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At least 361 records · Page 20Linked to original sources
PubMed1993

Continuous spirometry for detection of double-lumen endobronchial tube displacement.

Flow-volume and pressure-volume loops were measured with continuous spirometry in 49 patients in whom the trachea was intubated "blindly" with a double-lumen endobronchial tube for thoracic surgery. Nineteen endobronchial tubes were malpositioned by fibreoptic bronchoscopic criteria; 63% of these were suspected because of the configuration of the spirometric loops. During positioning of the patient and during operation, 34.7% of the endobronchial tubes migrated from the initially correct or corrected position. The secondary displacements were identified by abnormal loop configurations and confirmed with fibreoptic bronchoscopy. Continuous spirometric monitoring is helpful in detecting endobronchial tube displacement during intubation and surgery.

Adolescent↗
PubMedDate not supplied

A device for sampling of human alveolar breath for the measurement of expired volatile organic compounds.

This report describes the development of a portable spirometer capable of collecting primarily alveolar breath into 1.8-L canisters for subsequent gas chromatographic/mass spectrometric (GC/MS) analysis. Based on CO2 measurements, greater than 97% of the breath collected is alveolar in origin. Sample collection takes place in approximately two minutes. Clean air for inhalation is provided by two organic vapor respirator cartridges. Studies of the breakthrough volume of test compounds at both the 5- and 50-micrograms/m3 levels indicate that each cartridge filter can be used to sample over 300 L of air and that this volume is not altered by intermittent use and storage of the filter for up to five days. In experiments designed to mimic human breathing, recoveries of test compounds through the device at the 5-mu/m3 level ranged from 87 to 112%. Essentially no volatile organic compound (VOC) memory (i.e., adsorption carryover by the device) was measured at the 50-micrograms/m3 level. The data suggest that the device can be used successfully for organic compounds with volatilities greater than that of p-dichlorobenzene.

Air Pollutants↗
PubMedDate not supplied

Evaluation of early airway disease in smokers: cost effectiveness of pulmonary function testing.

We studied 73 young adults who were presently cigarette smokers to evaluate whether the identification of abnormalities in pulmonary function tests had a detectable influence on modification of smoking habits. Utilizing rate schedules for these tests presently applicable in Rochester, New York, we determined the potential cost to these subjects and community relative to the number of subjects who stopped smoking as a result of test findings. Subjects were evaluated by questionnaire and function testing including spirometry, flow-volume curves, body plethysmography and single breath nitrogen washout test (SBN2). Functional abnormalities were present in 75% of subjects screened. The SBN2 test was most sensitive, identifying 97% of subjects with any abnormality. The presence of common respiratory symptoms was found to be highly predictive of test abnormalities. Subjects were informed of results and counseled. At six-month follow-up, 7% of subjects with abnormal test results had stopped smoking. Utilizing even our most cost-effective test, the SBN2, it would cost +1,392 for each "benefit" defined as one subject not smoking for six months. Application of these screening techniques is unlikely to be effective in altering smoking habits in the absence of continued physician support.

Adult↗
PubMed2002

Are antihistamines useful in managing asthma?

There continues to be a great deal of interest in the anti-asthmatic role of antihistamines. Antihistamines have recently been shown to have anti-inflammatory properties that are more extensive than simply the blocking of histamine receptors. For example, new evidence suggests that the suppression of cell adhesion molecule expression occurs with these drugs. The anti-inflammatory and anti-asthmatic effects of antihistamines have been evaluated in patients with both allergic asthma and rhinitis, given the established association between allergic inflammation of the upper and lower airways, with evidence to suggest that antihistamines have clinically relevant anti-asthmatic properties. As well as conferring benefits in asthma symptom control and the measurement of lung function, studies assessing the effect of histamine receptor antagonists on bronchial hyperresponsiveness suggest that there is bronchoprotection during both methacholine and mannitol challenges. Recently, there has also been considerable interest in the effect of combining an antihistamine with a leukotriene receptor antagonist. This combination has an anti-asthmatic effect that is greater than that of either drug given alone and may be comparable to inhaled corticosteroid therapy.

