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Biomedical subjects

B Villiger

Publications and source records attributed to B Villiger.

At least 37 records · Page 2Linked to original sources
PubMed1997

Psychosocial predictors of long-term success of in-patient pulmonary rehabilitation of patients with COPD.

Studies of the long-term outcome of pulmonary rehabilitation have measured quality of life (QOL) mainly as disease-specific functional impairment, but long-term effects on overall satisfaction with health or life have not yet been adequately evaluated. Furthermore, the influence of personality traits on the long-term outcome of pulmonary rehabilitation have not so far been examined. The following questions were studied: 1) What are the short- and long-term effects of a rehabilitation programme on lung function (forced expiratory volume in one second as percentage of predicted (FEV1 % pred)), on satisfaction with life (defined as quality of life), and on health satisfaction (HS)? 2) Are there physical or psychosocial predictors for the success of pulmonary therapy? In this prospective clinical study, baseline data (FEV1 % pred, arterial oxygen tension (Pa,O2), QOL, HS, dyspnoea, coping scales) were studied at entry (t1); follow-up on discharge (t2); and 1 yr after hospitalization (t3) in 54 consecutive patients (mean age 64 yrs) with chronic obstructive pulmonary disease (COPD). Complete data were obtained at follow-up on 32 subjects. FEV1 % pred improved from 42% (t1) to 52% (t2) (p<0.001) but dropped to 46% at t3 (t1-t3: p<0.05). QOL improved significantly during hospitalization but dropped to initial levels 1 yr after discharge. A significant increase in health satisfaction during hospitalization was maintained at follow-up. Improvements in lung function were greater in patients with higher QOL scores on entry; subjects with the greatest tendency to use wishful thinking as a coping strategy had less improvement. In conclusion, the effects of pulmonary rehabilitation on lung function and health satisfaction are positive and enduring. Quality of life and coping have an effect on the long-term outcome of pulmonary rehabilitation, probably as expressions of patients' personality traits.

Adaptation, Psychological↗
PubMed1996

The interleukin-8 receptor B and CXC chemokines can mediate transendothelial migration of human skin homing T cells.

We studied the involvement of chemokines that bind to G protein-coupled receptors in the migration of skin homing T cells across a bilayer vascular construct (BVC) consisting of a fibroblast matrix underneath an activated endothelial (EC) monolayer. Based on the expression of the cutaneous lymphocyte-associated antigen (CLA), a skin homing receptor, CD45R0+ T cells freshly isolated from blood or HUT-78 cutaneous T lymphoma cells were separated into CLA+ and CLA- subpopulations. These T cells were incubated on interleukin (IL)-1 beta and tumor necrosis factor-alpha-activated EC, and the number of transmigrated cells was determined. The chemokine IL-8 was selectively involved in the enhanced migration of CLA+ T cells across activated EC as demonstrated by blocking antibody to IL-8 but not to GRO-alpha, MCP-1 and RANTES. Identical results were obtained with both human umbilical vein EC (HUVEC) and microvascular skin EC (HDMEC). Pertussis toxin selectively inhibited the enhanced transendothelial migration (TEM) of CLA+ T cells, suggesting that CLA-dependent TEM depends on Gi protein-transmitted signals. Moreover, the IL-8 receptor B (IL-8RB) appeared to be functionally involved in TEM, as demonstrated by receptor desensitization with the CXC chemokines IL-8 and GRO-alpha and by blocking the IL-8RB with specific monoclonal antibodies. Although only the IL-8RB was involved in CLA-dependent TEM, mRNA encoding IL-8RA and IL-8RB was expressed by both CLA+ and CLA- T cells. This correlated with IL-8RA and IL-8RB surface expression on these cells. Thus, the IL-8RB is selectively functional in TEM of T cells expressing the skin homing receptor CLA. Our results demonstrate a critical role for IL-8 and possibly other IL-8RB ligands in addition to the IL-8RB in TEM and suggest the involvement of these molecules in the homing of specific T cells to inflamed skin.

