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Biomedical subjects

H Worth

Publications and source records attributed to H Worth.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Transcutaneous blood gas measurements in ergometry].

Blood gases were determined simultaneously both transcutaneously and arterially in 23 healthy male subjects during spiroergometric, exhaustion-limited stress. The individual correlation coefficient between arterially and transcutaneously measured pO2/pCO2 was 0.66 and 0.80, respectively. The median correlation coefficient between the individual correlation coefficients of the pO2 and pCO2 measurements was 0.85 (p less than 0.01). Hence, the validity of transcutaneous blood gas measurement under stress is significantly dependent on individual factors that influence both the pO2 and pCO2 measurements to an equal degree.

Blood Gas Monitoring, Transcutaneous↗
PubMed1990

[Prevalence of polyneuropathies in patients with chronic obstructive lung disease].

A multicentric study of 151 COLD patients confirmed the increased prevalence of peripheral polyneuropathies (PNP) in hypoxaemic patients with chronic obstructive lung disease (COLD). 43 (28%) of these 151 COLD patients showed a clinically manifest PNP, whereas in a comparative group of 32 asthmatics there were only 2 clinical PNP cases. Patients with known risk factors for PNP were not included in the study. The polyneuropathy observed in such patients is usually mild, mainly sensorial, distal and leg-accentuated. Of 52 COLD patients with a PaO2 up to 55 Torr, polyneuropathy was seen in 21 (40%), and of 59 COLD patients with a PaO2 above 60 Torr, 10 (17%) had polyneuropathy. In multifactorial genesis (as would be expected), the degree of severity of hypoxaemia (calculated as reduction of the actual PaO2 value below the age-adjusted nominal value), as well as the age of the patient, are statistically significant predictors of clinically manifest PNP.

Aged↗
PubMed1990

[Pneumonia in AIDS: pathogen spectrum and diagnostic value of various fiberoptic bronchoscopy methods for the detection of pathogens].

39 fibre-bronchoscopic examinations were performed prospectively in 29 AIDS-patients with pneumonia. Specimens were obtained from the central bronchial system with a protected brush and by suction, from the infiltrated peripheral area by catheter suction, protected brush, bronchoalveolar lavage (BAL) and transbronchial biopsy in randomized order. In patients with non-bacterial pneumonia, pneumocystis carinii (n = 20) was the most frequent pathogen. In this group BAL had a significantly higher rate of pathogen detection than other techniques. In patients with bacterial pneumonia (n = 10) the pathogens were found in all cases by suction from the central bronchial system. Fibre-bronchoscopy in patients with AIDS and pneumonia should include specimens from the central bronchial system and a bronchoalveolar lavage.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Anxiety and illness behavior in bronchial asthma].

In 82 patients attending a one-week asthma self-management education program, asthma symptom anxiety, personality trait anxiety, and attack-related coping styles were correlated with attack frequency, medication regimen and pulmonary function parameters. In 21 patients, asthma symptoms anxiety was shown to influence illness behaviour at follow-up one year later: in patients with severe asthma, greater symptom anxiety was associated with more suitable illness behaviour. Moreover, suitable illness behaviour appears to be related to cognitive coping styles that take into account the asthmatic's feeling of dependency in attacks without denying them.

Adaptation, Psychological↗
PubMed1990

[Serologic studies in the diagnosis of pneumonia].

The importance of serological determination procedures for the diagnosis of pathogens was investigated in 207 episodes of pneumonia. The pathogenic organisms were detected in 138 cases; in 40 cases serological analysis helped to establish the diagnosis, while in 11 cases of pneumonia, the diagnosis was possible only with serology. The organisms most commonly found by serological investigations were Cytomegalovirus (n = 10), Aspergillus fumigatus (n = 7), and the influenza B virus (n = 7). Multiple infections, usually triggered by bacterial pathogens, were found in 48% of the cases of pneumonia with serological evidence of pathogens. In 71 episodes of pneumonia, the patients were immunosuppressed; in 11 cases, the causative organism was detected serologically.

Adult↗
PubMed1990

[Validity of calculating oxygen saturation at rest and during exercise].

Oxygen saturation calculated with the formulae proposed by Heck, Kelman, Lutz, Marsoner, Severing-haus and Siggaard-Andersen, was compared with oxygen saturation measured photometrically. An analysis of 1350 peripheral venous, mixed venous and arterial blood samples obtained during bicycle ergometry revealed that only the calculations using the Kelman, Siggaard-Andersen and Severing-haus formulae had adequate validity and reliability over a wide measuring range. If, however, the oxygen saturation figures are to be used for further calculations, direct measurement should be given preference to avoid errors (for example, in shunt calculation).

