Search PubMed⌕ Search

Biomedical subjects

V Wright

Publications and source records attributed to V Wright.

At least 109 records · Page 6Linked to original sources
PubMed1989

A double-blind placebo controlled study of desipramine in the treatment of ADD: I. Efficacy.

The tricyclic antidepressant drug desipramine (DMI) was evaluated in the treatment of young patients with attention deficit disorder with hyperactivity (ADDH) in an unselected sample of 62 clinically referred patients, 43 (69%) of whom previously responded poorly to psychostimulant treatment. The 42 children and 20 adolescents were assigned randomly to receive DMI (N = 31) or placebo (N = 31) for up to 6 weeks in a parallel groups, double-blind study. Clinically and statistically significant differences in behavioral improvement were found for DMI over placebo, at an average (+/- SEM) maximal daily dose of 4.6 +/- 0.2 mg/kg; 68% of DMI-treated patients were considered very much or much improved, compared with only 10% of placebo patients (p less than 0.001). DMI was well tolerated, even at the relatively high doses used. These findings suggest that DMI can be an effective treatment in the management of pediatric patients with ADDH, including patients who failed to respond to stimulants.

Adolescent↗
PubMed1989

A double-blind placebo controlled study of desipramine in the treatment ADD: II. Serum drug levels and cardiovascular findings.

In a 6-week study of children and adolescents with attention deficit disorder with hyperactivity (ADDH) in which desipramine (DMI) was highly effective and well tolerated, the mean maximal daily oral dose in the DMI-treated patients (N = 31) was 4.6 +/- 0.2 mg/kg. Additional data were obtained for 27 placebo nonresponders given DMI openly for 6 additional weeks following a nearly identical protocol and mean daily doses (total N = 58). Individual serum drug concentration varied widely at a given dose. The overall median serum DMI level was 152 ng/ml and in 6 of 56 cases with assayed serum (DMI), the level exceeded 500 ng/ml. Serum tended to be higher with older age and greater clinical improvement. Only small, clinically unimportant but statistically significant increases in diastolic blood pressure, heart rate, and electrocardiographic conduction parameters occurred. DMI-treated patients showed higher incidence during DMI treatment of sinus tachycardia and ECG evidence of intraventricular conduction defect (IVCD) of the right bundle branch block type, with two of these patients developing complete IVCD. Increases in ventricular rate and in ECG conduction parameters, as well as the incidence of IVCD, were higher in patients attaining serum levels of DMI above the median. These findings suggest that, although treatment with DMI at daily doses above 3.5 mg/kg may be needed in some cases of childhood ADDH, such doses require caution and monitoring of serum drug levels and ECG when they are used in the pediatric population.

Adolescent↗
PubMed1989

Shock absorption by the spinal column in normals and in ankylosing spondylitis.

The transmission of heel-strike vibration using skin-mounted accelerometers was measured in normal subjects and subjects with ankylosing spondylitis. In normal subjects transmissibility was enhanced between 5 and 13 Hz and attenuated at frequencies above 15 Hz. In ankylosing spondylitis transmissibility was enhanced at 4 Hz but less so between 5 and 13 Hz and little attenuation was observed at the higher frequencies. This difference is expected in view of the pathological changes occurring in the spinal column in ankylosing spondylitis. The results support the hypothesis that the normal spinal column has to bend in order to absorb vibrations with a frequency greater than 15 Hz.

Adult↗
PubMed1988

A clinical and biochemical evaluation of etretinate in rheumatoid arthritis.

Etretinate (Tigason; Roche), which is effective in the treatment of psoriatic arthritis has immunomodulating activity in vivo. We have therefore assessed this drug in an open clinical and biochemical assessment of 24 weeks duration in rheumatoid arthritis. The treatment dose was 1.0 mg/kg/day for the first 4 weeks reducing to 0.5 mg/kg/day thereafter. There was a modest clinical improvement though this only reached statistical significance for joint circumference at 12 and 16 weeks (P less than 0.05). Biochemical improvement only reached levels of statistical significance for IgM at week 16 (P less than 0.01). Eight out of 15 patients had discontinued the drug because of side-effects by week 12 and only three out of 15 patients showed individual improvement by week 24. Some biochemical parameters (ESR) worsened. These results suggest only modest clinical efficacy and use of the drug in rheumatoid arthritis is likely to be curtailed by unacceptable side-effects. The improvement in biochemical variables that occurs when the drug is used in psoriatic arthritis does not occur in rheumatoid arthritis.

