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Biomedical subjects

M J VandenBurg

Publications and source records attributed to M J VandenBurg.

18 recordsLinked to original sources
PubMed1992

A large scale comparative study in general practice with nitroglycerin spray and tablet formulations in elderly patients with angina pectoris.

In an 8-week comparative study, 410 patients were treated with nitroglycerin spray and 387 with conventional 500 mcg sublingual tablets. Data were analysed to compare the two treatments and to compare the results in older patients (greater than or equal to 65 y) with younger patients (less than 65 y). Spray was significantly superior to tablets in terms of number of patients helped, speed of pain relief and reduction in the number of attacks from pre-study levels. The occurrence of headache was significantly less in the spray group. There was no significant difference in the number or nature of adverse events but more spray patients reported taste disturbance. The clinical advantages seen in the entire population were maintained when the two age categories were considered separately. Further, 95% of patients found the spray convenient. The authors conclude that improved efficacy together with improved stability of the spray without loss of convenience makes Nitrolingual spray an acceptable alternative to tablets irrespective of patients' age.

Administration, Inhalation↗
PubMed1987

Efficacy and tolerability of cefuroxime axetil in patients with upper respiratory tract infections.

A study was carried out in general practice to assess the clinical effectiveness and tolerability of the oral cephalosporin, cefuroxime axetil, in the treatment of 369 patients presenting with acute infections of the upper respiratory tract. The main diagnoses were tonsillitis, pharyngitis, sinusitis and otitis media. Patients were treated for 7 days with 1 tablet of 250 mg cefuroxime axetil twice daily. Details of fever and signs and symptoms of infection such as pain, sinus tenderness and reddening of the eardrum were recorded before and after treatment. Response was assessed by the physician on the basis of the clinical findings (the microbiological findings will be reported separately), and by patients on their satisfaction with their therapy. The results indicated an overall clinical improvement rate of 89%: all clinical parameters showed significant improvement and most patients were symptom-free when seen after treatment. Only 2 patients were classified as treatment failures and withdrawn from the study. Complete resolution of the infection was seen more often in patients with tonsillitis and pharyngitis than in those with sinusitis or otitis media. Over 80% of patients expressed their satisfaction with therapy. Adverse events reported were few, even though patients were prompted with a non-leading question, and were mainly mild in nature. The most frequently reported were diarrhoea (5%) and loose motions (3%).

Administration, Oral↗
PubMed1985

Enalapril in the treatment of hypertension associated with impaired renal function.

This pilot study was undertaken to examine the safety and efficacy of enalapril in the treatment of hypertension associated with impaired renal function. Forty-one patients with glomerular filtration rate (GFR) < or = 50 ml/min received enalapril for up 12 weeks. Blood pressure, renal function, biochemistry and haematology were monitored weekly for 4 weeks and then monthly. Blood pressure was effectively reduced within 4 weeks; this reduction was maintained for at least 12 weeks. Renal function remained stable and there was no significant sustained alteration in any biochemical or haematological parameter. Requirement for additional antihypertensive drugs was reduced during enalapril therapy. These data suggest that enalapril may have a useful role in the management of hypertension associated with renal impairment.

Adult↗
PubMed1984

Reduced peripheral vascular symptoms in elderly patients treated with alpha-methyldopa--a comparison with propranolol.

A multicentre study of 6-10 weeks duration was performed in 60 ambulant hypertensive patients aged over 60 years to compare the efficacy of methyldopa and propranolol with particular reference to the occurrence of cold extremities and sleep disturbances. Blood pressure was effectively controlled by both drugs being reduced from a mean of 180/108 mmHg to 161/93 with methyldopa and 180/108 to 162/94 with propranolol. More patients treated with methyldopa (74%) achieved the target diastolic blood pressure of 95 mmHg or below compared with those treated with propranolol (58%). Side effects were more frequent in the propranolol group necessitating the withdrawal of four patients from the study. Only one patient on methyldopa was withdrawn. The incidence of cold extremities was significantly greater with propranolol. The occurrence of sleep disturbances was similar in both groups. In this group of elderly patients methyldopa was better tolerated than propranolol.

Aged↗
PubMed1984

Norfloxacin, amoxycillin, cotrimoxazole and nalidixic acid. A summary of 3-day and 7-day therapy studies in the treatment of urinary tract infections.

The results of clinical trials in which norfloxacin was used for 7 days compared with amoxycillin or cotrimoxazole, or for 3 days compared with citrated nalidixic acid, are presented. Additionally, the results of a concurrent open study of 3 days of norfloxacin in the management of simple urinary tract infections are discussed. Resistance to norfloxacin was only encountered in 0.2% of pathogens isolated. Norfloxacin was as effective in eradicating bacteriuria as amoxycillin, cotrimoxazole or citrated nalidixic acid. The response to 3 days of norfloxacin was similar to that seen after 7 days therapy with this compound, or to 7 days of cotrimoxazole. The incidence of adverse experiences to norfloxacin in 758 patients was below 10%.

Amoxicillin↗
PubMed1984

Cardiac arrhythmias following acute myocardial infarction: associations with the serum potassium level and prior diuretic therapy.

The relationship between the initial serum potassium level and the incidence of cardiac arrhythmias following myocardial infarction has been reviewed in a coronary care unit setting. The incidence of arrhythmias in general, and ventricular fibrillation, ventricular tachycardia and frequent ventricular ectopic beats in particular, were inversely related to the initial serum potassium level. Hyperkalaemia was also significantly associated with ventricular fibrillation and ventricular tachycardia. Hypokalaemia was significantly more common in patients previously treated with diuretics, though most patients with hypokalaemia had not been so treated. The occurrence of an acute hypokalaemic syndrome, independent of, but exacerbated by, diuretic therapy, is further supported by these results.

