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Biomedical subjects

G Anderson

Publications and source records attributed to G Anderson.

At least 307 records · Page 17Linked to original sources
PubMed1985

Cisplatin and etoposide alternating with vincristine, doxorubicin and cyclophosphamide in patients with small cell lung cancer.

Fifty-seven patients with small cell lung cancer were treated with cisplatin and etoposide alternating with vincristine, doxorubicin and cyclophosphamide. Seven patients were withdrawn because of drug toxicity. Of 50 evaluable patients 21 had limited and 29 extensive disease of whom 19 and 21 respectively achieved an objective response. Seven patients survived for longer than 2 years of whom 5 remained alive and tumour free 121-167 weeks from the start of treatment. Patients with limited disease and a complete response had a median survival of 72 weeks and the median survival of the whole group was 43 weeks. Seven out of 22 (32%) of patients who obtained a complete response relapsed and died with solitary evidence of cerebral metastases. This indicates the need for reassessment of the role of prophylactic cranial irradiation in patients achieving a complete response with effective systemic chemotherapy.

Adult↗
PubMed1985

Response rate and toxicity of etoposide (VP-16) in squamous carcinoma of the lung: report from the Lung Cancer Treatment Study Group.

In two multicenter studies, 325 patients with advanced squamous lung cancer were randomized to receive either no treatment v oral etoposide (VePe-sid) 300 mg/m2 on days 1 and 2 for 6 cycles, or the same dose of oral etoposide v the same dose of oral etoposide plus cyclophosphamide 300 mg/m2 IV on days 1 and 2, each given for 6 cycles. A total of 175 patients in both trials received oral etoposide alone. All patients assigned to treatment were included in the results. Remissions occurred in 20 (11%) patients (CR in 1; PR in 19). Leukopenia occurred in 2% of patients and other toxicity was acceptable.

Carcinoma, Squamous Cell↗
PubMed1985

A single dose of sulfametopyrazine versus 7 days of ampicillin in acute on chronic bronchitis.

Forty-two patients with acute on chronic bronchitis received in double-blind fashion either a single dose of 2 g of sulfametopyrazine or ampicillin 250 mg thrice daily for 7 days. There were no significant differences between treatments in the number of patients achieving white sputum, the time to do so, or the incidence of pathogens at the end of treatment. Blood levels of sulfametopyrazine between 8 and 24 hours and on the seventh day were likely to result in sputum concentration adequate to kill Haemophilus influenzae.

Acute Disease↗
PubMed1984

Possible change in noradrenergic receptor sensitivity following methylphenidate treatment: growth hormone and MHPG response to clonidine challenge in children with attention deficit disorder and hyperactivity.

Growth hormone (GH) and 3-methoxy-4-hydroxyphenelethylene glycol (MHPG) response was measured hourly for 4 hours in 8 children with Attention Deficit Disorder with Hyperactivity (ADD+H) following an acute single-dose of clonidine. The clonidine challenge was repeated before, during, and one day after 12 weeks of treatment with methylphenidate (MPH). Before MPH treatment, the plasma growth hormone (GH) rose to 31.3 +/- 4.6 (Mean +/- SE) ng/ml; during MPH treatment, the GH peak was only 14.8 +/- 3.2 ng/ml; one day after discontinuation of MPH, GH rose to only 20.8 +/- 3.9 ng/ml. MHPG release was inhibited by clonidine in all treatment conditions but tended to be more decreased during MPH treatment. Some children with ADD+H may have hypersensitivity of the post-synaptic alpha-1 noradrenergic receptor which is diminished by MPH treatment. The extent to which these effects are pharmacological or represent a change in receptor sensitivity requires further study.

Adolescent↗
PubMed1984

Diagnosis related group prospective payment: implications for health care and medical technology.

This paper reviews the major features of the new DRG prospective payment system which was introduced for the payment of hospitals under the Medicare program October 1, 1983 in the United States. It explores its general implications for the health sector, and then examines its specific implications for the development, diffusion, and utilization of medical technology. It concludes with some of the research questions that require investigation to provide an informed basis for modification to the payment system that will ensure that quality health care will be provided at an affordable cost.