Animals↗
PubMed1996

[Is inpatient rehabilitation of patients with chronic obstructive lung disease (COPD) useful? Results of a prospective 1-year follow-up study].

Success of inpatient therapy for patients with chronic obstructive pulmonary disease (COPD) has been assessed in a prospective study of 54 patients (mean age = 63.8y). During hospital stay (mean duration = 27.6d) FEV1% of predicted improved from 42.5% on admission to 51.9% on discharge (p < 0.001). Quality of Life (QoL) (p < 0.05) and Health Satisfaction (p < 0.001) improved significantly. The 22 drop-outs revealed a significantly more depressive coping strategy but did not differ from the remaining 32 patients regarding lung function, sociodemographic data and QoL. One year after the hospital stay the remaining 32 patients showed a still improved FEV1% (46.4%, p < 0.05) and Health Satisfaction (< 0.05) but QoL scores relapsed to entry levels. Better pulmonary long-term effects were achieved by patients with high QoL scores on entry; subjects that tended most to wishful thinking as a coping strategy had worse pulmonary outcome.

Adaptation, Psychological↗
PubMed1995

[Patients with lung diseases and sports].

Lung patients are suffering from dyspnea. These symptoms make any physical exertion unpleasant, and patients become sedentary. This behaviour leads to a deconditioning of the cardiocirculatory and muscular system which renders activity even more unpleasant, thus reinforcing the sedentary life style. This downward spiral can be interrupted by a program of progressive exercise which should be adapted to the type and severity of the pulmonary disease. In this context, the value of sport therapy in the treatment of asthma bronchiale and COPD is redefined. The possibilities and limitations for this form of treatment are explained.

Adult↗
PubMed1995

Accumulation of activated CD4+ lymphocytes in the lung of individuals infected with HIV accompanied by increased virus production in patients with secondary infections.

The lung is continuously exposed to infectious and non-infectious agents causing cell activation. Activated cells in the lung such as antigen-presenting cells which harbour HIV may favour this organ as a site for virus production. To test this hypothesis, cells from blood and bronchoalveolar lavage (BAL) of HIV-infected patients and healthy controls were obtained and the activation of the cells were analysed by measuring the expression of IL-2 receptor, HLA-DR and VLA-1. The HIV-infected individuals were subdivided into 'lung symptomatic' or 'lung asymptomatic' patients, depending on the presence or absence of secondary lung diseases besides HIV. All HIV-infected individuals demonstrated a decreased number of CD4+ lymphocytes in blood; however, normal numbers of these cells were found in BAL. The activation state of CD4+ and CD8+ T lymphocytes in blood and BAL was higher in lymphocytes from HIV-infected patients compared with controls. The activation state was highest in the lung symptomatic group. Lung symptomatic patients and lung asymptomatic patients with extrapulmonary infections had increased levels of free virus in plasma. Four out of four individuals without or with only low amounts of cell-free HIV in plasma belonged to the symptom-free subgroup. These results suggest that microorganisms other than HIV may promote viral replication via antigen-driven accumulation and activation of CD4+ cells in the lung or other organs, and thus may be responsible for the loss of helper T cells and the progression of the disease.

Bronchoalveolar Lavage Fluid↗
PubMed1994

Activated T cells and cytokines in bronchoalveolar lavages from patients with various lung diseases associated with eosinophilia.

