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Effects of oral lacidipine on cardiopulmonary function at rest and during exercise in normal subjects.

A randomized, double-blind, crossover, placebo-controlled study was carried out to evaluate the effects of a single oral 4-mg dose of lacidipine vs. placebo on cardiopulmonary circulation at rest and during exercise. Twelve healthy volunteers were randomized to receive either placebo or 4 mg of lacidipine once daily for 2 days, followed by a 3-day washout period, after which they received alternate treatment. Patients were assessed before and at 60, 90, and 180 min after dosing. At 120 min, a maximum exercise test with a treadmill was performed according to the Bruce protocol. No relevant changes with placebo or lacidipine were observed in the respiratory function tests whereas 4 mg of lacidipine increased pulmonary effective blood flow (Qp. eff.) and stroke volume index (SVI) at 60 min, reaching a peak at 90 min; at 180 min, these effects, although diminished, were still present. The arteriovenous oxygen difference [C(a-v)O2] decreased, but reverted to normal values by 180 min. No differences in maximum attained Qp. eff. and oxygen consumption (VO2) during exercise were observed. Only the heart rate was higher both before and after treatment with lacidipine. Lacidipine increased Qp. eff. in these normal subjects without relevant effects on respiratory function. Performance on exercise testing after dosing was normal, although drug-induced vasodilation was present.

Adult↗

The single-breath nitrogen test does not detect functional impairment in children with passive exposure to tobacco smoke.

Respiratory symptoms and pulmonary function were compared in 46 nonsmoking children aged 10 to 16 years, whose parents were smokers, and an identical number of children (matched for sex, age and height) whose parents were nonsmokers. Passive exposure to parental tobacco smoke resulted in a higher prevalence of respiratory symptoms, more frequent upper airway infections and a significant decrease in forced expiratory flows; these effects were more marked in boys. The single-breath nitrogen washout test, a sensitive test of small airways obstruction in adults, did not detect any effect of involuntary smoking in this limited sample of children.

Adolescent↗

Electrodiagnostic evidence of phrenic nerve demyelination in Charcot-Marie-Tooth disease 1A.

OBJECTIVE: To determine whether neurophysiologic findings correlate to clinical respiratory signs or spirometric abnormalities in patients with hereditary motor and sensory neuropathy type 1 (Charcot-Marie-Tooth disease). DESIGN: A total of 11 patients with hereditary motor and sensory neuropathy type 1A, genetically identified, (age range, 10-58 yr) were included and studied by physical pulmonary examination, chest radiography, respiratory function tests, and bilateral transcutaneous phrenic nerve conduction. RESULTS: No patient complained of respiratory symptoms or revealed abnormal spirometric or maximal respiratory pressure data, despite a phrenic nerve conduction significantly slower (P < 0.0001; median conduction time, 18.6 msec; 95th percentile, 31.97 msec) than that recorded in the control group of healthy subjects (median, 6.05 msec; 95th percentile, 8.82 msec); the amplitudes of compound muscle action potentials were not statistically different from the controls. CONCLUSIONS: Our study confirms a dramatic phrenic nerve involvement in absence of clinical and laboratory evidence of diaphragmatic weakness; further studies and an adequate follow-up are necessary to discover whether the disease progress might encompass respiratory dysfunction at later stages.

Action Potentials↗

[Value of the test of unilateral pulmonary artery blocking in the preoperative evaluation of bronchial cancer].

Results of the test of unilateral blockage of a pulmonary artery (UBPAT) were compared with those of respiratory function tests in the pre-operative investigation of 31 patients with bronchial cancer. Results were also compared with functional tolerance of patients treated by pneumonectomy. Follow-up hemodynamic explorations were performed postoperatively in eight of these patients. Values for pulmonary artery pressure obtained during the UBPAT appear to be much more discriminatory than the ventilatory parameters studied for predicting functional tolerance following pneumonectomy. Apart from some complexity in its performance this test appears to be a valid one, when associated with pulmonary angiography, for pre-operative investigation of bronchial cancer patients at high functional risk.

Aged↗

No effect of creatine on respiratory distress in amyotrophic lateral sclerosis.

OBJECTIVE: To evaluate the effect of creatine supplementation on the respiratory function of patients with advanced amyotrophic lateral sclerosis (ALS). METHODS: Five grams creatine daily were administered orally to 14 patients with definite advanced ALS. For comparison we used a group of 13 patients with a similar respiratory function. All patients performed pulmonary function testing including forced vital capacity (FVC), forced expiratory volume (FEV(1)), peak expiratory flow rate (PEF) and maximum voluntary ventilation (MVV) -- expressed as percent of the predicted value -- at baseline and each month thereafter. RESULTS: There was no significant difference in any measured variable between the treatment group and the control group at 1, 2, 3 and 4 months follow-up. Thereafter the high patient drop-out rate did not allow statistical evaluation. CONCLUSION: The present study did not show any clinically significant, long-term effect of creatine on the function of respiratory muscles in ALS patients with respiratory distress.

Amyotrophic Lateral Sclerosis↗

[A case of myotonic dystrophy with morning headache following sleep apnea syndrome].

We reported a 39-year-old man with myotonic dystrophy. He suffered from morning headache. Respiratory function tests showed restrictive pattern and arterial gas analysis showed hypoxia and hypercapnia with respiratory acidosis (PaCO2 50.8 mmHg, PaO2 63.8mmHg, pH 7.317, SaO2 89.8%). Polysomnograph showed central apneas exclusively in light sleep (stage 1 and 2). O2 saturation fell at most to as low as 50% during the apneas. We conclude that sleep apnea should be consider in patients with myotonic dystrophy associated with morning headache.

Adult↗