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Biomedical subjects

J G Edwards

Publications and source records attributed to J G Edwards.

At least 73 records · Page 4Linked to original sources

Prescription-event monitoring of 10,895 patients treated with alprazolam.

'Prescription-event monitoring' (PEM) is one of two national systems of post-marketing surveillance in operation in Britain. It identified 22,065 patients who had received NHS prescriptions for alprazolam, and data available on 10,895 of these were analysed. The main reasons for treatment with alprazolam were anxiety and depression. The patients provided 3360 patient-years of treatment and 7540 patient-years of follow-up. No serious events clearly associated with treatment were recorded. The main events reported during treatment, albeit infrequently, were drowsiness and depression, although depression is more likely to be due to the disorder being treated than to the drug. Some of the other alleged unwanted effects of alprazolam in published reports were not encountered. Since PEM is unable to determine the dependence potential of alprazolam, further evaluation of this problem is called for.

Adult↗

Vanadate inhibits both intercellular adhesion and spreading on fibronectin of BHK21 cells and transformed derivatives.

Both intercellular adhesion and spreading on fibronectin of BHK21 hamster cells are inhibited by vanadate at concentrations that cause specific regulatory effects rather than general metabolic inhibition. Inhibition of aggregation of these cells in suspension (half-maximal in 10(-5) M vanadate) is rapid and reversible. The extent of inhibition, and its decline with culture age parallel inhibition by agents that depolymerize microtubules. Vanadate also reversibly inhibits spreading of both BHK cells and transformed derivatives on fibronectin. If 10(-4) M vanadate is added to BHK cells that have spread in its absence, they remain spread, but transformed derivatives are sensitive to rounding by vanadate at 10(-6) M. The mechanisms by which vanadate inhibits both intercellular adhesion and spreading are unknown, and may be different for the two phenomena. Possible sensitive targets include cytoplasmic dynein for the former, and protein tyrosyl phosphatase for the latter.

Adenine↗

ASHG/NSGC activities related to education. The doctoral degree in genetic counseling: attitudes of genetic counselors.

All 565 full members of the National Society of Genetic Counselors were surveyed in September 1989 to assess their attitudes toward a potential doctoral degree in genetic counseling. The usable return rate was 59.6% (337/565) of the full membership. One hundred eighty (54.4%) respondents indicated a need for a doctoral degree in genetic counseling, 101 (30.5%) were undecided as to the need, and 50 (15.1%) did not see a need for such a degree. One hundred forty-seven (44.3%) respondents indicated their individual interest in pursuing a doctorate in genetic counseling, 109 (32.8%) would not pursue such a degree, and 76 (22.9%) were undecided. Beyond the generally accepted feeling that genetic counseling should expand as a professional field, the reasons cited most often for seeking the Ph.D. in genetic counseling were professional recognition, a desire to specialize in a particular area, and greater depth of knowledge. The study revealed a strongly positive attitude, among full members of the NSGC, toward establishment of a doctoral degree in genetic counseling.

Adult↗

Remoxipride and haloperidol in the acute phase of schizophrenia: a double-blind comparison.

The efficacy and safety of remoxipride in the treatment of schizophrenia were compared with those of haloperidol in a multicentre double-blind 6-week study which was randomized with a parallel group design and was preceded by a washout period. Eighty-nine consecutively admitted men and women meeting the Research Diagnostic Criteria for schizophrenia in an acute phase of the illness were treated with remoxipride 75-300 mg twice daily or haloperidol 5-20 mg twice daily. The efficacy assessments were the Brief Psychiatric Rating Scale, Krawiecka Rating Scale, and Clinical Global Impression. Both antipsychotic drugs produced clinical improvement with no significant differences between the efficacy of the two drugs. There were relatively few side effects. There were significantly fewer extrapyramidal symptoms and instances of blurred vision with remoxipride and less constipation with haloperidol. The results indicate that remoxipride is as effective an antipsychotic as haloperidol. Remoxipride has an advantage over haloperidol in respect to extrapyramidal side effects.

Acute Disease↗

Chronic benzodiazepine dependence. A comparative study of abrupt withdrawal under propranolol cover versus gradual withdrawal.

Thirty-one patients dependent on benzodiazepines were randomly assigned to either slow withdrawal (SW) or abrupt withdrawal under propranolol cover (PW). Of 16 patients in the SW group, 11 successfully withdrew from their drugs, while only 4 out of 15 in the PW group did so. Patients in the SW group had only mild withdrawal symptoms, while those in the PW group suffered more severe symptoms, which lasted around four weeks. In all, 81% of the whole group suffered withdrawal symptoms of some kind. Patients in both groups were significantly less anxious at the end of the study than at baseline. Younger subjects and those who were more severely anxious at the start of the trial had more difficulty in withdrawing than older and less anxious patients.

Adolescent↗

Improving house physicians' assessments of self-poisoning.

A questionnaire was developed to help the assessment of patients who take overdoses. Twenty-four house physicians in Southampton university hospitals were randomly divided into a group who used the questionnaire and another group who asked whatever questions they felt appropriate. One hundred and fifty patients who had taken overdoses were included in the study. After the house physician's assessment, a research assistant interviewed all of the patients and the two assessments for each patient were then compared. There was greater agreement between the research assistant and the house physicians who used the questionnaire than those who interviewed patients in an unstructured way with respect to assessments of severity of depression, purpose of the act, suicidal intent, diagnosis, and future management.

Adult↗

Effect of paroxetine on the electrocardiogram.

