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Biomedical subjects

R J Prescott

Publications and source records attributed to R J Prescott.

At least 163 records · Page 9Linked to original sources
PubMed1990

Pulmonary function and drug regimens in asthmatics.

Overall function, persistent obstruction and control of potentially reversible wheeze were related to drug regimen in 624 patients attending review clinics. Pulmonary function before and after correction for the effects of age, duration of asthma and social factors was studied for each drug regimen. The performance of those on regular bronchidilators only, particularly non-smokers, was disappointing, particularly with regard to control of potentially reversible wheeze. There was a group of patients who expressed dissatisfaction with their condition in whom no change in management was made despite objective evidence of poor control of potentially reversible wheeze. Subjective assessment of control bore little relationship to actual function in those patients on oral steroids. Nevertheless, throughout the clinics as a whole, subjects recorded pulmonary function which was on average 80 per cent of their potential.

Adolescent↗
PubMed1989

The influence of social factors on the control of asthma.

The relationships of pulmonary function with age, duration of asthma and social factors were studied in 630 asthmatics. Pulmonary function was assessed by peak flow rate at routine attendance (actual function). Persistence of obstruction was demonstrated by a trial of corticosteroids where necessary. The best obtainable peak flow rate was recorded (maximum function). Unrelieved potentially reversible obstruction was assessed by actual/maximum function. Age and duration of asthma were directly associated with poor control of reversible wheeze as well as with persistent obstruction. In addition poor control of potentially reversible wheezè was related to lower social class, current cigarette smoking and lack of central heating. Persistent obstruction was related to life time amount smoked, passive smoking and lack of central heating.

Adult↗
PubMed1988

Facial electroneurography. Standardization of electrode position.

Electroneurography is now regarded as a valuable method for quantitatively assessing facial nerve function. Controversy, however, still surrounds some aspects of the technique because of the large number of associated variables. This study establishes by experiment the optimum site for both the recording and stimulating electrodes and recommends that this be adopted as a standard to ensure consistency in results between different study groups.

Action Potentials↗
PubMed1988

Reproducibility of reactive hyperaemia test in the measurement of peripheral arterial disease.

The reproducibility and sources of variation in ankle and brachial systolic pressures were determined for a reactive hyperaemia test used to assess peripheral arterial disease in the lower limbs. Thirty-six subjects had repeat measurements taken by four observers on two separate days using a Doppler probe and random zero sphygmomanometer. Ankle pressures were measured before and after 4 min of arterial occlusion above the knee. The 95 per cent confidence limits for a postocclusion reduction in pressure was approximately +/- 25 mmHg and for the postocclusion ankle-brachial ratio was +/- 20 per cent. The corresponding figures for the mean of four measurements taken by two observers on 2 days was approximately +/- 17 mmHg and +/- 13 per cent. In patients with vascular disease analysis of variance showed that the greatest sources of variation in the postocclusion ankle-brachial ratio were the 'biological' variations between subjects and between legs. But for postocclusion reductions in pressure, variability due to observers and repeat readings was as important as the 'biological' differences between subjects and legs. Thus, in respect of variability, the ratio may be a better parameter to detect differences between subjects.

Adult↗
PubMed1988

Clinical or rhinometric assessment of the nasal airway--which is better?

Multiple regression analysis was used to examine the relationship between clinical and rhinometric assessment of the nasal airway and the subjective nasal airway. Clinical examination and rhinometry correlated poorly with the subjective overall nasal airway. Analysis of the data obtained on the differences between the right and the left nasal cavities showed that adding rhinometry did not improve on clinical examination in predicting the patient's subjective sensation of nasal airway.

Humans↗
PubMed1988

Post-transfusion non-A, non-B hepatitis: significance of raised ALT and anti-HBc in blood donors.

