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Biomedical subjects

M J Connolly

Publications and source records attributed to M J Connolly.

At least 55 records · Page 3Linked to original sources
PubMed1993

Ageing, late-onset asthma and the beta-adrenoceptor.

Late-onset asthma in old age is a common clinical problem. There are similarities between receptor and post-receptor beta 2-adrenoceptor abnormalities reported in young asthmatics and in elderly normal subjects. Recent evidence lends some support to the idea of the 'aging' beta 2-adrenoceptor as a contributory factor in the development of late-onset asthma, although questions of the validity of the peripheral mononuclear cell model and of receptor tachyphylaxis to intrinsic and extrinsic beta-adrenoceptor agonists remain unresolved. Further work should focus on in vivo studies of airway receptor function and on beta 2-adrenoceptor-mediated pathways other than smooth muscle-related bronchoconstriction.

Aged↗
PubMed1993

Naftidrofuryl treatment for rest cramp.

A double-blind placebo-controlled study was carried out in 14 subjects to investigate the effect of naftidrofuryl in the treatment of rest cramp. Naftidrofuryl caused a significant reduction in cramp frequency (median naftidrofuryl = 5; median placebo = 17; P < 0.004) and a significant 34% increase in cramp free days (median naftidrofuryl = 22; median placebo = 14; P < 0.004). Naftidrofuryl is an effective alternative to quinine in the treatment of this painful condition.

Adult↗
PubMed1993

Spontaneous biloma in an elderly patient.

A previously well 84 year old man without prior history of abdominal trauma, instrumentation or surgery presented with localized biliary peritonitis (biloma). An associated bile duct stone was detected by abdominal ultrasound and endoscopic retrograde cholangiopancreatography and was successfully treated with systemic antibiotics and percutaneous and endoscopic stenting. The case is unusual in that the presentation was spontaneous.

Aged↗
PubMed1993

Cerebral infarction in association with Ecstasy abuse.

A previously fit 35 year old man presented with a right hemiparesis and dysphasia 36 hours after abuse of Ecstasy (3,4-methylenedioxymethamphetamine). Computerized axial tomography scan demonstrated an extensive acute left cerebral infarction and carotid digital subtraction angiogram, 2 days after admission, revealed left middle cerebral artery occlusion. There were no other known risk factors and all other investigations were negative. The patient made a partial recovery. We propose an association between Ecstasy abuse and cerebral infarction.

3,4-Methylenedioxyamphetamine↗
PubMed1992

Impaired beta-adrenoceptor function, increased leukocyte respiratory burst, and bronchial hyperresponsiveness.

Inflammatory processes have potential importance in the pathogenesis of bronchial hyperresponsiveness and asthma. Because beta-adrenoceptor function may be impaired in asthma, we studied regulation of the leukocyte respiratory burst using blood samples from subjects with bronchial hyperresponsiveness to methacholine. Leukocytes from hyperresponsive subjects were less responsive to the beta-agonist isoproterenol than were leukocytes from healthy control subjects. The magnitude of the respiratory burst was increased in cells from hyperresponsive subjects and correlated with the degree of methacholine responsiveness. These results demonstrate that peripheral leukocytes reflect a functional impairment in beta-adrenergic responsiveness that parallels airway hyperresponsiveness. Because untreated subjects demonstrated a reduction in beta-adrenergic response, the impairment in beta-adrenoceptor function was not a result of drug therapy and may be associated with the pathogenesis of asthma.

Adult↗
PubMed1992

Clinical significance of crepitations in elderly patients following acute hospital admission: a prospective study.

Because of a clinical impression that lung crepitations are a common, non-specific sign in acutely ill elderly people, two investigators, blinded to each other's findings and to subject case notes, prospectively examined 207 consecutive elderly [aged 70-98 (mean 77) years] and 75 young patients [24-50 (41) years] acutely admitted to hospital. Crepitations and persistent crepitations (PCs) were commoner in the elderly patients (p less than 0.001) but agreement over their presence/absence was reduced (p less than 0.05). Both investigators agreed PCs were absent in 35% of elderly subjects suffering from conditions classically associated with their presence, and, conversely, were present in 29 elderly subjects in whom no cause for their presence was discovered (14% of the total elderly group or 42% of those with PCs). PCs without obvious cause were unrelated to smoking history and did not predict outcome, length of stay or development of cardiorespiratory complications. In view of poor sensitivity and specificity of crepitations in elderly patients undergoing acute hospital admission we caution against over-reliance on this sign in isolation in these circumstances.

Aged↗
PubMed1992

Reduced subjective awareness of bronchoconstriction provoked by methacholine in elderly asthmatic and normal subjects as measured on a simple awareness scale.

