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PubMed1965

THE CHILLIWACK RESPIRATORY SURVEY, 1963: 3. THE PREVALENCE OF RESPIRATORY DISEASE IN A RURAL CANADIAN TOWN.

The prevalence of chronic respiratory symptoms and of abnormalities in pulmonary function was determined by a survey of persons, aged 25 to 74, residing during May and June 1963 in a rural town, Chilliwack, B.C. Morning phlegm was reported by 26% of men and 13% of women. Chronic bronchitis was considered present in 21.5% of men and 11.3% of women. More serious obstructive lung disease, not related to heart disease, was found in 12.6% of men and 8.7% of women. These prevalences were higher than those found by the authors at Berlin, New Hampshire, U.S.A., in 1961. Demographic factors, such as birthplace, occupational class and measures of social stability, were not related to the prevalence of respiratory disease at Chilliwack. Some observer variation was found after analysis to be the result of non-randomization of respondents among the observers. An incidental observation was a high prevalence at Chilliwack of heart disease and hypertension under treatment.

Asthma↗
PubMed1982

[Diaphragmatic eventration in adults. Apropos of 20 cases].

Twenty adults with a mean age of 49 were operated on between 1972 and 1980 for eventration of the diaphragm. The etiology was probably traumatic in 11 cases; it was congenital in 2 and degenerative in 7. The functional signs were usually respiratory (55%) or digestive (10%). In all cases, the diagnosis was based on standard fluoroscopy showing superelevation of the hemidiaphragm, which was visualized fluoroscopically as immobile while a pneumoperitoneum showed a absense of any tear. Spirography confirmed a restrictive deficit which was sited broncho-spirometrically on the eventration side. Surgical repair was achieved in most cases by thoracotomy (19 cases) and consisted in plication (17 cases) or incision followed by suturing of the overlapping edges of the muscle (3 cases). Postoperative complications included the death of the patient with multiple trauma, on the eight postoperative day, as a result of the cerebrovascular accident, and in another case rutpure of the repair on the second day, requiring a second operation. Apart from one patient who died as a result of a fatal accident two years postoperatively, all the surgically treated cases are alive, and, with one exception, symptom free. After an average follow up period of 2 years and 2 months, the control respiratory function tests show a 21% improvement in vital capacity and a 20% increase in FEV1. On the basis of these results, the authors conclude that this functional surgery is justified in the case of patients presenting with typical clinical symptoms, and worth considering in cases where respiratory function tests show a restrictive deficit, but also in patients who do not complain of breathlessness.

Adult↗
PubMedDate not supplied

Developmental changes in respiratory mechanics in the neonatal rat.

The rat lung undergoes rapid changes during the first several weeks of life. Respiratory function on neonatal rats was performed to determine if physiologic alterations coincides with classically described lung growth, and morphologic and morphometric changes. The authors examined respiratory mechanics during normal postnatal lung development in the rat utilizing both a forced oscillation technique, which partitions the mechanical properties of the lung tissue from the airways, as well as pressure-volume (PV) curves to assess lung elasticity. Respiratory function testing was performed on each postnatal days of life 10 to 20. The PV curves were characterized by a leftward shift over days 10 to 16, followed by a shift back to the right over days 17 to 20. Both tissue damping (G) and elastance (H) decreased from days of life 10 to 15, and then equilibrated from days 15 to 21. Hysteresivity (=G/H) at positive end-expiratory pressure (PEEP) = 1 and 3 cm H2O declined significantly with age. The effect of PEEP was significantly greater in the younger animals than in the older animals. The respiratory function assessments coincide well with the classically described periods of lung growth. These studies provide a normal baseline for correlating changes in structural with respiratory function.

Animals↗
PubMed1996

Intrapleural fibrinolysis with streptokinase as an adjunctive treatment in hemothorax and empyema: a multicenter trial.

To test the efficacy of intrapleural fibrinolytic therapy in patients with loculated pleural effusions, we conducted an open, prospective, and multicenter trial among five hospitals in Mexico. We enrolled patients with hemothorax or empyema, clotted and/or loculated, that was not resolved through conventional pleural drainage with chest tube and antibiotics in patients with empyema. All patients received repeated doses of 250,000 IU of streptokinase through chest tube. Effectiveness criteria were before and after intrapleural streptokinase (IPSK) drainage, and poststreptokinase radiographic and respiratory function test improvement. Forty-eight patients were studied; there were 30 patients with empyemas, 14 with hemothorax, and 4 patients with malignant pleural effusions without lung trapping. Successful fibrinolysis was obtained in 44 patients, with complete resolution of the pleural collection and adequate radiologic and spirometric improvement. In three of four patients with multiloculated malignant hemothorax with high-yielding pleural drainage, IPSK allowed successful lysis of loci and an adequate pleurodesis was achieved. Only four patients required surgical treatment. The overall success rate in our series was 92%, similar to previous reports. The results in this first prospective and multicentric trial suggest that intrapleural fibrinolysis is an effective and safe adjunctive treatment in patients with heterogeneous pleural coagulated and loculated collections to restore the pulmonary function assessed by respiratory function tests and can obviate surgery in most cases.

Adolescent↗