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Biomedical subjects

M Scherrer

Publications and source records attributed to M Scherrer.

At least 19 recordsLinked to original sources
PubMed1992

Technetium-99m-DTPA aerosol and gallium-67 scanning in pulmonary complications of human immunodeficiency virus infection.

We retrospectively compared the results of 67Ga chest scans and 99mTc-DTPA aerosol clearance measurements with those of fiberoptic bronchoscopy in 88 patients infected with the human immunodeficiency virus. Of 100 investigations, a pulmonary infection was diagnosed in 39, mainly Pneumocystis carinii pneumonia and a noninfectious disorder was found in 42, mainly Kaposi's sarcoma and lymphocytic alveolitis. Gallium scans and DTPA clearance were abnormal respectively in 74% and 92% of infectious complications, and in 12% and 60% of noninfectious disorders. In 10 cases, DTPA clearance was accelerated, while chest x-ray, arterial blood gases and even gallium scanning were normal. A value of DTPA clearance greater than 4.5%.min-1 was both sensitive and specific for the diagnosis of Pneumocystis carinii pneumonia. The gallium scan was always normal in bronchopulmonary Kaposi's sarcoma. We conclude that in symptomatic patients: (1) DTPA clearance measurements are useful for detecting lung disease when chest x-ray and/or PaO2 are normal and (2) a gallium scan is indicated to distinguish progressive Kaposi's sarcoma from a superimposed second process when radiological abnormalities of pulmonary Kaposi's sarcoma are present.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Pregnancy and traffic accident. A case report].

The authors report the case of patient (second pregnancy, first birth) who had been involved in a traffic accident which occurred on October 5, 1989 after 7 months of pregnancy. The trauma was scored 2 on the international Overall Abbreviated Injury Scale. The impact was frontal and the patient driving and wearing her seatbelt. After being admitted to hospital on several occasions with metrorrhagia and uterine contractions, it was decided to carry out a cesarian and a baby was successfully removed. The child presented with angulation of the left fore-arm and skeletal X-ray, particularly of the arms, revealed a fracture line with a callous already formed.

Accidents, Traffic↗
PubMed1990

[The role of isotope methods in evaluating the left ventricular function].

Cardiac angioscintigraphy is a non-invasive, reproducible and reliable technique used to obtain a number of cardiac function parameters, the most important of which is left ventricular ejection fraction. Methodologically, the examination is simple. Fourier's analysis (a mathematical decomposition of ventricular mechanics) provides additional information on some abnormalities and is particularly useful in segmental kinetics studies and in the topographical diagnosis of cardiac rhythm disorders. The technique is indicated mainly for prognostic evaluation and follow-up of patients with left ventricular dysfunction. Metaiodobenzylguanidine (MIBG) cardiac scintigraphy makes it possible to evaluate the reuptake of noradrenaline by neurons, which represents the inactivation pathway of adrenergic neurotransmission and is the principal factor of noradrenaline extraction. MIBG scintigraphy is an indirect way of evaluating left ventricular function in congestive heart failure, as suggested by the results of studies showing correlations between MIBG uptake, left ventricular function indices and disease severity as judged on the basis of evolutive parameters.

3-Iodobenzylguanidine↗
PubMed1990

[Hypertrophic and/or obstructive primary cardiomyopathies: genetic, etiologic, physiopathologic aspects].

The morphological features, mode of presentation and physiopathology of hypertrophic cardiomyopathy (HCM) are variable. Autosomal dominant seems to be the usual mode of transmission but with variable presentation. From the anatomical point of view, the hypertrophy is asymmetrical with septal predominance. The main histological features are myocytic architectural disorganisation, fibrosis and abnormal coronary arteries of small diameter. Ventricular hyperkinesis is usually present and sometimes associated with outflow obstruction, the physiological role and mechanisms of which are still not fully understood. On the other hand, abnormal diastolic function is frequently observed, and, quite independently of disease of the epicardial coronary arteries, ischaemic phenomena may occur. Although the biological substrate of HCM is unknown, abnormalities of the adrenergic system and transmembrane calcium flux probably play a part in the expression of the disease.

