[Monitoring of continuous home oxygen therapy].
Explore the source record for details and available documents.
Aged↗
Biomedical subjects
J G Frey
Publications and source records attributed to J G Frey.
Bronchial provocation with cat allergen: correlation between the individual IgE-CRIE pattern and the occurrence of a late allergic reaction.
Twenty-one mild asthmatic patients allergic to cat dander underwent a bronchial provocation test (BPT) with a cat extract. An early allergic response (EAR) was observed in all 21 patients and a late allergic response (LAR) in 8/21 patients. In the EAR, the patients with subsequent LAR had a greater fall in FEV1. Their baseline FEV1, and total dose of inhaled allergen were not significantly different from patients who did not develop a LAR, but their serum specific IgE level was higher. Crossed immunoelectrophoresis (CIE) of the same cat extract showed that it contained eight different proteins. An IgE-CRIE was obtained from all 21 patients, using radiolabelled anti-IgE and autoradiography. Radiolabelled standards allowed a semiquantitative scoring of the radiostaining. The CRIE pattern of the eight patients with LAR showed a higher score of radiostaining and a greater number of proteins bound to IgE. The two major allergen cat albumin and Fel dI bound equally to IgE of patients with and without LAR whereas another protein (antigen No. 7) bound to IgE of 100% of patients with LAR but of only 38% of patients without LAR. These data suggest that the pattern of the IgE response to specific proteins of a cat extract may be related to the occurrence of LAR after BPT with this allergen.
Adolescent↗
[Campaign against smoking and the general practitioner. Evaluation of a simple method allowing immediate measurement of compliance with smoking cessation in the physicians office].
Recently, the Swiss Medical Association and the Swiss Federal Office for Public Health started a campaign against smoking. Portable carbon monoxide (CO) devices measuring alveolar CO concentration are now available. It is important to know how accurate they are in discriminating smokers (S) from nonsmokers (NS) in different environmental conditions. We administered a smoking questionnaire and measured alveolar CO concentration in 241 people living in an urban area (PU) and 112 people living in a mountain area (PM). Smoking prevalence was 39% in PU and 17% in PM. Alveolar CO concentration was significantly higher in S than in NS (27 +/- 11, 11 to 60, vs. 14 +/- 9, 4 to 52, p < 0.01 in PU and 23 +/- 13, 4 to 48, vs. 9 +/- 7, 4 to 46, p < 0.01 in PM). We found significantly higher CO-values in NF of PU than PM (p < 0.01). This test has a sensitivity of 80%, a specificity of 78%/79% (PU/PM) and a predictive positive value of 74%/80% (PU/PM). The cut-off point has to be adapted depending on the environmental exposure (PU: 15 ppm, PM: 10 ppm CO). Alveolar CO measurement is a cheap accurate method whose results are immediately available to the general practitioner in his fight against smoking. This method merits higher application.
Adolescent↗
[Thoracoscopy: diagnostic and therapeutic use].
From 1986 to 1989, we performed 74 thoracoscopies in 70 patients (37 persisting or relapsing pneumothoraces, 30 chronic pleural effusions, 3 primary pleural tumors, 2 chylothoraces, 1 empyema, 1 persisting bronchopleural fistula). 29 supplementary diagnoses were established by thoracoscopy: 11 carcinomas, 4 cases of pleural tuberculosis, 12 of nonspecific pleurisy, 1 pleural fibroma, and 1 hamartoma. Pleurodesis was done with talc under thoracoscopy with success in 32/34 cases of pneumothorax (94%) and in 19/20 patient with chronic pleural effusion (95%). Talc was also successful in 2 instances of chylothorax and the bronchopleural fistula. The empyema was successfully treated by drainage under thoracoscopy and local instillation of streptokinase. Altogether, we recorded 3 deaths in the 30 days following thoracoscopy in 3 plurimetastatic patients. No other major complication was observed. The procedure is a well tolerated tool for diagnosis and treatment of pleural diseases. The indication should however be established with care in debilitated plurimetastatic patients.
Adult↗
Retroperitoneal silicosis mimicking pancreatic carcinoma in an Alpine miner with chronic lung silicosis.
A miner, known to have had lung silicosis for 30 years, was investigated for abdominal pain. A retroperitoneal mass was found, in which histological examination showed an inflammatory reaction to silica.
Aged↗
Bronchodilating efficacy of an open-spacer device compared to three other spacers.
BACKGROUND: Spacers devices are commonly used in aerosol therapy; however, they are bulky and require regular cleaning. A compact open spacer (OS, Synchroner, Fisons, UK) has been developed to overcome this problem. We compared bronchodilator efficacy associated with its use to efficacy of same dose via three other spacers: Volumatic (Glaxo Laboratories), Nebuhaler (Astra Laboratories), Inspirease (Key Pharmaceuticals). MATERIALS & METHODS: Sixteen asthmatics (greater than 20% reversibility of FEV1) took part in the study. In random order, they used a different device on each of the 4 study days to inhale 2 puffs of a combination aerosol (1 mg reproterol and 2 mg sodium cromoglycate, Aarane). We recorded results of spirometry before and 5, 30, and 60 minutes after bronchodilator inhalation. RESULTS: At each time, we found no significant difference in bronchodilation. CONCLUSION: OS is as efficient as other commonly used spacers to produce bronchodilation resulting from a conventional dose of reproterol.
