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Biomedical subjects

L J Findley

Publications and source records attributed to L J Findley.

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

Variability in amplitude of untreated essential tremor.

Tremor amplitude was monitored in untreated patients with essential tremor by a procedure designed to minimise fluctuations due to factors known to influence tremor. Tremor was measured hourly for 6 hours in 14 patients and on five to seven occasions (separated by at least a week) in 22 patients. A wide range of within-patient variability was found, with some patients showing little and others showing considerable fluctuations in amplitude over the series of recordings. There was no simple relationship between variability and mean amplitude, frequency, age, duration of tremor or response to a single oral dose of propranolol. Variability did not differ between males and females or between patients with and without a family history of tremor. Diurnal fluctuations showed no consistent pattern. Long-term assessment revealed a significant trend towards lower amplitudes on successive occasions. To overcome systematic bias in data collection, clinical trials in essential tremor should employ large numbers of patients and rigorous randomisation of treatments in cross-over designs.

Adolescent↗
PubMed1987

Changes in breathing and the pharynx after weight loss in obstructive sleep apnea.

The effect of weight loss following dietary restriction on disordered breathing on the pharyngeal airway is controversial in patients with obstructive sleep apnea (OSA). We therefore prospectively studied eight patients before and after dietary-induced weight loss. Mean weight loss was 20.6 kg +/- 12.8 SD. After weight loss there were significant improvements in PO2 and PCO2 measured during wakefulness, and in the number of desaturation episodes per hour of sleep, average desaturation per episode, and number of movement arousals. The number of apneas and hypopneas significantly decreased in six of eight patients. There was a significant correlation between body mass index and number of disordered breathing events. Nasopharyngeal collapsibility and pulse flow resistance decreased in awake patients after weight loss. We conclude that moderate weight loss in obese patients with OSA improves oxygenation during both sleep and wakefulness, decreases the number of disordered breathing events in many patients, decreases the collapsibility of the nasopharyngeal airway.

Adult↗
PubMed1986

Attitudes to the administrative management of service patients with epilepsy and related disorders among army physicians.

The case histories of ten patients suffering from epilepsy or related disorders were sent to all serving Consultant Physicians and Senior Specialists in Medicine in the Army. They were asked their opinions on the PULHEEMS Grading and restriction of duty in each case. In many cases there was a wide range of opinion on the management. Clearer guidelines concerning the diagnosis and administrative management of patients need to be drawn up to allow Service physicians to be consistent and fair to their patients.

Adolescent↗
PubMed1986

PET before and after surgery for tumor-induced parkinsonism.

We studied a patient with left frontal meningioma and right-sided parkinsonism that resolved completely after operation. PET scans were performed before and after operation to measure regional cerebral blood flow, oxygen extraction ratio, oxygen utilization, and blood volume. A specific pattern of severe functional changes returned to normal postoperatively. The data suggest increased local tissue pressure due to edema, causing a functional disorder in the left basal ganglia that gave rise to reversible contralateral parkinsonism.

Blood Volume↗
PubMed1986

Cognitive impairment in patients with obstructive sleep apnea and associated hypoxemia.

Twenty-six patients with sleep apnea had neuropsychologic testing prior to nocturnal sleep study in a sleep disorders clinic. The cognitive functioning of patients who had sleep apnea with associated hypoxemia was compared to nonhypoxemic patients with sleep apnea. The patients who had sleep apnea with hypoxemia had more severe cognitive impairment than those with sleep apnea without hypoxemia. The hypoxemic patients with sleep apnea had significantly poorer cognitive functioning on four of eight tests (p less than 0.05). In addition, the patients who had sleep apnea with hypoxemia had mean performance scores in the impaired range on measures of attention, concentration, complex problem-solving, and short-term recall of verbal and spatial information. In contrast, the patients who had sleep apnea without hypoxemia had no mean performance score in the impaired range. The degree of hypoxemia during sleep and wakefulness significantly correlated with the degree of overall cognitive impairment as rated by a neuropsychologist; however, measures of sleep fragmentation did not significantly correlate with overall cognitive impairment in patients with sleep apnea. We conclude that patients who have sleep apnea with associated hypoxemia have cognitive impairment which is more severe than those with sleep apnea without hypoxemia.

