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Biomedical subjects

D C Sutherland

Publications and source records attributed to D C Sutherland.

At least 37 records · Page 2Linked to original sources
PubMed1989

Nasal histamine challenges in symptomatic allergic rhinitis.

Twenty subjects (seven with perennial allergic rhinitis, seven with symptomatic seasonal allergic rhinitis, and six normal control subjects) underwent assessment of nasal sensitivity to histamine. Nasal resistance was measured by posterior rhinometry under control conditions and after log incremental doses of histamine solution pipetted into the nose (0.5 to 5000 micrograms). Allergic subjects exhibited a twofold rise of nasal resistance with doses of 0.5, 5, or 50 micrograms of histamine, whereas the nasal resistance in normal subjects remained unchanged until 500 or 5000 micrograms of histamine had been administered. Nasal reactivity to histamine was not correlated with symptoms on the day of testing but was correlated with the number of positive wheals to skin prick testing. It was concluded that nasal resistance is more sensitive to histamine in subjects with allergic rhinitis than in normal control subjects and that this difference may be used as the basis of a diagnostic test.

Administration, Intranasal↗
PubMed1989

Kaposi's sarcoma of the palate in a patient with AIDS: an unusual presentation.

Kaposi's sarcoma formerly a rare tumour in the western world, is now found frequently in homosexual patients with the Acquired Immune Deficiency Syndrome. A common site of occurrence is the mouth. The characteristic intra-oral appearance of the lesion is of a flat or raised pigmented lesion. An intra-oral Kaposi's sarcoma which was not pigmented and which presented as a painless, soft swelling on the hard palate is reported. The unusual appearance of the lesion is described and the importance of accurate diagnosis of intra-oral lesions in patients with the Acquired Immune Deficiency Syndrome is emphasized.

Acquired Immunodeficiency Syndrome↗
PubMed1988

AIDS and the heart.

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Acquired Immunodeficiency Syndrome↗
PubMed1988

Biotyping respiratory Haemophilus species with the microbact system.

The biochemical characteristics of 114 respiratory Haemophilus isolates were examined by the Minitek and Microbact systems. The Microbact system was easy to use and read, although some of the less important reactions (glucose and xylose) were difficult to interpret on occasions. On the basis of the 3 crucial reactions--indole production, ornithine decarboxylase and urease activity--discrepancies between the two systems were minor. Given careful standardization of techniques the Microbact system is a suitable alternative to established techniques for the biotyping of H. influenzae and H. parainfluenzae.

Bacterial Typing Techniques↗
PubMed1986

Deaths from asthma in New Zealand.

We report the first complete population based study of childhood deaths due to asthma. All deaths ascribed to asthma in New Zealand children aged 0-14 were investigated as part of a two year national study of mortality from asthma. The 16 children who died from asthma all developed asthma by the age of 4; 15 had a family history of asthma, and 12 had associated atopic disorders. Disturbed pyschosocial relationships were evident in eight families. Seven children died in less than three hours from the onset of their final attack. All children died outside hospital. Mortality from asthma in Maori children (3.14 per 100 000) was five times that of European children. With hindsight, factors which if avoided could have led to a different outcome were identified in eleven cases. The circumstances surrounding these deaths were similar to those described for adults with asthma; this study, however, underlines the importance of parental care and knowledge in the management of children with asthma. Inadequate long term medical care, underassessment of severity by family and doctors, failure of the family to call for help when required, and inadequate responses of medical services contributed to the fatalities. Excess beta2 sympathomimetic dosage or overreliance on home nebulisers were uncommon. Most childhood deaths from asthma should be prevented by increased family awareness, better assessment of severity, improved long term treatment, and rapid access to emergency medical care.

Adolescent↗
PubMed1986

A case-control study of deaths from asthma.

A population based case control-study was initiated in 1981 to identify risk factors for death from asthma. Over a two year period all deaths in the Auckland population possibly due to asthma, in people less than 60 years of age, were investigated. From the 47 people who died from asthma 44 who had useful reversibility of airways obstruction (records showing greater than 20% variability of peak flow or a history indicating equivalent variability of shortness of breath) before death were selected as cases for the study. Both hospital and community based controls were used. The cases were more likely than were the community controls to have had severe disease, a hospital admission or visits to a hospital emergency department in the previous year (odds ratios 4.4, 16.0, 8.5 respectively). The asthmatic patients who died were more likely than either group of controls to have had a previous life threatening asthma attack. Poor management of the disease and poor compliance on the part of the patient increased the risk of death. In addition, use of three or more types of asthma drug within the past year was associated with an increased risk of dying that was independent of disease severity. Of interest was a similarity between asthmatic patients admitted to hospital and those who died. Nevertheless, a history of a previous life threatening attack and a recent admission to hospital identified a group at high risk.

Acute Disease↗
PubMed1985

Management of acute asthma attacks in Auckland A & E departments.

Many asthmatics in the Auckland area use hospital accident and emergency (A & E) departments as the primary source of treatment during acute asthmatic attacks. A review of A & E records has revealed important variations in the standard of care they receive, and highlights the need for further education of A & E officers.

