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Biomedical subjects

C Sturani

Publications and source records attributed to C Sturani.

34 records · Page 2Linked to original sources
PubMed1986

Pulmonary vascular responsiveness at rest and during exercise in idiopathic pulmonary fibrosis: effects of oxygen and nifedipine.

To detect whether pulmonary vascular responsiveness is a factor which can aggravate the pulmonary hypertension induced by irreversible pulmonary fibrosis, we examined the acute hemodynamic effects of low-flow oxygen and of nifedipine both at rest and during exercise in 8 patients with idiopathic pulmonary fibrosis (IPF). During exercise, the increments in pulmonary artery pressure, pulmonary vascular resistance (PVR), and right ventricular stroke work index relative to resting values were blunted by both treatments. During exercise, both systemic vascular resistance and PVR decreased more significantly after nifedipine than on oxygen (p less than 0.001). At exercise, nifedipine administration induced a greater increment in oxygen delivery (CaO2 X CI) than that produced by oxygen breathing (p less than 0.01). Our results in patients with IPF seem to confirm that active vasoconstriction of pulmonary vessels may contribute to the pulmonary hypertension during exercise. The evaluation of reversibility of pulmonary hypertension by nifedipine in IPF deserves further long-term studies.

Adult↗
PubMed1986

Respiratory flutter during carbon dioxide rebreathing in patients with obstructive sleep apnea syndrome.

In order to detect the dysfunction of the upper airway muscles in awake patients with obstructive sleep apnea syndrome (OSAS), we examined the effect of a chemical stimulus (CO2) on flow-volume loops obtained during tidal breathing. Six flow-volume curves during forced maneuvers and six flow-volume tracings during rebreathing of CO2 were recorded in 20 patients with OSAS. All patients had numerous obstructive apneas (mean apnea index 61 +/- SD 33, percentage of obstructive apneas 76 +/- 29) associated with moderate to severe degrees of arterial oxygen desaturation. Of the 18 patients in whom at least six flow-volume loops could be obtained during CO2 rebreathing, 13 exhibited respiratory flutter (range: grade 1 to 6) during tidal breathing in the flow-volume tracing (RF VtCO2). The greater the degree of RF VtCO2 during wakefulness, the less was the lowest oxygen saturation (LSaO2) during sleep. In fact, all four patients with RF VtCO2 score 6 had LSaO2 below 30%.

Adult↗
PubMed1985

Parasympathetic activity assessed by diving reflex and by airway response to methacholine in bronchial asthma and rhinitis.

It has been suggested that airway hyperreactivity in asthma is associated with increased parasympathetic tone. We have accordingly assessed parasympathetic responsiveness in five groups of subjects (17 normal controls, 8 patients with extrinsic rhinitis, 6 with intrinsic rhinitis, 10 extrinsic asthmatic patients, 7 intrinsic asthmatic patients) by examining their responses to both diving reflex and methacholine inhalation challenge. The mean fall in heart rate during the diving test was significantly greater in asthmatic subjects than in normal controls and in patients with rhinitis. The diving-induced bradycardia was significantly greater in intrinsic than in extrinsic asthmatic subjects. There was a good correlation between the drop in heart rate during diving test and the provocation dose of methacholine producing a 45% decrease in specific airway conductance both in patients with rhinitis and in asthmatic patients. There was a less good correlation between diving response and clinical severity score in the same asthmatic patients. These results indicate that intrinsic asthma is associated with a marked degree of cholinergic hyperreactivity. The diving test seems to provide an accurate method for the analysis of the parasympathetic system in asthma.

Adult↗
PubMed1984

[Radiological diagnosis of pulmonary arterial hypertension in idiopathic pulmonary fibrosis].

This study evaluates the usefulness of chest x-ray in the diagnosis of pulmonary arterial hypertension. Twelve patients with severe interstitial fibrosis were studied by respiratory functional tests and right heart catheterization. A quantitative radiologic diagnosis of pulmonary arterial hypertension in pulmonary fibrosis results more difficult than in chronic obstructive airway disease, mitral stenosis or pulmonary thromboembolism. Nevertheless in case of severe interstitial fibrosis pulmonary hypertension was regularly present even if specific radiologic findings were not available. We have found some interesting correlations, i.e. a trend to a relationship between mean pulmonary pressure and right descending pulmonary artery diameter.

Adult↗
PubMed1984

[Chests x-ray in status asthmaticus. Relations between radiological abnormalities and impaired respiratory function].

The chest radiographs of 78 adult asthmatic patients admitted with severe acute asthma over a three-years period were reviewed. Radiographic findings were compared with functional data. Overinflation was demonstrated in 32% of chest X-rays. In four patients the presence of atelectasis was shown. On admission only PaO2 was significantly lower in patients with radiological abnormalities than in patients with normal chest radiographs. The usefulness of chest radiographs in patients with acute asthma is discussed.

Adolescent↗
PubMed1983

Oral nifedipine in chronic cor pulmonale secondary to severe chronic obstructive pulmonary disease (COPD).

