PubMed Health⌕ Search

Biomedical subjects

A J Martin

Publications and source records attributed to A J Martin.

At least 109 records · Page 6Linked to original sources
PubMed1987

Children's understanding of cystic fibrosis.

Sixty-one children aged 4-18 years with cystic fibrosis were interviewed about their understanding of the illness and their attitude towards it. Responses were compared across three age groups: 4-6 years, 7-11 years and 12-18 years, corresponding to Piagetian stages of cognitive development. While there was an obvious progression in knowledge with advancing age, the children's attitude to their illness and therapy varied remarkably between age groups. Those in the 4-6 year group were more positive about themselves and about the effect of therapy than those in the older groups. More than half knew that they were born with the illness, in contrast to published reports of healthy children's concepts of illness causation for this age group. Children in the 7-11 year group were least likely to feel better after therapy and were least likely to mention anything positive about having cystic fibrosis, despite having a higher mean Schwachman clinical score than those in the oldest group.

Adolescent↗
PubMed1987

Affective disorders in general practice. Treatment of 6000 patients with fluvoxamine.

A total of 6258 patients seen in general practice complaining of low mood with or without associated somatic symptoms was studied. The mean patient entry score on the Montgomery-Asberg Depression Rating Scale (MADRS) was 29.69 (moderately severe depressive disorder). Three-quarters (73%) of the patients were female, average age was 46.1 years, and a reactive element was considered to be present in 43%. Patients received fluvoxamine, a novel anti-depressant, over a treatment period of 6 weeks, dosage starting at either 50 or 100 mg at night increasing after the first week, if necessary, to a maximum of 300 mg per day. Results were analyzed for 5625 patients. Efficacy of treatment was assessed using the MADRS, Psychosomatic Symptom Scale and Clinical Global Impression scales. During treatment, there was a marked improvement in mood and a parallel improvement in somatic symptoms; there was no difference in overall response between those with or without somatic symptoms. By Week 6, patients had improved by approximately 65%, with suicidal ideation being most marked at 81%. Patient compliance was good, the most commonly reported unwanted effect being nausea. In overdoses up to 2 g fluvoxamine no lasting toxic effects were observed. In an 'elderly' sub-group of 1096 patients aged 60 years and over, efficacy and the incidence of unwanted effects were similar, but the drop-out rate due to intolerance was greater than in the younger age sub-group.

Adult↗
PubMed1986

Respiratory muscle training in Duchenne muscular dystrophy.

Eighteen boys with Duchenne muscular dystrophy were entered into trials to assess the effects of specific ventilatory strength and endurance training programmes. The findings showed an improvement in ventilatory muscle endurance but not in strength as a result of specific respiratory muscle training. The clinical significance of these findings is uncertain, however, and needs further evaluation.

Adolescent↗
PubMed1985

Survival of cystic fibrosis patients in South Australia. Evidence that cystic fibrosis centre care leads to better survival.

Life tables were calculated for 205 South Australians with cystic fibrosis. An improvement in survival was noted between 1948 and 1982. Ninety-three per cent of patients who were diagnosed as having cystic fibrosis after 1973 were alive at 14 years of age, compared with 40% of those who were diagnosed between 1948 and 1973. A Cystic Fibrosis Clinic was established in 1973 and much of this improvement is attributed to the care provided by this centre. Deaths from meconium ileus fell from 58% of infants with this complication between 1948 and 1973 to only 8% between 1973 and 1983, in spite of the increasing incidence of patients who were chronically colonized with Pseudomonas aeruginosa (currently 68% of patients). These figures are similar to those from Victoria and from other cystic fibrosis centres in North America. The improvement in survival means that adults now comprise a quarter of the patients with cystic fibrosis in South Australia, and that adult institutions need to be aware of these patients and their needs.

Actuarial Analysis↗
PubMed1985

Percutaneous subclavian catheterization for prolonged systemic chemotherapy.

Recent experience with 108 Broviac catheters was reviewed. Sixty-eight were percutaneously placed in the subclavian veins of adults receiving systemic chemotherapy. For subclavian catheters perioperative and late complications were unusual. There was no pneumothorax or serious bleeding associated with insertion, even in severely thrombocytopenic patients. Mean catheter life was 93 days. Infection occurred in only five cases (7%). We conclude that percutaneous placement of right atrial catheters is a safe procedure which provides reliable access for prolonged chemotherapy in cancer patients.

Adolescent↗
PubMed1985

Supraclavicular approach to cervical esophageal atresia with tracheoesophageal fistula.

This is a report of a patient with esophageal atresia with a blind upper pouch and a lower pouch fistula, both in the neck. The preoperative radiologic appearance of an air-filled esophagus behind the trachea suggested a higher than normal fistula. Preoperative bronchoscopy confirmed the cervical position of the fistula and, as a result, a supraclavicular incision was used to approach both the atresia and fistula.

Esophageal Atresia↗
PubMed1985

The significance of fat-filled macrophages in the diagnosis of aspiration associated with gastro-oesophageal reflux.

Tracheal aspirates from 46 children were examined for the presence of fat-filled macrophages. They had no history suggestive of gastro-oesophageal reflux. The number of positive results from this group (46%) was compared with the number of positive results (73%) in a group of 40 children with proven gastro-oesophageal reflux. The difference in proportion of positive results between the two groups was statistically significant (P less than 0.05). In addition, subgroups of subjects, negative for gastro-oesophageal reflux and lower respiratory tract disease, were compared with children who had both conditions. A slightly greater difference, although at a similar level of significance, was found. The fact that 42% of subjects without lower respiratory tract disease or gastro-oesophageal reflux had tracheal aspirates positive for fat-filled macrophages would, however, suggest that this test is of limited clinical value and may need better quantitation before it can be recommended for widespread clinical use.

Child↗
PubMed1984

Mycoplasma pneumoniae: acute illness, antibiotics, and subsequent pulmonary function.

One hundred and eight children presenting with Mycoplasma pneumoniae infection were assessed during the acute illness and followed for three years. The incidence of wheezing with the acute infection (40%) was greater than expected in a normal childhood population. The initial illness precipitated wheezing for the first time in some subjects but others wheezed only with the acute illness. In non-asthmatic subjects significant bronchodilator responsiveness was present one month after infection. Children given erythromycin during the first seven days of their illness had a significantly shorter fever duration compared with those treated inappropriately. No significant effects of treatment were noted on pulmonary function three years later but non-asthmatic children had abnormal mean forced expiratory volume in one second and forced expiratory flow after 50% of the expired vital capacity compared with 64 healthy controls. These findings indicate impaired function three years after initial infection.

Adolescent↗
PubMed1983

Ritodrine in the treatment of preterm labour: a study of 213 patients.

In a study of 213 patients with diagnosed, uncomplicated preterm labour up to 33 weeks gestation, intravenous followed by oral ritodrine (Yutopar) was found to be an effective treatment. Success rate was related to Bishop score at commencement of therapy, the mean time to delivery being 36.9 days. It was greater than or equal to 56 days in 26.5% of patients and greater than or equal to 2 days in 91%. Relapse rate was low if infusion was followed by an adequate oral dosage. Concurrent signs and symptoms were seen in a third of patients but drug withdrawal was only necessary in seven. There was no significant difference in the incidence of respiratory distress syndrome between the infants of patients treated with ritodrine alone and those of patients treated with ritodrine plus steroids.

Administration, Oral↗