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Biomedical subjects

B J Goldstein

Publications and source records attributed to B J Goldstein.

At least 109 records · Page 6Linked to original sources
PubMed1984

Double-blind placebo-controlled multicenter evaluation of the efficacy and safety of nomifensine in depressed outpatients.

Outpatients with primary affective disorder-depression who scored at least 20 on the Hamilton Depression Rating Scale (HDRS) were randomly assigned to treatment for 1 month with nomifensine (100-200 mg/day) or placebo. Clinical laboratory and physical evaluations, including ECGs when feasible, revealed no clinically significant changes over the course of treatment. Nomifensine patients showed improvement compared to placebo on the HDRS total score endpoint analysis (p = .06) and the Cognitive Disturbance and Retardation factors (p less than or equal to .05). A better rate of improvement was seen with nomifensine on the Clinical Global Impressions severity of illness (p less than or equal to .05) and therapeutic index (p less than or equal to .05) components. No differences were seen between groups in the incidence of overall or specific side effects. Nomifensine thus appeared safe and superior to placebo on several key measures of depressive symptomatology in this multicenter study of depressed outpatients.

Administration, Oral↗
PubMed1984

Comparison of the electrocardiographic effect of dothiepin and amitriptyline.

Electrocardiograms of 65 patients treated with dothiepin, a sulphur substituted tricyclic antidepressant, were compared to those of 57 patients receiving amitriptyline and 62 patients given placebo. Amitriptyline produced an average heart rate increase of 10 beats/minute as compared to 5 beats/minute for dothiepin (p less than .02). Amitriptyline also produced a significant prolongation of the corrected QT interval as compared to both dothiepin and placebo (p less than .01 and p less than .001, respectively). Dothiepin had no significant effect on any index of myocardial conduction (PR interval, corrected QT interval, and QRS duration) as compared to placebo.

Adult↗
PubMed1983

A double-blind evaluation of zimelidine in comparison to placebo and amitriptyline in patients with major depressive disorder.

This paper presents the results from a large multicenter study, performed at three clinical research units in the USA. Prior to a three to seven days of placebo washout period, patients were randomly assigned to zimelidine, a potent and selective 5-HT reuptake blocker, amitriptyline or placebo. The scheduled treatment period was four weeks. Dosage range was 75-300 mg/day for active medications. The rating instruments were the Hamilton Depression Scale and the Clinical Global Impression scale. The side effects were recorded by using a side effect inventory (TESS). Vital signs, laboratory work including clinical chemistry, ECG, and plasma levels of drugs, were performed. In the main efficacy evaluation there were 229 depressed outpatients included, all having completed at least two weeks of treatment after the washout period. The patients treated with zimelidine as well as those treated with amitriptyline showed a significant improvement relative to the placebo treated patients. For the safety evaluation 263 patients were included. Side effects, in particular anticholinergic effects but also drowsiness and cardiovascular effects, were much less pronounced in the zimelidine group as compared to the amitriptyline group. Only marginal differences regarding side effects were reported for zimelidine compared to those reported for placebo.

Adolescent↗
PubMed1983

Zimeldine tolerability in comparison to amitriptyline and placebo: findings from a multicentre trial.

Zimeldine tolerability was compared to amitriptyline and placebo in a large multicentre study performed at three clinical research units in the U.S.A. Prior to a placebo washout period of 3-7 days, patients were randomly assigned to zimeldine, a potent and selective 5-HT reuptake blocker, amitriptyline or placebo. Dosage range was 75-300 mg/day for active medications, and the scheduled treatment period was 4 weeks. The side-effects were recorded by using a Treatment Emergent Symptom Scale (TESS). Vital signs were monitored and laboratory investigations, including chemistry and drug plasma levels, were performed. Two hundred and sixty-three patients were included in the safety evaluation. Side-effects, particularly anticholinergic effects but also drowsiness and cardiovascular effects, were much less pronounced in the zimeldine group compared to the amitriptyline group. Only marginal differences in side-effects were reported between zimeldine and placebo. Significantly more patients receiving amitriptyline were withdrawn from treatment as a result of adverse effects. Thus, zimeldine appears to be an effective antidepressant with marked advantages with regard to tolerability. It is therefore an important new contribution to the treatment of depressive disorders.

Adult↗
PubMed1983

A placebo-controlled, double-blind comparison of clobazam and diazepam in the treatment of anxiety.

In a randomized, placebo-controlled, double-blind study, the efficacy and safety of clobazam and diazepam were compared in 114 anxious outpatients. During the 4-week double-blind phase of the study, the mean daily dose was 59 mg for clobazam and 25 mg for diazepam. Results indicate statistically significant efficacy, measured by both patient and physician rating scales, for both active drugs compared to placebo. The incidence of sedation was similar for the two active treatment groups; dizziness was more frequent in the diazepam group.

Adult↗
PubMed1981

Insulin degradation by insulin target cells.

Recent findings illustrate the complexities associated with the interaction between insulin and its target cells. These results suggest that the processes involved in insulin action and those involved in insulin degradation may have certain steps in common. Both apparently begin when insulin binds to the insulin receptor. The next step is unknown but it ultimately leads to the internalization of the hormone before insulin dissociates from the cell surface. Furthermore, internalization appears to be a requirement for efficient degradation of insulin since the vast majority (perhaps all in certain cells) of the degrading activity is intracellular. Internalization may not be required to produce certain actions of the hormone, however, and the two processes may diverge at the point. It is not clear how insulin enters the target cell other than the process appears to be receptor-mediated. Also, further work is needed to more fully characterize the vesicles that contain internalized insulin. Finally, the actual location of insulin degradation and the enzyme(s) involved need further study, especially to clarify the relative contributions of lysosomes, cytosolic protease, and GIT to physiological insulin destruction. An understanding of the overall process of insulin degradation is required for a complete description of the physiologic disposition of the hormone at the target cell. Moreover, this system has subtle control mechanisms that may have important implications for the management of diabetes and other endocrine and metabolic disorders.

