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Biomedical subjects

P Faurschou

Publications and source records attributed to P Faurschou.

At least 37 records · Page 2Linked to original sources
PubMed1995

Diagnostic yield of transthoracic needle aspiration biopsy following negative fiberoptic bronchoscopy in 103 patients with peripheral circumscribed pulmonary lesions.

The diagnostic potential of secondary transthoracic needle biopsy (TNB) following negative fiberoptic bronchoscopy (FOB) in patients with peripheral circumscribed pulmonary lesions was evaluated in a retrospective study. The records from 224 patients who had TNB over a 5-year period were reviewed. Of these, 103 patients met the criteria for inclusion in this series. The overall diagnostic yield of TNB in malignancy was 73.8% (54 of 73 patients). TNB allowed cytologic classification of the tumor type in 72.2% (39 of the 54 patients). Five of the 54 patients (9.3%) presented with small-cell anaplastic bronchogenic carcinoma, diagnosed at TNB, and were referred to chemotherapy. Of the 49 patients with a negative TNB, 27 went on to diagnostic surgical procedures; 19 had malignancy, 3 benign tumor, 2 infection, and 3 sequelae after pulmonary infarction. The remaining 22 undiagnosed patients were followed up over a long period of time, 5 showed progression of the pulmonary lesion suggesting malignancy. TNB appeared unsuitable for the diagnosis of benign lesions. Unspecific inflammation was not considered evidence of benignity, and therefore no definitive benign diagnosis was made by TNB in this series. There were no serious complications to TNB. In 18.1% of the procedures a pneumothorax developed, indicating a chest tube in 8.6% of the procedures. TNB is a suitable diagnostic procedure with a high diagnostic yield in patients with peripheral localized malignant pulmonary lesions.

Adult↗
PubMed1994

[Oxygen therapy of chronic lung disease. Testing of a chemical oxygen generator--Vitaria].

Twenty patients (11 females, nine males, mean age: 70.6 years) with chronic obstructive pulmonary disease and hypoxaemia took part in a randomized single blinded placebo-controlled clinical trial, testing the efficacy of a new transportable oxygen delivery system (VITARIA). The system consists of a container and a sodium carbonate containing powder (75 mg). When the powder is stirred in water in the container pure oxygen with a max flow of 1 l/min is delivered over a period of approximately 15 minutes. All patients had been receiving home oxygen treatment of at least 0.5 l/min for at least one month. Their baseline oxygen levels in arterial blood were mean 7.66 kPa, with a mean oxygen response to 0.5 l/min of oxygen of 2.54 kPa. In the placebo group no oxygen responses were seen, while in the Vitaria group a small but insignificant rise in arterial PaO2 was seen. No side effects were seen. In conclusion we find the system handy and easy to use but the recommended dose of powder is insufficient.

Aged↗
PubMed1994

[Primary tuberculous pleurisy. The course of 3 untreated cases].

Three patients with pleurisy, all exposed to tuberculosis (TB) in their environment, are presented. The etiology of the pleurisy was not initially uncovered and as the pleurisy resolved spontaneously, the patients were discharged from follow up after four to 21 months. Within two to 12 months hereafter, the patients showed up with post-primary tuberculosis: (case I) with miliary tuberculosis incl. meningeal tuberculosis, case II with apical lung tuberculosis and case III with extrapulmonary tuberculosis of the bones. After six months of combined anti-tuberculosis chemotherapy all patients recovered completely. Primary tuberculous pleurisy is known usually to be self-limited but the reactivation rate is high; up to 65% of the adult patients develop post-primary tuberculosis within five years, if not treated. Therefore, prompt diagnosis and treatment are important. Pleurisy in patients with TB in their environment should be intensively examined with cultures of all potentially diagnostic specimens; cultures from pleura fluid alone have a low diagnostic yield and diagnostic blind closed or thoracoscopic open biopsy from the pleura for cultures and histologic examination should be performed whenever possible. If the etiology is not found, the patient should be followed for at least five years.

