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Biomedical subjects

K Prowse

Publications and source records attributed to K Prowse.

At least 19 recordsLinked to original sources
PubMed1996

Silicosis presenting as bilateral hilar lymphadenopathy.

Classical radiographic features of patients presenting with silicosis are diffuse interstitial shadowing with subsequent enlargement of hilar nodes, sometimes with "eggshell" calcification. Five case histories are described of workers who were exposed to silica and presented initially with bilateral hilar lymphadenopathy without radiographic evidence of interstitial lung disease. One case progressed to show features of silicosis.

Adult↗
PubMed1995

Validation of British Thoracic Society guidelines for the diagnosis of the sleep apnoea/hypopnoea syndrome: can polysomnography be avoided?

BACKGROUND: The British Thoracic Society report on the diagnosis and treatment of the sleep apnoea/hypopnoea syndrome (SAHS) suggests that, if the pulse oximetry baseline oxygen saturation is above 90%, then 15 4% oxygen desaturation/hour in bed will diagnose SAHS requiring treatment. The diagnostic outcome of applying these guidelines has been studied. METHODS: One hundred patients referred to a district general hospital sleep clinic were recruited. After initial clinical assessment, overnight pulse oximetry measurements were performed, followed by full polysomnography at the regional laboratory. RESULTS: Sixty nine patients underwent both pulse oximetry and polysomnography. All 10 patients with more than 15 4% desaturations/hour on pulse oximetry had SAHS confirmed on polysomnography (specificity = 100%). Twenty two patients with SAHS were misdiagnosed using pulse oximetry alone (sensitivity = 31%). These patients had low apnoea scores but high hypopnoea scores. CONCLUSIONS: The BTS pulse oximetry criteria are highly specific when positive (specificity = 100%), but may miss patients with the SAHS who have hypopnoeic episodes which cause arousal but not significant oxygen desaturation (sensitivity = 31%). It should be emphasised that pulse oximetry alone does not always give sufficient information to discriminate between those patients with or without SAHS. Patients with "negative" pulse oximetry and symptoms of SAHS should undergo polysomnography or multi-channel recording.

False Negative Reactions↗
PubMed1990

A single oral dose method for predicting steady state theophylline concentrations in clinical practice.

A single dose, single point method of predicting patients' oral maintenance theophylline dosage has been compared with a noninvasive method. Twenty patients with obstructive lung disease received an oral dose (6 mg kg-1) of micro-crystalline theophylline. The plasma theophylline concentration after 8-10 h was then used to calculate the optimum maintenance dose of sustained release aminophylline required to achieve steady state concentrations between 55 and 110 mumols l-1. The mean steady state plasma theophylline concentration for this dosage schedule was also predicted by a method using population average pharmacokinetic parameters (assumed clearance method). These predictions were then compared with observed concentration-time profiles at steady state. The mean difference between the observed values and those predicted from a morning test dose was -0.11 mumol l-1 (95% CI -7.0 to +7.2). A larger difference (-7.4 mumol l-1 95% CI -18.2 to +3.4) was found for the assumed clearance method. Since the confidence intervals contain zero, these differences are not significantly different from zero at the 5% level, although the morning test dose method allowed prediction of the whole concentration-time profile and was more precise. An evening test dose was also used in the study, but the mean difference between the observed values and those predicted from this method was larger at -24.8 mumol l-1 (95% CI -32.89 to -17.21) and was significantly different from zero. This study indicates that a morning test dose followed by a single blood sample can be used to establish maintenance theophylline therapy quickly and safely in selected patients.

Adult↗
PubMed1989

Respiratory symptoms and pulmonary impairment in male and female subjects with pottery workers' silicosis.

Respiratory symptoms, smoking habit, lung function and radiological category of silicosis were assessed in 276 present and former pottery workers who were receiving industrial disablement benefit for silicosis. There were 140 females and 136 males. The proportion with conglomerate disease (massive fibrosis) was similar in both sexes. The FEV1 declined with increasing X-ray category of silicosis irrespective of smoking habit and was most marked in subjects with symptomatic chronic bronchitis. In females who had never smoked the average decline of FEV1 in those with simple silicosis was 18 ml year-1 and for those with conglomerate disease 38 ml year-1. Symptomatic chronic bronchitis was common and only partly related to smoking, occurring in 69% of 101 nonsmoking female silicotic patients. No significant changes were observed in vital capacity, lung volume or transfer factor for carbon monoxide.

Aged↗
PubMed1989

Peripheral nerve function in patients with chronic bronchitis receiving almitrine or placebo.

A double blind prospective study of the effect of almitrine bismesylate and placebo on peripheral-nerve function was carried out in 12 patients with chronic bronchitis and arterial hypoxaemia (mean (SD) FEV1% predicted 38 (16), arterial oxygen tension (PaO2) 7.56 (0.76) kPa). Of the seven patients who took placebo, none developed symptoms or signs of peripheral neuropathy. One patient who had abnormal lower limb sensory nerve conduction initially showed improvement of sensory conduction but deterioration in motor conduction during the 12 month study period. Two further patients developed some slowing of motor conduction velocities in their right lateral popliteal nerve. Five patients received almitrine and all showed an improvement in PaO2 (mean from 7.0 to 7.9 kPa). None had symptoms or signs of peripheral neuropathy on entry to the study; one patient had evidence of impaired nerve conduction on electrophysiological testing. Three patients developed symptoms and signs of peripheral neuropathy during the 12 months of the study and a fourth developed peripheral neuropathy at 18 months, having continued to receive almitrine. Studies of nerve physiology showed abnormalities in the lower limbs of all four patients. Recovery was poor, possibly because of the long half life of almitrine. The studies suggest that almitrine may precipitate peripheral neuropathy in patients with chronic obstructive pulmonary disease. Patients should be warned of this potential complication so that the drug can be stopped as soon as symptoms develop.

Aged↗
PubMed1988

Sleep apnoea.

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Humans↗
PubMed1988

Bacteraemic Haemophilus influenzae pneumonia.

Bacteraemia with Haemophilus pneumonia is uncommon. To determine its incidence and features case notes of patients in whom Haemophilus spp. were isolated from blood and pleural fluid over a five-year period were reviewed. Eight adult patients with H. influenzae bacteraemia were identified, five of whom had pneumonia on clinical and radiographic criteria. Only one patient had a predisposing factor, chronic obstructive lung disease. Two patients had beta-lactamase producing isolates, one of whom developed an empyema, following treatment with ampicillin, which required surgical drainage. Four patients were elderly, aged 69-80 yrs and were clinically in shock at the time of diagnosis. Seven of the eight patients survived.

Aged↗
PubMed1981

Sleep apnoea.

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Endocrine System Diseases↗
PubMed1981

An evaluation of the vitalograph pulmonary monitor.

The Vitalograph pulmonary monitor has recently been altered by the manufactures to read in litres per minute. In 200 pairs of measurements comparing the monitor to the Wright peak flow meter (PFM) the mean difference between the instrument was 0.57 litres/min and there was a strong positive correlation (r = 0.92). The mean within subject coefficient of variation was 5.8% (range 2.6% to 10.7%). There was a statistical difference (P less than 0.05) in measurements obtained with different monitors but in practical terms this difference was small. The monitor is pocket-sized and light and is therefore suitable for following changes in peak expiratory flow away from the physiology laboratory.

Evaluation Studies as Topic↗