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Biomedical subjects

P Pitt

Publications and source records attributed to P Pitt.

At least 37 records · Page 2Linked to original sources
PubMed1986

Metabolic activity of erosions in rheumatoid arthritis.

The hands of 10 patients with rheumatoid arthritis were investigated with diphosphonate scanning and radiology. Increased uptake of isotope can be associated with some erosions but not all and also reflects other processes more linked to acute inflammatory areas unassociated with the development of erosions. If the latter are the hallmark of active rheumatoid arthritis then bone scans are not.

Adult↗
PubMed1986

Biochemical basis for the antagonism between aminoglutethimide and danazol in the endocrine treatment of breast cancer.

Only 13% of postmenopausal advanced breast cancer patients responded to endocrine treatment with aminoglutethimide plus danazol whilst 33% responded to aminoglutethimide alone, despite a similar suppression of serum oestradiol levels in the two groups. The patients on aminoglutethimide and danazol showed a marked suppression of sex hormone binding-globulin binding capacity and a consequent rise in percent-free oestradiol. This led to the concentration of free oestradiol being less well suppressed than that of total oestradiol and in some patients free oestradiol concentrations were higher on treatment than before. Patients on aminoglutethimide alone showed no change in the binding of oestradiol and the percentage suppression of the free oestradiol concentration was similar to that of total oestradiol. The opposing effects of danazol and aminoglutethimide on the concentration of the free, biologically active fraction of oestradiol in the circulation may explain the poor therapeutic efficacy of this combination in breast cancer patients.

Aminoglutethimide↗
PubMed1986

Remedial surgery for the adolescent with cerebral palsy: a 10-year survey of the numbers, types and results of operations on pupils at the Thomas De La Rue School, Tonbridge, Kent.

The Thomas De La Rue School caters for adolescents with cerebral palsy, many being severely disabled. Over the 10-year period (1967-77) out of a total of 355 pupils, 97 underwent surgery, a total of 147 operations, 145 orthopaedic, being performed, the majority on the lower limbs. The pupils involved, their parents, teachers and house-parents were invited to complete a questionnaire concerning the effectiveness of the operations, the anxieties and psychological problems resulting from surgery, and the effect on schooling. The results are discussed.

Adolescent↗
PubMed1985

Treatment of advanced prostatic cancer, resistant to conventional therapy, with aminoglutethimide.

Fifty-eight patients with advanced, progressing prostatic cancer resistant to conventional therapy have been assessed for their response to treatment with aminoglutethimide (A/G). Eleven men (19%) had objective regression of their disease while in a further eight (14%) progression of the disease was arrested. Median survival in the objective remitters (15 months) and in the group in whom stabilization of disease occurred (9.3 months) was significantly longer than in the non-remitting patients (4.7 months). The drug was well tolerated and no serious side-effects occurred. A/G appears to be a useful treatment in patients with advanced prostatic cancer resistant to conventional therapy.

Aged↗
PubMed1985

Low-dose aminoglutethimide without steroid replacement in the treatment of postmenopausal women with advanced breast cancer.

Fifty-seven patients with actively progressing advanced breast cancer have been assessed for their response to low-dose aminoglutethimide (125 mg bd) without steroid replacement. Eleven women (19%) had an objective response while a further eight had stabilization of disease. However, one patient died with apparent adrenal insufficiency and another developed low plasma cortisol and serum sodium. Furthermore, 4/17 patients who had failed to respond to low-dose A/G subsequently responded when changed to conventional-dose A/G + steroid replacement, while three patients had stabilization of previously progressing disease. These results indicate that low-dose A/G without steroid replacement is potentially hazardous and that low-dose and conventional-dose A/G + steroids do not produce identical results.

Adult↗
PubMed1985

Antagonism of aminoglutethimide and danazol in the suppression of serum free oestradiol in breast cancer patients.

The response rate of advanced postmenopausal breast cancer patients to treatment with aminoglutethimide (AG) + danazol was significantly worse than that with AG alone. The suppression of serum oestradiol levels by AG + danazol was similar to that by AG alone, but the combination treatment also suppressed sex hormone binding globulin (SHBG) levels and increased the % free oestradiol, whilst these parameters were unaffected by AG alone. The degree of suppression by AG + danazol of free oestradiol concentrations was less than the suppression of total oestradiol level and in some patients the concentration of the free fraction was increased above pretreatment levels. These effects on the presumed biologically active unbound fraction of oestradiol may explain the poor clinical response rate to AG + danazol.

Aminoglutethimide↗
PubMed1983

Sarcoid dactylitis.

Dactylitis is a rare rheumatological complication of sarcoidosis. It may be accompanied by underlying bone changes, and management is often difficult. We report these 4 cases of dactylitis in which there have been significant bone changes and associated management problems. One case is further complicated by biopsy-proved sarcoid synovitis, uncommon in a British resident, and 2 cases show destructive bone changes, which have rarely been reported in sarcoidosis.

