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Biomedical subjects

C J Bulpitt

Publications and source records attributed to C J Bulpitt.

At least 253 records · Page 14Linked to original sources
PubMed1977

The contribution of psychological features to the symptoms of treated hypertensive patients.

Twenty-seven symptoms of 859 treated hypertensive patients were evaluated using a self-administered questionnaire and correlated with the depression (DEP), free-floating anxiety (FFA), phobic anxiety (PHO), obsessionality (OBS) and extraversion (HYS) scores of the Middlesex Hospital Questionnaire. The psychological features were associated with 24 of the 27 symptoms, and the extent to which these measurements determined the presence of a symptom was calculated. DEP and FFA were correlated with most of the symptoms, PHO with weak limbs, blurred vision, slow walking pace, nocturia and a lessened interest in sex. HYS was positively associated with the frequency of sexual intercourse in men and negatively with complaints of dyspnoea, tingling in the limbs and a slow walking pace. OBS was only associated with diarrhoea.

Aged↗
PubMed1977

Eye symptoms in patients taking propranolol and other hypotensive agents.

1 Four hundred and eighty-three hypertensive patients being treated with propranolol or other hypotensive drugs were questioned about symptoms of gritty feelings, sore or red eyes, photophobia and use of eye drops. 2 Between 11.6% and 29.8% gave positive answers but there was no difference between the different drug regimes. The complaint of 'red eyes' was more common in smokers.

Antihypertensive Agents↗
PubMed1977

Endothelial cell loss and corneal thickness after intracapsular extraction and iris clip lens implantation: a randomised controlled trial (interim report).

Patients in a randomised controlled trial were chosen either to have iris clip lens implantation after intracapsular cataract extraction or intracapsular extraction only. They were assessed in terms of corneal thickness, postoperative epithelial oedema, and endothelial cell counts. All patients had 1 eye submitted to operation, which was carried out by the same surgeon. There was significantly greater increase in corneal thickness (P less than 0.05) on the 5th postoperative day in eyes which had lens implants (23 patients with intracapsular extraction and 19 with implant), but the difference between the 2 groups became insignificant at 1 month (17 patients in each group). Daily corneal thickness measurements and observations of epithelial oedema in a subgroup (20 patients divided equally into 2 groups) showed that postoperatively there was greater and more widespread corneal oedema after implant surgery. When the operated eye was compared with the unoperated eye, endothelial cell loss was significantly greater in those with implants (P less than 0.01) than in those with simple intracapsular extraction.

Aged↗
PubMed1977

Initial care of hypertensive patients. Influence of different types of clinical records.

The initial record of history and clinical findings has been studied in 278 patients attending three hypertension clinics. Half of these were randomly allocated to standard case notes and the other half to a special structured questionnaire record. The investigations carried out in a total of 521 patients with raised arterial pressures were examined. The records derived from the structured questionnaire were much more complete than the standard case notes but the difference was less obvious for a positive record than a negative one. None of the investigations was carried out in all patients, even though it was the policy of the clinics that most of them should be. A possible aetiological diagnosis was made in 28 patients and, at the time of writing, 3 patients had benefited from a surgical operation carried out as a result of investigation. These results raise the question of the quality of the initial care of hypertensive patients and suggest that the structured questionnaires might lead to an improvement. It remains to be established whether all the information collected does influence the outcome in patients with hypertension.

Humans↗
PubMed1976

Trial of combination of guanethidine and oxprenolol in hypertension.

Thirteen hypertensive patients entered a double-blind crossover trial of guanethidine and oxprenolol in combination. In nine patients who completed the trial there was an additive effect on blood pressure, but the combination had a smaller effect on heart rate than was expected from the individual effects, and side effects were not increased. During treatment with oxprenolol the plasma potassium concentration rose from 3.6 mmol (mEq)/1 to 3.9 mmol (mEq)/1. No correlation was found between the plasma oxprenolol concentration and changes in blood pressure or response to injected isoprenaline, but measurements of plasma oxprenolol concentrations were of value in determining compliance with the protocol.

Blood Pressure↗
PubMed1976

Randomised controlled trial of computer-held medical records in hypertensive patients.

A total of 278 hypertensive patients in three clinics were randomly allocated to have their medical records held in a computer system (136) or on standard hospital notes (142). For the computer system the doctor completed a structured input form, and the information on symptoms, physical findings, and diagnoses was more complete than that in the standard notes. This resulted in certain symptoms and risk factors being recognised more often when the computer system was used. The hypertension clinics' routines were not disrupted by the introduction of a computer-held system, and follow-up consultation times were not affected by the type of records kept, although the first consultation took eight minutes longer when computer documents were completed. The patients remained in the trial for one year and clinical management was assessed from blood pressure control, drop-out rates, and the frequency of performing investigations. These estimates of management showed no significant difference between the two groups, but the attempt to tailor the computer system to help management made the system acceptable to the doctors using it. The computer system continues to be used and is providing data for research into hypertension.

Computers↗
PubMed1976

Streptokinase in central retinal vein occlusion: a controlled clinical trial.

