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Biomedical subjects

R Sunderland

Publications and source records attributed to R Sunderland.

At least 19 recordsLinked to original sources
PubMed2004

Recurrent cerebral fever in the seventeenth and twenty first centuries.

The development of modern neuroscience away from the concepts of Hippocrates and Galen can be traced to the writings of some 17th century clinicians, especially Thomas Willis. His exceptional skills in observation and description allow a window into the experiences of our medical forebears. His approach to the management of infection-related coma in a child is amenable to modern interpretation and comparison with modern management because of the clarity of his clinical descriptions. Modern clinicians may benefit from this historical perspective into influences on the origins of neuroscience. The different outcome for a child presenting in the 17th and 21st century encourage grateful reflection on our current privileged position.

Anti-Bacterial Agents↗
PubMed2003

A case of pituitary adenoma: Thomas Willis revisited.

Thomas Willis (1621-1675) was the founder of modern clinical neuroscience. His habit of taking detailed histories with acute clinical observation often accompanied by post mortem studies has left a body of work which still provokes thought and debate. While we were considering a case of pituitary tumour described by Willis, a similar case presented coincidentally at our hospital. The two cases are compared and contrasted.

Adenoma↗
PubMed2001

Cholesterol lowering benefits of soy and linseed enriched foods.

Foods such as breads and breakfast cereals enriched with a combination of soy protein (soy grits and/or soy flour) and whole linseed are gaining popularity. Regular consumption of either whole grains or soy protein can lower risk factors for coronary heart disease. Furthermore, linseed is a rich source of the omega-3 fatty acid. alpha-linolenic acid (LNA), with purported cardiovascular benefits. The aim of this study was to determine the effect of daily consumption of soy and linseed containing foods and Canola (as an added source of LNA) on plasma lipid concentrations in 20 mildly hypercholesterolaemic postmenopausal women. Fasted blood samples were taken initially and after 3 and 8 weeks to assay plasma lipids and both plasma and erythrocyte membrane fatty acids. Urinary isoflavones were also measured. Data from 18 subjects were used for analysis. Plasma total, low-density lipoprotein (LDL) and non-high-density lipoprotein (HDL) cholesterol concentrations fell significantly (10, 12.5 and 12%, respectively) within 3 weeks. Although attenuated, there were still significant reductions in total and non-HDL cholesterol (5 and 6.5%, respectively) after 8 weeks of intervention. These reductions were associated with increases in urinary isoflavone excretion. This pilot study indicates that regular inclusion of foods containing soy and linseed in the diet may improve plasma lipids in subjects with hypercholesterolaemia.

Aged↗
PubMed2000

Declining incidence of episodes of asthma: a study of trends in new episodes presenting to general practitioners in the period 1989-98.

BACKGROUND: A study was undertaken to determine trends in the incidence of new episodes of asthma presented to general practitioners participating in the Weekly Returns Service of the Royal College of General Practitioners, comprising 92 practices with a registered population of approximately 680 000 persons well distributed throughout England and Wales. These practices monitor the morbidity presented at every consultation, distinguishing between new episodes of illness and ongoing consultations. METHODS: Age specific weekly rates of new episodes of asthma (and of acute bronchitis) presenting to the general practitioners over the years 1989-98 were examined in four week blocks and analysed by multiple regression, separating secular from seasonal trends. RESULTS: Quadratic trends in episodes of asthma were evident in each of the age groups with peaks in 1993/4. Corresponding analyses for acute bronchitis disclosed similar trends generally peaking in the winter of 1993/4. Mean weekly incidence data (all ages combined) decreased in all quarters since 1993. Regional analysis (North/Central/South) showed similar decreases. CONCLUSIONS: There has been a gradual decrease in the incidence of asthma episodes and of acute bronchitis presenting to general practitioners since 1993. The trend of an increase before 1993 followed by a decrease cannot be explained by changes in the patterns of health care usage or diagnostic preference of doctors.

Adolescent↗
PubMed2000

Comparison of the seasonal patterns of asthma identified in general practitioner episodes, hospital admissions, and deaths.

