Serum Transaminase Activity in Status Asthmaticus

Abstract

Vacuum Extractor-Chalmers MBICARJOURNAL anterior position. The more experienced practitioner may wish to extend the range of his intervention, but this should be limited to institutional conditions. There are many general practitioners in this country, including several of our former house-surgeons, who are using the instrument successfully. Further extension of this trend would help to reduce the dangers of forceps in unpractised hands and lead to improved figures for infant survival in the home, as we believe it has in the hospital. SummaryThe Malmstr6m vacuum extractor has been employed for 400 deliveries at the Obstetric Unit, Ronkswood Hospital, Worcester, during 1948-63. In this time the incidence of vacuum extraction has increased progressively, while that of forceps delivery has fallen.Foetal mortality has fallen progressively, and recently there has been a fall in the incidence of caesarean section. It is suggested that both of these are due in part to the use of the vacuum extractor.Indications are described for the use of the instrument in both the first and the second stage of labour, and the results are detailed.The method has proved effective in cases of malrotation of the foetal head and of foetal distress, and results for both mother and foetus have been satisfactory. I am grateful to my colleague Mr. A. T. Marshall for permission to quote many of his cases included in the above series.

The association between asthma, asthma therapeutic classes and hepatic enzyme elevation among adult HMO members

“…2,4,5 However, others have postulated that altered oxygen supply to the liver may not be the only mechanism, and that the increase in enzyme activity may be mediated by allergic reactions in the lung. 6 A few studies have reported abnormal liver function tests associated with long-term xanthine therapy, 7 long-term systemic corticosteroid use, 8 and with experimental treatment with zileuton, an inhibitor of the enzymatic pathway leading to leukotriene formation.…”

Serum lactate dehydrogenase isoenzyme activities in patients with asthma

“…Past attempts to relate increases in serum GOT levels with prognosis in asthma patients have been unsuccessful (El-Shaboury et al, 1964). The present finding of a lack of correlation between the clinical condition of the patient and the various isoenzyme levels, coupled with the further increases noted in certain clinically improved patients, indicates that the more specific assay is equally inapplicable for this purpose.…”

“…In addition, centrilobular necrosis has been detected at necropsy in 5% and steatosis in 23% of patients dying from asthma (Colldahl, 1971). El-Shaboury et al (1964), however, found no correlation between serum GOT activity and liver function tests in patients suffering asthma attacks, and suggested that the increase in circulating enzyme activity may have arisen from lung tissue damaged by allergic reaction.…”

“…It was concluded that the increases in serum enzyme activity resulted from liver damage caused by the altered tensions of oxygen and carbon dioxide in the circulation. Subsequently, El-Shaboury, Thomas, and Williams (1964) reported a rise in serum GOT activity in 40% of patients in status asthmaticus, and suggested, although with no supporting evidence, that a possible contribution to the increase in enzyme activity arose from allergic reactions in the lung.…”

Clinical Observation of Liver Chemistry Abnormalities in Asthmatics

“…The reason for this difference is not known, although one possible explanation would be a difference of disease severity. AST and ALT elevations have been reported in severe asthmatics and hypothesized to reflect hypoxic liver damage during acute status asthmaticus [7][8][9][10][11][12]. Retrospective analyses of health care system data have also revealed higher LFT elevation rates in severe asthma patients [13,14].…”