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Biomedical subjects

J A Friend

Publications and source records attributed to J A Friend.

At least 37 records · Page 2Linked to original sources
PubMed1993

Smoking habits of Grampian school children and an evaluation of the Grampian Smoke Busters campaign.

To determine the effect of a Smoke Busters club in reducing the numbers of children recruited to smoking, levels of smoking in Grampian amongst 11-14 year olds were determined at the launch of the club and again 22 months later, using a self-completion questionnaire. Initial smoking levels were similar to Scottish Office of Population Censuses and Surveys (OPCS) 1986 figures taken 2 years prior to the first Grampian survey. OPCS findings indicated that in Scotland smoking levels had remained fairly stable among girls and had increased among boys between 1986 and 1990. At the second survey in Grampian, smoking levels among girls and boys were lower than in Scotland generally, but it is not possible to know whether this was a result of the campaign or not. There was evidence of a relationship between the smoking habits of children and parents, particularly their mothers. Life-style questions showed that smokers were more likely to take part in activities characteristic of older teenagers and to prefer music which was associated with alternative, rebellious attitudes. Smoke Busters clubs aim to promote a non-smoking life-style amongst young teenagers. After 22 months of a Smoke Busters club, it was evident that at least 32.9% of the target group had joined the club at some point and that it was very popular with its members. Those who joined Smoke Busters were more than twice as likely to remain non-smokers as those who were non-members, but this might not be a function of cause and effect. A further survey is to be undertaken at 4 years after the launch of the club and may allow assessment of any longer-term effects of the club in Grampian.

Adolescent↗
PubMed1993

Prevalence of cystic fibrosis mutations in the Grampian region of Scotland.

We have identified all known sufferers of cystic fibrosis (CF) alive in the Grampian region, north east Scotland, on 1 January 1989. DNA samples were obtained for a prevalence study of the common mutations with near to complete ascertainment. A relatively high prevalence of the delta F508 mutation was found (82%), with one of four mutations being present on 92% of CF chromosomes. The high prevalence of these four easily detectable mutations in Grampian has local implications for genetic counselling, the efficacy of population carrier screening, and the usefulness of mutation analysis in cases where the diagnosis of CF is in doubt.

Adult↗
PubMed1993

Spontaneous sternal fractures in four patients with chronic airflow obstruction taking corticosteroids.

Four patients with chronic airflow obstruction developed spontaneous sternal fractures. All had received repeated courses of high dose corticosteroids and three were receiving long term treatment with low dose corticosteroids. It is important to consider sternal fracture in the differential diagnosis when patients with chronic airflow obstruction present with chest pain.

Adrenal Cortex Hormones↗
PubMed1993

Predicting patient attitudes to asthma medication.

BACKGROUND: Studies of patient attitudes to asthma and its control have focused on crisis action, and little attention has been paid to attitudes to regular preventive medication. It is not clear whether attitudes to regular medication are related to the degree of distress or interference with life perceived by patients as being caused by their asthma. For this reason this study examined how far dislike of medication related to dislike of other aspects of interference of asthma with daily life. METHODS: Three hundred and ninety one patients were surveyed with a questionnaire which assessed their dislike of the interference of asthma with their physical, social, and emotional functioning, together with dislike of regular asthma medication. A response was received from 320 patients (82%). RESULTS: Four attitude clusters were identified. Recorded in descending factor order, these were (1) dislike of asthma medication, (2) dislike of disability, (3) dislike of public life interference, and (4) dislike of social and emotional interference. The attitude clusters were not related: in particular, dislike of asthma medication could not be predicted from other dislikes, or from asthma best function ratio (ratio of best recorded peak expiratory flow rate in the previous year to predicted value), age, or sex. The most significant predictors of the patients' dislike of taking their own inhaled steroid were (1) dislike of using bronchodilator, (2) dislike of steroids generally, and (3) dislike of taking medicine every day. CONCLUSIONS: Patient attitudes to regular asthma medication are not related to general anxieties and dislikes about asthma, nor to the potential for asthma control as judged by the best function ratio. Patients were not always consistent in their attitude to inhaled steroids in general, nor to their own named inhaled steroid in particular. A general cluster of antimedication attitudes existed, independent of whether the medication was for prophylaxis or relief. Attitudes to asthma medication may be helpful in predicting patient behaviour.