Costs and Cost Analysis↗
PubMed1984

New traction devices to aid reduction of shoulder dislocations.

A set of traction devices that aid in the reduction of shoulder dislocations is described and their use and efficiency are discussed. A series of 47 consecutive patients seen over a six-month period and diagnosed as having shoulder dislocations with no other major trauma composed the study population. After radiographic confirmation and premedication with analgesics and muscle relaxants, the devices were used. The traction- countertraction method was used initially. When this method was unsuccessful, the Stimson method was performed using an alternate traction strap. These devices were successful in 96% of the relocations attempted. No complications were encountered. The traction devices were found to be effective and easy to use.

Adolescent↗
PubMed1984

Patterns of expenditures among high utilizers of medical care services. The experience of Medicare beneficiaries from 1974 to 1977.

The authors of this study examine temporal patterns of medical expenditures by Medicare beneficiaries. A random sample of 204,917 individuals who were alive and in the program from 1974 to 1977 was investigated. Individuals hospitalized in 1974 were found to have twice the rate of hospitalization in 1975, 1976, or 1977 compared with individuals who were not hospitalized in 1974. The increased rate of hospitalization remained constant throughout the 3 years. Individuals with large medical expenditures in 1974 were 20 times more likely to have large medical expenditures the following year, and this rate declined slowly in the following 2 years. The results suggest that the value of a Medicare voucher or the level of Medicare's payment to health maintenance organizations should include an adjustment factor for prior health care utilization. The results also suggest that multiyear limits on total Medicare coinsurance and deductible payments would be more equitable than single-year limits.

Actuarial Analysis↗
PubMed1984

Real and laboratory gambling, sensation-seeking and arousal.

The existence and importance of excitement in gambling, the effects of runs of wins and losses on gambling behaviour and the relationships of both with sensation-seeking were investigated using samples of students and experienced gamblers in real and artificial gambling situations. Heart-rate increases, gambling behaviour and events such as 'stake decision time' were recorded as subjects played blackjack. Significant differences between real and artificial casinos were found for mean heart-rate increases over base-lines, for gambling behaviour and in the relationships between sensation-seeking, arousal and gambling in the two conditions. Doubt is cast on laboratory gambling as a valid analogue of the real gambling situation. Sensation-seeking and arousal are discussed briefly in relation to explanations of gambling.

Arousal↗
PubMed1984

A dose response study of oxitropium bromide in chronic bronchitis.

In a dose response study 12 patients with chronic bronchitis and airflow obstruction received inhaled placebo and incremental doses of oxitropium bromide. Significant improvements in peak expiratory flow rate, forced expiratory volume in one second, and forced vital capacity were recorded at all times up to 10 hours after all doses of oxitropium bromide. Oxitropium bromide is an effective bronchodilator in chronic bronchitis with an optimal dose of 400-600 micrograms.

Aged↗
PubMed1984

A comparison of oxitropium bromide and ipratropium bromide in asthma.

Oxitropium bromide is a derivative of scopolamine and is an anticholinergic drug. Twenty asthmatics completed the study in which they received, in randomised double-blind fashion, placebo, ipratropium bromide 80 micrograms, and oxitropium bromide 200 micrograms. The patients recorded peak expiratory flow immediately before inhalation and up to 10 h afterwards. PEF were significantly higher than placebo between 10 min and 10 h, for both active treatments. There were no significant differences between values on oxitropium bromide and ipratropium bromide at any time points. Side effects were minimal and oxitropium bromide is an effective bronchodilator in asthma.

Aerosols↗
PubMed1984

Adverse selection under a voucher system: grouping Medicare recipients by level of expenditure.

Third-party payers increasingly are offering insured populations a choice of health insurance packages. This paper addresses the issue of adverse selection: the tendency of high-risk and thus high-cost individuals to disproportionately choose comprehensive plans and low-risk individuals to disproportionately choose plans with limited benefits. The adverse selection issue is first analyzed as it applies generally to multiple-choice plans, and then a methodology is developed for avoiding adverse selection in the case of the Medicare voucher plan. Although developed specifically for the Medicare voucher plan, the proposed pricing system could be applied to any insured population that is offered a multiple-choice insurance plan.

