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Biomedical subjects

C Bruschi

Publications and source records attributed to C Bruschi.

At least 37 records · Page 2Linked to original sources
PubMed1995

Chronic respiratory symptoms, bronchial responsiveness and dietary sodium and potassium: a population-based study.

A possible relationship between Na+ intake and increased prevalence and mortality from asthma and chronic obstructive pulmonary disease (COPD) has been suggested but not clearly proven for several reasons (difficulty in assessing Na+ and K+ both by 24 h excretion and dietary recall, too small an effect of these ions on the pathology, and the role of potential confounders). We wanted to determine the relationship of Na+ and K+ intake, assessed by means of a 7 day recall, with chronic respiratory symptoms and bronchial responsiveness in a sample of the general population. Two hundred and five subjects were studied, with complete dietary and respiratory questionnaires, and baseline respiratory function tests, together with a subsample of 146 subjects who underwent histamine challenge. The 7 day recall consisted of two parts: the first assessed discretionary Na+; and the second assessed Na+ and K+ contained in food. The whole sample was split into two groups based on the levels of consumption, and the statistical analysis was performed contrasting the three lower quartiles vs the highest. Smoking habit, social economic status, age and body mass index (BMI) were not confounders for Na+ and K+ intake. The prevalence of symptomatic subjects and baseline respiratory function values were not significantly different in the two groups of quartiles for Na+ and K+. Baseline respiratory values and dose-response slope of the subsample were also not significantly different. We did not prove a relationship between these dietary factors and either bronchial responsiveness or chronic respiratory symptoms. Although we consider that our questionnaire is more reliable than other methods for Na+ and K+ assessment, several potential biases still remain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Survival and prediction of successful ventilator weaning in COPD patients requiring mechanical ventilation for more than 21 days.

We studied survival and failure or success of weaning from mechanical ventilation (MV) in 42 consecutive chronic obstructive pulmonary disease (COPD) patients requiring prolonged MV (more than 21 days) after an episode of acute respiratory failure requiring admission to our Intermediate Intensive Care Unit (IICU). Parameters including arterial blood gases, pulmonary function tests, respiratory muscle force, neuromuscular drive, and nutritional status were recorded during a phase of clinical stability, in order to identify the features related to survival and weaning. All the patients were submitted to a comprehensive rehabilitation programme. Successful weaning from MV was defined as complete respiratory autonomy for at least 48 h. Twenty three patients were successfully weaned from MV after an average period of 44 days (Group A), requiring no further MV during their stay in hospital, whilst the remaining 19 patients were not able to be disconnected from the ventilator (Group B). The discriminant analysis showed that weaning from MV was significantly associated with arterial carbon dioxide tension (PaCO2), neuromuscular drive (P0.1), maximal inspiratory pressure (MIP), arterial oxygen tension (PaO2), the ratio of respiratory frequency to tidal volume (f/VT) and the serum protein level. Other pulmonary function tests (forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC), anthropometric data, nutritional status, number of pulmonary exacerbations during MV and evidence of cor pulmonale, were similar in the two groups. The discriminant equation considering PaCO2 and MIP could separate the two groups with an accuracy of 84%. The overall survival at 2 yrs was 40%; in Group B it was significantly lower than in Group A (22 vs 68%). Most of the deaths occurred within the first 120 days after intubation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Diagnosis of major depression in HIV-infected patients].

A survey of current mood disorders (and especially major depression) is performed after considering quoted literature over the last five years. The sample includes all the HIV-infected-patients continuously referred to the Outpatient Service of the Infectious Diseases dept. of Bologna's "Ospedale Maggiore" General Hospital during some five days (19-23rd, July 1993). Each of the 53 recruited subjects was seen by a psychiatrist in the same morning of his/her medical visit; then also BPRS, STAI, CGI, BDI and MADRS were administered. A psychiatric diagnosis has been found in the 45% of the sample. The results being discriminated on the basis of absence-presence and diagnostic category, they point out a significant prevalence of ARC among subjects with psychiatric diagnosis and prevalence of asymptomatic HIV-infection among those ones with absent psychiatric diagnosis. Drug dependence (72%) and personality disorder are markedly prominent among ARC patients. But the surprising outcome (lower than references data) is that the diagnosis of current major depression is found only in 1.9% of cases (mood disorder in 9.4%).

Adult↗
PubMed1992

Reference values of maximal respiratory mouth pressures: a population-based study.

