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Results for “EXPECTORANTS”

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At least 19 recordsLinked to original sources
PubMed1996

[Acute effect of use of the Flutter on expectoration of sputum in patients with chronic respiratory diseases].

The acute effects of use of the Flutter on expectoration of sputum were studied in patients with chronic respiratory diseases who had problems expectorating sputum. The Flutter is a handy, simple, physiotherapy device that is easy to use. Seventeen patients were enrolled in the study. For three consecutive days, the patients were asked to use the Flutter for 15 min when they had the hardest time expectorating sputum. They were also asked to measure the volume of the expectorant obtained during those 15 min and the following 30 min. Expectoration, coughing, and breathlessness were graded with visual analogue scales designed by us. Peak expiratory flow rate was also measured. For the control condition, the patients were asked to remove the stainless steel ball from the device and then to use the device as stated above on the three consecutive days immediately before or after the experimental days. Scores of "difficulty in expectoration" and "chest discomfort" were lower on the second and third experimental days than on the control days (mean+/-SE of difficulty in expectoration on the second day: 3.8+/-0.6 vs 4.4+/-0.6, p<0.05: on the third day: 3.0+/-0.5 vs 4.2+/- 0.6, p<0.02; chest discomfort on the second day: 2.9+/-0.6 vs 3.5/+-0.7, p<0.04; on the third day: 2.3+/-0.6 vs 2.9+/-0.6, p<0.01). No significant differences were noted in cough intensity, cough frequency, breathlessness, or peak expiratory flow. Sputum volume was larger on the second and third experimental days than on the control days (second day: 13.9+/-3.6 vs 11.3+/-3.1 ml, p<0.04; third day: 13.2+/-2.8 vs 9.9+/-2.1 ml, p<0.01). We conclude that use of the Flutter can increase the expectoration of sputum and can relieve related symptoms.

Adult↗
PubMed2002

Improved sputum expectoration following a single dose of INS316 in patients with chronic bronchitis.

UNLABELLED: Uridine 5'-triphosphate (UTP) is a naturally occurring agonist for P2Y(2) receptors on the apical surface of ciliated respiratory epithelium. UTP stimulates salt and water transport and cilia beat frequency in human airway epithelium in vitro. Single, inhaled doses of UTP stimulate mucociliary clearance in conscious, intubated sheep and in patients with mild chronic bronchitis (smokers and former smokers), suggesting that UTP may be useful for obtaining deep-lung sputum specimens suitable for diagnostic purposes. STUDY OBJECTIVE: UTP is being developed for the cytologic diagnosis of lung cancer under the compound number INS316 Solution for Inhalation (Inspire Pharmaceuticals; Durham, NC). Its ability to improve the quality of expectorated sputum was tested in the current study. DESIGN: Placebo-controlled, double-blind, escalating two-period cross-over study. SETTING: Outpatient volunteers. PATIENTS OR PARTICIPANTS: Twenty-six patients with mild chronic bronchitis. INTERVENTION: Patients attempted to expectorate a specimen spontaneously, following a single inhaled dose of INS316 (10 to 180 mg), and following placebo. MEASUREMENTS AND RESULTS: Sputum weight, sputum cell content, spirometry, and oxyhemoglobin saturation. Only 28% of these patients were able to expectorate a macrophage-containing, deep-lung specimen spontaneously or following inhalation of placebo. In contrast, 85% of the patients were able to produce a specimen following inhalation of INS316. The average weight of the sputum expectorated was increased fourfold by placebo and 10-fold by INS316. A mild transient decrease in pulmonary function was observed following INS316 administration. CONCLUSION: A single dose of INS316 safely improves the ability of patients with mild chronic bronchitis to expectorate a deep-lung sputum specimen suitable for cytologic evaluation.

Adult↗
PubMed1990

[Expectoration disorders in patients with chronic obstructive lung diseases].

The paper is concerned with an analysis of the original data and the conception regarding the pathogenesis of expectoration alterations and correction in patients with chronic obstructive pulmonary diseases (COPD). Expectoration defects in COPD are suggested to be classified according to duration of respiratory tract clearing from sputum. The disorders of the first and second degree amenable to correction by oral and inhalation expectorants are referred to compensation stage, those of the third degree resistant to the correction to decompensation stage. Efficiency of current expectorants is comparatively assessed as well as mechanisms of their actions. An approach to expectorants administration should be differential basing on the severity of relevant impairment and aimed at adequate maintenance or recovery of the sputum discharge in COPD patients.

