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E Crimi

Publications and source records attributed to E Crimi.

71 records · Page 4Linked to original sources
PubMed1990

Allergen-induced increase in airway responsiveness and inflammation in mild asthma.

The relationship between airway responsiveness to methacholine and inflammatory cells in bronchoalveolar lavage (BAL) was determined in patients with history of rhinitis and/or mild bronchial asthma either at baseline (10 patients) or 3-4 h after allergen inhalation challenge (11 patients). At baseline, airway responsiveness did not correlate with any BAL cell population. When data obtained after allergen challenge were included in the analysis, 44% of the variability of airway responsiveness was explained by a multiple regression model with BAL eosinophils as a directly correlated (P = 0.002) independent variable and with BAL macrophages as an inversely correlated (P = 0.045) independent variable. Changes in airway responsiveness after allergen challenge were predicted (82% of variance explained) by a model with BAL eosinophils and BAL lymphocytes as directly correlated (P = 0.0002 and P = 0.03, respectively) independent variables. We conclude that, in stable asymptomatic asthma, baseline airway responsiveness does not correlate with the presence in the airways of inflammatory and immunoeffector cells that can be recovered by BAL. Nevertheless the allergen-induced increase in airway responsiveness is associated with an influx of eosinophils and lymphocytes in the bronchial lumen.

Adult↗
PubMed1990

Effects of deep inhalation during early and late asthmatic reactions to allergen.

Eighteen asthmatic patients with a biphasic asthmatic reaction to house dust mite were studied. The effect of deep inhalation (DI) was quantitated by comparing the maximal expiratory flow at 40% (MEF40) of vital capacity from partial (P) and maximal (M) flow-volume curves, and specific airway conductance (SGaw) before and after DI (SGawDI). At baseline, the ratio MEF40M/P was significantly larger than unity (1.45 +/- 0.26 SD), whereas the ratio SGawDI/SGaw was not significantly different from unity (0.92 +/- 0.24). During early phase reaction, both MEF40M/P and SGawDI/SGaw were significantly increased to 2.66 +/- 0.97 and 1.96 +/- 0.47, respectively. During late phase reaction, when the FEV1 values were similar to those observed during early phase reaction, MEF40M/P and SGawDI/SGaw were 1.86 +/- 0.46 and 1.43 +/- 0.29, respectively, significantly higher than the values at baseline but significantly lower than those during early phase reaction. Similar results were obtained in a subgroup of nine patients when SGaw values during the late phase reaction were similar to those during the early phase reaction. We conclude that DI has a different effect during early and late asthmatic reactions, suggesting a different ratio of airway to parenchymal hysteresis. This may result from an increased parenchymal hysteresis (more peripherally located bronchial obstruction) or a decreased airway hysteresis (prominent airway inflammation) during the late phase reaction.

Adolescent↗
PubMed1989

Effect of nedocromil sodium on the late asthmatic reaction to bronchial antigen challenge.

The effect of inhaled nedocromil sodium (4 mg by pressurized aerosol) on the dual asthmatic reaction to bronchial antigen challenge was studied in eight patients with asthma. The following prechallenge/postchallenge treatment combinations were administered: nedocromil sodium/placebo, nedocromil sodium/nedocromil sodium, placebo/nedocromil sodium, and placebo/placebo. Each patient received three treatment combinations assigned with a balanced incomplete block design. Nedocromil sodium administered before antigen challenge was significantly more effective than placebo in blocking both the early (p less than 0.001) and late (p less than 0.01) fall in FEV1. Postchallenge administration of nedocromil sodium tended to delay the onset of late asthmatic reaction but did not provide significant protection compared to placebo. These results demonstrated that nedocromil sodium prevents both phases of the dual asthmatic reaction to bronchial antigen provocation when it is inhaled before challenge. Further investigation is necessary to elicit a definite answer to whether nedocromil sodium administered after bronchial challenge has an effect on late asthmatic reaction.

Adolescent↗
PubMed1988

The fluoroallergosorbent test: a comparison with rast and skin test in respiratory allergy.

Specific IgE antibodies to common inhalant allergen were measured in ten healthy and 82 rhinitic or asthmatic subjects by both FAST and RAST. Significant correlations were found between FAST and RAST results for grass, Parietaria, Dermatophagoides, and cat dandruff. For these allergens the agreement between FAST and prick test was similar to that between RAST and prick test. In contrast to RAST and/or prick test, for Tag alder and birch allergens, the FAST apparently gave false negative results. In conclusion, FAST seems to be a promising technique for in vitro measurement of specific IgE against most inhalant allergens but some improvement is still necessary in standardizing allergens for this assay.

