Biomedical subjects

C Farmer

Publications and source records attributed to C Farmer.

58 records · Page 4Linked to original sources

PubMedDate not supplied

Continuous transdermal dopaminergic stimulation in advanced Parkinson's disease.

The objective of the study was to determine the safety and efficacy of increasing doses of Rotigotine CDS in patients with advanced Parkinson's disease. The development of motor complications in Parkinson's disease has been linked to intermittent stimulation of dopamine receptors. Continuous, noninvasive, dopaminergic stimulation has not been available to date. Rotigotine CDS is a lipid-soluble D2 dopamine agonist in a transdermal delivery system that could fill this void. This inpatient study consisted of a 2-week dose escalation phase followed by a 2-week dose maintenance phase at the highest dose (80 cm2). Each individual's L-Dopa dose was back-titrated as feasible. The primary outcome measure was L-Dopa dose, and secondary outcome measures included early morning "off"-L-Dopa Unified Parkinson's Disease Rating Scale motor scores by a blinded evaluator and motor fluctuation data obtained from patient diaries ("on" without dyskinesia, "on" with dyskinesia, and "off"). Seven of 10 subjects provided data that could be evaluated. There were two administrative dropouts, and one individual was eliminated from the study because of recrudescence of hallucinations. The median daily L-Dopa dose decreased from 1,400 to 400 mg (p = 0.018, Wilcoxon test). Unified Parkinson's Disease Rating Scale motor scores were unchanged. Although diary variables improved in most individuals, only the reduction in "off" time attained statistical significance. Adverse effects were mild and consisted mainly of dopaminergic side effects and local skin reactions. The data suggest that Rotigotine CDS is an effective treatment for advanced Parkinson's disease and permits patients to substantially lower L-Dopa doses without loss of antiparkinsonian efficacy. Full-scale controlled clinical trials are warranted. In addition to potential therapeutic benefits, this drug can be used to test the hypothesis that continuous dopaminergic stimulation from the initiation of Parkinson's disease therapy will limit the development of motor complications.

Administration, Cutaneous↗

PubMedDate not supplied

Joint working with hospice teams: a renal collaborative approach.

There are over 600 million people in the world aged 60 years and over. This figure is expected to double by 2025 and to reach 2 billion by 2050 (1). Population ageing is characteristically accompanied by an increase in the burden of chronic non-communicable diseases such as diabetes, cardiovascular disease, cancers and renal failure. As a consequence, pressures on health systems worldwide will increase (1). Data produced by the National Renal Workforce Planning Group in 2002 (2), predicted that the demand for renal replacement therapy (RRT) will continue to rise beyond 2010 for many reasons one of those being demographic changes with an aging population. This will also have an impact on the numbers of patients predicted to commence dialysis and transplantation (Table 1). With this higher projection of patients requiring RRT, there is a need to look at new ways of working.

Continuity of Patient Care↗

PubMedDate not supplied

Child sexual abuse: helping children and their families.

The reality of child sexual abuse has only recently been accepted by professionals. Previously, treatment strategies were aimed at adult survivors rather than at children. Treatment programmes for children have a short history and their long-term effects cannot be validated yet, although some attempts have been made (Bentovim et al, 1987).

Adaptation, Psychological↗

PubMedDate not supplied

The use of delta osmolality to predict serum isopropanol and acetone concentrations.

We investigated whether serum delta osmolality will predict the total serum concentration of isopropanol and acetone metabolite. Three isopropanol ingestions were monitored by delta osmolality determinations followed by quantification of serum isopropanol and acetone concentrations. The delta osmolality was established by routine chemical analysis and standard freezing point depression osmometry. Serum isopropanol and acetone levels were quantified by gas chromatography-head space analysis (GC-HS). Patients were initially suspected of having isopropanol intoxication secondary to an elevated delta osmolality discrepancy (measured - calculated > 10 mOsm). Serum concentrations versus delta osmolality were analyzed by linear regression (correlation coefficient r = 0.713; p < 0.05). The delta osmolality paralleled and decreased relative to the total low molecular weight of volatile concentration in each case. In emergencies, delta osmolality may be a screening test to identify rapidly patients at risk for complications associated with isopropanol ingestion when GC-HS is not available.

1-Propanol↗