S. Godfrey

RELX Group (United States)

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Ephraim Bar‐Yishay

Ben-Gurion University of the Negev

Chaim Springer

University of Tennessee at Knoxville

A. Avital

Radboud University Nijmegen

Peter König

German Center for Lung Research

Janet Stocks

St. Cloud Hospital

Michael Silverman

Simon Fraser University

S A McKenzie

Thomas Jefferson University

A T Edmunds

Royal Hospital for Children

Channa Maayan

Hadassah Academic College

Mark Tooley

Royal United Hospital Bath NHS Trust

Cooperative Institutions

University of Toronto

Royal College of Physicians of Edinburgh

Hadassah Academic College

Royal College of Physicians and Surgeons of Glasgow

Western Regional Hospital

RELX Group (United States)

Fermi National Accelerator Laboratory

University College London

Hospital for Sick Children

Western University

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Clinical, physiological, and psychological study of asthmatic children attending a hospital clinic

Archives of Disease in Childhood (1977)

Mark Norrish Mark Tooley S. Godfrey

The results of an investigation into the relationship between clinical, physiological, and psychological factors in 63 children with asthma are reported. The children were classified according to the severity of their asthma by reference to their regular drug usage and also were assessed in terms of the quality of control of the asthma and the degree of compliance with medication. Lung function tests and exercise tests were also carried out. Standard questionnaires to detect emotional or behavioural `deviance9 in the children were completed by their mothers and by class teachers and assessments made of their personalities and the mental health of their mothers. Though the percentage of children with deviant scores on the questionnaire was high, it was not much greater than had been found among other (nonasthmatic) London children. Resting peak flow rate, measured as the mean of at least three tests on different clinical attendances, reflected the clinical grading of severity. Deviant children had lower levels of peak flow than non-deviant children, but their bronchial lability as measured by exercise-induced asthma was similar. Poor control of the asthma was associated with emotional or behavioural deviance, whereas deviance was independent of the severity of the asthma per se.

10.1136/adc.52.12.912

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Citations (39)

Home recording of PEF in young asthmatics: does it contribute to management?

European Respiratory Journal (1996)

Kamal Uwyyed Chaim Springer A. Avital Ephraim Bar‐Yishay S. Godfrey

The value of home monitoring of peak expiratory flow (PEF) as part of an action plan for asthma management in children and young adults is uncertain. We sought to determine whether home recording of PEF benefited asthma management and whether any contribution was affected by the severity of the asthma. Twenty-eight children and young adults with asthma of different severity (mean age 14 yrs; 95% confidence interval (95% CI) 12-16 yrs) recorded their symptoms, drug consumption and PEF twice daily for a mean of 82 days over a 12 week period, and attended the laboratory every 2 weeks for measurement of lung function. The number of individual patients with significant correlations for laboratory lung function tests compared with ambulatory PEF and diary scores averaged over the preceeding 2 weeks was low in all severity groups. When measured in the laboratory, PEF meter readings correlated poorly with PEF measured by spirometry. The proportion of patients with significant correlations for PEF, symptoms and rescue bronchodilator use on a day-to-day basis was 70-80% in the group of severe asthmatics and significantly less in the mild asthmatics. In a subgroup of 14 patients who were sick on a mean of 19 days, the mean difference in PEF between well and sick days was 14% of predicted. Diurnal PEF variation correlated poorly with other parameters in all groups. It is concluded that PEF monitoring adds little to daily recording of symptoms and bronchodilator use in the management of young patients with severe asthma, and it is too insensitive to register meaningful clinical changes in those with milder asthma.