Adolescent↗
PubMed1987

Effect of nedocromil sodium on adenosine- and methacholine-induced bronchospasm in asthma.

The effect of nedocromil sodium on adenosine-induced bronchospasm was investigated in eight asthmatic patients. Nedocromil sodium (4 mg) administered by aerosol 10 min before challenge, effectively inhibited adenosine-induced bronchospasm. In another group of six asthmatic patients, nedocromil sodium administered in the same way did not reduce the bronchial response to methacholine. These results support the view that adenosine-induced bronchospasm may be prevented by a membrane stabilizing drug and is not mediated through cholinergic pathways. The mechanism(s) by which nedocromil sodium inhibits adenosine-induced bronchospasm requires further investigations.

Adenosine↗
PubMed1986

Predictive accuracy of late asthmatic reaction to Dermatophagoides pteronyssinus.

Sixteen patients with asthma were challenged with solutions of Dermatophagoides pteronyssinus extracts. Fifteen patients demonstrated an early asthmatic reaction, and 10 patients also demonstrated a late asthmatic reaction, as demonstrated by a 15% decrease of FEV1 within 1 hour or between 3 and 8 hours after challenge, respectively. Airway responsiveness to inhaled methacholine, expressed as the dose causing a fall of FEV1 of 15% (Pd15), and the serum IgE level (RAST), expressed as percent of the total radioactivity added, were also measured. Multiple regression analysis of data demonstrated that both early asthmatic reaction, expressed as the allergen Pd15, and late asthmatic reaction, expressed as the FEV1 maximum fall from control values, can be predicted with similar accuracy (explained variance of 63% and 68%, respectively) by a model that incorporates simultaneously methacholine Pd15, percent of total radioactivity added by RAST, and baseline values of FEV1. We conclude that the late asthmatic reaction is more likely to occur and is more severe in patients with more severe underlying disease.

Adolescent↗
PubMed1986

Adenosine-induced bronchoconstriction: premedication with chlorpheniramine and nedocromil sodium.

The mechanism for adenosine-induced bronchospasm was investigated in asthmatic patients. Nedocromil sodium 4 mg given by aerosol 10 min before challenge effectively inhibited adenosine-induced bronchospasm. The H1-antagonist chlorpheniramine 4 mg given orally 1 h before challenge did not inhibit adenosine-induced bronchospasm, suggesting either that histaminergic pathways are not involved or that the dose was not sufficient to elicit an effect in the lung. Nedocromil sodium did not reduce the bronchial response to methacholine, supporting the view that adenosine-induced bronchospasm is not mediated through cholinergic pathways. The mechanism(s) by which nedocromil sodium inhibits the bronchial response requires further investigation.

Adenosine↗
PubMed1986

Dual asthmatic reactions to inhaled Dermatophagoides pteronyssinus: reproducibility and antagonism by cromolyn sodium.

Twenty-four asthmatic patients sensitized to Dermatophagoides pteronyssinus were challenged with a standardized extract of this allergen. All the patients selected on the basis of skin tests and RAST, had an early asthmatic reaction (EAR). Seventeen of them also had a late asthmatic reaction (LAR). Eleven patients were rechallenged in order to study the reproducibility of both EAR and LAR. Six patients were also challenged after cromolyn sodium premedication Results show that (1) reproducibility of both EAR and LAR is satisfactory (coefficient of variation = 14%), (2) patients with reproducible EAR also have reproducible LAR, and (3) a single dose of cromolyn given before challenge can prevent EAR and markedly attenuate LAR.

Adolescent↗
PubMed1985

Bronchial provocation tests with RAST-standardized allergens and dosimetric technique.

58 patients with proven allergic asthma (positive prick and RAST) were challenged with allergen extracts dosed in RAST arbitrary units; 14 of them were rechallenged after some months to evaluate the reproducibility of results; 41 underwent also a nonspecific challenge with methacholine. The results of the specific bronchial provocation test were well reproducible, with similar coefficients of variation for both early and late reactions. The specific bronchial provocation test was found to be more related to the allergic status, as reflected by specific IgE levels, than to nonspecific bronchial hyperreactivity, as reflected by response to methacholine.

Adolescent↗
PubMed1983

Total and specific IgE in serum, bronchial lavage and bronchoalveolar lavage of asthmatic patients.

