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Biomedical subjects

D A Stempel

Publications and source records attributed to D A Stempel.

36 records · Page 2Linked to original sources
PubMed1992

Management of chronic asthma.

The treatment of asthma is changing to reflect the importance of inflammation in the disease pathogenesis. Medicines that alter the inflammatory response are the cornerstone of therapy for patients with persistent symptoms. Bronchodilators are important in acute care, but in chronic illness they are adjuvant therapy. Patient education is essential for successful outcome.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Management of acute asthma.

Patients with acute asthma experience increased airway obstruction, increased work of breathing, and ventilation-perfusion mismatch. Careful observation and assessment of the patient are fundamental for successful treatment. Therapy is dictated by the severity of the acute episode. Prevention of subsequent flares of asthma needs to be initiated as the patient convalesces.

Acute Disease↗
PubMed1991

Use of methotrexate in the treatment of steroid-dependent adolescent asthmatics.

Five children 10 to 16 years of age with steroid-dependent asthma were treated with methotrexate. All were able to reduce their doses of prednisone and all had improvement in their clinical status. No significant side effects were noted in patients treated 1 to 3 years. This open study suggests that methotrexate should be considered in the treatment of older children with severe asthma and morbidity from their steroid therapy.

Adolescent↗
PubMed1987

Tobramycin elimination rate change from first to later doses in older cystic fibrosis patients.

Adults with cystic fibrosis frequently require larger than usual tobramycin dosages in order to achieve desired serum concentrations. The application of dosing methods utilizing first-dose pharmacokinetics has been advocated as a means for rapidly attaining therapeutic serum concentrations. Review of ten cystic fibrosis patients between ages 13 and 33 years admitted for exacerbation of pulmonary disease caused primarily by Pseudomonas aeruginosa (Staphylococcus aureus in two patients) was conducted. Elimination rate constant (ke, h-1) was calculated from two concentration-time pairs obtained following the first dose. Two concentration-time pairs were again measured between cumulative doses (n) 7 to 19, and ke was calculated. First dose ke varied significantly from nth dose ke (p = 0.018). First-dose pharmacokinetic analysis may not be a reliable predictor of maintenance tobramycin dosage requirements due to apparent changes in ke over time.

Adolescent↗
PubMed1984

Risk factors associated with the development of chronic lung disease in children.

By better understanding the intrinsic and extrinsic factors that predispose children to chronic lung disease, strategies to prevent its development can be proposed. This article addresses conditions, such as bronchiolitis, croup, hyaline membrane disease, hydrocarbon ingestion, and near-drowning, that have been found to result in long-term changes in lung physiology. Also considered are the possible relationships of common respiratory infection, asthma, smoking, and air pollution to the development of chronic respiratory infection.

Age Factors↗
PubMed1984

Management of acute severe asthma.

Discussed in this article are the pathophysiology of acute asthma and its differential diagnosis and management, placing special emphasis on rapid assessment, prompt and decisive therapeutic intervention, and on recognition of the severity of the disease.

Acute Disease↗
PubMed1984

Interferon inhibits agonist-induced cyclic AMP accumulation in human lymphocytes.

Wheezing episodes often accompany viral respiratory infections. Viral pathogens are also known to induce interferon production. Cyclic AMP (cAMP) levels affect bronchial reactivity; therefore, we analyzed cAMP accumulation in human lymphocytes as a model to determine if interferon might influence the accumulation of this important intracellular mediator. After an overnight exposure to interferon in whole blood, a reduction in agonist-stimulated cAMP accumulation was demonstrated. Basal cAMP concentrations were equivalent in control and interferon-exposed lymphocytes from the same donor, but the response to isoproterenol and prostaglandin E1 was significantly reduced by 61 and 30%, respectively. The decreased responsiveness persisted in the presence of RO 20-1724, a phosphodiesterase inhibitor, indicating that the effect was in part due to a decrease in cAMP synthesis in intact cells. These results suggest that interferon may play a role in inducing or potentiating bronchospasm.

Cyclic AMP↗
PubMed1982

Malignant histiocytosis presenting as interstitial pulmonary disease.

Three children presented with progressive respiratory symptoms and radiographic evidence of diffuse interstitial infiltrates. All three had a pulmonary pathologic diagnosis of malignant histiocytosis. The pulmonary manifestations of this disease appear to have been responsive to combined chemotherapy. Malignant histiocytosis needs to be considered in the differential diagnosis of interstitial pulmonary disease.

Adolescent↗
PubMed1981

Respiratory infection and airway reactivity.

The data reviewed demonstrate that viral and mycoplasma infections induce a spectrum of functional abnormalities in airways. Acute virus infections cause wheezing illnesses in both children and adults. Changes in peripheral airway function during infection with similar organisms are observed in other subjects, usually normal adults. The pathogenesis of these responses is unclear. Pathologic data do show that infection with these pathogens damages the airway epithelium. These changes appear to increase permeability of the respiratory epithelium to protein antigens and consequently may contribute to increased frequency of attacks in asthmatic subjects. In addition, increased mucosal permeability may enhance delivery of inhaled drugs to effector sites in airway walls to induce exaggerated bronchoconstrictor responses in clinical challenge situations. Whether changes in the epithelium during infection, inducing greater antigen entry into the interstitium, results in subsequent development of specific allergy is not known and requires further study.

Afferent Pathways↗
PubMed1981

Seasonal variations of serum IgE levels in normal children.

The importance of season as a variable in total IgE production in normal children is demonstrated. Recent history of allergen exposure as well as respiratory infection, both of which are seasonally determined, should be considered in evaluating serum IgE values.

Adenoviruses, Human↗
PubMed1980

Serum IgE levels and the clinical expression of respiratory illnesses.

The incidence, clinical manifestations, and infectious etiology of respiratory illnesses observed in a prospective longitudinal study were correlated with serum IgE values, which were used as objective markers of atopy. The incidence of wheezing illnesses was greater in children with elevated IgE levels, confirming an association previously reported. In contrast, the incidence of upper respiratory illness or middle ear disease showed no correlation with IgE values. The number and types of viral infections distributed evenly throughout the population. The results suggest that children with recurrent URI or MED deserve evaluation for allergy only if there are other clinical findings suggestive of atopy.

Bronchial Spasm↗
PubMed1978

Anemia in patients with juvenile rheumatoid arthritis.

Patients with juvenile rheumatoid arthritis may have an anemia attributable to the chronic disease, to iron deficiency, or to a combination of the two. The contribution of iron deficiency is often difficult to determine by routine laboratory studies. We studied 51 patients with pauciarticular and polyarticular juvenile rheumatoid arthritis with red blood cell counts, indices, free erythrocyte protoporphyrin, and serum ferritin. Fifteen of the 18 who were anemic were restudied after a 3 to 6-month period of iron therapy. Thirteen of the 15 responded by these criteria: a rise in hemoglobin of 1.0 gm/dl or more and an increase in mean corpuscular volume of 3 fl or more; in 11 of these 13, hemoglobin values returned to the normal range for age. These findings indicate that iron deficiency can be a major component of the anemia that is commonly found in patients with active juvenile rheumatoid arthritis.

Adolescent↗
PubMedDate not supplied

Serum opsonins and chemotactins in neutropenic oncology patients.

Serum opsonins and chemotactins, C3 and C5, were studied in neutropenic oncology patients. Our data indicate that these individuals possess normal serum chemotactins and adequate opsonin activity regardless of disease status or prior chemotherapy. Their sera should therefore support function of transfused granulocytes.

Adolescent↗