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E Neil Schachter

Publications and source records attributed to E Neil Schachter.

16 recordsLinked to original sources
PubMed2006

Respiratory findings in a nursing home population.

The prevalence of respiratory abnormalities was studied in an elderly nursing home population. This study investigated 475 female and 147 male individuals living in five nursing homes in Zagreb, Croatia. Chronic respiratory symptoms were recorded using the British Medical Research Council questionnaire. Ventilatory capacity was measured with maximum expiratory flow-volume (MEFV) curves on which forced vital capacity (FVC), one-second forced expiratory volume (FEV1), maximum expiratory flow rate at 50% FVC (FEF50), and maximum expiratory flow rate at 25% FVC (FEF25) were measured. A high rate of chronic respiratory illness and symptoms was found in both female and male nursing home residents. The highest rates were for asthma, chronic cough, and for chest tightness. Odds ratios (OR) showed that smoking and the length of employment were significant risk factors among men. Pulmonary function testing demonstrated a decrease in measured values compared to predicted (p<0.01). This was particularly pronounced for FEF50 and FEF25, suggesting obstructive changes in smaller airways. Regression coefficients were significant for smoking and employment primarily for FEF50 and FEF25. Our data suggest that older individuals residing in nursing homes exhibit an excess of respiratory symptoms, and lung function abnormalities. Smoking and past employment are important risk factors for these respiratory findings. Medical surveillance and preventive strategies should be implemented for this high risk population.

Aged↗
PubMed2006

Cilomilast.

The central role of cyclic nucleotides as intracellular second messengers dates back almost 50 years. The importance of phosphodiesterase in regulating this system was recognized early, and the potential therapeutic role of phosphodiesterase inhibitors in modulating pathologic conditions was also suggested. At that time, the methylxanthines represented major pharmacologic agents capable of inhibiting cyclic nucleotides and were widely used in respiratory medicine. Initially, bronchodilator effects were considered their major mechanism of action, but subsequent studies suggested other potential roles including an anti-inflammatory one. A number of developments led to the decline in popularity of this class of agents, the foremost being their side-effect profile. The discovery of multiple phosphodiesterase isoforms paired with a better understanding of the physiologic and clinical properties of the phosphodiesterases has re-awakened interest in therapeutic agents in this area and in particular the potential for the development of selective phosphodiesterase inhibitors. Cilomilast is a systemically available, second- generation, selective phosphodiesterase-4 inhibitor. It retains the therapeutic activity of the first generation phosphodiesterase-4 inhibitors (such as rolipram) but is believed to have less of an emetic effect. Cilomilast causes a reduction of tissue cells considered central to the ongoing inflammatory process (macrophages and CD8+ lymphocytes) in patients with chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease is now considered a chronic inflammatory disease of the lungs resulting from prolonged exposure to inflammatory agents in cigarette smoke and other environmental and occupational pollutants, and it is currently the principal target of cilomilast. It is characterized by progressive destruction of parenchymal tissue and punctuated by acute exacerbations. The inflammation is thought to begin in the peripheral airways and lung parenchyma. Chronic obstructive pulmonary disease is a progressive disease, leading to disability and eventual death despite conventional therapy. Cilomilast is completely absorbed following oral administration and has negligible first-pass metabolism. It exhibits low between-subject variability. Cilomilast is predominantly protein bound. Plasma clearance is almost entirely metabolic, through multiple parallel pathways. Its terminal elimination half-life is approximately 6.5 hours, and steady state is rapidly achieved. A dose of 15 mg twice daily has been found to be clinically effective. Smoking and age have no clinically relevant effects on cilomilast pharmacokinetics. Most drugs frequently used in patients with chronic obstructive pulmonary disease do not alter its side effect profile. Initial concerns of arteritis involving the gastrointestinal tract in rodent animal models have not been reported in clinical trials. Nausea, presumably of central origin, is the principal adverse reaction seen in healthy subjects taking cilomilast. It has not been associated with the serious cardiac or neurological adverse effects seen with theophylline. Preliminary clinical studies suggest a favorable clinical effect in chronic obstructive pulmonary disease. Cilomilast is generally well tolerated and has not generated safety concerns in reported clinical studies.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed2006

Alcohol--health effects, working environment and prevention.

