Effect of 0.5 ppm sulfur dioxide on the respiratory function of normal and asthmatic subjects.
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Biomedical subjects
Publications and source records attributed to H J Wittig.
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Plasma theophylline concentrations were measured in 20 adults after single doses of 8 mg/kg of each of six oral sustained-release theophylline preparations. Twelve subjects were studied in a multiple-dose trial. Comparison of bioavailability and absorption characteristics suggest usefulness of some of these products for the purpose of maintaining safe and effective blood levels with twice-a-day dosing.
Records of 2,190 patients with demonstrable allergic disease, including 1,148 patients with asthma and 557 patients with allergic rhinitis, were analyzed for the impact of certain risk factors on age of onset of allergic disease and on sensitization to certain specific antigens. The risk factors examined included race, sex, maternal age, family structure, life style, feeding history, environmental factors and heredity of allergic disease. Age of onset was significantly earlier (P less than 0.001) in males, blacks, children of younger mothers, bottle-fed babies, children of rural origin, children of smoking parents and children with a bilateral family history of allergy.
A double-blind, crossover study was performed with a new topical aerosol steroid, flunisolide, administered every 12 hours over a period of eight weeks to 36 adult patients with perennial allergic rhinitis. During the treatment period the majority of patients had significant relief of symptoms as compared with the placebo period. Most prominent improvement occurred with the symptoms of nasal stuffiness, sneezing, rhinorrhea and the number of times patients had to blow their noses. Best results were obtained in patients with higher degrees of atopy. Side effects were minimal and limited to nasal irritation in some patients. Criteria for optimal patient selection are discussed and an explanation for the lack of systemic effects of aerosolized use of the newer corticosteroids is given.
An analysis of the patterns of pulmonary function response to bronchodilators in 20 adult asthmatics reveal distinct categories of response. It is suggested that the pattern of response is related primarily to the degree of baseline abnormality in pulmonary function rather than to other characteristics of the disease or patient. Thus, one may predict pulmonary function response to bronchodilators in adult asthmatics based solely upon baseline function.
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Analysis of individual patterns of response to bronchodilation in asthmatics, rather than group averages, emphasizes the varying types of "asthma" as well as the need to examine all parameters of lung function when evaluating any new therapeutic agent. The often praised maximum mid-expiratory flow rate may be very misleading as a parameter of drug response.
A double-blind crossover study was performed on 34 adult patients with perennial allergic rhinitis, using an aqueous solution of 4% cromolyn sodium or a placebo substance six times daily over a 4-wk period with daily documentation of both symptoms and use of symptomatic medications. All patients had markedly positive skin test reactions to at least one antigen. Chemistry screens and IgE serum levels were determined. Significant reductions occurred in the symptom-scores for runny nose, stuffy nose, sneezing, and nose blowing while patients were on cromolyn treatment (p less than 0.005). Likewise, while on treatment, there was a significant reduction in the consumption of antihistamines. In an attempt to differentiate between good and poor cromolyn responders by clinical and laboratory parameters, we found that (1) patients with high IgE levels responded better than those with low IgE levels, (2) patients with markedly positive skin test reactions to epidermoids and to foods responded better than those with pollen allergy, and (3) females appeared to have a significantly better drug response than males. Age did not play a role in drug response, nor did drug sequence (placebo-active or active-placebo).
Two adrenergic aerosols were compared in a double blind, matched-pair study of 6 months' duration in 28 adult patients with chronic bronchial asthma, and in a double blind, crossover, short-term study in 18 children with severe asthma. In the adult study, one member of each pair was given either 150 mug of isoproterenol or 200 mug of carbuterol 4 times per day, by inhalation, for 6 months. In the childhood study, 18 children, 6 to 12 years of age, with moderate to severe asthma were studied in a double blind, crossover therapeutic trial in which high or low doses of aerosolized carbuterol or isoproterenol were given 4 times daily for 5 days each. Treatment results were evaluated by measuring forced vital capacity, 1-sec forced expiratory volume, and maximal mid-expiratory flow (FEF25-75%) at regulat intervals before and after administration of the respective test drugs. In the adult study, there was a significant difference between carbuterol and isoproterenol for forced vital capacity (P less than 0.02), for 1-sec forced expiratory volume (P less than 0.02), and for FEF25-75% (P less than 0.01) in favor of carbuterol. In the pediatric study, the difference between carbuterol and isoproterenol was significant (P less than 0.05) only for the FEF25-75% on the fifth day of treatment with the high dose administration of carbuterol. There was no associated toxicity of either drug with respect to electrocardiogram, blood chemistry, or subjective complaints. Tachyphylaxis (tolerance with time) to isoproterenol appeared to develop in one patient.
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A double-blind crossover study of inhibition of histamine-induced pruritus by three commonly prescribed antihistamines was conducted on 28 normal subjects. Drugs used included diphenhydramine HCl (Benadryl), cyproheptadine (Periactin), hydroxyzine HCl (Atarax), and a lactose placebo in identical capsules. Intradermal histamine dose-response thresholds of pruritus were obtained before and after pretreatment with the three antihistamines and placebo in each subject. Analysis of data revealed a fivefold increase above baseline of the histamine dose required to produce pruritus following both cyproheptadine and placebo. This compared to a tenfold increase following diphenhydramine and a 750-fold increase following hydroxyzine HCl. The most common side effect was drowsiness, which occurred with all three drugs.
Two South American species of the fire ant group, Solenopsis richteri and Solenopsis invicta, now occupy more than 150 million acres in 13 southern states and cause systemic allergic reactions to their stings. We report 49 cases of such reactions with case reports and documentation. Specificity of the sting was documented by either typical pustule formation or positive skin tests. Of 37 patients treated with hyposensitizing injections, 10 have subsequently been restung. Only one suffered a systemic reaction. Problems of cross-reactivity with other insects are discussed and the literature is reviewed. Hypersensitivity to the imported fire ant continues to be a serious problem in the southern United States and appears to be amenable to properly instituted hyposensitization therapy.
A review of the world literature regarding the relative efficacy, duration and toxicity of the available beta-adrenergic bronchodilator aerosols for the treatment of asthma is presented. Many of these agents will soon become available in the United States and some familiarity with their actions is necessary for optimal care of asthmatic patients.
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