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Biomedical subjects

J Wiggins

Publications and source records attributed to J Wiggins.

At least 55 records · Page 3Linked to original sources
PubMed1988

Accuracy of ultrasound diagnoses in pregnancies complicated by suspected fetal anomalies.

Referral of pregnancies complicated by suspected fetal anomalies to level III perinatal centres for further evaluation and management is increasing as use of real-time ultrasound spreads, but the sensitivity and specificity of the prenatal diagnoses made in this population are unknown. We undertook a prospective study that followed pregnancies referred to a designated programme dealing with suspected fetal abnormalities. Follow-up of 257 pregnancies revealed that 282 separate anomalies were accurately diagnosed in 212 cases. Normal anatomy was correctly predicted in 42 cases, 16 per cent of the referred population. False-positive and false-negative rates were 1.5 per cent (4/257) and 2 per cent (1/46), respectively. However, 37 per cent of those infants born with anomalies had additional problems not prenatally detected by ultrasound. These results indicate that prenatal ultrasound diagnoses are remarkably accurate overall but that they may be insensitive to associated anomalies in individual cases.

Congenital Abnormalities↗
PubMed1988

Pulmonary endometriosis mimicking an acute abdomen.

A case of pulmonary endometriosis is reported, to illustrate the classic catamenial symptoms of the disease. The patient also developed symptoms and signs suggesting a perforated abdominal viscus; laparotomy was normal and the features may have resulted from a previously unreported effect of diaphragmatic endometrial foci.

Abdomen, Acute↗
PubMed1987

Cardiotonic agents. 1. Novel 8-aryl-substituted imidazo[1,2-a]- and -[1,5-a]pyridines and imidazo[1,5-a]pyridinones as potential positive inotropic agents.

Several 8-arylimidazo[1,2-a]pyridines, 8-arylimidazo[1,5-a]pyridines, and 8-arylimidazo[1,5-a]pyridinones were prepared and tested in vitro for potential cardiac inotropic and electrophysiological activity. Selected analogues were further tested in vivo in canine hemodynamic and cardiac electrophysiology models. Compounds having an imidazole substituent consistently showed activity. A pharmacophoric relationship between heterocycle-phenyl-imidazole and positive inotropic activity was noted. The significance of this relationship is discussed.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1987

Blood fuel metabolites in asthma during and after progressive submaximal exercise.

Ten male stable asthmatic subjects and 10 matched control subjects performed a progressive exercise test on a treadmill to 85% of their predicted maximum heart rate. Blood lactate, pyruvate, hydrogen ion, glucose, alanine, glycerol and total ketone body concentrations were measured at frequent intervals during and up to 60 min after exercise. Carbon dioxide production, oxygen consumption, ventilation, respiratory exchange ratio and oxygen saturation were also measured during and up to 10 min after exercise. There were no significant differences between the asthmatic and control subjects in levels of carbon dioxide production, oxygen consumption and ventilation. The respiratory exchange ratio was greater in the asthmatic subjects during recovery from exercise (P less than 0.05). No changes in oxygen saturation were observed during exercise in either group. In both asthmatic and control subjects, lactate, pyruvate, hydrogen ion, alanine and glycerol concentrations showed an increase from baseline levels, reaching maximum levels up to 10 min after exercise and returning to baseline within 1 h after exercise. Total ketone body concentrations decreased during exercise. There were no significant differences between the asthmatic and control subjects in the concentration of any metabolite over the study period. These data indicate that fuel metabolism during and after short-term progressive exercise is similar in stable asthmatic and normal subjects.

Adult↗
PubMed1987

Effect of nifedipine on serum theophylline concentrations and asthma control.

The effect of adding slow release nifedipine to oral theophylline has been studied in eight patients with stable but symptomatic asthma, a double blind placebo controlled crossover protocol being used. No change in asthma control occurred during the nifedipine treatment period as assessed by serial peak flow measurements and symptom scores. Serum theophylline concentrations were significantly lower after nifedipine than after placebo (6.8 v 9.7 micrograms/ml) and in three patients were well below the therapeutic range (less than 4 micrograms/ml).

Aged↗
PubMed1986

Intravenous aminophylline in patients already taking oral theophylline: effect on calculated dose of knowledge of serum theophylline concentration on admission.

