Search PubMed⌕ Search

Biomedical subjects

R A Matthay

Publications and source records attributed to R A Matthay.

At least 127 records · Page 7Linked to original sources
PubMed1977

Lung carcinoma after radiotherapy and chemotherapy for Hodgkin's disease.

Two patients, aged 29 and 40, with nodular sclerosing Hodgkin's disease, in complete remission for four and six years respectively after intensive radiotherapy and combination chemotherapy, developed carcinoma of the lung in the previous radiation port. Although radiotherapy and chemotherapy can eradicate Hodgkin's disease involving the thorax, this treatment may be associated with the development of a secondary pulmonary malignancy, particularly in a previous radiation port, and several years may elapse before the new tumour becomes evident.

Adult↗
PubMed1977

Radiographic manifestations of acute smoke inhalation.

Acute smoke inhalation may lead to serious pulmonary injury and contribute significantly to mortality of fire victims. The chest radiographic findings in 21 patients with acute smoke inhalation are analyzed, and possible pathophysiologic mechanisms responsible for the radiographic abnormalities noted are discussed. Patients with surface injury burns were intentionally eliminated from this study. Our findings indicate that the standard chest radiograph is an insensitive means of determining pulmonary injury by smoke inhalation. The importance of blood carboxyhemoglobin levels and arterial blood gas determinations in the clinical evaluation of patients with acute smoke inhalation is stressed.

Acute Disease↗
PubMed1976

Intravenous aminophylline dosage. Use of serum theophylline measurement for guidance.

A practical method for monitoring serum theophylline concentrations has been used to investigate intravenous aminophylline dosage requirements. Initial serum theophylline concentrations were found to vary widely and correlate poorly with drug history. Aminophylline loading doses determined from these values more frequently resulted in drug concentrations in the therapeutic range (10 mug to 20 mug/ml) than when therapy was given without knowledge of serum theophylline concentrations. Continuous intravenous aminophylline therapy administered in a standardized dosage (0.9 mg/kg/hr in adults and 1.0 mg/kg/hr in children) produced variable and often excessive serum concentrations. This resulted from variable drug clearance rates, which in adults averaged 0.64 +/- 0.38 ml/kg/min (mean +/- SD), only half that previously reported. These observations suggest that it is not possible to achieve optimal therapeutic aminophylline dosage without monitoring serum theophylline concentrations.

Acute Disease↗
PubMed1976

Effect of dextran loading on left ventricular performance in chronic obstructive pulmonary disease.

The status of left ventricular function in patients with chronic obstructive pulmonary disease remains controversial. With a radionuclide technique left ventricular ejection fraction, left ventricular end-diastolic volume, cardiac output, and stroke volume were measured at rest and following infusion of dextran in 23 men with severe COPD. Resting, mean LVEF was normal in 19 subjects with COPD alone; four with COPD and coronary artery disease had a depressed mean LVEF. Left ventricular end-diastolic volume index and pulmonary capillary wedge pressure were both normal at rest indicating that the left ventricle was not volume underloaded. There was a normal response to dextran infusion (750 ml.) with no deterioration in LVEF and a significant increase in cardiac index, stroke volume index, LVEDVI, and PCW. These data suggest that at rest and following volume loading with dextran left ventricular function is normal in patients with COPD.

Aged↗
PubMed1976

Interstitial lung disease in polymyositis and dermatomyositis: analysis of six cases and review of the literature.

Interstitial pneumonitis may be the presenting manifestation of polymyositis-dermatomyositis, or may occur later in the evolution of the disease. The clinical picture is characterized by non-productive cough, dyspnea and hypoxemia. The chest radiograph demonstrates interstitial infiltrates with predilection for the lung bases, often with an alveolar pattern in addition. The histopathologic features are those of organizing and interstitial pneumonitis and pleuritis, with variable fibrosis. In the present series, the patients with mixed alveolar and interstitial infiltrates on chest radiograph and organizing pneumonia and bronchiolitis obliterans in addition to interstitial pneumonitis. In one patient evolution from pulmonary inflammation to interstitial fibrosis was demonstrated. The etiology of primary lung disease in PM-DM is not known, but cell-mediated autoimmunity to an unidentified component of lung tissue is suggested. Including the present series, 50 percent of patients have responded favorably to corticosteroids with decreased dyspnea, clearing of the chest radiograph and improved pulmonary function tests.

