Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
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Monaldi Arch Chest Dis · Jun 1996
Case ReportsParadoxical bronchospasm and cutaneous rash after metered-dose inhaled bronchodilators.
The authors describe a case of paradoxical bronchospasm with laryngospasm and cutaneous rash occurring in an asthmatic woman after the use, via metered-dose inhaler, of different bronchodilators containing soy-derived excipients. It is noteworthy that the patient was not affected by soy allergy. After a short review of the relevant literature, the authors consider the possible aetiopathogenetic factors and outline the importance of this rare adverse reaction in the care of asthmatic patients.
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Ambulatory oxygen therapy in patients with COPD and exercise hypoxaemia may improve exercise capacity and breathlessness. The improvement in exercise tolerance is related to the degree of exercise hypoxaemia. ⋯ For effective ambulatory oxygen delivery, oxygen should be provided either by small liquid oxygen tanks or by small lightweight cylinders and conserving devices. Studies are required to evaluate the longer term effects of ambulatory oxygen on daily life.
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Monaldi Arch Chest Dis · Apr 1996
Exercise-induced hypoxaemia in emphysematous type chronic obstructive pulmonary disease.
To investigate gas exchange response to exercise, we studied 16 male patients with moderate-to-serve airflow obstruction (forced expiratory volume in one second (FEV1) 39 +/- 10% of predicted value), mild-modest arterial hypoxaemia (arterial oxygen tension (Pa,O2) 9.6 +/- 0.87 kPa) and no arterial hypercapnia (arterial carbon dioxide tension (Pa,CO2) 5.04 +/- 0.45 kPa), referred to as emphysematous-type chronic obstructive pulmonary disease (COPD) clinical pattern. During maximal exercise tests, Pa,O2 increased by more than 0.3 kPa in eight patients (Group A) and fell by more than 0.3 kPa in the other eight patients (Group B). ⋯ We, therefore, showed that common pulmonary function measurements at rest and during exercise were not useful in identifying patients who underwent exercise-induced hypoxaemia. Furthermore, we suggest that patients with the same clinical pattern of chronic obstructive pulmonary disease and the same degree of airflow obstruction and gas exchange impairment could develop a different adaptation to a maximal exercise test, and that the presence of exercise-induced hypoxaemia might be related to pathological features of emphysema more than to different respiratory functional measurements.
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Wegener's granulomatosis and Churg-Strauss syndrome are the predominant pulmonary vasculitides. Next in frequency are the various diffuse alveolar haemorrhage syndromes, which may be related to the antineutrophil cytoplasmic autoantibody (ANCA)-associated diseases, such as Wegener's granulomatosis and Churg-Strauss syndrome, or may be a part of a collagen vascular disease, such as lupus erythematosus, or associated with antiglomerular basement membrane antibody (AGBM) and fall within the definition of Goodpasture's syndrome. ⋯ Entities previously confused with pulmonary vasculitis include lymphomatoid granulomatosis or polymorphic reticulosis, and benign lymphocytic angiitis and granulomatosis, which are probably in the spectrum of T-cell lymphomas. Necrotizing sarcoid and sarcoidosis can involve blood vessels, but do not follow a typical course associated with the traditional concept of vasculitis.
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Monaldi Arch Chest Dis · Feb 1996
Application of multivariate linear discriminant analysis to lung sounds in some pulmonary diseases.
In the past 15 yrs, a number of investigators have applied spectral analysis to respiratory sounds recorded from the chest wall or the trachea in order to objectively characterize them and to relate them with different pulmonary diseases. In the present study, we have applied multivariate linear discriminant analysis to the spectral features of respiratory sounds. Lung sounds and the airflow velocity were recorded from 15 normal adults and 37 patients falling into three different disease categories: chronic obstructive lung disease, bronchial asthma and bronchiectasis. ⋯ Admittedly, the specific results of this study are preliminary or even tentative in view of the inadequacies of sound recording and signal conditioning techniques that were available to us at the time of recording. However, we believe that the investigation serves to illustrate the potential of multivariate discriminant analysis in the diagnostic classification of patients on the basis of their lung sound patterns. We suggest that this technique be considered by investigators involved in lung sound research, because it also allows other patient variables to be combined with the selected parameters of lung sounds.