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Biomedical subjects

S M Gore

Publications and source records attributed to S M Gore.

At least 163 records · Page 9Linked to original sources
PubMed1986

Beneficial HLA matching in centers using cyclosporine A.

In this chapter the linear model for the relationship between cumulative HLA mismatches and graft loss is shown to be invalid. HLA-A and -B mismatches and HLA-DR mismatches appear to differ in potency. A single mismatch at the HLA-DR locus is associated with a maximum risk of graft loss. These findings permit a simple division of transplants into beneficially matched (000, 100, and 010) and nonbeneficially matched (all other 23 combinations). In centers where more than two-thirds of patients were treated with CsA at three months, a similar dichotomy between beneficially and nonbeneficially matched transplants was observed, confirming the view that CsA-treated patients benefit from good HLA-A,B and DR matching. Organ-sharing schemes are designed to realize the full potential of matching and their potential can be investigated by simulation studies. These indicate that if all organs were unconditionally offered to a multicenter pool of more than 3,000 recipients, more than 60% of transplants could be beneficially matched.

Cyclosporins↗
PubMed1985

Ocular hypotensive effect of late pregnancy with and without high blood pressure.

The mean ocular tension of third trimester hypertensive pregnant women did not differ significantly from that of third trimester non-hypertensives, in contrast to the tendency for open-angle glaucoma to be associated with vascular hypertension. Presumably there are different causes for the two types of vascular hypertension. The ocular hypotensive effect of late pregnancy (third trimester) was confirmed.

Adolescent↗
PubMed1985

Ocular fluid dynamics response to topical RU486, a steroid blocker.

A steroid antagonist applied to one eye of 18 young pigmented rabbits during a 10-week period caused a statistically significant fall in IOP, but no statistically significant nor clinically relevant change in the rate of aqueous humor turnover. The pressure change is therefore ascribed to an alteration in outflow channels. No changes occurred in a parallel group of 5 animals in which one eye was treated with vehicle and the contralateral eye was untreated. The drug effects became evident after two weeks of application, suggesting that a slow turnover pathway is involved.

Administration, Topical↗
PubMed1984

Zelen randomisation.

Explore the source record for details and available documents.

Clinical Trials as Topic↗
PubMed1984

Eye drops of RU 486-6, a peripheral steroid blocker, lower intraocular pressure in rabbits.

A peripheral corticosteroid blocker RU 486-6, instilled as a 1% suspension at random into one eye of 12 rabbits, produced a consistent fall in intraocular pressure as measured by a hand-held applanation tonometer, when compared with the fellow control eye. This or a similar drug may be applicable for treatment of human open-angle glaucoma, or ocular hypertension, by eliminating that part of ocular tension attributable to the effect on aqueous outflow of the normal and fluctuating level of tissue corticosteroids.

Animals↗
PubMed1984

Multicentre trial on feeding low birthweight infants: effects of diet on early growth.

A large multicentre study on the short and long term clinical and developmental outcome of infants randomised to different diets is being undertaken. This report represents an interim analysis of the early postnatal growth performance of an unselected population of 194 preterm infants (gestation, mean (SD) 31 . 0 (2 . 9) weeks; birthweight, mean (SD) 1364 (294) g), both ill and well, examined in two (of four) parallel trials. One trial compared banked breast milk with a new preterm formula (primary trial); the other compared these diets as supplements to maternal milk (supplement trial). A major dietary effect on the number of days taken to regain birthweight and subsequent gains in weight, length, and head circumference was observed in the primary trial. Infants fed banked breast milk and weighing less than 1200 g at birth took a calculated additional three weeks to reach 2000 g compared with those fed on the preterm formula. A significant influence of diet on body proportions was seen in the relation between body weight, head circumference, and length. Similar though smaller differences in growth patterns were seen in the supplement trial. By the time they reach 2000 g, infants of birthweights 1200 to 1849 g fed on banked breast milk and infants below 1200 g fed on either banked breast milk or maternal milk supplemented (as necessary) with banked breast milk, fulfilled stringent criteria for failure to thrive (weight less than 2 SD below the mean for age). Only infants fed the preterm formula as their sole diet had maintained their birth centile by discharge from hospital. The misleading nature of comparisons between extrauterine and intrauterine steady state weight gains is emphasised.

