Search PubMed⌕ Search

Biomedical subjects

A D Milner

Publications and source records attributed to A D Milner.

At least 163 records · Page 9Linked to original sources
PubMed1989

IgG and IgM antibodies to viral glycoproteins in respiratory syncytial virus infections of graded severity.

Serum antibodies to the fusion (F) and large glycoprotein (G) of respiratory syncytial virus in the serum of 57 infected infants were measured by enzyme linked immunosorbent assay (ELISA). Most serum samples taken at the time of admission to hospital contained antibodies to both glycoproteins, and overall there was no significant evidence of a selective deficiency of antibody to either viral antigen. Less than a quarter of the infants showed rising IgG antibody titres to either glycoprotein after infection, whereas over threequarters produced an IgM response. There was a significant correlation between IgG response to viral glycoproteins and the age of the infant. The correlation of age with the IgM response was less pronounced, and there was no correlation between serum IgG antibody derived transplancentally in the acute phase of infection and IgM response to either glycoprotein. Neither IgG or IgM responses correlated with a clinical assessment of the severity of infection in the infants. IgM responses, however, were weakly correlated with reduced secretion of infectious virus in the upper respiratory tract.

Antibodies, Viral↗
PubMed1989

Management of asthma: a consensus statement.

In developing these international guidelines there were several unifying themes in the diagnosis and simple management of childhood asthma. For the purposes of the meeting, asthma was operationally defined as 'episodic wheeze and/or cough in a clinical setting where asthma is likely and other rarer conditions have been excluded'. In making a diagnosis of asthma, a full history is a prerequisite. Additional tests are only used to support clinical impression and to provide objective evidence for therapeutic recommendations. General features of a multidisciplinary approach include an appreciation of the importance of psychosocial factors, counselling, and education. Drugs should be prescribed in a rational sequence: beta 2-stimulants for mild episodic wheeze; sodium cromoglycate for mild to moderate asthma; inhaled steroids for moderate to severe asthma; with xanthines, ipratropium bromide, and oral steroids having their place in more persistent and severe cases. Children and their parents should be reassured that if asthma is properly controlled there is no reason why the child should not lead a normal and physically active life. The management of asthma is rewarding and return to 'normal' lifestyle is nearly always possible with active participation in sporting activities.

Acute Disease↗
PubMed1989

Why nebulise for more than five minutes?

The output of the drug and the particle size produced by various nebulisers were assessed, and sensible nebulisation times for sodium cromoglycate calculated. Three of the four nebuliser systems tested produced over 80% of total drug output within the first five minutes of nebulisation. We suggest that five minutes is an optimum nebulisation time for sodium cromoglycate using these nebuliser combinations.

Cromolyn Sodium↗
PubMed1988

Problems encountered using temazepam syrup for sedation in infants.

Six infants with a history of wheezing were given temazepam syrup as sedation, to allow lung function tests to be performed. Despite doses ranging from 2.5 mg/kg-4.5 mg/kg only one infant remained a sleep for 1 h, the time taken for full lung function to be assessed. All other infants awoke within 15 min before test could be completed. Three infants developed hiccoughs and three were very irritable after awaking from sedation.

Anti-Anxiety Agents↗
PubMed1988

Is perinatal mortality still a good indicator of perinatal care?

The increasing influence of very immature infants on perinatal mortality rates (PMR) led us to question the usefulness of this parameter in assessing perinatal care. To examine this further we have compared the incidence of perinatal asphyxia amongst mature babies (greater than or equal to 35 weeks gestation) for two geographically-defined populations of over 500,000 people. Both areas have a teaching hospital-based maternity service and comparable perinatal mortality rates. The incidence of severe post-asphyxial encephalopathy showed a marked excess in one population (1.93 vs 0.61 per 1000 births), which was not obviously explicable. Taken in conjunction with the figures for stillbirth in labour, this represented a 2.8 times greater risk for either fetal death in labour or severe asphyxial insult. It would appear that perinatal mortality rates do not accurately reflect important differences in those perinatal outcomes most likely to be affected by perinatal care.

Asphyxia Neonatorum↗
PubMed1988

Aerosol treatment abuse.

A 4 year old boy with excellent inhaler technique was found to be abusing his salbutamol and beclomethasone dipropionate inhalers. This resulted in aggressive behaviour and probable hallucinations.

Aerosols↗
PubMed1988

Evaluation of infants by echo planar imaging after repair of diaphragmatic hernia.

