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Long-term follow-up of spinal fusion in spinal muscular atrophy.

From 1966 to 1983, 11 females and eight males with spinal muscular atrophy were treated by arthrodesis. Seventeen of 19 patients were evaluated by follow-up physical examination, roentgenograms, and questionnaires. In order to compare long-term versus short-term results, changes in management, and factors contributing to morbidity and mortality, three groups were identified for study. Group I consisted of 11 patients operated between 1966 and 1983 and alive at follow-up evaluation. Group II consisted of five patients operated between 1980 and 1983. Group III consisted of three patients, all deceased at follow-up evaluation and operated before 1980. In Group I, the preoperative curve averaged 119 degrees and at final follow-up examination, 99 degrees. The average preoperative curve in Group II was 80 degrees and at follow-up examination, 49 degrees. Long-term follow-up vital capacities were obtained in nine patients. The average preoperative vital capacity was 1033 cm3, and the average vital capacity seven years postoperation was 860 cm3. Most patients reported improvement in sitting, balance, and comfort. All patients are wheelchair-bound, as they were before surgery. Few long-term respiratory problems were reported.

Adolescent↗

Lung function in children following empyema.

Spirometry was performed and response to exercise was measured in 15 children following recovery from empyema to evaluate the impact of pleural infection on subsequent lung function. Seven children underwent chest tube drainage; eight did not. The two groups were similar in age (mean +/- SD, 6 +/- 5 years), sex distribution, bacterial pathogen-producing empyema, and age at follow-up evaluation (12 +/- 5 years). Only one child reported recurrent respiratory symptoms. No child had restrictive spirometric changes (total lung capacity, less than 80%; vital capacity, less than 80% predicted) but seven of 15 had a reduced forced expiratory volume in 1 second (less than 80% predicted) or forced expiratory flow during the middle half of the vital capacity (less than 75% predicted), suggesting mild airway obstruction. No child demonstrated reduced exercise tolerance due to restrictive ventilatory limitations. Mild obstructive abnormalities in lung function were identified with equal frequency in children treated with and without chest tube drainage.

Child↗

The effect of smoking cessation on pulmonary function: a 30-month follow-up of two smoking cessation clinics.

To obtain further information about the effects of cessation of smoking on pulmonary function, we followed subjects who attended 2 smoking cessation clinics during a period of 30 months. This paper reports the results from 15 persons who succeeded in stopping smoking for the full 30-month period and from 42 who did not succeed for more than one month. Testing included a respiratory questionnaire, spirometry, and the single-breath N2 test. Standardized methods, the same equipment, and the same experienced personnel were used throughout the study. We found that forced vital capacity, one-second forced expiratory volume, closing volume as a percentage of vital capacity, closing capacity as a percentage of total lung capacity, and the slope of the alveolar plateau of the single-breath N2 test all improved significantly in the subjects who stopped smoking. This improvement continued for as long as 6 to 8 months, and then remained stable. There was no sex difference in the response to smoking cessation, nor could we find a threshold of function below which cessation did not result in improvement. On the contrary, those subjects with the greatest impairment initially showed the greatest improvement. Respiratory symptoms virtually disappeared in those who stopped smoking. Subjects who continued to smoke showed an initial improvement in some function tests, probably due to a marked decrease in consumption, but no significant improvement during the whole period. We concluded from this study that cessation of smoking results in definite improvement in pulmonary function, that there is greater improvement in persons who begin with impaired function than in those whose function is initially normal, that respiratory symptoms disappear rapidly.

Adult↗

Orally exhaled nitric oxide levels are related to the degree of blood eosinophilia in atopic children with mild-intermittent asthma.

