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Biomedical subjects

P Sadoul

Publications and source records attributed to P Sadoul.

At least 37 records · Page 2Linked to original sources
PubMed1985

A longitudinal study of pulmonary function in coal miners in Lorraine, France.

A longitudinal study of pulmonary function and radiological change has been conducted on 141 nonsmoking coal miners and 256 smoking coal miners from Lorraine, France. At the time of the first examination occasioned by radiological change or shortness of breath, the men averaged between 46.6 years and 50.9 years of age, and they retired approximately 8 years after entering the study. They have been followed for average periods of about 18 years and a mean of five FEV1 observations per man were made over that period. Changes in radiological category have been documented. Average rates of decline of FVC and FEV1 were similar, and varied between -47 ml/yr in nonsmoking miners still alive, to -78 ml/yr in deceased smoking miners. These accelerated rates were similar before and after retirement from the mine.

Age Factors↗
PubMed1985

Influence of hypoxemia and respiratory acidosis on the plasma kinetics and tissue distribution of digoxin in the conscious dog.

The aim of the present study was to investigate the influence of hypoxemia combined with respiratory acidosis on the kinetics of digoxin in conscious dogs. One group of three beagles was exposed to air and 7 days later to 10% O2, 10% CO2, and 80% N2. In a second group of three dogs, the order of exposure to the two atmospheric conditions was reversed. The dogs received 25 micrograms/kg digoxin and blood and urine samples were collected over the next 29 h. At the conclusion of the second treatment, the dogs were sacrificed to determine digoxin concentrations in the left ventricle, liver, renal cortex, and skeletal muscle. Digoxin total body clearance increased from 6.2 +/- 0.9 in control to 9.0 +/- 1.0 mL X min-1 X kg-1 in hypoxemic and hypercapnic dogs (p less than 0.05). The digoxin apparent volume of distribution at steady state (Vss) was increased in the dogs with hypoxemia and hypercapnia (11.63 +/- 1.11 vs. 8.62 +/- 0.41 L/kg in the controls, p less than 0.05). As a consequence the digoxin plasma half-life remained unchanged (18.6 +/- 1.5 h in hypoxemic and hypercapnic dogs versus 20.1 +/- 2.8 h in the controls). In dogs with hypoxemia and hypercapnia, the ratio of tissue to plasma digoxin concentrations tended to increase in the liver, in the renal cortex, and in the left ventricle and remained unchanged in the left hind leg muscle. In vitro studies showed that the digoxin total binding to erythrocyte membranes was slightly increased in the dogs with hypoxemia and hypercapnia, resulting from an increase in the apparent intrinsic association constant for digoxin (p less than 0.003). It is concluded that hypoxemia combined with respiratory acidosis changes digoxin disposition in the conscious dog and is the cause of a digoxin redistribution into the tissues.

Acidosis, Respiratory↗
PubMed1984

[Bronchial expectorants : pharmacology of bronchial mucomodifiers].

Prescription of bronchial mucus modifiers has benefited from recent advances in the knowledge of biochemical constituents of bronchial fluids, their regulation and disturbances on the one hand, and the consequences of biochemical changes in these fluids on rheological characteristics of bronchial secretions on the other. In addition, the significance of these characteristics has been evidenced by the study of mucociliary transportation. Drugs which modify bronchial fluids are studied according to their mode of action upon the organized gel phase, mobilized by ciliary activity, and the aqueous sol phase, which enables this ciliary activity. Drugs which modify the gel phase are either true mucolytic agents or muco-regulators. True mucolytic drugs include reducing agents with a free thiol group, chiefly N-acetyl-cysteine which breaks disulfide bonds linking different protein chains, and proteolytic enzymes which break protein chains. The latter also have an appreciable anti-inflammatory effect but are rarely used at present owing to allergic reactions. Mucoregulating drugs are cysteine derivatives whose thiol group is not free. They are headed by carbocysteine which activates the synthesis of sialidized acid mucins. They enable reorganization of bronchial mucus, reversing former drops in viscosity and elasticity, thereby improving mucociliary transportation. They have a complementary anti-inflammatory action.

Animals↗
PubMed1984

[Obstruction of the peripheral airways : clinical aspects, radiological picture, therapeutic impact].

Peripheral airways obstruction (PAO) is a pathophysiologic syndrome combining normal values of the usual tests (one-second forced expiratory volume, airway resistance) and abnormalities of "sensitive" tests (dynamic compliance, closing volume, forced expiratory flows, response to helium-oxygen mixtures). Clinical data are scarce, and the radiological aspects nonspecific. The natural history of the PAO is not fully understood. Therapeutic measures could be useful, but their efficacy was not yet systematically evaluated. From the theoretic point of view, the notion of bronchiolar obstruction is important in as much as it represents the initial phase of any obstructive process. In practice, the detection of a PAO identifies the "at risk" subject allowing the application of efficient preventive measures.

Humans↗
PubMed1984

[Quality control of spirographic examinations in a health center].

