PubMed Health⌕ Search

Biomedical subjects

C A Gillespie

Publications and source records attributed to C A Gillespie.

At least 19 recordsLinked to original sources
PubMed1993

Absence of posterior subcapsular cataracts in young patients treated with inhaled glucocorticoids.

The prevalence of posterior subcapsular cataracts in young patients receiving inhaled glucocorticoids for treatment of chronic asthma is unknown. In a cross-sectional study, slit-lamp examinations were done on 95 consecutive young patients who were taking inhaled beclomethasone or budesonide. No posterior subcapsular cataracts were found. The median age of the patients was 13.8 (range 5.8-24.8). The median dose of inhaled beclomethasone or budesonide was 750 micrograms/day (range 300-2000), or 12.9 micrograms/kg per day (range 7.5-34.2). The median duration of treatment was 5 years (range 1-15). 77% of the patients had not used oral glucocorticoids in the year preceding the examination. This study suggests that routine screening for posterior subcapsular cataracts in this patient population is not warranted.

Administration, Inhalation↗
PubMed1990

Myospherulosis of the mastoid antrum: a case report.

Myospherulosis is a recently discovered iatrogenic disease caused by the implantation during surgery of mineral oil- or petrolatum-based products into various tissues. The condition results from the action of lipid substances on extravasated erythrocytes. The case report presented is the first detailed description of this uncommon, unique inflammatory lesion occurring in the mastoid and is the second otitic case reported in the literature. The lesion mimicked recurrent cholesteatoma 6 years following an intact canal wall mastoidectomy. As in myospherulosis of the paranasal sinuses, the symptoms and findings of otitic myospherulosis are those of the preceding disease.

Bacitracin↗
PubMed1986

Gorlin's basal cell nevus syndrome.

A case report is used to illustrate the characteristics of Gorlin's syndrome and to emphasize the need for early recognition by the physician and for thorough lifetime follow-up by the patient to prevent severe sequelae.

Adult↗
PubMed1986

Posttraumatic internal carotid aneurysm presenting as a nasal sinus lesion.

We report a case of an asymptomatic posttraumatic aneurysm of the internal carotid artery presenting in the sphenoidal and ethmoidal sinuses. Our initial clinical and radiographic diagnosis indicated a mucocele. There were two reasons for this. First, Maurer's triad of traumatic internal carotid aneurysm was not seen, since neither epistaxis nor visual disorder was present, and fracture was not evident on tomography or computed tomographic scans. Second, no symptoms or abnormalities were found in the sequential neurosurgical evaluations for a period of about six years after the head trauma. The successful results we have obtained in this case are attributable to localization by intraoperative arteriography and to hemostasis by electrothrombotic coagulation within the aneurysm alone, preserving internal carotid artery flow. A high index of suspicion preoperatively, with arteriography as indicated, may facilitate management of these cases, which are likely to become more frequent as medical advances produce more survivors of major head trauma.

Accidents, Traffic↗
PubMed1986

Sustained-release terbutaline vs sustained-release theophylline in young patients with asthma.

Twenty patients with asthma (mean age, 10.9 +/- 2 years) entered a six-week, randomized, double-blind, crossover comparison of sustained-release (S-R) terbutaline sulfate (Bricanyl Durules) vs S-R theophylline (Theo-Dur). In each two-week study period each patient received S-R theophylline twice daily in doses previously adjusted to give serum theophylline concentrations in the range of 10 to 20 mg/L (56 to 111 mumol/L); or S-R terbutaline sulfate, 5 mg twice daily; or S-R terbutaline sulfate, 7.5 mg twice daily. All treatment regimens produced significant improvement in one or more pulmonary function test values compared with prestudy values. The incidence of acute asthma episodes were similar during each treatment regimen. No clinically significant difference occurred between the regimens for daily symptom scores, peak expiratory flow rates, or use of a terbutaline metered-dose inhaler. At the end of the theophylline treatment period, the mean (+/- SD) theophylline level 12 to 14 hours after the last dose was 10.1 +/- 3.3 mg/L (56 +/- 18 mumol/L); at the end of the terbutaline treatment periods, the mean trough terbutaline levels were 2.22 micrograms/L (9.9 +/- 4.4 nmol/L) (S-R terbutaline sulfate, 5 mg twice daily) and 3.07 micrograms/L (13.7 +/- 5.4 nmol/L) (S-R terbutaline sulfate, 7.5 mg twice daily). Adverse effects, including tremor, occurred with similar frequency during all three drug regimens. Sustained-release formulations of theophylline and terbutaline, in the dosages studied, provided comparable control of asthma symptoms.

