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Biomedical subjects

J T Hutton

Publications and source records attributed to J T Hutton.

At least 19 recordsLinked to original sources
PubMed1992

Long-acting carbidopa-levodopa in the management of moderate and advanced Parkinson's disease.

Parkinson's disease patients treated chronically with levodopa often develop fluctuations in motor response. Motor fluctuations can be attributed in part to oscillating plasma levodopa concentrations. A controlled-release formulation containing 200 mg of levodopa and 50 mg of carbidopa provides superior plasma levodopa profiles compared with the standard preparation. A multicenter, double-blind trial involving 202 patients with fluctuating motor response found controlled-release carbidopa-levodopa to be safe and tolerable, with improved efficacy compared with the standard formulation. Long-term exposure to the controlled-release formulation, at least for a period of 3 years, does not appear to be associated with any increase in the incidence of adverse side effects.

Carbidopa↗
PubMed1991

Long-term evaluation of Sinemet CR in parkinsonian patients with motor fluctuations.

The safety and efficacy of Sinemet CR, a controlled-release formulation of carbidopa/levodopa, were investigated in a three year, open-label trial involving 18 parkinsonian patients with fluctuating motor response. The average daily levodopa dosing frequency did not change significantly during long-term treatment. Efficacy measures generally revealed a gradual progression of parkinsonian disability. Patient diaries of motor fluctuations revealed relative stability of time "on" but with a tendency toward increased time "on with dyskinesias" over the 36 month follow-up period. There were no adverse laboratory results deemed to be related to Sinemet CR and no unexpected side effects were observed.

Aged↗
PubMed1991

Spatial contrast sensitivity is reduced in bilateral Parkinson's disease.

We studied the contrast sensitivity functions of 41 patients with idiopathic Parkinson's disease (PD) with a wide range of parkinsonian symptomatology (Hoehn and Yahr stages 1 to 4) and 22 age-matched control subjects in a parametric design. Results demonstrated reduced contrast sensitivity in PD patients but only in those patients who had progressed beyond Hoehn and Yahr stage 1. Furthermore, there were deficits in contrast sensitivity related to the severity of PD.

Aged↗
PubMed1989

Multicenter controlled study of Sinemet CR vs Sinemet (25/100) in advanced Parkinson's disease.

Controlled-release carbidopa/levodopa 50/200 (Sinemet CR) and standard carbidopa/levodopa (Sinemet 25/100) were compared in a multicenter double-blind trial involving 202 patients with advanced Parkinson's disease and motor response fluctuations. Treatment with Sinemet CR significantly reduced daily "off" time. According to both physician and patient global ratings, patients showed significant improvements with Sinemet CR compared to treatment with standard Sinemet. Patients preferred Sinemet CR treatment by a ratio of approximately 2 to 1. Daily dosing frequency was 33% less with Sinemet CR, while daily intake of levodopa required was increased by 25%. The safety profiles of the 2 formulations were similar. We conclude that Sinemet CR is superior to standard Sinemet for many patients with advanced Parkinson's disease, although it does not solve the problem of fluctuating motor performance.

Aged↗
PubMed1988

Prolonged serum levodopa levels with controlled-release carbidopa-levodopa in the treatment of Parkinson's disease.

Twenty parkinsonian patients (Hoehn and Yahr scale, I through III) were treated with controlled-release carbidopa-levodopa (CR-2 or CR-3) and standard carbidopa-levodopa (Sinemet, 25 mg/100 mg) in a double-blind, crossover pharmacokinetic and clinical efficacy study. The controlled-release agents had a slower rise to peak plasma values and flatter pharmacokinetic curves than did the standard. The area under the curve for CR-3 was significantly increased by 55.5% as compared with standard agent and by 84.2% as compared with CR-2. No differences in clinical efficacy were found between controlled-release agents and the standard agent for this group of parkinsonian patients with mild to moderate severity. The dissociation between the prolonged serum levodopa levels and unimproved clinical efficacy may have resulted from the absence of patients with prominent motor fluctuations and/or substantial serum levodopa variability that was especially prominent with CR-3.

Adult↗
PubMed1988

Treatment of chronic Parkinson's disease with controlled-release carbidopa/levodopa.

