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Biomedical subjects

P B Terry

Publications and source records attributed to P B Terry.

At least 55 records · Page 3Linked to original sources
PubMed1987

Erythromycin-induced suppression of pulmonary antibacterial defenses. A potential mechanism of superinfection in the lung.

Erythromycin is a broad-spectrum antibiotic commonly used in patients with respiratory infections. Certain of these patients become colonized with new microorganisms and develop superinfections. Antibiotics have a number of effects other than simply killing or inhibiting the growth of bacteria and may have direct effects upon host cells, including phagocytes. In vitro and in vivo studies have demonstrated that erythromycin decreases polymorphonuclear leukocyte (PMN) directed migration. To test the hypothesis that erythromycin inhibits normal PMN migration into the alveoli in response to a bacterial challenge, mice were challenged by aerosol inhalation with Proteus mirabilis or Staphylococcus aureus and injected intravenously with erythromycin (50 or 100 mg/kg). Pulmonary bactericidal activity and total lavaged lung cell and differential counts were determined 4 h after bacterial challenge. In control mice, only 24 +/- 2% of the initial inoculum of P. mirabilis was viable at 4 h. At a dose of 100 mg/kg, lung defenses after erythromycin were ablated, allowing the proliferation of P. mirabilis to 113 +/- 5% of the initial inoculum. The number of PMN obtained by lavage after P. mirabilis challenge was also inhibited by erythromycin in a dose-dependent manner. In untreated animals, 5.0 +/- 0.2 x 10(6) PMN were recovered as compared with 3.1 +/- 0.4 x 10(6) and 1.1 +/- 0.3 x 10(6) with increasing doses of erythromycin. Intrapulmonary bactericidal activity against S. aureus was not impaired by erythromycin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

High-dose intravenous metoclopramide and intermittent intramuscular prochlorperazine and diazepam in the management of emesis induced by cis-dichlorodiammineplatinum.

Intravenous metoclopramide and IM prochlorperazine and diazepam were compared in the management of vomiting occurring during treatment with cis-dichlorodiammineplatinum (cis-platinum). A total of 104 cycles in 30 patients were evaluated. Twenty-two patients took part in a cross-over study in which emetic profiles for each patient managed with each anti-emetic schedule were compared. In all, 44 cycles of treatment in 22 patients were evaluated as part of a cross-over study. No significant difference in emetic control was observed between the two anti-emetic regimens. The side-effects observed using IV metoclopramide included extrapyramidal phenomena (19%) and flushing attacks (16%).

Antiemetics↗
PubMed1985

Complications of cone biopsy related to the dimensions of the cone and the influence of prior colposcopic assessment.

A retrospective study of the complications of cone biopsy showed that among 915 women examined between the years 1976 and 1982, 121 (13%) had primary or secondary haemorrhage, 153 (17%) cervical stenosis and 39 (4%) subsequent infertility or an abnormal pregnancy. Cervical stenosis was commonest among women who had had long cones removed. Stenosis occurred more often in the group of women who had been assessed by colposcopy before operation but this was due to the fact that prior colposcopy selected a favourable group of patients with lesions of limited extent that were susceptible to treatment by local destructive therapy, so that prior colposcopic assessment resulted in the removal of longer cones.

Adult↗
PubMed1985

Ethnic differences in congenital malformations.

Perinatal deaths and major lethal and non-lethal congenital malformations occurring in this hospital from 1979-82 inclusive were related to the ethnic group of the 15 438 mothers. The highest crude perinatal mortality rates occurred in Indian and Pakistani populations (18.3 per 1000 and 24.1 per 1000 respectively). The highest incidence of congenital abnormality also occurred in these groups (13.3 per 1000 and 12.8 per 1000 respectively), but there was considerable variation in the distribution of different malformations.

Adolescent↗
PubMed1984

Effects of physician counseling on the smoking behavior of asbestos-exposed workers.

