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Biomedical subjects

M E Hodson

Publications and source records attributed to M E Hodson.

At least 127 records · Page 7Linked to original sources
PubMed1991

High resolution computed tomography in adult cystic fibrosis patients with mild lung disease.

Chest radiography and high resolution computed tomography (HRCT) were used to evaluate the degree of lung involvement in 38 adult cystic fibrosis patients with unusually mild pulmonary disease. Abnormal features were present on the chest radiograph and/or high resolution CT scans of 35 patients, while in three patients both investigations were normal. Thickening of the wall of proximal right upper lobe bronchi was the earliest abnormal feature on HRCT. The commonest abnormal feature in these patients, including those whose chest radiograph was normal, was mild, uniform dilatation of proximal bronchi. The lumen dilatation was always less marked than the degree of thickening. Ten of the patients were first diagnosed in adult life. Although HRCT scans were normal in two of these patients, there were features suggestive of early pulmonary disease in the remaining eight.

Adult↗
PubMed1991

Non-invasive mechanical ventilation for cystic fibrosis patients--a potential bridge to transplantation.

The case histories of six cystic fibrosis patients awaiting heart-lung transplantation are reviewed. They all deteriorated with severe hypoxia and hypercapnia before donor organs became available. Nasal intermittent positive pressure ventilation was used in preference to conventional ventilation with excellent results in four patients. There were no episodes of hypotension or toxaemia and the patients were in a stable condition at the time of surgery and made an excellent post-operative recovery. The patients who were transplanted and the patient who died, for whom suitable donor organs did not become available, probably had a more comfortable time than they would have done if treated with conventional ventilation. This method of ventilation appears to be a useful bridge to transplantation when a patient suddenly deteriorates. It gives them a chance of survival for a few more days or even weeks during which time an urgent search for donor organs can be made. This is also a very cost effective method of ventilation and does not encroach on conventional Intensive Care Unit (ICU) facilities.

Adolescent↗
PubMed1990

Independent genetic determinants of pancreatic and pulmonary status in cystic fibrosis.

The concordance of pancreatic and pulmonary status among siblings with cystic fibrosis, the cystic fibrosis genotype, and non-genetic factors were analysed in adult patients with cystic fibrosis. Genetic factors were more important than non-genetic factors in affecting the severity of pancreatic and lung disease. The genetic factors were independent of each other and did not invariably cosegregate with specific mutations at the cystic fibrosis locus.

Adult↗
PubMed1990

Linked marker haplotypes and the delta F508 mutation in adults with mild pulmonary disease and cystic fibrosis.

The frequencies of the delta F508 mutation and haplotypes at the loci linked to the cystic fibrosis (CF) gene have been compared in adult CF patients with very mild and with severe lung disease. In patients who are compound heterozygotes for the delta F508 mutation, or who lack the mutation on both chromosomes, the as yet undefined mutations may influence the severity of lung involvement. In patients homozygous for the delta F508 mutation, non-genetic factors cannot fully account for variation in the severity of lung disease. Genes outside the CF locus may influence clinical expression of the disease.

Adolescent↗
PubMed1990

Antibody response of fibrocystic patients to homologous 0-typable and 0-defective isolates of Pseudomonas aeruginosa.

Antibody titres to Pseudomonas aeruginosa of sera from 60 adult fibrocystic patients were determined in an enzyme linked immunosorbent assay (ELISA) with whole cells of homologous isolates which had been classified according to 0-antigen state by their reactivity with 0-typing antisera. Patients who were continuously colonised with Ps aeruginosa gave the highest titres: range 1500-64000 (mean 11000) and 500-48000 (mean 9000) with homologous 0-typable and 0-defective isolates, respectively. Lower titres to both varieties of isolates were obtained with recently colonised patients, and non-colonised patients gave titres with reference laboratory strains marginally above those of healthy controls. Serum titres of patients with sequential isolates were strain dependent and did not correlate with the 0-antigen state of the strain. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblot analysis of these sera and strains showed antibody binding primarily to high molecular weight 0-repeating units of lipopolysaccharide. It is concluded that the 0-antigen of the strain of Ps aeruginosa used in the ELISA test does not influence the titre obtained with fibrocystic sera, and it is recommended that serum titres should be assessed with a panel of homologous isolates from patients.

Adult↗
PubMed1990

Effect of chest physiotherapy on oxygen saturation in patients with cystic fibrosis.

Decreasing arterial oxygen saturation has been reported in patients with cystic fibrosis during postural drainage when this was combined with other manoeuvres, which did not, however, include thoracic expansion exercises or pauses for relaxation and breathing control. When these features were included in an active cycle of breathing techniques during postural drainage in 20 patients with cystic fibrosis there was no fall in arterial oxygen saturation during the procedure (mean values 87.1%, 87.9%, and 86.7% before, during, and after treatment).

Adult↗
PubMed1990

Heart lung transplantation for cystic fibrosis.

The results of transplantation, both HLT or double lung transplantation for CF patients to date are very encouraging. Many of the patients that have been operated on are high risk patients. There are still many problems to overcome, but the CF transplant programme will continue. The physicians caring for CF patients in the UK are extremely grateful to our surgeons, Professor M Yacoub, Harefield and Brompton Hospitals, and Mr John Wallwork, Papworth Hospital, Cambridge for their pioneering work.

