Biomedical subjects

Caroline Wright

Publications and source records attributed to Caroline Wright.

5 recordsLinked to original sources

PubMed2006

Opiate therapy in chronic cough.

RATIONALE: Cough is the most common complaint for which medical attention is sought, and chronic cough can be both physically and mentally debilitating. There is currently no evidence supporting the use of antitussives in chronic treatment-resistant cough. OBJECTIVES: We tested the hypothesis that morphine sulfate in the dose of 5 mg twice daily would bring about a reduction in cough frequency and severity in patients failing to respond to specific measures. METHODS: Patients recruited from the Hull Cough Clinic were enrolled into a randomized double-blind placebo-controlled study using 4 weeks of slow-release morphine sulfate and a corresponding period of matched placebo. An open-labeled extension of the core study allowed dose escalation to 10 mg twice daily. Cough was assessed using the Leicester Cough Questionnaire, daily symptom diary, and citric acid cough challenge. RESULTS: Twenty-seven patients completed the core study. A significant improvement of 3.2 points over baseline was noted on the Leicester Cough Questionnaire (p < 0.01). A rapid and highly significant reduction by 40% in daily cough scores was noted among patients on slow-release morphine sulfate (p < 0.01). Objective testing of the cough reflex using citric acid cough challenge tests did not show any significant changes. Eighteen patients continued into the extension study. Two-thirds of these patients opted to increase the morphine to 10 mg twice daily. At the end of 3 months, there was a similar improvement in cough between the 5- and 10-mg groups. CONCLUSION: Morphine sulfate is an effective antitussive in intractable chronic cough at the doses of 5 to 10 mg twice daily.

Analgesics, Opioid↗

PubMed2006

Hysterectomy and sexual function.

Hysterectomy is one of the most common major gynaecological operations performed in the UK and the USA. Its impact on sexual function is a major cause of preoperative anxiety. Unfortunately, this anxiety is seldom articulated by patients, nor recognized and discussed by clinicians. Reports about the impact of hysterectomy on sexual function have been conflicting, partly due to the use of different and often unsatisfactory parameters to assess sexual function. The aim of this review is to assess the current evidence about the effect of hysterectomy on sexual function. Female sexual function is governed by psychological, social and physiological factors. A new model of 'the sexual response cycle', comprising physical, emotional and cognitive feedback, helps explain the sexual difficulties that arise before and after hysterectomy. Evidence is lacking for sexual dysfunction caused by the disruption of local nerve and blood supply, or by changing anatomical relationships. Removal of the ovaries at hysterectomy is associated with no change or even an improvement in sexual function, particularly in women on hormone replacement therapy. Thus, overall, hysterectomy improves sexual function, regardless of surgical method or removal of the cervix. This is probably due to the amelioration of the symptoms that have previously had a negative effect on sexual function.

Female↗

PubMed2006

Dispositional optimism and health behaviour in community-dwelling older people: associations with healthy ageing.

OBJECTIVE: Dispositional optimism measured with the Life Orientation Test has been associated with a variety of health outcomes. We assessed whether optimism was related to indices of healthy ageing, and if effects were mediated through health behaviours. METHOD: A community sample of 128 men and women aged 65 to 80 years was recruited from general practice lists. Optimism and health behaviours were assessed by questionnaire, and healthy ageing indexed by physical health summary scores from the Short Form 36, and by self-rated health. RESULTS: Optimism was associated with not smoking, moderate alcohol consumption, brisk walking, and vigorous physical activities (women only), independently of socio-demographic factors and clinical condition. Physical health status was associated with optimism, independently of socio-demographic factors, clinical condition, negative affectivity, and body mass. This effect was attenuated when health behaviours were taken into account. Self-rated health was also positively related to optimism, and this association was not mediated by health behaviours. Neither the optimism nor pessimism subscales of the Life Orientation Test showed as consistent effects as the full scale. CONCLUSIONS: We conclude that dispositional optimism is associated with healthy ageing. The relationship between optimism and healthy ageing was only partly mediated by the health behaviours assessed in this sample.

Affect↗

PubMed2004

Socioeconomic position and cardiovascular and neuroendocrine responses following cognitive challenge in old age.

Social disparities in health persist into old age, and differences in psychophysiological responsivity may contribute to this pattern. We assessed whether higher socioeconomic status (SES) is associated with attenuated cardiovascular and neuroendocrine responses elicited by cognitive tasks in old age. We tested 132 community-dwelling men and women aged 65-80 years, divided on the basis of educational attainment into higher and lower SES groups, and compared them with 26 higher educated participants aged 27-42 years. Blood pressure, hemodynamic variables and salivary cortisol were assessed in response to the performance of three cognitive tasks, and then during recovery. Older groups showed smaller heart rate and larger cortisol changes than younger participants. Post-task recovery in heart rate, stroke volume, pre-ejection period, and systolic blood pressure was greatest in the younger group, least in the older/lower education group, and intermediate in the older/higher education group. SES did not influence the increased cortisol responsivity of older participants. The results are consistent with the notion that higher SES protects against age-related changes in cardiovascular response profiles, particularly during recovery.

Adult↗

PubMed2004

Effect of salbutamol on smoking related cough.

Smokers have an increased prevalence of chronic cough and may complain of exacerbation of cough when attempting smoking cessation. We investigated the use of smokers cough as a model for testing anti-tussive agents. The effect of salbutamol was compared with placebo in healthy adult smokers. In a randomised double blind crossover study the effect of 400 microg salbutamol via MDI plus spacer versus placebo was studied. Cough was assessed before and after the first cigarette of the day (received at 20 minutes) and throughout the day. Cough frequency, citric acid cough challenge, change in cough symptoms and peak flow were recorded. Salbutamol reduced the mean cough frequency between 0 and 20 min. A mean of 4.5 compared to 6 on placebo (p<0.05). A significant reduction in cough followed cigarette consumption in those on placebo. Mean pre-cigarette 6 compared to 3.9 post-cigarette (p<0.02). The citric acid concentration causing two coughs (C2) at 60 min increased on salbutamol. Geometric mean 278.8 compared to 190.4 mM on placebo (p<0.03). Cough frequency is reduced in smokers following a cigarette. The reduction in cough frequency and evoked cough after salbutamol suggests that beta agonists have modest activity in smoking related cough and that smokers cough represents a sensitive model to test anti-tussive activity.

Adult↗