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Biomedical subjects

L J Findley

Publications and source records attributed to L J Findley.

At least 109 records · Page 6Linked to original sources
PubMed1985

Apnea duration and hypoxemia during REM sleep in patients with obstructive sleep apnea.

Nocturnal sleep studies of 12 patients with obstructive sleep apnea and a matched control group of 12 subjects without the sleep apnea syndrome were analyzed to compare arterial oxyhemoglobin saturation (SaO2) during REM and non-REM sleep. Mean percentage of total sleep time spent in REM sleep was not significantly different in patients with obstructive sleep apnea and in subjects without significant apnea (14.2 +/- SEM 2.2 percent in patients vs 12.0 +/- 2.2 percent in nonapnea subjects). Apneas were longer during REM than non-REM sleep in all 12 patients (p less than 0.01). Oxyhemoglobin desaturations were more frequent during REM than non-REM sleep in both apnea patients and the control subjects. In addition, there was a greater mean fall in SaO2 per desaturation episode in both the apnea patients and non-apnea subjects. We conclude: 1) sleep apneas are longer during REM sleep than non-REM sleep in patients with obstructive sleep apnea; 2) hypoxemia is greater during REM sleep than non-REM sleep in subjects with and without the sleep apnea syndrome.

Adult↗
PubMed1985

Oxyhemoglobin saturation during sleep in subjects with and without the obesity-hypoventilation syndrome.

The etiology of the obesity-hypoventilation syndrome (OHS) is unknown. Recent reports that treatment of obstructive sleep apnea with nasal continuous positive-airway pressure eliminates the manifestations of OHS suggests that obstructive sleep apnea may contribute to OHS. The purpose of this study was to determine whether hypoxemia during sleep was more severe in patients with OHS than in those without OHS. In our sleep laboratory, we studied 32 subjects with a ratio of the forced expiratory volume in one second over the forced vital capacity (FEV1/FVC) greater than 0.73 and no neuromuscular disease. Seven subjects had OHS characterized by obesity and daytime hypercapnia, and 25 subjects did not. The seven patients with OHS all had sleep apnea. Of the 25 without OHS, 23 had sleep apnea. Subjects with OHS had significantly greater oxyhemoglobin desaturation during sleep than subjects without OHS, even when subjects with and without OHS were matched for sex and weight. These findings are consistent with the hypothesis that severe sleep apnea is a contributing cause of OHS.

Adult↗
PubMed1984

Tremor.

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Humans↗
PubMed1984

Beta-adrenoreceptor mechanisms in essential tremor: a comparative single dose study of the effect of a non-selective and a beta-2 selective adrenoreceptor antagonist.

In order to study the mode of action of beta-adrenoreceptor antagonists in essential tremor the efficacy of single oral doses of 2, 4 and 10 mg LI 32-468, a peripherally acting, selective beta-2 adrenoreceptor antagonist, was compared with a single oral dose of 120 mg propranolol in a randomised, double blind, placebo controlled trial. Both the lowest dose of LI and propranolol were shown to be equally superior to placebo in attenuating tremor magnitude. This finding supports the contention that the beneficial effect of beta-adrenoreceptor antagonists in essential tremor is mediated via peripheral beta-2 receptor mechanisms.

Adrenergic beta-Antagonists↗
PubMed1984

Apneas and oscillation of cardiac ectopy in Cheyne-Stokes breathing during sleep.

Previous investigators have described heart rate oscillations (1,2) and various arrhythmias (3-5) during Cheyne-Stokes breathing. To our knowledge, however, this is the first report describing cardiac ectopic beats oscillating with the identical frequency as ventilatory movement and SaO2 in Cheyne-Stokes breathing during sleep. This case is also the first to document with polygraphic sleep recordings the suggested efficacy of acetazolamide (26) in abolishing the apneas of Cheyne-Stokes breathing during sleep. However, generalizations regarding the impact of ventilation on cardiac ectopy and the therapeutic effect of acetazolamide will require prospective studies on multiple patients with Cheyne-Stokes breathing during sleep.

