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Biomedical subjects

W Arossa

Publications and source records attributed to W Arossa.

At least 19 recordsLinked to original sources

Prolonged gastric pH monitoring in responder and nonresponder duodenal ulcer patients: response to placebo and to H2-blocker administration.

We evaluated the circadian pattern of gastric acidity by prolonged intraluminal pHmetry in 15 "responder" and 10 "nonresponder" duodenal ulcer patients after nocturnal administration of placebo, ranitidine, and famotidine. Acidity was measured during predefined periods under the different drug regimens in the two groups of subjects, and a comparison was performed both within and between groups. With placebo, significantly lower median 24-h pH values were detected in patients with resistant ulcer than in responders (1.13 versus 1.63). On the contrary, no statistical difference was detected between the two groups during any time of day after administration of either ranitidine or famotidine. Within each group, no significant difference was noted between the two different H2-blockers. Thus, our data suggest that patients with resistant duodenal ulcer display an increased gastric acidity in control conditions but a "normal" response to administration of antisecretory drugs.

Adult

Effect of ascorbic acid on increased bronchial responsiveness during upper airway infection.

We investigated the acute effect of ascorbic acid on histamine bronchial responsiveness (PC 20: concentration causing a 20% fall in FEV1) in 9 hospital staff members with upper respiratory tract infection (URI) and cough. Subjects were examined within 5 days from the start of illness and 6 weeks after. On day 1, the reproducibility of PC20 was assessed by 2 consecutive inhalation challenges 1 h apart; the two values were closely related (r = 0.96, p less than 0.001). Five subjects had bronchial hyperresponsiveness (PC20 less than 8 mg/ml histamine). On the following day, PC20 was measured before and 1 h after oral intake of 2 g ascorbic acid. Vitamin C produced a significant increase in average PC20 (p less than 0.01) from 7.8 +/- (SE) 1.2 to 25.1 +/- (SE) 1.2 mg/ml. None had airway hyperresponsiveness after treatment. Six weeks after the onset of URI, bronchial responsiveness was normal in all the subjects but one. The mean PC20 was 15.5 +/- (SE) 1.25 mg/ml, significantly higher than during URI (p less than 0.05); after ascorbic acid it increased nonsignificantly to 25.7 +/- (SE) 1.35 mg/ml. Our results indicate that vitamin C inhibits the transient increase in bronchial responsiveness occurring in otherwise normal subjects during URI.

Adult

Effects of vitamin C on airway responsiveness to inhaled histamine in heavy smokers.

Histamine bronchial threshold, the provocation concentration of histamine causing a 25% fall in maximal expiratory flow at 50% of forced vital capacity from the control value (PC25MEF50), was measured in seven heavy smokers and in seven sex- and age-matched nonsmokers before and one hour after ingestion, double-blind, of vitamin C (2 g) or placebo. Smokers had significantly lower baseline values of serum ascorbate, maximal expiratory flow at 50% of forced vital capacity (MEF50) and PC25MEF50: the latter was negatively related to serum ascorbate (r = -0.85; p less than 0.001). Acute treatment with vitamin C produced a significant decrease in PC25MEF50 in smokers (95% confidence limit (CL) from 4.87-3.36 to 2.91-2.01 mg.ml-1; p = 0.017), whilst it had no effect in nonsmokers. A preliminary open study on the effect of prolonged administration of vitamin C (1 g daily) was performed in smokers. One week of treatment produced a further significant decrease in PC25MEF50 (p less than 0.0001). Our results suggest that in heavy smokers histamine bronchial responsiveness may be attenuated by chronic ascorbate deficiency. In these circumstances, acute and short-term treatment with vitamin C may increase the bronchoconstrictive response to inhaled histamine.

Adult

Acute effect of intravenous magnesium sulfate on airway obstruction of asthmatic patients.

The bronchodilating effect of magnesium sulfate (MgSO4) was studied in ten asthmatic patients with moderate to severe airway obstruction. Two grams of MgSO4 or saline in double-blind crossover design was administered IV for 20 minutes (0.40 mmol/min) and forced expiratory capacity and forced expiratory volume in one second (FEV1) were studied at intervals. Only at the end of MgSO4 infusion did FEV1 increase significantly (109% of initial values). The bronchodilating effect was short lasting and far less than that observed after salbutamol.

Adult

Daily gastric pH in controls and in duodenal ulcer patients: basal condition and response to treatment.

