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Biomedical subjects

A D Milner

Publications and source records attributed to A D Milner.

At least 217 records · Page 12Linked to original sources
PubMed1983

Specialist approach to childhood asthma: does it exist?

Twenty six paediatricians and 21 consultant physicians concerned in the care of children with asthma answered a postal questionnaire on various aspects of the management of asthma, attitudes to referral, and the nature of advice given to parents and children. The 47 specialists had considerable differences in opinion for more than half the questions, including the role of allergen skin tests and the use of "breathing exercises." In addition, the paediatricians disagreed with the responses of the non-paediatricians on common issues such as whether to use aminophylline suppositories and whether swimming helps children grow out of asthma. These results have disturbing implications for the advice that specialists give to general practitioners, children, and parents.

Asthma↗
PubMed1983

Bronchiolitis.

Explore the source record for details and available documents.

Asthma↗
PubMed1983

Nasotemporal overlap in the human retina investigated by means of simple reaction time to lateralized light flash.

When light flashes are presented laterally simple vocal and manual responses are faster to stimuli in the visual half-field having direct access to the responding hemisphere (an "uncrossed" reaction) than stimuli which go initially to the nonresponding hemisphere (a "crossed" reaction). In the latter case an interhemispheric crossing is presumably necessary and so the crossed-minus-uncrossed difference (CUD) can be identified with interhemispheric transmission time. This paradigm was used to investigate the problem of whether or not there is an overlap of ipsi- and contralaterally projecting ganglion cells at the border between nasal and temporal areas of the human retina, resulting in dual representation of the midline in the brain. If such an overlap does exist then presenting stimuli on this region ought to result in an abolition of the CUD since information would be equally available to both hemispheres. Accordingly vocal and manual reaction times to flashes presented at 1/2, 1, 2, and 4 deg of visual angle were measured. In both cases a consistent CUD was found and this was present at all four points. These results are interpreted as arguing against the existence of overlap in man though some alternative possibilities are discussed.

Adolescent↗
PubMed1983

Stimulus sampling and the use of distal visual cues in rats with lesions of the superior colliculus.

Rats with bilateral ablation of the superior colliculus (SC) were compared with sham-operated rats in two experiments. In the first, it was found that discrimination performance deteriorated as a function of S-R separation, to a similar extent in both groups. In this experiment, unlike earlier ones which found a deficit, the separation was introduced in a horizontal direction. In the second experiment, spatial orientation in the Morris Swimming Pool was found to be impaired in the SC rats both when the target platform was visible and when invisible. During their presence on the platform, these rats also engaged less often in upward orienting movements, although horizontal movements were of normal frequency. It is proposed (i) that there is an anisotropy in the SC's control of orienting head and eye movements in rats, and (ii) that the swimming pool deficit may be due to an impairment of ambient vision.

Animals↗
PubMed1983

Lung function after acute bronchiolitis.

We performed 211 lung function measurements on 93 children in the first year after they had been admitted with acute bronchiolitis. During the convalescent phase of the illness, 77% of the infants were hyperinflated with a thoracic gas volume greater than 40 ml/kg and 3 months later 43% were hyperinflated. Twelve months after the initial illness, 17% still had lung function abnormalities and most of these children have had lower respiratory tract symptoms. For the group as a whole about 60% have had at least one episode of wheezing. Specific conductances were significantly lower in children from atopic families, indicating worse lung function, but the significance of this finding is unclear.

Acute Disease↗
PubMed1983

Nebulised therapy in acute severe bronchiolitis in infancy.

We have measured total work of breathing before and after the inhalation of water, salbutamol, and ipratropium bromide, given as nebulised solutions, in 39 studies on 25 infants with acute, severe bronchiolitis. Twenty minutes after nebulised water, mean work of breathing per minute was increased by 4% and work per litre by 10% with 2 infants having significant improvement and 2 others showing deterioration. After salbutamol, mean work of breathing per minute showed a 22% increase and work per litre a 0.5% rise. The condition of only one child improved by greater than 25% after this drug. Ipratropium bromide led to significant improvement in 6 out of 15 studies and no corresponding deterioration. The group results showed a fall in work of breathing, 18% in work per minute and 16% in work per litre.

