The pulmonary function was studied in 21 patients with viral diseases of the lungs 10 to 18 days after the acute episode. In 14 cases all the parameters tested were normal; in 7 cases the alterations found led to a diagnosis of obstructive syndrome of the smaller airways (increased intrapulmonary helium mixture time, increased expired CO2 alveolar slope and residual volume). The alterations were again found on repeating the tests after 6--10 months. The various mechanisms that might cause obstruction are discussed (persistent inflammation, increased tonus of the bronchiolar musculature, hypersecretion in the smaller airways, alteration of the surfactant). In conclusion the authors raise the question of whether the obstructive alterations following pulmonary viral diseases might not be one of the etiopathogenic factors of chronic, obstructive bronchopneumopathy.

Adult↗

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[The advantages of Reprimum therapy in pulmonary sarcoidosis and other granulomatous diseases].

In sarcoidosis and other granulomatous non-caseous diseases, the election treatment is immunosuppressive, mainly with cortisones that ensure more than 70% lasting remissions. Continuous use of cortisones for a long time (8-30 months) in high doses leads to serious side effects: gastric and intestinal ulcers, obesity, osteoporosis, suprarenal dysfunction, sensitivity to infections. Good results and elimination of the important side effects were obtained by treatment with Reprimum--a semisynthetic antibiotic with a wide spectrum and immunosuppressive properties--administered alone or with prednisone in small doses (15-20 mg once) in 6 weeks' series: 2 weeks--Reprimum 10/mg/kg daily +/- prednisone and for other 4 weeks--Reprimum 15 mg/kg twice a week +/- prednisone followed by two weeks' break. In 75 patients with histopathologically confirmed sarcoidosis (of whom 7-9.3% with outside-the-lung situs, too), the treatment with Reprimum gave: 94.7% lasting remission, only 5.3% failures, reduction of the treatment period to 6-12 months and the absence of any important side reaction. In other 37 sarcoidosis cases, failures of cortisone therapy (of which 11-30% relapses after 2-6 years), the treatment with Reprimum together with prednisone allowed recovery of 29 patients (78.4%). The same treatment with Reprimum, used in 22 patients with immunosuppressive treatment indication (dermatomyositis, Kaposi's syndrome, thrombocytopenias, nodose periarteritis, silicosis), of whom 18 (81.8%) were failures of the cortisone therapy, healed 20 of these cases (90.9%). Reprimum immunosuppressive property acts at the level of T4+ lymphocyte, involved in sarcoidosis pathogenesis. The functional blockage of T4+ lymphocyte can be also achieved by cyclosporine A.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

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