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Biomedical subjects

B Kidd

Publications and source records attributed to B Kidd.

14 recordsLinked to original sources
PubMed1998

Increased capsaicin-induced secondary hyperalgesia as a marker of abnormal sensory activity in patients with fibromyalgia.

In this study, capsaicin-induced secondary hyperalgesia was assessed as a marker of abnormal nociceptive processing in patients with fibromyalgia (FM). The area of mechanical secondary hyperalgesia induced by a standard solution of capsaicin placed on the volar forearm was measured in ten patients with FM and the results compared to those obtained in ten patients with rheumatoid arthritis (RA) and ten normal subjects. The area of secondary hyperalgesia was found to be substantially increased in both the FM and RA groups compared with controls. In the FM group the area of hyperalgesia correlated with the overall pain score and with the joint tenderness score. The results suggest that in FM there is enhanced sensitivity of nociceptive neurones at a spinal level, thereby supporting the concept of a generalised disturbance of pain modulation in this disorder.

Biomarkers↗
PubMed1997

Putative analgesic activity of repeated oral doses of vitamin E in the treatment of rheumatoid arthritis. Results of a prospective placebo controlled double blind trial.

OBJECTIVE: Vitamin E, the most potent naturally occurring lipid soluble antioxidant has been suggested to possess both anti-inflammatory and analgesic activity in humans. This double blind and randomised study used a broad spectrum of clinical and laboratory parameters to investigate whether there was any additional anti-inflammatory or analgesic effects, or both, of orally administered alpha-tocopherol in rheumatoid arthritis patients who were already receiving anti-rheumatic drugs. METHODS: Forty two patients were enrolled and treated with alpha-tocopherol (n = 20) at a dose of 600 mg twice a day (2 x 2 capsules) or with placebo (n = 22) for 12 weeks. The following parameters were measured: (1) Three clinical indices of inflammation--the Ritchie articular index, the duration of morning stiffness, and the number of swollen joints; (2) three measures of pain--pain in the morning, pain in the evening, and pain after chosen activity; (3) haematological and biochemical measures of inflammatory activity; (4) assays for the oxidative modification of proteins and lipids. RESULTS: All laboratory measures of inflammatory activity and oxidative modification were unchanged. Furthermore, the clinical indices of inflammation were not influenced by the treatment. However, the pain parameters were significantly decreased after vitamin E treatment when compared with placebo. CONCLUSION: The results provide preliminary evidence that vitamin E may exert a small but significant analgesic activity independent of a peripheral anti-inflammatory effect, but which complements standard anti-inflammatory treatment.

Administration, Oral↗
PubMed1996

Psychological aspects of excimer laser surgery for myopia: reasons for seeking treatment and patient satisfaction.

AIMS: To determine the reasons patients seek excimer laser treatment for myopia and to measure levels of patient satisfaction with each phase of this relatively new treatment. METHODS: A unique 38 item visual analogue questionnaire was developed and applied to 100 consecutive patients (n = 100) who had undergone excimer laser photorefractive keratectomy for myopia or myopic astigmatism at a single centre. All subjects underwent extensive ophthalmic assessment and patient education before treatment. RESULTS: A 90% response rate was achieved (n = 90). Improved unaided vision (85.6%), freedom from spectacles (83.3%), and difficulties with contact lens wear (72.7%) were the most common reasons for seeking treatment. The majority of patients felt that the quality of their life had improved (85.5%) and 82% felt that the quality of their unaided vision was as good as they had anticipated. overall, 95.5% of patients were pleased that they had undergone this procedure. The vast majority (98.9%) of patients felt that they fully understood the operation pretreatment but almost one quarter (23.9%) found the actual operation distressing. Only 15.7% found postoperative pain did not respond adequately to prescribed analgesia. CONCLUSIONS: This study demonstrates a very high level of patient satisfaction after excimer laser treatment for myopia and myopic astigmatism. It suggests that most patients seek treatment to enjoy better vision free from optical aids and that a high level of patient education preoperatively may establish realistic expectations and satisfaction with overall outcome.

Adult↗
PubMed1996

A multicenter, randomized, double blind study comparing lornoxicam with diclofenac in osteoarthritis.

