Biomedical subjects

C Rampulla

Publications and source records attributed to C Rampulla.

At least 37 records · Page 2Linked to original sources

PubMed1989

Smoking habit and bronchial reactivity in normal subjects. A population-based study.

The relationship between smoking habits and airway responsiveness has been studied in a cross-sectional sample of subjects in a small Lombardy (Italy) town. The subjects were between 15 and 64 yr of age; they were representative of the general population. There were 295 normal nonsmokers, 70 normal smokers, and 50 past smokers. All clinically asymptomatic and functionally normal subjects underwent methacholine challenge. The distribution of responsiveness to methacholine (as expressed by LnPD15FEV1) was found to be significantly different between these normal smokers and nonsmokers. A multinomial logistic regression model showed a statistically significant difference in the response to the challenge on the basis of pack-years. When the number of years of smoking and the daily number of cigarettes were separately considered, the current amount had the significant correlation with LnPD15FEV1. Bronchial reactivity for past smokers was found not to be different from that for normal nonsmokers. We conclude that smoking habits, especially current habits, affect bronchial reactivity even in the absence of airway obstruction.

Adolescent↗

PubMed1989

Bronchial responsiveness to inhaled methacholine in epidemiological studies: comparison of different indices.

We evaluated the sensitivity and specificity of different indices drawn from the forced expiratory curve in order to detect the best one for evaluating bronchial reactivity in the general population, and particularly, for distinguishing between normal and asthmatic subjects. 654 subjects, between 15 and 64 years of age, who were representative for age and sex of the general population of a small Lombardy town (Italy), were studied. Of the total sample, 448 subjects were clinically normal and asymptomatic, 87 were symptomatic or with acute upper respiratory disease within 30 days before the challenge with methacholine, 43 with allergic rhinitis, 26 asthmatics and 50 chronic bronchitics. All the subjects who had a baseline FEV1 greater than 85% predicted underwent methacholine challenge. Provocative LnDoses of a 6, 10, 15% fall in FEV1 (LnPD6, LnPD10, LnPD15) and provocative LnDose causing FEV1 to fall more than 2 SD below the mean of 5 FEV1 measurements following buffer inhalation (LnTD) were evaluated. Furthermore we calculated the "Dose-Response slope" (SL) proposed by O'Connor. The cut-off value of each index to define a responder was calculated by discriminant analysis of the response to the challenge in normal and in the asthmatic group. Sensitivity, specificity and predictive value of LnPD6, LnTD and SL were 79, 74, 14%; 71, 74, 13% and 46, 97, 48% respectively. LnPD10 had the best sensitivity (83%) with a high specificity (83%), but, as compared to LnPD15, whose sensitivity was 79% and specificity 89%, a lower predictive value (21% vs 27%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1989

Relationship between the perception of breathlessness and inspiratory resistive loading: report on a clinical trial.

We investigated the relationship between the sensation of breathlessness and progressively higher resistive inspiratory loadings in nine normal subjects (31 +/- 17 yr; forced expiratory volume in one second (FEV1) = 105 +/- 9% of predicted) and in eighteen chronic obstructive pulmonary disease (COPD) patients (63 +/- 7 yr; FEV1 = 43 +/- 17% of predicted). The sensation of breathlessness correlated with mouth pressure both in normals (r = 0.94) and in COPD patients (r = 0.95), with a steeper slope in patients. On this basis we studied the effect of inspiratory muscle training on the sensation of breathlessness in sixteen COPD patients (63 +/- 8 yr; FEV1 = 52 +/- 19% of predicted). After a baseline assessment of lung function, MIP (maximal inspiratory pressure), inspiratory muscle endurance and the sensation of breathlessness (Borg scale) at different inspiratory loads, the patients were divided into two groups: the first was trained by means of resistive breathing, the second used a placebo device. At the end of the training, MIP increased more in the trained group (56 +/- 10 to 69 +/- 15 cmH2O; p less than 0.001) than in the placebo group (50 +/- 17 to 56 +/- 22 cmH2O; p = NS). The Borg score fell significantly at all the considered inspiratory loads in trained patients, but not in the placebo group. We conclude that the training with inspiratory resistances decreased the sensation of breathlessness via an increase in inspiratory muscle strength and endurance.

