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Biomedical subjects

P Dorow

Publications and source records attributed to P Dorow.

At least 37 records · Page 2Linked to original sources
PubMed1993

Efficacy and tolerability of azelastine nasal spray in patients with allergic rhinitis compared to placebo and budesonide.

The efficacy and safety of a new antiallergic drug, intranasal azelastine (CAS 58581-89-8), in the treatment of seasonal allergic rhinitis was investigated in a 16 patient double-blind comparison with placebo and another 36 patient open comparison with budesonide (CAS 51333-22-3). Efficacy was assessed in terms of 13 signs and symptoms of allergic rhinitis and tolerability on the basis of spontaneously reported adverse events. In the first study, compared to placebo a one week's treatment with azelastine resulted in substantial relief of sneezing (p = 0.009), nasal itching (p = 0.009), swelling of the nasal mucosa (p = 0.067) and rhinorrhoea (p = 0.262) in patients having the above symptoms at baseline of at least moderate to severe intensity. According to the judgement of the supervising physician, 7/8 azelastine-treated patients but none receiving placebo responded well to therapy (p = 0.001). In the second study a two weeks' treatment with intranasal azelastine was found not to differ significantly from budesonide 67% of patients showed improvement in principal signs of rhinitis after one week's therapy irrespective of treatment. Nasal symptoms, including nasal obstruction, were most markedly improved by both treatments. Azelastine, but not budesonide, also relieved ocular symptoms associated with rhinitis. Adverse events did not occur more frequently under azelastine than under placebo treatment and were often of uncertain relationship to treatment.

Administration, Intranasal↗
PubMed1993

[Long-term treatment of sleep apnea with evening administration of oral retard theophylline].

In 776 patients suffering from sleep apnoea long-term treatment with sustained-release theophylline was investigated. Responders show a significant reduction of apnoea phases. Using an individual theophylline dosage with morning theophylline concentrations between 5 and 8 micrograms/ml, only few side effects occurred. Positive effects on cardiopulmonary capacity were seen.

Administration, Oral↗
PubMed1993

[Long-term follow-up of patients with central apnea].

This is a report on 297 patient with central asphycia. The patients were divided into three groups according to the blood gases. 21 patients were in group three. 16 patients died due to right heart failure. In group one and two no patients died. In group one spontaneous remissions were seen.

Arousal↗
PubMed1993

Intranasal treatment of perennial allergic rhinitis. Comparison of azelastine nasal spray and budesonide nasal aerosol.

The efficacy and tolerability of azelastine (CAS 58581-89-8) nasal spray (0.14 mg/nostril b.i.d.) and budesonide (CAS 51333-22-3) nasal aerosol (0.05 mg/nostril b.i.d.) were compared in a 6-week, multicentre, parallel group study of 193 patients suffering from perennial allergic rhinitis. Total rhinitis symptoms complex (TSC) scores derived from 10 rhinitis symptoms improved during treatment by a mean of 11.4 +/- 6.8 with azelastine and 10.8 +/- 6.4 with budesonide. Response rates, defined as a decrease in TSC of at least 50% at the end of therapy, was 79% with azelastine and 73% with budesonide. There were no significant differences between the treatment groups with respect to either target variable. Objective measurements of nasal flow rate showed a return to normal values during the 6-week therapy. Signs of rhinitis identified by rhinoscopic examination improved in parallel to symptoms. Both medications were well tolerated. The incidence of adverse events of possibly causal relationship to therapy was low. The most frequent event in azelastine treated patients was the experience of an "unpleasant" taste or smell. Occasional epistaxis occurred in both treatment groups but more frequently with budesonide. Results indicate that with the dose used azelastine nasal spray is an effective treatment for perennial allergic rhinitis comparable to that of budesonide nasal aerosol.

Administration, Intranasal↗
PubMed1992

Bradykinin and other inflammatory mediators in BAL-fluid from patients with active pulmonary inflammation.

We evaluated the levels of bradykinin, albumin, TAME-esterase activity, histamine, PGD2 and LTC4 in bronchoalveolar lavage fluid from asthmatics and from patients with pneumonia, sarcoidosis, fibrosis, and chronic bronchitis. Compared with the results of healthy volunteers and atopic asymptomatic asthmatics the bradykinin levels and TAME-esterase activity were significantly elevated. In all other groups, histamine was additionally elevated in asymptomatic asthmatics, whereas albumin was elevated in symptomatic asthmatics and fibrosis patients, and decreased in chronic bronchitis and pneumonia patients. Following local intrabronchial allergen challenge of mild grass pollen asthmatics out of season bradykinin levels increased significantly, correlated with albumin, histamine and TAME-esterase activity. In contrast to the increased mediator concentrations in the early phase reaction there was no change of BAL cells in asthmatics compared to baseline and healthy volunteers. The presence of bradykinin in the bronchoalveolar space of patients with active pulmonary inflammations and bradykinin generation in asthmatics as a result of intrabronchial allergen challenge provides strong evidence that kinins are involved in inflammatory disorders of the lower airways.

