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Biomedical subjects

J R Laporte

Publications and source records attributed to J R Laporte.

At least 91 records · Page 5Linked to original sources
PubMed1985

A multinational comparison of drug treatment in patients with cerebrovascular disease.

We have compared the frequency with which various drugs were used in patients with cerebrovascular disease in five countries (UK, Italy, Indonesia, Spain and Yugoslavia). There were very large variations in the use of anti-oedema agents, 'cerebral vasodilators', and vitamins, which were not explained by differences in the populations studied. This variation has probably less to do with any scientific validation for the various treatments, which in most cases does not exist, than with medical 'fashion' and commercial pressures. Large variations in prescribing habits for what is thought to be the same disease are undesirable, and reflect a dearth of facts and adequate clinical trials.

Aged↗
PubMed1984

Rifampicin in tuberculous meningitis: a retrospective assessment.

To shed some light on the potential value of rifampicin in the treatment of tuberculous meningitis (TBM) in adults, a retrospective analysis has been made of 143 medical records from 4 hospitals for the period 1967-80. Treatment of TBM with rifampicin and other antituberculous drugs in combination (Group B) was compared to other regimes which did not include rifampicin (Group A). There were 64 patients in Group B and 79 in Group A. The two groups of patients did not differ significantly in their prognostic characteristics. The total mortality was 14.7%: it was higher among patients not treated with rifampicin (24%; Group A) than amongst those given rifampicin (3.1%; Group B; chi 2 = 10.74; p less than 0.005). The difference was also statistically significant (chi 2 = 6.88; p less than 0.01) if patients who died during the first 48 h after the institution of treatment were excluded. No significant difference in mortality rate was found when patients treated with rifampicin plus isoniazid (INH) 8-10 mg/kg (1 death out of 41 patients) were compared to patients treated with INH 15 mg/kg (2 deaths out of 20 patients). Neurological sequelae recorded during a 6 month follow-up period were more severe among patients not treated with rifampicin.

Adolescent↗
PubMed1984

The potentiation of acenocoumarol anticoagulant effect by amiodarone.

Out of 690 patients (337 males and 353 females) on long-term acenocoumarol therapy, 80 (35 males and 45 females) were taking amiodarone. Forty patients had started amiodarone treatment while being treated with acenocoumarol. Of these, nine patients had begun amiodarone treatment while taking acenocoumarol. The relation between the daily dose of acenocoumarol and the prothrombin ratio (AC dose/PR ratio) has been considered a useful indicator to study the interaction between amiodarone and acenocoumarol. Differences of acenocoumarol daily dose between takers and non-takers of amiodarone were statistically significant (t = 5.35; P less than 0.001) for the whole population, for all the age groups, and also among males (t = 2.43; P less than 0.01) as well as among females (t = 5.38; P less than 0.001). Out of 40 patients chronically treated with acenocoumarol in whom amiodarone was instituted, 32 showed a decrease of the AC dose/PR ratio, while in eight patients no change was recorded (paired t-test, t = 5.82; P less than 0.001). In 15 patients who were being concomitantly treated with acenocoumarol and amiodarone, amiodarone was discontinued. An increase of the AC dose/PR ratio was recorded (paired t-test, t = 4.01; P less than 0.001). Nine patients had started treatment with amiodarone while receiving acenocoumarol and a decrease of the AC dose/PR ratio was documented; amiodarone was discontinued some months later, and an increase of the AC dose/PR ratio was seen.

Acenocoumarol↗
PubMed1984

Effect of age and sex on acenocoumarol requirements.

A group of 690 patients (337 males and 353 females) on long-term acenocoumarol therapy was studied. 62.8% of the values of the prothrombin ratio were within the chosen therapeutic range (1.8 to 2.7), 21.9% were below 1.8 and 15.3% were above 2.7. The daily maintenance dose, expressed on a weight basis, was found to significantly decrease with increasing age. The daily maintenance dose taken by females was significantly higher than the dose taken by males (P less than 0.05); the differences between males and females were maximal among patients aged between 21 and 50 years, and disappeared at older ages. Two hundred and twenty-eight haemorrhagic episodes in 160 patients were recorded during a total of 7797 months of follow-up. No lethal haemorrhages were observed. The overall incidence of bleeding episodes among females (3.6%) was higher than among males (2.2%) (P less than 0.001), even if menorrhagia was excluded (P less than 0.01).

Acenocoumarol↗
PubMed1984

Drugs in the Spanish health system.

This paper presents data on drug consumption in Spain, analyzed from a cultural as well as from a medical point of view. The overuse of medicines is an economic rather than a pharmaceutical problem, and the main characteristic of drug use in Spain seems to be the misuse of pharmacologic therapeutic strategies. Four factors which influence the quantity and quality of drug consumption are identified and analyzed: 1) the structure of the primary health care system, 2) general requirements for marketing drugs and the characteristics of pharmaceutical supply, 3) information about drugs used by health professionals, and 4) development and activities--pre-graduate teaching and continuing education--in the field of clinical pharmacology. Some recent activities in this area are also presented. These are intended as a contribution to the development of clinical pharmacology with the aim of turning benefit-risk ratios to the side of the benefit, through the promotion of a more rational drug therapy.

Drug Therapy↗