Search PubMed⌕ Search

Biomedical subjects

M Feely

Publications and source records attributed to M Feely.

At least 55 records · Page 3Linked to original sources
PubMed1986

Doctors' unawareness of the drugs their patients are taking: a major cause of overprescribing?

We studied the accuracy of both hospital and general practitioners' records of current drug treatment in consecutive patients who attended a general medical review clinic. Either the hospital or the general practitioner's records (obtained in a questionnaire), or both, were inaccurate for over 70% of 59 patients interviewed with their medicine. Most of the errors were due to patients taking drugs in addition to those shown in their records. Some of these were inappropriate, and many seemed unnecessary. It appears that neither hospital doctors nor general practitioners are fully aware which drugs their patients are taking, and this may contribute to overprescribing. We believe that considerable financial savings might be made if patients brought all their medicines to every consultation.

Awareness↗
PubMed1986

Tolerance to the anticonvulsant effect of clonazepam in mice: no concurrent change in plasma concentration.

Clonazepam was administered for 10 or more days on three different dose regimens (0.5, 0.25 and 0.08 mg kg-1 twice daily) to mice given pentetrazol by slow intravenous infusion. Plasma concentrations of clonazepam were assayed by high performance liquid chromatography. Tolerance developed to the anticonvulsant effect of clonazepam at all doses but was incomplete and could be overcome by increasing the dose. With the 0.5 and 0.25 mg kg-1 regimens there was no significant change in the drug plasma concentrations during development of tolerance; on the lowest dose, levels were below the limits of accurate detection. Anticonvulsant tolerance does not seem to be the result of a disturbance in clonazepam metabolism.

Animals↗
PubMed1984

Intermittent clobazam for catamenial epilepsy: tolerance avoided.

Clobazam, 20 or 30 mg/day was given for 10 days around menstruation in successive menstrual cycles to 13 women who had responded favourably to this drug in an earlier short-term placebo controlled cross-over study. Three patients have been successfully treated, with complete freedom from seizures around menstruation, for 3-3 1/2 years and two others responded favourably until pregnancy made treatment inappropriate. A further four patients did well during a shorter period (6-13 months) of follow-up. An increase in seizures between periods of clobazam therapy was observed in three patients, and led to the withdrawal of this drug in two of them. However, tolerance to the antiepileptic effect of clobazam was not observed in any patient, even though nine were treated for 1 year or more. In only once case was it necessary to discontinue treatment because of sedative side effects.

Adult↗
PubMed1984

Chondroblastoma of the skull.

A case of chondroblastoma of the temporal bone is reported, and the pathology of the lesion outlined. The rarity of these neoplasms in the skull makes accurate prognosis impossible.

Adult↗
PubMed1984

Antibiotic prophylaxis in neurosurgery. A randomized controlled trial.

A randomized trial was performed to support the contention that prophylactic antibiotics can reduce the incidence of postoperative neurosurgical wound infections. The regime outlined by Malis was followed. Vancomycin and gentamicin were administered systemically just prior to surgery and streptomycin was added to the irrigating solution. Patients were randomly assigned to two groups: control and treated. The infection rate in the control group was 3.5% and in the treated group 0.5%.

Adult↗
PubMed1982

Clobazam in catamenial epilepsy. A model for evaluating anticonvulsants.

The cyclical exacerbations of epilepsy (catamenial epilepsy) were used to assess the antiepileptic effect of a benzodiazepine, clobazam. Doses of 20 mg, and in some cases 30 mg, per day were compared with placebo over predetermined ten-day periods in a double-blind cross-over study. The results were evaluated by preference in a sequential procedure. In 14 of 18 patients who received both treatments clobazam was superior to placebo, and in 4 patients no preference was established. Clobazam completely prevented seizures in most of the patients, and toxic effects were of low frequency and severity.

Acute Disease↗
PubMed1982

Trigeminal evoked potentials in the cat.

Electrical stimulation of the infraorbital nerve in the cat resulted in a series of far-field evoked potentials at the vertex. The wave form of these potentials is similar to the auditory brain stem evoked response and the somatosensory far-field response; it is multicomponent, the amplitudes of individual components are of the order of 1 microV, and the latencies are all less than 4 msec. The anatomical origins of these evoked potentials were investigated. The results indicated that contributions due to the afferent trigeminal nerve, the principal sensory nucleus, and the spinal trigeminal nucleus are involved.