Acetates↗
PubMed2005

Effect of a very late antigen-4 receptor antagonist on allergen-induced airway responses and inflammation in asthma.

BACKGROUND: Very late antigen-4 (VLA(4)) plays a key role in the recruitment of eosinophils in allergic responses in animal studies. OBJECTIVE: We investigated whether pretreatment with multiple doses of a VLA(4) receptor antagonist, HMR 1031, protects against allergen-induced airway responses and airway inflammation in humans. METHODS: Fourteen asthmatics (7F/7M), 18-49 years, PC(20) forced expiratory volume in 1 s (FEV(1)) methacholine (M) (<8 mg/mL; FEV(1) 82.3-116.1% predicted) with dual responses to inhaled allergen participated in a double-blind, placebo-controlled, cross-over study. Each treatment period consisted of 9 days, separated by >or=2 weeks. Exhaled nitric oxide (eNO), PC(20)FEV(1)(M) and hypertonic saline-induced sputum was obtained on Days 1, 7 and 9. Subjects inhaled HMR 1031 (20 mg b.i.d.) or placebo (P) on Days 1--8. On Day 8, an allergen bronchoprovocation test was performed, the airway response was measured by FEV(1), and expressed as %fall from baseline. Data from 12 evaluable subjects are presented here. RESULTS: Both treatments were well tolerated. There was no significant difference between HMR 1031 and P in the early asthamatic response: mean AUC (0-3 h)+/-SEM (%fall h): 26.01+/-4.26 and 17.41+/-4.26, respectively (P=0.18), nor in the late response: mean AUC (3-9 h)+/-SEM (%fall h): 97.09+/-8.63 and 97.61+/-8.63, respectively, P=0.97. This corresponded to the absence of significant allergen-induced changes in PC(20)FEV(1)(M), eNO, sputum eosinophils and soluble inflammation markers between both treatment periods. CONCLUSIONS: Treatment with multiple inhaled doses of the VLA(4) antagonist, HMR 1031, did not result in detectable protection against allergen-induced airway responses or airway inflammation in asthma.

Administration, Inhalation↗
PubMed1996

Significance of IL-1beta and IL-1 receptor antagonist (IL-1Ra) in bronchoalveolar lavage fluid (BALF) in patients with diffuse panbronchiolitis (DPB).

We evaluated the effect of erythromycin therapy on pulmonary function tests and the airway inflammatory response of patients with DPB. The number of neutrophils in BALF obtained from DPB patients was significantly higher than that of healthy volunteers. Treatment with erythromycin (600 mg/day for 12.9+/-9.5 months (mean +/- s.d.)) significantly reduced the total number of cells and neutrophils in the airway, and significantly improved pulmonary function tests. The levels of IL-1beta and IL-8 were significantly higher in DPB compared with healthy volunteers (P<0.05, P<0.05, respectively). IL-1Ra in patients is considered to have a weak inhibitory activity for IL-1beta, with approximately five-fold concentration of IL-1beta compared with that in healthy volunteers (approx. nine-fold concentration of IL-1beta). Erythromycin therapy significantly reduced these cytokines to levels comparable to those of healthy volunteers, and produced a trend toward reduction in the level of IL-1Ra in BALF. The level of IL-1beta correlated significantly with the concentration of neutrophils in BALF (r=0.72, P<0.01), as well as with the level of IL-1Ra (r=0.688, P<0.05) and IL-8 (r=0.653, P<0.05). A nearly significant or significant correlation was observed between the concentration of neutrophils and levels of IL-1Ra or IL-8 in BALF (r=0.526, P=0.053 or r=0.776, P<0.01, respectively). There was also a significant relationship between FEV(1) and the concentration of neutrophils in BALF (r=0.524, P<0.05). Our results suggest that the relative amounts of IL-1beta and IL-1Ra or IL-8 may contribute, at least in part, to the neutrophil-mediated chronic airway inflammation in patients with chronic airway disease, and long-term erythromycin therapy may down-regulate the vigorous cycle between the cytokine network and neutrophil accumulation, with resultant reduction of neutrophil-mediated inflammatory response.

Adult↗