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Biomedical subjects

B Richards

Publications and source records attributed to B Richards.

At least 91 records · Page 5Linked to original sources
PubMed1988

Long-term therapy with a depot luteinizing hormone-releasing hormone analogue (Zoladex) in patients with advanced prostatic carcinoma.

We treated 191 patients with histologically proved locally advanced stage (T3 or T4) and/or metastatic prostate cancer with a biodegradable depot formulation of a luteinizing hormone-releasing hormone analogue (Zoladex). After an initial increase in serum testosterone in week 1 of therapy a continuous decrease of testosterone to castrate levels was obtained. With a monthly injection of the luteinizing hormone-releasing hormone analogue 4 patients (2 per cent) experienced a transient increase in bone pain, 1 had ureteral obstruction and 1 suffered paraplegia during the first few weeks of therapy. Over-all objective and subjective responses were similar to those obtained by castration or estrogen therapy. The absence of local and systemic (long-term) side effects proves the validity of this approach for patients with advanced prostatic cancer.

Aged↗
PubMed1988

Multichannel digital recording of intraluminal temperature in the upper gastrointestinal tract of man: techniques and analyses.

A recording system has been developed to measure intraluminal temperature changes from six sites simultaneously in the upper gastrointestinal tract at rates up to 10 Hz from each site. The temperature probe contains six type K thermocouples mounted in 14 French gauge orogastric tube. The data is logged, after digital conversion and signal multiplexing, onto disc storage by a dedicated microcomputer. The fluctuating temperature profile, defined as temperature spikes, has been subjected to novel computer analysis to allow definition of temperature load and dissipation within the oesophagus, stomach and duodenum. This system enables the effects of drinking and eating hot and cold foods on the physiological functions of the gastrointestinal tract to be studied accurately.

Body Temperature↗
PubMed1988

The staging of M1 disease: the role of bone scan, Xray and other imaging techniques.

Patients with newly diagnosed prostatic cancer should be investigated with regard to the presence or absence of distant metastases by (1) Taking a history especially of weight loss and recent onset backache (2) Examining them, looking especially for hepatic enlargement or peripheral lymph nodes (3) Performance status (4) Hemoglobin, Bilirubin, Liver enzymes, Alkaline and Acid phosphatase (5) Chest Xray. (6) Bone scan with specific Xrays directed at hot spots. (7) Ultrasound scan of liver if liver function tests are abnormal. Ultrasound scan of lymph nodes and kidneys is optional. (8) Any other tests indicated in special circumstances. Follow-up, 3-monthly as a rule, should include (1) The presence of pain and analgesic requirements (2) Weight (3) Performance status (4) Hemoglobin, Alkaline phosphatase, Acid phosphatase (5) Chest Xray, three monthly if abnormal. Annually otherwise. (6) Bone scan with Xray of new hot spots, 6-monthly. If there is doubt about the presence of a new hot spot, repeat the bone scan and Xray at 3 months.

Bone Neoplasms↗
PubMed1987

Analysis of C3 and C4 in ovine plasma.

The distributions of plasma concentrations of complement proteins C3 and C4 were studied in sample populations of merino and Suffolk sheep. No differences between the breeds or the sexes were observed. The distribution for ovine C4 was polymodal and very disperse relative to that for C3. It was found, however, that C3 concentrations were elevated in specimens from 20 merino sheep bred as high responders to a Trichostrongylus vaccine. Significantly decreased plasma C4 concentrations were observed in representatives of both merino and merino X Border Leicester cross-bred sheep affected with congenital progressive ovine muscular dystrophy. Agarose gel electrophoretic variants of ovine C3 were not detected. Evidence for electrophoretic variants of ovine C4 in agarose gels was found although individual allotypes could not be reliably identified. Sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) did not reveal size heterogeneity for the alpha and beta chains of immunoprecipitated ovine C3. Analysis of reduced immunoprecipitated ovine C4 by SDS-PAGE revealed considerable size heterogeneity in the alpha chain consistent with isotypic and/or allotypic variability. The data presented strongly suggest the presence of two C4 loci in sheep, each of which exhibits polymorphism.

Animals↗
PubMed1986

Oxytocin induction of labour: hyponatraemia and neonatal jaundice.

To determine the effects of fluid restriction in induced labour with oxytocin in 5% dextrose solution, maternal venous blood and fetal cord venous blood were examined in 164 mothers in induced labour and 29 mothers with a spontaneous onset of labour. After satisfactory uterine activity was induced either the oxytocin infusion was managed according to routine delivery unit practice (n = 36), or infusion rates were halved (n = 45), or quartered (n = 43), or discontinued (n = 40). Despite fluid restriction during labour the mean sodium concentration in maternal blood or cord blood had fallen to a similar extent in all four induced groups at delivery. Potassium, urea, creatinine, total protein, and albumin in maternal blood or cord blood were affected differently by induced labour as compared with sodium. The fall in sodium concentration in maternal blood was a more consistent reflection of the total volume of fluid received, mean infusion rates and cord blood sodium after infusion rates were quartered or discontinued. The incidence of hyponatraemia was 5% in mothers and 8% in infants. A comparison of hyponatraemic and normonatraemic cord blood showed no significant differences in serum bilirubin levels or red cell counts, but more hyponatraemic infants developed neonatal jaundice. It is suggested that in induced labour fluid restriction alone does not prevent hyponatraemia and neonatal jaundice.

Adolescent↗
PubMed1986

A comparison of the effect of diethylstilbestrol with low dose estramustine phosphate in the treatment of advanced prostatic cancer: final analysis of a phase III trial of the European Organization for Research on Treatment of Cancer.

