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Biomedical subjects

S L Spector

Publications and source records attributed to S L Spector.

At least 109 records · Page 6Linked to original sources
PubMed1981

Comparison between transillumination and the roentgenogram in diagnosing paranasal sinus disease.

The reliability of transillumination versus roentgenogram to diagnose maxillary and frontal paranasal sinus disease was assessed in 52 subjects with rhinitis and/or asthma. Two different otolaryngologists transilluminated the sinuses while the roentgenograms were evaluated by a radiologist and a third otolaryngologist. Patients filled in questionnaires of symptoms. There was excellent agreement (p < 0.001) between otolaryngologists regarding transillumination of the frontal sinuses but not the maxillary sinuses. Similarly, transillumination of the frontal sinuses correlated well with the roentgenograms. This was not true for transillumination of the maxillary sinuses. Although pain in the upper teeth related well to the presence of frontal disease, sinus headache was a frequent complaint but not useful as a predictor of sinus disease. Even though transillumination of the frontal paranasal sinus has some predictive value, the technique of transillumination has limited usefulness as a diagnostic tool and is not an adequate substitute for roentgenogram.

Adolescent↗
PubMed1981

Clinical response and serum prostaglandin levels in aspirin idiosyncrasy. Effect of aspirin and a new nonsteroidal anti-inflammatory agent.

Clinical measurements and serum prostaglandin concentrations were monitored in three normal subjects, three asthmatic controls and five asthmatic patients with aspirin (ASA) idiosyncrasy before and after oral challenge with small doses of aspirin. Additionally, in the latter group, the effects of ASA were compared with those of piroxicam, a new nonsteroidal anti-inflammatory agent. Challenge with either agent caused bronchospasm in patients with aspirin idiosyncrasy, but was more severe after piroxicam. Nasal stuffiness and/or rhinorrhea preceded or accompanied the changes in pulmonary function with both agents. Serum prostaglandin concentrations, which reflect synthesis by platelets during the clotting of blood, revealed significant decreases in PGE1, PGE2, and PGF2 alpha and thromboxane B2 within two to four hours after drug administration in all subjects with or without ASA idiosyncrasy. The change in serum PG concentration was presented when bronchospasm developed in patients with ASA idiosyncrasy, but persisted for a longer time, reflecting the irreversible effect of these agents on the cyclo-oxygenase enzyme in platelets. The results demonstrate that administration of minute doses of ASA and other nonsteroidal anti-inflammatory drugs alters prostaglandin synthesis in normal and asthmatic subjects with or without ASA idiosyncrasy. Alteration in arachidonate metabolism may be responsible for the induction of bronchospasm, and cautious use of cyclo-oxygenase inhibitors in patients with known or suspected ASA idiosyncrasy is indicated.

Adult↗
PubMed1981

Calibration and stability of Standard and Mini-Wright peak flow meters.

Periodic checks of peak flow meter (PFM) stability is essential to ensure meaningful application even when the PFMs are only used to measure the relative changes in patient peak flow rate. Calibration of PFMs becomes necessary, however, when peak flow readings are to be interpreted precisely. Techniques and flow systems which offer ease and accuracy in calibrating and/or checking PFMs were tested on Standard Wright and Mini-Wright PFMs. Individual Wright PFMs were found to be stable over a six-month testing period. The PFM readings varied from actual flow, however, and the variation from actual flow was greatest among the Mini-Wright PFMs.

Forced Expiratory Flow Rates↗
PubMed1980

The effect of troleandomycin on methylprednisolone elimination.

Troleandomoycin (TAO), a macrolide antibiotic, has an apparent "steroid-sparing" effect when used in the treatment of severe steroid-dependent asthma. This study was designed to investigate the effect of TAO on methylprednisolone elimination. Pharmacokinetic studies were performed before and 1 wk after starting TAO in 10 severe steroid-dependent asthmatics. Baseline total body clearance of methylprednisolone was 406 +/- 139 (mean +/- SD) ml/min/1.73 m2 and decreased significantly (p < 0.001) to 146 +/- 57 ml/min/1.73 m2 1 wk after TAO therapy was initiated. Methylprednisolone half-life was 2.46 +/- 0.75 hr before TAO and increased significantly (p < 0.01) to 4.63 +/- 1.35 hr after 1 wk on TAO therapy. A follow-up evaluation of methylprednisolone pharmacokinetics in three patients after at least 1 mo on TAO therapy demonstrated continuation of the reduced methylprednisolone elimination. TAO inhibition of methylprednisolone clearance may contribute to the beneficial effects observed initially with combined methylprednisolone-troleandomycin therapy in severe steroid-dependent asthma.

