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Biomedical subjects

G Bryce

Publications and source records attributed to G Bryce.

At least 19 recordsLinked to original sources
PubMed2001

A randomized trial of the efficacy of a new micronized formulation versus a standard formulation of isotretinoin in patients with severe recalcitrant nodular acne.

BACKGROUND: Isotretinoin is very frequently the drug of choice for the management of severe recalcitrant nodular acne. Recently, a new micronized and more bioavailable formulation of isotretinoin has been developed that permits once-daily administration in lower doses than usually used with standard isotretinoin (Accutane), regardless of whether it is taken with or without food. OBJECTIVE: Our purpose was to determine whether micronized isotretinoin and standard isotretinoin are clinically equivalent. METHODS: In this multicenter, double-blind, double-dummy study, 600 patients with severe recalcitrant nodular acne were treated with either 0.4 mg/kg of micronized isotretinoin once daily without food (n = 300) or 1.0 mg/kg per day of standard isotretinoin in two divided doses with food (n = 300). Lesion counts were monitored over 20 weeks. RESULTS: Both treatment groups in this well-controlled clinical trial experienced an equivalent reduction in the number of total nodules (facial plus truncal). In addition, an equivalent proportion of patients achieved 90% clearance of the total number of nodules. Both formulations had similar results for other efficacy variables. CONCLUSION: Once-daily use of the micronized and more bioavailable formulation of isotretinoin under fasted conditions is clinically equivalent to the standard twice-daily formulation under fed conditions in the treatment of severe recalcitrant nodular acne.

Acne Vulgaris↗
PubMed2001

Safety of a new micronized formulation of isotretinoin in patients with severe recalcitrant nodular acne: A randomized trial comparing micronized isotretinoin with standard isotretinoin.

BACKGROUND: Isotretinoin is a very effective drug for treating severe recalcitrant nodular acne. A new micronized formulation of isotretinoin has been shown to be clinically equivalent to standard isotretinoin with improved bioavailability and minimal food effect. The safety profile of the micronized formulation has not been described previously. OBJECTIVE: The objective of this article is to report the incidence and intensity of adverse events found in a comparative, double-blind efficacy study that showed clinical equivalence of the new micronized formulation of isotretinoin and the standard isotretinoin formulation (Accutane). METHODS: Six hundred patients with severe recalcitrant nodular acne were treated with micronized isotretinoin (n = 300) under fasted conditions or standard isotretinoin (n = 300) under fed conditions. One cohort received single daily doses of 0.4 mg/kg of micronized isotretinoin without food and the other cohort received 1.0 mg/kg per day of standard isotretinoin in two divided doses with food. Adverse events were monitored during 20 weeks of drug therapy. RESULTS: The proportion of adverse events in most body systems was generally lower in patients receiving micronized isotretinoin than in those receiving standard isotretinoin. CONCLUSION: Micronized isotretinoin appears to have a safety profile similar to that of standard isotretinoin and to carry a lower risk of mucocutaneous events and hypertriglyceridemia.

Acne Vulgaris↗
PubMed2000

Temporal bone necrosis: diagnosis, classification, and management.

OBJECTIVE: The goal of this study was to analyze temporal bone necrosis and classify its diagnosis and treatment according to extent of necrosis and cause. METHODS AND MATERIAL: Twenty-six cases of temporal bone necrosis were retrospectively reviewed between 1988 and 1997 at the University of British Columbia. RESULTS: Patients were classified on the basis of disease extent restricted to the tympanic bone or extension beyond the tympanic bone, as well as on the basis of the cause of disease; treatment based on classification. Patients with localized disease of the tympanic bone had minimal symptoms. Those with radiation-induced localized necrosis were less likely to respond to conservative medical management. Patients with diffuse disease were more likely to require surgical intervention. CONCLUSIONS: Temporal bone necrosis comprises a spectrum of disease from idiopathic tympanic bone necrosis, which rarely requires surgery, to the more severe forms of radiation-induced diffuse temporal bone necrosis that may cause life-threatening complications requiring surgical intervention.

Adolescent↗
PubMed2000

Managing child and adolescent mental health problems: the views of general practitioners.

OBJECTIVE: To investigate issues influencing the role of general practitioners in managing child and adolescent mental health problems. DESIGN: A postal questionnaire survey inviting respondents to rate statements about managing child and adolescent mental health issues. SETTING: Population of urban Scottish general practitioners. SUBJECTS: General practitioner principals. RESULTS: Of the 56% who responded, 31.3% reported that child and adolescent mental health services (CAMHS) were easy to access. Only a minority agreed that users' concerns prevented them from referring to CAMHS, and that these were more likely with young people or parents than with children. The number of respondents who considered their knowledge base, experience or training in this area to be adequate was particularly low. CONCLUSION: There may be a significant mismatch between what is expected of general practitioners in relation to child and adolescent mental health problems and what general practitioners themselves feel they are equipped to deliver.

Adolescent↗
PubMed1995

Psychosocial adversity in an adolescent psychiatry inpatient cohort: WHO ICD-10 findings from a multicentre prospective study.

