Biomedical subjects
Publications and source records attributed to E C Huskisson.
A double-blind comparative trial showed that intermittent levamisole therapy (150 mg daily for 3 days of each week) was as effective as continuous therapy (150 mg daily) in rheumatoid arthritis and with slightly fewer side effects.
Of 60 patients with rheumatoid arthritis treated with levamisole 35% showed a persistent decrease in neutrophil counts from pre-treatment levels and 6 (10%) develped severe neutropenia of less than 1.0 X 10(9)/1. One of these neutropenic patients recoverd without stopping therapy and the other 5 patients recovered rapidly when the drug was withdrawn. In some patients neutropenia recurred on reinstitution of levamisole.
Explore the source record for details and available documents.
A large-scale, double-blind comparative study was carried out in general practice to assess the relative efficacy and tolerance of difunisal and aspirin in patients suffering from acute painful conditions such as sprains and trains, osteoarthritis, etc. Patients received either 250 mg or 500 mg difunisal twice daily, or 600 mg aspirin 4-times daily for 5 days. The results of subjective assessments of pain relief from the daily records of 1902 patients (967 on diflunisal, 935 on aspirin), and the overall assessment of response by both doctors and patients, showed that diflunisal was significantly better than aspirin. Gastric side-effects were more common and more severe in patients receiving aspirin, and more often led to withdrawal of treatment.
Explore the source record for details and available documents.
Levamisole is a welcome addition to the list of penicillamine-like drugs. Many patients fail to respond to these drugs or develop adverse reactions requiring withdrawal of treatment. Levamisole will be a useful alternative for these patients.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
New methodology is required to evaluate new drugs. Trials designs and measurements developed for conventional anti-inflammatory therapy will fail to demonstrate the properties of a group of novel anti-rheumatic agents including gold, penicillamine and levamisole. These compounds act slowly, producing their maximum effect after 6 months of treatment. Trials must therefore be of at least this duration and it is useful to document the time course of the action. Measurements of rheumatoid arthritis must include not only conventional indices of disease activity (pain, morning stiffness, articular index, swelling) but also extra-articular features such as nodules, E.S.R., and rheumatoid factor titre. Reduction in technetium index is a feature of the action of drugs of this type. Changes in immunoglobulins and in some other immunological measurements may also be useful. Future trials must look increasingly at modes of action of drugs and the factors which determine the presence or absence of a response in an individual patient.
Explore the source record for details and available documents.
In a double-blind, single-dose, multiple cross-over study, floctafenine (200 mg) was shown to be an active analgesic and similar in potency to aspirin (600 mg). A graphic rating scale was used to measure pain relief. The use of such a scale without cut-off points at each end led to problems in the distribution of results.
The value of three visual analogue scales for measuring aspects of functional capacity was assessed in 22 patients with rheumatoid arthritis receiving long-term treatment. A scale in which patients were allowed to choose a function which was a particular problem gave the best results, with more severe initial impairment and greater change with treatment. This scale was as useful as pain in assessing the result of treatment.
Pain can be measured using a visual analogue scale in children with juvenile chronic polyarthritis. In a study of 100 children failures were uncommon after the age of 5. Pain severity was strikingly lower than in a group of adults with rheumatoid arthritis and correlated poorly with other measures of disease severity and activity. Because of the low scores, measurement of pain is likely to be less useful in children for assessing the effects of treatment than it is adults.
Two cases of Reiter's syndrome in women are described. The diagnosis was based on the presence of increased vaginal and cervical discharge containing excess leucocytes, arthritis, conjunctivitis, and HLA B27 tissue-typing antigen. In addition circinate lesions developed on the vulva similar to those seen on the glans penis. No previous description of these lesions has been traced and the name 'circinate vulvitis' is suggested for these lesions.