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Biomedical subjects

D J Godden

Publications and source records attributed to D J Godden.

48 records · Page 3Linked to original sources

Chemical specificity of coughing in man.

The purpose of this study was to test whether cough response to inhaled ultrasonically nebulized fluid is dependent on the ionic content of the fluid. Coughing was recorded in human volunteers during inhalation of aqueous solutions in a series of double blind randomized experiments. The occurrence of cough was found to be dependent on the concentration of chloride ions in the inhaled fluid, cough frequency progressively increasing as chloride ion concentration was reduced. It is proposed that the ion composition of the surface lining fluid of the airway may moderate the cough response by means of a chemo-receptor, although tonicity may also be important.

Acetates↗

Nutritional knowledge of medical staff and students: is present education adequate?

Knowledge of nutritional principles and attitudes to nutrition education of a group of clinical medical students and junior hospital doctors were examined by questionnaire. The percentage of correct answers to factual questions was 50.8 for students and 58.5 for doctors. Both groups considered that their teaching was inadequate and over 95 per cent requested education in applied nutrition. Undergraduate instruction by both doctors and dietitians was advocated as appropriate to the final clinical years.

Attitude↗

Sustained release theophylline in nocturnal asthma.

Twice daily sustained release theophylline gave satisfactory steady serum theophylline concentrations in asthmatic children aged 7 to 14 years. The children showed improvement in symptoms, less frequent waking at night, reduced use of beta agonist inhalers, and improved early morning peak flows while being treated with this preparation. There was no improvement in peak flow at other times, but the patients recorded increased use of beta agonists during the placebo period.

Adolescent↗

Comparison of oral prednisolone and intramuscular depot triamcinolone in patients with severe chronic asthma.

In a double blind crossover study oral prednisolone was compared with intramuscular depot triamcinolone in the treatment of 20 patients with severe chronic asthma. A short term study comparing each treatment over four weeks showed only minor differences in therapeutic efficacy, but at the end of 24 week periods on each of the two treatments triamcinolone was significantly more effective than prednisolone in terms of forced expiratory volume in one second and forced vital capacity. Better control of asthma was accompanied by a significant fall in weight and some evidence of reduced adrenal suppression (improved cortisol response following a short tetracosactrin test). Side effects, including menstrual irregularities, muscle pain, and hirsuitism, were, however, more common during treatment with triamcinolone.

Administration, Oral↗

Bullous skin eruption associated with carbamazepine overdosage.

A patient who developed a bullous skin eruption associated with carbamazepine overdosage is described. The authors believe this previously unreported phenomenon to be of clinical importance. Carbamazepine should be considered in the differential diagnosis of drug-induced coma with associated bullous lesions.

Aged↗

Rigid bronchoscopy under intravenous general anaesthesia with oxygen Venturi ventilation.

In a study of 100 patients undergoing rigid bronchoscopy under intravenous general anaesthesia with oxygen Venturi ventilation no major complications were observed. Minor complications included one adverse reaction to alphaxalone-alphadolone acetate (Althesin), one prolonged episode of laryngeal spasm after removal of the bronchoscope, and subsequent muscle pain attributed to suxamethonium in 36 patients. The last complication occurred significantly less frequently (p less than 0 . 025) in those patients who were pretreated with a small dose of a non-depolarising neuromuscular blocking agent. Serial arterial blood gas sampling in 10 patients showed adequate ventilation during bronchoscopy, but carbon dioxide retention developed in nine cases immediately after the bronchoscope was withdrawn. With adequate precautions, however, the procedure is safe and well tolerated, even in patients with severe impairment of respiratory function.

Adult↗

Twice daily inhalation of a new corticosteroid, budesonide, in the treatment of chronic asthma.

The efficacy and side-effects of a new corticosteroid, budesonide, was assessed by comparison with beclomethasone dipropionate in double-blind, cross-over study of 30 patients with chronic asthma. The treatment regimens were budesonide 200 micrograms twice daily by conventional pressurized aerosol with a tube spacer attached and beclomethasone 100 micrograms four times daily via a conventional inhaler. Each treatment was given for four weeks. Results were analyzed using Student's t-test for paired comparisons. No significant differences were found for morning and evening peak flow rates, symptom scores, bronchodilator inhaler usage or forced vital capacity. Forced expiratory volume in one second after 4 weeks on each treatment was significantly higher following budesonide therapy (p less than 0.05), but the absolute changes were small and unlikely to be of clinical relevance. There were no major side-effects during either treatment period, but compared with pre-treatment levels serum creatinine and lactic dehydrogenase levels rose significantly during treatment with budesonide (p less than 0.01 and p less than 0.05 respectively). None of these results reflected clinically important biochemical or haematological changes. There was a significant reduction in neutrophil counts following treatment with beclomethasone (p less than 0.05). In the short term treatment of chronic asthma, budesonide administered twice daily is as effective as four times daily beclomethasone. A twice daily dosage regimen should improve patient compliance with therapy.

Adolescent↗

Comparison of twice daily administration of a new corticosteroid budesonide with beclomethasone dipropionate four times daily in the treatment of chronic asthma.

The efficacy and side-effects of a new corticosteroid aerosol, budesonide and beclomethasone dipropionate were assessed in 30 patients with chronic asthma in a double-blind cross-over study. Budesonide was administered, 200 micrograms twice daily, from a conventional pressurized aerosol with a tube spacer extension attached and beclomethasone was given via a conventional inhaler in the recommended four times daily dose of 100 micrograms, each treatment being administered for one month. No clinically significant differences were found between the two treatments and no significant side-effects were observed.

Adolescent↗

An objective assessment of the tube spacer in patients unable to use a conventional pressurized aerosol efficiently.

The tube spacer, a device designed to simplify the inhalation of terbutaline from a pressurized aerosol, was objectively assessed in a group of patients with reversible airways obstruction who were found to have some difficulty in using conventional inhalers. Terbutaline was administered to 22 patients in a dose of 250 micrograms via the conventional pressurized aerosol and the tube spacer. In 16 the improvements in FEV1 were greater after the tube spacer, in four they were greater after the conventional inhaler and in two patients there was no difference. Using an open sequential plan for evaluation of paired preferences it was concluded that the tube spacer was better than the conventional inhaler in these patients.

Adult↗

Hyperventilation or exercise to induce asthma?

Bronchoconstriction was induced in asthmatic patients by means of isocapnic hyperventilation with dry air. Responses both within a day and between days did not differ significantly and corresponded closely with those observed after exercise. The mean fall in forced expiratory volume in one second (FEV1) observed with both techniques was equivalent to 36%. Isocapnic hyperventilation with dry air, as used in this study, was a potent stimulus and provoked a reproducible response. The method was physically less demanding than exercise and was more acceptable to patients.

Adolescent↗