PubMed Health⌕ Search

Biomedical subjects

E J Steenhuis

Publications and source records attributed to E J Steenhuis.

At least 19 recordsLinked to original sources
PubMed1990

Effect of theophylline on cortisol plasma concentrations in patients with chronic obstructive pulmonary disease.

To further understand the therapeutic action of theophylline, we investigated, in a randomized double-blind crossover study, the effects of a 4-day treatment with two different dosage regimens of theophylline on the circadian rhythm of cortisol plasma concentrations in seven COPD patients. Both theophylline regimens resulted in plasma concentrations in the therapeutic range (more than 7.5 mg/l). No significant differences between placebo and the active trial periods in the circadian rhythm of cortisol secretion were found. These results suggest that cortisol secretion is not influenced by therapeutic plasma concentrations of theophylline.

Aged↗
PubMed1989

Chronopharmacodynamics and kinetics after symmetric and asymmetric multiple theophylline doses in patients with chronic obstructive pulmonary disease.

In a randomized double-blind crossover study, the effects of 4 days of symmetric or asymmetric dosing with sustained-release theophylline (Sabidal-SR) were compared with placebo in ten patients with chronic obstructive pulmonary disease in a stable state. The doses were 450 mg b.i.d. and 270 mg plus 630 mg, respectively. Special attention was paid to circadian rhythms in pharmacokinetics and pharmacodynamic effects, during 24 h of measuring. The peak plasma theophylline concentrations at night with a symmetric dosage were lower than with an asymmetric dosage: 11.5 mg/l (+/- 3.8) and 13.6 mg/l (+/- 4.4), respectively. Both theophylline regimens caused a significant increase in vital capacity (8%) and in forced expiratory volume in one second (15%), and also a decrease of specific viscous work of breathing (49%). There were no significant differences in pharmacodynamic effects between the symmetric and asymmetric dosing regimen. An exception was the heart rate, that increased significantly only with an asymmetric dose. We found no correlation between the theophylline plasma concentration and the changes in lung function and heart rate. Theophylline had no influence on subjective findings of the patients, nor on the oxygen saturation of the blood during sleep.

Absorption↗
PubMed1988

A placebo-controlled comparison between the bronchodilatory effects of ipratropium bromide inhaled as a dry powder and by metered dose inhaler in chronic obstructive pulmonary disease.

A placebo-controlled study was performed to compare the effect of the inhalation of ipratropium bromide as a powder (capsule = 40 micrograms) and by pressurized aerosol (two puffs of 20 micrograms; ie, 40 micrograms). Fifteen patients (nine males and six females) with chronic obstructive pulmonary disease were studied in a double-blind crossover comparison of the two different modes of administration. The VC, FEV1 and viscous work of breathing time-response curves were almost identical, indicating bronchodilation. We conclude that in patients with chronic obstructive pulmonary disease, the powder inhalation was not more effective than the pressurized aerosol. It could, however, be offered as an alternative to patients with poor hand-lung coordination. The patients tolerated the two modes of administration without difficulties: no local irritation or coughing was observed.

Administration, Inhalation↗
PubMed1988

Moderately severe chronic airflow obstruction. Can corticosteroids slow down obstruction?

In a former study in patients with severe chronic airflow obstruction (CAO), (forced expiratory volume in one second (FEV1) ranging from 350-910 ml), we concluded that daily oral corticosteroids might slow down the progression of disease. The results of the present long-term (14-20 yr) study on 139 non-allergic patients with less severe CAO (FEV1 greater than or equal to 1200 ml, FEV1 as a percentage of vital capacity (FEV1%VC) 40-55%) confirm and extend our former observations. Four patterns of the course of FEV1 and inspiratory vital capacity (VC) in time were recognized: 1) linear decrease; 2) no change; 3) initial increase, followed by decrease; 4) initial decrease, followed by increase. Groups 1 and 3 had a higher functional residual capacity as a percentage of total lung capacity (FRC%TLC) as compared to group 2 and 4; the work of breathing was lower in group 2 than in the other three groups. Otherwise the initial 82 parameters, including the degree of reversibility of airflow obstruction and smoking habits were comparable in the four groups. The four patterns of FEV1 showed a strong association with the long-term use of prednisolone. When oral prednisolone was instituted or increased to a dose of at least 10 mg/day continuously, FEV1 either remained constant, decreased more slowly or even increased over many years of follow-up. When the oral dose was diminished to below 10 mg/day, FEV1 decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Ear oximetry studies during sleep in patients with severe chronic obstructive pulmonary disease in a stable state.

Changes in ear oxygen saturation (SaO2) during the night were measured in 12 elderly patients (mean age = 63.4 +/- 6.7 years) with stable severe chronic obstructive pulmonary disease. The mean FEV1 was 0.84 L (range = 0.45 to 1.30 L) and the mean SaO2 daytime value was 94.4% (range = 93% to 96%). The mean maximal decrease in SaO2 from daytime to sleep was 2.3% (range = 0% to 4%). There was no correlation between the decrease in SaO2 during sleep and the degree of airways obstruction, or the daytime SaO2. In contrast to published data, our 12 patients did not have a significantly lower mean minimum SaO2 than those without chronic obstructive pulmonary disease.

