Ventilation-Perfusion Imaging in Evaluating Regional Lung Function in Nonpenetrating Injury to the Chest: Pulmonary opacificationA normovolemic state was established and all blood or air drained from pleural cavities before V/Q studies. The impairment of ventilation was estimated by the percentage decrease of activity during the wash-in phase or delayed clearance of activity during the washout phase. Impairment of perfusion was reported in a similar manner. An AP chest roentgenogram was taken with patients supine within 6 h of V/Q studies. Chest x-ray film abnormality was assessed by two independent radiologists without prior knowledge of V/Q abnormalities on the basis of the estimated percentage of parenchymal opacification or volume loss of the total radiologic lung volume. itat on
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We addressed the question of whether ventilation-perfusion radionuclide studies performed early (within 24 h of admission) and repeated 24 h later in patients with moderate to severe NIC are more sensitive than conventional parameters to determine the extent of pathophysiologic abnormalities caused by chest wall and lung injury. We also assessed the value of such studies in predicting complications or outcome following NIC. Read the rest of this entry »

Ventilation-Perfusion Imaging in Evaluating Regional Lung Function in Nonpenetrating Injury to the ChestAnatomic evaluation of the thoracic cage and its contents after nonpenetrating injury of the chest (NIC) is done clinically and radiographically, while alterations in ventilation and perfusion have been studied by spirometry and blood gas analysis. However, it has been difficult to correlate the pathophysiologic changes found with the anatomic lesions present, especially in the early period following NIC. The sensitivity of these parameters (clinical, radiographic, spirometric, and blood gas analysis) within the first 24 h following NIC to evaluate the extent of pulmonary damage and to predict eventual outcome is questionable. Pulmonary contusion, for example, has been described to be more common and extensive than suggested by radiographic findings and arterial Po2 abnormalities. More info
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Neither atenolol nor celiprolol affected daily asthma control and inhaler use in our study. Four conditions of the study need to be borne in mind: (1) the dose and duration of beta-blockers used; (2) the small number of subjects studied; (3) the mild nature of their asthma; and (4) the absence of events such as chest infections which might have had more severe consequences in those on beta-blockers. In a previous study of subjects with mild asthma treated with 100 mg atenolol, only small clinically insignificant bron-choconstrictive changes were found. Judging by their low medication requirements (five required only intermittent treatment and three required a beta-2 agonist inhaler alone), as well as symptom scores and spirometry, most subjects in our study had only mild asthma. However, it is not known what would have happened to respiratory function if these subjects with asthma had been exposed to some asthma trigger factors other than withdrawal of beta-2 stimulation, for example, upper respiratory tract infection. more
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Comparison of Respiratory Effects in Asthmatics with Mild to Moderate Hypertension: DiscussionIn this study on a small group of selected patients Adth coexisting hypertension and asthma, a singledose challenge with atenolol, 100 mg, caused bron-choconstriction in most subjects, while the response to single-dose challenge with celiprolol, 400 mg, closely resembled that with placebo. Without the sustained bronchodilator benefit of beta-2 agonists during the preceding 10-h period, the adverse effect of atenolol on FEVi, FVC and PEF was obvious. canadian health&care mall

Following salbutamol inhalation, respiratory parameters improved to prechallenge levels (p<0.05), suggesting that atenolol, 100 mg, is sufficiently cardio-selective to preserve a clinical bronchial responsiveness to beta-2 agonists. Read the rest of this entry »

Adverse effects were mild and most occurred during the placebo phase. Two patients complained of tiredness and mild ankle swelling, and another had headaches while taking atenolol.
Blood Pressure and Pulse Rates
All diastolic blood pressures fell significantly during both celiprolol and atenolol treatment, but systolic blood pressure taken with the patient in a supine position was reduced only by atenolol therapy (Table 2). Mean diastolic blood pressure values during the two treatment periods were similar. Five patients who were taking celiprolol and four who were taking atenolol achieved ideal diastolic blood pressure values (below 90 mm Hg or a reduction of more than 10 mm Hg). Read the rest of this entry »

Comparison of Respiratory Effects in Asthmatics with Mild to Moderate Hypertension: Statistical ProceduresDuring each phase of the study, including the run-in period, patients recorded the following on diary cards:
1. Symptom scores of cough and dyspnea during the preceding 12 h (twice daily recordings). Cough was scored as follows: (a) no cough, (b) occasional cough, (c) bad cough— intermittently, (d) bad cough most of the time. Dyspnea was scored as follows: (a) did not wake up at night, (b) awoke one to three times but slept between, (c) awoke four to six times but slept between, (d) awoke more than six times. Read the rest of this entry »

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