Biomedical subjects

L Fuso

Publications and source records attributed to L Fuso.

At least 37 records · Page 2Linked to original sources

PubMed1998

Leucine enkephalin degradation in allergopathic versus normal human plasma.

The enzyme hydrolysis of labelled leu-enkephalin in the presence of plasma enzymes was studied by kinetic and chromatographic techniques in a group of allergopathic patients in the acute and quiescent stage; data obtained have been compared with those obtained with normal controls. Results shown indicate that in the quiescent stage substrate degradation is reduced, and that the pattern of the hydrolysis by-products is modified with respect to the controls. In the acute as compared to the quiescent stage, enkephalin hydrolysis is further reduced, and the pattern of hydrolysis by-products is further modified. ANOVA analysis of these data indicates that the dependency of hydrolysis reduction upon the grouping of subjects (i.e., controls, quiescent and acute stage) is statistically very significant. Reduced substrate hydrolysis, and modified hydrolysis pattern, appears to be associated with decreased activity of the enzymes involved and more significantly with increased activity of the low molecular weight plasma inhibitors. The combination of these two factors appears to define a hydrolysis pattern characteristic of the allergopathic subjects, similar in the quiescent and acute phase, and different from that observed in the controls.

Adolescent↗

PubMed1998

Predicting cognitive decline in patients with hypoxaemic COPD.

The objective was to identify predictors of cognitive decline in patients with hypoxaemic COPD on continuous oxygen therapy. Eighty-four consecutive ambulatory hypoxaemic COPD patients in stable clinical conditions were prospectively studied over the course of 2 yr. Baseline multidimensional assessment included respiratory function tests, blood gas analysis, Mini Mental Status (MMS) test, Geriatric Depression Scale (GDS), Activities of Daily Living (ADLs) and Charlson's index of comorbidity. Reassessments were made 1 yr and 2 yr thereafter. Sequential changes in MMS, GDS and ADLs were assessed by Friedman's ANOVA by rank test. Forty patients completed the study (group A), while 44 died or were lost to follow-up (group B). Group B was characterized by more severe respiratory function impairment and worse performances on ADLs and GDS. In group A, MMS deteriorated from baseline to the 1 yr and 2 yr reassessments (27 +/- 2.9 vs. 25.8 +/- 4.1 and 25.4 +/- 4, P < 0.005), whereas GDS and ADLs did not change significantly; the 23 patients experiencing a decline of MMS had baseline lower percentage predicted FVC (52.3 +/- 17.1 vs. 66.9 +/- 13.4, P < 0.03) and FEV1 (27.2 +/- 8.6 vs. 44 +/- 26.8, P < 0.02) values and better affective status (GDS score: 11.9 +/- 7.7 vs. 16.5 +/- 5.6, P < 0.04). Two-year changes in MMS and in GDS scores were inversely correlated (Spearman's p = -0.32, P = 0.04). Cognitive decline is faster in the presence of severe bronchial obstruction and parallels the worsening of the affective status in COPD patients on oxygen therapy. The onset of depression rather than baseline depressive symptoms seems to be a risk factor for cognitive decline.

Activities of Daily Living↗

PubMed1998

Acute oxygen supplementation does not relieve the impairment of respiratory muscle strength in hypoxemic COPD.

STUDY OBJECTIVES: To verify whether hypoxemia affects respiratory muscle strength in the absence of malnutrition and whether such effect, if present, is reversible with an acute oxygen supplementation. DESIGN: Case series analysis, before-after trial. SETTING: Outpatient pneumology departments of two university hospitals. PATIENTS: One hundred twenty patients affected by COPD in stable conditions having actual to ideal body weight ratio of > or =90%. MEASUREMENTS AND RESULTS: Maximal inspiratory pressure (MIP) was measured at functional residual capacity level in the whole sample of subjects and during oxygen supplementation in 58 patients having a PaO2< or =60 mm Hg when breathing in room air. Predictors of MIP were assessed by a multivariate analysis. MIP values before and after oxygen supplementation were compared by a paired t test. MIP was independently correlated with FVC (p<0.001), PaO2 (p<0.01), and age (p<0.01). In the subgroup of hypoxemic patients, MIP values did not change significantly after oxygen supplementation (3.08+/-1.74 vs 3.03+/-1.91 kPa, t=0.43, not significant). CONCLUSIONS: Hypoxemia is an important negative correlate of MIP even in well-nourished COPD patients. Its effect is not reversible with an acute oxygen supplementation.

