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Biomedical subjects

G R Reisz

Publications and source records attributed to G R Reisz.

6 recordsLinked to original sources

Pleurodesis by autologous blood, doxycycline, and talc in a rabbit model.

BACKGROUND: Management of recurrent spontaneous pneumothorax or symptomatic pleural effusion often uses thoracoscopic pleurodesis, about which many questions remain. Both effectiveness and toxicity of agents currently used for pleurodesis were evaluated in a rabbit model. METHODS: Agents administered were autologous blood 1 mL/kg, talc slurry (70 mg x mL(-1) x kg(-1)), and doxycycline 10 mg/mL, given through a chest tube to 30 rabbits. Controls had only chest tubes inserted. At 30 days surfaces were graded by gross observation and histologic examination. Blood and lung tissue from all animals were analyzed for enzymes and blood chemistries. RESULTS: Gross observations showed mediastinal thickening and adhesions with doxycycline, and threadlike adhesions with talc. Autologous blood was only slightly more effective than a chest tube alone. Talc significantly increased angiotensin converting enzyme activity in serum, whereas doxycycline changed liver function enzymes and produced tissue toxicity. CONCLUSIONS: Doxycycline produced effective pleurodesis but yielded remarkably severe local effects. The distant sequelae of talc and doxycycline pleurodesis-histologic changes in the contralateral lung and serum enzyme elevations-suggests undesirable systemic effects for the commonly used agents, and autologous blood exhibited no significant pleurodesis, short-term. The search for the ideal agent for chemical pleurodesis continues.

Animals↗

Oral clonidine in patients with asthma: no significant effect on airway reactivity.

Fifteen patients with asthma were randomized into a double-blind, placebo controlled, crossover trial evaluating whether clonidine increased airway resistance. After meeting entry criteria [demonstration of 20% improvement in any two of the following pulmonary function tests after bronchodilator therapy: FVC, FEV1, or forced expiratory flow over the mid-50% of the vital capacity(FEF(25-75)], patients were evaluated on two subsequent visits, receiving sequential doses of clonidine 0.1 mg (maximum cumulative dose 0.3 mg) or placebo in a random fashion. They returned to clinic after a 36-48 hour washout period at which time they received the opposite treatment. The end points were three doses of clonidine or placebo, decrease in blood pressure to < or = 90 mm mercury systolic, and/or < 70 mm mercury diastolic, or a 20% fall in FEV1. Airway reactivity was proved utilizing methacholine on each clinic visit, and blood pressures were monitored continuously during the study period. There were no significant differences in the provocative concentrations of methacholine inducing a 20% fall in FEV1 (PD20) between baseline (1.92), clonidine (1.10), and placebo (1.69). (Numbers in parentheses indicate PD20 values in cumulative dose units).

Adult↗

Empyema thoracis.

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Empyema, Pleural↗

Congenital unilateral absence of a pulmonary artery: a report of two adult cases.

Congenital unilateral absence of a pulmonary artery (UAPA) is a rare anomaly that is generally diagnosed in childhood and frequently associated with other cardiovascular abnormalities. Two patients with unilateral absence of a pulmonary artery first diagnosed as adults are reported. Our two cases demonstrate that presentation of UAPA may range from an incidental finding to chronic, life-threatening symptoms. Because UAPA may require urgent intervention, physicians should be alerted to the possibility of this entity presenting later in life.

Adult↗

Theophylline and diaphragmatic contractility. Investigation of a dose-response relationship.

Our study evaluated whether a dose-response relationship exists for theophylline and diaphragmatic contractility within the usual therapeutic range for theophylline. The study, involving 16 patients with mild to moderate chronic obstructive pulmonary disease, was done in a randomized, placebo-controlled, double-blind, crossover fashion. We found no statistically significant effect of theophylline on diaphragmatic contractility at mean theophylline concentrations of 5.13, 12.07, and 18.6 micrograms/ml.

Clinical Trials as Topic↗

Toxic pneumonitis from mixing household cleaners.

In the past year we have seen three cases of life-threatening toxic pneumonitis caused by exposure to mixtures of household ammonia and bleach. This particular mixture forms intermediary chloramine compounds that cause toxic pneumonitis. Each patient had a prolonged hospitalization and was left with symptomatic residual roentgenographic changes. Exposure to mixtures of household ammonia and bleach may be a frequent cause of acute pneumonitis that is not well recognized.

Aged↗