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Biomedical subjects

J R Naylor

Publications and source records attributed to J R Naylor.

10 recordsLinked to original sources
PubMed1994

A general population survey of rest cramps.

Two hundred and eighteen subjects, out of 250 individuals taken from a general practice register, returned completed questionnaires giving details about rest cramps, and a further 15 were contacted by telephone. The overall prevalence of rest cramps in the survey population was 37%. The symptom was more prevalent in older subjects. Rest cramps were most commonly experienced in the muscles of the leg, in 83% of the 86 cramp sufferers. Symptoms were usually present at night (73%). On average cramp episodes lasted for 9 min (95%CI 6.7-11.2). Most cramps sufferers experienced symptoms infrequently, but 40% had cramp episodes more than three times per week and 6% complained of at least one episode per day or night. Twenty-one per cent of cramp sufferers described their symptoms as very distressing. A minority, 32% of the 86 cramp sufferers, had reported the symptoms to a general practitioner although the 86 subjects self-rated their health more negatively than the individuals without muscle cramps. There was a significant, positive association between rest cramps and symptoms of angina or intermittent claudication although these two factors only accounted for 12% of the variance, suggesting that peripheral vascular disease may play a relevant but limited role in the aetiology of rest cramps.

Aged↗
PubMed1993

Commodes: inconvenient conveniences.

OBJECTIVES: To investigate use of commodes and attitudes of users and carers to them. DESIGN: Interview with semi-structured questionnaire of subjects supplied with commodes from Leeds community appliance centre. SUBJECTS: 140 users of a commode and 105 of their carers. RESULTS: Main reasons for being supplied with a commode were impaired mobility (130 subjects), difficulty in climbing stairs (128), and urinary incontinence (127). Main concerns of users and carers were lack of privacy (120 subjects felt embarrassed about using their commode, and 96 would not use it if someone was present); unpleasant smells (especially for 20 subjects who were confined to one room); physical appearance of commode chair (101 users said it had an unfavourable appearance, and 44 had tried to disguise it); and lack of follow up after commode was supplied (only 15 users and carers knew who to contact if there were problems). Users generally either had very positive or very negative attitudes to their commodes but most carers viewed them very negatively, especially with regard to cleaning them. CONCLUSIONS: Health professionals should be aware of people's need for privacy when advising them where to keep their commode. A standard commode is inappropriate for people confined to one room, and alternatives such as a chemical toilet should be considered. Regular follow up is needed to identify any problems such as uncomfortable or unsafe chairs. More thought should be given to the appearance of commodes in their design.

Aged↗
PubMed1993

Equine plasma and blood volumes decrease with dehydration but subsequently increase with exercise.

The effects of dehydration and 40 min of exercise at approximately 40% of maximal O2 consumption on plasma volume (PV) and blood volume (BV) were studied in six horses. Horses were exercised while euhydrated (C); 4 h after administration of furosemide (1.0 mg/kg i.v.; FDH), which induced isotonic dehydration; and after 30 h without water (DDH), which caused hypertonic dehydration. Dehydration resulted in decreases of 6.3 and 9.9% for PV and BV, respectively, with FDH and 10.7 and 8.5%, respectively, with DDH. During exercise in C, PV and BV increased by 12.7 and 20.0%, respectively; during exercise with FDH, they increased by 11.7 and 26.1%, respectively; and during exercise with DDH, PV decreased by 1.3% from predehydration values, while BV increased by 18.7%. Hematocrit and total plasma protein concentration rose to higher values throughout exercise in FDH and DDH than in C; plasma [Na+] was higher in DDH than in FDH and C, [Cl-] was higher in DDH and lower in FDH than in C, and [K+] was lower in FDH and DDH than in C through exercise and recovery. From these results, we conclude that increases in PV and BV are normal features of low-intensity exercise in the horse. The increases in BV not only augment O2 carriage but also help maintain circulating volume. These increases can be modified by preexercise dehydration, the nature of which affects the extent of modification.

Animals↗
PubMed1993

Effects of dehydration on thermoregulatory responses of horses during low-intensity exercise.

