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Biomedical subjects

J C Wells

Publications and source records attributed to J C Wells.

70 records · Page 4Linked to original sources
PubMed1989

Outbreak of beri-beri in The Gambia.

In 1988, an outbreak of beri-beri occurred in The Gambia during the rainy season. At least 140 people were affected, and 22 died. A clear response to thiamine was observed in 8 patients who were in hospital, and the outbreak resolved after distribution of thiamine in the community. Gradual replacement of traditional cereals with imported milled rice may have increased susceptibility to beri-beri.

Adolescent↗
PubMed1989

Coeliac plexus block and cephalic spread of injectate.

Extensive cephalic spread of solution occurred in three out of seven cases studied during coeliac plexus blockade. Spread on to cardiac nerves and plexus may be a factor in hypotension following this procedure. Incremental dosage and careful screening is recommended.

Autonomic Nerve Block↗
PubMed1988

Does acute hyperglycaemia influence heat pain thresholds?

The influence of acute hyperglycaemia on pain sensation was assessed in eight young adult non-diabetic subjects. Acute hyperglycaemia was induced with IV glucose in a double blind fashion, with IV saline as a control. Pain thresholds were assessed by a painful heat stimulus delivered by a Marstock thermode on the thenar eminence. Heat pain thresholds did not significantly alter during either acute hyperglycaemia or the control saline infusion. Previous work demonstrating a lowering of electrical pain thresholds by hyperglycaemia has therefore not been confirmed using a natural painful stimulus.

Adolescent↗
PubMed1987

The place of the pain clinic.

Chronic pain is a debilitating and degrading condition. Its aetiology is largely multifactorial, and only proper appreciation of the various factors which can combine to produce the patient's misery will allow appropriate therapies. If the mechanisms of chronic pain were better taught and the therapies available were better used by medical practitioners, then the standard of alleviation of pain would increase greatly. There is an urgent need for greatly improved facilities for treating chronic pain by multidisciplinary groups in specialized clinics, a fact which has been realized for over 30 years. However, in spite of this there is a great delay in the setting up of such units. There is also an urgent need for proper training of doctors in pain relief, and a need for a much larger amount of money to be spent on research into the causes and treatment of human pain. It is disturbing to me that so much money goes on research into possible cures of malignant disease in the future, which is all very well, but which does not help the sufferer from severe pain at the present time; whereas these poor unfortunates, dying with their misery unassuaged, must suffer unnecessarily because of lack of information amongst physicians, and lack of proper facilities for treatment. Likewise, our own unit and many others have extremely long waiting lists, making even more difficult the treatment of an already complex problem. In spite of this, more than 50% of patients who attend multidisciplinary pain clinics obtain long-term benefit from their therapy. The fact that facilities do not exist for many sufferers is not only disgraceful, but also very expensive both from social security payments and from inappropriate use of health care facilities as these patients wander from clinic to clinic in search of a cure which is not available. Chronic pain should be recognized for what it is--a severe and debilitating condition--and proper steps should be taken to provide the treatment within the health service for its alleviation.

Humans↗
PubMed1987

Natural history of herpes zoster ophthalmicus: predictors of postherpetic neuralgia and ocular involvement.

Seventy-one patients presenting with acute herpes zoster ophthalmicus were followed up for six months for a prospective analysis of the natural history of the disease. Acute and chronic ocular complications, nasociliary nerve involvement, age, sex, rash, and pain were assessed, and the results are presented. Acute pain was measured by a visual analogue scale. Postherpetic neuralgia (PHN) was more likely in patients over 80 and in those who scored their pain highly at presentation. Duration of rash was longer in patients who developed PHN. No other associations between the parameters studied were found. Nasociliary nerve involvement was associated with subsequent ocular disease.

Adult↗
PubMed1986

The effects of continuous intravenous naloxone on epidural morphine analgesia.

Forty-five patients undergoing Caesarean section under epidural anesthesia with bupivacaine were randomly allocated to three groups. Group 1 received 4 mg of epidural morphine immediately postoperatively and 2 mg naloxone by intravenous infusion for 12 hours postoperatively; group 2 was treated as group 1 but without naloxone infusion; group 3 received 10 mg morphine intramuscularly and 20 ml epidural saline after delivery of the baby. Epidural morphine 4 mg produced better postoperative analgesia than 10 mg of morphine intramuscularly (p less than 0.001) and the intravenous infusion of naloxone did not ablate the analgesic effects of epidural morphine. The incidence of itching and vomiting was higher in the epidural opioid groups (p less than 0.05) and intravenous naloxone, although it reduced the severity of the itching, did not reduce its overall incidence. Respiratory depression was not detected in any of the three groups.

Adolescent↗
PubMed1985

Percutaneous cervical cordotomy: results and complications in a recent series of 100 patients.

One hundred and twenty-two percutaneous cervical cordotomies were performed in 100 patients. Of these, 95 suffered from pain associated with malignant disease. Complete pain relief was achieved in 64% of patients, partial relief in 23% and no relief in 13%. Mortality was 6% and exclusively related to postoperative respiratory dysfunction. The results and complications observed in this recent series are discussed in relation to our previous and other authors' experience. For selected patients with cancer pain, percutaneous cordotomy is the most effective operative method available at the present time.

Adult↗
PubMedDate not supplied

Physical activity at 9-12 months and fatness at 2 years of age.

Previous research has shown that physical activity in early infancy does not predict later fatness, whereas in preschool children, such a relationship is found. The objective of this study was to investigate whether total energy expenditure (TEE) and behavior in late infancy are related to subcutaneous and total fatness in early childhood. Twenty-six infants were studied at 9-12 months and followed up at 2 years of age. Anthropometry, body composition, TEE, and behavior were measured in late infancy; skinfold thicknesses and total body fat were measured at 2 years of age. Infant TEE adjusted for fat-free mass was not related to later fatness. Infant behavior was related to later subcutaneous fatness, but not to total body fatness. Lower levels of infant activity were associated with greater skinfold thicknesses in childhood. Thus, by late infancy, physical activity level is related to subsequent skinfold thickness. Particular aspects of infant behavior appear to be more important than the sum of energy expended on activity. However, the relationship did not extend to total body fat.

Adipose Tissue↗
PubMedDate not supplied

Diet and behavioural activity in 12-week-old infants.

Deposition of excess dietary energy occurs if energy intake exceeds expenditure. Anthropometric differences between breast-fed and formula-fed infants due to differences in energy deposition are frequently reported. It has been suggested that infant obesity may result from decreased levels of energy expenditure on physical activity. Infant diet may therefore influence energy balance by affecting behaviour and hence energy expenditure. Behavioural and motor activity of 25 formula-fed and 25 breast-fed infants were compared using activity diaries, temperament questionnaires and actometers. There were no anthropometric differences between the two groups. The breast-fed infants fed significantly more slowly than the formula-fed infants despite taking in similar milk volumes, and also fed significantly more frequently. Otherwise there were no significant differences between the two groups with respect to the daily time spent awake and content, asleep, fussy, or crying, nor with respect to gross motor activity and temperament. It is unlikely that energy balance of the two groups differed significantly on account of behavioural activity.

Anthropometry↗