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Biomedical subjects

S A Spitzer

Publications and source records attributed to S A Spitzer.

At least 19 recordsLinked to original sources
PubMed1994

Effect of theophylline on exercise performance in patients with severe chronic obstructive pulmonary disease.

BACKGROUND: Theophylline is a well known bronchodilator which has been used for more than 50 years in the treatment of obstructive pulmonary diseases. In patients with severe chronic obstructive pulmonary disease whose cardiopulmonary performance is limited by their ventilatory capacity the administration of theophylline may improve exercise performance. METHODS: A randomised, placebo controlled, double blind, crossover trial was conducted in 22 patients with severe but stable disease. The patients (mean age 68 years) were studied before and after one month of placebo and one month of treatment with a sustained release preparation of theophylline administered orally. The theophylline dose was adjusted until a blood level above 55.5 mumol/l was achieved. The two treatments were administered in random order and separated by a two week washout period. After theophylline was administered for one month a mean level of 68.2 mumol/l was achieved. Pulmonary function tests, arterial blood gas measurements, maximal voluntary ventilation (MVV), and an incremental exercise test were performed before (baseline) and at the end of the first and second month of treatment. RESULTS: Pulmonary function tests showed no improvement in the flow parameters but showed an improvement in MVV after treatment with theophylline. Pulmonary gas exchange was improved after theophylline (resting arterial PO2 8.91 v 8.59 kPa, PCO2 5.38 v 5.56 kPa). The incremental exercise study showed improvement in maximal work rate (86.5 v 75.0 watts) and maximal ventilation (VEmax) (46.7 v 43.01/min). The dyspnoea index on maximal effort (VEmax/MVV), anaerobic threshold, and oxygen pulse remained unchanged. Resting and exercise heart rate were higher after theophylline. CONCLUSIONS: Theophylline improved cardiorespiratory performance in these patients with severe chronic obstructive pulmonary disease mainly by increasing the ventilatory capacity.

Aged↗
PubMed1993

Assessment of exercise capacity in asthmatic children with various degrees of activity.

Physical fitness in a group of 49 stable asthmatic children was determined by an incremental exercise test. Thirty-one normal children served as a control group. The asthmatic children were divided into three groups. Group 1 was comprised of 16 children who actively participated in organized sports, Group 2 of 16 children who did not participate in organized sports but who engaged in free-play, and Group 3 of 17 children with a sedentary life-style who avoided even free-play. The results of cardiopulmonary evaluation before and after maximal incremental exercise testing have shown that Groups 1 and 2 behaved like the control group and their physical fitness was similar. Group 3 whose life-style was sedentary had poor physical fitness as compared to the other asthmatics and to the control group. This was the result of poor cardiovascular conditioning and was unrelated to the respiratory limitation. We conclude that poor physical fitness in asthmatic children is the result of a sedentary life-style and can be potentially normalized.

Adolescent↗
PubMed1993

The effects of the modified intermittent sequential pneumatic device (MISPD) on exercise performance following an exhaustive exercise bout.

The Lymphapress, a pneumatic sequential intermittent device is recognized as one of the most effective conservative treatments for lymphoedema, due to its effective 'milking mechanism'. This led us to hypothesize that accelerated removal of fatigue-causing metabolites by mechanical massage could improve an athlete's performance capacity. We conducted trials with 11 men who exercised at a constant workload, on a cycle ergometer, until exhaustion. During a 20-min recovery period a new modified pneumatic sequential intermittent device (the MISPD) was applied to the subjects' legs. The men then performed a second constant load exercise bout. Cardiorespiratory parameters were measured during exercise and blood was withdrawn during recovery for the determination of lactate, pyruvate, ammonia, bicarbonate and pH. No difference was found in the blood levels of the 'fatigue causing metabolites' during passive recovery (PR) and recovery with the MISPD (MR). However, the MISPD effected a 45% improvement in the subjects' ability to perform the subsequent exercise bout. The accumulation of fluid in the interstitial space after exercise and its disappearance after the use of the MISPD offers one possible explanation for these results, although psychological effects cannot be discounted.

Adult↗
PubMed1993

Suture granuloma simulating lung neoplasm occurring after segmentectomy.

A suture granuloma was resected which developed after segmentectomy of a squamous cell carcinoma of the lung and radiologically mimicked a neoplasm. This report emphasises that although the appearance of the lesion may be typical for malignancy, the possibility of a benign suture granuloma should be considered, especially if the lesion appears shortly after surgery.

Carcinoma, Squamous Cell↗
PubMed1993

External high-frequency ventilation in severe chronic obstructive pulmonary disease.

We studied the effect of external high-frequency oscillation using an oscillator (Hayek oscillator [HO]) on 20 patients with severe chronic obstructive pulmonary disease (COPD). Of the 20 patients, 10 were eucapnic and 10 were hypercapnic. The HO generated frequencies from 60 to 140 cycles/min at an amplitude of 36 cm H2O (-26 to +10) and at an inspiratory/expiratory (I/E) ratio of 1:1. The results show that the HO is a powerful ventilator, reducing end-tidal PCO2 (PETCO2) by 6.7 to 9.1 mm Hg in eucapnic patients and by 6.1 to 7.9 mm Hg in hypercapnic patients. The oxygen saturation increased by 2 to 2.87 percent in the eucapnic patients and by 2.6 to 3.7 percent in the hypercapnic group in the various frequencies. The rate of elimination of CO2 and the levels of PETCO2 achieved within a short time were superior to those reported with other external ventilators. We conclude that the HO can be effectively used in severe COPD and respiratory failure for (1) assisting ventilation, thus replacing intubation and conventional mechanical ventilation, and (2) relieving muscle fatigue in short sessions.

