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Biomedical subjects

W Fox

Publications and source records attributed to W Fox.

At least 73 records · Page 4Linked to original sources
PubMed1976

Matching quality of agents employed in "double-blind" controlled clinical trials.

In an inquiry into the matching quality of preparations employed in double-blind controlled clinical trials, a panel of 4 observers studied 22 pairs of agents used in a sample of such trials, examining features which might make one preparation distinguishable from the other. 5 pairs of substances were an excellent match, being virtually indistinguishable, but in 7 pairs ther were obvious differences, detected by all 4 observers. The preparations used in cross-over studies were not specially well matched. Colour differences were most readily detected, followed by taste. The observers differed in their ability to detect differences between pairs of preparations, and 1 panel member was approximately 3 times more successful in doing so than another.

Bone Diseases↗
PubMed1976

An assessment of the carcinogenicity of isoniazid in patients with pulmonary tuberculosis.

In an assessment of the carcinogenicity of isoniazid, 3,842 adult tuberculous patients admitted to 2 sanatoria in the period 1950 to 1957 (that is, in the years immediately before and after the introduction of isoniazid) have been followed up for a mean period of over 19 years. Their mortality has been compared with that expected during the same calendar period in a general population group in England and Wales with the same age and sex distribution. The relative risk of death (the observed divided by the expected number of deaths) from all malignant neoplasms in patients first starting chemotherapy in 1950 to 1952, before the general introduction of isoniazid, was 0.8 for those who received isoniazid at some time, compared with 0.5 for those who never received it; for those first starting chemotherapy in 1953 to 1957, after the general introduction of the drug, the respective risks were 1.4 and 1.8. The relative risk of death from malignant neoplasms was 2.1 in the first 4 years after starting the treatment with isoniazid; this high relative risk is unlikely to be attributable to isoniazid and largely disappears subsequently, for in successive 4-year periods it was 1.3, 0.9, 1.2 and 1.4. The relative risks of death from all malignant neoplasms for patients receiving a total dosage of less than 50, 50-99, 100-199 and 200 g or more were 1.5, 1.5, 1.0 and 1.3, respectively. For patients receiving a maximum daily dose of less than 250 g the relative risk was 1.3, and for those receiving 250 g or more it was 1.2. There was a curious and unexplained difference in the mortality from malignant neoplasms in patients first starting chemotherapy in 1950 to 1952 (relative risk 0.6) and those first starting in 1953 to 1957 (relative risk 1.5). This is being studied further. This study has provided no evidence of a carcinogenic effect of isoniazid in a period of follow-up averaging nearly 20 years. The follow-up is being continued.

Adolescent↗
PubMed1976

Tuberculosis in Scotland: a national sample survey (1968-70). 2. A two-year follow-up of newly-diagnosed respiratory tuberculosis notified in 1968.

The methods and results of therapy during a two-year period of follow-up have been studied in a 50% random sample of the newly notified cases of pulmonary tuberculosis in Scotland for the year 1968. Of the 770 patients, 1.9% died of active tuberculosis, 2.6% were bacteriological failures, the regimen was changed for initial drug resistance in 0.9% and for drug toxicity in 2.6%. Default from chemotherapy in the first year occurred in 8.1% of patients, 4.7% absconding permanently. The bacteriological failure rate in the 372 positive cases was 7.3%. A further 20 patients were diagnosed at necropsy, 16 having died of the disease. Eighty-seven per cent of 372 initially positive patients were in hospital for an average of 18.0 weeks and 65% of 309 initially negative patients for an average of 11.0 weeks. Eighty per cent of the positive patients received streptomycin plus PAS plus isoniazid and a further 10% PAS plus isoniazid, the porportions for the negative patients being 57% and 35%. Side effects occurred in 53% of the patients on the triple regimen and 43% of those on PAS plus isoniazid. The mean duration of chemotherapy for the bacteriologically positive patients was 22.2 months and for those negative 19.1 months, the duration of the initial streptomycin supplement being 4.4 months and 3.4 months, respectively. Corticosteroids were given to 58 (8%) of the 770 patients. Only 6 (0.8%) had surgery for their tuberculosis. Forty-one per cent of the positive patients were off work for more than 6 months and 19% of the negative patients, and 18% and 8% never returned to work. In the two-year period an average of 12.5 radiographs were taken per patient and 10.8 bacteriological specimens were examined for tubercle bacilli. The number of clinic attendances in a full out-patient year averaged 4.2. Urine tests for antituberculosis drugs (invariably PAS) were performed in only 6 of 25 Burghs and 5 of 14 Counties, and were done infrequently in them. A continuous evaluation procedure for tuberculosis therapy programmes is recommended.

Adrenal Cortex Hormones↗
PubMed1976

Studies of immediate adverse reactions to different doses of a slow-release preparation of isoniazid.

'Double-blind' studies were carried out to assess the incidence of immediate adverse reactions to different doses of a slow-release preparation of isoniazid (matrix isoniazid). Individual doses of 30 mg/kg matrix isoniazid were well-tolerated but higher doses resulted in giddiness, the incidence being dose-related. The giddiness was characterized by a late onset and was usually present even at 24 hours. A few patients complained of gastro-intestinal symptoms. It is concluded that matrix isoniazid can be given to Madras patients in doses of 30-40 mg/kg without risk of an undue incidence of immediate adverse reactions.

Adult↗
PubMed1976

Study of adverse reactions to a once-weekly regimen of streptomycin plus a slow-release preparation of isoniazid in high dosage for six months.

