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Biomedical subjects

M J Ward

Publications and source records attributed to M J Ward.

At least 91 records · Page 5Linked to original sources
PubMed1983

Erythromycin compared with a combination of ampicillin and amoxycillin as initial therapy for adults with pneumonia including Legionnaires' disease.

In a double blind trial erythromycin was compared with a combination of ampicillin and amoxycillin for treating adults admitted to hospital with primary pneumonia. The clinical course of 42 patients treated with ampicillin and amoxycillin was similar to that of the 49 in the erythromycin group. Fall in temperature, symptomatic recovery and radiographic improvement were similar (two-thirds made an uncomplicated recovery). Infusion-related phlebitis was more common with erythromycin. Otherwise adverse reactions were unusual. The outcome was related principally to the cause of the pneumonia with bacteraemic/antigenaemic pneumococcal pneumonia, Legionnaires' disease, other bacterial pneumonias and psittacosis having a poor prognosis. Both forms of antibiotic therapy gave similar results but we suggest that a combination of erythromycin with ampicillin may be logical initial treatment for severe pneumonia of unknown cause.

Adult↗
PubMed1982

Hospital study of adult community-acquired pneumonia.

The cause of primary pneumonia was diagnosed in 124 of 127 consecutive adult patients admitted to hospital with community-acquired illness. Pneumococcal infection was found in 96 (76%) patients and legionnaries' disease was the second commonest infection identified (15%). Other bacterial infections were uncommon. 11 patients had atypical pneumonia, including 7 with psittacosis. There were several mixed infections and most of the 11 patients with viral infections also had bacterial pneumonia. 19 patients died (15%) and mortality was associated with increasing age, the presence of coexisting disease, and the cause of the pneumonia. Recognition of the most likely causes of severe pneumonia allows logical initial antibiotic treatment for such patients admitted to hospital.

Adolescent↗
PubMed1981

Ipratropium bromide in acute asthma.

Ipratropium bromide was given to patients admitted to hospital with acute asthma. A cumulative-dose-response technique in six patients showed that 500 micrograms given by nebuliser produced a maximal increase in peak expiratory flow rate. This dose of ipratropium bromide was included in a regimen in which it was given either two hours before or two hours after nebulised salbutamol to 22 patients. Ipratropium bromide given on admission was as effective as nebulised salbutamol. The two drugs in sequence produced greater bronchodilatation than either used alone, and the mean peak expiratory flow rate rose by 96% in four hours. Thus giving ipratropium bromide in addition to salbutamol in severe asthma enhances the bronchodilator effect. Further studies are needed to determine whether the same effect may be obtained by giving two maximal doses of salbutamol two hours apart.

Acute Disease↗
PubMed1981

Non-Hodgkin's lymphoma, chronic lymphatic leukaemia and the lung.

In a retrospective study of 81 patients with non-Hodgkins's lymphoma and 35 patients with chronic lymphatic leukaemia, pulmonary involvement was found in 25% of cases and pleural effusion in 19%. Twenty-four patients (20%) had intrathoracic lymphadenopathy and 12 of these had associated pleural or lung involvement. Infiltration occurred almost exclusively in diffuse lymphocytic lymphoma and chronic lymphatic leukaemia, whereas round lesions were seen only in undifferentiated lymphomas. Pleural effusion complicated most histological types of non-Hodgkin's lymphoma but was uncommon in chronic lymphatic leukaemia. Pleural biopsy was successful in diagnosing lymphoma in nine of ten patients with an effusion in whom it was performed. Both pulmonary and pleural involvement responded poorly to treatment and had an adverse effect on prognosis. In contrast, intrathoracic lymphadenopathy responded well to radiotherapy and/or chemotherapy and did not affect prognosis adversely when it occurred in the absence of other intrathoracic manifestations of lymphoma.

Humans↗
PubMed1980

The role of peritoneal biopsy in the diagnosis of ascites.

Percutaneous biopsies of the peritoneum were obtained in 23 patients with ascites of unknown cause. The only case of tuberculous peritonitis was correctly diagnosed. Peritoneal biopsy provided a diagnosis of malignancy in 6 patients (one lymphoma, one mesothelioma, 4 cases of disseminated carcinoma) but failed to recognize a further 13 cases of disseminated carcinoma. Previous literature is reviewed and the diagnostic usefulness of this procedure is discussed.

Adult↗
PubMed1978

Torsion of normal uterine adnexa in childhood: case report.

A case of torsion of a normal right ovary and tube in an 8-year-old child is presented. True infarction of the adnexa can be prevented only by considering this diagnosis early in the course of right lower quadrant pain. It is recommended that a routine exploration of the pelvis be carried out in any patient explored for acute appendicitis in whom that diagnosis cannot be made at the operating table.

Adnexal Diseases↗