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Biomedical subjects

M J Ward

Publications and source records attributed to M J Ward.

At least 73 records · Page 4Linked to original sources
PubMed1987

Deaths in three accident and emergency departments.

A survey of three London hospitals found that approximately 0.45 patients per thousand new attenders die in the accident and emergency department and that there is evidence of poor management in about 10% of these deaths. The commonest faults were excessive delay before starting appropriate treatment and neglect of the basic principles of emergency medicine. These points need to be emphasized in the training of accident and emergency staff.

Cause of Death↗
PubMed1986

Clinical trials in acute severe asthma: are type II errors important?

Many studies in acute severe asthma have had low power. Fifteen randomised double blind studies investigating the treatment of acute severe asthma published during 1974-84 were analysed for power and 95% confidence limits. Twelve studies failed to detect a significant difference in bronchodilatation produced by two treatments and reported the treatments to produce equal effect. Each study had, however, less than a 60% probability of detecting a true 25% difference in bronchodilatation.

Acute Disease↗
PubMed1986

Charcoal and isoniazid pharmacokinetics.

Activated charcoal (10 g) administered 1 h after a 600 mg oral dose of isoniazid to six healthy subjects did not reduce the area under the plasma concentration-time curve for isoniazid significantly. Charcoal administration is unlikely to be of value in isoniazid poisoning if delayed by an hour or more after the overdose.

Acetylation↗
PubMed1986

Immune complex deposition in the development of acute synovitis in the rabbit knee joint: quantitative, kinetic and morphological aspects.

The pathology of acute synovitis induced by immune complexes was investigated in this study. The reversed passive Arthus method of lesion induction was utilized, in conjunction with radiolabeled cell and protein markers, to quantitate inflammatory parameters and ascertain their kinetics in the synovial tissues of the rabbit. The rates of increased vessel permeability, polymorphonuclear leukocyte infiltration and platelet deposition were studied using 125-I-albumin, 51-CR-PMN-leukocytes and 111-In-platelets, respectively. Increase in vessel permeability over time was found to directly correlate with increased leukocyte infiltration (r = 9.08; P less than 0.01). Similar correlations between vascular permeability and platelet accumulation, and leukocyte infiltration and platelet accumulation, were not observed. The histological evaluation of synovial lesions corroborated the kinetic findings.

Acute Disease↗
PubMed1985

A place for ipratropium bromide in the treatment of severe acute asthma.

Twenty-four consecutive patients admitted to hospital with severe acute asthma were studied. Eleven were given 10 mg salbutamol by nebulizer followed 2 hours later by 500 micrograms of nebulized ipratropium bromide. These patients had a greater response in PEFR than 13 patients given two doses of 10 mg salbutamol 2 hours apart.

Acute Disease↗
PubMed1985

A case of herpes zoster associated encephalitis with rapid response to acyclovir.

A case of herpes zoster encephalitis which responded very rapidly to acyclovir is presented. The differential serum: cerebrospinal fluid antibody response was followed and its value in making the diagnosis is discussed. The penetration of acyclovir into the cerebrospinal fluid was measured, and found to be in agreement with predicted values.

Acyclovir↗
PubMed1985

Audit of nebuliser use.

The use of nebulisers was assessed in four hospitals. Nebulisers were checked in use and medical and nursing staff were interviewed. All but one nebuliser was driven by 100% oxygen and only 3 of 111 interviewees preferred air for patients with hypercapnia. In 5 of 44 nebulisers in use, water was used as the dilutant. The calculated times for complete nebulisation of the solutions ranged from 3.5 to 117 min. The results of this survey illustrate a need for better education concerning the use of nebulisers in hospitals.

Aerosols↗
PubMed1985

Generational boundary dissolution between mothers and their preschool children: a relationship systems approach.