Increasing evidence suggests an important role for cytokines in the regulation of eosinophilic inflammation. In the present study we investigated the distribution of leukocytes, lymphocyte subsets, their activation state, and the cytokine profile present in BAL fluid from patients with various lung diseases associated with eosinophilia. For this purpose, we analyzed the levels of IL-1 beta, IL-2, IL-4, IL-5, IL-6, IL-8, GM-CSF, TNF-alpha, and IFN-gamma, as well as soluble IL-2 and TNF receptors, in concentrated bronchoalveolar lavage (BAL) fluid obtained from clearly defined patients with allergic and nonallergic asthma, eosinophilic pneumonia, allergic bronchopulmonary aspergillosis (ABPA), hypersensitivity pneumonitis, and idiopathic pulmonary fibrosis. BAL fluid from normal individuals and sarcoidosis patients was analyzed as noneosinophilic controls. BAL cytokine levels were compared with the cellular infiltrate and the activation state of CD4+ and CD8+ T cells as measured by the expression of IL-2 receptors (CD25), HLA-DR, and the very late activation antigen VLA-1. Beside the characteristic leukocyte infiltrate in the various lung diseases, all patients demonstrated significantly increased numbers of activated CD4 and CD8 T cells compared with normal individuals. The analysis of the cytokine profile present in BAL fluid revealed a T helper type 2 (Th2) cell cytokine pattern, with elevated IL-4 and IL-5 but normal levels of IL-2 or IFN-gamma in allergic asthma. ABPA patients demonstrated significantly increased levels of IL-4 and IL-5, with low but significantly elevated concentrations of IL-2 and IFN-gamma. In contrast, the analysis of the cytokine profile in sarcoidosis patients revealed a Th1 cell cytokine pattern characterized by increased concentrations of IL-2 and IFN-gamma but normal levels of IL-4 or IL-5. All other patient groups showed a cytokine pattern incompatible with a pure Th1 or Th2 cell response, because IL-5, IL-2, and IFN-gamma were found to be significantly increased. The BAL fluid analysis of the other, mainly non-T cell-derived cytokines and soluble receptors showed increased levels in all patients compared with normal individuals and may represent the ongoing inflammatory responses. In conclusion, whereas increased IL-4 levels were found only in diseases characterized by increased IgE production, IL-5 was elevated in all patients with increased numbers of eosinophils. The close correlation between IL-5 levels, number of eosinophils, and activated T cells further supports a role for IL-5 in causing tissue eosinophilia.

Adult↗
PubMed1994

[Muscle aches and biochemical changes following a ultra-marathon in the cold--modification by diclofenac].

After the Swiss Alpine Marathon in Davos (67 km, altitude difference of 2300 m) the majority of the athletes are suffering from muscle soreness. The goal of the study was therefore to investigate muscle damage, inflammatory reactions and soreness perception during and after this ultramarathon. 27 athletes took part in the study. Creatine-kinase (CK) and C-reactive protein (CRP) were measured 24 hours before the race, immediately before and after the race as well as 2 hours, 24 hours and 48 hours, after the race respectively. Muscle soreness of the lower extremities before and during stretching were assessed at the same time points using a visual analog scale from 1 to 10 (VAS). Significant CK elevations were found in all runners ranging from 600 to 28,000 U/l. Compared to the values before and 48 hours after the start all athletes showed 24 hours after the start significantly elevated CRP values, indicating a pronounced systemic inflammatory reaction. Immediately after the race all runners reported a significantly elevated muscle soreness with maximal pain in the posterior muscles of the lower leg. In order to assess the influence of a nonsteroidal antiinflammatory agent on muscle damage, muscle soreness and inflammatory reactions 16 of the 27 runners received *Diclofenac SR. We were unable to find a difference in the mean plasma CK and CRP activity after the race between both groups, but there was a highly significant, till now to our knowledge never described correlation between the degree of muscle damage and systemic inflammatory reaction (r = 0.75, p < 0.02) in the control group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Effect of inpatient treatment on pulmonary findings and subjective well-being of patients with chronic bronchitis].

In a prospective study, inpatient therapy results (mean duration of hospitalization 27.3 days) has been assessed in 70 patients with COPD (mean age 62.4 years). Therapeutic success was observed in the objective pulmonary parameters (an increase of FEV1 from 50.5% to 57.6%, p < 0.001) and an increase in PaO2 from 7.7 kPa to 8.5 kPa (p < 0.001) as well as an improvement in life quality established by questionnaire. The best pulmonary results were achieved by patients with least pulmonary obstruction and by those with subjective well-being on entry. Women and younger patients experienced the biggest improvement in life quality. Furthermore, there was a correlation between coping with chronic bronchitis and subjective well-being. Importantly, no correlation between changes in the objective pulmonary parameters and changes in well-being was observed; a finding which puts in question the previous rating of inpatient therapy success in COPD.

