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Biomedical subjects

T W Meade

Publications and source records attributed to T W Meade.

At least 181 records · Page 10Linked to original sources
PubMed1982

Effects of progestogens on the cardiovascular system.

The progestogenic component of combined oral contraceptives (OCs) may contribute to the increased risk of stroke and ischemic heart disease in women who take these preparations. This effect is likely to be mediated, at least in part, through elevators in blood pressure. The progestogenic component of OCs does not appear to influence the risk of venous thromboembolism. In terms of reducing the risks of arterial disease in women taking OCs, the safest preparations will be those which minimize the dose of both estrogen and progestogen.

Adult↗
PubMed1982

ABH secretor status and pulmonary function.

Among current cigarette smokers in the Northwick Park Heart Study in N.W. London, England, secretors of ABH antigen had a higher mean peak expiratory flow rate than did nonsecretors. The relationship was independent of other factors known to affect peak expiratory flow rate. No significant differences in peak expiratory flow rate by secretor status were detected in nonsmokers or in pipe and cigar smokers, although a smaller difference was seen among secretors and nonsecretors who were ex-cigarette smokers than among those who were current cigarette smokers. It is concluded that secretion of ABH antigen into the respiratory tract may have a protective effect against pulmonary damage by noxious agents.

ABO Blood-Group System↗
PubMed1981

Overview of drugs in arterial thrombosis.

The recent history of randomized controlled trails in the prevention of ischaemic heart disease (i.h.d.) is considered. In 1970, it seemed that little could be done to prevent recurrent of the disease and there was almost no information on the potential for preventing its onset. Over the past decade, this rather pessimistic view has changed to one of guarded optimism. Yet there are still no drug régimes that command general support. One reason for the inconclusive results of recent trails may have been the assumption that myocardial infraction and sudden death share the same pathology. Another reason is the diversity of pathogenetic mechanisms and prognoses in i.h.d. Many patients probably stand little chance of benefiting from a particular drug either because it affects mechanisms other than those responsible for their disease or because their prognosis, excellent or hopeless, is unlikely to be influenced whatever treatment they receive. It is consequently difficult to ensure reasonable chances of demonstrating benefits in those who may really stand to gain. A tendency of pharmacological information to become available during or after a large trial, rather than beforehand, has added to the difficulties. Despite all their problems, randomized controlled trials remained the only way of testing drugs for the prevention of arterial disease. Suggestions are made for increasing the chances of clear results in future trails and of reaching the stage of benefit demonstrated sufficiently convincingly to form a basis for clinical practice. These suggestions include the use of factorial designs enabling the evaluation of more than one drug in a particular trial and the development of methods for selecting homogeneous groups of patients.

Blood Coagulation↗
PubMed1981

Multicentre trial of physiotherapy in the management of sciatic symptoms.

Four treatments for sciatic symptoms--traction, exercises, manipulation, and corset--were assessed in a randomised controlled trial in 322 outpatients. The design was factorial. There were thus sixteen treatment groups, enabling a comparison of combinations of methods as well as of individual methods. Treatment lasted for four weeks. Patients were reviewed at the end of this period and at four and sixteen months after entry to the trial. Progress was measured by the patient's account of symptomatic improvement or deterioration and by return to work or normal activities. At four weeks each of the treatments was associated with a small degree of benefit over and above the high rate of spontaneous improvement. For manipulation, the benefit was statistically significant on one of the scales used to measure progress. There was a significant increase in symptomatic improvement with increasing numbers of treatments used in combination. This was complemented by a clear tendency for those who had received fewer types of treatment during the trial to have further treatment in the ensuing three months. There were no beneficial effects of treatment detectable at four or sixteen months. In the short-term, active physiotherapy with several treatments appears to be of value in the outpatient management of patients with sciatic symptoms, but it does not seem to confer any longer-term benefit.

Adult↗
PubMed1981

Remedial therapy after stroke: a randomised controlled trial.

Of 1094 patients with a confirmed stroke admitted to Northwick Park, a district general hospital, 364 (33%) died while in hospital, 215 (20%) were fully recovered when discharged, and 329 (30%) were too frail or too ill from diseases other than stroke to be considered for active rehabilitation. Only 121 (11%) were suitable for intensive treatment. They and 12 patients referred direct to outpatients were allocated at random to one of three different courses of rehabilitation. Intensive was compared with conventional rehabilitation and with a third regimen which included no routine rehabilitation, but under which patients were encouraged to continue with exercises taught while in hospital and were regularly seen at home by a health visitor. Progress at three months and 12 months was measured by an index of activities of daily living. Improvement was greatest in those receiving intensive treatment, intermediate in those receiving conventional treatment, and least in those receiving no routine treatment. Decreasing intensity of treatment was associated with a significant increase in the proportions of patients who deteriorated and in the extent to which they deteriorated. Probably only a few stroke patients, mostly men, are suitable for intensive outpatient rehabilitation, but for those patients the treatment is effective and realistic.

Activities of Daily Living↗
PubMed1981

Management of urinary incontinence in patients with multiple sclerosis.

We investigated the management of urinary incontinence in 50 patients with multiple sclerosis (MS) in two London boroughs. Only seven appeared to be satisfied with the management of their bladder problems. A total of 51 suggestions was made for improving management in 33 of the patients. Most of these suggestions involved services which were available though not being used. The management of urinary incontinence in patients with MS should be tailored to the requirements of the individual. Alternative forms of management may often not be reaching patients who might benefit from them.

Adolescent↗
PubMed1980

Prevalence of urinary incontinence.

The prevalence of urinary incontinence was investigated by determining the number of incontinent patients under the care of various health and social service agencies in two London boroughs and by a postal survey of the 22 430 people aged 5 years and over on the practice lists of 12 general practitioners in different parts of the country. The prevalence of incontinence known to the health and social service agencies was 0.2% in women and 0.1% in men aged 15-64 and 2.5% in women and 1.3% in men aged 65 and over. The postal survey, to which 89% of the people whose correct address was known replied, showed a prevalence of urinary incontinence of 8.5% in women and 1.6% in men aged 15-64 and 11.6% in women and 6.9% in men aged 65 and over. Nulliparous women had a lower prevalence than those who had had one, two, or three babies, but within the parity range of one to three there were no differences in prevalence. The prevalence was appreciably increased in women who had had four or more babies. Incontinence was moderate or severe in a fifth of those who reported it in the postal survey, of whom less than a third were receiving health or social services for the condition. Incontinence is a common symptom, and many unrecognised cases appear to exist. There may be considerable scope for improving its management.

Adolescent↗
PubMed1980

Effect of treatment of hyperlipidaemia on haemostatic variables.

The haemostatic function of 11 men with hyperlipidaemia was measured before and after they were treated with a carbohydrate-reduced, fat-modified diet. After treatment, which significantly reduced serum triglyceride and cholesterol concentrations, they showed a significant fall in mean levels of clotting factors VII, VIII, and X and a rise in fibrinolytic activity. These findings suggest that haemostatic function may be important in the pathogenesis of ischaemic heart disease.

Adult↗