摘要:

The effectiveness of bromhexine in the treatment of patients with bronchiectasis, in a stage of clinical exacerbation, was assessed in a double-blind, placebo-controlled trial involving 88 in-patients. Bronchiectasis was diagnosed by bronchography and/or CT scan. Bromhexine or matched placebo was administered as 30-mg capsules three times daily per os. Ceftazidine, 1 g i.m., was given to all patients once a day for the first week only. Bromhexine seemed to improve the clinical picture, with significantly positive trends for expectoration, quantity of sputum and auscultatory findings. It also increased the FEV1 and was well-tolerated. Both patients and investigators judged it efficacious

ISSN:0025-7931    

DOI:10.1159/000195910

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

This study examined the effect of the standing versus the sitting position on spirometric indices in 94 healthy non-obese adult subjects (41 men and 53 women) with the order of testing randomised. On average all the spirometric indices examined, except the peak expiratory flow rate, were higher in the standing compared to the sitting position although the change was only significant at the 5% level for FEV1 in women. The fall in FEV1 with the change in position was statistically related to the ponderal index but not to age, height or the initial lung function level. A uniform posture for spirometry is recommended in epidemiological studies examining longitudinal trends in lung function, as well as in cross-sectional aetiological studies examining, for instance, the effects of environmental and/or occupational exposures. A uniform posture is also recommended for clinical studies which involve repeated measurements over time, for instance to measure the effect of treatment or the natural history of airways disease

ISSN:0025-7931    

DOI:10.1159/000195911

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

In 24 patients with severe chronic obstructive pulmonary disease (COPD), we investigated the evolution of pulmonary volumes, arterial blood gases (ABG) and mean pulmonary artery pressure (PAP), before (T0-T1) and during (T1-T2) long-term oxygen therapy (LTO). LTO was initiated at T1 on usual criteria (PaO2 persistently ≤55 mm Hg) and was given during ≥16 h/day. The T0-T1 period ranged from 12 to 186 months (mean 53 ± 41 months) and the T1-T2 period from 12 to 120 months (mean 44 ± 30 months). There was a significant worsening of the obstructive pattern (FEV1 decreasing from 1,084 ± 326 to 879 ± 318 ml, p < 0.005) and of ABG (PaO2 decreasing from 58.2 ± 9.2 to 51.6 ± 6.5 mm Hg, p < 0.01) before the onset of LTO, whereas there was a rather good stability of ABG during LTO and the changes in pulmonary volumes were modest and statistically nonsignificant (FEV1 decreased from 879 ± 318 to 809 ± 247 ml). PAP tended to increase from T0 to T1 and to decrease from T1 to T2, but these changes only reached the level of statistical significance when they were expressed as changes per year ( + 1.0 ± 2.7 vs. –1.3 ± 4.5 mm Hg, p < 0.05). The evolution of physiological variables was nearly identical in subgroups of patients who had died (n = 13) or were still alive (n = 11) at the time of data collection (T3) and this held particularly true for PAP. However, FΕV1 at T2 was significantly lower (p < 0.01) in patients who died. It is concluded that the progressive deterioration of pulmonary volumes, ABG and PAP, which is observed before the onset of LTO is reduced (lung volumes), stopped (ABG) or reversed (PAP) during LTO. In COPD patients under LTO, prognosis is not related to the evolution of PAP or ABG (in ambient air) but rather to the worsening of bron

ISSN:0025-7931    

DOI:10.1159/000195912

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Bilateral bronchoalveolar lavage (BAL) was carried out in right middle and left upper lobes of 22 nonsmoking females suffering from progressive systemic sclerosis in order to assess interlobar differences and functional correlation of the BAL composition. The patients’ age ranged from 20 to 66 years, and the mean disease duration was 10.4 years. The most frequent finding was a mild BAL lymphocytosis (right in 11 of 22 patients; left in 8 of 22), but eosinophilic (right in 11 of 22; left in 5 of 22 patients) and neutrophilic (right in 9 of 22 patients; left in 1 of 22) alveolitis was recognized as well. Differential counts suggestive of alveolitis limited to one of the lavaged lobes were demonstrated in about one fourth of the cases. Including increased cellularity among the criteria of pathological BAL fluid composition, 14% of the subjects showed bilateral BAL results within the normal range. OKT8-positive lymphocytes were significantly increased in 3 patients, but the mean values were not. Total lung capacity, vital capacity, and forced expiratory volume in 1 s correlated inversely with BAL neutrophil (p < 0.05) and granulocytic (p < 0.01) differential counts; the strongest, positive correlation was demonstrated regarding the lymphocyte/granulocyte ratios (p < 0.0005). In conclusion, several patterns of alveolitis as well as a bilaterally normal BAL composition were found in our series; moreover, even if in-homogeneous alveolitis did occur, a single lavage performed in the right middle lobe correctly detected or excluded the presence of an alveolitis in 95% of our patien

ISSN:0025-7931    

DOI:10.1159/000195913

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The relations between serum-erythropoietin (se-EPO), blood hemoglobin and lung function were investigated in patients with chronic obstructive pulmonary disease (COPD). In a randomized, double-blind, placebo-controlled design, the hypothesis was tested that se-EPO might increase after treatment with a calcium antagonist. In 18 patients with COPD, median se-EPO (19.2 mU ml”1) was in the low normal range. The correlations between se-EPO and blood hemoglobin (p = -0.63, p = 0.024) and between se-EPO and lung function indices were negative (n.s.) and the correlation between blood hemoglobin and lung function indices (n.s.) were positive. The hypothesis is proposed that the normal hemoglobin found in most patients with COPD is a result of a balance between a trend towards a decreased red cell mass, as found in chronic diseases, and a trend towards an increased red cell mass due to the erythropoietic effect of EPO. Se-EPO was not changed by the calcium antagonist, isradipi

