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Biomedical subjects

F H Anderson

Publications and source records attributed to F H Anderson.

At least 19 recordsLinked to original sources
PubMed2006

Daclizumab, a humanised monoclonal antibody to the interleukin 2 receptor (CD25), for the treatment of moderately to severely active ulcerative colitis: a randomised, double blind, placebo controlled, dose ranging trial.

BACKGROUND: An uncontrolled pilot study demonstrated that daclizumab, a humanised monoclonal antibody to the interleukin 2 receptor (CD25), might be effective for the treatment of active ulcerative colitis. METHODS: A randomised, double blind, placebo controlled trial was conducted to evaluate the efficacy of daclizumab induction therapy in patients with active ulcerative colitis. A total of 159 patients with moderate ulcerative colitis were randomised to receive induction therapy with daclizumab 1 mg/kg intravenously at weeks 0 and 4, or 2 mg/kg intravenously at weeks 0, 2, 4, and 6, or placebo. The primary end point was induction of remission at week 8. Remission was defined as a Mayo score of 0 on both endoscopy and rectal bleeding components and a score of 0 or 1 on stool frequency and physician's global assessment components. Response was defined as a decrease from baseline in the Mayo score of at least 3 points. RESULTS: Two per cent of patients receiving daclizumab 1 mg/kg (p = 0.11 v placebo) and 7% of patients receiving 2 mg/kg (p = 0.73) were in remission at week 8, compared with 10% of those who received placebo. Response occurred at week 8 in 25% of patients receiving daclizumab 1 mg/kg (p = 0.04) and in 33% of patients receiving 2 mg/kg (p = 0.30) versus 44% of those receiving placebo. Daclizumab was well tolerated. The most frequently reported adverse events in daclizumab treated patients compared with placebo treated patients were nasopharyngitis (14.6%) and pyrexia (10.7%). CONCLUSION: Patients with moderate ulcerative colitis who are treated with daclizumab are not more likely to be in remission or response at eight weeks than patients treated with placebo.

Adolescent↗
PubMed1997

Alteration of the dismal natural history of fibrosing cholestatic hepatitis secondary to hepatitis B virus with the use of lamivudine.

BACKGROUND: Fibrosing cholestatic hepatitis (FCH) is a severe form of hepatitis B virus (HBV) infection occurring as either primary allograft reinfection after liver transplantation for HBV or as severe HBV reactivation induced by immunosuppression in patients with previously latent infection. Without treatment, FCH is universally fatal within a few months of diagnosis. Some improvement has been reported with long-term ganciclovir, with and without foscarnet, but an effective and easily available treatment has not yet been reported. METHODS: We report the prolonged survival of a renal transplant recipient who developed histologically confirmed FCH 6 months after transplantation and was treated with lamivudine. RESULTS: At the time of diagnosis, the patient had jaundice, ascites, and a serum HBV-DNA level of 3868 pg/ml. Lamivudine was instituted 2 months later, and after 6 months of treatment, the HBV-DNA level was undetectable with the serum bilirubin within the normal range. Twelve months after the diagnosis of FCH, the patient remains stable without progression of liver dysfunction. CONCLUSION: Our experience demonstrates that lamivudine therapy can improve the dismal natural history of FCH.

Antiviral Agents↗
PubMed1997

Effect of intermittent cyclical disodium etidronate therapy on bone mineral density in men with vertebral fractures.

OBJECTIVES: to investigate the effects of oral intermittent cyclical etidronate therapy on bone mineral density (BMD) in men with idiopathic vertebral osteoporosis. DESIGN: consecutive case series. SETTING: regional specialist clinic for metabolic bone disease. SUBJECTS: 42 men aged 35-81 (median 60.5) with established vertebral crush fractures and back pain, in whom secondary causes of osteoporosis had been excluded. INTERVENTION: repeated cycles of treatment with oral disodium etidronate 400 mg daily for 14 days followed by oral calcium 500 mg as citrate daily for 76 days. OUTCOME MEASURES: BMD measurement of the lumbar spine and femoral neck by dual energy x-ray absorptiometry at 6-12-month intervals; bone biochemistry (serum calcium, phosphate, alkaline phosphatase and urine calcium/creatinine and hydroxyproline/creatinine ratios) at 6-month intervals. RESULTS: all 42 men have been treated for more than 18 months, and 35 of them for more than 24 months. Median follow-up for the group as a whole is 31 months (range 18-45). The treatment was well tolerated. BMD at the lumbar spine increased by a mean of 0.024 g/cm2 per year of follow-up (95% confidence interval 0.017-0.032 g/cm2). This is equivalent to an average annual rate of change of 3.2% of baseline values. There was a small, non-significant rise in mean BMD at the hip equivalent to 0.7% of baseline values per year. Serum alkaline phosphatase tended to fall in the first 6 months of treatment, returning to baseline values at 2 years. Serum calcium and phosphate were unchanged and no decrease in urinary calcium/creatinine ratio or hydroxyproline/creatinine ratio was seen. CONCLUSIONS: intermittent cyclical etidronate therapy increased lumbar spine BMD over a 2-year period in an unselected group of men with osteoporotic vertebral fractures. This treatment warrants further evaluation in a randomized controlled trial.

