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Biomedical subjects

G Alroy

Publications and source records attributed to G Alroy.

At least 55 records · Page 3Linked to original sources
PubMed1983

The treatment of asthma in adults using sodium cromoglycate pressurized aerosol: a double-blind controlled trial.

Sodium cromoglycate formulated as a pressurized aerosol (2 mg 4-times daily) and placebo were compared in 31 adult asthmatic patients in a double-blind crossover trial lasting 12 weeks. Sodium cromoglycate was superior to placebo in improving breathlessness at rest (p less than 0.001), breathlessness on exertion (p less than 0.05) and the quality of sleep (p less than 0.001), and also in improving the morning peak expiratory flow rate value (p less than 0.05). Both the patients' (p less than 0.05) and the clinicians' (p less than 0.01) treatment opinions, and their treatment preferences (p less than 0.05), favoured sodium cromoglycate. Moreover, usage of bronchodilators (theophylline and aerosol beta-stimulants combined) declined significantly (p less than 0.001) during sodium cromoglycate treatment compared to placebo. No side-effects were reported. The results of this study show that sodium cromoglycate delivered by pressurized aerosol was significantly superior to placebo, not only in improving asthmatic symptoms, but also in reducing the amount of concomitant bronchodilator therapy required.

Adolescent↗
PubMed1982

Nosocomial bacteremia due to Acinetobacter calcoaceticus.

In 1980, 13 patients with positive blood cultures for Acinetobacter calcoaceticus were detected in an 800 bed university medical center. Twelve of the 13 isolates were identified as Acinetobacter calcoaceticus var. anitratus and one as var. lwoffi. In the same period there were 361 positive specimens of A. calcoaceticus. Eight of the patients were classified as having significant bacteremia (Group A) with a serious infection in which Acinetobacter was considered a significant pathogen. Five additional patients, however, (Group B) had fever and only one set of positive blood cultures. The significance of these positive isolates was unclear to the attending clinicians. All but one Group A patient appeared to have acquired their infection during hospitalization. In this group, one patient had an underlying pneumonia as the source of bacteremia. In the remaining patients bacteremia was related to some form of invasive catheterization. Seven patients responded rapidly to appropriate antimicrobial therapy and one patient with terminal cancer died as a result of infection. This report reviews the clinical spectrum of Acinetobacter bacteremia, which can range from mild, possibly self-limiting bacteremia to serious, life-threatening septicaemia, especially in compromised hospitalized patients.

Acinetobacter↗
PubMed1982

Apneic and nonapneic breathing disorders in sleep.

Recent research has demonstrated that respiratory activities are stage dependent and that some breathing disorders appear only in sleep. Sleep apnea syndromes, defined as the occurrence of at least 30 apneas of greater than or equal to 10 sec, dramatically affect patients' sleep and waking behavior. During 1977-80, 114 patients with sleep apnea and 82 patients with nonapneic breathing disorders in sleep, were recorded in the Technion Sleep Laboratory. In both groups, patients were mostly male in the 30- to 50-yr age-group, whose primary complaint was excessive daytime sleepiness. Nonapneic breathing disorders in sleep included periodic breathing, periodic hyperpnea, and variations in rate of breathing without notable changes in volume. It is suggested that some of the patients with sleep apnea syndrome and with non-apneic breathing disorders in sleep belong to the same etiological group, each representing a different stage along a single continuum of breathing disorders.

Adult↗
PubMed1982

Excessive daytime sleepiness and insomnia.

Twenty-five adults with a deviated nasal septum, who complained about excessive daytime sleepiness, chronic fatigue, and nocturnal insomnia, were studied for one to two nights in a sleep laboratory. Recordings disclosed disordered breathing during sleep in the form of pronounced periodic breathing of alternating hypopneas and hyperpneas, isolated hypopneic episodes and central apneas and periodic sighs, all combined with electrophysiologic "microarousals," and a mixture of alpha and delta EEG wave activities. Surgical treatment of the deviated septum in 14 patients resulted in a subjective improvement in the level of diurnal alertness and in the quality of nocturnal sleep in 12 patients. Follow-up sleep recordings in seven of the patients who reported subjective improvement in sleep disclosed notably less waking and abnormal breathing during sleep. These results suggest that increased upper airway resistance can cause nonapneic breathing disorders in sleep and, consequently, sleep disturbances.

Adult↗
PubMed1981

[Transtracheal aspiration in pulmonary infections].

Transtracheal aspiration (TTA) was performed 35 times in 33 patients with acute pulmonary infections. The indications for the procedure included pulmonary infection in immune-depressed or debilitated patients in whom the pathogenic organism could not be identified, either because of lack of sputum or suspected over-colonization of the oral cavity. The procedure was performed under full sedation with diazepam (Valium), by introducing a catheter (Intracath) through the cricothyroid membrane into the trachea, without local anesthesia. This modification markedly reduces the cough reflex and complications like subcutaneous emphysema and bleeding. Only two of our cases developed subcutaneous emphysema. The procedure enables the physician to make accurate and rapid therapeutic decisions and is recommended as a diagnostic tool.

Diazepam↗
PubMed1981

Across-night lengthening of sleep apneic episodes.

Systematic trends in the length of apneas were investigated in 8 sleep apnea patients, all of whom had more than 200 apneas per night. Regression analysis performed on the length of apneas by thirds of the night revealed significant linear trends for apneas in sleep stage 2, and for apneas in all sleep stages pooled together. There were no significant trends in the index of apnea density. We suggest that the across-night lengthening of apneas reflects a progressive increase in the arousal threshold, either by a compensatory deepening of sleep or by progressive changes in respiratory chemoreceptor sensitivity. The lack of significant trends in rapid eye movement (REM) sleep supports the conclusion that apnea termination in REM sleep is mediated by a different mechanism than in non-REM sleep.

Adult↗
PubMed1981

The teaching of history-taking and diagnostic thinking: description of a method.

This paper describes the use of short videotaped doctor-patient history-taking encounters, which demonstrate the generated-hypothesis-verifying (GHV) method of enquiry. We urge that this method be taught formally to medical students, to complement the classical 'rigid' method of history taking.

Education, Medical, Undergraduate↗
PubMed1981

Spectral characteristics of normal breath sounds.

An objective and accurate measurement and characterization of breath sounds was carried out by a fast-Fourier-transform frequency-domain analysis. Normal vesicular breath sounds, picked up over the chest wall of 10 healthy subjects showed a characteristic pattern: the power of the signal decreased exponentially as frequency increased. Since the log amplitude vs. log frequency relationships were linear, they could be characterized by the values of the slope and the maximal frequency. The average slope of the power spectrum curves was found to be (in dB/oct +/- SD) 13.0 +/- 1.4 over the base of the right lung, 12.6 +/- 2.4 over the base of the left lung, 9.8 +/- 1.4 over the interscapular region, and 14.4 +/- 4.3 over the right anterior chest. The maximal frequencies of inspiratory and expiratory breath sounds, picked up over the base of the right lung, were (in Hz +/- SD) 446 +/- 143 and 286 +/- 53 (P less than 0.01), over the base of the left lung 475 +/- 115 and 284 +/- 47 (P less than 0.01), over the interscapular region 434 +/- 130 and 338 +/- 77 (P less than 0.05), and over the right anterior chest 604 +/- 302 and 406 +/- 205 (P less than 0.05). Breath sounds picked up over the trachea were characterized by power spectra typical to a broad spectrum sound with a sharp decrease of power at a cut-off frequency that varied between 850 and 1,600 Hz among the 10 healthy subjects studied.

Adult↗