摘要:

Summary:The frequency, range and severity of functional abnormalities during complete clinical remission of asthma were studied in 57 patients. Ninety per cent had abnormal tests, the usual pattern being impaired ventilatory capacity, hyperinflation, maldistribution of ventilation, ventilation/blood‐flow inequality and hyperventilation with norm‐al arterial oxygen tension and gas transfer. If spirometry had been used as the sole screening procedure, nearly one third of patients with abnormal function would have been missed. The measurement of lung volumes appeared to be the most practical way to detect these latter patients. Since there is a poor relation between symptoms and functional abnormalities in asthma, laboratory measurements are an important adjunct to clinical assessment. Although asthma is generally regarded as reversible airways obstruction, the extent of reversibility appears to be frequently incompl

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04293.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:The daily incidence of asthma as measured by the attendance of children with asthma in the season of low pollen numbers (April to September) is compared with total casualty attendance figures, the atmospheric pollen and fungal spore counts, and with climatic conditions including atmospheric ionization.A multiple regression computer programme with up to three days lag for the effect of climate factors on asthma attendance and fungal and pollen counts was used to demonstrate association between these factors. Statistical analysis of this data shows that there is a significant association between reduction in asthma attendance (p<0.05) and increased atmospheric ionization three days before, increased barometric pressure two days before, and increased temperature one day before. This association accounts for 16.18% of the daily variation in asthma attendance. There is also a significant association between increased fungal spore counts and increased asthma (p<0.05). In this April to September period there is no association between pollen grain counts and asthma. Climate factors, as might be expected, are significantly associated with variation in pollen (26.44%) and fungal spore numbers (21.74%). With the exception of atmospheric ionization three days before (being associated with both a reduction in fungal spore count and a reduction in asthma attendance), there is no coincidence between the climate factors associated with variation in air spora numbers and those associated with variation in attendance with asthma. It would appear that, in the Perth area between April and September, variation in climate factors and fungal spore counts are associated with variation in the asthma attendance rate.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04294.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:In 12 children with bronchial asthma, the factors determining maximum expiratory flow at different levels of lung inflation have been examined during forced vital capacity manoeuvres. The findings confirm the histopathological evidence of major changes in the small and medium sized airways in asthma. Changes in the function of these airways, especially those with small internal diameters, often remained undetected by conventional spirometry, whereas analysis of the maximum expiratory flow‐volume (MEFV) curves of these asthmatic children frequently revealed abnormalities. It is suggested that MEFV curves are simple and useful in the assessment of disease in the small airway

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04295.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Eight patients with IgA deficiency were investigated. Respiratory and gastrointestinal symptoms were prominent and manifest clinically by bronchitis, asthma, steatorrhoea or diarrhoea. In many instances these symptoms were of a relatively mild nature. Evidence of allergy or autoimmunity was present in all patients. Three patients were asthmatic and three had recurrent urticaria or hay fever. Other associated diseases were thyrotoxicosis, corticosteroid sensitive marrow aplasia, glutenenteropathy and allergic alveolitis. Five patients had antibodies against IgM in ruminant serum and in two instances these antibodies produced a second ring in the radioactive single radial immunodiffusion assay for IgE by precipitating sheep serum in the agar. One patient had milk precipitins. Autoantibodies were rheumatoid factor and parietal cell, thyroid epithelial cell and reticulin antibodies. It is considered that allergic and autoimmune phenomenon are due to defective mucosal defences in these patients. While cellular immunity appeared intact and IgA was the only immunoglobulin quantitatively defective, evidence for a broader abnormality of humoral immunity was provided by the findings of absent blood group isoagglutinin in one patient who was blood group A, low antistreptolysin 0 titres in five patients and poor germinal centre activity in three. Excellent symptomatic responses were obtained in five patients who received IgG therapy. A qualitative abnormality of IgG antibody synthesis may result from a relative underproduction of one or more IgG subclasses or kappa or lambda light chains. Parenterally administered IgG might correct such a deficiency.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04296.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Findings from 17 women who had unbroken histories of oral contraceptive use covering 4.5 years or longer were compared to a control group of 18 women, approximately matched for age, who had never used oral contraceptives.Anomalies of chromosome number and structure in blood lymphocytes, cultured for 48 hours with PHA, did not differ between the two groups. Lymphocyte transformation in response to PHA, as measured by mitotic index and cell uptake of tritiated thymidine, was reduced in oral contraceptive users compared to controls.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04297.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:The clinical features are presented of two hundred and fifty‐one (251) Aboriginal infants and children with diarrhoea treated over a recent two‐year period.Clinical evidence of malnutrition was present in 40 per cent of these patients and 37 per cent were anaemic. Sugar intolerance complicated the clinical course in one‐quarter of the cases. More than one‐half of the patients had enteric pathogens in their stools; they included a wide variety of intestinal parasites and enteropathogenic bacteria.The clinical pattern of diarrhoeal illnesses seen so commonly in young Aborigines resembles that seen in under‐privileged communities in developing countries. Improvement of this situation will depend on elevation of the presently unsatisfactory standards of living, nutrition, education and hygiene in the Aboriginal p

