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Biomedical subjects

B Hepburn

Publications and source records attributed to B Hepburn.

At least 19 recordsLinked to original sources
PubMed2005

Comparison of the effects of immediate-release omeprazole powder for oral suspension and pantoprazole delayed-release tablets on nocturnal acid breakthrough in patients with symptomatic gastro-oesophageal reflux disease.

BACKGROUND: Many patients treated with a proton-pump inhibitor for gastro-oesophageal reflux disease or erosive oesophagitis still have substantial night-time gastric acidity. A previous trial of a new immediate-release omeprazole oral suspension suggested that nocturnal gastric acidity could be more effectively controlled with a bedtime dose of immediate-release omeprazole than with a delayed-release proton-pump inhibitor administered before dinner or at bedtime. AIM: To compare the ability of immediate-release omeprazole with pantoprazole to control nocturnal gastric acidity, when they were dosed once daily and twice daily. METHODS: Thirty-six patients with nocturnal gastro-oesophageal reflux disease symptoms received immediate-release omeprazole and pantoprazole in this open-label, randomized-crossover trial. Median gastric pH, the percentage of time with gastric pH > 4 and the percentage of patients with nocturnal acid breakthrough, were evaluated with 24-h pH monitoring. RESULTS: Repeated once daily (bedtime) dosing with immediate-release omeprazole suspension produced significantly better nocturnal gastric acid control than repeated once daily (predinner) or twice daily (prebreakfast and bedtime) dosing with pantoprazole delayed-release tablets (median pH: 4.7 vs. 2.0 and 1.7; percentage of time pH > 4: 55 vs. 27 and 34; nocturnal acid breakthrough: 53 vs. 78 and 75). Twice daily dosing (prebreakfast and bedtime) with immediate-release omeprazole 20 and 40 mg achieved the best night-time control of gastric acidity. Repeated once daily bedtime dosing with immediate-release omeprazole 40 mg and twice daily dosing with pantoprazole 40 mg gave similar 24-h pH control. No safety issues were associated with either drug in this trial. CONCLUSIONS: Dosed once daily at bedtime, immediate-release omeprazole reduced nocturnal gastric acidity to a degree not observed with once daily dosing of delayed-release proton-pump inhibitors.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1996

Tenidap in patients with rheumatoid arthritis. A 4-week, placebo-controlled study.

The present double-blind, placebo-controlled study was conducted to compare the safety and efficacy of tenidap in patients with rheumatoid arthritis (RA). Patients with flare of active RA following NSAID withdrawal were randomized to receive either placebo (n = 67) or tenidap (n = 131; 40-200 mg/day). The mean changes from baseline in efficacy and biochemical variables were compared between treatment groups at endpoint (4 weeks). The improvements in four of the five primary efficacy variables were significantly greater in the tenidap group compared with the placebo group (p < 0.01). Tenidap was also associated with an 18% reduction in erythrocyte sedimentation rate (ESR) and a marked, 51%, reduction in serum C-reactive protein (CRP) level, both of which were significantly greater than the changes in the placebo group (p < 0.05). The percentage of patients who discontinued because of side effects was the same in both groups (3%). In conclusion, tenidap 40-200 mg/day was effective and well tolerated in the treatment of patients with RA for 4 weeks.

Administration, Oral↗
PubMed1994

Inspirational recruitment and the Maryland Plan: overcoming the stigma of public psychiatry.

University-trained psychiatrists frequently avoid public-sector employment because they do not wish to be associated with stigmatized institutions. Inspirational recruitment--the elevation of poorly paid and unpleasant work to a noble cause--is one way of temporarily destigmatizing state psychiatry. The authors describe the impact of one such effort, the Maryland Plan, on recruitment of graduates of the University of Maryland psychiatric residency program into the state's psychiatric system. Significantly more graduates entered state psychiatry in the 15 years after the plan was implemented in 1978 (78 of 164 graduates, or 47.6 percent) than in the eight years before (seven of 57 graduates, or 12.3 percent). Data indicate that low salaries did not hurt recruitment, nor did doubling the stipends prevent the majority of recruits from leaving the public sector after a few years of service.

Adult↗
PubMed1988

What is a disease modifying antirheumatic drug?

The disease modifying antirheumatic drugs (DMARD) used to treat rheumatoid arthritis (RA) are distinct from the nonsteroidal antiinflammatory drugs (NSAID) in their slow onset of antiinflammatory action, their lack of analgesic properties, their more frequent and severe toxicity, and in the opinion of some experts, their ability to produce more frequent remissions and slow the progression of erosions. New DMARD prospects include less toxic immune modulating agents, as well as NSAID/DMARD hybrids. Although currently available DMARD are considered primarily treatment for RA, sulfasalazine may be such a drug for B27 arthropathies as well. Future studies may lead to the development of agents that are specific modifiers of other rheumatic diseases, including lupus and scleroderma.

Anti-Inflammatory Agents↗
PubMed1987

Effect of divided daily dose prednisone therapy on circulating T cell subsets.

