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Biomedical subjects

S L Spector

Publications and source records attributed to S L Spector.

At least 127 records · Page 7Linked to original sources
PubMed1979

Medical outcome in asthmatic patients: effects of airways hyperreactivity and symptom-focused anxiety.

Hypotheses about medical outcome in asthma, indexed by rates of rehospitalization within 6 months after discharge from long-term intensive care, were evaluated. Predictions for rehospitalization were based on the levels of airways hyperreactivity, indexed by inhalation challenges with histamine or methacholine, and levels of anxiety focused upon and concurrent with periods of asthmatic distress, indexed by Panic-Fear symptomatology. Results indicated that, although some prediction could be made on the basis of levels of anxiety and airways hyperreactivity alone, the best predictions resulted from the combined effects of these factors. Almost half of the patients who had highly hyperreactive airways and a tendency to disregard symptoms of breathing difficulty were rehospitalized. By comparison, none of the patients who had less hyperreactive airways and a tendency to be vigilant about their symptoms were rehospitalized. The hypotheses and results are discussed with respect to symptom-focused and general, illness-dependent types of anxiety which have different effects upon medical outcome in chronic asthma. The results have implications for the application of anxiety-reducing forms of intervention in asthma.

Adolescent↗
PubMed1979

Methacholine and histamine inhalation challenges in asthma: relationships to age of onset, length of illness, and pulmonary functions.

Levels of airways hyperreactivity, as indexed by methacholine and histamine thresholds, were determined for hospitalized asthmatic patients using the serial concentration, constant-breath method. Airways hyperreactivity was categorized into low and high based on a split of the sample of subjects tested. These categories were unrelated to pulmonary function measurements obtained throughout hospitalization. Patients having high airways hyperreactivity to histamine or methacholine were admitted for intensive inpatient care at a young age, had an earlier age of onset, and had asthma of longer duration than patients having low airways hyperreactivity. These latter results suggested that relatively greater airways hyperreacticity is more likely to be associated with early onset of the illness.

Adolescent↗
PubMed1979

Treatment of perennial rhinitis with flunisolide corticosteroid spray.

Flunisolide nasal spray was compared to its propylene and polyethylene glycol vehicle in a randomized double-blind study of 20 adult patients with perennial rhinitis. After a two-week baseline period patients received either active flunisolide 50 microgram q.i.d. or placebo for four weeks. Laboratory studies included serum 8 a.m. cortisols, nasal air-flow measurements and nasal smears for eosinophils and fungi. Patients kept daily symptom diaries. There was no difference between active and placebo groups for sneezing, runny nose or nose blowing. Although post-nasal drip showed the greatest improvement in the active group, there was a trend for improvement in both groups. By the second week the percentage of eosinophils on nasal smear significantly decreased in both groups. Nasal air-flow measurements also showed improvement in both active and placebo groups. There was no change in serum cortisol levels compared to baseline. Side effects were similar in both active and placebo groups. Although no positive fungal cultures were obtained during the double-blind study. Candida was cultured during the long-term program in one patient.

Administration, Intranasal↗
PubMed1978

Long-term follow-up and bronchial reactivity testing in survivors of the adult respiratory distress syndrome.

Long-term follow-up of 9 survivors of the adult respiratory distress syndrome at 39 to 83 months demonstrated 2 patients with continued improvement of their restrictive pattern, 3 patients with stable mild obstructive disease, one patient who had had chronic obstructive pulmonary disease before the adult respiratory distress syndrome with continued pulmonary deterioration, and 4 patients without symptoms and with normal pulmonary function tests. Attention is drawn to bronchial reactivity as defined by a bronchodilator response of more than 60 per cent increase in maximal mid-expiratory flow, positive methacholine challenge, or development of bronchospasm after exercise in 3 patients having clinical symptoms of wheezing on recovery.

Adolescent↗
PubMed1978

Bronchoconstrictive suggestion in asthma: a role for airways hyperreactivity and emotions.

