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Biomedical subjects

W W Buchanan

Publications and source records attributed to W W Buchanan.

At least 109 records · Page 6Linked to original sources
PubMed1988

50-foot walking time: a critical assessment of an outcome measure in clinical therapeutic trials of antirheumatic drugs.

Fifty-foot walking time was used in 51 of 187 clinical therapeutic trials of antirheumatic drugs and in only 21 instances was statistical significance reached. Measurement of the 50-foot walking time showed no better performance in long-term trials of SAARDs than in short-term trials of NSAIDs. It is concluded that the 50-foot walking time is a poor outcome measure in rheumatic disease trials, despite a high intra- and interobserver reproducibility.

Adult↗
PubMed1988

Variability in response to nonsteroidal anti-inflammatory analgesics: evidence from controlled clinical therapeutic trial of flurbiprofen in rheumatoid arthritis.

1. A clinical trial was conducted with flurbiprofen 100 mg three times a day by mouth in rheumatoid arthritis to determine variability in response. 2. Forty patients entered the study, but only 32 completed it. Patients were treated with flurbiprofen on two occasions at a month's interval, each being preceded by a 3 day wash out period. Pain relief and a Ritchie articular index of joint tenderness was assessed at the beginning and end of each treatment period. 3. Flurbiprofen produced significant improvement in both pain relief and articular tenderness. No significant differences were observed between the two trial periods in the mean of these outcome measures. 4. No evidence was found to support the concept of responders and non-responders.

Adult↗
PubMed1988

Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.

Within the context of a double blind randomized controlled parallel trial of 2 nonsteroidal antiinflammatory drugs, we validated WOMAC, a new multidimensional, self-administered health status instrument for patients with osteoarthritis of the hip or knee. The pain, stiffness and physical function subscales fulfil conventional criteria for face, content and construct validity, reliability, responsiveness and relative efficiency. WOMAC is a disease-specific purpose built high performance instrument for evaluative research in osteoarthritis clinical trials.

Aged↗
PubMed1988

Radiological changes in rheumatoid arthritis: measurement of area of juxta-articular bone as outcome event in clinical therapeutic trials of antirheumatic drugs.

A high degree of intra - and inter - rater reproducibility was obtained in measurement of a standardized area of the head of the first right metacarpal using a precision digitizer. This instrument had an accuracy for every point digitized of 0.127 mm. Intra-rater difference between readings at approximately a month's interval showed no significant differences. The method is reasonably simple to perform and is applicable to small joints such as the proximal interphalangeal joints. The method may prove useful in following progression of joint damage in rheumatoid arthritis.

Anti-Inflammatory Agents↗
PubMed1988

An experiment in reducing interobserver variability of the examination for joint tenderness.

This experiment was designed to test the feasibility of reducing interobserver variability of the joint examination by agreement on a standard examination. Six rheumatologists independently examined 6 patients with rheumatoid arthritis (RA) in predetermined order, before and after a standardization of examination techniques. Results of an analysis of variance showed a reduction of the percent of variability due to observers from 13.8%, before standardization, to 3.2% after standardization, and an improvement in the percent variability related to patient differences from 70.7%, before standardization, to 86.3% after standardization. Such a reduction in observer variability has a potential for allowing a reduction in sample sizes required for RA clinical trials.

Analysis of Variance↗
PubMed1987

A legacy for rheumatology from Sir William Osler.

"Of the altruistic instincts, veneration is not the most developed at the present day; but I hold strongly with the statement that it is a sign of a dry age when the great men of the past are held in light esteem".

Canada↗
PubMed1987

The contribution of William Hunter (1718-1783) to the study of bone and joint disease.

William Hunter (1718-1783), the elder of the two famous Hunter brothers, is best known for his remarkable book The Anatomy to the Human Gravid Uterus, and for his contributions to the art of midwifery. However, Hunter also made significant observations in cardiovascular disease, in comparative anatomy, and paleopathology. It is perhaps not sufficiently known that he also made significant contributions in rheumatic disease, and in particular, the anatomy and physiology of cartilage.

Bone Diseases↗
PubMed1987

Effects of aspirin, naloxone and placebo.

This study was designed to examine the effects of aspirin, naloxone and placebo treatment on serum beta-endorphin concentration and joint pain in patients with rheumatoid arthritis (RA). Ten patients with definite or classical RA were studied. All treatments were administered in a randomized sequence. On each study day, the following measurements were carried out at specified time intervals: serum beta-endorphin concentration, serum salicylate concentration and joint pain score on a visual analogue horizontal scale. We conclude that in patients with rheumatoid arthritis suffering from chronic joint pain, serum beta-endorphin does not appear to play a role in pain relief.

Arthritis, Rheumatoid↗
PubMed1987

Gold induced thrombocytopenia: 12 cases and a review of the literature.

Gold induced thrombocytopenia is immune mediated, with the production of platelet associated IgG leading to peripheral platelet destruction. An association with HLA-DR3 has been demonstrated. Corticosteroid therapy is effective in treatment, although other modes of therapy may be as efficacious.

Arthritis, Rheumatoid↗
PubMed1987

Punched-card aid in rheumatological diagnosis.

A punched-card diagnostic system is described for use in rheumatological practice. The system is based on pattern recognition and provides a list of both common and rare possible diseases. The system is simple and can be manufactured cheaply, and may be of particular use to family doctors in remote areas of practice. The system has also potential as an educational tool for both undergraduate and postgraduate students of medicine.

Arthritis↗
PubMed1987

Observations on spontaneous improvement in patients with podagra: implications for therapeutic trials of non-steroidal anti-inflammatory drugs.

1 The natural history of acute gouty arthritis was studied in 11 volunteers with podagra. 2 Two patients withdrew from the study on day 4 because of severe persistent pain. Of the remaining patients all showed some improvement in pain by day 5 and in swelling by day 7. Tenderness improved in seven patients by day 7 but two continued to experience the same amount of discomfort as at trial entry. In spite of these improvements only three patients noted resolution of their pain during the study period. 3 These data indicate that while the majority of patients show spontaneous improvement, resolution is unlikely over a period of 7 days without the use of effective non-steroidal anti-inflammatory medication. 4 Documentation of the natural history of the acute gouty attack may assist clinical investigators in interpreting the results of uncontrolled evaluations of non-steroidal anti-inflammatory drugs.

Adult↗