Browsing by Subject "Placebos"

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    A comparative study of the effects of meclofenamate, diclofenac and placebo, in combination with physiotherapy, on the healing of acute quadriceps and hamstring muscle tears
    (1991) Reynolds, Jonathan F; Bowerbank, Patricia; Noakes, Timothy D
    A double-blind, placebo controlled research technique was used to determine the effects of two non-steroidal anti-inflammatory drugs, meclofenamate and diclofenac, in combination with physiotherapy treatment, on the rate and extent of healing of acute hamstring muscle tears. Sixty patients were recruited and treated at No's 1 and 2 Military Hospitals in Voortrekkerhoogte and Wynberg, Cape Town, respectively. Patients were randomly allocated to one of three treatment groups: meclofenamate, diclofenac and placebo. Patient assessments were performed on days 1, 3 and 7 of the 7-day study period. These assessments included pain assessment (visual analogue scale), swelling measurement (thigh circumference measurement at the site of the muscle tear) and muscle performance test (Cybex isokinetic dynamometer and data reduction computer). All patients received physiotherapy treatment on all 7 days of the study. This comprised early rest, ice, compression and elevation (RICE), and later, ultrasound and deep transverse friction massage. An intensive regime of strengthening and stretching exercises was used throughout the study, beginning with stretching and isometric exercises gradually moving onto isotonic exercises and aerobic exercise including swimming, running and cycling. No competitive sport was allowed during the study period. Statistical significance was determined using the analysis-of-variance (ANOVA) test with an acceptance level of p<0.05. No differences in pain, swelling or muscle performance were demonstrated between the three treatment groups. In terms of the pain and swelling assessments, the injuries did not appear to be very severe. Accordingly, the groups were divided into severe and non-severe sub-groups and statistical significance was determined using the ANOVA test with an acceptance level of p<0.05. A significant difference was found in the severe hamstring injury sub-group. In this group, pain reduction was greater in the placebo group than in the meclofenamate group on day 7. There were no other significant differences found in this sub-group analysis. Relatively few side effects were encountered, and those encountered were mild. No patients were withdrawn from the study as a result of these adverse events. Drowsiness and gastro-intestinal disturbance were the most common side effects reported. In conclusion, the study found that no benefit was gained from the use of meclofenamate or diclofenac in combination with physiotherapeutic modalities as compared to the use of physiotherapeutic modalities on their own. Thus, the widespread use of NSAIDs in the treatment of acute muscle injuries may not be justified.
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    Lipoprotein lipase activity is decreased in a large cohort of patients with coronary artery disease and is associated with changes in lipids and lipoproteins
    (1999) Hockman, Dorit; Henderson,Howard E; Hockman, Dorit; Kastelein, John P; Zwinderman, Aeilko H; Gagné, Eric; Jukema, J Wouter; Reymer, Paul W A; Groenemeyer, Björn E; Hockman, Dorit; Lie, Kong I; Bruschke, Albert V G; Hayden, Michael R; Jansen, Hans
    Lipoprotein lipase (LPL) is crucial in the hydrolysis of triglycerides (TG) in TG-rich lipoproteins in the formation of HDL particles. As both these lipoproteins play an important role in the pathogenesis of atherosclerotic vascular disease, we sought to assess the relationship between post-heparin LPL (PH-LPL) activity and lipids and lipoproteins in a large, well-defined cohort of Dutch males with coronary artery disease (CAD). These subjects were drawn from the REGRESS study, totaled 730 in number and were evaluated against 75 healthy, normolipidemic male controls. Fasting mean PH-LPL activity in the CAD subjects was 108 46 mU/ml, compared to 138 44 mU/ml in controls (P < 0.0001). When these patients were divided into activity quartiles, those in the lowest versus the highest quartile had higher levels of TG (P < 0.001), VLDLc and VLDL-TG (P = 0.001). Conversely, levels of TC, LDL, and HDLc were lower in these patients (P = 0.001, P = 0.02, and P = 0.001, respectively). Also, in this cohort PH-LPL relationships with lipids and lipoproteins were not altered by apoE genotypes. The frequency of common mutations in the LPL gene associated with partial LPL deficiency (N291S and D9N carriers) in the lowest quartile for LPL activity was more than double the frequency in the highest quartile (12.0% vs. 5.0%; P = 0.006). By contrast, the frequency of the S447X LPL variant rose from 11.5% in the lowest to 18.3% (P = 0.006) in the highest quartile. This study, in a large cohort of CAD patients, has shown that PH-LPL activity is decreased (22%; P = 0.001) when compared to controls; that the D9N and N291S, and S447X LPL variants are genetic determinants, respectively, in CAD patients of low and high LPL PH-LPL activities; and that PH-LPL activity is strongly associated with changes in lipids and lipoproteins.