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Biomedical subjects

C M Wicks

Publications and source records attributed to C M Wicks.

5 recordsLinked to original sources
PubMed1984

The protective effect of methylprednisolone on carbachol-induced bronchospasm.

We studied the effect of acute treatment with methylprednisolone in 12 asthmatics not dependent on steroids. Carbachol challenge was performed according to a standardized method. Baseline measurements of forced expiratory volume in one second (FEV1), specific airway conductance (SGaw), the provocative dose of carbachol for a 20% decrease in FEV1 (PD20), and that for a 35% decrease in SGaw (PD35) were established. Thereafter, patients returned for retesting at 2, 4, and 6 wk. Prior to each visit, the patients received 1 of 3 treatments: placebo, low-dose (32 mg) methylprednisolone, or high-dose (128 mg) methylprednisolone given orally and distributed in a randomized double-blind fashion. Blood levels confirmed compliance in all subjects. All subjects remained stable throughout the study, with intrasubject FEV1 values agreeing within 5% at the start of each session. The pairwise differences for low-dose methylprednisolone versus placebo were significantly different for both PD20 (p = 0.0004) and PD35 (p = 0.0068). The pairwise differences for high-dose methylprednisolone versus placebo were also significantly different for PD20 (p = 0.04) and PD35 (p = 0.0034). Blocked comparisons of the 2 different methylprednisolone doses were not significantly different. We conclude that methylprednisolone has a protective effect on carbachol-induced bronchospasm, and that this effect is not dose-related at the two doses studied.

Adult↗
PubMed1984

Predicting risk of pneumothorax in needle biopsy of the lung.

We prospectively studied results of 103 consecutive transthoracic needle biopsies of lung lesions suspicious for malignancy to determine if lesion size, depth within the lung, hyperinflation, second needle passes, or 100 percent oxygen breathing influenced the incidence of pneumothorax. Thirty-eight patients (37 percent) developed pneumothorax. Ten (10 percent) required tube thoracostomy for re-expansion. Five of the ten requiring the chest tube had clinically severe obstructive lung disease. In all patients, greater depth (D) in centimeters of needle penetration significantly increased the probability (p) of pneumothorax (p much less than .001) and can be estimated by the equation: (formula see text) The estimated probability of pneumothorax is 13 percent at 1 cm, 49 percent at 4 cm, and 86 percent at 7 cm. An increase in total lung capacity above predicted added additional risk of pneumothorax (p less than .02). Oxygen breathing did not significantly reduce the incidence of pneumothorax, but may reduce size by increasing the rate of reabsorption. The other factors had little influence. We conclude that the more central location of the lesion and pre-existing lung hyperinflation determine the risk of pneumothorax.

Adult↗
PubMed1983

Survival of patient with pleural involvement by breast carcinoma.

To determine factors which affect survival in patients with pleural involvement by breast carcinoma, we reviewed records of all patients at two community teaching hospitals presenting with malignant pleural effusion over a 6-year period. Forty-five patients had had mastectomy for breast cancer, no history of other malignancy, and cytologic confirmation of subsequent pleural metastases. All had received conventional combination systemic chemo- or hormonal therapy. Ten patients (group 1) in whom effusion was the initial and only site of recurrent disease had a median survival of 48 months. The median survival was 12 months in 35 patients (group 2) who developed effusion in association with other metastatic disease. Half of the patients in group 1 had no axillary node involvement at mastectomy. Twenty-eight patients (80%) in group 2 had had more advanced disease at initial diagnosis. This, and behavior of the effusion as regional rather than systemic disease, suggested by the high incidence of effusion on the ipsilateral side of the mastectomy, probably accounts for the better outlook in patients with effusion alone.

Adult↗
PubMed1982

The forgotten PPD.

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Evaluation Studies as Topic↗