A once-weekly regimen of streptomycin (1 g) plus a slow-release preparation of isoniazid (matrix isoniazid) in high dosage, namely 50 mg/kg body-weight for rapid inactivators of isoniazid and 35 mg/kg for slow inactivators, was prescribed for 6 months to 64 tuberculous patients (27 rapid, 37 slow). The regimen was tolerated by most the of the patients. However, 4 rapid and 3 slow inactivators had a modification of the regimen, mainly for giddiness. There were no cases of peripheral neuropathy. No adverse effects on haemopoiesis or hepatic or renal functions were observed in any of the patients. It is concluded that it is feasible to administer matrix isoniazid in dosages considerably higher than ordinary isoniazid, in once-weekly chemotherapy.

Adolescent↗
PubMed1976

5-year follow-up of cytotoxic chemotherapy as an adjuvant to surgery in carcinoma of the bronchus.

This report gives the 5-year findings of a double-blind study of long-term cytotoxic chemotherapy as an adjuvant to surgery in patients receiving busulphan or cyclophosphamide for carcinoma of the bronchus compared with a group receiving a placebo. Of 243 patients initially allocated busulphan, 234 cyclophosphamide and 249 placebo, 28%, 27% and 34% respectively were alive at 5 years. There were significant associations between mortality from bronchial carcinoma and histological involvement of the resected intrathoracic nodes and the histology of the tumour. Haematological toxicity, especially thrombocytopenia, was frequent and severe in the busulphan series, and low platelet counts continued long after chemotherapy was stopped.

Bronchial Neoplasms↗
PubMed1976

An investigation of the chest radiographs in a controlled trial of busulphan, cyclophosphamide, and a placebo after resection for carcinoma of the lung.

A standard series of radiographs of 588 patients allocated at random to treatment with busulphan (B patients), cyclophosphamide (C patients), or a placebo (P patients) for two years after surgery for bronchial carcinoma were viewed in three stages (following procedures which avoided bias) by an independent assessor, unaware of the allocated treatment of any patient, with a view to identifying pulmonary changes due to busulphan. Radiographic appearances consistent with busulphan lung were not reported in any of the 195 B patients (receiving a mean dosage of 464 mg of busulphan over 301 days) or of the 192 C patients but were present in one of the 201 patients receiving placebo.

Bronchial Neoplasms↗
PubMed1975

Pulmonary tuberculosis in Scotland: a national sample survey and follow-up (1968-70). 1. The characteristics of the cases notified in 1968.

A survey has been undertaken of a 50 per cent random sample of 865 patients notified as having pulmonary tuberculosis in 1968 in Scotland. The estimated notification rate for the total population was 33.3 per 100,000. The highest rate for males was 89.8 for those aged 55 or more and for females 29.5 for those aged 25 to 54. The rates for bacteriologically confirmed cases were 51.6 and 16.0, respectively, for these two groups. An independent radiological assessor reported the characteristic appearances of active tuberculosis in 50 per cent of the chest radiographs. Nearly half the patients were referred by general practitioners and 20 per cent were hospital inpatients when diagnosed. Contacts and mass radiography services produced many fewer cases and the proportion of infectious cases in these groups was low. The notification procedure is discussed and it is suggested that as progress towards eradication is made notification information is inadequate, and that standardised supplementary information on severity of disease and infectiousness should be collected, annually or periodically.

Adolescent↗
PubMed1975

The use of isoniazid as a marker to monitor the self-administration of medicaments.

1. Isoniazid was used as a marker to monitor the regularity of drug self-administration in a trial of chemoprophylaxis against natural influenza infection. Two hundred and sixty-two volunteers were treated for five weeks with a synthetic isoquinoline compound (U.K. 2371) or a matching placebo. 2. Five marker tablets containing isoniazid (150 mg) were incorporated into each regimen and their ingestion monitored by testing for acetylisoniazid in the urine. 3. Positive evidence of marker tablet consumption was obtained on 75% of the occasions on which urine samples were requested. The results obtained among the volunteers from each treatment group who returned urine specimens as requested (92%) indicated that they had swallowed at least 81% of their prescribed tablets. 4. The findings of the study suggest that when used in this way isoniazid is a very suitable compound for use on a few occasions for monitoring the self-administration of drugs in clinical trials.

Adolescent↗
PubMed1975

Survey of the sputum cytology service in England and Wales.

Of the 231 laboratories carrying out sputum cytology in England and Wales, information on the staffing, laboratory procedures, workload, records, and results for the year 1971 was obtained from 228 (98.7%) by means of a questionnaire, which was completed in 1973 in 81% of the laboratories and at the end of 1972 in the remainder. At the time the questionnaire was completed, the number of laboratories per region offering a service ranged from 6 to 25. Most of the processing of specimens was done by technicians and non-medical screeners (technicians without recognized qualifications) and most of the microscopy by pathologists and technicians. Papanicolaou and/or haematoxylin and eosin stains were used in 97% of the laboratories. During 1971, the number of specimens tested per laboratory ranged from 9 to 6000. A median of 381 specimens and 165 patients were tested per laboratory. Almost all specimens were submitted by hospitals and chest clinics and only 1% by general practitioners. An estimated median of 6.5% of all cytological specimens were sputum, most of the remainder being cervical smears. Laboratories varied greatly in their positive (0%-24%) and doubtful positive (0%-27%) rates. An estimated 63 000 patients had their sputum tested in 1971, and about 6300 had positive reports, rather less than one-quarter of all patients diagnosed as having lung cancer in England and Wales in 1971. The cost of the service was estimated to be of the order of pound375 000 at 1974 prices; that is, pound2.50 per specimen or pound6.00 per patient tested. An improved service might best be provided by district general hospital laboratories testing at least 1000 specimens per year so that a high level of accuracy in reporting could be assurred. A large proportion of the microscopy might be done by non-medical graduates and technicians under the supervision of pathologists.

Cervix Uteri↗