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Biomedical subjects

W H Lyle

Publications and source records attributed to W H Lyle.

At least 19 recordsLinked to original sources

Maintenance dose of penicillamine in rheumatoid arthritis: a comparison between a standard and a response-related flexible regimen.

There is much individual variation in the response of rheumatoid arthritis (RA) to penicillamine, some patients deriving benefit from very small doses. A dose of 750 mg daily is widely regarded as standard, and, while their RA commonly responds, many patients discontinue treatment because of adverse reactions to penicillamine. A more flexible prescribing policy might be more successful in the long term and was tested in 1 group of 20 patients, another receiving a 'standard' regimen, each beginning treatment at a low dose level. Of those who were given increases of dose only if response was poor 17 completed 1 year of treatment on an average maintenance dose of 308 mg daily, but only 11 of the other group on an average dose 613 mg daily. Proteinuria, which was found only in the latter group accounted for 6 withdrawals, all at doses of 625 mg daily or above. The reduction in rheumatoid activity appeared to be of about the same degree among the members of both groups who completed 12 months of treatment. Penicillamine should be given initially in a low dose and this should be raised only if there is lack of response after at least 4 weeks.

Adult

Dimethylformamide and alcohol intolerance.

Facial flushing and other symptoms were reported by 19 of a group of 102 men who worked with dimethylformamide (DMF). Twenty-six of the 34 episodes occurred after the workers had consumed alcoholic drinks. The metabolite N-methylformamide (MF) was detected in the urine on 45 occasions, the highest recorded concentration being 77 microliter/litre. The highest recorded concentration of DMF in air was 200 ppm. The DMF-ethanol reaction is possibly attributable to the inhibition of acetaldehyde metabolism, probably by MF.

Air Pollutants, Occupational

Haemodialysis and copper fever.

A syndrome of headache, chills, sweating, nausea, and exhaustion during and after haemodialysis is described and likened to metal fume fever. A patient has been cured of this syndrome following removal of copper-containing parts from the water-path of her home dialysis system.

Adolescent