Body Height↗
PubMed1983

Tardive dyskinesia: a 3-year follow-up study.

A prospective study of tardive dyskinesia was carried out to gain information regarding the natural history of the condition and to identify risk factors. Out of an original cohort of 182 psychiatric patients receiving maintenance antipsychotic drugs 99 were available for reassessment after 3 years. In this follow-up group the point prevalence of oro-facial dyskinesia increased from 39% to 47% over the 3-year period. Twenty-two patients developed the disorder, while remission occurred in 14 others. Risk factors predicting the presence of oro-facial dyskinesia at follow-up included being over 50 years of age and the presence of akathisia. There was no convincing association between the duration of antipsychotic drug treatment and the presence or severity of oro-facial dyskinesia. Patients receiving over 1000 mg chlorpromazine equivalents of antipsychotic drug per day were unlikely to have the condition. The amount of purposeless trunk and limb movement present proved to be a relatively stable phenomenon, showing only a slight increase with age and no change over the follow-up period. The implications of these findings are discussed, with particular consideration being given to the effects of loss of patients to follow-up.

Adult↗
PubMed1983

Graft survival after renal transplantation: agenda for analysis.

Simple life-table analyses have not identified the reasons for the steady improvement over the years in graft survival. The use of more sophisticated multifactorial statistical techniques is indicated to identify prognostic factors and to explore the "center effect" on graft survival. An agenda for retrospective analysis of graft survival is proposed as follows. The first item is organizing and checking both survival and covariate data to provide a general description of the transplant series so that one knows, for example, which covariates are interdependent. Plotting lifetables and the time-specific risk of graft failure for one covariate at a time is the next step. The limitations of such analyses are easy to demonstrate and are illustrated with examples which motivate a multifactorial approach. Standard regression models for survival data, such as the exponential, Weibull, proportional hazards, and log-logistic, are described with the caveat that in medical applications, particularly the relevance of covariates, may be time-dependent, not constant on a particular scale (hazard or log odds). The method which is described for exploring how the relevance of covariates changes with elapsed time since transplantation is a simple step-function extension of the idea of proportional hazards. Because discrepancies in graft survival between centers, the "center effect," may owe something to the patient's rehabilitation before transplantation, a scoring system for rehabilitation or performance status would be useful as a summary covariate. Even careful retrospective analysis will not usually promote or indict a treatment policy without confirmation from randomized comparisons. A survey of renal units to elicit research priorities is suggested and factorial designs are recommended as an efficient way of investigating several specific questions. Multicenter collaboration in clinical trials would ensure that answers were speedily available.

Graft Survival↗
PubMed1983

Clinical characteristics of akathisia. A systematic investigation of acute psychiatric inpatient admissions.

Assessment of drug-induced movement disorders was carried out regularly on 104 psychiatric patients requiring antipsychotic medication on admission to hospital. The data relevant to motor restlessness were subjected to a principal components' analysis. According to their component scores, patients were then classified into two main groups: an akathisia group and an illness-related-movement group, the former group showing the clinical and pharmacological characteristics expected of akathisia. Clinical features which distinguished between the two groups, and between grades of akathisia severity, were identified, so an objective, phenomenological description of the akathisia syndrome was possible. Our observations suggested two distinct types of acute akathisia; one related to severe parkinsonism and one not. The implications of these findings are discussed.

Adult↗
PubMed1982

Should adjuvant chemotherapy be withheld from any patient with operable breast cancer?

We examined the clinical course of operable breast cancer and looked at what effect tumour size had on the probability of death from the disease. We analysed data from 1936 patients who were classified as having international stage I and II disease: decision theory was used to show a technique for determining the best strategy for adjuvant chemotherapy in the overall management of breast cancer.To evaluate this approach further, studies need to be designed to yield numerical values for the total morbidity of treatment on a scale from 0 to 100-the concept of utility loss-where 100 represents the maximum utility loss in patients in the early stages of disease. Such studies would contribute more to determining the best overall management of such patients than the current proliferation of clinical trials that are designed to evaluate either different combinations of adjuvant drugs or the effect of known combinations in selected subgroups of patients.

Breast Neoplasms↗