Adult↗

PubMed1988

Effect of salbutamol and inhaled sodium cromoglycate on the airway and neutrophil chemotactic activity in "fog"induced bronchospasm.

To investigate whether salbutamol and sodium cromoglycate (SCG) inhibit airway response and the associated mediator release induced by ultrasonic nebulation of distilled water (UNDW, "fog"), we measured the serum neutrophil chemotactic activity (NCA) during bronchial challenge with "fog" with and without premedication with placebo, salbutamol, or SCG in 10 subjects with asthma, in four sets of studies. To assess changes in airway caliber, we measured FEV1. To assess changes in NCA, we measured the maximal distance reached by neutrophils in a filter when neutrophils were challenged with the subject's serum in a Boyden chamber. Treatment with placebo did not change baseline FEV1 or serum NCA; however, FEV1 decreased and serum NCA increased (p less than 0.05) after inhalation of "fog". Treatment with SCG did not affect either FEV1 and baseline serum NCA. After inhalation of "fog", no significant bronchoconstriction nor NCA increase was observed in eight of 10 patients with maximal mean percent decrease in FEV1 of -4.26, SEM 0.99, and maximal mean percent increase in NCA of +8.6, SEM 5.28. In the two patients who developed a bronchoconstriction after challenge with SCG pretreatment, an associated significant increase in NCA was observed but did not affect baseline NCA. After inhalation of "fog", no significant decrease in FEV1 (maximal mean percent decrease FEV1, -6.71, SEM 0.17) nor significant increase in serum NCA (maximal mean percent increase NCA, +3.6, SEM 7.1) was observed in nine of 10 patients. After salbutamol, only one patient developed a bronchoconstrictive response to "fog" associated with a significant increase in serum NCA. These results suggest that both SCG and salbutamol may prevent the bronchoconstriction induced by "fog" by inhibiting mediator release.

Adult↗

PubMed1988

Distribution of bronchial nonspecific reactivity in the general population.

We investigated 654 subjects of a small Lombardy (Italy) town between 15 and 64 years of age who were representative of the general population. By clinical examination, the sample included 535 normal subjects (164 normal smokers, 341 normal nonsmokers, 30 normal subjects with acute upper respiratory illness within 30 days before the challenge), 50 with chronic bronchitis, 26 with asthma, and 43 with allergic rhinitis. Subjects whose FEV1 was 75 percent or more than the predicted value (654) underwent methacholine bronchial challenge by means of 1 percent metered-dose solution. The test result was considered positive at a drop of more than 15 percent in FEV1 (compared with buffer). Normal smokers and all of the groups with disease had a significantly different distribution of reactivity compared with normal nonsmokers. The difference between asthmatic and these "normal" subjects was highly significant; nevertheless, a clear cut-off between the two groups does not appear to exist.

Acute Disease↗

PubMed1987

Epidemiological diagnosis of asthma: methodological considerations of prevalence evaluation.

Within an epidemiological survey on Chronic Obstructive Pulmonary Disease, before reporting data on the prevalence of bronchial asthma we checked the group of subjects defined as "pathological" by means of a suitable questionnaire and a group of "normals" as a control. We evaluated the sensitivity and specificity of the questionnaire, in comparison with a clinical evaluation made by two physicians and controlled the relationship among their results, non-specific bronchial hyperreactivity and skin tests. In particular the correspondence between diagnosis made by physicians from a clinical evaluation and that obtained by questionnaire was not satisfactory. We suggest the importance of employing physicians for an epidemiological approach to asthma, in absence of a valid objective criterion.

