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Biomedical subjects

A Tal

Publications and source records attributed to A Tal.

90 records · Page 5Linked to original sources
PubMed1984

Residual small airways lesions after kerosene pneumonitis in early childhood.

To assess residual lung damage after a single insult early in life, we studied 14 asymptomatic children, 10 years after an episode of kerosene pneumonitis. Immediately after kerosene ingestion all patients developed pulmonary symptoms. Eight had abnormal chest radiographs (group 1) whereas in six there were no radiographical changes (group 2). The average age at follow-up was 11.4 (range: 9.4-13.2). Lung volumes, expiratory flow-rates and their density dependence were measured and compared to an age, sex, and a height-matched control group. The volume of isoflow (Viso V) was significantly higher in patients in group 1 (27.75% +/- 6.7) when compared to group 2 (5.48% +/- 3.56) or controls (5.63% +/- 2.31) (P less than 0.02). The mean delta V max 50 was 13.5% +/- 3 for group 1, and 27.9% +/- 4.11 for group 2 (P less than 0.005). Airway reactivity assessed by an exercise test was normal in all children. Four of the eight patients from group 1 still had abnormal chest radiographs 10 years after kerosene pneumonitis. Thus, subclinical, prolonged small airway abnormalities after kerosene pneumonitis seem to be related to the severity of the acute insult.

Adolescent↗
PubMed1984

Fatal desquamative interstitial pneumonia in three infants siblings.

Desquamative interstitial pneumonia occurred in three siblings. Cough, difficulty in breathing, cyanosis, and failure to gain weight appeared during the first month of life; progressive hypoxia followed, and the three infants died in respiratory failure before the age of 4 months despite intensive drug and supportive treatment. The radiographic and the histologic appearance of pulmonary changes were similar in all three infants. Chest radiographs yielded normal findings initially, with rapid progression to a ground glass appearance of both lungs. Histologic findings of lung biopsies showed lymphoplasmocytic infiltration and fibrous thickening of the alveolar walls, swelling of alveolar lining cells, and large clumps of macrophages with PAS-positive foamy cytoplasm in the alveolar spaces.

Chronic Disease↗
PubMed1984

Response to cold air hyperventilation in normal and in asthmatic children.

To assess the sensitivity of isocapnic hyperventilation with cold air in detecting airway hyperreactivity in asthmatic children, we studied 13 asthmatic patients (mean age 11.1 years) and 10 normal children. Cold air challenge consisted of 4 minutes of moderate hyperventilation plus another 4 minutes of maximal hyperventilation, both with subfreezing air (-16 degrees to -18 degrees C). Exercise and IHCA tests were done within 5 days and in random sequence. Mean (+/- SE) maximal % delta FEV1 after IHCA was 27 +/- 5.1% in the asthmatic children vs 4.5 +/- 1.2% in the normal subjects (P less than 0.01), even though there were no significant differences in the maximal minute ventilation equivalent between the two groups. Mean maximal % delta FEV1 after exercise was 31.7 +/- 5.6 in the asthmatic group. There was no difference in the sensitivity of the exercise and IHCA tests to detect bronchospasm in asthmatic children. Airway obstruction after IHCA was sharp and brief: maximal at 3 minutes after challenge, and back to 10% of baseline after 11 minutes. In seven asthmatic children the refractoriness to cold air and exercise was studied by repeating each test within 30 minutes; all seven showed significant refractoriness to exercise, and six showed no refractoriness to IHCA. We conclude that exercise and cold air-induced bronchospasm have different physiologic mechanisms, and that cold air testing can be used as a routine challenge to identify airway hyperreactivity in children.

Adolescent↗
PubMed1984

Arterial oxygen desaturation following salbutamol inhalation in acute asthma.

The practicality and accuracy of a new ear oximeter was evaluated. The SaO2 measured with this instrument correlated significantly with simultaneous SaO2 measurements with another ear oximeter in 12 children (age three months to 20 years) with chronic pulmonary or cardiac diseases (r = 0.93, p less than 0.001), and also correlated significantly (r = 0.96, p less than 0.001) with calculated SaO2 based on blood gas measurements of blood from the left side of the heart obtained during cardiac catheterization. The SaO2 was then measured continuously and readings were taken before and five, 15, and 30 minutes after salbutamol inhalation by face mask in 18 children. Following treatment, mean PEFR increased significantly, and mean SaO2 was significantly lower than preinhalation values at five and 15 minutes postinhalation. At 30 minutes, SaO2 had returned to control values. In nine of 18 subjects, SaO2 fell greater than or equal to 5 percent. This response was not predictable on the basis of different parameters (treatment, heart rate, PEFR). The findings suggest that supplemental O2 may be required during the first 30 minutes posttreatment.

