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Biomedical subjects

M Feely

Publications and source records attributed to M Feely.

54 records · Page 3Linked to original sources
PubMed1982

Clobazam in catamenial epilepsy. A model for evaluating anticonvulsants.

The cyclical exacerbations of epilepsy (catamenial epilepsy) were used to assess the antiepileptic effect of a benzodiazepine, clobazam. Doses of 20 mg, and in some cases 30 mg, per day were compared with placebo over predetermined ten-day periods in a double-blind cross-over study. The results were evaluated by preference in a sequential procedure. In 14 of 18 patients who received both treatments clobazam was superior to placebo, and in 4 patients no preference was established. Clobazam completely prevented seizures in most of the patients, and toxic effects were of low frequency and severity.

Acute Disease↗
PubMed1982

Trigeminal evoked potentials in the cat.

Electrical stimulation of the infraorbital nerve in the cat resulted in a series of far-field evoked potentials at the vertex. The wave form of these potentials is similar to the auditory brain stem evoked response and the somatosensory far-field response; it is multicomponent, the amplitudes of individual components are of the order of 1 microV, and the latencies are all less than 4 msec. The anatomical origins of these evoked potentials were investigated. The results indicated that contributions due to the afferent trigeminal nerve, the principal sensory nucleus, and the spinal trigeminal nucleus are involved.

Animals↗
PubMed1982

Aspirin, prostacyclin and post-occlusive reactive hyperaemia in man.

We studied post-occlusive reactive hyperaemia using ecg-triggered mercury strain-gauge plethysmography in eight normal subjects treated with incremental doses of aspirin (27.5-1200 mg). The reactive hyperaemic response was measured in the finger (predominantly skin blood flow) and the calf (predominantly muscle). Concentrations of TXB2 and 6-oxo-PGF1 alpha were measured in venous effluent blood from the hand by RIA, following arterial occlusion. Levels of TXB2 were significantly higher at 0-10 and 60-70 seconds (p less than 0.01), and 90-100 seconds (p less than 0.05) following release of occlusion compared to pre-occlusion values. However there was no significant change in concentrations of 6-oxo-PGF1 alpha and therefore by this method release of prostacyclin during reactive hyperaemia in the hand. Aspirin had no influence on finger or calf reactive hyperaemia 90 minutes after dosing, despite marked inhibition of platelet MDA production (75% after 110 mg, maximal inhibition after 1200 mg). These data provide no support for the hypothesis that prostacyclin is involved in the determination of the post-occlusive reactive hyperaemic response in the finger and calf in man.

6-Ketoprostaglandin F1 alpha↗
PubMed1980

Phenobarbitone in previously untreated epilepsy.

In a prospective study we used phenobarbitone to treat 13 new patients with epilepsy (eight adults and five children). Full seizure control was achieved in 11 patients and poor compliance was documented in one of the remaining two patients (in both of whom seizures were reduced by over 50%). Doses sufficient to give mean steady state plasma levels of more than 43 mumol/l (10 microgram/ml) appeared to be associated with better seizure control than lower doses. No serious side effects were observed.

Adolescent↗
PubMed1978

Carbamazepine as a single drug in the treatment of epilepsy. A prospective study of serum levels and seizure control.

Serum levels and seizure control were investigated in a prospective study when carbamazepine was given as a single drug to 32 patients with a variety of seizures. The patients included 13 previously untreated patients (group 1), and 19 who were unresponsive to other anticonvulsant drugs used in different combinations or as a single treatment (group 2). Thirteen patients (10 from group 1, and three from group 2) became seizure-free, and a greater than 50% reduction in seizure frequency occurred in 10 patients (nine from group 2, and one from group 1). Less than 50% reduction in seizure frequency occurred in five patients from group 2. As a wide range of serum levels was associated with complete freedom from seizures, or a greater than 50% reduction in seizure frequency, it was not possible to define a therapeutic range for carbamazepine. Side effects occurred at the start of treatment or after a dose increase. A wide range of serum levels was associated with side effects, and some patients could not tolerate levels greater than 42 mumol/l.

Adolescent↗
PubMed1977

The effect of anticonvulsant drugs which induce liver microsomal enzymes on derived and ingested phenobarbitone levels.

