Browsing by Author "Field, Stephen K"
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- ItemOpen AccessAsthma Symptoms Do not Predict Spirometry(2007-01-01) Cowie, Robert L; Underwood, Margot F; Field, Stephen KBACKGROUND: Asthma is a disease characterized by variable airflow obstruction, but the measurement of airflow is often omitted in the process of diagnosis and management of the disease.OBJECTIVES: Features of asthma severity and control were examined to determine the extent to which objective measurements, including forced expiratory volume in 1 s and forced expiratory volume in 1 s/forced vital capacity, correlated with other manifestations of the disease.METHODS: Subjects were a consecutive sample of patients with asthma attending a university-based asthma clinic. All subjects underwent routine assessment using a standard questionnaire and spirometry.RESULTS: A total of 500 subjects were included in the present study, and their assessment showed that neither symptoms nor history could predict or be predicted by their measurements of lung function.CONCLUSION: Routine measurement of lung function should be performed on subjects with asthma if normal or near-normal lung function is a desired component of asthma control.
- ItemOpen AccessCongenital tuberculosis in an extremely preterm infant conceived after in vitro fertilization: case report(2017-02-20) Samedi, Veronica; Field, Stephen K; Al Awad, Essa; Ratcliffe, Gregory; Yusuf, KamranAbstract Background Congenital tuberculosis is a rare manifestation of tuberculosis. The diagnosis is often delayed, especially in preterm neonates because of the non-specific clinical presentation and the lack of awareness of maternal disease prior to pregnancy. Case Presentation We report a case of congenital tuberculosis in an infant born at 24 weeks of gestation to a mother who presented with uncontrolled seizures during preterm labor. Maternal diagnosis was initially made by placental pathology, and later confirmed by isolation of Mycobacterium tuberculosis in urine, gastric aspirates and sputum. Full screening was performed on the newborn infant, and both mother and infant were successfully treated for tuberculosis with a four drug regimen. Conclusion Pregnancy can exacerbate latent tuberculosis and women originating from endemic areas are especially susceptible. The best way to prevent congenital tuberculosis is to have a high index of suspicion and identify and treat tuberculosis in pregnant women.
- ItemOpen AccessInhaled Corticosteroid Therapy Does Not Control Asthma(2004-01-01) Cowie, Robert L; Underwood, Margot F; Field, Stephen KBACKGROUND: Randomized clinical trials demonstrate efficacy and show that inhaled corticosteroid therapy can control asthma, but details concerning their effectiveness in achieving this goal in the community are lacking.OBJECTIVES: To determine whether inhaled corticosteroid therapy is effective in controlling asthma and to examine the rates of asthma control in relation to inhaled corticosteroid use outside the realm of randomized controlled trials.METHODS: Different populations were examined cross-sectionally to determine whether self-reported use of inhaled corticosteroids was associated with control of asthma. Subjects with asthma in the community and those attending a university-based asthma program were studied. The definition of asthma control was based on the recommendations of the Canadian Consensus Report. The elements of asthma control were examined in the context of the subject's stated use and dose of the inhaled corticosteroid.RESULTS: Asthma was controlled in 20% (95% CI 18.7% to 21.3%) of the 3427 subjects included in the present study. Only 15% (95% CI 13.5% to 16.5%) of the 2437 subjects using inhaled corticosteroids exhibited asthma control compared with 33% (95% CI 31.1% to 35.9%) of the 990 subjects not using inhaled corticosteroids (Pud_less_than0.000001).CONCLUSIONS: Although it is known that inhaled corticosteroid therapy can result in asthma control in most individuals with asthma, the present study has shown that this result may not be attained outside the realm of randomized clinical trials. Inhaled corticosteroid use for asthma in a 'real world' setting appears to reflect disease severity.
- ItemOpen AccessSteroids and/or Cytotoxic Agents Should Be Used Early in the Management of Patients with IPF -- The Con Argument(2004-01-01) Field, Stephen KThe recently published American Thoracic Society/European Respiratory Society statement distinguishes idiopathic pulmonary fibrosis (IPF), also known as usual interstitial pneumonia (UIP), from the other idiopathic interstitial pneumonias (IIPs) (1). Although the current classification of IIPs is different from the one developed by Liebow and Carrington (2) in the 1960s, the description of UIP has not changed, and it is still recognized as having distinctive clinical and pathological features that distinguish it from the other IIPs. IPF responds differently to systemic corticosteroid (steroid) therapy and has a different prognosis than the other IIPs, such as nonspecific interstitial pneumonitis, which previously were felt to be variants of the same condition (1,3,4). Despite therapy, most patients with IPF experience a progressive decline in pulmonary function, leading to respiratory failure and death, unless they undergo lung transplantation.