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Biomedical subjects

R Bird

Publications and source records attributed to R Bird.

At least 37 records · Page 2Linked to original sources
PubMed1990

Lisinopril and enalapril in hypertension: a comparative study using ambulatory monitoring.

Detecting differences in the effect of two antihypertensive agents is bedevilled by the inherent variability of blood pressure itself. Using an ambulatory blood pressure monitoring technique, we compared, in a cross-over design study, the effects of four weeks' treatment with enalapril, 10 mg once daily, to lisinopril, 10 mg once daily, on the blood pressure of 19 patients with mild to moderate hypertension. A significant reduction in blood pressure was shown by both drugs. However, lisinopril produced a greater fall in mean 24 hour systolic pressure than did enalapril (difference; 5.94 (C.I. -0.77 to -11.1) mmHg, P = 0.027). The difference of 3.3 mmHg (C.I. +0.54 to -7.10) in diastolic pressure between the two agents, though in the same direction, was not significant. Plasma renin activity did not predict the responses to either agent. Studying the prevailing information for these two drugs one might expect there to be little difference between them when administered once daily in terms of antihypertensive effect. The explanation for the superiority of lisinopril may lie in the slightly longer pharmacokinetic half-life and possibly in differences in tissue distribution or persistence. The side effects of both drugs were mild and of similar frequency to those recorded during placebo treatment, illustrating the generally well tolerated nature of this class of antihypertensive therapy. The use of ambulatory blood pressure monitoring provides a method that can detect small, but possibly important differences between drugs. In the clinical setting it allows a more thorough assessment of a particular patient's response to therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Serum angiotensin converting enzyme in sarcoidosis--its value in present clinical practice.

Angiotensin converting enzyme (ACE) has a central role in blood pressure homeostasis. It is present in low and fairly constant concentration in the serum and in high concentration in the pulmonary capillary bed. Unusually high serum angiotensin converting enzyme (SACE) activity is present in active sarcoidosis, an observation now confirmed by many investigators. In spite of its lack of specificity as a test for sarcoidosis, SACE provides a good monitor of disease activity which clinicians find useful in the management of patients with sarcoidosis. There continues to be considerable interest in SACE in sarcoidosis and with the recent development of simpler assays, more centres may be expected to offer SACE measurements as a service. In this paper we discuss the indications for estimating SACE in sarcoidosis and its relevance to current clinical practice.

Humans↗
PubMed1988

Expression of CEA, CA125, CA19-9 and human milk fat globule membrane antigen in ovarian tumours.

The expression of five different antigens in ovarian tumours was studied by means of an immunohistochemical test with anti-CEA, HMFG1 and HMFG2, NS19-9 and OC125 antibodies. Considerable variation was noted not only between different histological types and between tumours of one type but also between areas in a single tumour. HMFG1 and HMFG2 were the most reactive of all the antibodies; NS19-9 and OC125 were expressed by different populations of cells. It is concluded that specific combinations of antibodies are more effective both for the monitoring of ovarian cancer as well as for immunodiagnosis and treatment, than any single one used.

Adenocarcinoma↗
PubMed1985

Tumors of the central nervous system studied by computed tomography and ultrasound.

Intraoperative ultrasound (US) was compared to computed tomography (CT) in 41 intracranial and 6 spinal cord tumors. The studies correlated closely except for primary gliomas. Eight of the 22 primary intracranial gliomas (37%), including 1 low-grade and 7 anaplastic tumors, were larger and more extensive on US than on CT. Margins of non-enhanced primary astrocytomas were shown by US but not CT. Four anaplastic tumors (19%) exhibited echogenicity extending beyond the enhanced area. In 4 patients an enhanced lesion contained a lucent center which proved to be echogenic. Low-grade astrocytomas were relatively homogeneous on US, while anaplastic astrocytomas were more inhomogeneous. Cysts could be found in both types of astrocytomas and were often small and multiple. The echo pattern was not helpful in differentiating metastases from primary tumors, although all of them had sharp margins. Sonography of the central nervous system can provide valuable information about tumor morphology and margins.

Astrocytoma↗
PubMed1983

Angiotensin-converting enzyme and its clinical significance--a review.

There have been considerable advances in understanding the metabolic role of the endothelial lining cells of the blood vessels. Angiotensin-converting enzyme activity is concentrated in these cells, especially those lining the pulmonary circulation. The enzyme exerts control over systemic vascular tone indirectly through the powerful pressor effect of angiotensin II. A number of therapeutic agents are now available which directly inhibit converting enzyme activity and thereby effect a reduction in blood pressure. Macrophages are the source of increased angiotensin-converting enzyme activity commonly found in association with active sarcoidosis. A better understanding of this phenomenon may give fresh insight into this puzzling condition. Pulmonary endothelial metabolism is affected by lung injury and it is likely that in this situation changing activities of serum angiotensin converting enzyme may indicate the extent of damage and the response to therapy. The full clinical significance of serum ACE measurements has yet to be established. However, raised activities have been reported in a number of other conditions and diabetes mellitus and hyperthyroidism are of particular current interest. The numerous methods and reference ranges described in the literature for the measurement of serum ACE activity require further assessment, and there is a clear need for an accepted reference method.

