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6,323,525 |
Effect of acyclovir treatment of primary genital herpes on the antibody response to herpes simplex virus.
|
Ashley R L RL, Corey L L
|
The Journal of clinical investigation . Vol. 73, No. 3, 1984 Mar
|
Sera from patients with first episode primary genital herpes infections who were treated with the antiviral drug acyclovir were studied to determine the effect of therapy on the immune response to herpes simplex virus (HSV) glycoproteins and polypeptides. 63 patients were evaluated, 35 patients received acyclovir: 11 intravenously, 12 orally, and 12 topically, while 28 received placebo. Topical application of acyclovir had no effect on the immune response to HSV infection. However, both oral and intravenous acyclovir were associated with later development of antibodies to two glycoproteins (of 80,000 and 60,000 mol wt [IIg80 and gD, respectively]) and one nonglycosylated polypeptide of 66,000 mol wt (vp66). Antibody to IIg80 was present in convalescent phase serum in 13/23 systemic acyclovir recipients vs. 18/19 placebo recipients (P = 0.01) and antibody to gD was detected in 8/23 oral or intravenous acyclovir recipients vs. 11/19 placebo recipients (P = 0.06). The mean time to seroconversion to IIg80 (39.0 d) and gD (55.5 d) was significantly longer for systemic acyclovir recipients than for the placebo controls, 23.4 and 18.5 d, respectively (P less than 0.05 for each comparison). 7 (30%) of 23 systemic acyclovir recipients compared with 100% of the placebo recipients had antibody to vp66 by 30 d after onset of the primary episode (P less than 0.001). Subsequent untreated recurrences of genital herpes were associated with seroconversion to gD, IIg80, and vp66. Patients who lacked antibody to both gD and vp66 in sera taken before their first clinical recurrence of disease experienced a longer duration of the recurrent episode (10.8 d) than those who possessed antibody to both vp66 and gD (6.3 d) (P less than 0.05). In addition, the mean duration of lesions, number of lesions, and mean lesion area were greater in patients who lacked antibody to vp66 but had anti gD, as compared with those who had anti-p66 but lacked anti-gD; suggesting that antibody to vp66 correlated more closely with subsequent disease severity than did antibody to gD. Acyclovir therapy appears to influence the frequency and time of development of antibody to a number of different HSV-specific polypeptides. Further studies of the effects of antiviral therapies on the immune response to these proteins may help clarify the role of these polypeptides in the pathogenesis of disease.
|
https://pubmed.ncbi.nlm.nih.gov/6323525/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article",
"Research Support, U.S. Gov't, P.H.S."
] |
6323525
|
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6,323,667 |
Efficacy of topical antibiotic therapy in acute conjunctivitis in children.
|
Gigliotti F F, Hendley J O JO, Morgan J J, Michaels R R, Dickens M M, Lohr J J
|
The Journal of pediatrics . Vol. 104, No. 4, 1984 Apr
|
We studied 102 children aged 1 month to 18 years in a randomized, double-blind trial designed to determine both the natural history of bacterial conjunctivitis and whether topical antibiotic therapy is beneficial. Affected eyes were treated four times a day for 7 days with drug (polymyxin-bacitracin ophthalmic ointment) or placebo. Eighty-four patients had proved bacterial conjunctivitis (Haemophilus influenzae 61, Streptococcus pneumoniae 22, both one); 66 of these received only topical therapy. By 3 to 5 days, 21 of 34 (62%) patients receiving topical antibiotic were clinically cured, whereas only nine of 32 (28%) patients given placebo were cured (P less than 0.02). By 8 to 10 days, 31 (91%) of the patients given antibiotic and 23 (72%) of the placebo group were cured (P = NS). The bacterial pathogen was eradicated by day 3 to 5 in 71% and by day 8 to 10 in 79% of patients given antibiotic, compared to 19% and 31% of the placebo group (P less than 0.001). Acute bacterial conjunctivitis is a self-limited disease, but topical antibiotic therapy with polymyxin-bacitracin shortens the duration of clinical disease and enhances eradication of the causative organism from the conjunctiva.
|
https://pubmed.ncbi.nlm.nih.gov/6323667/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6323667
|
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] |
6,323,866 |
Circadian rhythm of plasma aldosterone and time dependent alterations of aldosterone regulators.
|
Takeda R R, Miyamori I I, Ikeda M M, Koshida H H, Takeda Y Y, Yasuhara S S, Morise T T, Takimoto H H
|
Journal of steroid biochemistry . Vol. 20, No. 1, 1984 Jan
|
In order to investigate the relative contribution of ACTH, the renin angiotensin and dopaminergic system to the circadian rhythm of plasma aldosterone, hormone levels were determined at hourly intervals over a 24 h span in four supine healthy men. Blood was withdrawn under basal conditions (control), after either dexamethasone, captopril or bromocriptine++ (CB-154) administration. Plasma aldosterone rhythmicity was abolished in dexamethasone treated groups but not in captopril or CB treated groups. Time dependent alterations of aldosterone regulators were analyzed by multiple regression methods at 3 hourly intervals. These results indicate that plasma aldosterone rhythmicity is predominantly under the control of ACTH whereas the renin angiotensin or dopaminergic system plays a little role. In supine, sodium repleted states, ACTH is a potent stimulus of aldosterone at 000-0600 h and 1700-1900 h clocktime, whereas during daytime renin-angiotensin is an additional regulator.
|
https://pubmed.ncbi.nlm.nih.gov/6323866/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
6323866
|
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6,324,332 |
Treatment of gastric ulcer with ranitidine.
|
Schulz T B TB, Berstad A A, Rydning A A, Frislid K K
|
Scandinavian journal of gastroenterology . Vol. 19, No. 1, 1984 Jan
|
Forty-eight patients with endoscopically proven gastric ulcer were treated either with ranitidine tablets, 150 mg twice daily, or with placebo tablets under double-blind conditions. Three patients were for various reasons excluded from the study. After 6 weeks' treatment a second endoscopy was performed. The ulcer had healed in 22 (88%) of the 25 patients who had received ranitidine tablets and in 4 (20%) of the 20 patients who had received placebo tablets. The difference was statistically significant (p less than 0.002). The number of days and nights with pain attacks and the number of antacid tablets consumed were significantly (p less than 0.002) lower in the patient group treated with ranitidine. The 3 patients with non-healed ulcer after treatment with ranitidine had their ulcers healed after a further 6 weeks' treatment with ranitidine, and of the 16 patients with non-healed ulcer after treatment with placebo tablets, 13 had their ulcers healed after 6 weeks' open treatment with ranitidine, 150 mg twice daily. No serious side effects that could be ascribed to treatment occurred during the study.
|
https://pubmed.ncbi.nlm.nih.gov/6324332/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6324332
|
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] |
6,324,526 |
Photocoagulation in diabetic retinopathy. A multicentre study in Sweden.
|
Stenkula S S
|
Acta ophthalmologica. Supplementum . Vol. 162, 1984
|
Two hundred and eleven patients with diabetic retinopathy were assigned to a multicentre prospective study on the effect of photocoagulation therapy. Twenty Swedish eye clinics took part in the trial. Good visual function and symmetrical diabetic retinopathy of the non-proliferative or proliferative type were required. No patients with advanced new vessels on the optic disc or widespread fibrous proliferations were included. Further criteria for inclusion were that at the time of entry into the study the patients would be in good general health, should have no other eye diseases and should be receiving no other treatment for diabetic retinopathy. One eye was randomly chosen for photocoagulation therapy. The patients were given mild treatment with the panretinal, focal or panretinal and focal techniques and in most cases the short-pulse, small-spot xenon arc or argon laser methods were used. The patients were examined before treatment, after 6 months and subsequently every year. All follow-ups included careful measurement of corrected visual acuity, tonometry, and evaluation of the optical media and fundus changes. A medical examination was performed every second year. Fundus photographs were taken at all examinations. The diabetic lesions were graded with the aid of a modified Airlie-House system. The classification of all diabetic lesions was checked by the author with the help of the fundus photographs. Visual acuity and morphological diabetic changes were analysed in the whole material and also in four subgroups, namely those with mild non-proliferative, moderate-severe non-proliferative, mild proliferative and moderate-severe proliferative retinopathy. This subgrouping was done with regard to the stage of retinopathy at entry into the trial. One hundred and eighty-five patients were followed up for 4 years and 138 for 5 years. Twenty patients died, most of them from diabetic complications. Forty-one control eyes were treated. The majority showed progression before treatment. Treated eyes had better average visual acuity and a lower rate of blindness than control eyes at late follow-up. The various stages of retinopathy differed greatly with respect to the visual outcome. Patients showing mild non-proliferative changes at the time of entry had good mean visual acuity and no eyes became blind during the follow-up period. Patients with moderate-severe non-proliferative changes had a better mean visual acuity in the treatment group at late follow-ups and more eyes became blind in the control group.(ABSTRACT TRUNCATED AT 400 WORDS)
|
https://pubmed.ncbi.nlm.nih.gov/6324526/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6324526
|
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] |
6,324,570 |
Varicella vaccine trials in healthy children. A summary of comparative and follow-up studies.
|
Arbeter A M AM, Starr S E SE, Preblud S R SR, Ihara T T, Paciorek P M PM, Miller D S DS, Zelson C M CM, Proctor E A EA, Plotkin S A SA
|
American journal of diseases of children (1960) . Vol. 138, No. 5, 1984 May
|
Beginning in 1979, OKA and KMcC strains of varicella zoster virus (VZV) vaccine were administered to 369 healthy seronegative children in a sequence of ten comparative clinical trials. Postimmunization clinical reactivity was minimal with the OKA vaccines but was unacceptably high (32%) with the KMcC passage-40 vaccine. Ninety-three percent to 100% immunogenicity was noted by fluorescent antibody assay and in vitro lymphocyte proliferation to VZV antigens. Follow-up studies demonstrated persistence of antibody and in vitro lymphocyte proliferation responses and protection or modification of infection nine to 48 months after immunization. Only five episodes of mild varicella occurred in children in whom seroconversion had occurred. These episodes were noted after at least 281 known varicella exposures. Vaccine virus reactivation as zoster had not occurred in any child.
|
https://pubmed.ncbi.nlm.nih.gov/6324570/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
6324570
|
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] |
6,324,586 |
Intravenous immunoglobulin for modification of cytomegalovirus infections associated with bone marrow transplantation. Preliminary results of a controlled trial.
|
Winston D J DJ, Ho W G WG, Lin C H CH, Budinger M D MD, Champlin R E RE, Gale R P RP
|
The American journal of medicine . Vol. 76, No. 3A, 1984 Mar 30
|
The effects of immune globulin intravenous, 5 percent in 10 percent maltose, on cytomegalovirus infection and interstitial pneumonia in bone marrow transplants were evaluated in a randomized controlled trial. Eighteen patients were given weekly doses (20 cc/kg) of intravenous immunoglobulin before and after transplantation, and 18 patients were controls. The incidence of cytomegalovirus infection was similar in the control and intravenous immunoglobulin-treated groups, but symptomatic cytomegalovirus infection (eight of 18 versus three of 18, p = 0.14) and interstitial pneumonia (10 of 18 versus four of 18, p = 0.08) occurred less frequently in the group receiving intravenous immunoglobulin. Cytomegalovirus pneumonia developed in eight control patients and in three patients receiving intravenous immunoglobulin (p = 0.14), whereas two control patients and one patient receiving intravenous immunoglobulin experienced idiopathic interstitial pneumonia. These preliminary results suggest that intravenous immunoglobulin can modify the severity of cytomegalovirus infection and prevent interstitial pneumonia in bone marrow transplant recipients.
|
https://pubmed.ncbi.nlm.nih.gov/6324586/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S."
] |
6324586
|
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6,324,587 |
Prevention of cytomegalovirus infection by prophylaxis with an intravenous, hyperimmune, native, unmodified cytomegalovirus globulin. Randomized trial in bone marrow transplant recipients.
|
Condie R M RM, O'Reilly R J RJ
|
The American journal of medicine . Vol. 76, No. 3A, 1984 Mar 30
|
We have completed a randomized trial to evaluate the safety and effectiveness of hyperimmune cytomegalovirus intravenous human globulin in prevention of cytomegalovirus infection and related problems in bone marrow transplant recipients. Prophylactic intravenous administration of this native, intact, hyperimmune, cytomegalovirus IgG, at a dose of 200 mg/kg 25, 50, and 75 days following transplant resulted in complete protection against cytomegalovirus infection during the 120 days covered by the treatment (p = 0.009). There was no interstitial pneumonia or mortality in the group receiving the hyperimmune IgG. This is significant at the p = 0.014 when compared with the supporting treatment control group. In bone marrow transplant recipients, prophylaxis with a total dosage of 0.6 g/kg of an intravenous hyperimmune cytomegalovirus globulin was safe and afforded effective protection against cytomegalovirus infection and interstitial pneumonia in this high-risk population.
|
https://pubmed.ncbi.nlm.nih.gov/6324587/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, U.S. Gov't, P.H.S."
] |
6324587
|
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6,324,589 |
Symposium on infectious complications of neoplastic disease (Part II). Chemoprophylaxis of fungal infections.
|
Meunier-Carpentier F F
|
The American journal of medicine . Vol. 76, No. 4, 1984 Apr
|
As invasive fungal infection remains a common problem in the management of cancer patients, chemoprophylaxis of these opportunistic infections is desperately needed. The most frequently investigated antifungal agents have been nystatin, amphotericin B, and ketoconazole. In placebo-controlled studies, high doses of antifungal agents decreased the positive results from surveillance cultures, and there is some suggestion that such chemoprophylaxis may reduce the incidence of invasive candidiasis in neutropenic cancer patients. However, no oral chemoprophylaxis has effectively prevented aspergillosis or mucormycoses in these patients. There are still many areas of controversy, and the most adequate regimens, if any, remain to be defined.
|
https://pubmed.ncbi.nlm.nih.gov/6324589/
|
[
"Clinical Trial",
"Journal Article",
"Review"
] |
6324589
|
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] |
6,324,616 |
Captopril reduces the dose requirement for sodium nitroprusside induced hypotension.
|
Woodside J J, Garner L L, Bedford R F RF, Sussman M D MD, Miller E D ED, Longnecker D E DE, Epstein R M RM
|
Anesthesiology . Vol. 60, No. 5, 1984 May
|
The authors studied 12 patients who required deliberate hypotension for spinal fusion operations in order to investigate the efficacy of captopril for reducing dose requirement for sodium nitroprusside (SNP). Six patients, selected at random, were pretreated with captopril, 3 mg/kg po, and the remaining six patients served as controls. All patients received a similar anesthetic technique, consisting of thiopental 3 mg/kg, pancuronium 0.1 mg/kg, morphine 0.5 mg/kg, plus nitrous oxide 70% in oxygen. SNP was used to maintain mean arterial pressure (MAP) at 50-55 mmHg during deliberate hypotension lasting 140 +/- 13 minutes (mean +/- SE). Patients who received captopril required less SNP than untreated patients both early during hypotension (1.4 +/- 0.5 micrograms X kg-1 X min-1 vs. 4.8 +/- 0.8 micrograms X kg-1 X min-1, P less than 0.05), as well as late during hypotension (2.2 +/- 0.2 micrograms X kg-1 X min-1 vs. 5.6 +/- 0.6 micrograms X kg-1 X min-1, P less than 0.05). Whole blood cyanide was significantly lower in the patients pretreated with captopril than the untreated controls both early in the hypotensive period (2.7 +/- 0.6 mumol/l vs. 13 +/- 4 mumol/l, P less than 0.05) and also late in the hypotensive period (3.7 +/- 0.8 mumol/l vs. 30 +/- 10 mumol/l, P less than 0.05). MAP was reduced by captopril pretreatment both following induction of anesthesia (64 +/- 4 mmHg captopril vs. 80 +/- 4 mmHg control, P less than 0.05) and during surgery before deliberate hypotension (86 +/- 5 mmHg captopril vs. 100 +/- 4 control, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
|
https://pubmed.ncbi.nlm.nih.gov/6324616/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S."
] |
6324616
|
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6,324,710 |
Comparative interaction of cimetidine and ranitidine with racemic warfarin in man.
|
O'Reilly R A RA
|
Archives of internal medicine . Vol. 144, No. 5, 1984 May
|
Cimetidine potentiates the anticoagulant effect of warfarin sodium, but in one small study ranitidine hydrochloride did not. Furthermore, these drugs have not been compared in the same subjects. Eleven normal subjects received single oral doses of 1.5 mg/kg racemic warfarin sodium alone, with cimetidine (1,200 mg/day orally), or with ranitidine (300 mg/day orally), beginning three days before the warfarin and daily thereafter for the duration of hypoprothrombinemia. Blood samples were obtained daily for determination of prothrombin times and warfarin concentrations. Cimetidine augmented both the hypoprothrombinemia and the blood concentrations of warfarin, but ranitidine did not. Substituted imidazoles like cimetidine inhibit hepatic microsomal activity, which may cause reduced metabolic clearance of warfarin and augment its anticoagulant effect. Ranitidine, lacking these effects, may be safer for patients undergoing anticoagulation who require H2-receptor antagonists.
|
https://pubmed.ncbi.nlm.nih.gov/6324710/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S."
