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Biomedical subjects

T C Medici

Publications and source records attributed to T C Medici.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Small airway disease: facts or fiction?].

The term "small airways" has come to mean airways of less than 2 mm internal diameter, i.e. small bronchi and especially bronchioles. Since disturbed function and inflammation of the small airways is present in most airway and lung diseases and is regarded as an early stage of chronic airflow obstruction, the term "small airways disease" was coined. The newly created clinical entity and the hypothesis were criticized from the beginning, and this scepticism is strongly supported by new concerning the accuracy or validity of tests of small airways function on the one hand, and functional, morphological and prospective epidemiological investigations on the other. The use of the term "small airways disease" is doubtful when accompanying a well-defined pulmonary disease, and is inferior to the precise term "bronchiolitis" when present as an isolated disease of the bronchioles. Ultimately, it is still unproven that inflammation of "small airways" at an early stage leads to chronic airflow obstruction, i.e. emphysema.

Airway Resistance↗
PubMed1985

Smoking pattern of smokers with and without tobacco-smoke-related lung diseases.

The number of cigarettes smoked, the duration of the smoking habit, and the tar content of the smoke influence the occurrence of tobacco-smoke-related lung diseases, as may also patterns of smoke inhalation. We therefore determined the smoking pattern, especially the time relation between cigarette puff and inhalation, in smokers with and without tobacco-smoke-related lung diseases. On the basis of clinical and radiologic findings as well as pulmonary function tests, 91 smokers were classified as smokers without lung disease, with small airway disease, with simple chronic bronchitis, with obstructive bronchitis, with pulmonary emphysema, and with lung cancer. Smoking and breathing patterns were recorded, using a smoke-flow machine and a strain-gauge belt while the subject smoked a cigarette. Blood levels of COHb were determined before and after smoking. Of the smoking characteristics assessed, puff-inhalation time, puff peak pressure, and the venous difference in COHb level before and after smoking varied significantly among the smoker groups. Puff-inhalation time, reflecting the duration of smoke retention in the mouth, was only 0.08 s (i.e., practically zero) in smokers with pulmonary emphysema and differed significantly from the time in the other groups. This puffing characteristic may be the consequence or the cause of emphysema. If the latter is true, smokers with emphysema may perhaps lack the acute airway response to smoke inhalation that normally protects most smokers from immediately inhaling tobacco smoke.

Adolescent↗
PubMed1983

[Field experiences with the 6-month Singapore therapy in the treatment of open lung tuberculosis in Cambodian refugees].

The particular situation of a refugee camp with transit character, as represented by "holding Centre Khao-I-Dang" (KID) for Cambodian refugees in Thailand, had to be taken into consideration when determining the therapy plan for the disease that is epidemiologically most important, smear-positive pulmonary tuberculosis. Under Singapore conditions daily administration of isoniazid (H) and rifampicin (R) for 6 months combined with a 2-month intensive phase of streptomycin (S) and pyrazinamide (Z) daily proved highly effective. The large-scale transfers in KID in February and March 1981 led to consistent administration of this therapy plan, which is recommended by the WHO. By the end of September 1981 61 patients aged 15 years and over had entered the "Thai/Swiss Red Cross TB Programme". Criterion for entrance was the presence in sputum of acid-fast bacilli in the Ziehl-Neelsen stain. The routine examinations consisted of three microscopic sputum examinations per month, a sputum culture and a chest x-ray before commencement of therapy, followed by a chest x-ray at the end of the intensive phase and at the end of therapy. Efficacy and side effects of the 6-month therapy in our collective were similar to those of the Singapore study.

Adolescent↗
PubMed1983

[Does the manner of smoking affect chronic obstructive airway diseases and bronchial cancer?].

Duration of smoking career, number of cigarettes smoked and smoke inhalation pattern seem to have a bearing on the occurrence of tobacco-related lung diseases. The authors therefore determined the smoking pattern and especially the time relation between drawing on a cigarette and inhalation in smokers with and without tobacco-related lung diseases. Based on clinical and radiological findings as well as pulmonary function tests, 91 smokers (without lung disease, with small airway disease, with simple chronic bronchitis, with obstructive bronchitis, with bronchitis and predominantly emphysema and with lung cancer) were examined. Smoking and breathing pattern were recorded using a smoke flow machine and a strain-gauge belt while smoking a cigarette. The blood level of COHb was determined before and after smoking. Of the smoking characteristics peak pressure, peak flow, time from drawing to inhalation and COHb difference varied significantly among the different groups. Drawing-to-inhalation time was lowest in smokers with chronic bronchitis and predominantly emphysema, which differed significantly from the other groups. This characteristic may be the consequence or the cause of emphysema. Regarding the latter, smokers with emphysema may perhaps lack the acute airway response to smoke inhalation and thus be able to inhale the cigarette smoke directly.

