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Biomedical subjects

R Sims

Publications and source records attributed to R Sims.

14 recordsLinked to original sources

The effects of antihypertensive medications on the physiological response to maximal exercise testing.

This study compared the effects of clinically prescribed doses of cilazapril, nifedipine, and atenolol on maximal exercise performance in physically active subjects. In a double-blind crossover trial, 10 healthy male volunteers performed progressive aerobic exercise to exhaustion for determination of maximal oxygen consumption (VO2 max), after single dose ingestion of cilazapril, nifedipine, atenolol, and placebo. Measurements were made at exhaustion and at a single submaximal workload (250 W). Exercise time to exhaustion and peak workload were decreased by all agents (p less than 0.05 vs. placebo), but VO2 max was decreased by atenolol only (p less than 0.05 vs. placebo). Although both atenolol and cilazapril decreased the maximum systolic blood pressure, the peak heart rate was decreased only by atenolol (p less than 0.001 vs. placebo). Whereas submaximal oxygen consumption, minute ventilation, and blood lactate concentrations were not different between groups, ratings of perceived exertion were increased during submaximal exercise by atenolol and cilazapril (p less than 0.05 vs. placebo). Cilazapril, nifedipine, and atenolol all impaired exercise performance and increased ratings of perceived exertion during submaximal exercise without altering rates of oxygen consumption or blood lactate accumulation. Maximal exercise performance was impaired to a greater extent by atenolol than by nifedipine or cilazapril. This study suggests that either angiotensin-converting enzyme inhibitors or calcium-channel antagonists might be preferable for the management of hypertension in athletic patients as they have a lesser effect on exercise performance, at least in healthy individuals.

Adult

Cryptosporidiosis in the Isle of Thanet; an outbreak associated with local drinking water.

An outbreak of cryptosporidiosis occurred in the Isle of Thanet during December 1990 and January 1991. A total of 47 cases ranging in age from 2 months to 85 years were identified in residents from the Margate, Broadstairs and Ramsgate areas, with dates of onset of illness from 3 December to 14 January. A case-control study demonstrated a strong statistical association between illness and the consumption of unboiled tap water from a particular source, with evidence of a dose-response relationship. Although no cryptosporidial oocysts were identified in samples of untreated or treated water taken during the investigation, the results were consistent with the view that the source of infection was treated river water which was used to supplement borehole water.

Adolescent

Using DSM-III criteria to diagnose delirium in elderly general medical patients.

Studies of delirium in general medical populations have used criteria for delirium different from current DSM-III or DSM-IIIR criteria of the American Psychiatric Association, or have used DSM-III or DSM-IIIR criteria without operationalizing the components of these criteria. Therefore this prospective study was conducted to establish an approach to operationalizing DSM-III criteria and to determine the incidence and prevalence of delirium. Two hundred thirty-five consecutive subjects age 70 and over admitted to general medicine underwent daily standardized screening. Patients with low scores on screening tests or clinical evidence suggestive of any psychiatric disorder and controls were seen by a psychiatrist, who determined whether delirium was present by applying explicit operational definitions to each component of the DSM-III criteria for delirium. We conclude that the syndrome of delirium as defined by the American Psychiatric Association is prevalent on admission among elderly on general medical services, but the number of cases developing in the hospital is much less than often stated in the literature.

Aged

The effects of chronic lithium treatment on psychomotor performance related to driving.

A group of 16 psychiatric out-patients in remission, who had been taking lithium carbonate as their sole medication for at least three months, were compared with a control group of 22 healthy volunteers. On a computerised driving simulator which produced measures of reaction time, tracking ability and mistakes made, the patient group had a significantly slower reaction time. Patients should be warned therefore that lithium may affect their ability to drive or operate machinery and that psychomotor impairment and sedation are not synonymous.

Adult

G1/S transition in normal human T-lymphocytes requires the nuclear protein encoded by c-myb.

Exposure of peripheral blood mononuclear cells (PBMC) to an 18-base c-myb antisense oligomer before mitogen or antigen stimulation resulted in almost complete inhibition of c-myb messenger RNA and protein synthesis and blockade of T lymphocyte proliferation. Expression of early and late activation markers, interleukin-2 receptor and transferrin receptor, respectively, by PBMC was unaffected by antisense oligomer exposure as was the expression of c-myc messenger RNA. In contrast, histone H3 messenger RNA levels and DNA content were selectively decreased. These results suggest that c-myb protein deprivation does not perturb T lymphocyte activation or early molecular events that may prepare the cell for subsequent proliferation. Rather, it appears to specifically block cells in late G1 or early S phase of the cell cycle.

Cell Division

Continuing education for district nurses.

This paper describes a co-operative venture between Essex Institute of Higher Education and Southend Health Authority designed to meet the continuing education needs of district nurses by allowing them to analyse and develop their role in relation to the realism of service goals and resources. It considers briefly the background to the project and the conclusions reached by the initial working group that provided the impetus. It gives details of the programme for district nurses and of the evaluation of the course. The positive aspects of combining the resources of the health authority and of higher education - the expertise of the manager and of the teacher - are highlighted. The overall success of the project is evidenced by the further developments described in the conclusion viz the move towards Cumberlege style management and the establishment of nine district nurse co-ordinator posts across the authority.

Curriculum

Foraminal spurs: a normal variant in the lumbar spine.

A normal variant, the foraminal spur, is described in five patients. It was seen on computed tomographic studies as a bony process extending from either the pars or the pedicle into the neuroforamen dorsal to the nerve root. In four of the cases it was seen bilaterally. None of the patients had any symptoms related to these spurs. No associated disease of the neuroforamen or facet was present. These spurs most likely represent ossification of the ligamentum flavum at its point of insertion and should not be mistaken for osteophytes, free disk fragments that have calcified, or fracture fragments. Sagittal reformations are helpful in visualizing the extent of the foraminal spurs.

Humans