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Smith MR, Chu F, Forrest J, Malkowicz SB, Price D, Sieber P, Barnette K, Rodriguez D, Steiner M. 1015: Phase III Interim Analysis Demonstrates Toremifene Increases Bone Mineral Density in Men Receiving Androgen Deprivation Therapy for Prostate Cancer. J Urol 2007. [DOI: 10.1016/s0022-5347(18)31243-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Macleod SM, Clark R, Forrest J, Bain M, Bateman N, Azuara-Blanco A. A review of glaucoma treatment in Scotland 1994–2004. Eye (Lond) 2006; 22:251-5. [PMID: 17001326 DOI: 10.1038/sj.eye.6702593] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study evaluated the changing trends in glaucoma management in Scotland between 1994 and 2004. METHODS A retrospective analysis of national health statistics in Scotland from 1994 to 2004. The Scottish morbidity record was used to collect information on all episodes of trabeculectomy. Data on number of prescriptions were gathered for individual drugs and also for groups of active ingredient. The population likely to have glaucoma (PLG) was calculated from estimates of prevalence in individuals aged 40 years and older, based on published epidemiological studies. The outcome measures were trabeculectomy rates, corrected for population likely to be at risk of glaucoma (PLG), and prescribing volume and cost for glaucoma medications. RESULTS Trabeculectomy rates have fallen by 67% from 46 per 1,000 PLG in 1994 to 15.4 per 1,000 PLG in 2004. Over the same time period, the population likely to be at risk of glaucoma (PLG) increased by 16.6%. The cost of prescribing has increased by 122% over 11 years compared with an increase in number of items per 1,000 PLG by 27.5%. In 1994, beta-blockers accounted for 65.2% of prescribed drugs but by 2004 this had dropped to 33%. Since their introduction, the prescribing of prostaglandin analogues has increased rapidly and in 2004, they accounted for 39.4% of prescribed drugs. CONCLUSION The increasing use of prostaglandin analogues has led to an increase in prescribing rates and a rapid increase in cost. At the same time, prescribing of beta-blockers has declined and trabeculectomy rates have fallen.
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Smith MR, Chu F, Forrest J, Malkowicz SB, Price D, Sieber P, Barnette KG, Segal S, Steiner MS. Toremifene citrate increases bone mineral density in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4553 Background: In men with prostate cancer, androgen deprivation therapy by either surgical orchiectomy or treatment with a gonadotropin releasing hormone agonist decreases bone mineral density (BMD) and increases clinical fracture risk. In postmenopausal women, selective estrogen receptor modulators (SERMs) increase BMD and decrease fracture incidence. We conducted a multicenter randomized controlled trial to evaluate the efficacy of the SERM toremifene citrate in men with prostate cancer. Methods: In a 24-month prospective study, 1392 men with prostate cancer who have been treated with ADT for at least 6 months and are at increased risk of fracture based on either being older than 70 years of age or having evidence of osteopenia by baseline dual energy X-ray absorptiometry (DEXA) scan were assigned randomly (1:1) to receive either toremifene citrate 80mg or placebo (by mouth daily). The primary study endpoint is proportion of men with one or more fracture at 24 months. Secondary endpoints include changes in BMD of the hip and spine. Here we report the results of a planned interim analysis of 12-month changes in BMD for the first 200 subjects. Results: As summarized in the table below, toremifene citrate significantly increased BMD of the lumbar spine, total hip, and femoral neck compared to placebo. Conclusions: In men receiving ADT for prostate cancer, toremifene citrate significantly increased BMD of the hip and spine. In randomized controlled trials of SERMs in postmenopausal women, similar BMD improvements translated into statistically and clinically significant decreases in fractures risk. These interim results of BMD effects suggest toremifene citrate has the potential to provide a fracture reduction benefit in men with prostate cancer, the hypothesis being tested in the ongoing study. [Table: see text] [Table: see text]