Acetazolamide↗
PubMed1983

Effect of a single oral dose of propranolol on essential tremor: a double-blind controlled study.

The effect of a single oral dose of propranolol (120 mg) on essential tremor was investigated in a double-blind, placebo-controlled study in 26 patients. Hand tremor was recorded by means of accelerometers, and its frequency and amplitude calculated by using spectrum analysis. Recordings were made before and 1 1/2 hours after drug or placebo administration. Pretreatment tremor ranged from 4.2 to 9.6 Hz (median, 6.9 Hz) in frequency and from 0.002 to 1.33 cm (median, 0.014 cm) in amplitude. Neither propranolol nor placebo affected the frequency of the underlying tremor. The amplitude of tremor was reduced by 43 +/- 11% (SEM) after propranolol (p less than 0.01) and by 12 +/- 8% after placebo (NS). The reduction observed after propranolol was significantly greater than that observed after placebo. The tremor response after propranolol correlated negatively with baseline frequency and positively with pretreatment amplitude, duration of tremor, and age of the patient. No significant relationships could be found between tremor response, serum propranolol levels, and degree of cardiac beta blockade as assessed by the inhibition of standing tachycardia. There was a clear tendency for patients with small tremor amplitude (less than 0.006 cm hand displacement) to show the least satisfactory response to propranolol. These results indicate that a single oral dose of propranolol is effective in producing a rapid and marked reduction of essential tremor. Measurement of pretreatment amplitude and frequency might be useful in predicting the therapeutic outcome in these patients.

Adult↗
PubMed1983

The response of essential tremor to propranolol: evaluation of clinical variables governing its efficacy on prolonged administration.

The factors influencing the response of essential tremor to prolonged administration of propranolol (120 mg daily for two weeks followed by 240 mg daily for a further two weeks) were investigated in a double-blind, cross-over, placebo-controlled study in 16 patients. Hand tremor was assessed by means of accelerometers with off-line computer analysis. Propranolol was found to be superior to placebo only at the higher dosage regimen (240 mg daily). At this dosage, the median reduction in tremor amplitude (as compared to the control value) was by 45%. The response to the drug (expressed as percentage change in tremor amplitude) was correlated positively with the control amplitude (rs = 0.71, p < 0.01) and negatively (but more weakly) with the control peak frequency of tremor (rs = -0.53, p < 0.05). In the patients with hand tremor greater than 6 x 10(-3) cm hand displacement the tremor amplitude was reduced by 65%, as compared to only 17% in patients whose tremor amplitude was below this limit. No statistically significant relationship could be found between percentage change in tremor amplitude and duration of the disorder, age of the patients, degree of cardiac beta-blockade or serum propranolol levels. The results suggest that patients with small tremor amplitude should not be treated with propranolol unless their tremor becomes severely aggravated under conditions of excessive adrenergic discharge.

Adult↗
PubMed1983

Hypoxemia during apnea in normal subjects: mechanisms and impact of lung volume.

Seven normal awake males were studied to define the mechanisms and impact of lung volume on the hypoxemia occurring during apnea. During repeated 30-s voluntary breath holding, these subjects were studied at different lung volumes, during various respiratory maneuvers, and in the sitting and supine body positions. Analysis of expired gases and arterial O2 saturation during these repeated breath holdings yielded the following conclusions. Apnea of 30-s duration at low lung volumes is accompanied by severe arterial O2 desaturation in normal awake subjects. Initial lung volume is the most important determinant of hypoxemia during apnea. The hypoxemia of apnea at most lung volumes can be explained by simple alveolar hypoventilation in a uniform lung. The lung does not behave as a single-compartment model at lung volumes at which dependent airways are susceptible to closure.

Adult↗
PubMed1982

A normative study of postural tremor of the hand.

