Spirometry in healthy adult males in Botswana.
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Non-smoking patients (n:25) with stable symptomatic asthma were investigated with regard to the pulmonary effects of N-acetylcysteine (NAC), peroral dose 200 mg three times daily, in a crossover double-blind study. They were studied once a week for 9 weeks, with a run-in period and periods with NAC and placebo (3 weeks each). Functional residual capacity and specific airway resistance were 19 and 53% larger, respectively, and forced expiratory variables (FEV%, MEF25) were 20 and 53% lower than reference values. Distribution of ventilation-perfusion ratios (VA/Q), assessed by multiple inert gas elimination technique with peripheral venous sampling, was abnormal, although arterial PO2 and PCO2 were within normal limits. NAC medication had no effect on any spirometric, lung mechanic or gas exchange variable, nor on the frequency of pulmonary symptoms.
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A study of reproducibility and patterns of change in 7 control bicycle and respiration ergometric tests in 14 coronary anginal patients demonstrated consistent change in stress tolerance and gaseous exchange: a rapid adaptation period (first 2 or 4 tests) when stress tolerance, ventilation and maximum oxygen uptake increased significantly, and a slow adaptation period (most later tests) when tolerance grew gradually, while oxygen consumption first dropped and then stabilized above the baseline. Accidental stress tolerance variation exceeded 1 step in 20% of patients, obviously due to their inability to adapt to the testing procedure. It is suggested that pharmacodynamic studies of antianginal drugs, making use of bicycle and respiration ergometry can only be conducted in the slow adaptation period, provided the individuals showing wide spontaneous variability are excluded from the study.
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