Long-term results of permanent indwelling wallstents for benign mid-ureteral strictures.

Background: Benign ureteral strictures are a potentially difficult problem that typically has been solved by open surgery. However, minimally invasive methods would be preferable.

Patients And Methods: Three patients with benign ureteral strictures were treated with endoscopic placement of self-expanding permanent indwelling stents (Wallstents).

A practical method for the calculation of multileaf collimator shaped fields output factors.

Output factors of multileaf-collimator (MLC) shaped radiation fields were measured for a commercial linear accelerator whose MLC leaves form parts of the upper collimator system. The approach of taking into account the reduced phantom scatter due to the MLC shaping on the output factor has previously been shown to be inadequate for this type of machine because of the effect of the MLC leaves on the collimator factor [Palta et al., Med.

Ibuprofen stereochemistry: double-the-trouble?

Racemic ibuprofen is an important NSAID used in the treatment of pain and inflammation in a variety of musculoskeletal and rheumatic disorders. The metabolism of ibuprofen, and that of a number of the related 2-arylpropionic acid NSAIDs, involves chiral inversion of the relatively inactive R-enantiomers to their active S-antipodes, together with other potentially stereoselective conjugative and oxidative pathways. Enantiospecific analytical methodology suitable for the determination of both the drug and its metabolites is essential in order to evaluate the significance of stereoselectivity both in terms of drug action and disposition.

Single dose pharmacodynamics of thioridazine and remoxipride in healthy younger and older volunteers.

Phenothiazines are widely used in older patients, but little experimental work has been carried out in this age group. Two groups of healthy volunteers, a younger group (Y: six males and six females, aged 20-42 years) and an older group (O: six males and eight females, aged 65-77 years) took part in a randomized double-blind three-period crossover study in which they received by mouth single doses of thioridazine (Y: 50 mg; O: 25 mg) remoxipride (Y: 100 mg; O: 50 mg) or placebo. Measures of central nervous system (CNS) and haemodynamic function were carried out before drug administration and at 1.

Prevention of falls in the elderly trial (PROFET): a randomised controlled trial.

Background: Falls in elderly people are a common presenting complaint to accident and emergency departments. Current practice commonly focuses on the injury, with little systematic assessment of the underlying cause, functional consequences, and possibilities for future prevention. We undertook a randomised controlled study to assess the benefit of a structured inderdisciplinary assessment of people who have fallen in terms of further falls.

Psychomotor performance: investigating the dose-response relationship for caffeine and theophylline in elderly volunteers.

Objective: The aim of the study was to investigate the dose-response relationship for psychomotor performance, caffeine and theophylline in healthy elderly volunteers.

Methods: In a randomized, double-blind, placebo-controlled, six-period cross-over study we compared the effect of three doses of theophylline (predicted peak concentrations of 3, 6 mg. 1(-1) and 12 mg .

The use of over-the-counter medication by elderly medical in-patients.

Use of over-the-counter (OTC) medications by elderly patients is often not identified. This survey was performed to study the use of OTCs by medical in-patients aged 65 and over. Data on the use of OTC medications before and during hospital admission were collected by questioning patients and case notes were examined for documentation of their use of OTC medications.

Validity and sensitivity of visual analogue scales in young and older healthy subjects.

Background: Previous findings from studies on the acute effects of drugs indicate that older subjects report less change on visual analogue scales than do younger subjects, when the observed drug effects on objective performance measures are as great or greater.

Aim: To validate the use of visual analogue scales independently of internal perceptions.

Subjects And Methods: 50 younger and 50 older subjects rated attributes of four animals--tortoise, crow, tiger and wasp--on a series of 10 cm lines.

Impaired nitric oxide-mediated vasodilatation and total body nitric oxide production in healthy old age.

1. Basal release of nitric oxide from the vascular endothelium maintains a constant vasodilating tone. Impaired nitric oxide-mediated vasodilatation has been described in hypertension and atheromatous disease.

Stereospecific analysis of the major metabolites of ibuprofen in urine by sequential achiral-chiral high-performance liquid chromatography.

A sequential achiral-chiral HPLC method has been developed for the stereospecific analysis of the two major urinary metabolites of ibuprofen, namely hydroxyibuprofen and carboxyibuprofen. Achiral analysis was carried out using a Partisil column (250x4.6 mm, 5 microm) and a mobile phase of hexane:ethanol (98.

ACE inhibition: postsynaptic adrenergic sympatholytic action in men.

Background: The mechanisms by which ACE inhibitors produce a sustained clinical benefit are not entirely clear but may involve the sympathetic nervous system. We compared the effect of local brachial artery infusions of an ACE inhibitor (perindoprilat) with the effect of placebo (0.9% NaCl) on endogenously mediated (lower body negative pressure [LBNP]) and exogenously mediated (brachial artery infusions of norepinephrine) sympathetic vasoconstriction.

