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At least 73 records · Page 4Linked to original sources
PubMed1989

Natural course and response to interferon of chronic hepatitis B accompanied by antibody to hepatitis B e antigen.

The course of chronic hepatitis B was studied in 30 patients who had antibody to hepatitis e antigen and hepatitis B virus DNA in the serum and hepatitis B core antigen in the liver. Over a 2-year period, no patient experienced a sustained spontaneous remission of disease, and follow-up liver histology revealed worsening of the disease in four patients. After 2 years of observation, 24 patients were allocated randomly to one of two groups: 12 patients served as untreated controls and 12 received recombinant human alpha-interferon-2a in a dose of 9 million units intramuscularly three times weekly for 16 weeks. Patients who remained viremic after 16 weeks received 3 million units three times weekly for an additional 8 weeks. Abnormal amino-transferases and serum hepatitis B virus DNA persisted without appreciable changes in all untreated patients. Hepatitis B virus DNA rapidly became undetectable and serum aminotransferases fell to normal in eight treated patients. After the end of treatment, hepatitis B virus DNA became detectable once again in seven patients, in six of whom a peak of aminotransferases (range: 256 to 850 units per liter) ensued; subsequently, hepatitis B virus DNA disappeared, and serum aminotransferases again fell to normal in two of the seven. Overall, hepatitis B virus DNA was no longer detectable in serum and liver histology improved in three treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Effect of nicardipine infusion on the release of glutathione S-transferase following halothane anaesthesia.

To assess the possible protective effect of calcium channel blockade on hepatic function after halothane anaesthesia, 80 patients were allocated randomly to receive an i.v. infusion of either nicardipine or normal saline. Plasma concentration of glutathione S-transferase B1 subunits (GST) was measured as a sensitive index of hepatic damage. Data from 53 patients were analysed. Plasma GST concentration increased significantly at 3 and 6 h after induction of anaesthesia in the placebo group (P less than 0.01), and at 3 h (P less than 0.01) and 6 h (P less than 0.05) in the nicardipine group. The administration of nicardipine resulted in a greater increase in plasma GST concentrations at 3 h than did placebo (P less than 0.05), mainly because of a greater increase in males than in females. The increase in GST at 3 h was related inversely to plasma concentration of nicardipine both at the end of the exponential infusion (P less than 0.01) and at 2 h after induction (P less than 0.05), when males had lower plasma nicardipine concentrations than females (P less than 0.05). Calcium channel blockade with nicardipine in the dose administered was not shown to reduce liver dysfunction after halothane anaesthesia.

Adolescent↗
PubMed1990

Effect of humidification on inhalation induction with isoflurane.

Forty-two patients undergoing inhalation induction with isoflurane in nitrous oxide and oxygen, were allocated randomly to receive either humidified or non-humidified gas. Humidification resulted in a significantly lower incidence of problems during induction (P less than 0.05).

Adolescent↗
PubMed1992

Rapid administration of crystalloid preload does not decrease the incidence of hypotension after spinal anaesthesia for elective caesarean section.

Twenty parturients undergoing elective Caesarean section were allocated randomly to receive crystalloid preload 20 ml kg-1 over either 20 min or 10 min before spinal anaesthesia. Significant hypotension (systolic arterial pressure less than 100 mm Hg and less than 80% of baseline value) occurred in six of the 10 patients in the 20-min preload group and seven of 10 patients in the 10-min preload group (ns). Both groups had a significant (P less than 0.05) increase in central venous pressure during the preload period. The mean central venous pressure in the 10-min group was 11.9 mm Hg (range 6-19 mm Hg), which was significantly greater (P less than 0.05) than that in the 20-min group (mean 7.3 mm Hg, range 2-13 mm Hg). Three patients in the 10-min group had clinically unacceptable increases in central venous pressure. This study has demonstrated that rapid administration of crystalloid preload before spinal anaesthesia did not decrease the incidence or severity of hypotension, and questions the role of crystalloid preload.

Adult↗
PubMed1990

Local application of EMLA and glyceryl trinitrate ointment before venepuncture.

