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Biomedical subjects

J Robison

Publications and source records attributed to J Robison.

21 records · Page 2Linked to original sources

Clinical investigation of Duchenne muscular dystrophy. A methodology for therapeutic trials based on natural history controls.

Between 1979 and 1987 we documented the natural history of Duchenne muscular dystrophy in 170 patients, aged from 3 to 23 years, by making serial measurements in over 5000 individual evaluations. This database makes it possible to design and conduct therapeutic trials using natural history controls. Such trials do not replace the need for randomized placebo-controlled trials of promising agents but they do require fewer patients, are cost-effective, and permit the use of high-risk therapy where toxicity monitoring may be important. Natural history-controlled trials, therefore, may serve as a screening method for new therapeutic agents. Drugs showing a significant benefit can then be evaluated in a randomized controlled trial.

Adolescent

Norepinephrine kinetics during orthostatic stress in congestive heart failure.

To evaluate the determinants of the plasma norepinephrine (NE) response to orthostatic stress, NE kinetics were measured during steady-state infusion of [3H]NE of high-specific activity for two consecutive 90-minute periods; the first was supine, and the second was during 60 degrees head-up tilt. In 6 normal subjects, plasma NE increased from 242 to 570 pg/ml, and NE clearance decreased from 1.43 to 1.00 l/min X M2. In 6 patients with congestive heart failure, there was no significant change in plasma NE during orthostatic stress. This has been interpreted previously to indicate that there was little activation of the baroreflex arc. In fact, NE clearance decreased from 1.08 to 0.79 l/min X M2; however, there was a decrease in NE spillover from 4.04 to 2.88 nmol/min X M2. A reduction of organ blood flow with tilt could be responsible for the reduced NE clearance by both groups, but the mechanism for the reduction in NE spillover with tilt in congestive heart failure is unclear.

Adult

Significance of mixed features in acute mania.

We studied a group of 23 manic patients to ascertain the prognostic significance of mixed affective features. Eight patients (34.8%) presented with a mixed manic state. This mixed state correlated with a longer hospitalization and significantly worse disposition outcome. In the light of previous conceptual models the authors speculate about the meaning of DSM-III defined mixed bipolar disorder.

Acute Disease