The aim of our study was to measure values of maximal inspiratory (MIP) and expiratory (MEP) mouth pressures in 625 (266 male, 359 female) clinically and functionally normal subjects drawn out of a sample representative of the general population. MEP (near TLC and FRC) was found to be significantly higher when compared with MIP (near RV and FRC), and pressures in male subjects were significantly higher than those in female subjects. MEP values at TLC and FRC were found to be closely related, as were values of MIP near RV and near FRC. Among the tested body-size variables, body surface area (BSA) for all parameters had the highest degree of correlation. Stepwise linear regression analysis was performed to define the equation of normality for all four parameters, employing BSA, sex, age, and relative interaction terms. R2 values, although the variables employed for the equations were highly significant, were relatively low and didn't fully explain the source of variability. The influence of age was smaller than the influence of BSA, although age did reduce the unexplained variance in MEP and MIP. These results confirm that the most useful employment of MIP and MEP is to monitor their changes in each patient, but they point out, however, the usefulness of reliable reference equations.

Adolescent↗
PubMed1992

Pulmonary function in childhood connective tissue diseases.

The term connective tissue diseases (CTD) defines a group of illnesses characterized by the presence of immune abnormalities and by widespread inflammation involving various organs and tissues including the lung. These diseases are not frequent in the paediatric age group. Very few data on pulmonary function are available in paediatric CTD. We investigated possible early lung function abnormalities and any likely relationship with clinical activity of the disease in a group of 81 paediatric CTD patients, without clinical or radiological evidence of pulmonary involvement. Measurement of lung volumes and diffusion lung capacity were performed. A sample of 65 subjects, defined as normal on the basis of history and clinical examination, and matched by age and height with the group of patients, was chosen as control group. CTD patients did not show significant deviations from the control distribution with respect to functional residual capacity (FRC) and maximal expiratory flow at 75% of the forced vital capacity (MEF75) values. On the contrary, both vital capacity (VC) and diffusing capacity of the lungs for carbon monoxide (DLCO) were quite impaired in most CTD during the active phase of the disease. Our results show a functional lung impairment in most children with clinically active CTD, even in absence of abnormalities on chest X-ray pictures.

Adolescent↗
PubMed1991

Nocturnal sleep and oxygen balance in Duchenne muscular dystrophy. A clinical and polygraphic 2-year follow-up study.

A long-term, clinical and polygraphic investigation of nocturnal sleep was performed in nine non-ambulatory Duchenne muscular dystrophy patients (mean age 16.2 years, range 10-20) with normal daytime blood gas tensions. The data show that nocturnal sleep has some adverse influence on oxygen balance in these patients as suggested by the occurrence of arterial oxyhaemoglobin desaturation occurring mainly during REM stages. This adverse effect tended to worsen significantly within a 2-year period in the absence of any sleep-related symptoms. A significant correlation between the degree of oxygen imbalance during sleep and the degree of restrictive thoracic syndrome during wakefulness was shown.

Adolescent↗
PubMed1991

Respiratory patterns during sleep in mitochondrial myopathies with ophthalmoplegia.

Nocturnal polygraphic recordings (electroencephalography, electro-oculography, submental and intercostal muscle electromyography, electrocardiography, respiration by thoracic strain gauges and oronasal thermistors) with continuous monitoring of arterial oxyhemoglobin saturation by pulse oximeter were performed in 8 patients with ophthalmoplegia plus. All patients except 1 had normal blood gas values and normal lung volumes associated with a diminished ventilatory response to inhaled CO2 during wakefulness. Four patients showed pathological sleep-related breathing patterns consisting of sleep apneic polygraphic tracings mainly of the central type or of REM-related hypoventilation episodes. It is suggested that these disorders in patients with ophthalmoplegia plus may have a central origin and be related to the underlying metabolic disturbance.

Adult↗
PubMed1989

Breathing patterns and HbSaO2 changes during nocturnal sleep in patients with Duchenne muscular dystrophy.

A night-time polygraphic sleep recording with continuous HbSaO2 monitoring was performed in 11 chair-bound Duchenne muscular dystrophy patients with severe restrictive lung disease but with blood gas values within normal limits when awake. No abnormalities of sleep pattern were detected. Nocturnal sleep did not have significant adverse effects on respiration. However, in 6 patients, infrequent central apnoeas or hypopnoeas occurred which were associated with falls in HbSaO2 greater than those that have been reported to be in normal subjects. The magnitude of HbSaO2 falls appeared to be significantly correlated with functional residual capacity values. Overall, the findings revealed a relatively preserved, although unstable, blood O2 balance during nocturnal NREM and REM sleep in patients with Duchenne muscular dystrophy, even in an advanced stage of their illness.