Animals↗
PubMed1982

Aspirin, prostacyclin and post-occlusive reactive hyperaemia in man.

We studied post-occlusive reactive hyperaemia using ecg-triggered mercury strain-gauge plethysmography in eight normal subjects treated with incremental doses of aspirin (27.5-1200 mg). The reactive hyperaemic response was measured in the finger (predominantly skin blood flow) and the calf (predominantly muscle). Concentrations of TXB2 and 6-oxo-PGF1 alpha were measured in venous effluent blood from the hand by RIA, following arterial occlusion. Levels of TXB2 were significantly higher at 0-10 and 60-70 seconds (p less than 0.01), and 90-100 seconds (p less than 0.05) following release of occlusion compared to pre-occlusion values. However there was no significant change in concentrations of 6-oxo-PGF1 alpha and therefore by this method release of prostacyclin during reactive hyperaemia in the hand. Aspirin had no influence on finger or calf reactive hyperaemia 90 minutes after dosing, despite marked inhibition of platelet MDA production (75% after 110 mg, maximal inhibition after 1200 mg). These data provide no support for the hypothesis that prostacyclin is involved in the determination of the post-occlusive reactive hyperaemic response in the finger and calf in man.

6-Ketoprostaglandin F1 alpha↗
PubMed1980

Phenobarbitone in previously untreated epilepsy.

In a prospective study we used phenobarbitone to treat 13 new patients with epilepsy (eight adults and five children). Full seizure control was achieved in 11 patients and poor compliance was documented in one of the remaining two patients (in both of whom seizures were reduced by over 50%). Doses sufficient to give mean steady state plasma levels of more than 43 mumol/l (10 microgram/ml) appeared to be associated with better seizure control than lower doses. No serious side effects were observed.

Adolescent↗
PubMed1978

Carbamazepine as a single drug in the treatment of epilepsy. A prospective study of serum levels and seizure control.

Serum levels and seizure control were investigated in a prospective study when carbamazepine was given as a single drug to 32 patients with a variety of seizures. The patients included 13 previously untreated patients (group 1), and 19 who were unresponsive to other anticonvulsant drugs used in different combinations or as a single treatment (group 2). Thirteen patients (10 from group 1, and three from group 2) became seizure-free, and a greater than 50% reduction in seizure frequency occurred in 10 patients (nine from group 2, and one from group 1). Less than 50% reduction in seizure frequency occurred in five patients from group 2. As a wide range of serum levels was associated with complete freedom from seizures, or a greater than 50% reduction in seizure frequency, it was not possible to define a therapeutic range for carbamazepine. Side effects occurred at the start of treatment or after a dose increase. A wide range of serum levels was associated with side effects, and some patients could not tolerate levels greater than 42 mumol/l.

Adolescent↗
PubMed1977

The effect of anticonvulsant drugs which induce liver microsomal enzymes on derived and ingested phenobarbitone levels.

A comparison was made between the levels of derived Phenobarbitone in three groups of patients who were taking Primidone as a single drug, Primidone with Phenytoin and Primidone in combination with Phenytoin and Carbamazepine. The levels of ingested Phenobarbitone when this drug was taken as a single drug were compared with the levels when Phenobarbitone was taken in combination with Phenytoin in two other groups of patients. A significant increase in derived Phenobarbitone levels occurred when Primidone was used in combination with Phenytoin alone or with Phenytoin and Carbamazepine. The highest level occurred in a group of patients taking the three drug combination. There was no significant difference between the levels of ingested Phenobarbitone when this drug was used as single therapy or in combination with Phenytoin. We suggest that the increase in derived Phenobarbitone levels relates to the effect of Phenytoin on liver enzyme systems, and that the greater increase with triple therapy was related to the combined effect of Carbamazepine and Phenytoin on microsomal enzymes. As there was no increase in ingested Phenobarbitone levels when this drug was taken in combination with Phenytoin, we were unable to confirm previous suggestions that Phenytoin either inhibits the hydroxylation of Phenobarbitone or impairs its renal excretion.

Adolescent↗