Search PubMed⌕ Search

Biomedical subjects

J Wadsworth

Publications and source records attributed to J Wadsworth.

135 records · Page 8Linked to original sources
PubMed1978

Cardiovascular responses to mianserin hydrochloride: a comparison with tricyclic antidepressant drugs.

1. The cardiovascular responses of mianserin hydrochloride and tricyclic antidepressant drugs were investigated using non-invasive methods of cardiac investigation. A study of the interaction of mianserin and antihypertensive drug therapy is reported. 2. In six normal volunteers, mianserin hydrochloride 20 mg was shown to prolong the corrected Q-T interval at 150 min (P less than 0.001). It did not affect heart rate, systolic time intervals or the peak normalized derivative of the apexcardiogram. Amitriptyline 50 mg increased the corrected pre-ejection period interval (PEPI) and the PEP/left ventricular ejection time (LVET) ratio of the systolic time intervals at 150 min (P less than 0.001). Q-T interval was shortened at 90 minutes. 3. In a double-blind patient study, clomipramine increased heart rate, P-R interval, QRS and corrected Q-T interval in one patient at 2 weeks. Mianserin prolonged corrected Q-T interval at 1 week but this returned to the pretreatment time by 2 weeks in two patients. 4. In an open study, mianserin 20 mg three times daily did not antagonize the hypotensive action of propranolol or propranolol and hydrallazine in three patients. 5. In a double-blind study in three patients with desmethylimipramine 25 mg three times daily, mianserin 20 mg three times daily did not antagonize the hypotensive action of either guanethidine or bethanidine.

Adult↗
PubMedDate not supplied

Combined granulocyte and platelet transfusions. Development of alloimmunization as reflected by decreasing cell recovery values.

Twenty-three patients undergoing induction therapy for acute myelogenous leukemia (AML) received a total of 191 combined prophylactic granulocyte (PMN) and platelet (PLT) concentrates on alternate days (median 8, range 3-12 per patient). Each transfusion was assessed by monitoring the patient for reactions and by estimating the recovery of PMN in the circulation at 1 hour and of PLT at 1 and 20 hours. Seventeen patients developed alloimmunization to PLT from at least one donor, defined as either a PLT recovery of less than 15 percent at 1 hour and/or less than 10 percent at 20 hours. In this group there was a progressive reduction in PMN and PLT recovery with increasing transfusion number, strongly suggesting alloimmunization to both cells. Thirty-four transfusions were accompanied by transfusion reactions, thirty-two of which occurred in ten patients who had PMN recoveries of less than 5 percent after at least one transfusion (median 2.5, range 1-6 transfusions per patient). Actuarial calculations predicted that 70 percent of patients would become alloimmunized to PLT from at least two individuals after receiving 11 transfusions. These results suggest that combined PMN and PLT transfusion are associated with the rapid development of alloimmunization.

Cell Survival↗
PubMedDate not supplied

A developmental test based on the STYCAR sequences used in the National Childhood Encephalopathy Study.

During the National Childhood Encephalopathy Study, standard neurodevelopmental assessments had to be performed on a large number of children under 3 years of age scattered throughout Great Britain. Currently available tests were reviewed but were found to be impractical for this purpose. We describe a simple test procedure, based on the STYCAR sequences, suitable for use in a clinic or at home with the minimum of special equipment. Results were reliable and provided an informative record of a child's developmental progress. It may be possible to modify the scheme for general use.

Acute Disease↗
PubMedDate not supplied

Sexual behaviour among London GUM clinic attenders: implications for HIV education.

The aim of this study was to describe the sexual behaviour of a sample of genitourinary medicine (GUM) clinic attenders, 5 years after the launch of the UK government HIV media campaigns. A gender-specific and anonymous cross-sectional self-completion questionnaire was modified from the National Survey of Sexual Attitudes and Lifestyle and completed by 250 men and 250 women. The majority of the respondents were in their twenties, lived in London and were employed or students. Sixty-eight per cent of the men reported that one or more of their last 3 partners was not a regular partner. For those men whose last sexual encounter was with a new partner, 27% of heterosexuals and 33% of homosexuals reported using a condom. Fifty-one per cent of women reported one or more non-regular partners among their last 3 partners. For those women whose last sexual encounter was with a new partner, 43% of heterosexuals and 75% of bisexuals used a condom. Seventy-eight per cent of men and 75% of women had had a previous sexually transmitted disease (STD). These findings highlight the persistence of practices associated with the risk of contracting or transmitting HIV infection and which needs to be addressed in future educational campaigns. The GUM clinic population is an important population to monitor over time, either by longitudinal or serial cross-sectional studies. The results of this study provide a baseline against which to gauge the effects of future educational interventions.

Adult↗
PubMedDate not supplied

Survival and the use and costs of hospital services for London AIDS patients treated with AZT.

The aim of this study was to evaluate the survival patterns and use and cost of hospital services of AIDS patients treated with azidothymidine (AZT) at St Mary's Hospital, London. A retrospective analysis of inpatient and outpatient case notes was performed, as was a survey of HIV-related care costs in 37 clinical departments. Of the 183 AIDS patients managed between 1 January 1987 and 30 September 1989, 132 were treated with AZt and 51 without AZT. Mean age at time of AIDS diagnosis for these predominantly homosexual men was 37.5 years for those treated with AZT compared with 40.7 years for those not on AZT. Median survival time from date of AIDS diagnosis was significantly longer for patients treated with AZT compared with those not treated with AZT (23 vs 13.5 months, P = 0.0004). The interval from diagnosis of HIV infection to date of AIDS diagnosis did not differ significantly between groups. Inpatients and outpatients use of services was greater for those receiving AZT than for those who did not. Costs reflected this increase use of services and the costs for those treated with AZT were pounds 3061 per AIDS patient-year higher compared with AIDS patients not receiving AZT; 36% of this cost was directly attributable to the cost of AZT itself. The introduction of AZT into routine clinical practice seems to have been a cost-effective intervention though it has been associated with an increased use of hospital services and associated costs per AIDS patient-year as well as increases survival time from AIDS diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Steady-state pharmacokinetics of phenytoin from routinely collected patient data.

Previously reported routine phenytoin clinical pharmacokinetic data from Japan, England, and Germany were analysed to estimate population pharmacokinetic parameters. There were 780 steady-state phenytoin concentrations and associated dosage rates (mg/day) from 322 patients. The patient group spanned paediatric and adult ages, mean age being 18.4 +/- 17.3 (SD) years; 53% were males. The data were analysed using NONMEM, a computer programme designed for population pharmacokinetic analysis. Estimates of the influence of age, gender, data source, height and weight on the maximum elimination rate (Vm) and Michaelis-Menten constant (Km) were obtained. The Vm and Km of a 70 kg adult male European were estimated to be 415 mg/day and 5.7 mg/L, respectively. Vm is not influenced by gender, age or data source. The parameters of a power function of height and weight were estimated to adjust Vm for body size. The best function adjusts Vm in proportion to weight to the 0.6 power; height contains no useful information. Km is not influenced by gender. The Km for patients less than 15 years old is 43% less than that of older patients. The Km of Japanese patients appears to be 23% less than that for European patients. Even after adjustments for age, etc., apparent Vm and Km vary unpredictably among individuals with a coefficient of variation between 10 to 20% and approximately 50% respectively.

Adolescent↗