] |
6324710
|
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] |
6,324,832 |
Comparison of the prophylactic use of magnesium trisilicate mixture B.P.C., sodium citrate mixture or cimetidine in obstetrics.
|
Frank M M, Evans M M, Flynn P P, Aun C C
|
British journal of anaesthesia . Vol. 56, No. 4, 1984 Apr
|
The effects of magnesium trisilicate mixture B.P.C., sodium citrate mixture or cimetidine on gastric pH and aspirated gastric volumes were compared in 78 obstetric patients during elective (a), or emergency (b) surgery. Magnesium trisilicate mixture B.P.C. was associated with the most alkaline values of gastric pH (mean (a) 7.9, (b) 7.3; range 2.9-9.1). Sodium citrate 0.3 mol litre-1 mixture resulted in the narrowest range of pH values of gastric contents (mean (a) 5.4, (b) 5.9; range 3.9-7.7). The ranges of aspirated gastric volumes were wide with both antacid regimens (magnesium trisilicate 12-172 ml, sodium citrate 9-290 ml). Cimetidine increased gastric pH to greater than 2.5 in 82% of patients (mean (a) 6.2, (b) 5.0; range 1.6-7.3), and was associated with significantly smaller volumes of aspirated gastric contents (range 0.5-44 ml). When gastric pH and volume were considered together, the groups of patients who received cimetidine were found to be closest to the defined "safe limits", of pH greater than 2.5 and volume less than 25 ml.
|
https://pubmed.ncbi.nlm.nih.gov/6324832/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
6324832
|
[
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] |
6,325,044 |
The effect of ketanserin, a specific serotonin antagonist on the PRL, GH, ACTH and cortisol responses to hypoglycaemia in normal subjects.
|
Prescott R W RW, Kendall-Taylor P P, Weightman D R DR, Watson M J MJ, Ratcliffe W A WA
|
Clinical endocrinology . Vol. 20, No. 2, 1984 Feb
|
The role of serotonin in the prolactin, growth hormone, ACTH and cortisol responses to hypoglycaemia has been investigated in normal subjects using a selective serotonin (5HT2) receptor antagonist, ketanserin. Circulating concentrations of these hormones were measured after administration of insulin (0.1 units/kg body weight iv) to eight normal male subjects with and without simultaneous iv ketanserin (10 mg). Plasma glucose fell to less than 2.0 mmol/1 in all subjects and was unaffected by ketanserin. Ketanserin induced a 50% decrease in the serum prolactin response to hypoglycaemia, 45 and 60 min after administration of insulin (increase in serum prolactin at 60 min: 1145 +/- 295 mU/l without ketanserin; 558 +/- 176 mU/l with ketanserin, P less than 0.05). The peak ACTH response was reduced by 30% (95.3 +/- 33.6 ng/l without ketanserin; 60.0 +/- 22.9 ng/l with ketanserin, P less than 0.05) but the plasma cortisol response was not significantly altered. The serum growth hormone response was unaffected by serotonin blockade. These findings suggest that serotonin, probably acting through 5HT2 receptors, is involved in the stimulation of prolactin and ACTH release but not in the release of growth hormone, during insulin induced hypoglycaemia.
|
https://pubmed.ncbi.nlm.nih.gov/6325044/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6325044
|
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] |
6,325,065 |
Flunarizine, a new preventive approach to migraine. A double-blind comparison with placebo.
|
Frenken C W CW, Nuijten S T ST
|
Clinical neurology and neurosurgery . Vol. 86, No. 1, 1984
|
Seventeen patients with common or classic migraine were prophylactically treated with 10 mg flunarizine daily, whereas 18 patients received a placebo during a 12-week randomized double-blind study. In the gross flunarizine was significantly superior to the placebo. Only 3 patients felt that flunarizine had been useless and the investigator also guessed the medication code correctly in all but these 3 cases. After a 1-month starting period the difference between flunarizine and placebo in reducing the frequency of the migraine attacks became statistically significant in favour of flunarizine. The mean monthly number of attacks was respectively 3.3 and 3.8 before the study and 1.4 and 3.2 during the study. The limited scale of the trial precluded a judgment as to whether one type of migraine would respond better to flunarizine than the other. Side-effects were negligible, weight gain being secondary to the therapeutic effect rather than an untoward consequence of treatment.
|
https://pubmed.ncbi.nlm.nih.gov/6325065/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6325065
|
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] |
6,325,355 |
Maximal exercise tolerance after induced alkalosis.
|
Katz A A, Costill D L DL, King D S DS, Hargreaves M M, Fink W J WJ
|
International journal of sports medicine . Vol. 5, No. 2, 1984 Apr
|
Eight healthy males performed two rides to exhaustion at a work load corresponding to 125 VO2 max, 1 h after ingesting either 0.2 g NaHCO3/kg body weight (E) or NaCl (C). Mean +/- SE pre-exercise blood pH, HCO-3, and base excess (BE) values were respectively 7.42 +/- 0.01, 28.2 +/- 1.5 mmol/l, and 2.02 +/- 0.10 mmol/l for the E condition, and 7.39 +/- 0.01, 24.4 +/- 0.07 mmol/l, and -0.40 +/- 0.07 mmol/l for the C condition (P less than 0.05 for all variables). Cycling time to exhaustion (E = 100.6 +/- 6.1; C = 98.6 +/- 5.7 s) and total VO2 during recovery (E = 17.7 +/- 0.9; C = 17.3 +/- 0.8 1/30 min) did not differ significantly between treatments. Blood pH, HCO-3, and BE were significantly higher while the hydrogen ion to lactate ratio (nmol/mmol) was significantly lower in E than in C during recovery. Blood LA levels were also greater in E than in C during the latter part of recovery although peak individual values were not significantly different between trials (E = 14.4 +/- 0.4; C = 13.3 +/- 0.0 mmol/l). In view of the insignificant differences in cycling time, peak individual LA, and total recovery VO2, it is not likely that LA production was greater in E than in C. Rather it appears that LA efflux was enhanced by the NaHCO3 feeding. Additionally, the return of the acid-base status in blood to resting conditions was more rapid during alkalosis. Given this protocol, alkalosis does not help to sustain an intense exercise bout. These data suggest, however, that NaHCO3 may be of benefit following repeated work bouts.
|
https://pubmed.ncbi.nlm.nih.gov/6325355/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
6325355
|
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] |
6,325,522 |
Hemodynamic effects of vasodilators and long-term response in heart failure.
|
Franciosa J A JA, Dunkman W B WB, Leddy C L CL
|
Journal of the American College of Cardiology . Vol. 3, No. 6, 1984 Jun
|
Hemodynamic responses to vasodilators are commonly assessed when starting long-term vasodilator treatment in patients with chronic left ventricular failure, although the relation between short- and long-term responses is not established. Thus, short- and long-term hemodynamic responses to placebo and vasodilators (isosorbide dinitrate, minoxidil and enalapril or captopril) were measured and long-term clinical efficacy was assessed by changes in exercise capacity after 1 to 5 months of vasodilator administration (plus digitalis and diuretic agents) in 46 patients with New York Heart Association functional class II to IV heart failure caused by cardiomyopathy. There were no significant changes in hemodynamics or exercise capacity during placebo treatment. After initial doses and during long-term administration of vasodilator drugs, hemodynamics were significantly improved. After long-term vasodilator treatment, maximal oxygen uptake during exercise increased by 2.9 +/- 5.7 ml/min per kg from a control value of 14.1 +/- 5.6 ml/min per kg (p less than 0.01), and exercise duration also increased by 1.8 +/- 3.5 minutes (p less than 0.01). Changes in maximal oxygen uptake, however, did not correlate with short-term changes in pulmonary wedge pressure (correlation coefficient [r] = -0.14), cardiac index (r = -0.01) or systemic vascular resistance (r = -0.20). Long-term hemodynamic changes also failed to correlate with changes in exercise capacity. Baseline hemodynamics, cardiac dimensions and left ventricular ejection fraction before vasodilator administration all failed to correlate with baseline exercise capacity or with long-term changes in exercise capacity. Thus, hemodynamic measurements at initiation or during follow-up of vasodilator therapy do not relate to long-term clinical efficacy assessed by exercise capacity in patients with chronic left ventricular failure. Therefore, the rationale for making invasive hemodynamic measurements before initiating long-term vasodilator therapy for heart failure is questioned.
|
https://pubmed.ncbi.nlm.nih.gov/6325522/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article",
"Research Support, U.S. Gov't, Non-P.H.S."
] |
6325522
|
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6,325,612 |
Use of extraneous conversation in the teaching of nursing skills.
|
Benjamin G G, Benson R R, Crim B B, Edgar C C, Kautsch C C, Langland R M RM, Flynt T D TD, Raithel J A JA
|
The Journal of nursing education . Vol. 23, No. 3, 1984 Mar
|
The purpose of this study was to explore the use of extraneous conversation as a distractor while assessing students' level of skill acquisition in the laboratory. The sample consisted of 50 nursing students enrolled in Introduction to Nursing Methods at a large Midwestern university. Subjects were assigned randomly to experimental and control groups. Extraneous conversation was used as a distractor during skill demonstration of intramuscular injections by the 25 students in the experimental group. The 25 students in the control group were not verbally distracted during skill demonstration. These skill demonstrations were videotaped. Data were collected from three evaluations: during the skill demonstration, a rating was based on the inclusion of critical elements; later on viewing the video tapes, faculty assigned a score to the performance based on the number of elements included; students were re-evaluated in the clinical setting based on guidance given by the instructor, performance of critical and noncritical elements, and the smoothness of the performance. Analysis of data from the ratings of students in the laboratory and from the ratings of students from the video tapes with the Wilcoxon rank-sum test revealed no significant differences (a = .05) in performance for the experimental and control groups. Chi-square analysis of data from the evaluation in the clinical setting indicated that students in the experimental group performed at a higher level than students in the control group.
|
https://pubmed.ncbi.nlm.nih.gov/6325612/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6325612
|
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] |
6,325,657 |
Rapid diagnosis of adenoviral tonsillitis: a prospective clinical study.
|
Ruuskanen O O, Sarkkinen H H, Meurman O O, Hurme P P, Rossi T T, Halonen P P, Hänninen P P
|
The Journal of pediatrics . Vol. 104, No. 5, 1984 May
|
Adenovirus antigen was detected by radioimmunoassay in the nasopharyngeal specimens of 30 of 74 children with febrile exudative tonsillitis. In the other 44 children, the cause of tonsillitis was identified in 16 (beta-hemolytic streptococci or Epstein-Barr, parainfluenza, or herpes simplex viruses). The clinical picture of adenoviral tonsillitis was difficult to differentiate from that of streptococcal disease; 20 of the patients had originally been given antibiotics. In 68% of patients without complications, the serum concentration of C-reactive protein was less than 20 mg/L, suggesting a viral disease. No other hematologic test was found helpful in identifying the adenoviral tonsillitis. The rapid detection of adenovirus antigen permitted withdrawal of unnecessary and ineffective antibiotic treatment in most patients.
|
https://pubmed.ncbi.nlm.nih.gov/6325657/
|
[
"Clinical Trial",
"Journal Article"
] |
6325657
|
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] |
6,325,720 |
Inhibition of ischemia-induced thromboxane synthesis in man.
|
Lelcuk S S, Huval W V WV, Valeri C R CR, Shepro D D, Hechtman H B HB
|
The Journal of trauma . Vol. 24, No. 5, 1984 May
|
The ability of the imidazole derivative, ketoconazole, to inhibit thromboxane (Tx)A2 synthesis in response to ischemia was tested in ten volunteers. Two hours after taking placebo or ketoconazole 400 mg by mouth, plasma levels of the stable degradation product of TxA2, TxB2, were 300 +/- 129 pg/ml (mean +/- SEM) and 297 +/- 80 pg/ml, respectively. Arm ischemia for 10 min induced by inflation of a cuff to 220 mm Hg led to a rise in TxB2 levels to 657 +/- 157 pg/ml after placebo (p less than 0.05) and 337 +/- 81 pg/ml after ketoconazole. One hour after cuff deflation, TxB2 returned to pre-ischemia levels in both groups. Platelet TxB2 concentrations were 27 +/- 6 ng in the placebo and 35 +/- 6 ng/10(9) platelets in the ketoconazole group, and were unchanged by cuff inflation. The fact that plasma and platelet TxB2 values were not lower 2 hr after ketoconazole treatment was explored in another group of four nonstressed volunteers who received 400 mg of drug. After 2 hr, TxB2 values had fallen from 170 +/- 30 pg to 120 +/- 10 pg; at 4 hr, 6 hr, and 8 hr they were 30 +/- 20 pg, 5 +/- 5 pg, and 5 +/- 5 pg/ml, respectively. These results indicate that tourniquet ischemia provokes TxA2 synthesis, and that the source of this prostanoid is likely to be ischemic tissue and not platelets. Finally, ketoconazole can profoundly inhibit both background and stimulated TxA2 synthesis.
|
https://pubmed.ncbi.nlm.nih.gov/6325720/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, Non-P.H.S.",
"Research Support, U.S. Gov't, P.H.S."
] |
6325720
|
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6,325,730 |
Swine flu vaccine and multiple sclerosis.
|
Kurland L T LT, Molgaard C A CA, Kurland E M EM, Wiederholt W C WC, Kirkpatrick J W JW
|
JAMA . Vol. 251, No. 20, 1984 May 25
|
Using age-specific rates for multiple sclerosis (MS) based on a national survey, the number of "naturally occurring" new cases of MS among the 45 million swine flu vaccine recipients in the United States is estimated as 1,624 during the year after vaccination, or 31 cases per week. Information from available reports and publications indicates no excess over the expected frequencies. Analyses of admissions for MS before, during, and after the immunization program showed no increase to the US Army hospitals or to the Mayo Clinic. Three independent controlled clinical investigations performed on patients with MS showed no increase in the frequency of exacerbations among those receiving swine flu vaccine as compared with those receiving placebo. Epidemiologic features of MS do not implicate killed virus vaccine as an etiologic factor in onset or exacerbations of the disease. There is no indication from these analyses of any association or cause-and-effect relationship between swine flu vaccine and MS.
|
https://pubmed.ncbi.nlm.nih.gov/6325730/
|
[
"Clinical Trial",
"Journal Article"
] |
6325730
|
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6,325,909 |
Live attenuated varicella virus vaccine. Efficacy trial in healthy children.
|
Weibel R E RE, Neff B J BJ, Kuter B J BJ, Guess H A HA, Rothenberger C A CA, Fitzgerald A J AJ, Connor K A KA, McLean A A AA, Hilleman M R MR, Buynak E B EB
|
The New England journal of medicine . Vol. 310, No. 22, 1984 May 31
|
We conducted a double-blind, placebo-controlled efficacy trial of the live attenuated Oka/Merck varicella vaccine among 956 children between the ages of 1 and 14 years, with a negative clinical history of varicella. Of the 914 children who were serologically confirmed to be susceptible to varicella, 468 received vaccine and 446 received placebo. The vaccine produced few clinical reactions and was well tolerated. There was no clinical evidence of viral spread from vaccinated children to sibling controls. Approximately eight weeks after vaccination, 94 per cent of the initially seronegative children who received vaccine had detectable antibody to varicella. During the nine-month surveillance period, 39 clinically diagnosed cases of varicella, 38 of which were confirmed by laboratory tests, occurred among study participants. All 39 cases occurred in placebo recipients; no child who received vaccine contracted varicella. The vaccine was 100 per cent efficacious in preventing varicella in this population of healthy children (P less than 10(-9).
|
https://pubmed.ncbi.nlm.nih.gov/6325909/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
6325909
|
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] |
6,325,994 |
Effects of beta-receptor blockers in pharmacology EEG.
|
Eschmann G G, Irrgang V V, Rüther E E
|
Neuropsychobiology . Vol. 10, No. 2-3, 1983
|
10 normal volunteers (5 females, 5 males, 18-30 years) were treated for 4 days with the beta-blocker sotalol, 320 or 960 mg/day, 5 persons each in random order. A placebo was applied 5 days before and 2 days afterwards. Changes in blood pressure and pulse were not pronounced. EEG data from vigilance-controlled EEGs, evaluated in a spectral parameter analysis, showed a significant decrease of the absolute and relative alpha-power and the dominant alpha-amplitude and so far indicate a central nervous system action of sotalol.
|
https://pubmed.ncbi.nlm.nih.gov/6325994/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6325994
|
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] |
6,326,014 |
Lonidamine alone and in combination with other chemotherapeutic agents in the treatment of cancer patients.
|
Pacilio G G, Carteni G G, Biglietto M M, De Cesare M M
|
Oncology . Vol. 41 Suppl 1, 1984
|
The tolerance and antitumor activity of Lonidamine administered alone and in combination with other anticancer agents were studied. Myalgia was the most frequent side effect; there were no changes in the hematological parameters attributable to Lonidamine administration. 1 partial response out of the 16 patients treated with Lonidamine alone was observed.
|
https://pubmed.ncbi.nlm.nih.gov/6326014/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6326014
|
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6,326,063 |
Etoposide: a semisynthetic epipodophyllotoxin. Chemistry, pharmacology, pharmacokinetics, adverse effects and use as an antineoplastic agent.
|
Sinkule J A JA
|
Pharmacotherapy . Vol. 4, No. 2
|
Etoposide (VP 16) is a semi-synthetic derivative of 4'- demethylepipodophyllotoxin , a naturally occurring compound synthesized by the North American May apple (Podophyllum peltatum ) and the Indian species Podophyllum emodi Wallich . Although podophyllotoxins are classical spindle poisons causing inhibition of mitosis by blocking mitrotubular assembly, etoposide inhibits cell cycle progression at a premitotic phase (late S and G2), probably via inhibition of DNA synthesis. There appears to be a selective antileukemic dose response relationship when compared to normal hematopoietic elements. Etoposide is effective when administered orally at about twice the recommended parenteral dosage. Schedule dependency in both animal models and clinical trials has been observed; multiple dosing over three to five consecutive days is superior to weekly single dose administration. Etoposide's dose-limiting toxicity is myelosuppression (leukopenia), which is quite predictable; alopecia and Gl toxicity (nausea, vomiting, stomatitis) occur in about 20-30% of patients given recommended dosages. Etoposide appears to be one of the most active drugs for small cell lung cancer, testicular carcinoma (the Food and Drug Administration approved indication), ANLL and malignant lymphoma. Etoposide also has demonstrated activity in refractory pediatric neoplasms, hepatocellular, esophageal, gastric and prostatic carcinoma, ovarian cancer, chronic and acute leukemias and non-small cell lung cancer, although additional single and combination drug studies are needed to substantiate these data. Its contribution in front-line combination chemotherapeutic regimens for these cancers will be better defined in the forthcoming years. Etoposide appears to have minimal activity in breast cancer and, based on current data, it is inactive against malignant melanoma, colorectal adenocarcinoma and cancer of the head and neck, although the dosage and schedules used in many of the Phase II studies may have been suboptimal.
|
https://pubmed.ncbi.nlm.nih.gov/6326063/
|
[
"Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S.",
"Review"
] |
6326063
|
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] |
6,326,178 |
Biochemical correlates of antidepressant response. Results of a trazodone versus amitriptyline trial.
