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Biomedical subjects

S J Clarke

Publications and source records attributed to S J Clarke.

At least 55 records · Page 3Linked to original sources
PubMed1992

Cardiovascular and vasoactive hormone responses to bladder distension in spinal and normal man.

Many patients with high spinal cord injury experience exaggerated blood pressure rises in response to bladder distension. To examine the humoral mechanisms associated with these responses, ECG heart rate, blood pressure and vasoactive hormone levels were measured at baseline and during bladder distension following slow bladder filling in 23 subjects: 9 high spinal lesion patients, 7 low spinal lesion patients and 7 normal control subjects. Systolic blood pressure rose significantly during bladder distension in the high spinal lesion group by an average of 56 mm Hg (48%) and diastolic blood pressure rose by 22 mm Hg (47%), while heart rate fell by a mean of 7.4 beats per minute (15%). By contrast, neither systolic or diastolic blood pressure nor heart rate changed significantly during bladder distension in the low spinal lesion or normal control group. There were no significant changes in plasma levels of noradrenaline, renin, aldosterone, vasopressin, arginine, or atrial natriuretic peptide during bladder distension to account for the blood pressure rise in the high spinal lesion group. These findings suggest that humoral mechanisms are unlikely to play a major role in the mediation of pressor responses to bladder distension in high spinal lesion patients.

Blood Pressure↗
PubMed1992

Effect of acute inflammatory lung injury on the expression of monocyte chemoattractant protein-1 (MCP-1) in rat pulmonary alveolar macrophages.

Using a well-characterized rat model of immune complex-mediated acute inflammatory lung injury, we determined that there is a time-dependent elaboration of monocyte chemotactic activity in bronchoalveolar lavage fluid. Monocyte chemotactic activity is also significantly enhanced in culture supernatants from pulmonary alveolar macrophages (PAMs) from injured rat lungs. Northern hybridization analysis revealed markedly increased expression of rat monocyte chemoattractant protein 1 (MCP-1) mRNA in PAMs obtained from rats with immune complex-induced lung injury. The increased expression of MCP-1 mRNA and associated increase in monocyte chemotactic activity present in culture supernatants of PAMs from injured rat lungs suggest that PAMs may participate in the pathogenesis of acute inflammatory lung injury by the secretion of monocyte chemoattractants including MCP-1.

Animals↗
PubMed1991

Getting older--feeling younger: the changing health profile of the elderly.

In 1981 a survey was undertaken of the physical and mental health and social status of all those aged 75 years and over belonging to a large general practice which alone served the town of Melton Mowbray and its surrounding area. Seven years later the survey was repeated. This elderly population had increased by almost 30% in number between the two surveys despite a relatively stable practice population over this time period. After adjustment for the different age and sex distributions of the two survey populations, significant increases in independence levels were found over the time period for: getting in and out of a chair and bed, dressing, bathing and getting to and from the toilet. No differences were found for mobility around the home, feeding or continence of urine or faeces. A higher prevalence of cognitive impairment was found in 1988 than in 1981, 7.0% compared with 4.5%, but this appeared to be due to the larger number of unclassifiable respondents in 1981. A re-analysis of the data, excluding those living in the area less than five years confirmed that the differences found in health over time were not due to a group of elderly migrating into the area. This study provides evidence that the elderly of today appear fitter than previous cohorts of elderly. Service planners will need to take this into account if sensible provision of resources for this age group are to be made.

Activities of Daily Living↗
PubMed1991

Peterborough Hospital at Home: an evaluation.

An evaluation of the Peterborough Hospital at Home scheme was undertaken to examine the complementary roles of Hospital at Home, hospital ward and the District Nursing Service. The evaluation involved two surveys; the first was a retrospective study of records of patients admitted to one of the three care settings during 1983. The second survey was a prospective study of Hospital at Home patients in 1985 with the index diagnoses of malignant neoplasms, cerebrovascular accidents and post-operative patients discharged early from hospital. In 1985, 284 patients were admitted to Hospital at Home, and of these the largest group (73 patients) were terminally ill cancer patients. Hospital at Home provided care for more severely ill patients than those normally looked after by the District Nursing Service, and comparable in severity and outcome to those in hospital. There was an emphasis on terminal care by Hospital at Home which would make it appear to be an enhancement to the usual domiciliary nursing services available, as, for the majority of the cancer patients cared for by Hospital at Home, admission to hospital would probably not be sought.

Community Health Nursing↗
PubMed1981

Characteristics of the urethral pressure profile in flaccid male paraplegics.

Several aspects of urethral function were studied in an attempt to identify the factors causing urinary retention in the flaccid paraplegic patient. The urethral pressure was much higher in all patients at the external sphincter than at the bladder neck. In patients studied sequentially, even from very early following injury, there was little variation in the maximum urethral closure pressure. Radiological studies showed the point of maximal resistance to be distal to the verumontanum. The urethral pressure at this point was largely abolished by phentolamine infusion. There was no variation in the activity of this region with bladder filling or postural change. It is concluded that in flaccid male paraplegics the major component of urethral resistance is constant, adrenergically innervated muscular resistance in the external sphincter region.

Adolescent↗
PubMed1980

Whooping cough vaccination: some reasons for non-completion.

The decline in the number of children nationally being vaccinated against pertussis has caused anxiety and concern, both for parents and for professional workers. Publicity by the media and professional press has added to the confusion, and has been largely held responsible for the present situation. A survey was undertaken to analyse the factors which may have been responsible for the reduction in the number of children coming forward for pertussis vaccination in Leicestershire. These factors included social class, the position of the child within the family, and the reasons given by families for omission of the vaccine. Observations on the computerized record of immunization and vaccination, and the family's own record of the dates of immunization were made. The results of the survey present a more complicated picture than expected, with the consequence that solutions are difficult to find.

Child↗
PubMed1980

Urinary incontinence and minimal pyramidal disease.

Nine patients with detrusor instability and minimal pyramidal disease are presented. None had neurological symptoms. All had severe urinary symptoms. These patients may add support to the theory that all detrusor instability has a neurogenic basis.

Adolescent↗
PubMed1979

Selective sacral neurectomy in the management of urinary incontinence due to detrusor instability.

Since Torrens (1974) reported on the use of selective sacral neurectomy in the management of bladder instability, the procedure has been used increasingly in specialised centres. We report the clinical and urodynamic findings in 9 patients in whom this procedure has been performed. The results suggest that selective sacral neurectomy is a valuable procedure in a highly selected group of patients with neurogenic bladder dysfunction. Patient selection, contraindications and the choice of which sacral nerves to divide are discussed.

Adolescent↗
PubMed1979

The urological status of 86 females following spinal cord injury.

A review of the urological problems in 86 female spinal cord injury patients is presented. There were no urological or renal deaths. Three urinary diversions were performed. Fifty-five patients are catheter-free and 28 are managed with permanent catheter drainage. The problems of "bladder training" are presented.

Adolescent↗
PubMed1978

The use of the ureteric stent.

The use and placement of ureteric stents either endoscopically or as part of an open procedure are outlined. The ureteric stent can replace the pyelostomy or nephrostomy tube and significantly reduce the postoperative morbidity.

Child↗
PubMed1977

Cystinuria.

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Cystinuria↗