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Biomedical subjects

S Nightingale

Publications and source records attributed to S Nightingale.

At least 55 records · Page 3Linked to original sources
PubMed1989

A double-blind controlled trial of long chain n-3 polyunsaturated fatty acids in the treatment of multiple sclerosis.

A trial of n-3 polyunsaturated fatty acids in the treatment of multiple sclerosis has been conducted over a 5 year period. Ambulant patients (312) with acute remitting disease were randomly allocated to treatment or placebo. Both groups were given dietary advice to increase the intake of n-6 polyunsaturated fatty acids and the treatment group in addition received capsules containing n-3 polyunsaturated fatty acids. Analysis of clinical outcome at the end of 2 years of treatment was made in terms of the duration, frequency and severity of relapses and the number of patients who had improved or remained unchanged. The results showed no significant difference at the usual 95% confidence limits but there was a trend in favour of the group treated with n-3 polyunsaturated fatty acids in all parameters examined.

Adipose Tissue↗
PubMed1989

Developmental spinal canal stenosis and somatotype.

The hypothesis that somatotype and cervical spine developmental canal stenosis may be associated has been investigated by anthropometry and measurement of lateral projection cervical spine radiographs. A significant association of canal size with somatotype has been found such that those with developmentally narrow canals are more likely to have relatively shorter long-bones, particularly in the upper arm, and longer trunks.

Adult↗
PubMed1988

Microalbuminuria in diabetic subjects with chronic peripheral neuropathy.

Fifty-five patients with chronic peripheral neuropathy, 31 with and 24 without retinopathy, had albumin excretion rates determined on 2-h supine urine collections on three occasions by a radioimmunoassay method. Four patients with retinopathy had albustix-positive proteinuria and were excluded from subsequent analysis. Microalbuminuria was found in 20 of the 27 patients with retinopathy compared with 10 of the 24 patients with neuropathy alone. The mean albumin excretion rate (AER) was higher in neuropathic patients with retinopathy than in those patients with neuropathy alone (41.2 +/- 40.3 vs 18.8 +/- 33.2 micrograms/min, P less than 0.01). Multivariate analysis of the data was performed and this revealed a correlation coefficient of R2 = 0.33 (P less than 0.01) for AER as the dependent variable with respect to the independent variables HbA1, systolic blood pressure and known duration of diabetes. There was, however, no significant contribution separately of these individual variables to the regression equation. Microalbuminuria was significantly associated with retinopathy although almost half of the patients with neuropathy alone had microalbuminuria. The association between microalbuminuria and neuropathy even in the absence of retinopathy provides support for a microvascular element in the pathogenesis of diabetic neuropathy.

Albuminuria↗
PubMed1988

A new metabolic muscle disease due to abnormal hexokinase activity.

A 34 year old man presented with an 8 year history of mild muscle pain and stiffness on exertion especially in the cold. Clinical examination was normal. Apart from a mild persistent leucocytosis, his routine investigations were normal including creatine kinase activity, electromyography and nerve conduction studies. An ischaemic exercise test produced a slow and incomplete rise in lactate. Histological examination showed non-specific myopathic changes in some quadriceps femoris muscle fibres. Investigation of muscle metabolism by spectrofluorometric analysis of muscle enzyme activity and by muscle fibre incubation studies revealed a severe defect in glucose phosphorylation, associated with an electrophoretically abnormal hexokinase. Further metabolic studies suggest that the block in glucose metabolism is by-passed via an enhanced phosphorylation of fructose by the abnormal hexokinase.

Adult↗
PubMed1988

Progressive multiple cranial neuropathies presenting as a delayed complication of radiotherapy in infancy.

A 38 year old woman who had undergone irradiation during infancy for a left facial cutaneous arteriovenous malformation sequentially developed complete palsies of the ipsilateral VII, V, XI, IX, X, XII and VI cranial nerves. Apart from optic and olfactory nerve damage there are few reports of radiotherapy causing cranial nerve injury. We link the unusually extensive and progressive neural damage and the prolonged latency to the patient's age at time of irradiation.

Adult↗
PubMed1988

Joint planning. Unremarkable but productive.

Joint planning is widely practised and widely found disappointing. A group in Scunthorpe found it difficult but eventually, after nearly collapsing formed workable arrangements and some lesson which other groups should consider.

Community Mental Health Services↗
PubMed1988

Decreases in mortality on a large urban medical service by facilitating access to critical care. An alternative to rationing.

The admission and case fatality rate (CFR) on a large urban medical service for 12 months before and after the creation of an intermediate care unit were examined. In the year after the intermediate care unit was opened, total admissions to the ICU/CCU decreased by 7.1% as a result of a 14.6% decrease in admission of low-risk patients who did not require critical care services. The CFR of patients on the medical service decreased by 13.3% in the year after implementation of the intermediate care unit. The decrease in mortality was accounted for by a 25.0% decrease in general ward deaths and a 38.8% decrease in ward cardiac arrests. There was no significant difference in the ICU/CCU CFR. The admission of low-risk patients to an intermediate care unit provided greater access to intensive care and was associated with an overall lower medical service CFR.

Chicago↗
PubMed1987

Hindbrain hernia headache.

In six patients with episodic, severe, and disabling headaches with specific characteristics and in whom clinical examination and CT scanning were normal the symptoms were due to hindbrain herniation into the foramen magnum with resulting craniospinal pressure dissociation. This syndrome may be recognised by eliciting the typical history. In all patients myelography showed hindbrain herniation or Arnold-Chiari deformity and surgical decompression of the foramen magnum produced complete resolution of the headaches.

Adolescent↗
PubMed1986

Abnormal platelet aggregation in chronic symptomatic diabetic peripheral neuropathy.

