1,721,172 research outputs found
Usefulness of non-specific esterase stain for the morphometric evaluation of alveolar macrophage heterogeneity in human lung diseases
No full textAlveolar macrophage (AM phi) heterogeneity has been used as a parameter of AM phi involvement in animal models of disease. However, scarce and contradictory results have been reported in humans. In order to evaluate whether the use of non-specific esterase stain (Alpha-naphthyl-esterase: ANAE), a histochemical reaction characteristic of mononuclear phagocytes, could improve the study of bronchoalveolar cells (BAC) in humans, differential counts in slides of BAC stained with ANAE or conventional May-Grunvald Giemsa (MGG) were compared, and cell diameters were measured in ANAE-stained slides. No differences were observed between differential counts obtained with the two stains. However, when the distribution of cell diameters was investigated, ANAE provided better differentiation between small AM phi and large lymphocytes and better definition of cell limits of AM phi. Furthermore, an increase of AM phi heterogeneity was observed in patients with interstitial pulmonary diseases, due to an increase of large AM phi. Thus ANAE stain can improve the morphometric study of BAC and could be useful in the study of AM phi in human diseases
Behavior of serum lysozyme in sarcoidosis: comparison of 2 different determination methods [Comportamento del lisoźima sierico nella sarcoidosi: comparazione di due diversi metodi di dosaggio]
No full text
Late asthmatic reactions due to larvae of Calliphora erythrocephala used as fishing bait
No full textClinical characteristics of allergic asthma due to inhalation of insect antigens have been investigated very little. We describe two patients presenting with dyspnoea and wheezing several hours after exposure to larvae of Calliphora erythrocephala used as fishing bait. Both patients had a positive intradermal skin test and a high level of circulating IgE to the specific allergen. Bronchial challenge test with the whole larvae resulted in an isolated late response in one case, and in a dual response in the other, which were prevented by premedication with DSCG or beclometazone. The occurrence of late asthmatic reactions may render it difficult for the identification of insect antigens as the causal agent of extrinsic allergic asthma
Regular inhaled short acting beta2 agonists for the management of stable chronic obstructive pulmonary disease: Cochrane systematic review and meta-analysis
No full textBACKGROUND:
Despite the lack of reversibility, patients with chronic obstructive pulmonary disease (COPD) often report symptomatic improvement with inhaled short acting beta(2) agonist bronchodilators (ISABAs) in the management of both stable and acute exacerbations of COPD. A review of the literature was undertaken to determine the effectiveness of regular treatment with ISABAs compared with placebo in stable COPD.
METHODS:
A search for randomised controlled trials was carried out using the Cochrane Collaboration database of trials up to and including May 2002.
RESULTS:
Thirteen studies of 7 days to 8 weeks in duration on 237 patients aged 56-70 years with forced expiratory volume in 1 second (FEV(1)) 60-70% predicted were included in the review. All studies used a crossover design with adequate washout periods and were of high methodological quality. ISABA was delivered either through a nebuliser or a pressurised metered dose inhaler. Spirometric tests performed at the end of the study and after the treatment (post-bronchodilator) showed a slight but significant increase in FEV(1) and forced vital capacity (FVC) compared with placebo. In addition, both morning and evening peak expiratory flow rate (PEFR) were significantly better during active treatment than during placebo. An improvement in the daily breathlessness score was observed with ISABA treatment. The risk of treatment failure was reduced by more than 50% with ISABA. Preference for ISABA was nine times higher than for placebo.
CONCLUSIONS:
Use of ISABA on a regular basis for at least 7 days in patients with stable COPD is associated with improvements in post-bronchodilator lung function and decreases in both breathlessness and treatment failure. This review has shown that regular administration of ISABAs is an effective and inexpensive treatment for the management of patients with stable COPD
Epistemology and ethics of evidence-based medicine: putting goal-setting in the right place
No full textWhile evidence-based medicine (EBM) is often accused on relying on a paradigm of 'absolute truth', it is in fact highly consistent with Karl Popper's criterion of demarcation through falsification. Even more relevant, the first three steps of the EBM process are closely patterned on Popper's evolutionary approach of objective knowledge: (1) recognition of a problem; (2) generation of solutions; and (3) selection of the best solution. This places the step 1 of the EBM process (building an answerable question) in a pivotal position for the understanding of the whole process, and underscores a few aspects which are often overlooked in EBM courses. First in this step internal evidence (including personal expertise) must be appraised and integrated in the problem. Second, issues of applicability of the possible solution should be anticipated. Third, and possibly more important, the goal of the intervention should be set at this stage (typically by choosing the outcome in a PICO question). Depending whether or not goals depend on the goals of others, and whether they concern others' voluntary behaviour, goals may be classified as self-serving, moral, altruistic or moralistic. Thus, delicate ethical questions must be addressed at this stage, which means that patient preferences and values must be carefully sought, so that empathy, counselling and narrative medicine must be mastered to be able to formulate correctly an answerable question. The need to modify the current description of the EBM process to increase the recognition of implicit assumptions and increase the consistency of this model is discussed
Acoustic parameters of voluntary cough in healthy non-smoking subjects
No full textOBJECTIVE:
The aim of this study was to explore cough in healthy subjects.