|
Healy D D, Carney P A PA, Leonard B E BE
|
Psychopathology . Vol. 17 Suppl 2, 1984
|
Changes in the uptake of 3H-serotonin into platelets, serotonin receptor activity on platelets, and plasma free and bound tryptophan concentrations were determined in a group of 54 moderately to severely depressed patients (mean Hamilton Rating Scale 17) before and during treatment with either trazodone or amitriptyline. No difference was found between the free and bound tryptophan concentrations of the depressed patients or their controls nor was any change detected during drug treatment. Platelet serotonin receptor activity and uptake were significantly lower in the depressed patients than in the controls and in those patients which subsequently responded to drug treatment. There was no apparent correlation between the ability of trazodone to inhibit the uptake of serotonin into the platelets and the antidepressant response; all patients responding to drug treatment showed an enhanced serotonin uptake. There is evidence from this study that changes in serotonin receptor function and uptake into platelets may correlate with the clinical status of depressed patients.
|
https://pubmed.ncbi.nlm.nih.gov/6326178/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6326178
|
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] |
6,326,244 |
Prospective, randomized, comparative trials in the therapy for intraabdominal and female genital tract infections.
|
Harding G K GK, Nicolle L E LE, Haase D A DA, Aoki F Y FY, Stiver H G HG, Blanchard R J RJ, Kirkpatrick J R JR
|
Reviews of infectious diseases . Vol. 6 Suppl 1
|
The results of four prospective, randomized comparative trials, in which the authors' two university teaching hospitals participated, that compared selected antimicrobial regimens with the combination of clindamycin and an aminoglycoside in the therapy for intraabdominal and female genital tract infections are reviewed. In the first trial, the rates of cure for patients with intraabdominal infections were 33 (79%) of 42 treated with clindamycin and gentamicin, 43 (81%) of 53 treated with chloramphenicol and gentamicin, and 35 (90%) of 39 treated with ticarcillin and gentamicin. The rates of cure for females with genital tract infections were 16 (94%) of 17, 11 (100%) of 11, and 12 (92%) of 13 treated with the three respective combinations. The rates of cure in the second study were 22 (88%) of 25 treated with metronidazole and gentamicin and 23 (88%) of 26 treated with clindamycin and gentamicin. In the third study, the rates of cure were 23 (82%) of 28 treated with cefoxitin and tobramycin as compared with 24 (89%) of 27 treated with clindamycin and tobramycin. In the fourth study, 21 (87%) of 24 patients treated with ceftizoxime alone are cured as compared with 13 (87%) of 15 treated with clindamycin and tobramycin. These prospective, randomized trials suggest that chloramphenicol and gentamicin, ticarcillin and gentamicin, metronidazole and gentamicin, cefoxitin and tobramycin, or ceftizoxime alone are as effective as clindamycin and gentamicin or tobramycin in therapy for mixed aerobic/anaerobic infections.
|
https://pubmed.ncbi.nlm.nih.gov/6326244/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
6326244
|
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] |
6,326,562 |
Effects of guar gum in male subjects with hypercholesterolemia.
|
Aro A A, Uusitupa M M, Voutilainen E E, Korhonen T T
|
The American journal of clinical nutrition . Vol. 39, No. 6, 1984 Jun
|
Fourteen male subjects with hypercholesterolemia received daily supplementation with granulated guar gum or placebo, 15 g/day, during 12 wk in a double-blind, cross-over trial. A statistically significant reduction in serum total cholesterol (7.27 +/- 0.24 versus 8.23 +/- 0.26 mmol/l, mean +/- SEM, p less than 0.01) which was mainly due to a reduction in low-density lipoprotein cholesterol concentration (4.70 +/- 0.19 versus 5.32 +/- 0.23 mmol/l, p less than 0.05) was observed after 6 wk on guar gum as compared with placebo. Between 6 and 12 wk on guar gum the serum cholesterol and low-density lipoprotein cholesterol levels increased in most subjects, and after 12 wk the difference from placebo was no longer statistically significant. Serum high-density lipoprotein cholesterol levels were unaffected by guar gum. Serum and lipoprotein triglycerides showed no significant changes during the study, and the body weight of the subjects remained unchanged. Serum calcium, magnesium, phosphate, and iron levels, and urinary calcium excretion were not affected by guar gum supplementation. No severe side effects were observed, necessitating reduction of the dose or stopping the treatment. It is concluded that the hypocholesterolemic effect of guar gum seems to decrease during prolonged dietary supplementation. Further controlled studies are needed before the dose response and the long-term effects of guar gum in hypercholesterolemia can be evaluated.
|
https://pubmed.ncbi.nlm.nih.gov/6326562/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6326562
|
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] |
6,326,632 |
Oral acyclovir for prevention of herpes simplex virus reactivation after marrow transplantation.
|
Wade J C JC, Newton B B, Flournoy N N, Meyers J D JD
|
Annals of internal medicine . Vol. 100, No. 6, 1984 Jun
|
Oral acyclovir was found to be safe and effective for the prevention of herpes simplex virus reactivation after marrow transplantation in a double-blind, placebo-controlled trial. Acyclovir or placebo was administered to 49 patients for 5 weeks beginning 1 week before transplantation: 5 of 24 patients receiving acyclovir developed herpes simplex virus infection during prophylaxis, compared to 17 of 25 patients receiving placebo (p less than 0.01). The median time to first virus reactivation was significantly longer among patients receiving acyclovir (78 days versus 9 days after transplant, p = 0.006). The effect was even more pronounced when the analysis was adjusted for drug compliance: Among patients taking a minimum of 40% of their prescribed drug, acyclovir was 96% virologically effective and 100% clinically effective during the period of administration. Acyclovir use was also associated with significantly more rapid marrow engraftment in patients receiving methotrexate. No virus resistant to acyclovir was isolated. Oral acyclovir provides effective prophylaxis against reactivation of herpes simplex virus among severely immunosuppressed patients able to take orally administered drugs.
|
https://pubmed.ncbi.nlm.nih.gov/6326632/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S."
] |
6326632
|
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6,326,743 |
Field trials to test the efficacy of polyvalent Marek's disease vaccines in broilers.
|
Witter R L RL, Sharma J M JM, Lee L F LF, Opitz H M HM, Henry C W CW
|
Avian diseases . Vol. 28, No. 1
|
The efficacies of trivalent (Md11/75C + SB-1 + HVT), bivalent (SB-1 + HVT), and turkey herpesvirus (HVT) vaccines against Marek's disease (MD) were compared in commercial broiler flocks in four trials involving 11 farm locations and 486,300 chickens. In all four trials, chickens receiving polyvalent vaccines had lower leukosis (MD) condemnation rates than chickens vaccinated with HVT alone; when data were summarized for each vaccine type in each trial, condemnation rates for the bivalent- or trivalent-vaccinated groups were 56-96% (mean 78%) lower than those for HVT-vaccinated chickens. Polyvalent vaccination was clearly mor efficacious than HVT in 8 of 11 individual farms, although it did not always reduce leukosis condemnations to acceptable levels. Body weights of chickens vaccinated with polyvalent vaccines did not differ consistently from those vaccinated with HVT. Chickens inoculated with the trivalent vaccine had slightly lower overall leukosis condemnation rates (0.24%) than those inoculated with the bivalent vaccine (0.45%) in trials 1-3, where direct comparisons were made. Bivalent vaccines containing either 1,500 or 200 plaque-forming units of SB-1 virus were equally effective; thus, HVT may need to be supplemented with only small amounts of SB-1 to obtain the benefits of protective synergism. SB-1 virus did not appear to carry over from polyvalent-vaccinated flocks to subsequent HVT-vaccinated flocks in the same houses, even when old litter was used.
|
https://pubmed.ncbi.nlm.nih.gov/6326743/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article"
] |
6326743
|
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] |
6,326,785 |
Recovery characteristics following antagonism of atracurium with neostigmine or edrophonium.
|
Jones R M RM, Pearce A C AC, Williams J P JP
|
British journal of anaesthesia . Vol. 56, No. 5, 1984 May
|
The evoked reversal characteristics of atracurium were studied in 21 patients using edrophonium or neostigmine and a train-of-four pattern of stimulation. Reversal of residual atracurium -induced neuromuscular blockade was significantly more rapid using edrophonium compared with neostigmine. The ratio of the fourth twitch in the train-of-four to the first twitch--the T4 ratio--was significantly greater when the first twitch (T1) had recovered to 75% of control T1, using edrophonium compared with neostigmine. A T4 ratio of 0.5 was confirmed to be compatible with the reliable and safe reversal of atracurium -induced neuromuscular blockade.
|
https://pubmed.ncbi.nlm.nih.gov/6326785/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
6326785
|
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] |
6,326,784 |
Acute intravenous and sustained oral treatment with the beta1 agonist prenalterol in patients with chronic severe cardiac failure.
|
Currie P J PJ, Kelly M J MJ, Middlebrook K K, Federman J J, Sainsbury E E, Ashley J J, Pitt A A
|
British heart journal . Vol. 51, No. 5, 1984 May
|
Prenalterol, a beta1 agonist, was given in a single blind acute intravenous study to seven patients with cardiac failure (New York Heart Association class II and III). It was then given in a double blind crossover study of sustained oral prenalterol to six of them. As a result of dose titration studies the oral dose of prenalterol given was 100 mg twice a day in all patients. Erect bicycle sprint tests were performed to exercise tolerance before and after treatment had been started. Cardiac function was assessed at rest and during graded supine bicycle exercise by determining haemodynamic indices using a Swan-Ganz catheter and radionuclide left ventricular ejection fractions. In the intravenous study cardiac function was assessed at rest and during exercise after a control infusion of dextrose and after an infusion of 5 mg prenalterol. In the oral crossover study a placebo or prenalterol were given for two periods of two weeks; at the end of each period exercise tolerance was measured and cardiac function assessed at rest and during exercise. Throughout the study period there was no change in symptoms, medication, or exercise tolerance. Intravenous prenalterol significantly improved cardiac function; left ventricular ejection fraction and cardiac index increased and left ventricular filling pressure fell both at rest and during exercise. Sustained oral treatment with prenalterol, however, did not improve resting left ventricular filling pressure or left ventricular ejection fraction at rest or during exercise but did increase heart rate at rest, and mean blood pressure and peripheral vascular resistance at rest and during exercise; in fact, during exercise left ventricular filling pressure was significantly increased while cardiac index and stroke volume index were decreased by prenalterol. Sustained oral treatment with prenalterol did not have the beneficial effects on cardiac function produced by intravenous treatment and in fact had deleterious effect on the measured indices of cardiac function during exercise.
|
https://pubmed.ncbi.nlm.nih.gov/6326784/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
6326784
|
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] |
6,326,788 |
Prejunctional and postjunctional effects of tubocurarine and pancuronium in man.
|
Stanec A A, Baker T T
|
British journal of anaesthesia . Vol. 56, No. 6, 1984 Jun
|
The effects of small doses of tubocurarine and pancuronium on peak tetanic tension and tetanic maintenance were compared. Forty patients undergoing elective orthopaedic procedures under general anaesthesia were studied. Changes in neuromuscular transmission were measured by recording the isometric contraction of the adductor pollicis muscle evoked by supramaximal stimulation of the ulnar nerve at the wrist. Small doses of pancuronium affected predominantly the peak tetanic tension, while small doses of tubocurarine affected mainly tetanic maintenance. Thus, different degrees of depression of peak tetanic tension and tetanic maintenance were observed with tubocurarine and pancuronium. This clinical study supports Bowman's hypothesis, based upon laboratory findings in the cat, that prejunctional and postjunctional effects of neuromuscular blocking agents depend on their affinity for cholinoceptors at different sites.
|
https://pubmed.ncbi.nlm.nih.gov/6326788/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
6326788
|
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6,326,924 |
The effect of mianserin on alpha-2 adrenergic receptor function in depressed patients.
|
Charney D S DS, Heninger G R GR, Sternberg D E DE
|
The British journal of psychiatry : the journal of mental science . Vol. 144, 1984 Apr
|
Recent clinical investigations have shown that long term treatment with the tricyclic antidepressants desipramine and amitriptyline reduces the sensitivity of the alpha-2 adrenergic autoreceptor. In order to determine whether the tetracyclic antidepressant mianserin also has this action, the effect of clonidine, an alpha-2 adrenergic receptor agonist, on plasma levels of the norepinephrine metabolite 3-methoxy-4- hydroxyphenlethyleneglycol (MHPG), blood pressure, and patient-rated sedation were measured in fifteen depressed patients before and during mianserin treatment. Postsynaptic alpha-2 adrenergic receptor function was assessed by measuring the growth hormone response to clonidine before and during treatment. Mianserin had little or no effect on the ability of clonidine to lower plasma MHPG and blood pressure, and to increase sedation and growth hormone secretion. The findings of this investigation indicates that long term mianserin treatment does not produce significant subsensitivity of the alpha-2 adrenergic receptor and suggests that a reduction in alpha-2 adrenergic autoreceptor sensitivity is not a necessary action for all effective antidepressant treatments.
|
https://pubmed.ncbi.nlm.nih.gov/6326924/
|
[
"Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S."
] |
6326924
|
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] |
6,326,927 |
Analysis and management of renal failure in fourth MRC myelomatosis trial. MRC working party on leukaemia in adults.
|
British medical journal (Clinical research ed.) . Vol. 288, No. 6428, 1984 May 12
|
During March 1980 to February 1982, 73 out of 80 patients in renal failure admitted to the fourth MRC myelomatosis trial were managed by a planned policy of high fluid intake (greater than or equal to 3 1/24 h) in addition to receiving one of the two chemotherapeutic regimens being tested in the main trial. Patients were also randomised to receive either sodium bicarbonate to render their urine neutral or no supplement. Follow up continued till death or to April 1983. Of 49 patients who survived more than 100 days, 39 achieved reversal of their renal failure (18 complete, 21 partial). Recovery of renal function, as assessed by a fall in the serum creatinine concentration, was achieved even when light chain proteinuria persisted. Partial recovery of renal function was associated with prolonged useful life in several patients. In only 14 of the 80 patients studied was death directly attributable to renal failure. Survival of patients in the study was appreciably better than in equivalent groups of patients in other MRC trials in which less stringent policies of fluid intake were used. Patients randomised to receive alkali fared marginally better than the others, but the difference was not significant. These results show that in many cases patients with myelomatosis who develop renal failure may have this complication reversed by taking a high fluid intake. Furthermore, though light chain is an essential component of renal disease in these patients, other factors are also important and are accessible to treatment.
|
https://pubmed.ncbi.nlm.nih.gov/6326927/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6326927
|
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|
6,326,932 |
Radiotherapy in small cell cancer of the lung treated with combination chemotherapy: a controlled trial.
|
Souhami R L RL, Geddes D M DM, Spiro S G SG, Harper P G PG, Tobias J S JS, Mantell B S BS, Fearon F F, Bradbury I I
|
British medical journal (Clinical research ed.) . Vol. 288, No. 6431, 1984 Jun 02
|
Three hundred and seventy one patients with extensive or limited small cell cancer of the lung took part in a randomised trial to evaluate irradiation of the primary tumour in patients treated with combination chemotherapy. They were randomly allocated to treatment either with chemotherapy alone (198) or with both chemotherapy and radiotherapy (173). All 371 initially received 12 weeks of chemotherapy after which they were categorised according to response. Only those with stable or responding disease continued with their allotted treatment. Thus 144 received chemotherapy alone and 135 received both chemotherapy and radiotherapy. The design of the study permitted analysis of the effect of radiotherapy according to initial extent of disease and quality of early response to chemotherapy. Radiotherapy (40 Gy (4000 rad), one fraction a day over 20 days) did not improve the survival of patients in any category of initial extent of disease or early response to chemotherapy and was not effective in preventing local relapse.
|
https://pubmed.ncbi.nlm.nih.gov/6326932/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6326932
|
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] |
6,326,999 |
Combined modality therapy for Stage IIIMO non-small cell lung cancer. A five-year experience.
|
Madej P J PJ, Bitran J D JD, Golomb H M HM, Hoffman P G PG, DeMeester T T, Desser R K RK, Kaul R R, Raghavan V V, Newman S B SB, Skosey C C
|
Cancer . Vol. 54, No. 1, 1984 Jul 01
|
Between 1975 and 1980, 101 patients with inoperable Stage IIIMO non-small cell lung carcinoma were entered into combined radiotherapy and chemotherapy trials at Michael Reese Hospital and University of Chicago Hospital. Sixty-four percent of the patients responded. Median survival for all patients was 8.8 months. Responders survived 13.7 months and nonresponders 4.6 months (P = 0.002). Patients treated with 4200 rad had a higher response rate than those treated with 3000 rad (74% versus 54%, P = 0.04) but there was no difference in survival. Although all patients with squamous cell carcinoma died by 30 months, 18% of patients with adenocarcinoma and 20% of patients with large cell carcinoma are long-term survivors. Brain metastases occurred more frequently in patients with large cell or adenocarcinoma than in patients with squamous cell carcinoma (P = 0.02). The prognostic effect of age, initial performance status, sex, histology, and tumor extent are examined. Toxicity was substantial with a 13% treatment-related mortality. Combined modality therapy may benefit selected patients with non-squamous cell types, but more effective chemotherapeutic agents are needed. Prophylactic cranial irradiation in patients with large cell carcinoma or adenocarcinoma may decrease the incidence of subsequent brain metastases.
|
https://pubmed.ncbi.nlm.nih.gov/6326999/
|
[
"Clinical Trial",
"Comparative Study",
"Controlled Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
6326999
|
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] |
6,327,139 |
Slowly digested carbohydrate food improves impaired carbohydrate tolerance in patients with cirrhosis.
