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Biomedical subjects

I Ben-Dov

Publications and source records attributed to I Ben-Dov.

At least 37 records · Page 2Linked to original sources
PubMed1989

[The integrative cardiorespiratory exercise test: 2. Response to maximal exercise in heart and lung diseases].

Physiological measurements during integrative cardiorespiratory progressive exercise in different cardiovascular and respiratory disorders help discern and describe the characteristic exercise response patterns of different disorders. Cardiovascular limitation to exercise is characterized by reduced maximal exercise capacity and reduced anaerobic threshold and oxygen utilization. On the other hand, respiratory limitation of exercise is characterized by reduced breathing reserve with high ventilatory equivalents for a given metabolic load but with a normal cardiovascular response. Combined cardiovascular and respiratory disorders demonstrate both cardiovascular and respiratory types of limitation of exercise. We present 2 patients with cardiovascular disorders, 2 with respiratory, and 2 with combined cardiovascular and respiratory disorders. The interpretation of the physiological data of the progressive cardiorespiratory exercise test increased the accuracy of clinical evaluation and treatment. We therefore think the test will gain wide use in the clinical evaluation of patients with cardiovascular and respiratory disorders.

Cardiovascular Diseases↗
PubMed1989

[The integrative cardiorespiratory exercise test].

The cardiorespiratory incremental maximal exercise test is being used increasingly for clinical evaluation. It is based on the fact that during physical effort the output of the cardiovascular and respiratory systems increase to maintain a higher metabolic rate and stroke volume. Cardiac output increases by increase in both heart rate and stroke volume. Ventilation increases by increase in respiratory rate and tidal volume. All changes are synchronous, so that blood composition and gas partial pressures are constant over a wide range of work intensities. The response of a normal sedentary subject to incremental exercise is presented, as well as the improvement in an athlete's physical performance as a result of training. An obese subject, despite normal maximal oxygen uptake, felt compromised due to the high energy cost of moving his heavy torso. The large normal breathing reserve during exercise was demonstrated in 2 subjects who, despite lung disease, responded normally to the test. It is likely that this test will be widely used for evaluation of patients with heart and lung disease.

Exercise Test↗
PubMed1989

Foreign body aspiration in the adult: an occult cause of chronic pulmonary symptoms.

We describe two otherwise healthy subjects with many years sequelae due to lung aspiration. In both, diagnosis was delayed due to lack of history of aspiration. Recurrent pneumonia in the same segment in one, and migratory pneumonia in the other, could have suggested the diagnosis. Review of the literature shows that occult foreign body aspiration poses difficulties in diagnosis and that often a history of aspiration is lacking. However, the recurrent nature and the localization of the pneumonia, as well as the findings during bronchoscopy, should alert the physician to the possibility of foreign body aspiration.

Aged↗
PubMed1989

Prolonged pyrexia and lung metastases. A rare presentation of an occult epithelioid sarcoma.

A 31-year-old patient presenting with fever of unknown origin, night sweats and weight loss, associated later with pulmonary nodules, is described. Multiple invasive diagnostic procedures, including exploratory laparotomy and open-lung biopsy, suggested a benign inflammatory granulomatous disease. Metastatic epithelioid sarcoma was ultimately diagnosed after biopsy of an enlarging groin mass. Epithelioid sarcoma should be considered in the differential diagnosis of prolonged fever, associated with granulomas of obscure etiology.

Adult↗
PubMed1988

Post-partum isolated ovarian abscess in an asplenic host.

A 23-yr-old splenectomized female developed an isolated ovarian abscess, a very rare complication, following a normal delivery. Apart from the palpated 'cyst', findings on pelvic examination were unremarkable, as is often the case with ovarian abscess. The patient recovered after conservative 'cystectomy'. We suggest that the asplenic state plays a role in the development of this very rare complication.

Abscess↗
PubMed1987

Effect of endurance training on possible determinants of VO2 during heavy exercise.