Adolescent↗

PubMed1987

Influence of the carotid body on gas exchange during exercise.

The role of the carotid body in the ventilatory changes of exercise is reviewed. Peripheral chemoreceptor function was studied in 20 patients with chronic airways obstruction. The patients were treated double-blind and randomly allocated to placebo and almitrine bismesylate 50 mg b.d. before undertaking an exercise programme at day 0 and after 30 and 60 days of therapy. Patients on almitrine therapy had an improved resting arterial oxygen tension (PaO2) which was maintained during exercise. A statistically significant improvement of effort tolerance was observed after 60 days treatment with almitrine.

Aged↗

PubMed1986

Increased neutrophil chemotactic activity in exercise- and "fog"-induced asthma.

To investigate whether exercise- and ultrasonic "fog"-induced asthma are due to the same mechanism, i.e. mediator release induced by osmotic changes, we measured the serum neutrophil chemotactic activity before and after exercise and inhalation of "fog" in 15 asthmatic subjects. To assess changes in airway caliber we measured specific airway conductance (SGaw); to assess changes in neutrophil chemotactic activity we measured the maximum distance reached by neutrophils in a filter when challenged with the subject's serum in a Boyden chamber. In 10 subjects, SGaw decreased by more than 35% and neutrophil chemotactic activity increased significantly (P less than 0.05) both after exercise and "fog", whereas in five subjects no change occurred either after exercise or "fog". We conclude that both exercise- and "fog"-induced asthma are associated with increased serum neutrophil chemotactic activity, and that both stimuli may cause asthma by osmotically triggering mediator release from mast cells.

Adolescent↗

PubMed1986

A review of clinical studies carried out in Italy with almitrine bismesylate.

The authors refer to a double-blind versus placebo multicentric study, carried out in Italy on 128 hypoxaemic patients suffering from COLD, with Almitrine bismesylate, a new chemoreceptor stimulant drug, given by mouth for a period of two months. Almitrine induced significant changes (p less than 0.001) of PaO2, with a mean increase of 7.6 mmHg, and of PaCO2, with a mean decrease of 4.1 mmHg, without variations of lung volumes and caliber of large and/or small airways. Almitrine, well tolerated within the time limits of this trial, seems an effective oral respiratory drug, acting through a favourable effect on V/Q mismatching due mainly to a reduction of the shunt effect, but also to an improvement of the ventilatory pattern.

Almitrine↗

PubMed1985

Broxaterol: a double-blind clinical trial comparing broxaterol and salbutamol.

10 patients with reversible bronchospasm received by the oral route in a double-blind fashion broxaterol, Z. 1170, 0.250 and 0.500 mg in comparison with salbutamol 4 mg as base and a placebo. Measurements of FEV1, heart rate and arterial pressure were performed before and 0.5, 1, 2, 4, 6 h after each treatment. Z. 1170 was followed by increases in FEV1 over the baseline and the placebo values that were significant up to the 4th hour with the 0.500 mg dose, up to the 2nd hour with the 0.250 mg dose. The difference between the effects of the two dose levels of Z. 1170 was significant, and the effect of the 0.500 mg dose was not significantly different from that of salbutamol 4 mg. The maximum increments in FEV1 following Z. 1170 averaged 15.8% for the 0.250 mg dose, 24.3% for 0.500 mg dose, and they were recorded at the 2nd hour. At this time point the mean increment in FEV1 following salbutamol was 18.0%. The maximum increments in FEV1 with salbutamol averaged 18.7% and were recorded at the 1st hour. At this time the mean increments for Z. 1170 0.250 and 0.500 mg were 13.8 and 20.0%, respectively. Heart rate and arterial pressure did not show any changes of clinical significance.

Adrenergic beta-Agonists↗

PubMed1984

Classification of respiratory functional impairment in chronic obstructive pulmonary disease.

