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Biomedical subjects

R Hayton

Publications and source records attributed to R Hayton.

7 recordsLinked to original sources

An audit of pulmonary function laboratories in the West Midlands.

BACKGROUND: Pulmonary function testing has become an integral part of the assessment and follow-up of patients with pulmonary disease. Many factors can influence the results produced by a laboratory. This audit was performed to examine the extent of variation in the pulmonary function test results amongst all laboratories in the West Midlands. This was followed by an attempt to determine the cause of this variation. METHODS: Phase 1. Three normal healthy subjects each underwent a set of pulmonary function tests in all 22 laboratories in the West Midlands. Information regarding technicians' qualifications, training and seniority, protocol and equipment used were obtained in the form of a questionnaire. Phase 2. All 22 laboratories were asked to calculate the predicted values on the same nine sets of demographic data. These data included both sexes, ethnic minorities and range of ages. In addition technical aspects of each laboratory were investigated including the assessment of volume and gas analysers with standard gases containing known concentrations of helium and carbon monoxide. RESULTS: Phase 1. Significant variations (P < 0.05) were observed in all measured values of pulmonary function tests of the three subjects. Significant variations (P < 0.05) were also observed in all predicted values except total lung capacity. Phase 2. There were significant variations (P < 0.05) amongst laboratories in calculating the predicted values of all components of pulmonary function tests. No significant differences were observed in the measurement of volume or concentration of carbon monoxide or helium.

Adult

Consistency of morning stiffness: an analysis of diary data.

This study aimed to determine the within-individual daily variation in morning stiffness (MS) of RA patients, and to validate the routine clinically derived duration of MS against that recorded prospectively by patients. Forty-nine RA patients, who during a detailed clinical interview reported experiencing MS that week were studied. They were asked to prospectively record, using a diary, daily information on the duration of their MS. The times both of waking and of getting up were noted, as well as the times to first improvement, maximum improvement and complete disappearance of MS, providing six possible estimates of MS duration, three of which, using waking as starting points, could be compared with the interview. The daily variation of MS was assessed by the within-patient range. The median duration of the diary scores was then compared with the MS estimates recorded at the interview. There was a large intra-individual variation in duration of MS, whichever of the six definitions were used. Half of the patients recorded ranges of MS scores of 3 h or more within the same week. There was also marked variation between the median diary derived duration and that ascertained by interview. This variation was at its smallest when the duration of MS was calculated as time until maximum improvement. The routine recording of the 'typical' duration of MS seems to have little clinical value in the face of the large within-patient variation. Of the possible choices for estimating duration, the time from waking to maximum improvement appeared to be the best indicator of the average duration of MS in RA patients.

Aged

Symptom relief and the placebo effect in the trial of an anti-peptic drug.

In order to determine some of the factors involved in the response of duodenal ulcers to placebo treatment, the following factors were studied prospectively during a double-blind, placebo-controlled trial: demographic data; duration of illness and effect of treatment; expectation of success or failure of the new drug; presence of psychiatric problems; and suggestibility. Healing (measured by endoscopy) occurred in 37 patients, 17 of whom were receiving placebo; relief of symptoms occurred in 35 patients, 16 of whom were receiving placebo. There was no significant difference between drug and placebo. Healing was significantly associated with relief of symptoms but with no other variable. Relief of symptoms was more common in male patients and in those from higher social classes, as well as in patients who expected a complete cure and those without evidence of psychiatric problems. the natural history of the disease may be different in these patients. Unexpectedly, suggestibility was not associated with healing or relief of symptoms in the patients receiving placebo.

Adult

Three years' experience with implanted pacemakers.

At the University Hospital, Saskatoon, over the last three years, pacemakers have been inserted in 40 patients with complete or incomplete heart block. Fourteen of the patients were females and 26 were males. The average age was 65 years; 12 were over 80 years of age, and the youngest patient was 8 years of age. In none was the heart block due to operation. Thirty-three patients are still alive and well. There have been seven deaths three early and four late. One patient died because of a "runaway" pacemaker, and two as a result of infection persisting around the pacemaker. Twenty-nine Medtronic pacemakers were used and 14 Atricor pacemakers; currently we favour the latter instrument.

Adams-Stokes Syndrome