In a normative study of amplitude, frequency, and variability of postural tremor of the hand in 97 normal subjects, 15 to 80 years old, tremor was transduced using accelerometers and characterized by power spectral analysis. Tremor amplitude ranged from a 0.0015- to 0.035-g peak at the dominant frequency. The modal tremor amplitude was 0.01-g peak, and the threshold for "visible tremor" was 0.007-g peak. The modal tremor frequency was constant at about 7 Hz in those subjects up to 70 years old and thereafter decreased to about 6 Hz. The mean range of variability of the dominant frequency was 2.5 Hz. The tremor pattern, characterized by the shape of spectra, varied greatly from a single finely tuned peak to multiple broad peaks. More than two thirds of normal subjects showed complex spectral patterns with more than one peak of significance. Passive resonance of the hand tissues was an important factor in determining dominant tremor frequencies in most subjects. Many subjects showed a strong, albeit variable , cardioballistic component. The results provide baseline data for studies of the effects of drugs on tremor, particularly in cases of "essential" tremor, and provide warnings that such studies require objective recording methods for adequate evaluation and need recourse to measurement of several factors of the tremor to elucidate the component of tremor affected by a drug. A scaling of tremor can be used in terms of reference to the strength of gravitational acceleration (1.0 g), which provides simple numerical relationships.

Adolescent↗
PubMed1982

A case of Charcot-Marie-Tooth disease mimicking Friedreich's ataxia: is there any association between friedreich's ataxia and Charcot-Marie-Tooth disease?

The authors report a case of Charcot-Marie-Tooth disease that mimicked Friedreich's ataxia and featured impaired tendon reflexes in the limbs, incoordination mimicking cerebellar disease in the extremities, extensor plantar responses on both sides, bilateral foot deformity, imparied position sense in the toes, absent vibratory sense in the distal parts of the legs and minimal distal weakness with wasting. Motor conduction velocity in the upper limbs was substantially reduced. Other cases similar in nature reported in the literature resemble spino-cerebellar degeneration in general, and Friedreich's ataxia, in particular. It is emphasized that the natural history, EMG, motor conduction velocity studies and examination of other affected members of the family permit the correct diagnosis to be made in such cases. It is also emphasized that patients similar to the one reported here may also resemble, and should be differentiated from, cases of familial dorsal column ataxia (Biemond type). Stress is put upon the fact that when Charcot-Marie-Tooth disease mimicks spino-cerebellar degeneration, substantial slowing of motor conduction in the upper limbs is generally sufficient to establish the diagnosis. The relation between Friedreich's ataxia an Charcot-Marie-Tooth disease is reviewed and it is concluded that these two disorders are distinct clinical and pathological entities.

Adolescent↗
PubMed1982

Controlled study of metoprolol and propranolol during prolonged administration in patients with essential tremor.

The efficacy of propranolol and metoprolol in the treatment of essential tremor was compared in a double blind crossover placebo-controlled study in 16 patients. Each treatment was given for a period of 4 weeks at two different dosage regimens (150 and 300 mg daily for metoprolol, 120 and 240 mg daily for propranolol). Each dosage regimen lasted for 2 weeks. Tremor assessment was carried out by accelerometry, clinical evaluation, patient's self-rating and a battery of performance tests. At the lower dosage, propranolol was found to be superior to placebo on the basis of performance tests and patient's self-assessment. At the higher dosage, propranolol was superior to placebo on all methods of assessment. By contrast, the tremorolytic effect of metoprolol was not significantly different from that of placebo, irrespective of the dosage or of the method of assessment used. Propranolol (120 mg daily) was better than metoprolol (150 mg daily) on the basis of clinical evaluation and patient's self-assessment. Propranolol (240 mg daily) was superior to metoprolol (300 mg daily) on the basis of patient's self-assessment. Both drugs antagonised standing tachycardia to a similar extent. These results indicate that the effectiveness of metoprolol, previously demonstrated in a single-dose study in the same patients, is not fully maintained during prolonged administration. In the absence of specific contraindications, propranolol represents a better choice in the treatment of patients with essential tremor.

Adult↗