Asthma↗
PubMed1992

[Pleural diseases in magnetic resonance tomography (MRT)].

MR images of 48 patients with histologically confirmed benign and malignant diseases of the pleura were retrospectively compared with CT and bioptically/surgically obtained findings. In 47/48 patients pathological changes of the pleura were visualized by increased signal intensities on T2-weighted and contrast enhanced T1-weighted MR images. This lead to a slightly improved sensitivity compared to CT, where pathological pleura findings were confirmed in 45/48 patients. MRI was able to identify 24/28 confirmed pleural effusions, whereas CT was successful in 26/28 patients. In two cases effusions not identified on CT were visible on T2-weighted MRI. 4 pleural effusions were missed with MRI.. On CT images differentiation of pleural changes vs effusions or adjacent lesions of lung parenchyma was successful in 20/28 and in 17/23 cases, respectively. Contrast enhanced T1-weighted images achieved the highest diagnostic accuracy with 22/28 and 20/23 cases, respectively. Signal intensities on MRI were unsuitable as sole criterion for the differentiation of benign and malignant diseases of the pleura. Contour and pattern of spreading of pleural changes were helpful in differential diagnosis. Nodular changes, thickening of more than 10 mm and mediastinal, circumferential and entire hemithoracic affection of the pleura were suggestive for malignant pleural disease. Infiltration of the diaphragm and the chest wall were most indicative for malignancy; here MRI (2/2 resp. 18/19 cases) was superior to CT (0/2 resp. 14/19 cases). CT was superior in the detection of pleural calcifications and osseous destruction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Oxygen saturation and sleep structure in patients with dilated cardiomyopathy].

It is known that patients suffering from severe cardiomyopathy may develop cyclic changes in breathing (Cheyne-Stokes-breathing) (2, 3). Coughing and dyspnea may be linked to periodic breathing. Specific detailed polysomnographic studies of sleep architecture and oxygen saturation have not been published. Eight patients suffering from dilatative cardiomyopathy (NYHA III-IV) were studied by pulse oximetry and polysomnography. Six of eight patients had severe breathing irregularities. These disturbances became manifest partially as Cheyne-Stokes breathing, partially as central sleep apnea. During these periods, oxygen saturation dropped as far as to 65 per cent of the original level.

Adult↗
PubMed1991

[Therapy of sleep apnea with theophylline (Uniphylline) administration every evening].

Sleep apnoea (SA) has a prevalence of 1-10% in men. The physiological sleep is disturbed. SA is associated with cardiopulmonary disease (systemic arterial hypertension, cardiac arrhythmics, cor pulmonale) and the quality of the patient's life is reduced. Thirty male patients participated in a study to investigate the influence of an oral dose of theophylline on sleep apnoea. Under theophylline a significant reduction of apnoea events and of the apnoea index was seen.

Adult↗
PubMed1991

[Long-term follow-up of sleep apnea therapy with sustained-release theophylline administered every evening].

Sleep apnoea increases mortality and morbidity. The physiological sleep profile is disturbed and functional capacity is decreased. At present nasal CPAP breathing (continuous positive airway pressure) seems to be the best treatment method in obstructive sleep apnoea. However, this therapy is expensive, imposing a strain on the patient, and hence some patients will not tolerate it. Medical treatment of sleep apnoea with theophylline has proved effective. In 40 patients suffering from sleep apnoea, long-term treatment with sustained-release theophylline was investigated. Responders show a significant reduction of apnoeic phases and of apnoea index at the beginning and after long-term treatment. Using an individual theophylline dosage with morning theophylline concentration between 5 and 8 micrograms/ml, only few side-effects occurred. Positive effects on cardiopulmonary capacity could be detected. The Broca index does not change significantly. Sustained-release theophylline applied in the evening showed a positive effect on sleep apnoea in responders.

Adult↗
PubMed1991

[Hemodynamic changes with and without CPAP-ventilation in patients with sleep apnea].

In 21 patients suffering from severe sleep-apnoea syndrome we measured continuously haemodynamic parameters, blood gases, ECG, EEG, respiratory rate and ultrasonic cardiogram before and under treatment with nasal CPAP-breathing. All patients (male, age 29 to 58 yrs) had normal blood gases, heart-minute-volumes pulmonary artery pressures and left ventricular end-diastolic wedge pressures, when they were awake. During sleep all developed a decrease of pO2 and severe pulmonary artery hypertension with mean pulmonary artery pressures of 64 mmHg. In 10 patients an enlargement of the right ventricular diameter up to 13 mm difference could be seen. Treatment with nasal CPAP-breathing could reduce or even prevent changes in blood gases and in the haemodynamic system. The pulmonary artery pressures normalised in all patients. No right ventricular enlargement could be seen during nasal CPAP-breathing. Treatment with CPAP-breathing could normalise haemodynamic disorders in patients with severe SAS and may perhaps prevent development of cor pulmonale.

Adult↗