Adolescent↗
PubMed1982

Radiobiological studies with therapeutic neutron beams generated by p+ leads to Be or d+ leads to Be.

Mammalian cells cultured in vitro were used to study the radiobiological characteristics of neutron beams generated by 43 MeV protons on beryllium or 25 MeV deutrons on beryllium. For an unfiltered beam of neutrons generated by 43 MeV p+ leads to Be the relative biological effectiveness was found to be 8-12% higher at a depth of 2 cm than at a depth of 12 cm due to the presence of a large component of low-energy neutrons. The addition of a hydrogenous filter 4 cm thick preferentially removed the low-energy neutrons from the beam and, as a result, the neutron RBE was independent of depth. There was no significant difference in the oxygen enhancement ratio between the filtered neutrons produced by 43 Mev p+ leads to Be and neutrons produced by 25 MeV d+ leads to Be; for both beams the OER value was about 1.6.

Animals↗
PubMed1981

A comparison of free thyroxine concentration and the free thyroxine index as diagnostic tests of thyroid function.

Serum free thyroxine concentrations, measured by the Immo Phase kit, and free thyroxine index values were compared in 200 subjects classified according to age, sex, and clinical diagnosis. The free thyroxine concentration was as good as the free thyroxine index in hyperthyroid, hypothyroid, elderly, and acutely ill patients and a better diagnostic index of thyroid status in pregnancy and in oral contraception.

Acute Disease↗
PubMed1981

Osteogenic sarcoma of the mandible.

Osteogenic sarcoma of the mandible is a rare tumor and exhibits differences in age of onset, symptomatology, radiological appearance, and prognosis when compared to similar tumors in other location. While the prospects for cure remain poor, aggressive therapy can result in higher survival rates than are achieved for tumors in other sites. Seven cases of mandibular osteogenic sarcoma are presented and aspects of diagnosis and treatment are discussed.

Adult↗
PubMed1980

Micro-organisms in outpatient infantile gastroenteritis.

This study reports the results of an examination of the stools of 58 infants with gastroenteritis who were seen as outpatients. The stools were examined by routine bacterial culture, and by electron microscopy for virus particles. The stools of a comparable control group of infants who had no gastrointestinal symptoms were also similarly examined. Enteropathogenic Escherichia coli, Salmonella sp., and rotaviruses, as well as other viruses, particularly adenoviruses and coronaviruses, were isolated.

Acute Disease↗
PubMed1980

Biochemical findings in sarcoidosis.

The majority of patients with sarcoidosis in this large series have had a number of biochemical investigations performed. Abnormal calcium metabolism was demonstrated in 40% of the patients but permanent renal damage due to nephrocalcinosis as a result of persistent derangement of calcium metabolism was rare. Raised immunoglobulin levels were seen. Half the white and two-thirds of the West Indian patients had elevated IgG levels. Abnormal immunoglobulin levels carried no obvious diagnostic or prognostic significance. Raised alkaline phosphatase levels reflected space-occupying hepatic granulomas and occurred in 23% of patients. Serum angiotensin converting enzyme (SACE) was elevated in half the patients. The highest SACE activity was found in patients with severe parenchymal lung infiltration due to sarcoidosis, and the lowest levels in those with inactive disease or after successful management with steroid drugs. SACE levels were not significantly elevated in four other granulomatous conditions: Crohn's disease, primary biliary cirrhosis, Hodgkin's disease, and active tuberculosis.

Adult↗
PubMed1979

Optimal timing of doses of chenic acid in patients with gall stones.

Sixteen patients with gall stones were treated with chenic acid (14-16 mg/kg/day) given at three different times in random order for one month each. Before treatment the mean (+/- SE of mean) cholesterol saturation index (SI) of fasting gall-bladder bile was 1.28 +/- 0.06. During bedtime administration of chenic acid the mean SI fell to 0.78 +/- 0.04, which was significantly lower than that obtained with administration in the morning (0.92 +/- 0.05) or with three divided doses at mealtimes (0.92 +/- 0.04). The bile remained supersaturated in seven patients when they received a single morning dose, in five patients when they received mealtime doses, but in only one patient when a single bedtime dose was given. There was no significant difference in side effects between the three different dose timings, or in the proportion of bile acids present in the bile as chenic acid. This enhanced effect obtained with bedtime administration may be due to the enterohepatic circulation of bile acids being maintained during overnight fasting.

Adult↗