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Biomedical subjects

M Scherrer

Publications and source records attributed to M Scherrer.

At least 73 records · Page 4Linked to original sources
PubMed1976

[Lung neoplasms in the Berne region. Epidemiology and smoking habit, compared to histology].

223 lung cancer patients were observed from June 1974 to April 1976. The diagnosis was by histology (after biopsy, operation or autopsy). There were 125 (56%) squamous cell carcinomas (sqcc), 42 (19%) small cell carcinomas (smcc), 27 (12%) large cell carcinomas (lacc) and 29 (13%) adenocarcinomas (adec). There were only 6 women (2.7%) in the series (3adec, 2 smcc and 1 lacc). Heavy and very heavy smokers were common in each group; smoking habits--even of patients with adec - differed markedly (p less than 0.0005) from those of an age and sex matched control group of 90 asthmatic patients with atopy. Sqcc patients were evenly distributed over the rural and urban zones of our region. But smcc, lacc and adec were more often seen coming from urban zones (p less than 0.0025). The whole lung cancer group was divided into a small group of 6 non-smokers (2.7%), into a 6.7% group of 15 pipe smokers, into a large group of 69 cigar smokers (30.9%) and into a final group of 133 (59.6%) cigarette smokers. The cigar smokers usually had sqcc (p less than 0.0005). The cancer of cigar smokers is more often a central lesion than a peripheral one (p less than 0.025). A history of repeated airway infections on the one hand, and severe airway infection at the beginning of lung cancer history on the other, are a more frequent association in cigar smokers than in cigarette smokers (p less than 0.01). Therefore, the lung cancer of cigar smokers is especially difficult to recognize. Cigar smoking appears to be just as important a link in the chain of causative factors leading to lung cancer as cigarette smoking.

Adenocarcinoma↗
PubMed1975

[Proceedings: Home care in chronic respiratory insufficiency. Indications for the prescription of a home respirator, its various types and possibilities for use].

Justified doubts exist in regard to the effectiveness of a long term home care plan for patients with stable chronic obstructive lung disease (COLD), especially when intermittent positive pressure breathing (IPPB) home care is advocated. Conclusive long term studies are lacking, however. In conjunction with all other possibilities offered by a well organized home care plan, IPPB still appears to be an appropriate therapeutic adjunct in the form of regular airway cleaning 3-6 times per day. This entails repeated inhalations of an aerosol with bronchodilator and surface active humidifier, frequently repeated mobilization of mucus and expectoration, deepening of tidal volume with increase of alveolar ventilation, and consequent amelioration of the arterial blood gases and pulmonary arteriolar resistance. Two simple home care respirators may be useful in carefully selected and cooperative patients with stable COLD and chronic respiratory failure: 1. the Fluidic-Assistor, which is automated, simple to use and sterilize, and inexpensive, but noisy and difficult to adjust for pressure and flow by the patient; 2. the Monaghan 515, which is automated, fully adjustable for pressure and flow by the patient, quiet and of pleasing design but difficult to handle and expensive. A preliminary study of the Minibird 2 with apneustic flow time regulation has been performed with five stable COLD patients. A positive end-inspiratory pressure of 20 cm H2O, an inspiratory time of 3+/-0.5 sec and an apneustic flow time of 1.5+/-0.5 sec were used. An 20 mm Hg fall in blood pressure and additional arterial hypoxemia seemed to be due to a decrease in cardiac output. Also, apneustic flow time did not significantly increase the FEV1 and is therefore not recommended for home care.

Carbon Dioxide↗
PubMed1975

[Proceedings: Home treatment of chronic respiratory insufficiency: criteria of disability].

The degree of disability of a patient with chronic respiratory failure must be determined on a theoretical basis. Using a water filled spirometer, VC and FEV1 tracings are observed several times until the maximal values are clearly reproduced. The percentage deficit of the patients' ventilatory capacity is determined by the formula (see article) and represents the first approximation of the degree of disability (in %). The result must now be corrected by arterial blood gas data obtained during 5 mon exhaustive work on a bicycle or tread-mill ergometer. The percentage disability results from a correction depending on the arterial pO2 and the pCO2 found during exercise: deterioration of the arterial hypoxemia and/or hypercapnia leads to an increase and their normalization to a decrease in the disability quota found during spirometry. Patients with unstable chronic obstructive lung disease and respiratory failure should be evaluated only after adequate rehabilitation at home and at work, and after cessation of smoking. Patients under tuberculostatic treatment must also be excluded from disability evaluation. The degree of disability determined on the basis of lung function tests is a theoretical one; the tests must be performed by trained staff in a pulmonary function laboratory.

Blood Gas Analysis↗