Acute Disease↗
PubMed1983

The effects of chronic hyperinflation, nutritional status, and posture on respiratory muscle strength in cystic fibrosis.

We measured maximal static inspiratory and expiratory pressures (PImax and PEmax) in 25 patients with cystic fibrosis (CF) and 80 normal control subjects to determine whether chronic hyperinflation and malnutrition reduce PImax and PImax/PEmax, respectively. In addition, we examined the effect of posture on pressures generated. We used a diminution in PEmax as an index of a malnutrition effect on pressures generated. The patients with CF, although significantly hyperinflated (ratio of residual volume to total lung capacity, 0.49), generated PImax values similar to those of the control subjects (p greater than 0.05). Despite evidence of malnutrition (mean body mass percentile, 78%) the PEmax values of patients with CF and those of control subjects were comparable (p greater than 0.05). There was no postural effect on pressures generated in the normal subjects or the CF group as a whole. We conclude that respiratory muscle strength is normal or supranormal in CF, despite chronic hyperinflation and malnutrition.

Adolescent↗
PubMed1983

Dexamethasone and salbutamol in the treatment of acute wheezing in infants.

Thirty-two infants, aged 1 to 12 months, hospitalized with acute wheezing, were studied. They were randomly divided into four treatment groups of eight patients each. The treatments were intramuscular dexamethasone or placebo (double-blind), and salbutamol (oral and inhaled), or none (open), in all four possible combinations. The study was carried out as a randomized block design with eight blocks of four infants each, matched by age and clinical score. Average daily improvements, as reflected by changes in the clinical score and length of hospital stay, was essentially the same for infants treated with placebo, salbutamol alone, and dexamethasone alone. However, combined salbutamol-dexamethasone treatment resulted in more than twice the rate of improvement of the other treatments. The difference was statistically highly significant (P less than .01). Furthermore, the response of this combined treatment was observed within 24 hours; none of the ten infants in whom there was no significant improvement within 48 hours and neither of the two patients who developed respiratory failure received the combined salbutamol-dexamethasone treatment. A potentiating effect of corticosteroids on the beta-adrenergic responsiveness is a possible explanation for the advantage of this combined treatment in the management of acute wheezing in infancy.

Acute Disease↗
PubMed1982

Lack of response to bronchodilator of airway obstruction after mechanical ventilation in the newborn.

Thoracic gas volume (TGV) and specific airway conductance (SGaw) were measured in 6 infants, 21-42 weeks of age, who had been mechanically ventilated during the neonatal period. SGaw was significantly decreased while TGV was normal. Administration of a nebulized beta 2-sympathomimetic stimulant did not improve lung function. It is concluded that inhalation of beta 2 stimulant drugs is not effective in improving airway obstruction in infants with postventilation-elevated airway resistance and that this is likely to be of structural origin.

Albuterol↗
PubMed1978

A homologous tandem translocation [45,XX,-13,-13,+t(13;13) (q12;q34)].

Chromosomal investigation of a young girl with mental and motor retardation and congenital anomalies revealed a translocation between both members of pair No. 13. Banding analysis showed that the translocation was "tandem," leading to monosomy for segments in both the long and short arms of No. 13.

Abnormalities, Multiple↗
PubMed1975

Attenuation of "acute" habituation by scopolamine in the black-tailed prairie dog (Cynomys ludovicianus).

The hypothesis after scopolamine attenuates habituation occurring within a training session as well as that occurring between training sessions was tested and confirmed. Scopolamine injections (.5 mg/kg) reduced spontaneous wheel running in the prairie dog. The same dosage did not affect the threshold for wheen running induced by electrical brain stimulation (EBS). Another experiment demonstrated that EBS-induced running declined during a 10-min. stimulation period and indicated that the decline was habituative since the response was repeatedly dishabituated. In a final experiment .5 mg/kg of scopolamine reduced habituation of EBS-induced wheel running during 10-min. sessions.

Animals↗
PubMedDate not supplied

Endogenous opiates and response to exercise in asthmatic children and adolescents.