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Nickel JC, Barkin J, Forrest J, Mosbaugh PG, Hernandez-Graulau J, Kaufman D, Lloyd K, Evans RJ, Parsons CL, Atkinson LE. Randomized, double-blind, dose-ranging study of pentosan polysulfate sodium for interstitial cystitis. Urology 2005; 65:654-8. [PMID: 15833501 DOI: 10.1016/j.urology.2004.10.071] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2004] [Revised: 10/08/2004] [Accepted: 10/28/2004] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To compare the current recommended dose of pentosan polysulfate sodium (PPS) with doses two to three times higher. METHODS We evaluated three dosages (300, 600, and 900 mg) of PPS in a randomized, double-blind, double-dummy, parallel-group, multicenter, 32-week study. Adults (n = 380) with a diagnosis of interstitial cystitis (IC) as determined by a positive cystoscopic examination combined with bladder pain and urgency or a history of IC symptoms for at least 6 months were enrolled. Participants completed the Patient's Overall Rating of Symptom Index (PORIS) and the O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) at baseline (ICSI only) and during follow-up visits at 4, 8, 12, 16, 24, and 32 weeks. RESULTS Mean ICSI scores improved significantly during the 32 weeks for all dosages (baseline 11.2, 11.9, and 11.9 to endpoint 8.2, 8.1, 8.6 for 300, 600, and 900 mg, respectively; P <0.001) but the response to treatment was not dose dependent (no statistically significant difference in response among the three dosages). At baseline, 3.2%, 62.2%, and 34.6% reported mild, moderate, and severe symptoms, respectively, as assessed by the ICSI. At study end, 27.5%, 56.9%, and 15.7% reported mild, moderate, and severe symptoms, respectively. The PORIS scores improved within 4 weeks with 15.8% to 21.1% of all patients classified as responders (50% or greater improvement on PORIS). At 32 weeks, 49.6%, 49.6%, and 45.2% of all patients were responders at a dose of 300, 600, and 900 mg, respectively. Most adverse events were mild and resolved without intervention. CONCLUSIONS For all three dosages of PPS, a clinically significant but similar response was demonstrated. The duration of therapy appears to be more important than the dosage.
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Weiss J, Perham D, Forrest J. Build your own bariatric unit: Southwest Ambulance creates a better way to transport obese patients. JEMS : A JOURNAL OF EMERGENCY MEDICAL SERVICES 2003; 28:36-45. [PMID: 14699346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
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Marks LS, Roehrborn CG, Gittelman M, Kim D, Forrest J, Jacobs S. First dose efficacy of alfuzosin once daily in men with symptomatic benign prostatic hyperplasia. Urology 2003; 62:888-93. [PMID: 14624914 DOI: 10.1016/s0090-4295(03)00657-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate the onset of action of alfuzosin once daily (OD) as determined by uroflowmetry early after initial dosing. Alfuzosin OD is an extended-release formulation of a uroselective, alpha1-adrenoreceptor-blocking agent (alpha-blocker) used in the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. METHODS This was a randomized, placebo-controlled, two-way Latin square crossover study. Forty-nine patients were selected for this study on the basis of their symptomatic improvement during previous treatment with alpha-blockers and significant decreases in urinary flow rate when that treatment was withdrawn. RESULTS Our analysis showed that significant increases in the maximal urinary flow rate (Qmax) in 34 assessable patients occurred as soon as 8 hours after the initial dose of medication and persisted for at least 4 days. The DeltaQmax for alfuzosin 10 mg OD was 3.2 mL/s and for placebo it was 1.1 mL/s. The difference of means for the assessable population was 2.1 (95% confidence interval 0.8 to 3.4, P = 0.002). The overall incidence of adverse events was low. Only dizziness, experienced by 3 patients treated with alfuzosin compared with 1 patient treated with placebo, appeared to be related to the study drug. CONCLUSIONS Together, our findings suggest that alfuzosin OD exhibits a urodynamically measurable effect on bladder outlet obstruction due to benign prostatic hyperplasia in men with lower urinary tract symptoms within hours of the first administration.