ISSN:0025-7931    

DOI:10.1159/000195914

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Although diffuse panbronchiolitis (DPB) has carried a poor prognosis, long-term low-dose administration of erythromycin (EM) is very effective. We administered EM at a daily dose of 400–600 mg to 19 DPB subjects for more than 2 months. Sixteen subjects were relieved from productive cough and dyspnea, and their chest X-ray pictures were improved. We performed a pharmacokinetic study of EM in 11 DPB subjects (8 re-sponders; 3 nonresponders) after the long-term low-dose administration. The maximal serum and sputum levels of EM were below the MICs of clinically pathogenic H. influenzae and P. aeruginosa which were often isolated from the sputum of DPB patients. No difference was observed in the absorption of EM between responded and nonresponders. The results suggested that DPB patients might respond favorably to EM due to mechanisms other than antibacterial activity. Individual variation in the absorption of EM was observed. As EM was effective at very low serum and sputum levels, it was suggested that even 200 mg/day of EM would be effective in DPB patients who had high serum and sputum EM levels and it was necessary to monitor the concentrations of EM in serum and sputum for the treatment of DPB to determine the appropriate dose of EM individual

ISSN:0025-7931    

DOI:10.1159/000195915

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

The efficacy of Broncho-Vaxom®/Imocur® (OM-85 BV), an orally administered lyophilized bacterial extract, for recurrent respiratory and ear, nose and throat (ENT) infections was evaluated in 116 children aged 6 months to 19 years by comparing its activity in 61 children with that of a placebo in 55 children. The study was randomized, double-blind, and comprised a 90-day treatment period followed by a 90-day follow-up period without test drugs. Over the 180 days, 39.5% of patients taking OM-85 BV remained free from infection compared with 16.5% on placebo (p < 0.01). 44% on OM-85 BV did not need antibiotics compared with 23.5% on placebo (p < 0.05). These differences were even greater in the subgroup of children aged 6 years and less (34 vs. 3.5% for the absence of infections, p < O.Ol and 37 vs. 10% for the need of antibiotics, p < 0.05). Tolerance to OM-85 BV was excellent, and laboratory investigations showed no abnormalities attributable to this product. This work confirms that the immunomodulator OM-85 BV is an effective immunotherapy for recurrent respiratory and ENT infections in childr

ISSN:0025-7931    

DOI:10.1159/000195916

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

We studied the performance of a portable pulse oximeter in 123 consecutive adult patients by spot-checking with a finger probe and by spectrophotometry of oxygen saturation on a simultaneous arterial blood sample. 88 patients were overtly hypoxemic (HbO2 < 90%) and 26 showed severe hypoxemia (HbO2 36–70%). The differences between the two methods showed a skewed distribution with a positive tail due to the over-estimation of lower saturation values by the pulse oximeter. Overall, the 95% confidence interval for the median difference ranged from -0.6 to +0.5%. The limits of agreement (distribution-free 95% confidence interval for the sample) were -5.8 to +11.6%. Pulse oximetry can be recommended as a first assessment of the respiratory balance only if a cut-off value of HbO2 equal to 90% in nonsmoking, air-breathing subjects is acceptable. The finger probe implies a response delay of approximately 30 s, making the instrument rather insensitive to short hypoxemic transients. With a predictive value around 90%, the pulse oximeter may be a useful portable screening to

ISSN:0025-7931    

DOI:10.1159/000195917

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

Nonfiltered (NF) lung sounds from the apical area of the heart along with lung volumes and ECG signals were recorded from 5 normal subjects. The signals were digitized and subjected to three methods of heart sound cancelation: 75-Hz high-pass filtering (75 HF), ECG-triggered blanking (BL) and adaptive noise canceling (AF) [IEEE Trans. Biomed. Engng 33: 0.1). The data revealed a remarkable lack of variation within and between subjects, suggesting similar sites and mechanisms of production an

ISSN:0025-7931    

DOI:10.1159/000195918

出版商:S. Karger AG    

年代:1991

数据来源: Karger

摘要:

It has been reported that low concentrations of noradrenaline or isoprenaline reduce the resting tension of the smooth muscle cells and suppress acetylcholine release from the vagal nerve terminals through activation of β2-adrenoceptors. Procaterol, β2-adrenoceptor stimulant, has a high potency and selectivity for airway smooth muscle tissues. However, there is little documentation on the prejunctional actions of this chemical in airway smooth muscle, especially in man. In the present study, the effects of procaterol on excitatory neuroeffector transmission in the human bronchus were investigated. Procaterol (10-10 to 10-7M) dose dependency reduced the amplitude of the contractions evoked by electrical field stimulation in the presence of indo-methacin (10-5M), FPL-55712 (10-6M), and guanethidine (10-6M). By contrast, procaterol (10-10 to 10-9M) had no effect on the postjunctional response of smooth muscle cells to exogeneously applied acetylcholine. Pre-treatment with ICI-118551 (10-7M), a β2-adrenoceptor-blocking agent, reduced the inhibitory action of procaterol on the amplitude of twitch contractions evoked by field stimulations in the human bronchus. These results indicate that procaterol at low concentrations has a prejunctional action, inhibiting the excitatory neuroeffector transmission and presumably suppressing transmitter release from the vagal nerve terminals through β2-adrenoceptors in the human bronchial tissue. The prejunctional action of procaterol explains partly its potent bronchodilator effects in clinical

ISSN:0025-7931    

DOI:10.1159/000195919

出版商:S. Karger AG    

年代:1991

数据来源: Karger