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Biomedical subjects

R M Sly

Publications and source records attributed to R M Sly.

At least 37 records · Page 2Linked to original sources
PubMed1989

Lack of effect of geographic elevation on mortality from asthma.

One might expect prevalence of asthma to affect rates of mortality due to asthma. In France, asthma prevalence at 1350 m is less than at sea level. Calculation of asthma mortality rates for blacks and whites 5 to 34 years of age in 1980 for counties in the USA with populated places at elevations of at least 4000 feet disclosed no significant differences from rates at lower elevations. Nevertheless, asthma mortality rates were significantly higher for blacks than whites at both high and low elevations. The asthma death rates per 100,000 general population for elevations less than 4000 feet were .160 for whites and .896 for blacks. Asthma death rates for elevations of at least 4000 feet were .209 for whites and 1.150 for blacks.

Adolescent↗
PubMed1989

Regional distribution of deaths from asthma.

Data from the National Center for Health Statistics indicate rates of death from asthma at 5-34 years of age in the USA in 1980 were .166 per 100,000 general population for whites and .914 for blacks. Rates for blacks were higher in the Northeast (1.313) and North Central Region (1.179) than in the West (.905) and South (.659). The rate for whites was higher in the West (.263) than in the Northeast (.180), South (.149), or North Central Region (.108). During 1981-84 rates remained higher for blacks in the Northeast and North Central Regions than other regions and higher for whites in the West than elsewhere. Most deaths from asthma at 5-34 years of age from 1979-84 in the USA occurred at hospitals (70% of blacks, 77% of whites for the 40 states reporting this detail on death certificates). Rates of discharge from hospitals after admission for the treatment of asthma at 5-34 years of age have also been much higher for blacks than for whites from 1979-86. These rates have been highest in the Northeast and North Central Region for both blacks and whites. Accordingly, neither failure to reach a hospital nor lack of hospitalization can account for regional and racial differences in asthma mortality rates. Median household incomes have been lower for blacks than whites, and unemployment rates have been higher for blacks than whites. From 1980-84 unemployment rates for blacks were highest in the North Central Region. Economic factors may account in part for racial and regional differences in mortality from asthma.

Adolescent↗
PubMed1988

Mortality from asthma, 1979-1984.

Review of data from the National Center for Health Statistics to characterize deaths from asthma disclosed increases in rates of death from 1.2 per 100,000 in 1979 to 1.5 in 1983 and 1984. For black subjects, rates of death from asthma increased from 1.8 in 1979 to 2.5 in 1984; for white subjects, from 1.1 in 1979 to 1.4 in 1984. Age-adjusted rates of death from asthma increased from 1.9 in 1979 to 2.8 in 1983 and 2.6 in 1984 for black subjects, and from 0.8 to 1979 to 1.0 in 1984 for white subjects. Rates for other minority groups have been lower than rates for white subjects. A modest increase in prevalence of asthma among black subjects is insufficient to account for their much higher rate of death from asthma. Increases in rates of death have occurred in both metropolitan and nonmetropolitan areas in all regions of the country and in all but a few states. At least half the deaths from asthma have occurred at hospitals: this proportion did not change from 1979 to 1984. Increases in deaths from asthma have occurred in several other countries as well. Other reviews of deaths from asthma have implicated undertreatment and delays in treatment with bronchodilators and adrenal corticosteroids as factors contributing to death. High rates of death among black subjects suggest underutilization or lack of accessibility of health care. The large proportion of deaths that have occurred at hospitals suggests delays or other inadequacies of treatment at hospitals.

Adolescent↗
PubMed1988

Determination of theophylline concentrations by AccuLevel.

Determination of theophylline concentrations in 29 paired venous samples by AccuLevel and EMIT disclosed excellent correlation. Evaluation of precision of AccuLevel by 20 replicate analyses disclosed a coefficient of variation of 3.5%. AccuLevel is an accurate, precise, rapid method of determination of theophylline concentrations in whole blood.

Blood Chemical Analysis↗
PubMed1988

Impact of AccuLevel on treatment of acute asthma.