Peak flow meter

10.1183/09031936.96.09050872

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Citations (56)

An Evaluation of Rebreathing Methods for Measuring Mixed Venous P co2 During Exercise

Clinical Science (1972)

S. Godfrey Eliana Wolf

1. Measurements have been made of mixed venous Pco2 (PV̄co2) by two methods during exercise at 50 and 100 W in five adult male subjects. 2. The equilibration (plateau) method and the extrapolation (Defares) method were performed alternately, five times each, during the steady-state exercise. 3. The coefficient of variation of PV̄,co2 by the extrapolation method was much higher than that of the plateau method. The PV̄,co2 can be estimated to within ± 1 mmHg by the plateau method, and the derived cardiac output to within ± 0·5 1/min in most cases. The cardiac output calculated by this method agrees closely with that found by direct methods in other studies, whereas the extrapolation method usually overestimates the cardiac output in adults. 4. It is suggested that the degree of variation in the extrapolation method is due to technical factors in construction of the line and to the difficulty of deciding what constitutes the end-tidal Pco2.

Coefficient of variation

pCO2

Line (geometry)

10.1042/cs0420345

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Citations (29)

Cut-off points defining normal and asthmatic bronchial reactivity to exercise and inhalation challenges in children and young adults

European Respiratory Journal (1999)

S. Godfrey Chaim Springer Ephraim Bar‐Yishay A. Avital

An analysis was undertaken to determine the optimal cut-off separating an asthmatic from a normal response to a bronchial provocation challenge by exercise and the inhalation of methacholine or histamine in children and young adults. Data were extracted, after appropriate correction, from published studies available in Medline of large random populations that complied with preset criteria of suitability for analysis, and the distribution of bronchial reactivity in the healthy population for exercise and inhalation challenges were derived. Studies on the response to exercise and methacholine inhalation in 232 young asthmatics of varying severity were carried out by the authors and the distribution of bronchial reactivity of a young asthmatic population obtained. Comparisons of the sensitivity and specificity of the challenges were aided by the construction of receiver operating characteristic curves. The optimal cut-off point of the fall in forced expiratory volume in one second (FEV1) after exercise was 13%, with a sensitivity (power) of 63% and specificity of 94%. For inhalation challenges, the optimal cut-off point for the dose of methacholine or histamine causing a 20% fall in FEV1 was 6.6 micromol, with a sensitivity of 92% and a specificity of 89%. The cut-off values were not materially affected by the severity of the asthma and provide objective data with which to evaluate the results of bronchial provocation challenges in children and young adults.

Methacholine

10.1034/j.1399-3003.1999.14c28.x

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Citations (145)

Necrotizing tracheobronchitis following mechanical ventilation of the newborn.

PubMed (1989)

Ilan Arad Kamal Uwyyed O Peleg Irving M. Ariel S. Godfrey

Mechanical ventilation of newborn infants with respiratory distress is associated with diverse pathology of the lung. Recent reports have focused on a distinct lesion pattern of the tracheobronchial system--necrotizing tracheobronchitis. While many advanced cases of the disease proved fatal secondary to airway obstruction, others were successfully treated by removal of the occlusion. We describe two neonates with necrotizing tracheobronchitis, one of whom had a complete occlusion of the right main stem bronchus that was relieved by curettage during bronchoscopic examination.

Tracheitis

Airway obstruction

Curettage

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Citations (2)

Differential lung function in an infant with the Swyer-James syndrome.

Thorax (1989)

A. Avital David L. Shulman Ephraim Bar‐Yishay Natan Noviski Joseph Schachter

A previously healthy two year old boy had an adenoviral infection at the age of 13 months and developed hyperlucency of the left lung, chronic respiratory distress, and failure to thrive. Bronchodilators and steroid treatment had no effect. Radionuclide lung scans using an intravenous bolus of xenon-133 both before and after treatment showed substantially reduced function on the hyperlucent side and modestly reduced function on the other side. Fibreoptic bronchoscopy showed no structural abnormalities. Partial forced expiratory flow volume (PEFV) curves, generated from end inspiration by rapid compression of the chest wall with an inflatable jacket, were obtained from the total respiratory system and from each lung separately by inflating a Fogarty catheter in the contralateral mainstem bronchus. Expiratory flow rates and volumes during both tidal breathing and PEFV manoeuvres were considerably decreased in the hyperlucent lung. PEFV curves from the "healthy" right lung and from the total respiratory system were similar in shape and showed a moderately obstructive pattern. The right lung ventilated about four times as much as the left when measured by bronchospirometry and about three times as much when measured by the radionuclide technique. The lung scans appeared to reflect adequately the functional abnormality in this infant with the Swyer-James syndrome.