Adaptation, Psychological↗
PubMed1993

(+/-) isoprenaline revisited: adverse effects of sympathomimetics in asthma.

It is a matter of concern that regular, excessive use of contemporary sympathomimetics has been associated with morbidity and mortality from asthma. As a consequence, restrictions on sympathomimetic usage have recently been advocated in asthma management guidelines. he association between excessive use of inhaled (+/-)isoprenaline and an epidemic of asthma deaths in the 1960s provides a precedent; hence, we have reviewed the numerous clinical and experimental reports concerning (+/-) isoprenaline to provide insight into the present controversy.

Asthma↗
PubMed1993

Anomalous bronchospasm following inhalation of (+) isoprenaline by asthmatics.

Sympathomimetics (beta-adrenergic agonists) presently used in asthma therapy comprise racemic mixtures of bronchodilator and non-bronchodilator enantiomers. In a randomized, double-blind placebo-controlled study, asthmatic subjects inhaled a nebulized solution of the non-bronchodilator (+) enantiomer of isoprenaline. Substantial decreased forced expiratory volume (FEV1) was detected in 2 patients and of the remaining 8, a single subject had increased reactivity to histamine 7 h after inhalation of (+) isoprenaline. These effects of (+) isoprenaline may contribute to anomalous effects of (+/-) isoprenaline in asthma.

Administration, Inhalation↗
PubMed1992

[Bronchial asthma and sports].

Physical exercise can induce an acute attack in most asthmatics. Exercise-induced asthma (EIA) is therefore a common clinical presentation of bronchial asthma. EIA is likely a consequence of bronchial hyperreactivity whereby alterations in bronchial osmolarity, heat-loss by hyperventilation and physical activity per se are discussed as pathogenic triggers. Clinical presentation, pathogenesis and diagnosis of exercise-induced asthma are summarized. Pharmacologic and non-pharmacologic possibilities are covered in some depth. In this context the value of sports-therapy in treatment of asthma is redefined. The possibilities and limitations for this form of treatment are explained.

Airway Obstruction↗
PubMed1992

[Acute deterioration of the CO diffusion capacity following exposure to ski-wax vapors].

In cross country skiing use of hot wax is of importance. 90% of the active swiss cross country skiers have their own, self maintained equipment. Long unprotected exposure to hot wax fumes may cause disturbance of lung function. To examine short lasting disturbance in pulmonary function, CO-diffusion capacity and dynamic and static lung volumes in five healthy human subjects after exposure for one hour to hot wax (containing Paraffin and Cera-F) were determined. The subjects complained about burning eyes and tears, sore throat and coughing. Immediately after exposure all subjects showed a significant decrease of the CO-diffusion capacity of 10.6% (SEM 3.9), related to the ventilated alveolar space (DCOSB/VA). Maximal decrease of 13.6% (SEM 2.4) was after 90 min. After 24 hours the reduction persisted with 9.4% (SEM 2.1). The dynamic and static lung volumes remained unchanged. In summary a reduction of the CO-diffusion capacity after inhalative hot wax exposure was observed for at least 24 hours.

Adult↗
PubMed1992

Physiological changes and gastro-intestinal symptoms as a result of ultra-endurance running.