Female↗
PubMed1985

Comparison of disodium cromoglycate, terbutaline and thiazinamium in the prevention of exercise-induced asthma and its relation to non-specific bronchial responsiveness.

The protective effect of pre-exercise treatment with disodium cromoglycate (DC), terbutaline sulphate (TS) and thiazinamium methylsulphate (TM) on exercise-induced asthma (EIA) was investigated. Thirty-one adults each exercised for over 6 min on a bicycle ergometer. Each subject performed five tests. The first and last exercise tests served as controls. A profile of bronchial reactivity based on the combination of hyperreactivity - as measured by acetylcholine (a), histamine (h) and propranolol (p) - was drawn up. The following combinations and frequencies were based on the response (+ or -) in hyperreactivity studies: group (h+, a+, p+) was present in 21 of the 31 patients studied, group (h-, a+, p+) in 6 patients, group (h+, a+, p-) in 2 patients and group (h-, a+, p-) in 2 patients. The proportion of patients effectively protected from their EIA was 80% for TS, 60% for DC and 40% for TM. These findings suggest that there exists a consistent heterogeneity in the patients' response to exercise, possibly related to the individual distribution of receptors leading to bronchial hyperreactivity.

Adolescent↗
PubMed1985

Severe chronic airflow obstruction: can corticosteroids slow down progression?

A long-term (14-18 yr) prognostic study on patients with severe Chronic Airflow Obstruction (CAO) (FEV1 less than 1000 ml) is reported. In 65 of the 79 patients under study at least 7 serial FEV1 values were available. At the beginning of the study long-term treatment with oral prednisolone in doses of 10-15 mg/d was started. Side-effects and introduction of inhalation corticosteroid therapy resulted in a decrease or complete cessation of oral corticosteroid treatment. Three distinct patterns of the course of FEV1 were recognized: 1) no change, 2) initial increase followed by decrease, and 3) linear decrease. Initially 138 clinical parameters, including reversibility of airflow obstruction, were comparable in groups 1, 2 and 3; group 3 showed somewhat stronger evidence of emphysema in lung function parameters. The 3 patterns of FEV1 showed strong association with the long-term use of prednisolone. At an oral dose of 7.5 mg or less/d, FEV1 decreased, often after a considerable time-lag (6-32 months). The results of the study suggest that in CAO oral prednisolone, in doses above 7.5 mg/d, may slow down progression of the disease.

Female↗
PubMed1983

Prognosis in severe chronic obstructive pulmonary disease with regard to the electrocardiogram.

A long-term prognostic study of 128 patients with severe chronic obstructive pulmonary disease (initial value for Forced Expiratory Volume in one second, [FEV1] less than or equal to 1,000 ml) with regard to electrocardiographic and lung function parameters as obtained at the entry visit is reported. Many initial ECG-variables and lung function parameters were significantly different between survivors and non-survivors after five years. We used a discriminant analysis to determine which factors actually provided independent information for detection of those subjects with a survival less than five years. In a discriminant analysis of the initial 25 ECG-variables only P-amplitude in lead II and S-amplitude in lead V6 were predictors of five-year survival (diagnostic accuracy 66.1%). In a discriminant analysis in which initial lung function variables were also considered next to the ECG-variables, the best prediction of five-year survival was made by P-amplitude in lead II, increase of FEV1 after thiazinamium i.m., and residual volume as percentage of total lung capacity [RV/TLC, %] (diagnostic accuracy 73.2%).

Adult↗
PubMed1979

Prognosis in severe chronic obstructive pulmonary disease.

A long-term prognostic study of 129 patients with severe chronic obstructive pulmonary disease (initial value for forced expiratory volume in 1 sec [FEV1] smaller than or equal to 1,000 ml) is reported. Data from the patients (72 per patient) were obtained in a clinically stable phase during the first hospital admission and subsequent regular outpatient visits; the data were processed using multiple regression and discriminant analysis. Five- and 10-year cumulative survival rates were 69 and 40 per cent, respectively. Prediction of survival rate was determined mainly by the rate of decrease in initial FEV1 per year and the degree of increase of initial FEV1 after administration of thiazinamium, a bronchodilator. Initial FEV1 values per se contributed to prediction only when they were less than 450 ml. Study of the data from the individual patients showed the presence of different types of decrease in FEV1: linear, exponential, combined linear-exponential, and phasic. FEV1 sometimes remained unchanged for several years or even showed an increase. No sudden decreases were observed. The better survival rate in patients with greater reversibility of airway obstruction after administration of thiazinamium has important bearing on treatment policy. The hypothesis is put forward that the better survival rate in the present study might be the result of continuing medical care. Comprehensive treatment, provided it includes a component directed at preventing and treating reversible airway obstruction, may be of major importance in determining survival in patients with severe chronic obstructive pulmonary disease. The value of so-called dominant, survival-predicting factors is considered to be of secondary importance; their main function is to alert the physician to the fact that prognosis as concerns survival may be unfavorable and that preventive and therapeutic measures should be taken without delay.

Blood Pressure↗