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Biomedical subjects

B Stenius-Aarniala

Publications and source records attributed to B Stenius-Aarniala.

At least 37 records · Page 2Linked to original sources

The role of infection in asthma.

The possible role of bacterial, viral and fungal infections in the development, exacerbation and treatment of asthma are discussed. Although bacterial allergy has in the past been advocated as an important etiologic factor for asthma, the evidence is inconclusive. Hyposensitization with bacterial antigens is no longer an accepted treatment. Bacterial infection of the nasal sinuses and bronchi may exacerbate an asthmatic attack and in some cases patients benefit from antibiotic therapy. However, bacterial infections in asthma and allergic rhinitis do not always require treatment and if treated this is not sufficient alone to reverse symptoms. Opinions vary as to the importance of viral infections. There is evidence that the immunologic consequences of intrabronchial infection with Aspergillus fumigatus may cause exacerbations of asthma.

Antigens, Bacterial↗

Comparison of the effects of an angiotensin converting enzyme inhibitor and a calcium channel blocker on blood pressure and respiratory function in patients with hypertension and asthma.

A series of 12 adult patients with stable bronchial asthma and an established diagnosis of essential hypertension (WHO I or II) were studied in a randomized double-blind crossover study to assess the effect of captopril (50-100 mg/day) and verapamil (160-240 mg/day) on blood pressure, lung function, and asthmatic symptoms. The effect of the medication on blood pressure was significant. Blood pressure (mean 164/103 mm Hg initially) decreased to a mean of 145/90 mm Hg and 155/92 mm Hg after 4 weeks on captopril and verapamil, respectively, with fewer orthostatic changes caused by captopril. There were no marked changes of asthmatic symptoms or peak flow (PEF) or forced expiratory volume (FEV1) measurements during the trial.

Aged↗

Lack of clinical exacerbations in adults with chronic asthma after immunization with killed influenza virus.

The effects of immunization with killed influenza virus vaccine were assessed by comparison with placebo in a double-blind study of 318 adult patients with chronic asthma. The patients were randomly allocated to active vaccine and placebo. No difference was observed in peak expiratory flow rate or in clinical symptoms of bronchial obstruction between the groups receiving active vaccine and placebo during the first week after immunization. The data were analyzed separately for age, sex, duration of the disease, hypersensitivity to aspirin (acetylsalicylic acid), atopic status, patients with a history of attacks of asthma induced by viral infections, patients with a diurnal variation of baseline peak expiratory flow of 20 percent or more, and patients receiving continuous oral steroid medication, but none of these factors seemed to predict any short-term adverse effects of vaccination. Follow-up for eight months after the vaccination revealed no differences in asthmatic symptoms between the patients treated with active vaccine and those receiving placebo. The antiviral antibody response to vaccination was normal. The possible protection provided by the vaccination against exacerbation of asthma induced by influenza could not be evaluated, since the influenza epidemic expected during the season failed to occur in Finland. It is concluded that immunization with killed influenza vaccine is safe and is not associated with any significant side effects in adult patients with chronic asthma.

Adult↗

Natural killer cell activity in asthma.

Peripheral blood natural killer (NK) activity was analysed from 32 asthma patients and 13 control donors. Male patients and female patients with atopic asthma had significantly stronger NK activity against the leukaemic cell line K-562. Fractionation of patient mononuclear cells by discontinuous density gradient centrifugation suggested that large granular lymphocytes (LGL) were the main mediators of the NK activity in asthmatics. Based on the lytic unit calculations, the strong NK activity in asthmatics is mainly due to increased frequency of LGL in peripheral blood rather than activity of individual NK cells.

Adolescent↗

Comparison of pirbuterol and pirbuterol and hydroxyzine in patients with reversible airway obstruction.

The effects of single oral doses of pirbuterol 10 mg plus hydroxyzine 10 mg, and of pirbuterol 10 mg plus placebo, were compared in a single-blind cross-over trial in 17 adult patients with reversible airway obstruction. The initial bronchodilator response after the two treatments was similar, but mean specific airway conductance at 3, 4, 6 and 8 h, and mean FEV1 and FVC after 3 and 4 hours, were significantly higher after pirbuterol + hydroxyzine than after pirbuterol + placebo. The mean thoracic gas volume measured at 3 and 4 h was lower after pirbuterol + hydroxyzine. Heart rate, blood pressure and a continuous ECG record did not differ after the two treatments. The findings suggest that the combination of pirbuterol and hydroxyzine brings about more prolonged bronchodilatation in patients with reversible airway obstruction than does pirbuterol alone.