Age Factors↗

PubMed1998

Prevalence of sinusitis in young asthmatics and its relation to bronchial asthma.

In this paper, we present data on the prevalence of sinusitis and its relationship to bronchial asthma in 120 young male asthmatics evaluated without exacerbations of their disease. All patients reported respiratory symptoms during the preceding year, and in the most of them (74%), the severity of asthma was mild. Sinusitis was observed in 52 patients (43.3%), and the maxillary sinus was involved in 36 asthmatics. Sixteen of 52 patients with sinusitis had never had nasal symptoms of rhinitis. In all patients, physical examination of the lung was negative for wheezing. All patients had FEV1 (forced expiratory volume/forced vital capacity x 100 in 1 second of expiration) values in the normal range, and bronchial hyperresponsiveness was detected in 101 asthmatics (84.2%). One hundred sixteen patients (96.6%) were found to be skin reactors. We did not find statistical differences between asthmatics with or without sinusitis with regard to severity of asthma, basal lung function, and bronchial hyperresponsiveness. We suggest that antibiotic therapy for sinusitis should be given only to asthmatics with worsening respiratory symptoms and obvious signs of chronic sinusitis.

Adult↗

PubMed1998

Contemporaneous acute myeloid leukaemia and sarcoidosis. Report of three cases.

Three cases of contemporaneous acute myeloid leukaemia (AML) and sarcoidosis are described. The possible pathogenic mechanisms concerning their concurrent appearance are discussed: if sarcoidosis impaired T-cell response, it could perhaps predispose the development of AML; alternatively, the development of sarcoidosis during AML may be due to a reaction linked to a diffuse release of tumour antigens with a subsequent formation of a non-caseating granulomata.

Acute Disease↗

PubMed1998

Accuracy of a pulse oximeter in the measurement of the oxyhaemoglobin saturation.

The aim of the present study was to evaluate the accuracy, in comparison with a reference method, of the Nellcor N-20P pulse oximeter in the assessment of oxyhaemoglobin saturation (Sa,O2). Sa,O2 was monitored at rest by the Nellcor N-20P pulse oximeter in 100 subjects (82 males, mean age 68+/-12 yrs) consecutively enroled. At the same time, an arterial blood sample was collected for the measurement of Sa,O2, carboxyhaemoglobin, and methaemoglobin by an IL-282 Co-oximeter. A significant difference was found between Sa,O2 values measured with the two methods (t=11.78, p<0.05), but the two series of measurements were significantly correlated (r=0.97). Both the level and the limits of agreement between the two methods were satisfactory when the more appropriate Bland and Altman method was applied. Nevertheless, a lack of accuracy of the pulse oximeter was found, but only for Sa,O2 values <82% and >94%, as demonstrated by the Youden index. In conclusion, these data show that Nellcor N-20P is sufficiently reliable for the assessment and monitoring of oxyhaemoglobin saturation. The lack of accuracy does not seem clinically relevant since it is appreciable only for values at the extremes of the oxyhaemoglobin saturation range.

Aged↗

PubMed1997

Potential use of iodine-123 metaiodobenzylguanidine radioaerosol as a marker of pulmonary neuroadrenergic function.

Iodine-123 metaiodobenzylguanidine (123I-MIBG) radioaerosol is of potential use in the investigation of the neuroadrenergic function of the lungs; however, before the method can be successfully employed the following issues need to be clarified: (1) Does the nebulization affect the radiochemical purity of 123I-MIBG? (2) Is the pulmonary distribution of inhaled 123I-MIBG homogeneous in normal subjects? (3) Does the pulmonary clearance of inhaled 123I-MIBG reflect the functional status of the neuroadrenergic system of the lungs? In this study we performed: (1) a chromatographic study of nebulized 123I-MIBG; (2) a quantitative evaluation of the lung distribution of 123I-MIBG radioaerosol in normal subjects as compared with that of technetium-99m diethylene triamine penta-acetic acid (99mTc-DTPA) and (3) an assessment of 123I-MIBG lung clearance both under control conditions and after pharmacologically induced beta-blockade, again compared with 99mTc-DTPA. For these purposes, eight normal subjects were divided randomly into an "MIBG group" and a "DTPA group" (four subjects each) and submitted to three scintigraphic studies each: a baseline study, and studies after the administration of a low (80 mg) and a high (160 mg) dose of propranolol. Radiochemical purity of nebulized 123I-MIBG ranged between 97.18% and 98.70%. The lung distribution of 123I-MIBG, as judged by the aerosol penetration index, was identical to that of 99mTc-DTPA under all study conditions. The 123I-MIBG clearance rate was slower than that of 99mTc-DTPA under baseline conditions (135+/-32 min vs 69+/-27 min, P<0.01) and increased significantly after propranolol administrations, while the 99mTc-DTPA clearance did not change. The following conclusions were drawn: (1) the nebulization does not affect the radiochemical purity of 123I-MIBG; (2) the lung distribution of 123I-MIBG is homogeneous in normal subjects; (3) the pulmonary clearance of 123I-MIBG reflects the functional status of the neuroadrenergic system of the lungs. Thus this scintigraphic method is suitable for research and perhaps for future clinical use.

