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Biomedical subjects

J Wing

Publications and source records attributed to J Wing.

At least 37 records · Page 2Linked to original sources
PubMed1989

Clinical and biochemical responses to nadolol and clonidine in hyperthyroidism.

Some features of hyperthyroidism mimic sympathetic nervous system overactivity. We have compared the clinical (scored on the Wayne Therapeutic Index), hemodynamic (blood pressure and heart rate) and biochemical (plasma epinephrine, norepinephrine, glucose, free fatty acids, insulin, growth hormone and free thyroxine index) effects of clonidine (alpha 2-agonist, which reduces plasma catecholamine levels) with those of nadolol (non-selective beta adrenergic receptor antagonist) in ten female hyperthyroid patients. Each patient received nadolol for 1 week followed by clonidine for 1 week in a single-blind manner. All measurements were made before treatment and then repeated at the end of the nadolol and clonidine treatment periods. Thyroid function remained unaltered during the study. Both agents caused significant clinical improvement--the mean Wayne Index score was 18 pretreatment, 2 on nadolol and 6 on clonidine (P less than .003 for each). Heart rate was reduced by both drugs, but blood pressure was unchanged. Side effects occurred in eight out of ten patients while on clonidine. Nadolol increased plasma concentrations of epinephrine from 47 +/- 18 pg/mL to 87 +/- 24 pg/mL, and norepinephrine from 241 +/- 154 pg/mL to 338 +/- 224 pg/mL (P less than .001 for each). In contrast, clonidine depressed norepinephrine levels from 241 +/- 154 pg/mL to 110 +/- 49 pg/mL (P less than .001) without lowering plasma epinephrine significantly. Plasma free fatty acids tended to fall on both agents compared to pretreatment levels. The blood glucose, insulin and growth hormone concentrations were unaffected by either drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Drug therapy for Graves' disease in blacks--very low rates of remission.

The rates of remission after a course of antithyroid drugs in 71 black and 45 white patients with Graves' disease were compared. One year after stopping therapy 27% of blacks and 47% of whites were in remission (P less than 0.01); at 2 years the proportions were 7% and 27% respectively (P less than 0.05). Small size of goitre only was a weak predictor of remission; duration of therapy did not influence the outcome. HLA A2 and B17 may be less frequent in black patients who remain in remission (P = 0.048 and 0.067 respectively). The data suggest that it is not worth while undertaking a trial of medical therapy in unselected black patients with Graves' disease.

Adult↗
PubMed1988

The Composite International Diagnostic Interview. An epidemiologic Instrument suitable for use in conjunction with different diagnostic systems and in different cultures.

The Composite International Diagnostic Interview (CIDI), written at the request of the World Health Organization/US Alcohol, Drug Abuse, and Mental Health Administration Task Force on Psychiatric Assessment Instruments, combines questions from the Diagnostic Interview Schedule with questions designed to elicit Present State Examination items. It is fully structured to allow administration by lay interviewers and scoring of diagnoses by computer. A special Substance Abuse Module covers tobacco, alcohol, and other drug abuse in considerable detail, allowing the assessment of the quality and severity of dependence and its course. This article describes the design and development of the CIDI and the current field testing of a slightly reduced "core" version. The field test is being conducted in 19 centers around the world to assess the interviews' reliability and its acceptability to clinicians and the general populace in different cultures and to provide data on which to base revisions that may be found necessary. In addition, questions to assess International Classification of Diseases, ninth revision, and the revised DSM-III diagnoses are being written. If all goes well, the CIDI will allow investigators reliably to assess mental disorders according to the most widely accepted nomenclatures in many different populations and cultures.

Cross-Cultural Comparison↗
PubMed1987

The effect of kallikrein on spermatozoal ATP and other semen parameters.

