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Biomedical subjects

P Sadoul

Publications and source records attributed to P Sadoul.

At least 19 recordsLinked to original sources
PubMed1992

[Prognostic factors in survival of patients with obstructive respiratory insufficiency treated by long-term oxygen therapy. Data from the ANTADIR registry].

Prognostic survival factors in COPD patients obtaining long-term oxygen therapy (LTO) through 25 french associations were studied using data from the ANTADIR register. Selection criteria included age (50 to 79 yr), FEV1/VC < 60%, PaO2 < 60 mmHg and start of therapy between beginning 1984 and end 1988. A total of 1,775 patients were selected (1,462 men, 313 women, mean age 66.1 yr). PaO2 was 50.9 +/- 5.8 mmHg, PaCO2 47.1 +/- 5.8 mmHg, FEV1 8.81 +/- 0.31 l (30.4 +/- 11.1% of predicted values) and FEV1/VC 37.7 +/- 10.1%. Overall survival was 81.6% at 1 yr, 68.6% at 2 yrs, 55.7% at 3 yr, 44.9% at 4 yr and 37.3% at 5 yr (survival median 3.5 yr). Age was the most predictive survival factor (5 yr survival 48.8% for 50-59 yr-old patients vs 27.3% for 70-79). Survival was longer in women (49% at 5 yr vs 34.9% for men). After stratification by age, FEV1, FEV1/VC, PaO2, PaCO2 and Body Mass Index (BMI) were all significant predictive factors for men. FEV1/VC was the only prognostic factor for women. For all the population multivariate analysis showed that age, sex and BMI were the most significant variables. A prognostic score determined from the final Cox model and based on sex, age, BMI, FEV1, PaO2 will be validated in an independent patient series. Our data confirm the influence of age, airways obstruction and hypoxemia on survival of COPD patients under LTO. Furthermore they demonstrate a poorer survival in men, in underweight patients and in non hypercapnic patients.

Age Factors↗
PubMed1978

[Von Recklinghausen's disease: functional pulmonary changes. 2 case reports].

We report two cases of patients with Von Recklinghausen disease. They exhibited typical cutaneous and diffuse intrapulmonary lesions accompanied by effort dyspnea. Multiple radiological abnormalities were noticed and the pictures showed nodular and interstitial lesions as well as emphysematous areas. Pulmonary function tests revealed more or less marked hypoxemia without hypercapnia, and decreased maximal expiratory flows due, at least in part, to a loss of elastic recoil.

Adult↗
PubMed1978

[Current concepts of bronchial fluidifiers (author's transl)].

Having summarised recent studies of the biochemical and rheological nature of bronchial secretions, the authors envisage different types of drugs which modify bronchial secretions: mucolytic agents, drugs modifying local water equilibrium and mucoregulators. According to the modes of action of these drugs and the nature of the secretory disturbances, the authors propose new therapeutic schemes. The treatment of chronic bronchial hypersecretion should not necessarily aim to fluidify the secretions but should normalize their rheological properties in order to improve mucociliary transport. The various fluidifiers and regulators of bronchial secretions are in no way interchangeable and should only be used when appropriate.

Acute Disease↗
PubMed1978

Criteria for evaluating mucus functions and their disorders in chronic bronchitis.

In chronic bronchitis, disorders of the physical and chemical properties of mucus may contribute to bronchial obstruction. The abnormalities are analysed in sputum collected by physiotherapy. Measurements of the rheological properties (apparent viscosity and strain recovery), content analysis of secretory immunoglobulin A (S-IgA) and of serum albumin, and determination of the transport velocity of sputum on the ciliated frog palate provide reliable indices of the functional capacity of bronchial mucosa. The effectiveness of mucociliary clearance and coughing is analysed in patients by measuring the rate of removal of radioactive particles deposited on proximal airways. Different types of pathological secretions may be observed. In subjects with occasional cough and sputum, the secretions are characterized by a high content of S-IgA and serum albumin, and a high viscosity and low elasticity, reflecting their high degree of cross-linking. In chronic bronchitics, the S-IgA content and viscoelastic properties of sputum decrease as the illness progresses. During infection, purulent sputum exhibits high viscosity and low strain recovery. Such modifications of the rheological properties of mucus may impair mucociliary clearance. The role of the elastic component is predominant. Sputum, characterized by very low strain recovery (SR less than 4 units) or conversely by very high strain recovery (SR greater than 15 units), is transported at a low rate by mucociliary clearance. A marked hyperviscosity (no greater than 200 poises (120 N s m-2)) also appears as a limiting factor of the mucociliary clearance.

Animals↗
PubMed1978

The respiratory response to inhaled carbon dioxide in man after 3 hours exposure to 3% carbon dioxide.

1. The respiratory response to inhaled 3% and 6% CO2 was measured in 10 normal subjects after a 3 h acclimatization period to 3% CO2 in an environmental chamber. Control studies were carried out after a 3 h period of breathing air in the chamber. 2. At the end of the acclimatization period studies were carried out during 20 min periods breathing 3% CO2, 6% CO2 and air. 3. At 2-min intervals during the studies measurements were made of tidal volume (Vt), breathing frequency (fR), minute ventilation (Ve), viscous pulmonary rate of work (Wp) and total viscous rate of work across the lungs and apparatus (Wt). Blood gas tensions were measured at the end of this period. 4. After acclimatization to 3% CO2 there was a significant shift in the response curves Ve/Pa,CO2 and Wt/Pa,CO2 such that subjects showed higher Pa,CO2 values for given values of Ve or Wt. There was no significant change in the slope of the response curves. 5. No correlation was found between the slope of the response curve after the control period breathing air and the degree of shift of the response curve. 6. There was no difference in respiratory pattern or in pulmonary resistance. 7. Similar results were found in two subjects studied after 24 h acclimatization to 3% CO2 but one subject also showed a significant change in the slope of the Ve/Pa,CO2 curve.

Acclimatization↗
PubMed1978

[Prevalence of bronchitis in socio-professional groups. III. Unexposed workers (author's transl)].

Besides the two groups of exposed workers (building workers and workers of a steel mill), a reference group of age-matched (40--60 years) unexposed workers was studied. They were examined by the same procedures (interrogation by ESC questionnaire, vital capacity, forced expiratory volume in 1 sec residual volume, apnea CO test and steady-state Co test at rest and exercise of 40 W. Results are presented according to age and smoking habits. They are compared with results observed in the two exposed groups, and discussed.

Adult↗
PubMed1978

[Pathophysiology of chronic, bronchial hypersecretion (author's transl)].

The biochemical and rheological analysis of sputum allows one to detect abnormalities of the bronchial secretion and to describe the development of the bronchial disease. The main biochemical components of sputum and their biological activities are first described. The fibrillar structure of the mucus is related to heavy weight glycoproteins and these macromolecules contribute to the viscoelastic properties of the bronchial secretion, by their capacity to combine with other proteins such as secretory immunoglobulin A (S-IgA). As the chronic bronchial hypersecretory state progresses, the glandular synthesis of mucins and/or secretory proteins decreases while the passive filtration of blood-derived proteins, such as serumalbumin, increases. Such biochemical changes are frequently associated with a rise in viscosity and a loss in elasticity of sputum. These rheological modifications result in an impairment of the mucociliary clearance and therefore contribute to airway obstruction. The assessment of different indices such as the equilibrium in mucin secretion, S-IgA/serum-albumin ratio, viscosity and elasticity of sputum and its mucociliary transport rate, should lead to a better knowledge of the defense properties of the bronchial mucosa.

Airway Obstruction↗