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Biomedical subjects

H S Hosker

Publications and source records attributed to H S Hosker.

17 recordsLinked to original sources
PubMed2000

Primary pulmonary botryomycosis: a late complication of foreign body aspiration.

Primary pulmonary botryomycosis is a rare cause of haemoptysis and can enter the differential diagnosis of a mass on the plain chest radiograph. The case history is presented of a 63 year old man with botryomycosis which was initially thought to be a bronchial carcinoma. When the diagnosis was made several years later it was found to be secondary to persisting vegetable material in the bronchial tree following previous aspiration.

Bronchi↗
PubMed2000

Churg-Strauss syndrome associated with montelukast therapy.

Churg-Strauss syndrome is a rare form of eosinophilic vasculitis associated with asthma. There have been several recent case reports of the condition in association with leukotriene antagonists and it has been speculated that the Churg-Strauss syndrome was unmasked when oral corticosteroids were withdrawn. We report a case of Churg-Strauss syndrome associated with montelukast therapy in an asthmatic patient in whom there had been no recent oral corticosteroid use. We believe that this is the first such reported case and would suggest that clinicians need to be vigilant in all patients who develop systemic symptoms when starting treatment with leukotriene antagonists.

Acetates↗
PubMed1998

Modified ice study: a phase II study of an intensive, modified ICE regimen (ifosfamide, carboplatin and etoposide) in patients with better prognosis, small cell lung cancer.

A total of 30 with good prognosis small cell lung cancer were treated with a modified 'ICE' (ifosfamide, carboplatin and etoposide) chemotherapy regimen in an attempt to achieve a high response rate with less toxicity than is seen with the full 'ICE' regimen. This was given every 4 weeks for a maximum of six cycles. In total 25 patients (83%, 95% CI (70-97%)) experienced a partial or complete response at some stage of their treatment. Of these patients, 12 (40%, 95% CI (22-58%)) showed a complete response. A total of 19 patients (63%) had to have their dose reduced and/or delayed at some point due to toxicity. Nadir blood counts showed that 19 patients (63%, 95% CI (46-81%)) had WHO grade 3 or 4 thrombocytopenia, and 24 (86%, 95% CI (73-99%)) had grade 3 or 4 neutropenia. A total of 17 patients (53%) completed six cycles of chemotherapy. In total 3 patients died during treatment all due to treatment-related complications. Median survival was 12.6 months (95% CI (11.6, 14.7 months)). Nausea, vomiting, dysphagia, activity, mood and overall condition, as recorded using daily diary cards, were worse at the beginning of each chemotherapy cycle. Both response rates and survival were clinically acceptable. However, neutropenia and thrombocytopenia, although reduced from rates reported with the full ICE regimen, were still high. A prospective randomised controlled trial is now needed to assess this regimen in more detail.

Adult↗
PubMed1995

The prevalence and clinical significance of pulmonary infection due to non-tuberculous mycobacteria in Hong Kong.

An unexpected increase in positive sputum cultures of non-tuberculous mycobacteria (NTM) was noted in Hong Kong in 1990 compared to previous years, in contrast to a steady decline in the number of positive cultures of Mycobacterium tuberculosis. A retrospective case note study was therefore undertaken to ascertain the clinical importance of the rise in NTM isolates. A representative sample of 183 of the 675 patients with NTM isolates from sputum during 1990 was identified. Cases were assigned to groups according to whether there was evidence of progressive pulmonary disease due to NTM (group 1), persisting colonization without evidence of progressive disease (group 2) or transient isolation of NTM without evidence of progressive disease (group 3). Of 168 cases with adequate clinical and radiological records, 28 (16.7%) represented progressive disease due to NTM and 6 (3.6%) represented persisting colonization. The remainder were both transient and clinically insignificant. Most patients (71%) with progressive pulmonary disease due to NTM had pre-existing lung damage, and 50% had received anti-tuberculous therapy for documented M. tuberculosis previously. The commonest organism involved was the M avium complex. Eighty-six percent of patients with progressive disease and 83% of those with persisting colonization had at least one smear positive sputum specimen, whereas only 2% of patients with sputum contamination had a smear positive sputum sample (P < 0.0001). M. malmoense, M. xenopi and M. fortuitum all appear to be rare causes of significant NTM disease in Hong Kong. However, M. chelonei caused four cases of progressive disease within the study population, two of which were fatal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Assessment and provision of home nebulizers for chronic obstructive pulmonary disease (COPD) in the Yorkshire region of the U.K.

