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Biomedical subjects

A Tal

Publications and source records attributed to A Tal.

At least 73 records · Page 4Linked to original sources
PubMed1987

Proper use of metered-dose inhalers: the role of the primary care physician.

We interviewed 50 primary care pediatricians and family physicians in order to assess their skills in instructing patients on the proper use of inhalers. Although 36 of them claimed that they were personally instructing their patients, major defects in their skills were observed. Whereas only 3 could personally perform all seven essential steps of an inhalation maneuver correctly, 20 failed on three to seven steps. Twelve failed on all steps. It is suggested that inadequate patient instruction by physicians may play a significant role in the incorrect use of inhalers by asthmatic children.

Administration, Inhalation↗
PubMed1987

Monitoring theophylline therapy using citric acid-stimulated saliva in infants and children with asthma.

Saliva stimulation is required for measurement of drugs in saliva. Chewing on a piece of paraffin, which is the method usually used for saliva stimulation, requires cooperation of the patient and, thus, is inapplicable in infants and young children. To assess the value of determining theophylline concentrations from noninvasively obtained saliva in this age group, we studied the theophylline plasma to saliva concentration ratio in citric acid-stimulated saliva. Theophylline concentration was measured in 137 simultaneously obtained paired specimens of plasma and saliva from 68 patients 2 1/2 months to 14 years of age treated with theophylline for asthma (dosage 20.8 +/- 5.2 mg/kg/d, mean +/- SD). Saliva secretion was stimulated by placing citric acid crystals on the tongue. A strong and highly significant correlation was observed between both determinations (r = .96; P less than .01). The plasma to saliva ratio was 1.78 +/- 0.22 (mean +/- SD), with theophylline concentrations between 3.1 and 32.1 micrograms/mL of plasma. The ratio of estimated to actual plasma theophylline concentrations was 1.02 +/- 0.12 (mean +/- SD). Interindividual coefficient of variation of plasma to saliva theophylline concentrations ratios was 12.4%; mean intraindividual coefficient of variation was 5.3%. The use of citric acid for saliva stimulation is easily applicable to infants and young children. Compared with blood drawing, stimulation of saliva secretion by citric acid is painless and noninvasive, is more readily accepted to patients, is at least as clinically relevant for theophylline determination, and allows frequent measurements of drug levels for individualization of the dosage with samples taken at home.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Leukocytosis in non hematological malignancies--a possible tumor-associated marker.

Leukocytosis (WBC counts 10,000/mm3) was detected in 77 out of 252 patients (30%) with ten different types of nonhematological malignancy (NHM) at the time of diagnosis. A full search including serological and bacteriological screening was performed to exclude other possible causes of leukocytosis. Among the different tumors, carcinomas of the lung and colorectum were the most prevalently associated with leukocytosis. Absolute monocytosis was found in 25% of the patients and absolute eosinophilia in only 4.8%. The leukocytosis was attributed mainly to an increase in the mature polymorphonuclears, suggesting a release mechanism of WBC from storage pools by factors secreted or induced by the tumor. Neither the age nor the sex of the patients affected the incidence or magnitude of leukocytosis. However, the presence of metastases was associated with a significantly higher incidence of leukocytosis (p less than 0.05). The associated leukocytosis may be regarded as a poor prognostic sign, and was associated with a significantly (p less than 0.007) shorter survival time. In contrast, absolute lymphocytosis may have a positive effect on the survival time (p = 0.01). Tumor-associated leukocytosis may be an additional tumor-associated marker, of value in assessing and monitoring patients with NHMs.

Female↗
PubMed1986

Digital signal processing of stridor and snoring in children.

Stridor and snoring are common signs of upper airway obstruction. The nature and characteristics of the stridor and snoring depend upon the site of obstruction. Sophisticated analysis of these sounds may provide important information concerning the source of the sound helping to assess the patient more objectively. The preliminary results of computerized digital analysis of stridor and snoring sounds are presented in 5 children. Two main programs were applied to analyse the signal: the Power Spectral Density (PSD) function and the Estimated Cross-sectional Area (ECSA). A consistent pattern according to the site of the produced sound was seen. Further acoustical analyses are needed to standardize this method and to program the computer to indicate the various sites of lesions.

Child, Preschool↗
PubMed1986

Relationship between respiratory muscle strength, nutritional status, and lung volume in cystic fibrosis and asthma.

