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Biomedical subjects

D T Hughes

Publications and source records attributed to D T Hughes.

At least 19 recordsLinked to original sources
PubMed1996

Comparison of characteristics of patients and treatment outcome for pulmonary non-tuberculous mycobacterial infection and pulmonary tuberculosis.

BACKGROUND: Patients with non-tuberculous mycobacteria are usually started on conventional antituberculous triple therapy once acid fast bacilli are detected, before the exact type of mycobacteria has been identified. The ability to identify the characteristics of patients with tuberculous and non-tuberculous mycobacteria may be helpful in identifying before treatment those patients more likely to have non-tuberculous infection. METHODS: A retrospective study was conducted of all patients in one unit in whom non-tuberculous mycobacteria were identified in sputum or bronchoalveolar washings in the period 1987-93. The pattern of drug resistance was determined from laboratory records, and all case notes and chest radiographs were reviewed to identify the underlying disease and treatment outcome. All cases were compared with a matched control group of patients with culture positive Mycobacterium tuberculosis diagnosed during the same period. RESULTS: In the period studied there were 70 non-tuberculous and 221 tuberculous isolates. The non-tuberculous bacteria were typed as follows: M xenopi 23 (33%), M kansasii 19 (27%), M fortuitum 14 (20%), others 14 (20%). Of those with non-tuberculous mycobacteria, 83% were white subjects compared with 47% for tuberculosis. Patients with non-tuberculous mycobacteria were older than those with tuberculosis. Pre-existing lung disease or AIDS was present in 81% of patients with non-tuberculous mycobacteria and in 17% of patients with tuberculosis. Sensitivity to rifampicin and ethambutol was seen in 95% of M xenopi and 96% of M kansasii isolates. Relapse occurred in 60% of cases infected with M xenopi, 20% infected with M kansasii, and in 7% of cases with tuberculosis. CONCLUSIONS: In the population studied non-tuberculous mycobacteria occurred most frequently in elderly white subjects with pre-existing lung disease. If mycobacteria are detected in this group, consideration should be given to the possibility of non-tuberculous infection before embarking on treatment. A combination containing rifampicin and ethambutol is effective. The relapse rate for infection with M xenopi is high and prospective studies of the effect of the above combination of antituberculosis drugs are needed.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Sports medicine.

Explore the source record for details and available documents.

Humans↗
PubMed1989

The value of ear lobe oximetry in the assessment of disability in asbestos-related disease.

Thirty-four asbestos workers, with either asbestosis, diffuse pleural thickening, calcified pleural plaques, or with comparable asbestos exposure but no evidence of asbestos-related disease and seven normal controls underwent a progressive exercise test. The subjects were categorized on the basis of lung function tests and PA chest X-rays. During the exercise test oxygen saturation was measured continuously by an ear lobe oximeter. The asbestosis and diffuse pleural thickening groups showed significant oxygen desaturation on exertion, confirming that both these conditions give rise to appreciable respiratory disability.

Asbestosis↗
PubMed1987

The use of anticholinergic drugs in nocturnal asthma.

Nocturnal asthma is a common and potentially dangerous condition. The mechanisms in its production are multifactorial. One factor appears to be increased vagal tone at night so that an anticholinergic drug might prove effective. The evidence for a bronchodilator action of anticholinergic drugs is reviewed. A clinical trial of one such anticholinergic in nocturnal asthma is described. In 12 patients with morning dipping a dose of 160 micrograms of ipratropium bromide inhaled at night significantly reduced the extent of morning dipping. The implications are discussed.

Asthma↗
PubMed1986

Improved serodiagnosis of tuberculosis using two assay test.

An antigen capture immunoassay was developed for the detection of mycobacterial antigens in sera from patients with tuberculosis. The assay was evaluated together with an antibody measuring enzyme immunoassay in a clinical trial for serodiagnosis of tuberculosis. Sensitivity of the antibody assay for active pulmonary tuberculosis, including relapsed infections, was 75%, and specificity with other lung diseases was 97%. Sensitivity for extrapulmonary tuberculosis was 84.5% and specificity 84%. Sensitivity of the antigen assay for active tuberculosis was 45% with no false positive reactions. Combination of the results from the two assays increased total sensitivity to 96.5% with a positive predictive value of 0.81 and a negative value of 0.98. The two assay test was relatively simple to perform and offered improved serological diagnosis of tuberculosis over a single antibody test.