Using whole-body plethysmographic measurements, asthmatic patients inhaled aerosolized saline presented either as a neutral substance (day 1) or in the guise of a bronchoconstrictor (day 2). Bronchoconstrictive suggestion resulted in increased airway resistance and decreased specific airway conductance, whereas thoracic gas volume was unchanged. The variation in the response was analyzed in relation to airways hyperreactivity, as indexed by methacholine and histamine inhalation challenges, and physiologic measures of the emotional reaction to bronchoconstrictive suggestion, as indexed by changes in blood pressure, heart rate, finger pulse amplitude, and forehead electromyographic activity. It was found that the bronchoconstrictive response was significantly related to the degree of airways hyperreactivity and to the emotional response. These results suggest that asthmatic patients apt to respond to bronchoconstrictive suggestion with airways obstructions are characterized by highly hyperreactive airways. Responders also appear to be emotionally labile, although it is not yet clear whether the emotional response per se evokes airway obstruction or is merely a by-product of the occurrence of airway obstruction.

Adolescent↗
PubMed1977

Effect of bronkosol and its components on cardiopulmonary parameters in asthmatic patients.

Bronkosol and its components, isoetharine hydrochloride and phenylephrine hydrochloride, were compared in a double-blind randomized fashion for their effect on pulmonary and cardiovascular parameters in patients with reversible bronchospasm. Bronkosol and isoetharine produced significant bronchodilatation as measured by forced expiratory volume in one second (FEV), forced vital capacity (FVC), and mean forced expiratory flow during the middle half of the FVC (isovolume FEF 25% to 75%), and phenylephrine did not. There was no difference between Bronkosol and isoetharine in the degree or duration of bronchodilatation. Significantly more patients had to "discontinue" after 15 min on the day of testing with phenylephrine than with Bronkosol or isoetharine. Heart rate was not increased after Bronkosol or isoetharine, confirming its selective beta-2 action. The addition of phenylephrine to isoetharine had no beneficial effect on oxygen saturation. There was no significant difference between these drugs in systolic and diastolic blood pressure, pulse, or respiration. The results of this study cast doubt on the useful contribution of phenylephrine in Bronkosol.

Adolescent↗
PubMed1977

Dose-response effects of albuterol aerosol compared with isoproterenol and placebo aerosols: response to albuterol, isoproterenol, and placebo aerosols.

Albuterol aerosol was an effective bronchodilator as reflected by indices of pulmonary function obtained from spirometry and flow volume curves; Compared with isoproterenol, there were minimal side effects even at the highest doses, and bronchodilation lasted significantly longer. In addition albuterol was successfully used by a patient with idiopathic hypertrophic subaortic stenosis who was unable to tolerate isoproterenol, as well as by some patients with idiosyncratic responses to isoproterenol; A few patients appeared to derive little benefit from either albuterol or isoproterenol.

Adolescent↗
PubMed1977

Pulmonary infiltration with eosinophila. Recurrence in an asthmatic patient treated with beclomethasone dipropionate.

We present the findings in a young woman diagnosed as having pulmonary infiltration with eosinophilia and asthma who was treated with beclomethasone dipropionate. Although the aerosol corticosteroid controlled bronchospasm, it did not prevent recurrent pulmonary infiltration with eosinophilia when the patient was not receiving oral therapy with corticosteroids. It is postulated that when administered in the usual dosage, an adequate amount of beclomethasone dipropionate does not reach the alveoli or interstitium to prevent or resolve the process of pulmonary infiltration with eosinophilia. This case suggests that patients with pulmonary infiltration and eosinophilia who are treated with inhaled corticosteroids for asthma must be closely observed physiologically or roentgenographically for pulmonary infiltration. These patients may need to be protected from recurrent pulmonary infiltration by the concurrent oral use of corticosteroids.

Adult↗
PubMed1975

A comparison of methacholine and histamine inhalations in asthmatics.

Bronchial provocation tests using aerosolized serially diluted histamine and methacholine were given to nearly 200 asthmatics. Results were usually reproducible for a given patient and corticosteroids did not influence the procedures. Those patients who could tolerate high doses of methacholine were statistically the least severe asthmatics as measured by their discharge dose of corticosteroids. Reaginmediated asthmatics could not tolerate the higher doses of histamine. These tests help delineate subgroups of asthmatics and may have clinical usefulness since, when combined with other data, they differentiate pathogenetic mechanisms in some patients and suggest therapeutic approaches in others.

Administration, Intranasal↗