When moderate exercise begins, O2 uptake (VO2) reaches a steady state within 3 min. However, with heavy exercise, VO2 continues to rise beyond 3 min (VO2 drift). We sought to identify factors contributing to VO2 drift. Ten young subjects performed cycle ergometer tests of 15 min duration for each of four constant work rates, corresponding to 90% of the anaerobic threshold (AT) and 25, 50, and 75% of the difference between maximum VO2 (VO2 max) and AT for that subject. Time courses of VO2, minute ventilation (VE), and rectal temperature were recorded. Blood lactate, norepinephrine, and epinephrine were measured at the end of exercise. Eight weeks of cycle ergometer endurance training improved average VO2 max by 15%. Subjects then performed four tests identical to pretraining studies. For the above AT tests, training reduced VO2 drift substantially; reduction in each of the possible mediators we measured was also demonstrated. The training-induced decrease in VO2 drift was well correlated with decreases in end exercise lactate and less well correlated with the drift in VE seen at above AT work rates. The training-induced reduction in VO2 drift was not significantly correlated with attenuation of rectal temperature rise or decrease in end-exercise level of the catecholamines. Thus the slow rise in VO2 during heavy exercise seems linked to lactate, though a component dictated by the work of breathing cannot be ruled out.

Adult↗
PubMed1987

Drug-resistant tuberculosis in a southern California hospital. Trends from 1969 to 1984.

Resistance to one or more antituberculosis drugs was found in 98 of 281 (35%) patients hospitalized at Harbor-UCLA with culture-positive tuberculosis between 1980 and 1984. Resistance to antituberculosis drugs occurred in 23% of patients who had not been previously treated, whereas previously treated patients had a 59% rate of resistance. The overall rates of drug resistance had not significantly changed from prior studies at this hospital. Drug resistance was also found in patients with extrapulmonary disease, but tended to be less frequent than in patients with pulmonary disease. An analysis of risk factors for drug resistance rates revealed no significant differences between Hispanics, blacks, Caucasians, and Asians. Age was not found to be a significant factor to predict resistance rates. Resistance rates were higher if cavitary disease was present on radiographs. Furthermore, cavitary disease seems to be additive to prior antituberculosis treatment as a risk factor for drug resistance. Patients who had both of these risk factors present had 71% incidence of drug resistance rates.

Adolescent↗
PubMed1986

Bronchodilatation and attenuation of exercise-induced bronchospasm by PY 108-068, a new calcium antagonist.

The effect of a new dihydropyridine-derivative calcium antagonist, PY 108-068, on resting and postexercise flow rates was evaluated in 12 adult asthmatic subjects in a double-blind, randomized, placebo-controlled, cross-over study. The study consisted of 2 periods, each lasting for 3 days. For a given period a single dose of PY 108-068 (or placebo) was given orally, 75 mg on the first day and 150 mg on the second and third day. Spirometry was obtained at 30-min intervals thereafter. On Day 3, 75 min after the medication was given, a 6-min treadmill exercise test was performed breathing dry air. The mean maximal FEV1 recorded after 150 mg of PY 108-068 on Day 2 was 15 +/- 4% higher than the daily baseline (p less than 0.05), whereas after placebo the maximal FEV1 value was not different from the daily baseline. Also, the mean FEV1 values, expressed as percent of the daily predrug baseline, were significantly higher at 2 and 3 h after 150 mg of PY 108-068 than the respective values after placebo (110 +/- 4 compared with 95 +/- 1, and 106 +/- 5 compared with 91 +/- 3, respectively). Exercise-induced bronchospasm (EIB), expressed as maximal percent fall in FEV1 from preexercise baseline, was attenuated by PY 108-068 as compared with placebo (% delta FEV1 of 20 +/- 6 and 40 +/- 4, respectively; p less than 0.001). Protection against EIB did not correlate with the resting bronchodilation induced by PY 108-068, but was more likely if the patient had eosinophilia. Thus, PY 108-068 not only attenuates EIB but also causes resting bronchodilation, a unique finding for calcium channel blockers.

Adult↗
PubMed1986

Comparison of PY 108-068, a new calcium antagonist, with nifedipine in exercise-induced asthma.