|
Jenkins D J DJ, Thorne M J MJ, Taylor R H RH, Bloom S R SR, Sarson D L DL, Jenkins A L AL, Blendis L M LM
|
Clinical science (London, England : 1979) . Vol. 66, No. 6, 1984 Jun
|
To test whether impaired carbohydrate tolerance in cirrhosis could be modified by dietary means ten cirrhotic patients, five of them taking insulin, took as breakfast either lentils or wholemeal bread and cottage cheese containing the same amount of carbohydrate and protein. Lentils resulted in significantly diminished blood glucose, insulin (in those not on insulin) and gastric inhibitory peptide responses. Enteroglucagon and neutrotensin levels were high with lentils, suggesting that absorption of lentil carbohydrate continued into the ileum with perhaps some malabsorption, so confirming the results of earlier studies in vitro. However, breath hydrogen studies on a separate group of eight healthy volunteers indicated that the difference in carbohydrate malabsorption between lentil, and wholemeal bread was insignificant. It is suggested that slowly digested carbohydrate foods, such as leguminous seeds, may minimize carbohydrate intolerance in patients with cirrhosis.
|
https://pubmed.ncbi.nlm.nih.gov/6327139/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6327139
|
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] |
6,327,141 |
Cardiac sensitivity to isoprenaline, lymphocyte beta-adrenoceptors and age.
|
Fitzgerald D D, Doyle V V, Kelly J G JG, O'Malley K K
|
Clinical science (London, England : 1979) . Vol. 66, No. 6, 1984 Jun
|
The heart rate response to isoprenaline in 11 subjects aged 19-46 years was compared with lymphocyte beta-adrenoceptor numbers and lymphocyte cyclic AMP responsiveness. The dose of isoprenaline required to increase heart rate by 25 beats/min ( CD25 ) increased as a function of age (r 0.79; P less than 0.01). Lymphocyte receptor numbers also correlated directly with age (r 0.61; P less than 0.05), but there was no true correlation between CD25 and lymphocyte receptor numbers. Baseline and maximum lymphocyte cyclic AMP concentrations in response to isoprenaline stimulation in vitro were unrelated to age, CD25 or receptor numbers. This study confirms previous findings of a reduced responsiveness with age and a rise in receptor numbers in young and middle-aged adults. However, the decline in the heart response to isoprenaline was unrelated to any measurable change in beta-adrenoceptor concentration or responses, at least in the isolated lymphocyte.
|
https://pubmed.ncbi.nlm.nih.gov/6327141/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6327141
|
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] |
6,327,190 |
Veralipride versus conjugated oestrogens: a double-blind study in the management of menopausal hot flushes.
|
Wesel S S, Bourguignon R P RP, Bosuma W B WB
|
Current medical research and opinion . Vol. 8, No. 10, 1984
|
A double-blind, randomized study was carried out in 43 women, who had undergone spontaneous menopause at least 6 months earlier, to compare the effectiveness and tolerance of veralipride with that of a conjugated oestrogens preparation in the control of hot flushes. Twenty-one women received 100 mg veralipride per day and 22 were due to receive 1.25 mg per day of the hormone preparation over a period of 20 days but 3 women in the oestrogen group discontinued the trial without giving any reason. The number, duration and severity of hot flushes were assessed and scored at the start of the trial and during treatment. Statistical analysis of the results showed marked relief with both preparations but no significant difference between them in terms of effectiveness or tolerance. Veralipride, however, appeared to provide better control in patients who had complained of severe hot flushes initially.
|
https://pubmed.ncbi.nlm.nih.gov/6327190/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
6327190
|
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] |
6,327,346 |
The effects of oral and subcutaneous administration of terbutaline in asthmatic patients.
|
van den Berg W W, Leferink J G JG, Maes R A RA, Fokkens J K JK, Kreukniet J J, Bruynzeel P L PL
|
European journal of respiratory diseases. Supplement . Vol. 134, 1984
|
In 8 asthmatic subjects, serum concentrations of terbutaline were correlated with changes in volume of air expelled in the first second of forced expiration (FEV1), other parameters of lung function, c-AMP plasma concentrations and finger tremor values after administration of either 5 mg terbutaline sulphate orally, 0.5 mg terbutaline sulphate subcutaneously or an oral placebo. Prior to the investigation, the patients had not used bronchodilators for 10-14 days. All lung function parameters and tremor values showed a significant correlation with the terbutaline (serum) concentrations in the central compartment and with the c-AMP plasma concentrations. FEV1 was the least variable lung function test. The maximal effect on FEV1 occurred 30-60 min after the subcutaneous dose and 2-4 h after the oral dose, corresponding with the maximal terbutaline serum concentrations and c-AMP plasma levels. In this study, the FEV1 improvement showed a linear relationship with the terbutaline serum concentrations between 1.6 and 6 ng/mL. Three out of 8 asthmatics showed an increase in tremor of more than 6 dB after subcutaneous administration, which corresponded with the awareness of this side-effect. In contrast to theophylline and anticholinergic agents, terbutaline serum concentrations showed a very low interindividual variance. As a consequence, the serum terbutaline concentration was almost predictable. However, the lung function improvement was not predictable since there seems to exist an individual sensitivity for this agonist.
|
https://pubmed.ncbi.nlm.nih.gov/6327346/
|
[
"Clinical Trial",
"Comparative Study",
"Controlled Clinical Trial",
"Journal Article"
] |
6327346
|
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] |
6,327,479 |
Ranitidine: prophylaxis of duodenal ulcer recurrence.
|
Lee F I FI, Fielding J D JD, Holmes G K GK, Hine K R KR, Gibson J A JA, Lochee-Bayne E E, Mackay C C, Mitchell K G KG, Pickard W R WR, Orchard R T RT
|
Hepato-gastroenterology . Vol. 31, No. 2, 1984 Apr
|
Ninety-two patients with healed duodenal ulcer received prophylactic treatment with ranitidine, 150 mg at night, to prevent relapse. Patients were reviewed at 4-monthly intervals for clinical assessment and endoscopy. Eighty-two patients completed the trial. After one year sixty-two patients (76%) were in endoscopic remission; ten patients (12%) suffered symptomatic relapse and ten others had asymptomatic ulcers during treatment. There were no clinically significant untoward effects associated with the drug. A single nocturnal dose of 150 mg ranitidine reduces the relapse rate after duodenal ulcer healing.
|
https://pubmed.ncbi.nlm.nih.gov/6327479/
|
[
"Clinical Trial",
"Journal Article"
] |
6327479
|
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] |
6,327,513 |
Salt sensitivity in humans is linked to enhanced sympathetic responsiveness and to enhanced proximal tubular reabsorption.
|
Skrabal F F, Herholz H H, Neumayr M M, Hamberger L L, Ledochowski M M, Sporer H H, Hörtnagl H H, Schwarz S S, Schönitzer D D
|
Hypertension (Dallas, Tex. : 1979) . Vol. 6, No. 2 Pt 1
|
If high sodium intake is involved in the pathogenesis of essential hypertension, the effects of changing the sodium intake should be demonstrable in the susceptible part of the normotensive population. Therefore, we have investigated the effects of moderate salt restriction in 52 young normotensive subjects with and without a family history of hypertension; 22 (42%) responded to moderate salt restriction (200 to 50 mmol/day) over 2 weeks, with a significant fall in blood pressure shown by continuous automatic blood pressure recordings. Accordingly, these subjects were classified as salt-sensitive, and the remainder as salt-resistant. Compared to salt-resistant subjects, salt-sensitive subjects showed a 2.5-fold higher incidence of a positive family history of hypertension (p less than 0.01), and a significantly higher blood pressure and lower salivary sodium concentration during the usual high sodium diet. Although there were no differences in Na,K-ATPase activity and in Na-K cotransport of erythrocytes, the pressor response to infused norepinephrine in salt-sensitive subjects was double that of salt-resistant subjects independent of the diet and this was linked to indirect evidence for enhanced proximal tubular sodium reabsorption. On the usual high sodium diet, 40% of the normal population may be salt-sensitive and prone to develop hypertension. Hypersensitivity to catecholamines (genetically determined?) may be the cause of salt sensitivity. A low sodium concentration in saliva deserves further study as a simple screening test to identify salt-sensitive subjects.
|
https://pubmed.ncbi.nlm.nih.gov/6327513/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
6327513
|
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] |
6,327,543 |
Combination therapy of sodium stibogluconate and rifampin in cutaneous leishmaniasis.
|
Pareek S S SS
|
International journal of dermatology . Vol. 23, No. 1
|
Thirty-two patients having cutaneous leishmaniasis were divided into two groups: 16 were treated with sodium stibogluconate 600 mg intramuscularly daily for 12 days and 16 were treated with 600 mg rifampin daily for 21 days. The failure rate was 56% and 50%, respectively. The 17 patients who did not respond were treated with a combination of the two drugs, which produced better results in 13 of the 17 patients.
|
https://pubmed.ncbi.nlm.nih.gov/6327543/
|
[
"Clinical Trial",
"Comparative Study",
"Controlled Clinical Trial",
"Journal Article"
] |
6327543
|
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] |
6,327,600 |
Pivmecillinam for bacteriuria in pregnancy.
|
Sanderson P P, Menday P P
|
The Journal of antimicrobial chemotherapy . Vol. 13, No. 4, 1984 Apr
|
Pivmecillinam was given to 44 women with bacteriuria in pregnancy. Treatment was successful in 33 (87%) out of the 38 patients assessed. Thirty women subsequently received at random either a low-dose of pivmecillinam for up to three months or acted as a control group. Further bacteriuric episodes during pregnancy were recorded only in three patients in the control group. Thirty-nine out of the 41 women followed to term delivered healthy babies. One infant was stillborn and another child had a cleft palate. Neither was considered to be related to treatment with pivmecillinam.
|
https://pubmed.ncbi.nlm.nih.gov/6327600/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
6327600
|
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] |
6,327,758 |
The new steroid analog RU 486 inhibits glucocorticoid action in man.
|
Bertagna X X, Bertagna C C, Luton J P JP, Husson J M JM, Girard F F
|
The Journal of clinical endocrinology and metabolism . Vol. 59, No. 1, 1984 Jul
|
RU 486 [17 beta-hydroxy-11 beta-(4- dimethylaminophenyl )-17 alpha-(prop-1- ynyl )-estra-4,9-dien-3-one] is a new steroid analog which antagonizes glucocorticoid action at the receptor level in animals. To assess its potential antiglucocorticoid activity in man we studied the pituitary-adrenal response to RU 486 in normal men. The compound was administered at 0200 h and plasma cortisol and lipotropins (LPH) were measured hourly for 10 h. After 400 mg RU 486 significant and sustained elevation of both hormones occurred during the 0700-1200 h period: mean (+/- SE) plasma levels after placebo or RU 486 during this interval were, respectively, for cortisol (ng/ml), 63.4 +/- 8.2 and 112.7 +/- 2.9 (P less than 0.02); and for LPH (pg/ml), 34.8 +/- 11.3 and 71.6 +/- 15.4 (P less than 0.01). The 200- and 100-mg doses induced only transient cortisol and LPH increases. Administration of RU 486 (400 mg) at 1400 h induced no increase in plasma cortisol compared to placebo in the corresponding 2000 to 2400 h period. When RU 486 was administered concomitantly with dexamethasone (1 mg) at 2400 h, dose-dependent blockade of the dexamethasone-induced cortisol suppression at 0900 h was found (r = 0.62, P less than 0.01); this blockade was partial after the 100-mg dose, but complete after the 400-mg dose. Plasma LPH and ACTH showed parallel variations. We conclude that RU 486 antagonizes the negative pituitary feedback of both the nocturnal endogenous cortisol rise and exogenously administered dexamethasone. These actions are consistent with an antiglucocorticoid activity of this compound in man.
|
https://pubmed.ncbi.nlm.nih.gov/6327758/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
6327758
|
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] |
6,327,784 |
Systemic ketoconazole in tinea versicolor: a double-blind evaluation and 1-year follow-up.
|
Savin R C RC
|
Journal of the American Academy of Dermatology . Vol. 10, No. 5 Pt 1, 1984 May
|
A 4-week, double-blind comparison of ketoconazole and placebo was conducted in sixty-six patients with tinea versicolor. Two hundred milligrams of ketoconazole in a daily oral dose was effective in producing a clinical and mycologic cure: lesions in thirty-three of thirty-four patients on active drug were completely healed (97%), and one patient had a mild residual effect. Only three patients on placebo were considered to have responded, and none experienced complete healing. Potassium hydroxide (KOH) examinations were negative in all but one of the patients given ketoconazole. All patients receiving ketoconazole who were KOH-negative at week 4 also showed negative results when reexamined 8 weeks later. Patients who did not respond (virtually all of the patients given placebo) were subsequently treated with a topical imidazole lotion. Safety evaluation, including blood chemistry tests and a comprehensive liver function battery, showed no differences between the ketoconazole and placebo groups. Ketoconazole was well tolerated and produced no significant adverse effects. Follow-up after 1 year revealed that 64% of patients given ketoconazole were still clear, whereas only 11% of patients who received placebo (later treated with imidazole topically) were clear after 1 year.
|
https://pubmed.ncbi.nlm.nih.gov/6327784/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6327784
|
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] |
6,327,800 |
Lack of ACTH lowering effect of sodium valproate in patients with ACTH hypersecretion.
|
Loli P P, Berselli M E ME, Frascatani F F, Muratori F F, Tagliaferri M M
|
Journal of endocrinological investigation . Vol. 7, No. 2, 1984 Apr
|
The effect of an oral dose of 200 or 400 mg sodium valproate (DPA) on ACTH and cortisol secretion was assessed in 11 patients with Cushing's disease (3 bilaterally adrenalectomized), 3 patients with Nelson's syndrome and 6 patients with Addison's disease. In none of the patients examined DPA induced changes in ACTH (and cortisol) levels appreciably different from the fluctuations recorded after placebo administration. The effect of a long term administration of sodium valproate (600-1000 mg/day) was evaluated in 2 patients with active Cushing's disease and in 1 patient with Nelson's syndrome (3 weeks, 3, 9 months respectively); in the 2 patients with Cushing's disease ACTH and cortisol secretion, 17-hydroxy-corticosteroids (17-OHCS) urinary excretion did not change during DPA treatment. Similarly the cortisol response to hypoglycemia and the 17-OHCS urinary excretion after dexamethasone were not normalized. Long term DPA administration did not induce either clinical or hormonal modifications in the patient with Nelson's syndrome. These findings do not support the possibility that a deficiency of a GABAergic system plays a role in the pathogenesis of ACTH hypersecretion. DPA does not seem to be of therapeutical value in the medical management of Cushing's disease and Nelson's syndrome.
|
https://pubmed.ncbi.nlm.nih.gov/6327800/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
6327800
|
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] |
6,327,924 |
Increased incidence of acute nonlymphocytic leukemia following therapy in patients with small cell carcinoma of the lung.
|
Chak L Y LY, Sikic B I BI, Tucker M A MA, Horns R C RC, Cox R S RS
|
Journal of clinical oncology : official journal of the American Society of Clinical Oncology . Vol. 2, No. 5, 1984 May
|
A group of 158 patients with small cell carcinoma of the lung were followed for 174.5 person-years of observation to determine the risk of acute leukemia. Three cases of acute nonlymphocytic leukemia were observed at 2.3, 2.7, and 3.0 years. The relative risk of developing leukemia was 316 (95% confidence limit, 76-818) and the actuarial risk was 25% +/- 13% at 3.1 years. The relative risk for leukemia was significantly increased in these patients (p less than 0.0001).
|
https://pubmed.ncbi.nlm.nih.gov/6327924/
|
[
"Case Reports",
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Research Support, U.S. Gov't, P.H.S."
] |
6327924
|
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] |
6,327,927 |
Combined modality treatment of extensive small cell lung cancer: a Southwest Oncology Group study.
|
Livingston R B RB, Mira J G JG, Chen T T TT, McGavran M M, Costanzi J J JJ, Samson M M
|
Journal of clinical oncology : official journal of the American Society of Clinical Oncology . Vol. 2, No. 6, 1984 Jun
|
The Southwest Oncology Group entered 453 patients with extensive small cell carcinoma into a combined modality treatment program, involving a randomized comparison of three different chemotherapy regimens for remission induction, and of maintenance chemotherapy alone versus maintenance treatment with cycles of reinduction added at six and 12 months. In addition, there was systematic comparison of diagnosis by institutional pathologist versus review panel pathologist. No difference was observed among the three different induction arms with respect to the incidence of response to treatment (61%), complete response (16%), or survival duration (median, 31 weeks). Neither overall response rate nor survival are superior to previous results. However, patients who achieved a complete response demonstrated significant survival benefit if they were in the group who received reinduction chemotherapy, as opposed to maintenance alone. This observation may apply most importantly to patients with small cell lung cancer of limited extent, for whom complete response is achieved in a majority. Agreement of institutional and review panel pathologists on the diagnosis of small cell lung cancer was observed in 94% of reviewed cases. A final observation is that the omission of chest irradiation results in a dramatic increase in the incidence of initial relapse at the primary tumor site. This suggests that future studies will need to use better therapy for local control in responding patients.
|
https://pubmed.ncbi.nlm.nih.gov/6327927/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, U.S. Gov't, P.H.S."
] |
6327927
|
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] |
6,327,926 |
Neocarzinostatin versus m-AMSA or doxorubicin in hepatocellular carcinoma.
|
Falkson G G, MacIntyre J M JM, Schutt A J AJ, Coetzer B B, Johnson L A LA, Simson I W IW, Douglass H O HO
|
Journal of clinical oncology : official journal of the American Society of Clinical Oncology . Vol. 2, No. 6, 1984 Jun
|
Sixty-one of 76 patients entered on a prospective randomized trial of neocarzinostatin ( NCZ ) versus m-AMSA or doxorubicin were eligible for analysis. Among these 61 patients at least one episode of severe toxicity was documented in 39% of patients on NCZ and 58% on m-AMSA. Fifty-one of the 61 patients were previously untreated with chemotherapy. Among these 51 patients objective response was documented in two of 25 patients treated with NCZ , none of 17 treated with m-AMSA, and one of nine treated with doxorubicin. Among previously untreated North American and European (NA/E) patients the median survival times were: NCZ 11 weeks and m-AMSA 12 weeks. The data on South African (SA) patients with similar entrance criteria entered on earlier Eastern Cooperative Oncology Group trials were analyzed with that from the randomized trial and show that for SA patients the median survival times were: NCZ , 11 weeks (31 patients); m-AMSA, 13 weeks (33 patients); and doxorubicin, 15 weeks (29 patients).
|
https://pubmed.ncbi.nlm.nih.gov/6327926/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, U.S. Gov't, P.H.S."