BACKGROUND: Asthma death rates are rising, with the greatest rise and highest death rates in old age. A reduced cardiovascular response in the elderly may lead to the underestimation by physicians of the severity of acute asthma attacks. This would be compounded if elderly patients had reduced awareness of bronchoconstriction. METHODS: Methacholine provoked bronchoconstriction was compared in 34 elderly (17 asthmatic, 17 normal; age 60-83, mean 68 years) and 33 young subjects (16 asthmatic, 17 normal; 20-46, mean 30 years). None were smokers. All underwent inhaled methacholine challenge by the Newcastle dosimeter method, monitored by maximal expiratory flow-volume loops (MEFVL). The endpoints were a 35% fall in forced expiratory flow at 50% vital capacity or cumulative inhalation of 6.4 mg methacholine. The one second forced expiratory volume (FEV1) was derived from MEFVL. After challenge and before bronchodilatation subjects graded awareness of respiratory discomfort from 1 (no symptoms) to 4 (pronounced symptoms needing immediate treatment). RESULTS: Despite a greater fall in FEV1 in elderly asthmatic patients (mean (SE) 27.4% (2.2%)) than in young asthmatic patients (21.5% (1.7%)) elderly patients were less aware of bronchoconstriction (awareness score 2.00 (SE 0.15) than young patients (3.06 (0.11)). Similar differences in awareness score were seen between elderly normal subjects (1.53 (0.17)) and young normal subjects (2.76 (0.22)), despite no difference in degree of bronchoconstriction. CONCLUSIONS: Reduced awareness of moderate acute bronchoconstriction in old age may delay self referral in acute asthma and contribute to higher asthma mortality in the elderly.

Adolescent↗
PubMed1992

Relationship between nonspecific bronchial responsiveness to methacholine and peripheral mononuclear leukocyte beta-adrenergic receptor function in young drug-naive subjects.

Asthma is associated with dysfunction of the beta-adrenergic receptor adenylyl cyclase signal transduction pathway. It has been argued that this results from receptor down-regulation by beta-agonist therapy. This study examined the relationship between nonspecific bronchial responsiveness (NSBR) to methacholine (Newcastle dosimeter method) and beta-adrenergic receptor density (Bmax) and affinity (%KH) in membranes from peripheral blood mononuclear leukocytes (MNL) in 12 male (27.3 +/- 1.7 yr old) and 14 female (31.4 +/- 1.7 yr old) drug-naive subjects with and without symptoms of mild intermittent wheezing. None had ever smoked or received any antiasthma medication. "Hyperresponsive" subjects were defined as those (n = 11) whose simplified slope of FEF50 (calculated as the percent fall in FEF50 divided by the dose of methacholine) was more than one SD above the mean for asymptomatic subjects. The log of the slope was reproducible (repeatability coefficient = 0.43) on two nonconsecutive days. Multiple regression analysis (overall R2 = 0.57) revealed negative relationships between the log of the slope and both Bmax (p = 0.016) and %KH (p = 0.011). Analysis of variance confirmed a lower mean (+/- SEM) value of %KH in "hyperresponsives" (45.7 +/- 5.5%) than in "normoresponsives" (60.4 +/- 4.1%, p = 0.04) with a similar trend for Bmax (hyperresponsives = 33.5 +/- 4.1 fmol/mg, normoresponsives = 45.9 +/- 7.1 fmol/mg, p = 0.18). These relationships between bronchial responsiveness, Bmax, and %KH cannot be explained by drug therapy, and they provide further evidence that there is an intrinsic impairment in the function of beta-adrenergic receptors on peripheral MNLs from subjects with high levels of nonspecific bronchial responsiveness.

Adolescent↗
PubMed1991

Torsades de pointes ventricular tachycardia and terodiline.

We report five patients (four women, one man; mean age 74 years, range 55-87) taking terodiline who had torsades de pointes ventricular tachycardia associated with prolongation of the QT interval. The QT interval was normal before the introduction of terodiline in three patients and returned to normal after terodiline withdrawal in four. Atrioventricular conduction disturbance or bradycardia were evident in all patients. Terodiline should be prescribed with caution to elderly patients.

Aged↗
PubMed1990

Kitchen aids.

Explore the source record for details and available documents.

Aged↗
PubMed1990

The mass spectra of 4-aminophenanthrene and its trifluoroacetic anhydride and perfluoropropionic anhydride derivatives.

