Search PubMed⌕ Search

Biomedical subjects

I Gregg

Publications and source records attributed to I Gregg.

At least 37 records · Page 2Linked to original sources
PubMed1983

Provocation of airflow limitation by viral infection: implication for treatment.

This paper reviews accumulated knowledge concerning the role of virus infection in asthmatic bronchitis and describes several studies, carried out in the author's department, whose findings have elucidated this and other aspects of its aetiology. Rhinoviruses are associated with asthmatic bronchitis far more frequently than any other viruses, due in large part to their numerous antigenically distinct serotypes. Two host factors appear to be involved in the aetiology of asthmatic bronchitis. Impairment of the defence mechanisms of the lower respiratory tract would permit extension of viral infection into the bronchi, where it causes an inflammatory reaction. Reversible airflow limitation of sufficient magnitude to give rise to wheeze and dyspnoea depends upon the second host factor of bronchial hyperreactivity. Since inflammation is the major component of airflow limitation, beta-adrenoreceptor agonists are of limited value in reducing it, whereas corticosteroids are highly effective. The role of interferon is discussed in relation to prevention and treatment of asthmatic bronchitis.

Adult↗
PubMed1982

Disablement and care: a comparison of patient views and general practitioner knowledge.

A questionnaire was used to assess general practitioners' knowledge of handicaps and service use among disabled patients in a group practice. The disabled patients were identified by a postal screening questionnaire. Sixty-eight were subsequently interviewed to assess the severity of restrictions on their activities and to collect information about informal support and use of community or hospital services. The areas of life in which the disabled were most affected by their medical conditions were sleep and rest, household management, emotion and mood. Relatives assisted the disabled considerably with all daily activities but more help was requested. Most disabled patients had consulted their general practitioner or attended casualty and outpatient clinics, but only a minority had used other community services. Prescription of drugs was considered the most important service the doctor provided. A second questionnaire, which the general practitioners completed with the help of their records, revealed that they knew of only 50 per cent of the difficulties with daily living reported by the disabled and even less of the aids, appliances and services used. A better awareness of these facilities among general practitioners might lead to a more effective distribution of resources among their patients.

Activities of Daily Living↗
PubMed1980

A family study of the genetic basis of asthma and wheezy bronchitis.

The family histories relating to asthma and wheezy bronchitis were examined in 77 asthmatic, 78 wheezy bronchitic, and 87 control children, aged between 1 and 12 years. The percentage of children with at least one asthmatic relative was significantly greater in the asthmatic and wheezy bronchitic probands than in the controls; and asthma was more prevalent in the relatives of both groups of wheezy probands than in the relatives of controls. Similarly, the percentage of children with at least one wheezy bronchitic relative tended to be greater in asthmatic and wheezy bronchitic probands than in the controls; and wheezy bronchitis tended to be more prevalent in the relatives of both groups of wheezy probands than in the relatives of controls. However these differences did not reach significance. The strong similarities between asthmatic and wheezy bronchitic children in their family histories of asthma and wheezy bronchitis suggest that these two forms of wheezy illness share a common genetic defect.

Asthma↗
PubMed1980

Genetic factors in childhood asthma.

The prevalences of asthma and atopy were examined in the families of 77 asthmatic and 87 control children attending a London general practice. The prevalence of asthma in first degree relatives of asthmatic children was found to be significantly higher than in relatives of control children, and this difference was more pronounced for relatives of atopic probands than for relatives of non-atopic probands. Among the relatives of asthmatics, atopic asthma was more common than non-atopic asthma, irrespective of the atopic status of the proband. However, among the relatives of control children, neither the prevalence of asthma nor the atopic status of the asthmatic relatives was influenced by the atopic status of the proband. These findings support the hypothesis that asthma and atopy are inherited independently. Although atopy itself does not predispose to asthma, it may enhance a genetic susceptibility to the condition, thus increasing the likelihood that the latter will be expressed.

Asthma↗
PubMed1979

Respiratory viral infection and wheezy bronchitis in childhood.