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04298.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Medullary blood flow has been assessed in 29 analgesic‐fed rats and nine matched control animals and has been correlated with renal medullary histological changes and tests of glomerular and tubular function. The animals were gavage‐fed a variety of common non‐steroid anti‐inflammatory analgesic compounds over 20 weeks. Medullary perfusion was significantly reduced in analgesic‐fed animals and was further lowered in animals subjected to hypovolaemic shock. Dehydration, however, did not appear to influence medullary blood flow in analgesic‐fed rats. Medullary ischaemia appeared to be the earliest analgesic induced renal damage and developed before histological renal papillary necrosis. Ischaemia correlated with tests of medullary dysfunction — renal concentrating capacity and sodium conservation, but not with tests of glomerular function. On the basis of these findings the pathogenesis of analgesic induced renal papillary necrosis

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04299.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:The case histories of two patients suffering from neuropathic arthropathy are presented. One of them had Charcot“s disease of the lumbar spine secondary to a syphilitic infection. The second case, who was thought to have syringomyelia, gave a history of recurrent dislocation of the (R) shoulder. Clinical and radiological, examination of this joint suggested that it was of the neuropathic type. The pathophysiology and treatment of Charcbt's joints is briefly discusse

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04300.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Serial measurements of arterial pO2, pCO2and pH were made in 99 patients admitted to a coronary care unit with acute myocardial ischaemia or infarction. Samples were taken whilst the patients breathed room air and air enriched with oxygen in a concentration of approximately 40% via nasal cannulae. The degree of arterial hypoxaemia on room air correlated well with the degree of left ventricular failure. The increase in arterial oxygen tension produced by oxygen enrichment of the inspired air was greater in those with mild than in those with severe left ventricular dysfunction. The return of the arterial oxygen tension to normal after myocardial infarction may be protracted, suggesting that prolonged oxygen administration is advisable in the more severely ill patients. Levels of arterial pCO2and pH were not found to be helpful in management.

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04301.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY

摘要:

Summary:Fourteen infants and children with intracranial arteriovenous fistulae are presented. They were seen by the Cardiology department at the Hospital for Sick Children over an eighteen year period from 1954 to 1972.Two separate groups were distinguished. Older infants and children tended to present with neurological problems. Hydrocephalus and seizures were common. Heart murmurs and abnormal electrocardiograms were still frequent in this group. Cardiac failure did not occur. These children had a wide variety of arteriovenous malformations. In contrast, the group of infants presenting in the first week of life had severe cardiac failure without exception. All died despite attempted surgical palliation of the fistula in two cases. Neurological signs were present in some but were over‐shadowed by the severe cardiac failure. Cyanosis or a history of cyanosis at some stage was present. Cyanosis may be due to several different mechanisms.Twelve of the fourteen children had continuous cranial murmurs. However, only in one case was the diagnosis suspected clinically. The murmurs were usually detected after the diagnosis had been made at catheterization and angiography. Auscultation of one‐hundred unselected neonatal heads by us, has shown that the presence of a murmur is rare. The importance of listening for cranial bruits in the newborn child with cardiac failure is re‐empha

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1973.tb04302.x

出版商:Blackwell Publishing Ltd    

年代:1973

数据来源: WILEY