Increased levels of nitric oxide have been found in expired air of patients with asthma, and these are thought to be related to the airway inflammatory events that characterize this disorder. Since, in adults, bronchial inflammatory changes are present even in mild disease, the present study was designed to evaluate whether a significant proportion of children with mild-intermittent asthma could have increased exhaled air NO concentrations. Twenty-two atopic children (aged 11.1+/-0.8 yrs) with mild-intermittent asthma, treated only with inhaled beta2-adrenoreceptor agonists on demand and 22 age-matched controls were studied. NO concentrations in orally exhaled air, measured by chemiluminescence, were significantly higher in asthmatics, as compared to controls (19.4+/-3.3 parts per billion (ppb) and 4.0+/-0.5 ppb, respectively; p<0.01). Interestingly, 14 out of 22 asthmatic children had NO levels >8.8 ppb (i.e. >2 standard deviations of the mean in controls). In asthmatic patients, but not in control subjects, statistically significant correlations were found between exhaled NO levels and absolute number or percentage of blood eosinophils (r=0.63 and 0.56, respectively; p<0.01, each comparison). In contrast, exhaled NO levels were not correlated with forced expiratory volume in one second (FEV1) or forced expiratory flows at 25-75% of vital capacity (FEF25-75%) or forced vital capacity (FVC), either in control subjects, or in asthmatic patients (p>0.1, each correlation). These results suggest that a significant proportion of children with mild-intermittent asthma may have airway inflammation, as shown by the presence of elevated levels of nitric oxide in the exhaled air. The clinical relevance of this observation remains to be established.

Adolescent↗

Atropine and terbutaline aerosols in chronic bronchitis: efficacy and sites of action.

To examine the additive properties and the sites of action of inhaled atropine sulfate (0.05 mg/kg of body weight) and terbutaline sulfate (0.005 mg/kg) in patients with chronic airflow obstruction, we tested these aerosols separately and together in a double-blind random sequence. Twelve patients with chronic bronchitis and perennial obstruction of airflow were studied by measuring three indices of efficacy (specific airway conductance [Gaw/VL], the forced expiratory volume in one second [FEV1] and the forced vital capacity [FVC]) and three indices of the site of action within the airway (delta [(Gaw/VL)/FEV1], the difference between the change in forced expiratory flow at 75 percent of vital capacity and the change in forced expiratory flow at 25 percent of vital capacity, and the change in density dependence of maximal airflow at 50 percent of vital capacity). Both atropine and the combination of atropine and terbutaline improved all indices of efficacy significantly more than did terbutaline. With individual exceptions, the addition of terbutaline to atropine improved Gaw/VL but not forced airflow. All measures of site of action suggested an advantage for atropine in relatively proximal airways. These results indicate that combined therapy with beta-adrenergic and anticholinergic bronchodilator drugs is marginally more effective than therapy with atropine alone in these patients and suggest that anticholinergic aerosols dilate larger airways more effectively than the beta-agonists.

Aerosols↗

Comparison of effect of narcotic and epidural analgesia on postoperative respiratory function.

A prospective, randomized comparison was made of the value of meperidine versus epidural analgesia when used for the relief of pain after cholecystectomy in twenty patients without cardiopulmonary disease. Respiratory function was assessed the day before surgery and at 3 to 4 hours and 24 hours after operation by the bedside measurement of expiratory peak flow, vital capacity, and arterial blood gases. The two groups of patients were comparable as to age, height, weight, smoking habits, preoperative peak flow, vital capacity, and duration of operation. The arterial oxygen tension and oxygen saturation were significantly greater and carbon dioxide tension lower in the epidural analgesia group 24 hours after operation. At this time peak flow rates and vital capacity were not different. However, at 3 to 4 hours postoperatively, vital capacity was significantly greater in the epidural anesthesia group. This might account for the differences in arterial blood gases the following day. These findings suggest that epidural analgesia is valuable in the early postoperative period after upper abdominal surgery.

Adult↗

Five- to seven-year course of pulmonary function in cystic fibrosis.

