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Studies of cardioselectivity and partial agonist activity in beta-adrenoceptor blockade comparing effects on heart rate and peak expiratory flow rate during exercise.

1 The effects of beta-adrenoceptor antagonists given in single doses by oral or intravenous routes were examined in two double-blind controlled studies performed in healthy volunteers. Heart rate and peak expiratory flow rate (PEFR) were measured at rest and during standardized exercise. 2 Propranolol 80 mg and metoprolol 100 mg orally tended to reduce, and propranolol and metoprolol 0.2 mg/kg intravenously did reduce the physiological increase in PEFR during exercise; oxprenolol 80 mg orally and 0.2 mg/kg intravenously did not. Practolol 200 mg orally reduced this increase, but practolol 1 mg/kg intravenously did not. 3 In a third study of similar design, pindolol 0.05 mg/kg intravenously did not affect exercise-induced increase in PEFR. 4 Heart rate during exercise was reduced to a comparable extent at different times by all the active treatments. 5 Oxprenolol and pindolol share with practolol the property of partial agonist activity, which might contribute to their apparent lack of effect on airways resistance. A further possibility is that alpha-adrenoceptor blockade helps to maintain exercise-induced increase in PEFR.

Adrenergic beta-Antagonists

Peak expiratory flow rate in South Indian adults.

Peak Expiratory Flow Rate (PEFR) was measured with a Wright Peak Flow Meter in 851 healthy men and women of two categories; Group I--students and staff of the Medical College constituting the middle income group, and Group II--healthy individuals from the poorer class with an income of less than Rs.200/-per month, forming the lower income group. In both categories women had much lower values than men, and in both sexes the values in the subjects of the poor income group was significantly lower. The PEFR was found to correlate best with height in subjects below 30 years, and with age in older subjects. The mean values, standard deviations and regression equations are given for the different groups. Present values are also compared with some western and Indian data.

Adolescent

[Standardization of the peak expiratory flow rate].

Five successive measurements of the peak expiratory flow rate have been made on a large number of children and adolescents in various age groups and both sexes. The predominant part of the increase in individual performance is already achieved during the first three trials. Besides, the maximum value of the five measurements apparently does not differ essentially from the mean value of the two or three highest measurements.

Adolescent

Peak expiratory flow rate. Reference values for Swedish children.

Reference values for the peak expiratory flow rate assessed by the Wright-McKerrow peak flow meter have been established for Swedish children. The material consisted of 143 boys and 132 girls. We recommend the sexes be considered together. The equation of the regression line is 72.14 x height3 + 96.12. The coefficient of correlation is 0.93 and the residual standard deviation 13.7%.

Body Height

A procedure for using peak expiratory flow rate data to increase the predictability of asthma episodes.

An examinaton was conducted of the relationship between Peak Expiratory Flow Rate (PEFR) measurements obtained in the homes of two boys with asthma and the predictability of asthma episodes. An approach was developed for assessing the predictive utility of PEFR data. Results indicated approximately three-fold increases in the predictability of asthma episodes for the two experimental subjects. Potential applications of these results to the management of asthma are discussed.

Asthma

[Comparison between peak expiratory flow rate and daily report of the symptoms in asthmatic children (author's transl)].

In a group of 140 asthmatic children (6-15 years old) followed up for six months, the authors compared : (1) the daily transcription of asthmatic symptoms, of their intensity and of the use of antibiotics or corticosteroids ; (2) the peak expiratory flow rate measured daily at nine a.m. ; (3) the clinical history, coded every fifth day. A clinical score was computed by multiple linear correlation between (1) and (3), with a correlation coefficient of 0.84 (p less than 0.001), showing that the propounded quantification of symptoms and treatments was very good for estimating the clinical history. The coefficient of simple linear correlation between peak expiratory flow rate and score (r = --0.41) and between peak expiratory flow rate and clinical history (r = --0.65) was statistically significant ; however a further computation by stepwise multiple linear correlation showed that the peak expiratory flow rate was essentially correlated to the intensity of the symptoms, and to a lesser degree to the presence of breathlessness and prescription of corticosteroids. The correlation coefficient was -- 0.55 (p less than 0.01). Thus the peak expiratory flow rate does not very well account for the clinical state of asthmatics ; useful for the fast but superficial monitoring of patients, it cannot replace the daily transcription of symptoms and treatments : both methods are complementary.

Adolescent

[Peak expiratory flow rate among Swiss boys and girls between 4 to 19 1/2 years of age domiciled in the Canton of Geneva in 1972].

Peak expiratory flow rate (PEFR) was measured by means of a Wright peak flow meter on a sample of 2865 boys and 2712 girls selected at random in the Canton of Geneva, Switzerland (resident population of Swiss children and adolescents aged 4-19 1/2 in 1972). Technique of measurements and statistical analysis are described with an aim at standardization. Expected percentiles of PEFR (50, 25, 10 and 2.5) versus standing height are presented in tabular form for boys and girls separately. Nomograms are given allowing graphical determination of expected PEFR percentiles in either sex for any given standing height.

Adolescent

Diurnal variation in peak expiratory flow rate among workers exposed to toluene diisocyanate in the polyurethane foam manufacturing industry.

The diurnal variation in peak expiratory flow rate (PEFR) was studied in 26 mixers from eight factories making polyurethane foam, who were exposed to toluene diisocyanate (TDI), and 26 unexposed controls matched for age, race, and smoking. They were all men. The mean diurnal variation in PEFR of the mixers was 6.2%, which was significantly higher than the 4.3% for controls. Six mixers had a diurnal variation of greater than 15% on at least one day compared with none among the controls. There was, however, no overt cause of occupational asthma. All but one of the 24 environmental samples taken exceeded the short term exposure limit of 0.02 ppm for TDI. This accounted for the high prevalence (50%) of irritative symptoms such as cough and eye irritation. Forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity (FVC) (%) was negatively correlated with duration of exposure to TDI. Foam workers may still have high exposure to TDI, high prevalence of irritative symptoms, increased diurnal variation in PEFR and evidence of chronic airway obstruction, particularly in those with greater than or equal to 10 years of exposure.

Adult

Asthma in schoolchildren. Demographic associations and peak expiratory flow rates compared in children with bronchitis.

The frequency of asthma in 10 971 school-children between the ages of 5 and 14 years was reported by their parents to be 3-8%. Of these, 20-7% were said to have had bronchitis, 5-9% pneumonia, and 4-7% eczema. Asthma was reported more commonly in boys than girls and was greatest in children of social classes I and II. One-third of the children were reported to have their first attack before the age of 2 years. Few (18%) first attacks started after the age of 5 years. There was no evidence that bronchitis predisposed to the later development of asthma, or vice versa. Within each age-sex group children with a history of asthma had lower peak expiratory flow rates than children who gave no such history. These diffences in PEFR were greater than for children with a history of bronchitis.

Adolescent