Adult↗
PubMed1982

Lymphocyte studies in a patient with neurological complications of Behçet's syndrome.

We rapport here a case of Behcet's disease presenting with neurological complications who made a remarkable recovery to high dose steroids and azathioprine. Prior to initiation of steroid therapy the percentage of T lymphocytes (OKT3) was low, that of helper T lymphocytes (OKT4) was normal and suppressor T lymphocytes (OKT8) was slightly increased. The OKT4: OKT8 ratio was slightly reduced and the percentage of B lymphocytes was high. With steroid therapy there was an increase in the percentage of OKT3 and fall in the percentages of OKT4 and OKT8 and the OKT4: OKT8 ratio was maintained fairly normal. The percentage of B lymphocytes was reduced. On addition of azathioprine the percentage of OKT3 and OKT8 were substantially increased and the percentage of OKT4 was slightly increased. The net result was a significant reduction in the OKT4: OKT8 ratio. The percentage of B lymphocytes remained normal. On reviewing the absolute counts there was a paradoxical rise in OKT4 and OKT8 a week after high dose steroid therapy due to a substantial rise in the total number of lymphocytes. On reducing the dose of steroids the absolute count of OKT4 and OKT8 decreased in parallel with their percentages. A disparity was noted in the percentage of OKT3 and the sum of the percentages of OKT4 and OKT8, prior to commencement of therapy which was significantly reduced after treatment. It is likely that this disparity is due to the presence of doubly labelled cells (cortical thymocytes) released into circulation prematurely.

Azathioprine↗
PubMed1982

Aminoglutethimide in tamoxifen-resistant patients: The Melbourne Experience.

A group of 160 women with actively progressing metastatic breast cancer were treated with aminoglutethimide to induce medical adrenalectomy. The degree of adrenal suppression was monitored by measurement of dehydroepiandrosterone sulfate levels, and classification of response was carried out according to UICC criteria by two observers. Assessment of response is available for 136 patients, and of these 50 (36.7%) had an objective remission. In an additional 10 patients, the disease became static. Mean remission duration is 12.5 months (range, 4 to 30). Forty-one patients had previously remitted to tamoxifen and then relapsed, and of these 22 (53.6%) experienced another remission with aminoglutethimide. Fifty patients had failed to respond to tamoxifen, and of these 16 (32%) had a remission with aminoglutethimide. In the 20 patients who did not receive tamoxifen and in the 25 whose response to it could not be classified, the remission rates to aminoglutethimide were 25 and 28%, respectively. The high remission rate to medical adrenalectomy in patients who have previously responded to tamoxifen makes it the treatment of choice in tamoxifen-responsive patients.

Adrenal Glands↗
PubMed1981

Medical adrenalectomy with aminoglutethimide in the management of advanced breast cancer.

Sixty-five patients with actively progressing advanced breast cancer were treated with aminoglutethimide, a drug which inhibits adrenal steroid synthesis and decreases peripheral conversion of androgens to oestrogens. Of the 38 patients who have so far been classified, 13 (34%) have experienced objective regression of their disease, while in a further six patients (16%) the disease has become static. The median duration of the objective remission was in excess of 14 months, while in the group with static disease, the median duration of the static condition was longer than eight months. Side effects were either nonexistent or mild in the majority of cases, and the drug was well tolerated. Aminoglutethimide is an important new modality in the treatment of advanced breast cancer.

Adrenal Glands↗
PubMed1981

Medical adrenalectomy in patients with advanced breast cancer resistant to anti-oestrogen treatment.

Fifty-three women with actively progressing advanced breast cancer, who had all previously received tamoxifen, were treated with aminoglutethimide to induce medical adrenalectomy. Sixty-nine percent of the patients who had previously responded to tamoxifen subsequently responded to aminoglutethimide, while thirty-five percent of the nonresponders to tamoxifen subsequently responded to aminoglutethimide. The median duration of remission to aminoglutethimide was 12 months with a range from 4 to 22 + months. The drug was well tolerated and would appear to be the treatment of choice in tamoxifen responsive cases of advanced breast cancer.

Adrenalectomy↗
PubMed1980

Studies on breath methane: the effect of ethnic origins and lactulose.

The prevalence of methane production in an adult population of 256 subjects was 41%, but it was significantly higher in females (49%), than males (33%). When the population was subdivided into ethnic groups. Caucasians (48%) and Black (45%) had significantly more methane producers than Orientals (24%) and Indians (32%). when the ethnic groups were analysed by sex, female Caucasians had the highers prevalence (58%), significantly more than Caucasian males, Oriental males, and females and Indian males. In contrast with previous studies, a single dose of lactulose was found to significantly increase breath methane concentrations in six out of 12 methane producers, but not in 25 non-methane producers from the population study. In conclusion, any studies on breath methane must take into consideration the ethnic origin of the subjects and, contrary to previous advice, substrate intake, especially undigestible carbohydrates. Furthermore, a single breath sample may miss up to one-fifth of methane producers.

Adult↗