The pulmonary function records of 132 patients with cystic fibrosis followed for 5 to 7 years were reviewed. Changes in forced vital capacity, 1-sec forced expiratory volume, mean forced expiratory flow during the middle half of the forced vital capacity, and 1-sec forced expiratory volume as a percentage of forced vital capacity were examined. There was considerable variation in the rates of change, but the general pattern was consistent with a theory of exponential decline, mean forced expiratory flow during the middle half of the forced vital capacity showing the earliest and most dramatic changes. The pulmonary function of 33 patients (25 per cent) remained stable or improved throughout follow-up, possibly reflecting mild forms of lung disease or the efficacy of therapy. Twenty of these patients (15 per cent) maintained completely normal pulmonary function. The rate of decline in pulmonary function values, with progress of the disease, was steeper in the female patients.

Adolescent↗

[Perception of dyspnea in asthmatics--long-term study].

The authors investigated the relationship between perception of dyspnoea and some respiratory parameters (vital capacity - FVC, one-second vital capacity - FEV 1) in 43 patients with bronchial asthma. They followed up the changes of this relationship during repeated examinations within 3 - 60 months following the first examination. They were also interested to find out whether the patients perceive a reduction of the bronchial obstruction after Berotec. The authors provided evidence that: 1. a small proportion of the patients (18.4%) do not report subjective dyspnoea even in case of major obstruction of the respiratory pathways. 2. Another part of asthmatic patients (23.2%) have an increased perception of dyspnoea, i. e. they report a certain degree of dyspnoea when FEV 1 is higher than 85% of the appropriate value. 3. Acute reduction of bronchial obstruction is inadequately perceived by 39.5% of the patients. 4. During repeated assessment the perception of dyspnoea frequently changed markedly in the same patients. These findings justify the conclusion that treatment of asthmatic patients should depend not only on the score of the patient's symptoms but also on objective monitoring of the degree of obstruction in the home environment.

Adolescent↗

[Evaluation of respiratory tract function in healthy women in the last month of uncomplicated pregnancy].