Several aminophenanthrenes have been examined with electron impact mass spectrometry. The trifluoroacetic anhydride (TFAA) and perfluoropropionic anhydride (PFPA) derivatives of 4-aminophenanthrene have been studied with electron impact as well as both positive and negative ion chemical ionization mass spectrometry utilizing methane as a reagent gas. The resulting mass spectra indicate a loss of water from the derivatives and a mechanism is proposed to account for this loss. The spectra also indicate unique fragmentation patterns associated with the position of the substituent, particularly the four position which is in the region of the molecule termed the bay region. Another interesting aspect is the spectral differences observed for the TFAA and PFPA derivatives of 4-aminophenanthrene. The positive ion chemical ionization mass spectrum of the TFAA derivative indicates an ion [M + H - H2O]+; however, the mass spectrum of the PFPA derivative of 4-aminophenanthrene indicates no water loss from the [M + H]+ ion. The negative ion chemical ionization mass spectra of the two derivatives are also very different. The mass spectrum of the TFAA derivative shows an [M - 18]- ion and the PFPA derivative shows successive losses of HF with no apparent loss of water.

Mass Spectrometry↗
PubMed1989

Hypercalcaemia in association with enteric fever.

We report 2 cases of hypercalcaemia and hypercalciuria, with detectable levels of parathyroid hormone, which appeared to be precipitated by enteric fever. Extensive investigation of one case, including ultrasound, isotope scanning, angiography, computed tomographic scanning and surgical exploration, failed to detect a parathyroid adenoma. In both cases biochemical and hormonal abnormalities resolved several months after recovery of enteric fever. The mechanism of the proposed association is unexplained but it should be considered in any patient with hypercalcaemia and detectable parathyroid hormone levels, who is suffering from or has recently recovered from enteric fever. If such a patient is well, a period of several month's observation is recommended. We believe these two cases to be the first such reports of hypercalcaemia in association with enteric fever.

Adolescent↗
PubMed1989

Refractory period following bronchoconstriction provoked by histamine in asthmatic subjects.

To determine whether refractoriness to histamine induced bronchoconstriction occurs, 20 asthmatic subjects aged 19-50 years were tested. Subjects underwent two histamine challenge tests (1 and 2) on the same day, the second one being given 45-60 minutes after the first, once the FEV1 after test 1 had returned spontaneously to within 90% of baseline. A further "control" histamine challenge test was carried out on a different day at the same time (+/- 2 hours) as test 1. Bronchial responsiveness was recorded as the cumulative dose (microgram) of histamine provoking a 20% fall in FEV1 (PD20), and the ratio PD20 test 2:PD20 test 1 was used to assess refractoriness. The median value of this ratio (2.20) was significantly greater than 1 (p = 0.003), indicating refractoriness at the time of test 2. By contrast the median ratio PD20 control:PD20 test 1 of 1.03 was not significantly different from 1. Refractoriness could not be accounted for by failure to regain the initial baseline FEV1, though such failure may have exaggerated the effect. An increase in PD20 with the second test was observed uniformly in subjects with moderate or high initial PD20 values but not in those with low values. This suggests that there may be a PD20 threshold of the order 25-100 micrograms for refractoriness to occur. Refractoriness could exert an important confounding effect in investigations in which repeated histamine tests are carried out at short intervals.

Adult↗
PubMed1988

The use of sequential doses of inhaled histamine in the measurement of bronchial responsiveness: cumulative effect and distortion produced by shortening the test protocol.

We have evaluated a shortened protocol for measuring bronchial responsiveness to histamine. This safely eliminates unnecessarily low doses from a standard doubling dose sequence (i.e., full protocol) so that the dose provoking the definitive 20% decrement in FEV1 (PD20) is usually reached within two or three dose increments. In 20 subjects with asthma tested with both protocols, the ratio of geometric mean PD20 short protocol (86.8 micrograms) to PD20 full protocol (45.7 micrograms) was significantly greater than 1 when the results were expressed on a noncumulative scale (1.90 versus 1; p less than 0.001). When PD20 was expressed on a cumulative scale, the discordance was less striking (123.7 versus 89.2 micrograms, respectively), but this ratio (1.39) was still significantly greater than 1 (p = 0.007). By contrast, duplicated measurements of PD20 with the full protocol and the cumulative scale elicited a ratio of geometric mean PD20 day 1 (63.0 micrograms) to PD20 day 2 (67.0 micrograms) of 0.94, which was not significantly different from 1. Thus, the bronchoconstrictor effect of histamine depends on both the cumulative dose and the number of component doses. We conclude (1) that PD20 histamine is more nearly accurately expressed on a cumulative than on a noncumulative scale and (2) that histamine is less suitable for shortened protocols than methacholine because a reduction in the number of component doses produces significant distortion of the PD20 result.

Administration, Inhalation↗