1/7. Protective effect of ketotifen and disodium cromoglycate against bronchoconstriction induced by aspirin, benzoic acid or tartrazine in intolerant asthmatics.Oral challenge tests with acetylsalicylic acid, tartrazine or benzoic acid were performed in 7 intolerant asthmatic patients after a 3-day treatment with either orally taken ketotifen (1 mg twice daily) or inhaled disodium cromoglycate (20 mg four times daily) at random. Protection was noted with ketotifen in 5, with DSCG in 3 patients. On the evaluation of the mean percentage of the maximum decline in the forced expiratory volume in 1 sec (FEV1) only ketotifen afforded significant protection statistically (p less than 0.05). All the intolerant asthmatics studies showed, as an immunological abnormity, a slight, but significant decrease of the C1-inhibitor levels. Moreover, in three out of these the alpha 1-antitrypsin serum values were under the lower normal range.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
2/7. Utilization of pressure-volume curves in the pediatric patient.Seven patients treated with continuous mechanical ventialtion were monitored with static and dynamic pressure-volume curves. Three patients developed no pulmonary complications, and mechanical ventilation was discontinued within 96 hr. In four patients, pressure-volume curves were used as a diagnostic aid in the detection of the physiologic defect resulting from bronchoconstriction, atelectasis, loculated pleural fluid, pulmonary edema, and mucous plugging. These measurements were also utilized to evaluate the effectivess of therapeutic modalities such as treatment of bronchoconstriction with bronchodilators, mucous plugging with adequate suctioning, and drainage of loculated pleural effusion. pressure-v-lume measurements are simple, noninvasive, and require the smae equipment used in continuous mechanical ventilation. pressure-volume monitoring of pediatric patients with curves warrants further investigation to evaluate its value.- - - - - - - - - - ranking = 7keywords = volume (Clic here for more details about this article) |
3/7. airway obstruction due to inhalation of ammonia.ammonia is an important chemical in industry. Accidental inhalation of ammonia has resulted in upper airway and bronchoalveolar injury, and even fatal inhalation of anhydrous ammonia has occurred. We present herein a 5-year follow-up on a patient who had no prior history of smoking or pulmonary symptoms and had overwhelming exposure to ammonia which resulted in acute respiratory failure with diffuse lung parenchymal and airway involvement. The extreme inflammation and desquamation of the mucosa of the central bronchial tree, as observed bronchoscopically, have apparently resulted in a hyperreactive bronchoconstrictive component. Because our patient had never smoked and had no history of pulmonary symptoms or wheezing, we speculate that both the central and the peripheral residual airway obstructions were a result of his inhalation injury. In addition, peripheral airway disease, suggested by the postbronchodilator flow-volume curves present during the first year of follow-up, has gradually cleared even though there is evidence of parenchymal scarring.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
4/7. timolol eyedrop-induced severe bronchospasm.A patient with glaucoma simplex and chronic pulmonary obstruction was treated with the non-selective beta-adrenergic blocking agent timolol in ophthalmic solution of 0.25% for 11/2 years, when he had daily asthma attacks. In a provocation test, forced expiratory volume in the first second was reduced by 56% and bradycardia was induced after application of two drops of timolol eyedrops 0.25%. The severe systemic side-effects of timolol, when used as eyedrops, are related to the liver bypass and perhaps to the fast absorption from the cornea. It is suggested that when timolol ophthalmic solution is given for the first time to glaucoma patients with chronic obstructive pulmonary disease, they should be observed for one hour with special reference to difficulty in breathing.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
5/7. Protamine sulphate hypersensitivity.Protamine hypersensitivity has been documented by intra-dermal skin testing in three patients who demonstrated sudden cardiovascular collapse and bronchospasm following the use of intravenous protamine sulphate. All patients had been given protamine previously. The effects of the anaphylactic response were terminated quickly by the administration of intravenous adrenaline associated with plasma volume expansion. Intra-dermal skin testing against all anaesthetic agents is recommended so that the specific allergen can be identified. In patients who are shown to be allergic to protamine sulphate and who require cardiac or vascular surgery careful monitoring of heparin dosage and neutralisation with hexadimethrine (Polybrene) intravenously appears to be a safe alternative.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
6/7. Pulmonary effects of topical timolol.timolol, a beta-adrenergic blocking agent, recently became available for the treatment of glaucoma. We report the occurrence of acute bronchospasm in a previously asymptomatic asthmatic patient following topical use of timolol. Therapy with the drug was discontinued, and four weeks later the patient was challenged with two drops of 0.5% timolol. A 25% decrease in forced expiratory volume at one second (FEV1) was demonstrated at one hour. The fall in FEV1 was even greater (47%) when the patient was rechallenged with four drops. We emphasize the need to avoid topical beta-adrenergic blocking agents in asthmatic patients.- - - - - - - - - - ranking = 1keywords = volume (Clic here for more details about this article) |
7/7. Continuous spirometry: an aid to monitoring ventilation during operation.We present six case-reports of patients who experienced inadequate ventilation as a result of endobronchial or oesophageal intubation, or obstruction to the tracheal tube or airway and were monitored with on-line spirometry. The continuously displayed pressure-volume or flow-volume loops may be compared with previously recorded baseline loops. The changing configuration of the curves offers additional and instantaneous information about the cause of increased inspiratory airway pressure, decreased compliance or increased airway resistance. Monitoring flow-volume and pressure-volume loops in conjunction with currently available techniques provides a comprehensive method of monitoring ventilation.- - - - - - - - - - ranking = 4keywords = volume (Clic here for more details about this article) |