One hundred unpremedicated fit day surgery patients aged between 27 and 68 years were allocated randomly into one of four groups and EMLA, glyceryl trinitrate, EMLA and glyceryl trinitrate or a placebo ointment was applied to the dorsum of a hand. The pain and ease of venepuncture were determined at induction of anaesthesia 60 minutes later. Pain scores were also reassessed 1-2 hours after operation. Lower pain scores and easier venepuncture occurred when EMLA and glyceryl trinitrate ointment was applied to the dorsum of the hand.

Administration, Cutaneous↗
PubMed1990

Postoperative nefopam and diclofenac. Evaluation of their morphine-sparing effect after upper abdominal surgery.

The aim of the study was to assess the relative morphine-sparing effects of nefopam and diclofenac when used singly or in combination after upper abdominal surgery. Eighty-four patients of ASA grade 1 or 2 were allocated randomly to one of three groups. Group A received nefopam 20 mg by intramuscular injection 6 hourly after surgery for the 24-hour study period. Group B received diclofenac 75 mg 12-hourly and placebo injections at 6 and 18 hours after surgery. Group C received both 6-hourly nefopam and 12-hourly diclofenac. Supplemental analgesia was given on demand via a patient-controlled analgesia system which delivered intravenous morphine. Morphine requirements in the diclofenac group were significantly lower than in either of the other groups (p less than 0.01). Patients who received the combination of nefopam and diclofenac required significantly less morphine than those who received nefopam alone (p less than 0.01). Pain scores assessed 6 hours after surgery were significantly lower in the diclofenac and combination groups compared with the nefopam group (p less than 0.01).

Abdomen↗
PubMed1986

Anti-androgen treatment in women with acne: a controlled trial.

Ninety female patients with acne were allocated randomly to one of three groups and treated either with Diane, a high dose cyproterone acetate (CPA) regime with ethinyloestradiol, or Minovlar. The same dose of oestrogen was common to all three treatment groups. Patients were assessed every 2 months for 6 months, by grading for severity of the acne, lesion counts and photography, and subjectively using a visual analogue scale. In addition, bacteriological sampling and sebum excretion rate (SER) measurements were performed. The results showed a clinical improvement in all three treatment groups, but a more rapid and complete response was seen in those groups who received CPA. There was also a consistent trend suggesting a more favourable response in those in the high dose CPA group. Although there was a marked reduction in SER in the groups treated with CPA, there was no correlation between reduction in SER and clinical improvement in individuals, nor could a reduction in the surface bacterial population be shown to be a primary event in the success of anti-androgen therapy. We have shown that the addition of CPA to oestrogen adds significantly to the therapeutic effect in acne and that anti-androgen and oestrogen combinations are more effective than standard oestrogen and progestagen contraceptive pills.

Acne Vulgaris↗
PubMed1986

Low-dose etretinate in the maintenance of remission of palmoplantar pustular psoriasis.

Twenty patients with palmoplantar pustular psoriasis were treated initially for 4 weeks with 70 mg etretinate daily. This led to clinical improvement and a significant fall in pustule count. The patients were then allocated randomly to 30 mg etretinate daily or placebo for a further 12 weeks. There was a rapid deterioration in the clinical condition and a rise in pustule count in the placebo group. The etretinate-treated group still showed clinical improvement and a significantly lower pustule count after 12 weeks. Clinical side-effects were few and adverse effects on liver function and serum lipids were not found.

Clinical Trials as Topic↗
PubMed1985

Prevention of intraventricular haemorrhage by fresh frozen plasma.

Seventy three preterm infants weighing less than 1500 g or less than 32 weeks' gestation, or both, were allocated randomly to treatment (fresh frozen plasma 10 ml/kg on admission and at 24 hours of age) or control groups. Fifteen (41%) out of 37 control patients sustained intraventricular haemorrhage compared with five (14%) of 36 patients receiving treatment (X2 = 5.24, P = 0.022). No difference was found in coagulation factors measured at birth or at 48 hours of age in both groups. Fresh frozen plasma appears to have a beneficial effect in the prevention of intraventricular haemorrhage.

Blood Coagulation↗
PubMed1985

Relief of pain by infusion of morphine after operation: does tolerance develop?

