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Biomedical subjects

A Olinsky

Publications and source records attributed to A Olinsky.

At least 55 records · Page 3Linked to original sources
PubMed1987

Childhood asthma in adult life: a further study at 28 years of age.

A group of 323 subjects who had wheezed in childhood and 48 control subjects of the same age were studied prospectively from 7 to 28 years of age. A classification system based on wheezing frequency was found to correlate well with clinical and spirometric features of airway obstruction. The amount of wheezing in early adolescence seemed to be a guide for severity in later life with 73% of those with few symptoms at 14 continuing to have little or no asthma at 28 years. Similarly 68% of those with frequent wheezing at 14 still suffered from recurrent asthma at 28 years. Most subjects with frequent wheezing at 21 continued to have comparable asthma at 28 years. Of those with infrequent wheezing at 21, 44% had worsened at 28 years. Women fared better than men between 21 and 28 with 19% having worse symptoms compared with 28% of men. Treatment at all ages was generally inadequate. The number of smokers among those with asthma was of concern.

Adult↗
PubMed1987

Effect of ipratropium bromide on respiratory mechanics in infants with acute bronchiolitis.

The effect of nebulized ipratropium bromide in 14 infants (mean age: 20 weeks, range: 4-41) with acute respiratory syncytial virus bronchiolitis was examined. A modified rapid chest compression technique was used to obtain partial expiratory flow-volume curves and maximum flow at functional residual capacity. Passive respiratory mechanics were assessed by brief occlusion at end inspiration. Thoracic gas volume was measured in a body plethysmograph. No significant difference was found in forced and passive respiratory mechanics pre- and post-ipratropium bromide. No subgroups could be identified. These results do not support the use of ipratropium bromide in acute viral bronchiolitis.

Acute Disease↗
PubMed1987

Pulmonary restrictive effect of bracing in mild idiopathic scoliosis.

The use of bracing in the treatment of mild idiopathic scoliosis is controversial. A study of 33 adolescents showed that bracing significantly decreased lung volumes. Functional residual capacity was reduced by a mean of 26%, 18% of children showing a reduction of greater than 40%. The mean reduction in total lung capacity was 16% and in forced vital capacity 18%. This restriction of lung function by bracing might have a deleterious effect on lung growth or might impose an additional risk factor in the presence of other disorders, such as asthma and diaphragmatic weakness. The use of bracing in individuals with mild scoliosis should be judiciously reassessed.

Adolescent↗
PubMed1987

Failure of ipratropium bromide to modify the diurnal variation of asthma in asthmatic children.

Thirty one children with asthma were given 40 micrograms of ipratropium bromide and identical placebo by inhalation three times a day in a double blind, randomised crossover study to test the ability of an anticholinergic drug to modify the diurnal variation in airway calibre and bronchial reactivity. Subjects measured peak expiratory flow rate approximately eight hourly, before and after inhaled salbutamol, for four week periods. Paired t tests and cosinor analysis were used to assess the diurnal variation in airway calibre from the peak expiratory flow rate recorded before salbutamol and to assess the diurnal variation in bronchodilator responsiveness from the increase in peak expiratory flow rate after salbutamol. Maintenance treatment with ipratropium bromide 40 micrograms three times daily reduced the provocative dose of histamine which caused a 20% fall in FEV1 (geometric mean PD20 = 0.78 v 0.49 mg/ml, p less than 0.05), despite an eight to 12 hour gap between the last dose of ipratropium and histamine challenge. It did not, however, diminish the diurnal variation in airway calibre (mean amplitude = 12.7 v 10.1) or in bronchodilator responsiveness (mean amplitude = 62.4 v 63.5). There was no improvement in the clinical state of subjects while they were taking ipratropium bromide.

Adolescent↗
PubMed1986

The perception of asthma.

Subjective scores of 'wheeze' or 'tightness in the chest' were compared with the forced expiratory volume in 1 s (FEV1) in 40 asthmatic children before and after administration of nebulized salbutamol. Symptom scores were poor predictors of the degree of airways obstruction. Many children underestimated their improvement after salbutamol. The results suggest that reliance on the children's perception of his symptoms and his response to a bronchodilator may result in incorrect assessment and inappropriate treatment.

Adolescent↗
PubMed1986

Sarcoidosis in children.

Eight patients with sarcoidosis seen at the Royal Children's Hospital, Melbourne, during the past 10 years were reviewed. Five of the eight patients came from non-metropolitan areas. The major presenting symptoms were cough, fatigue and weight loss; peripheral lymphadenopathy and hepatomegaly were common. None of the patients had eye or central nervous system involvement. Seven patients had bilateral hilar adenopathy on chest radiograph and six had parenchymal lung changes. Angiotensin converting enzyme was measured in six patients and was elevated in all, while hypercalcaemia was present in three patients. Five patients had a tissue biopsy showing the characteristic non-caseating granulomas. Corticosteroid therapy was used for four patients and was given for hypercalcaemia in three patients and for severe restrictive lung disease in one patient.

