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Biomedical subjects

C N Martyn

Publications and source records attributed to C N Martyn.

At least 91 records · Page 5Linked to original sources
PubMed1987

Six-month treatment with sorbinil in asymptomatic diabetic neuropathy. Failure to improve abnormal nerve function.

The effect of long-term treatment with the aldose reductase inhibitor sorbinil (125 mg daily for 6 mo) was examined in 22 diabetic patients with subclinical abnormalities of nerve function. This was a placebo-controlled, double-blind crossover trial in which each of the two treatment periods lasted 6 mo. Peripheral nerve function was assessed electrophysiologically and by quantitative sensory testing; autonomic function was assessed by measurement of five cardiovascular reflexes and of mean heart rate from a 24-h ECG recording. Measurement of erythrocyte sorbitol concentrations demonstrated very significant inhibition of aldose reductase activity with sorbinil treatment, but no concomitant improvement in either peripheral or autonomic nerve function was observed.

Adult↗
PubMed1987

Noradrenaline response to edrophonium (Tensilon) and its relation to other autonomic tests in diabetic subjects.

Noradrenaline responses following 10 mg intravenous edrophonium were assessed in 32 insulin-treated diabetic men, allocated to 4 groups according to their responses to 5 cardiovascular autonomic tests. The group with the most severe autonomic involvement had no rise in plasma noradrenaline, in contrast to the other 3 groups, whereas the heart rate fell in all 4 groups. There were significant correlations between individual noradrenaline responses, cardiovascular reflex tests, 24 hour heart rate variation and pupil cycle time, depending on whether predominantly parasympathetic or sympathetic pathways or both were involved. These results indicate that the noradrenaline response to edrophonium cannot be used as a test of early sympathetic dysfunction in diabetics; and that autonomic nervous system involvement occurs simultaneously in different body systems.

Autonomic Nervous System Diseases↗
PubMed1986

Progression of subclinical polyneuropathy in young patients with type 1 (insulin-dependent) diabetes: associations with glycaemic control and microangiopathy (microvascular complications).

The progression of subclinical polyneuropathy over 2.5 years has been studied in a representative group of 75 young patients with Type 1 (insulin-dependent) diabetes (initial age 16-19 years). The relationships between changes in nerve function, glycaemic control and concurrently developing microvascular complications (retinopathy, microproteinuria) were investigated. Deterioration of motor, sensory and autonomic nerve function, retinopathy and microproteinuria was related to poor glycaemic control. In addition, there was an association between developing neural and microvascular complications which was not diminished when their common relationship to hyperglycaemia was taken into account. These findings suggest that, although poor glycaemic control is an essential permissive factor in the early development of diabetic polyneuropathy, other influences, shared with microvascular complications, must also be important.

Adolescent↗
PubMed1986

Pupil cycle time: a simple way of measuring an autonomic reflex.

Persistent regular oscillations of the pupil of the eye can be induced using a slit-lamp. The period of these oscillations, pupil cycle time (PCT), is simple to measure with a hand-held stop-watch. Evidence from pharmacological testing suggests that PCT is a sensitive measure of dysfunction of the parasympathetic efferent limb of the pupillary light reflex arc. This is confirmed by the finding that PCT is prolonged in a high proportion of patients with evidence of autonomic neuropathy judged by abnormalities of their cardiovascular reflexes. The method provides a simple, non-invasive way of quantifying an autonomic reflex and it may be of value in investigating patients with diseases affecting the autonomic nervous system.

Adult↗
PubMed1981

Why palpate the radial artery?

The palpability of the radial-artery wall was assessed before death in 43 patients and compared with the histology of the artery at necropsy. There was no relationship between the degree of palpability and the histological changes of atheroma or of Mönckeberg's sclerosis, or the presence of clinical vascular disease. It is suggested that palpation of the wall of the radial artery provides no useful clinical information.

Aged↗
PubMed1980

A simple low-magnesium diet.

Details are given of a semi-synthetic low-magnesium diet that provides adequate short-term nutrition. The diet is made up of proprietary foodstuffs and is suitable for short-term magnesium deprivation studies in man. After five days on the diet four subjects demonstrated a marked fall in urinary magnesium excretion.

Adult↗
PubMedDate not supplied

Mortality from Parkinson's disease and other causes in men who were prisoners of war in the Far East.