Hemodynamic effects of orally-administered nifedipine were evaluated in 12 patients with pulmonary hypertension secondary to severe COPD after short-term (30 and 60 minutes) treatment and then again in eight of these 12 patients after long-term (average 55 days) treatment. Pulmonary vascular resistance (PVR) decreased from 426 +/- 52 to 294 +/- 28 dynes.s.cm-5 (p less than 0.001) after therapy with 20 mg sublingual nifedipine (at 60 minutes). Cardiac index (CI) increased from 3.7 +/- 0.2 to 4.6 +/- 0.3 L/min/m2 (p less than 0.001). There was a decrease in mean pulmonary artery pressure (MPAP) only in 4/12 patients after Nifedipine. There was no significant fall in PaO2, while PvO2 and oxygen delivery (CI X CaO2) increased significantly 60 minutes after administration of sublingual nifedipine. PVR decreased from 482 +/- 82 to 374 +/- 44 dynes.s.cm-5 (p less than 0.05) after long-term nifedipine therapy. The changes in PVR and CI 60 minutes after administration of nifedipine in the patients on long-term treatment were similar to those observed with the same doses of nifedipine before initiation of therapy. Despite beneficial hemodynamic effects in two of eight patients, there was progressive clinical worsening. The benefit of long-term administration of nifedipine is difficult to predict on the basis of short-term effects.

Administration, Oral↗
PubMed1980

[The first stage of sarcoidosis: the actual diagnostic possibilities (author's transl)].

A correct staging of sarcoidosis is of the uppermost importance in the diagnosis and treatment of the disease. In the last few years new concepts have been stated: --radiological staging of sarcoidosis is particularly difficult --in no one phase the radiological pattern can be considered typical but sometimes it is highly suggestive for sarcoidosis --anatomical studies recently showed that sarcoid disease seems to begin with a non granulomatous interstitial pneumonia. Following this individual microscopic deposit may conglomerate to form the typical non caseating granulomas. In the lung the disease seems to procede from the interstitium to the lymphnodes. Usually, in the first stage, possible sarcoidosis is diagnosed by the radiologist, but a confident diagnosis needs a pathological confirmation. Transbronchial biopsy guided by fluoroscopy is the first diagnostic choice for obtaining confirmation of the disease and for determining the type and entity of parenchymal lesions.

Adult↗
PubMed1979

[Chronic eosinophilic pneumonia (author's transl)].

The clinical and radiologic findings of the chronic eosinophilic pneumonia are presented. A personal observation of one case is reported. This should be the first in the Italian roentgenologic literature. The importance of radiology in the diagnosis and in the evolution of the disease is stressed.

Adult↗
PubMedDate not supplied

Primary lymph node invasive aspergillosis.

A case of apparently primary lymph node granulomatous aspergillosis is described. A review of the so-called primary aspergillosis cases since 1977 shows that granulomatous instead of exudative inflammation patterns have been observed in histological sections only when neither major nor minor predisposing factors have been detected in the clinical history of the patients. A possible pathogenetic role of selectively impaired cell-mediated immune response in these cases is hypothesized. Flucytosine treatment is indicated in a few selected cases of deep aspergillosis.

Adolescent↗
PubMedDate not supplied

Pulmonary vascular reactivity and hemorheology in patients with chronic cor pulmonale: responses to pentoxifylline at rest and during exercise.

This study was carried out in order to evaluate changes in pulmonary vascular reactivity and in hemorheology induced by pentoxifylline infusion (100 mg) at rest and during standardized exercise in patients with chronic cor pulmonale secondary to chronic obstructive pulmonary disease. The administration of pentoxifylline at rest was associated with reduction in mean pulmonary artery pressure (p less than 0.01), pulmonary vascular resistance (p less than 0.01) and right ventricular stroke work index (p less than 0.02). Standard exercise performed after pentoxifylline infusion was also associated with significant reduction in mean pulmonary artery pressure and pulmonary vascular resistance. Rheologic tests showed less evident changes. Our data suggest that pentoxifylline significantly improves pulmonary hemodynamics at rest and partly reverses its changes, after exercise, in patients with chronic obstructive pulmonary disease.

Blood Viscosity↗
PubMedDate not supplied

Failure of automatic control of ventilation (Ondine's curse) associated with viral encephalitis of the brainstem: a clinicopathologic study of one case.

A case of Ondine's curse associated with hypothalamic dysfunction in an 8-year-old boy is described. The neuropathological examination revealed a viral encephalitis affecting the hypothalamus and the brainstem. In the medulla the inflammatory process involved the reticular formation and the nuclei considered to control automatic respiration such as the dorsal motor nucleus of the vagus, the nucleus tractus solitarii and the nucleus ambiguous. Although Ondine's curse following viral infection of the central nervous system has been previously reported this represents the first case of viral encephalitis to be pathologically documentated.

Autonomic Nervous System Diseases↗
PubMedDate not supplied

[Radiologic evaluation of bronchial asthma (author's transl)].

The physiopathologic and anatomic findings of bronchial asthma are shortly reviewed. A description follows of the radiologic patterns based on personal experience. Only seldom the radiologic investigations provide the possibility to reach the correct diagnosis of bronchial asthma. But they always complete the clinical evaluation and allow the demonstration of the numerous and frequent complications which influence the evolution and prognosis of the disease.

Asthma↗
PubMedDate not supplied

[The correlation between radiological and haemodynamic pictures in the diagnosis of pulmonary hypertension in chronic obstructive diseases (author's transl)].

A comparison between the radiographical findings and the haemodynamic data was made in 53 cases of chronic bronchial obstruction. The results were used in an assessment of the reliability of standard chest X-rays in the diagnosis of pulmonary hypertension. Reference is also made to quantitative indices. Several cases are presented by way of example.

Adult↗