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PubMedDate not supplied

Does the use of the combined oral contraceptive pill cause changes in the nasal physiology in young women?

BACKGROUND: Changes in nasal physiology have been observed during pregnancy and the menstrual cycle. The role of female hormones in these changes is unclear. The aim is to investigate the effect of the modern combined oral contraceptive pill (COCP). METHODS: Eleven women were recruited from a family planning clinic. Anterior rhinoscopy, peak inspiratory flow rate, acoustic rhinometry, anterior rhinomanometry, mucociliary clearance time, and rhinitis quality-of-life questionnaire (RQLQ) scores were recorded at days 1 and 14 pre- and post-COCP. RESULTS: Increased nasal obstruction midcycle pre-COCP, with significant differences for anterior rhinoscopy (p = 0.001) and peak inspiratory flow rate (p = 0.022), was found. No statistical difference was shown between pre- and post-COCP results apart from day 1 anterior rhinoscopy findings (p = 0.05). CONCLUSION: The modern COCP has no significant effect on nasal physiology.

Administration, Intranasal↗
PubMed2006

Tutorial on maximum inspiratory and expiratory mouth pressures in individuals with idiopathic Parkinson disease (IPD) and the preliminary results of an expiratory muscle strength training program.

Respiratory symptoms are recognized as sequelae of motor dysfunction in idiopathic Parkinson's disease (IPD) and these symptoms have the potential to cause problems with swallow, cough, voice and speech. Specifically, maneuvers that require rapid activation and coordination of upper airway and chest wall musculature become progressively impaired as motor dysfunction progresses during the natural course of the disease. This study reports on the maximum inspiratory and expiratory pressures produced by 28 participants (average age 64) diagnosed with moderate to severe IPD (average stage 2.5 with a range of 2.0-3.0). All measures were collected during the "medication on" state. Outcomes of a specific respiratory muscle strength training technique for improving maximum expiratory pressure are reported for three of the patients in this study. Techniques that focus on strengthening the respiratory muscles in patients with IPD (other than with low load breathing exercises), have not been previously reported. The results of this pilot study demonstrate that respiratory muscle weakness may be an important factor in the respiratory complications in IPD and that respiratory muscle strength training has the potential to improve expiratory muscle strength for this population. This improvement has the potential to positively impact high forced respiratory activities, such as forced breathing maneuvers, swallow, cough and speech functions that require greater magnitude and duration of expiration.

Adult↗
PubMedDate not supplied

[Use of a Transtec transdermal therapeutic system of buprenorphine for analgesia in the early periods after cardiosurgical operations].

The analgesic effect of a transdermal therapeutic system (TTS) (Transtec) of buprenorphine was evaluated for analgesia in cardiosurgical patients in the early postoperative period. Before sternotomy, Transtec was applied to the skin of the shoulder in 30 patients operated on the heart under extracorporeal circulation. A control group comprised 20 patients receiving the nonsteroidal anti-inflammatory agent Xifocam in an intravenous dose of 8 mg twice daily. The first injection of Xefocam was made 1.5-2 hours prior to tracheal extubation. With the use of Transtec, the degree of pain was 1.58 scores by the five-score scale at the moment of tracheal extubation; it reduced to 1 score 16 hours after extrubation; it was 0.76 scores by the end of the first day, less than 0.5 score by the middle of day 2, reduced to zero by the end of day 3. By the moment of tracheal extubation, the degree of pain in patients receiving Xefocam was 3 scores; by the end of 24 hours, it reduced to 2 scores and remained the same by the end of day 3. During more effective analgesia with Transtec, inspiratory lung capacity was much higher than during that with Xefocam. The difference in the mean values of this parameter was 510 to 830 ml (p < 0.05) at the stages of the investigation. The findings confirmed a rather long (72-hour) continuous and steady analgesic effect of Transtec TTS. Due to the analgesic effect of Transtec, there was a significant improvement of respiratory function in patients after cardiothoracic operations.

Administration, Cutaneous↗
PubMedDate not supplied

Artificial respiration in the anesthetized horse using bilateral, percutaneous, cervical phrenic-nerve stimulation with needle electrodes: a preliminary report.

In this preliminary study, artificial respiration was produced in four anesthetized horses using trains of stimuli applied to long needle electrodes inserted bilaterally at the base of the neck. The needles were insulated to within 1 cm of the tips. The frequency of the stimuli (0.1 msec) was 35/sec and the train duration (duration of inspiration) was 1 sec. Inspired volume increased with increasing stimulus intensity. In two animals, inspired volumes of 6 liters were achieved. In another animal 4.5 liters was achieved and in another, 2.5 liters. This lower value probably represented less-than-optimal electrode placement. Artificial percutaneous electrophrenic respiration was maintained for half an hour in every animal using a minute volume equivalent to that when breathing spontaneously.

