Search PubMedSearch

Biomedical subjects

M Jamieson

Publications and source records attributed to M Jamieson.

13 recordsLinked to original sources

Nicardipine sustained release in hypertension.

1. A novel formulation of nicardipine (25% standard, 75% sustained release--SR) was evaluated in mild hypertension in a double-blind, randomized, placebo-controlled comparison with standard nicardipine (STD), using clinic measurements (Hawksley) augmented by home recorded blood pressures (Copal UA 251). 2. At 2 h after dosing (peak effect) both STD nicardipine (30 mg three times daily) and SR nicardipine (60 mg twice daily) for 28 days produced a highly significant reduction in sitting and standing blood pressure. The mean sitting blood pressure was reduced by 20/16 mm Hg (STD) and by 25/18 mm Hg (SR) compared with placebo. 3. Predose (8-11 h after last dose of STD, 12-15 h after last dose of SR) the reductions in sitting blood pressure relative to placebo were 11/6 mm Hg (STD) and 14/7 mm Hg (SR). 4. Home recordings confirmed the hypotensive effect of both formulations. Both exhibited a distinct 'peak dose' effect between 1-3 h after dosing. The effect of the SR formulation was sustained throughout the 12 h dosing interval. 5. Of the 60 patients entering the study, one died of unexplained staphylococcal septicaema, two were withdrawn for non drug-related reasons and 14 (32%) were withdrawn because of adverse effects on active therapy (headaches, facial flushing, leg oedema, chest pain, dizziness). 6. In the 43 patients who completed the study adverse symptoms were reported more frequently while they were on the two active formulations of nicardipine compared with placebo. Most of these reactions were again of vasodilator origin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

The British Hypertension Society protocol for the evaluation of automated and semi-automated blood pressure measuring devices with special reference to ambulatory systems.

With the increasing manufacture of expensive systems for the measurement of ambulatory blood pressure there is a need for potential purchasers to be able to satisfy themselves that the systems have been evaluated according to agreed criteria. The British Hypertension Society has, therefore, drawn up a protocol of requirements for the evaluation of these devices. This protocol incorporates many features of the American National Standard for Non-Automated Sphygmomanometers but includes many additional features, such as strict criteria for observer training, interdevice variability testing before and after a month of ambulatory use, and a new system of analysis which permits the test system to be graded. It is recommended that manufacturers of ambulatory blood pressure measuring devices should obtain an unbiased evaluation according to a recognized standard before a device is marketed.

Blood Pressure Monitors

The Block Nurse Program.

In the Block Nurse Program, existing resources and agencies are used to help keep elderly persons in their own homes with case-management by public health nurses living in the community. In an external evaluation of the program it was documented that a neighborhood long-term care delivery model not only works, but keeps elderly persons in their homes at low cost and with high care standards.

Aged

Toxicities associated with monoclonal antibody infusions in cancer patients.

The toxicity during and following 291 infusions of 19 murine and three human monoclonal antibodies (MoAB) in 177 cancer patients with 10 different malignancies was assessed. Doses ranged from 0.5 to 500 mg administered over 0.25 to 24 hours. Various reactions in varying degrees were observed in 45 (28%) patients during their first MoAb infusion. Nine additional patients experienced toxicity following a subsequent antibody infusion. Antibodies that reacted with circulating cells were associated with toxicity in 20 of 28 (71%) of the first infusions, compared to 24 of 127 (19%) for patients receiving antibodies that did not react with circulating cells. Fevers, rigors, chills, and diaphoresis were observed in 10% to 12% of the patients and were associated with binding to circulating cells. Presumed hypersensitivity reactions, including urticaria, pruritus, bronchospasm, and anaphylaxis occurred in 20 patients (11%). There were five episodes of bronchospasm and a single episode of anaphylaxis. Liver transaminases were elevated in 14%. There was no correlation between dose or infusion rate and toxicity. Murine monoclonal antibodies that are not conjugated to cytotoxic agents can be given with an acceptable frequency of side effects and serious allergic reactions. There is a small risk of anaphylaxis, and one should avoid rapid infusion of high antibody doses in the presence of circulating target cells and/or circulating free antigen.

Animals

Stillbirths and fetal movements.