Alcoholism is a growing medical and public health issue both in adults and in the younger generation. It is a multietiological phenomenon influenced by genetic, psychological, cultural and other factors. Alcoholic beverages have traditionally been prepared from various ingredients such as grapes, hops, rice, honey, etc. Drinking prevalence has varied and is more pronounced in women and the youth. Alcoholism is shown to be of neurophysiological etiology and may lead to impairment of all human body systems. The most frequent cause of death in alcoholics are diseases of the cardiovascular system. The problem of alcoholism at workplace is very important since by affecting health and reducing work productivity it leads to accidents, injuries and decreased working capacity. Efficient solving of alcoholism and related problems includes early detection, so it is necessary to orient the health care services towards primary prevention and early interventions.

Alcoholic Beverages↗
PubMed2006

Chronic respiratory symptoms in Croatian Adriatic island metapopulations.

AIM: To investigate the prevalence of chronic respiratory symptoms in 9 metapopulations on Adriatic islands in Croatia, and the relationship between respiratory symptoms and individual genetic background. METHODS: We obtained random sample of 1001 adult inhabitants of 9 Adriatic island villages in Croatia, that also included immigrants to these villages. European Union respiratory health questionnaire and World Health Organization non-communicable diseases questionnaire were used. Personal genetic histories were reconstructed, based on the two-generation ancestral pedigrees. Bivariate and multivariate methods were used in the analysis. RESULTS: Women reported the occurrence of acute dyspnea (P=0.017), cough (P=0.002), and asthma (P=0.002) more often than men. Gender was the strongest predictor for acute and/or chronic cough (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.23-2.33) and asthma (OR, 2.00; 95% CI, 1.00-4.01), whereas smoking was the strongest risk factor for acute and chronic dyspnea (OR, 1.90; 95% CI, 1.21-2.99) and airway narrowing (OR, 1.84; 95% CI, 1.18-2.87). Residence on the northern islands increased the odds of allergy, whereas the highest odds ratio of 3.20 was associated with the interaction of northern residence and immigrant background. Genetic background was a significant predictor only for the occurrence of allergy symptoms. CONCLUSION: Differences in respiratory findings among the island inhabitants were often associated with smoking prevalence. Interaction of residence on northern Adriatic islands and immigrant background proved to be the strongest predictor for the occurrence of allergy symptoms. This study indicated that environmental factors played a very important role in the occurrence of respiratory symptoms.

Adult↗
PubMed2005

Airway responses to the inhalation of cotton dust and cotton bract extracts.

BACKGROUND: Exposure to dust in the cotton industry is associated with respiratory dysfunction. Healthy subjects challenged with cotton bract extract (CBE) develop transient airway hyperresponsiveness. CBE, a major component of cotton dust, is potentially an important agent for studying byssinosis. OBJECTIVES: To compare airway responses to cotton dust extract (CDE) and CBE in healthy subjects. METHODS: In 21 healthy, non-smoking subjects we compared the effects of CBE and CDE in a double-blind random order, following a 10-min aerosol inhalation. The response to methacholine (MCh) 2 h following CBE or CDE was measured. Lung function was recorded using maximal (MEFV) and partial expiratory flow volume (PEFV) curves, measuring MEF at 60% of baseline vital capacity below total lung capacity [MEF40%(P)] on the PEFV curve. Responders were subjects who developed a 20% or greater fall in MEF40%(P) following extract challenge. Endotoxin levels were low for CBE (5.71 EU/mg) and CDE (31.88 EU/mg). RESULTS: There were 18 responders to CBE and 17 responders to CDE. The average maximal falls in MEF40%(P) were 70 +/- 4.9 and 70 +/- 4.4% of baseline (nonsignificant) following CBE and CDE, respectively. All subjects enhanced their MCh response following CBE or CDE. The MCh dose which reduced MEF40%(P) by 40% was identical for CBE and CDE (1.3 microg/ml). CONCLUSIONS: We conclude that CBE and CDE exert similar physiologic effects.