Adolescent↗
PubMed1988

Measurement of nocturnal body motility: behaviour of osteoarthritic patients and healthy controls.

Nocturnal body motility has been compared in a sleep laboratory between patients with osteoarthritis and healthy age-, sex- and weight-matched controls using a Bio-medical timer and bedleg force transducers connected to a Disa polygraph. Four motility variables were derived (duration of movement; duration adjusted for sensitivity; number of movements; number of 30-s epochs containing movements) enabling an assessment of nocturnal body motility in the two groups. There was a trend for osteoarthritic patients to move more than controls during sleep on all variables measured, although this did not reach statistical significance. Temazepam elixir (0.4 mg/kg body weight/night) reduced all four motility variables in both osteoarthritic patients and controls, although only the reduction of the number of 30-s epochs containing movements (P less than 0.05) in the control group attained statistical significance.

Aged↗
PubMed1988

A comparison of prednisolone with azathioprine and prednisolone with intramuscular gold in rheumatoid arthritis.

Pulse prednisolone hemisuccinate therapy (500 mg given intravenously on three occasions over two weeks) has been combined with either intramuscular sodium aurothiomalate or azathioprine in an assessment of 30 patients with rheumatoid arthritis. Significant improvement in a variety of clinical and biochemical assessments was seen in both groups. Both treatments were well tolerated by the patients and prednisolone appeared to accelerate the response to sodium aurothiomalate and azathioprine but there was no great evidence that it enhanced it.

Adult↗
PubMed1988

A clinical and biochemical assessment of etidronate disodium in patients with active rheumatoid arthritis.

Diphosphonates reduce the rate of bone turnover. They have additional pharmacological properties improving adjuvant arthritis in rats and lowering ESR in this condition. We have evaluated etidronate disodium, a diphosphonate commonly prescribed in the United Kingdom for Paget's disease in patients with rheumatoid arthritis. Apart from an early improvement in articular index, perhaps reflecting anti-inflammatory activity, no significant change occurred in clinical variables or in laboratory indices of 'secondline' action at a dose of 5 mg/kg/day.

Adult↗
PubMed1988

Factor analysis of the St. Mary's Hospital Sleep Questionnaire.

The St. Mary's Hospital Sleep Questionnaire was designed to evaluate the sleep of hospital patients. To gain an understanding of possible underlying factors, the questionnaire was factor analysed using data collected from 222 hospitalised rheumatic patients. The analysis did not produce a completely clear factor structure. Two factors relating to "sleep latency" and "sleep quality" emerged more clearly than the other factors produced. These factors correspond with two sleeping state factors (ease of getting to sleep; quality of sleep) that were extracted by a previous factor analysis of the Leeds Sleep Evaluation Questionnaire. This suggests that the two most important aspects of subjectively perceived sleep are the process of going to sleep and the quality of sleep.

Arthritis, Rheumatoid↗
PubMed1988

Comparison of sleep in osteoarthritic patients and age and sex matched healthy controls.

A sleep laboratory comparison of the sleep of 14 osteoarthritic patients with that of 16 age and sex matched healthy controls was undertaken. After three nights of adaptation continuous recordings of electroencephalographic (EEG), electro-oculographic (EOG), and electromyographic (EMG) activity were obtained for the next two nights. A comparison of EEG sleep variables during this baseline period showed that osteoarthritic patients had a significantly greater percentage of stage 1 and significantly smaller percentage of stage 2 sleep than control subjects. These findings indicate sleep disturbance in osteoarthritic patients. The limited degree of disturbance observed in these patients may be due to the fact that they were allowed to continue with their normal anti-inflammatory and analgesic medication for the course of the study.