Animals↗
PubMed1991

Postural variation of the maximum inspiratory and expiratory pressures in obese patients.

Evaluating whether weight is a factor responsible for the decrease of muscle force in the supine position with respect to the upright and sitting positions, we measured maximum inspiratory and expiratory pressures (PImax and PEmax) in these postures in ten obese patients (age 38.7 +/- 9.1 years; height 168.7 +/- 8.9 cm; and weight 139.3 +/- 28.4 kg) and ten normal control subjects (age 38.4 +/- 8.2 years; height 169.3 +/- 7.9 cm and weight 66.9 +/- 11.9 kg.) In both study groups, PImax and PEmax values decreased in the supine posture with respect to upright and sitting positions. Differences between pressures in the various postures were similar for both groups with the exception of PEmax in obese females. The decrease in PEmax values from the sitting to supine positions was greater in obese than control females. Weight, sex and postural changes can influence the generation of maximal expiratory force.

Adult↗
PubMed1991

Peak nasal inspiratory flow and Wright peak flow: a comparison of their reproducibility.

The measurement of peak nasal inspiratory flow (PNIF) is a rapid, convenient, and objective way to assess nasal patency. It is used much less commonly, however, than Wright Peak Flow (WPF), in part, because of concerns about its reproducibility. In order to compare the reproducibility of PNIF with WPF, we obtained multiple measurements of both flows in each of ten healthy, nonsmoking, trained subjects five times throughout the same day and daily throughout the same week. Mean PNIFs (L/min) were 140 immediately after arising, 170 at breakfast time, 183 at lunch time, 170 at dinner time, and 161 at bedtime. Corresponding mean WPFs were 528, 528, 535, 535 and 531 L/min. Peak nasal inspiratory flow coefficients of variation representing minute to minute, hour to hour, and day to day variation were 9.8, 13.5, and 9.7, respectively. Corresponding coefficients of variation with WPF, 2.4, 1.9, and 2.3, were significantly lower. Variability of PNIF and WPF did not increase with increased time spans, suggesting that variation in airway size is less important than variation in technique. Responses to intranasal oxymetazoline, as determined by changes in PNIF and changes in subjective assessments of nasal patency, were then evaluated in ten patients with nasal obstruction. These persons noted a mean subjective improvement of 68% (P = .0002) and demonstrated a mean objective improvement of 21% (P = .05). Posttreatment PNIFs of many individuals who reported substantial subjective improvement failed to exceed the expected variability of the test. This experience fails to demonstrate the utility of PNIF determinations for routine clinical use.

Adult↗
PubMed1991

[Problems of the reproducibility of the inhaled dosage exemplified with the Pari provocation test I apparatus].

The unspecific bronchial provocation test--usually performed with histamine, metacholine or carbachol--is used to determine whether bronchial hyperreactivity is present, and to what degree. Epidemiological studies have shown, that an overlap exists between "healthy" and "sick". There are several reasons for this, the most important being the insufficient reproducibility of intrabronchial deposition and the fact that the total provocation dose is often unknown. The following factors must be taken into account to improve this situation: 1. Only those devices where the particle spectrum is not influenced by the inspiration flow (without additional airstream) should be used to produce aerosols. 2. The air current containing aerosols is vapour saturated when liquid aerosols are produced. As the vapour is derived from the nebulizing solution it forms part of the weight or volume loss, this can be up to 50% of the total weight/volume loss. The aerosol output is far more constant and practically independent of the vapour saturation and the temperature. The intrabronchial dose can therefore not be calculated according to the weight loss of the nebulizer, as this is incorrect. 3. The evaporation of the nebulizing solution leads to an increase in the concentration of the test substance, especially towards the end of the evaporation process. Thus, the volume of the nebulizing solution should always be as large as possible or renewed early. 4. The slower the inhalation maneuver, the less the reproducibility of the intrabronchial deposition is impaired. The intrabronchial deposition varies least, when a slow inspiratory vital capacity maneuver is carried out (inspiration time greater than 8 s). Exhalation should be normal or even rapid, as aerosol deposition is thus increased, due to airway collapse. Breath-holding at the end of inspiration, for about 3-4 seconds, is favourable. 5. The anatomy of the glottic region varies greatly interindividually, influencing intrabronchial deposition. To reduce this to a minimum, the average diameter of the particles should not exceed 2 microns. On the other hand, the diameter of particles should not be under 1 micron, as the inhaled amount of substance is then markedly reduced (volume approximately d3). 6. Reservoirs, storaging the aerosol before inhalation, increase reproducibility, since they stabilize the aerosol due to vapour saturation. Plastic reservoirs must either be of antistatic material, or made antistatic by being filled repeatedly. The reproducibility of intrabronchial deposition is in the range of +/- 15% for the PARI-Provokationstest device I, (determined by radioactive labelling).(ABSTRACT TRUNCATED AT 400 WORDS)

Aerosols↗
PubMed1991

[Modification of inspiratory phase angle behavior in oscilloresistometry].

