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Biomedical subjects

P Rogenes

Publications and source records attributed to P Rogenes.

4 recordsLinked to original sources

Improvement in health care utilization and pulmonary function with fluticasone propionate in patients with steroid-dependent asthma at a National Asthma Referral Center.

The impact of switching from other inhaled corticosteroids to fluticasone propionate was studied in patients with severe oral-steroid-dependent asthma over a 1-year period. In this open-label prospective study, patients on maintenance doses of oral and inhaled steroids were referred to a national asthma treatment center and were switchedfrom their previous inhaled corticosteroid to fluticasone propionate 880 microg BID. Compared with data collected from the year prior to enrollment, treatment with fluticasone propionate resulted in significant improvements in pulmonary function, oral steroid requirements, and health resource utilization. In addition, five patients were completely weaned off oral steroids.

Administration, Inhalation↗

Fluticasone propionate aqueous nasal spray compared with terfenadine tablets in the treatment of seasonal allergic rhinitis.

BACKGROUND: Comparative studies with topical corticosteroids and antihistamines for treatment of allergic rhinitis have not always demonstrated clear distinctions between the two on the basis of therapeutic efficacy. OBJECTIVE: This study was designed to compare the efficacy and tolerability of fluticasone propionate aqueous nasal spray with those of terfenadine in the treatment of seasonal allergic rhinitis. METHODS: Three hundred forty-eight patients with allergic rhinitis were given fluticasone propionate aqueous nasal spray (200 micrograms once daily), terfenadine tablets (60 mg twice daily), or placebo for 4 weeks in a multicenter, randomized, double-blind, double-dummy, parallel-group study. RESULTS: Clinician-rated total nasal symptom scores after 1, 2, 3, and 4 weeks of therapy and patient-rated total nasal symptom scores throughout treatment were significantly (p <0.05) lower in the fluticasone propionate group compared with the terfenadine group or the placebo group. Terfenadine was not statistically different from placebo on the basis of clinician-related nasal symptom scores, except for sneezing. Total nasal airflow, measured by rhinomanometry, significantly (p <0.05) improved in the fluticasone propionate group compared with the terfenadine group or the placebo group. More fluticasone propionate-treated patients compared with placebo-treated patients had reduced nasal mucosal eosinophil counts after 4 weeks of therapy (p <0.05). No serious or unusual drug-related adverse events were reported. Morning plasma cortisol concentrations after 4 weeks of therapy did not differ among groups. CONCLUSION: Fluticasone propionate aqueous nasal spray is more effective than terfenadine tablets for treatment of seasonal allergic rhinitis.

Administration, Intranasal↗

Renal chemoreceptors.

A study of the renal receptors and types of stimuli which give origin to supraspinal and spinal-mediated autonomic reflexes is presented. Multiunit and single unit recordings from the afferent renal nerves of male Sprague-Dawley rats have revealed two groups of renal chemosensitive receptors (chemoreceptors). These we have called renal R1 and R2 "chemoceptive" receptors. R1 receptors do not have a resting discharge but are activated after 38.7 +/- 3.3 (S.E) sec (n = 40) of complete renal ischemia (occlusion of the renal artery). Other activating stimuli are associated with a marked impairment in renal blood flow (prolonged occlusion of the renal vein and the hypotension of systemic asphyxia or hemorrhage). Their discharge is characterized by trains of impulses which cease abruptly upon re-entry of blood into the kidney. They are not responsive to increases or decreases in renal perfusion pressure or to increases in renal venous or ureteral pressure. In contrast, R2 receptors have a resting discharge and respond vigorously to backflow of normal urine (nondiuretic) into the renal pelvis. The results of the backflow into the pelvis of different test solutions (diuretic and nondiuretic urine, 1 M urea, 1 M mannitol and solutions of NaCl and KCl) indicate that this response is dependent upon the composition of the fluid bathing the renal pelvis rather than the increase in pelvic pressure or pelvic distension. The resting discharge rate is highest in nondiuretic conditions and declines substantially after diuresis is induced by extracellular volume expansion. R2 receptors are also activated by renal ischemia produced by clamping the renal artery. It is concluded that these two groups of afferent sensory units are renal chemosensitive receptors, (chemoreceptors) which respond to the chemical environment of renal interstitium.

Afferent Pathways↗

The effectiveness of hourly cuff deflation in minimizing tracheal damage.

The efficacy of hourly endotracheal tube cuff deflations in minimizing tracheal damage has not been clearly established. Two investigations which specifically address this question arrive at differing conclusions. These investigations fail to report important variables which may have explained the difference in their results. The present study examined the effects of hourly cuff deflations in minimizing tracheal damage in mechanically ventilated, anesthetized dogs over a 72 hour test period. Variables which may influence tracheal damage were measured and reported. Three groups of dogs received either continuous cuff inflation, hourly 5 minute cuff deflations, or a continuous air leak. The air leak group had significanlty less damage than the continuous inflation group (P less than 0.05) and the hourly deflation group (P less than 0.01). There was no significant difference between the continuous inflation group and the 5 minute hourly deflation group.

Animals↗