Subject(s)
Progeria/genetics , Aging/physiology , Animals , Cause of Death , Cell Division/genetics , Chromosome Aberrations/genetics , Chromosomes, Human, Pair 1/genetics , DNA Repair/physiology , Diagnosis, Differential , Female , Humans , Hyaluronic Acid/metabolism , Male , Mice , Mice, Knockout , Progeria/diagnosis , Prognosis , Telomerase/physiology , Telomere/geneticsSubject(s)
Aphasia/etiology , Brain Abscess/complications , Fever/etiology , Aged , Aged, 80 and over , Anti-Infective Agents/adverse effects , Brain Abscess/drug therapy , Humans , Male , Metronidazole/adverse effects , Peripheral Nervous System Diseases/chemically induced , Tomography, X-Ray ComputedABSTRACT
In 1986 and 1989 the British Hypertension Society published its recommendations on the techniques for the measurement of blood pressure and the level of pressure requiring drug therapy. In order to assess the impact of these recommendations on clinical practice among non-members of the society, we have conducted a survey using a self-reported questionnaire among 196 hospital-based clinicians, and compared our findings with a similar survey conducted in 1979. The response rate to the 1990 survey was 64% (126 respondents). Over one-third (37%) of respondents reported that they usually record the diastolic blood pressure at the fourth Korotkoff phase (muffling of sounds), 52% reported that they use the fifth phase (disappearance of sounds), and 10% reported that they record both the fourth and fifth phase. They also disagreed considerably on a number of other basic issues, including whether blood pressure should be routinely measured in the sitting or lying position, and whether readings should be taken to the nearest 2, 5 or 10 mmHg. A clear majority of clinicians indicated that they would prescribe antihypertensive drugs if the diastolic blood pressure was consistently over 100 mmHg. This represents a marked shift from the opinions expressed in 1979 and is in line with the British Hypertension Society's recommendations. However, many clinicians still measure blood pressure in a manner contrary to the society's guidelines.
Subject(s)
Blood Pressure Determination , Hypertension/diagnosis , Humans , Hypertension/therapy , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
Current practice with regard to the technique of blood pressure measurement in pregnancy was assessed by means of a self-completed questionnaire sent to all midwives (116) and obstetricians (11) working in a UK District General Hospital obstetric unit. The response rate was 72% (91 respondents). Over half of the respondents (53%) use the fifth phase diastolic end point (contrary to current recommendations). Of the 75 respondents who had access to a large adult cuff 54 (72%) had used it on 'less than two occasions' over the preceding four weeks. Only 10% (9) of respondents reported that they record blood pressure to the nearest 2 mmHg and 23% (22) reported that they round blood pressure readings to the nearest 10 mmHg. There were diverse views on the interpretation of multiple blood pressure recordings. The conclusion is that compliance with current recommendations on blood pressure measurement technique in pregnancy is poor. There is poor agreement among midwives and obstetricians as to how blood pressure should be recorded in pregnancy.
Subject(s)
Blood Pressure Determination/methods , Prenatal Care/methods , Clinical Competence , Female , Humans , Midwifery , Obstetrics and Gynecology Department, Hospital , Posture , Pregnancy , Sensitivity and SpecificityABSTRACT
As beta-adrenoreceptor blockers have been shown to reduce mortality following myocardial infarction by around 20%, a similar pattern of 'cardioprotection' was looked for in hypertensive patients. Several non-randomised retrospective studies have suggested that beta-blockers may reduce either the mortality or morbidity from vascular complications. In the three randomised studies published to date, the effect of beta-blockers was compared with other managements using the technique of meta-analysis or overview. The overall mortality rate ratio in hypertensive patients treated with beta-blockers compared with those receiving placebo or diuretic treatment was 0.93 (95% confidence interval, 0.8 to 1.1). The pooled rate ratio for coronary heart disease (CHD) events was 0.95 and for cerebrovascular accidents 0.92. When beta-blockers were compared with diuretics, the overall pooled mortality rate ratio was 0.93 (95% confidence interval, 0.8 to 1.1). The pooled rate ratios for CHD events and cerebrovascular disease events were 0.98 and 1.22, respectively. These results raise the possibility that, in hypertensive patients, treatment with beta-blockers is associated with a small reduction in overall mortality when compared with other treatments.
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Coronary Disease/mortality , Hypertension/drug therapy , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/mortality , Cerebrovascular Disorders/prevention & control , Coronary Disease/etiology , Coronary Disease/prevention & control , Diuretics/therapeutic use , Humans , Hypertension/complications , Meta-Analysis as TopicSubject(s)
Astrocytoma/complications , Cerebral Ventricle Neoplasms/complications , Diplopia/etiology , Exercise , Adult , Humans , Intracranial Pressure , MaleABSTRACT
In a series of 230 patients admitted to hospital with a stroke, the frequency and significance of epileptic seizures at onset was assessed. Thirteen (5.7%) suffered single or multiple witnessed seizures at the onset of their stroke. Seizures were evenly distributed among all pathological stroke sub-types but were restricted to lesions in the carotid artery territory. They indicated a poorer prognosis over the first 2 days. Six of the 13 presenting with stroke and seizures had prior seizures and, if they survived, continued to have fits. The five patients surviving with stroke and a first seizure were all fit-free after 30 months follow-up.
Subject(s)
Cerebrovascular Disorders/complications , Epilepsy/etiology , Adult , Aged , Cerebral Hemorrhage/complications , Cerebral Infarction/complications , Female , Humans , Ischemic Attack, Transient/complications , Male , Middle Aged , PrognosisABSTRACT
In a case-control study, evidence of previous epilepsy was sought in 230 consecutive patients under the age of 70 admitted to hospital with acute stroke. 8 (4.5%) of the 176 patients having their first stroke were epileptic, compared with 1 (0.6%) of the matched controls. 6 of the 8 epileptics started their seizures after the age of 30 years. 5 (9.3%) of the 54 patients who had had a previous stroke were epileptic, compared with none of the control patients. The findings support the idea that otherwise clinically undetectable cerebrovascular disease may present with seizures and that these can be a warning sign for a future stroke.
Subject(s)
Cerebrovascular Disorders/etiology , Epilepsy/complications , Acute Disease , Adult , Aged , Humans , Middle Aged , Prospective Studies , RiskABSTRACT
Incubation of unprimed spleen B cells with high concentrations of hapten-conjugates resulted in the induction of specific unresponsiveness or tolerance to a subsequent encounter with the hapten on a potentially immunogenic carrier. This process of tolerance induction could occur in the absence of extracellular calcium. In contrast B-cell activation to both proliferation and subsequent antibody secretion is known to be calcium dependent. This means that either (1) the decisions which determine immunity and tolerance in B cells are mediated through totally distinct signalling pathways, or that (2) if tolerance and immunity depend on same common signalling events, then the commitment of B cells to switch on or off must be determined at a very early stage.