] |
6327926
|
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6,328,297 |
Suppression of frequently recurring genital herpes. A placebo-controlled double-blind trial of oral acyclovir.
|
Straus S E SE, Takiff H E HE, Seidlin M M, Bachrach S S, Lininger L L, DiGiovanna J J JJ, Western K A KA, Smith H A HA, Lehrman S N SN, Creagh-Kirk T T
|
The New England journal of medicine . Vol. 310, No. 24, 1984 Jun 14
|
We studied 35 otherwise healthy adults with frequently recurring genital herpes (greater than or equal to 1 episode per month), in a double-blind trial comparing oral acyclovir with placebo capsules for suppression of recurrent infection. The patients were treated for 125 days unless herpes recurred. Among 32 evaluable patients, there were significantly fewer recurrences during acyclovir treatment (4 of 16) than during placebo treatment (16 of 16, P less than 0.001). The mean duration of therapy was significantly longer for patients receiving acyclovir than for those receiving placebo (114.9 vs. 24.8 days, P less than 0.001). Of 19 patients who had recurrences in the blind trial, only 2 had recurrences when given acyclovir in a second, open-study phase. All patients had recurrences after completing acyclovir treatment. The therapy was well tolerated, with minimal gastrointestinal upset and one hypersensitivity reaction. Studies of the viral isolates demonstrated that lesions developing in patients receiving acyclovir contained drug-resistant virus. Later recurrences in these patients were associated with drug-sensitive virus. We conclude that oral acyclovir suppresses genital herpes in patients with frequent recurrences, but the potential for problems with drug resistance and the long-term safety need to be more fully explored.
|
https://pubmed.ncbi.nlm.nih.gov/6328297/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6328297
|
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] |
6,328,298 |
A double-blind study of oral acyclovir for suppression of recurrences of genital herpes simplex virus infection.
|
Douglas J M JM, Critchlow C C, Benedetti J J, Mertz G J GJ, Connor J D JD, Hintz M A MA, Fahnlander A A, Remington M M, Winter C C, Corey L L
|
The New England journal of medicine . Vol. 310, No. 24, 1984 Jun 14
|
Patients with frequently recurring genital herpes were enrolled in a double-blind placebo-controlled trial comparing 200-mg acyclovir capsules, given five or two times daily, with placebo. Of 47 placebo recipients, 44 (94 per cent) had recurrences during the 120-day treatment period, compared with 13 (29 per cent) of 45 patients treated with acyclovir five times daily and 18 of 51 (35 per cent) treated with acyclovir twice daily (P less than 0.001 for each regimen compared with placebo). The median time to the first clinical recurrence was 18 days in placebo recipients, compared with over 120 days in both acyclovir-treated groups (P less than 0.001 for both groups compared with placebo). The mean monthly recurrence rate during the medication period was 0.86 in placebo recipients, compared with 0.13 in patients treated with acyclovir five times daily and 0.14 in patients treated with acyclovir twice daily (P less than 0.001 for both groups compared with placebo). While receiving therapy, 86 of 96 acyclovir-treated patients had over a 50 per cent reduction in their pretreatment recurrence rate. Breakthrough recurrences in acyclovir recipients were of shorter duration and associated with a lower frequency of viral shedding than recurrences in placebo recipients. After medication was discontinued, the subsequent recurrence rate returned to pretreatment frequencies. Daily oral acyclovir was well tolerated. We conclude that oral acyclovir given for four months markedly reduces but does not completely prevent recurrences of genital herpes and does not influence the long-term natural history of the disease.
|
https://pubmed.ncbi.nlm.nih.gov/6328298/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S."
] |
6328298
|
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6,328,390 |
Experience with the third generation cephalosporins, cefoperazone and cefotaxime: report.
|
Reddy J J
|
The New Zealand medical journal . Vol. 97, No. 755, 1984 May 09
|
The efficacy of the third generation cephalosporins, ceforperazone and cefotaxime, was evaluated in a provincial hospital in a small group of patients with severe infections. In one study, patients with severe sepsis were randomly allocated to a group receiving either cefoperazone or ampicillin (ticarcillin or cloxacillin) and gentamicin. In the other trial, a selected group of ill patients was given cefotaxime. Clinical and laboratory analyses showed that these two drugs are safe, well tolerated and effective in the blind treatment of severe infections.
|
https://pubmed.ncbi.nlm.nih.gov/6328390/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6328390
|
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] |
6,328,542 |
A single-blind comparison of oral and intravaginal treatments in acute and recurrent vaginal candidosis in general practice.
|
Miller P I PI, Humphries M M, Grassick K K
|
Pharmatherapeutica . Vol. 3, No. 9, 1984
|
Sixty-three patients with acute or recurrent vaginal candidosis were allocated to treatment with either oral ketoconazole (200 mg twice daily for 5 days) or clotrimazole 100 mg vaginal tablets (one per night for 6 days). Analysis of the results of doctor and patient assessment showed that both treatments were highly effective in reducing the signs and symptoms of infection. Mycological cure rates were similar for both ketoconazole (82%) and clotrimazole (86%). The corresponding mycological relapse rates were 0% and 18%. A significantly higher number of patients expressed a preference for oral treatment (p less than 0.05).
|
https://pubmed.ncbi.nlm.nih.gov/6328542/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
6328542
|
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] |
6,328,637 |
Gastric ulcer healing with ranitidine and cimetidine. A multicentre study.
|
Baron J H JH, Perrin V L VL
|
Scandinavian journal of gastroenterology . Vol. 18, No. 7, 1983 Oct
|
A single-blind study of 339 patients in 19 centres compared the efficacy and tolerance of ranitidine in treating endoscopically confirmed gastric ulcers. Ranitidine (150 mg twice daily) was compared with cimetidine (1 g daily in divided doses) over 4 weeks, followed by a second 4-week treatment for any patient whose ulcer was not healed. In 292 patients who completed the study, endoscopy showed healing in 69% of patients receiving ranitidine and 59% receiving cimetidine after 4 weeks, and 90% and 88%, respectively, by 8 weeks. These results were not significantly different, and, similarly, healing rates for different ulcer sites did not differ. There were no serious adverse drug reactions during the study. Ranitidine is an effective and safe treatment for healing gastric ulcers, with a tendency to produce a faster healing rate than cimetidine during the first 4 weeks of treatment.
|
https://pubmed.ncbi.nlm.nih.gov/6328637/
|
[
"Clinical Trial",
"Comparative Study",
"Controlled Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6328637
|
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] |
6,328,684 |
Ranitidine in the control of acute upper gastro-intestinal haemorrhage. A prospective randomized trial.
|
Santos J E JE, Bremner C G CG, Allen C C, Warman B B, Fotheringham G G, Chleboun J O JO
|
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde . Vol. 65, No. 25, 1984 Jun 23
|
Fifty patients with acute upper gastro-intestinal haemorrhage were given either oral or intravenous ranitidine ( Zantac ; Glaxo), the route of administration being allocated on a random basis. Two patients were excluded from the oral group and 5 were excluded from the intravenous group. The two groups were similar as regards age, sex, number of patients aged over 60 years and severity of bleeding. All the patients were carefully monitored for rebleeding, which occurred in a total of 7 cases (16,3%), 6 in the oral group (26%) and 1 in the intravenous group (5%). Statistically this represented a marked tendency towards a significantly lower incidence of recurrent haemorrhage in the patients treated with intravenous ranitidine (P = 0,07, tested according to Fisher's exact method). No patient in the intravenous group who bled again came to surgery, while 3 of the 23 patients in the oral group (13%) required surgery.
|
https://pubmed.ncbi.nlm.nih.gov/6328684/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
6328684
|
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] |
6,328,685 |
A comparison of 4-week peptic ulcer healing rates following treatment with antacids and ranitidine.
|
Bezuidenhout D J DJ, Perold J G JG, Adams G G
|
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde . Vol. 65, No. 25, 1984 Jun 23
|
Eighty-eight patients with endoscopically proven gastric and duodenal ulceration were treated with ranitidine ( Zantac ; Glaxo) or an antacid preparation containing aluminium hydroxide and magnesium trisilicate ( Gelusil ; Warner) over a 4-week period to assess healing. Clinical, haematological and biochemical assessment and endoscopy were performed at the beginning and at the end of this period. Of the duodenal ulcers, 74% healed on ranitidine therapy and 63% on Gelusil . This difference was not statistically significant (chi 2(1) = 0,55). Of the gastric ulcers 58% healed on ranitidine therapy and 35% on Gelusil , but this difference did not reach statistical significance (chi 2(1) = 1,79). There was no significant difference between the two therapies with regard to symptomatic relief in the duodenal ulcer group, but ranitidine produced significantly better results in the gastric ulcer group. No side-effects were noted in either group.
|
https://pubmed.ncbi.nlm.nih.gov/6328685/
|
[
"Clinical Trial",
"Comparative Study",
"Controlled Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6328685
|
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] |
6,328,686 |
Recurrence of duodenal ulceration in patients on maintenance ranitidine.
|
Marks I N IN, Wright J P JP, Girdwood A H AH, Lucke W W
|
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde . Vol. 65, No. 25, 1984 Jun 23
|
Fifty-seven patients with recently healed duodenal ulcers were entered into a 1-year trial of maintenance therapy with ranitidine ( Zantac ; Glaxo) 150 mg at night to assess the safety and efficacy of the drug. Twenty-two of the patients were withdrawn because they violated the trial protocol. No serious side-effects were noted, but only 19 of the 35 patients who met the requirements of the study were free of endoscopic evidence of ulcer recurrence at the end of the trial period. The relapse rate of 46% in the present study was of the same order as those found in two previous South African studies of maintenance therapy with cimetidine given in a dose of 400 mg at night. These findings leave the question whether routine maintenance therapy is warranted in our patients unanswered.
|
https://pubmed.ncbi.nlm.nih.gov/6328686/
|
[
"Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
6328686
|
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] |
6,328,729 |
Trials of an inactivated equid herpesvirus 1 vaccine: challenge with a subtype 2 virus.
|
Mumford J A JA, Bates J J
|
The Veterinary record . Vol. 114, No. 15, 1984 Apr 14
|
Serological responses following two and three doses of an inactivated equid herpesvirus 1 ( EHV -1) vaccine containing a subtype 1 strain were examined in yearling ponies. Complement fixing antibody responses were significantly higher against the subtype 1 vaccine strain than against a subtype 2 virus. Complement fixing antibody responses declined rapidly after the second dose of vaccine and had returned to almost pre-vaccination levels eight weeks after the second dose of vaccine. Complement fixing antibody titres to the heterologous subtype 2 strain increased after each successive dose of vaccine. The neutralising antibody responses following vaccination were weak although less strain specific than the complement fixing antibody responses. When challenged with a subtype 2 strain, 15 ponies which had received three doses of vaccine, two, eight and 12 weeks previously resisted challenge infection. However, 11 out of 15 ponies which had received two doses of vaccine eight and 12 weeks previously were susceptible to infection. While two doses of vaccine did not reduce duration of virus excretion or febrile responses in ponies challenged eight weeks after the second dose, the amount of virus excreted was significantly reduced.
|
https://pubmed.ncbi.nlm.nih.gov/6328729/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
6328729
|
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6,328,728 |
Trials of an inactivated equid herpesvirus 1 vaccine: challenge with a subtype 1 virus.
|
Burrows R R, Goodridge D D, Denyer M S MS
|
The Veterinary record . Vol. 114, No. 15, 1984 Apr 14
|
Vaccinated yearlings , two-year-old and in-foal pony mares with appropriate controls were exposed to aerosols of a subtype 1 virus one to two months after two or three vaccinations; all became infected. No obvious differences in the febrile responses, clinical signs and subsequent abortions were found between vaccinated and control mares. All vaccinated yearlings and two-year-old ponies developed a febrile respiratory disease but this was less severe than that suffered by the controls and the amounts and duration of virus shedding were reduced.
|
https://pubmed.ncbi.nlm.nih.gov/6328728/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
6328728
|
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] |
6,329,004 |
Differential inhibitory noradrenergic responses to clonidine in 25 depressed patients and 25 normal control subjects.
|
Siever L J LJ, Uhde T W TW, Jimerson D C DC, Lake C R CR, Silberman E R ER, Post R M RM, Murphy D L DL
|
The American journal of psychiatry . Vol. 141, No. 6, 1984 Jun
|
The authors measured plasma 3-methoxy-4-hydroxyphenylglycol (MHPG), plasma norepinephrine, blood pressure, and heart rate responses to the alpha 2-adrenergic agonist clonidine in 25 depressed patients and 25 normal control subjects. In the control subjects clonidine reduced plasma norepinephrine, blood pressure, and heart rate significantly more than placebo. In the depressed patients clonidine reduced blood pressure and the percent fall in plasma norepinephrine but not plasma MHPG or heart rate significantly more than placebo. The absolute and percent reductions in plasma MHPG and heart rate following clonidine were significantly less than in control subjects. These results raise the possibility that the sensitivity of the alpha 2-adrenergic receptors inhibitory to noradrenergic output may be reduced in depression.
|
https://pubmed.ncbi.nlm.nih.gov/6329004/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
6329004
|
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] |
6,329,012 |
Endotoxemia in human obstructive jaundice. Effect of polymyxin B.
|
Ingoldby C J CJ, McPherson G A GA, Blumgart L H LH
|
American journal of surgery . Vol. 147, No. 6, 1984 Jun
|
A clinical trial was undertaken to study endotoxemia in 14 patients with obstructive jaundice given the antiendotoxin polymyxin B, 13 patients with obstructive jaundice who were not given the antiendotoxin , and 13 nonjaundiced control patients undergoing comparable surgery. Endotoxins were detected by the limulus assay. Endotoxemia did not occur in the nonjaundiced patients but was common before (68 percent), during (70 percent), and after (81 percent) surgery in the jaundice patients. Thirty-six percent of the jaundiced patients had postoperative oliguria. Endotoxemia before surgery was associated with death after surgery, all deaths occurring in patients who were endotoxemic before operation (p less than 0.05). Polymyxin B infusion had no effect on endotoxemia or outcome. Measurement of indicators of fibrinolysis, soluble fibrin, and fibrin degradation products showed no prognostic significance. We conclude that preoperative endotoxemia is an important predictor of outcome in patients who undergo surgery for jaundice.
|
https://pubmed.ncbi.nlm.nih.gov/6329012/
|
[
"Clinical Trial",
"Journal Article"
] |
6329012
|
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] |
6,329,021 |
Oral ranitidine in labour.
|
McAuley D M DM, Moore J J, Dundee J W JW, McCaughey W W
|
Anaesthesia . Vol. 39, No. 5, 1984 May
|
Ranitidine 150 mg orally was given every 6 hours to 909 women in labour, while a control group of 378 women received conventional alkali therapy. No differences in incidences of operative intervention, placental retention or post-partum haemorrhage were observed between groups. Gastric sampling during emergency anaesthesia revealed a pH less than 2.5 in four of 51 women who received ranitidine and in two of 31 women who received magnesium trisilicate. Gastric volumes were slightly lower (mean 83 ml) in the study group than in the control group (mean 122 ml). Absorption of ranitidine was greatly slowed following narcotic administration and gastric volume was significantly higher in those patients given narcotics in labour. Apgar scores were similar in both groups of infants, and babies whose mothers were given ranitidine showed no delay in achieving high gastric acidity and no increase in bacterial colonization of the gastro-intestinal tract. Low levels only of ranitidine were found in the blood of babies at 2-3 hours and approximately 12 hours after birth.
|
https://pubmed.ncbi.nlm.nih.gov/6329021/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6329021
|
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] |
6,329,092 |
Comparative efficacies of pivmecillinam and ampicillin in acute shigellosis.
|
Kabir I I, Rahaman M M MM, Ahmed S M SM, Akhter S Q SQ, Butler T T
|
Antimicrobial agents and chemotherapy . Vol. 25, No. 5, 1984 May
|
The clinical efficacies of pivmecillinam and ampicillin were compared in a randomized double-blind trial in the treatment of acute shigellosis. Of 44 adult male patients, all culture positive for Shigella strains, 22 patients received 400 mg of pivmecillinam and 22 patients received 500 mg of ampicillin every 6 h. Both drugs were administered orally for 5 days. Four patients receiving ampicillin were infected with Shigella strains that were resistant to ampicillin but susceptible to pivmecillinam, and two patients receiving pivmecillinam were infected with Shigella strains resistant to both ampicillin and pivmecillinam. The mean duration of diarrhea in all patients receiving pivmecillinam was 3.3 days compared with 4.5 days in patients receiving ampicillin (P less than 0.05). When patients infected with the resistant strains were excluded, the mean duration of diarrhea in patients receiving pivmecillinam was 3.2 days compared with 4.1 days in patients receiving ampicillin. The patients infected with strains susceptible to both antibiotics had mean durations of fecal excretion of Shigella strains of 1.2 days for those treated with pivmecillinam and 1.4 days for those treated with ampicillin. The patients infected with organisms resistant to both drugs had longer durations of diarrhea and fecal excretion of Shigella strains. The results suggest that pivmecillinam is as effective as ampicillin and can be a useful drug for the treatment of shigellosis.
|
https://pubmed.ncbi.nlm.nih.gov/6329092/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6329092
|
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] |
6,329,121 |
The effects of ceruletide in schizophrenia.
|
Hommer D W DW, Pickar D D, Roy A A, Ninan P P, Boronow J J, Paul S M SM
|
Archives of general psychiatry . Vol. 41, No. 6, 1984 Jun
|
Eight neuroleptic-resistant schizophrenic patients were treated with ceruletide diethylamine, a cholecystokininlike peptide, in a placebo-controlled, double-blind, cross-over study. Ceruletide or placebo was administered intramuscularly twice a day for four consecutive days while patients received a constant dose of fluphenazine hydrochloride. Cholecystokinin octapeptide was also administered to four different schizophrenic patients in a double-blind, cross-over study. Cholecystokinin or placebo was administered as a slow intravenous infusion daily for four days. There were no changes in either the positive or negative symptoms of schizophrenia between the periods of placebo, ceruletide, or cholecystokinin administration. Furthermore, there was no tendency for the patients' conditions to either improve or worsen during the course of ceruletide or cholecystokinin treatment. In contrast to previous reports from uncontrolled studies, cholecystokininlike peptides appear to be devoid of antipsychotic properties when administered parenterally.