The electrocardiographic effects of paroxetine have been studied. High speed electrocardiograms were recorded on 20 patients with major depression before and after 4 weeks' treatment with either paroxetine or placebo. No patient had a history or clinical evidence of cardiovascular disease. The ECG measurements were made blind to patient, treatment and treatment interval. No significant changes in heart rate, PR, and QTc intervals or in T-wave height were found after treatment with active drug or placebo but there was a small increase from 81 to 85 ms in the QRS width in the paroxetine group which was significantly different from the small decrease that occurred in the placebo group. No significant changes in blood pressure were noted. The findings show that paroxetine has no clinically relevant cardiac effects when given in therapeutic doses to relatively young healthy subjects.

Adult↗

Serious assaults by inpatients.

Forty-nine hospital wards in the United States and Canada were surveyed during specified periods for one year to document assaults by inpatients on staff or other patients. Nine (5.7%) of the 158 assaults by adult psychiatric inpatients were sufficiently severe to require medical treatment. Four others occurred on the only children's service studied. Only one (2.6%) of 39 assaults on adult nonpsychiatric units required medical care. Injuries were rarely serious, with only four assaults in any setting leading to bedrest or missed workdays. The overall rate of assault (assaults per bed per year) on 27 adult psychiatric units was 1.36; for assaults requiring treatment, the rate was 0.08. The rate of assault of any kind on 22 adult nonpsychiatric units was 0.28 assaults per bed per year.

Adolescent↗

Personality profile and affective state of patients with inflammatory bowel disease.

The Eysenck Personality Inventory and Hospital Anxiety and Depression scale were administered to 80 patients undergoing medical treatment for long standing inflammatory bowel disease: 22 patients were studied before the diagnosis was established and 40 patients with diabetes mellitus served as controls. High neuroticism and introversion scores were more prevalent in the patients with inflammatory bowel disease than controls (p less than 0.05) and these characteristics were as prominent in patients before diagnosis as in established cases. Introversion scores increased with the duration of disease (r = 0.51). Depression was uncommon, occurring only in patients with active chronic disease. Patients believed there was a close link between personality, stress and disease activity. Fifty six of the patients recognised factors that initiated the disease and in 42 this was thought to be a stressful life event or a 'nervous personality'.

Affect↗

Influences of exogenous insulin on arterial blood pressure measurements of the rat.

Studies were undertaken with adult male rats to test the hypothesis that euglycemic hyperinsulinemia would alter mean arterial blood pressure (MAP) and heart rate (HR) relationships by activation of the sympathetic nervous system. Conscious rats were infused either with insulin or control vehicle (0, 0.47, 1.5, 4.7, 15.0 mU.kg-1.min-1) for 75 min before injection of hexamethonium. Compared with the control period, insulin infusion significantly increased MAP by 7.1 +/- 0.1, 12.7 +/- 2.0, and 19.7 +/- 0.3 (SE) mmHg and HR by 44 +/- 8.4, 66 +/- 10.3, and 95 +/- 6.3 beats/min, respectively, during the three highest rates of infusion. The dose-dependent increases in MAP and HR were due to increases in the activity of hexamethonium-sensitive pathways. In chemically sympathectomized rats, insulin infusion did not produce a significant increase in either MAP or HR. The influence of exogenous norepinephrine on MAP and HR was also studied after insulin infusion. Compared with the insulin-vehicle infusion, insulin infusion significantly depressed (P less than 0.05) the norepinephrine dose-response increase in MAP. In addition, isolated smooth muscle strips were studied to determine the influence of insulin on their in vitro responses to increasing doses of norepinephrine. Although insulin did not alter contractility, it significantly (P less than 0.05) decreased the sensitivity of the vascular strips to norepinephrine. Collectively, the data from these euglycemic experiments indicated that infusions of insulin caused increases in HR and MAP because of activation of the sympathetic nervous system, even though the responsiveness of the vascular smooth muscle was depressed.

Animals↗

A long-term prospective evaluation of the circumferential supracrestal fiberotomy in alleviating orthodontic relapse.

This prospective study conducted during a period of nearly 15 years initially involved 320 consecutively selected cases. The primary purpose of the investigation was to statistically evaluate the efficacy of the circumferential supracrestal fiberotomy (CSF) procedure in alleviating dental relapse following orthodontic treatment. The "Irregularity Index" method of Little for measuring the malposition of teeth was used to quantitatively record the relapse of the control and CSF cases at approximately 4 to 6 years after active treatment and again at 12 to 14 years after active treatment. The differences between the mean relapses of the control and the CSF cases were highly significant at both time intervals. The surgical procedure appeared to be somewhat more effective in alleviating pure rotational relapse than in labiolingual relapse. On a long-term basis, the CSF procedure was shown to be more successful in reducing relapse in the maxillary anterior segment than in the mandibular anterior segment. Nevertheless, a significant and unpredictable variation in individual tooth movement following orthodontic treatment was observed in both the control and CSF groups. No clinically significant increase in the periodontal sulcus depth nor decrease in the labially attached gingiva of the CSF teeth was observed at 1 and 6 months following the surgical procedure.

Adolescent↗

Comparative effects of fluoxetine and amitriptyline on cardiac function.

1. The effects of fluoxetine and amitriptyline on the electrocardiogram (ECG) and systolic time intervals (STIs) were measured during a double-blind parallel-group study in depressed patients. 2. ECGs and STIs were measured after a 1 week placebo run-in, following 1 week's treatment with fluoxetine 40 mg daily or amitriptyline 100 mg daily, and then after 3 weeks' treatment with fluoxetine 60-80 mg daily or amitriptyline 150-200 mg daily. 3. Fluoxetine had no effect on the ECG or STIs at any dose. Amitriptyline 150-200 mg daily shortened the sinus cycle length by a mean of 12%, prolonged the PR interval by 8% and the QRS duration by 10%. Amitriptyline did not significantly alter the STIs.

Adult↗