The unexplained stillbirth is an event distressing to patients, families and medical attendants alike. Many of these deaths can be prevented by the use of fetal movement record cards. In a retrospective study of stillbirths occurring over two consecutive twenty-month periods, the first twenty-month period being prior to, the second subsequent to the introduction of fetal movement record cards on a non-prescriptive basis a significant decrease in perinatal mortality and stillbirth rates was observed. The percentage of patients using fetal movement record cards in the second time period cannot be estimated, but in only one of twenty-seven unexplained stillbirths was the mother using a fetal movement record card. Examination of antenatal records for hospital clinic patients suffering unexplained stillbirths shows that systematic enquiry about fetal activity was absent in the first time period and rare in the second time period.

Female

Ro 31-1118, a new cardioselective beta-adrenoceptor antagonist. Pharmacokinetics and effects on heart rate and blood pressure in mild hypertensives.

Five patients with mild hypertension were given single oral doses of Ro 31-1118 (10,20,40, and 80 mg) and placebo in a randomized, double-blind, within-patient study. Plasma concentrations of Ro 31-1118 and supine, standing, exercise, and post-exercise heart rates and blood pressures were measured before and at regular intervals after drug administration. The pharmacokinetic data were consistent with a one-compartment model with first-order absorption and a variable time lag. Peak plasma concentrations and area under curve were linearly related to dose, whereas time to peak concentration, half-time, clearance and apparent volume of distribution were dose-independent. There was a reduction in exercise and post-exercise heart rate of approximately 10% after 10 mg and 20 mg Ro 31-1118, and of approximately 15% after 40 mg and 80 mg. At all doses standing systolic blood pressure was reduced by approximately 5%. A similar fall was seen in exercise and post-exercise systolic blood pressures. There was no substantial effect of Ro 31-1118 on supine or standing heart rates nor on diastolic blood pressure. No adverse effects were reported. It is concluded that Ro 31-1118 has linear pharmacokinetics over the dose range 10-80 mg, and has a weak antihypertensive effect when administered in single doses to patients with mild hypertension.

Absorption

A comparison of single doses of bucindolol and oxprenolol in hypertensive patients.

Single doses of bucindolol 50, 100 and 200 mg were compared to placebo and single doses of oxprenolol 40, 80 and 160 mg in seven patients with mild hypertension, in a double-blind randomized study. Both bucindolol and oxprenolol inhibited exercise induced tachycardia. The mean maximum inhibition of exercise heart rate was similar after each dose of both drugs (20%, P less than 0.001). Bucindolol produced a significantly greater reduction in blood pressure than either oxprenolol or placebo. This was most apparent in standing systolic and diastolic and post-exercise systolic blood pressures between 1 and 2 h after dosing and was dose-related. All seven patients experienced adverse effects related to hypotension within the first 2 h after ingestion of bucindolol 200 mg. Plasma concentrations of oxprenolol, bucindolol or 5-hydroxy-bucindolol, sampled 2 h after dosing, could not be related to either the changes in blood pressure or to the occurrence of symptoms. The results emphasise the need for careful dose-finding of new drugs prior to their more widespread evaluation in phase 3 studies.

Adrenergic beta-Antagonists

Haematological differences in three population groups.

The increased absolute lymphocyte counts of Indians and Blacks in comparison with Whites, observed in a former study, were shown, in a study on blood donors, to occur in women rather than men of these two groups. Neutrophil counts showed no sex differences, but were significantly highest in Whites and lowest in Blacks. Indians of both sexes had significantly higher mean red cell counts, together with smaller red cells, than subjects in the other two groups. In no group was a significant correlation observed between body mass and haemoglobin level.

Black People

Teaching medical students about epilepsy.

A small study was designed to evaluate three seminars on epilepsy for junior medical students. A self-completion questionnaire on knowledge and attitudes was constructed and administered to case and control students and, as part of a parallel study, to senior medical students, general practitioners, and a sample of patients attending general practice. Students undertaking seminars on epilepsy showed significant improvement in overall knowledge, but not in attitudes. Many students had observed an epileptic seizure before entering medical school, but neither this, nor close acquaintance with persons with epilepsy, appeared to affect their responses. Age appeared to influence knowledge in the sample of general practice attenders, with those aged 30-59 scoring a significantly higher mean score than older and younger subgroups.

Attitude to Health