Administration, Inhalation↗
PubMed1993

Identifying asthmatic patients in the community: a new method.

Identifying a random sample of patients in the community has long proved problematic. In 1989 changes were made in the management of adult asthmatic patients referred to specialist clinics in the Grampian Health Board area. In order to estimate the effect of these changes on the management of patients not referred, it was necessary to identify two random samples of adult asthmatic patients treated solely in general practice. As it was felt that existing methods were open to bias and other errors, a method using National Health Service drug prescription forms was devised. Following the computerization of the Pharmacy Practice Division in Aberdeen, a similar method for the identification of a follow-up sample had to be devised. Nearly 400 general practitioners (86% of those eligible) took part in the first sampling in 1989; 96% of those contacted participated in the second sampling in 1991. Both methods were effective in identifying asthmatic patients in the community. Computerization has made the task simpler, less time consuming and, as a consequence, most cost effective.

Adolescent↗
PubMed1991

Paraquat induced pulmonary fibrosis in three survivors.

Pulmonary lesions following paraquat poisoning are believed to be almost invariably fatal. The three patients reports here survived despite persistent radiological change. One of the patients died after taking a larger dose of paraquat one year later, and at necropsy histological changes attributable to the two episodes of paraquat poisoning were apparent.

Adult↗
PubMed1991

Air-driven nebulised high-dose salbutamol in severe chronic obstructive airways disease: is it safe?

The increasing use of air-driven nebulised bronchodilators by patients with airflow obstruction has raised concern about the safety of this practice. We have investigated the effects of 10 mg salbutamol, nebulised in air, on blood gas tensions, heart rate and plasma potassium (K+), when administered alone to 9 patients with severe chronic obstructive airway disease and then in combination with a therapeutic dose of oral sustained-release theophylline to 5 of them on 2 separate occasions. No significant reductions in PaO2 were observed with either treatments. Heart rate increased significantly from 77.8 +/- 3.7 beats/min (mean +/- s.e.m.) at baseline to a peak of 87.1 +/- 4.4 beats/min at 45 min (p less than 0.001) with salbutamol alone and there was a similar trend of increase after combined therapy. K+ decreased significantly from a baseline of 4.0 +/- 0.3 to a minimum of 3.6 +/- 0.2 mmol/l at 90 min (p less than 0.001) with combined therapy but did not change significantly with single therapy. No subject developed any significant cardiac arrhythmias on either occasion. Although the number of subjects studied is small, our data suggest that air-driven nebulised high-dose salbutamol may be safe in the treatment of severe chronic obstructive airway disease but when combined with oral theophylline, a significant fall in plasma potassium may occur. This could be of clinical significance in hypokalaemic patients. When combination treatment is used, monitoring of plasma potassium is recommended.

Aged↗
PubMed1988

Use of nebulised saline and nebulised terbutaline as an adjunct to chest physiotherapy.

To determine whether sputum clearance is increased by using nebulised saline or terbutaline as an adjunct to chest physiotherapy, a radioaerosol method (using technetium-99m labelled human albumin millimicrospheres) was employed in eight patients with stable bronchiectasis on four occasions, for comparison of sputum clearance with four different regimens. These were: control, with the patient resting in an upright position; chest physiotherapy, by the forced expiration technique with postural drainage; and chest physiotherapy following five minutes' inhalation of either nebulised normal saline or nebulised terbutaline 5 mg. Use of both nebulised saline and nebulised terbutaline immediately before chest physiotherapy gave a significantly greater yield of sputum than did physiotherapy alone, and terbutaline also significantly increased radioaerosol clearance from the whole lung and from regions of interest. The mechanism is unclear, but this method may provide a simple way of increasing the efficacy of conventional chest physiotherapy.

