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PubMed1976

[The Sharp syndrome ("mixed connective tissue disease")].

A new and distinct rheumatic disease with features of systemic lupus erythematosus (SLE), progressive systemic sclerosis and polymyositis is described. Typical symptons are Raynaud's syndrome, swollen hands and fingers, polyarthritis or polyarthralgia and myositis. Other symptoms are less common and include skin lesions, decreased pulmonary diffusing capacity, diminished esophageal motility, lymphadenopathy, and polyserositis. The diagnosis of mixed connective tissue disease (MCTD) can be established by demonstration of a high titer of antinuclear antibodies and antibodies against extractable nuclear antigen (anti-ENA). Both antibodies are directed against ribonuclease-sensitive antigen substrate, which permits differentiation of patients with MCTD from those with other rheumatic diseases. A relatively favourable prognosis and a good response to corticoid medication are further characteristics of this disease. Three personally observed patients with MCTD are described.

Adult↗
PubMed1975

Lung water accumulation with acute hemodilution in dogs.

Extravascular lung water content was determined in vivo, gravimetrically, and histologically in severely hemodiluted (Ringer's lactate), supine, spontaneously breathing, halothane-anesthetized dogs. One group of dogs was studied immediately after undergoing hemodilution to a hematocrit value of less than 10 per cent; a second group was studied after hemodilution and 1 hour of circulatory maintenance with Ringer's lactate; and a third group was evaluated after hemodilution, maintenance for one hour with Ringer's lactate, and reconstitution of oncotic pressure with 75 Gm human salt-poor albumin. Lung water content was increased significantly from a normal of 3.88 Gm water per gram of dry weight to 4.70 Gm per gram of dry weight by hemodilution; it was increased further to 5.71 tgm per gram of dry weight during 1 hour of maintenance with Ringer's lactate. Reconstitution of oncotic pressure decreased the water content significantly to 4.96 and decreased the units demonstrating perivascular-peribronchial cuffing from 81 to 23 per cent. Double indication-dilution measurement of PEVW failed to reliably reflect changes in lung water. Arterial PO2 with the animals breathing 100 per cent oxygen was unchanged in all of the groups. We made the following conclusions: (1) lung water accumulation occurs during severe hemodilution and serum protein depletion; (2) this may be partially reversed by restoration of oncotic pressure; (3) double indicator-dilution PEVW measurements do not reliably reflect changes in extravascular lung water of less than 47 per cent; and (4) interstitial edema of this magnitude does not interfere with blood-gas exchange.

Animals↗
PubMed2000

Chronic obstructive pulmonary disease.

COPD is the most common chronic condition in the UK and it varies in severity from mild through to disabling and severe disease with respiratory failure. The treatment of the disease is tailored to the severity of the symptoms and the cornerstones are stopping smoking, inhaled bronchodilator and inhaled corticosteroid therapy. Preoperative assessment of patients with COPD needs to be thorough; remember that these patients may have concomitant ischaemic heart disease. Patients with severe COPD are at particularly high risk when given intravenous sedatives, opiates or general anaesthetics.

Adrenergic beta-Agonists↗
PubMed1975

[Functional conditions of the respiratory system and work site pollution. II. Prevalence of respiratory function changes in workers employed in bichromate and chromic acid production (author's transl)].

The authors report the prevalence of respiratory function changes in two groups of workers employed in bichromate and chromic acid production. In the first group (82 subjects) examined at the Institute of Occupational Medicine, the following tests were performed: filling out of a questionnaire for cronic bronchitis; chest x-ray; spirometry; pulmonary diffusing capacity (DLco) measurement; blood gas analysis on arteriolized capillary; He and CO2 rapid expiratory curves determination. No environmental pollution data were available. In the second group (180 subjects) examined at the working site, the following tests were performed: filling out of a questionnaire -or chronic bronchitis; spirometric determination. Environmental pollution data were available. A causal connection is hypothesized by the authors between either roentgenologic or respiratory functional changes and chromium exposure, and an increased proportion between lung function changes and exposure length is stressed.

Adult↗
PubMedDate not supplied

[Bronchoalveolar lavage findings in the pulmonary impairment related to systemic sclerosis].