Adult↗
PubMed1994

[Broncholithiasis and lithoptysis].

Broncholithiasis and lithoptysis are rare phenomenons. A case of broncholithiasis in a woman, 58 years of age, with previous tuberculosis is presented, and the literature on broncholithiasis and lithoptysis is reviewed.

Bronchial Diseases↗
PubMed1994

[Lung cancer in 1993].

The incidence of lung cancer is increasing in Denmark, especially among women. Today, smoking is the most important risk factor for developing this disease. A review of the literature shows that the prognosis is still very poor regardless of histologic findings. Chemotherapy prolongs life moderately among patients with small cell carcinoma (SCLC). Furthermore, total resection of non small cell cancer (NSCLC) may improve survival over several years. In patients investigated for surgery, cancer dissemination should be determined, using radiologic and invasive investigations. A detailed spirometric investigation should also be performed, as lung function is a predictor of postoperative survival. Other kinds of treatment are available, and good coordination regarding information, supportive arrangements and symptomatic treatment is important.

Denmark↗
PubMed1994

The lack of bronchodilator effect and the short-term safety of cumulative single doses of an inhaled potassium channel opener (bimakalim) in adult patients with mild to moderate bronchial asthma.

The aim of this study was to assess the bronchodilator effect and short-term safety of cumulative single doses of inhaled bimakalim (E Merck, Darmstadt), a potassium channel opener, compared to placebo in 12 adult patients with chronic, mild to moderate, non-allergic bronchial asthma. The study was a randomized, placebo-controlled, cross-over study and the only efficacy variable measured was the forced expiratory volume in one second (FEV1). The patients had an FEV-1 > 50% of predicted normal value and a reversibility of more than 15% at entrance to the study. Inhaled bimakalim and placebo were delivered by a Pariboy nebulizer. The doses tested in a cumulative manner were 10, 25, 40 and 100 micrograms (total cumulative dose 175 micrograms), each individual dose given at 60-min intervals. Plasma bimakalim concentrations were measured at time 0 and 60 min after each dose. No bronchodilator effect was shown, with inhaled bimakalim at the doses tested. Reasons for the lack of efficacy of inhaled bimakalim in this study may be due to low doses of administered drug or to a true lack of bronchodilatation effect in the study patients. Inhaled bimakalim was well tolerated. No headache or cardiovascular events were seen with the cumulative dose of 175 micrograms bimakalim.

Administration, Inhalation↗
PubMed1994

Transbronchial lung biopsy through the fibre optic bronchoscope. Results and complications in 452 examinations.

During 1986-1989, diagnostic fibre optic bronchoscopy (FOB) was performed in local anaesthesia in 1144 consecutive patients. Of these, 405 (35%) patients, median age 59 years, had transbronchial lung biopsy (TBB) performed under fluoroscopic guidance; 47 patients had a rebronchoscopy, i.e. in total 452 FOB were evaluated. The indication for TBB was localized pulmonary lesions in 279 (69%) patients, and diffuse pulmonary lesions in 126 (31%) patients. Localized lesions: TBB yielded a clinically relevant diagnosis in 55.2% of the patients. Of the 110 patients with malignancy, the overall diagnostic strength was 45.5%. Of the 159 patients with non-malignant lesions, 65.4% were diagnosed by TBB. The diagnostic yield increased with the number of biopsy specimens (< or = 4 biopsies, 52%; > 4 biopsies, 70%. P < 0.05). In 155 patients with well defined, circumscribed lesions, the diagnostic yield of TBB increased with the size of the lesion (< 31 mm, 47%; 31-60 mm, 54%; > 60 mm, 60%, P = 0.09), and decreased with the distance of the lesion from the main carina < 61 mm, 70%; 61-100 mm, 52%; > 100 mm, 40% P < 0.02). Diffuse lesions: TBB yielded a clinically relevant diagnosis in 66.7% of the patients. Of the 15 patients with malignancy, 73.3% were diagnosed by TBB. Of the 93 patients with non-malignant lesions, 78.5% were diagnosed by TBB. The diagnostic yield showed a trend to increase with the number of biopsy specimens (< or = 4 biopsies, 65%; > 4 biopsies, 71%, P = 0.11).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Comparison between sodium cromoglycate (MDI: metered-dose inhaler) and beclomethasone dipropionate (MDI) in treatment of adult patients with mild to moderate bronchial asthma. A double-blind, double-dummy randomized, parallel-group study.

