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Biomedical subjects

D Bates

Publications and source records attributed to D Bates.

At least 19 recordsLinked to original sources
PubMed1992

Effect of the risk factors for stroke on survival.

In a case-controlled study into the risk factors for admission to hospital with stroke, 400 subjects and 400 age and sex-matched controls were recruited. All bar two subjects were followed until death or 6 months. Previous stroke and regular snoring (p = 0.0013 and p less than 0.0001 respectively) were the only two risk factors adversely to effect mortality. Transient ischaemic attack, ischaemic heart disease, hypertension, atrial fibrillation, diabetes mellitus did not significantly effect prognosis. An apparent beneficial effect of drinking alcohol and smoking became insignificant when the confounding influence of age was taken into account.

Cerebrovascular Disorders↗
PubMed1992

Is bed rest useful after diagnostic lumbar puncture?

A randomized study of 110 patients undergoing their first diagnostic lumbar puncture was performed to compare the effect of immediate mobilization with 4 hours bed rest on the incidence of post lumbar puncture headache. There was no difference between the mobile (n = 54) and bed rest (n = 56) groups in the incidence of post lumbar puncture headache (32% versus 31%, respectively). We conclude that bed rest following lumbar puncture may be an unnecessary imposition on the patient, as well as on nursing staff.

Adult↗
PubMed1992

Adult-onset motor neuron disease and infantile Werdnig-Hoffmann disease (spinal muscular atrophy type 1) in the same family.

We describe a family in which infantile Werdnig-Hoffmann disease and adult-onset progressive muscular atrophy both occurred. The possibility of these two diseases developing within the same family by chance is unlikely, and several genetic hypotheses may be put forward to explain the association. We suggest that the molecular pathogenesis of these two subtypes of lower motor neuron degeneration may be linked. The genetic defect in the childhood spinal muscular atrophies has been mapped to chromosome 5q in close proximity to the microtubule-associated protein 1B locus. The association of diseases within this family suggests that chromosome 5q should also be studied in relation to adult-onset familial motor neuron disease.

Aged↗
PubMed1992

Snoring increases the risk of stroke and adversely affects prognosis.

In a case-controlled study we recruited 400 patients admitted to hospital with stroke and 400 community controls matched for age, gender and family practitioner. Snoring history was obtained from 326 patients and 345 controls. Odds ratio for admission to hospital with stroke was 3.2 (95 per cent confidence intervals 2.3-4.4) for regular snorers against those who did not snore regularly. This risk was independent for age, gender and other risk factors for stroke. Snoring did not increase the chances of stroke during sleep. Level of consciousness was reduced more frequently in snorers (p = 0.0003). As the frequency of snoring increased so did the mortality to 6 months (p = 0.0006). Snoring is an important risk factor for stroke and adversely affects the prognosis in patients admitted to hospital with stroke.

Adult↗
PubMed1991

Encephalomyelitis with seroconversion to Listeria monocytogenes.

A previously healthy girl recovered from a lymphocytic encephalomyelitis with brain stem involvement after antibiotic and steroid treatment. Cultures of blood and cerebrospinal fluid were negative, but she seroconverted to Listeria monocytogenes serotype 4. Antilisterial treatment should be considered in similar cases.

Brain Stem↗
PubMed1991

Imaging modalities for evaluation of the spine.

The spine can be evaluated by a number of different imaging modalities. Although magnetic resonance imaging has assumed the dominant role in the diagnosis of spinal disease, the individual clinical situation still determines the procedure of choice. This review discusses the different imaging techniques and their currently accepted indications.

Angiography↗
PubMed1990

Motor recovery following acute stroke.

There is little information available from which normal patterns of recovery from acute stroke can be ascertained. Most attention has been directed towards functional recovery in stroke patients but the neurological basis on which this occurs needs to be documented in a large cohort of patients. One hundred and fifty-seven patients admitted to hospital with a clinical diagnosis of acute stroke were examined daily for up to 28 days to determine the patterns of recovery of limb tone, power and reflexes. Changes in these variables during the first 28 days after stroke are described.

Adult↗
PubMed1990

Historical risk factors for stroke: a case control study.

The aim of this study was to determine the risk factors for admission to hospital with stroke by means of a case-control study recruiting age- and sex-matched controls from the local community. Four hundred pairs of patients and controls were recruited. Of historical factors, preceding cerebrovascular disease contributed the greatest odds of stroke (odds ratio 9.8). Taking prescribed medicines (odds ratio 2.6), regular snoring (odds ratio 3.2), smoking (odds ratio 1.7) and some factors in the family history were also significant risk factors.

Adult↗
PubMed1990

A randomized double-blind controlled trial of naftidrofuryl in acute stroke.

There is evidence to support the use of naftidrofuryl in acute stroke with claims of increased recovery, reduced fatality and reduced bed occupancy in patients treated with either oral or intravenous preparations. One hundred patients presenting with acute hemisphere stroke (less than 72 hours) were randomized to receive either a new oral formulation of naftidrofuryl or placebo on a double-blind basis. Treatment was given for a total of 12 weeks and patients followed for 26 weeks with serial neurological and functional assessments by a single observer. Cumulative fatality and hospital-bed occupancy were determined at each assessment interval. No significant difference was demonstrated in cumulative fatality, hospital-bed occupancy or recovery of motor function in patients treated with either naftidrofuryl or placebo. There is no evidence from this study to support the use of oral naftidrofuryl in acute stroke.

