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Biomedical subjects

C S Smith

Publications and source records attributed to C S Smith.

At least 145 records · Page 8Linked to original sources
PubMed1972

Studies on the prophylactic and radical curative activity of RC-12 against Plasmodium cynomolgi in Macaca mulatta.

The compound 4-(2-bromo-4,5-dimethoxyphenyl)-1,1,7,7-tetraethyldiethylenetriamine (RC-12) has been shown to be active against the exoerythrocytic (EE) stages of the malaria parasite. Experiments on Plasmodium cynomolgi in rhesus monkeys showed that single weekly doses of 25 mg per kg of body weight would prevent the development and/or maturation of EE stages. The usefulness of RC-12 for effecting radical cures is, however, still open to doubt.

Animals↗
PubMedDate not supplied

Transrectal ultrasound-guided biopsy of the prostate gland: value of 12 versus 6 cores.

We investigated the effect on prostate carcinoma detection of 12 versus 6 core biopsies at transrectal ultrasound (TRUS), when all biopsies are taken from the lateral peripheral zone. This was a prospective study of 202 consecutive men, ages 51 to 81 years, referred for TRUS-guided biopsy of the prostate gland. All patients had prostate serum antigen levels higher than 4.0 ng/mL and/or abnormal digital rectal examination. In each case three biopsies were taken from the peripheral zones of the right and left lobes of the prostate. Biopsies were taken at the apex, midway between the apex and the base, and at the base. A second set of biopsies was taken from the same regions and analyzed separately. In total, twelve biopsies were taken. Note was subsequently made of additional carcinoma diagnosis increase in Gleason grade, and new diagnoses of carcinoma in the opposite side of the gland diagnosed on the second set of biopsies alone. Seventy-eight of the 202 men (38.6%) had prostatic carcinoma diagnosed on TRUS-guided biopsy. Of these 78 patients, six were diagnosed with malignancy based on the second set of biopsies alone, a 2.9% increase in the 202 patients, representing an increased yield of 8.3% (95% confidence interval, 5.3-28.6%). In nine cases (12.5%; 95% confidence interval, 6.2-22.9%), the Gleason tumor grade was increased on the second set of sextant biopsies; in an additional nine cases, carcinoma was detected in the opposite side of the gland. There were two complications (1%). A 12- versus six-core biopsy strategy for TRUS-guided biopsy of the prostate gland improves detection and histologic grading of prostate carcinoma. The added benefit of additional biopsies was lower in this series than in some prior studies using extensive biopsy protocols.

Biopsy, Needle↗
PubMedDate not supplied

Trends in alpha-blocker treatment of patients with benign prostatic hyperplasia and hypertension: dosing regimens and cost comparisons.

Dosing regimen is an important determinant of both drug cost and patient compliance. This retrospective analysis evaluated dosing regimens and drug acquisition costs for 101 patients identified from medical records in a large metropolitan hospital as having hypertension and/or benign prostatic hyperplasia and receiving alpha-blocker therapy with either doxazosin or terazosin. Although once-daily administration is generally recommended for both drugs, 25 (38%) of 66 patients receiving terazosin were treated twice daily compared with 6 (17%) of 35 patients treated twice daily with doxazosin. This difference was statistically significant. The average (mean +/- SD) daily treatment cost per patient for all individuals receiving terazosin during the period of the record review was $1.68 +/- 0.60. For patients treated with doxazosin, the average was $0.96 +/- 0.65-a highly statistically significant result. If all 66 patients receiving terazosin had been converted to doxazosin at the beginning of the study, annual savings would have been $17,345.00. These results demonstrate the importance of reviewing actual dosing regimens. The fact that doxazosin could be administered to a significantly higher percentage of patients once daily rather than twice daily substantially decreased its cost relative to terazosin. A once-daily treatment regimen may also enhance patient compliance, thereby improving the chances of therapeutic success.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

A prospective study of symptomatic hypoglycaemia in childhood diabetes.

A prospective study of symptomatic hypoglycaemia was conducted in 47 children over a 14-week period using a questionnaire completed at home for each episode of hypoglycaemia. Twenty-nine children (62%) experienced 150 episodes during the study. The average incidence was once every 33 days (range 0-5.2 mo-1). Hypoglycaemia occurred more frequently in children with lowest haemoglobin A1 levels. Episodes were not randomly distributed in time; hypoglycaemia occurred significantly more frequently in the evening, in the early morning and around midday. The majority of episodes were judged to be mild but 2 children had nocturnal convulsions and glucagon was used on three occasions. Symptomatic nocturnal hypoglycaemia occurred one or more times in 30% of the children. Daytime episodes were manifested by tremor, feeling weak, dizziness, pallor, and other symptoms and signs. In 46% of cases the cause was not evident to parents or children, but 25% were related to physical activity.

Child↗
PubMedDate not supplied

When you hear hoof beats: four principles for separating zebras from horses.

BACKGROUND: When a patient comes to the clinic with a new complaint, the often wide array of possible causes creates uncertainty about the optimal evaluation and treatment. Selecting an approach to evaluation involves values that range from ruling out all disease processes (all zebras) regardless of cost to limiting cost by looking only for those processes that are likely (assuming all hoof beats are created by horses). Neither extreme is an optimal approach. We do not want to spend money on unnecessary tests, but we also do not want to miss a rare but potentially serious and treatable disease. METHODS: We offer four principles and their accompanying corollaries that make it possible to separate more easily hoof beats for horses from those for zebras. RESULTS AND CONCLUSIONS: By applying these principles and the accompanying corollaries, a physician can more efficiently determine the most efficient and cost-effective approach to taking care of patients.

Diagnosis↗