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Biomedical subjects

T C Medici

Publications and source records attributed to T C Medici.

96 records · Page 6Linked to original sources

Cell vs. noncell airway temporal response in rats exposed to sulfur dioxide.

A modification of the sulfur dioxide (SO2)-exposed rat model proposed by Reid for the study of chronic bronchitis was employed to evaluate mucus retention and cytologic changes. Rats were exposed to from 600 to 700 ppm of SO2 for 3 hours per day, and groups were examined after 0, 9, 18, and 30 hours of cumulative exposure. Tracheal mucus retention and statistically significant increases (two- to four-fold) in the amount of solid material (cellular and mucus) recovered by bronchia lavage developed as a function of exposure time. The increase in bronchial solids was primarily due to inflammatory cells. The goblet cell population in secondary bronchi declined initially, with a significant increase after 30 hours of exposure (P less than .001). The cytologic data provide additional support to Reid's suggestion that the SO2-exposed rat may be considered as a chronic bronchitis model.

Animals↗

Comparison of trimethoprim-sulfamethoxazole with ampicillin in acute infectious exacerbations of chronic bronchitis: a double-blind crossover study.

Two separate acute bacterial exacerbations of chronic bronchitis or chronic asthmatic bronchitis were treated in 20 patients in a double-blind crossover study. One course of treatment consisted of 320 mg of trimethoprim (TMP) plus, 1,600 mg of sulfamethoxazole (SMZ) daily and the other of 2 g of ampicillin daily; each drug was given for 14 days. Patients were observed initially, twice a week during therapy, and weekly after therapy. Observations that were recorded included graded chest symptoms and physical findings, vital signs, pulmonary function, hematologic parameters, and objective sputum measurements (daily volume, purulence, differential quantitative cytology, quantitative bacterial counts, physical properties, levels of lactate dehydrogenase with its isoenzymes, levels of myeloperoxidase, and presence of deoxyribonucleic acid fibers). Both antibiotic regimens were effective in resolving these acute bacterial exacerbations. Paired t-test analysis revealed few and minor differences between TMP-SMZ and ampicillin during therapy, although three patients did not complete TMP-SMZ therapy because of adverse reactions. However, the period between the two bacterial exacerbations was significantly longer after ampicillin therapy. Innovative in this investigation are the study design and the objective quantitative measurements of inflammatory response and bacterial populations in sputum.

Acute Disease↗

Does eosinophil cationic protein in sputum and blood reflect bronchial inflammation and obstruction in allergic asthmatics?

In the assessment of asthma severity and monitoring of asthma drug therapy, eosinophils and eosinophil cationic protein (ECP) have been identified in blood but rarely in sputum. The aim of our study was to determine if ECP concentrations in blood and sputum reflect bronchial inflammation and obstruction in allergic asthmatics and if inhaled steroids influence this relationship. We carried out a descriptive, cross-sectional study of 42 allergic asthmatic outpatients from a respiratory medicine department, of whom 22 were on beta 2-adrenergic agonists only and 20 were treated with low doses of inhaled steroids. Spirometry and methacholine challenge were performed and eosinophils and ECP values in induced sputum and blood were determined. The age and FEV1 were similar in both groups. It was found that in patients receiving inhaled steroids, the methacholine PD20 was higher than in patients on beta 2-adrenergic agonists only. However, there were no significant differences in serum and sputum ECP between the groups (median 14.5 micrograms/l vs. 17.2 micrograms/l and 235 micrograms/l vs. 301 micrograms/l, respectively). In patients not receiving steroids, sputum ECP correlated positively with eosinophils in sputum (r = 0.61, p < 0.01) and inversely with FEV1 (r = -0.43, p < 0.05). Serum ECP correlated with blood eosinophils and methacholine PD20. In patients treated with inhaled steroids most correlations were no longer significant. We concluded that ECP in sputum, rather than in blood, seems to reflect both eosinophilic inflammation and bronchial obstruction in asthmatics not receiving inhaled steroids. Asthmatics on low doses of inhaled steroids had increased ECP levels in sputum and serum, indicating persistent eosinophilic inflammation of the airways.

Adrenergic beta-Agonists↗

No demonstrable effect of sobrerol as an expectorant in patients with stable chronic bronchial diseases.

A randomized double-blind cross-over study compared the clinical effectiveness of a 14-day treatment with 400 mg X day-1 of sobrerol and placebo in 23 patients with stable chronic bronchial disease. During the seven week trial, subjective symptoms and findings (cough frequency and severity, difficulty in raising sputum, dyspnoea) were recorded, pulmonary function tests performed and sputum physical characteristics (24-h sputum volume, purulence, cell concentration, protein, sputum dry weight and "apparent" viscosity) determined on a regular basis. Side-effects were closely monitored. Both subjective assessment of overall clinical efficacy as well as statistical analysis of the above mentioned factors failed to show any significant advantage of sobrerol to placebo--except for a transient decrease of the 24-h sputum volume. Sobrerol appears to be another example of an expectorant lacking evidence of clinical effectiveness in the management of chronic bronchial secretions.

Bronchial Diseases↗