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Biomedical subjects

H A Bird

Publications and source records attributed to H A Bird.

At least 91 records · Page 5Linked to original sources
PubMed1988

A clinical and biochemical evaluation of etretinate in rheumatoid arthritis.

Etretinate (Tigason; Roche), which is effective in the treatment of psoriatic arthritis has immunomodulating activity in vivo. We have therefore assessed this drug in an open clinical and biochemical assessment of 24 weeks duration in rheumatoid arthritis. The treatment dose was 1.0 mg/kg/day for the first 4 weeks reducing to 0.5 mg/kg/day thereafter. There was a modest clinical improvement though this only reached statistical significance for joint circumference at 12 and 16 weeks (P less than 0.05). Biochemical improvement only reached levels of statistical significance for IgM at week 16 (P less than 0.01). Eight out of 15 patients had discontinued the drug because of side-effects by week 12 and only three out of 15 patients showed individual improvement by week 24. Some biochemical parameters (ESR) worsened. These results suggest only modest clinical efficacy and use of the drug in rheumatoid arthritis is likely to be curtailed by unacceptable side-effects. The improvement in biochemical variables that occurs when the drug is used in psoriatic arthritis does not occur in rheumatoid arthritis.

Adolescent↗
PubMed1988

Measurement of nocturnal body motility: behaviour of osteoarthritic patients and healthy controls.

Nocturnal body motility has been compared in a sleep laboratory between patients with osteoarthritis and healthy age-, sex- and weight-matched controls using a Bio-medical timer and bedleg force transducers connected to a Disa polygraph. Four motility variables were derived (duration of movement; duration adjusted for sensitivity; number of movements; number of 30-s epochs containing movements) enabling an assessment of nocturnal body motility in the two groups. There was a trend for osteoarthritic patients to move more than controls during sleep on all variables measured, although this did not reach statistical significance. Temazepam elixir (0.4 mg/kg body weight/night) reduced all four motility variables in both osteoarthritic patients and controls, although only the reduction of the number of 30-s epochs containing movements (P less than 0.05) in the control group attained statistical significance.

Aged↗
PubMed1988

A comparison of prednisolone with azathioprine and prednisolone with intramuscular gold in rheumatoid arthritis.

Pulse prednisolone hemisuccinate therapy (500 mg given intravenously on three occasions over two weeks) has been combined with either intramuscular sodium aurothiomalate or azathioprine in an assessment of 30 patients with rheumatoid arthritis. Significant improvement in a variety of clinical and biochemical assessments was seen in both groups. Both treatments were well tolerated by the patients and prednisolone appeared to accelerate the response to sodium aurothiomalate and azathioprine but there was no great evidence that it enhanced it.

Adult↗
PubMed1988

How reliable is ESR as a measure of disease activity in rheumatoid arthritis treated with hydroxychloroquine?

Forty-two patients with active rheumatoid arthritis treated with hydroxychloroquine sulphate (400 mg day-1) for six months have been compared with patients treated with D-penicillamine (n = 14), aurothiomalate (n = 13), sulphasalazine (n = 15) and chloroquine (n = 17) to compare the changes in articular index, plasma viscosity and ESR. Results indicate that while articular index and plasma viscosity show significant improvement for all treatments, the ESR fails to improve during hydroxychloroquine therapy.

Arthritis, Rheumatoid↗
PubMed1988

A clinical and biochemical assessment of etidronate disodium in patients with active rheumatoid arthritis.

Diphosphonates reduce the rate of bone turnover. They have additional pharmacological properties improving adjuvant arthritis in rats and lowering ESR in this condition. We have evaluated etidronate disodium, a diphosphonate commonly prescribed in the United Kingdom for Paget's disease in patients with rheumatoid arthritis. Apart from an early improvement in articular index, perhaps reflecting anti-inflammatory activity, no significant change occurred in clinical variables or in laboratory indices of 'secondline' action at a dose of 5 mg/kg/day.

Adult↗
PubMed1988

What are the 'best' measurements for monitoring patients during short-term second-line therapy?

Seventy-one patients with active rheumatoid arthritis were treated with one of five second-line agents and monitored for 24 weeks using seven clinical and seven laboratory measurements. Statistical tests were used to determine which measures changed fastest, which changed most and which most closely reflected changes in the others. The results consistently showed that articular index and summated change score were the 'best' clinical measures while ESR and plasma viscosity were the 'best' laboratory measures. Traditional measures such as grip strength and joint size fared badly and cannot be recommended. Clinical variables improved slightly more rapidly than laboratory measures, but the latter showed the greater change.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1988

The effect of indomethacin on the psychomotor function of patients with rheumatic diseases.