Exercise Test↗
PubMed1990

[Pneumonia in patients with and without immunosuppression--value of bronchoscopic biopsy technics for the detection of pathogens].

Bronchoscopic diagnosis was performed in 91 patients with 100 episodes of fresh pneumonia. In already existing immunosuppression (n = 51, Group A) pathogens were most frequently identified via bronchoalveolar lavage (70%); in patients without immunosuppression (n = 49, Group B) the identification quota in respect of the central bronchial secretion (53%) and bronchoalveolar lavage (47%) were comparable. In Group A the most frequently occurring pathogens were Pneumocysti carinii (n = 18) and Aspergillus fumigatus (n = 7), in Group B Streptococcus pneumoniae (n = 8) and Staphylococcus aureus (n = 7).

Adult↗
PubMed1990

[Incidence, diagnosis and follow-up of bacterial pneumonia in AIDS].

In 36 patients suffering from AIDS (age: 21-62 years) the incidence, the efficiency of diagnostic procedures and the clinical course of bacterial pneumonias were analysed. 19 out of 20 episodes with bacterial pathogens were found in 18 patients via fibre-bronchoscopic sampling. The most frequently observe bacteria were S. pneumonia (n = 8), M. tuberculosis (n = 3) and atypical mycobacteria (n = 6). At least 2 pathogens of the pneumonia were observed in 9 episodes. An appropriate treatment with antibiotics on the basis of a proper microbiologic diagnosis was successful in 65% of the cases. Because of the unreliability of history, clinical findings, chest X-ray, and laboratory features, successful management of bacterial pneumonias of AIDS patients should be based on the knowledge of the causative agent which can be obtained by the efficient and safe procedure of bronchoscopic sampling.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Patient education in the treatment of bronchial asthma. Goals, content, pedagogic technics and evaluation of a structured program].

Despite the advances in the understanding of the pathogenic mechanisms, clinical assessment and medical treatment of asthma, an increase of mortality and morbidity has been observed. It is clear from several studies, however, that this discrepancy may be at least partly due to serious short-comings, amongst asthmatic patients, in their ability to judge the severity of their asthma, and their knowledge of medication and correct dosaging, in the event of deterioration. Therefore, to effectively manage asthma structured education programs for adult asthmatics appear to be useful including information about the disease and the medication as well as training of self-management of airflow limitation by the patients. The evaluation of the course of the disease before and after this education revealed a reduction in severe attacks, hospitalization and days lost from work in trained asthmatics.

Adult↗
PubMed1989

Effects of diagnostic procedures during fiberoptic bronchoscopy on heart rate, blood pressure, and blood gases.

To investigate the effects of several endoscopic procedures like introduction of the bronchoscope, removal of the instrument, catheter suction, bronchoalveolar lavage and transbronchial biopsy on heart rate, systemic blood pressure, and transcutaneously measured blood gases 77 consecutive patients (age, 20-83 years) were studied. All patients received 101 O2/min via face mask during bronchoscopy. Sedation was performed with midazolam or diazepam. The different characteristics of each patient, e.g. age, sex, smoking habits, baseline values of heart rate and systemic blood pressure, underlying pulmonary disease and kind of premedication were examined separately to analyse their special effects on the course of bronchoscopy. During the fiberoptic bronchoscopy neither a slight decrease in transcutaneous pO2 nor a small increase in transcutaneous pCO2 led to a critical situation. Nevertheless it should be stressed that the time after removal of the instrument and finishing supplemental oxygen may be critical regarding hypoxia and hypercapnia especially in older patients with hypoxia being already present before starting the endoscopy. The hemodynamic indices did not change significantly. There was no difference between midazolam or diazepam concerning the parameters under study. If supplemental oxygen is given and adequate premedication is performed, monitoring of hemodynamics and blood gases during fiberoptic bronchoscopy is not necessary in patients without cardiovascular or respiratory risk.

Adult↗
PubMed1989

Oxygen saturation calculation procedures: a critical analysis of six equations for the determination of oxygen saturation.