Physician antismoking advice has been shown to increase smoking cessation, particularly among patients who have medical problems or perceive themselves to be at risk. The present study tested three hypotheses: (a) providing 3 to 5 min of behavioral counseling regarding a cessation strategy would be more effective than simply warning the smoker to quit smoking; (b) smokers with abnormal pulmonary function would be more likely to comply with medical advice than would smokers with normal pulmonary function; and (c) that smokers with abnormal pulmonary function who receive behavioral counseling would be the group most likely to achieve prolonged abstinence. Asbestos-exposed smoking men undergoing screening in a mandated program for naval shipyard workers were categorized as having normal or abnormal pulmonary status on the basis of chest X ray and pulmonary function tests (PFT). They were then randomly assigned within PFT categories to receive either a simple warning or 3 to 5 min of behavioral cessation counseling from the physician who gave them the results of their pulmonary tests. Subjects' smoking status was evaluated at 3- and 11-month intervals following the physician intervention. Smokers who received behavioral counseling were more likely to quit and remain abstinent over the 11-month period (8.4% abstinent) than were smokers given a minimal warning (3.6% abstinent). Prolonged abstinence rates among abnormal PFT subjects (3.7%) did not differ from those of normals (5.9%). The group with normal PFT who received behavioral counseling achieved the highest level of abstinence (9.5%). Maintaining adequate physician compliance with the counseling protocol proved difficult; implications of this for future efforts are discussed.

Adult↗
PubMed1983

Pulmonary arteriovenous malformations. Physiologic observations and results of therapeutic balloon embolization.

Pulmonary arteriovenous malformations can result in severe hypoxemia and dyspnea. We measured pulmonary function, arterial blood gases, and hemodynamics in 10 patients with such malformations. Pulmonary-function tests were normal, but hypoxemia was associated with chronic hyperventilation at rest (mean, 12 liters per minute; mean carbon dioxide tension, 28 mm Hg). With exercise, ventilation increased more than expected for the level of carbon dioxide production. Balloon embolization of 58 of the 71 visible vascular malformations in the 10 patients resulted in an increase in arterial oxygen tension (43 vs. 64 mm Hg; P less than 0.001) and hemoglobin saturation (79 vs. 92 per cent; P less than 0.001). Nine patients had improved exercise tolerance. Forty-eight to 72 hours after correction of the hypoxemia, resting ventilation had decreased but was still above normal (mean, 9.3 liters per minutes; mean carbon dioxide tension, 29 mm Hg). We conclude that ventilatory responses in these patients are similar to those of people from sea-level areas who are acclimated to high altitudes and that dyspnea is due to inappropriately high levels of ventilation for a given workload under hypoxic conditions.

Adult↗
PubMed1983

Behavioral, attitudinal, and physiologic characteristics of smoking and nonsmoking asbestos-exposed shipyard workers.

The smoking characteristics of shipyard workers participating in an Asbestos Medical Surveillance Program (N = 3,991) were assessed. Sources of data were: (1) a self-assessment questionnaire on the smoking history and respiratory symptomatology of the 871 current smokers who participated in the smoking study, and (2) chest roentgenograms and pulmonary function test results and medical records for the entire population. The study population included 1,711 current smokers, 988 former smokers and 1,292 never smokers. The annual "quit rate" for former smokers had increased from less than 1% in 1961 to 4.2% in 1978. Of the 871 current smokers who participated in the smoking study, 19% had resumed smoking after having given up cigarettes for one year or longer. Men in the smoking study were reasonably well informed about the health consequences of smoking. While they perceived themselves to be susceptible to disease, and the disease to be serious, the benefits they saw in quitting were related more to economics and aesthetics than to health. When the results were age adjusted, no differences in rate of pulmonary function abnormalities and chest film abnormalities were found between current smokers who voluntarily participated in the smoking study and those who did not. All pulmonary function testing abnormality and chest film abnormality rates were significantly lower for former smokers and never smokers.

Adult↗
PubMed1983

Ethnic differences in birthweight-related parameters with particular reference to possible maternal nutritional risk factors.

Three birthweight-related parameters were examined in the deliveries occurring from January to July 1982 at Dudley Road Hospital, Birmingham, in 3 major ethnic groups and in relation to possible maternal nutritional risk factors in the European and Indian groups. Ponderal index did not correlate with either mean or 'corrected' birthweight especially in the West Indians. The 3 maternal nutritional risk factors appeared to be of greater fetal prognostic value in the Indian group than in the European group.

