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Biomedical subjects

M Loveland

Publications and source records attributed to M Loveland.

7 recordsLinked to original sources

Analytical toxicology.

1. Major advances in analytical toxicology followed the introduction of spectroscopic and chromatographic techniques in the 1940s and early 1950s and thin layer chromatography remains important together with some spectrophotometric and other tests. However, gas- and high performance-liquid chromatography together with a variety of immunoassay techniques are now widely used. 2. The scope and complexity of forensic and clinical toxicology continues to increase, although the compounds for which emergency analyses are needed to guide therapy are few. Exclusion of the presence of hypnotic drugs can be important in suspected 'brain death' cases. 3. Screening for drugs of abuse has assumed greater importance not only for the management of the habituated patient, but also in 'pre-employment' and 'employment' screening. The detection of illicit drug administration in sport is also an area of increasing importance. 4. In industrial toxicology, the range of compounds for which blood or urine measurements (so called 'biological monitoring') can indicate the degree of exposure is increasing. The monitoring of environmental contaminants (lead, chlorinated pesticides) in biological samples has also proved valuable. 5. In the near future a consensus as to the units of measurement to be used is urgently required and more emphasis will be placed on interpretation, especially as regards possible behavioural effects of drugs or other poisons. Despite many advances in analytical techniques there remains a need for reliable, simple tests to detect poisons for use in smaller hospital and other laboratories.

Doping in Sports

A four-year follow-up study of lung mechanics in smokers.

We performed a prospective study of pulmonary function in 21 smokers, 9 ex-smokers, and 12 nonsmokers. The smokers and ex-smokers were preselected, because they were participants in a smoking cessation clinic. An average interval of 4 years separated the first and second (follow-up) studies. The smoking group showed a significant decrease in maximal expiratory flow measured at low lung volume, loss of elastic recoil, increase in lung compliance, increase in total lung capacity; increase in the ratio of residual volume to total lung capacity, and an increase in the ratio of functional residual capacity to total lung capacity. The ex-smokers showed changes similar to those of the smokers, but of lesser magnitude. The nonsmoking group demonstrated few changes in function during the study interval. Commonly measured parameters of function, including the ratio of the forced expiratory volume in 1 sec to the forced vital capacity and the maximal expiratory flow after exhalation of 50 per cent of the vital capacity, did not change significantly in any group. Sensitive tests of lung function were abnormal in a very high percentage of the combined group of smokers and ex-smokers when measured at the time of the second study; only a small number of abnormalities in these parameters were noted in the nonsmoking group. We conclude that there was a deterioration of lung function in smokers far in excess of that predicted by age. These changes suggest the development of emphysema and were predictable for the group as a whole by a high prevalence of abnormality of dynamic compliance, closing volume, maximal mid-expiratory flow, and residual volume at the time of the initial study.

Adult

Anaerobic mediastinitis and septic shock secondary to esophageal perforation.

The authors report unusual complications arising from the ingestion of a small fish bone by a 68-year-old man. These included mediastinitis, empyema, pericarditis and septic shock, probably secondary to a small perforation of the esophagus. After appropriate surgical drainage, antibiotic therapy and supportive therapy the patient made a good recovery.

Aged

The relations between structural changes in small airways and pulmonary-function tests.

To examine the relation between small-airways abnormalities and specific lung functions, we performed pulmonary-function tests in 36 patients, of whom two were nonsmokers, one to three days before open-lung biopsy for localized pulmonary lesions. The primary lesion in the small airways was a progressive inflammatory reaction leading to fibrosis with connective-tissue deposition in the airway walls. Increase in disease in small airways correlated with deterioration in lung function. Lesions could be reliably detected (P less than 0.05) by tests for closing capacity, the volume at which air and helium flow ere equal (a test of airway caliber and elastic recoil), and the slope of phase III of the single-breath washout curve (which tests evenness of ventilation). These tests showed abnormalities at a time when the pathologic changes were still potentially reversible and when other tests were not appreciably changed.

Adult