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Biomedical subjects

C Corcoran

Publications and source records attributed to C Corcoran.

44 records · Page 3Linked to original sources
PubMed1989

[Efficacy and acceptability of rilmenidine in mild to moderate arterial hypertension. A multicenter, randomized, double-blind trial, in comparison with methyldopa in 157 patients].

UNLABELLED: A dissociation between the hypotensive activity and the central side effects has been demonstrated with rilmenidine (RIL) in previous studies. The object of this trial was to compare RIL with methyldopa (MD) during a 12 weeks' treatment (Day 0 to Day 84) and after stopping therapy (Day 84-Day 91). In particular, the trial was designed to evaluate the acceptability of the two agents. After 4 weeks of placebo, 76 men and 81 women (average age 55 years) were allocated according to a randomised double-blind protocol to RIL (N = 78) or MD (N = 79). The two groups were comparable with systolic/diastolic BP of 165/102 mmHg and 165/101 mmHg respectively. Monotherapy was administered to all the patients from Day 0 to Day 56 in order to compare RIL (1 mg every morning or 1 mg twice daily if necessary) and MD (250 mg morning and evening or 500 mg twice daily if necessary). Hydrochlorothiazide (25 mg daily) was associated from Day 56 to Day 84 if the supine diastolic BP was greater than or equal to 90 mmHg. A placebo was substituted from Day 84 to Day 91 to study the effect of withdrawing therapy. RESULTS: at Day 56 under monotherapy, the average supine systolic/diastolic BP had decreased significantly with RIL and MD to 140/110 mmHg and 140/100 mmHg respectively. An equivalent number of patients had normalised their blood pressures in both groups (systolic/diastolic BP less than or equal to 160/90 mmHg): 50% with RIL and 42% with MD (NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Computational tools for exact conditional logistic regression.

Logistic regression analyses are often challenged by the inability of unconditional likelihood-based approximations to yield consistent, valid estimates and p-values for model parameters. This can be due to sparseness or separability in the data. Conditional logistic regression, though useful in such situations, can also be computationally unfeasible when the sample size or number of explanatory covariates is large. We review recent developments that allow efficient approximate conditional inference, including Monte Carlo sampling and saddlepoint approximations. We demonstrate through real examples that these methods enable the analysis of significantly larger and more complex data sets. We find in this investigation that for these moderately large data sets Monte Carlo seems a better alternative, as it provides unbiased estimates of the exact results and can be executed in less CPU time than can the single saddlepoint approximation. Moreover, the double saddlepoint approximation, while computationally the easiest to obtain, offers little practical advantage. It produces unreliable results and cannot be computed when a maximum likelihood solution does not exist.

Adolescent↗
PubMedDate not supplied

Protecting patients as costs are cut.

In today's managed healthcare era, cost-control measures that encourage underutilization of resources create fears that patients will receive less care than their conditions, injuries, or illnesses warrant. Patients need protection now that the rules have changed. Traditionally, patients have relied on direct caregivers to put their patients first. As individuals, caregivers want to be patient advocates; however, changes in the healthcare environment make it difficult for them to maintain their advocacy role. Clinical decision support criteria that are contained in a resource management program can help providers and payers maintain a balance between cost containment and healthcare quality.

Cost Control↗
PubMedDate not supplied

[Rilmenidine, a new antihypertensive agent in the first line treatment of essential arterial hypertension. Multicenter double-blind study versus atenolol].

After 4 weeks on placebo, 90 hypertensive patients (37 men, 53 women, mean age 55 years) with systolic (SBP) and diastolic (DBP) blood pressures of 162/99 and 165/100 mmHg respectively received double-blind treatment with either rilmenidine 1 mg/day or atenolol 50 mg/day. This treatment was given alone for 8 weeks, with possible DBP greater than or equal to 90 mmHg, hydrochlorothiazide 25 mg/day was added between the 9th and 12th weeks of treatment. At week 13 all treatments were replaced by placebo. Both groups were similar at randomisation, and both treatments were similarly effective: after 8 weeks of monotherapy with rilmenidine or atenolol, the SBP/DBP had decreased by -18/-13 mmHg and by -21/-15 mmHg respectively, and the proportion of patients with normalised blood pressure (SBP/DBP less than or equal to 160/90 mmHg) was 66 percent and 65 percent. Effectiveness was maintained at 12 weeks, when less than 20 percent of the patients had taken hydrochlorothiazide. Both drugs were well tolerated clinically and electrocardiographically. There was a significantly greater decrease in heart rate on atenolol than on rilmenidine. Eleven patients (5 on rilmenidine, 6 on atenolol) dropped out of the trial, 2 and 3 patients in the respective groups on account of side-effects. Laboratory tests showed that the HDL-cholesterol level significantly decreased on atenolol and remained stable on rilmenidine (P less than 0.01), whereas the LDL-cholesterol level was stable on atenolol and decreased on rilmenidine (P less than 0.05). No rebound in blood pressure was observed on discontinuation of both treatments. This study shows that rilmenidine administered as first-line treatment is as effective as atenolol in lowering blood pressure, and it confirms that this drug is clinically and biochemically well tolerated.

Adult↗