PubMed Health⌕ Search

Biomedical subjects

C Counsell

Publications and source records attributed to C Counsell.

17 recordsLinked to original sources
PubMed1996

The incidence of cerebral glioma in the working population: a forgotten cancer?

We studied the incidence of intracranial tumours in Lothian Region in south-east Scotland in 1989-90. Among 106 patients resident in the Region, 60 (57%) were of working age (15-64 years). All but two cases (97%) were histologically confirmed. The average annual incidence of cerebral glioma in this age range was 5.9 (95% CI 3.8-8.0) per 100,000 per year. Cerebral glioma will affect approximately 2100 people of working age in the UK every year.

Adolescent↗
PubMed1996

Altered taste sensation in newly-diagnosed NIDDM.

OBJECTIVE: To assess gustatory appreciation in newly diagnosed NIDDM patients and to determine whether it altered with the improvement of glycemic control after treatment with diet and oral hypoglycemic drugs. RESEARCH DESIGN AND METHODS: Assessments of taste, peripheral and autonomic neural function, diet, and oral microbiological flora were performed in 20 patients before and after treatment of hyperglycemia, 20 matched nondiabetic control subjects, and 11 patients with long duration of diabetes and advanced peripheral neuropathy. RESULTS: Median total HbA1 fell from 12.6 to 8.8% in new diabetic patients after 3-5 months of treatment. Electrical taste thresholds, detection threshold for glucose, and recognition threshold for glucose and salt were increased in newly-diagnosed NIDDM patients compared with the control subjects. The dose-response curve to glucose (using a visual analogue scale [VAS]) of newly-diagnosed NIDDM patients was significantly impaired and improved after treatment. By contrast, newly-diagnosed NIDDM patients had normal VAS taste responses to fructose, salt, and urea. Measurements of somatic and autonomic nerve function did not correlate with electrical or chemical taste function. CONCLUSIONS: Newly-diagnosed NIDDM patients have a blunted taste response, which displays a degree of specificity to glucose, is partially reversed after correction of hyperglycemia, and is independent of somatic or autonomic nerve function. This taste abnormality may influence the premorbid choice of nutrients, with a preference for sweet-tasting foods, thereby exacerbating hyperglycemia.

Autonomic Nervous System Diseases↗
PubMed1995

Nimodipine: a drug therapy for treatment of vasospasm.

Cerebral vasospasm presents a challenge for the nursing staff. To date, no effective prevention methods have been identified. The key to decreasing the mortality rates is in discovering a method of preventing or reversing the arterial narrowing caused by vasospasm. The nurse needs to be aware of the theories of vasospasm and the rationale for treatment. Neurologic assessment skills are important for the nurse to detect minimal changes that may indicate vasospasm. Nurses who are informed will be able to provide optimal care to patients with cerebral vasospasm and provide the necessary support for family members. Drug therapy continues to be the first-line defense in treating vasospasm. Nimodipine is a very promising drug with demonstrated effectiveness to reduce the neurologic deficits caused by vasospasm. Further research on the treatment of vasospasm following SAH is currently in progress.

Humans↗
PubMed1995

School attainment, cognitive ability and motor function in a total Scottish very-low-birthweight population at eight years: a controlled study.

The prevalence of learning problems and of cognitive and motor impairment in a total geographically based very-low-birthweight population (N = 324) was compared at eight years of age with that in a population comprising two classroom peers, matched for gender and age (N = 590). 15 per cent of those with birthweights less than 1000g and 6 per cent of those weighing 1000 to 1499 g attended special schools. Index children in main-stream schools performed significantly less well in tests of neuromotor function than their comparison groups. Their mean IQs were 90.4 and 93.7 for those below and above 1000 g, respectively, while their comparison groups' IQs were 102.5 and 101.2. In all cognitive subscales apart from that testing short-term auditory sequential memory, both index groups were less competent. They were also less able in Word Reading and Basic Number Skills. These children placed heavy demands on mainstream schools, with 52 per cent and 37 per cent of the index groups, respectively, requiring learning support compared with 16 per cent in both comparison groups.

Achievement↗
PubMed1995

The Cochrane Collaboration Stroke Review Group. Meeting the need for systematic reviews in stroke care.

BACKGROUND: There is a pressing need to identify which interventions are definitely effective in the prevention of stroke and in the treatment and rehabilitation of stroke patients, which interventions are definitely ineffective, and which interventions require further research. This information is most reliably obtained from reviewing all the available evidence from randomized controlled trials in a systematic way. SUMMARY OF COMMENT: There have been many (at least 8000) randomized controlled trials relevant to stroke. It would be difficult for any one individual to keep track of all these trials, and therefore most clinicians, therapists, and researchers are dependent, to some degree, on reviews of this literature. However, most current reviews are unsystematic and tend to be either incomplete or biased, so that their recommendations can be seriously flawed. Until now there has been no attempt to systematically identify all randomized controlled trials relevant to stroke (including subarachnoid hemorrhage), to review the data they contain, and to keep these reviews up-to-date in the light of new evidence. The Stroke Review Group has now been established within the Cochrane Collaboration to try to perform these tasks. There are presently 40 collaborators from 13 countries working on approximately 25 reviews. CONCLUSIONS: Identifying and reviewing all randomized controlled trials relevant to stroke should bring important benefits to patients and all those involved in purchasing or providing care for patients with stroke. The Cochrane Collaboration Stroke Review Group has started this process and would welcome help from anyone interested in collaborating in this enormous task.

Bias↗
PubMed1995

[Antithrombotic treatment in acute ischemia stroke].

