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Biomedical subjects

N K Murthy

Publications and source records attributed to N K Murthy.

8 recordsLinked to original sources
PubMed1997

Sputum and pulmonary function in asthma.

STUDY OBJECTIVE: To assess the relevance of sputum production to pulmonary function, in particular, persistent obstruction in patients with a primary clinical diagnosis of asthma. DESIGN: Cross-sectional study of all patients currently followed up in secondary care in a defined locality. SETTING: National Health Service and private clinics in north-east England. PATIENTS: All attenders, aged 18 years or older, with asthma, confirmed by reversibility of peak expiratory flow (PEF) by > or =15% and to > or =200 L/min. INTERVENTIONS: Pro forma history. Pulmonary function at attendance. Assessment of best function according to protocol. Measurement of actual FEV1, FVC, and PEF at attendance. MEASUREMENTS AND RESULTS: We studied 772 subjects; 387 (50%) were male; mean age was 55 years; atopic, 51%; current smokers, 11.5%; ex-smokers, 36%; and never smokers, 52.5%. Best pulmonary function was lower in chronic sputum producers (PEF, 83.2 vs 95.8; FVC, 67.9 vs 81.7% predicted). Chronic sputum production and its negative relationship with best function was strongly associated with smoking. There was little relationship between chronic sputum and persistent obstruction in nonsmokers. There were no univariate associations between sputum during attacks, or its color, and pulmonary function, but after allowing for demographic factors, including smoking, green sputum was associated with persistent obstruction. There was little relationship between sputum and actual/best function at attendance. CONCLUSIONS: Chronic sputum production is associated with persistent obstruction principally in those who have smoked, suggesting that the association reflects smoking rather than asthma. There is no interaction with atopy. After allowance for cigarette smoking, there is an association between green sputum production during exacerbations and persistent obstruction. Green sputum during relapse in asthma may indicate inflammation that is relevant to prognosis.

Adult↗
PubMed1994

Tuberculin skin testing: present status.

The incidence of tuberculosis is on the rise, with a reported 18% increase between 1985 and 1992. There is every reason to think that this trend will continue in the 1990s. Expectedly, there is a renewed interest in early detection and prevention of this potentially life threatening disease. Tuberculin skin testing remains a valuable diagnostic tool for the detection, control, and elimination of tuberculosis. It involves the intracutaneous injection of culture extracts of tubercle bacilli as a classic example of delayed hypersensitivity reaction. Despite proper technique and interpretation of the test, its usefulness is limited by cross-reaction caused by other mycobacterial antigens. False-negative reaction is a common confounding problem. It is therefore important to interpret the test based on the overall clinical context of the individual being tested. This article aims to review the basic immunology, proper technique, interpretation, and indication for the test.

Aged↗
PubMed1992

Steroid-induced bone disease. Conflicting views of respiratory and bone physicians.

Physician members of the Thoracic Society and the Bone and Tooth Society were circularised about their views on the prophylaxis, screening and treatment for steroid osteoporosis. Bone physicians were more active than respiratory physicians in screening and prophylaxis and were more likely to favour bone densitometry in assessment and bisphosphonates in treatment. Further studies are required to establish the value of prophylactic agents in steroid osteoporosis but meanwhile respiratory physicians should appreciate the value of the relatively simple technique of bone densitometry in assessment and consider whether they should be more active in prophylaxis.

Adult↗
PubMed1991

Infection in exacerbations of asthma: views of different groups of practitioners.

A questionnaire designed to elucidate views on the frequency of infection in asthma and its management was circulated to general practitioners, general physicians, paediatricians and respiratory physicians in the north of England. On the whole, general practitioners agreed with the general physicians and paediatricians with respiratory physicians. The generalists, and to a lesser extent the specialists, tended to overestimate the risk of bacterial infection, which was perceived to be a particular risk following viral infection in intrinsic asthma. This resulted in more frequent prescription of antibiotics than is justified by the published evidence. There was a tendency for frequent prescribers of antibiotics to withhold corticosteroids. If prescribing habits are to be altered, education will have to be directed at those responsible for acute admissions to hospital as well as at general practitioners.

Acute Disease↗