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Biomedical subjects

T H Sher

Publications and source records attributed to T H Sher.

16 recordsLinked to original sources
PubMed1989

Metabisulfite sensitivity and local dental anesthesia.

A case of sulfite sensitivity first manifesting as urticaria and acute airway obstruction following local anesthesia is described. A positive parenteral provocation test to metabisulfite was observed weeks after recovery of the patient from the clinical event.

Adult↗
PubMed1987

Occult sinus abnormalities in the asthmatic patient.

Unrecognized sinusitis has been cited by others as a significant unrecognized factor in patients with asthma, chronic rhinitis, and urticaria. The current study examines the utility of roentgenography of the paranasal sinuses in such patients. Forty-seven percent of patients with flare-ups of asthma had abnormal sinus roentgenograms, a highly significant difference from the 29% prevalence in patients presenting with complaints of rhinitis. The patient's clinical history was most often not helpful in predicting whether or not roentgenographic abnormalities of the sinuses would be detected. Since maxillary sinusitis is the most frequent finding, the erect Waters' view is the most useful single roentgenogram.

Adolescent↗
PubMed1986

Studies in stinging insect hypersensitivity: postmortem demonstration of antivenom IgE antibody in possible sting-related sudden death.

The purpose of this study was to extend previous findings of elevated antivenom IgE antibodies in sera from persons experiencing fatal insect sting reactions. Elevated IgE antibodies to at least one venom were measured in sera from four of six witnessed fatal cases of sting anaphylaxis; in one of two unwitnessed cases of sudden, unexpected death in which the circumstances suggested possible sting anaphylaxis; and in one unwitnessed death where autopsy findings of massive swelling of the pharynx and larynx suggested anaphylaxis. Conversely, no elevated IgE antibodies were measured in serum from a boy who received more than 40 yellow jacket stings with subsequent cardiopulmonary arrest, from which he was successfully resuscitated. Measurement of IgE antibodies in postmortem sera may not only provide confirmatory evidence of fatal anaphylaxis following witnessed insect stings, but also may provide useful additional data in unwitnessed deaths where the clinical history or autopsy findings suggest unexplained anaphylaxis.

Adult↗
PubMed1984

Fenoterol dose-response study in children with asthma.

We have studied the effect of fenoterol, a selective beta-2 adrenergic agent, on airway obstruction in children with asthma. The drug was administered orally in single doses of 2.5, 5, and 7.5 mg to 20 children with chronic stable asthma of moderate severity. The mean age of the children was 11.6 yr. Pulmonary function tests were performed as baseline at zero time and at intervals over a 6-hour period after drug administration. Onset of action for all doses was within 1 hr with a peak effect noted at 1.5 to 3 hr, and sustained improvement was observed over the entire 6 hr. The doses of 5 mg and 7.5 mg were equally effective in producing significant improvement of pulmonary function compared to 2.5 mg (p less than 0.05). Side effects remained acceptable for all patients. The 5 and 7.5 mg doses produced significant adverse effects that involved the central nervous and musculoskeletal systems, whereas the 7.5 mg dose caused a significant incidence of tachycardia. Our findings indicate: (1) fenoterol is a potent oral bronchodilator for large and small airways in children, (2) the 7.5 mg dose does not achieve any additive effect over a 5 mg dose; and (3) 5 mg is the optimal oral dose of fenoterol for children from age 8 to 12 yr.

Adolescent↗
PubMed1982

Interaction between nutrition and theophylline metabolism in children.

The influences on theophylline metabolism are multifactorial, resulting in significant inter- and intrapatient variability in drug responsiveness. Clinical investigations with adult patients have demonstrated the influence of diet on theophylline metabolism following a single drug dose. We have undertaken this study to examine the effect of nutritional factors on theophylline pharmacokinetics in 14 asthmatic children receiving the drug on a chronic basis. For 12-day periods each patient received three separate diets with different proportions of protein and carbohydrate but with constant fat and caloric intake. Significant differences were detected for theophylline half-life, apparent volume of distribution, and metabolic clearance rate. The high-protein diet markedly shortened the drug-elimination half-life relative to a normal diet, and high carbohydrate significantly increased it (both p less than 0.001). Other kinetic parameters confirmed this pattern. Our findings in children clearly establish that nutritional factors have a significant environmental influence on theophylline metabolism during the drug's steady-state pharmacokinetics.

Adolescent↗