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Biomedical subjects

R Eccles

Publications and source records attributed to R Eccles.

At least 73 records · Page 4Linked to original sources

The effect of pressure and warmth applied to the axilla on unilateral nasal airway resistance and facial skin temperature.

The effect of pressure, warmth, and control stimuli applied to the axilla and lateral chest wall on unilateral nasal airway resistance and facial skin temperature was investigated in 60 healthy adults. Nasal resistance was measured by posterior rhinomanometry and skin temperature with an infrared thermometer. A significant increase in unilateral nasal resistance ipsilateral to the applied stimulus was seen with both pressure and warmth (p = 0.006, p = 0.02). A decrease in unilateral nasal resistance contralateral to the stimulus was seen in both these groups, but this was not significant (p = 0.45, p = 0.81). The control stimulus showed a non-significant increase in unilateral nasal resistance ipsilateral to the applied stimulus (p = 0.55), and a significant rise in unilateral nasal resistance on the contralateral side (p = 0.008). There were no significant differences between the ipsilateral and contralateral facial skin temperatures before or after the application of a unilateral pressure, warm or control stimulus. A significant bilateral increase in facial temperature was observed during the course of the experiment in all three groups. The mechanisms of induced changes in unilateral nasal resistance are discussed. The results increase our knowledge of the corporo-nasal reflex and demonstrate that the reciprocal changes in sympathetic tone to the nasal capacitance blood vessels are independent from any parallel reflex changes in sympathetic tone to cutaneous blood vessels.

Adolescent↗

Voluntary cough suppression as an indication of symptom severity in upper respiratory tract infections.

The aim of the present study was to determine whether the ability to suppress cough voluntarily is an index of cough severity in upper respiratory tract infection. Cough was measured by means of a microphone linked to a pen recorder and subjects were instructed to voluntarily suppress cough in order to determine cough suppression time. Subjective scores of symptom severity, mood and psychological parameters were made prior to cough measurements. The baseline frequency of cough showed a distribution towards the higher frequencies, with a median of 2.1 (lower quartile 1.2, upper quartile 3.2) coughs.min-1. The results for cough suppression fell into two distinct groups, one group reaching a breaking point within 12.6 min; and another group which did not cough during the 20 min cough suppression period. In the group of subjects which broke from the cough suppression, there was an inverse relationship between the cough suppression time and the baseline frequency of cough. The median frequency of cough following cough suppression was significantly greater than the baseline median frequency of cough. The subjects who reached a breaking point had a greater baseline frequency of cough and a greater symptom severity score, and they also felt more feeble, clumsy, sad and antagonistic than the group which did not reach a breaking point. The subjects who reached a breaking point had significantly greater scores for the psychology parameter of obsessional symptoms than the group which did not reach a breaking point.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Providing clinicians with problem-based access to knowledge: troubleshooting pulmonary artery catheter waveforms.

This paper describes a microcomputer system for providing computer-based access to expert knowledge in the area of troubleshooting pulmonary artery (PA) catheter waveforms. The system is used by both nurses and physicians in an 18-bed medical intensive care unit. Its dominant features are 1) problem-focused access to knowledge, and 2) heavy use of graphics and images to explicate knowledge. The system is used by both nurses and physicians in an 18-bed medical intensive care unit. An evaluation protocol is in place to examine the impact of the system on clinicians' knowledge, their decision-making skills, their satisfaction with the system, and costs of orientation related to PA waveform troubleshooting.

Catheterization, Swan-Ganz↗

Seasonal allergic rhinitis and its effects on eustachian tube function and middle ear pressure.

Middle ear pressure was recorded from 396 ears and aural symptoms inquired of 198 adult subjects with seasonal allergic rhinitis. Evidence of eustachian tube dysfunction was found in 24% of subjects. Increased duration of exposure to pollen over a further 2 weeks increased the incidence of eustachian tube dysfunction to 48%. The development of eustachian tube dysfunction did not correlate with the severity of nasal symptoms.

Adolescent↗

The effect of adenoid and tonsil surgery on nasalance.