Adolescent↗
PubMed1986

An investigation of the H1-receptor antagonist triprolidine: pharmacokinetics and antihistaminic effects.

A single oral dose of triprolidine hydrochloride, 0.04 mg/kg (mean dose 2.7 +/- SD 0.4 mg) was administered to seven healthy, fasting adult volunteers who had never been treated previously with H1-receptor antagonists. Blood sampling and intradermal tests with 0.01 ml of histamine phosphate (0.1 mg/ml) were performed at -0.25, 1, 2, 3, 4, 5, 6, 7, 8, and 12 hours after the dose. Wheal-and-flare circumferences were traced, and the areas were measured by planimetry. Pruritus was quantitated by use of a clinical score. Urine was collected in 6-hour pooled aliquots for a total of 24 hours. Serum and urine triprolidine concentrations were measured by high-performance liquid chromatography. Wheal-and-flare areas and pruritus decreased after the triprolidine dose. Suppression of mean flare size was statistically significant at 2, 3, 6 and 8 hours. Suppression of mean wheal size was not statistically significant at any time compared to predose values. The mean triprolidine serum half-life was 2.1 +/- 0.8 hours. The mean peak serum triprolidine concentration of 15.4 +/- 8.3 ng/ml occurred 2 hours after ingestion. No triprolidine was detected in the serum after 12 hours. The mean urinary excretion of unchanged triprolidine during 24 hours was 1.3 +/- 1.0% of the dose administered.

Adult↗
PubMed1986

Mechanisms of cholesteatoma formation following stapedectomy.

Poststapedectomy cholesteatoma is uncommon. We report a patient with bilateral cholesteatomas, each following an initially successful stapedectomy for conductive hearing loss due to stapedial fixation from otosclerosis. A revision right stapedectomy done in 1972 was complicated 4 years later by prosthesis extrusion and cholesteatoma. An extensive left cholesteatoma occurred 7 years after stapedectomy in 1977 and required a radical mastoidectomy. The etiology of poststapedectomy cholesteatoma in this patient was probably chronic eustachian tube dysfunction and negative middle ear pressures. The initial right cholesteatoma occurred following prosthesis extrusion, which is presumed to have been the portal of entry of squamous epithelium into the middle ear. The later-occurring left poststapedectomy cholesteatoma represented progression of an attic retraction pocket. Both of these complications were likely secondary to negative middle ear pressure. In addition to eustachian tube dysfunction, other proposed etiologies for poststapedectomy cholesteatoma formation include prosthesis extrusion independent of negative middle ear pressure, unrecognized presence of squamous epithelium in an oval window fat graft, an inverted tympanomeatal flap due to improper positioning, and a marginal perforation from a disrupted anulus. Poststapedectomy cholesteatoma is a rare phenomenon, but does occur. The preoperative exclusion of patients with eustachian tube dysfunction and proper surgical techniques should reduce this complication.

Adolescent↗
PubMed1985

The bronchodilator effect and pharmacokinetics of theobromine in young patients with asthma.

The bronchodilator effect of a 10 mg/kg dose of theobromine (3,7-dimethylxanthine) was compared with that of 5 mg/kg of theophylline (1,3-dimethylxanthine) in young patients with asthma. Bronchodilation, as assessed by forced vital capacity, forced expiratory volume in the first second, forced expiratory flows at 25%, 50%, and 75% of vital capacity, and percent of forced expiratory volume in the first second/forced vital capacity did not differ significantly between the two drugs. After each drug bronchodilation peaked at 2 hours and lasted for 6 hours, although it was not always statistically significant for theobromine. The mean peak serum concentrations of both drugs, the time at which peak serum concentrations occurred, and elimination half-life values were similar for theobromine and theophylline.

Adolescent↗
PubMed1985

Terbutaline by metered-dose inhaler: conventional inhaler versus tube spacer for children with asthma.