Adult↗
PubMed2005

Health problems in musicians--a review.

Among artists, musicians suffer from special health problems related to their occupation and lifestyle. These mainly include musculoskeletal disorders, skin disorders, respiratory disorders, and noise induced hearing impairment. In this review we point out the most prevalent health problems that musicians face in their professional lives as well as the means to prevent them. The characteristics of individual performer and the type of instrument that he/she plays will determine the occupational disorder or disease that a musician may suffer from. The main worry about health problems in musicians is that they can become potentially career-ending disabilities. Therefore well-planned preventive strategies should be employed to help musicians in obtaining long and healthy career.

Hearing Loss, Noise-Induced↗
PubMed2004

Immunological and respiratory changes in tobacco workers.

BACKGROUND: Tobacco workers develop respiratory changes following occupational exposure to tobacco dust. METHODS: This study investigated 102 tobacco workers as well as a group of 30 matched control workers. Immunological testing, symptom questionnaire, and lung function measurements were performed in all workers. RESULTS: Increased total IgE was found in 12.7% of tobacco workers but in none of the controls (P < 0.05). Increased specific IgE (tobacco allergen) was recorded in 26.7% of tobacco workers with positive skin tests to tobacco extract but in none of the controls (P < 0.05). Regression analysis of ventilatory tests in female tobacco workers indicated a significant association of FEF75 to employment and smoking among workers with positive skin tests to tobacco. There were, however, no other associations between positive immunologic findings and lung function abnormalities and symptoms. CONCLUSIONS: Our study found increased immunological reactions in the tobacco workers. However, with the possible exception of lung function at low lung volume in female workers, these reactions do not appear to contribute significantly to the symptoms and lung function abnormalities seen in these workers. Am. J. Ind. Med. 45:76-83, 2004.

Adult↗
PubMed2004

Respiratory findings in pharmaceutical workers.

BACKGROUND: Pharmaceutical workers may be at risk for the development of respiratory problems as a result of their work environment. METHODS: This study investigated 163 female and 35 male workers, employed in a pharmaceutical plant processing different types of medication, primarily antibiotics, in order to characterize the risk of this environment. Chronic respiratory symptoms were recorded by using the British Medical Research Council questionnaire. Acute symptoms, which developed during the work shift, were also recorded. Ventilatory capacity was measured by recording maximum expiratory flow-volume (MEFV) curves on which FVC, FEV1, FEF50, and FEF25 were measured. Controls (113) were selected from a food packing facility. RESULTS: A significantly higher prevalence of chronic respiratory symptoms was recorded among workers (compared to controls), the highest being for sinusitis, nasal catarrh, and dyspnea. There was also a high prevalence of acute symptoms recorded during the workshift. Odds ratio showed that the most significant risk factors for these respiratory findings were smoking and length of time worked in the pharmaceutical industry, particularly in men. Pulmonary function testing demonstrated significantly decreased measured values in comparison to predicted European pulmonary function measurements (P < 0.01). This was particularly pronounced for FEF50 and FEF25, suggesting obstructive changes in smaller airways. CONCLUSIONS: Our data suggest that workers employed in the pharmaceutical industry may develop respiratory symptoms accompanied by ventilatory impairment.

Adult↗
PubMed2004

Hyperresponsiveness to tobacco dust extract in sensitized guinea pig trachea.