Arrhythmias, Cardiac↗
PubMed1984

Differential efficacy of two non-steroidal anti-inflammatory drugs in the treatment of sports injuries.

Twenty-eight patients presenting with sports injuries were randomly allocated to receive either 200 mg sulindac twice daily or 400 mg ibuprofen 3-times daily. Pain symptoms (day and night ratings) and observer assessment of pain on movement, swelling and tenderness were recorded pre-treatment and after 3 and 7 days of therapy. One patient in the sulindac group was excluded from the study because initial symptoms were mild. Response, in terms of decrease in scores, was better in those receiving sulindac than in those given ibuprofen at both 3 and 7 days for the parameters of pain during the day (p less than 0.05 at 7 days) and pain on movement (p less than 0.05 at 3 days). Patient assessment of treatment at 3 and 7 days was significantly better in the sulindac group than in the ibuprofen group (p less than 0.025). The only reported side-effect was gastro-intestinal upset in a patient in the ibuprofen group. The results suggest that sulindac is an effective and well-tolerated treatment for the symptoms associated with sprain and strain injuries.

Adult↗
PubMed1984

Is the feeling of cold extremities experienced by hypertensive patients due to their disease or their treatment?

Patients with essential hypertension were interviewed prior to entering therapeutic studies in general practice. Patients' age, sex and details of antihypertensive therapy (if any) were noted, as were their spontaneously reported symptoms. Complaints of cold extremities were highest in those taking a beta-blocker (4.1%). Those untreated or taking other therapies complained less often. Those patients taking a beta-blocker with ISA complained less often (3.1%) of cold extremities than those taking a beta-blocker without ISA (5.2%).

Adrenergic beta-Antagonists↗
PubMed1984

Comparison of a fixed ratio combination of hydrochlorothiazide, amiloride and timolol ('Moducren') given once versus twice daily in mild to moderate hypertension.

An open, multi-centre study was carried out in general practice to compare the efficacy and tolerance of antihypertensive therapy with once-daily and twice-daily dosage of a fixed ratio combination of hydrochlorothiazide (25 mg), amiloride (2.5 mg) and timolol (10 mg). A total of 604 patients with mild to moderate hypertension were treated over a period of 12 weeks with either 1 to 2 tablets once-daily (294 patients) or 1/2 to 1 tablet twice-daily (310 patients). The results showed that there was a significant reduction in systolic and diastolic blood pressures in both groups after only 2-weeks' therapy and the overall reduction after 12 weeks was 31/19 mmHg, with 57% of patients being adequately controlled on the equivalent of 1 tablet per day, whether taken once daily or in divided doses. Forty-six (8%) patients withdrew from the study because of drug-related symptoms, mainly central nervous system in origin. Overall, treatment with either regimen was considered suitable and acceptable by over 80% of patients and doctors.

Adult↗
PubMed1983

A double-blind comparison of 'Osmosin', benoxaprofen and placebo in the treatment of osteoarthritis.

A double-blind crossover trial using the double-dummy technique was carried out in 30 patients with osteoarthritis. The original design was to compare the efficacy and tolerability of 1 'Osmosin', the new osmotic-release formulation delivering 7 mg indomethacin per hour for approximately 10 hours, with that of benoxaprofen (600 mg). Each treatment was to have been given as a single daily dose, at night, for 4 weeks, before crossing over to the alternative medication. Because of the withdrawal of benoxaprofen from the U.K. market just as 14 patients had completed their first treatment period, the study was continued as an 'Osmosin' versus placebo trial after crossover. Comparison of the results of first treatments showed that 'Osmosin' was significantly better than placebo and at least as effective as benoxaprofen in reducing pain scores, particularly day and weight-bearing pain. The crossover data supported these findings. 'Osmosin' proved to be well tolerated, with a side-effect profile similar to that of placebo.

Adolescent↗
PubMed1983

'Osmosin' in rheumatoid arthritis: interim results.

The interim results of an on-going trial in patients with active rheumatoid arthritis are reported. The findings from 17 patients so far treated and followed-up for 4 to 6 weeks suggest that 'Osmosin' (105 mg sodium indomethacin trihydrate), given once daily for the first 2 weeks and twice daily thereafter, is effective in reducing the inflammatory activity of joint disease, as assessed by visual analogue and 5-point semantic severity scales. Analysis showed that there was a strong association between the assessments on the two scales and this was stronger if patients were not conditioned by being allowed to see their previous visual analogue scale assessment.

Arthritis, Rheumatoid↗
PubMed1981

Hormonal and blood pressure changes during converting enzyme inhibition by teprotide.

Changes induced by i.v. and subcutaneous teprotide in plasma renin, angiotensin I, angiotensin II, aldosterone and bradykinin were studied in a renal transplant patient with severe high renin hypertension, before and after trinephrectomy. The immediate reduction in BP produced by teprotide was not solely attributable to the inhibition of conversion of angiotensin I to angiotensin II, because there was also a transient increase in serum bradykinin; however, the prolonged antihypertensive effect of teprotide appeared independent of bradykinin. After trinephrectomy, teprotide lowered systolic BP but had no significant effect on diastolic BP or plasma bradykinin. beta-Blockade prevented the secondary increase in plasma renin which followed teprotide, thereby potentiating its anti-hypertensive effect.

Aldosterone↗