Actuarial Analysis↗
PubMed1983

Distribution of disulfiram in brain after carotid ligation in gerbils.

Aiming whether intraperitoneal administration of disulfiram (tetraethyl thiuram disulfide, DS) achieves potentially therapeutic drug concentrations in brain tissue, the behaviour of blood-brain barrier (BBB) to 14C-labelled DS in cerebral ischemia with and without simultaneous administration of dimethylsulfoxide (DMSO) was studied in Mongolian gerbils subjected to left common carotid artery (CCA) occlusion. The results indicated that: (a) the permeability of DS through the BBB was significantly enhanced in the ischemic brain during the initial 30 min duration after DS administration; (b) administration of DMSO increased the entry of DS into the ischemic brain five-fold during the first 30 min and it was significantly higher even at the 60 min sampling period; (3) in general, the content of DS in the brain was quickly reduced with time.

Animals↗
PubMed1983

Changes in the concentration of 17 alpha,20 alpha-dihydroxypregn-4-en-3-one during pregnancy, labor, and delivery and the effect of dexamethasone treatment during the third trimester of pregnancy.

To study whether an alteration of placental steroid metabolism occurs during human pregnancy similar to that in the ewe, we measured the concentration of 17 alpha,20 alpha-dihydroxypregn-4-en-3-one (17,20 alpha-OHP) in peripheral plasma. As the pregnant ewe nears term, the utero-ovarian venous concentrations of 17,20 alpha-OHP increase, suggesting induction of placental 17 alpha-hydroxylase. The mean plasma concentration of 17,20 alpha-OHP measured by RIA in normal menstruating women was 1.1 +/- 0.12 (+/- SE) ng/ml. Similar values were found in plasma from ovariectomized women. In the first and second trimesters of pregnancy, the plasma values of 17,20 alpha-OHP were not significantly different from those in the nonpregnant women, while in the third trimester, the mean plasma concentration was significantly increased (mean +/- SE, 2.6 +/- 0.3 ng/ml). The plasma concentration of 17,20 alpha-OHP was studied in 15 women in late pregnancy, during labor, at delivery, and postpartum. The concentration increased during labor as delivery approached and reached a maximum at the time of delivery, ranging from 4.1-11.2 ng/ml, followed by a significant decrease within 1-4 h postpartum. The mean (+/- SE) 17,20 alpha-OHP concentrations in the venous and arterial cord blood were 8.7 +/- 1.6 and 5.8 +/- 2.0 ng/ml, respectively. To study the effect of increased circulating level of corticosteroids on the serum concentration of progestins, 74 women with premature labor with or without premature rupture of membranes were treated with either placebo or 4 im injections of dexamethasone phosphate (5 mg each) at 12-h intervals. Blood samples were drawn at 0, 14, 26, and 46 h, approximately 2 h after each dexamethasone dose. Plasma progesterone, 17 alpha-hydroxyprogesterone (17-OHP), and 17,20 alpha-OHP values at zero time were 140 +/- 15.8 (+/- SE; n = 21), 7.8 +/- 1.5 ng/ml (n = 16), and 2.3 +/- 0.3 ng/ml (n = 20), respectively. In patients treated with dexamethasone, the plasma progesterone values tended to increase at 14, 20, and 46 h, but 17-OHP and 17,20 alpha-OHP values decreased significantly compared to levels in placebo-treated patients. In conclusion, the concentration of plasma 17,20 alpha-OHP increased during the third trimester of pregnancy, and the increment continued through labor and delivery. During antenatal dexamethasone administration, progesterone in the maternal circulation tended to increase, while 17-OHP and 17,20 alpha-OHP decreased significantly. In the human, in contrast to the ewe, dexamethasone treatment in the third trimester does not appear to stimulate placental 17 alpha-hydroxylase activity.

Adolescent↗