Cardiomyopathy, Hypertrophic↗
PubMed1990

[A cost comparison of Pall filters versus chemical or thermal disinfection of ventilator tubes].

Filter manufacturers claim that the use of disposable filters for anesthesia and ventilation therapy would be more economical than changing the tubes and/or ventilation circuits every 24 h or 48 h. We therefore compared the costs of chemical disinfection or thermal disinfection of 4 different ventilation tube systems with those of disposable Pall filters. The cost of disinfecting tubes used for ventilation or anesthesia varies 1.81 DM to 12.60 DM and is therefore lower than that of the use of disposable filters changed daily. Tubes used for anesthesia should be changed after each patient and tubes for ventilation therapy can be changed every other day, but disposable filters must be changed daily or after each case when used for anesthesia.

Anesthesiology↗
PubMed1987

[Does tobacco abstinence in patients with chronic bronchial obstruction make sense?].

In 60 patients with advanced COPD, lung function was studied retrospectively at the beginning and end of a 12 to 175 months' test period. 25 patients continued to smoke 5 or more cigarettes daily (smokers). The other 35 patients were ex-smokers or smoked only 1 to 4 cigarettes daily during the trial (non-smokers). In the heavy smoker group FEV1 diminished much more rapidly than in the non-smoking group (p less than 0.01). We observed a significant dose-response ratio between the number of cigarettes smoked and the decrease in FEV1 (r = 0.27, p less than 0.025). No causes other than smoking were found for the fall in FEV1: age, weight, place of residence, profession, sputum evaluation and inhalation therapy were statistically equal in the non-smoking and the smoking group. However, one unexpected result was that more non-smokers had had long term treatment with steroids than smokers. This may mean that non-smokers have better compliance or that there is a subgroup more sensitive to COPD who thus take more steroids and are more inclined to stop smoking than a less sensitive population. The question remains open.

Aged↗
PubMed1986

[Budesonide (Pulmicort) and exertion-induced asthma].

Twelve young adult asthmatic patients were selected in an asthma-free interval to be tested for exercise-induced bronchoconstriction. The degree of bronchoconstriction was estimated indirectly by spirometry, using FEV1 as parameter. Exercise was performed on a 10% steep treadmill for six minutes, leading to a pulse rate of more than 180 beats/min. Spirometry was done before, immediately after, and 10 and 20 min after the work. Only patients with more than a 10% fall in FEV1 during the 20 min period of recovery were selected. In the randomized crossover double blind trial the asthmatic patients received placebo inhalations for one week and budesonide inhalations for another week (2 X 800 micrograms daily). Spirometry was repeated at the end of each week. Under placebo we found a surprisingly high rate of protection against exercise-induced bronchoconstriction (50%, p less than 0.05). With budesonide 8% additional protection (compared to placebo) was achieved (mean of all 12 patients). The patient-drug-interaction was significant at the level of F = 30, p less than 0.05. There are some nonresponders to budesonide. Of the 12 asthmatics, 8 recognized the drug inhalation period. We conclude that one week of high dosage budesonide regimen recudes the tendency to exercise-induced asthma in adults. Budesonide seems to influence and mitigate bronchial hyperreactivity in the responder group.

Adolescent↗
PubMed1985

[Air burden and respiratory and vascular diseases].