Kallikrein promotes the release of kinins, which have been shown in in vitro studies to improve motility, viability and metabolism in human spermatozoa. The effects of kallikrein therapy on 25 males attending an infertility clinic was assessed, regarding endogenous spermatozoal ATP content, as well as other semen parameters. Thirteen of the 25 patients showed an improvement in either count, morphology, motility, viability, or a combination of these, after 3 months Kallikrein therapy. ATP levels in responders dropped by 58.8% (p less than 0.001). In nonresponders ATP levels did not change significantly. This indicates that improvement in spermatozoal parameters corresponds with increased ATP consumption, following Kallikrein therapy.

Adenosine Triphosphate↗
PubMed1986

Parathyroid hypertension. A reversible disorder.

A retrospective study of 75 patients who were surgically cured of primary hyperparathyroidism from 1976 to 1984 was performed to evaluate the blood pressure and metabolic responses to parathyroid surgery. Published data on the population prevalence of hypertension (HT) in South Africa were used for comparison. The overall prevalence of HT before surgery was 47%, compared with 23% in the general population. Hypertension was most frequent in patients older than 60 years (62% vs 39% expected). Renal insufficiency was found in 13 of 35 hypertensive patients and in two of 40 normotensive patients. However, the prevalence of HT in patients with normal creatinine levels (37%) exceeded that expected. The frequency of urolithiasis and mean levels of serum and urine calcium and phosphate were similar in normotensive and hypertensive patients. Parathyroidectomy resulted in a substantial fall in both mean systolic and mean diastolic blood pressures in 54% of the hypertensive subjects, unrelated to improvement in renal function.

Blood Pressure↗
PubMed1982

High radio-isotope uptakes in patients with hypothyroidism.

Hypothyroidism is usually associated with a low radio-isotope uptake by the thyroid gland. We report 8 cases of Hashimoto's thyroiditis with clinical and biochemical hypothyroidism and with borderline high or overtly increased technetium-99m pertechnetate and/or iodine-131 uptakes.

Adolescent↗
PubMed1982

Severe airway obstruction associated with rheumatoid arthritis and Sjögren's syndrome. A case report.

Numerous pulmonary complications associated with rheumatoid arthritis (RA) and Sjögren's syndrome (SS) have been described. Mild airway obstruction has recently been recognized in these disorders, severe obstruction occurring in only a few patients with RA. We report a patient with RA and SS who developed severe irreversible airway obstruction, an association not hitherto described. The airway disease failed to respond to bronchodilators, steroids or immunosuppressive agents.

Arthritis, Rheumatoid↗
PubMed1981

The adult respiratory distress syndrome. A review, some thoughts and a few new ideas.

Adult respiratory distress syndrome is being recognized more frequently as a complication of a number of conditions. The causes, pathophysiology, pathology, clinical manifestations and management are reviewed in this article. The use of positive end-expiratory pressure (PEEP) and super-PEEP is discussed. The value of measurements of mixed venous oxygen partial pressure (PVO2) in the treatment of respiratory failure, especially in the presence of high inspired oxygen tensions, is explained and emphasized.

Humans↗
PubMed1977

Further developments of the 'present state examination' and CATEGO system.

Some further developments of the PSE and CATEGO system are reported. The shorter ninth revision of the PSE, together with its glossary of definitions of symptoms, has proved useful in skilled hands and certain sources of error in the eighth edition have been reduced. The Syndrome Check List and Aetiology Schedule have proved useful in decreasing the number of coding errors.

Adult↗
PubMed1975

[The evaluation of community psychiatric services. Some methodological problems (author's transl)].

We have now come to accept that any new pharmacological treatment must be comprehensively and intensively evaluated before it is introduced into general clinical practice. The thalidomide tragedy has illustrated the dangers of inadequate testing. It is less obvious, however, that psychosocial treatments need to be assessed just as stringently. The claims made for new forms of social treatment and new forms of service are very large. The effects, for example, of turning from a predominantly hospital-based service to one which depends on the co-ordination of a large number of smaller community agencies, are potentially much greater than anything that could be expected from the introduction of a new drug. Itis essential that psychiatrists play their full part in this new and rapidly developing field of investigation.

Community Mental Health Services↗