[Asthma therapy in medical practice].
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Biomedical subjects
Publications and source records attributed to D Nolte.
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For the respiratory tract immunologic reactions of type I and type III according to Coombs and Gell are most important. The classical example for type-I-reaction is extrinsic (= "allergic") asthma. Mechanisms of sensitzation, of mediator release out of mast cells and of immunotherapy by specific hyposensitization are summarized. Immunologic type-III-reactions may lead to immune complex diseases of the lung. There are two different pathways: In the several forms of extrinsic alveolitis the interstitial lung tissue is involved, whereas the intrinsic forms of immune complex diseases mainly result in lung vasculitis. The diagnostic and therapeutical essentials of immunologic and allergic lung disease are discussed in detail.
In 14 patients in the age of 55 to 72 years (mean 60,5 years) with chronic nonspecific lung disease the long lasting effect of the "oxygen-multistep-therapy" are arterial oxygen pressure (paO2) has been proved. By the applied regimen of "O2-multistep-sleeping" after a cumulative O2-application-time of 56 hours mean paO2 of 68,1 Torr did not improve significantly.
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In chronic bronchitis antibiotic therapy is no causative therapy, because infection rarely is the beginning but the complication of an already existing airway disease. While sputum cultures are very limited in their value, blind chemotherapy of bacterial infections by substances like tetracycline, ampicilline, azidocilline or cotrimoxazole is allowed. In cases of additional obstruction a combination with corticosteroids sometimes may be useful.
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25 asthma patients regularly showed an increase in respiratory resistance, as measured by the oscillation method, after propellant from a dosage aerosol had been sprayed into their buccal or nasal cavity. This effect, which was also seen in three laryngectomised patients, could be blocked by ipratropium bromide, an anticholinergic agent. Evidently it is due to a bronchoconstrictor reflex elicited by the local low-temperature stimulus produced by the propellant.