3-Iodobenzylguanidine↗

PubMed1997

Evaluation of pulmonary ventilation and diaphragmatic movement in idiopathic scoliosis using radioaerosol ventilation scintigraphy.

Regional distribution of lung ventilation and diaphragmatic movement were evaluated using a non-invasive scintigraphic method in patients with idiopathic scoliosis. Twenty-four non-smoking patients aged 20 +/- 9 years (mean +/- S.D.), all with a right convex dorsal curve (mean Cobb's angle of 65.1 +/- 26.4 degrees), underwent lung ventilation scintigraphy after inhalation of 99Tcm-labelled human albumin microspheres. The distribution of the inhaled aerosol was assessed and scored based on four scintigraphic patterns, ranging from homogeneous distribution (score = 1) to diffuse severe hypoventilation (score = 4). Diaphragmatic movement, evaluated in 11 of the 24 patients, was assessed using an index (DM-Index) computed for each hemi-diaphragm by the normalization and subtraction of two digital scans obtained during maximal inspiration and expiration respectively. The left lung, situated on the concave side of the scoliotic curve, showed a more uneven distribution of ventilation (scintigraphic score: 2.62 +/- 1.17 vs 1.50 +/- 1.02, P < 0.01) and a reduced hemi-diaphragm movement (DM-Index: 29.2 +/- 4.0 vs 35.9 +/- 2.9, P < 0.001). A significant inverse correlation was found between Cobb's angle and both the right and left DM-Index (r = -0.82 and -0.66 respectively). In a stepwise multiple-regression analysis, the scintigraphic score correlated significantly with the functional index of distribution of inspired gas (IDI) derived from the multiple-breath nitrogen washout curve (P = 0.02). We conclude that lung ventilation scintigraphy provides information on the regional distribution of ventilation and on diaphragmatic movement in idiopathic scoliosis. The pulmonary function derangements in scoliotic patients were mainly localized in the lung on the concave side of the scoliotic curve and were related to the severity of the spinal curvature.

Adult↗

PubMed1997

Co-morbidity contributes to predict mortality of patients with chronic obstructive pulmonary disease.

The aim of this study was to assess the prognostic role of co-morbidity in severe chronic obstructive pulmonary disease (COPD). A cohort of 270 COPD patients, mean (+/-SD) age 67+/-9 yrs, consecutively discharged from a University Hospital after an acute exacerbation was studied. Mean (+/-SD) forced expiratory volume in one second (FEV1) was 34+/-16% of predicted and FEV1/forced vital capacity (FVC) was 40.5+/-13.8%. The most common co-morbid diseases were: hypertension (28%), diabetes mellitus (14%), and ischaemic heart disease (10%). Clinical, electrocardiogram (ECG), and respiratory function data taken at the time of discharge were collected from the clinical records. The Charlson's index was used to quantify co-morbidity. Follow-up was conducted by means of telephone calls. Multivariate survival analysis was used to identify the independent predictors of death. The median survival of the cohort was 3.1 yrs. Death was predicted by the following variables: age (hazard rate (HR) 1.04; 95% confidence intervals (95% CI) 1.02-1.05), ECG signs of right ventricular hypertrophy (HR 1.76; 95% CI 1.30-2.38), chronic renal failure (HR 1.79; 95% CI 1.05-3.02), ECG signs of myocardial infarction or ischaemia (HR 1.42; 95% CI 1.02-1.96), FEV1 < 590 mL (HR 1.49; 95% CI 0.97-2.27). A score based upon these variables predicted mortality at 5 yrs with a sensitivity of 63% and a specificity of 77%. Selected co-morbid diseases and electrocardiogram signs of right ventricular hypertrophy play a major prognostic role in advanced chronic obstructive pulmonary disease. The clinical assessment of patients with chronic obstructive pulmonary disease should include these important and easily measurable variables.