Three infants were studied by echo planar imaging after repair of congenital diaphragmatic hernias. Total lung volume and individual lung volumes were estimated using echo planar imaging. In the two patients with left sided hernias, the right lung was more than twice as large as the left. The patient with a right sided hernia had developed emphysema on the right side, and the right lung was twice as large as the left when estimated by echo planar imaging. Echo planar imaging studies took less than five minutes to perform and no sedation was required.

Female↗
PubMed1988

Nebulised salbutamol does have a protective effect on airways in children under 1 year old.

Ten infants under the age of 1 year each of whom gave a history of recurrent wheezing attacks were studied with a total body plethysmograph. All the infants were free of wheeze when studied and were sedated with chloral hydrate. All 10 showed a significant deterioration in lung function when given nebulised water for two minutes with an increase in airways resistance and a decrease in specific conductance at one and five minutes after nebulisation compared with baseline readings. Measurements returned to baseline values within 15 minutes. When the same amount of nebulised water was given 20 minutes after nebulised salbutamol, however, there was no significant deterioration in lung function at one and five minutes after administration of nebulised water. We conclude that the airways were protected against the bronchoconstricting effect of nebulised water by the beta 2 adrenoreceptor stimulant salbutamol.

Airway Resistance↗
PubMed1988

Event related potentials from closed head injury patients in an auditory "oddball" task: evidence of dysfunction in stimulus categorisation.

Event-related potentials (ERPs) were recorded from 19 closed head injury (CHI) patients, at least 6 months after injury, and an equal number of control subjects, during a task requiring the covert counting of rare auditory "target" stimuli against a background of frequent "non-targets". In both groups, ERPs to targets contained enhanced frontal N2 and parietal P3 components. N2 was larger in amplitude in the CHI patients than in the controls, and its peak latency was delayed. P3 amplitude was smaller in the patients, but its latency was not significantly different from that of the control group. The delay in N2 latency is interpreted as evidence of an increase in the time needed to achieve stimulus categorisation in CHI patients. The larger N2s in this group are thought to reflect the additional cognitive effort required after CHI to cope with the task. The negative findings with respect to P3 latency suggest that this may be a less sensitive measure of information-processing efficiency in this task than the latency of N2.

Adult↗
PubMed1987

High frequency ventilation in the neonatal period.

There are three forms of high frequency ventilation, high frequency jet ventilation (HFJV, up to 400/min), high frequency oscillation (HFO, up to 40 Hz), and high frequency positive pressure ventilation (HFPPV, rates between 60 and 150/min). The first two forms of ventilation are still experimental and have been used only in critically ill children where respiratory failure has been unresponsive to more conventional therapy. Unfortunately, however, HFJV has already been associated with a high incidence of tracheal lesions. High-frequency positive pressure ventilation, on the other hand, using conventional ventilators, has been used and studied widely. Certain neonatal ventilators function suboptimally at increased rates, resulting in a reduction in tidal exchange with a consequent clinical deterioration. Using appropriate ventilators, arterial oxygen tensions improve and carbon dioxide tensions are reduced at fast rates in non-paralysed infants. Air-trapping, however, may be a problem in infants paralysed and ventilated at fast rates. HFPPV have been associated with a reduced incidence of pneumothoraces, but there is no knowledge of the effect of this form of ventilation on subsequent lung growth.

Follow-Up Studies↗
PubMed1987

Modulation of visual event-related potentials by spatial and non-spatial visual selective attention.

Event-related potentials (ERPs) were recorded in two experiments involving selective visual processing. In Experiment 1, subjects attended to light flashes emanating from one visual field, in order to detect occasional slightly deviant "targets", while ignoring equiprobable stimuli from the opposite field. ERPs elicited by stimuli in an attended field were characterised by larger posteriorly distributed P120 and N170 components, and a larger anteriorly distributed N145 component. In addition, these ERPs were, in comparison to those elicited by unattended stimuli, more negative-going in the latency region of approx. 200-400 msec. This late effect had a marked fronto-central distribution. In Experiment 2 subjects attended to either horizontal or vertical bars, displayed equiprobably in the same spatial location. No enhancement of early components was observed as a function of attention but, as in Experiment 1, a late, sustained, fronto-centrally distributed negative shift was observed in ERPs elicited by "attended" compared to "unattended" stimuli. It was concluded that the enhancement of P120 (P1) observed in Experiment 1 reflects the engagement of attentional mechanisms specific to the selection of stimuli on the basis of spatial cues. The later sustained negative shift seen in both experiments was considered to reflect a feature of within-channel processing common to both spatial and non-spatial selective tasks.

Adult↗