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Biomedical subjects

P Small

Publications and source records attributed to P Small.

At least 37 records · Page 2Linked to original sources
PubMed1991

Subacute effects of respiratory syncytial virus infection on lung function in lambs.

We examined the effects of ovine respiratory syncytial virus (RSV) infection on lung mechanics, lung histology, and airway reactivity in lambs. Nine lambs were inoculated with ovine RSV and seven control lambs with normal saline or viral media. Serum neutralization titers were obtained prior to and 3 weeks post-inoculation (PI). Open lung biopsies were performed 1 and 3 weeks PI. Lung mechanics including dynamic compliance (Cdyn), resistance of the lung (RL), and functional residual capacity (FRC) were measured 2 and 6 weeks PI using a plethysmograph. Airway reactivity to aerosolized carbachol, citric acid, and histamine was determined 2 and 6 weeks PI. Most RSV and control lambs were asymptomatic after inoculation. Control lambs had significantly greater average daily weight gain by the third week after inoculation. Seven RSV lambs tested had a fourfold or greater rise in serum neutralization titers, while two control lambs had a fourfold increase. At 2 weeks PI, RSV lambs had significantly lower FRC and higher RL. At 6 weeks RL remained significantly elevated in the RSV lambs. Airway reactivity was not increased in the RSV group. This animal model is useful for studying the effects of RSV infection on lung growth and lung function over time.

Animals↗
PubMed1991

A three-month comparison of twice daily inhaled formoterol versus four times daily inhaled albuterol in the management of stable asthma.

We compared the efficacy of inhaled formoterol, a long-acting beta 2-agonist, with inhaled albuterol in 145 stable adult asthmatics in a 12-wk multicenter trial. Patients were allocated in randomized double-blind fashion to maintenance therapy with either formoterol 12 micrograms twice a day or albuterol 200 micrograms four times a day in addition to their other asthma medications. Patients were allowed to use "rescue" 100-micrograms albuterol puffs on an as-needed basis. Mean baseline FEV, in the morning before bronchodilator was 2.14 +/- 0.76 L and 1.98 +/- 0.71 L for the formoterol and albuterol groups, respectively, these values being used as baseline covariates in subsequent analysis of predrug and postdrug FEV1. Measured at each clinic visit, morning predrug FEV1 rose significantly with formoterol treatment and was significantly greater at all visits than in the albuterol group, the greatest difference being in Week 8 (2.40 +/- 0.77 versus 1.92 +/- 0.66 L, p less than 0.001). Morning FEV1 30 min postdrug was significantly higher in the formoterol group at Weeks 2 and 8, the trend not reaching statistical significance at other times. Diurnal variation in prebronchodilator peak flow rates was significantly reduced in the formoterol group throughout the trial (17 versus 42 L/min at Week 12, p less than 0.0001). The number of asthma episodes per week was significantly less in the formoterol group during Weeks 4, 8, and 12 as were the number of sleep disruptions during Weeks 2, 4, 6, 8, and 12. Significantly more rescue albuterol was required in the albuterol group by Week 2 and throughout the remainder of the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1991

Helicobacter pylori and Meckel's diverticulum.

Helicobacter pylori is invariably associated with peptic ulceration of the upper gastrointestinal tract. This has led to speculation about its pathogenic role in peptic ulceration. The literature and this present study show that H. pylori is not often associated with peptic ulceration in Meckel's diverticulum and hence it is unlikely that it has any significant role in peptic ulceration at this site.

Adolescent↗
PubMed1991

Effects of high doses of topical steroids on both ragweed and histamine-induced nasal provocation.

Patients with ragweed-induced seasonal allergic rhinitis were assigned randomly to be challenged intranasally either with ragweed or histamine while asymptomatic before the ragweed season. After initial challenge, all were treated either by placebo (P), beclomethasone dipropionate (BE), 400 micrograms daily, or budesonide (BU), 1200 micrograms daily, intranasally for 14 days. Repeat challenge was then compared with the previous ones in order to assess the effects of both usual (400 micrograms) and high doses (1200 micrograms) of topical steroids on both allergen-induced and nonspecific (histamine) nasal reactivity. Incremental doses of either histamine or ragweed were insufflated intranasally until a positive response defined the threshold reactivity. Reactions were assessed by a combination of changes in flow rates (rhinomanometry), secretions (mL), and sneezes with ten minutes of challenge. There was no difference in initial threshold reactivities among the treatment groups. Neither BE nor BU changed reactivity to ragweed. There were no adverse reactions except epistaxis in two BU patients. Histamine challenges disclosed a change in threshold reactivity, BU (P much less than .01) greater than BE (P much less than .05), compared with placebo. In summary, even high doses (1200 micrograms) of topical steroids had minimal effects on the early response to intranasal ragweed challenge. In contrast, both usual and high doses affected nonspecific histamine reactivity; this may contribute to some of the clinical improvement noted in symptoms of allergic rhinitis.

Administration, Topical↗
PubMed1990

Estimation of lung volume in infants by echo planar imaging and total body plethysmography.

Echo planar imaging (an extremely fast method of magnetic resonance imaging) was used to measure lung volume in a group of nine infants, all of whom had had respiratory problems. The mean echo planar imaging estimate of total lung volume was 44 +/- 9 ml/kg. In each case the right lung was larger than the left (ratio 52.8:47.2%). The mean thoracic gas volume was 36 +/- 8 ml/kg. The entire sequence of images of the thorax (about 400) takes five minutes to complete, infants require no sedation, and there are no side effects.