A quality control of spirographic examinations in a health centre was carried out by repeating, after a fortnight's interval, measures of vital capacity (CV) and FEV1 (VEMS) in 629 subject of both sexes, aged 18 to 62. Water spirometers were used and their cylinders were regularly calibrated. The first series of spirographic measurements were made during a routine health check (which included other examinations) by 7 technicians who usually do the work, while the second series of measurements was made of fortnight later by the most experienced three. The overall mean values show a significant difference for vital capacity between the first and second measurement; this difference was so for young male subjects (less than 30 years). The scatter was greater for subjects over 50 years of age. The varied results observed for the same subjects obtained by two different technicians, or the same technician, underlines the fact that the scatter of the results depends largely on the technician even though spirographic tests are classically considered easy to perform.

Adolescent↗
PubMed1984

Is it possible to predict pulmonary arterial hypertension from an exercise test?

In patients with chronic lung disease, the response to exercise can be impaired by ventilatory and/or circulatory disturbances. The response to a standard exercise varies according to the load in relation to the maximum load the subject can tolerate. Thus it seems more suitable to study the maximum tolerated, i.e. maximum workload expressed as VO2 max. We compared the results of VO2 max and pulmonary haemodynamic variables in 43 patients with chronic bronchitis. VO2 max ranged from 0.720 to 3.010 l/min. The relation between VO2 max and pulmonary artery pressure at rest or its increase with low level exercise was very poor, but there was a trend towards an increase in pulmonary vascular resistance in patients with low VO2 max, although a number of patients with low VO2 max had normal pulmonary vascular resistance. The ratio between heart rate at maximum workload and maximum heart rate according to age (heart rate obs/pred) was above 95% in the patients with pulmonary vascular resistance above 250 dyn.s. cm-5; it varied widely in the patients with normal or slightly elevated pulmonary vascular resistance. When VO2 max was below normal, and heart rate obs/pred low, it is probable that the decrease in VO2 max was due to ventilation impairment, or to a lack of cooperation. Oxygen pulse at VO2 max was also reduced in patients with high pulmonary vascular resistance, but a large range of values was observed in the rest of the patients. A high oxygen pulse at VO2 max however allows to rule out severe pulmonary artery hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Rheology of sputum collected by a simple technique limiting salivary contamination.

Rheological studies of sputum are often considered unreliable because expectorated secretions can be contaminated by saliva. The in vitro dilution of gel mucus by 50% of saliva results in a marked decrease in apparent viscosity and elasticity. A simple technique for collecting sputum "protected" from salivary contamination is described. It consists of using dental cotton-wool swabs placed immediately before expectoration between the cheek and the gum and under the tongue to absorb saliva. The rheological and transport properties of sputum, collected by the protected and unprotected technique in 20 patients with either recurrent or chronic bronchitis, are compared. The protected sputum samples are characterized by a significantly lower pourability (p = 0.02) and sol phase percentage (p = 0.01) and a higher apparent viscosity (p = 0.05). A marked, although not significant, increase in viscoelastic modulus is also noticed with the protected sputa. No difference is observed in the mucociliary transport velocity according to whether the sputum is protected or not. The reproducibility and reliability of the measurements are considerably improved when sputum is collected by the protected technique. The ratio of inter- to intrasample variability is twice to three times as high for the unprotected samples.

Humans↗
PubMed1983

Noncompetitive enzyme immunoassay for the measurement of bronchial inhibitor in biological fluids.

An enzyme-linked immunosorbent assay (ELISA) of bronchial inhibitor using rabbit antibronchial inhibitor antibody-coated polystyrene balls as the solid-phase antibody and peroxidase-labeled antibody as the conjugate is described. A crude antibody fraction is used for coating the solid phase. The assay can be run within 8 h and gives reproducible results in the range of 6 to 60 micrograms/l of bronchial inhibitor (mean within-run coefficient of variation, 7%). It can detect bronchial inhibitor concentrations as low as 2 micrograms/l (10(-10) M) and recovery of varying amounts of bronchial inhibitor added to bronchial liquids is greater than 90%. This enzyme immunoassay appears to be a convenient way to quantify bronchial inhibitor in biological fluids such as serum, sputum, or bronchoalveolar lavage fluid.

Antibody Specificity↗
PubMed1983

The pulmonary haemodynamic effects of almitrine infusion in men with chronic hypercapnia.