Adolescent↗
PubMed1980

Clinical and nasal biopsy response to treatment of perennial rhinitis.

Nasal biopsies of patients with perennial rhinitis were performed at baseline and compared with biopsies performed 4 wk after active flunisolide, 50 micrograms four times per day, or placebo. An effort was made to relate histologic findings to other subjective and objective parameters as an indication of response to treatment. Although patients admitted to the study had severe subjective nasal symptoms, biopsies varied considerably. Some resembled biopsies from normal individuals, and others showed marked edema and inflammation; the latter findings were more typically present in the biopsies of patients with the most severe disease. A decrease in edema and loss of inflammatory cells on biopsy as well as a corresponding decrease in eosinophils on the nasal smear usually accompanied clinical improvement, which occurred in both the active and placebo groups.

Adolescent↗
PubMed1979

Relationship between airways response to allergens and nonspecific bronchial reactivity.

Bronchial inhalation challenges to histamine, methacholine, and at least one antigen were performed on 183 asthmatic patients who previously had received skin tests to at least 16 different antigens. Individuals with a positive skin test and a positive antigen inhalation challenge to the same antigen had lower thresholds of response to both histamine and methacholine. This pattern was statistically significant for mixed trees, mixed grasses, mixed molds, and house dust but not for mixed ragweed. For those individuals who had a negative antigen inhalation challenge, skin test reactivity (positive or negative) alone was not associated with a different threshold of response to histamine or methacholine. Also, a higher percentage of positive antigen inhalation challenges were seen in the group of individuals with a low threshold of response to both histamine and methacholine than in groups with either a moderate or high threshold of response to these chemical agents. The results imply that at least two factors are associated with a positive bronchial inhalation challenge to a specific antigen: nonspecific airways hyperreactivity, as indexed by a methacholine or histamine inhalation challenge, and a positive skin test.

Adolescent↗
PubMed1979

Aspirin and concomitant idiosyncrasies in adult asthmatic patients.

The nasal and respiratory symptoms observed after oral challenge to aspirin (ASA), tartrazine, and other nonsteroidal anti-inflammatory substances are best described as idiosyncratic reactions. A positive response to oral challenge, defined as a 20% fall in forced expiratory volume in 1 sec (FEV1) from baseline for up to 4 hr, occurred in 44 of 230 patients with ASA, 11 of 277 with tartrazine, 2 of 93 with sodium salicylate, and 2 of 69 with acetaminophen. No one had a positive response to tartrazine, sodium salicylate, or acetaminophen who was not also positive to ASA. The dose of ASA causing a positive response was less than 5 grains in 95% of the patients. Of 50 patients with a suspicious history studied in detail, 96% of those with ASA idiosyncrasy had sinusitis and 71% had nasal polyps. Methacholine challenges and random circulating and sputum eosinophils did not differentiate patients with a negative challenge from those with a positive challenge. However, patients with a positive history and positive challenge had significantly more random nasal eosinophils than those with negative aspirin challenges. The term "aspirin triad" has outlived its usefulness since ASA idiosyncrasy can exist in patients lacking certain components of the triad. ASA idiosyncrasy is unsuspected in many patients and possibly overdiagnosed in others.

Acetaminophen↗
PubMed1979

Effect of a selective beta 2 adrenergic agonist and theophylline on skin test reactivity and cardiovascular parameters.

Fenoterol, a selective beta 2-adrenergic agent, and aminophylline in the "therapeutic range" were compared with placebo for their inhibitory effect on skin test reactivity to allergens and histamine. Cardiovascular parameters were also assessed. A new, inexpensive micrometer adaptor to a tuberculin syringe was used to deliver allergens and histamine more accurately. No inhibition of skin test reactivity to antigens or histamine was found after a loading dose or after 1 wk of round-the-clock therapy with these bronchodilators. Although there was increased heart rate after 1 and 2 hr with fenoterol, there was no patient preference for one bronchodilator over the other. The results of this study point out some of the difficulties in trying to extrapolate in vitro findings to in vivo correlates since neither fenoterol nor therapeutic doses of theophylline interfere with immediate skin test reactivity.

Adolescent↗