UNLABELLED: The aim of this work was to examine the function of the respiratory system in pregnant women in the last month of non-complicated pregnancy. Spirometry with Lungtest 1000 was performed in 31 pregnant women at a mean gestational age of 37.72 weeks. In 24 of them the test was repeated after delivery (mean time from delivery = 39.40 days). The results were compared with a control group of 31 healthy non-pregnant resident of Szczecin. Prior to spirometry, all women underwent a physical examination with measurement of blood pressure, heart rate, body weight and height, chest and abdominal circumference, symphysis-fundus distance and blood analysis. Dyspneic symptoms characteristic of pregnancy were assessed with the St. George Hospital questionnaire. Spirometric parameters were recorded during three stages of the examination: 1. Components of vital capacity (IRV, ERV, TV, IC), breathing rate and minute ventilation. 2. Forced respiratory parameters (FEV0.5, FEV1, FEV1/FVCEX, FEV1/FVCIN, FEV2, FEV3, FVCEX, VPEF, FIV1, PIF, MIF50, FVCIN, VPIF, PEF, MEF25, MEF50, MEF75, FEF25/75, FEF75/85, MEF25/FVCIN, MEF50/FVCEX, MEF50/FVCIN, MEF75/FVCIN, FET, FET/FIT, FIT, TTOT, TMEF25, TMEF50, TMEF75, TPEF, TPIF, TPEF/FET, TPIF/FIT, MTT, AEX). 3. Maximum voluntary ventilation, maximum breathing frequency and breathing reserve. The results in all groups were compared with reference values. Furthermore, comparative analysis was performed in the same women before and after delivery. Data from questionnaires were related to results of spirometry. Parametric and nonparametric tests were applied. Spearman's rank test was used to study relations between respiratory symptoms and spirometric parameters. Most spirometric parameters deviated from reference values. Vital capacity was greater than expected. FEV0.5, FEV3, FEV1/FVCEX were reduced. FEV1/FVCIN were reduced in pregnant women only. Parameters of forced expiratory flow: FEF25/75, FEF75/85, MEF25, MEF25/FVCIN, MEF50/FVCEX were lower than expected. Significant difference were disclosed for MTT, AEX and MVV. MTT and MVV were increased and AEX was reduced. PEF and MEF75 were decreased in pregnant women. Other parameters did not differ significantly. Detailed analysis performed in 24 women before and after delivery revealed differences in components of vital capacity. Additionally, FEV0.5, FEV1/FVCEX, FEF25/75, MEF25, MEF50, MEF25/FVCIN, MEF50/FVCEX were increased in pregnancy. Time parameters of forced expiration--FET and TMEF25 were shorter. Minute ventilation was increased in pregnancy although the breathing rate was decreased. Values of maximum voluntary ventilation and breathing reserve were decreased in pregnancy. Correlation analysis revealed that respiratory symptoms in pregnant women depended on changes in proportions among static components of vital capacity and abnormalities in forced inspiration (FIT, TPIF/FIT). Intensity of symptoms was related to increased heart rate and diastolic pressure. CONCLUSIONS: 1. Chief spirometric parameters in the examined women differed significantly from reference values. Reliable information about respiratory function in pregnant women requires comparison of findings during and after pregnancy. 2. Vital capacity in the last month of pregnancy did not differ from values after delivery and in the control group. Component volumes changed: tidal volume was increased, expiratory reserve volume was decreased, inspiratory reserve volume remained unchanged. 3. Minute ventilation recorded at rest in pregnancy increased despite decreased breathing rate, whereas maximum voluntary ventilation was lower than after delivery and in the control group, evidencing reduced breathing reserve. 4. Chief forced expiratory parameters remained unchanged in pregnancy. Parameters characterizing bronchioles revealed increased air flow (bronchodilation). 5. Dyspneic symptoms found in pregnant women correlated with changes in vital capacity components. Symptoms depended on the mechanics of ventilation and not on the status of bronchi.

Adult↗

Lung growth and function in children and adolescents with idiopathic pectus excavatum.

Patterns of lung growth and function were studied retrospectively in 103 patients (73 male and 30 female) with idiopathic pectus excavatum in order to determine: 1) the prevalence of restrictive lung defect and/or other lung function abnormalities; 2) the possible association between type of lung function abnormalities and age of the patient; and 3) whether the type of lung function is associated with other clinical conditions. Forty-three patients (42%) were between 5-9 years of age; 36 (35%) were between 10-14 years; and 24 (23%) were between 15-19 years. Restrictive lung disease was detected only in 5 patients (5%), whereas 42 patients (41%) had evidence of obstructive pattern, and the remaining 56 patients (54%) had a normal pattern. The mean values for lung volume (total lung capacity (TLC) and/or forced vital capacity (FVC)) were lowest in the 10-14-year group, whereas the mean values of the indices of lower airway function (forced expiratory volume at 1 sec (FEV(1)), FEV(1)/FVC, forced expiratory flow at 25-75% of forced vital capacity (FEF(25-75)), and FEF(25-75)/FVC) were higher in the younger group. Residual volume (RV) and RV/TLC were elevated in all age groups, but they declined toward normalization with increasing age. There were no significant differences between groups (stratified either by pattern of lung function or by age) with regard to their demographics or clinical characteristics (scoliosis, direction of sternal rotation, history of asthma/reactive airways disease, or exercise intolerance). We conclude that idiopathic pectus excavatum may be associated with a variety of lung function abnormalities (in particular, lower airway obstruction) even in the absence of overt clinical symptoms. There was no evidence of significant worsening of lung function with increasing age.

Adolescent↗

Pneumoconiosis and pulmonary function defects in silica-exposed fire brick workers.

