Northwick Park Hospital

About: Northwick Park Hospital is a healthcare organization based out in London, United Kingdom. It is known for research contribution in the topics: Population & Blood pressure. The organization has 4387 authors who have published 4184 publications receiving 192933 citations.

Effect of general anaesthesia on the pharynx.

Abstract: Conventional lateral radiography was used in 18 elderly male patients to investigate the changes induced by general anaesthesia in the upper airway The effect of tongue traction under anaesthesia was studied similarly in another 11 patients Following induction of anaesthesia, there were highly significant approximations to the posterior pharyngeal wall of the soft palate (median change 13 mm, 95% confidence interval (Cl) 03-26 mm; P = 0006), tongue base (mean change 65 mm, 95% Cl 53-77 mm; P less than 0001) and epiglottis (mean change 38 mm, 95% Cl 31-45 mm; P less than 0001) Apparent radiographic occlusion of the airway occurred most consistently at the level of the soft palate (17 of 18 patients), sometimes at the level of the epiglottis (four patients), but the tongue base did not touch the posterior pharyngeal wall in any patient Traction on the tongue failed to clear the nasopharyngeal obstruction Attempted inspiration under anaesthesia caused major secondary collapse of the pharynx, with multiple sites of obstruction, similar to that found in obstructive sleep apnoea

Determinants of 2,000 m rowing ergometer performance in elite rowers

Abstract: This study examined the physiological determinants of performance during rowing over 2,000 m on an ergometer in finalists from World Championship rowing or sculling competitions from all categories of competion rowing (19 male and 13 female heavyweight, 4 male and 5 female lightweight). Discontinuous incremental rowing to exhaustion established the blood lactate threshold, maximum oxygen consumption (VO(2max)) and power at VO(2max); five maximal strokes assessed maximal force, maximal power and stroke length. These results were compared to maximal speed during a 2,000 m ergometer time trial. The strongest correlations were for power at VO(2max), maximal power and maximal force (r=0.95; P<0.001). Correlations were also observed for VO(2max) (r=0.88, P<0.001) and oxygen consumption (VO(2)) at the blood lactate threshold (r=0.87, P=0.001). The physiological variables were included in a stepwise regression analysis to predict performance speed (metres per second). The resultant model included power at VO(2max), VO(2) at the blood lactate threshold, power at the 4 mmol x l(-1) concentration of blood lactate and maximal power which together explained 98% of the variance in the rowing performance over 2,000 m on an ergometer. The model was validated in 18 elite rowers, producing limits of agreement from -0.006 to 0.098 m x s(-1) for speed of rowing over 2,000 m on the ergometer, equivalent to times of -1.5 to 6.9 s (-0.41% to 1.85%). Together, power at VO(2max), VO(2) at the blood lactate threshold, power at 4 mmol x l(-1) blood lactate concentration and maximal power could be used to predict rowing performance.

The importance of the toes in walking

Abstract: The importance of well-functioning toes has long been recognised but has not previously been assessed in biomechanical studies. We have examined the weight-bearing function of the foot in 160 normal subjects by use of the pedobarograph. The function of the toes was assessed by reference to the time they were in contact with the ground and the peak pressures they exerted individually in comparison with other parts of the foot. The toes were in contact for about three-quarters of the stance phase of gait and exerted peak pressures similar to those of the metatarsal region. When the foot was bearing the second peak of total force, the area in contact with the ground (the metatarsal heads and toes) was decreasing.

Array CGH analysis of copy number variation identifies 1284 new genes variant in healthy white males: implications for association studies of complex diseases

Abstract: The discovery of copy number variation in healthy individuals is far from complete, and owing to the resolution of detection systems used, the majority of loci reported so far are relatively large ( approximately 65%>10 kb). Applying a two-stage high-resolution array comparative genomic hybridization approach to analyse 50 healthy Caucasian males from northern France, we discovered 2208 copy number variants (CNVs) detected by more than one consecutive probe. These clustered into 1469 CNV regions (CNVRs), of which 721 are thought to be novel. The majority of these are small (median size 4.4 kb) and most have common boundaries, with a coefficient of variation less than 0.1 for 83% of endpoints in those observed in multiple samples. Only 6% of the CNVRs analysed showed evidence of both copy number losses and gains at the same site. A further 6089 variants were detected by single probes: 48% of these were observed in more than one individual. In total, 2570 genes were seen to intersect variants: 1284 in novel loci. Genes involved in differentiation and development were significantly over-represented and approximately half of the genes identified feature in the Online Mendelian Inheritance in Man database. The biological importance of many genes affected, along with the well-conserved nature of the majority of the CNVs, suggests that they could have important implications for phenotype and, thus, be useful for association studies of complex diseases.

Sound therapy (masking) in the management of tinnitus in adults

Abstract: BACKGROUND This is an update of a Cochrane Review first published in The Cochrane Library in Issue 12, 2010.Tinnitus is described as the perception of sound or noise in the absence of real acoustic stimulation. Numerous management strategies have been tried for this potentially debilitating, heterogeneous symptom. External noise has been used as a management tool for tinnitus, in different capacities and with different philosophical intent, for over a century. OBJECTIVES To assess the effectiveness of sound-creating devices (including hearing aids) in the management of tinnitus in adults. Primary outcome measures were changes in the loudness or severity of tinnitus and/or impact on quality of life. Secondary outcome measures were change in pure-tone auditory thresholds and adverse effects of treatment. SEARCH METHODS We searched the Cochrane ENT Group Trials Register; CENTRAL; PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 8 February 2012. SELECTION CRITERIA Prospective randomised controlled trials recruiting adults with persistent, distressing, subjective tinnitus of any aetiology in which the management strategy included maskers, noise-generating device and/or hearing aids, used either as the sole management tool or in combination with other strategies, including counselling. DATA COLLECTION AND ANALYSIS Two authors independently examined the 387 search results to identify studies for inclusion in the review, of which 33 were potentially relevant. The update searches in 2012 retrieved no further potentially relevant studies. Both authors extracted data independently. MAIN RESULTS Six trials (553 participants) are included in this review. Studies were varied in design, with significant heterogeneity in the evaluation of subjective tinnitus perception, with different scores, scales, tests and questionnaires as well as variance in the outcome measures used to assess the improvement in tinnitus sensation/quality of life. This precluded meta-analysis of the data. There was no long-term follow-up. We assessed the risk of bias as medium in three and high in three studies. Following analysis of the data, no significant change was seen in the loudness of tinnitus or the overall severity of tinnitus following the use of sound therapy compared to other interventions such as patient education, 'relaxation techniques', 'tinnitus coping strategies', counselling, 'tinnitus retraining' and exposure to environmental sounds. No side effects or significant morbidity were reported from the use of sound-creating devices. AUTHORS' CONCLUSIONS The limited data from the included studies failed to show strong evidence of the efficacy of sound therapy in tinnitus management. The absence of conclusive evidence should not be interpreted as evidence of lack of effectiveness. The lack of quality research in this area, in addition to the common use of combined approaches (hearing therapy plus counselling) in the management of tinnitus are, in part, responsible for the lack of conclusive evidence. Other combined forms of management, such as tinnitus retraining therapy, have been subject to a Cochrane Review. Optimal management may involve multiple strategies.