Aged↗
PubMed1988

Kinetic investigations into the possible cause of low serum histidine in rheumatoid arthritis.

To investigate the cause of low serum histidine in rheumatoid arthritis (RA) single oral and intravenous doses of L-histidine were administered to patients with active RA, and to an equal number of age and sex matched control subjects. In the first study 13 patients and their controls received a 100 mg kg-1 dose of L-histidine as an aqueous slurry. Significant differences were seen in body weight, predose baseline serum histidine concentration, Cmax, t1/2, and area under curve, AUC0-infinity. In a second study six patients and six controls each received a 50 mg kg-1 dose of L-histidine both orally and intravenously on two separate occasions. The patients with RA had a lower baseline serum histidine concentration, a lower volume of distribution, and a shorter plasma half life than the controls, but these differences were not statistically significant. No difference was seen in bioavailability or clearance. Low serum histidine in RA is unlikely to be due to malabsorption from the gut, uptake by abnormal gut flora, or increased metabolism.

Adult↗
PubMed1988

An evaluation of the dynamic qualities of isometric grip strength.

A strain gauged torsion dynamometer linked to a microprocessor was used to assess the dynamic qualities of isometric grip strength in patients with rheumatic diseases. Maximum grip strength, time to maximum grip, and percentage fatigue provide independent information on the grip. Time to maximum grip does not appear to be an objective correlate of subjective stiffness. The usefulness of these dynamic variables for the assessment of stiffness appears limited in arthritic disease, where pain may interfere with the maximum voluntary effort of the test.

Arthroplasty↗
PubMed1988

Lack of objective evidence of stiffness in rheumatoid arthritis.

Metacarpophalangeal joint stiffness was measured using a new microprocessor controlled arthrograph in 135 patients with rheumatoid arthritis. Subjects were prospectively subdivided according to the stage of the disease in the joint. Compared with a normal population stiffness variables in active rheumatoid arthritis were decreased, significantly so for non-elastic stiffness. This study casts doubts on the literal interpretation of symptomatic stiffness as an indicator of disease activity in rheumatoid arthritis and suggests a number of explanations for the discordant result.

Arthritis, Rheumatoid↗
PubMed1988

A comparison of blood loss caused by two prolonged-release formulations of indomethacin ('Flexin Continus' and 'Indocid' R) in normal healthy male volunteers.

Faecal blood loss arising from two prolonged-release formulations of indomethacin was compared in a double-blind, parallel group study in 12 healthy male volunteers. After a 1-week run-in period on placebo, subjects were allocated at random to receive 150 mg indomethacin per day, either as controlled-release 'Flexin Continus' tablets or as slow-release 'Indocid' R capsules, for 2 weeks and followed up for a further 1 week. Faecal specimens were collected over a 4-day period in each week and blood loss calculated using a 51Chromium-labelled red cell count method. Mean blood loss during the placebo run-in period was 2.6 ml/4 days in both study groups. Mean blood loss during treatment Weeks 2 and 3 with 'Flexin Continus' was 8.6 ml/4 days and 7.9 ml/4 days, respectively, and during treatment with 'Indocid' R capsules was 13.9 ml/4 days and 14.2 ml/4 days, respectively. There was a carry-over effect from both preparations as seen by a steady decrease in blood loss during the week after treatment. The mean value for 'Flexin Continus' was 6.9 ml/4 days and for 'Indocid' R was 8.3 ml/4 days during the wash-out week. Faecal blood loss was not statistically significantly different between the two formulations. No significant deterioration in haematological or biochemical results occurred in either group. Adverse symptoms were less frequent with 'Flexin Continus' tablets.

Adult↗
PubMed1988

Desipramine and cutaneous reactions in pediatric outpatients.

The association of adverse cutaneous effects with administration of the tricyclic antidepressant drug desipramine was systematically reviewed in a clinic population of 205 child psychiatry outpatients over a 3-year period. Transient maculopapular rashes developed in 12 children and adolescents treated with desipramine. The rashes had a benign course, disappearing completely in 2 to 7 days, and were not associated with clinical or chemical hepatitis or any other physical symptoms.

Adolescent↗