This study compared the efficacy and tolerability of sodium cromoglycate (SC) and beclomethasone dipropionate (BDP) in adult patients with bronchial asthma inadequately treated with bronchodilators alone. The study was a double-blind, randomized, double-dummy, parallel-group study. Patients with mild to moderate symptomatic asthma, inadequately treated with bronchodilators only, were, after a 2-week run-in (base-line) period, randomized to 8 weeks of treatment with either SC 10 mg four times daily or BDP 100 micrograms four times daily. Salbutamol metered-dose inhaler was given as relief medication. A total of 37 patients were randomized for treatment, 19 patients in the SC group and 18 patients in the BD group. Efficacy and safety were determined by daily record card data: morning and evening peak-expiratory-flow rates (PEFR), daytime and nighttime asthma symptom scores, and rescue salbutamol use. At clinic visits, FEV1 and FVC were measured, as were the physician's and the patient's assessment of the medication at the end of the study. The safety and tolerability of the trial medication were assessed by monitoring adverse events throughout the study. A clinically and statistically significant improvement of the asthma in FEV1, symptom scores, rescue medication, and global opinion of efficacy was observed, and both groups provided equivalent efficacy. The morning PEFR as well as the evening PEFR for both groups improved, but was statistically significant only for the BDP group (M-PEFR). Both drugs were well tolerated with only a few minor adverse events. This trial shows that SC and BDP are equally effective anti-inflammatory treatments for mild to moderate bronchial asthma in adults.

Adult↗
PubMed1994

Salmeterol in two different doses in the treatment of nocturnal bronchial asthma poorly controlled by other therapies.

This study compared the efficacy of inhaled salmeterol (SM) 50 micrograms twice a day with SM 100 micrograms once a day (at night) and placebo in patients with poorly controlled nocturnal asthma despite treatment with corticosteroids, oral long-acting bronchodilators, or both. This was a two-center, double-blind, randomized, crossover study with three treatment periods, each of 3 weeks' duration. The first treatment period was preceded by two 1-week run-in periods, and the last treatment period was followed by a 2-week follow-up period. In the three treatment periods, patients received either SM 50 micrograms twice a day, SM 100 micrograms nightly, or placebo, in randomized order. Salbutamol metered-dose inhaler was given as relief medication. Of the 41 randomized patients, 38 were evaluable for more than one treatment period. Efficacy and safety were determined by daily record card data: morning and evening peak expiratory flow rates (PEFR), daytime and nighttime asthma symptom scores, and rescue salbutamol use. At clinic visits, FEV1 and FVC were measured, and the physicians' and the patients' respective assessments of the study mediation were noted. The study showed that the two doses, SM 50 micrograms twice a day and SM 100 micrograms nightly, were equally effective in controlling nocturnal asthma symptoms and were significantly better than placebo. SM was well tolerated, and no unexpected problems were revealed. The adverse events reported during this study were related either to the patient's underlying disease or to an intercurrent respiratory infection.

Adult↗
PubMed1994

Pulse oximetry during fibreoptic bronchoscopy in local anaesthesia: frequency of hypoxaemia and effect of oxygen supplementation.

