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Biomedical subjects

L Groves

Publications and source records attributed to L Groves.

14 recordsLinked to original sources
PubMed2005

Chip fractures from the distal lateral trochlear ridge of the talus of a quarter horse gelding: a veterinary medicine clinical report.

An eighteen-month old quarter horse gelding was diagnosed with chip fractures from the distal lateral trochlear ridge of the talus. The horse presented with the symptom of persistent synovitis. The diagnosis was based on radiographic evidence. The horse was treated initially with arthroscopic surgery. He was given a non-steroidal anti-inflammatory agent, and a chondroprotective agent to prevent further damage to, and aid in the healing of, the damaged joint.

Animals↗
PubMed1999

An open-label study of repeated use of diazepam rectal gel (Diastat) for episodes of acute breakthrough seizures and clusters: safety, efficacy, and tolerance. North American Diastat Group.

PURPOSE: To assess safety of diazepam rectal gel (DZPRG) for control of acute seizures in epilepsy patients and to evaluate tolerance with repeated use of DZPRG at intervals of > or =5 days. METHODS: Subjects were persons with epilepsy, age 2 years or older, with seizure clusters or prolonged seizures. Onset of a treatable episode was defined; caregivers were trained to administer DZPRG and to monitor respiration, seizures, and adverse effects (AEs). DZPRG was dispensed in a single-use, prefilled syringe; dosage was determined by age and weight. Maximal use was > or =5-day intervals, < or =5 times/month. After use, caregivers returned data booklets and syringe. Caregivers and physicians completed global ratings yearly. RESULTS: In 149 subjects treated, 77% of 1,578 administrations resulted in seizure freedom for the next 12 h. One hundred twenty-five received two or more treatments (two to 78; median, 8), 0.03-4.3/month (median, 0.4). To evaluate tolerance, subjects with two or more episodes were divided into low (two to seven episodes) and high use (eight to 78 episodes treated). There was no difference in proportion seizure free 12 h after the first administration versus last administration, for either infrequent or frequent administration. Sedation occurred in 17%, attributed to DZPRG in 9%. No respiratory depression was attributable to DZPRG. Three subjects withdrew because of AEs attributable to (agitation) or possibly attributable to DZPRG (chest pain, rash). Five subjects withdrew because of AEs unrelated to DZPRG. Caregiver and physician global ratings were highly positive at both 12 and 24 months. CONCLUSIONS: DZPRG is safe and effective in children and adults with epilepsy with breakthrough seizures. Neither tolerance nor significant medication-related AEs were seen with repeated DZPRG administration at intervals > or =5 days.

Administration, Rectal↗
PubMed1999

A controlled pharmacokinetic evaluation of tizanidine and baclofen at steady state.

Clinical trials with tizanidine when administered alone have shown that 5-chloro-4-(2-imidazolin-2-ylamino)-2,1,3-benzothiodiazole (tizanidine) is safe and effective for spasticity control. However, given its mechanism of action and requirement for titration, clinical experience suggests that tizanidine is likely to be used in combination with other antispastic agents with different mechanisms of action, such as baclofen. The objective of this study was to examine the pharmacokinetics of both tizanidine and baclofen under steady-state conditions when administered alone or concomitantly. This was a randomized, three-period, multiple-dose, Latin Square design study consisting of tizanidine HCl, 4 mg t.i.d. for seven consecutive doses; baclofen, 10 mg t.i.d. for seven consecutive doses; and both regimens simultaneously for seven consecutive doses. Drug administration was performed every 8 h, three times daily. Fifteen normal men served as study subjects. A priori, a clinically significant difference was set as 30%. Concentrations of tizanidine and baclofen were nearly identical during the single and concomitant dosing periods. All of the calculated steady-state pharmacokinetic parameter changes for baclofen, tizanidine, and its major metabolites were within the 30% criterion. Small differences in renal clearance were observed when the two drugs were coadministered, but these changes are unlikely to be clinically important. Thus, it is unlikely that coadministration of tizanidine and baclofen during dose-titration of the former will result in a pharmacokinetic interaction.

Adrenergic alpha-Agonists↗
PubMed1994

Comparative profile of tizanidine in the management of spasticity.