Starting from a paper published in 1964 by Wilson et al., we explored the possibility of classifying the clinical and functional deficit of patients with chronic obstructive lung disease into six classes, class 0 representing normality and class 5 greatest severity. Each symptom or sign was classified into six degrees of increasing severity. Next, we looked for a possible dependence of the collegially assigned score on anthropometric, clinical, or instrumental data in each case. More particularly, we tried (1) to identify such combinations of variables as would permit classification of the patient with the smallest possible error, and (2) to determine which of the variables reflected the severity of the case more faithfully. The results emerging from this study suggest the possibility of evaluating and classifying respiratory impairment in three different ways, as follows: (1) On the basis of clinical data only. This method is the easiest to use and affords a fairly good determination coefficient (R2 = 0.812). (2) Using only some combinations of laboratory data (static and dynamic pulmonary volumes, blood gases, etc.), with or without the addition of vital statistics and anthropometric data. These subensembles would allow a posteriori estimates in cases where the subject is no longer available for questioning and examination. In that case the best multiple regression affords a determination coefficient R2 = 0.82. (3) Using all clinical and laboratory data available. In that case, the best multiple regression (R2 = 0.899) for predictive purposes is that which includes the sum of clinical data, the pulmonary volumes before and after pharmacological bronchodilation, and the PaCO2 value. For practical purposes, however, the most convenient function is the one that includes the sum of clinical data plus FEV1 and RV (R2 = 0.863). Even with the best of the three functions proposed in this paper, however, the standard error of estimate entails tolerance limits sometimes amounting to one whole class of severity. Still, the probability of making an error exceeding one class of severity occurs in only 3.7% of the cases, an average which seems quite acceptable from the clinical point of view.

Adolescent↗

PubMed1982

Relation of kinetocardiogram to systolic time intervals in patients with old myocardial infarction.

Left ventricular function was studied noninvasively in a group of 35 patients with noncomplicated and complicated old myocardial infarction (MI) by means of kinetocardiography (KCG) and systolic time intervals (STI). Discriminant analysis with a group of 130 normal subjects documented that STI were significantly abnormal and that the abnormalities, i.e. prolongation of the preejection period, shortening of left ventricular ejection time and increase of PEP/LVET were more evident in patients with complicated old MI. KCG was more or less abnormal in all the patients studied, with the more striking abnormalities in those with complications. A good correlation was found between KCG and STI abnormalities. We consider that KCG is able to detect in a sensitive way abnormalities of left ventricular contraction in patients with old MI and that, most probably, alterations of STI in these patients are mainly due to incoordinate left ventricular contraction.

Adult↗

PubMed1982

Double-blind clinical trial of domiodol vs S-carboxymethylcysteine in chronic obstructive lung disease.

The results of a double-blind trial on the clinical and functional effects induced by domiodol and S-carboxymethylcysteine (SCMC) on 40 patients with chronic obstructive lung disease are discussed. Although the therapeutic effects of the two drugs showed no statistical differences both substances had a positive effect on all patients. In general domiodol took effect more rapidly, a feature that is often very convenient.

Adult↗

PubMed1981

Effect of (dl) 3,7-dihydro-1,8-dimethyl-3-(2-methylbutyl)-1H-purine-2,6-dione on exercise-induced bronchospasm.