Female↗
PubMed1990

How hospital medical record departments can benefit from retrospective DRG review.

DRGs and PPS have had a major, negative effect upon hospital reimbursement. Hospitals now focus upon methods for improving and increasing reimbursement from third-party payers. More payers are using DRG-based reimbursement methods. DRG payment review offers a viable solution to the problems brought by stringent payment plans and has potential benefits for the MRD as well. MRD directors should investigate DRG payment review alternatives and from such efforts, attempt to maximize the benefits to the hospital and their own departments. Success with DRG payment review identifies the MRD as an objective, results-oriented revenue generator and, thereby, can improve performance throughout the hospital and among the medical staff.

Diagnosis-Related Groups↗
PubMed1990

Relationships among ragweed skin tests and both allergen specific and nonspecific nasal provocation.

Twenty-six patients with ragweed-induced allergic rhinitis were evaluated prior to the onset of seasonal symptoms. Ragweed skin tests and nasal challenges were performed 2 weeks after histamine nasal provocation. A correlation between ragweed skin tests and nasal challenges was detected (r = .4867, P much less than .01). Histamine challenges did not correlate with either of the other variables. A properly performed skin test predicts nasal reactivity to the same allergen. A clinical role for nonspecific nasal provocation could not be determined.

Adult↗
PubMed1990

Effects of azatadine, terfenadine, and astemizole on allergen-induced nasal provocation.

Fifty-six patients with ragweed seasonal rhinitis were challenged intranasally with ragweed. A clinical score (0-12)--including measurements of rhinomanometry, secretions, and sneezes--was generated. Each patient then received either azatadine (A), terfenadine (T), astemizole (AS), or nothing (control), for 1 week. Repeat challenges revealed changes in clinical score with A 3.6 (P less than .01), AS 3.1 (P less than .02), and T 2.7 (P less than .05). All three antihistamines similarly inhibited the nasal provocation response to ragweed.

Adolescent↗
PubMed1989

Sebaceous carcinoma of the eyelids. The role of adjunctive cryotherapy in the management of conjunctival pagetoid spread.

The extension of sebaceous carcinoma of the eyelid within the epithelium of the palpebral, forniceal, and bulbar conjunctiva (pagetoid spread) is a frequent indication for exenteration, but this recommendation is controversial. Six patients with upper eyelid tumors and variable degrees of epibulbar pagetoid extension were treated without exenteration. All underwent wide local resections of their upper eyelids (repaired by Cutler-Beard procedures), with adjunctive cryotherapy to the involved epibulbar surfaces after preoperative map biopsies of the conjunctiva had been done. Cryotherapy was applied during the second-stage Cutler-Beard procedure after initial resection of the tumor bulk. Follow-ups ranging from 12 to 50 months, with conjunctival biopsies at 6-month intervals, showed no recurrence of pagetoid tumor. Although exenteration was avoided, dry-eye symptoms, symblepharon, corneal erosion, and vascularization were side effects, which the patients were willing to tolerate to avoid radical surgery. The complications were most severe in the two patients who were either elderly or had more than two quadrants of epibulbar pagetoid disease.

Adult↗
PubMed1989

Probable azathioprine hepatotoxicity: a case report.

A patient with polymyositis was treated initially with corticosteroids. Subsequently, azathioprine was added but was associated with transient hepatotoxicity on two separate occasions, 6 months apart. Both episodes occurred 3 weeks after starting the latter drug. This is the first case of azathioprine toxicity documented by both histopathology and drug challenge.

Arthritis, Rheumatoid↗
PubMed1988

Evaluation of infants by echo planar imaging after repair of diaphragmatic hernia.

Three infants were studied by echo planar imaging after repair of congenital diaphragmatic hernias. Total lung volume and individual lung volumes were estimated using echo planar imaging. In the two patients with left sided hernias, the right lung was more than twice as large as the left. The patient with a right sided hernia had developed emphysema on the right side, and the right lung was twice as large as the left when estimated by echo planar imaging. Echo planar imaging studies took less than five minutes to perform and no sedation was required.

Female↗
PubMed1988

Comparison of alum-precipitated aqueous extracts and modified ragweed tyrosine adsorbate vaccine in the treatment of ragweed hay fever.

Thirty-five ragweed-sensitive patients received immunotherapy with either alum-precipitated aqueous extracts (AP) or modified ragweed tyrosine adsorbate vaccine (Pollinex-R). Symptoms decreased with AP therapy only. Immunologically, there was a blunted specific IgE response and little specific IgG increase associated with both groups. Alum-precipitated aqueous extracts appeared to be more efficacious than Pollinex-R.

Adsorption↗
PubMed1987

Isolated Raynaud's phenomenon--a benign disorder.

Ninety-seven patients presenting with isolated Raynaud's phenomenon were evaluated clinically and immunologically. Three patients developed progressive systemic sclerosis in a 3-5-year follow-up. Nineteen patients had positive antinuclear antibody, 32 depressed serum complement, and 31 elevated serum immune complexes. None of the immunologic abnormalities had obvious diagnostic significance.

Adolescent↗