We measured static inspiratory and expiratory pressures (PImax and PEmax) in 29 patients with asthma for comparison with a previously reported group of 25 patients with cystic fibrosis (CF) and 80 normal control subjects. The purpose of the study was to assess the relationship between respiratory muscle strength, nutritional status, lung volumes, and training effect of the increased work of breathing in patients with chronic air-flow limitation. PEmax was similar in the asthma group, CF group, and normal control subjects despite a significant degree of malnutrition in the CF group (mean body mass percentile (BMP), 78 versus 107% in the asthma group, p less than 0.001). There was no correlation between BMP and PImax or PEmax in either study group. PImax, when corrected for lung volume, was greater than age- and sex-matched control values in 24% of the patients with CF and 48% of the patients with asthma. We conclude that respiratory muscle strength is not related to nutritional status (as measured by BMP) in patients with CF and asthma. Above-normal inspiratory muscle strength may result from a training effect of the increased work of breathing in both CF and asthma, regardless of nutritional status.

Adolescent↗
PubMed1985

Reduced peripheral presynaptic adrenoceptor sensitivity following chronic antidepressant treatment in rats.

Responses of the isolated vas deferens of the rat to clonidine (inhibition of contractions to field stimulation at 0.1 Hz) and noradrenaline (contraction of longitudinal muscle) were determined after one or 21 daily injections of the animals with desmethylimipramine, clorgyline, selegiline or tranylcypromine. Desmethylimipramine (10 mg kg-1) and clorgyline (2 mg kg-1) increased the clonidine EC50 in the isolated vas deferens after 21 but not after one daily injection(s). Tranylcypromine (5 mg kg-1) increased clonidine EC50 after both one and 21 injections and selegiline (1 mg kg-1) did not affect clonidine EC50 after either one or 21 injections. Only desmethylimipramine had a significant effect on noradrenaline responsiveness, producing an inconsistent decrease in EC50 with a consistent increase in maximum contractile response after 21 but not after one daily injection(s). Clorgyline (10(-5) M) increased the contractile response of the isolated vas deferens to field stimulation and antagonized the inhibitory effect of clonidine when added directly to the isolated tissue preparation. Neither clorgyline (5 mg kg-1), selegiline (1 mg kg-1) nor tranylcypromine (2.5 mg kg-1) affected significantly the inhibitory response to clonidine (1 microgram kg-1) on contractions of in situ sympathetically stimulated vas deferens in pithed rats. These results show that down-regulation of alpha 2-presynaptic adrenoceptors by chronic treatment with desmethylimipramine and clorgyline occurs in peripheral organs as well as in the central nervous system.

Animals↗
PubMed1985

Interference of cardiovascular sounds with phonopneumography in children.

We have used fast Fourier transform and power spectra analysis to determine possible interference of cardiovascular sounds with the analysis of breath sounds in children. Ten normal children, 8 to 13 yr of age, were studied with sound transducer over midprecordium, right upper lobe, and right lower lobe along with simultaneously recorded ECG and air flow. Detection of R-waves facilitated sampling of sound segments at defined flow rates, with inclusion or exclusion of heart sounds. Measurements during breath-holding and without heart sounds served as baseline values. Heart sounds were only slightly attenuated over the right upper lobe. There was a considerable overlap in the power spectra of heart and breath sounds, mainly in frequencies below 100 Hz. Analysis of low-frequency components of normal breath sounds requires sampling during parts of the cardiac cycle that are free of cardiovascular sounds.

Adolescent↗
PubMed1985

The effect of anticholinergic treatment on postexertional wheezing in asthma studied by phonopneumography and spirometry.

Postexertional wheezing is an important clinical sign of nonspecific airway hyperreactivity. We have studied wheezing after exercise in 6 asthmatic subjects, 13 to 20 yr of age, using spectral analysis of recorded tracheal sounds. Automated spectral characterization was used to measure wheezing as a proportion of respiratory time. Anticholinergic treatment with ipratropium bromide (Atrovent) was compared with placebo to investigate effects on postexertional wheezing, and pulmonary function was compared with the result of respiratory sound analysis. Atrovent did not abolish exercise-induced bronchospasm but improved preexercise lung function and thereby caused a parallel upward shift in the response curves. Wheezing after Atrovent was significantly less, later in onset, and mainly expiratory at 20 min after exercise. Wheezing as a percentage of total respiratory time correlated well with FEV1, Vmax50, and SGaw. Analysis of respiratory sounds and automated quantification of wheezing may be a useful complementary test of bronchial obstruction in asthma.

Adolescent↗
PubMed1985

Familial meconium ileus with normal sweat electrolytes.

Meconium ileus (MeI) is the presenting symptom in 10 to 15 percent of infants with cystic fibrosis (CF), but it is a rare phenomenon in patients who do not have this disease. We report four Bedouin siblings who had MeI with no laboratory evidence of CF.

Electrolytes↗
PubMed1985

Psychotropic drugs and long QT syndromes: case reports.

Two depressed patients with long QT syndrome who experienced torsade de pointes ventricular tachycardia when treated with psychotropic drugs are discussed. These cases emphasize the significance of electrocardiographic evaluation of depressed patients, particularly in patients who show evidence of a long QT interval.

Aged↗