Antithrombotic drugs (especially heparin and aspirin) are widely used to treat patients during the acute phase of ischemic stroke, yet there is no evidence of any beneficial effect on the course of the disease. Although these drugs can reduce the risk of such complications as deep venous thrombosis and, possibly, the number of recurrences of stroke, they can also give rise to systemic or cerebral hemorrhage. Given the uncertainty about the efficacy and safety of antithrombotic drugs, and specifically about the risk/benefit ratio, large clinical trials are needed to determine the indications for their use in the management of acute ischemic stroke. We stress the importance, because of its magnitude, of the International Stroke Trial (IST), the results of which will be available in 1996.

Acute Disease↗
PubMed1994

Meta-analyses.

Explore the source record for details and available documents.

Cerebrovascular Disorders↗
PubMed1993

[Use of fluorine-19 nuclear resonance spectroscopy for the measurement of changes induced in blood perfusion volume in experimental tumors in vivo].

The biological response of some anti-cancer therapeutic agents is probably mediated via the tumour vasculature. A novel approach using 19F NMR spectroscopy in vivo has been developed to directly measure changes in vascular perfusion volume in experimental tumours. A 100% w/v perfluorooctylebromide (PFOB) emulsion was used as a tracer. For a fixed position of a 7 mm surface coil placed over the tumour, the signal from the PFOB rapidly reached an equilibrium value remaining unchanged for at least 2 hours. Since the strength of the fluorine signal is directly proportional to the perfusion volume of the tumour vasculature, reduction of signal intensity should correspond directly to any reduction in volume which may be a manifestation of a change in the tumour blood flow. This hypothesis was investigated using hydralazine as a physiological modifier of tumour blood flow. Administration of 5 mg/kg of hydralazine following dosing with the PFOB emulsion reduced the 19F signal intensity from the murine tumors RIF-1 and KHT and from the human tumour HT29 with no or little reduction in the SCCVII/Ha murine and HX118 human tumours. Changes in blood volume in KHT tumour accompanied local changes in tumour blood flow rate as measured by the Xe-133 clearance rate technique. Thus, these data demonstrate the potential of the PFOB emulsion as a 19F NMR tracer of the vasculature to measure changes induced by therapeutic agents on blood volume in accessible tumours. This method may also be useful to detect early changes in blood volume produced during angiogenesis of solid tumours or angiostatic activity of anti-cancer drugs.

Animals↗
PubMed1992

Use of fluorine-19 nuclear magnetic resonance spectroscopy and hydralazine for measuring dynamic changes in blood perfusion volume in tumors in mice.

BACKGROUND: One method of evaluating the mechanism of action of agents which alter tumor oxygenation is to determine their effects on tumor blood flow. PURPOSE: This study tests applicability of a new approach using an emulsion of the inert fluorocarbon perfluorooctylbromide (PFOB) at nontoxic doses as a tracer in fluorine-19 (19F) nuclear magnetic resonance (NMR) spectroscopy to evaluate dynamic changes in vascular perfusion volume in transplanted tumors. METHODS: The PFOB emulsion (100% wt/vol) was injected into the tail vein in tumor-bearing C3H/He or nu/nu mice immobilized in a magnet interfaced to a spectrometer, either as a single bolus injection of 8 mL/kg body weight or in multiple injections to a total dose of 24 mL/kg. A 7-mm external surface coil was placed over the tumor. Signal from the PFOB in the tumor volume seen by the coil rapidly reached equilibrium and was maintained for at least 2 hours, and multiple doses of PFOB emulsion resulted in a linear increase in 19F signal strength. Since the 19F signal strength was directly proportional to the perfusion volume of the tumor vasculature, reduction of signal intensity should correspond directly to any reduction in volume caused by a change in the tumor blood flow. To investigate this hypothesis, the vasoactive agent hydralazine (5 mg/kg) was injected intravenously after administering the PFOB emulsion to induce changes in tumor blood supply. KHT and RIF-1 murine sarcomas, the HT29 human colon carcinoma, and the HX118 human melanoma tumors were studied. In a comparative analysis of changes in blood flow induced by hydralazine, we studied Xe-133 clearance in KHT murine sarcoma and SCCVII/Ha (SCCVII) murine squamous cell carcinoma. RESULTS: Hydralazine significantly reduced the 19F signal intensity in the murine tumors RIF-1 and KHT and in the HT29 human tumor, with little reduction in the SCCVII/Ha murine and HX118 human tumors. Hydralazine induced a statistically significant 64% decrease in mean clearance rate in the KHT tumor, while SCCVII/Ha tumors showed no significant change, indicating that hydralazine restricted blood flow to a greater extent in the tumor type that showed reduced 19F signal from the PFOB emulsion. CONCLUSION: These data demonstrate the potential of PFOB emulsion as a tracer in NMR spectroscopy for studying tumor vasculature.

Animals↗
PubMedDate not supplied

Interface skin pressures on four pressure-relieving devices.

Nurses employed in acute care hospitals frequently encounter patients who require a pressure-relieving device. It is often difficult for nurses to decide which support surface should be used to best meet a patient's need for a pressure-reducing device because of the multiplicity of products available. One of the variables studied was found not to statistically influence the effectiveness of the various pressure-relieving devices. Body build is not a consideration when determining which support surface is effective in a healthy population of subjects. The two air-flotation low air-loss beds would be defined as effective pressure-relieving devices. The interface pressure readings vary from individual to individual on various bony prominences. The population studied was that of healthy volunteers. Healthy subjects have an increased fat pad in their sacral area compared with the critically ill patient. The heel had the highest interface pressure of the five that were studied. This is a bony prominence that requires additional attention if skin integrity is to be maintained.

Beds↗