The role of pre-existing airway inflammation in the pathogenesis of occupational airway disease is poorly understood. Previously we studied an extract of tobacco dust (TDE) and determined that it causes concentration dependent contractions of nonsensitized guinea pig trachea (GPT). In the present study animals were sensitized using Ovalbumin (OA) and subsequently challenged with an aerosol of 2.5% OA on day 21. A control group of nonsensitized GPs were divided into rings in which the epithelium was retained (EPI+) or removed (EPI-). Concentration related contractions of sensitized and nonsensitized GPTs were elicited with TDE. Sensitized GPTs demonstrated a greater contractile response to TDE than did nonsensitized GPTs. In nonsensitized animals the EPI- GPTs demonstrated a lesser response to TDE than did the EPI+. Similar findings were demonstrated in sensitized GPTs with and without epithelium. When epithelium was removed, sensitized and nonsensitized GPTs behaved similarly. Moreover, sensitized GPTs without epithelium and nonsensitized with epithelium responded similarly. These findings suggest that presensitization with an unrelated antigen enhances the response to an occupational agent and that in sensitized animals at least part of the enhanced response is mediated by the epithelial layer.

Animals↗
PubMed2003

Pharmacologic effects of tobacco dust extract on isolated Guinea pig trachea.

STUDY OBJECTIVE: To determine the effects of tobacco dust extract (TDE) on isolated guinea pig tracheal smooth muscle. DESIGN: A controlled, in vitro smooth-muscle study of the effect of pharmacologic agents on TDE. METHODS: The effect of TDE on isolated guinea pig tracheal smooth muscle was tested using water-soluble extracts of dust obtained from machines in a cigarette manufacturing plant. Dose-related contractions of nonsensitized guinea pig trachea were demonstrated using these extracts. The dust extracts contained significant quantities of bacterial components (eg, endotoxin). Pharmacologic studies were performed by pretreating guinea pig tracheal tissue with drugs known to modulate smooth-muscle contraction: atropine, indomethacin, pyrilamine, nordihydroguaretic acid, acivicin, bromophenacyl bromide, 3,4,5-trimethoxybenzoic acid-8-(diethylamino)octyl ester, captopril, and capsaicin. RESULTS: Atropine strikingly reduced the contractile effects of these extracts. Inhibition of contraction by blocking other mediators was less complete. There was no inhibition of contraction by hexamethonium (10(-4) mol/L, 10(-5) mol/L, 10(-6) mol/L), suggesting that nicotine was not the major contractile mediator of TDE. A separate analysis using different molecular weight fractions of TDE indicated that the constrictor activity appears to be primarily in the fraction with a molecular weight < 10 kd. Additionally, the constrictor effect resided entirely in the nonlipid fraction of the extract. We suggest that TDE causes dose-related airway smooth-muscle constriction by nonimmunologic mechanisms involving a variety of airway mediators and possibly cholinergic receptors. CONCLUSIONS: The bronchoconstrictor activity of TDE resides primarily in its low molecular weight, nonlipid fraction, and hexamethonium studies suggest that this agent is not nicotine.

Air Pollutants, Occupational↗
PubMed2003

Respiratory findings in tobacco workers.

OBJECTIVES: To screen for respiratory symptoms and lung function impairment in workers occupationally exposed to tobacco dust in a tobacco-processing plant. PARTICIPANTS: One hundred twenty-one tobacco workers (97 women and 24 men) were included in the study. In addition, a group of 98 control workers (73 women and 25 men) were studied. METHODS: Acute and chronic respiratory symptoms were recorded in all tobacco workers. Lung function was measured by recording the maximum expiratory flow-volume curves on which FVC, FEV(1), and flow rates at 50% of FVC (FEF(50)) and the last 25% of FVC (FEF(25)) were read. RESULTS: There was a high prevalence of chronic respiratory symptoms among these workers, and this prevalence was significantly higher in exposed female workers than in female or male control workers (p < 0.01 and p < 0.05, respectively). Occupational asthma was recorded in 6 female tobacco workers (6.2%) and in none of the control subjects (p < 0.05). None of the male workers were found to have occupational asthma. There was also a high prevalence of acute symptoms that were noted during the work shift (particularly for nose and throat dryness, as well as eye irritation). Among these tobacco workers, the odds ratios for respiratory symptoms were frequently significant for employment and smoking among male tobacco workers but were not significant in general for female tobacco workers. The ventilatory capacity data in tobacco workers showed statistically significant reductions in FEV(1), FEF(50), and FEF(25) in relation to predicted values. These reductions were demonstrated in smokers as well as in nonsmokers. Regression analysis suggested that there were significant changes according to employment status for FVC, FEV(1), and FEF(25) in female tobacco workers. Measurements of ventilatory capacity during the course of the work shift in 38 female tobacco workers demonstrated significant mean acute reductions in FEV(1) (-5.7%), in FEF(50) (-15.7%), and in FEF(25) (-23.4%). CONCLUSIONS: Our data indicate that tobacco workers may develop respiratory disorders related to tobacco dust in their work environment.

