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Biomedical subjects

G Ciappi

Publications and source records attributed to G Ciappi.

At least 55 records · Page 3Linked to original sources
PubMed1986

Comparison of bronchial responses to ultrasonically nebulized distilled water, exercise, and methacholine in asthma.

We compared the responses to inhaled methacholine, ultrasonically nebulized distilled water, and exercise in 25 subjects with atopic asthma. The methacholine inhalation test and challenges with distilled water and exercise were performed on three separate days 48 hours apart. Bronchial responsiveness to methacholine and ultrasonically nebulized distilled water was measured as the concentration of methacholine (PC20M) and the volume output of the ultrasonic nebulizer (PO20 UNDW) producing a 20 percent fall in the forced expiratory volume in one second (FEV1). The response to exercise was expressed as the percentage of fall in FEV1 from the value before exercise. Seventeen subjects showed a fall in FEV1 of more than 20 percent after exercise. Eight subjects had a stimulus-response curve to distilled water that was flat up to the maximal volume output from the nebulizer, but only four of them also showed no significant response to exercise. The response to exercise correlated better with PO20 UNDW (r = -0.66; p less than 0.01) than with PC20M (r = -0.19; p greater than 0.5) in those responding to distilled water. In all of the tested subjects, exercise-induced bronchoconstriction correlated with PC20M (r = -0.61; p less than 0.01). The mean PC20M was significantly lower in the subjects with a significant response to distilled water and exercise (p less than 0.001 and p less than 0.0001, respectively). We concluded that ultrasonically nebulized distilled water and exercise provoke significant bronchoconstriction in the subjects with more severe nonspecific bronchial hyperresponsiveness. The correlation found between the two stimuli supports the hypothesis that they act by similar mechanisms.

Adolescent↗
PubMed1986

Protective effect of disodium cromoglycate on allergen-induced bronchoconstriction and increased hyperresponsiveness: a double-blind placebo-controlled study.

The protective effect of 40 mg cromolyn on allergen-induced late response and increased hyperresponsiveness were studied in five asthmatic children to whom this drug and saline placebo were administered 20 minutes before allergen inhalation, at random, double-blind. Cromolyn reduced the magnitude of early and late responses and abolished the increase in methacholine responsiveness.

Adolescent↗
PubMed1986

The use of digitalis in patients with chronic respiratory failure.

The effect of slow digitalization was tested by radioisotopic angiocardiography in 33 patients with stable and compensated chronic obstructive pulmonary disease (COPD); most of these had severe chronic respiratory failure (CRF). After a 10 days course of digoxin, 0.25 mg/die per os, both the left ventricular ejection fraction (LVEF) and the peak ejection rate (PER), initially slightly abnormal, improved significantly (t = -3.474, p less than 0.005; t = -2.438, p less than 0.025), while right ventricular ejection fraction (RVEF) and peak filling rate (PFR) did not. Ventricular diastolic interdependence and abnormal myocardial calcium kinetic are likely to account for PFR behaviour. Digoxin effects upon RVEF and LVEF suggest that the right ventricular systolic function is to some extent independent from the left one when blood gas derangement and abnormal thoracopulmonary mechanics are the major determinant of right ventricular afterload. The lack of significant correlation between digoxin effects on right and left ventricular function indices confirms this hypothesis. Digoxin can improve the left ventricular ejection phase indices, when these are initially abnormal, while its effect on RVEF is unpredictable.

Adult↗
PubMed1985

The immediate and short-term effects of corticosteroids on cholinergic hyperreactivity and pulmonary function in subjects with well-controlled asthma.

We investigated the immediate effect of corticosteroids on pulmonary function (FEV1 and forced expiratory flow measured between 25% and 75% of vital capacity) and methacholine airway reactivity during a period of 8 hours after an intravenous bolus of 6-methyl-prednisolone (1 mg/kg) or saline placebo administered in a double-blind, crossover schedule in 12 patients with well-controlled asthma. The short-term effect of corticosteroids was also studied with bronchial reactivity to methacholine and pulmonary function measured before and at the end of 8 days of 6-methyl-prednisolone therapy (32 mg once a day, orally) in a group of six treated subjects as well as in a control group. There were no immediate or short-term effects from 6-methyl-prednisolone on bronchial response to inhaled methacholine. After 8 days of corticosteroid administration, forced expiratory flow measured between 25% and 75% of vital capacity significantly increased in the treated group (p less than 0.025). We concluded that "primary hyperreactivity" appears to be insensitive to an intravenous bolus or 8 days of treatment with oral corticosteroids and that the improvement in respiratory function is slight and slowly evolving in subjects with well-controlled asthma.

Adolescent↗
PubMed1985

A simple method of predicting left ventricular function in stabilized chronic respiratory failure.

A simple method of assessing left ventricular function in stabilized chronic respiratory failure (CRF) is proposed. 21 patients with CRF were ranked according to the prediction of left ventricular function derived from eight elementary clinical criteria including standard chest X-ray and conventional basal electrocardiography. Equilibrium radionuclide angiocardiography was performed at rest (rERNA) for the evaluation of left ventricular systolic function (ejection fraction, LVEF; peak ejection rate) and diastolic function (peak filling rate). Right ventricular ejection fraction (RVEF) was also measured. The clinical evaluation of the left ventricular function showed a high correlation with rERNA data (p less than 0.01 by Spearman's rank test). No correlation was found between rERNA parameters and PaO2 and between RVEF and LVEF. The clinical criteria proposed can thus predict left ventricular function in stabilized CRF with a high degree of confidence.

Angiocardiography↗
PubMed1985

Detection of ventilation unevenness by nitrogen washout and forced vital capacity manoeuvres: its limits and reliability.

We investigated the behaviour of several indices of ventilation unevenness in a sample of 234 normal subjects aged between 20 and 80 years, divided into 12 classes of 5 years each. The aim of the present study was to find out whether it is possible to predict a reliable value for each of these indices as a function of age, height and TLC. For each index a large dispersion of experimental points and a high unexplained variance was found, so that it does not seem worthwhile predicting its value as a function of age, height and TLC. We concluded that there is no reason to employ these indices to detect the beginning of a lung function impairment.

Adult↗
PubMed1984

Respiratory function during pregnancy.

We studied the respiratory mechanics, acid-base status, alveolar ventilation and ventilatory response to hypercapnia in pregnant women at the first and third trimesters and postpartum. We found alveolar hyperventilation and hypersensitivity of the respiratory centers to carbon dioxide with no significant differences between the first and third trimesters. After delivery we found a sudden decrease in these parameters. The changes seem to be due to a direct primary (probably hormonal) stimulation on the medulla oblongata and cannot be correlated to the metabolic needs of the fetus and are aimed at favoring placental gas exchanges, especially at the beginning of the pregnancy, when the fetal cardiovascular system is not yet developed.

Acid-Base Equilibrium↗
PubMed1980

[Computer evaluation of hemodynamic changes during mechanical ventilation with a body respirator].

The Authors study the variations of the cardiac output (C.O.), of the mean pulmonary arterial pressure (mPAP) and of the pulmonary vascular resistance (P.V.R.) in fine patients, affected by chronic respiratory failure, during the mechanical ventilation with a body respirator. In all the patients a reduction of the mPAP and of the CO are present. The PVR varies proportionally to the improvement of the respiratory indices. The Authors conclude that the haemodinamic changes are not exclusively due to the mechanical effect of the body respirator, but also to the correction of the respiratory situation and particularly due to the intra-alveolar pressure.

Aged↗