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Biomedical subjects

S R Braun

Publications and source records attributed to S R Braun.

At least 37 records · Page 2Linked to original sources
PubMed1984

Predictive clinical value of nutritional assessment factors in COPD.

Thirty-nine stable outpatients with moderate-to-severe chronic obstructive pulmonary disease (COPD) were studied prospectively to determine the predictive value of several nutritional factors on the clinical outcome. Physiologic evaluation including FEV1, diffusing capacity, PaO2, as well as nutritional evaluation including triceps skin fold (TSF), midarm muscle circumference, body weight percentage of standard, history of 5 percent weight loss in the year prior to clinic visit, and average daily caloric intake based on a three-day diet record were all done at the clinic visit. Hospitalization or death during the six months to one year following the initial evaluation were the clinical outcome factors evaluated. Five of the 16 patients (31 percent) needing hospitalization during that time had weight loss during the year prior to the initial evaluation, while eight out of the 23 (35 percent) not requiring hospitalization had weight loss. There was a significantly lower TSF percent standard (TSF%) in the subgroup who subsequently required hospitalization (p less than 0.05). Nonhospitalized patients with severe depletion of body fat (TSF% less than 60) at initial evaluation ingested significantly more calories per kilogram than the severely depleted patients requiring hospitalization in the next six to 12 months (p less than 0.05) suggesting a protective effect of increased caloric intake. Increased caloric intake did not improve mortality statistics.

Aged↗
PubMed1984

The prevalence and determinants of nutritional changes in chronic obstructive pulmonary disease.

Sixty outpatients with chronic obstructive pulmonary disease underwent nutritional, physiologic, and psychologic evaluation to determine the prevalence of nutritional depletion and the relationship to physiologic and psychologic factors. Weight loss was reported in 27 percent. Triceps skinfolds (TSF) were less than 60 percent of standard in 33 percent, none had mid-arm muscle circumference (MAMC) less than 60 percent of standard, and 5 percent had body weight (BW) less than 60 percent of ideal. Values for BW-percent of ideal, TSF-percent of standard, and MAMC-percent of standard were inversely correlated with the percent of estimated caloric expenditure ingested. Also, BW percent was correlated with FEV1 percent predicted, diffusion capacity percent predicted, and oxygen consumption/kg at rest (VO2 percent/kg). There were five variables that explained 62.6 percent of the variation in BW percent: VO2/kg at rest explained 22.2 percent; ventilatory equivalent 13.5 percent; PaCO2 9.8 percent; log vital capacity percent predicted 9.2 percent; and depression 7.8 percent. It is concluded that increased caloric utilization without adequate compensation in dietary intake is the reason for nutritional depletion.

Body Weight↗
PubMed1984

Improving the cough in patients with spinal cord injury.

Eleven patients with complete cervical and two patients with complete thoracic spinal cord injury were evaluated during both a forced vital capacity and cough. The mean peak flow was 3.74 +/- .171 L/sec during the forced vital capacity and 3.73 +/- 1.5 L/sec during the cough. Both values are low. Using the abdominal push assist during cough there is 13.8% improvement in peak flow which was significant. (p less than 0.01). This was not true with the forced vital capacity even though 9/10 subjects did improve. While peak flow is only one aspect of effective cough the improvement plus the increased intrathoracic pressure suggests this maneuver may be an effective modality in individuals with spinal cord injury.

Abdomen↗
PubMed1983

Importance of anti-lung antibody in farmer's lung disease.

The presence of anti-lung antibody was evaluated in 20 patients with farmer's lung disease. Antibody was found in 14. In patients with disease of less than five years' duration, there was no evidence of any significant differences in vital capacity, total lung capacity, diffusion capacity, and PaO2 between those with and without anti-lung antibody. However, in patients with disease of longer than five years' duration, the diffusion capacity was lower in the anti-lung antibody-positive group (p less than 0.05). The prevalence of abnormalities of vital capacity and diffusion capacity and fibrosis on chest roentgenograms was higher in those who had anti-lung antibody and disease of more than five years' duration. The study suggests that anti-lung antibody is present before permanent measurable physiologic abnormality occurs and may potentiate the pulmonary damage during subsequent episodes.

Adult↗
PubMed1982

Exercise training in patients with COPD.

