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Biomedical subjects

W W Addington

Publications and source records attributed to W W Addington.

At least 19 recordsLinked to original sources
PubMed1979

Tuberculosis. A chemotherapeutic triumph but a persistent socioeconomic problem.

There is evidence that man has suffered from tuberculosis for more than 5,000 years, and through crowded living conditions, debilitation, and malnutrition, tuberculosis became epidemic in Western civilization and was a major cause of mortality. Identification of the tubercle bacillus as the causative agent in 1882 firmly established the infectious nature of the disease and the development of sanatoriums soon followed. Before the advent of effective chemotherapeutic agents, treatment involved rest, diet, and various surgical procedures, which were of little or no benefit to the patient. The discovery of dihydrostreptomycin, aminosalicylic acid, and isoniazid in the late 1940s and early 1950s meant that tuberculosis was now entirely curable in virtually all patients. Despite these effective chemotherapeutic and preventive agents, tuberculosis has receded to socioeconomically disadvantaged urban and rural areas, where the incidence parallels that of developing countries. Conquest of the disease will require improved health care delivery to the indigent and dispossessed.

Antitubercular Agents↗
PubMed1979

Bronchiectasis: a cause of pulmonary symptoms in heroin addicts.

Extensive and severe bronchiectasis was found in 7 heroin-addicted individuals with pulmonary symptoms whose chest roentgenograms were not suggestive of severe airway disease. Abnormalities consisted of varicose and cylindrical alterations. Pulmonary function tests revealed airflow obstruction, decreased lung volumes, and diffusion capacity impairment. Arterial blood gas analysis demonstrated mild hypoxemia in all patients and chronic hypocapnia in 4. Serial pulmonary function tests in 2 patients revealed only modest improvement in the degree of airflow obstruction. The occurence of bronchiectasis appeared to be related to episodes of heroin-induced pulmonary edema and infection.

Adult↗
PubMed1979

Arrhythmogenic effects of orally administered bronchodilators.

The respiratory and circulatory effects of orally administered ephedrine sulfate, 25 mg, aminophylline, 400 mg, terbutaline sulfate, 5 mg, and placebo were evaluated in 20 patients with ventricular arrhythmia by a double-blind crossover method. The bronchodilator effect of terbutaline was similar to that of aminophylline over four hours but superior to ephedrine at the fourth hour. Both terbutaline and ephedrine exhibited chronotropic effects, with the effect of terbutaline greater than that of ephedrine at the fourth hour. The effect of aminophylline on heart rate did not differ from placebo. Only terbutaline was associated with an increase in ventricular ectopic beats. Ventricular tachycardia occurred in three patients treated with terbutaline and in one patient with ephedrine. There were no significant changes in blood pressure. Orally administered terbutaline should not be regarded as safer than orally administered ephedrine or aminophylline in patients with arrhythmias.

Adult↗
PubMed1979

The treatment of pulmonary tuberculosis. Current options.

Appropriate chemotherapy must be received by the patient if the treatment of pulmonary tuberculosis is to be successful. The choice of the antituberculous regimen depends on the susceptibility and number of organisms infecting the patient and the side effects and cost of the drugs. The patient's life-style and the resources available in the community need to be considered to ensure compliance with the prescribed chemotherapy. If treatment is to be unsupervised, meaning that each dose is not actually witnessed by a health provider, a daily isoniazid and ethambutol hydrochloride treatment for 18 months or daily isoniazid and rifampin treatment for nine months is suggested. If each dose of chemotherapy is to be directly supervised, necessary for the noncompliant patient, then the following regimens are recommended: intermittent isoniazid and ethambutol, isoniazid and streptomycin, or intermittent isoniazid and rifampin following an initial period of daily therapy.

Antitubercular Agents↗
PubMed1977

Occurrence with bacteriologically positive pulmonary tuberculosis.

Fever was unchanged by chemotherapy in ten patients with bacteriologically positive pulmonary tuberculosis. Blood cultures were positive for Gram-positive organisms in six patients and for Gram-negative organisms in four patients. The same organism was present in sputa and blood in six patients and in urine and blood in two patients. Leukocytosis was not found, and roentgenographic findings did not suggest superinfection. Nine of the ten patients survived. Blood cultures must be obtained in patients with pulmonary tuberculosis whose fever is not altered by antituberculous chemotherapy, so that concomitant septicemia is not neglected.

Adult↗
PubMed1977

Respiratory failure in pulmonary tuberculosis.

Of 852 patients admitted to Cook County Hospital with bacteriologically-proved pulmonary tuberculosis, 16 suffered respiratory failure. Of these 16, 5 died and 11 recovered. On follow-up, the survivors demonstrated significant improvement in oxygenation, but continued to show a severe restrictive ventilatory defect. Our patients, unlike those in previous reports, did not show airway obstruction. The principles of management are the same as for other pulmonary patients. Arterial blood gas analyses should be done on patients with advanced tuberculosis so that abnormalities of gas exchange will not be missed.

Adult↗