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Biomedical subjects

P Newman

Publications and source records attributed to P Newman.

At least 73 records · Page 4Linked to original sources
PubMed1984

Effect of cold stimulation on myocardial perfusion. An investigation using thallium-201 scintigraphy.

Thallium-201 scintigraphy was used to investigate the effects of cold stimulation on myocardial perfusion in 12 patients with documented coronary artery disease (group 1), nine with chest pain but without evidence of structural coronary artery disease (group 2), and 10 normal volunteers (group 3). The scintigrams were assessed both visually and numerically using a circumferential profile technique. Transient perfusion defects were identified by both techniques in six subjects in group 1, three in group 2, and two in group 3. The haemodynamic responses (assessed by the double product) of subjects with or without transient perfusion defects were not significantly different. Thus cold stimulation can provoke abnormalities of myocardial perfusion not only in patients with coronary heart disease but also in those with structurally normal coronary arteries and in some normal subjects. These results may reflect a spectrum of coronary vasomotor responsiveness to cold stimulation in both normal and ischaemic populations, and it is concluded that cold pressor techniques cannot be relied on to differentiate patients with coronary heart disease from those with atypical chest pain syndromes or even from normal subjects.

Blood Pressure↗
PubMed1984

Diabetic control and left ventricular ejection fraction during cold stimulation tests in insulin-dependent diabetes.

Abnormal cold stimulation (CS) tests have been reported in diabetic patients compared with normal controls. This result could be influenced by factors such as age, autonomic neuropathy, duration of diabetes and diabetic control and a group of type I (insulin-dependent) diabetic patients were therefore investigated to assess the effect of these factors on the CS test. Fifteen out of 31 patients (48.4%) had an abnormal change in left ventricular ejection fraction (LVEF) during CS. There was no correlation between the change in LVEF and age, autonomic function tests, duration of diabetes or plasma glucose levels during the test. There was a significant negative correlation between the change in LVEF and HbA1 levels (r = 0.42; p = 0.02). We cannot say whether these results indicate a functional abnormality or a structural lesion of the coronary arteries or myocardium. They suggest, however, that diabetic control may influence cardio-vascular responses in diabetic patients.

Adult↗
PubMed1983

Intermittent epoprostenol (prostacyclin) infusion in patients with Raynaud's syndrome. A double-blind controlled trial.

Two groups of outpatients (7 in each group) with Raynaud's syndrome, matched for severity of illness, were randomly allocated to receive at weekly intervals for three weeks either a 5 h intravenous infusion of buffer or epoprostenol (prostacyclin, PGI2) in buffer (7.5 ng/kg/min after the first hour). PGI2 reduced the frequency and duration of ischaemic attacks (both p less than 0.01). Hand temperature measurements with a thermocouple were significantly improved at 1 week; 6 weeks after the last infusion hand temperatures had returned to baseline. There was a corresponding loss of clinical response 8-10 weeks after the last infusion.

Clinical Trials as Topic↗
PubMed1983

Reduced transcutaneous oxygen tension and impaired vascular response in Type 1 (insulin-dependent) diabetes.

Measurements of transcutaneous oxygen tension were made on the foot and arm in 16 Type 1 (insulin-dependent) diabetic patients with no evidence of vascular or neurological disease on simple clinical examination and in 30 non-diabetic subjects. The mean transcutaneous oxygen tension measured at 45 degrees C on the foot was significantly lower in the diabetic patients than in the non-diabetic subjects. The hyperaemia response in the arm after cuff occlusion (measured by transcutaneous oxygen tension at 37 degrees C) was also significantly lower in the diabetic patients. These results may reflect abnormal capillary blood flow in diabetic patients. As the methods are simple and non-invasive, they may prove useful in the early assessment and subsequent monitoring of peripheral vascular problems in diabetes.

Adolescent↗
PubMed1983

Dazoxiben, a thromboxane synthetase inhibitor, in the treatment of Raynaud's syndrome: a double-blind trial.

1 UK-37248 (dazoxiben), an orally active thromboxane synthetase inhibitor, was evaluated in a double-blind trial of patients with severe Raynaud's syndrome. 2 Twenty patients were enrolled in the study. Eleven of these patients received dazoxiben 400 mg day and nine received matching placebo capsules. Treatment was given for 6 weeks and the patients reviewed at 2 weekly intervals during the study. 3 Assessment of response was judged by clinical symptoms and hand temperature measurements. Haematological and haemostatic studies were also carried out. 4 Results show a significant clinical improvement in patients receiving dazoxiben for six weeks. Hand temperature measurements, and haematological and haemostatic blood tests remained unchanged, however, apart from the expected lowering in plasma thromboxane B2 levels. 5 The mechanism of action of the drug would appear not to be mediated through increased prostacyclin production and further studies are under way to determine how improvement has been obtained in these patients.