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Bateman DN, Clark R, Azuara-Blanco A, Bain M, Forrest J. The effects of new topical treatments on management of glaucoma in Scotland: an examination of ophthalmological health care. Br J Ophthalmol 2002; 86:551-4. [PMID: 11973253 PMCID: PMC1771141 DOI: 10.1136/bjo.86.5.551] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND The management of glaucoma has been changed in the past decade by the introduction of new drugs. The impact of these changes on clinical care of patients was examined by examining operation and prescribing rates for glaucoma in four geographical areas of Scotland for the years 1994 to 1999. METHODS A retrospective analysis of national health statistics: primary care prescribing data, hospital derived operation rates, consultant numbers, optometrist numbers, and eye test data, expressed by estimated population at risk of glaucoma. The outcome measures were prescribing volume and cost for glaucoma medications, and operation rates, corrected for population estimated to be at risk of glaucoma (PEG), for trabeculectomy, for Scotland as a whole, and for four geographical "regions" (north east, south east, central, and south west Scotland). RESULTS Prescribed items per 1000 population estimated to have glaucoma (PEG) increased by 24.9% between 1994 and 1999. This was above the general increase in prescribing in Scotland (17.8%). This increase varied in the four health regions evaluated (14.3% to 31.9%). Prescribing of topical beta blockers increased little (6.4%), but there was a large increase in the use of new products (topical prostaglandins, carbonic anhydrase inhibitors, and alpha(2) agonists), at the expense of miotics (47.7% fall), and older sympathomimetics. This change in prescribing pattern was accompanied by a 61.5% increase in cost (range 42.2% to 73.4% in the four regions). New drugs accounted for more than half of total glaucoma expenditure in 1999. Operation rates (corrected for PEG) fell by 45.9% (range 43.1 to 58.6%) between 1994 and 1999. Other indicators suggested increased activity in ophthalmic areas (for example, cataract operations, eye tests, numbers of optometrists and ophthalmic surgeons all increased). Within north east Scotland operation rates decreased and prescribing increased less than in other regions, both from lowest regional baseline in 1994. CONCLUSIONS The introduction of new drug classes has had dramatic effects on the prescribing of glaucoma treatments. There has been a decline in older treatments and an increase in new agents, which has been associated with a large reduction in operation rates for glaucoma in Scotland over 6 years. Comparison of prescribing and operation data indicates regional differences in healthcare delivery for glaucoma.
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Summers C, Forrest J, Norval M, Michael Sharp J. The potentially insecticidal Narcissus pseudonarcissus lectin demonstrates age-related mitogenicity. FEMS IMMUNOLOGY AND MEDICAL MICROBIOLOGY 2002; 33:47-9. [PMID: 11985968 DOI: 10.1111/j.1574-695x.2002.tb00571.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Lectins from monocotyledonous plants such as Narcissus pseudonarcissus (NPA) possess insecticidal properties and have the potential to increase pest resistance in transgenic crops. Therefore it is of interest to investigate the mitogenic properties of such lectins. Mononuclear cells purified from human umbilical cord and adult peripheral blood samples were stimulated with NPA and compared to phytohaemagglutinin as an example of a lectin from a dicotyledonous plant. Here we report that NPA is slightly mitogenic for adult human lymphocytes but mitogenicity is increased more than sevenfold for lymphocytes from umbilical cord blood. Similarly, NPA was found to be mitogenic for peripheral blood mononuclear cells (PBMC) from lambs and not adult sheep, supporting the age-related mitogenicity and indicating that further examination of the younger human population is warranted.
