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Biomedical subjects

D Bates

Publications and source records attributed to D Bates.

At least 91 records · Page 5Linked to original sources
PubMed1986

Early intellectual dysfunction following coronary bypass surgery.

As part of a major prospective study of neurological and psychological complications of coronary artery bypass graft surgery, involving 312 patients, detailed psychometric testing was carried out before and after operation on 298 patients using a battery of 10 standard tests of intellectual function. This report is concerned with the early neuropsychological dysfunction detectable one week after operation. Two hundred and thirty-five patients (79 per cent of the cohort) showed impairment in some aspect of cognitive function at the seventh day after operation. Only 63 patients (21 per cent) showed no deterioration from levels before operation in any of the 10 test scores. One hundred and twenty-three of the patients whose scores deteriorated had no symptoms while in hospital. Eighty-nine patients complained of cognitive impairment, and 23 patients were considered to be overtly disabled by their intellectual dysfunction, during the period soon after operation. There is therefore a high incidence of early cerebral dysfunction detectable by psychometric testing following coronary artery bypass graft surgery. Often this was not of sufficient severity to cause serious concern to the patients or to interfere with their everyday activities in the hospital environment.

Adult↗
PubMed1985

Early neurological complications of coronary artery bypass surgery.

A prospective study of 312 patients undergoing elective coronary artery bypass surgery was undertaken to determine the incidence, severity, and functional impact of postoperative neurological complications. Detailed evaluation of the patients showed that neurological complications after surgery were common, occurring in 191 of the 312 patients (61%). Although such a high proportion of the total developed detectable changes, serious neurological morbidity was rare. Neurological disorders resulted in death in only one patient (0.3%) and severe disability in only four (1.3%). Forty eight patients were mildly disabled during the early postoperative period, and the remaining 138 with neurological signs had no serious functional disability. The postoperative neurological disorders detected included one death from cerebral hypoxic damage. Prolonged depression of conscious level was observed in 10 patients (3%) and definite stroke in 15 (5%); 78 (25%) developed ophthalmological abnormalities and 123 (39%) primitive reflexes; postoperative psychosis was observed in four (1%); and 37 (12%) developed disorders of the peripheral nervous system. The incidence of serious neurological problems such as fatal cerebral damage, stroke, and brachial plexopathy is in accordance with experience elsewhere. Lesser abnormalities, whose detection required detailed neurological examination, were much commoner than expected from previous reports.

Adult↗
PubMed1985

Hyperbaric oxygen and multiple sclerosis: short-term results of a placebo-controlled, double-blind trial.

In a study of 120 patients with chronic multiple sclerosis the effects of treatment with 100% oxygen at 2 atmospheres absolute for 90 min daily for a total of 20 exposures were compared with those of normal air at normal pressure for a similar length of time within the same compression chamber. No patient in either group showed any improvement on the Kurtzke disability status scale. 12 of 51 patients in the hyperbaric-oxygen group and 3 of 47 control patients improved on the Kurtzke functional systems scale on the subjective bowel/bladder parameter only. Such a degree of improvement can also be achieved with medication for urinary symptoms, but none of the patients in this study received such medication. The short-term results of this trial do not support the claims made for hyperbaric oxygen in the management of multiple sclerosis.

Adolescent↗
PubMed1985

Predicting recovery from medical coma.

Advances in resuscitation create the risk that patients may be saved with a brain so damaged that they can never recover cognition. It is imperative that those who provide intensive care facilities determine the prognosis of such patients at a relatively early stage. This review suggests ways in which such predictions may be derived for patients in medical coma.

Coma↗
PubMed1984

Carotid endarterectomy in patients with transient cerebral ischaemia.

A randomised controlled trial of endarterectomy in patients with carotid artery disease showed that operation significantly reduced the frequency of transient ischaemic attacks (TIA) in the relevant vascular territory. Because of the high post-operative morbidity in the surgical group, the trial was abandoned before conclusions could be drawn as to the influence of endarterectomy on long-term survival or on the incidence of subsequent strokes.

Aged↗
PubMed1984

Use of the mental function index in older adults. Reliability, validity, and measurement of change over time.

The Mental Function Index is a weighted combination of scores on three brief tests. The Index was developed to aid in the discrimination of elderly persons with early cases of senile dementia from nondemented elderly individuals. In a previous report (Am J Epidemiol 1981;114:515-27), the authors described preliminary results with the Index in 195 elderly persons in a southern California retirement community. The present study seeks to assess whether similar results can be achieved in samples other than that from which the discriminant function defining the Index was derived. Seven separate studies were done on a total of 210 persons, comprising subjects recruited from a teaching hospital which serves a predominantly lower to lower-middle class population, referrals from the same physicians as in the earlier study, and (for the reliability sample) persons from the upper-middle class community which was the major referral source. It was found that scores on the brief measures correlate 0.86 with those on the three Halstead-Reitan subtests most sensitive to brain damage and to aging. The Index provides a graded measure of disease severity comparable to global neurologic assessment (r = -0.84) and level of social function (r = 0.76). Entry Index is a crude predictor of cognitive status in older adults after several years. Changes in the Index over time parallel those in independent measures of change. The results suggest that the Index will be useful for assessment of disease severity and of longitudinal change, as well as for diagnostic screening, in population studies of senile dementia.

Aged↗
PubMed1984

Multiple sclerosis, HLA, and lymphocyte surface markers.

The frequencies of lymphocytes of different types in the blood of 96 multiple sclerosis patients in different phases of the disease were examined by rosetting, in relation to the HLA antigens present. In the total series of patients, there is a significant deficit of A2, and this is also suggested in the active and progressive cases, but there is no evidence of association of particular HLA haplotypes with the different phases of the disease. There was little variation among the patient categories in the frequency of T cells of different types, but patients in relapse showed a higher proportion of cells showing surface IgG. In general, there is little association of cell surface markers with HLA type, but when B8 is present there appear to be fewer E and EAC rosettes in patients in exacerbation, fewer E and IgG surface markers in remission, and more of the IgG markers in progression.

Antigens, Surface↗
PubMed1984

Conservative treatment of delayed cerebral radiation necrosis.

A 63-year-old man developed delayed cerebral radiation necrosis following radiotherapy to a nasopharyngeal carcinoma. Complete resolution of his neurological deficit resulted from corticosteroid therapy alone. Serial CT scans showed the disappearance of the patients' mass lesion. The literature on cerebral necrosis following radiotherapy of extracranial neoplasms is reviewed with particular emphasis on management.

Brain↗
PubMed1984

Spinal cord compression by extramedullary haematopoiesis in myelofibrosis.

A 50-year-old man with a 20-year history of myelofibrosis developed mild impairment of dorsal column sensation and ataxia of gait. A myelogram and subsequent peroperative biopsy demonstrated spinal cord compression due to extramedullary haematopoiesis. There was an excellent clinical response to surgery and radiotherapy. The characteristic clinical features and the pathogenesis of this unusual complication of myelofibrosis and extramedullary haematopoiesis are discussed.

Hematopoiesis↗
PubMed1984

Linoleic acid and multiple sclerosis: a reanalysis of three double-blind trials.

Data from three double-blind trials of linoleic acid in the treatment of multiple sclerosis (MS) were reanalyzed to examine whether inconsistency in the results was due to a relationship between patient characteristics and treatment response. The combined data consisted of neurologic assessments over 2 1/2-year trials for 87 treated patients and 85 control patients. Treated patients with minimal or no disability at entry had a smaller increase in disability than did controls (p less than 0.05). In addition, treatment reduced the severity and duration of relapses at all levels of disability and duration of illness at entry to the trials.

Clinical Trials as Topic↗
PubMed1982

The genetic contribution to multiple sclerosis. Evidence from North-East England.

A study of 206 patients with multiple sclerosis in the north-east of England and their families shows no evidence of monogenic involvement in the disorder. Much more likely is a multifactorial etiology in which the genetic component is polygenic. On this model the heritability is calculated at 52.1% or 40.9% if age variation in incidence is allowed for. The genetic component is present but no more then moderate in extent.

Adult↗
PubMed1982

Polymyalgia rheumatica with diffuse cerebral disease responding rapidly to steroid therapy.

A 58-year-old woman presented with the classical features of polymyalgia rheumatica. She also had a global dementia; CT scan and EEG showed diffuse cerebral disease. After steroid treatment, the polymyalgia rheumatica and dementia rapidly resolved and the CT scan and EEG became normal. The inter-relationships of the giant cell arteritides are discussed in the light of this report of the association of polymyalgia rheumatica and steroid-responsive diffuse cerebral disease.

Aged↗