The change in nasalance following adenoidectomy, tonsillectomy and adenotonsillectomy was studied in 44 children. A subjective assessment of each child's naso-pharyngeal airway was made preoperatively based on a questionnaire completed by the parents. There was no significant change in the nasalance of children following adenoidectomy, but there was a significant increase in the nasalance following tonsillectomy (P = 0.02) and after adenotonsillectomy (P = 0.001). There was no relationship between the change in nasalance and the adenoid volume removed at operation. There was good agreement between the parental subjective assessment of the naso-pharyngeal airway and the preoperative nasalance score, with the best correlation in the adenoidectomy group (r = -0.8) and the adenotonsillectomy group (r = -0.7). Nasalance is more closely related to the size of the naso-pharyngeal airway than to the actual adenoid volume, and measurements of nasalance are of no benefit in predicting adenoid volume. Tonsillectomy had a significantly greater effect on nasalance than adenoidectomy, and adenotonsillectomy had the greatest effect. Further studies are needed to relate nasalance to the size of the naso-pharyngeal airway, but it appears to relate well to the subjective assessment of the airway and may be of use in patient selection for surgery.

Adenoidectomy↗

Lack of effect of codeine in the treatment of cough associated with acute upper respiratory tract infection.

Codeine is often used as a standard antitussive against which new antitussives are compared. However there is little information available about the effects of codeine on cough associated with upper respiratory tract infection. The present study investigated the effects of codeine syrup B.P. (30 mg/10 ml, q.d.s.) or syrup vehicle on cough frequency and the subjective severity of cough during a 3-h laboratory phase and a 4-day home phase of treatment. Cough frequency and subjective scores of cough severity were significantly decreased during the 3-h laboratory phase but at no time point was there a significant difference between the codeine- and placebo-treated groups. The results of the 4-day home phase diary were similar to those of the laboratory phase as at no time point was there a significant difference between the mean scores for the codeine- and placebo-treated groups. The results indicate that codeine, either as a single 30-mg dose or in a total daily dose of 120 mg, is no more effective than the syrup vehicle in controlling cough associated with acute upper respiratory tract infection.

Acute Disease↗

Nasal airflow asymmetry and the effects of a topical nasal decongestant.

Nasal airway resistance (NAR) is normally asymmetrical due to the nasal cycle. The aims of this study were to determine the degree of this asymmetry in healthy subjects and those with acute rhinitis associated with common cold, and to investigate how the administration of a topical nasal decongestant (xylometazoline) influenced the asymmetry in NAR. Unilateral NAR was measured by active anterior rhinomanometry, and was shown to be asymmetrical in both healthy subjects and those suffering with acute rhinitis. The asymmetry in NAR was greater in those with acute rhinitis than in the healthy group, with a ratio between "high" and "low" sides of 2.3:1 in the rhinitis group compared to a ratio of 1.7:1 in the healthy subjects. Administration of a topical nasal decongestant caused a significant decrease in total NAR in both groups and abolished the asymmetry in NAR in the healthy subjects (ratio is 1:1 after decongestion). However, significant asymmetry of NAR was still present in the group with acute rhinitis following the administration of decongestant (ratio is 1.5:1 after decongestion). These findings show that the normal asymmetry in NAR was increased during acute rhinitis associated with common cold, and that in healthy subjects (but not in those with rhinitis) the asymmetry was abolished by administration of a topical decongestant. The results are discussed in relation to nasal sympathetic tone and nasal blood flow.

Acute Disease↗

Nasal airway resistance and nasal sensation of airflow.

Nasal obstruction is a common symptom which is most frequently associated with an increased nasal airway resistance. However it is important to appreciate that the objective measurement of nasal airway resistance does not always correlate with the subjective perception of the degree of nasal obstruction. Damage to trigeminal sensory nerve endings can cause a sensation of nasal stuffiness without any change in nasal airway resistance and similarly inhalation of menthol can cause a subjective improvement in nasal sensation of airflow without any change in nasal resistance.

Airway Resistance↗

Relationships between vital capacity, height and nasal airway resistance in asymptomatic volunteers.

Nasal airway resistance (NAR), vital capacity and height were measured in 76 asymptomatic volunteers aged between 18 and 71, mean age 28 +/- 1.4 years. Total NAR ranged from 0.15-0.39 Pa/cm3/s, with a mean total NAR of 0.23 +/- 0.006 Pa/cm3/s. Despite a good correlation between vital capacity and height in these subjects (r = 0.76) no relationships were found between either total NAR and vital capacity or total NAR and height. Physiological NAR is not related to vital capacity or height in normal healthy individuals.

Adult↗

The effect of postural change and upper respiratory tract infection on middle ear pressure.

The effect of a change in posture from sitting erect to lying supine and horizontal on middle ear pressure was investigated in 5 healthy adults and 5 adults with symptoms of an acute upper respiratory tract infection (URTI). The change in posture had no significant effect on middle ear pressure in the healthy subjects (p greater than 0.05). In those with URTI mean middle ear pressure increased from -39.5 daPa (erect) to -16.9 daPa (supine) (p = 0.026, n = 10). In the supine posture the middle ear pressure in subjects with URTI was raised. The cause of the increase in middle ear pressure is discussed in terms that the postural change may alter middle ear physiology such that in the supine posture there is a net production of middle ear gas as opposed to a net reabsorption in the erect posture. This may indicate that an increase in jugular venous pressure causes a net positive production of middle ear gas.

