but not in syngeneic controls. The P.A. is also induced in activated macrophages from animals infected with BCG of T. cruzi and challenged with specific antigen. Production of the P.A.I. in MLC reactions depends on the presence of thymus-derived (T) lymphocytes and is closely correlated with the appearance of macrophage migration inhibition factor (MIF). The induction of macrophage P.A. and other proteases provides an important pathway for activating macrophages in delayed hypersensitivity reactions and could contribute significantly to tissue destruction in chronic inflammatory diseases in joints.

Animals↗
PubMed1975

Studies of in vitro infection by Trypanosoma cruzi. I. Ultrastructural studies on the invasion of macrophages and L-cells.

The interactions of Trypanosoma cruzi with L-cells, and with normal and activated macrophages in vitro were studied by ultrastructural techniques. T. cruzi actively invades cultured L-cells and uniformly destroys them. Normal macrophages could control a 1:1 (parasite to host cell) infection, but were destroyed by a 10:1 infection. BCG-activated macrophages, however, controlled a 10:1 infection but not one at a ratio of 100:1. It appears that parasites that survive within host cells do so outside cytoplasmic vacuoles, whereas when they are relegated to host cell phagosomes they are destroyed. Culture forms of T. cruzi have several means of access into host cells. Marcrophages are better able to survive infection than are non-phagocytic cells. Finally, it is suggested that control of an experimental infection in vitro is dependent upon numbers of parasites to macrophages as well as the state of the macrophages.

Animals↗