Adolescent↗
PubMed1986

Reproducibility of hyperventilation of cold dry air in children with cystic fibrosis.

Wheezing is a significant problem in some patients with cystic fibrosis. Currently available tests are not reliable at determining whether this wheezing is due to co-existent asthma or to the underlying pulmonary disease. The reproducibility of hyperventilation of cold dry air (HVCDA) was studied over eight days in 11 children with cystic fibrosis. A group with mild lung disease were selected to minimize the variability due to underlying pulmonary disease. Fifty-six per cent of subjects had consistent responses to HVCDA. A test of reproducibility was performed on the respiratory heat exchange, the percentage fall in FEV1 after HVCDA and the ratio of these two (R). Respiratory heat exchange was found to be highly reproducible with a reproducibility co-efficient of 0.97. The percentage fall in FEV1 after HVCDA and R were not reproducible over the eight-day period. Hyperventilation of cold dry air did not give reproducible results in children with cystic fibrosis, suggesting that a single test may not be suitable for judging bronchial liability.

Adolescent↗
PubMed1985

Proximal airway function 8 to 16 years after laryngomalacia: follow-up using flow-volume loop studies.

Twenty children who had endoscopically confirmed laryngomalacia were reviewed at 8 to 16 years of age. All had developed stridor in the first 6 weeks of life; stridor had stopped or largely resolved by age 4 years. Proximal airway function was assessed by expiratory and inspiratory flow volume loops and compared with control values. These children as a group had variable extrathoracic obstruction to inspiratory airflow, as indicated by a significantly low maximal inspiratory flow at 50% of vital capacity and a high mean ratio of maximal expiratory to maximal inspiratory flow at 50% vital capacity. Although limitation to inspiratory airflow was detectable in later childhood, it was not associated with troublesome symptoms. Significant stridor always resolved by 4 years of age, but some children experienced minor stridor under stress in later childhood.

Adolescent↗
PubMed1984

Assessment of proximal airway obstruction in children by analysis of flow-volume loops.

The usefulness of maximal expiratory and inspiratory flow-volume (F-V) loops was assessed in ten children with clinical evidence of tracheal or laryngeal obstruction. Normal values from 514 healthy children are presented. Measurement of maximal flow, and expiratory/inspiratory flow ratios and observation of the characteristic contours of the F-V loops distinguished between proximal and peripheral airways obstruction in all cases. Most children over the age of 7 years could perform the test adequately. F-V loop analysis is a valuable technique in the assessment of the child with proximal airway obstruction. Unlike endoscopic and radiological investigation, it measures the functional rather than the anatomical degree of obstruction, and provides a simple non-invasive way of monitoring the response to treatment.

Adolescent↗
PubMed1984

Response to acute hypercapnia in the parents of victims of sudden infant death syndrome.

The ventilatory response to acute hypercapnia was studied in 68 parents of victims of sudden infant death syndrome and 56 control subjects. Tidal volume, inspiratory time, and total respiratory cycle time were measured before and immediately after a vital capacity breath of 13% CO2 in oxygen. Instantaneous minute ventilation, mean inspiratory flow (tidal volume/inspiratory time), and respiratory timing (inspiratory time/total respiratory cycle time) were calculated. Both groups of subjects showed a marked increase in tidal volume (48.4% +/- 26.5%), instantaneous minute ventilation (56% +/- 35%), and tidal volume/inspiratory time (56.8% +/- 33.5%) after inhalation of the test gas, with little change in inspiratory time/total respiratory cycle time. There were no significant differences between the two groups for ventilation before or after inhalation of the test gas. The ventilatory response to acute hypercapnia is mediated by the peripheral chemoreceptors. These results suggest that an inherited abnormality of peripheral chemoreceptor function is unlikely to be a factor leading to sudden infant death syndrome.

Acute Disease↗
PubMed1982

Long term pulmonary consequences of oesophageal atresia with tracheo-oesophageal fistula.

Lung function was studied in 20 children, aged 8-17 years, who had successfully repaired oesophageal atresia with tracheo-oesophageal fistula. Spirometry and plethysmography showed mild restrictive lung disease. Airways obstruction was assessed using maximal expiratory and inspiratory flow-volume loops in air and after breathing a helium-oxygen mixture. Analysis of the flow-volume data demonstrated significant obstruction at the level of the trachea and little evidence of small airways disease. Bronchial hyperreactivity, as assessed by histamine challenge, was present in 22% of subjects. Respiratory and oesophageal symptoms were common, but decreased in frequency with increasing age. The mechanisms involved in the frequent respiratory symptoms these children suffer are discussed in the light of the physiological findings.