OBJECTIVE: To compare the efficacy and tolerability of lornoxicam and diclofenac in the treatment of patients with osteoarthritis (OA) over 12 weeks and to assess the efficacy and tolerability of lornoxicam over a followup period of 40 weeks. METHODS: In a double blind, parallel group study, 135 patients (mean age 63 years) with OA of the hip and/or knee were randomized to receive lornoxicam 4 mg 3 times daily (tid), lornoxicam 8 mg twice daily (bid), or diclofenac 50 mg tid for 12 weeks. 85 patients who completed this 12 week treatment period subsequently received lornoxicam 4 mg tid or 8 mg bid for up to 40 weeks. RESULTS: Over the initial 12 week treatment period, intention-to-treat analysis revealed improvements in the functional index of severity for OA in all 3 groups by -1.5 to -1.9 points and pairwise testing demonstrated significant intergroup equivalence (p < 0.033). Confirmatory analysis demonstrated the expected efficacy as outlined in the sample size calculation. The percentage of patients showing improvements in disease activity (about 46%) and pain intensity (42 to 48%) was also similar and a clear majority of patients also reported "some" or "excellent" pain relief (80 to 89%). A per protocol analysis produced similar results. During the 40 week lornoxicam followup treatment period there was slight deterioration in the functional index of severity of OA (0.3 to 1.1 points). This minor change may reflect the natural course of the disease rather than a loss of efficacy in lornoxicam. Disease activity and pain intensity continued to improve but in a lesser proportion of patients (< 23%) compared to the previous phase. Nevertheless, a similar high percentage of patients (78 to 89%) reported "some" or "excellent" pain relief. Adverse events in both phases of this study were consistent with those commonly reported during treatment with nonsteroidal antiinflammatory drugs and included headache and gastrointestinal events. There was no difference in the frequency or severity of adverse events between any of the treatment groups. Lornoxicam was well tolerated in the long term. CONCLUSION: Lornoxicam 4 mg tid and 8 mg bid were as effective as diclofenac 50 mg tid for the treatment of OA. There was no significant difference in tolerability of these regimens. Thus, lornoxicam appears to be a useful therapeutic alternative to diclofenac in patients with OA.

Adolescent↗
PubMed1992

A double blind, multicentre, placebo controlled trial of lornoxicam in patients with osteoarthritis of the hip and knee.

Lornoxicam is a new non-steroidal anti-inflammatory agent (NSAID) with a similar pharmacological profile to other oxicams and a potency 10 times greater than piroxicam. A multicentre, randomised, double blind, parallel group study was undertaken to compare the efficacy and tolerance of four weeks' treatment with lornoxicam (6 mg once daily, 4 mg twice daily, and 6 mg twice daily) and placebo in patients with osteoarthritis of the hip or knee. A dose related efficacy of lornoxicam was shown by the numbers of patients in each treatment group who withdrew from the trial owing to inadequate symptom relief (12/40 (30%) receiving placebo, 6/40 (15) receiving lornoxicam 6 mg daily, 4/40 (10%) receiving lornoxicam 8 mg daily, and none receiving lornoxicam 12 mg daily). This effect was confirmed by pain relief scores, which were significantly better than placebo during treatment with lornoxicam 8 mg and 12 mg daily, the effect of 12 mg daily being significantly superior to that of 8 mg daily. Similar results were obtained from functional status scores. Mean functional index (Lequesne) scores were significantly greater than placebo only at a daily dose of 12 mg lornoxicam. Lornoxicam was generally well tolerated, though some gastrointestinal side effects were seen as has been reported with other NSAIDs. Laboratory investigations showed no evidence of drug toxicity.

Administration, Oral↗
PubMed1988

Disease expression of ankylosing spondylitis in males and females.

The clinical features of 35 female patients with ankylosing spondylitis were compared with 70 male controls individually matched for disease duration. Mean age of onset and presenting symptoms were similar in both groups. No differences were observed as regards spinal symptoms, chest expansion, peripheral arthritis, extraarticular features or functional outcome. However, males had significantly greater spinal radiological change that was positively associated with hip arthritis. Our findings suggest that although axial disease is more severe in males the overall pattern of clinical disease is similar in both sexes.

Activities of Daily Living↗
PubMedDate not supplied

Screening for psychiatric distress and low self-esteem in patients presenting for excimer laser surgery for myopia.

BACKGROUND: Patients presenting for photorefractive keratectomy (PRK) may have unusual psychological profiles. Certain psychological variables may impact treatment outcome, making early identification crucial. We report a controlled questionnaire study of psychiatric "anxiety/distress" and self-esteem in myopic patients who presented for excimer laser treatment. METHODS: Ninety consecutive myopic individuals (patients) who presented for excimer laser PRK and 50 consecutive myopic individuals who presented to an optometrist for contact lens fitting (controls) were assessed using two self-completion questionnaires-the GHQ30 and Hudson Index of Self-Esteem ISE. The questionnaires were distributed during assessment for treatment. RESULTS: PRK patients had a 90% response rate for both questionnaires and control patients, 98% for GHQ30 and 100% for Hudson ISE. PRK patients were significantly older (p = 0.000003), had a greater myopic spherical equivalent refraction (p = 0.012) and had better spectacle-corrected visual acuity (p = 0.0096). No significant differences were demonstrated with regard to anxiety/distress in terms of absolute scores (p = 0.07), or the proportion of patients being positive or negative (p = 0.10). Similarly, self-esteem was not significantly different between the two groups (absolute scores p = 0.69; positive/negative p = 0.29). The high response rate shows that the GHQ30 and Hudson ISE are easy to use and well tolerated by myopes in a busy clinic setting. The fact that the patients were older, with a greater refractive error, may partly reflect the onset of contact lens intolerance. CONCLUSION: The psychological findings suggest that PRK patients cannot be considered more distressed or anxious than other myopic individuals. There is no evidence that their decision to undergo surgery is driven by abnormally low self-esteem.

Adolescent↗