Biomedical subjects

Andrew M Wilson

Publications and source records attributed to Andrew M Wilson.

24 records · Page 2Linked to original sources

PubMed2003

Peak inspiratory flow rate is more sensitive than acoustic rhinometry or rhinomanometry in detecting corticosteroid response with nasal histamine challenge.

Nasal histamine challenge testing is a standard method of assessing upper airway hyperreactivity although there is still debate as to the best measure of response. The aim of the study was to evaluate peak nasal inspiratory flow rate (PIFR) as an endpoint during histamine challenge and compare this with rhinomanometry (Rhino) and acoustic rhinometry (AR). Twenty two patients with perennial allergic rhinitis (PAR) were enrolled into a 2-way randomised crossover study comparing placebo with intra-nasal mometasone furoate (MF) 200 mg once daily, with laboratory measurements of PIFR, AR and Rhino being made during histamine nasal challenge after each 10-14 day treatment period. Patients also recorded their domiciliary nasal symptoms and PIFR on a daily basis. With nasal challenge testing using PIFR PC30 there was a significant (p < 0.05) difference between MF and placebo but not with PC30 AR or PC175 Rhino. There was also significant (p < 0.05) improvement in terms of domiciliary total nasal symptom scores but not domiciliary PIFR. In conclusion PIFR after nasal challenge with histamine is a sensitive test of response to treatment with intra-nasal corticosteroids in PAR.

Administration, Topical↗

PubMed2002

5-Lipoxygenase polymorphism and in-vivo response to leukotriene receptor antagonists.

OBJECTIVE: To determine whether genetic polymorphisms of the core promoter region of the 5-lipoxygenase gene contribute to the clinical response to leukotriene receptor antagonists. METHODS: We retrospectively genotyped 52 asthmatics for mutations of this gene from four placebo-controlled studies measuring leukotriene receptor antagonist responses. All studies measured bronchodilator response, and bronchial hyperresponsiveness to adenosine monophosphate was measured in three studies ( n = 34). RESULTS: Of the 52 patients genotyped, 40 were homozygous wild type, 12 heterozygous, and none was homozygous mutant. There was no significant difference in any improvements conferred by leukotriene receptor antagonists versus placebo in the forced expiratory volume in 1 s (0.20 l for wild-type homozygotes and 0.01 l for heterozygotes), forced mid-expiratory flow rate (0.16 l/s and 0.14 l/s), peak expiratory flow rate (10 l/min and 29 l/min) and adenosine monophosphate 20% fall in forced expiratory volume in 1 s (2.8-fold shift and 2.3-fold shift) between the two genotypes. CONCLUSION: In our population, screening for this polymorphism as an aid to guiding treatment is probably not worthwhile. In addition, we found no difference between homozygous wild types and heterozygotes in terms of bronchodilator response or bronchial hyperresponsiveness with leukotriene receptor antagonists.

Acetates↗

PubMed2002

Improvement in timing and effectiveness of external cardiac compressions with a new non-invasive device: the CPR-Ezy.

Prompt and effective cardiopulmonary resuscitation (CPR) is the first link in the chain of survival following cardiac arrest. We assessed a new device, the CPR-Ezy (Medteq Innovations Pty Ltd., Brisbane, Australia), to aid timing and effectiveness of external cardiac compressions (ECC), by 32 subjects who had prior community-based training in CPR. ECC was performed on a manikin for 4 min by all subjects without and with the device. There was a statistically significant improvement in timing of ECC. Effectiveness of compressions was also improved over the whole time period, especially so in the last minute. We conclude that the CPR-Ezy can improve timing and effectiveness of ECC, and reduce the effects of resuscitator fatigue, in community-trained subjects.

Compressive Strength↗

PubMed2002

Are antihistamines useful in managing asthma?

There continues to be a great deal of interest in the anti-asthmatic role of antihistamines. Antihistamines have recently been shown to have anti-inflammatory properties that are more extensive than simply the blocking of histamine receptors. For example, new evidence suggests that the suppression of cell adhesion molecule expression occurs with these drugs. The anti-inflammatory and anti-asthmatic effects of antihistamines have been evaluated in patients with both allergic asthma and rhinitis, given the established association between allergic inflammation of the upper and lower airways, with evidence to suggest that antihistamines have clinically relevant anti-asthmatic properties. As well as conferring benefits in asthma symptom control and the measurement of lung function, studies assessing the effect of histamine receptor antagonists on bronchial hyperresponsiveness suggest that there is bronchoprotection during both methacholine and mannitol challenges. Recently, there has also been considerable interest in the effect of combining an antihistamine with a leukotriene receptor antagonist. This combination has an anti-asthmatic effect that is greater than that of either drug given alone and may be comparable to inhaled corticosteroid therapy.

Acetates↗

PubMed2002

Therapeutic ratio of hydrofluoroalkane and chlorofluorocarbon formulations of fluticasone propionate.

OBJECTIVES: To compare the therapeutic ratio of chlorofluorocarbon (CFC) and hydrofluoroalkane-134a (HFA) formulations of fluticasone propionate (FP). METHODS: We performed a randomized, placebo-controlled, crossover study comparing 6 weeks of treatment with FP using 500 micro g/d and 1,000 microg/d formulations of CFC and HFA. The primary end points were provocative dose of methacholine causing a 20% fall in FEV1 (PD20) and overnight urinary cortisol/creatinine excretion. RESULTS: Eighteen patients with mild-to-moderate asthma and geometric mean (SEM) PD20 of 82.3 micro g (19.2 micro g) completed the study. All treatments significantly improved PD20 values and morning peak expiratory flow vs placebo, while 1,000 microg/d was significantly better than 500 microg/d for the CFC formulation of FP (CFC-FP) but not the HFA formulation of FP (HFA-FP). Only 1,000 microg/d of CFC-FP caused significant suppression of overnight urinary cortisol/creatinine compared to placebo. There were no differences between formulations at either dose. CONCLUSIONS: The increased airway benefit with CFC-FP > 500 microg/d was offset by greater systemic effects. Although HFA-FP had fewer systemic effects than CFC-FP at 1,000 microg/d, there was no benefit to increasing HFA-FP to > 500 microg/d.

Administration, Inhalation↗

PubMed2002

Short-term repeatability and correlates of laboratory measures of nasal function in patients with seasonal allergic rhinitis.

The purpose of this study was to determine the variability of laboratory nasal function tests in 26 patients (18 female) with seasonal allergic rhinitis (SAR) (mean age 38.1 years). Their usual medication for SAR was withheld for 2 separate one week washout periods, separated by at least 2 weeks, in order to produce clinically significant nasal airflow obstruction. Measurements were made on both occasions for nasal nitric oxide (NO), nasal peak inspiratory flow (nPIF), oral PIF (oPIF), nasal forced inspiratory flow rate in 1 second (nFIV1), oral FIV1 (oFIV1). The respective nasal-oral ratios for FIV1 and PIF were also determined. The intra-individual coefficient of variation was: NO = 14%, nFIV1 = 4%, nFIV1/oFIV1 ratio = 10%, nPIF = 8% and nPIF/oPIF ratio = 12%. Linear regression analysis showed significant (p < 0.05) correlations between nPIF and nFIV1 (R2 = 0.45) and between nPIF/oPIF and nFIV1/oFIV1 (R2 = 0.20). In conclusion, there was a good correlation between the two methods of nasal inspiratory flow, although FIV1 had a lesser degree of variability.

Adult↗