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Biomedical subjects

J Stammers

Publications and source records attributed to J Stammers.

5 recordsLinked to original sources
PubMed1992

Two different low birth weight formulae compared.

The performance of two different, commercially available, low birth weight formulae feeds was compared in preterm infants. The aim of the study was to determine the effect of compositional differences on tolerance, stool frequency and consistency, fat balance and weight gain. Inborn infants with birth weight less than 1500 g were randomised at birth to receive Prematil or Osterprem. Thirty infants received more than 900 ml/kg per week of designated formula alone during a total of 70 weeks of study. Three day fat balance was performed on 23 infants. Osterprem contains 40% more fat than Prematil. The composition of this fat is different in that Osterprem contains no medium chain triglycerides (MCT) compared to 30% in Prematil. Clinical evaluation demonstrated that Osterprem is associated with a significantly higher mean energy intake compared to Prematil (3442 and 3127 kJ/kg per week) but mean weight gain is not significantly different (123 and 112 g/kg per week). Mean stool frequency is higher on Osterprem (20.5 and 14.5 stool/week) and the consistency of stools firmer. This is attributable to a higher mean fat output (2.3 and 0.9 g/kg per day) secondary to the higher fat content of the feed and lower mean absorption (71.6 and 83.5%). Both feeds are well tolerated. The study also confirms that absorption of unsaturated fatty acids is inversely proportional to chain length.

Dietary Fats↗
PubMed1992

Evaluation of techniques for delivery of steroids to lungs of neonates using a rabbit model.

Little is known about delivery of aerosolised steroids to neonatal patients undergoing assisted positive pressure ventilation and after extubation. A rabbit model has been established to investigate factors influencing drug delivery. Beclomethasone dipropionate, in a metered dose inhaler, was radiolabelled with technetium 99m. The mass median aerodynamic diameter of the aerosol was 3.3 (2.0) microns and the impactor measurements confirmed that the technetium distribution corresponded with that of the drug particles. The metered dose inhaler was actuated into a collapsible spacer that was used to ventilate and deliver aerosol to anaesthetised rabbits by a tracheostomy. From each actuation of the drug 2.9 (0.4)% of the aerosol deposited in the trachea and main bronchi and 1.2 (0.4)% in the lung. When the drug was delivered by a spacer device, with face-mask attachment, to rabbits breathing freely through a tracheostomy, aerosol deposition increased to 4.4 (2.1)% in the trachea and main bronchi and 1.9 (0.9)% in the lung lobes. The maximum change in systolic blood pressure after administration of aerosol by the collapsible spacer was a decrease of 13%. The methods described may prove useful for the delivery of inhaled steroids to neonatal patients likely to develop bronchopulmonary dysplasia.

Administration, Inhalation↗
PubMed1992

New aerosol delivery system for neonatal ventilator circuits.

There is mounting evidence that a variety of drugs delivered as aerosols are likely to be of benefit in neonatal units. To avoid many of the problems associated with the use of jet nebulisers in ventilator circuits, a chamber was designed to be used in conjunction with a metered dose inhaler (MDI). The dimensions (4 cm x 11 cm) were chosen in an attempt to maximise drug delivery. In vitro studies were subsequently performed in order to determine the optimum operating conditions. Sodium cromoglycate delivered via this system was collected on a filter placed between the tip of an endotracheal tube and a model lung. The dose delivered was determined by means of an ultraviolet spectrophotometric assay. Using a Draeger Babylog 8000 ventilator it was found that drug delivery as maximised by actuating the device just before the inspiratory cycle when the chamber was placed adjacent to the endotracheal tube and by using a long (one second) inspiratory time. Under these conditions 1.5-2% of the original dose was deposited upon the filter at tidal volumes of 11-22 ml. When considered in terms of body weight this is many times the equivalent dose delivered to adults from an MDI. Effective drug delivery to the filter was confirmed using a radiolabelled aerosol. Radiolabelled studies delivering aerosol to the lungs of intubated rabbits demonstrated that deposition aerosol was distributed uniformly between lobes when corrected for the weight of each lobe. In conclusion, the device appears likely to deliver significant, reproducible quantities of drug to the lower respiratory tract while being simple to use.

Aerosols↗
PubMed1987

The effects of dietary supplementation with fish oil in patients with psoriasis.

Ten patients with psoriasis resistant to conventional topical treatment were given dietary supplements of fish oil, providing approximately 12 g of eicosapentaenoic acid daily for a period of at least 6 weeks. In eight patients there was a modest improvement in their psoriasis, the principal effects being a diminution of erythema and scaling. The dietary treatment resulted in a substantial inhibition of leukotriene B4 production by the peripheral blood polymorphonuclear leukocytes in vitro. The discrepancy between the high degree of inhibition of leukotriene B4 synthesis and the modest therapeutic effect suggests that leukotriene B4 is not the only mediator involved in the development of the psoriatic lesion. Furthermore, the in vivo cutaneous levels of leukotriene B4 might not have been inhibited to the same extent as the polymorphonuclear leukocyte levels in vitro. Further studies on the use of fish oil supplements, both on their own and in conjunction with other forms of treatment in psoriasis are warranted. It will also be important to determine whether the altered profile of 5-lipoxygenase products found in the blood is also seen in the skin.

Adult↗