To see whether continuous intravenous infusion of opiates provides more effective postoperative relief of pain than conventional intramuscular injection these regimens were compared in a prospective double blind trial. Thirty patients undergoing elective cholecystectomy were allocated randomly to receive an infusion of morphine or an infusion of placebo (control group) for 24 hours. Both groups were allowed supplementary morphine boluses as requested. During the first 48 hours after operation the degree of pain was almost identical between the groups. Surprisingly, the group that was given the infusion of morphine received as much supplementary morphine as the control group during the first 24 hours and appreciably more during the 24 hours after the infusion had been withdrawn. Nausea and vomiting were more prevalent among the patients given the infusion of morphine. These results suggest that continuous infusion of morphine may be an inferior regimen to intermittent bolus administration in the relief of postoperative pain. This may be explained by the development of tolerance in patients who received the infusion of morphine.

Adult↗
PubMed1987

General practitioner assistance with gold and penicillamine therapy of rheumatoid arthritis--a four year prospective study.

One hundred patients with active rheumatoid arthritis, uncontrolled by symptom relieving agents, were allocated randomly to intramuscular gold or oral penicillamine therapy. Their general practitioners (97 in all) were requested to assist with blood, urine, skin and mucous membrane monitoring. After four years, 16 patients in each treatment group remained on their original therapy, and three-quarters of these continued attending their family doctor for toxicity monitoring. Most GP monitoring problems occurred in the first six months of treatment. Sustained improvement in haemoglobin and ESR was seen in both treatment groups. Second-line drug toxicity monitoring by general practitioners allows specialist time to be diverted to rheumatological problem solving but may make it more difficult to relate rare but serious adverse adverse events to drug therapy.

Arthritis, Rheumatoid↗
PubMedDate not supplied

The haemodynamic effects of sodium nitroprusside following cardiopulmonary bypass: a clinical study.

Measurements of cardiac index were made in 18 patients (14 male and 4 female) preoperatively and thereafter during a 12-hour period immediately following coronary artery bypass grafting for stable angina pectoris. Patients with evidence of impaired left ventricular function were not included in the study. Individuals were allocated randomly to one of two groups. The first group received sodium nitroprusside as a constant, variable dose infusion during the post bypass study period (nitroprusside group). The second group received no nitroprusside (control group). The operative and postoperative management of these patients was otherwise identical. Following bypass, both groups showed a gradual drop in cardiac index with an associated increase in peripheral vascular resistance. In the control group, the mean cardiac index fell below the mean preoperative value. In the nitroprusside group, however, the mean cardiac index always remained above the mean preoperative level for the group, the differences between the groups being statistically highly significant at 1 1/2 hours postoperatively (p less than .005) and still significant at 3 hours postoperatively (p less than .05). The subsequent rise in cardiac index over the next 9 hours was more rapid in the nitroprusside treated patients and left ventricular function was better as demonstrated by a consistently higher mean cardiac index for any given left ventricular filling pressure. It is concluded that nitroprusside increases cardiac output and improves left ventricular function in the early postoperative period following cardiopulmonary bypass.

Blood Pressure↗
PubMed1983

Adriamycin alone or combined with vincristine in the treatment of advanced breast cancer.

One hundred and nineteen women with advanced breast cancer treated previously by endocrine therapy but no prior chemotherapy were given adriamycin 70 mg/m2 i.v. on day 1 of a 3-weekly cycle for 8 courses, followed by a regimen of cyclophosphamide, methotrexate and 5-fluorouracil (CMF) until relapse. They were allocated randomly to receive either no treatment (group A) or vincristine 1.4 mg/m2 i.v. on days 1 and 8 during treatment with adriamycin (group AV). In 107 evaluable patients objective responses were seen in 30/53 patients (57%) in group A and in 28/54 patients (52%) in group AV. The projected dose of adriamycin received was 78% in group A and 75% in group AV; and 60% for vincristine in group AV. The subjective and haematological toxicity for adriamycin was similar in both groups, but 65% of patients treated with vincristine developed neurotoxicity. The median duration of objective regressions was the same for both groups (7 months), and the median time to failure was 5 months for group A and 6 months for group AV respectively. The median survival of the responders tended to be longer in group AV (17.5 months) than in group A (13 months), but this difference was not statistically significant (P = 0.112). It is concluded that there is no advantage therapeutically in combining vincristine and adriamycin in patients with advanced breast cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1979

Operative blood loss and the frequency of haemorrhage associated with adenotonsillectomy in children: a double-blind trial of ethamsylate.