Age Distribution↗

PubMed1997

Verbal memory impairment in COPD: its mechanisms and clinical relevance.

STUDY OBJECTIVES: Identification of mechanisms accounting for verbal memory impairment in patients with severe COPD; assessing the relationship between verbal memory and the overall cognitive performance; verifying if verbal memory impairment affects medication adherence. DESIGN: Case-comparison study. SETTING: Outpatient Departments of Pneumology and Neurology, Day Hospital of General Surgery. PATIENTS: Forty-two COPD ambulatory patients, age 70+/-9.7 years, with hypoxemia and hypercarbia (group A); 27 normal subjects of comparable age and educational level (group B); 31 patients with Alzheimer's disease (group C); and 26 older normal subjects (group D). MEASUREMENTS AND RESULTS: The overall cognitive function and verbal memory were evaluated by the Mental Deterioration Battery and 14 indexes of verbal memory. Defective retrieval and recognition mechanisms distinguished group A from group B. According to discriminant analysis, verbal memory profile of COPD patients was group specific in 38.1% of cases and conformed to that of group B, C, and D in 19%, 16.7%, and 26.2% of cases, respectively. In COPD patients, both immediate and delayed recall, the strongest determinants of the discriminant function, were significantly correlated with the overall cognitive performance (rho=0.64, p=0.001; rho=0.61, p=0.001, respectively). Poor adherence to medication regimen was significantly associated with abnormal delayed recall score (82.3% vs 36% in subjects with normal delayed recall, p<0.008). CONCLUSIONS: Decline of verbal memory parallels that of the overall cognitive function in COPD patients and is due to the impairment of both active recall and passive recognition of learned material. It could be an important determinant of the level of medication adherence.

Aged↗

PubMed1997

[Usefulness of pulse oximetry in respiratory diseases].

The aim of the present study was to verify the usefulness and the limits of the pulse oximeter (po) in the management of patients with pulmonary disease. To this end oxyhemoglobin saturation measured with the po (SpO2) in 81 outpatients (mean age 67.7 +/- 12.7 years) was compared to oxyhemoglobin saturation calculated from a Radiometer computerized system (ScO2) and measured with a Co-oximeter (SaO2), considered as a reference value. Both SpO2 values and ScO2 values were, in average, significantly higher than SaO2 values (p < 0.001). In a multiple stepwise regression analysis, carboxyhemoglobin was the determinant of both SaO2-SpO2 and SaO2-ScO2 differences. The relationship between SpO2 values and the arterial gas data revealed that a wide range of PaO2 and PaCO2 values could be related to a narrow range of SpO2 values showing a clear variability of PaO2 and PaCO2 for the same value of SpO2. These findings seem to indicate that the po can be regarded as a simple, non-invasive, and non-expensive method to measure the oxyhemoglobin saturation with a sufficient reliability. The SpO2 values could be used in the management and follow-up of patients with hypoxemia, but SpO2 values could be misleading in presence of hypercapnia and/or hemoglobinopathies.

Adult↗

PubMed1996

Postural variations of pulmonary diffusing capacity in insulin-dependent diabetes mellitus.

STUDY OBJECTIVE: To assess whether posture-related changes of diffusing capacity could be considered as an early sensitive marker of pulmonary abnormalities in patients with insulin-dependent diabetes mellitus (IDDM) and whether the postural variations of pulmonary capillary blood volume (Vc) could reflect the lung capillary damage that characterizes the diabetic microangiopathy. DESIGN: Carbon monoxide diffusing capacity (DCO) was measured by the single-breath method. Four DCO measurements, two in sitting and two in supine position, were performed in each subject using gas mixtures containing different oxygen concentrations. Membrane and capillary volume components of the diffusion capacity were calculated and both were expressed as absolute value and corrected by alveolar volume (VA). PATIENTS: Twenty IDDM patients and 20 normal subjects matched for age and sex were studied. MEASUREMENTS AND RESULTS: The IDDM patients showed normal pulmonary volumes and flows. No significant differences between the two groups were found for DCO, coefficient of diffusion, Vc, and pulmonary capillary blood volume corrected by alveolar volume in sitting position. All these indexes significantly increased in normal subjects but not in diabetics, by changing the posture of the subject from sitting to supine position. In a multivariate analysis, the presence of diabetes mellitus and the age of the subjects were the only significant predictors of Vc postural changes. CONCLUSIONS: This postural test, adjusted for age, could be included in a screening diagnostic procedure for an early assessment of pulmonary abnormalities in diabetic patients. The lack of Vc postural increase in diabetics could reflect the presence of a microangiopathy involving the pulmonary small vessels.

