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Biomedical subjects

W R Gibb

Publications and source records attributed to W R Gibb.

65 records · Page 4Linked to original sources

Persistent rheumatic chorea.

A 79-year-old woman had rheumatic chorea that persisted after age 5 years and increased in severity at age 73. The continued chorea and late decompensation could have been due to incomplete functional resolution in the basal ganglia and decreasing reserve of striatal neurons with age. Sydenham's chorea persisting into late life has not been reported previously.

Age Factors↗

The neuroleptic malignant syndrome--a review.

The neuroleptic malignant syndrome (NMS) is an uncommon disorder characterised by muscular stiffness and hyperthermia. It is caused by the administration of neuroleptics or by the acute withdrawal of levodopa therapy in idiopathic Parkinson's disease. An identical syndrome may be seen rarely in untreated catatonic schizophrenia. Shock, respiratory failure and myoglobinuria occur sometimes with serious consequences. Treatment should include active cooling measures and the administration of dopamine agonists. Dantrolene may also be of benefit in severe cases.

Animals↗

Generalised allergic reactions to aminophylline.

Details of three patients who developed allergic responses to aminophylline are presented, together with data on such reactions compiled from reports submitted to the Committee on Safety of Medicines. Two of the patients developed generalised rashes within one day of starting treatment with oral aminophylline. Other symptoms included malaise and confusion. A third patient had severe generalised symptoms and a high fever, which was reproduced on challenge testing. Forty five of 147 reactions to aminophylline reported to the Committee on Safety of Medicines referred to dermatological or allergic reactions and in two instances exfoliative dermatitis was described. In contrast, only seven of 61 reported reactions to theophylline described skin or allergic responses and in none of these was dermatitis or a specified rash mentioned. The available evidence suggests that ethylenediamine rather than the xanthine component of aminophylline may be the principal cause of the reactions.

Adolescent↗

Idiopathic Parkinson's disease and the Lewy body disorders.

A common clinical manifestation of idiopathic Lewy body disease is levodopa responsive idiopathic Parkinson's disease. Infrequently features such as dementia or autonomic failure predominate. The Lewy body is also reported; as an incidental finding in 7-10% of normal individuals mostly over the age of 60 as an incidental sporadic finding in Parkinson's syndrome from other causes, mostly over the age of sixty; in an additional group of degenerative disorders at a younger age, some with familial inheritance. The incidental finding of Lewy bodies can precede clinical Parkinson's disease. It is though they do not occur as an age-related feature, although this cannot be stated with certainty. Current evidence suggests that about 10% of the population may possess the pathological substratum for idiopathic Parkinson's disease.

Aging↗

The significance of the Lewy body in the diagnosis of idiopathic Parkinson's disease.

A retrospective study of 269 patients with a clinical diagnosis of Parkinson's syndrome was carried out. Seventy-eight were selected as cases of Parkinson's disease on the basis of generally accepted criteria. Of these, 73 were found to have Lewy bodies and cell loss in the substantia nigra, two had the pathological changes of striatonigral degeneration, two had extensive neurofibrillary tangles and nigral cell loss compatible with post-encephalitic parkinsonian syndrome, and one had Lewy bodies and striatonigral degeneration. Pathological examination of the remaining brains revealed Lewy bodies with cell loss in the nigra, a different pathological diagnosis, or normal basal ganglia. No unclassifiable 'senile' patients, or cases with neurofibrillary tangle degeneration or extranigral pathology of unknown cause were found. As a result of these findings clinico-pathological diagnostic criteria for Parkinson's disease are proposed. All patients with this diagnosis had Lewy bodies in surviving neurons of two unilateral 7 microns sections of the mid-part of the substantia nigra. The frequency of Lewy bodies in multiple system atrophy, Steele-Richardson-Olszewski syndrome and Alzheimer's disease was low and similar to that in age-matched 'normal' controls. Pathological findings were compatible with the notion that these individuals have preclinical or coincidental Parkinson's disease.

Aged↗