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Biomedical subjects

P Spiro

Publications and source records attributed to P Spiro.

8 recordsLinked to original sources
PubMed1996

A comparison of ipratropium and albuterol vs albuterol alone for the treatment of acute asthma.

To evaluate the role of inhaled ipratropium bromide in acute asthma, a double-blind study of 384 emergency department patients compared the effect of the combination of ipratropium and albuterol with that of albuterol alone. Patients were randomized to receive nebulizer treatments with either 2.5 mg of albuterol or 2.5 mg of albuterol mixed with 0.5 mg of ipratropium bromide at entry and at 45 min. Spirometry, vital signs, and oxygen saturation were measured before and at 45 and 90 min following the nebulizer treatments. Serum potassium levels were obtained at entry and 90 min. The two groups did not differ significantly in age (mean +/- SD = 33.4 +/- 9.3 and 32.5 +/- 9.7 years for the albuterol and ipratropium group and the albuterol group, respectively), baseline FEV1 (mean +/- SD = 1.22 +/- 0.42 and 1.25 +/- 0.44 L respectively), or prior use of asthma medications. At 45 min, there were significantly more responders (15% increase in FEV1 over baseline) in the group receiving albuterol and ipratropium compared with albuterol and saline solution (85% and 78%, respectively; p = 0.045), but the median change in FEV1 from baseline did not differ (0.530 L for the albuterol and ipratropium group and 0.420 L for the albuterol and saline solution group; p = 0.347). By 90 min, the percentage of responders did not differ (88% and 89%, respectively), and the median change in FEV1 was 0.680 L for the group receiving albuterol and ipratropium and 0.650 L for the group receiving albuterol and saline solution (p = 0.693). There were no significant adverse events experienced by patients in either group. Furthermore, there were no significant differences in the number of patients requiring additional therapy in the emergency department or hospitalization. We conclude that in this population of inner city asthmatics, we were unable to demonstrate significant additive benefit of nebulized ipratropium bromide to nebulized albuterol.

Acute Disease↗
PubMed1995

Maximal inspiratory pressure: does reproducibility indicate full effort?

BACKGROUND: Maximal inspiratory pressure (MIP) is often relied upon as an index of inspiratory muscle strength, and reproducibility of MIP taken to indicate maximal effort. This study was designed to determine whether reproducibility is a valid indicator of maximal effort. METHODS: Ten normal subjects were studied, all of whom were familiar with the MIP test but none was an experienced subject. They were told that the purpose was to measure how accurately they could generate 50% of their MIP. Each performed nine MIP efforts and nine submaximal efforts. Means and coefficients of variation of peak negative inspiratory pressure (Pmax) and the ranges of the best three efforts were calculated for each type. RESULTS: Mean (SE) Pmax averaged-93.8 (6.0) cm H2O for the maximal efforts and -60.6 (7.7) cm H2O for the submaximal trials, with coefficients of variation averaging 8.71 (1.75)% and 14.58 (2.63)%, respectively and the ranges averaging 6.5 (1.1)% and 13.4 (3.5)%, respectively. There was no clear separation between the coefficients of variation or ranges of maximal and submaximal efforts. In four cases the ranges of the best three submaximal efforts were less than 5 cm H2O and less than 5% -criteria that have been used to validate MIP results. These four subjects had lower ranges for submaximal than maximal efforts, even when expressed as percentages of the means. CONCLUSION: Reproducibility should not be relied upon to indicate a valid MIP test, especially for research purposes when relatively small changes in inspiratory muscle strength must be discriminated.

Female↗
PubMed1994

Treatment of orbital capillary haemangioma with interferon.

BACKGROUND: Capillary haemangiomas are vascular tumours of childhood characterised by proliferative and involutional phases and affecting 1% to 2% of newborns. Recently, recombinant interferons have been used in the treatment of life and sight threatening complications of these tumours. METHODS: The history, results of examination, investigations, management and outcome of two patients with sight-threatening orbital capillary haemangiomas treated with recombinant interferon alpha-2a and 2b respectively were reviewed. RESULTS: Orbital and systemic lesions displayed good response to interferons. Side effects noted were transient pyrexia and elevated serum aminotransferase levels. Disturbed liver function test results occurred in one case and normalised with temporary cessation of therapy. CONCLUSIONS: The interferons are a useful alternative treatment of orbital capillary haemangioma in selected cases.

Female↗
PubMed1984

A follow-up of a randomized study comparing two chemotherapy treatments for advanced diffuse histiocytic lymphoma.

In 1976 we began a randomized study for the treatment of patients with stage III and IV diffuse histiocytic lymphoma. The therapy was either ACOMLA (doxorubicin, cyclophosphamide, vincristine [oncovin], methotrexate with leucovorin rescue, and cytarabine) or CHOP-B (cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [oncovin], prednisone, and bleomycin). A complete response (CR) was achieved in 13 (65%) of 20 patients treated with ACOMLA and in 20 (71%) of the 28 patients treated with CHOP-B. Four patients achieving CR with ACOMLA and three patients treated with CHOP-B have relapsed for an overall relapse rate of 21%. Partial response (PR) was obtained in four patients treated with ACOMLA and five patients treated with CHOP-B. Median follow-up time is 36 months for the combined treatment groups. Multiple regression analysis demonstrated that those patients who were classified by the Lukes-Collins criteria as having histiocytic lymphoma not of follicular center-cell origin (combined T- and B-cell immunoblastic sarcoma) had a significantly worse survival as compared to patients classified with follicular center-cell origin lymphoma (large cell noncleaved, large cell cleaved, and large cell unclassified) with a 40% five-year survival versus an 80% five-year survival (P = .011). The CR rate however for these two large categories of patients was 63% v 73% respectively, and the relapse rates were equivalent. The increased survival in the follicular center-cell origin lymphomas may be related to a longer survival of PRs and relapsed patients as compared to the patients with nonfollicular center-cell lymphomas.

Adolescent↗