Biomedical subjects
Publications and source records attributed to R Grahame.
Feprazone, a new anti-inflammatory drug, is a useful antirheumatic preparation which causes little gastrointestinal upset. This short cross-over study shows no significant gastrointestinal blood loss with either feprazone or phenylbutazone by the red-cell chromium-51 labelling method.
Sulindac (400 mg/day) has been compared with ibuprofen (1200 mg/day) in 40 patients with osteoarthrosis of the hip, over an eight-week period, in a double-blind controlled clinical trial. The two drugs were comparable in terms of patient preference, effects on hip movements, and toxicity. Sulindac showed superior analgesic properties to ibuprofen, resulting in a significantly greater reduction in pain on weight-bearing and with passive movements (P less than 0.01).
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Ketoprofen has, over the last few years, undergone extensive clinical trials in many centres throughout the world and these are reviewed. Adequately controlled trials have established its undoubted clinical efficacy as an antirheumatic agent in all the major rheumatic diseases, and have demonstrated therapeutic potency, comparable with other established non-steroidal anti-inflammatory analgesic drugs.
Inhibition of dermal activity by cortisol in culture was partially reversed by two naturally occurring androgens, testosterone and dihydrotestosterone. ACTH and the androgen precursor dehydroepiandrosterone sulphate showed not such antagonistic effect. These results suggest that increased production of adrenal androgens during ACTH therapy may account for the relative absnece of 'skin-thinning' and 'steroid-bruising' which are common side-effects of corticosteroid therapy.
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In this retrospective study of 57 patients with primary hyperparathyroidism who underwent parathyroidectomy, the overall incidence of chondrocalcinosis was 40%. Neither joint symptoms nor chondrocalcinosis regressed after the operation. In several patients the condition appeared to deteriorate both clinically and radiologically after the operation, while in a few both the chondrocalcinosis and the associated symptoms first appeared some time after the operation.
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Ketoprofen (100 mg/day) and indomethacin (100 mg/day) were compared in a double-blind cross-over trial of four weeks duration in 46 patients with rheumatoid arthritis. The drugs were equally effective in all parameters measured, apart from the paracetamol (rescue drug) tablet count which favoured indomethacin. In a similarly designed study the same dosages of the two drugs were compared in 44 patients with osteoarthrosis of the hip. No significant differences occured between the two groups. A further double-blind cross-over study of 4 weeks duration compared 200 mg ketoprofen/day and 300 mg phenylbutazone/day in 47 patients with osteoarthrosis of the hip. No significant differences occured between the two drugs. In all three studies, side-effects with ketoprofen were infrequent and mild. Biological monitoring throughout revealed no abnormality. These studies have shown ketoprofen to be an effective anti-inflammatory for the treatment of rheumatoid arthritis and osteoarthrosis of the hip with an efficacy comparable to those of indomethacin and phenylbutazone.
The telemetered electromyographic (EMG) activity of quadriceps, hamstrings, triceps surae and pretibial muscles on the affected side of 20 adult hemiplegic subjects was examined during locomotion. The subjects ranged in age from 29 to 68 years (mean, 52.1). Duration of the lesions ranged from 1 month to 8 years: in 11 subjects the duration of the lesions ranged from 1 to 9 months (mean, 4.9 months), and in the remaining 9 subjects from 1 to 8 years (mean, 4 years 2 months). Shoes with five microswitches, two in the heel and three in the sole, were used to correlate the EMG activity with eight specific components of the gait cycle. The results of the study showed a loss of the phasic pattern associated with normal locomotion. The hemiplegic subjects showed the greatest activity in the period of midstance. Expressed as a percentage of the total cycle, the mean stance time of the paretic lower limb was 67% and the mean swing time was 33%. The unaffected lower limb showed a stance phase of 80% and a swing phase of 20%.
In this study the value of undertaking routine blood and urine estimations was assessed in relation to achieving maximum efficacy and safety in chrysotherapy. It was found that a favourable response to gold was forthcoming in approximately two-thirds of patients and occurred irrespective of the patients' disease duration or severity, or the mean serum gold level or the mean urinary gold excretion, estimated immediately before the next gold injection was due. The presence of rheumatoid nodules and the patients' advancing age were associated with a less favourable clinical response to gold. Those patients who derived a marked benefit from chrysotherapy did so significantly earlier in their course than those who derived only moderate benefit. A frequent correlation was seen in individual patients between serum gold levels and urinary gold excretion. This was most marked in those patients showing a favourable response to gold.
The study concerns the clinical, haematological, serological, radiological and histocompatibility antigenic status of eleven in-patients suffering from long-standing sero-positive rheumatoid arthritis at the Royal Hospital and Home for Incurables in London. The study revealed a striking degree of widespread bony ankylosis affecting the peripheral joints and cervical spine. In large part, this bony ankylosis accounted for the disability but it is considered that the cervical spine ankylosis may protect the spinal cord from damage. The absence of the histocompatability antigen HLA 27 is a useful pointer in the exclusion of Ankylosing Spondylitis. Despite the clinical impression that the disease was inactive, the elevated sedimentation rate (23-66, mean 41 mm) suggests that the rheumatoid process remains active.
A double-blind cross-over trial of Prenazone 600 mg and Aspirin 4 g daily was carried out on 20 patients suffering with rheumatoid arthritis. The analgesic and anti-inflammmatory activity was indistinguishable from that of aspirin under the conditions of the trail. Twelve patients expressed a general preference for Prenazone and six for aspirin. Prenazone appeared to be well tolerated and free from serious side-effects. These results suggest that it will be a useful drug in the management of rheumatoid arthritis.
The results are recorded of a number of studies performed over the last few years using a simple and reproducible method for investigating the extensibility of intact skin. A major advantage of this method lies in the fact that it causes the patient no discomfort and leaves his skin without blemish. We have found abnormal behaviour of skin in response to applied stress in the heritable connective tissue disorders: Ehlers-Danlos Syndrome, cutis laxa, and pseudoxanthoma elasticum, and in the acquired disorders of acromegaly, hypopituitarism and scleroderma. An abnormal elastic modulus, however, was found only in pseudoxanthoma elasticum and the growth-hormone disorders.
Ninety-three patients with lumbar disc prolapse of less than six months duration were treated with Chymoral or an identical placebo in a double-blind study. Those patients given Chymoral exhibited significantly greater improvement of straight-leg raising and received significantly fewer analgesics. However, no difference was apparent with regard to other parameters, and similar numbers from both groups required further therapy. Over-all, the value of Chymoral in the treatment of lumbar disc prolapse seemed little better than a placebo.
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