BACKGROUND: During World War II, more than 140000 Allied prisoners of war (POWs) were held captive by the Japanese in conditions of extreme privation. There have been concerns that the survivors are at increased risk of degenerative neurological disorders, especially Parkinson's disease. We assembled a cohort of British ex-POWs and analysed their mortality in a 46-year follow-up study. METHODS: Using records held by the War Pensions Agency, we abstracted data on 11915 British former POWs. 11134 men were traced, and observed numbers of deaths between 1952 and 1997 were compared with those expected from national rates for the male population of England and Wales. Standardised mortality ratios (SMR) were calculated. FINDINGS: Overall, mortality was lower than expected (7474 deaths vs 8796.2 expected; SMR 0.85 [95% CI 0.83-0.87]). Death rates from Parkinson's disease among the former POWs were slightly below the national average, though this difference was not statistically significant (35 deaths vs 43.2 expected; SMR 0.81 [0.56-1.13]). A similar pattern was seen for other degenerative neurological disorders (motorneuron disease 0.62 [0.31-1.11], multiple sclerosis 0.88 [0.42-1.61], and dementia 0.88 [0.68-1.11]). The former POWs had significantly lower than expected mortality from all major causes of death (ischaemic heart disease 0.81 [0.78-0.85], cerebrovascular disease 0.88 [0.81-0.95], all malignant neoplasms 0.92 [0.88-0.95], and respiratory disease 0.79 [0.74-0.85]). They also had below average rates of death from tuberculosis (0.44 [0.26-0.71]) and suicide (0.77 [0.57-1.02]), though the latter relation was not statistically significant. Mortality from diseases of the liver was increased (chronic liver disease and cirrhosis 1.68 [1.28-2.17], primary carcinoma of the liver 2.42 [1.75-3.26]). INTERPRETATION: There is little evidence that men who were POWs in the Far East have higher rates of death than the male population generally. The only exception is diseases of the liver, which may be due to infection with hepatitis B or C virus during captivity. Death-certification data cannot provide a complete picture of physical and mental health, but the period of severe malnutrition, frequent infections, exhaustion, and intense psychological stress seems not to have increased susceptibility to neurodegenerative disease.

Aged↗
PubMedDate not supplied

Two examples of CNS lipomas demonstrated by computed tomography and low field (0.08 T) MR imaging.

The low field (0.08 T) magnetic resonance (MR) findings in two lipomas of the central nervous system (CNS), one adjacent to the corpus callosum, the other in the cervical cord, are described. The characteristic short T1 of fat and the image acquisition in the sagittal plane permit accurate localisation of these lipomas. Low field MR can provide images of diagnostic quality in a number of CNS lesions.

Adult↗
PubMedDate not supplied

The value of cardiovascular autonomic function tests: 10 years experience in diabetes.

Five simple, noninvasive cardiovascular reflex tests have been used to assess autonomic function in one center over the past 10 yr. Seven hundred seventy-four diabetic subjects were tested for diagnostic and research purposes. In 543 subjects completing all five tests, abnormalities of heart rate tests occurred in 40%, while abnormal blood pressure tests occurred in less than 20%. Their results were grouped as normal (39%), early (15%), definite (18%), and severe (22%) involvement. Six percent had an atypical pattern of results. Two hundred thirty-seven diabetic subjects had the tests repeated greater than or equal to 3 mo apart: 26% worsened, 71% were unchanged, and only 3% improved. The worsening followed a sequential pattern with first heart rate and later additional blood pressure abnormalities. Comparison between a single test (heart rate response to deep breathing) and the full battery in 360 subjects showed that one test alone does not distinguish the degree or severity of autonomic damage. These tests provide a useful framework to assess autonomic neuropathy simply, quickly, and noninvasively.

Adolescent↗
PubMedDate not supplied

Effects of sorbinil treatment on erythrocytes and platelets of persons with diabetes.

Thirty-three diabetic subjects were given the aldose reductase inhibitor sorbinil (Pfizer, UK) for 3 wk. There was a significant fall in mean erythrocyte sorbitol concentration over this period. In all subjects erythrocyte sorbitol concentrations after treatment were within or below the range found in normal subjects. No changes in erythrocyte 2,3-diphosphoglycerate (2,3-DPG) or myo-inositol concentrations, plasma beta-thromboglobulin (beta-TG) concentration, or P50--a measure of the oxygen affinity of hemoglobin--were observed. There was a high incidence of adverse reactions to the drug.

Adult↗