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Biomedical subjects

R W Light

Publications and source records attributed to R W Light.

At least 217 records · Page 12Linked to original sources

Falsely high refractometric readings for the specific gravity of pleural fluid.

For 128 pleural fluids, the relationship between the protein content and the reading for the specific gravity obtained from a refractometer calibrated for urinary specific gravity was analyzed. The refractometer gave falsely high levels for the specific gravity of the pleural fluid. A reading for 1.019 (rather than 1.016) corresponded to a concentration of protein of 3.0 gm/100 ml, and each deviation of 0.005 (rather than 0.003) coresponded to a concentration of 1 gm/100 ml; however, determinations of the concentration of protein in the pleural fluid directly from the refractometer's scale for protein (calibrated for serum) was rapid and accurate. Calculation of the protein content of the pleural fluid from the reading for specific gravity on the refractometer is erroneous and sometimes misleading.

False Positive Reactions↗

Pleural effusions.

Many different conditions result in the accumulation of pleural fluid. A diagnostic thoracentesis should be performed on all patients with pleural effusion from whom pleural fluid can be easily obtained. Empirically we have found that when the pleural effusion is more than 10 mm thick on the lateral decubitus roentgenogram, pleural fluid is easily obtained. At least 30 cc fluid should be obtained and distributed to the various laboratories as outlined in Table 2. The results of these tests will show whether the fluid is a transudate or an exudate. If the fluid is a transudate, no further diagnostic procedures need be directed towards the pleura. If the fluid is an exudate, the diagnosis will frequently be made by these original tests and therapy for the pleural disease can be instituted. If the diagnosis has not been made, the results of these tests should lead to a rational diagnostic attack.

Amylases↗

Oral atropine in the treatment of chronic asthma.

Six adult patients with chronic asthma were treated with oral atropine sulfate 0.5 mg or placebo four times a day in a double-blind, crossover trial lasting eight weeks. Subjects returned at weekly intervals for spirometry and clinical evaluation. The baseline pulmonary functions did not differ significantly between the atropine and placebo periods. The only side effects noted were slight dryness of the mouth in three patients. The three patients who complained of mouth dryness felt that they were better while they were taking oral atropine in that they had fewer acute episodes of asthma. The administration of 0.5 mg oral atropine four times a day is ineffective in improving baseline pulmonary functions in chronic asthmatics, although it may decrease the incidence and severity of acute asthmatic episodes.

Administration, Oral↗

Comparison of albuterol and isoproterenol aerosols in bronchial asthma.

Albuterol and isoproterenol aerosols were compared with placebo in a double-blind manner in 18 patients with bronchial asthma. Both drugs elicited significant improvement in flow rates and vital capacity. Duration of action was longer with albuterol than with isoproterenol. Neither was associated with significant increases in heart rate or blood pressure.

Adolescent↗

Late pulmonary function in survivors of adult respiratory distress syndrome.

Early recognition and improvements in treatment have brought an appreciable decline in mortality from the adult respiratory distress syndrome. Physiologic changes during the acute illness include restriction of lung volumes and a defect in gas transfer. Until recently, pulmonary function of long-term survivors has not been discussed. This report concerns the pulmonary function of two patients studied 19 and 22 months, respectively, after surviving an episode. No residual changes in lung volume or compliance were found. A mild decrease in diffusing capacity was noted, and alveolar-arterial oxygen gradients were at the upper limit of normal in both.

Follow-Up Studies↗

Clinical and roentgenographic manifestations of acute and chronic blastomycosis.

Roentgenograms and hospital records of 50 patients with blastomycosis proven by cultures were analyzed to determine possible differences between the acute and chronic forms of the illness. Six patients had acute blastomycosis with symptoms occurring three weeks or less prior to hospitalization. The remaining 44 patients had chronic illnesses with symptoms occurring up to six years (mean duration, ten months before hospitalization). The acute illness was characterized by toxic symptoms, chest pain without visible effusions, pneumonic-type consolidations on the chest films, and a relatively benign course. The chronic illness had less severe toxicity, but a high incidence of dissemination, with pleural reactions, hepatosplenomegaly, and cutaneous and osseous involvement. Sputum cultures were positive for Blastomyces dermatitidis in 36 of 46 patients; however, several specimens were frequently required for demonstration of the organism on wet preparations. Pleural fluid and material from skin lesions were also likely sources of the fungus. Skin tests and serologic studies were not helpful in most cases of either the acute or chronic form of the disease.

Acute Disease↗

Incidence and significance of pleural effusion after abdominal surgery.

Two hundred patients who had undergone abdominal surgery received bilateral decubitus chest roentgenograms between 48 and 72 hours after surgery to evaluate the incidence of pleural effusion after abdominal surgery. Ninety-seven (49 percent) had some pleural fluid visible on the x-ray films. In 50 patients the thickness of the fluid was less than 4 mm on the decubitus film; in 26, it was between 4 mm and 10 mm; and in 21, it was greater than 10 mm. The incidence of pleural effusions was higher after upper-abdominal surgery, in patients with postoperative atelectasis, on the side on which the surgery was performed, and in patients with free abdominal fluid. Thoracocentesis was performed on 20 patients, and in 16 patients the effusions were exudates. All of the effusions resolved without specific therapy except one. The pleural fluid in this patient was characterized by a low pH (6.93) and positive culture for Staphylococcus aureus. Small pleural effusions are common after abdominal surgery, and most resolve spontaneously within a few days.

Abdomen↗

Severe slowly resolving heroin-induced pulmonary edema.

Severe heroin-induced pulmonary edema occurred in three previously healthy young men. Adequate arterial PO2 could only be achieved with the use of positive endexpiratory pressure (PEEP). Recovery was characterized by the gradual clearing of the pulmonary infiltrates and a gradual lessening of the severe restrictive ventilatory defects over many weeks. Concomitant aspiration of gastric acid was thought to be the explanation for the severity of these cases. In cases such as these, initial vigorous therapy, including PEEP for hypoxia, corticosteroids for possible aspiration and volume replacement for hypotension, is recommended.

Adrenal Cortex Hormones↗

Response of patients with chronic obstructive lung disease to the regular administration of nebulized isoproterenol. A double-blind crossover study.

The effect of the regular use of neublized isoproterenol in 14 patients with symptomatic chronic obstructive lung disease (COLD) was evaluated in a double-blind crossover 16-week study. FEV1, FVC and SGaw were measured before and 45 minutes after bronchodilator therapy every two weeks, while arterial blood gases were measured every eight weeks, before and 45 minutes after bronchodilator therapy. When the patients were considered as a group, there was no significant difference in mean symptom scores or objective pulmonary functions during the drug and placebo periods. Four patients had significantly higher (p less than .05) and two patients significantly lower mean values for at least one of the pulmonary function tests during the isoproterenol period. The patient who is most likely to benefit from isoproterenol on a regular basis appears to have the following characteristics; (1) consistent improvement in pulmonary function tests 45 minutes after use of nebulized bronchodilator; (2) moderate rather than severe COLD; and (3) a relatively normal DLCO.

Aerosols↗