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Biomedical subjects

J R Budd

Publications and source records attributed to J R Budd.

13 recordsLinked to original sources
PubMed1993

Comparison of Tc-99m DTPA aerosol ventilation studies with pulmonary function testing in cystic fibrosis.

In 43 patients with cystic fibrosis, the results of 122 Tc-99m DTPA aerosol ventilation (DAV) studies were compared with pulmonary function tests (PFTs) that were performed within 24 hours of the DAV studies. The DAV studies were evaluated blindly for (A) number of pulmonary segments showing little or no ventilation, (B) number of foci of bronchial deposition of aerosol, and (C) subjective overall improvement, lack of change, or worsening from the previous study. (A) and (B) correlated significantly with all PFTs (p's < .001, r's = -.51 to -.73). Changes in (A) and (B) also correlated with changes in PFTs (p's < or = .001, r's = -.37 to -.58). The three populations in (C) were significantly different from each other with respect to changes in all PFTs (p < or = .002). Intervals between studies showing subjective improvement, no change, and worsening averaged 60, 133, and 306 days, respectively. These results suggest that DAV is an indicator of both regional and global pulmonary function and may be useful in evaluating patients with cystic fibrosis.

Adolescent↗
PubMed1992

Aerosol scintigraphy in the assessment of therapy for cystic fibrosis.

Thirteen patients with cystic fibrosis (aged 11 to 32 years) who were hospitalized for exacerbation and who had sputum cultures positive for Pseudomonas organisms were treated initially for 4 days with bronchodilators and physiotherapy followed by the addition of antibiotic (14 days, n = 8) or placebo (14 days, n = 4; 7 days, n = 1). Tc-99m DTPA aerosol scintigraphy was performed on the day before bronchodilators and physiotherapy, on the day before antibiotic or placebo, and on the day after completion of antibiotic or placebo therapy. Scintigrams were evaluated for change in the number of nonventilated segments and change in the number of bronchial deposits of aerosol. Sixty-nine percent of patients showed improvement after bronchodilators and physiotherapy alone. Sixty-two percent showed further improvement after antibiotic or placebo was added; this improvement was independent of whether antibiotic or placebo was administered (P greater than 0.1). These aerosol scintigraphy results failed to demonstrate that the effectiveness of bronchodilators and physiotherapy is enhanced by antibiotics in the treatment of cystic fibrosis exacerbations.

Adult↗
PubMed1988

A medical information relational database system (MIRDS).

A medical information relational database system (MIRDS) which is resident on a relational database machine and is accessed via microcomputers has been created for a pediatric pulmonary division of a research hospital. The power and flexibility of MIRDS has permitted the integration of clinical tasks, research interests, and laboratory functions. Procedures have been devised to assure data integrity, allow flexibility in data retrievals, produce standardized report formats, and permit data access for users with a wide range of query expertise. There are few impediments to the integration of additional clinical, research, and laboratory functions as the system evolves.

Child↗
PubMed1988

A rule for the early detection of chronic changes in cystic fibrosis patient status.

A statistical decision-making system has been developed which will predict the clinical status of a patient with cystic fibrosis based on daily self measurements obtained at home. The data for the study were collected from CF patients within 7-12 years of age. Thirty-two participants recorded four daily measurements (weight, vital capacity, breathing rate, and resting pulse) and one weekly measurement (height). In addition to the 4 daily measured values, the clinical status of each patient at his/her most recent previous clinic visit was used as a predictor variable. The measured values were used as the basis for the development of a discriminant rule. The goal of the rule was to determine whether each patient's clinical status was deteriorating, stable, or improving at the time of the most recent set of weekly measurements. Three types of analysis were performed: linear discriminant analysis, quadratic discriminant analysis, and nearest neighbor. Quadratic discriminant analysis provided the best discrimination due to the differences in the covariance matrices among the populations. The rule was able to correctly classify 77% of the 103 cases in the learning set. To further evaluate the rule, both a weighted classification percentage and weighted kappa statistic were calculated for the rule. Bootstrapping was used to predict the performance of the rule on the population with results of 77% correctly classified overall.

Body Weight↗
PubMed1988

A home-based pulmonary function monitor for cystic fibrosis.

As care for the chronically ill makes increasing demands upon our medical system, cost-effective methods for addressing those demands are being sought. The use of self-monitoring coupled with telecommunication of results to the health-care provider can be expected to provide a partial solution in the appropriate clinical setting. An electronic spirometer with telecommunication ability for use by cystic fibrosis patients in the home has been developed.