We have compared the effect of single and multiple doses of indomethacin and placebo on objective measurements of psychomotor impairment in patients. Following a single 50 mg dose (n = 8), indomethacin produced psychomotor disturbance in only those patients who had no recent history of NSAID exposure. After multiple doses of indomethacin (25 and 50 mg tid for 5 days), significant psychomotor impairment was observed. We conclude that other NSAIDs may induce cross-tolerance to the psychomotor effects of indomethacin. Tachyphylaxis may develop to the psychomotor disturbance caused by indomethacin.

Arthritis, Rheumatoid↗
PubMed1988

The use of a pharmacological indicator to investigate compliance in patients with a poor response to antirheumatic therapy.

Twenty-six patients with rheumatoid arthritis which was poorly controlled despite high dose D-penicillamine were studied. Compliance was assessed by standard methods (return tablet count and interview). In addition low-dose phenobarbitone was included in the penicillamine formulation as a pharmacological indicator of compliance. Using these techniques incomplete compliance was apparent in 11 patients (42%). All such patients were identified by the pharmacological marker. Only one admitted poor compliance at interview and only six returned more than a few tablets too many. The reason for the high incidence of poor compliance in this selected group is not apparent but it may represent a significant cause of failure with D-penicillamine therapy. The use of low-dose phenobarbitone may have wider applications in the investigation of patients with other conditions who fail to respond adequately to treatment.

Adult↗
PubMed1988

Factor analysis of the St. Mary's Hospital Sleep Questionnaire.

The St. Mary's Hospital Sleep Questionnaire was designed to evaluate the sleep of hospital patients. To gain an understanding of possible underlying factors, the questionnaire was factor analysed using data collected from 222 hospitalised rheumatic patients. The analysis did not produce a completely clear factor structure. Two factors relating to "sleep latency" and "sleep quality" emerged more clearly than the other factors produced. These factors correspond with two sleeping state factors (ease of getting to sleep; quality of sleep) that were extracted by a previous factor analysis of the Leeds Sleep Evaluation Questionnaire. This suggests that the two most important aspects of subjectively perceived sleep are the process of going to sleep and the quality of sleep.

Arthritis, Rheumatoid↗
PubMed1988

The effect of allopurinol on the steady-state pharmacokinetics of indomethacin.

The effect of 5 days treatment with allopurinol (300 mg) on the pharmacokinetics of indomethacin at steady-state was investigated in eight patients. Allopurinol produced no significant effect on the indomethacin serum concentration-time curve. Allopurinol did not alter significantly the amounts of indomethacin excreted in the urine within 8 h. However, the urinary ratio of N-deschlorobenzoylindomethacin to indomethacin was reduced significantly by allopurinol administration (P less than 0.05).

Adult↗
PubMed1988

Comparison of sleep in osteoarthritic patients and age and sex matched healthy controls.

A sleep laboratory comparison of the sleep of 14 osteoarthritic patients with that of 16 age and sex matched healthy controls was undertaken. After three nights of adaptation continuous recordings of electroencephalographic (EEG), electro-oculographic (EOG), and electromyographic (EMG) activity were obtained for the next two nights. A comparison of EEG sleep variables during this baseline period showed that osteoarthritic patients had a significantly greater percentage of stage 1 and significantly smaller percentage of stage 2 sleep than control subjects. These findings indicate sleep disturbance in osteoarthritic patients. The limited degree of disturbance observed in these patients may be due to the fact that they were allowed to continue with their normal anti-inflammatory and analgesic medication for the course of the study.

Aged↗
PubMed1988

Kinetic investigations into the possible cause of low serum histidine in rheumatoid arthritis.

To investigate the cause of low serum histidine in rheumatoid arthritis (RA) single oral and intravenous doses of L-histidine were administered to patients with active RA, and to an equal number of age and sex matched control subjects. In the first study 13 patients and their controls received a 100 mg kg-1 dose of L-histidine as an aqueous slurry. Significant differences were seen in body weight, predose baseline serum histidine concentration, Cmax, t1/2, and area under curve, AUC0-infinity. In a second study six patients and six controls each received a 50 mg kg-1 dose of L-histidine both orally and intravenously on two separate occasions. The patients with RA had a lower baseline serum histidine concentration, a lower volume of distribution, and a shorter plasma half life than the controls, but these differences were not statistically significant. No difference was seen in bioavailability or clearance. Low serum histidine in RA is unlikely to be due to malabsorption from the gut, uptake by abnormal gut flora, or increased metabolism.