Adolescent↗
PubMed1981

Croup, recurrent group, allergy, and airways hyper-reactivity.

One hundred and ten children were studied 9 years after each had been in hospital for croup. They were evaluated with a questionnaire, physical examination, allergy skin testing, pulmonary function tests, and a histamine inhalation challenge. Fifty-seven of them had recurrent episodes of croup, and 33 were defined as allergic. The association between allergy and recurrent croup was highly significant. Airways hyper-reactivity was found in 23 of them, and was associated with allergy and recurrent croup. The group of children with a history of recurrent croup could be distinguished from the group with one or two episodes by male predominance, onset of the disease at a younger age, familial predisposition, a significantly greater association with allergy and airways hyper-reactivity, slightly lower expiratory flow rates in pulmonary function tests, and a tendency towards the subsequent development of asthma.

Adolescent↗
PubMed1981

Variability of airways hyper-reactivity and allergy in cystic fibrosis.

The importance of bronchial hyper-reactivity and allergy, and treatment with bronchodilators and corticosteroids, in the management of patients with cystic fibrosis is poorly understood. Three tests generally regarded as useful in the diagnosis of asthma were evaluated in 25 children with cystic fibrosis. The constancy of a child's response was assessed by histamine bronchial provocation, exercise challenge, and tests of skin allergy during a 6-month period. Although a positive response to these tests was related to impaired pulmonary function, 44% of children had variable responses to histamine, 56% to exercise, and 24% to skin tests which were unrelated to exacerbations of chest infection or to changes in pulmonary function. These results show the complex nature of airways hyper-reactivity and allergy in cystic fibrosis, and suggest that 'anti-asthma' therapy is not justified solely on the basis of one positive response to these tests.

Adolescent↗
PubMed1981

Hypoxic and hypercapnic response in asthmatic subjects with previous respiratory failure.

Three children and two young adults with severe asthma who had frequent episodes of respiratory failure were studied. Isocapnic hypoxia and hyperoxic hypercapnia were produced separately using a rebreathing apparatus. Alveolar carbon dioxide tension and oxygen tension were estimated by continuously sampling expired gases. The three young children had a diminished response to hypoxia but a normal response to hypercapnia when compared to control asthmatic children (p less than 0.05) or healthy children (p less than 0.05). The two young adult patients had a normal response to hypoxia but one had a low response to hypercapnia. Studies of parents of these patients suggested that the chance combination of a possibly familial, inappropriate response to hypoxia with severe asthma would lead to a risk of respiratory failure.

Adolescent↗
PubMed1976

An unusual experience of neonatal necrotising enterocolitis.

Fifty-three patients with neonatal necrotising enterocolitis, who were seen over a 1-year period, were reviewed with regard to weight, gestational age, type of feed and incidence of exchange transfusion. These babies were larger and more mature than those in whom this disease is usually described. A significantly smaller number of babies with necrotising enterocolitis than control babies were breast-fed. A high positive association with exchange transfusion was noted.

Enterocolitis, Pseudomembranous↗
PubMed1976

Prolonged rupture of fetal membranes and neonatal infections.

Fifty-one babies with prolonged rupture of fetal membranes (longer than 24 hours) were studied for evidence of latent infection. Cord blood was taken from all babies for a full blood count and blood culture. Gastric aspirates were collected and vernix swabs were taken immediately after delivery. Microscopy, culture and antibiotic sensitivity tests were done on the appropriate specimens. Each baby had a thorough medical examination immediately after birth, and 3 and 7 days afterwards. After the initial investigation they were allocated to a treatment (penicillin 50 000 U/kg/d and kanamycin 10 mg/kg/d) or a non-treatment group by randomised card selection. Six patients became infected, as was shown by a positive blood culture, while 4 of the 6 had clinical signs of infection as well. These infants were treated with penicillin and kanamycin, and all did well. None of the remaining babies showed any signs of infection. There were no deaths. Blood culture was found to correlate well with clinical infections, and many be used as a guide to latent infection and treatment.

Bacterial Infections↗
PubMed1976

A simple method of measuring total respiratory system compliance in newborn infants.

A new method of measuring the static compliance of the respiratory system in the awake, non-paralysed infant is described. The static compliance was measured by this method in 12 healthy premature infants aged from 1 day to 30 weeks. In addition, the dynamic compliance was measured by the oesophageal balloon technique. The static compliance was significantly higher than the dynamic, and this difference was related to the respiratory rate. These infants therefore demonstrated frequency dependence of dynamic compliance.

Compliance↗