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Biomedical subjects

T Todisco

Publications and source records attributed to T Todisco.

At least 55 records · Page 3Linked to original sources

Effect of N-acetylcysteine in subjects with slow pulmonary mucociliary clearance.

There is significant evidence that in the general population there are subjects either with fast or slow pulmonary mucociliary clearance rates. At the moment we do not know the physiological importance of such finding. Slow clearers should be regarded as a subpopulation at risk for bronchopulmonary diseases. Therefore, it would be of considerable interest if their mucociliary function could be stimulated by drugs for preventive purposes. Twelve apparently healthy subjects with slow mucociliary clearance rate, selected in an epidemiologic survey in a non-smokers population were given 0.6 g oral N-acetylcysteine/day/60 days in a double-blind cross-over randomized study. After treatment their mucociliary clearance rates increased by about 35% as compared with baseline values, and returned to pre-treatment values after the washout period. Subjects were unresponsive to placebo treatment. It would seem that slow clearers are protected against lung aggressions by prevention and/or mucus-active drugs.

Acetylcysteine↗

Laryngeal cancer: long-term follow-up of respiratory functions after laryngectomy.

Pulmonary function of 31 heavy smokers with laryngeal cancer was evaluated before and during the 1st year after total (n = 21) and conservative (n = 10) laryngectomy. 2 of them died because of recurrences, 1 for bronchopulmonary complications. Long-lasting hoarseness was the only presenting symptom in all patients. Preoperative lung function data and mucociliary clearance were consistent with a coexisting chronic obstructive lung disease in most subjects and was probably due to smoking. No differences were observed comparing pre- and postoperative data in the 10 conservative laryngectomy patients. On the contrary, the total-laryngectomy patients showed a progressive impairment of bronchial obstruction and bacteriological infection of the trachea during the 1st year after the operation. An impressive increase in mucociliary clearance rates has been observed 2 months after total laryngectomy during the postoperative hypersecretory phase. the obtained data allow us to hypothesize that when clinical conditions of laryngectomized patients in whom local or distant recurrences have been excluded deteriorate, this is related to a progressive bronchial obstruction at any level of the bronchial tree due to descending bacterial infection of the airways. To our knowledge this is the only work demonstrating that total laryngectomized patients need a complete pre- and postoperative evaluation of lung function, airway dynamics, mucociliary function and tracheal bacteriology for long-term prognosis and treatment.

Aged↗

Ciliary ultrastructure and nasal mucociliary clearance in chronic and allergic rhinitis.

The authors have studied nasal specimens collected by means of nasal brushing in eight patients affected by allergic rhinitis and in eight affected by chronic rhinitis, while in other four patients affected by allergic rhinitis a lower turbinate biopsy was performed. All twenty patients showed an increased mucociliary clearance time and a reduced velocity regardless to the pathology during a previously performed saccharin test. Different ultrastructural alterations have been observed, such as: both central and peripheral microtubules alterations; absence of dynein arms; absence of radial spokes; ciliary membrane alterations; "compound" cilia; disorientation of central tubules. These alterations have been observed variously associated in both allergic and chronic rhinitis patients groups. Basing on their data, the authors state that ciliary abnormalities cannot be considered specific of a particular pathology but they can coexist in different situations. They also think that the mucociliary clearance parameters determination represents the only method to evaluate, even if in an indirect fashion, the percentage of ciliary abnormalities, as no direct quantitative method has been described. Ciliary ultrastructural alterations can be of diagnostic value only if associated with mucociliary clearance time and velocity determination.

Cilia↗

Exhausted platelets in chronic obstructive pulmonary disease.

Experimental and clinical evidence has suggested that vasoconstrictor substances released from activated platelets could play a role in mediating the pulmonary hypertension of hypoxemic patients with chronic obstructive pulmonary disease. In order to extend previous knowledge on platelet function in such patients, platelet production of malondialdehyde and plasma levels of beta-thromboglobulin were assayed in 12 patients before and after a short-term treatment with the platelet-inhibiting drug, dipyridamole. The impairment of platelet malondialdehyde generation concomitant with the increase of plasma levels of beta-thromboglobulin suggests that in patients with chronic obstructive pulmonary disease, blood platelets undergo chronic overstimulation and become exhausted. Dipyridamole can antagonize this platelet activation and thus may prove useful in reducing the pulmonary hypertension of these patients.

Aged↗

Changes in respiratory function in disorders of the thoracic cage. With special reference to the ventilatory mechanism and the regulation in scoliosis.

