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Biomedical subjects

N Quinn

Publications and source records attributed to N Quinn.

At least 127 records · Page 7Linked to original sources

A double blind trial of sulpiride in Huntington's disease and tardive dyskinesia.

Eleven patients with Huntington's disease and nine patients with tardive dyskinesia participated in a randomised double-blind crossover trial of sulpiride (as sole antidopaminergic therapy) versus placebo. Although functional improvement was not seen in Huntington's disease patients, sulpiride reduced movement count and total dyskinesia score in both conditions. Sulpiride differs pharmacologically in several respects from conventional neuroleptics, and has not been convincingly shown to cause tardive dyskinesia. Among currently available treatments, it may therefore be considered a drug of choice for treatment of tardive dyskinesia.

Adult↗

Control of on/off phenomenon by continuous intravenous infusion of levodopa.

In 10 parkinsonian patients with severe, chaotic clinical response fluctuations, oral levodopa treatment was replaced by continuous intravenous infusion of levodopa (with orally administered benserazide). Four patients were also given levodopa infusions in addition to their usual oral treatment. All patients remained continuously mobile and ambulant during the infusions. Side effects were minimal, except in two patients with diphasic dyskinesias whose abnormal movements were consistently suppressed by a further increase in the rate of levodopa administration, only to return after an interval. If a soluble nonacidic dopamine replacement drug can be developed for continuous subcutaneous infusion, "brittle" parkinsonians may be chronically controlled by portable, minipump technology.

Administration, Oral↗

Health hazards of operating video display terminals.

Today, millions of employees work on video display terminals (VDTs) and their numbers are growing. Concern over the health effects of operating VDTs is also growing as the hazards of working on these terminals are identified. This article discusses four major hazards associated with VDTs. Solutions to control these hazards and decrease employee symptoms are offered. Utilizing a theoretical framework of stress and stress reduction, solutions are presented, based on the multi-disciplined background of the occupational health nurse practitioner.

Data Display↗

Complicated response fluctuations in Parkinson's disease: response to intravenous infusion of levodopa.

The cause(s) of response fluctuations in patients with Parkinson's disease treated chronically with levodopa is unknown. In some subjects it is difficult to establish a clear relation between levodopa dosage and timing and the resultant clinical effects. This may be due to variation in the degree of absorption of the drug, and in the latency from ingestion to peak plasma level and from plasma peak to central action. In one patient illustrated, careful analysis of "on-off" charts reveals an underlying pattern of end-of-dose deterioration at a time when history alone suggested a completely random response to levodopa. In three patients replacement of oral treatment by continuous intravenous infusion of levodopa, with oral administration of decarboxylase inhibitor, produced a prolonged and stable clinical response, even when ambulant. This response was maintained not only in one subject showing predictable fluctuations, but also in two subjects with unpredictable response to oral treatment. The addition of intravenous levodopa infusion to the usual oral regimen of the first patient when she was experiencing prolonged "off" periods despite generous doses of oral levodopa with decarboxylase inhibitor also produced stable clinical benefit. These results suggest that, even in patients with complicated response swings, central dopamine receptors remain available for stimulation providing levodopa can be delivered at a constant rate and in an adequate quantity to the brain.

Administration, Oral↗

Pergolide in late-stage Parkinson disease.

Twenty-six patients with late-stage Parkinson disease were given 0.4 to 15 mg of pergolide mesylate daily in addition to, or as replacement for, levodopa or bromocriptine therapy. Despite treatment with individually determined optimum doses of levodopa, bromocriptine, and anticholinergics, they had shown response failure or fluctuating response. Forty percent (11 patients) were unable to tolerate pergolide. Nausea and vomiting, somnolence, and psychiatric disturbances were the most frequent side effects. Eleven of the remaining patients improved on pergolide, 2 were unchanged, and 2 were slightly worse. Among the patients who benefited, pergolide improved dose-related response fluctuations more than non-dose-related fluctuations, with a reduction in number and duration of "off" periods and improvement in quality of sleep and early morning akinesia but little change in freezing episodes. Despite treatment failure in many cases, pergolide is at present the best available drug for specific late-stage management problems.

Bromocriptine↗

Concentrations of GABA and other amino acids in CSF from torsion dystonia patients.

Free amino acid concentrations were measured by conventional amino acid analysis, and gamma-aminobutyric acid (GABA) concentrations were determined, by an ion-exchange fluorometric technique, in CSF specimens from 16 patients with torsion dystonias and in CSF from a large number of control subjects. The mean CSF GABA concentration of the dystonia patients (97 +/- 11 nmol/L) did not differ significantly from the means for CSF GABA in two groups of adult control subjects. Mean concentrations of all commonly determined amino compounds were normal in the CSF of torsion dystonia patients, except for ornithine, which was modestly but significantly reduced.

Adolescent↗

Bromocriptine in Parkinson's disease: a study of cardiovascular effects.

Blood pressure and pulse rate were studied in 20 Parkinsonian patients on no treatment, and during treatment with bromocriptine (mean dosage 148 mg/day) as the sole anti-Parkinsonian therapy. The drug was shown to reduce erect systolic and diastolic and supine systolic blood pressure and to increase erect pulse rate, in a predictable dose-dependent manner. The occurrence of episodes of significant postural hypotension was less predictable and was a transitory phenomenon in all patients. Peripheral dopamine receptor blockade with domperidone did not alter the findings, suggesting that the principal mechanism for these cardiovascular effects is a central dopaminergic one.

Benzimidazoles↗

Bromocriptine and domperidone in the treatment of Parkinson disease.

In a single-blind trial of therapy in 20 patients with idiopathic Parkinson disease, domperidone prevented nausea and vomiting induced by bromocriptine without diminishing beneficial central effects. Combination of the two drugs permitted rapid increase in bromocriptine dosage from 22.5 mg per day to 148 mg per day, with 71% mean clinical improvement over baseline score; continuing efficacy of the regimen was evident for a mean follow-up of 2 months.

Benzimidazoles↗