Acute Disease↗
PubMed2003

Ventilatory functions in Croatian population in comparison with European reference values.

AIM: To compare ventilatory capacity of Croatian population with the ventilatory function values predicted by conventional equations based on measurements among European populations. METHODS: Ventilatory capacity and respiratory symptoms were determined in a group of 2,482 healthy non-smokers (1,162 men and 1,320 women). The measurements were performed with a pneumotach spirometer. Maximum expiratory flow volume curves (MEFV) were registered, and forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and flow rates at 50% (MEF50) and the last 25% of the vital capacity (MEF25) were recorded. Anthropometric data were also noted. Reference values were calculated using multiple linear regressions. RESULTS: Comparisons of our values with the prediction summary equations issued by the European Community for Steel and Coal (ECSC) and the European Respiratory Society (ERS) showed that healthy Croatians had consistently lower values of FVC (92.1-/+14.0% of the predicted volume for men and 86.2-/+11.7% for women) and FEV1 (93.7-/+14.8% of the predicted values for men and 95.3-/+13.1% for women), but higher values of MEF50 (107.8-/+30.1% of the predicted values for men and 103.4-/+22.8% for women) and MEF25 (117.3-/+41.0% of the predicted values for men and 117.9-/+34.0% for women) than the ECSC/ERS recommendations. The comparison was also made with the most commonly used North American reference standards based on populations of European origin, with similar findings. On the basis of the results of multiple linear regressions, we constructed prediction equations for ventilatory function in Croatian population. CONCLUSION: The ECSC/ERS recommendations are not satisfactory for the Croatian population.

Adult↗
PubMedDate not supplied

Pharmacological studies of the effect of wheat grain extract.

BACKGROUND: Agricultural farm workers exposed to wheat grain dust are at risk of developing respiratory abnormalities. The pathogenesis of this injury is only partially understood. OBJECTIVES: To determine the effect of wheat grainextract on isolated guinea pig tracheal smooth muscle. METHODS: In the current study, pharmacologic properties of wheat grain extract (WGE) were tested using guinea pig tracheas studied in vitro. Dose-related contractions of nonsensitized guinea pig trachea were demonstrated using these extracts. Pharmacologic studies were performed by pretreating guinea pig tracheal tissue with drugs known to modulate smooth muscle contraction: atropine 10(-6)M, indomethacin 10(-6)M, pyrilamine 10(-6)M, acivicin 10(-5)M, nordihydroguaretic acid (NDGA) 10(-5)M, bromophenacyl bromide (BPB) 10(-5 )M, 3,4,5-trimethoxybenzoic acid-8-(diethylamino)- octyl ester TMB8 10(-5)M, captopril 10(-5)M and capsaicin 5 x 10(-6)M. RESULTS: WGE causes a dose-dependent constriction of guinea pig tracheal smooth muscle. Atropine, pyrilamine, TMB8 and acivicin significantly reduced the contractile effects of the WGE. Inhibition of contraction by blocking of other mediators was significant but less complete. CONCLUSION: We conclude that WGE causes a dose-related constriction of airway smooth muscle by nonimmunological mechanisms involving a variety of airway mediators and possibly cholinergic receptors.

Animals↗