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Biomedical subjects

D J Beard

Publications and source records attributed to D J Beard.

47 records · Page 3Linked to original sources
PubMed1983

The use of dichloromethylene diphosphonate for the management of hypercalcaemia in multiple myeloma.

We have assessed the effects of the diphosphonate, dichloromethylene diphosphonate (Cl2MDP), in 19 patients with hypercalcaemia and increased bone resorption due to myeloma. Cl2MDP (800-3200 mg daily by mouth or 300 mg daily by intravenous infusion) decreased plasma calcium and biochemical indices of increased bone resorption in 16 of 19 patients. This effect persisted for the duration of treatment (up to 14 weeks). Prolonged treatment was associated with a progressive rise in serum alkaline phosphatase and only a transient fall in hydroxyproline suggesting the stimulation of bone repair. Since myeloma is associated with significant morbidity and mortality due to progressive bone loss, these results suggest that long-term treatment of myeloma with Cl2MDP is worthy of further study.

Aged↗
PubMed1983

Study of the effects of oral administration of CDP-choline on EEG changes and lethality induced by epidural compression in the anaesthetised cat.

The effects of repeated oral administration of cytidine diphosphate choline (CDP-choline, citicoline, Somazina) and vehicle on the EEG changes induced by epidural brain compression have been studied in the anaesthetised cat. The effects on arterial pressure and heart rate were also monitored. CDP-Choline-treated cats exhibited a statistically significant increase in resistance to the effects of mechanical compression of the brain when compared with the vehicle-treated group. In addition the onset of abnormal EEG waveforms occurred at greater levels of brain compression in drug-treated cats. CDP-Choline also imparted protection against the cardiovascular and respiratory effects of brain compression; animals were apparently less susceptible to cardiac and respiratory failure under the influence of the test compound. A statistically significant protection against the lethal effects of epidural compression was also noted in CDP-choline treated cats. It may be concluded that repeated oral treatment with CDP-Choline provides an apparent protection against the effects of acute mechanical compression of the brain.

Anesthesia↗
PubMed1981

Biochemical markers of bone turnover in Paget's disease.

The two most commonly used biochemical markers of bone turnover are the serum alkaline phosphatase and the urinary excretion of peptide-bound hydroxyproline, both of which are increased in Paget's disease. Serum alkaline phosphatase is assumed to be derived from osteoblasts during the process of bone formation, whereas small peptides containing hydroxyproline are excreted in the urine following the degradation of bone collagen. The alkaline phosphatase is probably the more useful measurement for diagnosis and for following response to treatment, whereas hydroxyproline, although very sensitive, presents technical difficulties in collection and measurement. Several other biochemical changes in Paget's disease indicate abnormal bone metabolism. These include increased urinary excretion of hydroxylysine and its glycosides derived from collagen, as well as the release into the circulation and subsequent urinary excretion of fragments of pro-collagen indicative of increased collagen formation. Proteins specific to bone, such as osteocalcin, are increased in serum, bone, such as osteocalcin, are increased in serum, as are various enzymes possibly derived from bone cells, including acid phosphatase and proline imino-peptidase. Treatment of Paget's disease results in a fall in urinary hydroxyproline before alkaline phosphatase. This indicates that drug treatment, whether with diphosphonates, calcitonin or mithramycin, has a primary action to inhibit bone resorption, with a subsequent adaptive reduction in bone formation rate.

Alkaline Phosphatase↗
PubMed1981

Paget's disease: improvement of spinal cord dysfunction with diphosphonates and calcitonin.

The clinical and radiographic features of spinal cord dysfunction secondary to Paget's disease are described. Long-term medical management with the use of the diphosphonates, calcitonins and mithramycin resulted in marked and rapid clinical improvements in 8 of 10 of our own patients. These results are comparable to those seen in 19 other patients previously described in the literature, and are also similar to those obtained by surgical treatment. The recurrence rate and mortality (approximately 10%) of surgical treatment suggest that drug treatment now has a place in the management of paraparesis, particularly when this is of gradual onset. Medical management may also provide a valuable adjunct in those cases where surgery is required (e.g. sudden onset of paraparesis). In patients with cord dysfunction, but without significant anatomical compression of the spinal cord, it is suggested that paraparesis may be caused by a "vascular steal" syndrome, a notion which is supported by the rapidity with which drug-induced remission occurs.

Adult↗
PubMed1980

Biochemical and clinical responses to dichloromethylene diphosphonate (Cl2MDP) in Paget's disease of bone.

Dichloromethylene diphosphonate (Cl2MDP, or clodronate disodium) is one of the most potent of the known diphosphonates as an inhibitor of bone resorption and differs from EHDP in that it does not inhibit skeletal mineralization. It is one of the second generation diphosphonates now undergoing clinical evaluation. In the study described here Cl2MDP was given by mouth (800-1600 mg/day for 6 months) to 35 patients with symptomatic Paget's disease of bone. Cl2MDP induced a marked fall in serum alkaline phosphatase and urinary hydroxyproline to normal or near normal values in all patients. This was accompanied by clinical improvement in all but 4 patients. Cl2MDP appears to be another effective oral drug for the treatment of Paget's disease of bone and compares favorably with the calcitonins and EHDP.

Alkaline Phosphatase↗
PubMedDate not supplied

Reflex muscle contraction in anterior shoulder instability.

Reduced proprioception may contribute to recurrent anterior shoulder instability. Twelve patients with unilateral shoulder instability were investigated for evidence of deficient proprioception with an activated pneumatic cylinder and surface electromyography electrodes; the contralateral normal shoulder was used as a control. The latency between onset of movement and the detection of muscle contraction was used as an index of proprioception. No significant difference in muscle contraction latency was detected between the stable and unstable shoulders, suggesting that there was no significant defect in muscular reflex activity. This study does not support the use proprioception-enhancing physiotherapy in the treatment of posttraumatic anterior shoulder instability.

Adult↗
PubMedDate not supplied

Cruciate ligament loading during isometric muscle contractions. A theoretical basis for rehabilitation.

A model of the knee in the sagittal plane was used to investigate the ligament forces resulting when an external load applied to the tibia resisted either extension or flexion of the knee under increasing isometric quadriceps or hamstrings contractions, respectively. An elementary mechanical analysis showed which ligament, the anterior or posterior cruciate, was loaded at a given flexion angle and known line of action of the external load. Ligament force, as a proportion of the external load, was also calculated. The results serve as guidelines for the design of injury-specific physical therapy techniques for use after cruciate ligament reconstruction.

Anterior Cruciate Ligament↗