A double-blind comparison of meptazinol versus placebo in chronic rheumatoid arthritis and osteoarthritis.

A double-blind, placebo-controlled, between-patient evaluation of the analgesic properties of oral meptazinol was carried out in 60 patients suffering from chronic pain due to rheumatoid arthritis and osteoarthritis. Patients were allocated, at random, to receive either 200 mg meptazinol every 3 to 6 hours as required or identical matching placebo for a total period of 72 hours. Data from 57 patients (30 on meptazinol, 27 on placebo) were suitable for analysis. Pain intensity in five major categories was assessed using a 4-point verbal rating scale by a clinician before the first dose and at the end of the trial period. Patients performed a self-assessment of pain prior to taking the first dose and subsequently at 2,4,24, 48 and 72 hours using 100 mm visual analogue scales and verbal rating scales. The clinician-rated pain scores showed no significant difference between the two groups in initial pain intensity. After 72-hours' treatment , there was a significant (p less than l.01) reduction in pain intensity after 2 hours which was maintained throughout the trial period. There was no significant reduction in pain intensity inpatients taking placebo. Visual analogue scale scores and pain intensity difference scores showed significantly (p less than 0.01) greater reduction in pain intensity at all time points in the meptazinol- treated patients.(ABSTRACT TRUNCATED AT 250 WORDS)

The effects of high dose inhaled beclomethasone dipropionate on glucose and lipid profiles in normal and diet controlled diabetic subjects.

We determined the effect of high doses of inhaled beclomethasone dipropionate (2000 micrograms day-1 for two weeks) on the glucose tolerance test, insulin levels, fasting cholesterol and triglyceride concentrations in fourteen normal and ten elderly diet controlled diabetic patients, in a single blind, placebo controlled trial. No significant disturbance of glucose or lipid metabolism was found in either group. This study suggests that at this high dose, BDP does not exhibit significant disturbance of glucose and lipid metabolism after two weeks use.

Does ipratropium bromide by nebulizer and face-mask have local ocular effects?

No acute ocular atropinic effect of nebulized ipratropium bromide administered by carefully applied or deliberately misplaced face-mask has been demonstrated.

Nutritional status of the social class groups.

There is a marked increase in mortality and morbidity with decreasing social class status so that the death rate of adult males in social class V is twice that of men in social class I. Differences in nutritional status between the social classes could account for this phenomenon. In this survey the nutritional status of 254 consecutive adult admissions to a teaching hospital was assessed by anthropometric and biochemical measurements and delayed hypersensitivity skin tests. No significant difference in nutritional status was detected between the five social class groups. There was no significant difference between the combined social class groups I and II compared with IV and V. A similar result was obtained with the same assessment of 167 fit adult individuals of comparable age and sex distribution living in the community. There is no significant difference in nutritional status between the social classes when they are well or ill and therefore the differences in mortality and morbidity in lower social classes are unlikely to be caused by inadequate nutrition.

Hepatic necrosis with doxapram hydrochloride.

We report the first case of acute hepatic necrosis, which we believe to have been caused by the administration of the respiratory stimulant, doxapram hydrochloride (Dopram).

The effects of dopamine and a low protein diet on glomerular filtration rate and renal plasma flow in the aged kidney.

The aims of this study were to determine the effects of dopamine and a low protein diet on glomerular filtration rate and effective renal plasma flow in the aged kidney. Effective renal plasma flow was measured using 125I-labelled hippuran and glomerular filtration rate using 51Cr-labelled EDTA. Low-dose continuous intravenous dopamine 3 micrograms.kg-1.min-1 in 10 healthy elderly volunteers caused a significant increase in effective renal plasma flow but not in the mean glomerular filtration rate when compared with baseline. However, glomerular filtration rate did increase substantially in 5 subjects (mean 14.4, SD 1.3). This implied that the elderly kidney was working maximally without reserve capacity in half the elderly. Since renal function is likely to be even more reduced in elderly patients with congestive cardiac failure, dopamine infusions may have little place in this condition in some older patients. A low protein diet (0.69 g.kg-1) in the same volunteers reduced glomerular filtration rate, suggesting that protein restriction may help to reduce the increased filtration rate in the remaining nephrons, thereby leading to structural and functional preservation in the aged kidney.

Renal prostaglandins, effective renal plasma flow and glomerular filtration rate in healthy elderly subjects.

This study tests the hypothesis that the age-associated reduction in glomerular filtration rate (GFR) and the presence of glomerulosclerosis renders effective renal plasma flow (ERPF) prostaglandin dependent. Ten healthy elderly volunteers were studied in a single-blind placebo-controlled manner using indomethacin to suppress the renal prostaglandins. There was no significant difference in ERPF or GFR following indomethacin when compared with placebo. These results suggest that blocking renal prostaglandins does not significantly alter ERPF or GFR in healthy elderly people.

Fatal self-poisoning with benoxaprofen.

A report of the first fatal self-poisoning due to primary toxicity of benoxaprofen. Benoxaprofen is toxic in acute overdosage to the central nervous system, myocardium and kidneys, but appears to spare the liver.

Bone tuberculosis: results and experience in Leicestershire.

Management of tuberculosis falls to the thoracic physician and includes extrapulmonary sites. We have conducted a survey of notification of bone tuberculosis in Leicestershire from 1978 to 1983 inclusive. Eighty-one cases were notified, 75 were traced and 69 confirmed tuberculosis (mean age 40.2 years, 39 male, 54 from the Indian sub-continent (ISC)). Mean length of symptoms was 8.4 months, the commonest being pain and swelling. The diagnosis was established by evidence of bone involvement plus at least one of the following: positive Heaf test (54/56), positive culture at bone sites for Mycobacterium tuberculosis (45/47), or suggestive histology (30/34). There were no resistant organisms. Chemotherapy (mean duration 16.2 months) was well tolerated. Spine was the site most often involved (37 patients, 34 ISC), with abscess formation common (17 patients). Four who presented with spinal cord compression received a mean of 8 months' bed rest, three required decompression and one died. No patient developed new neurological signs on treatment. Fourteen others received an average of 2.3 months' bed rest. In this predominantly ISC immigrant population, spinal tuberculosis is common but does not progress to cord compression on treatment. For those without cord compression the course and outcome were similar whether or not they were treated with bed rest.