Forty patients with central retinal vein occlusion were allocated at random either to a treatment group given streptokinase followed by anticoagulatns or to a control group given no specific treatment. The two groups, which were each of 20 patients, were broadly similar in respect of clinical and laboratory values and similar in their initial visual acuity. At follow-up ("final" vision) the visual acuity in the treated group was significantly better than in the untreated group. Only one treated patient developed thrombotic glaucoma compared with four controls. Streptokinase may, however, have been responsible for vitreous haemorrhage (and permanent loss of vision) in three patients and hence probably has only a limited role in the treatment of central retinal vein occlusion.

Adult↗
PubMed1976

Factors affecting antipyrine metabolism in West African villagers.

Saliva half-life of antipyrine was studied in 49 healthy Gambians between 20 and 60 yr of age of whom 27 were male (mean age, 44.5) and 22 female (mean age, 39.1). Body wieght, height, ponderal index, albumin, and hemoglobin were moderately reduced compared to accepted normal values. Antipyrine half-life was 13.6 +/- 0.58 (SEM) hr. Multiple regression analysis showed that sex, cola nut consumption, hemoglobin in women, and height in men were statiscally significant independent predictors of antipyrine half-life. Half-life was shorter in women, decreased with an increase in height in men, and was prolonged by cola nut consumption. Half-life in women increased with hemoglobin. These factors explained 36% of the variation and suggest that geographic differences in the environment could be important in drug metabolism in man.

Adult↗
PubMed1976

Plasma concentration of phenylbutazone and its therapeutic effect-studies in patients with rheumatoid arthritis.

1 Phenylbutazone in doses of 50, 100, 200 and 300 mg/day has been given for four periods of 3 weeks to seven patients with rheumatoid arthritis. The trial was double-blind and the order of administration of doses was arranged to eliminate order and carry-over effects. 2 Before the trial and at the end of each period, the patient's responses were assessed by measurement of the duration of morning stiffness, the pain score, paracetamol tablet count, grip strength, digital joint size and articular index. 3 The plasma phenybutazone concentration was measured by gas-liquid chromatography and was also predicted by prior measurement of the phenazone half-life. 4. Compared with the pretreatment period, phenylbutazone had a significant therapeutic effect, as judged by morning stiffness, pain score and articular index, in a dose of 50 mg/day, but no statistically significant differences in effect were seen between the various doses of phenylbutazone. 5 There were no significant coorelations between the plasma concentration of phenylbutazone and any of the clinical assessments. 6 The plasma phenylbutazone concentration agreed closely with that predicted at doses of 50 and 100 mg, but at higher doses the plasma concentration was significantly lower than predicted (P less than 0.05). This may have been due to saturation of the protein binding sites at these doses.

Adult↗
PubMed1976

Change in symptoms of hypertensive patients after referral to hospital clinic.

At their first visit to a hospital clinic 178 patients referred with a diagnosis of hypertension were given a self-administered questionnaire. They received a similar questionnaire 12 months later. Of the 178 patients 99 were not initially on treatment. Similarly 78 normotensive subjects were drawn randomly from the local population and sent a second questionnaire 10 months later. The symptoms at the first visit of the normotensive controls, the untreated hypertensive patients, and 477 patients on long-term treatment in the hypertension clinic were compared. Treated and untreated hypertensive patients complained more of nocturia and also of unsteadiness either on standing or in the morning. Treated hypertensives complained more of sleepiness, dry mouth, diarrhoea, and, in men, impotence and failure of ejaculation. Similarly, untreated hypertensives complained of excessive depression, blurred vision, and waking headache. Fifty-five of the normotensive subjects and 110 of the newly referred hypertensive patients responded to the second questionnaire. The proportions losing and gaining symptoms were calculated together with the proportions always complaining and never complaining of a symptom. Hypertensive patients tended to lose the complaints of unsteadiness and headache but to gain the symptoms of vivid dreams, a slow walking pace, and diarrhoea. The net improvement for a symptom was defined as the excess of patients who lost a symptom over those who gained the symptom, expressed as a percentage. Over the follow-up period the control subjects had a net improvement averaged over 14 symptoms of +2-4 per cent. A similar result was obtained for the hypertensive patients of +2-0 per cent, the symptoms lost being balanced by those gained. The changes in symptoms with time were related to the changes in blood pressure and it is suggested that only headache, 'unsteadiness, lightheadedness, or faintness' and nocturia can actually result from raised blood pressure and then only in a proportion of patients complaining of these symptoms.

Blood Pressure↗
PubMed1976

Plasma urea in hypertensive patients.

The annual increase in plasma urea was measured in 253 hypertensive patients. On average there was a significant increase in plasma urea with time which did not depend on the sex of the patient or the type of hypertension. It did, however, depend on the initial level of plasma urea. A table giving the upper limits for expected annual increment may prove useful in clinical assessment. The relation between plasma urea and presenting blood pressure and age was examined in 1217 patients seen at the Hammersmith Hospital hypertension clinic from 1952 to 1967. The plasma urea was significantly related to both age and diastolic and systolic blood pressure. It was higher in men than in women up to 60 years of age, but not above that age, and it increased with presenting mean blood pressure in both sexes, but the increase was greater in men. There was a quadratic relation between age and plasma urea in both men and women. In both sexes the plasma urea increased between the ages of 60 and 80.

Age Factors↗