Search results for "Respiratory medicine"
showing 10 items of 1534 documents
Exercise intolerance at high altitude (5050 m): critical power and W'.
2011
Abstract The relationship between work rate (WR) and its tolerable duration (tLIM) has not been investigated at high altitude (HA). At HA (5050 m) and at sea level (SL), six subjects therefore performed symptom-limited cycle-ergometry: an incremental test (IET) and three constant-WR tests (% of IET WRmax, HA and SL respectively: WR1 70 ± 8%, 74 ± 7%; WR2 86 ± 14%, 88 ± 10%; WR3 105 ± 13%, 104 ± 9%). The power asymptote (CP) and curvature constant (W′) of the hyperbolic WR–tLIM relationship were reduced at HA compared to SL (CP: 81 ± 21 vs. 123 ± 38 W; W′: 7.2 ± 2.9 vs. 13.1 ± 4.3 kJ). HA breathing reserve (estimated maximum voluntary ventilation minus end-exercise ventilation) was also comp…
Tiotropium Respimat® in asthma: a double-blind, randomised, dose-ranging study in adult patients with moderate asthma
2013
Tiotropium, a once-daily long-acting anticholinergic bronchodilator, when administered via Respimat® SoftMist™ inhaler (tiotropium Respimat®) significantly reduces the risk of severe exacerbations and improves lung function in patients with severe persistent asthma that is not fully controlled despite using inhaled corticosteroids (ICS) and long-acting β2-agonists. To further explore the dose–response curve in asthma, we investigated the efficacy and safety of three different doses of tiotropium Respimat® as add-on to ICS in symptomatic patients with moderate persistent asthma. In this randomised, double-blind, placebo-controlled, four-way crossover study, patients were randomised to tiotro…
Inhaled Corticosteroids and the Beneficial Effect of Deep Inspiration in Asthma
2005
Deep inspiration-induced bronchoprotection and bronchodilation are impaired in asthma. We evaluated the effect of inhaled glucocorticosteroids on these phenomena. Two groups of subjects with asthma, 9 with moderate/severe hyperresponsiveness to methacholine, and 12 with mild/borderline hyperresponsiveness to methacholine, received inhaled fluticasone (880 microg daily) for 12 weeks. Serial bronchoprovocations were performed at Weeks 0, 6, and 12. The impact of deep inspirations on the airway response to methacholine was evaluated on the basis of inspiratory vital capacity and FEV(1). Fluticasone produced a wide spectrum of changes in the beneficial effects of deep inspiration, but the mean …
The effect of challenge method on methacholine-induced changes in sensitivity and air trapping
2010
Summary Background The methacholine challenge test performed with the tidal breathing method induces a greater fall in FEV 1 than the dosimeter method; however, the effect of the challenge method on methacholine-induced fall in FVC has not been investigated. Objective To determine the influence of the challenge method on methacholine-induced changes in FEV 1 and FVC. Methods Airway responsiveness to methacholine was determined by dosimeter method and tidal breathing method in 37 subjects with suspected asthma. The dosimeter was modified to deliver an identical volume to that obtained with the tidal breathing method and the same nebulizer model was used for the two challenges. The response w…
Cardiac surgery outcomes in patients with coronavirus disease 2019 (COVID-19): A case-series report
2020
Abstract Objective The impact of coronavirus disease 2019 (COVID-19) on the postoperative course of patients after cardiac surgery is unknown. We experienced a major severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in our cardiac surgery unit, with several patients who tested positive early after surgery. Here we describe the characteristics, postoperative course, and laboratory findings of these patients, along with the fate of the health care workers. We also discuss how we reorganize and reallocate hospital resources to resume the surgical activity without further positive patients. Methods After diagnosis of the first symptomatic patient, surgery was suspended. Naso…
Non-contact breath sampling for sensor-based breath analysis
2019
Breath analysis holds great promise for real-time and non-invasive medical diagnosis. Thus, there is a considerable need for simple-in-use and portable analyzers for rapid detection of breath indicators for different diseases in their early stages. Sensor technology meets all of these demands. However, miniaturized breath analyzers require adequate breath sampling methods. In this context, we propose non-contact sampling; namely the collection of breath samples by exhalation from a distance into a miniaturized collector without bringing the mouth into direct contact with the analyzing device. To evaluate this approach different breathing maneuvers have been tested in a real-time regime on a…
Exhaled Nitric Oxide Measurement Is Not Useful for Predicting the Response to Inhaled Corticosteroids in Subjects With Chronic Cough
2009
Background Increased concentrations of exhaled nitric oxide (ENO) are identified predominantly in subjects with chronic cough due to conditions that habitually respond well to therapy with inhaled corticosteroids (ICSs). The aim of this study was to assess the usefulness of ENO in predicting the response to ICS therapy in subjects with chronic cough and to determine the relationship between either methacholine or adenosine 5′-monophosphate (AMP) responsiveness and the response to ICS therapy. Methods A total of 43 patients with chronic cough were studied. During the baseline period, ENO measurement, spirometry, and concentration-response studies with both methacholine and AMP were performed…
Dose-Related Effect of Beclomethasone Dipropionate on Airway Responsiveness in Asthma
1990
The effects of twice daily inhaled beclomethasone dipropionate (BDP) at two dose levels (500 and 1,000 micrograms daily) on the airway responsiveness to inhaled histamine was evaluated by a randomized, single-blind, cross-over study in 10 patients with stable asthma. The 12-week study began with a 3-week run-in period of baseline treatment, which was continued unchanged throughout the study, and the two treatment periods were separated by a 3-week placebo period. Patients attended the laboratory every 3 weeks for spirometry and histamine inhalation tests to determine the provocative concentration of histamine causing a 20% fall in forced expiratory volume in 1 s (PC20 of FEV1). There was a …
The Lack of the Bronchoprotective and Not the Bronchodilatory Ability of Deep Inspiration Is Associated with Airway Hyperresponsiveness
2001
In healthy subjects, deep inspiration (DI) acts both as a bronchodilator and a bronchoprotector. The latter is impaired in asthmatics. We have now evaluated whether the lack of bronchoprotection is related to bronchial hyperresponsiveness (BHR), and whether the bronchodilatory effect is also lost in asthmatics. Ten healthy subjects (PC20 > 75 mg/ml), 12 asthmatics with moderate to severe BHR (PC20 < 1 mg/ml), 14 asthmatics with mild to borderline BHR (1 < PC20 < 25 mg/ml), and 10 rhinitics with mild to borderline BHR (1 < PC20 < 25 mg/ml) underwent single-dose methacholine provocations inducing at least 20% reduction in FEV1 after 20 min of DI inhibition. To measure the bronchodilatory effe…
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…