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Biomedical subjects

B G Loftus

Publications and source records attributed to B G Loftus.

28 records · Page 2Linked to original sources
PubMed1985

Effects of ketotifen on in vitro bronchoconstriction.

We have studied the effects of Ketotifen [Ke] (10(-4)M and 10(-6)M) on two in vitro models of bronchoconstriction: actively sensitized guinea-pig trachea (GPT), and passively sensitized human bronchial muscle (HBM). Experiments were performed on matched pairs of tissues. Cumulative dose response curves [CDRC] for histamine and acetyl choline were constructed, and repeated after pre-incubation with Ke or saline control. The effect of Ke on maximal antigen induced contractions was also studied. Contraction of GPT by histamine and acetyl choline was inhibited by Ke 10(-4)M, though this effect was not apparent at high doses of acetyl choline. Ke 10(-6)M had a weaker inhibitory effect on histamine and acetyl choline induced responses. Contraction of GPT by antigen was unaffected by Ketotifen. In the HBM model, Ke 10(-4)M inhibited acetyl choline and antigen induced responses. Ketotifen, 10(-6)M had an inhibitory effect on acetyl choline induced contractions, though this was small, and not seen at higher agonist doses. Contraction of HBM by antigen was unaffected by Ke 10(-6)M. We were unable to obtain reproducible CD RC's to histamine with HBM. The weaker or absent effects of Ke 10(-6)M, a level close to that obtained in clinical practice, may explain some of the poor results of clinical trials, and suggest that efficacy may be improved by the use of higher doses.

Acetylcholine↗
PubMed1985

Treatment of asthma in preschool children with slow release theophylline.

Fifty two preschool children with asthma were given a recommended regimen of slow release theophylline. There was wide variation in the metabolism of theophylline. The approach adopted gave disappointing results. Nine children did not comply, and 16 stopped treatment because of side effects. Of the remainder, control of asthma was poor in 15 and satisfactory in 12.

Asthma↗
PubMedDate not supplied

Knowledge of statistical methods and their implications for clinical practice: a survey of paediatricians.

Improvements in computer software have contributed to an increase in the use of multivariate statistical analyses e.g. multipLe regression in recent times. Our aim was to assess the familiarity with, and understanding of these complex statistical methods among Irish paediatricians. Questionnaires were sent to all paediatric specialist registrars (SpRs) and consultants in the Republic of Ireland. The questionnaire detailed information about clinical practice, and contained a short quiz on statistical methods. 137 questionnaires were distributed, and 62 (45.6%) were returned. Eighty four percent of respondents aimed to read journals weekly but only 46.7% managed to. The commonest journals used were; Archives of Disease in Childhood (93%), Pediatrics (53%), British Medical Journal (46%) and Journal of Paediatrics (45%). 28 of 61 (45.9%) of respondents have had further training in statistics. Only 19% felt they had a clear understanding of regression. Fifty-eight of 62 respondents (93.5%) completed the short test. The average score was 5.1/10. Sixty seven percent of questions on basics were answered correctly, 37.9% of questions on application of tests were answered correctly and 25.8% of questions on regression were answered correctly. Only 3.4% answered all questions on regression correctly. The overall knowledge of advanced statistical methods was poor. There is a poor overall understanding of the concept of regression, despite its increasingly common use.

Health Knowledge, Attitudes, Practice↗
PubMedDate not supplied

Home environment and childhood asthma.

The prevalence of childhood asthma has increased dramatically in the past 20 years. The reasons for the increase are unclear but many authors suggest that changes in the home environment favourable to proliferation of the house dust mite are to blame. Our study aimed to compare home environment of children with asthma and controls. A questionnaire on home environment was administered to the parents of 134 children with asthma and 118 controls. Detailed studies of home temperature, humidity and dust mite allergen (DERp1) levels were performed in 20 homes (10 from each group). The questionnaire response rate was 86%. There were no significant differences between asthma and control homes with respect to social class, type of housing, smoking habits, pets, insulation, home heating, bedding, carpeting and domestic cleaning habits. A first degree family history of atopy was obtained in 42% of asthmatic families and in 16% of controls. Temperature, humidity and dust mite allergen levels were similar in both groups. The majority gave readings exceeding recommended norms. Values for DERp1 were above thresholds by a factor of 5 in 48%. Home environment does not significantly differ in children with or without asthma. The home environment is now generally mite friendly, and large segments of the childhood population are now exposed to high levels of DERp1. This may account for the increasing prevalence as more and more children with an atopic background develop overt symptoms in response to high levels of allergen load.