Adipose Tissue↗
PubMed1980

Insulin degradation by adipose tissue. Studies at several levels of cellular organization.

A systematic study of the degradation of physiological concentrations of 125I-labelled insulin was performed in intact fat-pads, isolated adipocytes and subcellular fractions of isolated adipocytes. The findings indicate that insulin is rapidly degraded to low-molecular-weight peptides and/or amino acids by the intact tissue and isolated cells. Of the total insulin-degradation products present after incubation with an intact fat-pad, 94% is recovered in the medium, indicating that these products are not retained by the cells or tissue. The plasma membranes do not degrade insulin significantly in the absence of reduced glutathione, and over 99% of the cellular degradative capacity is found in the postmicrosomal supernatant (cytosol). The cytosol degrades insulin to several labelled fragments that are intermediate in size between insulin and insulin A chain, as well as to the low-molecular-weight tissue degradation products. Inclusion of plasma membranes with cytosol accelerates the cleavage of the intermediate fragments to the size of the small products seen with the intact tissue. However, plasma membranes do not increase the initial step in the degradation of insulin when incubated with cytosol, suggesting that the insulin receptor is not involved with the direct cleavage of insulin. This study supports the hypothesis that the bulk of insulin degradation occurs in the adipocyte cytosol, where intermediate-sized fragments are generated and rapidly cleaved to smaller products by the plasma membrane and quickly released into the surrounding medium.

Adenosine Triphosphatases↗
PubMed1980

An overview of seventeen years of experience with dothiepin in the treatment of depression in Europe.

The European clinical experience with dothiepin since 1962 indicates that it is efficacious in the treatment of depression (neurotic, psychotic, and with concomitant anxiety) in dose of 75-200 mg/day. The side effects profile is similar to the tricyclic antidepressant drugs with significantly less anticholinergic side effects and cardiotoxicity then amitriptyline. The result of the current ongoing clinical trails in the United States with several hundred patients will more precisely define the efficacy, dosage and side effect profile of dothiepin.

Adolescent↗
PubMed1978

Effects in adipocytes of diamide on GSH levels, glucose uptake and cell integrity.

Concentrations of insulin and chemical agents (H2O2, vitamine K-5) which stimulate hexose transport in fat cells do not alter the cellular levels of glutathione (reduced form; GSH). Diamide, another agent used in studies of insulin action, markedly reduces GSH levels and increases the movement of sugar into the cell. However, unlike insulin, H2O2 or vitamin K-5, diamide causes a change in the permeability of fat cells that allows entry of compounds (insulin, sucrose, L-glucose) which are normally excluded by the plasma membrane. Moreover, the accelerated rate of methylglucose uptake produced by diamide treatment is not inhibited by cytochalasin B, an agent that blocks basal and insulin-stimulated methylglucose transport. These results indicate that diamide does not cause a stimulation of the glucose transport system and should not be used (or used with caution) in transport studies. Furthermore, oxidation of GSH does not appear to be necessary for the stimulation of hexose transport in adipocytes by insulin, H2O2 or vitamin K-5.

Adipose Tissue↗
PubMed1978

The measurement of psychological states by use of factors derived from a combination of items from mood and symptom checklists.

The similarities in structure and usage of two widely used adjective checklists, the Profile of Mood States (POMS) and Symptom Checklist (SCL), suggested the feasibility of pooling the items from the two scales into a single factor analysis. This procedure was clinically appealing, statistically sound, and provided an efficient method to reduce and refine assessments of psychopathology. Data from 413 Miami Symptomatic Volunteers were used in this factor analysis. Nine factor dimensions were found to meet the dual criteria of statistical salience and clinical meaningfulness. The results demonstrated the factorial stability of the SCL and the POMS and identified the dimensions of psychopathology in which items from the two scales tended to complement each other in factor structure. Some factors were found to be unique to each scale. In addition, it was found that pooling the items from both scales yielded two new factor dimensions that were not previously available from either of the individual scales.

Adult↗
PubMed1976

Uptake of branched-chain alpha-keto acids in Bacillus subtilis.

Bacillus subtilis has a constitutive system for the uptake of alpha-keto-beta-methylvalerate, alpha-ketoisovalerate, and (probably) alpha-ketoisocaproate. A mutation, kauA1, which blocks the uptake of alpha-keto-beta-methylvalerate and alpha-ketoisovalerate, is located between metB and citK on the B. subtilis chromosome.

Bacillus subtilis↗
PubMed1975

Metiapine: a double-blind comparison with chlorpromazine in acute schizophrenic patients.

Sixty newly admitted acute schizophrenic patients were randomly assigned to a double-blind trial of metiapine with a maximum dose of 450 mg per day versus a maximum dose of 450 mg per day versus a maximum daily dose of 900 mg chlorpromazine per day. At the conclusion of the study, 21 patients in each group showed marked to moderate improvement. There were significantly more marked improvers in the metiapine group then the chlorpromazine group on the Physician's Posttreatment Global Impression. Evaluation by analysis of covariance of the Brief Psychiatric Rating Scale showed a significant difference between treatment groups favoring chlorpromazine on the item of blunted affect. The spectrum of side effects was similar in the two groups, except for six patients treated with metiapine who displayed tachycardia on the EKG. This pulse elevation was reflected in the group data and is probably dose related. In conclusion, both drugs appeared to be equally efficacious in the treatment of newly admitted acute schizophrenic patients.

Acute Disease↗