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Biomedical subjects

G Ciappi

Publications and source records attributed to G Ciappi.

65 records · Page 4Linked to original sources

Bronchial responsiveness in children living in areas with different air pollution levels.

This study evaluated the prevalence of increased bronchial responsiveness (BR) in children living in two areas with different air pollution levels. A total of 1,215 methacholine challenge tests were performed among a random sample of primary schoolchildren in an industrial town polluted by oil-fired thermoelectric power plants and in a rural area chosen as a control. The two groups showed similar lung function data (forced vital capacity [FVC] and forced expiratory volume in 1 s [FEV1.0]) and prevalence of positive prick tests to common aeroallergens. All children responding with a 20% drop in FEV1.0 to a methacholine concentration < or = 64 mg/ml, "all responders" (PC20FEV1.0 < or = 64 mg/ml), and the subgroup of "strong responders" (PC20FEV1.0 < or = 4 mg/ml) were compared separately with "nonresponders" (PC20FEV1.0 > 64 mg/ml), calculating odds ratios (ORs). There were more "all responders" (57.2% versus 41.4%) and "strong responders" (20.0% versus 14.8%) among subjects living in the industrial area; the excess remained when several potential confounders were taken into account ("all responders": OR = 2.0, 95% confidence interval [95% CI] = 1.5-2.6; "strong responders": OR = 1.9, 95% CI = 1.3-2.8), and it was even more pronounced among girls. When the effect of clinical predictors of increased airways responsiveness (history of asthma, allergic rhinitis, baseline airways caliber, skin reactivity, recent respiratory infection) was considered through multiple logistic regression, the odds ratios associated with living in the industrial area were still significantly increased in girls. The cross-sectional approach and the lack of individual exposure data limit the interpretation of the findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Chronobiological aspects of bronchial tone.

The aim of the investigation was to demonstrate the existence of cyclic variations of bronchial tone, correlated with the increase of vagal tone during nocturnal hours and with the increase of adrenergic tone in the late morning and afternoon. Twenty-five healthy subjects were tested, utilizing forced expiration curve (V/V loop), Raw and SGaw. We did not detect a statistically significant rhythm for FVC, FEV1, PEF, because they are effort-dependent parameters. On the contrary, we demonstrated significant fluctuations for V max50, FEF25.75 (acrophase in the later morning and early afternoon), for Raw (acrophase in late evening) and for SGaw (Acrophase in antiphase with Raw); these parameters are effort-independent as well as direct and sensitive indexes of the tone of peripheral and central airways.

Adult↗

Airway disease: anatomopathologic patterns and functional correlations.

Airways represent a serial and parallel branched system, through which the alveoli are connected with the external air. They participate in the mechanical and immune defense against noxious agents, regional flow regulation to optimize the perfusion/ventilation ratio and provide lung mechanical support. Functional exploration of central airways is based on resistance measurement, flow-volume curve or spirometry, while peripheral airways influence parameters as the upstream resistance, the slope of phase III nitrogen washout and the residual volume. Bronchodynamic tests supply important information on airway reversibility and nonspecific reactivity. Anatomopathologic alterations of obstructive chronic bronchitis, pulmonary emphysema and bronchial asthma account for their specific functional and bronchodynamic alterations. There is a growing interest for bronchiolitis in the clinical, radiologic and functional field. This type of lesion, always present in COPD, asthma and interstitial disease, becomes relevant when isolated or predominant. The most useful anatomofunctional classification separates the "constrictive" forms, the cause of obstruction and hyperinflation, from "proliferative" forms where an intraluminal proliferation more or less extended to alveolar air spaces as in BOOP (bronchiolitis obliterans organizing pneumonia) results in restrictive dysfunction. Constrictive bronchiolitis obliterans represents a severe and frequent complication of lung and bone marrow transplantation. Idiopathic BOOP may occur with cough or flue-like symptoms. In other cases, constrictive and proliferative forms may have a toxic (gases or drugs), postinfective or immune etiology (rheumatoid arthritis, LES, etc). Respiratory bronchiolitis or smokers' bronchiolitis, an often asymptomatic lesion, rarely associated to an interstitial lung disease, should be considered separately. The relationships between respiratory bronchiolitis, COPD and initial centriacinar emphysema is still to be elucidated. The diagnostic combination of the more sensitive functional tests with HRCT will allow a better understanding of the natural history of the various forms of bronchiolitis.

Bronchiolitis↗

Respiratory function impairment in pulmonary tuberculosis.

Main alterations of respiratory function in pulmonary tuberculosis are analyzed. Due to the wide range of clinical manifestations, all possible patterns of dysfunctions are described with particular reference to the impact on gas exchange. Possible sequelae of pulmonary tuberculosis are also reported.

Humans↗