Photometrically measured values of O2-saturation (SO2) were compared with SO2 predictions on the basis of the equations proposed by Heck, Kelman, Lutz, Marsoner, Severinghaus, and Siggaard-Andersen on 1350 occasions. Capillary, venous and mixed venous blood samples from 23 healthy subjects and 30 patients, suffering from cardio-pulmonary diseases were analyzed at rest, during exhaustion, limited exercise and during the recovery phase of ergometric tests. Overall the best agreements with the measured values were found for the equations of Kelman, Severinghaus and Siggaard-Andersen. The results of Heck's, Lutz', and Marsoner's predictions were in reasonable agreement with the measured SO2 only under special physiological conditions. No calculation mode can be performed with constant accuracy and reliability when covering a wide range of acid-base values. If SO2 values are used for further calculations, e.g. for determination of cardiac output, measured values are preferred.

Adult↗
PubMed1989

Endobronchial versus intravenous application of the vasopressin derivative glypressin during diagnostic bronchoscopy.

Glypressin is a vasopressin derivative which is used in the present study to stop pulmonary bleeding. The effects of endobronchially versus intravenously applied glypressin were examined during diagnostic fibreoptic bronchoscopy in 27 patients. Transcutaneously measured blood gases and haemodynamics were analysed after 1 mg glypressin was given. The glypressin plasma level was 251 fold higher after the intravenous than after the endobronchial administration. After endobronchial application no significant changes were observed for blood pressure, heart rate or blood gases. Following the intravenous glypressin application there was a significant increase in diastolic blood pressure. The bronchial mucosa pallor appeared earlier after topical than after systemic glypressin application. The haemostyptic effect was similar for both routes of application.

Adult↗
PubMed1988

Lung function disturbances versus respiratory muscle fatigue in patients with systemic lupus erythematosus.

In 23 consecutive patients (mean age, 38.6 years) with systemic lupus erythematosus (SLE) and in 17 healthy subjects (mean age, 37.5 years) fatigue of respiratory (diaphragm, musculi intercostales externi) and leg muscles (musculus gastrocnemius) was determined comparatively by electromyography. Additionally, routine lung function parameters, including maximum inspiratory (PImax) and expiratory (PEmax) mouth pressures, were measured. The SLE patients showed lower values of vital capacity (VC), total lung capacity (TLC), thoracic gas volume (TGV), FEV1, PImax and PEmax than the healthy controls, while FEV1/VC, residual volume and specific airway conductance were not significantly different in either group. Lung compliance, corrected for TGV, was normal in the SLE group. Breathing through stenoses with increasing resistances resulted in fatigue of the diaphragm in 73% of the SLE group and in 41% of the control group. The corresponding values of the external intercostal muscles were 74% (SLE group) and 29% (control group). Electromyographic signs of respiratory and leg muscle fatigue occurred at lower loads in the SLE group than in the healthy subjects. The pattern of lung function data in patients with SLE was characteristic neither of lung restriction nor of airway obstruction. Respiratory muscle weakness can explain the decrease in TLC, VC, TGV, FEV1, PImax and PEmax.

Adult↗
PubMed1988

[Instrumentation support in respiratory kinesiotherapy].

The points of impact of instrumental support in respiratory physiotherapy are numerous; they concern primarily the pulmonary expansion, bronchial drainage and function of respiratory muscles. The pulmonary expansion may be helped by incitant spirometry and either intermittent or continuous positive pressure respiration, or indirectly by the utilisation of respiration against resistance (expiratory bottles, masks with uni-directional valves and expiratory resistances etc.). These different techniques may be used in the presence of instability of the respiratory units, secondary to an alteration of surfactant or to closure of the small airways induced by a transitory reduction (in the post-operative period) or permanent reduction (such as parietal wall disease of mechanical or neuro-muscular origin) of the functional residual capacity (CRF). If the continuous positive airway pressure (CPAP) seems particularly helpful for the CRF to recover to the pre-operative level it also appears on the contrary as the least efficacious technique to increase trans-pulmonary pressure. The instrumental support for bronchial drainage may theoretically affect the tension activity of the transport (instrumental help in the pulmonary expansion and in hyperventilation), muco-ciliary transport (external parietal vibration or internal vibrations applied to the upper airways), the biphasic flow (expiratory assistance by negative pressure and humidifiers). The function of the respiratory muscles may in certain cases be improved by the use of abdominal pneumatic cuirasses, by hyperventilation exercises in an isocapnoeic milieu or in breathing exercises against an additional inspiratory or expiratory resistance. If the physiological foundation of mechanical support in respiratory education may be frequently identified, the clinical results reported in the literature are often contradictory.

Drainage↗