Effects of dehydration on thermoregulatory and metabolic responses were studied in six horses during 40 min of exercise eliciting approximately 40% of maximal O2 consumption and for 30 min after exercise. Horses were exercised while euhydrated (C), 4 h after administration of furosemide (FDH; 1.0 mg/kg i.v.) to induce isotonic dehydration, and after 30 h without water (DDH) to induce hypertonic dehydration. Cardiac output was significantly lower in FDH (144.1 +/- 8.0 l/min) and in DDH (156.6 +/- 6.9 l/min) than in C (173.1 +/- 6.2 l/min) after 30 min of exercise. When DDH, FDH, and C values were compared, dehydration resulted in higher temperatures in the middle gluteal muscle (41.9 +/- 0.3, 41.1 +/- 0.2, and 40.6 +/- 0.2 degrees C, respectively) and pulmonary artery (40.8 +/- 0.3, 40.1 +/- 0.2, and 39.7 +/- 0.2 degrees C, respectively). Temperatures in the superficial thoracic vein and subcutaneous sites on the neck and back and peak sweating rates on the neck and back were not significantly different in DDH and C. In view of higher core temperatures during exercise after dehydration and decrease in cardiac output without concomitant increases in peripheral temperatures or reduced sweating rates, we conclude that the impairment of thermoregulation was primarily due to decreased transfer of heat from core to periphery.

Animals↗
PubMed1992

Test/inform/retest: a useful technique in undergraduate rheumatology teaching.

Twenty final year medical students had their ability to interpret rheumatological physical signs tested by 10 multiple choice questions (MCQ) on days 1 and 4 of an educational study. Ten theory questions were used as controls. They were then given an information sheet on the interpretation of physical signs, and repeated the MCQ on day 26. There was a progressive improvement in the theory scores but no improvement in clinical scores until after the information sheet was available. The improvement in clinical scores was significantly greater than the improvement in theory scores (P less than 0.001). We suggest that the use of an information sheet in conjunction with an MCQ paper can improve undergraduates' ability to interpret physical signs when used in the pattern test/inform/retest.

Education, Medical, Undergraduate↗
PubMed1992

Intracellular free Ca2+ fluxes and responses to phorbol ester in T lymphocytes from healthy elderly subjects.

A group of healthy elderly subjects (greater than or equal to 75 years) was selected by the strict criteria of the SENIEUR protocol, and compared with healthy young (less than or equal to 35 years) volunteers. Mitogenic responses of peripheral blood mononuclear cells to phytohaemagglutinin and anti-CD3 were significantly reduced in the elderly (P less than 0.0002), thereby confirming that even though in perfect health, elderly individuals show impaired cell-mediated immunity. However, no abnormality of intracellular free Ca2+ fluxes could be detected in purified T cells from the elderly subjects when stimulated with anti-CD3 antibody. Nevertheless, both the proliferative responses of purified T cells to phorbol ester and calcium ionophore (Ionomycin) and the phorbol ester-induced inhibition of the Ca2+ response were defective in the elderly subjects (P less than 0.003 and P less than 0.0002, respectively). These data suggest that signal transduction and the generation of second messengers proceed normally in T cells from the elderly, but downstream events mediated by activation of protein kinase C are dysfunctional.

Adult↗
PubMed1991

Surgical collars: a survey of their prescription and use.

We report the results of a questionnaire survey of 124 orthopaedic, rheumatology, medical and accident and emergency outpatients prescribed a surgical collar during a 3-month period. Of these, 99 (80%) returned the questionnaire. Instructions received about when to wear the collar differed widely, especially between specialties. Most patients (76%) found benefit in wearing the collar. Pain was the symptom helped most (78%) whilst dizziness was helped least (40%). Problems with the collars were common, many being too hot (69%) and uncomfortable (48%). A third had difficulty putting the collar on. Despite these problems, compliance was good with 19 patients discontinuing collars for reasons other than recovery or medical advice. We believe this study highlights further areas for research and stimulates a re-evaluation of collar usage.

Adolescent↗