Acoustic Impedance Tests↗

Cyclical changes in nasal airway resistance and middle ear pressures.

The relationship between unilateral changes in nasal airway resistance and the ipsilateral middle ear pressure were investigated in 8 otologically and rhinologically normal adults over the course of 7 1/2 h under laboratory conditions. Despite mean changes in unilateral nasal resistance of 0.75 Pa/cm3/s associated with the nasal cycle, no correlation existed with changes in ipsilateral Eustachian tube function, as judged by serial middle ear pressure recordings (r = 0.06, r2 = 0.00, p = 0.461). Middle ear pressure in healthy adults in a controlled environment remained very constant (mean = -6.71 +/- 0.52 daPa). 69% of middle ear pressures were equal to or above 0 daPa, which represents evidence in favour of a net positive production of middle ear gas.

Adult↗

The effects of menthol on reaction time and nasal sensation of airflow in subjects suffering from the common cold.

The effects of sucking a lozenge containing 11 mg L-menthol on reaction time and nasal sensation were investigated in a double blind trial on 60 subjects suffering from the common cold. Reaction time was determined by measuring the response time to a stimulus presented on a microcomputer screen and nasal sensation was scored on a visual analogue scale. Menthol ingestion compared to placebo caused a significant increase in nasal sensation of airflow which persisted for up to 30 min. The simple and choice reaction times measured before ingestion of the lozenge were similar to those found in healthy uninfected subjects and there was no change in reaction time after ingestion of menthol.

Adolescent↗

The effects of oral administration of (-)-menthol on nasal resistance to airflow and nasal sensation of airflow in subjects suffering from nasal congestion associated with the common cold.

The effects of oral administration of a lozenge containing 11 mg (-)-menthol on nasal resistance to airflow (NAR) and nasal sensation of airflow in 62 subjects suffering from nasal congestion associated with naturally acquired common cold infection have been studied. NAR was measured by posterior rhinomanometry and nasal sensation of airflow by means of a visual analogue scale (VAS). The effects of the lozenge were compared with a candy placebo lozenge in a double blind randomized trial. NAR showed a significant increase (P less than 0.05) in both the menthol and placebo groups over the 2 h experiment with no difference between the groups at any time. The VAS scores showed significant changes of subjective improvement in nasal sensation of airflow (P less than 0.001) in the menthol-treated group 10 min after dosing whereas the placebo group showed no change. It is concluded that dosing with 11 mg menthol in subjects with common cold has no effect on NAR as measured by posterior rhinomanometry but causes a marked change in nasal sensation of airflow with a subjective sensation of nasal decongestion.

Administration, Oral↗

The effects of D and L isomers of menthol upon nasal sensation of airflow.

Objective and subjective measurements of nasal airflow were made before and after inhalation of Vanilla, D-Menthol and L-Menthol separately. Despite the fact that the menthol isomers were mirror images of one another, only L-Menthol produced the sensation of increased nasal airway patency. No objective change in resistance was found after inhaling either D-Menthol, L-Menthol or the vanilla control. These findings demonstrate that L-Menthol exerts a specific action upon nasal sensory nerve endings, which are responsible for the subjective appreciation of nasal airflow.

Adult↗

The effects of menthol isomers on nasal sensation of airflow.

The effects of inhalation of L-menthol, D-isomenthol and D-neomenthol, upon nasal resistance and sensation to airflow were investigated in 40 subjects. L-menthol caused a highly significant enhancement of nasal sensation of airflow but despite their great similarity in structure and a similar peppermint smell the isomers D-isomenthol and D-neomenthol had no effect on nasal sensation of airflow. These findings show that L-menthol has a specific pharmacological action on nasal sensory nerve endings which is not related to its peppermint smell.

Adolescent↗

The effect of aromatics on inspiratory and expiratory nasal resistance to airflow.

Unilateral inspiratory and expiratory nasal resistance to airflow were measured in 35 subjects using active anterior rhinomanometry. No significant difference was found between inspiratory and expiratory resistance. Inhalation of a mixture of aromatics, camphor, menthol, oil of pine needles and methyl salicylate had no effect on inspiratory or expiratory nasal resistance. Factors influencing inspiratory and expiratory resistance and the actions of aromatics are discussed.

Adult↗