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Author

J G Douglas

Other affiliations: University of Edinburgh
Bio: J G Douglas is an academic researcher from Northern General Hospital. The author has contributed to research in topics: Breathing & Artificial ventilation. The author has an hindex of 3, co-authored 4 publications receiving 41 citations. Previous affiliations of J G Douglas include University of Edinburgh.

Papers
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Journal ArticleDOI
05 Jan 1985-BMJ
TL;DR: Jet nebulisers are increasingly being used to provide high dose bronchodilator treatment, both in hospital and at home, and the flow rate of the driving gas through a nebuliser directly affects the size of the particles generated, which could imply that at lower flow rates the response to a bronchidilator aerosol would be diminished, even if the same dose of the drug is inhaled.
Abstract: Jet nebulisers are increasingly being used to provide high dose bronchodilator treatment, both in hospital and at home. The flow rate of the driving gas through a nebuliser directly affects the size of the particles generated, and for most nebulisers flow rates of less than 6 1/min produce droplets with a mass median diameter that is considered to be too large for tracheobronchial deposition.1 This could imply that at lower flow rates the response to a bronchodilator aerosol would be diminished, even if the same dose of the drug is inhaled. We tested this hypothesis by comparing the bronchodilator response to rimiterol nebulised at 4 1/min and 8 1/min in a group of patients with chronic stable asthma.

22 citations

Journal ArticleDOI
TL;DR: A man with acute Q fever developed hyponatraemia associated with inappropriate secretion of anti-diuretic hormone and seroconversion indicated chronic Q fever.

13 citations

Journal ArticleDOI
18 Jun 1983-BMJ
TL;DR: The most frequent complication was bronchopulmonary infection which occurred in almost every patient, Staphylococcus pyogenes, Pseudomonas pyocyanea, and coliforms being the organisms most commonly isolated.
Abstract: During the 10 year period 1972-81, 39 patients with neurological disorders referred to a respiratory unit required artificial ventilation, seven on two occasions. The decision to undertake ventilation was usually made on clinical grounds because of deteriorating respiratory effort, ineffective cough, or inability to swallow. Arterial blood gas studies were of limited value in assessing the need for ventilation. The most frequent complication was bronchopulmonary infection which occurred in almost every patient, Staphylococcus pyogenes, Pseudomonas pyocyanea, and coliforms being the organisms most commonly isolated. In contrast, serious complications of tracheostomy and pulmonary thromboembolism occurred infrequently. There were 10 deaths among the 39 patients ventilated on 46 occasions; six were directly attributable to the neurological disease itself but four resulted from complications of artificial ventilation.

5 citations

Journal ArticleDOI
06 Aug 1983-BMJ
TL;DR: It is misleading of Dr Shepherd to imply that maternal serum X fetoprotein screening is only marginally helpful, as regions may be deterred from taking advantage of an important means of reducing the incidence of severe handicap.
Abstract: years 17 707 pregnancies were screened.' Since then the programme has expanded and in 1981 was used by 73% of pregnant women in a population estimated to be 2-9 million. Up to the end of 1981 a total of 440 of 112 065 pregnancies screened were terminated-270 because of anencephaly and 170 because of spina bifidaa2-and for 1981 it is estimated that the 54 pregnancies terminated because of anencephaly and the 56 terminated because of open spina bifida represent a 72°o reduction in all neural tube defects expected in the west of Scotland. As it is believed that 68 \" ,, of infants with open spina bifida detected by serum a fetoprotein screening survive to at least 6 months,3 the effect of our programme in reducing the burden of this condition in our community must be considerable. It is misleading of Dr Shepherd to imply that maternal serum X fetoprotein screening is only marginally helpful, as regions may be deterred from taking advantage of an important means of reducing the incidence of severe handicap.

1 citations


Cited by
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Journal ArticleDOI
TL;DR: The diagnosis of Q fever relies mainly upon serology, the most commonly used method being the immunofluorescence assay, and serological testing for Q fever should always be done for a patient with a febrile illness and negative blood cultures.
Abstract: My colleagues and I compliment Dr. Fournier and coauthors on an excellent review (3). However, we were surprised to read the statement that there is no commercially available enzyme-linked immunosorbent assay (ELISA) for the serological detection of Q fever, since papers describing these assays have been published (1, 2, 4). These ELISAs, for the detection of specific immunoglobulin M (IgM), IgA, and IgG antibodies produced during Q fever, are available from PanBio Pty Ltd., Brisbane, Australia. All tests use a common assay method, including the provision of cutoff control sera, and take less than an hour to perform. The availability of these tests in part contradicts the claim made by Fournier et al. (3) that ELISA is a more laborious technique than immunofluorescence assay (IFA) and requires considerable experience in interpreting the results. The IgG ELISA has been shown to have good correlation with immunofluorescence, and all patients determined to have a significant level of antibody by IFA were positive in the PanBio test (2, 4). The IgM and IgA ELISAs showed a significant correlation with the complement fixation test, with sensitivity of 100% and specificity of 89% being reported for each assay (1).

555 citations

Journal ArticleDOI
01 Aug 1996-Chest
TL;DR: In this article, the performance of medication nebulizers is affected by fill volume, flow, and nebulizer brand, and the amount of albuterol trapped in the dead volume was determined spectrophotometrically.

225 citations

Journal ArticleDOI
Margaret Johnson1, Newman Sp1, Roy D. Bloom1, N Talaee1, Stewart W. Clarke1 
01 Jul 1989-Chest
TL;DR: In this paper, bronchodilator responses to both nebulized albuterol (salbutamol) and ipratropium bromide and aerosol delivery to the tracheobronchial tree have been assessed in eight patients with chronic stable asthma.

113 citations

Journal ArticleDOI
TL;DR: It is concluded that attempts to use CI-generated data from quality control testing to compare products for bioequivalence are likely to have only limited success, as links between laboratory-measured APSD, particle deposition in the respiratory tract, and clinical response are not straightforward.
Abstract: The purpose of this review is to discuss the roles of cascade impactor (CI) data in inhaler assessment and to examine the relationship between aerodynamic particle size distribution (APSD) and the clinical response to inhaled drugs. A systematic literature search of studies linking APSD to clinical response was undertaken. Two distinct roles for CI-generated data were identified: (1) the control of inhaler/drug product quality; and (2) the provision of data that may be predictive of particle deposition in the respiratory tract. Method robustness is required for the former application, combined with simplicity in operation, resulting in rudimentary attempts to mimic the anatomy of the respiratory tract. The latter necessitates making the apparatus and its operation more closely resemble patient use of the inhaler. A CI cannot perfectly simulate the respiratory tract, since it operates at constant flow rate, while the respiratory cycle has a varying flow-time profile. On the basis of a review of studies linking APSD to clinical response of inhaled drugs, it is concluded that attempts to use CI-generated data from quality control testing to compare products for bioequivalence are likely to have only limited success, as links between laboratory-measured APSD, particle deposition in the respiratory tract, and clinical response are not straightforward.

101 citations