Total and specific IgE were assessed in serum, bronchial lavage (BL) and broncho-alveolar lavage (BAL) of allergic asthmatics and healthy controls. Serum total IgE were found to be correlated with total IgE in BAL but not in BL. Total IgE/K+ ratio in serum and BL was higher in asthmatics than in controls, while the total IgE/albumin ratio was significantly higher in asthmatics than in controls in serum but not in BL and BAL. The mean of specific IgE in serum and BL was significantly higher in the group of patients with positive specific bronchial provocation test (sBPT) than in the group with negative sBPT. Similar results were observed between specific IgE serum level and BL and prick tests (PT), which show that BL does not always reflect the total IgE level of serum; in asthmatics, albumin can not be used to determine the degree of dilution in the recovered fluids; as in the serum, there is agreement between specific IgE in BL and PT or sPBT results.

Adolescent↗
PubMed1980

Comparison between intracutaneous and prick tests in detecting sensitizations to common Mediterranean allergens.

The role of the intracutaneous test (IC) in clinical allergy routine was evaluated comparing its results with those from the prick test, the radioallergosorbent test (RAST), and the specific bronchial provocation test (BPT). The study was carried out making an a posteriori survey of 384 patients suffering from symptoms of perennial and seasonal rhinitis and/or bronchial asthma. They were tested with the most common allergens in the Mediterranean countries; 681 prick tests and 489 IC tests were compared with RAST and 69 with BPT. The IC tests showed disagreement with RAST and BPT more frequently than prick tests: this is attributable to a lesser degree of specificity of IC test performed with the usual concentrations, and depends on the nature of the allergens. On the other hand the prick test is no less sensitive than the IC test, being the occurrence of RAST positivity in patients with negative skin tests similar for the prick and IC tests. These results support the concept of the prick test as preferable with respect to the IC test because of its specificity and sensitivity.

Adolescent↗
PubMed1980

A clinical trial of oral clenbuterol (NAB 365) in chronic airways obstruction.

A new oral bronchodilator, clenbuterol, was compared with terbutaline during a 5-week single-blind crossover study in 16 patients with chronic airways obstruction and with cough and sputum production. After a run-in period (1 week), the study was performed in two separated 2-week periods (Phase II and Phase IV), separated by a 1-week drug-free period. Oral clenbuterol was administered at 20 to 30 micrograms 3-times daily, oral terbutaline at 2.5 to 5 mg 3-times daily. The forced expiratory volume in 1 second (FEV1) was measured at the beginning and end of Phase II and Phase IV under baseline conditions, and 1 hour after an oral dose of clenbuterol or terbutaline. Parents recorded subjective and objective information in a daily diary and used no bronchidilator therapy for 12 hours before each visit. Clenbuterol and terbutaline significantly improved baseline FEV1 and the bronchodilator effects of single oral doses were similar. The mean dyspnoea, cough and sputum score values after treatments were lower than during the wash-out period (p less than 0.05). Tremors were noted in 6 patients on clenbuterol and 5 on terbutaline. It is suggested that clenbuterol is a good alternative oral drug for treatment of chronic airways obstruction.

Administration, Oral↗
PubMedDate not supplied

Two doses of oral ketamine, given with midazolam, for premedication in children.

BACKGROUND: Oral premedication is common practice in paediatric anaesthesia. The aim of this study was to assess the quality of premedication using oral ketamine, with midazolam. METHODS: Clinical randomized and blind-study on 120 patients, aged between 2 and 6 years, listed for minor surgery. Patients were divided in three groups: first group (group MK1) received midazolam and ketamine at the doses of 0.3 mgxkg-1 and 1 mgxkg-1, respectively; the second (group MK2) received 0.3 mgxkg-1 of midazolam and 2 mgxkg-1 of ketamine; the control group 0.5 mgxkg-1 of midazolam (group M). Success of premedication was assessed by assigning 1-4 points to the quality of anxiolysis and sedation every 5 min after drug administration and then at the moment of separation from parents, entrance to theatre and response to mask induction of general anaesthesia. RESULTS: More patients were successfully premedicated in the MK2 group, statistical significance was observed after 20 min (p<0.05). The MK2 group accepted separation from parents (p<0.05) and face mask for induction of anaesthesia (p<0.05) more willingly. Side effects were observed in 4 MK2 group patients (nausea, headache and diplopia), but all these effects resolved spontaneously. CONCLUSIONS: Two mgxkg-1 of ketamine given orally with midazolam improve anxiolysis and sedation and achieve more success of premedication, better acceptance of parental separation and better acceptance of face mask for induction of anaesthesia.

Adjuvants, Anesthesia↗