Cognition Disorders↗
PubMed1986

Essential tremor.

Essential tremor is a common disorder whose aetiology is unknown. Characteristically it is present on maintaining posture, absent at rest, and not made significantly worse with movement.

Diagnosis, Differential↗
PubMed1985

Cheyne-Stokes breathing during sleep in patients with left ventricular heart failure.

Fifteen patients with left ventricular heart failure (LVF) without known breathing disorders during sleep had full-night recordings of sleep and breathing to study the incidence and impact of the apnea of Cheyne-Stokes breathing. This group showed a marked degree of sleep-related breathing abnormalities, 40% demonstrating Cheyne-Stokes breathing with five or more central apneas per hour of sleep. Cheyne-Stokes breathing during sleep in patients with LVF predicted an increased short-term mortality rate. All six patients with LVF and Cheyne-Stokes breathing with more than five apneas per hour of sleep were dead within six months, while only three of nine patients without recurrent apnea died within six months, a significant difference (P less than .05) even in this small group. Among seven patients with LVF studied with the polysomnogram, there were statistically significant differences between the Cheyne-Stokes and non-apnea groups in total sleep time, awakening per hour, and the number of arterial desaturations. Although sleep disturbances have been anecdotally described in patients with LVF, no previous investigation has determined the incidence and impact of Cheyne-Stokes breathing during sleep in LVF. Our findings that Cheyne-Stokes breathing predicts an adverse short-term mortality rate confirm the clinical impression that Cheyne-Stokes breathing is a poor prognostic sign in LVF.

Adult↗
PubMed1985

Primidone in essential tremor of the hands and head: a double blind controlled clinical study.

Uncontrolled clinical studies have suggested that primidone may be effective in reducing essential tremor thus providing a valuable alternative to beta-adrenoreceptor antagonists which are currently the drugs of first choice. A double blind, placebo controlled trial of primidone in essential tremor of the hands and head was carried out using both clinical and objective methods of assessment. Primidone was significantly superior to placebo in reducing the magnitude of hand tremor, its efficacy being comparable to that of propranolol. In two patients tremor was reduced to non-symptomatic levels, an effect rarely seen with propranolol. No consistent attenuation of head tremor was found. There was no correlation between serum primidone or derived phenobarbitone concentrations and the reduction of hand tremor. An acute toxic reaction to an initial small dose (62.5 mg) of primidone was seen in six of 22 patients.

Adolescent↗
PubMed1985

Changes in heart rate during breathing interrupted by recurrent apneas in humans.

Heart rate varies with breathing patterns, especially in sleep apnea. To assess the effects on heart rate of recurrent apneas interrupting tidal breathing, we studied five normal awake male subjects. These subjects voluntarily changed their breathing pattern from regular tidal breathing to tidal breathing interrupted by breath holding at end expiration. This recurrent apneic breathing pattern did not change mean heart rate but increased its variance significantly. In addition, the variations in heart rate formed a cyclic pattern of oscillation with a mean cycle length identical to both arterial O2 saturation (SaO2) (R = 0.95; P less than 0.01) and ventilation (R = 0.92; P less than 0.01). Cyclic changes in either SaO2 or ventilation reproduced the oscillatory patterns of heart rate seen with tidal breathing interrupted by multiple apneas, but the amplitude of the variance in heart rate was smaller. Finally, preventing the cyclic declines in SaO2 with supplemental O2 did not significantly alter the heart rate changes seen in tidal breathing interrupted by apneas.

Adult↗
PubMed1985

Phenobarbitone in essential tremor.

We conducted a double-blind, placebo-controlled trial of phenobarbitone on a fixed-dose regimen in 12 patients with essential tremor. The drug was better than placebo on accelerometric measurement and clinical assessment, but not according to patient self-assessment or measures of manual performance. Phenobarbitone may be an alternative to beta-adrenoreceptor antagonists in treating essential tremor.

Adult↗