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Biomedical subjects

C J Mumford

Publications and source records attributed to C J Mumford.

16 recordsLinked to original sources
PubMed1995

Airline policy relating to passengers with epilepsy.

OBJECTIVE: To identify the policy of international airlines for the carriage of passengers with epilepsy. DESIGN: Postal questionnaire asking about policy for epileptic passengers, training of cabin crew, onboard drugs suitable for the treatment of seizures, and details of any problems reported by crews as a result of in-flight passenger seizures. PARTICIPANTS: The questionnaire was addressed to the medical advisors of 42 international airlines. RESULTS: Thirty (71%) of 42 airlines responded. Eleven (37%) of the 30 airlines that responded had a stated policy or restriction on the carriage of passengers with epilepsy. Five of these airlines advised increasing the dose of anticonvulsant drugs before travel. One airline insisted that epileptic passengers travel with a companion. Twenty-five (83%) of 30 airlines dealt specifically with epilepsy in the training program of their cabin crews. Seventeen (57%) of 30 airlines carried diazepam onboard, mostly in injectable form. Most airlines reported no, or very few, incidents of in-flight passenger seizures annually. CONCLUSIONS: The advice offered to intending epileptic passengers differs greatly between airlines. Some airlines instruct intending passengers to increase their regular medication, probably without justification, since in-flight seizures are very infrequent. Training of cabin crew and the medical equipment carried onboard also vary and in some cases are inadequate.

Aerospace Medicine↗
PubMed1994

British Isles survey of multiple sclerosis in twins: MRI.

64/105 subjects who have a twin with multiple sclerosis included in a study of clinical concordance also underwent MRI of the brain. 8/23 monozygotic and 1/41 dizygotic co-twins from this subgroup were clinically concordant of whom 8/9 had MRI appearances typical of multiple sclerosis. Of the 48 clinically discordant twins aged less than 60, abnormalities on MRI were detected in 6/15 (40%) monozygotic and 13/33 (39%) dizygotic twins compared with 7/37 (19%) healthy age-matched controls. Abnormalities on MRI typical of multiple sclerosis (defined by the Fazekas criteria) were, however, present in only 2/15 (13%) monozygotic and 3/33 (9%) dizygotic twins and 0/37 controls. These results suggest that about 10% of monozygotic and dizygotic twins have "subclinical multiple sclerosis". It is likely that most of the MRI abnormalities seen in clinically discordant twins, however, represent incidental pathology.

Adolescent↗
PubMed1994

The British Isles survey of multiple sclerosis in twins.

During a 27-month recruitment period, we identified 146 individuals with multiple sclerosis (MS) who have a twin. A single clinician interviewed and examined 105 pairs of twins, and we confirmed zygosity using minisatellite probes. Including two suspected cases, 11 of 44 (25%) monozygotic twin pairs were concordant compared with two of 61 (3%) dizygotic twin pairs--two of 33 (6%) like-sexed and zero of 28 (0%) opposite-sexed. MRI was performed in 64 of 105 co-twins, and showed abnormalities consistent with demyelination in 13% of monozygotic and 9% of dizygotic co-twins who were clinically unaffected. These findings are similar to the results of most previous studies of MS in twins in which zygosity was not unequivocally established and where the majority of clinically unaffected co-twins were not studied by MRI; the difference in concordance rates in monozygotic and dizygotic twins indicates a significant genetic component in the etiology of MS.

Adolescent↗
PubMed1993

Problems with rating scales for multiple sclerosis: a novel approach--the CAMBS score.

Current rating scales for multiple sclerosis are unsatisfactory because they score each patient's condition without indicating the clinical context in which that score has been obtained. The Cambridge Multiple Sclerosis Basic Score (CAMBS) offers a solution to this problem by recording current status in the context of the clinical course. CAMBS distinguishes disability from handicap and indicates the independent contribution of relapse and progression to current clinical activity. Single scores of between 1 and 5 are assigned to each of these indices, giving a simple four component analysis for each clinical encounter, e.g. disability 3; relapse 1; progression 2; handicap 1.

Humans↗
PubMed1992

Occurrence of a multiple sclerosis-like illness in women who have a Leber's hereditary optic neuropathy mitochondrial DNA mutation.

Eight women are described who presented with bilateral, usually sequential, optic neuropathy, six of whom later developed a neurological syndrome indistinguishable from multiple sclerosis (MS). Magnetic resonance imaging, performed in five of the patients with an MS-like illness and in the two others with optic neuropathy alone, showed widespread white matter lesions as seen in MS. All of these women had matrilineal relatives with Leber's hereditary optic neuropathy, although this was not always apparent at presentation, and the most common mitochondrial DNA mutation associated with this disorder was detected in each of the women and their affected relatives. On the basis of observations made in these patients, the clinical features of Leber's hereditary optic neuropathy in males, and evidence for mitochondrially encoded peptides involved in the immune response in rodents, we propose that optic nerve damage in this disease could be immunologically mediated and that mitochondrial genes may contribute to susceptibility to MS.

Adult↗
PubMed1992

Multiple sclerosis in the Cambridge health district of east Anglia.

A survey of multiple sclerosis (MS) in the Cambridge Health District has identified 374 cases in a population of 288,410, giving a prevalence of 130 per 100,000. A total of 322 cases (86%) had either clinically definite or probable multiple sclerosis on 1 July 1990 (112 per 100,000) and 52 cases (14%) had suspected multiple sclerosis (18 per 100,000.) The incidence during 1989-91 was 5.94 per 100,000 per year. The prevalence figure is higher than in recent surveys from other southern parts of the United Kingdom, but correction for the age and sex characteristics of the at risk population eliminates these differences. The overall prevalence of multiple sclerosis is probably between 108 and 120 per 100,000 in the southern United Kingdom.

Adolescent↗
PubMed1990

A clinical survey of head injuries sustained in the M1 Boeing 737 disaster: recommendations to improve aircrash survival.

On 8 January 1989 at 20:25 h, a British Midland Boeing 737/400 on approach to East Midlands Airport crashed across the M1 motorway with the immediate loss of 39 lives from the 126 people on board. In the aftermath of the accident a clinical review was commenced to determine the mechanisms of injury in the 87 initial survivors and hopefully provide data to improve commercial aircraft safety in the future. Seventy-seven survivors sustained head and facial trauma in the crash, 45 of whom had periods of amnesia surrounding the event. Twenty-one received injuries from behind, including five of the six severely head-injured adults. Loss of consciousness and duration of amnesia were directly related to the degree of superficial head trauma. Adoption of the fully flexed brace position for crash-landing offered significant protection from head injury and concussion, and possibly reduced injuries from behind. Suggestions are made for potentially improving the survivability of aircraft accidents.

Accidents↗
PubMed1989

Papilloedema delaying diagnosis of Wernicke's encephalopathy in a comatose patient.

A case of acute Wernicke's encephalopathy due to hyperemesis gravidarum is described. Florid bilateral papilloedema was present, resulting in diagnostic uncertainty and delay in treatment. Attention is drawn to the rare occurrence of papilloedema in Wernicke's encephalopathy, and possible underlying mechanisms for this physical finding are considered.

Adult↗