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Biomedical subjects

C Duffy

Publications and source records attributed to C Duffy.

5 recordsLinked to original sources

Asthma: a provincial study.

To identify factors contributing to increased mortality and morbidity we prospectively evaluated 200 consecutive adult (greater than 17 years) asthmatic presentations (105 patients) referred to Gisborne Hospital over a 28 month period between 1985 and 1987 using a modified protocol adapted from previous national studies. In the moderate asthmatic group (113 presentations, 56%), 6% failed to use beta agonists prior to admission and 43% were not on regular steroid inhaler therapy. No patient had a crisis plan although 45 (22.5%) had received oral steroid therapy before admission. Poor drug compliance was twice as common in the Maori. Fifty-eight percent of patients were on regular long term oral theophylline whereas 48 (43%) patients with moderate and severe asthma were not on corticosteroid inhalers. We conclude that patient education and more liberal use of steroid inhalers have the greatest potential for improving morbidity and mortality.

Administration, Inhalation

Determinants of low serum concentrations of salicylates in patients with Kawasaki disease.

The mechanisms leading to the previously reported difficulties in achieving therapeutic serum concentrations of salicylates in Kawasaki disease were studied in eight children, once during the acute (febrile) phase and again during the nonfebrile (subacute) phase of the disease. Salicylate bioavailability was impaired during the acute phase of the disease (47.7% +/- 6.6%), and increased significantly thereafter to 75.1% +/- 9.3%. During the febrile phase there was a significant correlation between salicylate bioavailability and steady-state serum concentrations. Salicylate renal clearance was significantly higher during the febrile phase (14.45 +/- 2.5 mL/kg.h), compared with the nonfebrile phase (7 +/- 1.6 mL/kg.h, P less than 0.05). The change in salicylate clearance could be explained by decreased protein binding in the acute phase (82.5% +/- 1.9%) with substantially more free salicylates caused by significantly lower serum albumin concentrations. Changes in urine metabolites during the acute and subacute phases were consistent with the changes in dose administered (100 mg/kg in the acute phase vs 10 mg/kg in the subacute phase). The pattern of metabolites excreted in the urine of children with Kawasaki disease receiving 100 mg/kg was similar to that in children with juvenile rheumatoid arthritis receiving the same dose.

Arthritis, Juvenile

Trichinella spiralis in an agricultural ecosystem. II. Evidence for natural transmission of Trichinella spiralis spiralis from domestic swine to wildlife.

Epidemiological investigations of an outbreak of trichinellosis were carried out in a domestic swine herd and it was established that the parasite also occurred in rats, and in skunks, opossums, and raccoons. Because considerable uncertainty exists regarding the role of sylvatic trichinellosis as a reservoir for the synanthropic cycle, studies were conducted to determine the genetic nature of the various isolates from this ecosystem. Pig infectivity trials, isoenzyme analyses, and repetitive DNA sequence analyses were performed. The results showed that all isolates from the farm environs were genetically similar and that they are related to Trichinella spiralis isolated from domestic pigs. The implication of these findings, in contrast to studies on isolates from wildlife elsewhere, is that this parasite is transmitted from domestic swine to sylvatic hosts and that any control or eradication efforts must take into account the potential for reinfection of hogs from wild animals.

Animals

Factor VIII procoagulant and antigen content of antihemophilic factor (AHF) concentrates.

Antihemophilic factor concentrates from six manufacturers were studied for factor VIII procoagulant and antigen content. Marked lot-to-lot differences were found in the factor VIII antigen:procoagulant ratio. The average antigen content was 2.33 times that of procoagulant activity in 21 lots studied, indicating a significant loss of activity during the fractionation process.

Antigens