Investigation of possible genetoxic effects of feverfew in migraine patients.
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Chromosome Aberrations↗
Biomedical subjects
E S Johnson
Publications and source records attributed to E S Johnson.
An interim report of the efficacy and safety of anisoylated plasminogen streptokinase activator complex (APSAC).
Anisoylated plasminogen streptokinase activator complex (APSAC) is a thrombolytic agent which can be administered to patients with acute myocardial infarction by intravenous injection rather than prolonged infusion, and which has sustained fibrinolytic activity, inducing thrombolysis with a low risk of early rethrombosis. In clinical trials, APSAC 30U intravenously produced angiographically confirmed reperfusion in 86/156 patients (55%) and coronary patency (in the absence of pretreatment angiography) in 131/161 patients (81%) up to 90 minutes after treatment. These figures compared with a reperfusion rate of 65% (71/110 patients) for intracoronary streptokinase, and a patency rate of 53% (27/51 patients) with intravenous streptokinase. Reperfusion occurred at a mean of about 45 minutes after either APSAC or streptokinase, and APSAC was more effective when administered within 4 hours, than between 4 and 6 hours, after the onset of symptoms of infarction. Reocclusion occurred in 4% (3/80) of infarct-related arteries assessed angiographically 1 to 3 days after APSAC, compared with 10% (7/74) after streptokinase. Preliminary analysis of mortality data from studies involving APSAC suggests a trend towards improved survival with APSAC in comparison with conventional therapy. Among 1855 patients treated with APSAC, and observed for periods of 1 month to 1 year, there have been 115 deaths (6.2%). This compares with a mortality of 12.3% among patients receiving non-thrombolytic therapy (n = 708). The results of large controlled mortality studies are awaited before evaluation of the precise extent of improvement with APSAC can be made. APSAC has been associated with relatively few serious side effects. Analysis of case records for 834 patients who received APSAC 30U intravenously revealed at least 1 suspected side effect in 44%, compared with in 33% of placebo-treated patients (n = 138). Cardiovascular (e.g. arrhythmias and reduction in blood pressure) and haemorrhagic events (mostly associated with puncture sites) were reported most frequently. Cerebrovascular accidents occurred in 15/1598 patients (0.9%) treated with APSAC, of which 10 cases could possibly have been related to treatment. Allergic-type reactions (e.g. anaphylaxis, bronchoconstriction, skin rashes) occurred in 61/1152 patients (5%) after APSAC and may have resulted from previous exposure to streptococcal infection. APSAC induces systemic fibrinogenolysis and a 'lytic' state characterised by reductions in fibrinogen, plasminogen, Factors II, V and VIII and alpha 2-antiplasmin, and an increase in fibrin degradation products, which return to normal over a period of 2 days.(ABSTRACT TRUNCATED AT 400 WORDS)
Anistreplase↗
Noncancer mortality in the meat industry: white males.
This paper reports on the noncancer mortality among 13,844 white males of a meatcutters' union in Baltimore, who were studied to examine whether there is increased risk of death from particular diseases associated with the meat industry. The group was divided into four main job-categories of the industry, and a control group. Cause-specific standardized mortality ratios (SMRs) were calculated for each subgroup, using the US white male rates for comparison. Abattoir workers had an SMR of 3.73 (P less than .05) for diseases of blood and blood-forming organs; workers in meat-packing plants had an SMR of 2.08 (P less than .01) for liver cirrhosis; and workers in the meat department of grocery stores/supermarkets had an SMR of 2.02 (P less than .01) for diabetes. The role of occupational exposures in the etiology of these diseases was examined.
Abattoirs↗
Holoprosencephalic synophthalmia (cyclopia) in an 8 week fetus.
Histopathological examination of an 8-week-old human cyclopic fetus revealed holoprosencephaly, synophthalmia, and malformed midfacial features. The telencephalon was undivided and projected a single median optic stalk partially subdivided into optic vesicles contained in a single orbit. Aberrant midfacial ossification underlay arrhinia and uncleft lips and palate. Maxillary anodontia and mandibular hypodontia prevailed. Postcranial normality was disturbed by pedal postaxial hexadactyly, suggesting trisomy 13. The exceptionally young age of the specimen distinguishes its detailed analysis from the majority of older cyclopic specimens previously reported.
Abnormalities, Multiple↗
Angioneurotic edema, agranulocytosis, and fatal septicemia following captopril therapy.
Captopril, an angiotensin converting enzyme inhibitor used in the treatment of hypertension, has been associated with hematologic as well as dermatologic side effects. Two patients with captopril-induced angioneurotic edema, one of whom had fatal granulocytopenia and overwhelming polymicrobial sepsis, are presented.
