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Biomedical subjects

J Wadsworth

Publications and source records attributed to J Wadsworth.

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

Treating hypertensive diabetics: a comparison of verapamil and metoprolol in black and white patients.

Ca2+ antagonists may be particularly effective in "low-renin" patients, including black subjects and diabetics, as metabolically sound antihypertensive therapy. This paper reports a double-blind randomized crossover trial of verapamil SR (to 240 mg b.i.d.) versus metoprolol (to 100 mg b.i.d.) in 20 black and 15 Caucasian non-insulin-dependent patients with entry blood pressures (BP) greater than 160/90 mm Hg. Mean age was 61 +/- 4.8 years; duration of diabetes 5.8 +/- 4.9 years. Each subject took 4 weeks placebo, then two 6 week active phases, with an intervening 2 week washout. Erect (E)/lying (L) BP, weight, and fasting blood were taken at each visit with overnight urine collections. In blacks mean entry BP (L) +/- SD were 165.8 +/- 16/98.7 +/- 11 mm Hg. On verapamil BP (L) fell significantly by -12.6 +/- 16/-6.6 +/- 9.7 mm Hg (p less than 0.01), but there was no overall fall on metoprolol (+1.65 +/- 14.5/-1.3 +/- 9.7 mm Hg). Heart rates fell on both drugs from 76.1 +/- 18.3 to 68.4 +/- 11 and 59.4 +/- 7.6 beats/min, respectively, indicating tablet compliance. In whites, BP fell on both drugs, as did heart rates. Changes in HbA1c, plasma glucose, and renin were statistically insignificant. Change in BP was unrelated to initial renin levels in either blacks or whites. In blacks, mean entry urine Na, K, and Ca were 77.4 +/- 39.3, 20.9 +/- 10, and 2.35 +/- 1.5 mmol/l and in whites 84.1 +/- 42, 22 +/- 17.2, and 3.56 +/- 3.2 mmol/l, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Albuminuria↗
PubMed1986

Three-year prospective study of HTLV-III/LAV infection in homosexual men.

170 symptom-free homosexual men were recruited in London in 1982-83 and 133 were evaluable in 1983-85. Of the 33 who were seropositive to HTLV-III/LAV at entry, 4 (12%) progressed to AIDS, 16 (48%) progressed to persistent generalised lymphadenopathy (PGL), and 13 (40%) remained symptom-free. A further 15 men seroconverted during the study (7% per annum), of whom 8 progressed to PGL. Serial estimations of T lymphocyte subsets showed progressive reduction in T4 numbers in the seropositive groups, but these indices also varied widely in the seronegative group. Counts of T4 and T8 cells or T4/T8 ratio at entry were not of prognostic value. Seronegative subjects were as likely as seropositives to have abnormal immunological tests. Serial measurement of T lymphocyte subsets seems to be of little prognostic or clinical value in the monitoring of populations infected with the HTLV-III/LAV virus. The strongest association with prognosis was an episode of sexually transmitted disease in the six months before entry to the study. This supports the hypothesis that intercurrent infection may be an important co-factor in the acquisition of HTLV-III/LAV infection, and in subsequent disease progression.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Long term respiratory sequelae of whooping cough in a nationally representative sample.

The long term respiratory consequences of whooping cough in childhood were sought among members of the National Survey of Health and Development. Peak expiratory flow rate was measured when the survey members were 36 years old and seven respiratory symptoms were reported at the same time. Peak expiratory flow rate was slightly reduced in those who had had whooping cough as a child, and this difference became non-significant when other factors were taken into account. Unexpectedly, chronic cough was significantly less likely to be reported by those who had had whooping cough, and this difference remained significant only among men after other factors had been taken into account. This study failed to show a long term detrimental effect of whooping cough on the respiratory system.

Adult↗
PubMed1986

Factors affecting seropositivity to human T cell lymphotropic virus type III (HTLV-III) or lymphadenopathy associated virus (LAV) and progression of disease in sexual partners of patients with AIDS.

Fifty four sexual partners of homosexual men with the acquired immune deficiency syndrome (AIDS) were studied, of whom 32 were seropositive and 22 seronegative for human T cell lymphotropic virus type III or lymphadenopathy virus (HTLV-III/LAV) antibody, which showed that repeated exposure by anal intercourse does not necessarily lead to seroconversion. Seropositivity to HTLV-III/LAV was not associated with the absolute number of sexual partners, receptive anal intercourse, or the use of recreational drugs, but was associated with a history of other sexually transmitted diseases (STDs), particularly in the year preceding the patient's initial examination. Acquisition of an STD after the date of last sexual contact with a person with AIDS was strongly associated (p less than 0.001) with the development of persistent generalised lymphadenopathy (PGL). Concurrent or recent STDs would seem to be an important cofactor in developing antibody to HTLV-III/LAV and in the progression of infection from a person being asymptomatic to having PGL.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Study of middle ear disease using tympanometry in general practice.