Three atmospheric pollutants are discussed: Sulfur dioxide (SO2) acts as irritant gas on upper airways, trachea and large bronchi. Bronchoconstriction by SO2 is enhanced during work. Dose-response correlation may be observed with SO2 concentrations and bronchial hyperreactivity. Deaths and morbidity rates of patients with COPD parallel peaks of SO2 concentration such as occurred in the 1956 London smog. The mechanisms involved seem to be the same in cross sectional as in long term SO2 effects on human airways. Ozone (O3) is a major irritant pollutant. O3 penetrates deeply into the small airways, kills the macrophages and promotes infections. As peroxide it ruptures the cell membranes and thus lipogenases arise. Neutrophil leukocytes are attracted and transit into the peribronchiolar tissue, an enrichment which may be stopped in hydroxy-urea treated dogs. A marked correlation is observed between peribronchiolar tissue neutrophilia and bronchial hyperreactivity. This may even be a new pathway in the physiopathology of bronchial asthma. Lead is a constituent of exhaust particles and is easily absorbed into the blood. As in the case of drinking-water lead or otherwise absorbed lead, blood lead levels may be markedly reduced by adequate preventive measures. Diastolic and systolic blood pressures correlate significantly with the blood lead level. A further decrease would lower the incidence of myocardial infarctions, strokes and essential hypertension.

Air Pollutants↗
PubMed1984

[Pirbuterol and salbutamol aerosol for exercise-induced bronchoconstriction].

Exercise-induced bronchoconstriction was produced in 12 asthmatic patients after a 6 minutes run on a 10% steep treadmill ergometer. FEV1 decreased by 12-73% (average 27%) of the control value measured before the run. The rather severe exercise-induced bronchoconstriction remained constant for 10-20 minutes after the run. 21 minutes after the run two puffs of a bronchodilator (salbutamol 0.2 mg or pirbuterol 0.4 mg) were inhaled in an open randomized cross-over fashion at intervals of 1 to 3 days. Following both bronchodilators FEV1 returned to the control value within 5 minutes. There was no significant difference between the bronchodilating effect of salbutamol versus pirbuterol. Furthermore, no significant differences were observed in pulse rates after inhalation of the two selective beta-2-stimulators. In our trial both pirbuterol and salbutamol seemed to be well tolerated; side effects were not observed for either drug.

Adult↗
PubMed1984

[Bronchial asthma, nasal polyposis and analgesic intolerance (the ASA triad). A successful computer based analysis of free texts].

In the period 1977 to 1980 the case histories were collected of 1731 asthmatics and 3590 non-asthmatics and stored in free text form in a computer data bank. Analyzing the data, 1643 primary asthmatics were selected comprising 537 seasonal and 417 perennial asthmatics. The incidence of nasal polyposis and chronic sinusitis on the one hand, and intolerance to analgesics on the other, was, at 9.5% and 4.5% respectively, higher in asthmatics than in non-asthmatics. In perennial asthmatics the particularly high incidences of 16% and 7.2% were observed for the two symptoms. As expected, the ASA triad (common occurrence of nasal polyposis, intolerance to analgesics and asthma) was found to be particularly frequent in perennial asthma (3.1%). A higher rate of coincidence of nasal polyposis and intolerance to analgesics was found in asthma patients than pure chance would suggest. This association is statistically significant for all asthma subpopulations. The mechanism which leads to the ASA triad is still unknown. Computer-aided analysis of free text information proved of great assistance in this study.

Analgesics↗
PubMed1984

[Normal values of spirometry for the 15- to 20-year-old age group].

In 130 healthy young men and women aged 15 to 20 years, all non-smokers, volume flow curves were recorded during forced expiratory vital capacity measurements. The forced vital capacity (FVC), the forced expiratory volume of 1 sec (FEV1) and the mid-expiratory flow rate (MEF50) were evaluated in order to establish new standard values for normal people in this particular age group. FVC is strongly height and sex dependent. Our new normal values are in good agreement with those of the literature. Our FVC values, however, are in general slightly higher than those of previous authors. MEF50 turns out to be sex independent but height dependent, but not as much as FVC. Our new normal values for MEF50 are in good agreement with those of Knudson et al., though slightly lower. The FEV1/FVC quotient was found to decrease significantly with height from 0.9 to 0.8. This decrease may be due to the increase in lung volume with growth. It could also be due to lung damage caused by atmospheric air pollution in young adults who are still growing.

Adolescent↗
PubMed1982

[Exercise-induced asthma and arterial hypoxemia].

