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H Lewis

Publications and source records attributed to H Lewis.

At least 145 records · Page 8Linked to original sources

Is the combination inhaler of salbutamol and beclomethasone dipropionate as effective as the same agents from separate inhalers in the management of childhood asthma?

A double-blind crossover study lasting 16 weeks was carried out in children with chronic extrinsic asthma to compare the clinical effects of regular inhalations of salbutamol and beclomethasone dipropionate from a combination inhaler and regular inhalations of the same two drugs used sequentially from separate inhalers. Eighteen patients entered the study and 16 completed both 8-week treatment periods. However, there was a large amount of missing data, with only 9 complete sets of paired data; efficacy analyses were performed on data from 10 patients on separate inhaler therapy and from 14 patients on combination inhaler therapy. There were no significant differences between daily peak flow rate measurements, symptom scores, additional symptomatic bronchodilator therapy, acute exacerbations of asthma or incidence of adverse events, demonstrating that both treatments were similarly effective in controlling the patient's asthmatic symptoms. There was, however, a trend for higher peak flow values and lower symptom scores on separate inhaler therapy in this small group of asthmatic children. Although the results suggest that regular therapy using a combination inhaler is as effective as sequential administration of salbutamol and beclomethasone dipropionate from separate inhalers, it is concluded that the study should be extended to a larger group of patients to determine whether there might be any statistically significant differences between the two regimens.

Adolescent↗

Chorioretinal juncture. Multiple extramacular drusen.

A clinicopathologic study of multiple extramacular drusen (MED) was performed on 784 eyes of 412 consecutive autopsies and on 100 eyes of 50 consecutive patients with MED. The clinical and histopathologic characteristics of MED and its correlation with reticular degeneration of the pigment epithelium (RDPE) and with macular degenerative abnormalities are presented. Multiple extramacular drusen was associated with macular degenerative abnormalities in 88% of autopsy cases, in contrast to 2% of cases in a control population without MED or RDPE. Multiple extramacular drusen and macular degenerative abnormalities are associated findings and apparently have similar pathogenetic mechanisms.

Adolescent↗

Nutrients supplied by food groups in diets of teenaged girls.

Sources of nutrients were determined in diets of teenaged girls, a group generally thought to be at nutritional risk. This study of Southern adolescent girls of two races examines intakes of energy, energy-yielding nutrients, vitamins, minerals, and other components of various food groups. Effects of race, age, place of residence, and per capita income on nutrients furnished by food groups were determined from two 24-hour dietary recalls from each of 1,195 girls, aged 12, 14, or 16. Of the food groups examined, foods of low nutrient density provided the most energy, fat, and carbohydrate. The meat group provided the most protein. Dairy products, which supplied the largest amounts of six vitamins and minerals of any food group, were used less by black, rural, or older teenagers than by white, urban, or younger girls. Blacks obtained more vitamin A from vegetables and more thiamin from meat than whites. Amounts of meat, starchy, and low-nutrient-density subgroups also varied with race, age, and/or place of residence. As income increased, consumption of starches (especially breakfast cereals) and eggs decreased and that of fruit increased.

Adolescent↗

Fluorescein angiography in reticular degeneration of the pigment epithelium.

We studied reticular degeneration of the pigment epithelium by fluorescein angiography in 32 eyes of 50 consecutive patients who had ophthalmoscopic indications of this aging-related entity. In this type of degeneration, fluorescein angiography delineated extensive abnormalities of the retinal pigment epithelium and demonstrated normal-appearing retinal vessels and choriocapillaries in the affected areas.

Aged↗

Bone lining cells and hematopoiesis: an electron microscopic study of canine bone marrow.

Hematopoietic bone marrow in the dog is enclosed by a nearly complete and rather complex layer of endosteum, consisting of a diverse group of cells collectively called bone lining cells (BLC). Cell types comprising BLC include osteoblasts and osteoclasts, and other cell types, among which are elongated, flat cells with a spindle-shaped nucleus, and small cytoplasmic vesicles. The composition and thickness of the layer of BLC varies along the perimeter of the marrow. The layer may be simple or stratified. Occasionally a zone of tightly packed regularly arranged collagenous fibers lies between the bone lining cells and bone. Hematopoiesis, particularly neutrophilic, often occurs in the bone marrow next to the BLC. Cytoplasmic processes of BLC occasionally extend into the hematopoietic spaces and stromal cells in the hematopoietic compartment may extend processes to the layer of BLC. Occasionally cells of the BLC are similar in appearance to stromal cells within the marrow. Our observations together with the experimental findings of others (that fibroblastic stromal cells contribute to the hematopoietic inductive microenvironment, that hematopoietic stem cells are concentrated subosteally, that cells responsible for regeneration of the marrow stroma are derived from the endosteal layer, and that high concentrations of hematopoietic colony-stimulating factors are produced there) indicate that the hematopoietic capacities of bone marrow may be regulated by BLC.

