Search results for "Intensive Care Medicine"
showing 10 items of 2228 documents
Effect of Salmeterol on Seasonal Changes in Airway Responsiveness and Exhaled Nitric Oxide in Pollen-Sensitive Asthmatic Subjects
2002
Objective Using a model of natural allergen exposure, we examined the effect of regular treatment with salmeterol on allergen-induced changes in airway responsiveness and exhaled nitric oxide (ENO). Design Double-blind, randomized, parallel-group study. Setting Specialist allergy unit in a university hospital. Patients Asthmatic patients sensitized to pollen allergens were randomly allocated to monotherapy with salmeterol (n = 14) or placebo (n = 13). Interventions Salmeterol, 25 μg, and placebo inhalers, two puffs bid, for 6 weeks. Measurements Spirometry, the level of a provocative concentration of a substance (methacholine) causing a 20% fall in FEV 1 (PC 20 ), the PC 20 level for adenos…
Airway Responsiveness to Histamine in Patients Refractory to Repeated Exercise
1988
To investigate the mechanisms contributing to refractoriness in exercise-induced asthma (EIA), airway responsiveness to histamine was studied in eight asthmatic patients. Patients were included in the study on the basis of their refractory response to multiple exercise challenges. Incremental challenges with inhaled histamine were performed at rest and 40 minutes after single and paired exercise tests. The geometric mean histamine concentration required to produce a 20 percent fall in FEV1 (PC20) for the challenge after paired exercise test (4.34 mg/ml) was significantly higher (p greater than 0.001) than those for the challenges after a single exercise (1.05 mg/ml) and for the challenge at…
Effects of Inhaled Fenoterol on the Circadian Rhythm of Expiratory Flow in Allergic Bronchial Asthma
1983
Metered-dose aerosol treatment with fenoterol for three consecutive days, in eight patients suffering from allergic asthma, caused the disappearance of FEV1 and MEF50 circadian rhythm. We attribute such behavior to the suppression of the bronchomotor tone induced by fenoterol. The administration on different days of a single dose of fenoterol aerosol in another group of eight patients pointed out the variability of the effects of the drug at different hours of the day. We believe the results obtained are important for a better dosage and time distribution of the therapy with beta2 agonists.
Characteristics and Prognostic Value of Morning Dipping of Peak Expiratory Flow Rate in Stable Asthmatic Subjects
1985
Characteristics and prognostic relevance of morning dip of peak expiratory flow rate (PEFR) were evaluated in stable asthmatic subjects. Among 246 outpatients monitored four times daily for two weeks, 38 (group A) showed a significant difference between morning reading of PEFR and each of the others; they were compared to 38 randomly selected patients (group B) not showing morning dip in PEFR. Less frequent seasonal course, extrinsic pathogenesis, and sensitization to mites characterized group A; starting airflow limitation was more severe in those with morning dip, but no significant difference between mean PEFR measured throughout two weeks was found. At 6 to 12 weeks, morning dip was not…
Spontaneous gastroesophageal reflux and airway patency during the night in adult asthmatics
2000
Controversies still exist on the role of nighttime gastroesophageal reflux (GER) in precipitating nocturnal asthma. We tested the relationship between GER and nocturnal bronchoconstriction by continuously and simultaneously monitoring both respiratory resistances and esophageal pH in seven asthmatics with moderate to severe GER disease. Twenty-nine GER episodes were found during the study night lasting more than 5 min (LGER) and 72 not longer than 5 min (SGER). Both long (LGER) and short (SGER) gastroesophageal refluxes were able to maintain significantly higher lower respiratory resistances (RLR) at the resolution of each GER episode (RLR(e)) with respect to baseline values. RLR, expressed…
Rapid left ventricular filling in untreated hypertensive subjects with or without left ventricular hypertrophy
1992
In this study, independent contribution of age, HR, BMI, casual and ambulatory blood pressure, LVM and LVEF in evaluating diastolic filling have been investigated in 34 never-treated hypertensive patients and in 15 healthy normotensive subjects. All the subjects were free from coronary artery disease, valvular disease, heart failure, renal disease and psychiatric problems. All the hypertensive subjects (never treated) were subgrouped according to presence or absence of LVH. The PFR decreased significantly and tPFR increased significantly in hypertensive patients in comparison with normotensive subjects and they did not change in the presence vs absence of LVH. The PFR was inversely correlat…
Do childhood respiratory infections continue to influence adult respiratory morbidity?
2008
The aim of the present study was to examine the influence of childhood respiratory infections on adult respiratory health. In 1992-1994, the European Community Respiratory Health Survey recruited community based samples of 20-44-yr-old people from 48 centres in 22 countries. Study participants completed questionnaires and underwent lung function testing. On average, 8.9 yrs later, 29 centres re-investigated their samples using similar methods. Mixed effects models comprising an estimate for the random variation between centres were used to evaluate the relevant associations. In total, 9,175 patients participated in both studies, of whom 10.9% reported serious respiratory infections (SRI) be…
Multicentric evaluation of model for end-stage liver disease-based allocation and survival after liver transplantation in Germany - Limitations of th…
2010
Summary Since the introduction of model for end-stage liver disease (MELD) in 2006, post-orthotopic liver transplantation (OLT) survival in Germany has declined. The aim of this study was to evaluate risk factors and prognostic scores for outcome. All adult OLT recipients in seven German transplant centers after MELD implementation (December 2006–December 2007) were included. Recipient data were analyzed for their influence on 1-year outcome. A total of 462 patients (mean calculated MELD = 20.5, follow-up: 1 year) were transplanted for alcoholic cirrhosis (33.1%), hepatocellular carcinoma (26.6%), Hepatitis-C (17.1%), Hepatitis-B (9.5%), primary sclerosing cholangitis (5.6%) and late graft-…
Specific allergen immunotherapy for the treatment of allergic asthma: a review of current evidence.
2017
Asthma is frequently associated with atopy, characterized by the production of specific immunoglobulin E in response to environmental allergens. Currently, two types of allergen immunotherapy (AIT) are used in clinical practice: subcutaneous and sublingual immunotherapy, both accepted as key components of the therapeutic repertoire for allergic rhinitis and conjunctivitis. However, their role in asthma remains controversial. The present document is aimed at providing the clinicians with a review of the evidence on the use of AIT in asthma, focusing on the most relevant aspects of its mechanism of action, its efficacy, and existing data on safety, tolerability, and cost-effectivity, both in …
Economic aspects of different muscle relaxant regimens.
2000
Objective At a time of cost reduction in medical care efforts to manage the ever-increasing costs of new pharmaceutical drugs become increasingly important. Costs of four different muscle relaxant regimens including the new intermediate-acting neuromuscular blocking drugs (NMBD) cisatracurium and rocuronium will be analyzed. Methods Eighty patients undergoing laparoscopic cholecystectomy were prospectively studied. All patients received standardized general anaesthesia with desflurane/fentanyl. Muscle relaxation was achieved with atracurium, cisatracurium, vecuronium, or rocuronium with 20 patients in each group. Intraoperatively muscle relaxants were added to maintain two twitches of the t…