Treatment of respiratory failure.
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Biomedical subjects
Publications and source records attributed to B G Simonsson.
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Inhalation of aerosols of citric acid, histamine phosphate, or carbon dust, or air cooled to - 20 degrees C or rapid respiratory maneuvers (inspiration or expiration) results in an increase in airway resistance in some patients with asthma or bronchitis. It has been shown previously in animals that stimulation of cough receptors results in bronchoconstriction through efferent cholinergic pathways. In the patients studied, the administration of atropine sulfate, which would block such pathways, abolished the bronchoconstrictor effects of all the stimuli except large doses of histamine, which may exert a direct effect on airway smooth muscle. These data suggest that sensitized cough receptors may be involved in triggering reflex airway constriction in such patients.
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Psychological, clinical, and pulmonary physiological measurements were studied in ten patients with weather-sensitive chronic airway obstruction during one month in Gothenburg, Sweden, and immediately after for one month in the Canary Islands, a change to a drier and warmer climate. All patients improved according to psychological tests and claimed to be better. Objective measurements including peak expiratory flow rate, airway conductance, static lung volumes, and elastic lung recoil showed improvement in eight of ten patients, a change that we believe is due to the effect of climate.
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Lesions in small airways may cause increased central deposition of inhaled aerosol. This may enhance airway constriction following methacholine (MCh) challenge. Heterozygous alpha 1-antitrypsin deficiency (PiMZ) and smoking may both act on the lung parenchyma and may also influence small airways. We, therefore, have related bronchial reactivity to MCh to the function of the small airways and to smoking habits in 31 normal (PiM) male subjects aged 48-50 years and 34 PiMZ male subjects, all from a population study. A total of 23 subjects with increased bronchial reactivity was found. The number of reacting smokers (14/23) was significantly higher than that of the reacting ex-smokers (7/23) (p less than 0.05) and nonsmokers (2/19) (p less than 0.05). The smokers who had increased reactivity to MCh challenge had significantly higher closing capacity %, RV/TLC %, and volume of trapped gas % than the smokers who did not have increased reactivity. This difference was not seen with regard to closing volume %, slope index, delta N2 %/1, or washout volume. There was no significant difference between the PiM and the PiMZ subjects with regard to any of the lung function variables or the response to the MCh challenge. It is concluded that there may be a correlation between dysfunction of the small airways and increased bronchial reactivity.