Acute Disease↗
PubMed1990

Red blood cell and adipose tissue fatty acids in mild inactive multiple sclerosis.

The fatty acid profiles of phosphatidyl ethanolamine (PE) and phosphatidyl choline (PC) of the red blood cells of 30 patients with mild inactive multiple sclerosis (MS) and 30 healthy controls were studied by gas chromatography. The groups were well matched for factors likely to influence tissue lipid levels, including diet. The MS patients showed a significant reduction in PE eicosapentaenoic acid (p = 0.009) especially in women, and an increase in both PE dihomo-gamma-linolenic acid (p = 0.004) and PC stearic acid (p = 0.04). No reduction in linoleic acid was observed in either the PC or PE fractions of the MS subjects. A similar study of the fatty acid profile in adipose tissue in 26 MS and 35 healthy controls found no detectable eicosapentaenoic acid in either group. However, whereas docosahexaenoic acid was not detectable in any MS patient, 40% of the controls had measurable levels varying from to 0.1 to 0.3% of total estimated fatty acid (p = 0.0003). No reduction in linoleic acid in MS subjects was observed. Supplementation with oral fish body oil demonstrated that n-3 fatty acids were incorporated into red blood cells over 5 weeks and this occurred equally in MS and controls. The effects of oral supplementation on adipose tissue were studied after 1 and 2 years. Whereas many fatty acids such as linoleic acid were raised at 1 year, but did not rise subsequently, eicosapentaenoic acid and docosahexaenoic acid continued to rise through the 2-year period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1990

Cauda equina syndrome associated with multiple lumbar arachnoid cysts in ankylosing spondylitis: improvement following surgical therapy.

A case of cauda equina syndrome with multiple lumbar arachnoid cysts complicating ankylosing spondylitis (AS) is described. The value of computerised tomography (CT) and magnetic resonance imaging (MRI) as a non-invasive means of establishing the diagnosis is emphasised. In contrast to previously reported cases the patient showed neurological improvement following surgical therapy. Surgery may be indicated in some patients, particularly when there is nerve root compression by the arachnoid cysts and when the patient is seen early before irreversible damage to the cauda equina has occurred.

Aged↗
PubMed1990

Dietary lipids and multiple sclerosis.

The epidemiological and biochemical evidence supporting a role of dietary lipids in Multiple Sclerosis is reviewed. The published controlled trials of omega six Polyunsaturated Fatty Acids including 172 patients with Acute Remitting Multiple Sclerosis are discussed and the results of recent study with omega three Polyunsaturated Fatty Acids in a Double Blind controlled study involving 312 patients are presented. It appears that there is a trend suggesting that the addition of omega six and omega three Polyunsaturated Fatty Acids to the diet of patients with Multiple Sclerosis results in a reduction of the severity and frequency of relapses and in a mild overall benefit in a two year period.

Dietary Fats, Unsaturated↗
PubMed1989

Recovery of visual fields in acute stroke: homonymous hemianopia associated with adverse prognosis.

In a prospective study of 157 patients (median age 73 years) admitted to hospital within 72 hours of acute cerebral hemisphere stroke, there was clinical evidence of homonymous hemianopia (HH) as assessed by confrontation in 99 (63%). Patients were followed with serial neurological examinations for 28 days. Complete recovery of visual fields occurred in 14 (17%) of the 81 patients with a complete HH on admission and in 13 (72%) of the 18 patients with a partial HH on admission. Cumulative fatality at 28 days was greater in patients with a complete HH (49%), compared with patients with a partial HH (11%). These two patterns of recovery and outcome probably reflect the differing extent of cerebral damage in the two groups.

Acute Disease↗
PubMed1989

PHA-induced interferon in multiple sclerosis: association between gamma interferon and clinical and genetical variables.

Gamma interferon (INF-gamma) production, after PHA stimulation of peripheral blood mononuclear cells, from multiple sclerosis (MS) patients with the acute remitting and chronic progressive forms, in attack and remission phases, and from normal controls, was studied by immunoradiometric assay. MS patients in all these 4 clinical states of disease produced less INF-gamma (log value range from 2.55 to 2.65). MNC from the total MS patients produced significantly low levels of INF-gamma compared to the control group (log values 2.60 vs. 2.82; P = 0.001). No association between the interferon production and antigens at any HLA locus (A, B, C, Dw and Bf) was found. There was no correlation between IFN-gamma production and age, sex, duration of disease, or disability index. However there was a slight tendency to negative correlation with the progression index of the disease. The results suggest that this lower IFN-gamma production in MS may be secondary to the disease, and the primary defect may be a severe reduction of the essential lymphocyte populations required for an effective lymphokine cascade to produce the normal immune response against infection.

Adult↗
PubMed1989

A double-blind controlled trial of long chain n-3 polyunsaturated fatty acids in the treatment of multiple sclerosis.

A trial of n-3 polyunsaturated fatty acids in the treatment of multiple sclerosis has been conducted over a 5 year period. Ambulant patients (312) with acute remitting disease were randomly allocated to treatment or placebo. Both groups were given dietary advice to increase the intake of n-6 polyunsaturated fatty acids and the treatment group in addition received capsules containing n-3 polyunsaturated fatty acids. Analysis of clinical outcome at the end of 2 years of treatment was made in terms of the duration, frequency and severity of relapses and the number of patients who had improved or remained unchanged. The results showed no significant difference at the usual 95% confidence limits but there was a trend in favour of the group treated with n-3 polyunsaturated fatty acids in all parameters examined.

Adipose Tissue↗