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Parsons CL, Forrest J, Nickel JC, Evans R, Lloyd LK, Barkin J, Mosbaugh PG, Kaufman DM, Hernandez-Graulau JM, Atkinson L, Albrecht D. Effect of pentosan polysulfate therapy on intravesical potassium sensitivity. Urology 2002; 59:329-33. [PMID: 11880064 DOI: 10.1016/s0090-4295(01)01586-2] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To evaluate further the intravesical potassium sensitivity test (PST) as an indicator of the epithelial leak of interstitial cystitis (IC) and determine whether successful pentosan polysulfate (PPS; Elmiron) treatment is associated with a change in PST results. Most individuals with IC appear to have an abnormally permeable epithelium that allows urinary solutes such as potassium to penetrate to the bladder interstitium, provoking symptoms. METHODS Data were from an optimal dose trial of PPS in IC. Patients underwent a PST before and after a 32-week trial of 300, 600, or 900 mg PPS/day. The response to PPS treatment was measured using the Patient Overall Rating of Improvement in Symptoms scale. The before and after treatment PSTs and Patient Overall Rating of Improvement of Symptoms scores were compared. RESULTS Of 377 patients with IC at 28 centers, 302 (80%) had a positive PST at entry. Of the 198 patients who completed the study, 153 were PST positive at entry and 92 (60%) showed clinical improvement at exit. Clinically improved patients had significant improvement on the PST analog pain and urgency scales (3.2 to 1.3 and 3.6 to 1.9, respectively; P <0.0001). In contrast, patients with no clinical improvement had no significant change in pain (3.1 to 2.7) or urgency (3.6 to 3.2). CONCLUSIONS PST shows abnormal epithelial permeability in most patients with IC and a significant reduction in this permeability after successful PPS therapy. PST appears to be a valid indicator of epithelial abnormality and a reliable test in the diagnosis of IC.
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Bateman DN, Clark R, Azuara-Blanco A, Bain M, Forrest J. The impact of new drugs on management of glaucoma in Scotland: observational study. BMJ (CLINICAL RESEARCH ED.) 2001; 323:1401-2. [PMID: 11744564 PMCID: PMC60985 DOI: 10.1136/bmj.323.7326.1401] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Nickel JC, Forrest J, Barkin J, Payne C, Mosbaugh P. Safety and efficacy of up to 900 mg/day polysulfate sodium (elmiron) in patients with interstitial cystitis. Urology 2001; 57:122-3. [PMID: 11378111 DOI: 10.1016/s0090-4295(01)01078-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
OBJECTIVE To establish the incidence and severity of congenital and neonatal varicella in Australia. METHODOLOGY Demographic and clinical details were obtained by postal questionnaire regarding cases notified to the Australian Paediatric Surveillance Unit by over 930 participating clinicians in 1995-97 inclusive. RESULTS Seven cases of congenital varicella (1: 107 000 pregnancies/year) followed maternal infection at 8-26 weeks: five had defects, two did not. Four of the seven infants with congenital varicella developed herpes zoster in the first 15 months of life. Forty-four infants had neonatal varicella (1: 17 000 pregnancies/year). CONCLUSION : There is an ongoing, albeit low, incidence of congenital and neonatal varicella in Australia.
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Heatley C, Ricketts T, Forrest J. Recruitment of general practitioners to a randomized trial. Br J Gen Pract 1999; 49:66-7. [PMID: 10622030 PMCID: PMC1313331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
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McIntyre P, Forrest J, Heath T, Burgess M, Harvey B. Pertussis vaccines: past, present and future in Australia. Commun Dis Intell (2018) 1998; 22:125-32. [PMID: 9684530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In August 1997, a workshop was convened by the National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases to consider current issues in the use of pertussis vaccines and implications for the Australian immunisation schedule. Topics covered included the history, efficacy and reactogenicity of whole-cell and acellular vaccines and vaccine schedules. Acellular pertussis vaccine is preferred by the National Health and Medical Research Council for the primary course as well as the 18 month and 4-5 year old childhood doses. At the time of the workshop, a 3-component acellular vaccine (DTPa) had been approved (licensed) in Australia for all doses in the childhood schedule. It was the first vaccine subject to a cost-effectiveness evaluation under the new vaccine funding arrangements. Issues considered in the evaluation of the cost-effectiveness of the vaccine were discussed. These included comparative efficacy, adverse events and compliance, and the question of community as well as individual benefit from the use of the vaccine.