This study was conducted to investigate the health effects of exposure to silica dust in firebrick manufacturing plants. A cross-sectional study was designed, and the health effects in 526 exposed workers were compared with 164 nonexposed control workers. The medical examination included chest x-rays, pulmonary function tests, and a respiratory symptom questionnaire. Radiological evidence of pneumoconiosis was evident in 6.9% of the exposed firebrick workers, and the prevalence of pneumoconiosis increased with duration of employment. No differences in forced vital capacity were noted between the exposed and control groups; however, in both smokers and nonsmokers of the exposed group, forced expiratory flow in 1 s/forced vital capacity, mean maximal expiratory flow, forced expiratory flow at 50% vital capacity, and forced expiratory flow at 75% vital capacity were significantly lower than in the control group. Pulmonary function decreased as the duration of employment increased. The exposed group experienced significantly more wheezing, compared with the control group. There was evidence of a dose-response relationship between prevalence of pneumoconiosis/pulmonary function defects and estimated dust exposure levels. Pneumoconiosis and pulmonary function defects occurred frequently in workers who participated in the crushing and burning operations, both of which cause exposure to high levels of silica dust. We concluded that exposure to silica dust in workers at firebrick factories leads to radiological changes, pneumoconiosis, and pulmonary function damage.

Adult↗

Cutaneous vasoconstrictor response induced by inspiratory gasp in relation to sex and age.

1. Vasoconstrictor responses to inspiratory gasp were determined in fingertip skin by laser Doppler flowmetry in relation to age and gender of healthy adults. Variations of the responses were examined together with variations in body mass index and vital capacity. 2. In the absence of any significant difference in the baseline blood flow, the index of vasoconstrictor response (per cent change) induced by inspiratory gasp was higher in young males than in young females (71.4% versus 59.4%; P < 0.05), and in the same direction as the change in vital capacity determined in the same laboratory setting. Similar parallel differences in the indexes of vasoconstrictor response and vital capacity existed between young and middle-aged males, suggesting that the differences observed were not due to gender or age per se. 3. Strong positive correlations between the index of the vasoconstrictor response and vital capacity in the same subject were found when young males and females were pooled together and when young and middle-aged males were pooled together. Furthermore, after graded inspiratory gasp, graded vasoconstrictor response was observed in the same subject, indicating a close relationship between the depth of inspiration (magnitude of stimulus) and the index of the vasoconstrictor response (reactivity). 4. We concluded that the index of the vasoconstrictor response induced by inspiratory gasp depends significantly on the magnitude of the vital capacity. These results provide a new approach for quantifying dynamic changes in skin blood flow and raise caveats about comparing differences in neurovascular functions using single measurements of vasoconstrictor response induced by inspiratory gasp as an index.

Adult↗

Effect of age and preoperative airway obstruction on lung function after coronary artery bypass grafting.

To determine whether age or obstructive lung disease affects pulmonary function changes caused by uncomplicated coronary artery bypass grafting, we measured pulmonary function before operation and then 3 or 4 days, 7 days, and 17 +/- 2.2 weeks after operation in elderly patients (age, 74.8 +/- 3.3 years) and patients with obstructive lung disease (ratio of forced expiratory volume in 1 second to forced vital capacity, 0.60 +/- 8.8) and compared the results with those of a "normal" group. In all three groups a severe restrictive defect developed on day 3 (vital capacity, 61% +/- 20% of the preoperative value). Vital capacity recovered to 76.4% +/- 18.5% of the preoperative value on day 7. Three months after coronary artery bypass grafting, lung function had recovered to preoperative baseline (p > 0.2). The percent change from baseline in vital capacity, forced expiratory volume in 1 second, total lung capacity, and diffusing capacity for carbon monoxide was the same in all three groups throughout the study. A severe, reversible restrictive pulmonary function change follows coronary artery bypass grafting. This change is not affected by age or preexisting moderately severe obstructive lung disease.