Several calcium antagonists, each with significantly different chemical structures, have demonstrated variable attenuation of exercise-induced asthma. Quantitative comparisons have been hampered by differences in the intensity of challenge and the severity of the underlying disease between groups of patients. In 12 asthmatic adults with relatively severe exercise-induced asthma, we compared the effect of a new calcium antagonist, PY 108-068, in doses of 75 mg and 150 mg with nifedipine (30 mg) and placebo on resting flow rates and flow rates after exercise. Over a three-week period, each patient completed a four-day, randomized, double-blind Latin-square study. After receiving one of four oral drugs, spirometry was repeated every 30 minutes for two hours, followed by a six-minute treadmill exercise test breathing dry air. The exercise tests were well matched for work rate, ventilation, heart rate, and oxygen uptake. Spirometry was then repeated seven times over the next 30 minutes after exercise. Though both 150 mg of PY 108-068 and nifedipine were associated with mild bronchodilation before exercise, only the latter was significant (p less than 0.05). Exercise-induced asthma (expressed as maximal percent fall in the forced expiratory volume in one second from before baseline) was significantly attenuated only by 150 mg of PY 108-068 compared to placebo (24 +/- 13 vs 40 +/- 16; p less than 0.05). Headache, which occurred in six subjects after nifedipine, five after 150 mg of PY 108-068, one after 75 mg of PY 108-068, and none after placebo, was subjectively more severe after nifedipine. We conclude that in these patients, there was a tendency for mild bronchodilation before exercise with both 150 mg of PY 108-068 and nifedipine, but only the 150-mg dose provided significant protection against exercise-induced asthma two hours after the drug.

Adolescent↗
PubMed1985

Poststreptococcal neprhitis and acute rheumatic fever in two adults.

In two adult subjects who suffered acute episodes of rheumatic fever, sever kidney involvement developed with proteinuria and renal insufficiency. The clinical and histologic picture was typical of poststreptococcal (infectious) glomerulonephritis. During a follow-up period of more than three years, no clinical or biochemical abnormalities have been detected; thus, it is likely that both patients have recovered from their renal diseases. The coexistence of rheumatic fever and acute glomerulonephritis, which is uncommon even in your age groups, may be observed in adult subjects.

Acute Disease↗
PubMed1984

Relation between efficacy of sodium cromoglycate and baseline lung function in exercise- and hyperventilation-induced asthma.

The protective effect of sodium cromoglycate (SCG) against exercise- and hyperventilation-induced asthma with respect to basal lung function was investigated in young asthmatics. The subjects performed standardized exercise or isocapnic hyperventilation challenge tests breathing cold dry air; in each case the effect of SCG was compared with that of a placebo in a double-blind fashion. With exercise as the challenge in 24 subjects, there was a strong positive correlation between the protective effect of SCG and the basal level of lung function. Using hyperventilation as the challenge in 11 subjects, there was no such correlation, but excluding two known placebo responders, there was a negative correlation between the protective effect of SCG and basal lung function. There findings suggest that exercise and hyperventilation operate differently in inducing asthma.

Adolescent↗
PubMed1983

Refractory period following induced asthma: contributions of exercise and isocapnic hyperventilation.

To compare the refractory period that follows exercise and isocapnic hyperventilation, 10 asthmatic children performed two pairs of challenge tests in random order at least six hours apart. In pair A a hyperventilation challenge was followed by an exercise challenge and in pair B the order was reversed. Both pairs of tests were done while the children were breathing cold dry air. Tests were matched in terms of work load, ventilation, and end tidal carbon dioxide tension (PCO2). The mean percentage fall in FEV1 (delta FEV1) after the first challenge (hyperventilation) of pair A and the first challenge (exercise) of pair B were the same (30% (SEM 2%)) and 30% (4%) respectively). The mean delta FEV1 of the exercise test following hyperventilation in pair A and of hyperventilation following exercise in pair B was 22% (4%) and 18% (4%) respectively. Both these latter results were significantly lower than the respective delta FEV1 when the challenge was the first test of the pair. Although the mean refractoriness index (reduction in induced asthma in the second test of each pair compared with the first test) was greater when exercise was the first challenge, the difference was not significant.

