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Biomedical subjects

A Ragaz

Publications and source records attributed to A Ragaz.

10 recordsLinked to original sources
PubMed1991

[Acute dyspnea, cough, headache].

Six hours after work in an empty, non-ventilated silo a 27-year-old Yugoslav worker suffered acutely from cough, dyspnea and general weakness. He was admitted to the hospital with severe partial respiratory insufficiency, and after emergency intubation artificial respiration had to be installed. X-ray showed a severe symmetrical alveolo-interstitial opacity. The heart configuration was normal. History revealed that the neighbouring silo had been filled with green corn the day before. Both silos were connected by a common drain-wall. Furthermore, a yellowish discolouration of the new paint in the empty silo was noted. Based on these facts silo-filler's disease was diagnosed. The patient recovered rapidly under high doses of steroids. Lung function was normalized within nine days, and the patient was released from the hospital. Steroid therapy was continued for six weeks.

Adult↗
PubMed1990

[Acute effects of the natural atmospheric ozone exposure on lung function of clinically normal smokers and non-smokers].

The influence of moderate ambient ozone exposure on spirometric lung function and bronchial responsiveness was analyzed in 13 healthy adult nonsmokers and 11 asymptomatic smokers. The study was divided into an initial investigation at low atmospheric ozone concentrations of about 80 (range 68-102) micrograms/m3 and a subsequent similar testing at moderately elevated ozone concentrations above 140 (range 145-205) micrograms/m3. Overall there was a slight but significant impairment in forced expiratory volumes (p less than 0.002) at elevated compared with low ozone concentrations. Furthermore, a significant increase in bronchial responsiveness was shown, with a decrease in threshold dose for inhaled metacholine to produce a 50% fall in specific airway conductance (p less than 0.02). In both smokers and nonsmokers there was a similar change in lung function at ambient ozone concentrations, with more pronounced bronchial irritation in the smokers group. It is concluded that even moderately elevated ambient ozone concentrations can induce slight but significant ventilatory obstruction and an obvious increase in bronchial responsiveness in healthy adults. Although the minor impairment of lung function did not cause manifest acute respiratory problems, it still reduced maximal physical ventilation capacity. The results further support the assumption that air pollution may act as a primary trigger in the development of obstructive airway disease.

Airway Obstruction↗
PubMed1985

[Oxygen home therapy in chronic respiratory insufficiency. Report of experience with 70 patients].

The effect of home long-term oxygen therapy has been evaluated in 70 patients (52 men and 18 women) with chronic respiratory insufficiency due to chronic obstructive pulmonary disease. The mean duration of the observation period was 17.5 months, lasting at least 6 months and in a few cases over 40 months. The cumulative death rate was 22.6% in the first 12 months, 36.5% after two years and 40.7% in the third year. Compared to a previous period of 19.5 months there was an obvious reversal in hypoxemia, an increase in physical capacity and a reduction in the hospitalization rate. Patients with marked respiratory failure and with the clinical features of the "blue bloater" type of chronic bronchitis responded better to the home oxygen therapy than a group of "advanced pink puffers" with hypercapnia and high pulmonary arterial pressure. The present results do however confirm the beneficial effects of long-term domiciliary oxygen administration, and should encourage critical use of this new therapeutic regimen according to the indications so far recommended.

Aged↗
PubMed1985

Predictors for early mortality in patients with long-term oxygen home therapy.

The follow-up of 87 patients with long-term oxygen therapy over a 3-year period revealed a mortality of 23.7% during the first year, of 37.4% after 2 years and of 45% after 3 years, respectively. The retrospective analysis of baseline characteristics in order to evaluate the causes for early deaths showed no difference in age, lung function tests nor the degree of respiratory insufficiency documented by serial blood gas analysis between the survivors (n = 61) and the dead (n = 26). However, in the group of early deaths there was a significant increase in pulmonary hypertension (mean pulmonary arterial pressure 40.1 +/- 12.0 mm Hg) compared with the survivors, who had only mild hypertension (mean pulmonary arterial pressure 29.4 +/- 8.9 mm Hg). In addition there was also a lesser response in pulmonary vasodilation during oxygen breathing in the patients who died within the first 2-year period. We conclude that marked pulmonary hypertension with poor response to oxygen breathing is a major limiting factor in the prognosis of patients with long-term oxygen therapy. In contrast neither severe airway obstruction nor pronounced hypoxemia are related to early mortality and should therefore not be considered as a criterion for rapid deterioration and fatal outcome despite oxygen therapy.

Aged↗
PubMed1979

Evolution, maturation, and regression of lesions of psoriasis. New observations and correlation of clinical and histologic findings.

The evolution, maturation, and regression of lesions of psoriasis were studied histologically. The earliest histologic changes in pinhead-sized macules of psoriasis consist of a superficial perivascular infiltrate of lymphocytes and histiocytes and dilation and tortuosity of the blood vessels in the dermal papillae. Some lymphocytes move upward into the spinous zone of the epidermis and slight intercellular edema develops. Above these slight spongiotic foci, and after the granular layer disappears, the cornified layer becomes compact, and parakeratosis and epidermal hyperplasia develop. Only then do neutropils move through the epidermis into the mounds of parakeratosis. These changes, initially focal and episodic, become more confluent and constant, resulting in formation of clinical plaques. In spontaneously resolving lesions, inflammatory cells disappear first, the other changes next, and tortuosity of blood vessels in the dermal papillae last.

Capillaries↗
PubMed1979

Is actinic granuloma a specific condition?

Evidence is presented that actinic granuloma is not a specific connective tissue disorder as it is thought to be by O'Brien. Granulomatous inflammation does not result simply from a response to elastotic fibers, but is a consequence of primary pathologic processes that are unrelated to damaged elastotic material. Twenty-one of 30 lesions in our series that fulfill O'Brien's criteria of his concept of actinic granuloma were clinically and histologically examples of granuloma annulare. The other nine lesions were of other granulomatous diseases such as foreign-body reaction and late secondary syphilis.

Adult↗
PubMed1978

[Lung function tests in emphysema].

Several lung function tests are capable of detecting typical functional abnormalities in pulmonary emphysema, such as reduced elastic recoil of lung tissue, elevation of intrathoracic gas volumes, expiratory bronchial collapse or uneven patterns of ventilation. The measurement of elastic recoil by means of an esophageal catheter also seems to be a reliable technique for detecting early stages of emphysema, but its use for routine clinical investigations remains impracticable. The elevation of intrathoracic gas volumes determined by body plethysmography or helium dilution technique may sometimes be influenced by reversible bronchial obstructions or additional restrictive ventilatory defects. Expiratory collapse of the intrathoracic airways, however, proves to be a regular finding in advanced pulmonary emphysema. It results from decreased stability of the peripheral and central bronchial wall as well as from a shifting of bronchial and transmural pressure gradients to the peripheral airways. The occurrence of a pressure dependent expiratory stenosis can easily be demonstrated by the spirometric flow-volume curve during forced expiration, thus differentiating patients with asthma from those with chronic bronchitis and emphysema. The minimal program for detection and evaluation of emphysematous alterations of the lung by functional tests should consist in the measurement of intrathoracic gas volumes, recording of the forced expiratory volume and the analysis of the flow-volume curve.

Emphysema↗