Administration, Inhalation↗
[Continuous oxygen therapy at home. Observations of oxygen users after an instruction program].
The benefit of continuous domiciliary oxygen therapy (OCD) directly depends on the number of hours the oxygen is used daily. The observance of a correct regime is rarely met at present. For this reason we have done a prospective study for 24 months, assessing the compliance of 64 patients from 28 to 82 years of age. All these patients received a systematic and personal programme of education for 2 days in hospital. We subsequently measured, without the knowledge, either of the patient or the person caring from them, the quarterly oxygen usage. The mean duration of oxygen therapy was 14.7 +/- 3.6 hours. It remained stable during the 2 years of observation: 51% of the patients achieved a treatment of 15 hours or more and 10%, 10 hours or less. We did not find a significant correlation between the hours of compliance and the age, sex, FEV1, FVC and PaO2 or haemoglobin saturation. A significant statistical correlation with the PaCO2 was obtained. The more educated patients had better compliance levels than those of lesser education. The results obtained were better than those found in the literature at the present time. Perhaps it is explained by the level of education given. It cannot be excluded, however, that our severe criteria for the prescription of OCD has selected a population which was more susceptible to achieving good compliance. However, these results encourage the initiation of another prospective study using a control group to make a better assessment of the impact of education on the patient and his carers by the improved compliance in OCD.
Adult↗
[The treatment of acute cardiac insufficiency: toward a physiopathological approach].
The development of new inotropic or vasodilator agents, with different spectra of action makes possible a physiological approach to the treatment of acute cardiac failure. The choice depends on the functional disturbances measured and is then adapted to the response obtained. In the most serious cases, where pharmacological treatment proves insufficient, there need be no hesitation in using invasive methods which were formerly reserved for the treatment of cardiogenic shock. Systematic application of therapeutic formulae gives way to rational selection of the agent best adapted to the particular conditions brought about by a specified cardiopathy in a given patient.
Acute Disease↗
[Chylothorax: treatment using talc pleurodesis].
Chylothorax is a rare complication of lymphoma with a poor prognosis. The treatment is not well established. We report a case of lymphoma complicated by bilateral chylothorax in which, despite optimal chemotherapy and radiotherapy, pleural effusion persisted. Pleuroscopy was performed under local anesthesia, followed by pleural instillation of pure talc. The immediate result was satisfactory and six months later there was no recurrence of chylothorax. Talc pleurodesis appears to be a simple and safe way of treating chylothorax resistant to conventional therapy.
Chylothorax↗
Fatal cardiac arrhythmias and shock following yew leaves ingestion.
A 40-year-old woman presented with vomiting and abdominal pain following voluntary ingestion of 150 yew leaves. She developed ventricular conduction defects and arrhythmias unresponsive to medical treatment after admission. She expired five hours after yew ingestion from irreversible cardiogenic shock. More attention should be given to this rare but severe intoxication for which no effective therapy is known.
Adult↗
Prediction of properties from simulations: a re-examination with modern statistical methods.
We discuss models fit to data collected by Duffy and Jorgensen to predict solvation free energies and partition equilibria of drugs, organic molecules, aromatic heterocycles, and other molecules. These data were originally examined using linear regression, but here more recently developed statistical models are applied. The data set is complicated due to the presence of discrepant observations and also curvature in the response. In some cases it is possible to discard a small number of the observations to get good fit to the data, but, in others, discarding an increasing proportion of the observations does not improve the fit. Our general preference is to use robust parameter estimation which downweights to reduce the influence of discrepant observations on the fitted models. Models are selected for four responses using linear or more complicated representations of the explanatory variables, such as cubic polynomials, B-splines, or smoothers via generalized additive models (GAMs). Variables are chosen using the traditional approach of formal tests to assess contribution to the fit of a model, and resampling methods including bootstrap are also considered to assess the prediction error for given models. Results of our analysis indicate that GAMs are an improvement on linear models for describing the data and making predictions. In general robust regression models and GAMs have the smallest conditional expected loss of prediction over the four responses. In addition, robust regression models offer the advantage of identifying molecules that perform poorly in the fit. In general, models were identified that yielded an improvement of approximately 50% in the conditional expected loss of prediction compared with the original parametrization of Duffy and Jorgensen. It was also found that the use of cross-validation to compare models was unreliable, and bootstrapping is preferred.
Journal Article↗
Bringing chemical data onto the Semantic Web.
Present chemical data storage methodologies place many restrictions on the use of the stored data. The absence of sufficient high-quality metadata prevents intelligent computer access to the data without human intervention. This creates barriers to the automation of data mining in activities such as quantitative structure-activity relationship modelling. The application of Semantic Web technologies to chemical data is shown to reduce these limitations. The use of unique identifiers and relationships (represented as uniform resource identifiers, URIs, and resource description framework, RDF) held in a triplestore provides for greater detail and flexibility in the sharing and storage of molecular structures and properties.
Journal Article↗