In a randomized phase III trial performed by the Urological Group of the European Organization for Research on Treatment of Cancer low dose estramustine phosphate (280 mg. twice daily for 8 weeks and 140 mg. twice daily thereafter) was compared to diethylstilbestrol (1 mg. 3 times daily) in patients with stages T3 to T4, M0 or M1 prostatic cancer. Of 248 patients entered 227 were evaluable for analysis: 115 received estramustine phosphate and 112 received diethylstilbestrol. The best response of the local tumor as assessed by palpation was seen in patients receiving diethylstilbestrol. There was no significant difference between treatments for response rate of metastases, interval to local progression, distant progression, over-all survival and death of carcinoma of the prostate. Duration of survival was correlated with the assessment of local response as determined by palpation. The response of distant lesions also was correlated closely with survival. Diethylstilbestrol (1 mg. 3 times daily) was associated with a significantly worse degree of cardiovascular toxicity than estramustine phosphate. This finding was especially obvious in patients who had no history of cardiovascular disease. Gastrointestinal toxicity occurred in 25 patients treated with estramustine phosphate, including 6 in whom cessation of treatment was necessary. Further studies are required to determine the optimum dose of diethylstilbestrol and estramustine phosphate, and to establish the best form of hormonal treatment for prostatic carcinoma.

Aged↗
PubMed1986

Laboratory assessment of disease activity in childhood Crohn's disease and ulcerative colitis.

The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and serum orosomucoid were measured in children with Crohn's disease and ulcerative colitis in various states of disease activity. Results were matched with a clinical assessment to determine the correlation between laboratory test values and disease activity. Regression analysis showed that serum orosomucoid reflected disease activity better than ESR in both diseases. Orosomucoid but not ESR discriminated between disease in remission and mild disease in ulcerative colitis. No test invariably predicted presence or absence of active disease. Orosomucoid and ESR were complementary, but CRP was of no additional value. The usefulness of orosomucoid and ESR as objective measures of inflammatory activity was not masked by corticosteroid medication.

Adolescent↗
PubMed1986

Biochemical monitoring of carcinoma of prostate treated with an LH-RH analogue (Zoladex).

The levels of prostatic specific antigen (PSA) and prostatic acid phosphatase (PAP), both measured by radioimmunoassay, and two cancer indices given by the ratio of serum alpha-1 acid glycoprotein to prealbumin (AGP:Palb) and alpha-1 acid glycoprotein to alpha-2 HS globulin (AGP:HS) were evaluated as markers to assess the response of prostatic cancer to treatment with Zoladex, an LH-RH agonist. A rise in PSA and PAP occurred in 8/65 patients (12%) during the initial induction phase. In metastatic disease prior to treatment none of these indices was significantly different between patients who attained a sustained response and those whose response was nil or only transient. Responders and non-responders could, however, be distinguished by the levels of various analytes after treatment. At 6 months the median PSA in those who responded was 2.5 ng/ml compared with 51.5 ng/ml in the non-responders. At 12 months the figures were 3.0 and 155 ng/ml respectively. The corresponding median PAP levels were 1.4 and 19 ng/ml at 6 months and 1.3 and 18 ng/ml at 12 months. The AGP:Palb ratio was also significantly different in these two groups at 6 and 12 months. PSA appears to be the most sensitive indicator of the response to treatment. The likelihood of obtaining a prolonged clinical response can be assessed within 6 months of the start of treatment.

Acid Phosphatase↗
PubMed1986

Head size, brain growth, and lateral ventricles in very low birthweight infants.

Ninety eight newborn infants weighing less than 1500 g at birth and with gestational ages from 26 to 32 weeks were followed prospectively. They were grouped according to real time ultrasound scans in the neonatal period: infants in group A (n = 20) had periventricular haemorrhage (PVH) and normal ventricles; infants in group B (n = 26) had PVH and dilated ventricles (none with clinical hydrocephalus); and infants in group C, who formed the control group (n = 52), had no PVH and normal ventricles. At outpatient follow up a static image ultrasound scanner was used to measure the width of the lateral ventricles and brain hemispheres. The three groups of infants showed similar growth in occipitofrontal circumference, biparietal diameter, and brain hemispheres irrespective of a history of PVH or ventricular dilatation. The relation of ventricle size to biparietal diameter was similar in those infants in groups A (PVH alone) and C (controls) who had a good outcome. About a third (n = 8) of the infants in group B had persistent ventricular dilatation in relation to biparietal diameter and a poor outcome associated with developmental delay and cerebral palsy. By contrast, the remaining two thirds (n = 18) of the infants in group B who later had smaller ventricles in relation to biparietal diameter showed fewer neurodevelopmental sequelae. It is suggested that persistent ventricular dilatation in relation to biparietal diameter at follow up carries a bad prognosis, which might be due to brain atrophy.

Brain↗
PubMed1985

Mitomycin C in superficial bladder cancer: 24-month follow-up.

Twenty-three patients who were given intravesical Mitomycin C for treatment of superficial bladder cancer have been followed up for a further 12 and 24 months after an initial assessment 5 weeks after completing therapy. At 5 weeks 17 (74%) showed complete disappearance of tumour and 4 (17%) showed a partial response. Twelve months later 8 (35%) remained tumour-free and 15 (65%) had recurrences; 5 of these (22% of all patients) had progressed to invasive cancer. The results at 24 months were little different except that one further patient (27% in all) progressed to invasive cancer. Six patients with symptomatic carcinoma in situ became symptom-free after Mitomycin C, but despite remaining free of symptoms three have progressed to invasive cancer. This small series shows that involvement of large areas of bladder urothelium by tumour, carcinoma in situ and previous therapy for tumour are unfavourable prognostic indices.

Antibiotics, Antineoplastic↗