|
https://pubmed.ncbi.nlm.nih.gov/6329121/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
6329121
|
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] |
6,329,254 |
Essential fatty acids in the plasma phospholipids of patients with atopic eczema.
|
Manku M S MS, Horrobin D F DF, Morse N L NL, Wright S S, Burton J L JL
|
The British journal of dermatology . Vol. 110, No. 6, 1984 Jun
|
We have measured all the essential fatty acids (EFA) in plasma phospholipids in forty-one adults with atopic eczema and fifty normal controls. The major dietary n-6 EFA, linoleic acid, was significantly elevated, but all its metabolites, 18:3n-6, 20:3n-6, 20:4n-6, 22:4n-6, and 22:5n-6 were significantly reduced. The major dietary n-3 EFA, alpha-linolenic acid, was also elevated, though not significantly, while all its metabolites were also significantly reduced. These observations suggest that atopic eczema is associated not with any defect of EFA intake, but with abnormal metabolism, possibly involving the enzyme delta-6-desaturase. Treatment with oral evening primrose oil produced partial correction of the n-6 EFA abnormality, but had no effect on the n-3 EFAs.
|
https://pubmed.ncbi.nlm.nih.gov/6329254/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
6329254
|
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] |
6,329,395 |
A study of the effect of misonidazole in conjunction with radiotherapy for the treatment of head and neck cancer. MRC working party on misonidazole in head and neck cancer.
|
The British journal of radiology . Vol. 57, No. 679, 1984 Jul
|
The effect of the hypoxic cell sensitiser misonidazole as an adjuvant to radiotherapy of head and neck cancer was tested in a randomised double blind study. Patients with squamous carcinoma of the upper alimentary and respiratory tract, excluding those with early disease for which the prognosis was good, who were deemed suitable for radical radiotherapy and fit to receive the drug were entered into the study. Two radiotherapy regimes were employed, 10 fractions in 3 weeks to a modal tumour dose of 4000-4500 cGy, and 20 fractions in 4 weeks to a modal tumour dose of 5000-5750 cGy. Participating radiotherapists opted for one of the two schemes. Misonidazole or placebo capsules were administered 4 to 5 hours before each fraction of radiotherapy to a total of 11 to 13 g/m2. 168 patients were treated with 10 fractions and 99 with 20 fractions, between March 1979 and November 1981, when entry was stopped because of the high incidence of drug toxicity and lack of benefit. The estimated hazard ratio for local control was 0.89, indicating a slight advantage to misonidazole which was not statistically significant (p = 0.5). Peripheral neuropathy occurred in 56 patients who received misonidazole, and was more severe when treatment was given in 10 fractions.
|
https://pubmed.ncbi.nlm.nih.gov/6329395/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6329395
|
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|
6,329,405 |
Single blind comparison of ketoconazole 200 mg oral tablets and clotrimazole 100 mg vaginal tablets and 1% cream in treating acute vaginal candidosis.
|
Bingham J S JS
|
The British journal of venereal diseases . Vol. 60, No. 3, 1984 Jun
|
A single blind study of 103 women with vaginal candidosis was undertaken to compare treatment with conventional topical clotrimazole and oral ketoconazole. Both treatment regimens were equally effective in terms of clinical symptoms, negative results on culture for Candida albicans, and relapse rates. As treatment for vaginal candidosis takes several days, patient compliance is important and the success of a treatment regimen may depend on its acceptability to patients. Those in this study who had previously been treated for vaginal candidosis were asked to compare their current and previous treatments. Significantly more (p less than 0.001) of those treated with ketoconazole than those treated with clotrimazole found it more acceptable than previous treatment. This indicated a strong preference for oral treatment, and oral antifungal agents may be the treatment of choice for vaginal candidosis in the future.
|
https://pubmed.ncbi.nlm.nih.gov/6329405/
|
[
"Clinical Trial",
"Comparative Study",
"Controlled Clinical Trial",
"Journal Article"
] |
6329405
|
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] |
6,329,547 |
Enalapril in patients with chronic heart failure: a placebo-controlled, randomized, double-blind study.
|
Sharpe D N DN, Murphy J J, Coxon R R, Hannan S F SF
|
Circulation . Vol. 70, No. 2, 1984 Aug
|
A number of studies have shown short-term hemodynamic and symptomatic improvement in patients with congestive heart failure treated with angiotensin converting-enzyme inhibitors. The long-term efficacy of the oral long-acting converting-enzyme inhibitor enalapril remains to be established in controlled studies. We evaluated this drug in 36 patients with New York Heart Association functional class II to III heart failure who were clinically stable on digoxin and diuretic therapy. After baseline assessment of symptoms, exercise capacity, and results of echocardiographic examination and right heart catheterization, patients were randomly assigned to treatment with 5 mg enalapril twice daily (n = 18) or placebo (n = 18) in a double-blind fashion. The two groups had similar clinical, echocardiographic, and hemodynamic characteristics before treatment. After 3 months of treatment, the enalapril group showed a significant improvement as judged by subjective patient impression, functional class, and exercise duration (9.3 +/- 5.7 vs 17.6 +/- 5.6 min; p less than .001). Diuretic dosage was reduced in six patients and increased in one patient, one patient had died and another had been withdrawn from the study. In the placebo group there was no significant change with respect to patient impression, functional class, or exercise duration; diuretic dosage was increased in seven patients and four patients had died. Echocardiographic left ventricular dimensions were significantly reduced and left ventricular shortening fraction significantly increased in the enalapril group but were unchanged in the placebo group.(ABSTRACT TRUNCATED AT 250 WORDS)
|
https://pubmed.ncbi.nlm.nih.gov/6329547/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
6329547
|
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] |
6,329,567 |
Effect of interferon alpha on natural killer cell cytotoxicity in kidney transplant recipients.
|
Kelly A P AP, Schooley R T RT, Rubin R H RH, Hirsch M S MS
|
Clinical immunology and immunopathology . Vol. 32, No. 1, 1984 Jul
|
Natural killer (NK) cell cytotoxicity was monitored in 32 kidney transplant recipients during a double-blind, placebo-controlled trial of interferon alpha prophylaxis. During the first month following transplantation, NK cytotoxicity diminished in both interferon and placebo-treated patients. Thereafter, mean values for NK cytotoxicity decreased further in interferon recipients, whereas they returned toward baseline in placebo recipients. Paradoxically, interferon alpha consistently augmented NK cytotoxicity of all patients in vitro. Various immunosuppressive regimens were employed in these patients. NK cytotoxicity was slightly diminished in patients receiving prednisone and azathioprine, moderately depressed in those who received prednisone, azathioprine, and OKT3 antibody. Three or four placebo recipients with clinically severe cytomegalovirus (CMV) infections had diminished NK cell function. These studies indicate that a variety of factors including exogenous interferon, immunosuppressive regimens, and CMV infections can influence NK cytotoxicity in renal transplant recipients.
|
https://pubmed.ncbi.nlm.nih.gov/6329567/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article",
"Research Support, U.S. Gov't, P.H.S."
] |
6329567
|
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] |
6,329,613 |
Decreased insulin requirement and improved control of diabetes in pregnant women given a high-carbohydrate, high-fiber, low-fat diet.
|
Ney D D, Hollingsworth D R DR, Cousins L L
|
Diabetes care . Vol. 5, No. 5
|
Five quantitative measures of diabetic control [HbA1c determinations, mean 24-h plasma glucose values, mean amplitude of glycemic excursions (MAGE), mean 24-h urinary loss of glucose, and daily exogenous insulin requirement] were compared in 20 pregnant women who were randomly assigned to either a high-carbohydrate, high-fiber diet (HCF) that was low in fat or to a control diet commonly prescribed for pregnancy. Eleven women followed the HCF diet and nine subjects, the control diet, from baseline entry into the study until delivery. Dietary compliance was excellent, with 78% of the women in each group rated good or acceptable. HbA1c values were similar in both groups at baseline (HCF: 11.0 +/- 0.5% versus control: 10.2 +/- 0.6%), with no different predelivery values (8.6 +/- 0.4%). Mean 24-h plasma glucose levels improved in patients on both diets, with lower values noted in the HCF group at predelivery. MAGE values and standard deviations did not differ significantly in the two groups. Glycosuria decreased markedly in both dietary groups, but differences between groups were not significant. Improved control of diabetes on the HCF diet was achieved with significantly lower increments in insulin dose during gestation (HCF baseline: 32 +/- 8 U/24 h to 66 +/- 10 U/24 h versus control baseline: 27 +/- 9 U/24 h to 108 +/- 12 U/24 h, P less than 0.03). Outcome of pregnancy did not differ in the two groups of patients, but women on the HCF diet gained less weight than those on the control diet (26 +/- 3 lb versus 35 +/- 5 lb, P less than 0.05). Mean newborn gestational age was similar in the two groups (HCF: 37.2 +/- 0.7 wk versus control: 36.5 +/- 0.7 wk). Mean birth weight in infants of HCF mothers was 3809 +/- 248 g versus 3313 +/- 278 g in infants of control mothers (P less than 0.05). We conclude that although marked improvement of diabetic control occurred on both regimens, patients on the HCF diet achieved better control of diabetes with significantly lower increments in exogenous insulin.
|
https://pubmed.ncbi.nlm.nih.gov/6329613/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, U.S. Gov't, P.H.S."
] |
6329613
|
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] |
6,329,769 |
Protective effect of oral oxyphenonium bromide, terbutaline and theophylline against the bronchial obstructive effects of inhaled histamine, acetylcholine and propranolol.
|
Koëter G H GH, Meurs H H, Jonkman J H JH, Greving J J, Leferink J J, Sluiter H J HJ, de Zeeuw R A RA, de Vries K K
|
European journal of clinical pharmacology . Vol. 26, No. 4, 1984
|
The protective effects of oxyphenonium bromide, terbutaline and theophylline were compared in 8 asthmatic patients by determination of the degree of non-specific airway reactivity after 1 week of oral treatment according to a fixed dose scheme in a double-blind random order: oxyphenonium bromide 3 X 10 mg; terbutaline 3 X 5 mg; theophylline 2 X 300 mg and placebo. Controlled, standardized inhalation provocation tests were carried out with histamine, acetylcholine and propranolol. The study was monitored by measuring blood concentrations of the 3 drugs, and their effect on the plasma cAMP concentration was also determined. Significant protection by oxyphenonium bromide against the bronchial obstructive effects of acetylcholine and propranolol was observed, but not against the effect of inhaled histamine. The other two drugs provided no significant protection against the inhaled agents. The absence of any protective effect of terbutaline and theophylline might have resulted from too low a blood concentration. The observed differences in protection could not be explained by changes in pulmonary function. The study suggests dissociation between the bronchodilating effect of a drug and its protective effect against inhaled substances.
|
https://pubmed.ncbi.nlm.nih.gov/6329769/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6329769
|
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] |
6,329,862 |
Ranitidine in reflux oesophagitis. A double-blind placebo-controlled study.
|
Hine K R KR, Holmes G K GK, Melikian V V, Lucey M M, Fairclough P D PD
|
Digestion . Vol. 29, No. 2, 1984
|
This study was designed to assess the effect of ranitidine on patients with symptomatic oesophageal reflux. In a double-blind comparative trial in 46 patients a twice daily dose of 150 mg ranitidine was compared with placebo. Relief of pain, endoscopic healing and histological improvement were significantly better in those treated with ranitidine. Thus, ranitidine is of value in the management of patients with reflux oesophagitis and may prevent the development of peptic stricture.
|
https://pubmed.ncbi.nlm.nih.gov/6329862/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article"
] |
6329862
|
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] |
6,329,863 |
Effects of an increased content of cereal fibre in the diet of Type 2 (non-insulin-dependent) diabetic patients.
|
Karlström B B, Vessby B B, Asp N G NG, Boberg M M, Gustafsson I B IB, Lithell H H, Werner I I
|
Diabetologia . Vol. 26, No. 4, 1984 Apr
|
The metabolic effects of an increased dietary content of cereal fibre were studied in 14 Type 2 diabetic subjects. They were given two isoenergetic diets in randomised order during two consecutive 3-week periods. A diabetic diet, containing 18.9 g dietary fibre/6.7 MJ (1600 kcal), was compared with a diet of identical composition except for an increased content of cereal fibre (42.4 g dietary fibre/6.7 MJ). The mean blood glucose level and the urinary glucose excretion were significantly lower in patients on the cereal-fibre-rich diet, while the serum insulin concentrations were similar. The mean blood glucose level was significantly reduced at 0700 h by 6% (p less than 0.05) and at 1100 h by 13% (p less than 0.01) on the high-fibre diet. Consequently the insulin/glucose ratio was higher (33%, p less than 0.02) in patients on the fibre-enriched diet. There were only minor differences with regard to the serum lipoprotein concentrations. The lipoprotein lipase activities were similar in the two dietary groups. The reduction of blood glucose concentrations together with unchanged serum insulin concentrations is compatible with improved peripheral insulin sensitivity.
|
https://pubmed.ncbi.nlm.nih.gov/6329863/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
6329863
|
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] |
6,329,980 |
The association of ranitidine and sucralfate in the short-term treatment of duodenal ulcers, as compared to other forms of treatment.
|
Magnanelli M M, Belvisi A A, Toninelli A A, Matergi M M, Camarri E E
|
International journal of tissue reactions . Vol. 6, No. 2, 1984
|
Results of the treatment of duodenal ulcer with ranitidine (150 mg X 2/die) and sucralfate (1 gr X 2/die) have been compared with other common schemes of therapy. Administration of the drugs was carried out for 8 weeks, and the evolution of the ulcer lesion was followed with endoscopic controls at the beginning and end of the treatment. Ulcer healing occurred in 92% of 25 patients, as compared with 83,3% of 30 cases treated with ranitidine only; 80% of 30 cases with cimetidine 1 g/day; 80% of 20 cases with cimetidine 800 mg/b.i.d.; 75% of 20 cases with sucralfate 3 g/day; 73,3% of 30 patients with pirenzepine 150 mg/day; 60% of 20 cases with sulglycotide 0.5-1 g/day; and 50% of 40 ulcerous patients treated with placebo. From these results it is concluded that the association of sucralfate with an H2-antagonist improves the possibility of short-term healing of duodenal ulcer.
|
https://pubmed.ncbi.nlm.nih.gov/6329980/
|
[
"Clinical Trial",
"Comparative Study",
"Controlled Clinical Trial",
"Journal Article"
] |
6329980
|
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1,703,608 |
Double-blind study of dilevalol and captopril, both in combination with hydrochlorothiazide, in patients with moderate to severe hypertension.
|
McGrath B P BP, Matthews P G PG, Louis W W, Howes L L, Whitworth J A JA, Kincaid-Smith P S PS, Fraser I I, Scheinkestel C C, MacDonald G G, Rallings M M
|
Journal of cardiovascular pharmacology . Vol. 16, No. 5, 1990 Nov
|
Sixty-one patients (41 men, 20 women) aged 29-73 years, with moderate to severe hypertension, were enrolled in a multicentre study to compare the efficacy, safety, and tolerability of dilevalol (D) and captopril (C). At the end of the baseline period, supine diastolic blood pressure (SuDBP) was 105-140 mm Hg on hydrochlorothiazide (HCTZ) 25 mg once daily and placebo t.i.d. Patients were randomly assigned to D + HCTZ (n = 29) or C + HCTZ (n = 32) and entered phase II titration of D (100-800 mg b.i.d.) or C (12.5 mg b.i.d. to 50 mg t.i.d.). If SuDBP was greater than 99 mm Hg, hydralazine was added (25 mg once daily to 50 mg b.i.d.). If SuDBP was less than or equal to 99 mm Hg, patients entered phase III, a 3-month maintenance period. Demographic profiles were not significantly different between the two groups. Baseline supine BP (mean +/- SEM) was similar in the two groups (D + HCTZ: 182 +/- 3/112 +/- 1; C + HCTZ: 179 +/- 4/113 +/- 1 mm Hg), as was baseline standing BP (D + HCTZ: 175 +/- 3/114 +/- 2; C +/- HCTZ: 173 +/- 4/113 +/- 1 mm Hg). At the end of phase II, there were no significant differences between treatments with respect to the changes in BP from baseline.(ABSTRACT TRUNCATED AT 250 WORDS)
|
https://pubmed.ncbi.nlm.nih.gov/1703608/
|
[
"Clinical Trial",
"Journal Article",
"Multicenter Study",
"Randomized Controlled Trial"
] |
1703608
|
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] |
1,703,611 |
Melatonin response to atrial natriuretic peptide administration in healthy volunteers.
|
Lissoni P P, Pelizzoni F F, Grugni G G, Guzzaloni G G, Mauri O O, Archili C C, Galli M A MA, Morabito F F
|
Journal of cardiovascular pharmacology . Vol. 16, No. 5, 1990 Nov
|
Recent observations have demonstrated that the pineal hormone melatonin (MLT) plays a role in the neuroendocrine control of the cardiovascular system. On the other hand, it has been observed that the cardiac hormone alpha-atrial natriuretic peptide (ANP) may regulate the neuroendocrine functions. The present study was carried out to investigate the possible relationship between cardiac and pineal endocrine functions. Six healthy volunteers were treated on two different occasions with placebo or ANP at a dose of 0.1 mg i.v. as a bolus. An increase of greater than 100% in MLT serum levels was seen in 2/6 subjects. These preliminary results would suggest that ANP may play a role in the regulation of MLT secretion. Further studies will be needed to define better the cardiac-pineal interactions.
|
https://pubmed.ncbi.nlm.nih.gov/1703611/
|
[
"Clinical Trial",
"Controlled Clinical Trial",
"Journal Article"
] |
1703611
|
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] |
1,703,618 |
Improved detection of rotavirus shedding by polymerase chain reaction.
|
Wilde J J, Yolken R R, Willoughby R R, Eiden J J
|
Lancet (London, England) . Vol. 337, No. 8737, 1991 Feb 09
|
To improve identification of children excreting rotavirus a method for the amplification of rotavirus RNA by the polymerase chain reaction (PCR) was developed. The assay was compared with a solid-phase enzyme immunoassay in the detection of rotavirus shedding by infants in hospital during the winter peak of rotavirus infections. Forty children were studied in an intermediate care unit after transfer from intensive care units. Only two were admitted primarily because of diarrhoea; the other thirty-eight were admitted for management of various other disorders. Rotavirus shedding was detected by enzyme immunoassay in twenty of the infants, and nine of these (aged 1 week to 8 months) remained in hospital for more than 5 days after the initial detection of rotavirus and could be studied long term. Of 103 faecal samples from the nine infants, 60 (58%) contained rotavirus RNA detected by reverse-transcriptase (RT)/PCR, whereas only 37 (36%) were positive for rotavirus antigen by the immunoassay (chi 2 = 10.3, p less than 0.002). The geometric mean time of rotavirus shedding was 9.5 (range 1-19) days as detected by RT/PCR and 5.7 (range 1-17) days by the immunoassay (p less than 0.018). In five of the nine children, RT/PCR detected rotavirus shedding for 2-7 days longer than the immunoassay and in four children RT/PCR was positive 1 or more days before rotavirus antigen was detected. Further studies should attempt to find out whether infected infants are capable of spreading wild-type virus during periods when they are not shedding antigen as detectable by enzyme immunoassay.
|
https://pubmed.ncbi.nlm.nih.gov/1703618/
|
[
"Clinical Trial",
"Comparative Study",
"Controlled Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S."