Sixteen Axis 5 ICD-10 codes were applied to a prospective multicentre study of 276 adolescent psychiatric inpatients. Frequency distributions were obtained for the whole cohort and separately for each of the seven main ICD-9 psychiatric diagnoses. Certain abnormal psychosocial situations were associated with particular diagnoses, and many significant correlations were found between Axis 5 codes. Factor analysis with varimax rotation produced four factors accounting for 46% of the total variance.

Adolescent↗
PubMed1995

Treatment goal-planning: outcome findings of a British prospective multi-centre study of adolescent inpatient units.

A set of 16 treatment goals, related to 4 areas of adolescent functioning, were defined and employed in the initial and discharge assessments of 276 patients, admitted to 4 inpatient units, examined during a multi-centre prospective study of adolescent psychiatric hospitalizations. At discharge, subjects showed a substantial improvement across all treatment goals; least improvement was observed amongst those goals most frequently targeted. The clinical investigators consider the treatment goal definitions used in this study a meaningful way of measuring psychiatric disturbances in adolescence as well as a useful measure of change in an inpatient population. Further development of the treatment goal definitions would produce a robust clinical and audit tool.

Adolescent↗
PubMed1992

Public awareness of home accident risks--some implications for health promotion.

Through daily contact with injured people there was a feeling that most people are sufficiently aware of the dangers in specific risk factor activities, but were not fully aware that they could do a lot to prevent harm coming upon themselves. This paper describes the results of a self-administered questionnaire about the accidents people suffered at home, their level of awareness of the risk they were undertaking, whether they had had a similar accident before, what they think the recovery period from their injury is likely to be and knowledge of, and accidents involving, 17 generally known risk activities. The results confirm that most people are indeed aware of dangers yet a large number still have accidents in spite of that. The results also indicate that campaigns advising people how to avoid these dangers could be successful.

Accident Prevention↗
PubMed1986

The influence of age on bone mineral regulating hormones.

The objective of this study was to determine the effect of age on the blood levels of 1,25-dihydroxyvitamin D (1,25(OH)2D) and immunoreactive parathyroid hormone (iPTH) in normal, healthy males and females. A total of 855 normal subjects (361 males and 494 females) were studied. The results show that for healthy males, blood concentrations of 1,25(OH)2D remained essentially constant with increasing age up to age 65, and then the concentrations decreased significantly. For healthy females, 1,25(OH)2D increased up to age 65, and then decreased at a significant rate. Serum iPTH in males increased with advancing age, but the rate of increase was greater after age 65. In females a significant increase in iPTH concentrations did not occur until after age 65. Serum creatinine increased in both males and females with advancing age.

Adult↗
PubMed1986

Precipitating a crisis: family therapy and adolescent school refusers.

This paper describes the use of family therapy with adolescent school refusers. School refusal is assessed and formulated from a family systems perspective, and therapy proceeds with the crisis precipitated by insisting on the adolescent's early return to school. Some of the common problems encountered in this approach are considered along with its results.

Adolescent↗
PubMed1984

Differences in serum bone GLA protein with age and sex.

Serum bone Gla protein (BGP) was measured by radioimmunoassay in 166 healthy men and women aged 30-90 years. Serum BGP levels increased with age in both sexes and were higher in women than in men at all ages. The most striking rise occurred in women after age 40-49. BGP was significantly correlated positively with serum alkaline phosphatase and negatively with midshaft and distal bone mass in both sexes. In women only, BGP levels were significantly positively related to levels of immunoreactive parathyroid hormone (iPTH). When age was included in the multiple regression analysis BGP was still correlated with alkaline phosphatase in both sexes and iPTH in women only. Serum BGP levels were significantly higher in 13 osteoporotic patients than in age-matched controls. It is postulated that with increasing age 1,25-dihydroxyvitamin D levels fall, causing a rise in iPTH and thus in bone turnover, which is reflected by a rise in BGP levels.

Adult↗
PubMed1981

Alterations in circulating vitamin D metabolites in the young insulin-dependent diabetic.

To assess the relationship between the decreased bone mass observed in young insulin-requiring diabetic patients and vitamin D metabolism, we measured serum 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, and 1,25-dihydroxyvitamin D concentration in 45 white, insulin-dependent diabetic subjects, 7-18 yr of age. Metacarpal cortical thickness in 87% of these diabetics was below the mean for their respective ages, while 16% had a cortical thickness value greater than 2 sDs below the mean. Serum calcium and phosphate concentrations were normal, immunoreactive parathyroid hormone was in the low normal range, and total serum alkaline phosphatase was elevated compared to age- and sex-matched controls. Circulating 24,25-dihydroxyvitamin D concentrations were significantly elevated, and 1,25-dihydroxyvitamin D was significantly decreased. The increase in 24,25-dihydroxyvitamin D was greater in the diabetics with the most severe bone loss and was maximally increased during the first 5 yr of clinical diabetes. No apparent correlation was seen between metabolic control, as measured by hemoglobin A1C and urine and plasma glucose, and the circulating levels of the vitamin D metabolites. Despite appropriate insulin replacement, alterations in vitamin D metabolism occur in the young insulin-dependent diabetic and could relate to the decrease in cortical bone mass observed in these patients.

24,25-Dihydroxyvitamin D 3↗