PubMed Health⌕ Search

Biomedical subjects

W W Downie

Publications and source records attributed to W W Downie.

At least 19 recordsLinked to original sources
PubMed1991

Misuse of misoprostol.

Explore the source record for details and available documents.

Abortifacient Agents, Nonsteroidal↗
PubMed1991

Prostaglandins and NSAID in the kidney.

In patients with underlying renal impairment, administration of nonsteroidal anti-inflammatory drugs (NSAID) can produce a marked reduction of renal function via inhibition of renal prostaglandin (PG) synthesis. Recent findings indicate that administration of misoprostol can at least partially prevent NSAID induced nephrotoxic effects, suggesting a role for exogenous PG in this setting. These agents may also have important immunomodulatory effects. Other recently reported data show that use of misoprostol in renal transplant patients receiving immunosuppressive therapy with cyclosporine and prednisone was associated with a significant reduction in the incidence of acute graft rejection, as well as improved graft function irrespective of the occurrence of rejection.

Administration, Oral↗
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↗
PubMed1979

Diclofenac sodium (Voltarol) and indomethacin: a multicentre comparative study in rheumatoid arthritis and osteoarthritis.

A five-centre double-blind crossover trial of two two-week periods using diclofenac and indomethacin showed that both drug groups (51 patients) with rheumatoid arthritis responded similarly in relation to pain scores and morning stiffness. It was noted that the response was better in inpatients than in outpatients, despite differences in disease severity. In the osteoarthritis trial (58 patients) it was shown that neither drug significantly reduced resting pain, although both drugs were significantly better in reducing pain on movement; however, patient preference was for diclofenac. Three patients treated with indomethacin withdrew owing to side-effects, compared with one on diclofenac. A slight but significant decrease in haemoglobin levels was observed in both treatment groups with osteoarthritis, but this did not appear to be symptom-related.

Arthritis, Rheumatoid↗
PubMed1978

The bioavailability of benorylate in hot beverages.

It has been recommended that benorylate may be administered with hot beverages to overcome the problem of its relative unpalatability. Urine salicylate recovery used as a measure of bioavailability in 20 normal subjects has shown that hot coffee has no significant effect on drug availability from the orally administered suspension.

Adult↗
PubMed1978

Studies with pain rating scales.

Good correlation has been shown between pain scores derived from 4 different rating scales. The correlation was maintained when presentation of the scales was separated by a series of questions and by physical examination. There is good evidence that the 4 scales are measuring the same underlying pain variable as they calibrate well. There is also evidence that an 11-point (0-10) numerical rating scale performs better than both a 4-point simple descriptive scale or a continuous (visual analogue) scale.

Humans↗
PubMed1978

The visual analogue scale in the assessment of grip strength.

The accuracy of information derived from a visual analogue scale has been assessed by comparing the measured grip strength of 100 subjects against their estimate of grip strength scored on a visual analogue scale. There was relatively poor correlation between the measured and assessed values, suggesting that similar inaccuracies may occur when the scales are used to assess subjective phenomena.

Hand↗
PubMed1978

Gamma glutamyl transpeptidase levels in arthritis: a correlation with clinical and laboratory indices of disease activity.

Gamma glutamyl transpeptidase (GGTP) was measured in 62 patients with rheumatoid arthritis (RA) and 27 with osteoarthrosis (OA). The values for GGTP were significantly higher in the subjects with RA compared with the OA group. The prevalence of elevation of GGTP was higher in the RA subjects (77%) than in the OA patients (33%). Levels of GGTP correlated significantly with a number of objective indices of activity of RA in a separate group of 28 patients. Following treatment with penicillamine, GGTP levels showed a significant drop towards normal levels.

Aged↗
PubMed1978

A comparative study of floctafenine (Idarac) and ibuprofen in the treatment of osteoarthrosis.

A two-by-two-week crossover trial was conducted in patients with osteoarthrosis, using a double-dummy technique of drug administration. The drugs used were floctafenine (Idarac) and ibuprofen both given in a dose of 200 mg four times daily. Both drugs provided comparable relief of pain. Side-effects were few and generally mild. The results indicate that in the treatment of osteoarthrosis, floctafenine is comparable to ibuprofen (in the dose used in the study) in terms of efficacy and toxicity.

Aged↗
PubMed1977

Dose dependent pharmacokinetics of prednisolone.

The pharmacokinetics of prednisolone elimination have been studied in both arthritic patients and normal volunteers using tritiated prednisolone alone, and in conjunction with unlabelled prednisolone in doses of 0.15 mg-kg-1 and 0.3 mg-kg-1 body weight. With increasing dose there is prolongation of the plasma half-life and increase in the volume of distribution and plasma clearance of prednisolone. It is proposed that these changes in pharmacokinetic parameters may be associated with non-linear binding of the steroid to plasma proteins.

Adult↗
PubMed1976

Effects of enzyme induction on metabolism of prednisolone. Clinical and laboratory study.

The addition of phenobarbitone in therapeutic dosage to the drug regimen of prednisolone-treated subjects with rheumatoid arthritis produced measurable deterioration in the clinical status of the patients associated with a more rapid clearance of prednisolone from plasma. It is considered that phenobarbitone induced the hepatic metabolism of prednisolone, effectively reducing the steady state plasma level and resulting in clinical relapse. A slight but significant improvement in the adrenocortical response to tetracosactrin (Synacthen) was noted after phenobarbitone therapy.

11-Hydroxycorticosteroids↗
PubMed1976

Steroid therapy.

Explore the source record for details and available documents.

Adrenal Cortex Hormones↗
PubMed1975

Assessment of clinical competence using objective structured examination.

To avoid many of the disadvantages of the traditional clinical examination we have introduced the structured clinical examination. In this students rotate round a series of stations in the hospital ward. At one station they are asked to carry out a procedure, such as take a history, undertake one aspect of physical examination, or interpret laboratory investigations in the light of a patient's problem, and at the next station they have to answer questions on the findings at the previous station and their interpretation. As they cannot go back to check on omissions multiple-choice questions have a minimal cueing effect. The students may be observed and scored at some stations by examiners using a check list. In the structured clinical examination the variables and complexity of the examination are more easily controlled, its aims can be more clearly defined, and more of the student's knowledge can be tested. The examination is more objective and a marking strategy can be decided in advance. The examination results in improved feed-back to students and staff.

Clinical Laboratory Techniques↗