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Biomedical subjects

N F Sheahan

Publications and source records attributed to N F Sheahan.

27 records · Page 2Linked to original sources
PubMed1981

Is cough as effective as chest physiotherapy in the removal of excessive tracheobronchial secretions?

The relative value of chest physiotherapy (including cough) and cough alone for the removal of excessive tracheobronchial secretions has been assessed in six patients with stable chronic obstructive lung disease. After labelling with inhaled radioactive tracer particles, clearance of secretions from selected central and peripheral lung regions was followed with a gamma camera linked to a computer. Cough alone and chest physiotherapy (including cough) were equally effective in the enhancement of central lung clearance. Physiotherapy but not cough along accelerated peripheral lung clearance (p less than 0.05). Sputum yield was greater during physiotherapy than during cough (p less than 0.05). These findings confirm the value of chest physiotherapy and high-light the limitation of cough in patients with excessive tracheobronchial secretion and impaired mucociliary clearance.

Bronchi↗
PubMed1981

Lung mucociliary clearance in patients wit Young's syndrome.

Lung mucociliary clearance was measured in 14 patients with primary obstructive azoospermia and chest involvement (Young's syndrome) using the objective, in vivo radioaerosol technique. Lung mucociliary transport was significantly reduced in patients with Young's syndrome compared to 14 control subjects matched for physical characteristics, tobacco consumption and initial topographic distribution of tracer particles within the lungs. This finding indirectly supports the hypothesis that congenital abnormality in the propulsion of sperm in the ciliated epididymis results in the absence of sperm in the ejaculate.

Adult↗
PubMed1981

Pulmonary disorders associated with Sjögren's syndrome.

Pulmonary disease is recognized to occur as a complication of Sjögren's syndrome and we have studied 17 patients, the majority middle-aged women, with this association. Eight had sicca syndrome alone and nine had Sjören's syndrome in association with a connective tissue disease. Various pulmonary disorders were found: 10 had diseases mainly affecting pulmonary parenchyma (recurrent pneumonia, granulomatous infiltration, pseudolymphoma and fibrosing alveolitis) and six had disorders of the airways (bronchitis, bronchiectasis and asthma). One patient presented with a mediastinal immunoblastic lymphoma. To test the hypothesis that physical factors such as the retention of viscid mucus may play a part in the development of lung disease in Sjögren's syndrome, we have measured mucociliary clearance in patients with Sjögren's syndrome using 99Tc-labelled polystyrene particles. The mucociliary clearance rate was found to be normal from central airways and the whole lung clearance rate was significantly increased in Sjögren's syndrome compared with normal controls. The latter was attributed to the failure of penetrance of the radioaerosol into the periphery of the lung consistent with obstruction of small airways in Sjögren's syndrome. The patients with Sjögen's syndrome and lung disease were characterized by a number of immunological markers irrespective of the presence or type of associated connective tissue disorder. The commonest found were speckled antinuclear antibody by indirect immunofluorescence, antibodies to the acidic nuclear antigen B by counterimmunoelectrophoresis, increased serum DNA binding, increased levels of circulating immunoglubulins, rheumatoid factor in high titre and circulating soluble immune complexes as detected by Clq binding assay.

Adult↗
PubMed1980

Clearance of lung secretions in patients with chronic bronchitis: effect of terbutaline and ipratropium bromide aerosols.

A placebo controlled, double-blind, cross-over study was carried out to examine both the bronchodilator properties and the effect on lung mucociliary clearance of terbutaline (Bricanyl), a beta agonist, and ipratropium (Atrovent), a synthetic anticholinergic drug. Both were given regularly (two puffs four times a day for 1 week) from pressurised metered dose inhalers to patients with chronic obstructive bronchitis. A total of 10 patients completed the terbutaline study and 12 patients the ipratropium study; of these, seven patients were common to both studies. Measurements of the pulmonary function indices, forced expiratory volume in 1 s, forced vital capacity (FVC), peak expiratory flow rate and the flow rate at 50% of FVC measured from maximal expiratory flow-volume curves, confirmed the bronchodilator action of both drugs in these patients. Clearance of lung secretions was measured by the non-invasive, radioaerosol technique. No evidence was found that either drug had any effect on the rate of mucociliary clearance. The radioaerosol tracer particles used for measuring lung clearance, although inhaled under strictly controlled conditions, were deposited significantly more towards the lung periphery after treatment with ipratropium only. This suggested that ipratropium reduced the resistance to the entry of inhaled aerosols in the small airways.

Aerosols↗
PubMed1979

Effect of ipratropium bromide on mucociliary clearance and pulmonary function in reversible airways obstruction.

The effects of (a) regular use for one week and (b) a single dose of a synthetic anticholinergic (ipratropium bromide) on lung mucociliary clearance and as a bronchodilator was ascertained in a controlled, double-blind, cross-over study in 12 patients with reversible airways obstruction (mean increase in FEV after isoprenaline: 17% range 10-50%). Two puffs from a metered dose inhaler of either placebo (propellants only) or drug (40 microgram) were administered four times a day for one week (regular use), and mucociliary clearance was measured, by radioaerosol tracer, at the end of each treatment period and after a control period in which no treatment was given. On the mornings of the measurements after the placebo and drug periods one final dose (single dose) of ipratropium (40 microgram) or placebo was given 2.5 hours before the start of the test. There was no statistically significant difference between the three mean mucociliary clearance curves (control, placebo, and drug) for the group; however, there was a significantly greater penetration towards the periphery of the lung of the tracer in the test after drug administration compared with the other two. This increased penetration was attributed to bronchodilatation caused by the drug. Ipratropium bromide does not appear to impair mucociliary clearance, and it acts an effective bronchodilator.

Aged↗
PubMedDate not supplied

Effect of oral corticosteroids on mucus clearance by cough and mucociliary transport in stable asthma.

Inhaled radioaerosol particles have been used to assess mucus clearance in 12 patients with stable asthma. Patients who coughed frequently showed faster clearance than those who coughed infrequently. Treatment with medium and high dose oral corticosteroids reduced coughing and thereby reliance on mucus transport by cough. Despite this, and despite increased penetration of the particles into the bronchial tree, mean particle clearance was slightly faster after four week treatment (two weeks on 15 mg prednisolone orally each day, plus two weeks on 30 mg). Mean clearance remained, however, markedly slower than in normal subjects. Five patients who were initially sputum producers (mean 1.4 g . h-1) ceased to produce sputum after four week treatment.

Administration, Oral↗