The therapeutic profile of a new antispastic drug cannot be defined solely on the basis of placebo-controlled studies. Its potential advantages must be evaluated in comparison with existing drugs. This review compares the efficacy and tolerability of tizanidine, a newer muscle relaxant, with that of baclofen and diazepam, the most widely used antispastic agents, for a variety of diagnoses and target symptoms associated with spasticity. More than 20 double-blind, comparative studies were conducted between 1977 and 1987. These included a total of 777 patients suffering from spasticity of various causes. The collected clinical data have been integrated into a combined analysis. Tizanidine emerges from this comparison as a valuable drug in the treatment of spasticity related to cerebral and spinal disorders.

Activities of Daily Living↗
PubMed1992

Efficacy and side effects of methylphenidate for poststroke depression.

BACKGROUND: Depression after stroke impedes the rehabilitation process and causes additional suffering to patient and family. Few studies have systematically examined pharmacologic treatments of poststroke depression. In the present paper, the use of the stimulant methylphenidate is studied in a depressed, elderly stroke population. METHOD: Ten subjects (mean age = 73.2 years) meeting DSM-III-R criteria for major depression were followed-up during a 3-week efficacy and side effect trial involving methylphenidate. Subjects were selected from rehabilitation patients referred for psychiatric consultation. RESULTS: A total of 80% (8 of 10) of the subjects showed either a full or partial response as measured by Hamilton Rating Scale for Depression scores. The incidence of problematic side effects was low, and no subjects had to be discontinued from the study. CONCLUSION: Results of this methylphenidate trial for poststroke depression in elderly patients suggest that it is a safe and effective treatment for poststroke depression. Future studies are called for in which methylphenidate is compared with placebo controls and antidepressant medication.

Age Factors↗
PubMed1988

Methylphenidate in treating poststroke depression.

The authors retrospectively studied the charts of 25 patients with poststroke depression who were treated with methylphenidate. The 13 patients (52%) who recovered completely from their depression did not differ significantly from the 12 nonresponders on demographic characteristics, location of cerebrovascular accident, and other variables. Mood usually improved within 48 hours; only 3 (12%) patients had side effects. Rapid response to treatment and lack of significant side effects indicate that methylphenidate may be a valuable treatment for poststroke depression.

Aged↗
PubMed1987

Use of the dexamethasone suppression test with depressed and demented elderly.

Although some researchers have suggested that the dexamethasone suppression test (DST) may be useful in differentiating between major depression and dementia in the elderly, recent reports of abnormal DST results in nondepressed, demented elderly have questioned the validity of the test in this population. This study compared the frequency of abnormal DST results in three groups of elderly inpatients: depressed/not demented; demented/not depressed; and depressed and demented. Two geropsychiatrists independently evaluated 33 patients for symptoms of depression and/or dementia and then assigned each patient to one of the three groups. Subjects in the demented/not depressed group had a significantly larger proportion of abnormal DSTs (P less than .01), and the mean postdexamethasone, 4 PM blood cortisol level of the demented/not depressed group was significantly greater than the means of the other two groups (P less than .005). In this sample, the DST was more likely to identify dementia than depression. Until further investigations clarify the parameters of DST use in the elderly, the diagnosis of depression and dementia should continue to be determined by sensitive interpretation of clinical findings, history, and other diagnostic tests.

Aged↗
PubMedDate not supplied

Tizanidine treatment of spasticity: a meta-analysis of controlled, double-blind, comparative studies with baclofen and diazepam.

To conduct a meta-analysis of the antispastic efficacy and tolerability of tizanidine, we reviewed records of the European sponsor of tizanidine trials and selected double-blind, randomized studies of moderate duration in which oral tizanidine was compared with baclofen or diazepam. Studies were required to have individual patient data; three key outcome measures (Ashworth Rating Scale for muscle tone, a measure of muscle strength, and Global Tolerability to Treatment Rating); and patients with multiple sclerosis or cerebrovascular lesions. Ten trials involving 270 patients met these criteria. Seven studies used baclofen as the positive control; three used diazepam. As measured by Total and Lower Body Ashworth scores, tizanidine and similar spasticity-reducing effects to both baclofen and diazepam. Muscle strength was affected less by tizanidine than by either comparator, and investigators judged tizanidine to have greater tolerability. Within the limits of these comparisons, tizanidine, baclofen, and diazepam were equally effective in decreasing excessive muscle tone in patients with multiple sclerosis or cerebrovascular lesions. Muscle strength improved in all three treatment groups, but improvement was greatest with tizanidine.

Adolescent↗