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Biomedical subjects

B Pentland

Publications and source records attributed to B Pentland.

87 records · Page 5Linked to original sources
PubMed1981

Effects of microsomal enzyme induction on paracetamol metabolism in man.

1 The metabolism of paracetamol after a single oral dose of 20 mg/kg was compared in fifteen patients with microsomal enzyme induction taking anticonvulsants or rifampicin and twelve healthy volunteers. 2 Induction was confirmed by measurement of the plasma antipyrine half-life (mean 6.4 h in the patients compared with 12.8 h in the volunteers). 3 The glucuronide conjugation of paracetamol was enhanced in the induced patients as shown by lower plasma paracetamol concentrations, a shorter paracetamol half-life, higher paracetamol glucuronide concentrations and an increased ratio of the area under the plasma concentration time curves of the glucuronide to the unchanged drug. There were no significant differences in sulphate conjugation. 4 There was a corresponding change in the pattern of urinary metabolite excretion. The induced patients excreted significantly less unchanged drug and sulphate conjugate and more glucuronide conjugate than the healthy volunteers. 5 The urinary excretion of the mercapturic acid and cysteine conjugated of paracetamol was the same in both groups. 6 Conversion of paracetamol to its potentially hepatotoxic metabolite does not seem to be increased in patients induced with anticonvulsants or rifampicin. There would seem to be no contraindication to the use of these drugs in combination.

Acetaminophen↗
PubMed1980

Acute diarrhoea in the elderly.

One hundred consecutive patients admitted to hospital because of acute diarrhoea are described. The commonest causes of diarrhoea were found to be faecal impaction, infection and drugs, although in a third of the cases no cause was found. Faecal impaction was significantly more common in those living alone or in institutions than in those living with their families. The study suggests that the elderly population is very intolerant of the symptom of diarrhoea, and a case is made for the provision of facilities for more efficient assessment and treatment.

Acute Disease↗
PubMed1980

Azathioprine in chronic relapsing idiopathic polyneuropathy.

A 33-year-old housewife with a 14-year history of relapsing polyneuropathy of unknown cause who has apparently responded to azathioprine therapy is described. The place of this form of treatment in idiopathic polyneuropathy is discussed.

Adult↗
PubMed1979

Campylobacter enteritis-an in-patient study.

During the first eight months of 1978, 26 patients were admitted to the Communicable Diseases Unit at King's Cross Hospital, Dundee with a diagnosis of campylobacter enteritis. The variety of clinical features encountered is described. Although diarrhoea occurred in all cases, it was preceded or accompanied by abdominal pain in the majority of cases and by fever in over half of the patients. The article emphasises the need to consider campylobacter infection in patients presenting with bloody diarrhoea, acute abdominal pain or pyrexias of unknown origin.

Abdomen↗
PubMedDate not supplied

Spontaneous and mutagen-induced sister chromatid exchange in motor neurone disease.

Spontaneous and mutagen-induced sister-chromatid exchange frequencies have been studied in the peripheral blood lymphocytes of 6 patients with motor neurone disease. Their values were compared with those obtained in age- and sex-matched healthy controls. No significant differences were observed between the 2 groups. These results do not support the hypothesis of a defect in the repair of DNA damage as the primary abnormality in the development of the disease.

Amyotrophic Lateral Sclerosis↗
PubMedDate not supplied

Wernicke-Korsakoff syndrome in head injury: a missed insult.

A survey of the use of thiamine in patients at risk from Wernicke-Korsakoff syndrome (WKS) in Scottish specialist neurosurgical units, and a 2-year retrospective study of 218 at-risk patients admitted to a regional neurosurgical unit with a head injury were undertaken. Although responses to the survey indicated otherwise, the study revealed that there was no consistent practice regarding thiamine administration. Overall, 20.6% of patients received thiamine, with an alcohol history being the only factor correlating with thiamine administration. Of known alcoholics and heavy drinkers, 56.1% and 26.2% respectively received thiamine as in-patients; 44.5% of patients received additional carbohydrate loads in the form of i.v. dextrose or parenteral nutrition, but only 28.9% of these received thiamine as well. Although the actual thiamine status of these patients was not known, given the difficulties of diagnosing WKS in the presence of a head injury, the conclusion is that written protocols are needed in units to ensure that head injury patients at risk of WKS receive appropriate thiamine treatment or prophylaxis.