BACKGROUND: Seasonal variations in asthma are widely recognised. This study was undertaken to investigate the relative differences in seasonal patterns by age as they impact on episodes of care in general practice, hospital admissions, and deaths. METHODS: General practice episode data from the Weekly Returns Service of the Royal College of General Practitioners, hospital admissions for asthma in England, and deaths registered as due to asthma in England and Wales over the years 1990-7 were examined. Age specific weekly rates of new episodes of asthma presenting to general practitioners, numbers of hospital admissions and deaths were analysed by the multiplicative decomposition method to separate secular from seasonal trends. The seasonal indices thereby obtained were plotted as three week moving averages. RESULTS: In children aged 0-4 and 5-14 years general practice episodes and admissions to hospital were strikingly congruent in timing and in magnitude, except in September when particularly high rates of admission (absolute and relative to general practice episodes) occurred. In the 15-44 age group there were marked mid summer peaks of general practice episodes and deaths but admissions to hospital were at about the annual average; in September/October there were peaks of episodes and admissions whereas deaths peaked in November. In the 45-64 age group a peak in general practice episodes of asthma was evident in mid summer when admissions were about average and deaths were at a minimum; all three measures tended to increase gradually with the approach of winter. Finally, in those age over 65 years, general practice episodes of asthma, admissions to hospital, and deaths followed similar 'U' shaped patterns with substantial peaks in mid winter. CONCLUSIONS: The seasonal pattern of asthma evolves with age. There are important differences in the seasonal pattern of general practice episodes, admissions to hospital, and deaths. Individual seasonal histories are important for the management of asthma. The combined analysis of these three data sets provides a new perspective on the epidemiology of asthma.

Adolescent↗
PubMed1996

The relationship between recognition, rewards and burnout in AIDS caring.

The positive psychological and sociological dimensions of AIDS care provision may produce important information to assist burnout prevention. While most studies on stress and burnout in AIDS health care have focused on the negative and difficult aspects of this work, few have considered the notion that the rewards of care-giving may buffer against stress or counterbalance experiences that may otherwise lead to burnout. A study of HIV/AIDS volunteers examined the relationship between stressors, rewards and burnout, using the HIV Volunteer Inventory and the Maslach Burnout Inventory. Correlation data indicates that a lack of a sense of personal accomplishment is a contributor to frequency of burnout. Over a fifth of the variance of burnout frequency can be accounted for by both stress and reward factors. Qualitative interview data also support the importance of rewards. Rewards in the form of gratitude from clients and recognition and support from management positively influenced the organizational climate. This study points to the need to find ways to increase the recognition and rewards experienced by carers. The potential benefits include reduced attrition and burnout and enhanced quality of life in the work setting.

Analysis of Variance↗
PubMed1990

Ethnic differences in incidence of sudden infant death syndrome in Birmingham.

Among the 45,204 live births in Birmingham in the three calendar years 1981-3, there were 218 postneonatal deaths, giving a postneonatal mortality rate of 4.82 per 1000 live births. Postneonatal mortality rates were 4.22 for whites, 5.91 for Asians (relative risk 1.26, 95% confidence interval (CI) 1.04 to 1.53) and 8.20 for Afro-Caribbeans (relative risk 1.78, 95% CI 1.25 to 2.55). Among Asians malformations were common (3.36) and sudden infant death syndrome rare (1.18), in contrast to Afro-Caribbeans among whom the rates were 0.66 and 5.25, respectively. Logistic regression analysis demonstrated a significantly lower risk of sudden infant death syndrome (SIDS) in Asians and significantly raised risks of SIDS in very low birthweight babies and those with unemployed parent(s). Ethnic differences persisted after controlling for maternal age, social class, and birth weight. Studies of sociocultural differences in child rearing practices are needed and may uncover important aetiological factors of sudden infant death syndrome.

Birth Rate↗
PubMed1989

As sick as a pigeon--psittacosis myelitis.

An association between acute transverse myelitis and psittacosis in a teenage boy is described. Closer collaboration between doctors and vets might have made the diagnosis sooner. A full paediatric history should include details of contact with pets and other animals.

Acute Disease↗