Search PubMed⌕ Search

Biomedical subjects

A K Webb

Publications and source records attributed to A K Webb.

At least 109 records · Page 6Linked to original sources
PubMed1990

Pathology of common bile duct stenosis in cystic fibrosis.

A case of cystic fibrosis complicated by common bile duct stenosis is described. Surgery successfully relieved the obstruction, but was complicated by Candida septicaemia. The previously unreported histological abnormalities of the common bile duct are discussed.

Adolescent↗
PubMed1989

Effect of exercise and physiotherapy in aiding sputum expectoration in adults with cystic fibrosis.

The role of exercise in aiding sputum expectoration in patients with cystic fibrosis and the comparative roles of exercise and physiotherapy in sputum expectoration were assessed in two studies. In the first study 19 adult patients undertook a two month programme of home exercise using a cycle ergometer. In the 12 patients completing the study peak work capacity, maximum oxygen consumption, and maximum minute ventilation had increased significantly by the end of the exercise programme; the increase in daily sputum weight (from 24 to 37 g) was not significant (p = 0.055). In the second study (with 10 patients) more sputum was expectorated during and after physiotherapy than during and after exercise (9.8 v 4.0 g). Exercise may have a role in aiding sputum expectoration in patients with cystic fibrosis but should not be considered as a replacement for physiotherapy.

Adolescent↗
PubMed1989

Infective respiratory exacerbations in young adults with cystic fibrosis: role of viruses and atypical microorganisms.

Thirty six adults with cystic fibrosis were studied over one year to determine the incidence of infection with respiratory viruses and atypical organisms. Nineteen patients entered the study during an acute exacerbation of respiratory symptoms with an increase in purulent sputum production, cough, or breathlessness accompanied by a fall in FEV1 (group 1); 17 patients entered when they were stable both clinically and in terms of lung function values (group 2). Group 1 patients had a mean of 2.6 (range 1-4) infective exacerbations during the year and group 2 patients a mean of 1.1 (0-2) exacerbations. Eleven patients developed serological evidence of viral (influenza virus A and B, cytomegalovirus, human rhinovirus 2, adenovirus) or Mycoplasma pneumoniae infection. There was no difference in seroconversion rates between group 1 (five patients) and group 2 (six patients). There was a weak association between viral seroconversion and the isolation of Pseudomonas aeruginosa from sputum, though this was not significant.

Adolescent↗
PubMed1987

Regular exercise and reduction of breathlessness in patients with cystic fibrosis.

The influence of regular exercise on breathlessness and its relationship to ventilation has not been studied previously. We have examined the effects of a training programme on eight patients (5 males, 3 females, mean age 20 years, range 17-27 years) with cystic fibrosis. Eleven minutes of exercise was undertaken each day for 2 months according to the Royal Canadian Air Force protocol. Daily diary cards were kept and the programme was supervised. Pulmonary function and responses to maximal exercise on bicycle ergometer were determined before and after completion of the training schedule. Breathlessness was assessed using visual analogue scales (VAS) and related to ventilation during submaximal exercise on two occasions prior to training, and at the end. Apart from a reduced RV (pre 1.90 +/- 1.11, post 1.20 +/- 0.28 P less than 0.05), all other indices of pulmonary function and exercise performance were unchanged. Before training the relationship of breathlessness to ventilation was highly reproducible for each patient. After training there was a statistically significant reduction in breathlessness but ventilation was unchanged. At a mean standardized ventilation of 31.6 litres/min the VAS scales were 26.7% pre- and 12.9% post-training (P less than 0.01). Breathlessness can be favourably influenced by exercise training independent of ventilation with a consequent improvement in submaximal exercise tolerance in patients with cystic fibrosis.

Adolescent↗
PubMed1984

The effect of cimetidine on the relative cardioselectivity of atenolol and metoprolol in asthmatic patients.

The effects of chronic cimetidine therapy on the pharmacodynamic properties of atenolol and metoprolol were assessed in eight asthmatic patients using a placebo-controlled trial. When atenolol and metoprolol were administered at doses which achieved an equivalent degree of beta1-adrenoceptor blockade, metoprolol caused a significantly greater reduction in mean forced expiratory volume in one second (FEV1). This demonstrates the greater cardioselectivity of atenolol. The reductions in mean FEV1 induced by either atenolol or metoprolol were each unaffected by cimetidine. Plasma levels of each of the beta-adrenoceptor blockers were not affected by the addition of cimetidine. The FEV1 in one patient was further reduced when cimetidine was administered with metoprolol, although there was no corresponding change in plasma levels of drug. In this patient there was no such further reduction in FEV1 with atenolol. This study has not provided evidence for a pharmacodynamic interaction between cimetidine and either atenolol or metoprolol, but further studies are indicated.

Asthma↗
PubMed1983

Cause of death in patients admitted to hospital for pulmonary tuberculosis.

Study of hospital case-notes and necropsy reports of 60 patients certified as dying from tuberculosis over 7 years identified a group of 16 patients (27%) who died suddenly and unexpectedly and in whom the cause of death was obscure. In 14 of the 16 death followed initiation of antituberculous chemotherapy.

Adrenal Cortex Hormones↗
PubMed1981

Herpes encephalitis and herpetic corneal disease.

A case of herpes encephalitis is reported in a patient who had cranial irradiation and high dose steroids for a cerebral neoplasm. Before radiotherapy the patient had had herpetic infections of the skin and eye.

Brain Neoplasms↗
PubMed1979

Splenomegaly and splenectomy in sarcoidosis.

The natural history of 30 patients with sarcoidosis who showed histological evidence of granulomatous involvement of the spleen has been studied; 24 patients had splenomegaly, 16 of whom had splenectomy. The main indication for splenectomy was splenomegaly and resultant discomfort. Corticosteroids reduced spleen size but reduction or withdrawal of the relatively high dosage required resulted in rebound splenomegaly within a period of three months to three years. Haematological abnormalities were controlled by splenectomy in all patients so affected, but the natural history of their sarcoidosis remained unaltered.

Adolescent↗
PubMed1979

Severe bronchial asthma requiring ventilation. A review of 20 cases and advice on management.

The natural history and outcome of 20 asthmatics who required mechanical ventilation is reviewed. Seven of these patients died. The majority of the deaths could have been prevented if: (1) The patient had been followed-up in an asthma clinic and had been fully informed of the danger of an asthmatic attack. (2) The medical staff had been trained more fully in the evaluation and management of a severe asthma attack. Careful sequential assessment will enable timely transfer of patients with severe bronchial asthma to a unit experienced in their management.

Adolescent↗
PubMed1979

Iatrogenic nondiabetic hyperosmolar states.

Four cases of the iatrogenic nondiabetic hyperosmolar state are presented. The clinical presentation, biochemical findings and management are discussed. No hypertonic solution should be infused at a rate above the level of patient tolerance; irrigation of a hollow viscus with a hypertonic solution should be avoided, and salt should not be used as an emetic. Patients under stress are particularly prone to this condition, largely because of the high circulating cortisol levels. The use of corticosteroids, salt-containing solutions in excess of patient requirements, water depletion and intravenous nutrition in the absence of careful biochemical monitoring, are all factors which may precipitate the hyperosmolar state in the critically ill.

Acid-Base Imbalance↗