Birth Weight↗
PubMed1983

Ethnic differences in the distribution of congenital malformations.

Major lethal and non-lethal congenital malformations occurring in babies born in Dudley Road Hospital in 1979, 1980 and 1981 were related to the ethnic group of the mother. There was an increased incidence of gastrointestinal malformations in the Indian group and an increased incidence of abnormalities that could be associated with consanguinity and increased maternal age in the Pakistani group. A sample population (2000 mothers) was obtained in the first 7 months of 1982 to determine the maternal age distribution and consanguinity rates in the various ethnic groups.

Congenital Abnormalities↗
PubMed1983

Ethnic differences in the distribution of normally formed singleton stillbirths.

The normally formed singleton stillbirth deliveries occurring in Dudley Road Hospital in 1979, 1980 and 1981 were classified according to the primary aetiology. There was a higher than normal stillbirth rate in the Indian group which was almost entirely accounted for by the increased number of stillbirths falling into the 'intrauterine death before labour' group.

England↗
PubMed1983

Transbronchial needle aspiration in the diagnosis and staging of bronchogenic carcinoma.

Lung cancer often requires an invasive surgical procedure to document inoperability. Using a fiberoptic bronchoscope with a flexible needle that can penetrate the walls of the trachea and major bronchi, we sampled mediastinal and hilar lymph nodes in 32 patients. Of 18 patients presenting with a diagnostic problem, 11 had aspirates that were positive for cancer. Surgery in 6 of the remaining 7 showed cancer in 4 (false negative). Ten other patients presented with a staging problem. Four had positive mediastinal aspirates; 3 of these 4 had a normal or equivocally normal mediastinum on chest roentgenogram. Surgery in 4 of the remaining 6 showed no cancer in 4 (true negatives). The procedure was also diagnostic in 2 of 4 patients with recurrent mediastinal small cell carcinoma and in 3 patients with intrabronchial necrotic tumors. There were no complications. We conclude that this is a safe, easily performed procedure that can replace more invasive procedures in the diagnosis and staging of lung cancer.

Biopsy, Needle↗
PubMed1983

Angioarchitecture of pulmonary arteriovenous malformations: an important consideration before embolotherapy.

Seventeen patients with 91 pulmonary arteriovenous malformations were evaluated by superselective angiography. Seventy-two (79%) of the malformations consisted of a simple type characterized by a single feeding artery draining into a bulbous, nonseptated aneurysmal communication with a single draining vein. The other 19 (21%) were complex, consisting of two or more pulmonary artery branches communicating with a bulbous septated aneurysmal part with two or more draining veins. Two patients had diffuse pulmonary arteriovenous malformations confined to multiple lobes of the lung. Balloon embolotherapy was effective in permanently obliterating the malformations in 14 patients treated. Therapy provided a sustained rise in arterial PO2 in the sitting position from a mean value of 44 mm Hg before occlusion to 65 mm Hg after occlusion. In three patients the process was too diffuse and/or the malformations too large for therapy to be effective. Complex pulmonary arteriovenous malformations required occlusion of all feeding arteries. Balloon embolotherapy provided an effective treatment for pulmonary arteriovenous malformations regardless of anatomic type.

Adolescent↗
PubMed1983

The longitudinal study of chronic sarcoidosis.

Although spontaneous remissions are frequent in sarcoidosis, chronic persistent disabling disease is also observed. This feature seems more frequent and more severe in black patients, as has been previously reported (10). The more extensive and severe the initial disease manifestations, the more likely it is that the disease will continue. Corticosteroids are usually beneficial and complications are infrequent. Delayed or interrupted treatment seems to allow progression or irreversible disease or both. Patient compliance is an obvious important factor. Relapses are frequent as treatment is withdrawn but are usually at least partially reversible. Some deterioration is observed with repeated relapses. Low dose daily prednisone (5-15 mg) seems to prevent relapses. Patient compliance is facilitated with daily treatment rather than alternate day therapy. Prolonged treatment for 10 to 15 or more years is often required. Chloroquine is particularly helpful in skin and mucosal disease. The necessity for long-term thoughtful management is obvious.

Adult↗