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Müller WE, Scheffer U, Perovic S, Forrest J, Schröder HC. Interaction of prion protein mRNA with CBP35 and other cellular proteins Possible implications for prion replication and age-dependent changes. Arch Gerontol Geriatr 1997; 25:41-58. [PMID: 15374100 DOI: 10.1016/s0167-4943(96)00770-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/1996] [Revised: 08/26/1996] [Accepted: 10/22/1996] [Indexed: 11/30/2022]
Abstract
A study of the intracellular distribution of prion protein (PrP) in N2a neuroblastoma cells which had been infected with prions (ScN2a cells) revealed that most PrP is present in the cytoplasm. However, a significant amount of PrP is also present in the nucleus (predominantly in the nucleoli) of these cells, as analyzed by confocal laser scanning microscopy. By contrast, no PrP could be detected in the nucleus of uninfected N2a cells. The steady-state level of PrP mRNA did not markedly differ between the two cell strains. Likewise, no changes were found in the rate of transcription and in the half-life of PrP mRNA. A number of cellular proteins, among them the nuclear lectin CBP35, was identified that bound to the predicted RNA stem-loop structure of PrP RNA. CBP35 could also be detected in purified infections prions, suggesting a possible role in prion replication. Age-dependent studies revealed that the content of normal cellular PrP (PrPC) in brain extracts of rats did not change significantly during ageing, while the level of certain proteins that associate with PrPC mRNA decreases with age. In addition, we show that rat cortical cells when challenged with infectious PrP (PrPSc) undergo cell death (apoptosis) in vitro. This deleterious effect was prevented by memantine (1-amino-3,5-dimethyladamantane) and other blockers of N-methyl-D-aspartate (NMDA) receptor channels.
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Theis SL, Cohen FL, Forrest J, Zelewsky M. Needs assessment of caregivers of people with HIV/AIDS. J Assoc Nurses AIDS Care 1997; 8:76-84. [PMID: 9249671 DOI: 10.1016/s1055-3290(97)80051-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This descriptive study assessed 34 caregivers of people with HIV/AIDS to learn their perceived needs, concerns, and use of services. Results indicated the most common health problems of the care recipient were fatigue and weight loss; care recipients needed help with climbing stairs, walking, and bathing; caregivers helped with the household chores, transportation, and companionship; caregivers were concerned about coping with loss and responsibilities; caregivers had help from family, case manager, and neighbor; caregivers wanted help such as a companion and counseling. Discussion relates to the implications of the study for health care professionals.
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Washburn D, Forrest J, Blincoe D. Natural History of the Traditional Quilt. JOURNAL OF THE ROYAL ANTHROPOLOGICAL INSTITUTE 1997. [DOI: 10.2307/3034380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Chalmers J, Forrest J, Cant B, Hollinsworth M. Congenital anterior abdominal wall defects. Rate of abdominal wall defects is higher in Scotland than England and Wales. BMJ (CLINICAL RESEARCH ED.) 1997; 314:371-2. [PMID: 9040346 PMCID: PMC2125845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Forrest J, Forman S. Diagnosing America: Anthropology and Public Engagement. JOURNAL OF THE ROYAL ANTHROPOLOGICAL INSTITUTE 1996. [DOI: 10.2307/3034320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Park J, Forrest J, Kolesar R, Bhola D, Beattie S, Chu C. Oral clonidine reduces postoperative PCA morphine requirements. Can J Anaesth 1996; 43:900-6. [PMID: 8874906 DOI: 10.1007/bf03011802] [Citation(s) in RCA: 63] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE The purpose of this study was to evaluate the effect of perioperative oral clonidine on postoperative analgesia and PCA morphine requirements in adult patients after major orthopaedic knee surgery. METHODS In this prospective, double blind, placebo-controlled study 44 patients undergoing either total knee replacement or hemiarthroplasty of the knee were randomly assigned