A particular perspective on relationship systems served as the basis for this research. Postulates within this perspective include qualitative aspects of relationships are stable over time, and there are lawful relations among relationships within the same system. Previously, a concept of seductive mother-toddler relationships was initially validated. From the theory surrounding this concept, later forms of this pattern were conceived, and a hypothesis concerning complementary mother-daughter relationships was formulated. In the present research we showed first that the pattern of "seductiveness" was stable, though transformed, from 24 to 42 months. Second, the same mothers were not found to be seductive with male or female siblings. Third, mothers who showed the seductive pattern (almost always with boys) were, as predicted, hostile toward their daughters in a particular way ("derision"). 2 other scales used at 42 months ("nonresponsive intimacy" and "generational boundaries") were elevated for target mother-male dyads and not for mother-daughter pairs. In fact, mothers who were seductive with sons were rated significantly lower on the intimacy scale when seen with daughters than were control mothers. It is suggested that maternal relationships across siblings are coherent, however distinct, and that these connections derive from the totality of the mother's relationship history.

Adult↗
PubMed1984

Pulmonary responses of salbutamol tolerant guinea-pigs to aminophylline and ipratropium bromide.

Groups of guinea-pigs were pretreated with salbutamol (15 micrograms/kg s.c. 3 times/day for 7 days) and compared with controls (saline treated) by measurement of the effects of i.v. dosage with salbutamol (1-10 micrograms/kg), aminophylline (5-20 mg/kg) or ipratropium bromide (1-10 micrograms/kg) on total lung resistance in the anaesthetised state. The bronchodilator effects of these three drugs were measured as attenuation of the bronchoconstrictor response to a standard dose of histamine (3 micrograms/kg i.v.). The salbutamol-pretreated guinea-pigs gave significantly reduced responses to salbutamol (at 2, 5 and 10 micrograms/kg) and to aminophylline (at 10 and 20 mg/kg) whilst the responses to ipratropium bromide were similar to controls. A further group of control guinea-pigs was used to examine the effects of beta-adrenoceptor blockade (propranolol 4 mg/kg) on the responses to the bronchodilators. Propranolol blocked completely the responses to salbutamol (10 micrograms/kg) and to aminophylline (5, 10 and 20 micrograms/kg) without affecting the response to ipratropium bromide. The findings indicate that the pretreatment regime employed causes the development of tolerance to the bronchodilator effects of salbutamol and that this tolerance extends to aminophylline, but not to ipratropium bromide. The effects of propranolol and of tolerance to salbutamol suggest that the bronchodilator response to aminophylline is mediated in large part by activation of airway beta-adrenoceptors. The findings also suggest that ipratropium bromide may provide effective bronchodilation (in the presence of parasympathetic tone) in lungs which have become tolerant to beta-adrenoceptor agonists, though whether this may be extrapolated from the guinea pig to man remains to be demonstrated.

Albuterol↗
PubMed1984

The effects of chronic inhalation of salbutamol on the acute airway responsiveness to salbutamol and ipratropium bromide in the conscious and the anaesthetized guinea-pig.

The effects of chronic exposure to a nebulized mist of salbutamol on the capacity of systemic salbutamol to prolong the time taken for inhaled histamine to produce bronchospasm in guinea-pigs have been examined. Initially a reproducible cough time to inhalation of histamine acid phosphate (0.5 ml ml-1) in 100% O2 was established. Antagonism of this response by intraperitoneal salbutamol or ipratropium Br was assessed to establish submaximal responses to these drugs. A fresh group of animals was then exposed to a persistent mist of nebulized water for 16 days, before and during which each animal was tested by exposure to histamine mist either alone or shortly after salbutamol (10 micrograms kg-1 i.p.) or ipratropium Br (5 micrograms kg-1 i.p.). The nebulized water had no effect on the response to the drugs. The same animals were rested for 7 days and then exposed to nebulized salbutamol solution (5 mg ml-1) for 15 days, during which time tachyphylaxis developed to salbutamol (i.p.) but not to ipratropium Br. At the end of the 15 days the animals were anaesthetized and total lung resistance (RL) measured. At this time, the protective effect of intravenous salbutamol was also diminished by comparison with untreated guinea-pigs while the response to ipratropium Br was unaffected. A separate group exposed to 1 mg ml-1 of nebulized salbutamol for 20 days developed selective tachyphylaxis to intraperitoneal salbutamol. The animals were then allowed to breathe room air and the response to intraperitoneal salbutamol after 13 days returned to normal as did the effects of intravenous salbutamol on the RL response to histamine.

Aerosols↗