] |
1703618
|
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] |
1,703,746 |
Initial treatment of bacterial meningitis in Yaounde, Cameroon: theoretical benefits of the ampicillin-chloramphenicol combination versus chloramphenicol alone.
|
Tetanye E E, Yondo D D, Bernard-Bonnin A C AC, Tchokoteu P F PF, Kago I I, Ndayo M M, Mbede J J
|
Annals of tropical paediatrics . Vol. 10, No. 3, 1990
|
A prospective 6-month study in Yaounde evaluated 49 children aged from 2 months to 8 years, hospitalized with bacterial meningitis. They were randomly assigned to one of two initial treatment groups, either an ampicillin-chloramphenicol combination (group A) or chloramphenicol alone (group B). The majority of patients were infected with Haemophilus influenzae, and the majority of deaths were caused by Streptococcus pneumoniae. Altogether, 17.9% of Haemophilus influenzae isolates were ampicillin-resistant and 3.6% chloramphenicol-resistant. We found no isolate resistant to both antibiotics. Response to both treatments was similar in both groups. The theoretical risk of treatment failure with ampicillin was higher than with the ampicillin-chloramphenicol combination (p less than 0.05). There was no statistically significant difference between the risk of treatment failure with the ampicillin-chloramphenicol combination and the risk with chloramphenicol alone (p less than 0.05), but the latter was increased by the occurrence of chloramphenicol-resistant isolates of Streptococcus pneumoniae (11.1%). Although treatment with an ampicillin-chloramphenicol combination is four times more expensive than treatment with chloramphenicol alone, costwise it is also one-quarter the price of a third-generation cephalosporin (moxalactam). At present, the ampicillin-chloramphenicol combination can be suggested as the first choice for initial treatment considering both the epidemiological data and the cost/efficiency ratio in the area of Yaounde.
|
https://pubmed.ncbi.nlm.nih.gov/1703746/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
1703746
|
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0.34732872247695923,
0.21876685321331024,
0.13062508404254913
] |
1,703,769 |
Phase III trial of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) versus cisplatin, etoposide, bleomycin and prednisone (CisEBP) for the treatment of advanced non-Hodgkin's lymphoma of high grade malignancy. The Danish Lymphoma Study Group.
|
Andersen J J, Thorling K K, Bentzen S M SM, Brincker H H, Christensen B E BE, Pedersen M M
|
Acta oncologica (Stockholm, Sweden) . Vol. 29, No. 8, 1990
|
The trial included 85 previously untreated patients (median age 61 years) with stage III or IV non-Hodgkin's lymphoma (NHL) of the subtypes centrocytic lymphoma, diffuse centroblastic lymphoma, immunocytoma, immunoblastic lymphoma, or unclassified lymphoma of high grade malignancy. The patients were randomized to 9 monthly treatment cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or CisEBP (cisplatin, bleomycin, etoposide, prednisone). Patients who had failed to achieve even a partial response (PR) after the completion of 2 cycles were switched to the alternative regimen. Complete response (CR) on primary treatment was obtained in 70% (55-83%) of CHOP-treated patients and in 25% (13-41%) of CisEBP-treated patients (p = 0.0004). Secondary CHOP treatment produced CR in 7 (30%) of 24 patients and secondary CisEBP treatment led to CR in 2 (15%) of 14 patients. The median survival was 3.4 years in the CHOP arm and 2.6 years in the CisEBP arm (p = 0.78). Hematologic toxicity was mainly leukocytopenia and anemia in both treatment arms. Non-hematological toxicity was slight, and late toxicity was insignificant. Three treatment-related deaths were noted. We conclude that CHOP induces more remissions than CisEBP in advanced lymphomas of high grade malignancy.
|
https://pubmed.ncbi.nlm.nih.gov/1703769/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
1703769
|
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1,703,780 |
The relationship between clinical and biochemical changes following neuroleptic treatment in schizophrenia.
|
Cooper S J SJ, Leahey W W, Liddle J J, King D J DJ
|
Schizophrenia research . Vol. 3, No. 4
|
Clinical improvement in psychotic symptoms is not immediate when neuroleptic treatment is commenced. Previous studies have demonstrated the development of biochemical tolerance to the effects of neuroleptics on the dopamine system. This study demonstrates a relationship between this biochemical change and the clinical changes occurring in the patients. The results can be explained in terms of dopamine receptor changes in a way that is compatible with the Dopamine Hypothesis for schizophrenia.
|
https://pubmed.ncbi.nlm.nih.gov/1703780/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
1703780
|
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] |
1,703,808 |
Plateletapheresis with the new cell separator AS-104.
|
Kretschmer V V, Middelbeck T T, Gerlach A A, Göddecke W W, Söhngen D D, Prinz H H, Pflüger H H HH
|
Beitrage zur Infusionstherapie = Contributions to infusion therapy . Vol. 26, 1990
|
Summarizing several studies, it can be shown that the new cell separator AS-104 (Fresenius), in comparison to the older systems, provides a real advantage concerning the separation efficiency, the purity of the platelet concentrates (PC), the platelet function and the donor safety. The results of 5 different separation protocols demonstrate the technical flexibility and developmental potential of this system. From the experience of 580 plateletapheresis runs the successful improvement of the cell separator, and the disposables can be documented as the frequency of disturbances and discontinuations are reduced considerably. The preliminary results of an uncontrolled, not randomized transfusion study of 244 transfusions in 49 patients show comparable posttransfusion increments as obtained with PC of the CS-3000 (Baxter).
|
https://pubmed.ncbi.nlm.nih.gov/1703808/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article"
] |
1703808
|
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] |
1,703,915 |
Multimodality cisplatin treatment in nonresectable alpha-fetoprotein-positive hepatoma.
|
Epstein B B, Ettinger D D, Leichner P K PK, Order S E SE
|
Cancer . Vol. 67, No. 4, 1991 Feb 15
|
Twenty-eight patients with alpha-fetoprotein-positive (AFP+) nonresectable hepatoma have been enrolled in a new multimodality Phase I, II program. Induction therapy consisted of 50 mg/m2 intravenous cisplatin followed by 2100 cGy irradiation to the tumor volume in seven fractions over 10 days. Hepatic arterial infusion of 50 mg/m2 cisplatin (IA-CDDP) was then administered at monthly intervals. Twenty-one patients have completed induction and at least two cycles of IA-CDDP. Twelve-month cumulative survival was 52% for all 28 patients and 69% for the 21 patients completing induction and IA-CDDP. Median survival has not yet been reached. Response rate (complete and partial) was 36% overall and 48% among the 21 patients who completed treatment. The improved survival of the present series of patients as well as the minimal hematologic toxicity suggests possible further integration of new modalities for therapy.
|
https://pubmed.ncbi.nlm.nih.gov/1703915/
|
[
"Clinical Trial",
"Journal Article"
] |
1703915
|
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] |
1,703,917 |
Salvage chemotherapy for patients with germ cell tumors. The Memorial Sloan-Kettering Cancer Center experience (1979-1989).
|
Motzer R J RJ, Geller N L NL, Tan C C CC, Herr H H, Morse M M, Fair W W, Sheinfeld J J, Sogani P P, Russo P P, Bosl G J GJ
|
Cancer . Vol. 67, No. 5, 1991 Mar 01
|
Twenty-eight of 124 (23%) advanced germ cell tumor (GCT) patients who were treated on four successive platin-based induction regimens and who failed to achieve a durable complete response (CR) remain alive (median follow-up, 50 months). An analysis of prognostic factors for response and survival was conducted on the 94 patients who received salvage chemotherapy. Survival and/or response to salvage therapy were significantly enhanced for patients with a prior CR to induction chemotherapy, treatment with a cisplatin-based salvage regimen, a testis primary site, a normal serum human chorionic gonadotropin level, a normal serum lactate dehydrogenase level, one site of metastasis, and an Indiana Class of 6 or less. Patients with a prior incomplete response (IR) had a particularly poor prognosis (P = 0.00007) with only 4 of 52 (9%) patients alive (median follow-up, 37 months) compared with 15 of 42 (36%) patients with a prior best response of a CR (median follow-up, 35 months). The poor survival of patients who fail to achieve a durable CR to induction chemotherapy warrants the continued investigation of new salvage therapy. The identification of prognostic features may direct salvage therapy and aid in the interpretation of clinical trials of salvage regimens.
|
https://pubmed.ncbi.nlm.nih.gov/1703917/
|
[
"Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't",
"Research Support, U.S. Gov't, P.H.S."
] |
1703917
|
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1,703,916 |
Combined chemotherapy and radiation therapy in advanced inoperable squamous cell carcinoma of the head and neck. The final report of a randomized trial.
|
Merlano M M, Corvo R R, Margarino G G, Benasso M M, Rosso R R, Sertoli M R MR, Cavallari M M, Scala M M, Guenzi M M, Siragusa A A
|
Cancer . Vol. 67, No. 4, 1991 Feb 15
|
Between 1983 and 1986, the National Institute for Cancer Research in Genoa and affiliated institutions conducted a randomized study to compare two different ways of combining chemotherapy (CT) and radiation therapy (RT). One hundred sixteen patients were randomized to receive neoadjuvant CT followed by definitive RT (treatment arm A) or alternating CT and RT. In treatment arm A, RT consisted of 70 Gy to the involved areas and 50 Gy to the uninvolved neck at 2 Gy/fraction, five fractions per week. In treatment arm B, RT consisted of 60 Gy to involved areas and 50 Gy to the uninvolved neck in three courses of 20 Gy each, 2 Gy/fraction, ten fractions/2 weeks alternated with four courses of CT. CT consisted of vinblastine 6 mg/m2 intravenously followed 6 hours later by bleomycin 30 IU intramuscularly, day 1; methotrexate 200 mg intravenously, day 2; leucovorin rescue, day 3. CT was repeated every 2 weeks up to four courses. The same CT was used in both treatment arms of the study. Fifty-five patients were entered in treatment arm A and 61 in treatment arm B. Complete responses were 7/48 and 19/57 in treatment arms A and B, respectively (P less than 0.03). Four-year progression-free survival was 4% in treatment arm A and 12% in treatment arm B (P less than 0.02), and four-year survival was 10% in A and 22% in B (P less than 0.02). Mucosal tolerance was significantly worse in treatment arm B (P less than 0.00004). The subgroup analysis shows the major improvement of alternating CT and RT in patients with the worst prognostic characteristics.
|
https://pubmed.ncbi.nlm.nih.gov/1703916/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
1703916
|
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] |
1,703,920 |
Hemodynamic comparison of combined therapy by nitroglycerin tape and ibopamine with combination of nitroglycerin tape and nifedipine.
|
Taniguchi K K, Tsujibayashi T T, Itoh H H
|
Cardiology . Vol. 77 Suppl 5, 1990
|
Fifteen congestive heart failure patients (NYHA: class III or IV) were enrolled in the study and were classified into two groups. Six patients (group I) received combined therapy by nitroglycerin tape (5 mg) and ibopamine (100 mg), while the remaining 9 patients (group II) were given nitroglycerin tape (5 mg) and nifedipine (10 mg). The effects of the combined treatments on hemodynamics were compared between the two groups using Swan-Ganz catheter method. No significant differences were noted in the hemodynamic baseline values of the two groups before treatment. In group I mean pulmonary arterial pressure (mPA) and systemic vascular resistance (SVR) decreased and the cardiac index (CI) increased, while the heart rate (HR) and mean blood pressure (mBP) remained unchanged. In group II mBP, mPA and SVR were lowered, whereas CI and HR were augmented. There were no significant differences between the two groups with respect to mPA and CI. However, mBP decreased in group II, while it remained unchanged in group I, with significant difference between the two groups (p less than 0.01). Preload and afterload, on the base of mPA and SVR, respectively, decreased in both groups, while cardiac output increased, suggesting that both treatments were useful for the improvement of cardiac output. Mean BP decreased in group II, although it remained unchanged in group I. These results suggest that the combination of nitroglycerin and ibopamine may be more useful in hypotensive patients with heart failure.
|
https://pubmed.ncbi.nlm.nih.gov/1703920/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
1703920
|
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] |
1,703,975 |
Prospective trial for early detection of pancreatic cancer by elevated serum immunoreactive elastase.
|
Hayakawa T T, Kondo T T, Shibata T T, Kitagawa M M, Katada N N, Kato K K, Takeichi M M
|
Gastroenterologia Japonica . Vol. 25, No. 6, 1990 Dec
|
Early detection of pancreatic cancer was prospectively evaluated by measuring serum immunoreactive elastase (IRE) in 722 patients in two hospitals during the past 18 months. Patients included in the study were over 40 years of age and had symptoms suggestive of pancreatic disease such as upper abdominal pain, discomfort or mass, jaundice, weight loss, or diabetes. Among the 722 patients, 171 exhibited elevation of serum IRE. Pancreatic diseases were subsequently found in 42% of the 171 patients. Pancreatic cancer was found in 22 patients, among which 17 had elevated serum IRE. Among the 17 pancreatic cancer patients with elevated IRE, 10 underwent radical resection of the cancer but in none of the five patients with normal serum IRE could radical resection be carried out. Three of the 10 patients had a small cancer less than 2 cm in diameter and two of them survived for more than three years. Patients over 40 or 45 years of age complaining of upper abdominal pain of recent onset that cannot be explained by diseases other than that of the pancreas would be candidates for measurement of serum elastase, and this is an effective way to detect pancreatic cancer at an early stages.
|
https://pubmed.ncbi.nlm.nih.gov/1703975/
|
[
"Clinical Trial",
"Journal Article",
"Research Support, Non-U.S. Gov't"
] |
1703975
|
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] |
1,704,026 |
The influence of food temperature on postprandial blood pressure reduction and its relation to substance-P in healthy elderly subjects.
|
Kuipers H M HM, Jansen R W RW, Peeters T L TL, Hoefnagels W H WH
|
Journal of the American Geriatrics Society . Vol. 39, No. 2, 1991 Feb
|
Blood pressure (BP) in the elderly may decrease after a meal or oral glucose loading. The mechanism of this phenomenon is still unclear. In addition, the effect of the temperature of a meal on postprandial BP is unknown. However, it has been suggested that vasoactive gastrointestinal peptides are involved in the etiology of postprandial BP reduction. Therefore, we studied the effects of a cold and a warm glucose solution on BP, heart rate, plasma glucose, insulin, and substance-P levels in 15 healthy elderly subjects with a mean age of 74 +/- 3 (SD) years. With an interval of at least 2 days, a warm (50 degrees C) and a cold (5 degrees C) solution (75 g glucose/300 mL water) were given in random order. After the cold glucose loading mean arterial pressure increased by a maximum of 3.9 +/- 1.3 mmHg (P less than 0.01). In contrast, BP decreased after the warm solution by a maximum of 8.0 +/- 1.1 mmHg (P less than 0.001). Neither test had an influence on plasma substance-P levels. Our data suggest that postprandial blood pressure reduction in the elderly is dependent on food temperature. Substance-P does not seem to play a role in this phenomenon.
|
https://pubmed.ncbi.nlm.nih.gov/1704026/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
1704026
|
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0.010271656326949596,
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] |
1,704,089 |
Comparison of continuous subcutaneous and intravenous hydromorphone infusions for management of cancer pain.
|
Moulin D E DE, Kreeft J H JH, Murray-Parsons N N, Bouquillon A I AI
|
Lancet (London, England) . Vol. 337, No. 8739, 1991 Feb 23
|
To compare the safety and efficacy of subcutaneous and intravenous infusion of opioid analgesics, a randomised, double-blind, crossover trial was carried out in inpatients. 15 patients with severe cancer pain received two 48 h infusions of hydromorphone--one subcutaneously and one intravenously in randomly allocated order. The study was made double-blind by the use of two infusion pumps throughout; during the active subcutaneous infusion the intravenous pump delivered saline and vice versa. Serial measurements of pain intensity, pain relief, mood, and sedation by means of visual analogue scales showed no clinically or statistically significant difference between the two infusion routes. Side-effects were slight, and the mean number of morphine injections for breakthrough pain did not differ significantly between the routes (4.8 [SD 4.5] for intravenous vs 5.3 [5.6] for subcutaneous). Plasma hydromorphone concentrations measured at 24 h and 48 h of infusion showed stable steady-state pharmacokinetics; the mean bioavailability from subcutaneous infusion was 78% of that with intravenous infusion. Because of the simplicity, technical advantages, and cost-effectiveness of continuous subcutaneous opioid infusion into the chest wall or trunk, intravenous opioid infusion for the management of severe cancer pain should be abandoned.
|
https://pubmed.ncbi.nlm.nih.gov/1704089/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
1704089
|
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] |
1,704,153 |
Malignant pleural effusion.