to receive oral placebo or clonidine (5 micrograms . kg-1) 1.5 hr before surgery, and at 12 hr, and 24 hr after the initial dose. Five patients were subsequently withdrawn from study. No other preoperative drugs were given. Preoperative sedation score was recorded. A standardized general anaesthetic was administered to all patients. Postoperative blood pressure, heart rate, PCA morphine use, visual analogue score (VAS) for pain, sedation, nausea, and pruritus were recorded for 36 hr postoperatively. RESULTS The cumulative PCA morphine used was 37% lower after clonidine 57.3 +/- 26.8 mg (mean +/- SD) compared with placebo 91 +/- 31.6 mg (P = 0.031). There was no difference in pain or sedation scores postoperatively but patients who received clonidine were more sedated preoperatively (P < 0.001) and had a lower mean arterial blood pressure throughout the period of study by 10 to 26 mmHg (P < 0.0001). Clonidine reduced the incidence of postoperative nausea (25% vs 74%) (P < 0.01) and vomiting compared with placebo (10% vs 53%) (P < 0.01) and required less antiemetic (dimenhydrinate 37.5 +/- 20.9 mg vs 82.1 +/- 49.4 mg) but not statistically significant (P = 0.065). CONCLUSIONS Oral clonidine is a useful component to postoperative balanced analgesia as it decreases PCA morphine requirements and decreases the incidence of nausea and vomiting.
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Perovic S, Pergande G, Ushijima H, Kelve M, Forrest J, Müller WE. Flupirtine partially prevents neuronal injury induced by prion protein fragment and lead acetate. NEURODEGENERATION : A JOURNAL FOR NEURODEGENERATIVE DISORDERS, NEUROPROTECTION, AND NEUROREGENERATION 1995; 4:369-74. [PMID: 8846229 DOI: 10.1006/neur.1995.0044] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Flupirtine belongs to the class of triaminopyridines and is successfully applied clinically as a non-opiate analgesic drug with additional muscle relaxant properties. Recently it was reported that flupirtine acts like an antagonist of the N-methyl-D-aspartate (NMDA) receptor complex in neuronal cells both in vitro and in vivo. Here we have used primary cortical cells from rat embryos to demonstrate that this compound is also neuroprotective against the toxic effects caused by the prion agent PrPSc and lead acetate (Pb). These two agents display pleiotropic effects on neurons, which include activation of the NMDA receptor complex. At concentrations above 30 microM the toxic-peptide fragment of PrPSc causes apoptotic fragmentation of DNA and is consequently neurotoxic. Pb is neurotoxic at concentrations above 10 microM. Co-administration of flupirtine (10 microM) with either of these agents resulted in reduced neurotoxicity. These data indicate that the cytoprotective effect of flupirtine is measurable in vitro against these noxious agents which show their effects, including modulation of the NMDA receptor complex, pleiotropically.
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Forrest J, Ricketts T. A cognitive approach to panic disorder. NURSING TIMES 1995; 91:27-9. [PMID: 7494694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Panic disorder can be a chronic and disabling problem, with sufferers frequently using of medical and psychiatric services. In this paper, the nature of panic attacks and panic disorder is outlined, and a cognitive model of panic disorder described. Treatment is outlined, and a case example given.
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Abstract
Accurate pain detection and assessment preserves functional status and independence in older adults. Pain should not be an expected outcome of the "normal" aging process. Chronic pain behaviors are less recognizable and less easily detected by health care providers and family members resulting in minimal correlation between caregiver evaluation of pain and the intensities reported by patients.
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Campbell CA, Forrest J, Musgrove C. High-strength pancreatic enzyme supplements and large-bowel stricture in cystic fibrosis. Lancet 1994; 343:109-10. [PMID: 7903734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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