Cystic Fibrosis↗
PubMed1990

The effect of nicardipine, a calcium channel blocker, on the sweat test in adult patients with cystic fibrosis.

In vitro studies have suggested a potential role for calcium channel blockers in manipulating the basic ionic defect of cystic fibrosis. In 17 adult patients with cystic fibrosis nicardipine was administered either intravenously or topically using iontophoresis or occlusive dressings. Sweat tests were performed before and after drug administration and examined using two way analysis of variance. No statistically significant difference was observed. We conclude that nicardipine used in vivo does not exert the easily demonstrable effect on the chloride ion defect that has been observed with other agents in vitro.

Adult↗
PubMed1990

Nasal potential difference: a clinical diagnostic test for cystic fibrosis.

Patients with cystic fibrosis (CF) demonstrate a markedly more negative potential difference (PD) across respiratory epithelia than normal or "diseased" controls. A technique is described for the measurement of nasal PD in both children and adults. 145 non-CF subjects showed a mean PD of -19.0 mV (range -2 to -36) in comparison to 60 patients with cystic fibrosis with mean of -46.0 mV (range -32 to -77). Amongst the latter group those with more severe disease had a more negative PD. Measurement of nasal PD is easily learnt and rapidly performed and may provide an additional means of diagnosis for CF.

Adolescent↗
PubMed1989

Liver disease and bile duct abnormalities in adults with cystic fibrosis.

A quarter of adults with cystic fibrosis, 57 of 233, had abnormal liver function. Patients with hepatic dysfunction were further investigated by ultrasound, hepatobiliary scintigraphy, and endoscopic retrograde cholangiography (ERC). 17 of the 23 patients studied had abnormalities on imaging. All 15 patients who underwent ERC had abnormal intrahepatic ducts, but only 2 had stricture of the common bile duct. These findings suggest that, in patients with cystic fibrosis, intrahepatic impairment of biliary drainage may be important in the pathogenesis of liver disease.

Adolescent↗
PubMed1989

High dose salbutamol in chronic airflow obstruction: comparison of nebulizer with Rotacaps.

Patients with severe chronic airways obstruction often respond poorly to inhaled salbutamol in conventional dosage from a pressurized aerosol. We have investigated the response to high dose salbutamol in 18 patients with chronic airways obstruction (mean age 64.4 years, mean FEV1 40.2% predicted, less than 15% response to 400 micrograms salbutamol). Patients were given 1 mg, 2 mg and 5 mg of salbutamol by either Rotacaps or nebulizer in random order on separate days. Response was measured over 8 h as a change in airway calibre (FEV1, FVC and PEF). The frequency of tremor, palpitations and arrhythmias was noted. Area under the curve for change from baseline values for FEV1, FVC and PEF showed that larger doses of salbutamol (nebulized or Rotacaps) result in larger areas from all three variables. Analysis of peak response, for FEV1, FVC and PEF showed no significant difference for the six treatments used except that the peak response for 2 mg Rotacaps for FEV1 was significantly larger than that for 1 mg Rotacaps (P less than 0.05). The results of this study show that in severe chronic airflow obstruction 1, 2 and 5 mg of salbutamol inhaled via a rotahaler device are just as effective as 1, 2 and 5 mg salbutamol inhaled from a nebulizer in producing bronchodilation. High dose salbutamol is well tolerated and side effects are minimal. Rotacaps have the advantage of being more portable than a wet nebulizer.

Administration, Inhalation↗
PubMed1989

Long term venous access using a totally implantable drug delivery system in patients with cystic fibrosis and bronchiectasis.

A completely implantable, subcutaneous, venous access system (Port-a-Cath) has been used for antibiotic therapy in 26 patients with cystic fibrosis or bronchiectasis over a period of 45 months. During this period there were ten complications in eight patients and in four patients all or part of the system had to be replaced. Nevertheless, the actuarial median functional survival of the implanted system exceeded 30 months. The Port-a-Cath system provides longer periods of venous access and has a lower complication rate than conventional, percutaneous central venous lines.

Adolescent↗
PubMed1989

The effect of nicardipine, a calcium channel blocker, on the sweat test in adult patients with cystic fibrosis.

Impaired cell membrane chloride ion movement in cystic fibrosis results in reduced resorption of sodium and chloride from sweat gland ductules producing the high concentrations measured in the sweat as a diagnostic test. Normal chloride ion movement can be restored in vitro by blocking transepithelial calcium flux with lanthanum, suggesting a potential role for calcium channel blocking drugs in the management of cystic fibrosis. We studied the effect of nicardipine, a calcium channel blocker, on the sweat sodium in 17 adult patients with cystic fibrosis. Nicardipine was administered intravenously or topically using iontophoresis or occlusive dressing. No significant change in sweat sodium concentration was observed between pre- and post-drug administration. We conclude that nicardipine used in vivo does not exert the same effect as lanthanum demonstrates in vitro on transepithelial cell membrane chloride ion movement in cystic fibrosis.

Administration, Topical↗