Biomedical subjects

K K Sheth

Publications and source records attributed to K K Sheth.

3 recordsLinked to original sources

PubMed1994

Reversal of persistent postbronchiolitis airway abnormalities with dexamethasone in rats.

Viral bronchiolitis is a common disease that may result in persistent airway abnormalities. Previous studies of neonatal bronchiolitis in rats revealed chronic sequelae, including airway obstruction, airway hyperresponsiveness, increased production of airway eicosanoids, and increased numbers of bronchiolar mast cells. To address the hypothesis that postbronchiolitis airway obstruction is caused in part by reversible processes, we tested whether obstruction could be reversed by a brief course of high-dose corticosteroids. Neonatal Brown Norway rats (5 days of age) were inoculated with parainfluenza type 1 virus or sterile vehicle. At 8 wk of age, rats were treated with dexamethasone (1.4 mg.kg-1 x day-1 sc) or saline for 3 days and were evaluated for lung mechanics, gas exchange, and lung inflammatory cells 1 day after the last injection. Dexamethasone normalized the chronic virus-induced airway obstruction and reduced the numbers of bronchiolar mast cells and other inflammatory cells. Resistance and dynamic compliance correlated significantly with bronchiolar mast cells but not with other airway inflammatory cell infiltrates. We conclude that the airway abnormalities that persist in rats after recovery from neonatal bronchiolitis are associated with increased numbers of bronchiolar mast cells and are largely due to corticosteroid-sensitive mechanisms.

Airway Resistance↗

PubMed1991

Pathogenesis of asthma.

Asthma is the most common chronic lower respiratory tract condition in children. Thus, it is imperative that physicians caring for asthmatic patients understand the pathophysiology of asthma and its implications for optimal therapeutic management. A precise understanding of asthma pathophysiology has been impeded due to the fact that a universally acceptable definition for asthma has been difficult to formulate. Clinicians treating asthmatic patients should be aware that the airway obstruction present in these individuals is the result of multiple interrelated factors. Although bronchial smooth muscle spasm can be effectively treated producing rapid symptomatic relief, other factors contributing to airway obstruction, such as airway inflammation and edema, need to be a major focus of therapeutic strategies for more chronic management. While the concepts of reversibility and hyperresponsiveness have been appreciated for some time, the idea that asthma should be viewed as an inflammatory lung disease (or syndrome) has only recently received appropriate emphasis. In this regard, the late phase asthmatic response has provided a convenient model to study the biochemical and cellular interactions that contribute to the pathogenesis of asthma. Further, these responses will aid in the analysis of the potential beneficial effects of various pharmaceuticals as they undergo development and testing for use in asthmatic patients.

Airway Obstruction↗

PubMedDate not supplied

Developing and marketing a community pharmacy-based asthma management program.

OBJECTIVE: To develop a community pharmacy-based asthma management program and successfully market the program to a managed care organization. SETTING: Community-based ambulatory care. PRACTICE DESCRIPTION: Independent community pharmacy. PRACTICE INNOVATION: Development of a structured, stepwise approach to creating, testing, delivering, and marketing a community pharmacy-based disease management program. MAIN OUTCOME MEASUREMENTS: Peak expiratory flow rates, quality of life, use of health care services, HMO contract renewal. RESULTS: A pharmacy-based asthma management program was developed, pilot tested, and successfully marketed to a local HMO. During the first full year of the program, HMO patients experienced significant improvements in quality of life and decreases in use of health care services, including a 77% decrease in hospitalization, a 78% decrease in emergency room visits, and a 25% decrease in urgent care visits. A contract that pays the pharmacy a flat fee for each patient admitted to the program has recently been renewed for a third year. CONCLUSION: The program has proved to be an effective, practical, and profitable addition to the portfolio of services offered by the pharmacy.

Adolescent↗