Adult↗

Miliary tuberculosis.

Twenty-six cases of miliary tuberculosis were studied in retrospect. The mean age of the patients was 62 years. Eighteen patients suffered from another underlying chronic disease. Nine had been treated with corticosteroids or cytotoxic agents. A limited manifestation of tuberculosis had been previously verified or suspected in ten cases. Fever was present in 85% of the patients, frequently combined with fatigue or abdominal pain. Serum alkaline phosphatase was elevated in 81% of the cases. Minor haematological abnormalities (anaemia, etc.) were found in 16 cases and pancytopenia, stimulated lymphocytes or chronic myeloid leucaemia in six. Miliary mottling was found in the chest radiographs of 13 patients. Other findings were pleural effusion, mediastinal node enlargement, opacities suggesting pneumonia or old, possibly tuberculous lesions. Antituberculosis therapy was initiated in 12 patients, two of whom died within a few days. There was a high frequency of liver or system involvements. It is concluded that laparoscopy or liver needle biopsy are valuable diagnostic procedures in patients with fever and elevated alkaline phosphatases of unknown aetiology. A therapeutic test with antituberculous drugs should be undertaken in suspected cases.

Adult↗

Clinical correlations between long-term (IgE) and short-term (IgG S-TS) anaphylactic antibodies in atopic and 'non-atopic' subjects with respiratory allergic disease.

The sera of atopic and non-atopic persons with allergic pulmonary disorders were examined for long-term sensitizing, IgE and short-term sensitizing heat-stable (S-TS) antibodies which were present separately or together in the sera of some patients sensitive to antigens such as budgerigar serum proteins and Aspergillus funigatus. In fourteen atopic patients with extrinsic asthma, six had both types of antibody to common allergens, and of nine non-atopic patients with crytogenic (intrinsic) asthma, four had only heat-stable short-term sensitizing antibodies. The sera of atopic subjects with type I prick test reactions and positive RAST's, showed specific IgE antibody by baboon PCA tests to budgerigar serum proteins, A. funigatus, Timothy grass pollen extract and hen egg extract, and not to Dermatophagoides farinae, possibly because of naturally occurring mite antibodies in the baboon. The sera of non-atopic asthmatics, who had given negative prick test but positive immediate, dual or late intracutaneous tests, and only late asthmatic reactions, contained precipitins in most cases and gave little or no RAST reaction. On baboon PCA these sera contained either, S-TS antibody alone, or S-TS plus long-term sensitizing antibody, or long-term sensitizing antibody alone. Some of the sera with long-term sensitizing antibody contained blocking antibody which could diffuse away in the 24 hr delay for the baboon PCA test and could also be responsible for the negative RAST. Tests with insoluble anti-IgE immuno-adsorbents on two sera from persons sensitive to aspergillus confirmed that the S-TS activity was not due to IgE, and on two sera with negative RAST and negative prick tests to budgerigar serum antigens confirmed that the 24 hr monkey PCA responses were due to IgE.

Allergens↗

Effect of ipratropium bromide and fenoterol on airway obstruction in chronic pulmonary tuberculosis.

Single-blind, cross-over comparison of standard doses of ipratropium bromide (2 puffs of 0.02 mg each) and fenoterol (2 puffs of 0.2 mg each) in 36 pairs of experiments in 6 patients with partially reversible airway obstruction, presumably secondary to chronic widespread pulmonary tuberculosis, revealed no difference between the drugs in bronchodilating effect, evaluated by peak-flow measurements and spirometry. The inhalation of isoprenaline at the end of the experiment induced no further improvement in the lung function variables measured. The results suggest that a vagal reflex mechanism plays a major role in bronchoconstriction connected with severe chronic pulmonary tuberculosis.

Adult↗

Correlation of tartrazine hypersensitivity with specific serum IgD levels.

The clinical diagnosis of hypersensitivity to the food dye tartrazine in 16 subjects correlated with levels of tartrazine-specific IgD antibodies determined by a solid phase radioimmunoassay inhibition test. This is the first study associating hypersensitivity to a low molecular weight chemical with an antibody response of the IgD class. There was little or no correlation between clinical sensitivity and IgE antibodies.

Antibody Formation↗

[Allergic alveolitis].

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Alveolitis, Extrinsic Allergic↗