The role of respiratory viral infection in wheezy bronchitis was studied in 163 children, aged 0-12 years, in a London general practice. Virological investigations were also performed when these same children had acute upper respiratory illness without wheeze. A virus was isolated in 146 (26.4%) of 554 episodes of wheezy bronchitis, rhinoviruses accounting for almost half of the isolations. The relative frequency with which individual viruses were isolated in wheezy bronchitis was similar to that in acute upper respiratory illness in 180 other children who had never had wheezy bronchitis. The large number of isolations of rhinoviruses in wheezy bronchitis is probably due to their numerous serotypes and the absence of cross-immunity between them. Our findings have confirmed that infection by respiratory viruses can provoke wheezy bronchitis in certain children, in whom host factors are an important predeterminant. In children with a previous history of wheezy bronchitis infection by rhinoviruses was associated significantly more often with such an episode than with upper respiratory illness. The maturation of protective mechanisms, including the acquisition of specific immunity to a progressively larger number of viruses, could explain the fall in the age-incidence of wheezy bronchitis.

Age Factors↗
PubMed1979

A long-term study of labetalol in general practice.

1 Forty-one patients with mild to moderate hypertension have been treated with labetalol for up to 5 years. 2 Mean BP before treatment was 180/107 mm Hg, after 2--3 yr treatment was 136/81 mmHg and after 5 yr was 136/74 mmHg. 3 One patient developed a licheniform rash and two patients have died of myocardial infarction. No other side-effects, not already observed in a previously reported double-blind trial, have emerged.

Adult↗
PubMed1977

Experience of the use of beclomethasone dipropionate aerosol in general practice.

1. The findings of an open trial of beclomethasone dipropionate aerosol (BDA), carried out in 1972 in the author's general practice, are discussed in the light of subsequent, more extensive experience of its use of BDA. 2. An important reason why BDA may be unsuccessful in controlling asthma, and may give rise to various problems, is that patients are often given an inadequate explanation of the purpose and proper use of this treatment.

Adrenal Cortex Hormones↗
PubMed1977

The difficult asthmatic.

The most common reason why asthma presents difficulties in management is the failure to treat it with drugs which are appropriate and taken in adequate dosage. An understanding of the pathophysiology and aetiology of asthma is essential if full advantage is to be taken of the wide range of drugs now available for treating it. Airflow obstruction due to bronchial muscle constriction is usually readily reversible by bronchodilators, whereas that due to the inflammatory component of asthma is refractory to the latter and can only be reversed by steroids. Refractory airflow obstruction is liable to be confused with irreversible obstruction which occurs in those patients whose asthma is complicated by chronic obstructive bronchitis or other lung disease. The choice between symptomatic, preventive and suppressive forms of treatment should be made only after a careful assessment has been carried out with objective measurement of airflow obstruction. The Wright peak flow meter is unsurpassed for this purpose. By its means it should be possible to estimate how much of a patient's airflow obstruction is readily reversible, how much is refractory and how much is irreversible. In general, the aim of treatment is to relieve airflow obstruction rather than to counteract supposed aetiological factors. Both doctor and patient must understand the purpose, limitations and possible dangers of any drug which is prescribed. Steroids are the only form of treatment which is effective in persistent refractory asthma. Prejudice against steroids has resulted in many patients being deprived of their benefit, but this situation may change with the recent introduction of steroid aerosols.

Adrenal Cortex Hormones↗
PubMed1976

Double-blind trial of labetalol.

1 A new anti-hypertensive agent (labetalol) with alpha- and beta-adrenoreceptor-blocking properties has been assessed in 30 patients in a general practice. 2 Significant reduction in blood pressure and pulse rate occurred at a dose of 400 mg/d. A further significant reduction in blood pressure but not of pulse rate occurred at a dose of 800 mg/d. 3 After 4 weeks' treatment on the higher dose the mean fall in systolic and diastolic pressures compared with the pre-trial pressures was 36 and 24 mmHg, respectively. Side-effects were generally mild.

Adult↗
PubMed1975

Respiratory viral infection in childhood. A survey in general practice, Roehampton 1967-1972.

The role of viruses and M. pneumoniae in episodes of acute respiratory illness in childhood has been studied in a London general practice. The total isolation rate was 31-7 per cent, but the rate varied from 32-6 per cent in upper respiratory infections to 64-0 per cent in pneumonia. The clinical features associated with infection were influenced not only by the type of agent but also by age and other host factors in infected children. Rhinoviruses were more commonly isolated than any other agent and were frequently associated with wheezy bronchitis.

Adenoviridae↗