Biomedical subjects
Publications and source records attributed to J R Gibson.
7 patients with a diagnosis of common and/or plantar warts present for at least 1 year and resistant to previous vigorous therapy were studied. All patients entered completed the study and during the trial period the warts of 4 patients receiving intralesional injections were completely cleared. 2 other patients demonstrated partial clearance of their warts.
20 patients with a diagnosis of chronic idiopathic urticaria were entered into a double-blind placebo-controlled cross-over study. All patients completed the trial and during the assessment period they were treated with placebo, BW 825C (4 mg) and BW 825C (8 mg) according to a fully randomised and balanced treatment plan. Both doses of BW 825C were found to be highly effective and significantly better than placebo in controlling signs and symptoms of urticaria. Few adverse reactions were reported and in this small group of patients there was no significant difference from placebo in reports of drowsiness or any other side-effects.
52 patients with a clinical diagnosis of verruca plantaris were entered into a randomised study of acyclovir cream versus placebo cream versus liquid nitrogen. 47 completed the initial 8-week assessment period. At first, liquid nitrogen was used as a positive control but after the entry of 33 patients it was discontinued as an initial therapy in order to obtain maximal numbers of patients on the cream treatments. At the end of the 8-week assessment period 5 of 18 (placebo cream), 7 of 18 (acyclovir cream) and 1 of 11 (liquid nitrogen) patients were completely cleared of their plantar warts. Patients who failed to clear on cream or liquid nitrogen treatments after the initial assessment period but who wished to continue therapy were subsequently treated with liquid nitrogen. Of a total of 27 patients treated vigorously with liquid nitrogen, for periods of time ranging from 2 to 34 weeks, only 11 were completely cleared of their warts at the end of the study. It is concluded that liquid nitrogen should not be considered as a routine treatment for plantar warts and that acyclovir cream is no better than placebo in the treatment of this condition.
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Two-hundred and thirty patients with a diagnosis of presumptive bacterial conjunctivitis were assessed in a randomized double-blind multicentre trial. In two of the centres the patients had been treated with either trimethoprim-polymyxin B or neomycin-polymyxin B-gramicidin ophthalmic solution. In the other two centres the patients had been treated with either trimethoprim-polymyxin B or chloramphenicol ophthalmic solution. All of the preparations used were shown to be effective and very few adverse reactions were encountered. No significant difference in clinical efficacy could be demonstrated between trimethoprim-polymyxin B and neomycin-polymyxin B -gramicidin but trimethoprim-polymyxin B was found to be significantly better (P = 0.03) than chloramphenicol in reducing signs and symptoms.
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Two series of tests have been performed in order to assess the vasoconstrictor potency of several diluted and undiluted proprietary corticosteroid preparations. Results showed that differences in concentration of a particular corticosteroid were not always reflected as significant differences in vasoconstrictor potency. A previous finding that Eumovate ointment exhibits early vasoconstrictor activity similar to that of Betnovate ointment was confirmed. The extemporaneous dilution of proprietary corticosteroid preparations remains a widespread but controversial habit. In addition, several proprietary products are represented by a range of dilutions of the same corticosteroid with each concentration targeted at a different segment of the market place. Recent work by our group has revealed some interesting results concerning the vasoconstrictor potency of both diluted and undiluted preparations (Gibson et al., 1982). The aim of this study was to extend the investigation to cover a number of widely used preparations.
10 subjects were assessed using the vasoconstrictor assay technique in a double-blind study in order to evaluate the relative potencies of several diluted and undiluted proprietary corticosteroid preparations. Dermovate ointment achieved a significantly higher score than any other preparation but there was no significant difference between the scores for Betnovate ointment (betamethasone valerate 0.1%), Propaderm Forte cream (beclomethasone dipropionate 0.5%), Propaderm ointment (beclomethasone dipropionate 0.025%), Nerisone Forte ointment (diflucortolone valerate 0.3%), and Nerisone ointment (diflucortolone valerate 0.1%). Furthermore, no significant difference in scores could be demonstrated between Adcortyl ointment (triamcinolone acetonide 0.1%), Ledercort ointment (triamcinolone acetonide 0.1%) and extemporaneous dilutions of these ointments 1 part in 4 in their recommended diluents (triamcinolone acetonide 0.025%). The relevance of these findings to clinical practice is discussed.
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The effect of a single oral dose of triprolidine and pseudoephedrine, singly and combined, on histamine-induced wheal and flare reactions, was assessed in a fully randomised, placebo-controlled, double-blind crossover study. Triprolidine alone and the combination had a significantly greater effect of (p less than 0.05) in reducing skin reactions than pseudoephedrine alone or placebo, but there was no significant difference between triprolidine ane the combination (p less than 0.05).
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Ten subjects were assessed using the vasoconstrictor assay technique in a double-blind study in order to evaluate the potencies of several diluted and undiluted proprietary corticosteroid ointments. Results showed that clobetasol propionate 0.05% (Dermovate) ointment at a dilution of one part in ten (clobetasol propionate 0.005%) in white soft paraffin was equipotent with betamethasone valerate 0.1% (Betnovate) ointment; and no difference in potency was demonstrated between beclomethasone dipropionate 0.025% (Propaderm), betamethasone valerate 0.1% (Betnovate) and clobetasone butyrate 0.05% (Eumovate).
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48 patients witha diagnosis of presumptive bacterial conjunctivitis were assessed. They had been treated with either trimethoprim-polymyxin or neomycin-polymyxin-gramicidin eye drops in a randomised double-blind trial. There were 24 patients in each treatment group. There were no significant differences between the two preparations proved with regard to the eradication of organisms or clinical improvement, and both preparations proved to be very effective. Patient compliance was good and no adverse reactions were encountered with either preparation.