A survey was undertaken to determine the current practice in the Yorkshire Health Region for the assessment and provision of home nebulizers for adults with chronic obstructive pulmonary disease (COPD). A detailed postal questionnaire on assessment methods was sent to each of the 22 consultant physicians in respiratory medicine. The 17 consultants who also organized the adult home nebulizer service for their health district were asked about the services offered and funding for the service. Replies were received from all consultants. All physicians use objective measurement for assessing patients for home nebulizer therapy, but there is a variable emphasis on laboratory studies, walking distance and home trials with peak flow measurements. The majority (86%) incorporate a home trial into their assessment. Many physicians also take into account subjective response to nebulized bronchodilators. There is considerable variation in the provision and funding of home nebulizer services. Those districts with a coordinated service appear to offer a more comprehensive service. A consensus on nebulizer provision, with recommendations for minimum levels of provision in each health district, should result in a more uniform delivery of service.

Adult↗
PubMed1993

Mycoplasma pneumoniae infection in Hong Kong--clinical and epidemiological features during an epidemic.

An epidemic of infection due to Mycoplasma pneumoniae occurred in Hong Kong in 1986-1988. One hundred and seventy-nine cases were identified at the Prince of Wales Hospital over this period. Clinically significant infection predominantly affected children under 12 years, with 32% of all infections occurring in children aged between 6 and 11 years, and 39% in children between 1 and 5 years. Ninety-seven percent of childhood infections were respiratory in nature, the other 4 presentations were neuropsychiatric. Adequate information was available on 36 of the 43 subjects over 12 years. One teenager presented with acute psychosis; all other cases (35) were respiratory. In these cases cough was universal, and fever was present in 34 (97%). A variety of non-specific symptoms (rigors/chills, malaise, headache, sore throat, sweating) were frequently noted. Sputum production was documented in 75% of cases, and was frequently purulent. Radiological consolidation was very common (95% of cases), but resolved fully after 4 weeks. Complications were rare and included acute pericarditis in 1 patient and haemolysis in another, and both patients recovered subsequently. Clinical recovery was otherwise rapid and complete in all other patients. Persisting dry cough was the only symptom documented at follow-up. Although infection due to M. pneumoniae in an ethnic Chinese population appears similar to that described in other populations, a higher incidence in younger children was recorded in this study.

Adolescent↗
PubMed1991

Alveolar macrophage and blood monocyte function in lung cancer.

A lucigenin-enhanced chemiluminescence (CL) assay was used to assess alveolar macrophage (AM) and blood monocyte (BM) function in patients with lung cancer (LC). Ten patients with LC (7-SCLC, 3-NSCLC) and ten matched controls underwent bronchoalveolar lavage, and AMs were subjected to CL with and without stimulation with latex beads. Peak CL was recorded as counts per minute (CPM)/10(3) cells/min. BM activity was similarly assessed in 17 LC patients (13-SCLC) and 17 matched controls. Peak activity of both unstimulated and latex stimulated AMs in the LC group was higher than controls. Similarly, BM activity was enhanced in LC patients compared with controls. There was no correlation between AM CL responses and disease extent, but BM function at diagnosis correlated with subsequent response to cytotoxic chemotherapy. Results indicate both local and systemic activation of the monocyte/macrophage system in LC even in patients with limited disease.

Bronchoalveolar Lavage Fluid↗
PubMed1989

Assessment of phagocytic function using chemiluminescence.

Chemiluminescence is a simple and reliable method of assessing phagocytic function. The bactericidal properties of phagocytes are dependent on the production of powerful oxidising species by the respiratory burst. These reactive oxygen radicals react with biological substrates to form excited compounds which then relax to their ground state by photon emission. This energy release is in the form of light which can be amplified by chemiluminescent probes and measured in a luminometer. Activation of cells is achieved using various agents that stimulate the respiratory burst. There is a close correlation between chemiluminescence and other methods of assessing phagocytic function, including bactericidal ability. The technique can be used to assess the function of polymorphonuclear leukocytes, monocytes, and tissue macrophages in response to disease, drugs, and toxins. This article describes the theory of cellular chemiluminescence, and the use of chemiluminescent probes and various cellular stimuli. Practical aspects of cell isolation and factors affecting chemiluminescence are considered. Finally, the clinical applications of chemiluminescence are discussed.

Humans↗
PubMed1989

Recent advances in the treatment of small cell lung cancer.

Small cell lung cancer is a rapidly dividing tumour that is susceptible to combination chemotherapy and radiotherapy. Improvements in treatment regimens have resulted in better response rates, but long-term survival has not improved over the past decade.

Carcinoma, Small Cell↗
PubMed1988

Incidence and types of acute viral hepatitis in Newcastle upon Tyne.

The incidence and types of viral hepatitis in the city of Newcastle upon Tyne have been studied by serological analysis of (a) all blood samples sent to the virological laboratory for hepatitis testing and (b) all blood samples sent by general practitioners to the biochemical laboratory for liver function testing. The annual detection rate of acute viral hepatitis was found to be 31.5 cases/100,000 population, of which 9.1 were hepatitis B. Only three sporadic cases of non-A non-B hepatitis were identified. The incidence of hepatitis is at least four-fold greater than suggested by notification rates and may be substantially higher as general practitioners rarely requested laboratory confirmation of household contacts of index cases.

Adolescent↗