Analog-Digital Conversion↗
PubMed1988

Implementation of a home-based program for early detection of clinical deterioration in cystic fibrosis.

A statistical decision-making system, based on daily self measurements obtained at home, has been developed that will predict the clinical status of a patient with cystic fibrosis (CF). The data for the study were collected from patients randomly selected from those served by the University of Minnesota CF Center. Participants recorded four daily measurements (weight, vital capacity, breathing rate, and resting pulse) and one weekly measurement (height) and returned completed diaries to the coordinating center each week. The goal of the rule was to determine whether each patient's clinical status was deteriorating, remaining stable, or improving at the time of the most recent set of weekly measurements. This early detection and intervention criterion (EDIC) is being used in the clinical setting to aid in the management of patients with cystic fibrosis. The computer hardware and software, particularly the relational database, have provided an efficient basis for the continued use of EDIC.

Adolescent↗
PubMed1986

Feasibility and compliance studies of a home measurement monitoring program for cystic fibrosis.

A home measurement monitoring system has been developed for assessing progress and planning changes in care for patients with cystic fibrosis. Daily diary recording of specified measurements, quantitative symptom data, and free text are to be used for early detection of deteriorating trends before serious complications develop. Daily measurements made at home are lung capacity, body weight, breathing rate, and pulse. The program has been in place for the past two years, and has maintained a 75-80% consistent diary response rate among the 111 patients initially committed to the program. Measurements are easy to perform, equipment design is simple and rugged, and data handling routines designed for the program using the INSIGHT clinical data base system perform satisfactorily. Checking for data entry errors and validity checks of home measurements are a regular part of the data handling activity. Patient acceptance and long-term compliance in this program agrees very favorably with reports of other diary programs in chronic disease. Diary compliance was significantly greater among younger patients and those who lived long distances from the hospital. This study has demonstrated that home monitoring is a feasible program for patients with cystic fibrosis. It presents the possibility of detecting adverse health trends earlier than is now practical, so that patients can be treated before serious complications develop, thereby preventing the large fluctuations in health status that often accompany CF.

Adolescent↗
PubMed1982

Comparison of two forms of enteric-coated pancrelipase In six teenagers with cystic fibrosis.

The digestive efficiency of two forms of enteric-coated pancrelipase, Cotazym-STM and Pancrease, was compared in three boys and three girls, aged 12 through 15, with cystic fibrosis. Each patient served as his or her own control, taking one type of pancrelipase for half of the two-week study and the other type for the second half of the study. Monitoring of the patients' oral intake (calories, protein, fat, carbohydrate), collection and analysis of their stools (volume, nitrogen, fat, fat loss, protein loss), and tests of their urine (creatinine, uric acid), blood (24 determinations), and pulmonary function revealed no significant differences in any of the measures between patients taking Cotazym-S and those taking Pancrease.

Adolescent↗
PubMedDate not supplied

Automated noninvasive determination of mixed venous pCO2.

The determination of mixed venous pCO2 is desirable for assessing the metabolic and respiratory status of a patient. A totally automated, laboratory computer-controlled noninvasive system has been developed to determine mixed venous pCO2 by an equilibrium rebreathing method or by an exponential compartmental analysis for cases in which equilibrium is not achieved. A gas mixture is charged to a 2-liter anesthesia bag contained in a thermostatically controlled chamber used to maintain the temperature at 37 degrees C. This feature improves upon past rebreathing methods and eliminates water vapor as a variable in gas composition measurement. This bag is connected to a rebreathing circuit controlled by a minicomputer. The subject breathes from a mouthpiece attached to a two-way valve and rebreathes the gas mixture for a period of 30 seconds. Inspirate and expirate hoses are placed in the rebreathing bag to ensure a more uniform gas distribution than is generally found in rebreathing systems. Exchange of CO2 takes place between lungs and rebreathing bag, and the concentration of CO2 is continuously monitored by a mass spectrometer. After a period of time, the concentration of CO2 in the rebreathing bag, the alveoli, and the mixed venous blood come into equilibrium, demonstrated by a plateau on the record of CO2 concentration vs. time. Compartmental analysis predicts the mixed venous pCO2 even if an equilibrium is not established. This feature is a significant benefit of this new method, eliminating problems associated with establishing an equilibrium, such as gas mixture volume adjustment, recirculation, and poor ventilation. The predicted value agrees with the equilibrium valve for cases in which equilibrium is reached.(ABSTRACT TRUNCATED AT 250 WORDS)

Automation↗