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Biomedical subjects

J L Carter

Publications and source records attributed to J L Carter.

At least 19 recordsLinked to original sources
PubMed1994

Ventilatory dysfunction in multiple sclerosis.

Multiple sclerosis (MS) can produce a variety of different respiratory abnormalities because of the multi-focal nature of central nervous system involvement in the disease. This article reviews the different patterns of respiratory involvement in MS and correlates them with the known neuroanatomy of respiratory control. Methods of monitoring pulmonary function in MS are explored, and the treatment of acute ventilatory failure in MS is discussed.

Adult↗
PubMed1994

Tizanidine treatment of spasticity caused by multiple sclerosis: results of a double-blind, placebo-controlled trial. US Tizanidine Study Group.

This multicenter, stratified, randomized, placebo-controlled, double-blind trial evaluated tizanidine for use in the United States for spasticity secondary to MS. The 15-week trial was divided into baseline (weeks 0 and 1), titration (2 mg to a maximum of 36 mg/d; weeks 2 to 4), and plateau (weeks 5 to 13) phases, followed by dose tapering (week 14) and a final visit (week 15). Primary efficacy parameters were scores on muscle tone (Ashworth Scale) and type and frequency of muscle spasms (patient diaries). All efficacy parameters were evaluated by the physician/assessor, and the physician/prescriber was responsible for all dosage adjustments. The patient, physician/assessor, and physician/prescriber made global evaluations of antispastic efficacy. Tizanidine produced a significantly greater reduction than placebo in spasms and clonus (patient diaries) but no significant differences in Ashworth scores. Patients and physician/prescribers, but not physician/assessors, gave significantly better scores in the overall assessment of efficacy and tolerability. No significant differences in other secondary efficacy parameters were noted. Adverse events were reported for 66 (61%) of the 109 placebo-treated patients and 101 (91%) of the 111 tizanidine-treated patients; 6 (6%) and 14 (13%) discontinued treatment, respectively. Patient and physician perception of improvement demonstrated more consistent differences between groups than did the Ashworth Scale, perhaps because of inexperience with this measure or failure to consider time between drug administration and assessment.

Adolescent↗
PubMed1993

Pituitary-adrenal axis response to arginine vasopressin in patients with major depression.

Arginine vasopressin (AVP) was administered to 21 patients with major depression and 20 normal control subjects. Thirty-two subjects also underwent an overnight dexamethasone suppression test. The patient group did not differ significantly from the control group in adrenocorticotropic hormone (ACTH) or cortisol response. Dexamethasone suppression status did not affect ACTH or cortisol response. This study supports the hypothesis that unlike the response to corticotropin releasing hormone, the ACTH response to AVP is not attenuated in depression.

Adrenocorticotropic Hormone↗
PubMed1992

Peripheral sensory abnormalities in patients with multiple sclerosis.

Although multiple sclerosis primarily affects myelin within the central nervous system, both pathologic and physiological studies suggest that mild deficits in peripheral nervous system myelin may be common. To evaluate this question further, we performed near nerve studies on sural nerves of 14 patients with multiple sclerosis. Peak-to-peak amplitude and maximum conduction velocity were normal in 9 of 14 patients, while minimum conduction velocity, or the velocity of the slowest-conducting component of the sensory action potential, was abnormally reduced in 9 patients. In addition, the supernormal period was evaluated for patients and compared with a control sample; multiple sclerosis patients showed a significant reduction in the amplitude of supernormality. Both the reduction in minimum conduction velocity and the alteration in the supernormal period are consistent with a mild defect in peripheral myelin.

Action Potentials↗
PubMed1992

Blunted ACTH response to hypoglycemic stress in depressed patients but not in patients with schizophrenia.