We compared terbutaline administered through an 80-mL, 10 X 3.2-cm tube spacer versus a conventional metered-dose inhaler in 34 asthmatic patients, aged 8 to 16 years. In this double-blind, single-dose study, three groups of children (spacer active, conventional active, and placebo) were assessed clinically and with spirometry before and at one-half hour intervals for two hours after therapy. One investigator taught inhaler use and monitored patients' errors in technique. Compared with placebo, terbutaline delivered by either the tube spacer or the conventional inhaler significantly improved pulmonary function from one-half to two hours after treatment. Both the spacer and conventional inhaler were equally effective in improving pulmonary function from the baseline state. Only 4/34 (11.7%) children used both inhalers without any error. Adverse effects were mild, transient, and infrequent and did not differ between the groups. Terbutaline aerosol, whether delivered by the tube spacer or conventional actuator, provides effective bronchodilation for children with asthma, in spite of frequent errors in technique of inhaler use.

Aerosols↗
PubMed1984

The bronchodilator effects and pharmacokinetics of caffeine in asthma.

We compared the bronchodilator effects and pharmacokinetics of orally administered caffeine (10 mg per kilogram of body weight) and theophylline (5 mg per kilogram) in a double-blind, single-dose study in asthmatic patients 8 to 18 years of age. After 48 hours of withdrawal of all methylxanthines, 13 patients received caffeine and 10 received theophylline. Significant improvements in forced vital capacity, forced expiratory volume in one second, and forced expiratory flow rates occurred from one to six hours after administration of either caffeine or theophylline. The bronchodilator effect of caffeine did not differ significantly from that of theophylline and was maximal two hours after ingestion of each drug. Peak serum levels of caffeine (13.5 +/- 2.9 mg per liter) occurred at one hour, and peak levels of theophylline (8.4 +/- 1.7 mg per liter) at 2.2 +/- 0.8 hours. The mean serum half-time for caffeine was 3.9 +/- 1.4 hours and that for theophylline was 5.8 +/- 1.7 hours. All patients receiving caffeine metabolized it to paraxanthine, theobromine, and theophylline. Mild, transient side effects were seen after both caffeine and theophylline. Vital signs did not change significantly after either drug. We conclude that caffeine, a commonly available chemical, is an effective bronchodilator in young patients with asthma.

Adolescent↗
PubMed1982

Ketotifen: a new drug for prophylaxis of asthma in children.

Ketotifen, an orally active, prophylactic anti-asthmatic drug, was compared with placebo in a double-blind, three-month parallel-group trial in 20 children. Children receiving ketotifen were more likely to reduce concomitant medications and had significant improvement over time in asthma scores and mean flows at 75%, 50%, and 25% of vital capacity. They also had a significantly increased incidence of dry mouth and significant weight gain compared to those receiving placebo. In some children with asthma, ketotifen may be a useful alternative to existing drugs.

Acute Disease↗
PubMed1980

Inner ear lidocaine concentrations following iontophoresis.

This study has established the feasibility of measuring perilymph lidocaine levels after iontophoresis for local tympanic anesthesia in the rabbit model. A subsequent study may now be performed to produce a valid, dose-response curve correlating perilymph lidocaine levels and cochlear responses. In this manner the effects of and safety of lidocaine iontophoresis for tympanic anesthesia can be determined with certainty. After intravenous sedation, eight rabbits underwent iontophoresis followed by diagnostic vestibulotomies. Perilymph samples were taken and analyzed for lidocaine levels. Significant amounts of perilymph lidocaine were found in both the intact and perforated tympanic membrane groups. In the perforated tympanic membrane group, the perilymph lidocaine level was eight times that of the intact tympanic membrane group. Future studies to determine the dose-response relationship of perilymph lidocaine to cochlear responses are now possible. Thus, the safety of lidocaine iontophoresis and the degree of inner ear toxicity of lidocaine can be established quantitatively.

Animals↗
PubMed1974

Motor unit recruitment as reflected by muscle fibre glycogen loss in a prosimian (bushbaby) after running and jumping.

A qualitative histochemical assessment of glycogen loss in biopsies was made in bush-babies after running and jumping. Glycogen loss was related to the specific type of exercise. After running, glycogen loss was greatest in the slow-twitch oxidative fibre and depletion in the fast-twitch oxidative glycolytic fibres was similarly greater than in the fast-twitch glycolytic fibres. After jumping, the opposite pattern of glycogen utilization occurred (FG>FOG>SO).

Adenosine Triphosphatases↗