Biomedical subjects
C Martyn
Publications and source records attributed to C Martyn.
Snapshots from the decade of the brain. Exciting, but no cause for triumphalism
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Dementia and occupational exposure to organic solvents.
OBJECTIVES: To investigate whether occupational exposure to organic solvents increases the risk of dementia. METHODS: Cases of dementia were identified from the computed tomography records of eight neuroradiology centres in England and Wales, and were compared with two sets of controls investigated at the same centres. The first set of controls were patients with brain cancer and the second set were patients with other disorders that were not chronically disabling. Lifetime occupational histories were obtained through a postal questionnaire completed by the subjects or their next of kin. Associations between dementia and occupation were examined by logistic regression. RESULTS: Usable questionnaires were returned for 204 (61%) of the cases, 225 (51%) of the controls with brain cancer, and 441 (61%) of the other controls. The findings with each of the two sets of controls were similar. In comparison with all controls combined, cases had less often worked ever as a painter or printer (odds ratio (OR) 0.6, 95% confidence interval (95% CI) 0.3 to 1.2), and were less likely to have worked for > 1 year as a printer, painter, or launderer or dry cleaner (OR 0.6, 95% CI 0.3 to 1.4). CONCLUSIONS: These findings provide no support for the hypothesis that occupational exposure to solvents is a cause of dementia. An excess risk in subsets of workers with extremes of exposure cannot be discounted, but the data indicate that any influence of exposure to solvents on the overall incidence of severe dementia in the general population of England and Wales is small.
More than an end of term report.
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Mortality from aortic aneurysm in migrants between counties of England and Wales: evidence for causes acting early in life.
We assessed whether the causes of aortic aneurysm underlying its distinctive geographical distribution in England and Wales act early or later in life from the OPCS data on deaths in England and Wales during April 1969-December 1972. From these data, we calculated proportional mortality ratios (PMRs) for aortic aneurysm by county of birth and county of death, for men and women aged 45-74. Among people resident in the county of their birth, PMRs for aortic aneurysm by county ranged from 31 in Pembrokeshire to 194 in Surrey. Among 'migrants', who died in a different county from that in which they were born, PMRs by place of death varied from 85 in the group of counties which had the lowest mortality in non-migrants to 111 in those with the highest mortality in non-migrants, and PMRs by place of birth varied from 74 in counties with lowest mortality in non-migrants to 113 in those with highest mortality in non-migrants. After adjustment for place of residence at death, the relation of mortality to place of birth was highly significant statistically (P < < 0.001). These findings indicate important causes of aortic aneurysm acting early in life, perhaps related to the formation of elastin in the arterial wall.
Contrasting epidemiology of aortic aneurysm and peripheral vascular disease in England and Wales.
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Not quite as random as I pretended.
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Sports injuries and the accident and emergency department--ten years on.
A six month prospective survey in 1990 of sports injuries presenting to the A+E department of St James and the Mater hospitals revealed 1594 patients, accounting for 3.8% of the total number of new patients seen in that period. These results were compared to a similar study conducted in the Mater in 1980. Comparison with the 1980 study showed similar patterns with respect to sex, sport and site of injury. There was an increase of the age at which sport was played as evidence by the age of those injured. Whilst delay in presentation has improved somewhat, 57% of patients stil waited more than 12 hours before attending. Management of the total spectrum of injury has changed. More X-Rays were taken and on-site physiotherapy has been established in both A+E departments. Despite such an accessible facility the use of physiotherapy in sports injuries could be improved. There was also variation in the treatment of non-orthopaedic injury. We recommend that education of sport participants continue, especially in the areas of protective equipment and early presentation for medical assessment. We further propose that A+E staff be educated in the special needs of sports men and women, and that as recommended previously in the 1980 study, a Central Sports Injury Clinic for the six Dublin hospitals be established.
End-organ responses to thyroxine therapy in subclinical hypothyroidism.
We studied variables known to change with thyroid hormone status in 18 patients with subclinical hypothyroidism before and during treatment with thyroxine in a dose sufficient to restore the plasma TSH response to TRH to normal. There was an associated increase in both plasma total T4 and free T4 within the normal range but plasma total T3 and free T3 were unchanged. As a result of thyroxine treatment there was a small but significant increase (P less than 0.05) in left ventricular ejection fraction (LVEF) with maximal exercise but no significant changes in LVEF at rest and moderate exercise, continuously monitored mean sleeping heart rate, day/night ratios of urinary sodium excretion, peripheral nerve conduction velocities, fasting serum triglycerides, total cholesterol (TC), high density lipoproteins (HDL) or TC/HDL ratios. On this evidence we do not consider that thyroxine replacement therapy is indicated in patients with subclinical hypothyroidism.
Lipid storage myopathy: successful treatment with propranolol.
Lipid storage myopathies are a rare but serious cause of muscle weakness characterised by the accumulation of abnormal amounts of neutral fat in type 1 fibres. A case is reported in which the patient presented with weakness of the proximal limb muscles and greatly increased activities of creatine kinase and lactate dehydrogenase. After two years lipid myopathy was diagnosed when electron microscopy confirmed the presence of large numbers of lipid particles within muscle fibres. Twelve years after the initial presentation propranolol (40 mg thrice daily) was started. Strength gradually improved and enzyme activities returned to normal. The improvement in the patient's condition was almost certainly due to the propranolol, although the mode of action of the drug remains unknown.