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Biomedical subjects

C K Connolly

Publications and source records attributed to C K Connolly.

At least 73 records · Page 4Linked to original sources
PubMed1985

A simple method of exercise testing patients with ventilatory impairment on the bicycle ergometer.

The relationship between symptoms and objective findings is often poor in patients with ventilatory impairment and reduction in exercise tolerance. It is often difficult to know at what level to set the task, when attempting to do submaximal exercise evaluation in such patients. A method for assessing whether performance is appropriate for ventilation, which would also predict a reasonable level to set a submaximal exercise test, would be of value. A test has been devised to satisfy these requirements and is described in this paper. Patients were exercised on a bicycle ergometer using a rapidly progressive geometrical scale increasing the load at 10-second intervals. In 760 patients with airflow obstruction the work done was correlated with the forced vital capacity (r = 0.80). In 169 subjects the test was used to predict a satisfactory level for submaximal testing. Using two thirds of the maximum load achieved 70% of subjects achieved the task exercising for more than 5 min and reaching a pulse of greater than 130. The test has proved to be a satisfactory method for assessing whether performance is appropriate for measured ventilation and as an indicator of the right level at which to set a submaximal exercise test.

Adolescent↗
PubMed1984

A comparison of three methods of measuring broncholability in asthmatics, bronchitic cigarette smokers and normal subjects.

Bronchial lability was measured in 10 normal subjects, 33 typical asthmatics, and 23 smokers with ventilatory defect, by three different methods in the course of a week. There was little difference between exercise/bronchodilator lability index, spontaneous diurnal variation, and histamine challenge in detecting bronchial lability. It was possible that histamine challenge was more sensitive and more specific to asthma. It is recommended that this test is used first in studies to detect bronchial lability but those apparently normal should also be tested by the other methods. There was no correlation between the numerical value of these indices of broncholability in abnormal subjects. The asthmatic and bronchitic subjects were not separated by any of the three methods.

Adult↗
PubMed1983

Management of asthma in out-patients.

Five hundred and twenty-nine patients attended five different clinics supervised in three different ways in two adjacent, but socially different, health districts. Performance was apparently better in the clinics supervised by the consultant personally or by specialised junior staff. Non-atopic asthma appeared to be more frequent in clinics attended by patients with a social advantage, where it also appeared to be more easily controlled. This difference in control was less apparent in atopic asthma. These differences and deliberate selection probably account for the differences in performance between the clinics. Prescription policy appeared to be uniform throughout the clinics, though there was a tendency for drugs to be given at a lower level of pulmonary function in those clinics where performance was generally worse. Five per cent of all patients failed to achieve satisfactory treatment after a whole year's observation. This was not influenced by supervision or social group. Analysis of the pulmonary function of patients for whom drugs had been prescribed suggested that there was possible under-use of disodium cromoglycate as opposed to inhaled corticosteroids. The exercise proved a rapid and useful assessment of the performance of the clinics supervising asthma.

Age Factors↗
PubMed1981

The effect of bronchodilators on diurnal rhythms in airway obstruction.

A previous study suggested that bronchodilators were more effective in preventing diurnal variation of peak expiratory flow rate (PEFR) in patients with chronic obstructive bronchitis than asthma (Connolly 1979). In a further investigation of 100 patients there was an association between characteristic patterns and the size of the morning dip. After the use of bronchodilators there was a residual morning dip which was large enough to produce a regular pattern in most asthmatics but few bronchitics. Response to bronchodilators during the middle of the day was a poor predictor of both the presence and size of diurnal variation of PEFR and of the efficacy of regular bronchodilator therapy. Regular assessment of PEFR and its response to bronchodilator therapy over a few days is required to assess the extent of potential variation in airway obstruction.

Adolescent↗
PubMed1981

House dust mite hypersensitivity: morning dipping and severity of wheeze.

Atopic subjects with asthma are frequently hypersensitive to house dust mite (Dermatophagiodes pyteronyssinus). Exaggerated nocturnal or early morning wheezing might occur in these patients, because of exposure to the allergen during the night, particularly in view of the biphasic response that it produces in airway resistance. This might be of diagnostic value in determining the relevance of house dust mite to the asthma of a particular subject. This hypothesis was tested in 100 patients with diurnal variation in airway obstruction, 78 of whom were predominantly asthmatic. Hypersensitivity to house dust mite was measured by a simple prick test. Morning dipping was seen in patients without hypersensitivity to house dust mite. There was no significant quantitative relationship between morning dip and hypersensitivity. There was a significant relationship between morning dip and severity of wheeze. This study confirms the view that morning dipping is a reflection of the severity of asthma, rather than a feature of any particular type.

Adult↗
PubMed1979

Diurnal rhythms in airway obstruction.

Diurnal patterns of variation in peak expiratory flow rate were studied in patients with all types of airway obstruction. Most regular patterns fall into one of two types: morning dip (M) with the lowest reading in the morning and (P) or double dip with the lowest readings morning and evening. Regular patterns were most frequently seen in asthmatics, but occurred also in bronchitis, particularly those with a history of wheeze. Treatment with bronchodilators reduces the prevalence of all regular patterns but does not abolish them. M pattern is characteristic of asthma but P pattern is the most frequent regular pattern seen in bronchitis. Amplitude of variation is greater in asthmatics than in simple bronchitis. It is reduced by about 20% with bronchodilators. Random observation of magnitude of response of peak flow rate to a bronchodilators is not a good indicator of amplitude of variation over the day. Because of the occurrence of a peak pattern in many patients the magnitude of diurnal variation may be underestimated by twice-daily peak flow rate readings. Treatment with corticosteroids does not appear strongly to influence either characteristic patterns or amplitude of variation.

Adolescent↗
PubMed1970

Comparison of the effect of alprenolol and propranolol on specific airway conductance in asthmatic subjects.

Alprenolol did not cause a significant fall in the mean of the specific airway conductance in nine asthmatic subjects who did show a significant fall with propranolol. Thus alprenolol is not contraindicated in asthmatic subjects, though it should be used with caution intravenously, as one subject showed a substantial fall in airway conductance at three minutes which recovered within 30 minutes. Until further studies are completed these results should not be applied to bronchitics with increased airway resistance.

Adrenergic beta-Antagonists↗
PubMed1969

Osteomalacia.

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Female↗
PubMed1969

Plasma "cortisol" levels in right and left ventricular failure.

Plasma ;cortisol' values are reported in 36 patients during or following right ventricular failure, and 12 during or following left ventricular failure. In patients with right ventricular failure the normal circadian rhythm was abolished with elevation of midnight values. Disturbance of rhythm was less marked in left ventricular failure, although midnight values were usually raised. Dexamethasone suppression of plasma ;cortisol' levels was abolished or reduced in right ventricular failure. These results confirm our earlier findings and further support our contention that the disturbance of circadian rhythm is not due to a simple stress mechanism. The results are of importance in the differential diagnosis of Cushing's syndrome based on plasma ;cortisol' values, if there is concomitant right ventricular failure.

Adrenocorticotropic Hormone↗