Agranulocytosis↗
Cancer mortality among white males in the meat industry.
A study was conducted among 13,844 members of a meat-cutter's union, from July 1949 to December 1980, to examine cancer occurrence in the meat industry. Separate analyses were carried out for the whole group, and for subgroups defined by job-categories characteristic of the industry, including a control group. Mortality was compared with that of the United States through the estimation of standardized mortality ratios (SMR) and proportional mortality ratios. A statistically significant proportional mortality ratio of 2.9 was obtained for Hodgkin's disease among abattoir workers; the SMR of 2.2 was not significant. Among meat-packing plant workers, highly statistically significant SMRs were recorded for bone cancer, SMR = 9.6; cancer of the buccal cavity and pharynx, SMR = 3.4; and lung cancer, SMR = 1.9. The role of oncogenic viruses and other carcinogenic exposures was investigated.
Abattoirs↗
Duration of exposure as a surrogate for dose in the examination of dose response relations.
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Animals↗
Occurrence of cancer in women in the meat industry.
A follow up study of 7261 white women from a meatcutters' union was conducted between July 1949 and December 1980. Proportional mortality ratio (PMR) and standardised mortality ratio (SMR) analyses, using the United States general population mortality rates, were conducted for the group as a whole and for subgroups defined according to the four main job categories in the meat industry, and a fifth category of workers from outside the industry but belonging to the same union (control group). At least a threefold risk of death was observed both for myeloid leukaemia and non-Hodgkin's lymphomas among workers in the meat department of retail food stores. No excess risk from these diseases was observed in the control group. SMRs of 4.56, 4.02, and 1.95, which were statistically significant, were observed for lung cancer among workers in chicken slaughtering plants, meatpacking plants, and retail food stores respectively. The lung cancer SMR for abattoir workers was 1.41 (not significant) and 1.11 for workers in non-meat companies. The role of potentially harmful exposures within the industry in the occurrence of these excesses is discussed.
Abattoirs↗
Acalvaria, holoprosencephaly, and facial dysmorphism syndrome.
An estimated 85-day-old human fetus exhibited a malformation complex consisting of holoprosencephaly, absent calvaria, exophthalmic hypertelorism, and severe bilateral midfacial orofacial clefting involving the maxillary/frontonasal prominences (oblique facial clefts), upper lip (bilateral clefts), and palate (complete cleft). This combination of dysplasias precludes assignment to previously described syndrome complexes. The presence of an olfactory nerve/ethmoidal bone complex does not conform with "classic holoprosencephaly," nor does acalvaria without cerebral dysraphism fit into the cranioschisis and exencephaly syndromes. It is postulated that this combination of anomalies is due to faulty embryogenesis of the prechordal cephalic mesenchyme, leading to failure of telencephalic cleavage and of neural crest-mediated development of the calvaria and facial prominences.
Abnormalities, Multiple↗
Aztreonam: early clinical studies in New Jersey.
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Aged↗
Noncomparative trial of ticarcillin plus clavulanic acid in skin and soft tissue infections.
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Adolescent↗
Efficacy of feverfew as prophylactic treatment of migraine.
Seventeen patients who ate fresh leaves of feverfew daily as prophylaxis against migraine participated in a double blind placebo controlled trial of the herb: eight patients received capsules containing freeze dried feverfew powder and nine placebo. Those who received placebo had a significant increase in the frequency and severity of headache, nausea, and vomiting with the emergence of untoward effects during the early months of treatment. The group given capsules of feverfew showed no change in the frequency or severity of symptoms of migraine. This provides evidence that feverfew taken prophylactically prevents attacks of migraine, and confirmatory studies are now indicated, preferably with a formulation controlled for sesquiterpene lactone content, in migraine sufferers who have never treated themselves with this herb.
Adult↗
Naproxen sodium in the treatment of migraine.
Seventy patients with classical or common migraine were treated during their attacks with either naproxen sodium or placebo in a randomised, double-blind parallel group study. The initial dose of naproxen sodium was 825 mg followed one hour later by a further 550 mg, if symptoms were the same or had improved. If the migraine symptoms had worsened, patients were offered an escape analgesic combination of 1000 mg paracetamol and 10 mg metoclopramide. Patients were assessed at monthly intervals for changes in the severity and duration of headache, premonitory symptoms (mainly visual disturbances) and photophobia, nausea and vomiting associated with migraine attacks that had occurred since the previous visit. Patients were studied for a maximum of ten attacks and significant improvement was observed in the severity and duration of headache when the patients were on naproxen sodium. Also the premonitory symptoms and photophobia improved significantly on naproxen sodium and significantly less rescue analgesics were required. Patients suffering from common migraine had less severe headaches and photophobia when taking naproxen sodium than when taking placebo and the headaches were shorter in duration and patients took less rescue analgesic. No significant difference was observed between the treatment groups in patients with classical migraine. Ten patients in the placebo group and six in the naproxen sodium group reported side-effects but these were possibly related to the use of rescue medication. Naproxen sodium proved safe and effective in common migraine attacks, but in this study efficacy was not established for classical migraine.