A comparison was made between the levels of derived Phenobarbitone in three groups of patients who were taking Primidone as a single drug, Primidone with Phenytoin and Primidone in combination with Phenytoin and Carbamazepine. The levels of ingested Phenobarbitone when this drug was taken as a single drug were compared with the levels when Phenobarbitone was taken in combination with Phenytoin in two other groups of patients. A significant increase in derived Phenobarbitone levels occurred when Primidone was used in combination with Phenytoin alone or with Phenytoin and Carbamazepine. The highest level occurred in a group of patients taking the three drug combination. There was no significant difference between the levels of ingested Phenobarbitone when this drug was used as single therapy or in combination with Phenytoin. We suggest that the increase in derived Phenobarbitone levels relates to the effect of Phenytoin on liver enzyme systems, and that the greater increase with triple therapy was related to the combined effect of Carbamazepine and Phenytoin on microsomal enzymes. As there was no increase in ingested Phenobarbitone levels when this drug was taken in combination with Phenytoin, we were unable to confirm previous suggestions that Phenytoin either inhibits the hydroxylation of Phenobarbitone or impairs its renal excretion.

Adolescent↗
PubMed1977

The effects of toxic and non-toxic serum phenytoin levels on carbohydrate tolerance and insulin levels.

The effect of toxic and non-toxic phenytoin levels on carobhydrate tolerance and insulin levels was studied in 18 patients with epilepsy and 17 control subjects. Toxic levels were defined as a serum level greater than 20 microgram/ml. Toxic levels occurred in 11 patients and nontoxic levels in seven patients. Blood glucose and insulin levels were measured at 30-min intervals for a period of 3 h following the ingestion of 50 g glucose. Blood glucose levels were measured by the ferricyanide method, and serum insulin levels by immunoassay of insulin with insulin antibody precipitate. Serum phenytoin levels were measured by gas liquid chromatography. The insulin profiles were the same for all three groups, but there was a significant delay in reaching peak glucose concentrations in patients with toxic levels of phenytoin. It was therefore confirmed that non-toxic levels of phenytoin do not affect carbohydrate tolerance or insulin levels when phenytoin is used in the routine treatement of epilepsy, and it has also been shown that toxic levels of phenytoin do not affect carbohydrate tolerance when the high levels are detected at an early stage.

Adolescent↗
PubMed1977

Relapsing neurological disorder associated with rubella virus infection in two sisters.

A disseminated relapsing neurological disorder presented simultaneously in two sisters. Encephalitic features were present in one case. The illness was associated with a significant increase in rubella specific IgM in both sisters. Despite the absence of a rubella rash, this increase would be compatible with a recent infection by the rubella virus as a basis for the illness, and the persistent elevation, with active antigenic stimulation. It is suggested that both patients might represent the clinical manifestations of perivenous demyelination caused by the rubella virus, which, in view of the relapsing nature of the illness, has progressed to plaque formation.

Adolescent↗
PubMed1976

Experimental carotid-basilar bypass.

A procedure for anastomosing the carotid to the vertebrobasilar circulation in the dog is described. A total of 20 experiments (10 acute and 10 chronic) were performed on dogs. The grafted vessel was found to be patent in 2 out of 4 dogs at 3 months after operation. The flow through the grafts, recorded by electromagnetic flowmeter, was 5-9 ml/min.

Animals↗
PubMedDate not supplied

Use of 'very low-dose phenobarbital' to investigate compliance in patients on reducing doses of methadone (detoxification).

Incorporation of very low doses of phenobarbital into a methadone linctus has enabled us to monitor the compliance of 7 patients receiving a reducing dose of methadone (detoxification) for treatment for opioid addiction. By measuring both plasma phenobarbital and methadone we detected 4 patients who consumed extra illicitly obtained methadone during the detoxification regime. Treatment outcome was poor; 11 of the original 18 patients dropped out of treatment within 14 days and of those who remained, 4 patients relapsed and reabused illicit drugs and 2 returned to a fixed dose of methadone. Laboratory measurements were successfully used to detect poor methadone compliance.

Adult↗
PubMedDate not supplied

Studies on the clinical pharmacokinetics of imidazopyrazole.

Plasma decay kinetics were analyzed for seven patients (400-5700 mg) during a Phase I clinical trial of imidazopyrazole. A two-compartment open pharmacokinetic model was able to account for the data. The median alpha-phase half-life was found to be 0.65 hour, with a median beta-phase half-life of 23.1 hours. Twelve per cent of the administered drug was excreted unchanged in 72 hours, whereas the total amount of imidazopyrazole equivalents excreted in that period was 38.6%. The median plasma equivalent space was found to be 15.9 l./m2, and volume of distribution at steady state was 40.2 l./m2. Renal and plasma clearance for imidazopyrazole was found to be 0.2 and 1.7 l./m2/hr, respectively.

Antineoplastic Agents↗