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Biomedical subjects

A C Raimondi

Publications and source records attributed to A C Raimondi.

At least 19 recordsLinked to original sources
PubMed1997

Treatment of acute severe asthma with inhaled albuterol delivered via jet nebulizer, metered dose inhaler with spacer, or dry powder.

Despite the increasing use of dry powder formulations in the ambulatory setting, there is a paucity of information on the efficacy of this therapeutic modality to treat acute severe asthma. In addition, studies that compared wet nebulization vs metered dose inhalers formulated with chlorofluorocarbon (CFCMDI) attached to holding chambers have yielded discrepant results. Thus, it is unclear which of the three delivery systems would elicit a superior bronchodilator response, particularly in patients with life-threatening asthma. In a prospective, randomized open design, we studied the response to inhaled albuterol (salbutamol) in 27 adult asthmatics presenting to the emergency department (ED) with an FEV1 <30% predicted. Subjects were treated with one of the following regimens (nine subjects in each group): group A, mean (SD) baseline FEV1 of 0.7 (0.2) L, received albuterol solution, 5 mg, via a nebulizer (Puritan-Bennett Raindrop; Lawrenceville, Ga) impelled with oxygen (O2) at 8 L/min; group B, baseline FEV1 of 0.6 (0.15) L, received albuterol, 400 microg, via a CFCMDI attached to a 145-mL valved aerosol holding chamber (Aerochamber; Trudell Medical; London, ON); and group C, baseline FEV1 of 0.6 (0.17) L, received albuterol powder, 400 microg, by another means (Rotahaler; Glaxo; Research Triangle Park, NC). All groups received the respective treatments on arrival in the ED, every 30 min during the first 2 h, and then hourly until the sixth hour. Clinical parameters and FEV1 were recorded on ED admission and 15 min after each dose of albuterol. At the time of ED admission, all patients also received continuous O2 and one dose of I.V. steroids (dexamethasone, 8 mg). The total dose of inhaled albuterol administered during the 6-h treatment was 45 mg of nebulized solution in group A and 3,600 microg of albuterol aerosol and dry powder in groups B and C, respectively. No significant differences were found in the population demographics, baseline FEV1, and arterial blood gas values on air. FEV1 improved significantly in all patients after the 6 h of treatment. The 6-h area under the curve FEV1 improved similarly with the three delivery methods despite differences in the total dose administered. No patient was discontinued during the trial or admitted to hospital and no evidence of cardiovascular adverse events was apparent in any of the study groups. These data support the view that the three delivery methods appear adequate to treat subjects with acute severe asthma.

Administration, Inhalation↗
PubMed1986

Asthma, cardiac arrhythmias, and albuterol aerosol.

Twenty asthmatic patients clinically free of heart disease were studied for the possible arrhythmogenic action of albuterol (salbutamol). Two puffs of either albuterol or placebo were inhaled four times per day on two consecutive days and continuous ECG recordings obtained during each 24-hour period. Sixteen patients had atrial extrasystoles, four with albuterol, one with placebo, and 11 with both drugs. The extrasystoles/hour were 6.55 (23.75 SD) with albuterol and 8.37 (33.82) with placebo, a nonsignificant difference. Ventricular extrasystoles were shown in 11 patients, two with albuterol, two with placebo, and seven during both treatments. The extrasystoles/hour were 2.57 (6.36) and 3.10 (7.61) with albuterol and placebo, respectively. This difference was not significant. These findings suggest that therapeutic doses of albuterol aerosol in asthmatic patients without evidence of heart disease and severe hypoxemia should not be considered a cause of cardiac arrhythmias.

Adult↗
PubMed1986

Comparison between high and moderate doses of hydrocortisone in the treatment of status asthmaticus.

In a group of 40 adult patients in status asthmaticus, the responses to two different dosages of hydrocortisone were studied. All patients received a uniform treatment and were sequentially assigned to one of the following two groups: high dosage of hydrocortisone (80 mg/kg/day); or moderate dosage (6 mg/kg/day). The hydrocortisone was given intravenously in divided doses every six hours. The study lasted five days, and forced spirometry was performed daily at noon. The condition of all of the patients improved gradually, and when comparing both groups, no statistically significant differences were found in their spirometric measurements. We did not find any difference in the reversal of airway obstruction in the treatment of status asthmaticus by using a high dosage of hydrocortisone when compared with a lower moderate one.

Adult↗
PubMed1978

Acute miliary tuberculosis presenting as acute respiratory failure.

A 42 year old pregnant woman was admitted in acute respiratory failure. Viral pneumonia was suspected and oxygen therapy, CPAP, water restriction and diuretics were started with good response. She remained febrile and had an abnormal chest X-ray, a diagnosis of miliary tuberculosis was confirmed by transbronchial fibreoptic lung biopsy.

Acute Disease↗
PubMed1975

Effects of physical training on enzymatic activity of human skeletal muscle.

Enzymatic activities of GOT, LDH, MDH and CPK were assessed in four normal subjects, before and after a 12 week training period on a cycle ergometer. Determinations were made in muscle at rest and immediately after submaximal and maximal exercise tests and in serum at rest. Muscle biopsies were obtained from the quadriceps by the needle biopsy technique. Maximal oxygen uptake (VO2) increased significantly after training. The after training GOT and MDH muscle resting activities increased significantly. Correlations were found between resting muscle GOT and MDH vs maximal VO2. An increase on resting enzymatic serum activity after training was found for LDH and CPK and a decrease for MDH for the same period. Correlations were found between resting serum and muscle activities of LDH; MDH and LDH serum resting values vs maximal VO2. Finally, it were observed after training increments of muscle activities of GOT and MDH at rest and that these increments correlated adequately with performance. It was also found that muscle GOT activity changes after exercise were modified by training and that it could partly explain serum modifications. Resting serum enzymes levels did not necessarily correlate with muscle levels and these serum levels could be an index of the achieved training.

Adaptation, Physiological↗