Development of prescribing indicators for elderly medical inpatients.

Aims: To identify and improve suboptimal prescribing for elderly patients we have developed a number of prescribing indicators which focus on areas of concern and allow evaluation of the benefit of interventions. We report here on fourteen indicators.

Methods: The indicators are of three types: a) purely descriptive with no attempt to define optimal values, e.

Aspartame pharmacokinetics - the effect of ageing.

Aspartame is an intense sweetener which is increasingly used in the UK. It is registered at an acceptable daily intake (ADI) of 40 mg/kg, although there are no previous data relating to the metabolism of aspartame in older people. Twelve young and 12 elderly volunteers each received a single dose of approximately 40 mg/kg of aspartame.

Attitudes and beliefs about exercise among persons with non-insulin-dependent diabetes.

This study examined attitudes and beliefs about exercise among 83 persons with non-insulin-dependent diabetes who had completed outpatient diabetes counseling. An adaptation of the Health Belief Model, labeled the Exercise Behavior Model, guided perceptual measures. Fifty-two percent of the subjects were exercising 3 or more days per week.

Hawksley random zero sphygmomanometer versus the standard sphygmomanometer: an investigation of mechanisms.

There has been recent controversy over the accuracy of the Hawksley random zero sphygmomanometer (RZS). In most instances, there has been a bias towards lower recordings with the RZS. In an attempt to identify the mechanism, we designed a study to test the hypothesis that biased error is due to: (1) the magnitude of the random zero; and (2) the magnitude of the pressure being recorded.

Twenty-four-hour ambulatory blood pressure monitoring in healthy elderly people: reference values.

One hundred and two healthy elderly volunteers (aged 65-83 years) underwent 24-hour ambulatory blood pressure monitoring. Mean day- and night-time pressures were higher than reported for younger subjects. Removing outlying BP measurements from individual 24-hour recordings only minimally affected mean figures of the group but in some individuals mean day diastolic BP may be up to 5 mmHg lower on editing.

Investigation of ambulatory blood pressure monitoring data editing criteria.

Ambulatory blood pressure monitoring (ABPM) allows multiple measurements of BP over a 24h period but often produces a proportion of measurements which are distant from the mean and unlikely to be genuine. The software which accompanies the SpaceLabs 90207 monitor requires criteria to be set which excludes outliers (autoediting) but there is no published data evaluating at what levels these autoediting criteria should be set. This study set out to ascertain whether outlying BP measurements represent true blood pressures or machine error, the determinants of machine error and appropriate autoedit criteria.

Pharmacokinetics and prescribing in the elderly.

The use of prescribed medication in general is higher in the elderly than in the young and it is possible that existing patterns of antimicrobial agent prescribing may predispose to suboptimal response, certain adverse drug reactions (ADR) and the emergence of resistant strains of organisms. Age is an important variable affecting the pharmacokinetics of drugs, including many antimicrobials. Changes which may affect Cmax/MIC ratios and/or the time above MIC include reduced first-pass metabolism, altered distribution volume, reduced binding to albumin, reduced metabolic biotransformation and reduced renal elimination.

Psychomotor performance and antihypertensive treatment.

1. The aim of treatment of hypertension is prevention of cardiovascular complications without adverse drug reactions. Psychomotor performance can be measured objectively yet there remains uncertainty concerning the psychomotor effects of antihypertensive drugs during chronic treatment.

The pharmacokinetics and pharmacodynamics of medifoxamine after oral administration in healthy elderly volunteers.

The pharmacokinetics and psychomotor effects of medifoxamine, a 5 HT reuptake inhibitory antidepressant, were studied in healthy elderly volunteers after single and multiple dosing. The elimination half life (t1/2z) after single doses of 300 mg was 2.8 h--almost identical to that found in young volunteers.

Assessment of changes in psychomotor performance of elderly subjects.

1. The repeatability of a computerised psychomotor test battery on a day-to-day and week-to-week basis was assessed by determining its test-retest reliability and variations in group-means and intraindividual psychomotor performance scores of elderly people. 2.

Computerised psychomotor performance testing: a comparative study of the single dose pharmacodynamics of minaprine and amitriptyline in young and elderly subjects.

The psychomotor and cardiovascular effects of minaprine 100 mg, a novel antidepressant, were compared with amitriptyline 25 mg, as a positive control, and placebo in a single dose randomised double-blind crossover trial using an automated psychomotor test battery (APT), postural sway (PS), blood pressure (BP) and pulse in nine young and nine elderly healthy subjects. Analysis of variance, taking into account baseline values, showed that continuous attention test (CAT), critical flicker fusion threshold (CFFT), decision making test (DMT) and paired word association (PWA) were significantly impaired with amitriptyline compared with minaprine and placebo. Minaprine did not differ from placebo.