Acute Disease↗
PubMed1985

Asthma mortality in New Zealand: a two year national study.

The epidemic of deaths from bronchial asthma in New Zealand was investigated by a two-year national review of all deaths of persons under 70 years where "asthma" appeared in part I of a death certificate or in a coroner's report of cause of death. Information about the patients, the characteristics and management of their asthma and the circumstances of the fatal episode was obtained by interviewing relatives and general practitioners and perusal of hospital records. The reviewing panel of the asthma task force of the Medical Research Council considered 271 of the 342 deaths studied were due to asthma. A high national asthma mortality rate (5.1 per 100 000) was confirmed, with rates for Maoris (18.9) and Pacific Islanders (9.4) considerably higher than that for Europeans (3.4 per 100 000). After standardising for age and ethnic groups, there remained a threefold variation in mortality rates among health districts suggesting regional differences in prevalence, severity or management of asthma. No single cause for these high mortality rates was found. One-quarter of the deaths occurred in patients who had had previous life threatening attacks. Excessive use of bronchodilator drugs did not account for the high mortality rates, but inappropriate prolonged use of a home nebuliser may have delayed institution of other therapy in a few cases.

Adolescent↗
PubMed1984

Death from asthma in Auckland: circumstances and validation of causes.

New Zealand has experienced an epidemic of asthma deaths since 1977 with mortality rates of over 3.0/100 000 for people aged 5-34 years, more than three times the rate of comparable countries. To examine the reasons for this high mortality rate all deaths from asthma in people under 70 years in the Auckland region in 1981-82 were investigated. A total of 84 possible cases were studied and the validity of death certificates was found to be excellent for people under the age of 50 years. Fifty-three cases had usefully reversible asthma at the time of death and the mortality rate was almost four times higher in Pacific Islanders than in caucasians, with the Maori rate being intermediate. Sixty-seven percent (35) of the deaths in people with usefully reversible asthma occurred at home. In only 40% of cases had the patient reached some form of medical care. No deaths occurred in the patients admitted to hospital with the diagnosis of asthma during this period.

Adolescent↗
PubMed1983

Decrease in mitogen responsiveness of mononuclear cells from peripheral blood after epinephrine administration in humans.

A single subcutaneous injection of 0.2 mg epinephrine into healthy human subjects caused a transient lymphocytosis in peripheral blood. Mononuclear cells (MNC), isolated at various times after epinephrine administration, were cultured in the presence of mitogens. The blastogenic responses to pokeweed mitogen (PWM) and phytohemagglutinin (PHA) were significantly reduced for up to 60 min post-epinephrine (p less than 0.05); the response to concanavalin A (Con A) was reduced in the 15-min samples only. All responses returned to pre-injection levels by 120 min post-injection. Removal of adherent monocytes from MNC isolates before culture did not restore normal mitogen responsiveness. When MNC were cultured in the absence of mitogens, there was no difference in survival between pre- and post-epinephrine samples. Incubation of untreated MNC for 2 hr or 18 hr in vitro with various concentrations of epinephrine (10(-5) to 10(-1) mg/ml) had no effect upon the subsequent blastogenic response to mitogens. Other workers have reported that epinephrine administration causes alterations in the composition of the circulating lymphocyte pool. Taken together, these data suggest that the reduction in mitogen responsiveness after epinephrine is the result of changes in the distribution of lymphocyte subclasses in peripheral blood.

Adult↗
PubMed1982

Mortality from asthma: a new epidemic in New Zealand.

Trends in mortality attributed to asthma in the 5-34-year age group were examined in New Zealand, Australia, England and Wales, the United States, Canada, and West Germany for the years 1959-79. An epidemic of deaths from asthma occurred in the mid-1960s in New Zealand, Australia, and England and Wales but not in the other countries. In Australia and England and Wales the death rate quickly returned to pre-epidemic levels, but in New Zealand the decline in mortality was slow, and by 1974 the death rate was still almost double the pre-epidemic level. Of great concern was an abrupt increase in reported deaths from asthma in New Zealand after 1976 with the mortality rate during 1977-9 being greater than during the previous epidemic. In contrast, asthma mortality had remained relatively stable in the other populations.The new epidemic in New Zealand was investigated and appeared to be real. It could not be explained by changes in the classification of deaths from asthma, inaccuracies in death certification, or changes in diagnostic fashions. The most likely explanation appeared to be related to the management of asthma in New Zealand, and this is being investigated.

Adolescent↗
PubMed1981

Has the change to beta-agonists combined with oral theophylline increased cases of fatal asthma?

An apparent increase in young people dying suddenly from acute asthma has been noted in the past 2 years in Auckland. 22 fatal cases were reviewed. Prescribing habits for asthma therapy have been changing in New Zealand, with a considerable increase in the use of oral theophylline drugs, particularly sustained-release preparations, which in many patients have replaced inhaled steroids and cromoglycate. It is suggested that there may be an additive toxicity between theophylline and inhaled beta 2-agonists at high doses which produces cardiac arrest. Also when regular symptomatic treatment with bronchodilators replaces inhaled steroids or cromoglycate the patient's perception of an asthma crisis may be delayed.

Administration, Oral↗