One hundred and seventy-two competitors of the Swiss Alpine Marathon, Davos, Switzerland, 1988, volunteered for this research project. Of these volunteers 170 (158 men, 12 women) finished the race (99%). The race length was 67 km with an altitude difference of 1,900 m between the highest and lowest points. Mean age was 39 (SEM 0.8) years. Average finishing times were 8 h 18 min (men) and 8 h 56 min (women). Loss of body mass averaged 3.4% body mass [mean 3.3 (SEM 0.2)%; 4.0 (SEM 0.4)%; men and women, respectively]. Blood samples from a subgroup of 89 subjects (6 women and 83 men) were taken prior to and immediately after completion of the race. Changes in haemoglobin (9.3 mmol.l-1 pre-race, 9.7 mmol.l-1 post-race) and packed cell volume (0.44 pre, 0.48 post-race) were in line with the moderate level of dehydration displayed by changes in body mass. Mean plasma volume decreased by 8.3%. No significant changes in plasma osmolality, sodium, or chloride were observed but plasma potassium did increase by 5% (4.2 mmol.l-1 pre-race, 4.4 mmol.l-1 post-race). Mean fluid consumption was 3290 (SEM 103) ml. Forty-three percent of all subjects, and 33% of those who gave blood samples, complained of gastro-intestinal (GI) distress during the race. No direct relationship was found between the quantity or quality of beverage consumed and the prevalence of GI symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Tuberculosis therapy 1990].

The goal of modern therapy of tuberculosis is the rapid killing of all bacilli with potent and relatively atoxic antituberculous drugs. Currently available first-line drug regimens are highly effective, well tolerated and relatively easily administered. The addition of Pyrazinamide enables the minimum treatment period to be shortened to six months (two months Isoniazid, Rifampin, Pyrazinamide and four months Isoniazid, Rifampicin). This article reviews the available first-line drugs in treatment of tuberculosis, the rationale for the recommended chemotherapeutic regimens, the follow-up of treated patients and special issues related to the treatment of extrapulmonary tuberculosis and tuberculosis in HIV-infected patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Short-term therapy of lung tuberculosis using a fixed combination of isoniazid, rifampicin and pyrazinamide. Results after 2 years].

Treatment of tuberculosis should be as short and as simple as possible in order to improve patient compliance; and combinations of at least three drugs should be used in order to kill the different populations of mycobacteria and to avoid development of drug resistance.--In a controlled multicentre study two regimens were compared in 93 patients with newly-diagnosed pulmonary tuberculosis: 1) Six-month therapy (47 cases): Daily rifampicin and isoniazid, supplemented with pyrazinamide for the first 2 months. A tablet with a fixed combination of 120 mg rifampicin, 50 mg isoniazid and 300 mg pyrazinamide (Rifater) was used. 2) Present Swiss standard therapy (46 cases): Daily rifampicin, isoniazid and ethambutol for 2 months followed by rifampicin and isoniazid for 7 months.--The time-course of culture negativation and the frequency of adverse events were similar in the two groups. During a follow-up period of at least two years only one relapse was observed in the six-month regimen, 3 months after completion of treatment. This was one of three patients with pretreatment resistance to isoniazid. Nevertheless, two of them were cured with the six-month regimen containing Rifater.--Patient compliance, assessed during outpatient treatment by detecting isoniazid metabolites in the urine, was very good (93% of tests were positive in each group).--These results with a follow-up of more than 2 years, indicate that short-course therapy of 6 months duration with the fixed combination tablet may be recommended as treatment of choice in pulmonary tuberculosis except in cases of isoniazid resistance and other special situations (i.e. large cavitations, large number of viable bacilli).

Adult↗
PubMed1985

Ultrastructural distribution of fibronectin in normal and fibrotic human lung.

We studied the distribution of fibronectin in normal and fibrotic adult human lung and normal hamster lung using affinity-purified antifibronectin Fab'-horseradish peroxidase conjugates. In normal lung, fibronectin staining was present in alveolar capillary and epithelial basal lamina and associated with interstitial collagen fibers. In airway and larger vessels, fibronectin staining was associated with the basal lamina of smooth muscles. In contrast to the relative paucity of staining in normal lung, the alveolar basal lamina of fibrotic lung stained intensely for fibronectin. In addition, there was strong, periodic (approximately 600 A) staining of native collagen fibers for fibronectin. We conclude that fibronectin antigenicity is present in the alveolar epithelial and capillary endothelial basal lamina of normal human and hamster lung. The marked alterations in the apparent amounts and distribution of fibronectin in fibrotic human lung suggest its involvement in the cellular events accompanying human lung fibrosis.

Animals↗