Gastric pH was monitored, by means of a computerized system, in healthy controls (C) and in patients with active duodenal ulcer (ADU) and inactive duodenal ulcer (IDU). The test was performed before treatment and during administration of a single dose of ranitidine 150 mg, cimetidine 400 mg, and pirenzepine 50 mg, in random sequence at 12-h intervals, (10 am, 10 pm). Under basal conditions, progressively lower median pH values were detected in ADU and IDU patients, compared with controls. A significant difference was found between C and ADU during daytime (1.38 vs. 0.85), nighttime (1.29 vs. 0.81), and 24 h (1.35 vs. 0.81) and between C and IDU during 24 h (1.35 vs. 1.11). However, no statistical difference was observed between patients with active and inactive ulcer disease. Administration of ranitidine and cimetidine significantly increased gastric pH during nighttime but not during daytime. Ranitidine, at the doses studied, proved to be more potent than cimetidine in suppressing gastric acidity. Gastric pH was unaffected by pirenzepine in most cases.

Adult

Reduction of histamine-induced bronchoconstriction by magnesium in asthmatic subjects.

The effects of inhaled MgSO4 on histamine bronchoprovocation test (BPT) were studied in nine asthmatics in clinical remission (FEV1 greater than 80% of predicted). Patients performed histamine BPT on 2 separate days, one day after saline and the other after MgSO4 inhalation, in a randomized double-blind design. Spirometry and flow/volume curve were recorded on each test day before and 5 min after NaCl or MgSO4. No significant difference was observed in lung function measurements 2 days before and after either NaCl or MgSO4. The dose of histamine which produced a 20% decrease in control FEV1 (PD20FEV1) was significantly increased by aerosolized MgSO4 (from 0.177 +/- 0.036 mg after NaCl to 0.350 +/- 0.085 after MgSO4, P less than 0.05. After MgSO4 the dose-steps of histamine concentration increased two-fold in two subjects and one-fold in five.

Administration, Inhalation

Magnesium attenuates methacholine-induced bronchoconstriction in asthmatics.

The effects of inhaled MgSO4 on methacholine bronchoprovocation test (BPT) were studied in 16 asthmatics in clinical remission (FEV1 greater than 80% of predicted). The patients performed methacholine BPT on two separate days, one day after saline, the other day after MgSO4 inhalation, in double-blind cross-over design. Spirometry was recorded on each test day before and 5 min after NaCl or MgSO4. Neither NaCl nor MgSO4 was found to have a significant effect on spirometric measurements. A significant inhibition of reactivity to methacholine was observed with an increase in log PD20 FEV1 from 1.31 +/- 0.11 inhalation units after NaCl to 1.56 +/- 0.11 inhalation units after MgSO4 (p less than 0.01). The most attractive hypothesis to explain the latter, is that Mg2+ might interfere with Ca2+ handling in the bronchial smooth muscle cells similar to that shown for other types of smooth muscle.

Adolescent

Duration of oral procaterol protection from methacholine-induced bronchial obstruction.

The duration of action of procaterol, a beta-2-adrenoceptor agonist with an entirely new chemical structure, was assessed, in comparison to that of salbutamol, by inhalation of 43 inhalation units of methacholine at time intervals of 1, 3, 5, 7, and 9 hours after intake of the drugs. Procaterol and salbutamol were given in a double-blind random fashion, on different days, to 12 asthmatic children; pulmonary function tests (FVC, FEV1, MEF50, MEF25), skeletal muscle tremor, and vital signs (heart rate and blood pressure) were measured. Although there was no statistical significant difference between procaterol and salbutamol, protection of large and medium airways lasted for about five hours, while normal small airway patency was still present at seven hours. It is concluded that procaterol can be a good alternative beta-2-adrenoceptor agonist when the oral route is needed.

Adrenergic beta-Agonists

Effect of nifedipine on salbutamol-induced bronchodilation in partially reversible airway obstruction.

The effects of the combination of oral nifedipine (20 mg) and inhaled salbutamol (400 mcg) were studied in ten stable patients with chronic partially reversible airway obstruction in a double-blind crossover design. Specific airway conductance (SGaw), forced expiratory volume in 1 second (FEV1), heart rate and blood pressure were recorded before and 30 min after administration of nifedipine or a placebo and 30, 60, 90, 150, 210 and 270 min after salbutamol inhalation. The mean value of FEV1 30 min after nifedipine was significantly (p less than 0.05) higher than after the placebo. The increase of SGaw and FEV1 produced by salbutamol was not significantly affected by pretreatment with nifedipine at any time. Nifedipine produced a significant increase of the heart rate which persisted throughout the study, but it did not influence blood pressure. No untoward effect was noticed during the study.

Adult

A multivariate analysis of the risk in chronic obstructive lung disease (COLD).