Adult↗

PubMed1996

Maximal inspiratory pressure in elite soccer players.

The respiratory muscle strength of elite athletes has been assessed only for some competitive sports and different conclusions have been reported. The aim of this study was to evaluate the inspiratory muscle strength in a group of professional soccer players in comparison with a group of sedentary subjects. Maximal Inspiratory Pressure (PImax) was measured both at Functional Residual Capacity (FRC) and at Residual Volume (RV) in 130 subjects: 27 of these were elite soccer players (all males, aged 22 +/- 3 years) and 103 were normal sedentary subjects (77 males and 26 females, aged 44 +/- 19 years). Predictive linear models were produced by a stepwise regression analysis in the whole sample of subjects. Both PImaxFRC and PImaxRV models included female gender and ageing as negative predictors, and Body Mass Index (BMI) as positive predictor of the inspiratory pressures. The model predicting PImaxFRC was slightly more accurate than the model predicting PImaxRV (r-squared: 0.38 vs 0.36, respectively). After adjustment for the variables entered in these models, PImaxFRC and PImaxRV were respectively 1.54 KPa and 1.08 KPa higher in soccer players than in sedentary subjects but this result was statistically significant (p < 0.02) only for PImaxFRC. We conclude that the inspiratory muscle strength is increased in soccer players and PImax measured at FRC seems more sensitive in order to discriminate between subjects with different level of physical activity.

Adolescent↗

PubMed1995

Predicting mortality of patients hospitalized for acutely exacerbated chronic obstructive pulmonary disease.

PURPOSE: To identify factors affecting the short-term prognosis of patients with acutely exacerbated chronic obstructive pulmonary disease (COPD). PATIENTS AND METHODS: The 590 patients having COPD as primary disease who were hospitalized in the pneumology unit of a university hospital from 1981 to 1990 were studied. A standardized protocol for the treatment of acutely exacerbated COPD was adopted for all the patients. The patient records were retrospectively analyzed by two observers, and 23 clinical and laboratory variables defining the patient status on admission were collected. Age and arterial gas data were also taken into account, and the outcome mortality was recorded. Interobserver reproducibility was tested by computing the kappa coefficient and Spearman's rho for dichotomous and continuous variables, respectively. The relationship of clinical and laboratory factors to the outcome was assessed first by univariate analysis and then by a logistic regression analysis assessing the independent predictive role of variables previously shown to be univariately correlated with mortality. RESULTS: The mortality rate was 14.4%. The logistic regression analysis identified four independent predictors of death: age (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.04 to 1.11), alveolar-arterial oxygen gradient greater than 41 mm Hg (OR 2.33; 95% CI 1.39 to 3.90), ventricular arrhythmias (OR 1.91; 95% CI 1.10 to 3.31), and atrial fibrillation (OR 2.27; 95% CI 1.14 to 4.51). CONCLUSIONS: Patients with acutely exacerbated COPD having a high risk of death can be identified at the time of admission. Variables reflecting heart dysfunction are important determinants of this risk. Among pulmonary function data, only alveolar-arterial oxygen gradient contributes to the predictive model.

Acute Disease↗

PubMed1995

Effects of a filter at the mouth on pulmonary function tests.

The aim of this study was to verify whether the increase of resistance to airflow using a filter at the mouth could determine significant systematic errors of measurement or change the diagnostic performance in a respiratory physiology laboratory. The effect of the new filter Spirobac (DAR Spa, Italy) was assessed on out-patients referred to our laboratory for routine functional evaluation. The following tests were performed: maximal expiratory flow-volume curve, plethysmographic lung volume and airway resistance, bronchodilator test, and methacholine challenge test. Each test was performed randomly, twice with the filter and twice without. Significant differences between measurements with and without filter were found for forced vital capacity, forced expiratory volume in one second, airway resistance, and specific airway conductance (sGaw). These differences were unrelated to the average values of the measurements, except for sGaw. The limits of agreement were within the range of intraindividual short-term repeatability for almost all of the function indices. The overall concordance between tests performed with and without filter was 78% for bronchodilator test and 53% for methacholine test. However, in all the cases but one, the concordance of the methacholine test was inside the short-term repeatability. We conclude that the filter Spirobac has a statistically significant effect on the results of some pulmonary function tests. However, this is not considered to be clinically significant, since the changes due to the filter were within the intraindividual variability of repeated measurements for almost all the function indices and no appreciable classification error was found in diagnostic tests.