Age Factors↗

[High resolution and spirometric synchronization computerized tomography in chronic obstructive bronchopneumopathy].

PURPOSE: To assess the feasibility of spirometrically gated HRCT in patients with chronic obstructive pulmonary disease and to correlate the density measures with the results of pulmonary function tests. MATERIAL AND METHODS: Pulmonary function tests and spirometrically gated HRCT were performed, on the same day, in 20 patients with chronic obstructive pulmonary disease. Spirometrically gated HRCT scans at 90 and 10% of the patient's vital capacity were acquired, at three anatomical levels (carena, carena plus 5 cm, carena minus 5 cm). In each section, lung parenchyma was isolated from the other thoracic structures and from the main bronchi and a densitometric evaluation was applied to the regions of interest. A histogram showing the distribution of the pixel frequencies versus lung densities, the mean CT number and the pixel index at -910 HU (for scans acquired at 10% of the patient's vital capacity) and at -950 HU (for scans obtained at 90% of the patient's vital capacity) were obtained. Average acquisition time for the spirometrically gated HRCt was 15-20 minutes, average data processing time was 20 minutes. RESULTS: The mean CT number and the pixel index at -910 HU obtained at 10% of the patient's vital capacity correlated with the Tiffeneau index (r = 0.85; R = 0.78 respectively). The pixel index at -910 HU correlated also with the ratio of residual volume to total lung capacity (r = 0.65). The mean CT number and the pixel index obtained at 90% of the vital capacity correlated with the lung diffusion of carbon monoxide (r = 0.64 and r = 0.79 respectively). CONCLUSIONS: In our study, we found good correlation between the densitometric values obtained with spirometrically gated HRCT and the respiratory function tests routinely employed to assess the presence and the gravity of obstructive pulmonary disease. A good reproducibility of the data is guaranteed by the spirometical gating which enables standardization of the lung acquisition volume, and by the semiautomatic contour tracing program combined with an automated densitometric evaluation. The main disadvantages of the technique are the relatively long acquisition and evaluation times. Spirometrically gated HRCT densitometry is a promising tool for longitudinal studies of diffuse lung disease (pulmonary emphysema and fibrosis).

Adult↗

Prevalence of primary T-wave changes in young men and their relationship to psychological and anthropometric data.

The T wave in leads II, V4, and V6 in the electrocardiograms of 1,401 consecutively entering 18-year-old male conscripts at a military processing center in 1975 were classified, and the relationship between the frequency of the T-wave changes relative to the psychosocial and medical data of the subjects was examined. One percent of the conscripts had a negative T in one or more of these leads, and twelve percent showed some deviation from the "normal T," usually a T wave of less than ten percent of the R-wave amplitude. A common finding was the presence of a "notch" in the T wave of lad V4 (a negative deflection in the middle of a positive T wave). Those with T-wave changes showed the same incidence of signs and history of heart disease as those with a normal T. However, those with an abnormal T showed higher heart rate and systolic blood pressure at rest. Further, they had more nervous symptoms and a higher consumption of alcohol and tranquilizers. These findings were as common in the larger group of flat T waves as in the smaller group with T-wave changes of the type normally attributed to organic heart disease (i.e., having notched, or more or less inverted T waves without ST depression). The maximal work capacity and vital capacity were slightly lower in subjects with abnormal T waves. However, this was fully explained by lesser height. It is suggested that in the majority of these cases, T-wave changes in young adults are due to increased sympathetic tone rather than to organic heart disease.

Adolescent↗

Effects of bracing on lung function in idiopathic juvenile kyphosis.