The FDA has recommended that all blood collected in the USA should be screened for antibody to hepatitis B core antigen (anti-HBc) and for raised alanine aminotransferase (ALT) as possible indicators of non-A, non-B hepatitis carriage. As part of an assessment of the medical and economic implications of such a screening programme, we have screened 1,742 regular blood donors for ALT and 2,086 (including the same 1,742) for anti-HBc. 42 (2.4%) of the 1,742 donors had ALT levels above 45 units/l. Clinical assessment of 33 of these revealed that 26 exceeded their ideal body weight by more than 10% and 15 by more than 20%. 11 admitted to an alcohol intake of over 40 g daily. In all, 82% of donors with raised ALT had a 'non-viral' clinical explanation for this abnormality. Anti-HBc was detected in 42 (2.0%) of the 2,086 donors screened. 27 (64%) also had anti-HBs, and 11 (26%) had anti-HBe. There was no overlap between donors with raised ALT and those with anti-HBc. Combined screening would lead to a loss of at least 4.4% of donations in the population studied. In view of the medical and economic implications of the introduction of these screening tests, and the poverty of data on the clinical significance of post-transfusion non-A, non-B hepatitis, we conclude that such a screening programme cannot be justified at present. Further studies are required, including a prospective controlled trial of the effects of screening.

Alanine Transaminase↗
PubMed1988

Variability of ankle and brachial systolic pressures in the measurement of atherosclerotic peripheral arterial disease.

The aim of this study was to determine the variability of measurements of ankle and brachial systolic pressures and ankle brachial ratios in order to assess their suitability for use in epidemiological studies of arterial disease in the lower limbs. Thirty-six subjects had repeat measurements taken by four observers on two separate days using a Doppler probe and random zero sphygmomanometer. The variability in the measurement of ankle systolic pressure was comparable to that for brachial systolic pressure. The 95% confidence limits of one measurement of the ankle brachial ratio was estimated to be +/- 16%, reducing to +/- 10% for the mean of four measurements taken by two observers on two days. Analysis of variance indicated that the variability in the measurement of ankle brachial ratios attributable to observers, days, timing of measurements on the same day, and repeat measurements was considerably less than the "biological" variability between subjects and between legs. These results suggest that repeatability of the ankle brachial ratio is such that a single measurement is suitable for most epidemiological studies of atherosclerotic peripheral arterial disease.

Adult↗
PubMed1988

The relationship between age and duration of asthma and the presence of persistent obstruction in asthma.

Persistent obstruction was assessed in 630 asthmatic subjects by measurement after bronchodilator of the maximum potential peak flow rate and forced vital capacity. Persistent obstruction was directly related to duration of asthma. The fit was slightly better after logarithmic transformation, suggesting that the early stages of asthma may be as important as the later ones in the development of persistent obstruction. On multivariate analysis age was an additional factor in males, but made no significant difference to females. Atopy did not prove relevant. Measurements of peak flow suggested a more rapid deterioration in males of social classes III, IV and V than classes I and II. Although current smokers had lower peak flow rate and vital capacity than non-smokers, there was no evidence of a steeper decline in smokers than non-smokers suggesting that the effect of cigarette smoking was at most additive to that of duration of asthma.

Adolescent↗
PubMed1988

Does right ventricular function predict survival in patients with chronic obstructive lung disease?

Non-invasive measurements of the right ventricular ejection fraction by radionuclide ventriculography were made in 115 patients with chronic obstructive lung disease. Survival was assessed over a mean period of 918 days. The right ventricular ejection fraction was reasonably normal in most patients (mean 0.42, range 0.10-0.66) but was lower in those with peripheral oedema, indicating cor pulmonale (mean 0.31 (SD 0.07); p less than 0.0001). Right ventricular ejection fraction was related to survival, but the relationship was weak (p = 0.03) by comparison with the association between the arterial oxygen and carbon dioxide tensions and survival (both p less than 0.0001). It is concluded that, although right ventricular function is predictive of survival in patients with chronic obstructive lung disease, it is probably a reflection of severity of disease and does not directly affect the prognosis.

Adult↗
PubMed1988

Methylprednisolone, etoposide, vindesine, and chlorambucil (PEEC) alone or alternating with CHOP as initial or salvage therapy for non-Hodgkin's lymphoma.

A novel cytotoxic drug combination, PEEC, has been tested in the initial or salvage treatment of lymphomas. The PEEC combination alone is active in high grade or intermediate grade NHL with two complete and two partial remissions out of four patients so treated. When combined with standard CHOP therapy using an alternating regime, seven out of 11 patients obtained a complete remission and four partial remission. Ten patients were well, off treatment, beyond one year from presentation. The combination was less impressive, however, as salvage therapy with two partial responses in a heavily pre-treated group of nine patients.

