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Biomedical subjects

T C Medici

Publications and source records attributed to T C Medici.

At least 73 records · Page 4Linked to original sources
PubMed1981

[Sputum viscosity and respiratory tract obstruction in chronic unspecific airway diseases].

The relationship between the physico-chemical characteristics of sputum and pulmonary function tests was investigated in patients with chronic nonspecific airway diseases. 141 sputum specimens were categorized on the basis of neutrophil content as slightly inflammatory (mucoid), inflammatory (mucopurulent) and highly inflammatory. "Apparent" viscosity, fucose and N-acetylneuraminic acid content were determined. Forced vital capacity, forced expiratory volume in one second and maximal voluntary ventilation measurements were performed simultaneously for each patient. "Apparent" viscosity and fucose content did not differ among the sputum categories; N-acetylneuraminic acid was slightly increased in the inflammatory sputa. There was a statistically significant inverse correlation between "apparent" viscosity, forced expiratory volume and maximal voluntary ventilation. In contrast, "apparent" viscosity did not correlate with forced vital capacity. As for the bronchial glycoprotein components, fucose correlated directly with "apparent" viscosity, whereas N-acetylneuraminic acid did not. "Apparent" viscosity was approximately the same in all sputum categories; it did not depend on the sputum neutrophil frequency except in the case of the slightly inflammatory, mucoid sputa in which "apparent" viscosity correlated indirectly with the sputum neutrophil frequency. These results show that physicochemical characteristics of sputum or bronchial secretions may play an important role in obstruction of the airways in patients with chronic nonspecific airway diseases. In the case of low inflammation of the bronchi, bronchial glycoproteins produced in the hypertrophied tracheobronchial glands and goblet cells are mainly responsible for increased "apparent" viscosity. With increasing inflammation of the bronchi, factors other than bronchial glycoproteins appear to determine this flow property.

Adult↗
PubMed1980

[Thiamphenicol versus trimethoprim-sulfamethoxazole in bacterial exacerbations of chronic unspecific respiratory tract diseases. A controlled study].

To document the efficacy of trimethoprim-sulfamethoxazole (TMP-SMZ) in treating bacterial exacerbations of chronic bronchitis, and to evaluate the efficacy of thiamphenicol (TAP), 29 patients with chronic bronchial disease were treated for two separate bacterial exacerbations, once with 0.48 g of TMP and 2.4 g SMZ daily, and once with 1.5 g of TAP daily, for 14 days. Patients were evaluated weekly and different measurements, including graded clinical observations, ventilatory tests, sputum measurements, quantitative bacterial counts and blood studies were performed. Side effects were closely monitored. Of the 29 patients entered, 20 finished the trial and hence 40 exacerbations were evaluated. All graded clinical observations were improved by the antimicrobials, whereas no marked change in the ventilatory tests was seen. Of the sputum measurements the daily volume, purulence, numbers of neutrophils and bronchial epithelial cells decreased, as did the numbers of Haemophilus influenzae and pneumococci. Of the blood studies the red blood cell count fell by more than 20% of the pretreatment value in 2 patients on TAP and 2 on TMP-SMZ. Using the same criterion, the hemoglobin level fell in 4 patients on TAP and in the hemoglobin level fell in 4 patients on TAP and in 2 patients on TAP-SMZ, while the hematocrit fell in 4 patients on TAP and in 1 on TMP-SMZ. However, all these changes were completely reversible. Minor gastrointestinal side effects were observed in 11 patients receiving TAP, compared to 3 patients on TMP-SMZ. 1 patient on the latter drug experienced a rash at the end of therapy. From the viewpoint of overall clinical assessment, 16 patients improved and 4 remained unchanged during therapy with TAP. The corresponding figures for TMP-SMZ were 17 patients improved, 2 the same and 1 worse at the end of therapy. The average relapse time after TAP was 184 days and after TMP-SMZ 180 days. In conclusion, 80% or more of exacerbations were improved by the two drugs. For all the variables measured, no significant differences were statistically detectable between the two antimicrobials, whether given in the sequence TAP first and TMP-SMZ second, or vice versa.

