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Biomedical subjects

O Resta

Publications and source records attributed to O Resta.

46 records · Page 3Linked to original sources

Interleukin-6 is increased in breath condensate of patients with non-small cell lung cancer.

Despite recent advances in the diagnosis and treatment of non-small cell lung cancer (NSCLC), most patients still present with advanced stage disease at the time of diagnosis. Recent studies suggest that IL-6 is involved in the development of lung cancer. The aim of the present study was to investigate whether the measurement of IL-6 levels in the breath condensate of NSCLC patients could be used to bring forward the moment of diagnosis and to monitor the progression of the disease. Twenty patients with histological evidence of NSCLC (14 men and 6 women, age 63+/-8 years) and 15 healthy controls (8 men and 7 women, age 45+/-6 years) were enrolled in the study. IL6 was measured in the exhaled breath condensate of patients and controls by means of a specific enzyme immunoassay kit. Higher concentrations of exhaled IL-6 were found in NSCLC patients (9.6+/-0.3 pg/mL) than in controls (3.5+/-0.2 pg/mL). A statistically significant difference was observed between patients with NSCLC at different stages: higher concentrations of IL-6 (10.9+/-0.5 pg/mL) were found in patients with metastatic disease than in those with stage III (9.7+/-0.4 pg/mL), stage II (8.9+/-0.3 pg/mL) and stage I disease (7.9+/-0.3 pg/mL). These findings suggest that the measurement of IL-6 in the breath condensate of patients with NSCLC could be proposed as a parameter to take into account in early diagnosis and disease monitoring.

Aged↗

The mechanics of the lung parenchyma and airway responsiveness to metacholine.

The lung parenchyma is anatomically and mechanically connected to the intraparenchymal airways. Due to forces of interdependence the lung parenchyma represents a mechanical load that opposes bronchial narrowing during airway smooth muscle activation. The mechanical load caused by the parenchyma is a function of the number of the alveolar attachments to the airways, and of the mechanical properties of the parenchyma. The extracellular matrix is a major component of the lung parenchyma responsible of most of its mechanical properties. The excessive airway narrowing observed in the asthmatic population may be the consequence of the altered mechanical properties of the extracellular matrix reducing the mechanical load that opposes airway smooth muscle contraction.

Animals↗

Effects of fixed compared to automatic CPAP on sleep in Obstructive Sleep Apnoea Syndrome.

BACKGROUND: Automatic CPAP has been developed to improve CPAP efficiency and compliance. Continually matching the effective pressure may be associated to more frequent arousals that could disturb sleep. The aim of the present study was to compare sleep architecture after one month's home therapy with CPAP or with an AutoCPAP device. METHODS: Twenty OSAS patients (18 M / 2 F) after polysomnographic study with CPAP titration received either an automatic (AutoSet T, ResMed, Sydney, Australia) or a fixed level CPAP machine in a random, single blind fashion for one month. At the end of the home treatment period polysomnography was repeated while CPAP was administered by the same machine used at home. RESULTS: There was no significant difference between groups in terms of age (50.0 vs 45.5, NS), sex, BMI (38.3 vs 35.1, NS), RDI (45.4 vs 48.0, NS), and CPAP effective level (9.8 vs 10.8, NS). After one month of therapy the correction of sleep respiratory disturbances and of sleep structure was satisfactory in both groups. No difference in any polysomnographic variable or in subjective sleepiness was found at re-evaluation. CONCLUSIONS: The results of this study demonstrate that on average CPAP administered by a fixed CPAP machine and by the AutoSet T autoCPAP device has similar effects in improving respiratory function during sleep, nocturnal sleep architecture, and subjective daytime sleepiness after a one-month therapy. As autoCPAP devices are more expensive than fixed CPAP machines, their prescription should be considered only after a clear demonstration of an increase in compliance to treatment by these devices.

Analysis of Variance↗

Sleep related O2 desaturation in COPD patients with normoxaemia and mild hypoxyaemia.

It is unknown whether daytime features predict oxygenation during sleep in COPD patients with normoxaemia or mild hypoxaemia. In this study our purpose was to evaluate by a pulse oxymeter, nocturnal desaturation in 33 COPD with PaO2 > 60 mmHg and to examine some daytime parameters as possible predictors of nocturnal hypoxaemia. A significant nocturnal desaturation has been defined by spending > or = 30% of total sleep-time with a TSTSaO2 < 90% > 30. According to this criterion we classified our patients in Desaturators (D) and Non Desaturators (ND). Our results showed that 39% of our patients were D and 61% ND. Among anthropometric and respiratory functional data we found that daytime SaO2B (r = 0.74 p < 0.001) daytime PaO2 (r = 0.47 p < 0.01) and daytime PaCO2 (r = 0.45 p < 0.05) were significantly correlated with the nocturnal oxygen desaturation and can predict the presence of sleep related hypoxaemia. In conclusion, our study confirms that a relatively high percentage of COPD patients with normoxaemia or borderline hypoxaemia exhibits significant nocturnal hypoxaemia. Further studies will suggest whether sleep related hypoxaemia deserves nocturnal oxygen therapy.