Adult↗
PubMed1976

Grand mal seizure induced by oral theophylline.

A grand mal convulsion occurred in a patient with decompensated cor pulmonale. Although only modest doses of oral theophylline were being administered at the time of the convulsion the serum theophylline level was markedly raised and the theophylline clearance was very low. After treatment for cor pulmonale theophylline clearance improved; however, with the subsequent onset of fever and pneumonia the clearance decreased again, illustrating the potential lability of theophylline clearance.

Administration, Oral↗
PubMed1976

Hypertrophic osteoarthropathy in adults with cystic fibrosis.

Three adult patients with cystic fibrosis presented with arthralgia, and investigation for the usual causes of arthritis proved negative. Radiographs of long bones revealed periostitis and new bone fromation characteristic of hypertrophic osteoarthropathy. Symptomatic improvement occurred after analgesic and anti-inflammatory therapy. In patients with cystic fibrosis and bone or joint pain, the diagnosis of hypertrophic osteoarthropathy should be considered and long bone radiographs obtained.

Adult↗
PubMed1976

Transbronchial lung biopsy via the fiberoptic bronchoscope in the diagnosis of diffuse pulmonary infiltrates in the immunosuppressed host.

The differential diagnosis of diffuse pulmonary infiltrates in the immunosuppressed patient is broad. Many of the etiologies are amenable to specific therapy. Although endobronchial brush biopsy has been used to identify many infections, including Pneumocystis carinii, it was less effective in the diagnosis of noinfectious infiltrates. Transbronchial lung biopsy via the fiberoptic bronchoscope provided lung tissue that could be studied histologically, which increased the diagnostic yield without the morbidity and mortality of open or percutaneous lung biopsies.-

Adolescent↗
PubMed1975

Pulmonary manifestations of systemic lupus erythematosus: review of twelve cases of acute lupus pneumonitis.

Acute lupus pneumonitis was the presenting manifestation of systemic lupus erythematosus in six of 12 cases in this series. The clinical picture was characterized by severe dyspnea, tachypnea, fever and arterial hypoxemia. Radiographic findings included an acinar filling pattern which was invariably found in the lower lobes and was bilateral in 10 of the cases. Studies failed to reveal evidence of infection as a cause of the acute pulmonary infiltrates. All patients were treated with oxygen and corticosteroids; seven received azathioprine. Six patients survived and are clinically well 14 months to four years following their acute illness. Three of these patients have residual interstitial infiltrates with persistent pulmonary function test abnormalities indicating progression to chronic interstitial pneumonitis. Histologic sections of the lungs available from four patients revealed hyaline membranes and interstitial edema (four cases), acute alveolitis (two cases), arteriolar thrombosis (one case) and a prominent lymphocytic interstitial pneumonitis with organizing bronchiolitis (one case).

Acute Disease↗
PubMed1975

Theophylline-induced seizures in adults. Correlation with serum concentrations.

Eight patients developed grand mal seizures during intravenous theophylline therapy. None had a history of neurologic disorder, and all were acutely ill with severe pulmonary or cardiovascular disease, or both. Serum theophylline concentrations obtained within 1 hour of the seizure ranged from 25 mug/ml to 70mug/ml, with a mean value (53 plus or minus 4.8 mug/ml) more than twice the upper limit of the recommended therapeutic concentration. This serum theophylline concentration was greater than the concentration found in a group of patients with less severe drug-related symptoms (35 plus or minus 1.8 mug/ml, P less than 0.01). A third group of patients without drug-related symptoms had a mean theophylline serum concentration of 19 plus or minus 2.0 mug/ml, which was less than that found in either group with toxicity symptoms (P less than 0.05). Factors predisposing to the high serum concentrations in the patients with seizures were both higher drug dosage, compared with the other groups (P less than 0.01), and hepatic dysfunction, which was more common in both groups with drug-related symptoms.

Adult↗