Adolescent↗
PubMed1983

Effect of negative ionisation of inspired air on the response of asthmatic children to exercise and inhaled histamine.

To evaluate the effect of negative ionisation of inspired air on bronchial reactivity, 11 asthmatic children were challenged twice by exercise and 10 were challenged twice by histamine inhalation. The children breathed negatively ionised air (4 X 10(5) - 10 X 10(5) ions/cm3) or control room air in random order in a double-blind fashion. All challenges were matched in terms of basal lung function and the exercise tests were matched in terms of ventilation and respiratory heat loss. Exercise-induced asthma was significantly attenuated by exposure to negatively ionised air, the mean postexercise fall in one-second forced expiratory volume (FEV1) being 29% (SE 5%) of the initial value after the control and 21% (3%) after the ionised air test (p less than 0.02). Ten of the 11 subjects developed less exercise-induced asthma while breathing ionised air. Although the median dose of histamine (cumulative breath units) which caused a constant fall in FEV1 for each individual was higher with the ionised air challenge than with the control challenge the difference was not significant. Five of the 10 subjects were less sensitive to histamine and the other five more sensitive when breathing ionised air. It is concluded that negative ionisation of inspired air can modulate the bronchial response to exercise but the effect on the response to histamine is much more variable.

Adolescent↗
PubMed1983

Heterogeneity in the response of asthmatic patients to pre-exercise treatment with cromolyn sodium.

The protective effect of pre-exercise treatment with cromolyn sodium (CS) on exercise-induced asthma (EIA) was investigated. Ten children and young adults each exercised for 6 min by cycling on a cycle ergometer while breathing cold dry air. Each subject performed 2 tests in which ventilation, heart rate, and gas exchange were closely matched; 15 min prior to each test, the patient inhaled either placebo or CS powder in a double-blind, randomized fashion. All subjects were found to be protected by CS, as manifested by a postexercise fall in FEV1 of 14 +/- 4% SE compared with the control postexercise fall of 39 +/- 5%. All 10 subjects had participated in a previous study (7), and we found that the 3 subjects who were not rendered refractory to EIA by a prior warm humid exercise test were only minimally protected by CS, whereas the 7 other patients who were rendered refractory to EIA, even by warm humid exercise, were greatly protected by CS. This finding suggests that there exists a consistent heterogeneity in the response of asthmatic patients to exercise, possibly related to the individual site of receptors or of airway hyperreactivity.

Adolescent↗
PubMed1983

Refractory period after hyperventilation-induced asthma.

Nine young asthmatic subjects undertook isocapnic hyperventilation while breathing air under different conditions. Each subject undertook 2 pairs of tests. Pair A consisted of 2 hyperventilation challenges performed while breathing cold (2.8 +/- 1.4 degrees C) dry (2.3 +/- 0.05 mg H2O/L) air. Pair B consisted of an initial warm (38.0 +/- 0.9 degrees C) saturated air challenge followed by a cold dry challenge. Tests were closely matched in terms of ventilation and respiratory heat loss in the cold dry tests. The subjects were rendered refractory by the first cold dry hyperventilation challenge, the fall in forced expiratory volume in one second (FEV1) after hyperventilation in the first test (delta FEV1 = 39 +/- 5%) being significantly greater than that after the second challenge of Pair A (delta FEV1 = 21 +/- 5%, p less than 0.005). In test Pair B, the warm humid hyperventilation challenge neither caused significant asthma (delta FEV1 6 +/- 3%) nor rendered the subjects refractory to the subsequent cold dry test (delta FEV1 38 +/- 4%). Because in a previous study it was shown that exercise while breathing warm humid air could induce a refractory period without itself causing asthma, we conclude that hyperventilation-induced asthma is not the same as exercise-induced asthma in most subjects.

Adolescent↗