Aged↗

Nocturnal oxygen desaturation in patients with congestive heart failure.

The aim of our study was to evaluate the modifications of the respiratory pattern during sleeping in patients with congestive heart failure (CHF) by a simple pulse-oxymetry. We studied 10 subjects (8M/2F), mean age 71.4 +/- 12.4 yrs, admitted to sub-intensive cardiological therapy unit, with diagnosis of CHF due to left ventricular insufficiency by ischemic, hypertensive or idiopathic cardiopathy, when in a stable clinical condition. All patients presented arterial blood gas values within normal limits. The ejection fraction of left ventricle showed a mean value of 30.4 +/- 8.2% (range 20%-45%). Nocturnal pulse-oxymetry was performed by pulse-oxymeter (PULSOX 7 Minolta) provided with a digital probe at a sliding speed 24 cm/h. Our data showed that all patients presented nocturnal desaturation episodes (mean oxygen desaturation index 15.7 +/- 18.4). In two patients, we found an "Overlap Syndrome" (obstructive sleep apnoea in presence of cardiopathy). In other patients pulse-oxymetry showed a typical sequence of "fall-rise" basal O2 saturation lasting from 36 to 72 seconds, collected in "wave trains" which were present from 14% to 70% of total sleep time compatible with periodic breathing. In conclusion, our study shows that patients affected by CHF, even if in stable condition and with a PaO2, within normal values, present more or less severe disturbances of nocturnal SaO2, with periodic and regular sequences of SaO2 fall-rise that may be referred to ventilatory troubles such as periodic breathing or Cheyne-Stokes breathing. In these patients the pulse-oxymetry may be considered an efficacious, simple, cheap and well tolerated method.

Aged↗

Functional assessment of airways bronchoconstriction with nebulized acetyl salicylic acid.

The aim of our study was to verify the functional modifications affecting central and peripheral airways during bronchoconstriction induced by aerosolized aspirin, so as to better understand the pathophysiologic mechanisms of the asthmatic crises in A.S.A. sensitive patients. The preliminary results were presented of a study carried out o 12 asthmatic A.S.A. sensitive patients, 7 of whom were females and 5 males, between the ages of 22 and 57 years. A.S.A. sensitivity was found in their medical history, in some cases, it had been confirmed by oral A.S.A. challenge. Among these patients, 6 were also affected by nasal polyposis. The method used was recently described by Bianco et al. although slightly modified by us: a fresh aqueous solution (18%) of A.S.A. -L is diluted 1:3 in saline; 4 ml of this solution is transferred to a glass nebulizer activated by a small compressor. The patients underwent treatment for 60 sec, during which a dose of approximately 1,8 mg of A.S.A. was inhaled, corresponding to about 40 mg of aspirin taken orally. In comparison with the reactions induced by oral challenge, those obtained with this treatment are easier, faster and confined only to the respiratory system. Before giving A.S.A. to the patients, control tests using saline aerosol were done. The functional assessment was performed under basal conditions, and 1, 15, 30, 60, 90 and 120 minutes following administration of A.S.A. since bronchoconstriction caused by nebulized A.S.A. usually reaches peak values between the 60th and 90th min. after which it gradually decreases over the following two hours. Our results show that, though A.S.A. induced bronchoconstriction prevails at large airways, it also influences the distal tracts of the tracheobronchial tree, since both SRAW, FEV1 and Vmax50C are modified at the same time.

Adult↗

Depressed baroreceptor reflex in patients with obstructive sleep apnea (OSA).

In this study we evaluated the cardiovascular autonomic function in twenty-five OSA patients and in twenty-five control healthy subjects, by computerized spectral analysis of R-R interval variation at rest and during orthostatism by head-up tilt maneuver to up-right position (80 degrees) as a sympathetic provocation. The results of our study show that most patients affected by OSA have a sympathetic overactivity and a decreased baroreflex response in comparison with normal subjects. The method here described is simple, objective and very sensitive and may be utilized to discover early signs of an autonomic dysfunction consequent to OSA leading to cardiovascular complications of the late stage of the disease.

Baroreflex↗