Adult↗
PubMed1980

[Short-term effect of ketotiphen on physicochemical sputim characteristics in patients with chronic reversible respiratory diseases].

Antihistaminic drugs may interfere with ion and water transport across bronchial epithelium, decreasing the water content of the bronchial mucus and thus adversely affecting mucociliary clearance. A double-blind trial was therefore undertaken to study the short-term effects of ketotifen, a new antiasthmatic drug with antianaphylactic and antihistaminic properties, on the physicochemical properties of sputum in 16 patients with clinically stable chronic reversible airway diseases. The study lasted 5 weeks, during which the patients received 2 mg ketotifen daily for two or three weeks and placebo for the remaining weeks; thus, all patients received both the active drug and a placebo. The patients were evaluated weekly and different measurements, including graded clinical observations, ventilatory tests and blood studies were carried out. Objective sputum measurements included 24-hour volume, dry weight, "apparent" viscosity (at a shear rate of 900 s-1), content of fucose, neuraminic acid, immunoglobulin A and acid mucus glycoprotein fibers. Of the sputum characteristics the daily volume decreased slightly after ketotifen. In contrast, sputum dry weight appeared to increase. The "apparent" viscosity showed a tendency to decrease. Fucose, neuraminic acid and immunoglobulin A content varied slightly, as did the percentage of acid mucus glycoprotein fibers. Since none of the sputum characteristics changed significantly during short-term therapy with ketotifen, this drug probably does not alter either the water content or the mucus biopolymers--both of which are responsible for the flow properties of bronchial mucus--thus presumably leaving mucociliary transport unchanged in patients with chronic reversible airway diseases.

Adult↗
PubMed1979

[Drug-induced lung diseases].

Drug-induced lung diseases may present themselves as bronchial reactions (e.g. bronchial asthma), diseases of the parenchyma (e.g. pulmonary infiltrates with eosinophilia, diffuse fibrosing alveolitis), of the pulmonary vasculature (vasculitis) and of the pleura (e.g. pleurisy or pleural fibrosis). Pathogenetically the two most pertinent types of reaction are hypersensitivity or toxic reactions, and less often biologic reactions such as opportunistic infections after cytotoxic and immunosuppressive therapy. Many drug-induced respiratory diseases are reversible upon withdrawal of the offending agent; others may be irreversible or even progress.

Aspirin↗
PubMed1979

[Current chemotherapy of pulmonary tuberculosis].

Tuberculosis has today lost much of its dread for mankind: in 1976, 1823 persons contracted tuberculosis and 182 died of pulmonary tuberculosis in Switzerland. In contrast, 1375 died of pneumonia, 1309 of non-specific airway disease and 2202 of bronchial cancer in the same year. The present data on morbidity and mortality in Switzerland resemble those of the other industrial European countries or the USA. The decrease in morbidity and mortality of pulmonary tuberculosis was caused-among other factors-by chemotherapy. Chemotherapy not only profoundly changed the infectivity of tuberculous patients and made ambulatory, domiciliary treatment possible, but cured pulmonary tuberculosis. The introduction of the bactericidal rifampicin led to the latest major landmark in the chemotherapy of tuberculosis in the past 20 years: namely, short-course chemotherapy. Together with the other first-line drugs (isoniazid, streptomycin, ethambutol), rifampicin shortened the duration of chemotherapy from 18--24 to 9--12 months. Short-course chemotherapy is today the therapy of choice for most patients with pulmonary tuberculosis.

BCG Vaccine↗
PubMed1978

[Benign spontaneous pneumothorax: possibilities and prognosis of conservative therapy].