One hundred children were allocated randomly to receive either ethamsylate (Dicynene) or a placebo before undergoing adenotonsillectomy. Blood loss at operation was estimated from the haemoglobin content of swabs and aspirated fluid. Mean blood loss in the ethamsylate-treated group was not significantly less than in the controls. The frequency of secondary haemorrhage was significantly less in children treated with ethamsylate (P less than 0.01). No side-effects were reported in either group.

Adenoidectomy↗
PubMed1990

Analgesic efficacy of perioperative buccal morphine.

We have studied the effect of regular perioperative administration of buccal morphine sulphate on postoperative analgesic consumption in female patients undergoing lower abdominal surgical procedures. Ten matched pairs of women were allocated randomly to receive either placebo or buccal morphine before operation and at 12-h intervals up to 44 h after operation. Pain was assessed using a visual analogue scale and taste assessed using evaluation forms. Postoperative analgesic requirements were compared using a patient-controlled analgesia system which was set to deliver bolus doses of pethidine without a background infusion. There was no significant difference in pain scores between the two groups. Compared with placebo, buccal morphine did not reduce significantly postoperative pethidine consumption. All patients receiving buccal morphine reported a taste which reduced its acceptability.

Administration, Buccal↗
PubMed1980

Double-blind trial of trimipramine in the treatment of duodenal ulcer.

Twenty-three patients with chronic duodenal ulcer were allocated randomly to receive either trimipramine 25 mg or placebo, as a single night-time dose, for six weeks. Ulcer healing was determined by endoscopy. The ulcer healed in two of 10 patients receiving trimipramine and in seven of 13 patients receiving placebo. Trimipramine in this dosage does not assist ulcer healing.

Clinical Trials as Topic↗
PubMed1983

Ventilatory depression related to plasma fentanyl concentrations during and after anesthesia in humans.

Twenty-four patients were allocated randomly into four groups for the study of the pharmacokinetics of, and effects on postoperative ventilation of, two doses of fentanyl (10 micrograms/kg or 25 micrograms/kg) administered at the start of general anesthesia in which ventilation was controlled at a fixed volume, but arterial PCO2 was adjusted to a range of either 38-42 torr, or 20-25 torr. During the first 2 hr after anesthesia, ventilatory depression (CO2 responsiveness decreased to less than 50% of awake values, PaCO2 greater than 48 torr) occurred only in patients who had received 25 micrograms/kg fentanyl, and was more marked in patients who were hyperventilated to a low PaCO2 during anesthesia. Plasma fentanyl concentrations associated with 50% depression of CO2 responsiveness were in the range 1.5-3.0 ng/ml, the lower values found in patients hyperventilated to a low PaCO2. Whole-body clearance of fentanyl was significantly decreased by hypocapnic hyperventilation.

Adult↗
PubMed1986

Tiapamil, a new calcium channel blocking agent for the treatment of effort induced chronic stable angina pectoris.

The anti-anginal efficacy of tiapamil, a new calcium channel blocking agent was studied in 24 patients with established effort induced chronic stable angina pectoris. The patients were allocated randomly in a double-blind fashion to tiapamil 300 mg thrice daily or placebo for 2 weeks and thereafter all the patients received tiapamil 300 mg thrice daily in a single-blind fashion for a further 2 weeks. All patients performed symptom limited multistage graded exercise testing with computer-assisted analysis of the electrocardiogram before entering the study and at the end of the double-blind and single-blind phases. The mean exercise time to develop angina during the control test in the group which received placebo during the double-blind phase was 7.1 min; this increased to 8.5 min after 2 weeks of placebo and 9.7 min after 2 weeks of subsequent tiapamil therapy. Similarly in the group which received tiapamil during the double-blind phase the mean exercise time on control test was 6.4 min, increasing to 9.7 min and 9.7 min after 2 and 4 weeks of tiapamil therapy respectively. There were no statistical significant differences between the changes from control, seen with tiapamil and placebo during the double-blind phase. However, the changes observed between control and active therapy in the tiapamil group did reach statistical significance (p = 0.003). Similarly, 1 mm ST-segment depression time was prolonged by tiapamil therapy. The heart rate at rest and maximal exercise remained unaltered with tiapamil therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