METHODOLOGY:
We studied 234 coughs generated by 24 (12 males) healthy non-smokers (forced expiratory volume in 1 s (FEV1) 103+/-8% of predicted), who had no significant differences in FEV1 and age between males and females. For each subject, several bouts of voluntary coughing were recorded using a personal computer with an A/D converter (sampling rate 10 kHz, 8 bit resolution) and the first and second coughs of each bout were analysed using short-time Fast Fourier Transformation. For each cough we studied the three phases that are produced. In particular, we studied the duration of the three parts, loudest frequency in the first part, lowest and highest frequencies, number of continuous frequencies and lowest and highest continuous frequencies in the second part, and the loudest frequency of the third part if present.
RESULTS:
We found significant differences between males and females in length of the first part (41.4+/-14 vs 44.7+/-10.4 msec, P = 0.04), loudest frequency of the first part (362+/-145 vs 449+/-145 Hz), lowest frequencies (282+/-100 vs 348+/-135 Hz) and highest continuous frequencies (3877+/-571 vs 4147+/-362 Hz; P < 0.001) of the second part. An interesting finding was that healthy males and females had the same number of continuous frequencies. Different frequencies are probably a consequence of anatomical differences in airway geometry involved in the cough.
CONCLUSION:
In cough frequency spectrum studies the differences between the two sexes should be taken into account to reduce the variability of the results.OBJECTIVE:
The aim of this study was to explore cough in healthy subjects.
METHODOLOGY:
We studied 234 coughs generated by 24 (12 males) healthy non-smokers (forced expiratory volume in 1 s (FEV1) 103+/-8% of predicted), who had no significant differences in FEV1 and age between males and females. For each subject, several bouts of voluntary coughing were recorded using a personal computer with an A/D converter (sampling rate 10 kHz, 8 bit resolution) and the first and second coughs of each bout were analysed using short-time Fast Fourier Transformation. For each cough we studied the three phases that are produced. In particular, we studied the duration of the three parts, loudest frequency in the first part, lowest and highest frequencies, number of continuous frequencies and lowest and highest continuous frequencies in the second part, and the loudest frequency of the third part if present.
RESULTS:
We found significant differences between males and females in length of the first part (41.4+/-14 vs 44.7+/-10.4 msec, P = 0.04), loudest frequency of the first part (362+/-145 vs 449+/-145 Hz), lowest frequencies (282+/-100 vs 348+/-135 Hz) and highest continuous frequencies (3877+/-571 vs 4147+/-362 Hz; P < 0.001) of the second part. An interesting finding was that healthy males and females had the same number of continuous frequencies. Different frequencies are probably a consequence of anatomical differences in airway geometry involved in the cough.
CONCLUSION:
In cough frequency spectrum studies the differences between the two sexes should be taken into account to reduce the variability of the results
Modulation of macrophage suppressive activity and prostaglandin release by lymphokines and interferon: comparison of alveolar, pleural and peritoneal macrophages
No full textIn order to better characterize the mechanisms which regulate the immune response at the pulmonary level, the effects of beta-interferon (IFN-beta) and lymphokines (LK) on prostaglandin E (PGE) release and the suppressive capacity of mouse resident alveolar (AM phi) and pleural macrophages (PlM phi) were investigated in comparison with peritoneal macrophages (PM phi). After in vitro exposure to IFN-beta, PlM phi and PM phi showed a significant decrease of suppressive capacity and PGE release, whereas LK treatment did not affect such activities. In contrast, pre-treatment of AM phi with LK caused a strong impairment of their suppressive capacity. This effect was optimal after an incubation time of 20 h, was evident also at very low doses of LK and was not paralleled by any change of PGE release. Again in contrast with PlM phi and PM phi, suppressive capacity of AM phi was decreased only by very high doses of IFN-beta, whereas lower doses caused either an increase or no change of this activity. Furthermore, PGE release by AM phi was markedly increased after treatment with IFN-beta. Thus, suppressive capacity of AM phi appears to be controlled by different mechanisms from those of PlM phi and PM phi. In addition, a dissociation is evident between suppressive capacity and PGE release by AM phi
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