|
Moores D W DW
|
Seminars in oncology . Vol. 18, No. 1 Suppl 2, 1991 Feb
|
Malignancy is the most common cause of exudative pleural effusion in patients over the age of 60 years. Control of the effusion significantly reduces morbidity and improves quality of life. Tube thoracostomy with subsequent chemical pleurodesis is the treatment of choice for patients with tumors that are relatively insensitive to systemic chemotherapy. The agents most commonly used for chemical pleurodesis are tetracycline and bleomycin. A 13-center randomized trial compared tetracycline 1 g and bleomycin 60 U. Median time to recurrence or progression of the malignant effusion was 32 days for tetracycline and more than 46 days for bleomycin (P = .037). The recurrence rate within 30 days of instillation was 36% for bleomycin (10 of 28 patients) and 67% (18 of 27 patients) for tetracycline (P = .023). At 90 days, the recurrence rate was 30% (11 of 37) for bleomycin, and 53% (19 of 36) for tetracycline (P = .047). From this study, the authors concluded that intrapleural bleomycin appears superior to tetracycline for controlling malignant pleural effusions. Selected patients who fail tube thoracostomy and chemical pleurodesis should be considered for pleuroperitoneal shunting or pleurectomy.
|
https://pubmed.ncbi.nlm.nih.gov/1704153/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
1704153
|
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] |
1,704,168 |
Propafenone versus quinidine slow-release for the treatment of chronic ventricular arrhythmias.
|
Nielsen H H, Sørum C C, Rasmussen V V, Madsen J K JK, Hansen J F JF
|
Acta cardiologica . Vol. 45, No. 5, 1990
|
The efficacy and side-effects of oral propafenone 300 mg b.i.d. were compared to those of quinidine slow-release 800 mg b.i.d. in a randomized double-blind placebo controlled cross-over study in 12 patients with symptomatic premature ventricular complexes (PVCs). Furthermore during steady-state the plasma levels of propafenone and quinidine were measured repeatedly over an 8-hour period and correlated to the numbers of PVCs. In 6 patients both drugs reduced PVCs by 80%. In 2 patients this effect was obtained by propafenone and not by quinidine, while the reverse was found in another 2 patients. In 2 patients neither of the drugs was able to reduce PVCs by 80%. During treatment with quinidine 4 patients experienced diarrhoea and 1 patient suffered headaches taking propafenone. The plasma levels showed great variation. No correlation between the plasma levels expressed as area under the concentration-time curve and the reduction of PVCs was found.
|
https://pubmed.ncbi.nlm.nih.gov/1704168/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
1704168
|
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] |
1,704,212 |
Loculated fluid. A previously undescribed fluorescein angiographic finding in choroidal neovascularization associated with macular degeneration. Macular Photocoagulation Study Reading Center.
|
Bressler N M NM, Bressler S B SB, Alexander J J, Javornik N N, Fine S L SL, Murphy R P RP
|
Archives of ophthalmology (Chicago, Ill. : 1960) . Vol. 109, No. 2, 1991 Feb
|
The Foveal Photocoagulation Study, a component of the Macular Photocoagulation Study, is designed to evaluate whether laser treatment can reduce the risk of severe visual loss in eyes with well-defined choroidal neovascular membranes associated with macular degeneration that extend through the foveal center. On one third of the 554 baseline angiograms of study patients enrolled in and whose eyes were graded in the study as of January 31, 1990, the Reading Center staff has noted an unusual pattern of hyperfluorescence in the late-transit frames that has not been described previously. This pattern, which we call "loculated fluid," consists of a well-demarcated area of hyperfluorescence that appears to represent pooling of fluorescein in a compartmentalized space anterior to the choroidal neovascular leakage. Although the loculated fluid may conform to a pattern of typical cystoid macular edema, it can also pool within an area deep to the sensory retina in a shape that does not bear any resemblance to cystoid macular edema. This pattern is important to recognize because it (1) should not be confused with the angiographic pattern or extent of choroidal neovascularization and (2) should be differentiated from a serous detachment or tear of the retinal pigment epithelium.
|
https://pubmed.ncbi.nlm.nih.gov/1704212/
|
[
"Case Reports",
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, U.S. Gov't, P.H.S."
] |
1704212
|
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] |
1,704,245 |
Self-help materials for anxiety: a randomized controlled trial in general practice.
|
Donnan P P, Hutchinson A A, Paxton R R, Grant B B, Firth M M
|
The British journal of general practice : the journal of the Royal College of General Practitioners . Vol. 40, No. 341, 1990 Dec
|
The efficacy of a self-help package in treating chronic anxiety was evaluated in a randomized controlled trial in which the intervention group received self-help materials in the form of an audiotape and booklet, in addition to their current treatment. The intervention was successful in terms of mean depression scores (P = 0.01), anxiety scores (P = 0.04) and general health questionnaire scores (P = 0.02) which were significantly lower for the intervention group than for the controls. In addition, the depression scores fell faster for the intervention group than for the controls. The overall mean reduction in three months in adjusted depression scores was approximately two points greater for the intervention group than for the controls (P = 0.02). Clinicians welcomed the package as a valuable addition to the therapies available for managing chronic anxiety problems. Further studies should include larger sample sizes, taking into account the non-response to postal questionnaires over time.
|
https://pubmed.ncbi.nlm.nih.gov/1704245/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
1704245
|
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] |
1,704,494 |
Maxillofacial considerations in orthotopic liver transplantation.
|
Ziccardi V B VB, Abubaker A O AO, Sotereanos G C GC, Patterson G T GT
|
Oral surgery, oral medicine, and oral pathology . Vol. 71, No. 1, 1991 Jan
|
Orthotopic liver transplantation is now a widely used treatment for patients with end-stage liver disease. Lifelong pharmacologic immunosuppression renders these patients susceptible to many infections. The purpose of this article is to provide guidelines for treating the patient with end-stage liver disease, both before and after transplantation. In addition, we shall discuss some of the medical implications associated with end-stage liver disease and their clinical presentations and appropriate presurgical management. Adverse side effects of long-term immunosuppression and their effect on the oral and maxillofacial region shall also be discussed. Last, a brief discussion of FK506, the latest immunosuppressant, will be presented together with the implications of its use on our surgical treatment of these patients.
|
https://pubmed.ncbi.nlm.nih.gov/1704494/
|
[
"Guideline",
"Journal Article"
] |
1704494
|
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] |
1,704,534 |
True incidence of pacemaker syndrome.
|
Heldman D D, Mulvihill D D, Nguyen H H, Messenger J C JC, Rylaarsdam A A, Evans K K, Castellanet M J MJ
|
Pacing and clinical electrophysiology : PACE . Vol. 13, No. 12 Pt 2, 1990 Dec
|
Although the purported incidence of pacemaker syndrome according to the literature is only 5%-15%, this is based on a series of patients with VVI pacing. Increasing numbers of studies are being reported in which patients prefer the dual chamber mode despite little benefit being demonstrated on objective testing, suggesting that pacemaker syndrome may be more common than is generally reported. This study was designed to evaluate the reported symptoms in a series of patients programmed to both the VVI and one or more dual chamber modes. Forty unselected patients with dual chamber pacemakers were entered into a blind, randomized trial comparing the symptoms associated with VVI pacing to those associated with dual chamber pacing. Patients were randomized to either VVI or dual chamber pacing. At the end of 1 week, questionnaires rating 16 different symptoms were completed. Blood pressure, LV function, presence of ventriculoatrial conduction, and ability to override the pacemaker were evaluated. The pacemaker was then programmed to the other mode. Overall, 12 of 16 symptoms were significantly worse in the VVI as compared to dual chamber mode. The most highly significant (P less than 0.005) were shortness of breath, dizziness, fatigue, pulsations in the neck or abdomen, cough, and apprehension. Pacemaker syndrome was clinically recognized in 83% of patients paced in the VVI mode with 65% of patients experiencing moderate to severe symptoms. There were no readily identified clinical, hemodynamic, or electrophysiological parameters that predicted which patients would develop pacemaker syndrome. Thus, when patients have an opportunity to experience both pacing modes in close proximity to one another, there is a high incidence of pacemaker syndrome in the VVI mode.
|
https://pubmed.ncbi.nlm.nih.gov/1704534/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
1704534
|
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] |
1,704,545 |
A randomized double-blind, cross-over study of the linear and nonlinear algorithms for the QT sensing rate adaptive pacemaker.
|
Baig M W MW, Green A A, Wade G G, Kovanci E E, Constable P D PD, Perrins E J EJ
|
Pacing and clinical electrophysiology : PACE . Vol. 13, No. 12 Pt 2, 1990 Dec
|
We have compared the pacing rate responses during cardiopulmonary exercise testing in 11 patients (mean 59 years, six female) with implanted QT sensing rate adaptive pacemakers who were randomly programmed to 1-month periods in the linear and nonlinear algorithms using a double-blind, cross-over design. Exercise testing was performed at the end of each month block and symptoms were scored with the MacMaster questionnaire. With exercise, the time to a 10 beats/min increment in rate was significantly less with the nonlinear compared to the linear algorithm (126 sec vs 255 sec, P = 0.02) but there were no significant differences in exercise duration, the peak pacing rate, the peak VO2, the VO2 at the anaerobic threshold or the mean correlation coefficients of the pacing rate VO2 relationship. Rate oscillation occurred in seven patients in the linear algorithm and in two patients in the nonlinear setting. Initial deceleration of the pacing rate at the onset of exercise occurred in seven patients in the linear algorithm and in four patients in the nonlinear setting. The nonlinear algorithm is associated with a faster response time during exercise and fewer instances of rate instability. However, it has not overcome the problem of a dip in the pacing rate at the beginning of exercise. The major difference in the function of the two algorithms is faster initial acceleration with the nonlinear algorithm. This is explained by the significantly higher values of the slope setting at the lower rate limit for the nonlinear versus the linear algorithm (6.3 ms/ms vs 5.1 ms/ms).
|
https://pubmed.ncbi.nlm.nih.gov/1704545/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial"
] |
1704545
|
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] |
1,704,547 |
Intrapatient comparison between chronic VVIR and DDD pacing in patients affected by high degree AV block without heart failure.
|
Menozzi C C, Brignole M M, Moracchini P V PV, Lolli G G, Bacchi M M, Tesorieri M C MC, Tosoni G D GD, Bollini R R
|
Pacing and clinical electrophysiology : PACE . Vol. 13, No. 12 Pt 2, 1990 Dec
|
In patients affected by high degree AV block without preexisting congestive heart failure there is no definite demonstration that DDD pacing gives real clinical advantages in respect to VVIR pacing. We performed an intrapatient, long-term study between the two pacing modes in 14 high degree AV block patients, using the Medtronic Synergyst 7027 dual chamber pacemaker, who could be programmed alternatively in DDD or VVIR mode. After a 4-week run-in period following the pacemaker implant, patients completed a randomized, double-blind, cross-over study to compare the effect of 6-week period VVIR and DDD pacing on symptoms and cardiovascular parameters. A semiquantitative score scale was used to quantify the symptoms of general well-being, palpitations, dizziness, pulsating sensation in the neck or abdomen, shortness of breath at rest and during effort, chest pain, and NYHA classification. The sum of symptom scores was 10.4 +/- 6.7 in VVIR period and 4.6 +/- 2.7 in DDD period (P less than 0.001); five patients (36%) crossed over early from VVIR to DDD because of intolerable symptoms; overall, eight patients preferred the DDD mode and no one preferred the VVIR. Cardiac output at rest (echo-Doppler method) was 4.7 +/- 1.4 versus 5.7 +/- 1.6 liter/min (P less than 0.01), body weight was 65.9 +/- 6.6 versus 64.9 +/- 6.1 kg (P less than 0.02), atrial natriuretic peptide was 236 +/- 112 versus 198 +/- 110 pg/mL (P less than 0.01), respectively, during VVIR and DDD modes. Effort tolerance was similar with the two modes of pacing (68 +/- 15 vs 70 +/- 18 watts/min).(ABSTRACT TRUNCATED AT 250 WORDS)
|
https://pubmed.ncbi.nlm.nih.gov/1704547/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
1704547
|
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] |
1,704,550 |
Superior cardiac hemodynamics of atrioventricular synchrony over rate responsive pacing at submaximal exercise: observations in activity sensing DDDR pacemakers.
|
Lau C P CP, Wong C K CK, Leung W H WH, Liu W X WX
|
Pacing and clinical electrophysiology : PACE . Vol. 13, No. 12 Pt 2, 1990 Dec
|
The relative hemodynamic profile between dual chamber pacing (DDD) and activity sensing rate responsive pacing (VVIR) was compared in ten patients with dual chamber rate responsive pacemakers (Synergist II). With a double blind, randomized exercise protocol, DDDR pacemakers were programmed into VVI, VVIR, and DDD (AV interval 150 msec) modes and in seven patients the test in the DDD mode was repeated with the AV interval programmed at 75 msec. A treadmill exercise test of 6-minutes duration (2 stages, Stage I at 2 mph, 0% gradient and Stage II at 2 mph, 15% gradient) was performed at each of the programmed settings, with a rest period of 30 minutes in between tests. Cardiac output was assessed using continuous-wave Doppler sampling ascending aortic flow and expressed as a percentage of the value achieved during VVI pacing. During exercise, pacing rate between DDD and VVIR pacing was similar but was higher with DDD at the first minute of recovery (91 +/- 4 vs 81 +/- 3 beats/min, respectively). Cardiac output was significantly higher at rest, during low level exercise, and recovery with DDD pacing compared with VVIR pacing (resting: 21 +/- 14 vs -2 +/- 7%; Stage I: 36 +/- 6 vs 16 +/- 7%; Stage II: 25 +/- 15 vs 10 +/- 8%; recovery: 26 +/- 12 vs 4 +/- 9%; P less than 0.05 in all cases). Systolic blood pressure was significantly higher during low level of exercise in the DDD mode. Shortening of the AV interval to 75 msec did not significantly affect cardiac output during exercise, but cardiac output after exercise was reduced (2 +/- 6 vs 23 +/- 6% at an AV interval of 150 msec, P less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)
|
https://pubmed.ncbi.nlm.nih.gov/1704550/
|
[
"Clinical Trial",
"Journal Article",
"Randomized Controlled Trial",
"Research Support, Non-U.S. Gov't"
] |
1704550
|
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] |
1,704,561 |
Steroid-tipped leads versus porous platinum permanent pacemaker leads: a controlled study.
|
Wish M M, Swartz J J, Cohen A A, Cohen R R, Fletcher R R
|
Pacing and clinical electrophysiology : PACE . Vol. 13, No. 12 Pt 2, 1990 Dec
|
There is little data directly comparing steroid-tipped permanent pacemaker leads to otherwise state-of-the-art porous platinum leads. Eighteen patients receiving unipolar generators capable of low voltage outputs were randomized at the time of implant to receive either steroid-tipped leads or porous platinum leads. All leads were unipolar, tined, passive fixation, and placed in the right ventricular apex or atrial appendage. This study is single center. At implant, threshold pulse width was determined at 3 voltages (2.5, 1.5, and 0.8 V). Follow-up thresholds were determined at weeks 1, 2, 3, and 4, and at 3 and 6 months. There was no difference in implant thresholds or amplitudes for sensing. By 2 weeks postimplant, lower thresholds were noted for the steroid leads, and this discrepancy grew more significant with time. There was no significant postimplant rise in threshold for steroid-tipped leads. At 6 months, the average threshold pulse width for ventricular steroid leads at 0.8 V was 0.3 +/- 0.1 msec. In contrast, five patients with standard leads did not capture at maximum pulse width at 0.8 V (P less than 0.0001). There was no significant difference in the amplitude of the chronic atrial electrogram. This study shows steroid-tipped leads to offer a significant advantage in reducing thresholds early postimplant and chronically.
|
https://pubmed.ncbi.nlm.nih.gov/1704561/
|
[
"Clinical Trial",
"Comparative Study",
"Journal Article",
"Randomized Controlled Trial"
] |
1704561
|
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] |
1,704,606 |
Predictors of ventricular tachycardia inducibility in programmed electrical stimulation and the effectiveness of serial drug testing: Polish multicenter study.
|
Wnuk-Wojnar A M AM, Giec L L, Drzewiecki J J, Trusz-Gluza M M, Dabrowski A A, Pasyk S S
|
Pacing and clinical electrophysiology : PACE . Vol. 13, No. 12 Pt 2, 1990 Dec
|
In 100 patients with IHD and complex ventricular arrhythmias, programmed electrical stimulation was performed using up to three extrastimuli at sinus rhythm, and paced 100, 120 and 140 beats/min delivered from the RV apex, outflow tract or the LV with ventricular mapping to evaluate late potentials (LP) in 41 patients. Sustained monomorphic VT (SMVT) was provoked in 91% of 42 patients with a history of VT/VF, P less than 0.001, all five patients had SMVT in 24-hour ECG, P less than 0.005, and 91% of 21 patients with LV dyskinesis, P less than 0.01. After depolarizations were found in 62% of 21 patients with a history of VT, in 58% of 31 patients with inducible VT, P less than 0.01 and in five of six patients with LV dyskinesis. In patients with inducible VT, LP had a higher amplitude (105 +/- 35 vs 60 +/- 47 microV) and were more delayed (202 +/- 96 vs 133 +/- 75 msec) than in noninducible patients. In 17 patients, serial drug testing was performed after oral administration using mexilitene, disopyramide, chinidine, propafenone, sotalol, and amiodarone. If one drug was tested, the therapy efficacy was 25%, if two drugs-60%, and if three drugs-75%. In eight patients, VT was inducible in all tests, but in only one of these patients chronic antiarrhythmic therapy was not effective. We conclude that the most important predictors of VT inducibility are a history of VT or 24-hour ECG, and LV dyskinesis. Serial drug testing is efficient only when many drugs are tested, but even if VT is inducible, it does not exclude the possibility of a good clinical outcome in chronic therapy.
|
https://pubmed.ncbi.nlm.nih.gov/1704606/
|
[
"Clinical Trial",
"Journal Article",
"Multicenter Study",
"Research Support, Non-U.S. Gov't"
] |
1704606
|
[
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