After describing the clinical and functional effects of pathological changes in the thoracic cage ("mechanical syndrome" and "neuromuscular syndrome"), the authors discuss the disorders of respiratory function observed in a group of patients with poliomyelitic scoliosis. The aim was to establish the type and nature of these changes with a view to clarifying certain pathogenetic aspects. Two factors suggest that the altered geometry of the thoracic cage in scoliosis is responsible for the mechanical inefficiency of the thoracopulmonary apparatus, namely: 1. changes in respiratory function, since there was a strict correlation between the severity of the scoliosis and the degree of change in certain indices of respiratory function (vital capacity, maximum expiratory volume per second, maximum ventilation per minute); 2. changes in the regulation of ventilation, indicated by: a) good correlation between the ventilatory response to CO2 and the severity of the anatomical lesion; b) a reduction in the occlusion pressure, which is regarded as the pressure available to produce ventilation.

Adolescent↗

The oto-respiratory reflex.

The oto-respiratory (O-R) reflex consists of the cough reflex produced by direct mechanical stimulation of the deep portion of the posterior wall of the external auditory meatus. Because the efferent pathways are different for coughing and bronchoconstriction, some subjects can have an O-R reflex (coughing) without the oto-bronchial (O-B) reflex (bronchoconstriction). This study also states that on stimulation of the mechanoreceptors in the external ear, 20 out of 125 normal subjects (16%) presented with the O-R reflex; in 7 of the 20 subjects, bronchoconstriction ('responders') was also documented (O-B reflex). The O-B reflex was particularly evident in 3 of the 7 responders. These normal subjects referred a family history of atopy. Only through animal experimentation can the exact nervous pathway of the O-R reflex be defined. From the physiological point of view, it is difficult to imagine how this 'irritative' reflex could have a protective function against auditory aggression.

Acoustic Stimulation↗

[Bronchial mucociliary function. A new diagnostic technic].

To study mucociliary clearance of central airways we used a recently described method consisting of the inhalation of 99mTc labeled autologous spherocytes aerosol. In 3 of 8 normal non smoking subjects, an abnormally low rate of m.c.c. was observed. The m.c.c. rate was also very low in 2 of 6 patients with bronchial cr. who never smoked. These observations provide considerable evidence that those non smoking subjects presenting with low mucociliary clearance may be regarded as "high risk subjects" for broncho-pulmonary diseases. The good central deposition pattern of the inhaled spherocytes may provide, in very ill patients, a non-invasive visualization of the central airways.

Adult↗

Thoracoabdominal mechanics in dyspnea.

80 severely ill patients with various lung diseases were studied in order to relate the feeling of breathlessness at rest with the severity of lung mechanical impairment. Moderate to severe dyspnea (grade 2 to grade 3) at rest was present only in 46 of 80 patients (57%) with severe lung disease. The prevalence of breathlessness at rest among the various lung diseases was as follows: 80% in acute bronchial asthma, 70% acute interstitial pneumonia, 50% in diffuse lung fibrosis and 30% in chronic obstructive lung disease. None of the 10 X 9 measured or calculated parameters (IVC, FEV1, FEV1/IVC X 100, TGV, RV, RV/TLC X 100, TLC, MMEF, CC/TLC X 100, SGaw I-E, FV curve indices, quasi-static transpulmonary pressure, dynamic compliance, gastric pressure and RR) seemed to characterize the patients presenting with severe dyspnea. High breathing frequency, low SCdyn and a near negative abdominal pressure consistently identified a small group of subjects with severe dyspnea at rest, regardless of the underlying lung disease.

Abdomen↗

Pulmonary function studies in adenoid hypertrophy.

Tests of pulmonary function were performed on children with severe adenoid hypertrophy, before and one month after adenoidectomy. Five types of subjects were selected: (1) normal; (2) cases with isolated increase of residual volume (RV); (3) supernormal type with increased RV; (4) obstructive type of ventilatory defect, and (5) restrictive type of ventilatory defect. Following adenoidectomy there is an objective evidence of improved pulmonary function. The data suggest that 65.7% of clinically normal children with adenoid hypertrophy show pulmonary function abnormalities.

Adenoidectomy↗

Reference values for flow-volume curves during forced vital capacity breathing in male children and young adults.

127 non-smoking males aged 8-25 years were studied to obtain normal reference values for flow-volume (FV) curves. Analysis of variance (ANOVA) showed significant differences for all indices (PEF; MEF 25%, 50%, 75%; PIF; MIF 25%, 50%, 75%) in the first three age-groups (8-10, 11-13 and 14-16 years); the three last groups (17-19, 20-22 and 23-25 years) did not show any significant variation of FV curve data. Male subjects older than 16 years showed a negative correlation between maximal expiratory flow at 50% of forced vital capacity and standing height. Multiple regression equations relating FV curve indices to age and anthropometric data are calculated.

Adolescent↗