PubMed HealthSearch

Biomedical subjects

E Angelici

Publications and source records attributed to E Angelici.

7 recordsLinked to original sources

Alveolar cell population in HIV infected patients.

Alveolar lymphocytosis, in the face of blood lymphopenia, is a common finding among patients with AIDS. We studied by bronchoalveolar lavage (BAL), the alveolar cell profile of 43 human immuno deficiency virus (HIV) seropositive patients divided into three groups involving the advanced stages of the disease: group A (n = 9; CDC III), ambulatory individuals without systemic or respiratory symptoms; group B (n = 15; CDC IV) patients admitted for evaluation of fever of unknown origin (FUO) without pulmonary involvement; group C (n = 19; CDC IV), patients admitted for evaluation of an acute pulmonary condition. Sex, age and risk factor were comparable among the groups. Alveolar lymphocytosis was found in no group A patients, in 2 out of 15 group B patients (both with P. carinii lung infection) and in all group C patients, where pulmonary involvement was due to opportunistic infection or to nonspecific interstitial pneumonitis. Our findings suggest that in patients with advanced HIV infection alveolar lymphocytosis may be an expression of a concomitant process within the lungs either clinically manifest or inapparent, or possibly related to HIV primary lung involvement.

Acquired Immunodeficiency Syndrome

Effects of fenoterol on oxygen transport in patients with chronic airflow obstruction.

A rise in cardiac output and a fall in arterial oxygen tension are well known side effects of bronchodilator drugs, particularly beta-adrenergic agonists. In recent years, fenoterol (Berotec), an effective beta-adrenergic agonist, has been used at increasing rates in asthmatic subjects, as well as in patients with chronic obstructive pulmonary disease (COPD). The effects of fenoterol on systemic hemodynamics or arterial oxygenation (or both) in patients with COPD have not been investigated; in these individuals, who often have increased sympathetic tone and hypoxemia even at rest, cardiovascular stimulation and a fall in arterial oxygen tension would be particularly undesirable side effects. In 14 patients with COPD (seven without a reversible component of airflow obstruction [group 1]; and seven with a reversible component of airflow obstruction [group 2]), we studied all of the important parameters of oxygen transport before and 60 minutes after administration of fenoterol. Studies were performed at rest and after exercise. At baseline, group 1 showed a faster heart rate, a lower cardiac output, a lower arterial oxygen flow, a wider arteriovenous oxygen content difference (C[a-v]O2), and a higher fraction of oxygen extracted by the tissues from a given arterial oxygen flow. In both groups, all measured parameters, including cardiac output and arterial oxygen pressure (PaO2) remained statistically unchanged one hour after administration of fenoterol; with exercise, the heart rate, blood pressure, minute ventilation, oxygen consumption, C(a-v)O2, and the percentage of oxygen extracted from arterial oxygen flow, as well as cardiac output and PaO2, increased in all instances; the exercise responses were not affected by the drug. These results suggest that at the time of its maximal effect on the airways (60 minutes), fenoterol has no untoward effect on the oxygen transport system, at rest or during exercise, in patients with COPD with or without a reversible component.

Aged

Tolerance to inhaled Duovent. A long-term study.

Fenoterol with ipratropium bromide (Duovent) is a recently used combination between an anticholinergic and a beta-adrenergic drug useful in obtaining a more effective bronchodilatation and/or reducing the single drug doses. It has been suggested that, as in the case of beta-agonists, its clinical efficacy may be limited by the development of tolerance. We studied the effects of inhaled Duovent in 15 asthmatic patients for 3 months, using a rigidly controlled protocol. Appropriate serial physiological measurements were made at regular intervals during the 90-day study. In all instances the day-one bronchodilator response was significant, prompt and sustained: at 1, 4, 8 and 12 weeks the response was statistically the same as on day 1. It is concluded that, when the important variables are properly controlled, no evidence of tolerance to long-term therapy with Duovent is demonstrable.

Adult

Tolerance to inhaled fenoterol.

Fenoterol ( Berotec ; Th 1165a , Boehringer- Ingelheim , Spa., Firenze , Italy) is an effective, widely used bronchodilator. It has been suggested by some investigators that, as in the case of other beta-adrenergic agonists, its clinical usefulness may be limited by the development of tolerance; others have found no tolerance. These conflicting results appear to be related to differences in study designs. We studied for 3 months the effects of inhaled fenoterol in 15 asthmatics, using a rigidly controlled protocol. Appropriate serial physiologic measurements were made at regular intervals during the 90-day study. In all instances the day 1 bronchodilator response was significant, prompt, and sustained: at 1,3,4,8 and 12 wk the response was statistically the same as on day 1. It is concluded that, when the important variables are properly controlled, no evidence of tolerance to long-term therapy with fenoterol is demonstrable.

Adult

[Determination of cardiac output by thoracic electric impedance: comparison with thermodilution].

When an alternating current of high frequency is applied to the thorax, the first derivative of the impedance (dZ/dt) is affected by the cardiac cycle, resulting in a characteristic wave form. The maximum negative of this wave occurring during systole together with the length of ejection time (VET), the blood resistivity, the basal impedance (ZO) and the distance between the inner detecting electrodes (L) makes it possible to calculate stroke volume (SV) and related parameters, as cardiac output (CO) and cardiac index (Cl) by a formula developed by Kubicek. Thoracic electrical impedance has been proposed as a non invasive technique to evaluate cardiac emodinamics. In the present study we have evaluated thoracic electrical impedance by comparing it with thermodilution, simultaneously performed in 21 catheterized patients. Reproducibility was assessed by comparing Cl measured several times in the same patient during ten minutes of rest in the supine position: coefficient of variation, expressed as CV = SD/m X 100 was 8,5 +/- 4,2% and 9,4 +/- 3,2% (p = NS) for thermodilution and thoracic electrical impedance respectively. Cl values obtained by both methods correlated well, with little scatter either baseline (r = 0,784, n = 40, p less than 0,001), either after an handgrip manoeuvre (r = 0,629, n = 15, p less than 0,05). This degree of correlation is similar to that observed comparing invasive techniques (Fick, thermodilution, dye dilution) either among them, or with noninvasive methods (echocardiography, gated equilibrium blood pool scintigraphy and ultrasonic Doppler).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult