Pentoxifylline for prevention of transient ischaemic attacks.
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Biomedical subjects
Publications and source records attributed to F C Rose.
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The study aimed at determining the main factors responsible for the speech and communication problems in motor neurone disease to try to assess the suitability of commercially available aids. Sixteen patients suffering from motor neurone disease with communication problems had their speech assessed by using the Frenchay dysarthria assessment. It was found essential to offer a choice of aids to the patient since suitability of a particular aid could not be evaluated without the patient practising with it.
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During severe exercise or noradrenaline infusion in healthy male volunteers, the platelet count first rose and then fell. Platelet monoamine oxidase activity per unit protein rose and fell in parallel and the correlation with the platelet count was highly significant (P less than 0.001). The increase in observed specific monoamine oxidase activity might be due to the release of a population of platelets with higher specific activity, and the decrease to their selective removal.
The frequency distribution of deaths from cerebrovascular disease in England and Wales in 1975 by month of occurrence is described. The distribution is compared with that for related diseases, in particular ischaemic heart disease, hypertensive disease, pneumonia and bronchitis. The principal feature in all these diseases is high mortality in winter and spring and low mortality in late summer, but the range of variation is wider for pneumonia and bronchitis. The seasonal distribution of cerebrovascular disease death is similar in both sexes, all ages at death and for deaths at home and deaths in a hospital or institution. For both sexes the proportion of cerebrovascular disease deaths occurring at home increases significantly with age at death. Four hypotheses are examined to explain this characteristic seasonal mortality pattern, which is related inversely to ambient temperature, and similar to the seasonal pattern of the incidence and prevalence of cerebrovascular disease.
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Incidence rates for cerebrovascular disease reported by community-based and hospital-based studies during the past 15 years are analysed. The range of variation between area is wide, with Japan and Finland experiencing the highest age-adjusted rates. Of 16 studies reporting incidence rates by sex, 15 showed a male excess, and nine of these were significant when the incidence rate was age-adjusted. Overall, the excess is about 30% for both community-bases and hospital-based studies. For cerebral infarction the excess is about 45%. Intracerebral haemorrhage shows little difference between the two sexes and subarachnoid haemorrhage shows a male deficit of about 50%. These findings are self-consistent.
Visual evoked responses were obtained in 47 Parkinsonian patients and 26 age-matched controls. The stimulation to binocular and uniocular latency of the major positive peak was longer in the Parkinsonian patients and its amplitude was smaller than in the control subjects. There was a large interocular difference suggesting that at least part of the delay occurs at prechiasmatic level. The latency and amplitude varied markedly following ingestion of levodopa as Sinemet. Auditory evoked potentials were obtained in 16 Parkinsonian patients and 11 age-matched controls. The latency of the NV wave was prolonged in the former although the amplitude was the same, suggesting that the abnormality may be a widespread one.
Mean platelet monoamine oxidase activity was reduced compared with control values in groups of headache-free male (but not female) patients suffering from classical migraine and from tension headache. Mean activity in male cluster patients, headache free, both during acute and quiescent phases of their illness, was also notably reduced. Retesting some migraine subjects after up to four years, showed that low activity may be a persistent feature: the correlation coefficient for repeated assays was 0.91 (p less than 0.01). There was no relationship between platelet monoamine oxidase activity and history of dietary migraine. A subgroup of headache patients with permanently low monoamine oxidase activity values may have been defined.
Patients with classical migraine whose auras included paraesthesiae or numbness in the hands have been reviewed. In 55 of 111 patients the symptoms were on the same side of the body as the headache and in only 20 on the opposite side to the headache. In the remaining 36 patients one or other was incompletely lateralised. Five right handed patients described dysphasia at the same time as paraesthesiae in the their non-dominant hand. These findings are incompatible with the notion that the headache is due to reactive hyperaemia following localised cerebral ischaemia, and it is suggested that the ischaemic and hyperaemic processes are both the result of some more generalised vasomotor disturbance.
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