Controlled-release carbidopa/levodopa 50/200 (SINEMET CR) and standard carbidopa/levodopa (SINEMET 25/100) were compared in a double-blind, six-month, crossover study involving 21 patients with chronic Parkinson's disease and motor response fluctuations. Daily dosage frequency was significantly reduced with SINEMET CR compared with SINEMET 25/100, while the daily amount of levodopa required with SINEMET CR was significantly greater. No significant differences in disability ratings, motor response fluctuations, or safety were detected during double-blind conditions. In the open-label, dose-finding phase of the study, SINEMET CR was superior to standard SINEMET 25/100 in patient ratings of percent "on" time (good motor function), clinical assessments of motor function, and activities of daily living. This finding resulted from a depreciation of the value of the "old drug" rather than an overestimation of the value of the experimental drug. This double-blind study also suggested that elderly male patients with Parkinson's disease derived the greatest benefit from SINEMET CR.

Aged↗
PubMed1987

A novel, adaptable and inexpensive computerized activity meter.

A number of activity meters ranging from fully manual to fully automated have been described. A computerized activity meter, used primarily as a rotational activity chamber, is described. This inexpensive system is built around a Commodore 64 computer interfaced through a circuit board to the meters. Each computer can run four chambers and, as a rotometer, can distinguish quarter and full turns in either direction. The system is easily adapted to record data from various behavioral chambers, including an open field with photocell beams.

Animals↗
PubMed1987

Abnormal ocular motor function predicts clinical diagnosis of familial ataxia.

Ocular motor performance was significantly impaired in familial ataxia patients as compared with normal controls. Ataxic patients showed prolonged saccadic latencies, longer saccadic refixation times, reduced visual tracking performance, and increased hypermetria. Cutoff values were derived and applied to 15 subjects at risk for developing familial ataxia. Three of 15 showed abnormal values in three or more of four categories of ocular motor performance. Within 3 years, all three subjects were diagnosed on clinical grounds as having familial ataxia. We conclude that ocular motor performance is impaired in familial ataxia and may prove useful for earlier diagnosis.

Eye Movements↗
PubMed1987

Alzheimer's disease: evolving clinical concepts and management strategies.

The prevalence of Alzheimer's disease is rising dramatically. This increase results from a "graying" of our population and a redefinition of the term Alzheimer's disease. Alzheimer's disease is recognized to be a progressive neurologic disorder of unknown cause but is not associated with any increased cerebral arteriosclerosis as compared to age-matched controls. The course of the illness on average is about ten years. A variety of inclusion and exclusion criteria, if used conservatively, can accurately predict the pathologic diagnosis of Alzheimer's disease. Whereas no specific cause or clearly effective treatment is currently available, care consists of pharmacologic therapy aimed at specific symptoms and measures designed to reduce patient confusion and care-giver burden. The physician can benefit the patient and care giver by providing an accurate diagnosis, providing therapy where available, counseling the family, and providing referrals to available community-support services.

Age Factors↗
PubMed1986

Lateral saccadic latencies and handedness.

Lateral saccadic latencies were determined in 18 right-handers and 18 left-handers. Within the right-handed group the mean latency was significantly shorter when looking from the left to the right (242.7 msec) than from right to left (265.0 msec), whereas no significant directional difference was found in the left-handed group. An age effect was also found with longer latencies being associated with increased age. These findings agree with those of Pirozzolo and Rayner (Neuropsychologia 18, 225-229, 1980) and provide further evidence of the pervasiveness of functional asymmetry in the human brain. The present findings suggest that motoric or central integrative mechanisms may contribute more to saccadic directional asymmetries than do perceptual differences.

Adult↗
PubMed1986

Families of Alzheimer's victims. Family support to the caregivers.

This study examined the instrumental and social-emotional support provided by families to the primary caregivers of Alzheimer's patients. It was anticipated that the more adequate the support provided by the family, the less sense of burden and the better the coping effectiveness of the caregiver. Ratings of instrumental assistance, social-emotional support, adequacy of support, and coping effectiveness were made by trained raters from transcribed interviews with 23 primary caregivers. Also, a second family member who was usually next closest of kin to the caregiver was interviewed in order to provide another perspective of the support the family provided. While the major caregiving tasks were performed by the primary caregiver, the types of assistance from family that seemed most appreciated were visits and having persons stay with the patient so that the caregiver could take a trip, rest, run errands, or get out of the house for social activities. The majority of caregivers felt a high degree of support from their families and reported low levels of emotional upset resulting from family support efforts. The most common family problems reported were lack of visits, disagreement over level of patient's mental and physical functioning, and disagreement over the type of care required. The data confirmed the hypothesis that family support was positively associated with the caregiver's coping effectiveness. In addition, caregivers who did not receive enough support were most burdened; however, the group receiving the greatest amount of support was the next most burdened, a finding which was unanticipated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