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Biomedical subjects

C K Connolly

Publications and source records attributed to C K Connolly.

At least 19 recordsLinked to original sources
PubMed1995

Fatal chickenpox pneumonia in an asthmatic patient on oral steroids and methotrexate.

A 49 year old man with a long history of severe chronic asthma, treated with oral corticosteroids and weekly doses of methotrexate, contracted chickenpox from his son whose chickenpox rash had developed three weeks before presentation. Five days before admission the patient developed a vesicular skin rash which became extensive, with general malaise, bilateral pneumonia, and acute deterioration of his asthma. He died two weeks after admission despite treatment with acyclovir.

Acyclovir↗
PubMed1994

Asthma control.

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Albuterol↗
PubMed1994

Actual over best function as an outcome measure in asthma.

Several guidelines for the management of asthma suggest that actual/best function is a useful outcome measure. This implies accurate assessment of best function, and a standard for the proportion of best function to be achieved. Seventeen clinics observed their practice simultaneously during four periods in 1990. The aims of the study included testing a protocol for the assessment of best function, and validating actual/best function as an outcome measure. The proposed target for actual/best function to indicate satisfactory control was 80%. The protocol for assessment of best function required formal trial of steroids if best function was < 70% predicted; with regular recording of peak expiratory flow (PEF) if < 80% predicted. PEF was recorded in 515 and FEV1 in 680 of 767 subjects, following the usual clinic practice. If the protocol for best function was not satisfied, mean actual/best function was no higher than if it was, except when best PEF was < 70% predicted. This suggests the need for a PEF chart in these latter patients. Best function was greater in females than males, but actual/best function was almost identical. Whilst best function declined with increasing intensity of treatment, actual/best function was almost independent of regimen step, particularly in the centre which most closely adhered to the protocol. These results confirm that actual/best function is a valid outcome measure. Mean actual/best was > 80% except for FEV1 in two centres. It is suggested that the target in chronic management of asthma is raised from 80 to 85% of best, when actual/best PEF is used as a spot check in patients believed to be on optimal therapy.

Asthma↗
PubMed1992

Steroid-induced bone disease. Conflicting views of respiratory and bone physicians.

Physician members of the Thoracic Society and the Bone and Tooth Society were circularised about their views on the prophylaxis, screening and treatment for steroid osteoporosis. Bone physicians were more active than respiratory physicians in screening and prophylaxis and were more likely to favour bone densitometry in assessment and bisphosphonates in treatment. Further studies are required to establish the value of prophylactic agents in steroid osteoporosis but meanwhile respiratory physicians should appreciate the value of the relatively simple technique of bone densitometry in assessment and consider whether they should be more active in prophylaxis.

Adult↗
PubMed1991

The relationship between work done and pulmonary function; validation of a method.

A two-stage bicycle exercise test with logarithmic intervals of load has been described, and the results reported in 760 patients. The test is now validated in a second group of 553 subjects. Performance data and FEV1 were available in all subjects and forced vital capacity in 366 of them. Regression equations of pulmonary function on work done stratified by sex and age were similar to those previously reported. Multiple regression showed that more than 57.8% of the variance could be explained in terms of vital capacity, height and age, with small contributions from weight and sex; with more than half being accounted for by vital capacity alone (R2 = 0.53). In an alternative equation predicted vital capacity, age (independently), percentage deficit of vital capacity below predicted, sex and weight/height2 explained 58.7% of the variance. In this approach, the percentage of vital capacity below predicted accounts for 25% of the variance after allowance for predicted vital capacity. It is confirmed that the first logarithmic stage of the test predicts a work rate that can be maintained for more than 5 minutes, producing a pulse rate of greater than 130 in two-thirds of the subjects. As the majority of those who failed to achieve this work rate had poor pulmonary function and were elderly, it is recommended that the second phase is set at a lower work load for these subjects.

Adult↗
PubMed1991

Infection in exacerbations of asthma: views of different groups of practitioners.

A questionnaire designed to elucidate views on the frequency of infection in asthma and its management was circulated to general practitioners, general physicians, paediatricians and respiratory physicians in the north of England. On the whole, general practitioners agreed with the general physicians and paediatricians with respiratory physicians. The generalists, and to a lesser extent the specialists, tended to overestimate the risk of bacterial infection, which was perceived to be a particular risk following viral infection in intrinsic asthma. This resulted in more frequent prescription of antibiotics than is justified by the published evidence. There was a tendency for frequent prescribers of antibiotics to withhold corticosteroids. If prescribing habits are to be altered, education will have to be directed at those responsible for acute admissions to hospital as well as at general practitioners.

Acute Disease↗
PubMed1990

NHS trusts.

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State Medicine↗