The indication for oxygen supplementation during diagnostic fibreoptic bronchoscopy (FOB) in local anaesthesia was evaluated by means of pulse oximetry in 160 patients (108 men, 52 women), median age 62 years. The patients were allocated at random into four groups of each 40 persons, which were comparable concerning pulmonary function and the dose of benzodiazepine used for premedication. The oxygen saturation of the haemoglobin (SpO2) in the tip of the index finger and the pulse rate were continuously recorded. Group 1 was examined without O2 supplement. Group 2a received O2 2 litres/min through a catheter placed in the vestibulum nasi. Group 2b received O2 2 litres/min through a pharyngeal catheter. Group 3 received O2 3 litres/min through a pharyngeal catheter. SpO2 mean values during FOB were 92 +/- (SD) 3% in group 1 and 96 +/- 2% in groups 2a, 2b and 3 (p < 0.001). SpO2 trough levels were mean 87 +/- 4% in group 1 vs. 93 +/- 2% in groups 2a and 2b, and 94 +/- 3% in group 3 (p < 0.001). Transient hypoxaemia, i.e., SpO2 < 85%, occurred with a frequency of 35% in group 1, 2.5% in group 2a, 0% in group 2b, and 2.5% in group 3. Tachycardia and bradycardia during FOB occurred with a frequency of 20% in group 1, 25% in group 2a, 18% in group 2b, and 10% in group 3. Pulse oximetry increases the safety of FOB, and is recommended for routine use. During FOB, oxygen supplement 2-3 litres/min should be administered to all patients, preferably through a pharyngeal catheter, as a preventive measure against hypoxaemia.

Adult↗
PubMed1993

The protective effect of inhaled levomepromazine (Nozinan) on histamine-induced bronchial constriction.

The effect of inhaled levomepromazine (Nozinan, Veractil) on bronchial responsiveness to inhaled histamine was investigated in asthmatics. In a double blind, randomized controlled study, 12 asthmatics (FEV1% pred 52-96%, and PC20 histamine 1.01 mg/ml (geometric mean)) were challenged before and after inhalation of levomepromazine in three different doses. Before and after each inhalation of levomepromazine, PC20, FEV1, the continuous reaction time (CRT) and the subjective sedation score (VAS) were determined. A dose-dependent increase in PC20 was observed after inhalation of levomepromazine. PC20 was increased by up to 4.02 two-fold concentration differences (doubling), i.e. up to a 38-fold increase from the basic values. Inhalation of the two higher doses of levomepromazine had a small sedative effect evaluated from an increase in CRT and the VAS-score and corresponding to the plasma concentrations. We conclude that inhaled levomepromazine has a dose-dependent protective effect on histamine-induced bronchial hyperresponsiveness in asthmatics and that inhalation of levomepromazine was well tolerated. The mechanism by which levomepromazine acts on histamine-induced bronchial hyperresponsiveness is not known but it could be partly explained by the antihistaminic effect. In this respect levomepromazine bears comparison with the most potent second generation antihistamines. The plasma concentrations of levomepromazine measured corresponded to those seen after oral intake of 5-10 mg levomepromazine.

Administration, Inhalation↗
PubMed1993

The effect of filtration on the cellular components in bronchoalveolar lavage fluid.

The effect of filtration through two layers of cotton gauze on the cellular composition of bronchoalveolar lavage (BAL) fluid was studied in 25 patients with pulmonary disease. There was no significant difference between median total cell count in unfiltered and filtered BAL (P = 0.73) or in the distribution of neutrophils or eosinophils. The percentage of bronchial epithelial cells was significantly higher in unfiltered than in filtered BAL (P = 0.02). Furthermore, differential cell counts showed a significantly lower percentage of alveolar macrophages (P = 0.04), and a significantly higher percentage of lymphocytes (P = 0.04) in unfiltered compared with filtered BAL. Thus, gauze filtration results in a loss of bronchial epithelial cells and lymphocytes, and is not recommended in the routine analysis of cellular components in BAL fluid.