Exercise is a useful therapeutic intervention for many COPD patients. The progressive stress test is the single most important means of clinical evaluation, although a thorough physical examination and preexercise ECG are also mandatory. The exercise program is prescribed according to duration of exercise and the maximal load reached by the patient during testing. As tolerance builds, exercise time, speed, and grade level are increased. Patients who exercise routinely should be watched carefully for problems, such as hypoxia, hypertension, abnormal right-sided cardiac function, and air tapping. Supplemental oxygen is required for those who are hypoxic.

Aged↗
PubMed1982

Chest wall and abdominal motion during exercise in patients with chronic obstructive pulmonary disease.

The study was undertaken to evaluate the role of coordination between the chest wall and abdomen during exercise in patients with chronic obstructive pulmonary disease (COPD). There were 40 patients with COPD and 6 control subjects with normal lung function who underwent a progressive exercise stress test on a treadmill ergometer. The normal subjects exhibited symmetrical motion between the chest wall and abdomen. Three separate patient groups were differentiated by differences in abdominal response to increasing exercise. Group I was similar to normal or showed an early abdominal peak. Group II had a prolonged outward motion of the abdomen, and Group III had an inward motion of the abdomen during inspiration. Resting pulmonary function (FEV1, VC, DL, RV/TLC) and exercise response (duration, O2 saturation, and maximal VO2) were progressively more abnormal from Group I through Group III. The addition of oxygen to Group III had no effect on the pattern observed. However, when 2 patients with a Group III response were reexercised flexed 45 degrees at the waist they no longer were completely paradoxical, they were less dyspneic, and they could walk farther. It is concluded that the chest-abdominal coordination is related to the underlying pulmonary abnormality, and the paradoxical pattern seen in some patients (Group III) is associated with very severe exercise limitation.

Abdomen↗
PubMed1982

Oxygen saturation during sleep in patients with spinal cord injury.

Sleep is associated with moderate or severe arterial desaturation in many disease states. This study was undertaken to evaluate whether hypoxemia during sleep was a significant problem in the spinal cord injured patient. Eleven patients with cervical or thoracic cord injury who had significant respiratory deficiency were evaluated. The mean age was 29.2 +/- 14. Vital capacity (VC) for the group revealed a mean of 43.1 +/- 18.1% of predicted, inspiratory capacity (IC) was 51.6 +/- 20.2% of predicted, and expiratory reserve volume (ERV) was 23.6 +/- 24.7% of predicted. In eight patients blood gases revealed a mean PO2 of 81.5 +/- 8.4 mmHg and PCO2 of 38.9 +/- 3.4 mmHg. Sleep screening studies were done using the Hewlett-Packard ear oximeter. They were studied for a mean of 2.6 +/- 1.1 hours. The initial O2 saturation was 96.6 +/- 1.6% and dropped to a mean of 90.6 +/- 6.4%. Only 1/11 reached saturation to less than 85% and 2/11 reached levels lower than 90%. Only age was significantly correlated with amount of desaturation (p less than .01). The level of the lesion, and % predicted ERV were not. One of the two patients who had hypoxemia with sleep had unilateral diaphragmatic paralysis. It is concluded that young quadriplegic patients with normal diaphragmatic function have no severe desaturation during sleep, but older patients and patients with some diaphragmatic dysfunction should be screened for sleep desaturation.

Adolescent↗
PubMed1980

Serologically detectable HLA-A, B, and C loci antigens in farmer's lung disease.

The frequency of serologically detectable (SD) HLA-A, B, and C loci antigens in subjects with farmer's lung disease (N = 100) was compared with that of age- and sex-matched normal normal farmers with no precipitating antibodies to extracts of thermophilic actinomycetes. A subset of the farming population with antibodies to the thermophilic actinomycetes and no evidence of clinical disease (N = 55) was also agae- and sex-matched to the farmer's lung disease population. No significant associations between any of the SD HLA antigens tested and farmer's lung disease were found in the study. The data demonstrated that there was no association between SD HLA antigens and farmer's lung disease in random populations.

Actinomycetales↗
PubMed1979

Farmer's lung disease: long-term clinical and physiologic outcome.