UNLABELLED: The main objective of the study was to evaluate the relationship between the findings of the bronchoalveolar lavage (BAL) and the lung function in patients with systemic sclerosis and subsequent pulmonary impairment. The study was retrospective and included 17 cases with systemic sclerosis and pulmonary involvement investigated at "Marius Nasta" Institute. Bucharest, between January 1999-August 2001. Lung function assessment found the following: VC (% of predicted) = 82.5 +/- 14; DLCO (% of predicted) = 67.5 +/- 23.2. Cell count in BAL fluid showed: total number of cells x 10(6) = 11.5 +/- 6; lymphocytes (%) = 22.9 +/- 15.4; neutrophils (%) = 15.2 +/- 13.4; eosinophils (%) = 1.9 +/- 0.9; macrophages (%) = 58.1 +/- 19.8. We also compared the cell pattern according to DLCO value: the patients with DLCO > 80% had increased levels of eosinophils (5.2 +/- 4.9 vs 0.9 +/- 0.2, p = 0.007) while the group with DLCO < 80% presented significantly higher levels of neutrophils (16.1 +/- 15.5 vs 12.6 +/- 2.8, p = 0.003) compared to the group with normal lung function. CONCLUSIONS: Patients with systemic sclerosis and normal lung function present an increased level of eosinophils in BAL fluid, suggesting a transitory alveolitis. In change, those with DLCO < 80% have a higher level of neutrophils, usually associated to pulmonary fibrosis. The investigation by BAL appears to be a reliable tool for the assessment of the pulmonary impairment related to systemic sclerosis.

Adult↗
PubMed2003

[Concentration of nitric oxide exhaled air (eNO) in patients with COPD and bronchiectasis].

UNLABELLED: Exhaled nitric oxide (eNO) concentration measurement may allow for noninvasive estimation of severity of airways inflammation in respiratory tract diseases. Exhaled nitric oxide concentration is a sensitive marker of bronchial inflammation in asthma. The purpose of this study was: to evaluate eNO concentration in patients with COPD and bronchiectasis; to evaluate correlation between eNO concentration and the degree of airways obstruction in patients with COPD as well as correlation between eNO and extent of bronchiectasis in HRCT; to evaluate the effect of smoking on eNO concentration in COPD group. There were two groups of patients and the control group. The first group consisted of 20 patients with COPD (17 men, 3 women aged 41-68 yr). Ten patients were ex-smokers, and ten were current smokers. The second group consisted of 15 nonsmokers (10 men, 5 women aged 45-72 yr) with the diagnosis of bronchiectasis based on high-resolution CT criteria. The control group consisted of 11 healthy, nonsmoking subjects who had no respiratory disease or allergy, aged 28-52 years. Exhaled NO was measured by means of SIEVERS 280 Nitric Oxide Analyser (Boulder, Colorado, USA). RESULTS: The highest eNO concentration was found in patients with bronchiectasis (9.83 ppb +/- 3.09; median 8.0). It was significantly elevated compared to the values found in patients with COPD (5.3 ppb +/- 0.57, median 4.46; p = 0.002) or in the control group (5.17 ppb +/- 0.73, median 4.32; p = 0.007). Ex-smokers with COPD had higher eNO levels (6.3 ppb +/- 0.73; median 5.7) than did active smokers with COPD (4.3 ppb +/- 0.80; median 3.39; p = 0.017). Exhaled NO did not differ between exsmokers and healthy nonsmokers. There was no correlation between eNO and number of packyears (r = -0.022; p = 0.928). The extent of bronchiectasis expressed as CT score did not correlate with eNO concentration. There was also no significant relationship between eNO and FEV1 (r = -0.046; p = 0.87).

Adult↗
PubMed2004

[Prognostic analysis of lung function and chest X-ray changes of 258 patients with severe acute respiratory syndrome in rehabilitation after discharge].

OBJECTIVE: To analyze the clinical characteristics and prognostic changes of rehabilitating severe acute respiratory syndrome (SARS) patients through regular lung function tests and lung imaging studies after discharge and to retrospectively analyze the treatment data of these patients. METHODS: 258 discharged SARS patients received regular SARS-Co virus IgG test, lung function test and chest X-ray and/or high resolution computerized tomography (HRCT) examination at General Hospital of PLA two months after discharge, and the treatment data of these patients were retrospectively analyzed. RESULTS: 80.6% patients (208 of 258 patients) were positive for SARS-Co virus IgG. 21.3% patients (55 of 258 patients) showed lung diffusion abnormity (D(LCO) < 80%pred). Compared to 155 SARS-Co virus IgG positive patients without lung diffusion abnormity and 50 SARS-Co virus IgG negative patients, the 53 SARS-Co virus IgG positive patients with lung diffusion abnormity had longer fever course, higher dosages of glucocorticoid therapy, higher percentage of oxygen therapy and non-invasive ventilation. 51 of the 53 patients with lung diffusion abnormity received lung function test after one month, and the results of D(LCO) improved in 80.4% patients (41 of 51 patients). 40 of 51 patients with lung diffusion abnormity showed lung fibrosis, and the fibrosis decreased in 55% patients (22 of 40 patients) after one month. CONCLUSIONS: This finding suggests that lung fibrosis caused by SARS mostly occurs in severe patients, and it can resolve spontaneously. D(LCO) may be more sensitive than HRCT in evaluating the fibrotic changes.

Adolescent↗