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Biomedical subjects

C G Clough

Publications and source records attributed to C G Clough.

26 records · Page 2Linked to original sources
PubMed1984

Cholinergic and dopaminergic mechanisms in Parkinson's disease after long-term L-DOPA administration.

A study of parkinsonian patients suffering from ON-OFF phenomena, who had been on long-term treatment with L-DOPA, to the parenteral administration of apomorphine and physostigmine is reported. All patients, whether of the end-dose failure type or of the randomly occurring variety, when given apomorphine in an OFF phase, showed prompt reversal to an ON phase. Physostigmine given during an ON phase produced the opposite effect with induction of parkinsonian symptoms. These findings are interpreted as indicating that the dopaminergic receptors are available for stimulation during the OFF phase but are not receiving sufficient neurotransmitter, that is, dopamine, to stimulate their activity. The response to physostigmine is indicative of a return of cholinergic supersensitivity after long-term L-DOPA administration, the mechanisms by which this may occur are discussed. Based on these findings, therapeutic strategies are suggested that may overcome this major limitation of the use of L-DOPA in the treatment of parkinsonism.

Acetylcholine↗
PubMed1983

Oculogyric crises and parkinsonism. A case of recent onset.

Oculogyric crisis in association with postencephalitic parkinsonism has been reported only following encephalitis lethargica (Economo's disease). Generally, it has been assumed that this phenomenon would fade away with the demise of these postencephalitic patients. Therefore, we report a case of recent onset of persistent oculogyric crisis with parkinsonism in a 35-year-old man following an apparent attack of encephalitis in 1972.

Adult↗
PubMed1982

A controlled study of dementia in Parkinson's disease.

Tests of cognitive functions were carried out in a group of patients with Parkinson's disease and repeated after a three-year interval. Comparison was made with a control group drawn from a population of psychiatric patients, matched for age and sex. No differences in cognitive functions were found between the groups, either initially, or between those surviving for three years. Deaths among the index group included a high proportion of patients with cognitive impairment and there was an increasing prevalence and severity of dementia in the index group which exceeded that observed in the control group. Requirements for a methodologically sound study of dementia in Parkinson's disease are discussed.

Aged↗
PubMed1981

A case of sporadic juvenile Parkinson's disease.

Juvenile Parkinson's disease is rare. Virtually all reported cases are either associated with a family history or additional neurologic findings. We report a sporadic case of classic Parkinson's disease, without other abnormal neurologic signs and age at onset of 15 years.

Adult↗
PubMedDate not supplied

Does type II diabetes predispose to retinal vein occlusion?

Retinal vein occlusion (RVO) not infrequently occurs in diabetic patients. Although the aetiology is unclear, it could relate to the other microvascular complications of diabetes. In the non-diabetic, both the central (CRVO) and branch (BRVO) forms are commonly associated with hypertension and hyperlipidaemia. We have therefore studied fifty type II diabetic patients with RVO compared to a carefully matched diabetic control group (n = 50) to elucidate underlying medical conditions and hence the aetiology of RVO in diabetic patients. The two groups were well matched. Diabetics with RVO showed a strikingly high prevalence of hypertension compared to the controls (72% versus 32%: p < 0.001) and a trend to increased hyperlipidaemia (54% versus 36%). Diabetic microvascular complications were more common in the control group (diabetic retinopathy and proteinuria). No significant differences were observed in mean HbA1 or weight, but current smoking habits and blood pressure levels were increased in the diabetics with RVO. 80% of diabetic patients with the BRVO form, were hypertensive. We conclude that the main underlying medical conditions for RVO in diabetics are hypertension and hyperlipidaemia, and these may be important in the aetiology as in the non-diabetic. RVO is more common in type II rather than type I diabetes, and does not associate with the presence of diabetic microvascular complications. Clinical assessment for hypertension and hyperlipidaemia is therefore important in diabetic patients with RVO, especially if recurrence of the condition and further visual loss is to be prevented.

Adult↗
PubMedDate not supplied

New developments in medical specialty training.

Medical specialty training is changing which will result in shorter, more focused training programmes. Senior house officer posts will disappear from August 2007, and be replaced by training posts and trust grade doctors. Eventually specialist registrars in higher specialty training will join with these new training posts to create run-through training. Curricula development and delivery with quality assurance is now the responsibility of a new training board--the Postgraduate Medical Education and Training Board (PMETB). There is an opportunity to create a new specialty of acute medicine to help meet the crisis of care for acutely ill patients in our hospitals.

Education, Medical↗