Adolescent↗
PubMed1983

Corticosteroid-induced bone loss. A longitudinal study of alternate day therapy in patients with bronchial asthma using quantitative computed tomography.

Treatment with corticosteroids can produce osteoporosis. It is generally held that bone loss occurs when steroids are administered daily, but recent findings indicate that bone may also be lost on alternate day therapy. Cortical and trabecular bone, which may be affected differently, can be assessed independently, by quantitative computed tomography. This technique has been applied to the appendicular skeleton in following 20 patients with bronchial asthma during one year of chronic alternate day corticosteroid therapy. The trabecular bone loss was considerable; prednisone 25 mg on alternate days caused an average reduction in trabecular bone of 3.5% over one year. Bone loss was dose- and age-dependent. Young patients on 50 mg/2 days lost up to 17% trabecular bone in one year. Cortical bone was not significantly affected over the same period.

Adrenal Cortex Hormones↗
PubMed1983

Eosinophilic granuloma of the skeleton with involvement of the lung: a report of three cases.

Three adult patients with chronic bilateral pulmonary infiltrates due to eosinophilic granuloma are described. The diagnosis was based on histologically proven antecedent or concomitant osseous eosinophilic granuloma in all cases. Electron microscopy was performed in two cases, showing abundant Lx-bodies in both. Pulmonary tissue was obtained in the same two cases, yielding eosinophilic granulomas in one and non-specific septal infiltrates in the other. In the third case the assumption of pulmonary eosinophilic granuloma was made by clinical analogy, thus, avoiding lung biopsy. The course was characterized by lasting benefit from skeletal surgery in all patients and by refractoriness of pulmonary lesions to immunodepressants given to two patients. Progression of pulmonary disease was minimal or none during the observation period of four, three, and three years, respectively. Diffuse pulmonary infiltrates may be a manifestation of a covert osseous eosinophilic granuloma. Skeletal screening by x-ray or scintigraphy should be part of the work-up of otherwise unexplained diffuse lung lesions. It may obviate the need for lung biopsy.

Adult↗
PubMed1982

[Sobrerol as expectorant in patients with stable chronic respiratory tract infections. A controlled study].

A randomized double-blind crossover study compared the clinical effectiveness of 14-day treatment with 400 mg/day of sobrerol and placebo in 23 patients with stable chronic bronchial disease. In a further open trial phase all patients received 2.0 g glyceringuaiacol per day. During the 9-week trial, subjective symptoms and findings were recorded by numerical code, side-effects listed, pulmonary function tests performed and sputum physical characteristics determined on a weekly basis. Data was statistically analyzed using an analysis of variance adapted from HILLS and ARMITAGE, the Wilcoxon matched-pairs signed-ranks test, the paired t-test and the %2 test. Both subjective assessment of overall clinical efficacy and statistical analysis of the above factors failed to show any significant advantage of sobrerol over placebo. Sputum physical characteristics failed to reveal a significant difference between sobrerol and placebo, with the exception of a temporary reduction in sputum volume (p less than 0.05) on the fourth day of therapy with sobrerol. Similarly, 2.0 g glyceringuaiacol for 14 days failed to influence subjective symptoms, pulmonary function tests or sputum physical characteristics. In conclusion, sobrerol is a further example of an expectorant lacking evidence of clinical effectiveness in the management of bronchial secretions in patients with stable chronic bronchial disease.

Adult↗
PubMed1982

[Long-term oxygen therapy in ambulatory patients with chronic respiratory diseases].

While in Switzerland long-term home oxygen therapy has had little appeal in the management of patients with advanced chronic obstructive pulmonary diseases, hypoxemia, cor pulmonale and secondary polycythemia, it has been part of the therapy program in the USA and Great Britain for the last twenty years. Results from two controlled studies in those countries, showing a reduction of mortality in selected patients under long-term oxygen therapy, and the guidelines recently published by the Swiss Society of Pulmonology, justify an appraisal of our own situation. The pathophysiological basics are presented and the requirements and indications for long-term home oxygen therapy are outlined. The two controlled studies are summarized and commented on, and finally the practical application of this therapy in the Canton of Zürich is critically reviewed. Unsolved questions still exist with regard to the indication for its use, the unknown late complications, the considerable costs, and the inconvenient treatment period of 15 hours a day over a period of months, as well as the principal question, that of whether such therapy merely prolongs chronic suffering. These factors oblige us to maintain our reserved attitude about the use of this therapy and to employ it only after all the advantages and drawbacks have been carefully considered.

Ambulatory Care↗