Adolescent↗
PubMed1989

Smoking habit and bronchial reactivity in normal subjects. A population-based study.

The relationship between smoking habits and airway responsiveness has been studied in a cross-sectional sample of subjects in a small Lombardy (Italy) town. The subjects were between 15 and 64 yr of age; they were representative of the general population. There were 295 normal nonsmokers, 70 normal smokers, and 50 past smokers. All clinically asymptomatic and functionally normal subjects underwent methacholine challenge. The distribution of responsiveness to methacholine (as expressed by LnPD15FEV1) was found to be significantly different between these normal smokers and nonsmokers. A multinomial logistic regression model showed a statistically significant difference in the response to the challenge on the basis of pack-years. When the number of years of smoking and the daily number of cigarettes were separately considered, the current amount had the significant correlation with LnPD15FEV1. Bronchial reactivity for past smokers was found not to be different from that for normal nonsmokers. We conclude that smoking habits, especially current habits, affect bronchial reactivity even in the absence of airway obstruction.

Adolescent↗
PubMed1989

Bronchial responsiveness to inhaled methacholine in epidemiological studies: comparison of different indices.

We evaluated the sensitivity and specificity of different indices drawn from the forced expiratory curve in order to detect the best one for evaluating bronchial reactivity in the general population, and particularly, for distinguishing between normal and asthmatic subjects. 654 subjects, between 15 and 64 years of age, who were representative for age and sex of the general population of a small Lombardy town (Italy), were studied. Of the total sample, 448 subjects were clinically normal and asymptomatic, 87 were symptomatic or with acute upper respiratory disease within 30 days before the challenge with methacholine, 43 with allergic rhinitis, 26 asthmatics and 50 chronic bronchitics. All the subjects who had a baseline FEV1 greater than 85% predicted underwent methacholine challenge. Provocative LnDoses of a 6, 10, 15% fall in FEV1 (LnPD6, LnPD10, LnPD15) and provocative LnDose causing FEV1 to fall more than 2 SD below the mean of 5 FEV1 measurements following buffer inhalation (LnTD) were evaluated. Furthermore we calculated the "Dose-Response slope" (SL) proposed by O'Connor. The cut-off value of each index to define a responder was calculated by discriminant analysis of the response to the challenge in normal and in the asthmatic group. Sensitivity, specificity and predictive value of LnPD6, LnTD and SL were 79, 74, 14%; 71, 74, 13% and 46, 97, 48% respectively. LnPD10 had the best sensitivity (83%) with a high specificity (83%), but, as compared to LnPD15, whose sensitivity was 79% and specificity 89%, a lower predictive value (21% vs 27%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Effects of celiprolol on the bronchial reactivity in asthma.

In 10 patients with bronchial asthma but normal ventilatory function, celiprolol, a cardioselective beta-adrenoreceptor antagonist, did not significantly affect forced expiratory volume in 1 second (FEV1) or airways resistance (Raw). In contrast, metoprolol substantially reduced FEV1 and increased Raw. In addition, compared with metoprolol, celiprolol induced a greater recovery of FEV1 and Raw after methacholine-induced bronchoconstriction.

Adrenergic beta-Antagonists↗
PubMed1988

Sleep and oxyhemoglobin desaturation patterns in chronic obstructive pulmonary diseases.

A polysomnographic study with noninvasive oxyhemoglobin saturation (HbSaO2) monitoring has been conducted in 11 consecutive male nonobese subjects with chronic obstructive pulmonary disease (COPD). The patients with a high arterial CO2 level and markedly reduced functional residual capacity appeared to be more prone to undergo HbSaO2 desaturation during sleep compared to patients with less severe functional and clinical respiratory impairment. The HbSaO2 desaturations were mostly linked to REM sleep and appeared to be concomitant to the inhibition of the tone of the intercostal muscles. Regarding sleep architecture, the patients with less severe COPD and scarce or absent tendency to HbSaO2 desaturation during sleep showed light and fragmented sleep with a marked tendency to arousals and awakenings.

Aged↗
PubMed1988

Distribution of bronchial nonspecific reactivity in the general population.