Aged↗
PubMed1992

[Cardiopulmonary exercise testing in asthmatic patients].

In order to obtain objective information on physical fitness of asthmatic patients, mainly those with severe chronic airway obstruction, an incremental exercise test was carried out in 50 asthmatics. A control group of 48 healthy subjects had similar anthropometric characteristics. The 2 groups achieved similar maximal heart rates: 96.1 +/- 8 of predicted rate in the asthmatics as compared to 98.4 +/- 4 in the controls. Maximum oxygen consumption (VO2max), anaerobic threshold and oxygen pulse (VO2/hr) were significantly lower in the asthmatics. While in mild and moderate cases performance was limited by the cardiovascular system, in severe asthmatics the limitation was respiratory. There was no correlation between severity of airway obstruction and cardiac parameters such as oxygen pulse, anaerobic threshold and VO2max. On the other hand, there was good correlation between FEV1% and the dyspnea index (Ve/MVV%). The latter was less than 60% in all asthmatics when measured during exercise testing at 75% of maximal predicted heart rate. It is thus possible for an asthmatic to engage in physical activity of the intensity that can potentially improve his physical fitness. We assume that reduction in cardiac parameters is a result of poor physical fitness related to prolonged inactivity, quite common in asthmatics as a result of inappropriate physical education.

Asthma↗
PubMed1989

Nedocromil sodium and placebo in the treatment of bronchial asthma. A multicenter, double-blind, parallel-group comparison.

The efficacy of nedocromil sodium (4 mg twice daily by inhalation) in treating bronchial asthma was assessed by double-blind, placebo-controlled group comparison in 69 adults from three centers. The patients (34 active, 35 placebo) had a history of bronchial asthma with at least 15 percent reversibility. Inhaled corticosteroids, used by 22 and 24 subjects in the active and placebo groups respectively, were discontinued before the study, in which a two-week baseline was followed by six weeks of treatment. Two-weekly clinic assessments of lung function, symptoms and final opinions of treatment were significantly (p less than 0.05 p less than 0.001) in favor of nedocromil sodium. Daily diary cards showed a similar trend with significant drug effects seen after the third week. Blood and urine samples showed no abnormalities and the majority of patient withdrawals (five from nedocromil sodium and six from placebo treatment) were due to worsening asthma. Overall, we found nedocromil sodium to be well tolerated and effective in the management of bronchial asthma.

Administration, Inhalation↗
PubMed1987

Theophylline-induced alterations in cellular immunity in asthmatic patients.

Twenty patients with bronchial asthma, on long-term oral therapy with theophylline, demonstrated an increased number of suppressor T-cells and impaired graft vs host reaction. Ten asthmatics on other therapy, not including theophylline, as well as ten normal healthy controls, failed to show similar findings. Elimination of suppressor T-cells corrected the above immunological abnormalities in the theophylline-treated patients, while addition of serum from theophylline-treated asthmatic patients to lymphocytes from normal healthy controls, affected the graft vs host reaction of these lymphocytes. We conclude that theophylline induces quantitative as well as qualitative immunological alterations by increasing the number and activity of suppressor T-cells, which most probably secrete a serum factor, responsible for some of the abnormalities observed.

Adolescent↗
PubMed1981

Pulmonary function abnormalities in Sjögren's syndrome and the sicca complex.

The frequency of pulmonary involvement in a group of 20 patients with Sjögren's syndrome or the sicca complex was evaluated with pulmonary function studies. In 12 patients pulmonary functional abnormalities were demonstrated. The most common abnormality was airway obstruction. Nine out of 13 patients with the limited variant of the disease (sicca complex) and three out of seven patients with the complete syndrome had abnormal pulmonary function.

Adult↗
PubMed1980

Unilateral increased transradiancy of the lung caused by bronchial carcinoid tumour.

Two patients with an intraluminal carcinoid tumour obstructing the right main bronchus in one, and the left main bronchus in the other, resulting in unilateral increased transradiancy from hypoperfusion of the lung, are described. Resection of the tumours and reconstruction of bronchial continuity was followed by return of perfusion to normal between three and 18 months after the operation. The patient in whom the diagnosis was delayed showed a much slower rate of return of perfusion and a small lung resulted. The finding of increased transradiancy of lung even in an asymptomatic patient should be an indication for bronchoscopy.

Adult↗
PubMed1980

Oxygen affinity of hemoglobin in polycythemia of undetermined etiology.

High oxygen affinity hemoglobinopathy, as an eventual cause for polycythemia of undetermined etiology, was investigated in 40 unclassifiable polycythemia subjects. The determination of 2,3-diphosphoglycerate and P50 in the polycythemic and in the control groups has not demonstrated any sigificant difference between them. The routine search of this condition in similar patients does not seem to be warranted.

2,3-Diphosphoglycerate↗
PubMed1980

Autoimmune antibodies in intrinsic (non-atopic) asthma.

Tests for autoimmune antibodies (AA) were carried out in 70 patients suffering from chronic obstructive disease of the airways and in 18 healthy subjects, who served as a control group. AA were found in 55% of the patients with intrinsic asthma as compared to 21% of those with extrinsic asthma, 25% of the patients with bronchitis and 16% of the healthy controls. The difference between the intrinsic and the other groups was found to be statistically significant (p less than 0.05 - less than 0.02).

Adult↗