Acute Disease↗
PubMed1983

Face mask resuscitation: does it lead to gastric distension?

Inflation and oesophageal pressures were recorded simultaneously during bag and mask resuscitation of 9 asphyxiated babies. After half a minute of standard inflation pressures, higher pressures were applied for at least 5 inflations by occluding the blow-off valve. No air entered the oesophagus until a high mean inflation pressure of 5.4 kPa was exceeded. These findings were confirmed in 4 fresh stillborn babies studied similarly. We conclude that resuscitation using bag and mask, applying pressures less than 3.5 kPa, should not lead to gastric distension.

Asphyxia Neonatorum↗
PubMed1983

Effects of artificial surfactant on lung function and blood gases in idiopathic respiratory distress syndrome.

We have investigated the effect of giving two 25 mg doses of dry surfactant powder to the airways of 10 preterm babies with severe idiopathic respiratory distress syndrome requiring intermittent positive pressure ventilation. No useful change in static total compliance or blood gases was seen. We conclude that dry surfactant powder does not have a role in the management of severe idiopathic respiratory distress syndrome.

Carbon Dioxide↗
PubMed1983

Role of labour in the establishment of functional residual capacity at birth.

Intrathoracic pressure and volume changes were measured during the spontaneous first breath in 11 healthy term neonates delivered by emergency caesarean section (CS). Although inspiratory and expiratory rates were higher than those found among babies delivered by elective CS, inspiratory volume was very similar and these babies, unlike those delivered by elective CS, had all formed a functional residual capacity at the end of the first breath. We obtained cord arterial and venous samples for catecholamine analysis concurrently, and found that most of the babies had concentrations of plasma noradrenaline similar to babies delivered by elective CS--high values were found only among infants who had suffered fetal distress. Both catecholamine excretion and method of delivery may be important in the formation of the functional residual capacity at birth.

Cesarean Section↗
PubMed1983

Respiratory problems 2 years after acute bronchiolitis in infancy.

We assessed the clinical progress of 55 children 2 years after admission to hospital with acute bronchiolitis and performed lung function tests on 40. During the 2 year follow up period 75% of the children had wheezed, 36% had 2 or more lower respiratory symptoms lasting more than 2 weeks, 33% had more than 100 days of lower respiratory symptoms, and 13% were readmitted to hospital with acute respiratory disease. In addition 60% of the children were hyperinflated on lung function tests. Many of the children with hyperinflation at the 2 year assessment had not been hyperinflated 1 year earlier, suggesting variable airways obstruction. Reversibility of airways obstruction was also assessed by response to nebulised salbutamol. Nine children had a fall greater than 15% in airways resistance after salbutamol and these children had the highest baseline airways resistances. Airways resistance was higher in the children with a family history of atopy.

Acute Disease↗
PubMed1983

Bronchodilator effect of two inhaled H1-receptor antagonists, clemastine and chlorpheniramine, in wheezy school-children.

Chlorpheniramine, clemastine and a placebo have been compared for their ability to relieve bronchoconstriction in 14 childhood asthmatics between the ages of 6 and 14 years. Each attended on three separate occasions, inhaling a 2 ml solution containing either 4 mg of chlorpheniramine, 1 mg of clemastine or placebo under double-blind conditions. Lung function was assessed before and at intervals for 30 minutes after the inhalation by peak expiratory flow and spirometry. Each child then inhaled 5 mg of salbutamol in 2 ml of water and the lung function tests were repeated. A significant degree of bronchodilatation was seen 30 minutes after all three inhalations, but considerable coughing occurred after inhaling chlorpheniramine. Actual changes in raw data showed a significant improvement after clemastine between the 20 and 30 minute recordings and that at 30 minutes clemastine produced significantly greater bronchodilatation than placebo. Inhaled H1-receptor antagonists merit further investigation to delineate their role in childhood asthma.

Albuterol↗