Adolescent↗
PubMedDate not supplied

Thiamine deficiency in head injury: a missed insult?

Practice regarding the use of thiamine in head-injured patients at risk of Wernicke-Korsakoff syndrome in Scottish neurosurgical units was surveyed by questionnaire and revealed no clear policy. A 2 year retrospective study of 218 admissions to one of these units of patients who had taken alcohol shortly before sustaining head injury is also described. The minority (20.6%) of the total had been given thiamine, with just over half (56.1%) of those categorized as alcoholic receiving this treatment. Additional carbohydrate loads, in the form of i.v. dextrose or parenteral nutrition, had been given to 44.5% of patients and only 28.9% of this group had also been given thiamine. The dose and duration of thiamine given was inadequate in most cases. It is suggested that failure to ensure that head injury patients at risk of Wernicke-Korsakoff syndrome receive appropriate thiamine prophylaxis represents a missed and treatable additional insult to the damaged brain.

Adolescent↗
PubMedDate not supplied

Decreased skin wrinkling in diabetes mellitus.

Skin wrinkling, which may be dependent on peripheral autonomic innervation, was assessed in 100 normal and 42 diabetic subjects using a temperature-controlled water bath with immersion of the hands for 30 min. Markedly decreased skin wrinkling was observed in diabetic subjects and in manual workers, but did not correlate with cardiovascular tests of autonomic function, control, type or duration of diabetes, or diabetic complications. The cause of decreased skin wrinkling in people with diabetes is unexplained.

Adult↗
PubMedDate not supplied

The functional effects of head injury in the elderly.

The nature of head injury in the elderly differs from that in younger adults. Fifty-four consecutive patients, aged 65 years or older admitted to a neurotrauma unit with head injury over a six-month period, were identified to determine the causes and medical and social consequences. Falls accounted for the great majority of cases, and alcohol consumption was an important contributory factor in males, while pedestrian road accidents were responsible for most deaths. A routine investigative screening procedure was evaluated. When visited after discharge, 72% of survivors had experienced a change in functional status with increased family involvement and use of community support services. This group was significantly older (p less than 0.01) than those whose status had not changed. A third of the survivors had changed their living circumstances at review. It is suggested that such patients could benefit from increased involvement of the geriatric services.

Accidental Falls↗
PubMedDate not supplied

Fluoxetine as a treatment for emotional lability after brain injury.

Emotional lability or emotionalism is a relatively common phenomenon and frequently occurs following vascular or traumatic brain injury. It is distressing and embarrassing to sufferers and their families, and often interferes with rehabilitation. At present there is no satisfactory or reliable treatment for this condition. We describe an open trial using fluoxetine, a newer antidepressant with a specific serotonergic action, in the treatment of emotional lability due to brain injury. Six consecutive cases of emotional lability attending a rehabilitation unit were studied (five cases of cerebrovascular accident and one of traumatic brain injury). Response to treatment was measured using a modification of the scale described by Lawson and MacLeod [1]. All showed a marked improvement within one week of commencing fluoxetine and the drug was well tolerated with no reported side-effects. The speed of onset and degree of improvement suggest that fluoxetine may be a useful agent in the treatment of emotional lability due to brain injury. Our observations indicate that further investigation of the role of fluoxetine in the treatment of emotional lability is warranted.

Adult↗
PubMedDate not supplied

Clinical management of a man with complex partial seizures and a severe head injury.

A case history of a man with complex partial seizures resulting from a severe head injury following a road traffic accident is presented. Details of medical intervention and neuropsychological assessment are also presented and discussed, highlighting the difficulties of balancing therapeutic doses of anticonvulsant medication with cognitive functioning adequate to maintain expected quality of life. An interesting finding revealed that the patient's blood-sodium levels increased rather than decreased with rising doses of anticonvulsant medication.

Adult↗