10.1136/thx.44.4.298

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Citations (8)

LITERATURE ABSTRACTS

Therapeutic Drug Monitoring (1979)

Shawn McKenzie E. Eugene Baillie S. Godfrey

Log in or Register Subscribe to journalSubscribe Get new issue alertsGet alerts Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Subscribe Register Login Articles & Issues Current IssuePrevious IssuesPublished Ahead-of-Print For Authors Submit a ManuscriptInformation for AuthorsLanguage Editing ServicesAuthor Permissions Journal Info About the JournalEditorial BoardAdvertisingOpen AccessSubscription ServicesReprintsRights and Permissions All Articles Images Videos Podcasts Blogs Advanced Search

Logo (programming language)

10.1097/00007691-197901000-00071

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Citations (0)

Inhibition of exercise-induced asthma by different pharmacological pathways.

Thorax (1976)

S. Godfrey Peter König

Exercise-induced asthma (EIA) was provoked by standardized treadmill running for 6 minutes in 15 asthmatic children. The tests were carried out after the administration of a placebo, salbutamol, sodium cromoglycate, choline theophyllinate, and atrophine methonitrate aerosol in randomized fashion on different days. The mean post-exercise percent fall in peak expiratory flow rate was 45-2, 4-1, 19-6, 18-3, and 24-9 respectively. The proportion of children having significant amelioration of their EIA compared with those taking the placebo was 100% for salbutamol, 80% for cromoglycate and theophyllinate, and 60% for atropine. Salbutamol, choline theophyllinate, and atropine were bronchodilators at rest whereas cromoglycate was not, and the ability to suppress EIA was unrelated to bronchodilator effect. Even after bronchodilatation at rest, further broncho-dilatation occurred during the exercise period.

Exercise-induced asthma

Bronchodilatation

10.1136/thx.31.2.137

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Citations (166)

Total population survey of the frequency and severity of asthma in 17 year old boys in an urban area in Israel.

Thorax (1993)

I Auerbach Chaim Springer S. Godfrey

There is evidence that the prevalence of asthma in children and young people is increasing.An examination of a total population (35,170) of 17 year old Jewish boys of one seaside urban area in Israel was undertaken during two years, 1986 and 1990, by trained respiratory physicians in a regional recruiting office of the Israel Defence Forces. All boys who had ever been diagnosed as having asthma or symptoms that could have been due to asthma underwent a further examination by respiratory physicians that included spirometry at rest. A test to evaluate exercise induced asthma was performed on a treadmill in 88% of the boys.Lifetime prevalence (asthma in the past or at present) increased from 7.9% in 1986 to 9.6% in 1990. Point prevalence (current asthma) increased from 5.0% to 5.9%. The prevalence of current asthma increased in all degrees of severity (mild disease from 3.3% to 3.7%, moderate disease from 1.7% to 2.2%, and severe disease from 0.03% to 0.04%). By the age of 17, 77.4% of boys who had suffered from asthma had no or only very mild symptoms.It is considered that the measured increase in prevalence of asthma from 1986 to 1990 reflects a true increase among the Jewish Israeli population.

10.1136/thx.48.2.139

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Citations (66)

The place of radioisotopic lung function studies in paediatrics.

Archives of Disease in Childhood (1977)

S. Godfrey S A McKenzie

An analysis of the clinical value of radioisotopic lung function (RLF) tests has been carried out on the results of studies in 123 children with heart or lung disease. The overall incidence of useful RLF tests was 53%, but in children between 6 months and 6 years the incidence was higher (69%). The incidence of useful RLF test was similar whatever the question to be answered, although rather higher when information about differential pulmonary blood flow was required. Lists of conditions are presented for which the incidence of useful RLF tests is likely to be high (72%), moderate (46%), and low (14%).

10.1136/adc.52.11.859

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Citations (12)