Measurement of serum theophylline concentration is usually recommended before intravenous aminophylline is given to patients taking oral theophylline. Fifty patients with worsening airflow obstruction, all of whom were taking oral theophyllines and who had no contraindication to the use of parenteral aminophylline, were randomly allocated into two groups before treatment was given. The dose of aminophylline was calculated without (group A) and with (group B) knowledge of admission serum theophylline concentration. In group A a regimen incorporating corrections to account for factors affecting theophylline clearance was used in an attempt to represent a "knowledgeable" approach; in group B a formula incorporating the known serum theophylline concentration at the time of admission was used. All loading doses were given over 30 minutes as "mini infusions." The two groups were well matched for age, blood gas tensions, and severity of airflow obstruction. The results for four patients (one from group A and three from group B) were excluded from analysis after completion of the study. In each group the mean admission serum theophylline concentration measured (group A: 8.4 (SD 6.0)mg/l; group B: 7.2 (5.7)mg/l) and the aminophylline doses used (group A: loading bolus 172 (45.5)mg, infusion 815 (198)mg; group B: loading bolus 233(189)mg, infusion 788(214)mg) were similar. Mean serum theophylline concentrations during 24 hours' aminophylline treatment, number of patients with a serum theophylline concentration greater than 20 mg/l, symptoms of toxicity, and outcome were also similar in the two groups. Although satisfactory use of parenteral aminophylline was achieved for most patients without knowledge of serum theophylline concentration at the time of admission to hospital (with the aid of a "knowledgeable" clinical approach and constant infusion pumps), prompt measurement of serum theophylline concentration at the time of admission identified patients with either suboptimal or potentially hazardous theophylline concentrations.

Administration, Oral↗
PubMed1985

A study of the use of ultrasonically nebulized lignocaine for local anaesthesia during fibreoptic bronchoscopy.

The use of nebulized lignocaine, with and without intravenous diazepam premedication, was compared with lignocaine given by bolus in 52 patients undergoing fibreoptic bronchoscopy (FOB). Changes in airflow, cardiac rhythm, and transcutaneous PO2 were recorded, and patient acceptability, blood lignocaine levels, and the duration of the procedure were also monitored. Nebulized lignocaine alone provide adequate anaesthesia and the procedures were performed more quickly (P less than 0.05) than when bolus lignocaine was used. Nebulized lignocaine without diazepam was acceptable to the patients and was not associated with the significant (P less than 0.03) falls in transcutaneous PO2 which followed diazepam administration. Nebulized lignocaine, with and without, diazepam premedication is a safe, effective and acceptable method of inducing topical anaesthesia for FOB.

Aerosols↗
PubMed1985

The use of parenteral aminophylline in patients taking slow release theophylline preparations: an observation of clinical practice.

Parenteral theophylline usage was studied in 53 patients with worsening airflow obstruction who had been prescribed slow release theophylline drugs and were admitted to a hospital lacking facilities for rapid serum theophylline concentration estimation. Individual clinicians varied in their practice with respect to parenteral aminophylline, but in general its use was favoured in patients with asthma rather than simple chronic airflow obstruction. There was no significant difference in admission serum theophylline concentrations between 31 patients who were subsequently given intravenous aminophylline and 22 who were not. There was also no significant difference in admission serum theophylline concentrations between ten patients given an aminophylline bolus and an infusion, seven patients given a bolus alone and 14 patients given an infusion alone. Individual patient's serum theophylline concentrations were variable during infusions and often suboptimal. The results indicate that the use of parenteral aminophylline in patients receiving slow release theophyllines is imprecise and possibly hazardous without facilities for prompt serum theophylline concentration estimations. This facility should be available in hospitals where parenteral aminophylline is used.

Adolescent↗
PubMed1984

Subcutaneous terbutaline and control of brittle asthma or appreciable morning dipping.

In a pilot study two patients with brittle asthma and two with morning dipping received terbutaline or a placebo administered subcutaneously either by continuous infusion or in injections every six hours. In two patients brittle asthma was completely suppressed by terbutaline 1 mg/day given by either method. In the two others early morning dipping responded only to continuous subcutaneous infusions of terbutaline 12 mg/day. Terbutaline administered subcutaneously may be an effective treatment in asthmatic patients who show important diurnal variations in air flow.

Adult↗