Summary of combined clinical analysis of controlled clinical trials with tizanidine

Data from three placebo-controlled and 11 active-controlled studies of tizanidine were combined to permit analysis of the subsets, which were too small to evaluate within the individual studies. Overall analysis of placebo-controlled data confirms the effectiveness of tizanidine in reducing muscle tone in patients with spasticity of spinal cord origin. Subset analyses suggest that patients with more severe spasticity are more likely to respond, but age, sex, and race were not predictive of response. Comparisons of tizanidine with active controls showed no differences in efficacy compared with baclofen or diazepam. However, when compared with controls, patients treated with tizanidine did not experience increased weakness. Furthermore, patients tolerated tizanidine better than the control medications. More patients experienced adverse events during tizanidine treatment than did patients receiving placebo. The most common adverse events reported were dry mouth, somnolence, asthenia, and dizziness. Mild elevations in liver function tests were noted occasionally, but improved in all patients with dose reduction or withdrawal. Three patients from the double-blind database reported formed visual hallucinations. All three cleared; two continued tizanidine, and one discontinued.

Relationships among ewe milk production and ewe and lamb forage intake in Targhee ewes nursing single or twin lambs

Targhee ewes with single or twin lambs were used in four trials during early lactation through weaning to evaluate ewe milk production (MP), kilograms of lamb weaned, and forage intake by ewes and lambs. During Trial 1, ewes with lambs were individually penned, fed .45 kg of barley-ewe-1.d-1 and allowed ad libitum access to chopped alfalfa hay. Trials 2, 3, and 4 were conducted on three different types of Western range environments. Forage intake of ewes in Trials 2, 3, and 4 and of lambs in Trials 3 and 4 was estimated using chromic oxide. Estimates of milk production were obtained by hand-milking. Average lamb age was 4, 50, 78, and 106 d at the beginning of Trials 1, 2, 3, and 4, respectively. Milk production was greater (P = .01) for ewes nursing twins than for those nursing singles at d 4 and 14 in Trial 1. In Trials 2, 3, and 4, all ewes had similar (P > .18) milk production. Ewe DMI during Trials 1 and 2 was greater (P < .05) for ewes nursing twin lambs than for those nursing singles. There was no difference (P > .88) in DMI between ewes with single and those with twin lambs in Trials 3 and 4. Forage DMI by twin lambs, expressed as either kilograms.ewe-1.day-1 or percentage of lamb BW, was higher (P = .01) than intake by single lambs in Trials 3 and 4.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of biological efficiency of free-grazing beef cows under semidesert conditions

Effects of cow BW, hip height, and estimated genetic potentials (EBV) for weaning weight direct and milk on cow productivity, fecal OM output, OM intake, and efficiency (kilograms of calf BW/kilogram of OM intake by the cow) were evaluated with 44 free-grazing crossbred cows under semidesert conditions. Calf BW were measured during early, mid-, and late lactation. Data were collected in four periods: Period 1 = late spring (early lactation), Period 2 = late summer (mid-lactation), Period 3 = mid-autumn (late lactation), and Period 4 = mid-winter (nonlactation). Calf BW increased linearly with cow BW (P < .01) in Periods 1, 2, and 3. Fecal OM output and OM intake increased with cow BW in Periods 2 (P < .01) and 4 (P < .01), and on average (P < .02). Overall efficiency decreased with increasing cow BW (P < .04). Taller cows excreted more fecal OM and had greater OM intake throughout the study (P < .02 to P < .11). Overall efficiency decreased with increasing cow hip height (P < .05). Weaning weight direct EBV of cows was related linearly to cow BW (P < .01 to P < .07) and to calf BW (P < .01 to P < .07). Calf weight in all periods increased linearly with milk EBV (P < .001). Overall, fecal OM output, OM intake, and efficiency were not affected by milk EBV.

Bone lead measurement using X-ray fluorescence

An in-vivo x-ray fluorescence (XRF) bone lead analyser, based on the Somervaille design, has been constructed and tested as the first step towards developing a deep bone lead analyser to expand the range of bone tissue available for assessment, to include more deep seated bones such as the femur & vertebrae. These bones represent a major component of the total body bone tissue and therefore the lead body burden. A new test analyser, constructed by modification to the basic design of a superficial bone analyser, has been used to investigate the feasibility of using changes in source-detector geometry and collimation to improve deep bone lead sensitivity for in-vivo measurement techniques. Initial results indicate that the relative detection sensitivity of the test analyser is approximately 6 times that of the Somervaille based system. The results of examination of a series of lead loaded plaster of paris phantoms (0 ppm - 360 ppm) confirmed there was good correlation (r = 0.996, p < 0.0005) between the measured ratio (lead X-rays/coherent scatter photons) and the lead concentrations using data from both XRF analyser systems.

