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Biomedical subjects

S Atkin

Publications and source records attributed to S Atkin.

10 recordsLinked to original sources
PubMed1999

Cushing's disease masking coincidental steroid-responsive diseases.

Two cases of Cushing's disease are presented. In both cases successful treatment was followed by the development of a steroid-responsive disease condition, a seronegative arthritis in the first case and retinal vasculitis in the second. It is likely that both these conditions were unmasked by the fall in the endogenous steroid levels following the successful treatment of the Cushing's disease by trans-sphenoidal hypophysectomy.

Adrenocorticotropic Hormone↗
PubMed1995

Prospective, randomized trial of epinephrine, metaproterenol, and both in the prehospital treatment of asthma in the adult patient.

STUDY OBJECTIVE: To compare the effectiveness and incidence of adverse reactions with three treatment regimens for asthma in adults in the prehospital setting. DESIGN: Prospective, randomized clinical study. SETTING: Inner-city emergency medical service system providing basic and advanced life support and transport to 14 urban area hospital emergency departments. PARTICIPANTS: One hundred fifty-four adult asthmatic patients, 18 to 50 years old, who presented to paramedics with shortness of breath and wheezing. RESULTS: Eligible patients were randomly assigned by the base station physician to one of three treatment groups: subcutaneous epinephrine, nebulized metaproterenol, or subcutaneous epinephrine and nebulized metaproterenol. Peak expiratory flow rate (PEFR), blood pressure, heart rate, and respiratory rate were measured before and after treatment in each patient. During a 9-month period (October 1992 through June 1993), 154 patients were enrolled in the study; 53 (34%) received epinephrine, 49 (32%) received metaproterenol, and 52 (34%) received both. There were no significant differences in patient demographics, initial vital signs, or pretreatment PEFR among the three groups. The mean difference between pretreatment and posttreatment PEFR was 73 L/min and did not significantly differ among the treatment groups. Significant changes in vital signs were seen in no treatment group. CONCLUSION: Nebulized metaproterenol is as effective as subcutaneous epinephrine in the prehospital treatment of adult patients with acute asthma. The combination of these two treatments offered no additional clinical benefit in the patients we studied.

Adrenergic beta-Agonists↗
PubMed1989

Oral nifedipine vs oral clonidine in the treatment of urgent hypertension.

Fifty-one patients with urgent hypertension were treated in the emergency department with either oral nifedipine or oral clonidine in a randomized double-blind prospective study. Nifedipine was administered as a single dose of 20 mg. Clonidine was administered as an initial dose of 0.1 mg with hourly doses of 0.1 mg. Nifedipine was successful in reducing diastolic blood pressure in 83% of the patients within 45 minutes and in 96% of the patients within two hours, with a mean reduction in systolic blood pressure of 47 mm Hg and diastolic blood pressure of 29 mm Hg. Thirty percent of those who initially responded to nifedipine experienced a subsequent increase in diastolic blood pressure to pretreatment levels within three hours. Clonidine was successful in reducing diastolic blood pressure in 79% of the patients within four hours, with a mean reduction in systolic blood pressure of 51 mm Hg and diastolic blood pressure of 30 mm Hg. Our results indicate that both nifedipine and clonidine are safe and effective in the treatment of urgent hypertension. Nifedipine had a much more rapid onset of action with a greater initial success rate, and it was free from the sedative side effects of clonidine. We believe that either nifedipine or clonidine may be used as first-line therapy in the treatment of urgent hypertension.

Administration, Oral↗
PubMed1988

Observations on the causes of rheumatoid arthritis.

Inflammatory, symmetrical peripheral polyarthritis is observed in a small proportion of patients following a variety of parasitic, viral and microbial infections. The development of such a post-infective arthritis disorder may depend on a sequence of events, which need not be confined to one extrinsic pathogenic organism.

Arthritis, Infectious↗