Animals↗
PubMedDate not supplied

Spectrum of childhood asthma in Galway.

We administered a questionnaire to the parents of 832 children in 4th class. 134 had wheezed in the previous 12 months. These children and matched controls were invited to attend for a brief clinical evaluation. 118 children with a history of wheeze and 118 age and sex matched wheeze free controls were seen. A brief questionnaire was administered. Heights and peak flow were measured. Children were assessed for the presence of chest deformity and eczema. There was a male predominance (1.7:1). Exercise induced symptoms were noted by 86% of children, but only 65% of parents in contrast, 65% of parents complained of night cough as against 28% of children. Over half had missed school because of asthma. Controls were asymptomatic. Height and peak flow measurements were similar in both groups. Chest deformity was evident in 25% of children with asthma, 8% had eczema and 27% were taking prophylactic medication. Childrens perception of asthma differs from that of their parents. School absence remains a problem and clinical evidence of hyper-inflation is common, though the absence of an overt effect on height and peak flow is encouraging.

Absenteeism↗
PubMedDate not supplied

Prevalence of asthma in Galway city school children.

To determine the prevalence of asthma in the past 12 months in nine year old Galway school children, a questionnaire on respiratory symptoms was distributed to children for completion by parents and returned to the school. We issued 896 questionnaires and 832 (426 boys and 406 girls) were returned completed. The overall response was 93%. The prevalence of wheeze in the past 12 months was 16.1%. A history of wheeze was more common in boys than in Girls. (19.7% Vs 12.3%). Overall, 67% of those reporting wheeze also reported a history of diagnosed asthma and 74% had used a bronchodilator. 60% reported a history of exercise induced wheezing and 67% had nocturnal cough. 28% were taking prophylactic medication. The current prevalence of asthma in Galway city school children is high. There is an increased willingness to diagnose and treat asthma in this community.

Asthma↗
PubMedDate not supplied

Benign neonatal sleep myoclonus.

Benign neonatal sleep myoclonus is a disorder characterised by abnormal episodic jerky movements, which occur exclusively during sleep. When the history is suggestive of the diagnosis, and physical examination and basic investigations are normal, a confident diagnosis can usually be reached, and other potentially more serious neonatal seizure disorders excluded. This allows the doctor to reassure the parents as to the prognosis--the condition resolves spontaneously within the first year, most often within the first three months, with no sequelae. We describe four patients who presented to one unit with this condition.

Diagnosis, Differential↗
PubMedDate not supplied

Can we increase breast feeding rates?

Breast feeding rates in Ireland have stagnated at around 33% over the past 10 years. We aimed to assess the effect of a simple intervention in late pregnancy on breast feeding rates. The study was randomised and prospective. In the intervention group a sheet illustrating eight positive aspects of breast feeding was presented to mothers at their 36 week antenatal visit. This information was reinforced with a questionnaire on the topic of breast feeding. The control group received a routine antenatal care. There were 98 mothers in the intervention group and 95 controls. A similar percentage in each group had medical cards. On discharge from hospital 31.5% of controls and 43.9% of the test group were breast feeding. This difference just failed to reach statistical significance (P = 0.07). The intervention, which took just three minutes of a medical student's time, appeared to result in an improved breast feeding rate. Though the difference did not reach statistical significance, this reflects, in part, the small numbers in the study. About half of the women in the study indicated that no doctor had offered any advice on the choice of feeding. Since this minor intervention produced a good response, it would seem appropriate to adopt a more positive attitude in the promotion of breast feeding.

Breast Feeding↗