40 young asthmatic patients performed submaximal work on a treadmill ergometer for 6 minutes. In 20 cases the PaO2 was found to be below 77.5 mm Hg (arterial hypoxemia) at the 10th or the 20th minute of post-exercise recovery time. A first subgroup A of 9 asthmatics presented hypoxemia together with a fall of FEV1 below 90% of control at the first to the 20th minute post-exercise recovery phase. A second subgroup B of 11 asthmatics showed hypoxemia with FEV1's higher than 90%, often higher than 100% of the control value. The following features of the recovery period were observed: 1. 10 minutes delay of onset of hypoxemia in relation to the FEV1 drop in group A. 2. Progressive hypoxemia despite a clear return of FEV1 versus the control value during the late recovery phase of group A. 3. Appearance of arterial hypoxemia despite unchanged normal FEV1's in group B. These three observations suggest that there are 2 kinds of post-exercise bronchoconstrictions. The first may be situated in the large bronchi (FEV1-drop), the second in the small peripheral airways (PaO2-drop), from the first to the 20th and from the 20th to the 40th minute respectively after the end of submaximal work load. It is concluded that there must be 2 sequential bronchoconstrictions due to cooling of the airways and these constrictions may guarantee alveolar homeostasis for body temperature and full saturation with water vapour. However, the first barrier in the large airways can be abolished by high blood levels of adrenaline. In such cases the second barrier in the small airways becomes important and may protect the alveoli from cooling and dry air.

Adult↗
PubMed1981

[Protection from exercise-induced asthma after salbutamol (Ventolin) in powder form, inhaled with the Rotahaler].

15 asthmatic patients with exercise-induced asthma proved by a first run of 6 minutes were selected for a second run some days later. Salbutamol powder (0.4 mg) was inhaled from a Rotahaler immediately before the second run. FEV1 decreased to 83 +/- 10%, 75 +/- 9% and 78 +/- 14% at the end, and 10 and 20 minutes after the first run. FEV1 increased to 110 +/- 16%, 110 +/- 15% and 113 +/- 14%, respectively, when salbutamol powder was inhaled from the Rotahaler before the second run (p less than 0.0005). Control values of FEV1 before the two runs were comparable (p less than 0.25). The heart rate increased to 186 +/- 3 per minute during the first run, to 182 +/- 3 after the second run (p less than 0.0025). Bronchodilation by salbutamol was evident in spite of the 6 minutes of exhausting exercise (p less than 0.0125). Furthermore, salbutamol powder partially or totally suppressed exercise-induced bronchoconstriction in 14 out of 15 cases. Powder inhalation of salbutamol from the Rotahaler is recommended as a valuable alternative medication to inhalation from a pocket pressurized metered aerosol device. The Rotahaler offers advantages, e.g. in patients with known exercise-induced asthma before exhausting athletic activity. The absence of fluorohydrocarbons in the airways may be important in such situations.

Adolescent↗
PubMed1981

[Allergic alveolitis as a result of mold on the bedroom wall].

A 23-year-old woman patient became seriously ill with the typical signs and symptoms of allergic alveolitis and with deep hypoxemia during exercise. A broad spectrum of positive precipitating antibodies was found in the serum, mainly against Penicillium casei and Aureobasidium pullulans. Although she was intensively questioned on hobbies and on possible antigens at home and at work, it was only possible to trace an antigen source after a controlled antigen free period away from home in another environment and after a controlled reexposure experiment at home: it proved to be a patch of mould of 0.5 m2 on the bedroom wall. The filaments and the spores of the fungi of the mould were shown directly by microscope. Precipitating antibodies were also present against these fungi. After several antigen-free months (the patient moved into a dry and sunny new apartment) the threatening respiratory failure (severe hypoxemia during exercise) disappeared completely together with the clinical signs and symptoms. Thus, mould on bedroom walls may constitute a threat and should be considered in cases of allergic alveolitis of apparently unknown origin.

Adult↗