Tympanometry was used to provide evidence of middle ear effusions in a prospective study of middle ear disease in 264 children aged 3 months to 6 years in general practice. Adequate measurements on both ears were obtained in 220 children, of whom 68 (31%) had evidence of middle ear effusion in one ear (29 children) or both ears (39 children) at entry to the study. In 28 (42%) of the 68 children persistence of the tympanometric findings was recorded for at least three months. Children of European descent were more likely to have evidence of middle ear effusion at the initial examination compared with African and West Indian children, as were those children whose siblings had a positive history of otitis media compared with those whose siblings had no such history. Children under 3 years were more likely to have evidence of an effusion than older children. Middle ear effusion as shown by tympanometry was not associated with a previous history of otitis media in the child but was associated with recent symptoms of respiratory infection or otalgia. A previous consultation for otitis media was, however, strongly associated with a greater likelihood of a consultation for otitis media during the follow up period. Comparing evidence of effusion by tympanometry with that by pneumatic otoscopy showed that using the appearance of the eardrum alone the sensitivity of otoscopy was 55%; the addition of mobility improved the sensitivity to 76% with little reduction in specificity. Further studies on populations using tympanometry are needed to determine the natural history, aetiology, and indications for referring children with middle ear effusion.

Acoustic Impedance Tests↗
PubMed1985

Renal adaptation and gut hormone release during sodium restriction in ileostomized man.

The renal excretion of water, electrolytes, aldosterone and kallikrein was monitored in 12 ileostomized patients before and during sodium deprivation. Changes in plasma renin activity (PRA), plasma aldosterone and plasma arginine vasopressin (AVP) concentrations were measured, together with aldosterone in ileal fluid. The pattern of gut peptide release in response to a test meal was also examined to assess whether a circulating gut peptide might be involved in the renal adaptation to sodium restriction, and compared with healthy normal subjects who were under no dietary constraint. In each patient renal sodium excretion fell within 8-12 h of sodium deprivation and was associated with a prompt and significant rise in PRA; much later increases in plasma aldosterone concentration and renal aldosterone excretion occurred, and were established by day 2 of sodium restriction. No consistent change in renal kallikrein excretion was found. Ileal sodium loss was little changed by sodium deprivation, but ileal potassium concentration rose steadily and became significantly correlated with PRA, and to a lesser extent with renal aldosterone excretion. Of the gut peptides measured in plasma, only the insulin profile was altered by sodium deprivation, with an increase in the test meal response; insulin has previously been shown to have a significant antinatriuretic action at physiological concentrations. Plasma levels of pancreatic polypeptide and motilin were increased in ileostomized patients when compared with normal subjects, but were unaffected by the change to a low sodium diet. An early increase in urine flow and water diuresis occurred during sodium deprivation, following a cyclical pattern with peaks each evening.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1985

The influence of family type on children's behaviour and development at five years.

Development and behaviour at five years were assessed in children from a national cohort; comparisons were drawn between those living in one-parent families, in step-parent families and with both natural parents. On average, children from one-parent families scored worst and children from two-parent families best on tests of behaviour, vocabulary and visuomotor co-ordination. The differences remained significant after allowing for associated influences. The behaviour of children from one-parent families and step-parent families was perceived on average as more 'anti-social' than that of children from two-parent families. Children in one-parent families were seen on average as marginally more 'neurotic' than children in two-parent families.

Child Behavior↗
PubMed1985

Pertussis vaccine and whooping cough as risk factors in acute neurological illness and death in young children.

The National Childhood Encephalopathy Study received reports on 1182 cases of serious acute neurological illnesses in children admitted to hospital in Britain. The frequency of risk factors in cases was compared with matched controls. A personal or family history of convulsions was found significantly more often in cases than in controls, but no such excess was found for a history of allergy. Case children were significantly more likely to have received diphtheria, tetanus and pertussis (DTP) vaccine within seven days before onset and to have a history of whooping cough during the month of onset. The risk of serious acute brain conditions after the disease was more than six times that of three doses of DTP. In addition, there is evidence that deaths attributed to whooping cough may seriously underestimate the number associated with pertussis infection.

Brain Diseases↗
PubMed1984

Changes in the reported prevalence of childhood eczema since the 1939-45 war.

Rates of reported eczema during early childhood were studied in 3 national cohorts of children born in 1946, 1958, and 1970. Overall rates rose from 5.1% in children born in 1946, to 7.3% in those born in 1958, to 12.2% in the 1970 cohort. In the 1958 and 1970 cohorts there was a positive association between eczema and breastfeeding. This relationship remained significant after allowing for parental history of allergy and socioeconomic status. Social classes I and II children born in 1946 were less likely to be reported as having eczema, compared with children from lower social classes, whereas children born into higher social classes in 1958 and 1970 had higher rates. These findings may reflect secular changes in the diagnosis of eczema or may represent a real increase in the disorder. The positive association with breastfeeding in the more recent cohorts suggests a new environmental agent may be crossing in breast-milk. The agent(s) may well be in other infant foods, since the rate of reported eczema in non-breastfed children rose from 5.7% in the 1946 and 1958 cohorts to 11.1% of children born in 1970.