Adult↗

PubMed1995

Use of metaiodobenzylguanidine (MIBG) in pneumology.

Norepinephrine (NE) is one of the many biologically active substances that are metabolized by the lung. The norepinephrine uptake in the lung has been widely investigated in animal studies in order to detect abnormalities of the endothelial cells. 131I- or 123I-labelled metaiodobenzylguanidine (MIBG) is a radioactive tracer that shares several metabolic pathways with NE; it has been used instead NE or both in animal and in human studies for the same purposes. It has been definitely demonstrated that MIBG lung uptake following intravenous administration is a reliable marker of minimal endothelial cell lesions and it allows one to investigate several conditions involving damage to the lung vasculature such as adult respiratory distress syndrome, post-actinic lung fibrosis or chemotherapic lung toxicity. MIBG could also potentially be used as a tracer of the neuroadrenergic system of the airways, once it has been deposited in the whole branches of the bronchial tree. With this in mind we evaluated the feasibility of the administration of MIBG in radioaerosol form. We first performed a chromatographic study on [123I]MIBG aliquots aerosolized for variable lengths of time (2-30 minutes). Radiochemical purity was always over 96%, thus demonstrating that aerosolization does not significantly modify the stability of the tracer. We then compared both the lung clearance curves and the scintigraphic images in two groups of normal subjects who respectively underwent [123I]MIBG and 99mTc-DTPA radioaerosol dynamic scintigraphy. We found that MIBG clearance to be significantly lower than that of DTPA (135 +/- 32 minutes versus 69 +/- 27 minutes, p < 0.01), probably due to its being trapped in the adrenergic nerve endings of the airways. The pulmonary distribution of both tracers was homogeneous, as demonstrated by the correspondence of the values for the aerosol penetration index in both groups of subjects. Such results warrant further research and pharmacologic tests.

3-Iodobenzylguanidine↗

PubMed1994

The cardiopulmonary response to incremental exercise test: the effect of aging.

The aims of the present study were to define the respective roles of the cardiac and respiratory response to exercise as determinants of the age-related physiological decrease in exercise performance, and to assess the relationship between aging and interindividual variability in the response to effort. We studied 91 normal subjects recruited in three age-groups: Group A (42 children, aged 10 +/- 2 years); Group B (29 young adults, aged 27 +/- 5 years); Group C (20 elderly, aged 74 +/- 9 years). All the subjects underwent an incremental cycle ergometer exercise test with a work load increase of 15 W every 2 minutes in groups A and C, and 25 W every 2 minutes in group B, until they achieved 80% of the predicted maximal heart rate. Ventilatory equivalent changes during exercise were significantly lower in group A than in the other two groups, and in group B compared to group C. Exercise-induced changes in oxygen pulse were significantly higher in group A, but no difference was found between groups B and C. Thus, gas-exchange function and overall exercise performance decrease with advancing age, whereas cardiovascular performance is well maintained in normal elderly subjects. Discriminant analysis showed that the exercise response conformed to the group-specific model in 74% and 79% of subjects in groups A and B, but only in 50% of the group C subjects; 5% and 45% of the elderly subjects were functionally classified in groups A and B, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗

PubMed1994

Bronchial asthma: still an inadequately assessed and improperly treated disease.

In this paper we present data on the assessment and treatment of asthma in a large sample (13,899 subjects) representative of the population of young males living in four districts of the Tuscany region (Italy). In this group, 404 asthmatics (2.9%) were identified and 365 of the eligible patients were included in the study. A total of 323 asthmatics (88.5%) reported respiratory symptoms during the preceding year. A total of 162 asthmatics (44%) had previously had lung function tests to assess asthma, whereas in 89% of the patients the atopic component of asthma had been previously evaluated by prick tests. Fifty-seven percent of the patients in whom bronchial obstruction was observed and 38% of the asthmatics with severe bronchial hyperresponsiveness (BH) were receiving either no medication or treatment with only one drug. The drugs prescribed most frequently during the preceding year were beta agonists (56%) as opposed to sodium cromoglycate (22%) and inhaled steroids (17%); the latter two drugs were included in the therapy of 143 asthmatics (39%) and represented the treatment of choice in 16% of the subjects with bronchial obstruction and in 38% of the subjects with severe BH. We conclude that in our sample of young asthmatics the pulmonary function tests and the inhaled anti-inflammatory drugs were insufficiently utilized.

Asthma↗