Biomedical subjects

D S Brudno

Publications and source records attributed to D S Brudno.

9 recordsLinked to original sources

PubMed1992

Unrecognized exercise-induced bronchospasm in adolescent athletes.

OBJECTIVE--As part of their preparticipation physical examinations, 1241 middle and high school student athletes completed a questionnaire and were interviewed to elicit risk factors for unrecognized exercise-induced bronchospasm (EIB). Spirometry was then performed when the students were at rest. RESEARCH DESIGN--All participants completed a questionnaire, were interviewed, and underwent baseline testing to determine forced expiratory volume in 1 second (FEV1). SETTING--All testing was performed in a school setting. SELECTION PROCEDURES--Athletes known to have EIB who were receiving appropriate treatment (46 athletes [4%]) and athletes with no risk factors based on medical history and normal results of spirometry (847 athletes [68%]) were eliminated from further evaluation. Students with medical histories indicating risk of unrecognized EIB and students with abnormal results of spirometry were eligible for exercise challenge by standard treadmill protocol. MEASUREMENTS AND RESULTS--Of the 348 eligible students, 230 (66%) completed the exercise challenge. Sixty-six of the 230 students had greater than 15% reduction in FEV1, and 50 of the 66 students had greater than 20% reduction, representing a 29% occurrence of previously undiagnosed EIB in a population of students identified with screening to be at risk of unrecognized EIB. Of the 179 students identified to be at risk based on medical history only, 28% had EIB. Of 33 students with positive results of spirometry but no medical history that put them at risk, 15% had EIB. Of the 18 students with medical histories that put them at risk and positive results of spirometry, 61% had EIB. Including the subpopulation with reduction in FEV1 of greater than 15%, students shown to be at risk after screening, and students previously identified as having EIB, 145 students were identified as having EIB (12%). CONCLUSIONS--These data are in accord with results of previously reported studies of college and Olympic athletes. The data may have implications for more extensive screening in the adolescent population.

Adolescent↗

PubMed1990

Compliance, alveolar-arterial oxygen difference, and oxygenation index changes in patients managed with extracorporeal membrane oxygenation.

Eighteen patients with meconium aspiration syndrome who failed conventional management were treated with extracorporeal membrane oxygenation (ECMO) for reversible respiratory failure. Dynamic lung compliance measurements were made prior to, during, and after ECMO support. P(A-a)O2 and oxygenation index (OI) measurements were calculated prior to and after ECMO support. Lung compliance decreased significantly comparing before-ECMO to during-ECMO, and increased significantly comparing during- to after-ECMO, but not comparing before- to after-ECMO measurements. P(A-a)O2 and OI decreased significantly from before to after ECMO. The improvement in oxygenation allowing removal from ECMO does not appear to be related to improved pulmonary mechanics, but may rather be secondary to increased effective pulmonary capillary blood flow.

Extracorporeal Membrane Oxygenation↗

PubMed1990

Impaired interferon-alpha enhancement of neonatal monocyte phagocytosis.

Monocyte phagocytic activity was tested in 10 healthy term newborns using a latex phagocytic assay. The baseline phagocytic activity in the cord blood monocytes (37.7 +/- 3.8%) was comparable to adult controls (38.5 +/- 9.4%). When enhanced with 1,000 U/ml of alpha-interferon, the phagocytic activity was lower in cord blood monocytes (40.5 +/- 3.4%) than in the adult controls (47.9 +/- 10.6%), but this difference reached statistical significance only when the cord blood monocytes were enhanced with 2,000 U/ml reaching 43.6 +/- 4.3% in cord blood monocytes, as compared to 54.6 +/- 9.6% in adult controls. These findings may explain an inherent functional deficiency in the neonatal mononuclear phagocytic system which may not be evident during the quiescent phase of monocyte/macrophage activity, but may become apparent during an infectious challenge.

Female↗

PubMed1989

Bilateral absence of the ulna in twins as a manifestation of the split hand--split foot deformity.

Bilateral absence of the ulna and ulnar rays in twin female infants are described as a manifestation of the split hand--split foot deformity (ectrodactyly). Family history revealed the father had a unilateral split hand. Given the wide variability of expression of this disorder and the availability of prenatal diagnosis, there is a need for obstetricians and pediatricians to recognize parents with this malformation and appreciate the potential for severely affected offspring.