Adult↗
PubMed1988

Complications of pregnancy and benign familial joint hyperlaxity.

A family is described in which four generations were affected by benign familial joint hyperlaxity and, in the two generations for which obstetric data were available, pregnancies were complicated by unexplained mid-trimester vaginal bleeding. This prompted a study to determine whether unexplained antepartum haemorrhage (APH) and premature rupture of the membranes (PROM) both of which might reflect the structure of fetal collagen, were associated with joint hyperlaxity in offspring. The joint hyperlaxity of children born from such pregnancies was slightly greater than that found in age matched children born from uncomplicated pregnancies.

Adult↗
PubMed1988

Co-trimoxazole in rheumatoid arthritis: a comparison with sulphapyridine.

The antirheumatoid activity of sulphasalazine and sulphapyridine may result from their antibacterial properties. The second line activity of sulphamethoxazole, in the form of cotrimoxazole (CTZ), has been investigated by treatment of 13 patients with RA for 24 weeks with CTZ (480 mg three times a day). The drug was found to be poorly tolerated, only five of the thirteen patients recruited completing the study. High circulating concentrations of sulphamethoxazole were found, with mean (SD) steady state serum concentrations reaching 54.02 (23.38) micrograms/ml. A significant reduction in serum IgM from 280 to 130 IU/l was observed, but otherwise disease activity remained unchanged or deteriorated throughout the course of the study. In contrast, patients with RA treated with sulphapyridine (1.25 g a day) showed improvement in disease activity. The results argue against an antibacterial mechanism of action for sulphasalazine and sulphapyridine in rheumatoid arthritis, unless this occurs at a site inaccessible to sulphamethoxazole.

Arthritis, Rheumatoid↗
PubMed1988

A double-blind comparison of ibuprofen, placebo and ibuprofen with meptazinol in soft tissue rheumatism.

The administration of ibuprofen potentiates and prolongs the analgesic effect of meptazinol when the two drugs are given simultaneously to mice. A double-blind three-way crossover study of placebo, ibuprofen (1600 mg/day) and ibuprofen (1600 mg/day) plus meptazinol (400 mg/day) was carried out in 45 patients with soft tissue rheumatism to see if the same potentiation could be demonstrated in man. Treatment order was randomized and each regimen was given for 2 weeks preceded by 1 week on paracetamol alone. Assessments were made, on entry and after each treatment period, of pain parameters using visual analogue or verbal rating scales. Patients' overall impression and final preference showed both active treatments to be better than placebo and demonstrated a slight preference for the combination.

Adolescent↗
PubMed1988

A comparison of blood loss caused by two prolonged-release formulations of indomethacin ('Flexin Continus' and 'Indocid' R) in normal healthy male volunteers.

Faecal blood loss arising from two prolonged-release formulations of indomethacin was compared in a double-blind, parallel group study in 12 healthy male volunteers. After a 1-week run-in period on placebo, subjects were allocated at random to receive 150 mg indomethacin per day, either as controlled-release 'Flexin Continus' tablets or as slow-release 'Indocid' R capsules, for 2 weeks and followed up for a further 1 week. Faecal specimens were collected over a 4-day period in each week and blood loss calculated using a 51Chromium-labelled red cell count method. Mean blood loss during the placebo run-in period was 2.6 ml/4 days in both study groups. Mean blood loss during treatment Weeks 2 and 3 with 'Flexin Continus' was 8.6 ml/4 days and 7.9 ml/4 days, respectively, and during treatment with 'Indocid' R capsules was 13.9 ml/4 days and 14.2 ml/4 days, respectively. There was a carry-over effect from both preparations as seen by a steady decrease in blood loss during the week after treatment. The mean value for 'Flexin Continus' was 6.9 ml/4 days and for 'Indocid' R was 8.3 ml/4 days during the wash-out week. Faecal blood loss was not statistically significantly different between the two formulations. No significant deterioration in haematological or biochemical results occurred in either group. Adverse symptoms were less frequent with 'Flexin Continus' tablets.

Adult↗