Distribution of body water in patients with cirrhosis: the effect of liver transplantation

We compared total body water and intracellular-extracellular distribution of body water between male patients with mild liver disease without ascites (n = 9), male patients with severe liver disease and gross ascites (n = 6) and a group of age-, sex-, height- and weight- matched controls (n = 6). In addition, we documented the effects of liver transplantation on intracellular, extracellular and total body water in 12 patients (6 men and 6 women) by means of deuterium oxide dilution and whole-body potassium counting. We saw no significant difference in total body water between the healthy controls, patients without ascites and patients with ascites (46.5 +/- 9.2 kg, 45.4 +/- 6.6 kg and 50.4 +/- 5.1 kg, respectively), although, as expected, extracellular water was increased in patients with ascites compared with healthy controls and cirrhotic patients without ascites (36.9 +/- 6.5 kg vs. 25.4 +/- 4.4 kg, p = 0.005; and 36.9 +/- 6.5 kg vs. 27.0 +/- 5.3 kg, p = 0.002, respectively). We found no difference between non-ascitic patients and healthy controls (25.4 +/- 4.4 kg vs. 27.0 +/- 5.3 kg). However, intracellular water was significantly reduced in patients with severe liver disease compared with that in controls (13.6 +/- 3.3 kg vs. 21.5 +/- 4.2 kg, p = 0.005) or patients without ascites (13.6 +/- 3.3 kg vs. 18.3 +/- 2.9 kg, p = 0.01). The reduction of intracellular water appears to be due to loss of body cell mass.(ABSTRACT TRUNCATED AT 250 WORDS)

Efficacy and safety of zonisamide: results of a multicenter study

The safety and efficacy of zonisamide (ZNS), a new antiepileptic drug, was tested in 167 adult participants who entered a historical-controlled 16-week open label, multicenter study. The median percent reduction from baseline of partial seizures was 51.8% in the fourth month of the study (baseline median = 11.5 sz/month; treatment weeks 13-16 = 5.5 sz/month). Persons completing the efficacy study successfully were eligible for a long-term safety study; 113 entered this study. Adverse effects involved principally the CNS and were similar to those seen with other antiepileptic drugs. Four persons (3.7%) developed kidney stones and were withdrawn from the study 250-477 days after starting ZNS. Because of the high percentage of kidney stones, development of ZNS was stopped in the United States but was continued in Japan.

Supraventricular tachycardia in patients with right hemisphere strokes

BACKGROUND AND PURPOSE

The physiological basis for the arrhythmias commonly observed after a stroke is not well understood. Based on evidence that the right and left cerebral hemispheres influence cardiac function in different ways, we sought to determine whether the nature and severity of cardiac arrhythmias in the context of an acute stroke vary in relation to whether the stroke is located in the left or the right hemisphere.

METHODS

Data were obtained from the medical records of nineteen patients with left hemisphere strokes and nineteen patients with right hemisphere strokes who had also had 24-hour electrocardiographic (Holter) recordings within 2 weeks of admission to a stroke unit. Written Holter monitor reports already on file were used for the data analysis.

RESULTS

All four patients with supraventricular tachycardia had right hemisphere strokes (p = 0.05). There was a nonsignificant trend for left hemisphere stroke patients to have more severe ventricular arrhythmias.

CONCLUSIONS

These data provide partial support for the hypothesis that the two cerebral hemispheres have a differential influence on the nature and severity of arrhythmias following an acute stroke. We speculate that parasympathetic tone was diminished ipsilateral to the affected hemisphere associated with a reciprocal rise in sympathetic tone on that side and recommend that a prospective study be undertaken to test this hypothesis more definitively.

Genomic DNA microextraction: a method to screen numerous samples

Many experimental designs require the analysis of genomic DNA from a large number of samples. Although the polymerase chain reaction (PCR) can be used, the Southern blot is preferred for many assays because of its inherent reliability. The rapid acceptance of PCR, despite a significant rate of false positive/negative results, is partly due to the disadvantages of the sample preparation process for Southern blot analysis. We have devised a rapid protocol to extract high-molecular-weight genomic DNA from a large number of samples. It involves the use of a single 96-well tissue culture dish to carry out all the steps of the sample preparation. This, coupled with the use of a multichannel pipette, facilitates the simultaneous analysis of multiple samples. The procedure may be automated since no centrifugation, mixing, or transferring of the samples is necessary. The method has been used to screen embryonic stem cell clones for the presence of targeted mutations at the Hox-2.6 locus and to obtain data from human blood.