Whether endorphins secreted during stressful exercise may play a role in the physiologic response of asthmatics was investigated. Thirteen asthmatic subjects were studied: seven (mean age 16 years +/- 2.8 SEM) had perennial asthma and exercise-induced bronchospasm (EIB), and six (mean age 18 years +/- 2) had mild seasonal asthma without EIB. Each subject performed two matched progressive exercise challenges on consecutive days. Baseline lung function was measured before each challenge and was measured again after exercise at regular intervals for 30 minutes. One minute before exercise each subject received intravenously either i.v. naloxone (0.04 mg/kg), an opiate receptor blocker, or saline, in a double-blind crossover fashion. Heart rate, oxygen consumption, minute ventilation, tidal volume, and arterial oxygen saturation were recorded throughout the tests. During the two challenges these parameters were not significantly different for all 13 patients. The mean percentage reduction in FEV1 after exercise for the seven subjects with EIB was slightly but not significantly less with naloxone (25% +/- 7 SEM) than with placebo (32% +/- 7) during the first 10 minutes after exercise. Naloxone had no obvious effect on EIB or the other parameters measured in association with strenuous exercise in asthmatic patients.

Adolescent↗
PubMedDate not supplied

The functional response of infants with persistent wheezing to nebulized beclomethasone dipropionate.

Lung function was measured in nine infants, ages 15-36 weeks, who had persistent wheezing, apparently following acute bronchiolitis, before and after 2 weeks of treatment with either inhaled nebulized beclomethasone dipropionate (BDP) or placebo in a randomized, double blind, crossover trial. The effect of nebulized albuterol (Salbutamol) was measured before and after the steroid treatment. Thoracic gas volume (TGV) and specific airway conductance (SGaw) were determined using a whole body plethysmograph, and forced expiratory flow at resting lung volume (VmaxFRC) was determined with a thoracoabdominal compression jacket. All infants had marked airways obstruction before treatment with mean +/- SE VmaxFRC of 24 +/- 4% predicted and SGaw of 37 +/- 5% predicted. Two weeks of placebo treatment had no significant effect on lung function, but after 2 weeks of BDP inhalation there was a significant rise in SGaw to 61 +/- 7% (P less than 0.005). VmaxFRC increased to 42 +/- 13% but the difference did not reach significance. Respiratory rate and clinical score for retractions and wheezing also fell significantly with BDP therapy (P less than 0.01 and P less than 0.001 respectively). Albuterol had no effect on lung function either before or during steroid therapy. Steroids may have a role in the management of persistent wheezing following bronchiolitis.

Administration, Intranasal↗
PubMedDate not supplied

The need for intubation in serious upper respiratory tract infection in pediatric patients (a retrospective study).

Serious bacterial infections occurred in ten children (1.4%) of 710 patients with croup admitted to the Soroka Medical Center during the years 1983-1989. Sixty-four patients (9% of all croup patients) were admitted to the pediatric intensive care unit (PICU), and 13 of them (20%) required intubation. Bacterial infections were noted in nine of the 13 intubated patients, in none of the other 51 PICU patients who did not require intubation and in one of the 646 patients (0.2%) who were not admitted to the PICU (p less than 0.0001). There was no difference in age, ethnic origin, or body temperature on arrival between the two PICU groups. Causative microorganisms were isolated from blood samples (three cases) and tracheal pus (eight cases). All intubated PICU patients were seriously ill: eight had bacterial tracheitis and one supraglottitis. Patients with bacterial tracheitis required frequent suctioning of the trachea for copious purulent secretions. The single patient with bacterial infection who was not admitted to the PICU had transient bacteremia. We conclude that the need for intubation in croup patients was an indicator for the presence of a serious bacterial infection.

Anti-Bacterial Agents↗
PubMedDate not supplied

Emotionally induced decreases in pulmonary flow rates in asthmatic children.

This study found that vividly remembered incidents of intense anger and similarly recalled fear decreased 1-sec forced expiratory flow rates (FEV1)in 35 male and 25 female chronic asthmatic children who had no psychopathology. FEV1 increased with relaxation. Changes in FEV1 following anger correlated with changes following fear as highly as the reliabilities of the responses permitted, although anger produced a greater decrease than fear. FEV1 decrease following anger and fear correlated with FEV1 increase due to relaxation. The amount of change in each of the three conditions correlated with history of emotionally precipitated asthma. This pattern was interpreted to mean that the same phenomenon underlies emotional-bronchoconstriction, relaxation-bronchodilitation, and emotionally triggered asthma. No relationship was found between degree of allergic sensitivity (atopy) and FEV1 changes in any of the three conditions nor did atopy correlate with history of emotionally triggered asthma. These results do not support the view that psychological and allergic factors are inversely related, alternative causes of asthma.

Adolescent↗