Adult↗
PubMed1987

A controlled trial of weekly ultrasound therapy in chronic leg ulceration.

In a controlled trial to ascertain whether ultrasound given weekly in conjunction with a standard treatment for chronic leg ulcers improves the rate of healing 56 patients were randomised to standard treatment (paste impregnated bandage and a self-adhesive elastic bandage) and 52 to standard treatment plus pulsed ultrasound given weekly. After 12 weeks the proportion of ulcers healed was 20% greater in the ultrasound than in the control group.

Aged↗
PubMed1987

Overview of randomized trials comparing radical mastectomy without radiotherapy against simple mastectomy with radiotherapy in breast cancer.

An overview of mortality in the mature randomized trials comparing radical mastectomy without radiotherapy against simple mastectomy with radiotherapy has been conducted. These trials mark a transitional period between radical mastectomy and simple mastectomy as the generally preferred surgical treatment and as such are not strictly trials assessing the value of postoperative adjuvant radiotherapy. All known mature trials have been included and these four trials have entered a total of 3236 patients, in whom 1678 deaths have been recorded. Overall, no significant difference in survival was seen, but there was a nonsignificant trend for patients given radiotherapy to do worse after 15 years of follow-up.

Breast Neoplasms↗
PubMed1986

Sex differences in presentation of cutaneous malignant melanoma and in survival from stage I disease.

To explain the improved survival rates of females with malignant melanoma compared with that of males in this region of the United Kingdom (a recognized low incidence area for melanoma), clinicopathologic differences between the sexes of 477 patients presenting with primary melanoma at all stages, were examined between 1961 and 1976. The survival of 356 males and females presenting with Stage I melanoma were also compared, taking death from melanoma as the critical event. The data were analyzed using the Cox multivariate model, which allows several prognostic variables to be considered simultaneously, and enabled the assessment of the effect of, and interactions between, these variables. Female superiority in survival was due to: more lesions on the female lower limb, a site associated with a good prognosis; thinner lesions at presentation in the female; an interaction with age in which females between the age of 50 and 79 years fare significantly better than a similar age group of males. This age/sex interaction has not been observed in high incidence areas. It suggests, therefore, that melanoma may behave differently in different geographical areas.

Arm↗
PubMed1986

Controlled environment unit in the care of the below-knee amputation stump.

A controlled environment unit has been compared with plaster dressings in the management of the below knee stump in 60 patients undergoing amputation for advanced vascular disease. The main criteria were stump healing and the speed of rehabilitation. There were 30 patients in each group. Three patients died within 10 days of operation. Primary healing was obtained in 65 per cent, secondary healing in 22 per cent and revision to above knee was required in 13 per cent. There were no statistically significant differences between the two groups. Neither did they differ in the times taken to reach the various stages of rehabilitation from bed exercises to independent walking with final prosthesis. While the controlled environment unit was as effective as the plaster dressing it tended to impede the patients' early mobility and to hinder nursing care. In particular it is not recommended for patients who may be confused or restless in the early postoperative period.

Aged↗
PubMed1986

Determinants of ADP-induced platelet aggregation in diabetes mellitus.

ADP-induced platelet aggregation was measured in 15 Type 1 (insulin-dependent) diabetic patients, 15 Type 2 (non-insulin-dependent) diabetic patients and in 15 non-diabetic control subjects. Simultaneous measurements were made of fasting blood glucose, glycosylated haemoglobin, serum insulin, total plasma cholesterol, cholesterol in the lipoprotein subfractions, total triglycerides and platelet phospholipid fatty acid levels. Regression analysis of aggregation against the biochemical variables within the three groups revealed that there was no significant difference in the associations with aggregation between the groups. When the data was pooled, blood glucose (p less than 0.01) and glycosylated haemoglobin (p less than 0.05) demonstrated significant associations with aggregation. Multiple regression analysis was then applied; only blood glucose (p less than 0.05) had an independent effect on aggregation. Platelet aggregation in diabetic patients and non-diabetic patients appears to be related directly only to blood glucose levels.

Adenosine Diphosphate↗