Adult↗
PubMed1993

Percutaneous transthoracic fine-needle lung biopsy with 3 different needles. A retrospective study of results and complications in 224 patients.

During 1986-1990, 307 percutaneous transthoracic fine-needle biopsies (PTNB) were performed on 224 patients (mean age 63 years, range 27-83) with three types of needles (Nordenström, Vacu-Cut and Franzén). The overall sensitivity regarding malignant disease in central and peripheral pulmonary lesions was 67.0%. In 71 patients with suspected malignancy and a negative PTNB, the examination was repeated and the sensitivity was increased to 79.5%. Each needle had the following sensitivity: Nordenström 67.4%, Vacu-Cut 75.7%, Franzén 75.9%. The overall pneumothorax frequency was 24.7%, being highest with the Nordenström needle. Hemoptysis was seen in 5 examinations. In conclusion, the Franzén and Vacu-Cut needles have a significantly higher sensitivity and a lower complication frequency compared to the Nordenström needle.

Adult↗
PubMed1992

[Foot zone therapy and bronchial asthma--a controlled clinical trial].

Thirty patients with proved bronchial asthma receiving treatment with inhaled steroid in dosages of less than 1,000 micrograms daily were subdivided at random into two groups of 15 patients. One group received foot zone therapy and the other merely uniform clinical care but without "placebo foot zone therapy". The "active" group received a total of ten foot zone therapy sessions of one hour at intervals of one week. The asthmatic symptoms, consumption of medicine and the objective pulmonary function parameters were followed-up during the subsequent six months. Decrease in consumption of beta-2-agonists and increase in peak-flow levels were observed in the group which had received foot zone therapy, but the same changes were observed in the control group. The authors do not find that this investigation demonstrates that foot zone therapy is of effect on the disease bronchial asthma. They conclude, however, that the favourable effect in both of the groups are due to increased care and control which occurred in both patient groups.

Adolescent↗
PubMed1992

Histamine-induced bronchoconstriction in conscious guinea pigs measured by strain-gauge transduction. A new method.

A new objective method for measuring histaminedihydrochloride-induced bronchoconstriction in conscious guinea pigs has been developed. The aim of the present work was to investigate whether identical results could be obtained when the clinical observation of conscious guinea pigs with symptoms of respiratory distress (bronchoconstriction) was compared to an objective measuring technique of this parameter. An evaluation of the repeatability of the method was made and the respiration frequence (fR) and histaminedihydrochloride challenge concentration were compared to see whether there was a correlation between the two. Consequently, an apparatus was built that allowed simultaneous recording of breathing pattern and clinical observation of the animal being challenged. The breathing pattern was recorded by a strain-gauge transducer, connected to a measuring bridge, and the curves obtained on a jet ink x-y writer were used for calculating changes in duration of expiratory phase (Te) and fR. During the attacks of histaminedihydrochloride-induced bronchoconstriction a significantly prolonged Te could be calculated from the respiration curves. A high degree of agreement was found between this objective measure and clinically observed respiratory distress. The repeatability of the method was comparable to that of corresponding methods used for histaminedihydrochloride challenge in man. No obvious correlation was found between changes in fR and histaminedihydrochloride challenge concentration.

Animals↗
PubMed1992

Fine structure of neutrophils from turpentine-induced pleuritis in mice, simulating rheumatoid arthritis cells.

Pleural effusions were made by intrapleural turpentine installation in mice. The fine structure of inflammatory cells from the effusions was normal except for lipid inclusions. The same type of inclusion was previously found in neutrophils from pleural effusions in patients with tuberculous infection, rheumatoid disease, or carcinomatosis. The lipid inclusions observed in neutrophils from an irritative turpentine-induced pleurisy should be considered as "fatty change", and are structurally similar to the rheumatoid arthritis cells seen in patients with different diseases.

Animals↗