Administration, Oral↗
PubMed1997

Androgen supplementation in eugonadal men with osteoporosis: effects of six months' treatment on markers of bone formation and resorption.

There is no established treatment for osteoporosis in men, a common and disabling condition the incidence of which is increasing rapidly. We conducted an open study to investigate the efficacy and mode of action of testosterone therapy in eugonadal men with osteoporotic vertebral crush fracture. Twenty-one men, aged 34-73 (mean 58), were treated with intramuscular testosterone esters (Sustanon 250) every 2 weeks for 6 months. Bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry was performed at baseline and 6 months. We also measured biochemical markers of bone turnover, testosterone, estradiol, sex hormone binding globulin (SHBG), and gonadotrophins at baseline and after 3 and 6 months of treatment. Treatment was well tolerated, and side effects were uncommon. Lumbar spine BMD increased by 5% from 0.799 to 0.839 g/cm2 (p < 0.001). All bone markers decreased, indicating that treatment suppressed bone turnover. Although serum osteocalcin levels fell only slightly, there were large reductions in urinary deoxypyridinoline and N-telopeptide (p < 0.05), which were correlated with the increase in spinal BMD. Interpretation of the findings with other markers, such as bone-specific alkaline phosphatase and pyridinoline, was confounded by the wide scatter of values. Serum testosterone increased by 55%, while SHBG decreased by 20%, leading to a rise in free androgen of 90%. Serum estradiol also increased by 45%. The change in spine BMD was significantly correlated with a change in serum estradiol but not with a change in serum testosterone. We therefore conclude that testosterone is a promising treatment for men with idiopathic osteoporosis, acting to suppress bone resorption by a mechanism that may involve estrogen.

Absorptiometry, Photon↗
PubMed1996

Androgen supplementation in eugonadal men with osteoporosis-effects of 6 months of treatment on bone mineral density and cardiovascular risk factors.

This open, prospective therapeutic trial studied the effects of regular moderate androgen supplementation on bone mineral density in eugonadal men with established osteoporosis, and collected data on the safety of androgen therapy used in this setting. 23 men, aged 34-73 years, with vertebral crush fractures and back pain, in whom secondary causes of osteoporosis had been excluded, were treated with fortnightly intramuscular injections of 250 mg testosterone esters (Sustanon 250(R)) for 6 months. Blood pressure was recorded monthly; fasting lipids, glucose, haematocrit, plasma viscosity, and testosterone levels were measured every 3 months. Psychological effects were assessed using the Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), together with questioning on libido changes. Principal outcomes measured were changes in bone mineral density at the hip and spine by dual-energy X-ray absorptiometry (DEXA) over the treatment period. 21 men completed the study period. Mean bone mineral density at the lumbar spine increased from 0.799 g/cm(2) to 0.839 g/cm(2) during treatment (p < 0. 001), a rise of 5% in 6 months. Bone mineral density at the hip did not change. There were significant, favorable changes in diastolic blood pressure (-4.7 mmHg, p < 0.01), serum triglyceride levels (-0.405 mmol/L,p < 0.01), and total cholesterol (-0.27 mmol/L, p < 0.05). Adverse changes included a fall in HDL cholesterol (-0.087 mmol/L, p < 0.05) and a rise in plasma viscosity which was significant at 3 months but not at 6 months. The expected rises in hematocrit (0.434 to 0.456) and FAI (0.504 to 0.887) occurred. We conclude that testosterone supplementation significantly increased bone mineral density in this heterogeneous group of men with idiopathic primary osteoporosis, without an overall adverse effect on cardiovascular risk factors. This treatment warrants further evaluation in a randomized, controlled trial.

Absorptiometry, Photon↗
PubMed1996

Seasonal change in the exacerbations of Crohn's disease.