There is much divergence of opinion as to how spontaneous pneumothorax should be treated or even whether it should be treated at all. Nowadays this benign pulmonary disease is primarily treated surgically, although conservative management of spontaneous pneumothorax seems to provide equally good results, as already indicated in 1932 by KJAERGAARD. Histories and clinical findings for 87 patients who were initially treated for spontaneous pneumothorax were reviewed and the factors responsible for the choice of treatment established. The mean age of the patients was 34 years, and 60% of the patients were below 30. Males predominated over females by 8:1. No coexisting pulmonary diseases were found in 80% of the patients. 54 patients were treated conservatively (no treatment except antitussives or analgesics). 46 conservatively treated patients had pneumothorax for the first time; 4 patients each had pneumothorax for the second or third time or more. 46 of 66 patients with idiopathic pneumothorax received no treatment, whereas 12 of 20 patients who had coexisting pulmonary diseases were treated surgically. The pneumothorax did not recur in 30 of 37 patients treated conservatively and observed for 1--15 years. These data suggest that conservative management is as effective as surgical treatment in uncomplicated spontaneous pneumothorax.

Adolescent↗
PubMed1977

[Drug-induced lung diseases].

Adverse drug reactions involving different organs, including the lung, are numerous; much more numerous, however, are the offending drugs. According to the results of the Boston Collaborative Drug Surveillance Program, adverse reactions occur in about 6% of all drug exposures and 28% of all patients. Drug-induced lung diseases may present as bronchial reactions (e.g. bronchial asthma), diseases of the parenchyma (e.g. pulmonary infiltrates with eosinophilia, diffuse fibrosing alveolitis), of the pulmonary vasculature (vasculitis) and of the pleura (e.g. pleurisy or pleural fibrosis). Pathogenetically the two most pertinent types of reaction are hypersensitivity or toxic reactions, and less often biologic reactions such as opportunistic infections after cytotoxic and immunosuppressive therapy. Many drug-induced respiratory diseases are reversible upon withdrawal of the offending agent; others may be irreversibly or even progress.

Alveolitis, Extrinsic Allergic↗
PubMed1977

[Does steroid therapy have an effect on the course of Löfgrenn syndrome? Catamnestic studies on 25 patients with Löfgren syndrome at the Zürich county hospital].

To investigate whether steroids influence the course and prognosis of acute sarcoidosis (Löfgren syndrome) 35 patients who developed this disease during the period 1960-1970 were examined and retrospectively divided into two groups, one of which had received steroids and the other not. At the onset of the disease all the patients had had typical symptoms of acute sarcoidosis: bilateral hilar lymphadenopathy, erythema nodosum, arthralgia, fever and elevated sedimentation rate. Biopsy of hilar lymphnodes had revealed non-caseating granulomas in all cases, whereas such granulomas were present in only 7 of 15 liver biopsies. The Kveim reaction was positive in 89% and the tuberculin skin test was negative in 51%. The duration of the disease was 6-7 weeks in both groups, i.e. steroid treated and non-steroid treated. The radiological chest abnormality had usually disappeared within one year. All chest X-rays had completely normalized after two years. Neither the course nor the prognosis differed in the two groups. However, patients receiving steroids had had more side effects. Acute sarcoidosis should not be treated with steroids; symptomatic therapy with other, less toxic antiinflammatory drugs suffices. The outcome is good. None of the patients has progressed to chronic sarcoidosis.

Anti-Inflammatory Agents↗
PubMed1976

Methacycline compared with ampicillin in acute bacterial exacerbations of chronic bronchitis. A double-blind crossover study.

In order to objectively document the accepted clinical efficacy of ampicillin in treating bacterial exacerbations of chronic bronchitis, as well as to evaluate the efficacy of methacycline, a double-blind crossover study was designed. Twenty patients with chronic bronchial disease were treated for two separate acute bacterial exacerbations, once with 2 gm of ampicillin daily, and once with 600 mg of methacycline daily, for 14 days. There were a few significant differences when comparing the efficacy of the antimicrobials. For example, the daily volume of sputum significantly went from 35.6 ml initially to 20.5 ml at the end of treatment with methacycline, and from 37.4 to 18.0 ml with ampicillin. Sputum neutrophils excreted per day went from 446 to 147 million with methacycline and from 433 to 94 million with ampicillin. Gram-positive diplococci and cocci on gram stains of sputum significantly decreased form 10.6 to 3.3 with methacycline and from 16.8 to 2.1 with ampicillin. This investigation objectively documents with accepted clinical efficacy of ampicillin and proves methacycline to be an equally effective agent.

Acute Disease↗