To determine the long-term effects of farmer's lung disease and the factors influening the outcome, 141 patients with farmer's lung disease were evaluated. At the time of the last follow-up, 29 patients had died and 92 (mean age, 54 years) were studied clinically, physiologically, and radiologically. The mean length of disease was 14.8 years (range, 2.25 to 40 years). Symptoms at the time of the last follow-up included complaints of cough (33 per cent of the patients), breathlessness while walking on the level (20 per cent), breathlessness on minor exertion (14 per cent), and breathlessness while at rest (3 per cent). Twenty-eight per cent had chronic bronchitis. Thirty-nine per cent (36 of 92 patients) had some evidence of interstitial changes on roentgenogram. Abnormal vital capacity was present in 11 patients (12 per cent), abnormal total lung capacity in 11 (12 per cent), and abnormal CO difussing capacity in 27 (30 per cent). The ratio of one-sec forced expiratory volume to forced vital capacity was abnormal in 23 patients (25 per cent), and arterial PO2 was abnormal in 39 (40 per cent). Patients with a history of 5 or more symptomatic recurrences had significantly smaller values (P less than 0.05) for vital capacity, total lung capacity, and CO diffusing capacity than did those patients with less than 5 recurrences. There was no significant relation between continued farming or length of disease and lung function. On the basis of several measurements of airway function, 34 of the patients (58 per cent) were found to have some abnormality, It is concluded that symptomatic recurrences may be the most important factor in determining the danger of progressive disease. Persistently positive precipitins were correlated with decreased CO diffusing capacity. Moreover, airway disease is relatively uncommon but does occur, and in some cases it is a possible consequence of farmer's lung disease.

Adult↗
PubMed1979

Pulmonary abnormalities in art glassblowers.

Art glassblowing is a profession bringing the lung in close contact with many potential hazards. Forty-seven art glassblowers with a mean age of 34.5 years answered a questionnaire and had pulmonary function studies performed. While this was generally a young, healthy population, 21% had "usual cough" and 31% had wheezing. Pulmonary functions were most often normal. However, using multiple linear regression analysis, the functions associated with volume, VC and FEV1 showed a significant drop with increase in the total lifetime hours exposed to glassblowing. Both the presence of a cough and the production of phlegm were related to hours of exposure. Thus it seems there may be some unknown toxic effect of art glassblowing which in the future may prove to be hazardous to health.

Adult↗
PubMed1978

Pre- and postoperative pulmonary function abnormalities in coronary artery revascularization surgery.

Pulmonary function studies were conducted one to two days prior to, two weeks after, and an average of 116 days after coronary artery revascularization surgery. Preoperation it was found that 11 of 19 patients had mild to moderate obstruction, 8 of 17 had diffusing capacity less than 80 percent of predicted, and 9 of 17 had mild hypoxemia. Many of these abnormalities seemed related to smoking. After surgery, significant reductions in volumes, diffusion and PaO2 were found at two weeks. By the last study, there was improvement in volumes and diffusion, but they remained significantly reduced in comparison to preoperative levels. Arterial oxygen tension (PaO2) had returned to preoperative levels. Correction of diffusion for volume showed there to be no change in any of the study periods suggesting chest wall alteration is a major component of the abnormality. It is concluded that close monitoring of pulmonary function is indicated before and after operation in this patient population even if the patient is asymptomatic.

Carbon Monoxide↗
PubMed1975

Low-dose radiation pneumonitis.

A case demonstrating fulminant radiation pneumonitis following a course of prophylactic whole lung irradiation at doses below 2000 rads, resulting in death, is presented. The importance of predisposing factors and the suspected "sensitizing" factor in this case are discussed.

Dactinomycin↗
PubMed1970

Evaluation of the renal toxicity of heme proteins and their derivatives: a role in the genesis of acute tubule necrosis.

This investigation studies the toxicity of heme proteins and/or their break-down products on renal function. Heme proteinemia precedes acute tubule necrosis at a frequency great enough to suggest a causal relationship between the two events. Physiological and metabolic functions of kidney slices are investigated in several models of acute tubule necrosis. Organic acid and organic base transport is depressed earliest. These alterations in tubule function cannot be explained by ischemia or obstruction alone. Heme proteinemia in rats or incubation of renal slices in medium containing heme proteins yields several interesting observations. Neither in vivo or in vitro do hemoglobin and methemoglobin alone produce a depressive effect on the transport systems studied. However, parallel to many clinical situations, when such secondary insults as hypoxia and elevated ammonia concentrations are included in the experimental design, transport functions are depressed. Ferrihemate, a molecule smaller than hemoglobin or methemoglobin, depresses transport function without secondary insults. From these studies it is concluded that heme proteins play a role in tubule dysfunction seen in acute tubule necrosis. A model is presented that collates these data with other factors known to play a part in the pathogenesis of this renal syndrome.

Acute Kidney Injury↗