This study was undertaken to assess the validity of cluster analysis for stratifying patients with severe COLD into homogenous subgroups in view of further prospective studies. To this aim, physiological measurements and questionnaire data were obtained from 532 outpatients with severe COLD (e.g. a 1 sec forced expiratory volume (FEV1) below 1.5-1/sec). The model variables selected for the partition in cluster were FEV1, PaO2, response to bronchodilators and heart rate. Two subgroups of patients were identified by the analysis: cluster I with significantly greater physiological impairment than cluster II. The comparison of the prevalences of the variables outside the model between the 2 clusters showed, in fact, that cluster I had a significantly higher prevalence of subjects with heavy smoking (p less than 0.01), prolonged occupational exposure (p less than 0.05), low body weight (p less than 0.05), recent hospitalizations for respiratory troubles (p less than 0.02) and emphysema (p less than 0.01). In conclusion, cluster analysis based on few physiological variables was able to identify, among patients with severe COLD, those with poorer general conditions and higher exposure to specific risk factors, for whom a worse prognosis of life can be expected. The advantages of cluster analysis in comparison to other techniques of classification in this kind of patient is discussed.

Analysis of Variance

Salbutamol plus beclomethasone dipropionate versus theophylline for the prevention of methacholine-induced bronchospasm in patients with chronic bronchitis.

Forty patients suffering from chronic bronchitis with basal forced expiratory volume in one second (FEV1) values at least 20% below ECSC (European Community Steel and Coal) predicted values were treated with a combination of salbutamol plus beclomethasone dipropionate or with theophylline for a period of 4 weeks. Methacholine bronchial inhalation challenges were performed before and after treatment. Both treatments produced significant increases in FEV1, forced vital capacity (FVC) and FEV1 100/FVC, while only the salbutamol plus beclomethasone dipropionate combination significantly reduced the decrease in FEV1 values after bronchial inhalation challenge.

Adult

The effects of air pollution on the respiratory health of children: a cross-sectional study.

To investigate the effects of air pollution on the respiratory health of children, a subject of some controversy, a comparative study was undertaken of 2,385 school children who lived in central urban, peripheral urban, and suburban areas. Daily monitoring of sulphur dioxide and total suspended particle concentrations in all areas showed that pollutant concentrations in central and peripheral urban areas were above commonly accepted safety levels for respiratory health, while concentrations in the suburban area were within acceptable limits. A questionnaire administered to each mother assessed environmental exposure to pollutants in the household, the occurrence of respiratory symptoms as well as lung diseases as diagnosed by a physician, and general information. Children were interviewed about smoking habits and any acute respiratory symptoms. Children also performed standard lung function tests. Results showed that children from both urban areas had lessened pulmonary function and a higher prevalence of bronchial secretion with common colds than did those from the suburban area. These differences persisted after corrections for exposure to indoor pollutants, active or passive smoking, socioeconomic status, and sex. Parental cigarette smoking was related to a fall in forced expiratory volume in 1 second and an increased incidence of acute respiratory illnesses and chronic cough in children. Although boys had higher lung volumes and lower air flow, regression analysis showed no significant influence of the interactions "sex-geographic area" and "sex-smoking" on lung function. It was concluded that air pollution has a significant effect on the respiratory health of children.

Air Pollutants

Changes in lung function of children after an air pollution decrease.

Forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1.0), forced expiratory flow between 25 and 75% of FVC (FEF25-75), and maximal expiratory flow at 50% of FVC (MEF50) were measured in 1,880 school children who lived in urban areas before and after a decrease of air pollution. A group of 162 children from a suburban area served as controls. In the first survey, FEV1.0, FEF25-75, and MEF50 of children from urban areas were significantly lower, while in the second survey they were not significantly different from those of controls. The slopes over time of FEV1.0, FEF25-75, and MEF50, adjusted for sex and anthropometric variables, were closely related to the decrease of pollutants concentration. Our results suggest that a decrease of air pollution may produce an improvement of lung function.

Adolescent

Chronic bronchitis in the iron and steel industry: prevalence study.

The paper reports the results of a prevalence study on functional impairment and chronic bronchitis in 733 foundry workers and in a control group of 1041 workers not exposed to the specific risks of the iron and steel industry. This study is the first part of a longitudinal study lasting 5 years within the framework of the Fourth Research Programme of the European Coal and Steel Community. Data on microclimate and particulate pollution for the various departments showed uniformly cold and damp conditions. Concentrations of pollutants were generally below the current T.L.V.'s. The subjects were subdivided into groups according to age, smoking and length of exposure. All the subjects were administered the "E.C.S.C. Questionnaire for the study of chronic bronchitis and pulmonary emphysema" and underwent a chest X-ray and spirometry to measure FVC, FEV1 and Vmax 50. The prevalence of functional impairment and chronic bronchitis was higher in the foundry workers than in the group of non-exposed workers. A statistical standardization was made of the effect of age and smoking thus accentuating the effect of exposure. The results are compared with the data obtained by other epidemiologic studies on working populations exposed to a similar risk.

Adolescent