Both diabetic nephropathy and retinopathy result from microangiopathic processes although there is controversy as to whether this is true for neuropathy. Increased platelet aggregation has been reported in diabetics with nephropathy and retinopathy. The presence of increased platelet aggregation in diabetics with neuropathy could be due to the other coincident microvascular complications. We have, therefore, studied in vitro platelet aggregation in 10 diabetics with chronic symptomatic neuropathy but no other complications, 10 with neuropathy and severe retinopathy, 17 with retinopathy alone, and 23 diabetics with no complications. Increased platelet aggregation to adenosine diphosphate (ADP) and adrenaline was seen in diabetics with neuropathy alone (peak responses 85.0 +/- 5.5% and 82.9 +/- 6.2%, respectively) when compared with uncomplicated diabetics (peak response 74.9 +/- 10.1%, p less than 0.005, and 74.3 +/- 12.5%, p less than 0.01, respectively). The increased platelet aggregation in the patients with neuropathy alone was similar to that found in the diabetics with severe retinopathy. We conclude that increased platelet aggregation is associated with established microangiopathy and is also present in otherwise uncomplicated patients with neuropathy, and this may have pathogenic and therapeutic implications.

Adenosine Diphosphate↗
PubMed1986

Visual evoked cortical potentials and pattern electroretinograms in Parkinson's disease and control subjects.

Parkinson's disease patients have been shown to have abnormal visually evoked cortical potentials (VEPs) to pattern stimulation. Whereas dopamine is not an important neurotransmitter in the central visual pathways, the retina is rich in dopamine and, together with previous animal and human studies, this suggests that the abnormal VEPs in Parkinson's disease patients may be due to a biochemical and electrophysiological disorder in the retina. This hypothesis has been examined by studying the VEPs and pattern electroretinogram (PERG) of Parkinson's disease patients and matched control subjects. The amplitudes of the cortical and retinal evoked potentials were significantly reduced in Parkinson's disease patients compared with the control subjects and this could not be attributed to any particular feature of the disease or its treatment. There was a significant relationship between the VEP P100 latency and the PERG amplitude. Moreover for those subjects in whom there was an interocular difference in both cortical and retinal evoked potentials, the abnormality was more commonly found in the potentials from the same eye. These findings suggest that the abnormality of the VEP in Parkinson's disease patients is, at least in part, secondary to an abnormality of the retina itself.

Aged↗
PubMed1986

A study of histocompatibility antigens in patients with motor neuron disease in the northern region of England.

Histocompatibility antigen (HLA A, B and DR) serotyping was performed on 65 patients with motor neuron disease in the northern region of England and compared to a large control population from the Newcastle upon Tyne area. Thirty two patients had amyotrophic lateral sclerosis, 17 had progressive bulbar palsy and 16 had progressive muscular atrophy. Ten patients had a more slowly progressive course. No significant HLA associations were observed in the motor neuron disease patients. Subdivision of the patients by the clinical course of their disease did not reveal any significant associations. Forty six motor neuron disease patients from the Newcastle upon Tyne area had a reduced frequency of HLA DR4 compared to the local control population. The relevance of histocompatibility antigens to the pathogenesis of motor neuron disease is discussed.

Adult↗
PubMed1986

A randomized comparison of nifedipine and sodium nitroprusside in severe hypertension.

We randomized patients with severe hypertension in the Medical Intensive Care Unit to a treatment regimen of oral nifedipine or intravenous nitroprusside. Patients treated with nifedipine achieved a sustained reduction in diastolic blood pressure to less than or equal to 120 mm Hg in an average of less than five hours. Patients treated with nitroprusside achieved a similar reduction in 14 hours (p less than 0.05). Treatment with nifedipine was less expensive and required less time in the ICU than treatment with nitroprusside and was accompanied by no associated increase in morbidity or mortality. Oral nifedipine can be used as an alternative to intravenous nitroprusside in severe uncomplicated hypertension.

Administration, Oral↗
PubMed1984

Visual, cortical somatosensory and brainstem auditory evoked potentials following incidental irradiation of the rhombencephalon.

Visual, cortical somatosensory and brainstem auditory evoked potentials were recorded before incidental irradiation of the rhombencephalon and at 11 weeks and eight months after completion of treatment. No patient experienced neurological symptoms during this period. No consistent changes in evoked potentials were found. The failure to demonstrate subclinical radiation-induced demyelination suggests either that the syndrome of early-delayed radiation rhombencephalopathy occurs in an idiosyncratic manner, or that any subclinical lesions are not detectable by serial evoked potential recordings.

Adenocarcinoma↗
PubMed1984

Spinal cord compression by extramedullary haematopoiesis in myelofibrosis.

A 50-year-old man with a 20-year history of myelofibrosis developed mild impairment of dorsal column sensation and ataxia of gait. A myelogram and subsequent peroperative biopsy demonstrated spinal cord compression due to extramedullary haematopoiesis. There was an excellent clinical response to surgery and radiotherapy. The characteristic clinical features and the pathogenesis of this unusual complication of myelofibrosis and extramedullary haematopoiesis are discussed.

Hematopoiesis↗
PubMed1982

Psychometric assessment in absence status.

A 66-year-old woman had a ten-year history of attacks of absence status lasting two days. The clinical and psychometric manifestations of absence status in this patients were identical to those found in dementia. Unless a history of fluctuation in the behavioral disturbance is obtained, such a case of absence status may be misdiagnosed as dementia. The results of the longitudinal assessment indicated that the patient suffered more frequent episodes of cognitive impairment than she realized and that such dificits lasted longer than was initially believed.

Aged↗