Although considerable information is available on the effects of bracing on lung function in kyphoscoliosis, there is a paucity of data on idiopathic juvenile kyphosis (IJK). The present study was designed to investigate the immediate effect of bracing on lung function in children and adolescents with mild-to-moderate IJK. Spirometry, measurement of lung volumes, and arterial oxyhemoglobin saturation (SaO(2)) were performed in 24 patients, 9-17 years of age, who were treated with a corrective brace for mild-to-moderate IJK (Cobb angle, 46-75 degrees ). Children were studied when braced and unbraced. When children were unbraced, mean percent predicted values (+/-standard deviation) for total lung capacity (TLC), vital capacity (VC), functional residual capacity (FRC), and forced expiratory volume in 1 sec (FEV(1)) were 100.0% (+/-13.0%), 92.7% (+/-14.2%), 108.2% (+/-20.4%), and 95.0% (+/-16.3%), respectively. With the brace on, significant reductions occurred in all lung function measurements: TLC decreased by 9.5% (P < 0.001), VC by 9.3% (P = 0.001), FRC by 14.2% (P = 0.005), and FEV(1) by 8.9% (P = 0.009). SaO(2) decreased from 96.2% (+/-1.6%) to 95.2% (+/-1.4%) (P = 0.027). An inverse relationship was observed between pre- and postbracing change in TLC and Cobb angle children (P = 0.021). Our findings indicate that corrective bracing in mild-to-moderate IJK results in mild lung restriction and a clinically insignificant drop in SaO(2). The effect of bracing on TLC decreases as the severity of kyphosis increases in these patients.

Adolescent↗

A randomized controlled trial comparing periodic mask CPAP with physiotherapy after abdominal surgery.

BACKGROUND AND PURPOSE: Physiotherapists use a variety of techniques aimed at improving lung volumes and secretion clearance in patients after surgery. Periodic continuous positive airway pressure (PCPAP) is used to treat patients following elective upper abdominal surgery. However, the optimal method of application has not been identified, more specifically, the dosage of application of PCPAP. The present randomized controlled trial compared the effects of two dosages of PCPAP application and 'traditional' physiotherapy upon functional residual capacity (FRC), vital capacity (VC), oxyhaemoglobin saturation (SpO2), incidence of post-operative pulmonary complications and length of stay with a control group receiving 'traditional' physiotherapy only. METHOD: Fifty-seven subjects were randomly allocated to one of three groups. All groups received 'traditional' physiotherapy twice daily for a minimum of three post-operative days. In addition, two groups received PCPAP for 15 or 30 minutes, four times per day, for three days. RESULTS: Fifty subjects (39 male; 11 female) completed the study. There were no significant differences in any variables between the three groups. The overall incidence of post-operative pulmonary complications was 22% in the control group, 11% and 6% in the PCPAP 15-minute and PCPAP 30-minute groups, respectively. Length of hospital stay was not significantly different between the groups but for subjects who developed post-operative pulmonary complications, the length of stay was significantly greater (Z = -2.32; p = 0.021). CONCLUSIONS: The addition of PCPAP to a traditional physiotherapy post-operative treatment regimen after upper abdominal surgery did not significantly affect physiological or clinical outcomes.

Abdomen↗

Endothelin-1 expression during early response after antigen challenge in brown-norway rats.

The objective of this study is to investigate if endothelin-1 (ET-1) gene expression changes during the early response phase following antigen challenge. We used sensitized Brown-Norway rats known to develop an early airway response after antigen challenge. After ovalbumin challenge, sensitized rats presented an early response, characterized by an increase in pulmonary pressure (209+/-14.53%,P<0. 01) and diminished functional parameters (inspiratory capacity, forced vital capacity (FVC) and expiratory flow at 75% of FVC), compared to their respective basal values. ET-1 mRNA expression was assessed by reverse transcription and polymerase chain reaction using specific primers for prepro-ET-1. A group of unsensitized rats was used as control. ET-1 expression was significantly enhanced in sensitized rats during the early response (290+/-62%,P<0.01) compared to the control group. In conclusion, antigen challenge induces an activation of ET-1 gene expression during the early response in Brown-Norway rats, suggesting a contribution of this protein to the development of bronchoconstriction.

Animals↗