Adult↗
PubMed1982

Ignoring the obvious: doctors' wives as patients.

There is a widely held belief among doctors and nurses that when a colleague is in hospital, if anything can go wrong during the course of his illness it invariably will. To investigate this belief, we studied prospectively a group of pregnant doctors and doctors' wives, comparing the number of obstetric, paediatric, and psychiatric complications with those in two control groups of similar social class, race, and parity. These were teachers and lecturers and a group of State registered nurses. The occurrence of obstetric and paediatric problems was similar in the three groups. Psychiatric problems, however, were more common among teachers and lecturers (p less than 0.001); this difference was due to the way the nurses on the postnatal wards failed to report mild psychiatric problems among doctors' wives to their colleagues. This difference was not related to the amount of preferential treatment that doctors and doctors' wives received while in hospital.

England↗
PubMed1981

Successful treatment of Raynaud's Syndrome with prostacyclin.

There is evidence to suggest that platelet activation occurs in Raynaud's syndrome. We evaluated the effect of prostacyclin (PGI2) a potent antiplatelet and vasodilator agent in 5 female patients with Raynaud's syndrome. Outpatient visits were made at weekly intervals for 4 weeks. At the first visit buffer solution (Wellcome Laboratories) was infused intravenously for 5 hrs, thereafter three five hr infusions of PGI2 at a peak dose of 10 ng/Kg/min were given. Six weeks after the infusions patients were reviewed. Symptomatic improvement, including healing of ischaemic ulcers, occurred in 4 out of 5 patients. Thermography confirmed an increase in hand temperature after PCI2. Subjective and objective improvement has persisted for at least 6 weeks after the last treatment.

Ambulatory Care↗
PubMed1981

Thermography as a predictor of sacral pressure sores.

Ninety-one patients admitted to a geriatric unit with apparently undamaged sacral skin were examined by thermography. Nineteen per cent showed a thermal pattern consistent with occult skin damage, and 35% of these developed an overt pressure sore at the thermographically abnormal site within 10 days of admission. None of the remaining patients developed a sore within this time. Thermography can provide a more precise indication of the risk of early development of a sacral pressure sore than the Norton score.

Aged↗
PubMed1980

A unique case of musicogenic epilepsy.

Musicogenic epilepsy associated with spastic paraparesis, the latter probably secondary to multiple sclerosis, occurred in a patient. Detailed analysis of a variety of musical stimuli demonstrated consistent susceptibility to a particular popular tune. It is postulated that temporal lobe demyelination may be the etiological factor in this patient.

Adult↗
PubMed1980

Non-spherocytic haemolytic anaemia in mother and son associated with hexokinase deficiency.

The case history, laboratory findings and properties of the enzyme in a patient with hexokinase deficiency are reported. The mother had a haemolytic disorder of similar severity. In these cases the expression of the disease in both mother and son suggests a dominant mode of inheritance. This family further illustrates the necessity of taking the reticulocyte level into account when interpreting red cell enzyme levels.

Adult↗
PubMed1980

Two-dimensional echocardiography in mitral annulus calcification.

Mitral annular calcification, established by fluoroscopy, was studied by M-mode and two-dimensional echocardiography in 18 patients. M-mode echocardiography revealed the typical dense, linear echo of mitral annular calcification, but not its extent. Two-dimenstional echocardiography demonstrated a dense, elipsoidal echo at the junction of the left atrium and ventricle in the long axis view, and an area of calcification below the mitral valve in the short axis view. These patterns were not seen in 20 control patients without mitral annular calcification by fluoroscopy. Two-dimensional echocardiography establishes the site and extent of mitral annular calcification, minimizes the potential for diagnostic error associated with M-mode echocardiography, and is superior to M-mode echocardiography for the recognition of mitral annular calcification.

Aged↗
PubMed1980

The role of craniectomy in the treatment of chronic subdural hematomas.

A consecutive series of 48 adult patients with a chronic subdural hematoma is reported. These patients were treated according to a protocol consisting of a sequence of conventional surgical procedures ranging from simple burr-hole drainage to craniotomy and subdural membranectomy. Seven patients (15%) continued to demonstrate severe neurological dysfunction, or suffered acute neurological deterioration after completion of this protocol. However, after undergoing excision of the cranial vault overlying the hematoma site, six of these seven patients demonstrated a significant clinical improvement. Based on analysis of these seven cases, the authors suggest that craniectomy be considered in those patients who suffer a symptomatic reaccumulation of subdural fluid following craniotomy and membranectomy, or who demonstrate further neurological deterioration as a result of cerebral swelling subjacent to the hematoma site. However, this procedure probably has no efficacy once extensive cerebral infarction has occurred.

Aged↗