Ciliary Motility Disorders↗
PubMed2000

A comparison of induced and expectorated sputum for the microbiological diagnosis of community acquired pneumonia.

BACKGROUND: Sputum induction has proved useful in the diagnosis of Pneumocystis carinii pneumonia and mycobacterial infections but there are scant data on its use in the diagnosis of community-acquired pneumonia (CAP). OBJECTIVE: To better define the usage of sputum induction by hypertonic saline in the setting of CAP. METHODS: A retrospective review of records of patients admitted to a community teaching hospital in the year 1995 with a diagnosis of CAP. RESULTS: Of 492 patients admitted with CAP, 71 (14%) had attempted sputum induction. A group of 66 patients with CAP and attempted sputum collection by spontaneous expectoration was compared with this group. Sputum induction failed to yield a sample in 22 patients (31%). Forty-five of 49 patients (92%) with induced sputum had received prior antibiotics as compared to 23 of 34 patients (68%) with expectorated samples (p < 0.05), due to sputum induction often being attempted later in the hospital course. The diagnostic yield of sputum induction was 14 of 71 (20%) compared to 16 out of 66 (24%) for attempted spontaneously expectorated samples. Antibiotic therapy was changed for 5 of 34 patients (15%) who spontaneously expectorated samples and for 9 of 49 patients (18%) with successful induction. CONCLUSIONS: Sputum induction is effective in obtaining sputum in some patients with CAP who fail to expectorate a sample. Attempting induction early, preferably before starting antibiotics, may increase its diagnostic yield.

Administration, Inhalation↗
PubMed1998

A comparison of induced and expectorated sputum for the diagnosis of Pneumocystis carinii pneumonia.

STUDY OBJECTIVES: To compare the sensitivities of expectorated and induced sputum for the diagnosis of Pneumocystis carinii pneumonia (PCP). DESIGN: Retrospective review. SETTING: Academic medical center. PATIENTS: Forty-five patients diagnosed as having PCP who had direct fluorescent antibody testing for P carinii on either expectorated or induced sputum. RESULTS: Patients were stratified according to the method of sputum production (induced vs expectorated). The two groups were similar with respect to demographic characteristics, use of prophylaxis with aerosolized pentamidine, serum lactate dehydrogenase level, and arterial oxygen level. When only the initial sputum for each patient was analyzed, there was a similar sensitivity of induced sputum, positive in 10 of 18 samples (56%), and expectorated sputum, positive in 14 of 27 samples (52%) (p>0.05). CONCLUSION: There was no significant difference in the sensitivity of induced and expectorated sputum for the diagnosis of PCP when the direct fluorescent antibody method of staining was used.

AIDS-Related Opportunistic Infections↗
PubMed1992

Methods for clinical assessment of expectorants: a critical review.

The purpose of the paper is to discuss some aspects of the methods that are most appropriate for the clinical assessment of new expectorants. Expectorants are drugs devised to help in the removal of bronchial secretions. The evaluation of these drugs is aimed at demonstrating, in controlled trials, their efficacy, safety and, if possible, mechanism of action. Unfortunately, there is no universally accepted assessment technique available. Evaluation of symptoms with the use of self-reported measures is imprecise. Studies of quality of life can assist as a means of assessing the usefulness of this class of drug for patients. Lung function tests evaluate only the possible indirect effects of expectorants; the changes observed are often minor and they do not correlate with other methods of evaluation. Mucociliary clearance studies evaluate bronchial drainage by mucociliary transport and cough. They are a useful pharmacological approach but they cannot replace therapeutic trials. In vitro and ex vivo studies of bronchial secretion, while improving knowledge of the mechanisms of bronchial secretion, fail to predict the modifications of bronchial drainage produced in vivo by cough or mucociliary transport. To be considered efficient, expectorants should not only ease the removal of bronchial secretions, but also improve the patient's condition for the duration of treatment.

Animals↗
PubMedDate not supplied

[Metabolism of 4-carbomethoxythiazolidine chlorohydrate to cysteine through human expectorate and lung homogenates, and its action on glycoproteins of mucus].