Animals↗

Reticular degeneration of the pigment epithelium.

A clinicopathologic study of reticular degeneration of the pigment epithelium (RDPE) was done on 750 eyes of 396 consecutive autopsy cases and on 100 eyes of 50 consecutive patients with RDPE. The clinical, angiographic, macroscopic, and histopathologic characteristics of RDPE and its correlation with macular degenerative abnormalities in the autopsy and clinical eyes are presented. Reticular degeneration of the pigment epithelium and macular degeneration were found to be concomitant manifestations of the aging process, and RDPE may be a significant risk factor associated with age-related macular degeneration. Evaluation of the peripheral fundus is of value in assessing patients with macular degenerative abnormalities.

Aged↗

Age at clinical onset and at ultrasonographic detection of adult polycystic kidney disease: data for genetic counselling.

Few reports are available on the age-related risk of relatives of affected persons to manifest adult polycystic kidney disease (APKD). For 371 persons in 17 kindreds, at risk for APKD by virtue of having an affected first degree relative, we calculated the estimated probability of clinical diagnosis of APKD to be 0.011 by age 20, 0.041 by age 30, 0.115 by age 40, 0.299 by age 50, and 0.404 by age 60 years (expected = 0.50). Ultrasonographic examination of 172 asymptomatic persons at risk showed definite APKD in 60. The probability of ultrasonographic detection of asymptomatic APKD is estimated as 0.222, 0.657, and 0.855 at age 5, 15, and 25 years, respectively. The probability of having APKD following normal ultrasonogram results (conservatively assuming 90% specificity) is estimated as 0.46, 0.28, and 0.14 for persons at 50% risk in their first, second, or third decade. The marginal benefit of ultrasound as a diagnostic test for APKD for persons in the second or third decade is estimated as 0.37 and 0.41, respectively for a "positive" test and 0.22 and 0.37 for a "negative" test.

Adolescent↗

The correlation of changes in systolic blood pressure with regional anatomical regression of hypertensive left ventricular hypertrophy in patients on chronic antihypertensive therapy (greater than 1 year): alpha-methyldopa compared to propranolol.

Twenty patients with mild to moderate hypertension and evidence of left ventricular hypertrophy (relative wall thickness greater than or equal to 0.45), who previously had not received either alpha-methyldopa or propranolol, were allocated at random to treatment with one or other of these drugs as monotherapy after a 2-week baseline period on no medication. Dosage was titrated until normotension was attained and patients were then maintained on this treatment for a year. Analysis of blood pressure measurements and echocardiograms taken before and during maintenance therapy showed that there were significantly correlated changes in systolic blood pressure and heart rate with left ventricular cavity and regional wall changes during chronic drug administration. In the alpha-methyldopa group there were significant correlations between changes in erect and supine systolic blood pressure and the posterior wall index, and in erect systolic blood pressure and left ventricular mass. In the propranolol group, there were significant correlations between changes in supine systolic blood pressure and interventricular septal thickness, and in erect heart rate and supine systolic blood pressure with the percentage change in internal diameter of the left ventricle. It is suggested that these observations may have important therapeutic implications for hypertensive patients with documented left ventricular hypertrophy.

Adult↗

Ethical assessment.

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Ethics, Professional↗

Nutrient intakes of female adolescents from eight southern states.

Nutrient intakes were calculated from two 24-hour recalls for 1,247 adolescent black and white girls. Whites consumed more vitamins E, C, and B-12, niacin, folacin, calcium, phosphorus, magnesium, and zinc and had higher intakes per 1,000 kcal of those nutrients, protein, vitamin D, and iron than blacks. Intakes of calcium (whites) and magnesium (both races) decreased with age. Urban girls consumed more energy and magnesium than rural ones. Folacin intake increased with income. Folacin intakes were most frequently below 67% RDAs, followed by intakes of iodine, vitamin D, iron, calcium, vitamin B-6, zinc, magnesium, and vitamin A. The majority of diets met or exceeded RDAs for protein, vitamins E, C, and B-12, riboflavin, and thiamin. Intakes are reported for most nutrients for which safe ranges have been set.

Adolescent↗

The iron status of Black and white female adolescents from eight Southern states.

Hb, hematocrit, plasma iron, and transferrin saturation were measured in approximately 1000 girls aged 12, 14, or 16 yr in eight southern states. The iron status parameters did not differ significantly among the three age groupings or between menstruating and nonmenstruating girls. Blacks had significantly lower mean Hb (p less than 0.0001), hematocrit (p less than 0.0001), and transferrin saturation (p less than 0.05) levels than whites and a greater proportion of Blacks exhibited low Hb (p less than 0.05) and low hematocrit levels (p less than 0.01). Adjusting for dietary iron intakes and per capita income levels did not adequately account for significant race differences for iron status parameters. These findings support the contention that genetic as well as environmental factors are responsible for the frequently reported Black-white differences in Hb and hematocrit levels.

Adolescent↗