Supplemental corn grain for steers grazing native rangeland during summer

Effects of supplemental corn grain on forage OM intake (FOMI), digesta kinetics, ruminal fermentation patterns, in vitro OM digestibility (IVOMD), and in situ OM digestion were examined in steers grazing summer blue grama rangeland in northeastern New Mexico during July and August 1988. Sixteen ruminally cannulated steers (average BW 507 kg) were allotted to four treatments and individually fed whole-shelled corn at 0, .2, .4, and .6% of BW in a complete random design with repeated measurements over time. Forage OMI decreased linearly (P = .02) with increasing levels of supplemental corn; however, a tendency toward greater FOMI, as well as faster particulate and fluid passage, was observed when corn was fed at .2% of BW compared with 0, .4, or .6% of BW. Molar proportions of butyrate increased (P less than .10) but molar proportions of acetate and propionate, ruminal pH, and total VFA concentration did not change (P greater than .10) with added corn. Added corn linearly decreased (P less than .10) ruminal ammonia N concentrations in July, but patterns were inconsistent in August. A cubic response (P less than .05) for in situ OM disappearance with added corn was noted after 24, 72, and 96 h of incubation. Supplemental whole corn fed at .2% of BW had no detrimental effects and tended to increase FOMI. However, supplemental corn fed at .4 or .6% of BW decreased FOMI compared with 0 or .2% of BW.

Effects of milk intake on forage intake and performance of suckling range calves

A study to examine the relationships between milk intake, forage intake, and performance of Hereford-Angus suckling range calves was conducted during July, August, and September of 1984 and 1985. Twenty calves were used each year. The study was conducted at the Red Bluff Research Ranch located 56 km west of Bozeman, Montana. Average daily gain, milk intake (MI), forage digestibility, and fecal output (FO) were measured at 28-d intervals, beginning when the average calf age was 66 +/- 4 d. Milk intake was estimated using weigh-suckle-weigh techniques. Total fecal collections were used to measure FO. Forage digestibility and rates of passage were determined using nylon bag in situ techniques and external markers in ruminally cannulated calves of the same age. Fecal output by calves increased as body weight and age increased. Milk intake was higher (P less than .05) in 1985 than in 1984, but FO was higher (P less than .01) in 1984 than in 1985. Fecal output by calves was negatively correlated to MI in July (r = -.62; P less than .05) and August (r = -.56; P less than .05). No significant correlations were detected between MI and ADG (P greater than .10). Forage intake estimates were derived from FO, rate of passage, and in situ digestibility values. During July, calves consumed .3 kg more forage for each kilogram of reduction in fluid MI (P less than .05). In both August and September, calves consumed .6 kg more forage for each kilogram of reduction in fluid MI (P less than .10). Calves maintained similar digestible energy (DE) intake both years, although the source of DE varied.

Condensed tannins and nutrient utilization by lambs and goats fed low-quality diets

In the first of two experiments, four wether lambs (BW = 26.8 kg) and four wether Angora goats (BW = 31.7 kg) were used in two simultaneous 4 x 4 Latin squares to study the influence of condensed tannins (CT) on nutrient usage and concentrations of serum urea N, somatotropin (GH), and insulin (INS) when the animals were fed low-quality diets containing mountain mahogany (MM; Cercocarpus montanus) leaves. Diets were 8% CP and contained 25% or 50% MM (with hay or straw, respectively), either untreated or treated with polyethylene glycol (PEG; molecular weight 3,350) to reduce total reactive CT. Diets treated with PEG and 25% MM diets had less (P less than .05) CT than diets without PEG or those with 50% MM. Diets containing 50% MM resulted in greater N balance and lower serum urea N (P less than .01) than 25% MM diets. Concentrations of GH and INS were similar in animals fed the 25% and 50% MM diets. Reducing CT by adding PEG did not affect N balance or improve nutrient digestion by lambs or goats fed low-quality diets. In Exp. 2, four wether lambs (BW = 28.4 kg) were used in a 4 x 4 Latin square and fed the same diets as animals in Exp. 1 to study the influence of CT on ruminal fermentation and digesta kinetics. Dietary PEG treatment did not affect digesta kinetics except for a 30% increase in ruminal volume; 50% MM diets had faster particulate passage rates (P less than .05) than 25% MM diets. Ruminal ammonia N was greater (P less than .01) in lambs fed PEG-containing or 25% MM diets; however, rate of in situ NDF disappearance was not reduced by the lower ammonia N in the latter diets.

Evaluating and predicting outcome of acute cerebral vascular accident

An innovative evaluation method is used to study the outcomes and clinical predictions for 97 patients with acute cerebral vascular accidents. The technique involved the participation of several professional disciplines in selecting baseline and treatment variables and making independent predictions about the functional status of patients upon discharge from the stroke treatment center. The data suggest that (1) baseline variables were more important than treatment variables in the participants' predictions about the patients' short-term outcomes; (2) stroke unit staff members were generally successful in predicting patients' functional status; and (3) stroke extensions and other complications are important factors which affect stroke patients' short-term outcomes.