A study has been carried out on the formation of -SH groups and of cysteine and cystine from 4-carbomethoxythiazolidin HCl through human expectorate mucus and lung homogenates. Both the expectorate and the homogenate, revealed to be able to metabolize TCM to cysteine releasing free -SH groups. The speed of cysteine formation is higher for the homogenate, but also the expectorate revealed to be very effective for the metabolization to cysteine. Furthermore it has been demonstrated that the TCM, incubated with human expectorate in presence and in absence of lung homogenate, can modify the chemical-physical characteristics of the mucus, rendering it more soluble and less viscous, i.e. displaying a mucolytic activity. These results account for the in-vitro experimental base to the observation that the product has a mucolytic activity whether administered by os or by aerosol.

Cysteine↗
PubMed1991

Liver, lung and kidney homogenates used as an activation system in mutagenicity studies of airborne particles and of expectorate and urine samples from exposed workers in a coke plant.

A comparison was made between lung and kidney homogenates on the one hand and liver S9 from rats on the other hand in order to compare their ability to activate promutagens. The Salmonella reversion assay was used on extracts of airborne particles from the top of coke oven batteries, and of expectorate and urine samples from exposed workers in the same coke plant. The contents of benzo[a]anthracene and benzo[a]pyrene in the different test solutions were measured by high-resolution gas chromatography/mass spectrometry. Both mutagens were detected in the filter extract and in the expectorates from the exposed workers but not in the expectorates from the control groups or in the urine samples. The liver S9 gave significantly higher mutagenicity than lung and kidney activation with both filter samples and expectorate and urine samples.

Adult↗
PubMed1989

Effect of exercise and physiotherapy in aiding sputum expectoration in adults with cystic fibrosis.

The role of exercise in aiding sputum expectoration in patients with cystic fibrosis and the comparative roles of exercise and physiotherapy in sputum expectoration were assessed in two studies. In the first study 19 adult patients undertook a two month programme of home exercise using a cycle ergometer. In the 12 patients completing the study peak work capacity, maximum oxygen consumption, and maximum minute ventilation had increased significantly by the end of the exercise programme; the increase in daily sputum weight (from 24 to 37 g) was not significant (p = 0.055). In the second study (with 10 patients) more sputum was expectorated during and after physiotherapy than during and after exercise (9.8 v 4.0 g). Exercise may have a role in aiding sputum expectoration in patients with cystic fibrosis but should not be considered as a replacement for physiotherapy.

Adolescent↗
PubMed1990

Indium-111 labelled granulocyte scanning to detect inflammation in the lungs of patients with chronic sputum expectoration.

Thirty eight patients with chronic sputum expectoration underwent indium-111 labelled granulocyte lung scanning and measurement of whole body loss of indium-111 labelled granulocytes. Twenty four patients had radiologically proved bronchiectasis and 14 had mucus hypersecretion without radiological evidence of bronchiectasis. None was having an acute exacerbation at the time of the scan. The median 24 hour volume of sputum expectorated was 17 (range 2-175) ml. The 24 hour volume of purulent sputum was 5 (0-142) ml; six patients expectorated mucoid sputum only. Twenty one of the 38 patients had a positive granulocyte lung scan. All nine patients expectorating more than 20 ml purulent sputum in 24 hours had positive lung scans and all had lost more than 19% of the indium-111 from the body after five to seven days. Of the six patients with mucoid sputum, only one had a positive scan and these subjects lost only 6-11% of the indium-111 in five to seven days. The percentage loss of indium-111 from the body correlated with 24 hour purulent sputum volume (r = 0.41, n = 38, p less than 0.001) and total elastolytic activity in 24 hour sputum (r = 0.54, n = 14, p less than 0.01). The loss of indium-111 was not related to the extent of bronchiectasis when purulent sputum volume was allowed for. Indium-111 labelled granulocyte scanning provides a sensitive and objective method for detecting inflammation in the lungs and should help to improve understanding of chronic bronchial sepsis and possibly treatment in selected cases.

Adult↗
PubMed2001

Primary endobronchial leiomyosarcoma. Diagnosis following expectoration of tumor fragment.

A case is presented with spontaneous expectoration of a small piece of solid tissue. Pathologic examination of the expectorated tissue was found to be consistent with leiomyosarcoma. After further work-up, there was no evidence of another primary site of leiomyosarcoma except for the right lower lobe. Right lower lobectomy was performed. The surgical specimen showed a tumor that was histologically identical to the patient's previous expectorated tissue. To the authors' knowledge, this is the first report of partial expectoration of a primary endobronchial leiomyosarcoma.

Biopsy, Needle↗