Adolescent↗
"Shaker" calf syndrome: a newly recognized inherited neurodegenerative disorder of horned Hereford calves.
The clinical and pathological features of a newly recognized, inherited neurodegenerative disorder in horned Hereford calves are described. The disorder is expressed in newborns by tremulous shaking of the head, body and tail, difficulty in rising, a wobbly spastic gait, and aphonia. Transient improvement is followed by deterioration and progressive spastic paraplegia. Generalized tremors can be induced easily by a variety of stimuli, and spinal reflexes may be exaggerated or depressed. The major pathological finding is an excessive accumulation of neurofilaments within neurons of the central, peripheral, and autonomic nervous systems. The involvement of multiple systems of neurons and the similarity with some forms of human motor neuron disease and spinocerebellar degeneration suggest that this unique bovine disease may serve as a suitable animal model for these human neurodegenerative disorders.
Animals↗
The relative bioavailability of paracetamol and codeine after oral administration of a combination of buclizine, paracetamol and codeine, with or without docusate, and of paracetamol alone in healthy volunteers.
A randomized, double-blind, crossover study was carried out in 10 healthy volunteers to investigate whether the inclusion of the wetting agent docusate sodium (10 mg) in a combined oral formulation ('Migraleve') with buclizine hydrochloride (6.25 mg), codeine phosphate (8 mg) and paracetamol (500 mg) had any effect on the bioavailability of the analgesics. On 3 occasions at weekly intervals, the subjects were given 2 tablets of the standard formulation, the combination without docusate or 500 mg paracetamol alone. Blood samples were taken before and at fixed times during the 4 hours after administration of each preparation for estimation of plasma concentrations of paracetamol, by gas-liquid chromatography, and of codeine, by radioimmunoassay. The results showed that there were no significant differences between the mean paracetamol concentrations achieved after administration of each of the 3 preparations at any of the time points. Peak paracetamol plasma concentrations were 11.25 +/- 1.74 micrograms/ml at 0.5 hours, 9.6 +/- 1.04 micrograms/ml at 0.75 hours, and 9.53 +/- 1.66 micrograms/ml at 0.5 hours, respectively, after the standard formulation, the combination without docusate, and paracetamol alone. Mean elimination half-lives for paracetamol were 2.83 +/- 0.51, 1.92 +/- 0.20 and 2.49 +/- 0.46 hours, respectively, and the differences were not significant. The difference between mean plasma concentrations of codeine after the two preparations including this analgesic bordered on significance at 3 hours and was significant at 4 hours, but the areas under the curve were not significantly different. Peak codeine plasma concentrations after the standard formulation were 42.1 +/- 9.4 ng/ml at 0.75 hours compared with 36.9 +/- 3.4 ng/ml at 1.5 hours after the combination without docusate.(ABSTRACT TRUNCATED AT 250 WORDS)
Acetaminophen↗
Pentamidine treatment of Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome. Association with acute renal failure and myoglobinuria.
A 31-year-old man with acquired immunodeficiency syndrome and biopsy-proved Pneumocystis carinii pneumonia developed acute renal failure, elevated creatinine kinase levels, and myoglobin in both serum and urine while being treated with pentamidine. The patient was receiving no other nephrotoxic medications at the time, and these unusual complications were directly related to the pentamidine.
Acquired Immunodeficiency Syndrome↗
High-altitude adaptation and maximum work performance.
The treadmill work performance of rats at sea level with normal or elevated hematocrits was compared with that of rats conditioned in a hypobaric chamber at 450 Torr for 3 wk with similar hematocrit adjustments. A mean increase in hematocrit to 62 significantly improved the work performance of rats at sea level and at ambient O2 tensions of 100, 75, and 35 Torr. By contrast, rats conditioned in a hypobaric chamber with mean hematocrits of 40 and 58 performed similarly at all O2 tensions compared with sea-level rats with hematocrits of 43. Thus, although an increase in O2-carrying capacity of the blood of sea-level animals increased work capacity, altitude adaptation did not appear to result in any positive effect on work capacity, and indeed, seemed to interfere with the beneficial effect of polycythemia on maximum work performance.
Adaptation, Physiological↗