BACKGROUND: Ulcerative colitis (UC) has been reported to run a clinical course with seasonal exacerbations in both retrospective and prospective studies; such a seasonality was not been observed, however, in Crohn's disease (CD). METHODS: The monthly distribution in the relapse of CD was retrospectively studied to ascertain whether there is any seasonal variation in the exacerbations of the disease. During the period of 1972 to 1993, 139 patients who had been regularly followed up for at least 13 consecutive months were analyzed. RESULTS: In a total of 10,693 follow-up months for these patients 592 relapses occurred in the study period. The highest relapse rate was found in the autumn and winter, whereas the lowest was in the summer. CONCLUSION: This study shows that CD runs a clinical course with seasonal exacerbations, suggesting that seasonal or exogenous factors may be involved in the relapse of CD.

Adolescent↗
PubMed1995

A comparison of the effectiveness and cost of treatment for vertebral fractures in women.

Of the treatments available for the management of established vertebral osteoporosis, hormone replacement therapy (HRT), intermittent cyclical etidronate therapy and salmon calcitonin have been shown in randomized, controlled trials to reduce the risk of further vertebral fractures. In order to compare the cost effectiveness of these different treatments we examined the cost and efficacy of each treatment using previously published data. HRT, cyclical etidronate and salmon calcitonin all decrease the incidence of further vertebral fracture by 50-60%. Estimation of the cost per vertebral fracture averted therefore reflects the underlying cost of medication, with HRT costing 138-680 pounds per fracture averted compared with 1880 pound for cyclical etidronate therapy and 9075-25 013 pounds for salmon calcitonin therapy. HRT is therefore the treatment of choice for post-menopausal women with osteoporosis, particularly as it may also decrease the risk of ischaemic heart disease. Although salmon calcitonin appears as effective as the other treatments, it is considerably more expensive, so should be reserved for situations where HRT and cyclical etidronate are inappropriate.

Aged↗
PubMed1991

Hepatic hemangioblastoma. An unusual presentation in a patient with von Hippel-Lindau disease.

We report a case of multiple capillary hemangioblastomas of the liver occurring in a patient with von Hippel-Lindau disease and a history of previous cerebellar and spinal hemangioblastomas. Although rare examples of this tumor have previously been recorded in the pancreas, kidney, and urinary bladder, this appears to be the first recorded case with hepatic involvement. The histology and immunohistochemical appearance of this neoplasm are identical with those of the cerebellar tumor. We believe it represents a separate primary neoplasm rather than metastatic disease.

Adult↗
PubMed1991

Lymphocytic gastritis and giant gastric folds associated with gastrointestinal protein loss.

Lymphocytic gastritis is a recently described lesion which occurs in a significant proportion of patients with celiac sprue. This paper describes two patients with lymphocytic gastritis and no evidence of celiac sprue. Both patients had markedly enlarged gastric folds and serum hypoproteinemia, which were clinically suggestive of Ménétrier's disease. These cases indicate that lymphocytic gastritis may cause a protein-losing gastropathy and should be considered in the differential diagnosis of Ménétrier's disease.

Adult↗
PubMed1989

Progressive aphasia without dementia: further documentation.

Two patients with progressive aphasia without dementia had magnetic resonance imaging findings of focal left temporal lobe abnormality. Unlike most of the other documented cases of progressive aphasia, onset was not presenile, occurring at ages 68 and 69.

Aged↗
PubMed1985

Acute liver failure: a possible consequence of severe hypophosphatemia.

A patient with acute liver failure, in whom no infectious, toxic, or other cause of hepatic damage could be found, developed severe hypophosphatemia along with hepatocellular necrosis. We propose that phosphate depletion may be responsible for the liver cell damage, as hypophosphatemia impairs tissue oxygenation and depletes cellular ATP.

Acute Disease↗
PubMed1984

Relationship between iron deficiency and cholestasis associated with parenteral nutrition.

In a study of 22 patients receiving total parenteral nutrition (TPN), we found that iron-deficient patients were less likely to develop cholestasis than patients with normal iron stores. The mean and S.D. of serum iron, total iron binding capacity and percent saturation in the 12 patients developing cholestasis were 12.7 +/- 5.2 micromol/L, 37.1 +/- 8.5 micromol/L and 37 +/- 24% whereas in the 10 patients who did not develop cholestasis, the values were 7.3 +/- 3.6 micromol/L, 54.8 +/- 17.9 micromol/L and 14 +/- 7% respectively. All differences were statistically significant. The relationship between iron stores and TPN-associated cholestasis deserves further study.

Journal Article↗