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Effect of esophageal variceal sclerotherapy (EVS) on lung function. A prospective controlled study.

A prospective, controlled study to determine the short- and long-term effects of esophageal variceal sclerotherapy (EVS) on lung function was carried out on 11 patients with cirrhotic portal hypertension and variceal hemorrhage. Eleven patients with chronic liver disease undergoing diagnostic endoscopy served as controls. There was no difference in lung function tests and gas exchange in both the EVS or control groups after either procedure. No change in these parameters was noted during follow-up on continued sclerotherapy in the EVS group. Ventilation-perfusion scans and chest roentgenograms, performed before and after EVS, demonstrated no significant change. We conclude that in patients with stable liver disease and without hepatic failure, EVS does not result in serious short- and long-term impairment of lung function.

Adult↗

Pulmonary functions and respiratory symptoms and diseases among adult Israelis. Variations by country of origin.

A study group of 1,299 adult Israelis aged 30 to 65 years was chosen from persons referred for evaluation of possible pulmonary diseases in two outpatient chest clinics. They were interviewed using the ATS-NHLI (American Thoracic Society-National Heart and Lung Institute) health questionnaire and underwent the pulmonary function test (PFT), which included the following parameters: forced vital capacity (FVC), forced expiratory volume in 1st sec (FEV1), FEV1/FVC, peak expiratory flow (PEF), FEF50 and FEF25 (forced expiratory flow at 50 and 25% of FVC, respectively). The effect of the country of origin of the subjects on the distribution of respiratory symptoms, pulmonary diseases and PFT was analyzed. The lowest PFT values and an excess of reported respiratory symptoms and chronic obstructive airways diseases--especially asthma--among subjects and their parents were found among immigrants from Iraq-Iran. In immigrants from Morocco, reported respiratory symptoms, pulmonary diseases and impaired PFT were relatively uncommon. The different distribution of reported respiratory symptoms, pulmonary diseases and impaired PFT by country of origin could not be explained by environmental factors, such as smoking habits and socioeconomic background. The high prevalence of reported asthma among immigrants from Iraq-Iran is most probably due to a genetic factor.

Adult↗

Mean and instantaneous expiratory flows, FVC and FEV1: prediction equations from a probability sample of Michigan, a large industrial state.

Prediction equations for FVC, FEV1, FEV1/FVC, FEF25-75%, FEF75-85%, FEF50% and FEF75% were modelled for 396 normal non-obese adult lifetime nonsmokers and continuing smokers. Subjects came from a random cross-section of the white population of Michigan, a large industrial state. In both sexes, linear models utilizing age and height were appropriate for FVC, FEV1/FVC and FEV1; flows were better described by logarithmic transformation. These regression equations provided similar predicted values for FVC and FEV1 in nonsmokers to other models in wide use. Previous equations for instantaneous flows have yielded inconsistent predicted values. It is hoped that the present equations will be useful for these measurements. Duration of cigarette smoking was a significant prediction variable for FEV1, FEV1/FVC and mean and instantaneous flows in these normal men, but not in normal women. For FEV1, the effect of each year of smoking was 40% of the effect of ageing.

Adult↗

The use of labetalol for the treatment of hypertension in patients with reversible airway obstruction.

Beta-adrenergic blocking agents are commonly used for the management of hypertension, cardiac arrhythmias, and angina pectoris; several of these agents are now available for clinical use (1-5). A significant side effect of these agents in patients experiencing reversible airway obstruction is that they block the effects of beta-adrenergic agonists and can precipitate or worsen bronchospasm (6-8). Labetalol, a new adrenergic antagonist with both alpha- and beta-adrenergic blocking effects, has been shown to have certain advantages for the management of hypertension and is widely used for this purpose in many countries (9). To evaluate its effects on airway resistance in patients with obstructive lung disease, the authors conducted two separate clinical studies. This article summarizes the results of these trials.

Airway Resistance↗

[Respiratory function in chemical workers].

The authors have evaluated the trend of the forced expiratory flows at low lung volumes and of the diffusing capacity for CO in a group of chemical workers of a dye factory, exposed to mineral dusts, organic pigments and solvents. Prevalences of chronic bronchitis and dyspnea, as evaluated by CNR questionnaire, were 15 and 32%. FEF25-75, MEF50 and MEF75 showed statistically significant differences with reference values. The reduction of KCO% was almost completely accounted for by smoking habit. During exercise, DLCOSS2 did not reach the expected values. 71% of the subjects with a diagnosis of COLD had worked more than 15 years in the dye factory. These results suggest a negative effect of the working environment, together with cigarette smoking, on lung function of subjects with a medium-long-term exposure.

Carbon Monoxide↗

Studies of respiratory function in volunteers given live influenza virus vaccine.

Measurements of peak flow, vital capacity, FEV1 and flow volume studies were performed in healthy volunteers for 20 weeks following intranasal vaccination with live-attenuated A/Victoria/3/75 recombinants or placebo. Despite differing attenuation of the two candidate strains, no effect on pulmonary function was detected.

Adult↗