Diseases in Twins↗

PubMed1989

Response of pulmonary mechanics to terbutaline in patients with bronchopulmonary dysplasia.

Terbutaline was administered to eight ventilator-dependent infants with evolving bronchopulmonary dysplasia to determine the potential for reductions in airway resistance. The drug was administered by nebulization through the endotracheal tube. Pre-treatment and post-treatment pulmonary mechanics measurements were performed. Patients had reductions in inspiratory (-14%, p = NS), expiratory (-47%, p less than .05) and total (-24%, p = NS) resistances. Tidal volume increased 36% (p less than .01). This study demonstrates that nebulized terbutaline can improve pulmonary mechanics in ventilator-dependent infants with evolving bronchopulmonary dysplasia.

Airway Resistance↗

PubMed1989

Noninvasive determination of effective (nonshunted) pulmonary blood flow in normal and injured lungs.

PEEP is utilized in acute respiratory failure to decrease intrapulmonary shunting and improve oxygenation. Despite these beneficial effects, PEEP may adversely affect cardiac output, thus reducing oxygen delivery. To monitor some of the cardiopulmonary effects of PEEP, we utilized a noninvasive rebreathing technique to measure effective (nonshunted) pulmonary blood flow (Qepr) and compared the results to those measured by thermodilution (Qepi) in normal and oleic acid-injured canine lungs. Qepr was highly correlated with Qepi (r = .92, r2 = .85, p less than .001) despite large variations in PEEP before lung injury (0 to 15 cm H2O) and after lung injury (0 to 20 cm H2O). This close correlation was found even with wide ranges in cardiac output (1.01 to 6.45 L/min) and intrapulmonary shunt fractions (0.03 to 0.67). This technique may prove valuable as a noninvasive method by which to monitor and adjust PEEP therapy in patients with acute lung injury.

Animals↗

PubMed1985

Controlled trial of dexamethasone in respirator-dependent infants with bronchopulmonary dysplasia.

A randomized trial was conducted of dexamethasone therapy in infants with bronchopulmonary dysplasia who were dependent on respirators and were not progressing clinically despite conventional treatment. Babies were admitted to the study if they had a roentgenogram and clinical diagnosis of bronchopulmonary dysplasia, were 2 to 6 weeks in age, weighed less than 1,500 g, had made no progress in weaning for the preceding five days, and were free of sepsis, patent ductus arteriosus, and congenital heart disease, and had had no intravenous fat for at least 24 hours. After parental consent was obtained, infants were randomly assigned to control or treatment groups. The study hypothesis was that with steroid treatment, babies could be weaned from the respirator within 72 hours and would show a significant improvement in lung compliance within that time. Sequential analysis exceeded criterion (P less than .05) when seven consecutive untied pairs showed weaning with dexamethasone and failure to wean in control infants. Pulmonary compliance improved by 64% in the treated group and 5% in the control group (P less than .01). No significant intergroup differences were noted in mortality, length of hospital stay, sepsis, hypertension, hyperglycemia, or electrolyte abnormalities. Study design permits the conclusion that dexamethasone can produce substantial short-term improvement in lung function, often permitting rapid weaning from the respirator, but long-term efficacy and safety must be demonstrated by further investigations.

Bronchopulmonary Dysplasia↗

PubMedDate not supplied

The teething virus.

A prospective study was carried out on 500 teething infants which demonstrated that a new infectious agent, the human teething virus, is responsible for the febrile response that accompanies the eruption of deciduous teeth. Speculations are made concerning whether or not primary care physicians will began prescribing amoxicillin instead of Jack Daniel's to treat teething infants and their parents.

Child, Preschool↗

PubMedDate not supplied

Evaluation of the SonoClot Analyzer for the measurement of platelet function in whole blood.

A viscoelastometer, the SonoClot Coagulation Analyzer, has been proposed for use in the evaluation of platelet function. The purpose of this study was to evaluate systematically this instrument when used with whole blood. Under laboratory conditions, the coefficient of variation (cv) of determinations of whole blood activated clotting time (ACT) on the instrument was approximately 7.0 percent. In contrast, the cv of measurements on whole blood related to the graphic events associated with clot formation ranged from 9.2 to 41.7 percent. Because of the large and variable cvs associated with these measurements of clotting, the SonoClot Analyzer cannot presently be recommended for use in studies designed to examine quantitatively the clotting function in whole blood.

Blood Platelets↗