Adolescent↗
PubMed1984

Modification of oral methotrexate absorption in children with leukemia.

The effect of administering oral methotrexate in different formulations to children with acute lymphoblastic leukemia was evaluated. Methotrexate tablets alone achieved higher mean plasma levels and larger area under the absorption curve than either methotrexate liquid alone or methotrexate tablets taken concurrently with metoclopramide.

Absorption↗
PubMed1984

Sexual function and perineal wound healing after intersphincteric excision of the rectum for inflammatory bowel disease.

The technique of intersphincteric excision of the rectum in patients with inflammatory bowel disease was introduced with the aim of avoiding postoperative sexual dysfunction and, combined with primary perineal suture, should decrease morbidity from delayed perineal wound healing. In a series of 98 patients so treated at St. Mark's Hospital, permanent sexual dysfunction from sympathetic nerve damage occurred in one male patient among 23 aged 60 years or less assessed postoperatively. No patient exhibited evidence of permanent parasympathetic nerve damage. Primary healing of the perineal wound was successful in 50 per cent of the cases and in 69 per cent the wound healed within three months of operation. It is suggested that this combination of operative techniques significantly decreases morbidity from rectal excision compared with more extensive procedures and should be more widely adopted.

Adult↗
PubMed1984

Teenage mothering: child development at five years.

Developmental outcome at 5 yr was compared in 1031 singleton children of teenage mothers and 10,950 singleton children of older mothers in a national longitudinal study. Children born to teenage mothers and living with them through the first 5 yr performed less well than other children in tests of vocabulary and behaviour at 5 yr of age; they were also shorter on average and had a smaller head circumference. These differences remained significant after allowing for certain social and biological factors, whereas a difference on visuomotor coordination did not. Teenage mothering thus appears somewhat disadvantageous to children's development.

Adolescent↗
PubMed1984

Breast feeding and child development at five years.

The influence of breast feeding on developmental tests at five years of age was assessed in a national study of 13,135 children. A positive correlation was found between duration of breast feeding and performance in tests of vocabulary and visuomotor co-ordination, behaviour score, and measurements of height and head circumference. The effect on vocabulary and visuomotor co-ordination persisted when allowance was made for intervening social and biological variables, but that on height and head circumference disappeared. The breast-feeding/behaviour score association remained significant but became non-linear after adjustment. Breast feeding had no discernable effect on speech problems during the first five years. It is concluded that breast feeding may have an effect on children's development at five years: the effect is relatively small but resistant to attempts at statistical control.

Body Height↗
PubMed1984

Inquiries into perinatal and early childhood deaths in a health care district.

A controlled study was made of stillbirths and deaths of children under 2 years of age born to families residing within the boundaries of the Exeter District Health Authority between 1 October 1980 and 30 September 1981. The study was concerned primarily with methodology and feasibility; the numbers involved were, with few exceptions, too small to permit significant conclusions to be drawn. In practice, the design and implementation of the project proved to be effective. It is suggested that if adopted as a routine service procedure in each health district, information not currently available may be retrieved. This information has epidemiological importance and will also help to identify local problems.

Confidentiality↗
PubMed1983

Identification of high-risk pregnancy by the routine measurement of pregnancy-specific beta 1-glycoprotein.

A prospective study of 1,040 women who underwent delivery during 1977 at St. Bartholomew's Hospital was undertaken to evaluate the role of measurement of maternal circulating pregnancy-specific beta 1-glycoprotein (SP1) in the detection of high-risk pregnancy. A comparison of the predictive value of this test was also made with a variety of clinical, ultrasonic, and biochemical variables in the detection of high-risk pregnancies. The best antenatal predictors of fetal risk were severe preeclampsia and depressed maternal serum levels of human placental lactogen and SP1. It is suggested that measurement of SP1 may provide valuable information on fetal compromise in late pregnancy.

Female↗
PubMed1983

Peroxide oxidation of primary alcohols to aldehydes by chloroperoxidase catalysis.

Chloroperoxidase catalyzes the peroxidation of primary alcohols, specifically those that are allylic, propargylic, or benzylic. Aldehydes are the products. The reaction displays appreciable activity throughout the entire pH range investigated, namely pH 3.0-7.0. This enzyme is the only haloperoxidase of four tested capable of carrying out the reaction. These results further establish chloroperoxidase as a unique haloperoxidase.

Alcohols↗