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Biomedical subjects

D T McLeod

Publications and source records attributed to D T McLeod.

27 records · Page 2Linked to original sources
PubMed1985

Intramuscular triamcinolone acetonide in chronic severe asthma.

Seventeen subjects with chronic severe asthma completed a 48 week prospective, double blind study with crossover of treatment at 24 weeks, in which triamcinolone acetonide 80 mg intramuscularly every four weeks was compared with oral prednisolone 10 mg daily. Spirometry, twice daily measurements of peak expiratory flow rate, and self assessment of asthma symptom scores showed significant improvement during triamcinolone treatment; less extra prednisolone was required and there was significant weight loss. Two patients withdrew, one because of dissatisfaction with prednisolone and one because of side effects while taking triamcinolone. Three were withdrawn, one with proximal muscle weakness and two because of intercurrent illness. Adrenal suppression, bruising, and hirsuitism were worse with triamcinolone, other side effects being comparable. On completion of the study 16 of the 17 patients opted to continue taking triamcinolone acetonide. This treatment is an important addition to the therapeutic options available for chronic severe asthma.

Administration, Oral↗
PubMed1985

Further experience of Corynebacterium parvum in malignant pleural effusion.

The outcome of drug induced pleurodesis has been evaluated in a non-randomised retrospective study of 67 patients with recurrent malignant pleural effusions treated during 1976-83. Fourteen died within 30 days of treatment. Of the remaining 53 patients, 26 studied during 1976-80 were treated with intrapleural mustine hydrochloride, while 27 studied during 1978-83 were treated with intrapleural Corynebacterium parvum. There was no significant difference between the groups in age, sex, or tumour type, most tumours being secondary to bronchial neoplasms. Corynebacterium parvum successfully prevented reaccumulation of the effusion in 24 (92%) patients, while mustine was effective in only 17 (65%) (p less than 0.05). Data on survival were obtained on 47 cases where a single agent was used to induce pleurodesis. In 25 patients treated with C parvum the mean survival was 251 (range 31-1143) days, compared with 119 (range 31-380) days for the 22 patients in whom mustine was used. Survival of the C parvum group was significantly greater (p less than 0.01). The difference was principally due to the greater number of long term survivors in the C parvum group, nine of this group living for more than 180 days (mean 574, range 180-1143 days) compared with only four such survivors in the mustine group (mean 263, range 193-380 days). This study confirms our initial impression that C parvum is highly effective in controlling recurrent malignant pleural effusions. The finding of unexpected long term survivors with C parvum treatment suggests that this treatment may have an additional effect on the progression of disease, a finding that merits further investigation.

Adult↗
PubMed1985

Infection and Branhamella catarrhalis.

Of the Gram-negative cocci found in the nasopharynx to which any pathogenic status can be attributed, Neisseria meningitidis and Neisseria (Branhamella) catarrhalis have gained significant notoriety. Traditionally, B. catarrhalis is regarded as a nasopharyngeal commensal and thus there is, in general, considerable reluctance to accept that B. catarrhalis may be a pathogen when it is seen. Hence, it is under-reported or totally ignored though there is more awareness regarding its pathogenic potential, particularly as an increasingly high incidence of beta lactamase producing strains is being reported from many countries. The importance of this development concerns the choice of routine antibiotic therapy as ampicillin, to which this organism was previously sensitive, may no longer be effective.

Conjunctivitis↗
PubMed1984

Antimicrobial susceptibility of Branhamella catarrhalis isolates from bronchopulmonary infections.

Fifty-four clinical isolates of Branhamella catarrhalis from patients with bronchopulmonary infections were studied. The MICs for 50 and 90% of the isolates and the geometric mean MICs were determined for 11 antimicrobial agents. All the strains were resistant to trimethoprim but were susceptible to clavulanate-potentiated amoxicillin (Augmentin; Beecham Research Laboratories, London), chloramphenicol, co-trimoxazole, erythromycin, cefotaxime, and cefuroxime. Beta-lactamase-negative strains were uniformly susceptible to penicillin and ampicillin.

Anti-Bacterial Agents↗
PubMed1983

Bronchopulmonary infection due to Branhamella catarrhalis.

Over six months Branhamella catarrhalis was isolated in pure culture from the sputum of 81 patients with symptoms of acute respiratory tract infection. Of 38 patients who were infected in the community, over half required admission to hospital. The remaining 43 patients acquired the infection in hospital. Forty one of the 81 isolates produced beta-lactamase, 24 of these being hospital acquired infections. As a result 40% of patients who were treated with ampicillin did not respond. Most patients had chronic lung diseases or lung cancer or were taking corticosteroids. Three patients died and one required assisted ventilation; strains producing beta-lactamase were isolated in each case. Acute bronchitis developed in one previously healthy young non-smoker. It is concluded that B catarrhalis is an important pathogen of the lower respiratory tract which should be reported, and strains producing beta-lactamase should be identified. Otherwise, treatment with inappropriate antibiotics may result in increased morbidity or mortality.

Adult↗
PubMedDate not supplied

Pulmonary diseases in patients infected with the human immunodeficiency virus in Zimbabwe, Central Africa.

During the 11 month period up to 30 September 1987, 37 patients (26 male, 11 female, mean age 27 years) with respiratory symptoms who were human immunodeficiency virus (HIV) positive, were studied prospectively on 40 occasions to determine the cause of any pulmonary complications. HIV was heterosexually transmitted. Predominant symptoms were cough (89%), fever (89%), weight loss (83%), and dyspnoea (60%). Transnasal fibre-optic bronchoscopy (with bronchoalveolar lavage, bronchial brushings and transbronchial lung biopsies) was performed on 35 patients, twice on 3 patients. 'Tru-cut' lung biopsies were obtained from 2 patients who died before bronchoscopy. Pulmonary tuberculosis was the commonest disease, being found in one-third of the patients (12 of 37). Mycobacterium tuberculosis was cultured from 4; the remainder of the plates were contaminated. Pneumocystis carinii was present in 8 patients: as the sole pathogen in 3, with Streptococcus pneumoniae in 4, Staphylococcus aureus in 2, and one also had tuberculous lymphadenitis. Endobronchial Kaposi's sarcoma was seen in 6 of 7 patients with skin nodules. Bacterial pathogens isolated included Staph. aureus (5), S. pneumoniae (5), Klebsiella pneumoniae (2), Haemophilus influenzae (2), H. parainfluenzae (1) and Pseudomonas aeruginosa (1). Invading Aspergillus fumigatus was diagnosed by lung biopsy in one. No diagnosis was reached for 8 patients. It is concluded that in Central Africa pulmonary complications in AIDS patients are similar to those in Europe and North America but the incidence of different pathogens depends on the prevalence of pathogens in the community. M. tuberculosis is probably the commonest pathogen. This study has confirmed that P. carinii pneumonia does occur, but occurs less frequently.

Adult↗