The authors studied the clinical activity of a synthetic theophylline derivative, (dl)-dihydro-1,8-dimethyl-1-3-(-2-methyl-butyl)-1 H-purine-2,6 dione, both after short-term treatment and in prevention of Exercise-Induced Asthma (EIA). The action of the new compound at two dosages was compared with that of anhydrous theophylline at a standard dose of 600 mg/day. The trial included 15 asthmatics, 11 males and 4 females, who showed EIA with reversible bronchospasm (improvement of at least 15% of FEV1 after administration of salbutamol at a dose of 200 mcg by means of a predosed aerosol). Asthma had been provoked by free running on a flat surface. The test was considered positive if the FEV1 was reduced at least by 20% compared with baseline level. Only 11 patients completed the protocol. In four cases the treatment had to be withdrawn due to the onset of adverse side effects. After 3 days of treatment, the drug caused a statistically significant improvement of FEV1 in comparison with baseline, but no difference from that caused by theophylline. Likewise no significant difference was noted between low and high doses of the tested drug. As regards the behavior of EIA under treatment, in 8 of 14 patients theophylline and the investigational drug proved equally effective. Two patients were protected only by theophylline, one only by the investigational drug, and three failed to be protected by either agent. The higher dose of the investigational drug protected against EIA in all the subjects protected by theophylline with one exception. Of the two doses tested, the lower one should be preferred since it has the same therapeutic effect without the most important side effects.

Adult↗

PubMed1980

A comparison between different methods for detecting bronchial hyperreactivity. Bronchial hyperreactivity: methods of study.

The authors evaluated bronchial hyperreactivity comparing two different methods for aspecific bronchostimulation (H2O ultrasonic mist and free running) and a bronchodilation test. The investigation had been carried out on three groups of subjects. The first included 15 nonsmoking normal subjects, the second 23 asthmatic patients and the third 16 rhinitic patients. All subjects were submitted to bronchodynamic tests in three different ways. The ventilatory parameters were FVC, FEV1, MMEF and Vmax25. In normal subjects no significant changes were found. In asthmatic patients the bronchodilation test was positive in 65% of the cases, regarding FEV1 and in 87% regarding the forced flows. The running test was positive in 26% of the cases (FEV1) and in 61% of the cases (forced flows). The ultrasonic mist caused a significant drop in FEV1 in 17% of the cases, while flows were significantly reduced in 30% of the cases. In rhinitic patients the bronchodilation test was positive in 25% of the cases both considering FEV1 and forced expiratory flows. Ultrasonic mist never induced a decrease of FEV1, while flows decreased in 12.5% of the cases. The free running test was positive in 12% of the cases regarding FEV1 and in 25% regarding forced flows.

Adolescent↗

PubMed1980

Clinical efficacy trial: theophylline vs (dl) 3,7-dihydro-1,8-dimethyl-3-(2-methylbutyl)-1H-purine-2,6-dione.

The authors give a synopsis of the results of a clinical efficacy trial involving a comparison of a new synthetic xanthine derivative (CK 0383) and theophylline, with emphasis on the prevention of exercise-induced asthma (EIA) by both theophylline and the new drug. Although the results are quite preliminary, being based on only five cases, the authors are continuing this study due to findings that show CK 0383 has a good bronchodilating activity without any important side effects.

Adolescent↗

PubMed1979

[Effect of an adrenergic-parasympatholytic aerosol combination on the respiratory function].

The ventilatory and cardiocirculatory effects of salbutamol-ipratropium aerosol were examined in 27 subjects with bronchial obstruction. The activity of the association was compared with that of the two components at therapeutic doses. Then the effects and possible side-effects of the association were assessed at increasing doses. Lastly, the association was compared with its components. The association had the same latency time, but a more prolonged effect (still effective after 120'), when compared with salbutamol. It was decidedly superior to the parasympatholytic. No side-effects of any kind were observed.

Aerosols↗

PubMed1979

Clinical pharmacology of a combination of bronchodilators.

27 hospitalized patients (15 suffering from chronic bronchitis with evident bronchospasm and 12 with extrinsic asthma) were evaluated with regard to the bronchodilating effects of a Salbutamol + Ipratropium Bromide combination administered by aerosol. For comparison, the bronchial spasmolytic effectiveness of both drugs administered separately at therapeutic doses was also evaluated. Subsequently, the activity of increasing doses of the combination was studied, with particular regard to possible side-effects. The pharmacological combination studied exerted a strong bronchodilating activity, independently of dose increase, both in asthmatic and in bronchitic patients. No side-effects were observed.

Aerosols↗