Prednisone induced reductions in the circulating human T cell population follow a characteristic time curve which persists even after a single daily dose of oral prednisone has been administered many times. If prednisone doses are administered every 6 h, so that a dose occurs near the point of maximum response from a previous dose (4-6 h), the reduction in size of the circulating T cell population will persist so long as administration of prednisone continues. A chronically depressed ratio of OKT4+ to OKT8+ cells is observed in most patients when as little as 2.5 mg of prednisone is administered every 6 h.

Adult↗
PubMed1986

Sulfasalazine in rheumatoid arthritis. A double-blind, placebo-controlled trial.

Sulfasalazine (SSZ), 3 gm daily, was compared with placebo for treatment of rheumatoid arthritis, in a 15-week randomized, parallel, double-blind trial. Joint tenderness and swelling, morning stiffness, grip strength, and pain score all showed significantly more improvement with SSZ than with placebo. Adverse effects, particularly gastrointestinal reactions, led to withdrawal from the study of 28% of the patients who had been receiving SSZ, but these effects were all readily reversible and not life-threatening. These results confirm previous findings that suppression of rheumatoid synovitis may be induced by SSZ, within 2 months after full maintenance doses are reached.

Arthritis, Rheumatoid↗
PubMed1983

Prednisone-induced alterations of circulating human lymphocyte subsets.

Peripheral lymphopenia occurs in man after administration of glucocorticoids. By using subset-specific monoclonal antibodies, the number of peripheral T cells (OKT11+) and the number of cells in the helper-inducer (OKT4+) and suppressor-cytotoxic (OKT8+) subsets were determined in four healthy subjects before and after ingestion of 20 mg of prednisone. In all subjects, the number of circulating T cells declined. The mean ratio of OKT4+ to OKT8+ cells dropped from 2.3 to 1.6 at 4 hr after prednisone ingestion and returned to baseline at 24 hr. The changed ratio was due to a disproportionate decrease in OKT4+ cells. A smaller decrease in the absolute number of circulating OKT8+ cells occurred, but the proportion of OKT8+ cells did not change. There was a direct relationship between prednisone dose and the reduction in circulating OKT4+ cells in the one subject who took four different doses of prednisone; there was a lymphopenic effect at the 5 mg dose. In vitro exposure of lymphocytes to methylprednisolone did not result in significant lympholysis or in alteration of the relative numbers of cells in the OKT4+ and OKT8+ subsets. The lymphopenia produced by prednisone in a splenectomized healthy subject was indistinguishable from that observed in nonsplenectomized subjects. The number of circulating B cells was unaffected by 20 mg of prednisone. These studies demonstrate that prednisone-induced lymphopenia involves the OKT4+ subset to a greater degree than the OKT8+ subset. The effect could not be accounted for by lympholysis or by redistribution of lymphocytes to the spleen.

Adult↗
PubMed1982

Nonsteroidal anti-inflammatory drugs in the treatment of hemophilic arthropathy.

This study was undertaken to investigate the safety and efficacy of nonaspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) in controlling the pain and stiffness of hemophilic arthropathy. Data were collected from eight adult hemophilic patients in successive double-blind controlled studies using choline magnesium trisalicylate (CMT) and ibuprofen (IPF). In seven patients, neither drug consistently affected bleeding times, platelet aggregation studies, frequency of joint hemorrhages, or frequency of factor infusions. In one patient, platelet aggregation appeared to be affected by CMT and bleeding time became markedly prolonged after IPF therapy. Three patients taking CMT and four patients taking IPF reported greater relief of pain and stiffness with the drugs than with placebos. Our results suggest that IPF and CMT can benefit the hemophiliac and that they can be used safely in most hemophilic patients under closely supervised conditions.

Adult↗
PubMed1976

Impaired blastogenic response of lymphocytes from synovial fluid and peripheral blood of patients with rheumatoid arthritis.

Synovial fluid lymphocytes from patients with rheumatoid arthritis demonstrated a markedly diminished blastogenic response to both phytohemagglutinin and pokeweed mitogens, when compared to normal peripheral blood lymphocytes. The blastogenic response to rheumatoid peripheral blood lymphocytes to both mitogens was also depressed, when compared to the response of normal lymphocytes, but the difference was less marked and was within limits which could be accounted for by recent salicylate therapy. Lymphocytes of both peripheral blood and synovial fluid of rheumatoid patients showed a delayed response to PHA (five days to achieve maximum thymidine incorporation vs four days for normals).

Arthritis, Rheumatoid↗
PubMed1975

Suppression of lymphocyte transformation after aspirin ingestion.

To learn whether in vitro blastogenesis of lymphocytes is affected by in vivo salicylate ingestion, blood samples were obtained from 19 normal volunteers before and after therapeutic doses of aspirin. Lymphocyte transformation studies performed on these blood samples showed marked and statistically significant suppression of blastogenesis. Maximum suppression was observed in blood samples obtained 12 hours after the last aspirin ingestion. As compared to controls, samples obtained at this time showed mean blastogenic responses to phytohemagglutinin and pokeweed mitogens of 49 and 56 per cent respectively. No correlation could be demonstrated between the plasma salicylic acid level and the degree of suppression of blastogenesis. Aspirin ingestion altered neither the proportions of circulating T and B cells nor the viability of lymphocytes in culture.

Administration, Oral↗