Biomedical subjects

E N Schacter

Publications and source records attributed to E N Schacter.

4 recordsLinked to original sources

PubMed1996

Respiratory function and immunologic status in workers processing dried fruits and teas.

BACKGROUND: Workers exposed to different organic aerosols may develop respiratory symptoms and lung function changes. OBJECTIVES: To study the immunologic status and respiratory function in workers processing dried fruits and teas. METHODS: The study was performed in 54 exposed and in 40 non-exposed female workers. Skin prick testing was performed with occupational allergens derived from the workplace. Respiratory symptoms were recorded for all workers. Lung function was measured in exposed workers by recording maximum expiratory flow-volume (MEFV) curves. RESULTS: Significantly more exposed workers than controls reacted with positive skin tests to at least one of the occupational allergens (P < .01). Only the response to sage was significantly greater in exposed (60.0%) than in control workers (20.0%) (P < .01). Thirty percent of these workers had elevated IgE level (compared with 2.5% of control workers) (P < .01). Higher prevalences of all chronic respiratory symptoms were noted in exposed compared with control workers. The exposed workers with positive skin tests had significantly higher prevalences of dyspnea (P < .05) and nasal catarrh (P < .01) than those with negative skin tests. A large number of exposed workers complained of acute symptoms that developed during the work shift. In exposed workers there were statistically significant across-shift reductions of ventilatory capacity, particularly for FEF50 and FEF25 on Monday and the following Thursday. Skin test status was not associated with more severe changes in lung function. The mean FEF25 measured before the Monday shift was significantly lower than predicted (P < .01). CONCLUSION: Our data suggest that following exposures to aerosols of dried fruits and teas some workers develop deleterious immunologic and respiratory changes.

Adult↗

PubMed1996

A comparison of ipratropium and albuterol vs albuterol alone for the treatment of acute asthma.

To evaluate the role of inhaled ipratropium bromide in acute asthma, a double-blind study of 384 emergency department patients compared the effect of the combination of ipratropium and albuterol with that of albuterol alone. Patients were randomized to receive nebulizer treatments with either 2.5 mg of albuterol or 2.5 mg of albuterol mixed with 0.5 mg of ipratropium bromide at entry and at 45 min. Spirometry, vital signs, and oxygen saturation were measured before and at 45 and 90 min following the nebulizer treatments. Serum potassium levels were obtained at entry and 90 min. The two groups did not differ significantly in age (mean +/- SD = 33.4 +/- 9.3 and 32.5 +/- 9.7 years for the albuterol and ipratropium group and the albuterol group, respectively), baseline FEV1 (mean +/- SD = 1.22 +/- 0.42 and 1.25 +/- 0.44 L respectively), or prior use of asthma medications. At 45 min, there were significantly more responders (15% increase in FEV1 over baseline) in the group receiving albuterol and ipratropium compared with albuterol and saline solution (85% and 78%, respectively; p = 0.045), but the median change in FEV1 from baseline did not differ (0.530 L for the albuterol and ipratropium group and 0.420 L for the albuterol and saline solution group; p = 0.347). By 90 min, the percentage of responders did not differ (88% and 89%, respectively), and the median change in FEV1 was 0.680 L for the group receiving albuterol and ipratropium and 0.650 L for the group receiving albuterol and saline solution (p = 0.693). There were no significant adverse events experienced by patients in either group. Furthermore, there were no significant differences in the number of patients requiring additional therapy in the emergency department or hospitalization. We conclude that in this population of inner city asthmatics, we were unable to demonstrate significant additive benefit of nebulized ipratropium bromide to nebulized albuterol.

Acute Disease↗

PubMed1983

A review of the hospital course of asthmatic children and adults.

We reviewed 82 consecutive hospital admitted patients treated for acute severe asthma over a seven-month period at a University medical center and an additional 25 patients at an affiliated community hospital. Those asthmatics treated on the adult medical service had a significantly longer length of hospitalization when compared to those treated on the pediatric service (t = 5.12; p less than 0.005). In addition, longer hospitalization periods were noted for those asthmatics who smoked (t = 2.98; p less than 0.005) and for those with a history of chronic bronchitis (t = 2.32; p less than 0.025). Drug regimens were frequently suboptimal; 30% of the patients reviewed were receiving no therapeutic agents prior to admission. Of those patients receiving theophylline 53% had serum levels of less than 10 mcg/ml on their post admission assessment. Although frequently suboptimal, inadequate drug regimens prior to admission did not lengthen hospital stay. Poor compliance with medications was recorded as a major cause of decompensation in nine patients whose mean age was 13 years. Finally, occupational exposure to airway irritants was elicited from 24% of the adult population at the University medical center. Increased length of stay in the hospital for adult asthmatics may reflect relatively fixed airway disease among these patients since a significant proportion of them related a history compatible with chronic bronchitis or were smokers. Occupational histories should be evaluated in adult asthmatics to rule out workplace exposures as a cause for severe decompensation. In addition, the importance of educational efforts addressing therapeutic non-compliance is evident from this study.

Adolescent↗

PubMed1980

Monitoring of oxygen delivery systems in clinical practice.

The measurement of hypopharyngeal FIO2, is a simple and rapid method for evaluating oxygen delivery systems in clinical practice. Hypopharyngeal FIO2 measurements were compared to other established methods of inspired gas measurement, namely, tracheal gas sampling and exhaled gas analysis. Hypopharyngeal sampling and exhaled gas analysis. Hypopharyngeal sampling compared favourably with these methods. Furthermore, arterial blood gas samples from patients receiving oxygen by aerosol mask correlated with the hypopharyngeal measurements but not with the delivery system's settings. In normal, healthy subjects, the authors studied variables known to influence FIO2. Using nasal prongs as well as an aerosol mask system, the authors studied the interaction of the wall flow rates, the concentration (Venturi) settings (in the case of the aerosol mask), and the subject's respiratory rate. Under these controlled conditions of tidal breathing, the hypopharyngeal FIO2 was directly related to the total flow of gas from the delivery system and the concentration of the Venturi setting but inversely related to the respiratory rate. Hypopharyngeal gas sampling offers a simple method for evaluating and correcting a patient's inspired oxygen concentration.

Humans↗