Study of the impact of rapid availability of theophylline concentrations on emergency treatment of acute asthma disclosed use of AccuLevel in 50 children significantly shortened the time required to reach concentrations of at least 10 micrograms/mL and shortened time spent in the emergency room as compared with 50 children in whom serum concentrations were measured only by EMIT.

Acute Disease↗
PubMed1988

Delivery of albuterol aerosol by aerochamber to young children.

Inhalation of albuterol aerosol, 200 micrograms, delivered from metered dose inhalers via Aerochamber, elicited a highly significant improvement in peak expiratory flow rate from 70% to 84% and 91% predicted normal 5 and 20 minutes after treatment, respectively, in 30 asthmatic children 3 to 6 years of age. No significant increase in peak expiratory flow rate followed inhalation of placebo by a similar group of 16 asthmatic children. Use of the Aerochamber permits effective delivery of medication from metered dose inhalers to children as young as 3 years of age.

Administration, Inhalation↗
PubMed1988

Mortality from asthma in children 1979-1984.

Deaths from asthma in children less than 15 years of age in the USA increased from 63 in 1979 to 111 in 1983 and then decreased slightly to 106 in 1984. Rates of death from asthma have been higher among boys than girls, probably due to higher prevalence of asthma among boys. Increases in rates of death from asthma have occurred in most age groups because of much higher rates of death and greater increases in rates of death among blacks than whites. Prevalence of asthma is not sufficiently greater among blacks to account for rates of death 3 to 5 times as great as those for white children. Increases in deaths due to asthma have occurred in 47 states, and deaths have occurred in metropolitan children of both races in approximate proportion to their distribution to metropolitan areas. At least 46% of deaths from asthma in children and adolescents less than 20 years of age have occurred at hospitals. Reviews of deaths from asthma have implicated delays in implementation of appropriate therapy, including adrenal corticosteroids, psychosocial dysfunction that has interfered with compliance with recommended management, and underestimation of the seriousness of airway obstruction. Some deaths have been sudden and unavoidable.

Asthma↗
PubMed1986

History of exercise-induced asthma.

Strenuous exercise prolonged for several minutes can cause airway obstruction in asthmatic subjects. Initial obstruction becomes most extreme 5-10 min after the completion of exercise and usually remits within a few minutes but may recur 3-6 h later. The response to exercise depends upon the type of exercise. Swimming is less likely to cause exercise-induced asthma than running. Recent exercise or pretreatment with a bronchodilator or cromolyn can inhibit exercise-induced asthma. Nasal breathing or inhalation of warm, fully humidified air during exercise can minimize exercise-induced asthma. Local changes in osmolarity or cooling of mast cells probably causes release of mediators that cause airway obstruction.

Asthma↗
PubMed1986

Evaluation of determination of theophylline concentrations by Seralyzer.

Determination of theophylline concentrations by Seralyzer in 28 paired serum and plasma samples disclosed almost identical results. Comparison of determinations by Seralyzer and enzyme-multiplied immunoassay in 31 paired serum samples disclosed significant underestimation by Seralyzer when recalibrated whenever results of analysis of a 15-micrograms/mL control exceeded limits of +/- 3 micrograms/mL. Determinations by Seralyzer did not differ significantly from enzyme-multiplied immunoassay with narrower limits of 15 +/- 2 micrograms/mL for Seralyzer calibration for 18 paired samples. Seralyzer results are sufficiently reliable for clinical use if the instrument is recalibrated whenever analysis of the 15-micrograms/mL control falls outside limits of +/- 2 micrograms/mL.

Child↗
PubMed1985

Causes of death from asthma in children.

There were seven deaths from asthma at Children's Hospital National Medical Center from 1944 to 1984. There have been none since 1971 despite an increased frequency of admissions for the treatment of asthma. Review of records implicated undertreatment, infection, and sedation as factors that may have contributed to deaths.

Adolescent↗
PubMed1985

Evaluation of HealthScan Assess peak flow meters.

Comparison between peak expiratory flow rates obtained using a standard Wright Peak Flow Meter and a HealthScan Assess peak flow meter disclosed a highly significant correlation. Comparison of six Assess peak flow meters showed highly significant correlations despite some lack of consistency with some units.

Adolescent↗