The diagnosis of pulmonary emphysema and fibrosis is possible by measuring the inspiratory behaviour of phase angle PSI of oscillation method. In addition to the different lung compliance as the main reason an influence of the shifting intrathoracical blood volume as the result of the pressure change is discussed especially for the appearing secondary PSI-periodic. Because a direct experimental evidence is not present in this study it was attempted to describe qualitatively the blood volume shift. Thoracic electrical impedance plethysmography and methods of nuclear medicine were used as methodological base. Although impedance plethysmography appears theoretical suitable and there are references, that alterations being independent from the heart rhythm may be detected, the originally aim of the study was not reached by the used method. The registration of radioactive labeled blood over the thoracical region by means of methods of nuclear medicine was applied as an alternative method. In contrast to the theoretical concept of a suction effect of the decreasing pressure during inspiration a decrease of the impulse rate and an increase of the latter during expiration was found. The reason could be the isolated registration of changes in the alveolar vessels. Possible secondary oscillations, which could be in relation with findings of lung mechanics, were not observed.

Adult↗
PubMed1990

[Chronic kidney insufficiency and respiratory muscle function. Changes induced by treatment with 1,25(OH)2D3].

A myopathy basically involving proximal respiratory muscles can develop in uremia. To evaluate respiratory muscle force in uremia, maximal inspiratory pressure (MIP) was measured in 27 patients with renal failure. MIP was very limited in patients with a creatinine clearance (Crc) lower than 10/ml/min 1.73 m2 not treated with hemodialysis (HD) and in patients on HD who were not treated with 1.25 (OH)2D3 (45 +/- 9 and 43 +/- 5 cm H2O, respectively), moderately reduced in patients on HD treated with 1.25 (OH)2D3 (58 +/- 5 cmH2O) and normal in patients with Crc higher than 10 ml/min 1.73 m2 (86 +/- 6 cmH2O). The treatment with 1.25 (OH)2D3 during 3 months promoted a significant increase in MIP and serum calcium level and a reduction in parathyroid hormone in patients with Crc lower than 10 ml/min. It was concluded that, in uremia, a respiratory muscle weakness partially reversible with vitamin D therapy may be found.

Adult↗
PubMed1989

Effects of propranolol, nalorphine and haloperidol on the breathing and on the metabolism of PGI2 and TXA2 of normotensive and spontaneously hypertensive rats.

The influence of propranolol, nalorphine and haloperidol on the breathing pattern and on the blood levels of cyclooxygenase products of anaesthetized spontaneously-breathing normotensive Wistar rats (WR) and of spontaneously hypertensive rats (SHR) were investigated. The respiratory rate was higher and the effective lung resistance was smaller in the SHR than in the WR. Breathing frequency decreased after nalorphine in both groups, while only in SHR after haloperidol. Propranolol augmented the dynamic lung resistance in both groups. The blood 6-keto-PGF1 alpha level was higher and the TXB2 level was lower in the SHR than in the WR. The central inspiratory activity as well as the levels of peripherally acting substances involved in the regulation of respiration and in the control of bronchial smooth muscle tone are different in the SHR and WR.

Animals↗
PubMed1989

Exercise training in patients with chronic airways obstruction.

Some studies concerning the effects of specific and non-specific techniques of respiratory muscle training and new strategies in exercise training of both skeletal and respiratory muscles, are reviewed. Breathing and exercise training show some evidence of improved gas exchange. Breathing through an inspiratory resistance has some advantages but also disadvantages. This technique has caused immediate hypoxaemia and pulmonary arterial hypertension in one third of the subjects studied. High intensity exercise with correspondingly high levels of ventilation may induce improvements in ventilatory muscle function. Two new techniques are described: the "above anaerobic threshold 40 min constant exercise" and the "45 min square-wave endurance exercise test" (SWEET), simulating an interval-training session. The effects on the cardiorespiratory, metabolic, arterial blood gases and acid base balance responses, were measured in normal subjects and in patients with chronic airway obstruction (CAO). After training, the magnitude of ventilation (VE) reduction was correlated with the reduction in end-exercise lactate. In addition, maximal ventilation and maximal oxygen consumption (VO2max) can increase after training. Finally, an interesting hypothesis is proposed about the use of arm-training.

Aged↗