In this study, 7 hospitalized patients with major depression (MD), 5 hospitalized patients with schizophrenia (S), and 13 control subjects (C) were administered 0.15 units/kg of regular insulin at 1600 h by intravenous bolus infusion. ACTH, cortisol, and glucose levels were measured intermittently for 2h following infusion. Baseline ACTH, cortisol and glucose levels were similar in Cs, MDs, and Ss. The mean glucose nadir was equivalent for Cs, patients with MD, and patients with S. Patients with MD had a blunted ACTH response (F = 3.28; df = 12,126; p = .0004) and cortisol response (F = 4.20; df = 12,132; p = .0001) to hypoglycemia when compared to Cs and patients with S. Carroll Depression Rating Scale scores in patients with S (23 +/- 10) were similar to patients with MD (30 +/- 8) and significantly higher than in controls (1 +/- 2) (F = 55.2; df = 2.22; p = .0001). These findings suggest that patients with MD show different ACTH and cortisol responses to hypoglycemic stress which are not explained by negative feedback of baseline ACTH or cortisol, glucose nadir, or the number of depressive symptoms per se.

Adrenocorticotropic Hormone↗
PubMed1992

Subchronic toxicity study of Caramel Colour II in F344 rats.

Caramel Colour II is a distinct type of colourant with a pronounced reddish hue. It is made with sulphite reactants but without ammonia. The red colour and a high alcohol solubility provide functional characteristics that are important in foods or beverages containing natural flavour extractives. Caramel Colour II is widely used in ice creams and liqueurs; however, it represents less than 1% of total caramel colour manufacture. The toxicity of Caramel Colour II was evaluated in a 13-wk study in Fischer-344 (F344) rats. The test material was mixed with demineralized water and the solutions were given to the animals ad lib. in the drinking fluid. The concentrations of caramel colour in the drinking fluid were adjusted periodically to achieve the desired caramel colour intake/kg body weight/day. Groups of 20 rats/sex were given Caramel Colour II at levels of 0, 4, 8, 12 or 16 g/kg for at least 13 wk. There were no deaths in any of the groups fed Caramel Colour II. All rats fed caramel colour had soft faeces. All treated groups also had lower fluid consumption that was attributed to poor palatability of the high concentrations of caramel colour that were fed. A number of changes observed (reduced food consumption in all treatment groups except males given 4 g/kg; significantly lower body weights for males given 12 g/kg or more and for females given 8 g/kg or more; lower urine volume and higher specific gravity) were attributed to the reduced water intake and not considered to be toxicologically significant. There were no consistent treatment-related alterations in haematology or blood chemistry variables, and random changes noted were not associated with macroscopic or microscopic pathological alterations. There were no toxicologically important pathological findings. Based on this study, Caramel Colour II was not toxic in F344 rats treated for 13 wk. The highest dose level tested in this study (16 g/kg) was considered to be the no-observed-adverse-effect level.

Animals↗
PubMed1992

Visual, somatosensory, olfactory, and gustatory hallucinations.

Hallucinations that involve any of the sensory modalities may accompany a number of functional and organic conditions. Although characteristics of the hallucinations are not specific, they are characteristic and suggestive of specific disorders. Appropriate evaluation and treatment require consideration of the past psychiatric, neurologic, and medical history; assessment of accompanying psychiatric and neurologic signs and symptoms; and degree of response to conventional therapy. Any patient with hallucinations of recent onset or presenting a significant change in the nature of prior hallucinations, particularly when the patient does not respond to conventional therapy, deserves an evaluation to rule out treatable organic factors.

Female↗
PubMed1990

A clinical and biomechanical assessment of the Hall surgical miniplate system.

The Hall surgical miniplating system has been evaluated for use in maxillofacial trauma and orthognathic surgery. The biomechanical characteristics of the plates have been examined and experience gained, using 53 plates, in 25 patients is presented. The feature which distinguishes these plates is the narrow bridge between paired screw platforms. The specially designed screwdriver has a splined head which allows screw transfer to be carried out as a one-handed procedure. The plates show considerable advantages over existing small plate systems in their size, malleability and consequent ease of handling.

Adolescent↗
PubMed1989

Immunosuppressive treatment of multiple sclerosis.

Multiple sclerosis is thought, by many investigators, to be an immunologic disease. Therefore, a rationale exists for treating this disease by immunosuppressive therapy. In exacerbating-remitting multiple sclerosis, corticosteroids and adrenocorticotropic hormone are the most widely used drugs; high doses of intravenously administered methylprednisolone have recently gained favor. Chronic progressive multiple sclerosis has been treated with a number of immunosuppressive regimens, several of which have shown promise to date. Cyclophosphamide and azathioprine have been used most often and are reviewed in this report, as are other agents currently under investigation. No firm guidelines for the treatment of chronic progressive multiple sclerosis can be offered, but an approach to immunosuppressive therapy is suggested in this review.

