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Biomedical subjects

P Howard

Publications and source records attributed to P Howard.

At least 163 records · Page 9Linked to original sources
PubMed1982

Oxygen in the home.

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Home Care Services↗
PubMed1982

Oedema in cor pulmonale.

The mechanisms of oedema in cor pulmonale remain unexplained. On the basis of a small number of studies, cor pulmonale is not caused by cardiac muscle failure, at least in early oedematous phases. Progressive and persistent elevation of pulmonary vascular resistance may exceed the pumping capacity of the right ventricle in later stages. Alternative explanations for the sharp fall in renal blood flow as oedema appears should be sought. The renin-angiotensin-aldosterone system seems causally related to oedema. The curious position of hypercapnia remains an enigma. Surprisingly few studies of hypercapnia, renal blood flow and renal hormones are reported. Redistribution of body water from intracellular to the extracellular space may be in part due to the need to buffer extracellular respiratory acidosis caused by hypercapnia. It provides an explanation for one form of hypercapnic oedema. Cyclical loss and gain of tissue mass seems more evident in cor pulmonale than ischaemic or valvular heart failure.

Animals↗
PubMed1979

Hypoxaemia in chronic obstructive bronchitis.

Arterial blood gas tensions were studied for six years in 85 patients (59 men, 26 women, mean age 58.8 years) with hypoxaemia associated with chronic bronchitis. All patients who died had a precipitous fall of arterial oxygen tension (PaO2) breathing air. In patients dying within two years of the first appearance of ankle oedema the mean rate of fall of PaO2 was 0.11 kPa/month. Patients who survived two years appeared to deteriorate more slowly (0.017 kPa/month) until some months before death, when they too deteriorated rapidly. Hypoxaemic patients with obstructive airways disease suffer a terminal rapid decline in arterial oxygen tension, which probably indicates real pathological change in the lungs and has important implications for long-term domiciliary oxygen treatment.

Aged↗
PubMed1979

Triamcinolone in corticosteroid-resistant asthma.

In an uncontrolled study 38 patients with chronic asthma were treated for up to 4.5 years (mean 2.9) with depot injections of triamcinolone acetonide. About half had proved difficult to control on large doses of corticosteroid tablets. Three-quarters were helped and the incidence of hospital admission amongst them was reduced. Side effects were tolerable and adrenal function was only moderately depressed. Spirometry showed continuing improvement up to three years after starting triamcinolone. Whether similar improvement could have been achieved by a different dosage regimen of corticosteroid tablets or whether it might have ocurred spontaneously was not tested. A controlled trial seems warranted.

Adult↗
PubMed1978

Domiciliary oxygen.

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Home Care Services↗
PubMed1977

Resolution of hypoxic changes in the heart and pulmonary arterioles of rats during intermittent correction of hypoxia.

1. Rats kept in a hypoxic chamber (10% O2) for 3 or more weeks developed right ventricular hypertrophy, muscularization of pulmonary arterioles and polycythaemia. These changes resemble those found in human hypoxic disease and, in particular, in patients dying from chronic airways obstruction. 2. Resolution of these changes was studied in a normal environment and in an intermittently normal, intermittently hypoxic environment. The latter regimen modelled the situation of patients with cor pulmonale receiving long-term intermittent oxygen therapy. 3. In a normal environment right ventricular hypertrophy and polycythaemia were resolved in 6 weeks but vessel changes were not resolved in 12 weeks. 4. In the intermittently normoxic environment (40 or 80 h in air per week) there was some resolution of right ventricular hypertrophy in 6 weeks but no significant reduction in vessel thickening or in polycythaemia in 12 weeks.

Animals↗
PubMed1977

Transbronchial lung biopsy: A review of 85 cases.

Transbronchial lung biopsy using the fibreoptic bronchoscope was carried out in 85 patients. There were no serious complications; two patients had a 10% pneumothorax and 17 had slight haemoptysis lasting less than 24 hours. The problems of interpreting small biopsy specimens are considered. Satisfactory specimens were obtained without fluoroscopic guidance, particularly in diffuse and lobar lesions. A histological diagnosis was made in 62% of diffuse lesions and compatible histology was found in a further 22%. In a further case Pneumocytis carinii infection was diagnosed. Blind biopsy of discrete periheral lesions was less successful with only one positive diagnosis in 12 patients.

Adult↗
PubMed1977

Studies with live attenuated influenza virus in chronic bronchitis.

The use of live, recombinant virus for immunisation against influenza produced a number of respiratory illnesses, some severe, in patients with chronic obstructive airways disease. These patients are probably more susceptible to the influenza virus than are normal subjects. Special care will be needed in testing these viruses on patients with respiratory disease.

Aged↗
PubMed1977

Lignocaine aerosol and persistent cough.

Four patients with intractable cough improved for periods of between one and six weeks after treatment with 400 mg of lignocaine by aerosol spray. Suprisingly the lignocaine increased airways resistance in some of them. It is suggested that the excessive cough is due to excessive sensitivity of tracheal cough or irritant receptors, secondary to mucosal damage. The dangers of lignocaine inhalation are referred to.

Adult↗