Adult↗
PubMed1984

An electromyographic method of objectively assessing cough intensity and use of the method to assess effects of codeine on the dose-response curve to citric acid.

The integrated surface abdominal electromyogram (EMG) has been used as a simple measurement of cough intensity which correlates well with the volume, air flow and noise produced in different coughs. Using the integrated abdominal EMG as a measure of cough intensity, dose response curves to inhaled citric acid can be drawn which are highly reproducible. We have studied the effects of codeine (60 mg) on these curves, and have demonstrated a reduction in cough intensity. It is suggested that this method of testing the effects of an antitussive on such a dose-response curve may be a useful one.

Action Potentials↗
PubMed1984

Comparison of pseudoephedrine and triprolidine, alone and in combination in preventing nasal congestion in subjects with allergic rhinitis using nasal histamine challenge.

The abilities of triprolidine 2.5 mg and pseudoephedrine 60 mg, alone and in combination, to protect against an increase in nasal airway resistance (NAR) after histamine challenge were determined in eighteen individuals with grass pollen allergy. The study was conducted outside the pollen season using a double-blind, placebo controlled crossover design. The prior administration of pseudoephedrine 60 mg and triprolidine 2.5 mg alone or in combination was superior to placebo in reducing the increase in NAR after challenge with 1.0% histamine. However, such NAR measurements did not differentiate between pseudoephedrine 60 mg and triprolidine 2.5 mg administered alone or in combination. Challenge with 0.1% histamine failed to discriminate between any of the test medications.

Adult↗
PubMed1984

Ipratropium bromide in patients with nocturnal asthma.

Fourteen patients with nocturnal asthma were recruited to a two period crossover trial which compared a run-in period on nightly salbutamol (200 micrograms) with a period on nightly ipratropium bromide (160 micrograms) and a period on nightly salbutamol plus ipratropium at night. Morning dipping, as assessed by the fall in peak flow overnight, was significantly reduced in the periods when ipratropium bromide was taken. Peak flow in the morning and also at night was improved when taking ipratropium bromide. Ipratropium bromide in adequate dosage appears to be effective in reducing morning dipping in asthma.

Adult↗
PubMed1983

Asthma in merchant seamen and laboratory workers caused by allergy to castor beans: analysis of allergens.

Three merchant seamen and two laboratory workers who developed allergic symptoms following exposure to castor beans have been investigated. Bronchial-provocation testing with castor beans in the merchant seamen demonstrated a late reaction in two. Specific IgE against whole castor-bean extract and ricin, ricinus agglutinin and dericinated extracts of castor bean were found in the patients' sera using radioallergosorbent tests (RAST). RAST inhibition, toxocological and haemagglutination tests suggest that the ricin and dericinated extracts contain distinct allergens.

Adult↗
PubMed1983

Clinical assessment of a rebreathing method for measuring pulmonary gas transfer.

A rebreathing method for measuring carbon monoxide transfer factor (TLCO) and transfer coefficient (KCO) is evaluated. The test was performed on 42 subjects. Seventeen of these had normal lung function while the remainder suffered from various conditions, most having fibrosing alveolitis. No patients with severe airways obstruction were included in the group. The results were compared with single-breath measurements and close correlations were found between single-breath KCO and rebreathing KCO (r = 0.78, p less than 0.001) and between single-breath TLCO and rebreathing TLCO (r = 0.97, p less than 0.001). The reasons for discrepancies between single-breath and rebreathing values are discussed. It is concluded that measurement of rebreathing gas transfer is a useful supplement to routine tests of lung function, particularly in breathless patients with a small vital capacity.

Adult↗
PubMed1982

The effect of orally administered triprolidine and pseudoephedrine singly and combined on histamine-induced skin reactions.

The effect of a single oral dose of triprolidine and pseudoephedrine, singly and combined, on histamine-induced wheal and flare reactions, was assessed in a fully randomised, placebo-controlled, double-blind crossover study. Triprolidine alone and the combination had a significantly greater effect of (p less than 0.05) in reducing skin reactions than pseudoephedrine alone or placebo, but there was no significant difference between triprolidine ane the combination (p less than 0.05).

Double-Blind Method↗