We investigated 654 subjects of a small Lombardy (Italy) town between 15 and 64 years of age who were representative of the general population. By clinical examination, the sample included 535 normal subjects (164 normal smokers, 341 normal nonsmokers, 30 normal subjects with acute upper respiratory illness within 30 days before the challenge), 50 with chronic bronchitis, 26 with asthma, and 43 with allergic rhinitis. Subjects whose FEV1 was 75 percent or more than the predicted value (654) underwent methacholine bronchial challenge by means of 1 percent metered-dose solution. The test result was considered positive at a drop of more than 15 percent in FEV1 (compared with buffer). Normal smokers and all of the groups with disease had a significantly different distribution of reactivity compared with normal nonsmokers. The difference between asthmatic and these "normal" subjects was highly significant; nevertheless, a clear cut-off between the two groups does not appear to exist.

Acute Disease↗
PubMed1987

Epidemiological diagnosis of asthma: methodological considerations of prevalence evaluation.

Within an epidemiological survey on Chronic Obstructive Pulmonary Disease, before reporting data on the prevalence of bronchial asthma we checked the group of subjects defined as "pathological" by means of a suitable questionnaire and a group of "normals" as a control. We evaluated the sensitivity and specificity of the questionnaire, in comparison with a clinical evaluation made by two physicians and controlled the relationship among their results, non-specific bronchial hyperreactivity and skin tests. In particular the correspondence between diagnosis made by physicians from a clinical evaluation and that obtained by questionnaire was not satisfactory. We suggest the importance of employing physicians for an epidemiological approach to asthma, in absence of a valid objective criterion.

Adolescent↗
PubMed1987

A clinical, EEG and CT study in 21 cases of chronic respiratory failure.

A clinical, EEG and CT study was carried out on 21 patients with chronic stable respiratory failure. The neurological disturbances and mental deterioration observed were of a mild degree, and no severe alterations were detected at EEG. CT showed cerebral atrophy, but the type and prevalence did not differ substantially between patients studied and normal sex- and age-matched control subjects. The data gave evidence that in chronic stable respiratory failure cerebral function is only slightly affected.

Aged↗
PubMed1985

Acute effect of indenolol on human airways.

Airways resistance and expiratory flow have been investigated in 6 healthy volunteers given single doses of indenolol, propranolol, atenolol and placebo in a randomized, double-blind, cross over study. The three active drugs significantly decreased the effort-induced rise in systolic pressure, and they also reduced the resting heart rate. The relative potency against exercise-tachicardia was propranolol greater than atenolol greater than indenolol. The double and triple product were significantly decreased, too, without any difference between the active treatments. After placebo or indenolol, an exercise-induced increase in the forced expiratory flow at low pulmonary volumes (MEF50 and MEF75) was observed. The two control beta-blockers caused a fall in exercise expiratory flow as compared to the resting values. The noncardioselective agent (propranolol) was more effective than the cardioselective compound (atenolol) in decreasing the expiratory flow. The mechanism of action of indenolol is discussed in the light of the lack of its acute effect on airways resistance.

Adolescent↗
PubMed1981

Computer-assisted karyotyping system of banded chromosomes.

The banding automatic system (BAS) we describe in this paper is a computer-assisted karyotyping system suitable for the analysis of both normal and abnormal karyotypes in banded chromosome specimens. In the BAS system recognition of the various features and constituents of the chromosomes is performed by an operator, whereas chromosome identification and classification are entrusted to a computer. The connection between operator and computer is the CYGEN1 program, which is tailored to distinguish chromosome morphology on the basis of the operator input band patterns alone. The karyotyping operation is therefore significantly speeded up: the operator simply has to read through a certain number of banded metaphases, encoding band-pattern data to the computer. The machine signals when the operation has gone through the whole karyotype or, for instance, when chromosomes are missing or present in extra number above the significance level from the analyzed metaphases. Chromosome identification and classification are then carried out by the computer, which performs as a real-time recognizing key. Moreover, the data being accumulated in the computer will provide a file of cytogenetic records accessible to the operator, as well as to the computer, for further diagnostic operations. The efficacy of the BAS system is demonstrated for the diagnosis of various structural aberrations, including a complex translocation. The processing of 20 metaphases by the method described takes 40-45 min, and a cytogenetic technician can make effective use of the system after 25-30 h of intensive training.

Chromosome Aberrations↗