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Biomedical subjects

R Weiser

Publications and source records attributed to R Weiser.

14 recordsLinked to original sources

Pergolide monotherapy in the treatment of early PD: a randomized, controlled study. Pergolide Monotherapy Study Group.

OBJECTIVE: To determine whether pergolide monotherapy provides symptomatic relief in early PD. BACKGROUND: Early treatment with dopamine agonists may reduce the risk of motor fluctuations, which are most likely linked to levodopa therapy. Pergolide, a D1-D2 dopamine agonist, has been studied as "add on" therapy in PD, but no controlled clinical trial studying the efficacy of pergolide monotherapy is available. METHODS: The efficacy and tolerability of pergolide were evaluated in a multicenter, double-blind, randomized, parallel-group, 3-month trial versus placebo. Patients with a diagnosis of idiopathic PD, a modified Hoehn & Yahr score of 1 to 3, and a score greater than 14 points on the Unified Parkinson's Disease Rating Scale (UPDRS) part III at baseline were enrolled in the study (pergolide, n = 53; placebo, n = 52). RESULTS: Patient characteristics at study entry were comparable in the two study groups. The pergolide group showed a significantly greater percent of responders (defined as a -30% decrease in UPDRS part III score at end point) compared with placebo (57% versus 17%; p < 0.001). Pergolide-treated patients experienced a significantly greater improvement than placebo-treated patients (p < 0.001) in UPDRS (overall, part II, and part III) score, Schwab & England score, and Clinical Global Impression improvement score. By the study end the mean dose of pergolide was 2.06 mg/day. Six patients in the pergolide group versus two patients in the placebo group discontinued the study because of treatment emergent side effects. CONCLUSION: This study suggests that pergolide monotherapy may be an efficacious and well-tolerated first-line treatment in patients with early-stage PD.

Aged↗

Scaphotrapezoid arthritis: prevalence in thumbs undergoing trapezium excision arthroplasty and efficacy of proximal trapezoid excision.

Between June 1995 and May 1998, 37 patients underwent trapezium excision arthroplasty. Preoperative radiographic assessment for scaphotrapezoid arthritis was performed. At the time of surgery intraoperative inspection of the scaphotrapezoid joint allowed calculation of the true prevalence of arthritis as well as sensitivity and specificity of the radiographic diagnosis. The true prevalence of scaphotrapezoid arthritis was 62%. The sensitivity of the radiographic diagnosis was 44% and the specificity was 86%. Comparison of surgical results in 23 patients who underwent both trapezium excision arthroplasty and proximal trapezoid excision, with 14 patients who underwent the former procedure, only showed that there was no morbidity associated with the latter. Because of the potential that scaphotrapezoid arthritis may cause residual symptoms following trapezium excision arthroplasty, and in light of the low sensitivity of radiographs, routine intraoperative assessment of the joint is recommended so that proximal trapezoid excision can be performed if degenerative change is present.

Adult↗

Dystonic storms: a practical management problem.

On rare occasions, torsion dystonia can rapidly worsen and produce life-threatening symptoms. We present reports on two children who had generalized dystonia and who demonstrate the management difficulties of "dystonic storms."

Child↗

Moebius syndrome, peripheral neuropathy and hypogonadotrophic hypogonadism.

The association of congenital ophthalmoplegia and facial paresis (Moebius syndrome) with a variety of other developmental somatic defects has been widely recognised. Its co-existence with hypogonadism of hypothalamic/pituitary origin and subclinical peripheral neuropathy has been reported and in this paper we describe the second case of the Moebius syndrome in association with hypogonadotrophic hypogonadism and a progressive peripheral neuropathy of mixed axonal and demyelinating type.

Adolescent↗

Localised nodular myositis: a clinical and pathological variant of polymyositis.

Three cases of a painful, inflammatory, nodular myopathy in young and middle-aged adult males are described. In two of the cases the nodular process gradually evolved into a diffuse proximal myopathy accompanied by dysphagia, and manifesting the so-called "facioscapulohumeral syndrome". The electromyogram (EMG) in all three cases was "myopathic" in type and in two cases abnormalities consistent with an inflammatory muscle disorder were seen. Muscle biopsy revealed a consistent pattern of intense, predominantly interstitial, pleomorphic infiltration of muscle with scattered foci of muscle fibre destruction and regeneration, which resembled muscle infarcts. It is suggested that this syndrome, whilst readily recognizable from both the clinical and pathological standpoints, is not a nosological entity in its own right but rather an unusual presentation of polymyositis.

Adult↗