1. Almitrine, an agonist of peripheral chemoreceptors, has been shown to be effective in lowering PaCO2 in patients with chronic obstructive lung disease. The aim of this investigation was to evaluate the pulmonary haemodynamic response to almitrine in clinically stable patients with chronic airflow obstruction and chronic hypercapnia (PaCO2 7.1 +/- 0.5 kPa, mean +/- SD). 2. Seven men, aged from 55 to 64 years, had the following values for pulmonary function (means +/- SD): FEV1.0 0.67 +/- 0.16 litre; VC 2.12 +/- 0.52 litres; FEV1.0/VC 33 +/- 8%. They had haemodynamic monitoring during 1 h of almitrine (1 mg/kg intravenously) and solvent (placebo) in a random fashion while receiving 28% oxygen. Before infusion, six patients had evidence of pulmonary hypertension and the mean pulmonary artery pressure (PAP) for all seven patients was 4.3 +/- 1.6 kPa (mean +/- SD); the pulmonary vascular resistance (PVR) was 0.61 +/- 0.22 kPa 1(-1)s (mean +/- SD). 3. There were no significant changes from baseline values during placebo. During almitrine, however, the PAP and right ventricular stroke work (mean +/- SD) increased significantly at 30 min (6.0 +/- 2.1 kPa, P less than 0.001, 0.38 +/- 0.12 J, P less than 0.05, respectively) with maximum increase of PVR at 45 min (1.01 +/- 0.34 kPa 1(-1)s, P less than 0.001, mean +/- SD). The lowest PaCO2 (mean +/- SD) was observed at the end of the infusion (5.7 +/- 0.5 kPa, P less than 0.001). 4. These results confirm the benefit of almitrine in lowering PaCO2 in patients with chronic airflow obstruction who have chronic hypercapnia but also demonstrate significant pulmonary vasoconstriction.

Almitrine↗
PubMed1983

Vectarion International Multicentre Study (VIMS): a long term double blind placebo controlled trial in COLD patients.

In a previous six month study almitrine bismesylate ( Vectarion ) administration has been shown to be effective and safe in the treatment of hypoxaemic and hypercapnic chronic obstructive pulmonary disease (COLD). The protocol of the present VIMS study has been designed to complete the evaluation of the clinical benefit obtained after oral almitrine bismesylate administration on a larger scale and over at least a one year period in hypoxaemic COLD patients. Male and female outpatients will be included with an age 35-75, weight 50-95 kg, PaO2 45-65 mmHg, PaCO2 35-60 mmHg, FEV1/FVC 30-65%. Patients with primarily restrictive pulmonary disease, with cardiac, renal, central nervous system or hepatic impairment, and female patients of child bearing potential, will be excluded. After a three week stabilization period, patients will enter the study and receive on a random basis either almitrine bismesylate or placebo with a stratified allocation within each centre and whether patients receive or not long term continuous domiciliary oxygen therapy. Clinical examination, arterial blood gases, dyspnoea score, 6 mn walking distance, pulmonary function tests, haematological, biochemical profiles and plasma levels will be measured on a quarterly basis and electrocardiogram at six monthly intervals. Hospitalizations, new signs and symptoms, and changes in concomitant treatment will be recorded at each visit. Administration of the drug will be 50 mg b.d. during the first three months with a possible increase of 50 mg after the third and/or the sixth month visits if, and only if, PaO2 increase is less than 5 mmHg and if the drug is well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

[General problems posed by the domiciliary treatment of chronic respiratory insufficiency].

Hypoxaemia secondary to chronic bronchopulmonary disease may lead to total invalidity and be complicated by right heart failure. Consistent and meticulous medical care may produce a notable improvement by not smoking, using bronchodilators, mucolytics and physiotherapy. If, despite these measures, frank hypoxaemia persists, then domiciliary oxygen should be considered. The need for prolonged oxygen therapy of more than 15 hours is often countered by the scepticism and lack of discipline of the patient and family. In cases of hypoxaemia which are partially refractory or are associated with hypercapnia prolonged mechanical ventilation with a tracheotomy will ensure considerable salvage in those with severe restrictive defects and right heart failure. The supervision of oxygen therapy requires not only adequate control of blood gases, but also collaboration between the family doctor, the respiratory physician and home visitors such as the nurse or technician.

Chronic Disease↗
PubMed1983

The frog palate for studying mucus transport velocity and mucociliary frequency.

The palate of the frog possess a pseudostratified epithelium with mucus secreting cells and numerous ciliated cells covered with a continuous mucus blanket of 4 to 8 micron thickness. This palate can be used as a simple model for studying mucus transport and giving rapid information on the transportability of pathological bronchial secretion by the ciliary mechanism. The analysis of the relationship between the rheological properties of sputum an their transport rates on the frog palate showed that the highest transport rates were obtained with sputum samples characterized by a high spinability (Sp greater than 70 mm) and an intermediate range of viscosity (25-180 P) and elasticity (SR = 4-12 units). The mucociliary frequency (Fm) of the frog palate was measured by a photoelectric method and analyzed as a distribution function of the ciliary frequencies by the Fast Fourier Transform method. Fm decreased significantly after mucus depletion and was restored when adding a drop of frog mucus collected on a freshly excised frog palate. On the other hand, it remained about 20% lower than the original predepleted value, when adding purulent sputum collected in patients with chronic bronchitis and cystic fibrosis. The frog palate appears as a valuable model for analyzing the mucociliary transport rate and also for studying the effect of pathological secretions on the ciliary beating frequency.

Animals↗