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Biomedical subjects

R J Fink

Publications and source records attributed to R J Fink.

31 records · Page 2Linked to original sources
PubMed1986

Pulmonary function abnormalities in long-term survivors of childhood cancer.

Pulmonary function testing (PFT) was performed on 29 long-term survivors of childhood cancer. The patients, whose mean age was 11.7 years and whose mean age at diagnosis was 3.7 years, included 12 females and 17 males. Original diagnoses included 15 patients with leukemia and 14 individuals with solid tumors. Nine patients had received cyclophosphamide and 20 had received radiation therapy. Included in this latter group were five patients who had received radiation therapy to the thorax. Eight patients had acquired pneumonia during their treatment. Physical examination was normal in all the patients, and none had a history of acute or chronic pulmonary disease. PFT demonstrated an incidence of abnormalities in forced vital capacity (FVC) and/or total lung capacity (TLC) in 48% of the patients. Patients who were under 3 years of age at the time of diagnosis or who had received radiation to the thorax were more likely to demonstrate PFT abnormalities, but these differences did not reach statistical significance. The natural history of pulmonary function and subsequent respiratory disease in survivors of childhood cancer requires further definition.

Adolescent↗
PubMed1986

Effectiveness of continuous positive airway pressure in the treatment of bronchomalacia in infants: a bronchoscopic documentation.

Continuous positive airway pressure (CPAP) was used to treat severe respiratory distress in four infants with bronchomalacia. Fiberoptic bronchoscopy diagnosed the area of bronchomalacia, documented the effects of CPAP on the airway, and helped determine an effective level of CPAP. CPAP immediately decreased respiratory distress, and was correlated with improved airway patency in the formerly collapsed airways. All four infants, including three who had required prolonged mechanical ventilation, maintained spontaneous ventilation on CPAP.

Bronchial Diseases↗
PubMed1986

Effect of naltrexone on apnea of prematurity and on plasma beta-endorphin-like immunoreactivity.

Plasma levels of beta-endorphin-like immunoreactivity (beta-ELI) were measured in premature infants with apnea (n = 11) and compared to those in nonapneic controls (n = 9). Naltrexone (1-3 mg/kg) was given to the infants with apnea, 6 of whom were also receiving methylxanthines. Chest wall movements, nasal airflow, transcutaneous PO2 and electrocardiogram were recorded for 4-6 h prior to and for 4-6 h after administration of naltrexone. Samples for beta-ELI were taken prior to and 1 h post naltrexone. beta-ELI levels were significantly higher (p less than 0.007) in infants with apnea of prematurity than in control infants. No significant difference was found in beta-ELI levels before and after naltrexone. Naltrexone did not decrease the incidence of apnea.

Apnea↗
PubMed1980

Echocardiography in cystic fibrosis: A proposed scoring system.

An echocardiographic scoring system was developed on the basis of an observed sequence of echo abnormalities, beginning with RV hypertrophy, through RV dilation, to abnormal RV systolic time intervals, noted to be associated with the progressive pulmonary disease of cystic fibrosis. This score correlated significantly with both the Shwachman-Kulczycki (r = 0.87, P < 0.001) and Taussig-NIH (r = 0.86, P < 0.001) clinical scoring systems, the Brasfield chest roentgenogram score (r = 0.86, P < 0.001), and pulmonary function test results. The scoring of echos appears to be useful for the early detection and systematic quantitation of the cardiac effects of the progressive pulmonary disease. Preliminary sequential echo studies suggest that this system provides a method for assessing the progression of cardiac disease and evaluating prognosis in individual patients, and may prove to be useful in monitoring therapeutic interventions for cor pulmonale.

Adolescent↗
PubMed1978

Pulmonary function and morbidity in 40 adult patients with cystic fibrosis.

Pulmonary function and cardiopulmonary complications were studied in a group of 40 patients with cystic fibrosis who reached the age of 25 years. Mean values for vital capacity (VC), functional residual capacity, residual volume (RV), the ratio of RV over total lung capacity (RV/TLC), conductance, and the ratio of the forced expiratory volume in one second over VC were abnormal. There was a variable pattern of progression from patient to patient. The men differed from the women only in that they had a significantly larger TLC and inspiratory capacity than the women. The resultant preservation of VC may have an advantage for survival in those patients in whom it is observed. Pseudomonas aeruginosa was encountered with increasing frequency with age. Massive hemoptysis did not result in early death. The occurrence of rightsided heart failure secondary to cor pulmonale, with or without respiratory failure, was a poor prognostic sign.

Adolescent↗
PubMedDate not supplied

Use of home apnea monitors.

OBJECTIVE: To examine the frequency of use of home apnea monitors, reasons for not using them, and factors associated with their use among families of infants for whom home monitoring had been prescribed. DESIGN: Cross-sectional study, including a telephone interview to collect demographic data and a mailed questionnaire to obtain data on monitor use. SETTING: The apnea clinics in two tertiary-care centers. PARTICIPANTS: Ninety-three families (representing an 80.9% response rate) with infants considered at increased risk of sudden infant death syndrome and requiring home monitors. Infants with tracheostomies or bronchopulmonary dysplasia and families with monitored twins, a mother known to be drug addicted, or no home telephone were excluded. RESULTS: Of concern were that 23.1% of mothers reported using the monitor 12 or fewer hours per day and that 10.8% believed their infants did not need a monitor. Of 11 variables examined, only color change in the infant was associated with frequency of monitor use. CONCLUSIONS: Clear, consistent communication with families regarding the use of apnea monitors is essential to improve compliance with proper monitoring techniques.

Cross-Sectional Studies↗
PubMedDate not supplied

Home apnea monitoring and risk factors for poor family functioning.

As part of a comprehensive study on the impact of home apnea monitoring on family functioning, we undertook an in-depth analysis of risk factors for poor family functioning in 93 families of monitored infants. A multistep correlation and regression analysis was used to examine the ability of 16 demographic, infant, family, and monitor-related variables to predict poor functioning in each of 12 different aspects of family life. Of note was the fact that monitor-related variables failed to be important predictors of poor family functioning. Rather, previous family problems and low satisfaction with social support were the most broad and powerful predictors of poor functioning. To enhance the capabilities of families to manage the added responsibility of home monitoring, clinicians might wisely assess both of these aspects of family life and then target extra support services to families identified to be at risk in these areas.

Adult↗