Adult↗
PubMed1985

How well do asthma clinic patients understand their asthma?

Fifty asthmatic patients attending a hospital asthma clinic were interviewed to determine their understanding of their asthma and its treatment. Serious defects were found in their ability to judge the severity of their asthma, in their knowledge of medication, and in the correct action to take when deterioration in control occurred. Several risk factors previously identified in studies of asthma deaths were also present in this living population--in particular, delay in seeking medical help until critically ill, and lack of awareness of danger signs. There was evidence of poor patient-doctor contact and unsuccessful patient education.

Adrenal Cortex Hormones↗
PubMed1983

Acute renal failure due to continuous rifampicin.

We describe the clinical and pathological features of acute renal failure which occurred in a patient receiving a first course of antituberculous therapy, including daily rifampicin. Renal biopsy specimens demonstrated an interstitial nephritis. The renal lesion resolved three weeks after the cessation of rifampicin, as evidenced by improvement in renal function and the return of nuclear magnetic resonance tomographic studies to normal. This is only the fifth reported instance of renal impairment following continuous rifampicin therapy, despite widespread use of the drug in a daily dose. The possible toxic interaction of rifampicin and antituberculous drugs which are excreted predominantly by the kidneys is also described.

Acute Kidney Injury↗
PubMed1981

Progressive lung disease in a malt-worker.

We described a malt-worker whose initial symptoms suggested extrinsic allergic alveolitis. The ensuing cavitating lung disease, Aspergillus fumigatus infection with mycetomata, vigorous immune response, and granulomatous liver disease are unusual features.

Adult↗
PubMed1980

Sarcoid pleural effusion: three cases and review of the literature.

Pleural sarcoidosis is rare--it is little recognised in Birtian although several cases have been reported in the international literature. Three white men with pleural effusions caused by sacroidosis have been seen in a two-year period when approximately 60 new cases of thoracic sarcoidosis have been presented. In one patient a recurrent massive effusion was only diagnosed as being caused by sarcoidosis after thoractomy, and in two further patients small symptomatic pleural effusions were present at the onset of typical sarcoidosis. Two patients were successfully treated with steroids and the third improved spontaneously. Percutaneous biopsy is not always helpful in diagnosing pleural sarcoidosis, but a lymphocytic, often blood-stained, pleural aspirate is highly characteristic. While other diseases may coexist, a pleural effusion in a patient with histologically proven sarcoidosis is more likely to be caused by the primary disease than by any other condition.

Adult↗
PubMed1979

Blood flow in pulmonary veins: I. Studies in dog and man.

The pattern of blood flow in the large extra parenchymal pulmonary veins is pulsatile in both dog and man. This pulsatility is dominated by the changes in left atrial pressure taking place throughout the cardiac cycle. No pulsatile component of low in the large pulmonary veins could be attributed to forward transmission of a flow pulse conducted from the lung capillaries. The findings suggest that there must be a region of considerable compliance in the pulmonary venous system which can absorb pulsations from the lung capillaries and eliminate their transmission to the left atrium.

Animals↗
PubMed1979

Blood flow in pulmonary veins: II. The influence of events transmitted from the right and left sides of the heart.

The wave form of blood flow in the large extra parenchymal pulmonary veins has an inverse relationship to the pressure wave form in the left atrium during each cardiac cycle. However, when vein flow from the lungs is separated from the left atrium by diverting it into a constant pressure reservoir, its wave form then resembles a lung capillary flow pulse, though delayed from it in time and reduced in ampliture. The pulsatility of flow in pulmonary veins separated from the left atrium is further reduced when transcapillary pressure is elevated by lung inflation. However, in the intact state, the relation between the pattern of pulmonary vein flow and left atrial pressure remains unaffected by lung inflation. It is postulated that the thin walled extraperenchymal pulmonary veins together behave as a collapsible reservoir which enables outflow from them to be determined by changes in left atrial pressure, in spite of variations of pulsatile flow into them from the lungs.

Animals↗