Adrenal Cortex Hormones↗
PubMed1988

Cold-induced peripheral nerve damage: involvement of touch receptors of the foot.

A 31-year-old male developed paresthesia and numbness of mainly the right foot following exposure to nonfreezing temperatures under moist conditions over a period of 1 week. The symptoms gradually improved over several months. When seen for electrophysiological studies 6 months after the injury, there was no sensory loss on clinical examination, although he continued to complain of distal numbness of the right foot. The right extensor digitorum brevis muscle was atrophic, and the distal motor latency in the peroneal nerve was prolonged. Conduction studies of the right sural nerve showed a predominantly distal diminution of the SAP evoked by electrical stimulation at the dorsum pedis. Action potentials evoked by tactile stimulation of Pacinian corpuscles showed a prolonged latency on the symptomatic side, suggesting that the most pronounced pathological changes in immersion injury may be localized to the very distal portion of the nerve at the nerve fiber-receptor junction.

Action Potentials↗
PubMed1988

Immunosuppression with high-dose i.v. cyclophosphamide and ACTH in progressive multiple sclerosis: cumulative 6-year experience in 164 patients.

One hundred sixty-four patients with chronic progressive multiple sclerosis (MS) have been treated with a regimen of high-dose IV cyclophosphamide and ACTH over the past 6 years. Their status was reviewed to determine complications associated with treatment, dosage of medication used to induce a remission, factors which may predict a response to therapy, and subsequent course following treatment. One year following initial treatment, 81% of patients were improved or stabilized. Reprogression occurred in 69% of patients at a mean time of 17.6 months. Fifty-eight patients who initially stabilized after treatment and then reprogressed were treated a second time. One year after retreatment, 70% of these patients were improved or stabilized. Alopecia, nausea and vomiting, and minor infections were the most frequent complications. There were no deaths associated with treatment, the complication rate did not change with multiple treatments, and no late complications have yet been observed. Improvement tended to occur in younger patients with shorter disease duration. Although this treatment regimen is generally well tolerated and can favorably affect the course of chronic progressive MS in a majority of patients, a single treatment does not induce a permanent remission, and some form of maintenance treatment or retreatment is required. Current treatment programs involve testing a modified induction regimen and periodic outpatient booster injections to maintain remission.

Adrenocorticotropic Hormone↗
PubMed1986

Teicoplanin as a prophylactic antibiotic for dental bacteraemia.

The potential of teicoplanin, a new glycopeptide antibiotic, was assessed according to its ability to decrease the occurrence and severity of bacteraemia following dental extraction. Preliminary studies with ten volunteers showed that mean peak serum concentrations of teicoplanin were reached 3 hours after intramuscular administration and were 2.6 mg/l (1.5 mg/kg regimen) and 5.0 mg/l (3 mg/kg regimen). Three groups of ten patients participated in the bacteraemia study. Group one received no prophylaxis whereas groups two and three received 200 mg of teicoplanin intramuscularly, or 3 g amoxycillin orally respectively, 1 h prior to extraction. Sequential blood cultures were inoculated at timed intervals from a single venous blood sample taken 2 min after commencing surgery. Bacteraemia was detectable in all patients who received no prophylaxis whereas those given teicoplanin and amoxycillin had detectable bacteraemia in 6/10 and 4/10 cases, respectively. Teicoplanin was clearly effective in reducing the incidence and degree of post dental extraction bacteraemia although apparently rather less so than amoxycillin. In-vitro tests of susceptibility and bactericidal activity showed that teicoplanin possesses comparable activity to those antibiotics which are either in use or have been used for the suppression of bacteraemia following dental extraction.

Adult↗
PubMed1985

Multifocal idiopathic fibrosis presenting as facial pain and trismus.

An unusual case of idiopathic sclerosing fibrosis is described in which there was involvement of the face, neck, mediastinum and lungs with sparing of the thyroid and retroperitoneal tissues. In contrast to previous cases, facial pain and limitation of jaw movements were the presenting complaints and major causes of disability. Prednisolone treatment failed to arrest the disease.

Contracture↗