Effects of high doses of beclomethasone dipropionate in bronchial asthma

Fifteen bovine herpesvirus-1 (BHV-1)-negative calves were vaccinated intramuscularly with 10(7.4) plaque-forming units of a double-deletion BHV-1 mutant (IBRV(NG)dltkdlgIII), and 6 remained as nonvaccinated controls. Thirty days after vaccination, the animals were challenged by nasal instillation of 10(8.2) CCID50 of a virulent BHV-1 strain (Cooper). The vaccinated calves were protected against wildtype virus challenge as demonstrated by clinical evaluation. Most of the vaccinates developed only a mild rhinitis (lasting an average of 6.5 days) with almost no systemic symptoms, whereas the controls developed a serious illness characterized by rhinitis (mean = 11.5 days), conjunctivitis, hyperthermia, apathy, loss of appetite, and dyspnea. The vaccinates also shed significantly less virus and for a shorter period of time (mean = 5.5 days) than the controls (mean = 9 days). Thirty days after vaccination, the vaccinates were negative in an anti-gIII specific blocking enzyme-linked immunosorbent assay (ELISA), despite the fact that most of them had developed neutralizing antibodies (serum neutralization titers ranging from 1:2 to 1:16). Seroconversion to gIII was detected as early as 7 days postinfection (dpi). Fourteen days after the challenge, all the animals exposed to wildtype BHV-1 had developed anti-gIII antibodies and were positive in this differential serologic test. Six controls plus 8 vaccinates kept in isolation were still positive to gIII when tested at 75 dpi. The use of the IBRV(NG)dltkdlgIII strain in conjunction with an anti-gIII specific blocking ELISA kit represents a powerful tool for BHV-1 control/eradication programs.     

Evaluation of antiarrhythmic efficacy of sotalol in various doses in patients with ventricular tachyarrhythmias

Antiarrhythmic efficacy of sotalol--noncardioselective beta-adrenergic blocking agent with class III antiarrhythmic action was evaluated in 34 patients [pts] (mean age 55 +/- 11) with chronic ventricular arrhythmias and coronary artery disease, 38% with previous myocardial infarction. Two schedules of dosing were tested: 3 x 80 mg and 2 x 160 mg during 28 days of therapy. Pts with Lown class II and IV arrhythmia derived from 24-hours Holter recording were assigned. Ventricular premature complexes [VPCs] and couplets reduction by 80% and total elimination of runs defined antiarrhythmic efficacy. Proarrhythmia was defined by four times increase in VPCs, ten times increase in couplets and runs or sustained VT episodes. RESULTS: Antiarrhythmic efficacy of two doses of sotalol according to study criterion was: 31% for lower dose (3 x 80 mg) and 24% for higher dose (2 x 160 mg). Overall efficacy for both doses was 55%. According to Morganroth criterion, lower dose was effective in 29% pts and both doses, lower and higher, in 41% pts. According to other commonly used criterion: 70% VPCs reduction, 90% couplets reduction and total elimination of runs, lower dose of sotalol was effective in 32% pts and both doses in 47% pts. Significant reduction of heart rate and prolongation of QT and QTc were observed. In 3 pts QT was prolonged over 500 ms. Proarrhythmia according to Velebit criterion was suspected in one patient after one week of 3 x 80 mg teratment which caused premature cessation of therapy. No significant abnormalities in laboratory values were observed. CONCLUSIONS: Antiarrhythmic efficacy of sotalol was comparable to other studies. Its value in pts with malignant ventricular tachyarrhythmias: sustained ventricular tachycardia and ventricular fibrillation requires further studies with higher number of patients.     

Recent view on drug therapy of bronchial asthma

PURPOSE: Our goal was to determine if there are any T2-weighted MR signal characteristics of Toxoplasma encephalitis that might be useful in diagnosis and/or in gauging the effectiveness of medical therapy. METHOD: We retrospectively analyzed the MR, CT, thallium-201 SPECT brain scans, and medical records of 27 patients with medically proven (26) and biopsy proven (1) Toxoplasma encephalitis, supplemented by autopsy findings in 4 additional patients, 2 of whom had postmortem MR correlation. The neuropathologic literature was also reviewed. RESULTS: Among the 27 patients, we discovered three distinct imaging patterns. Ten (37%) patients had predominantly T2-weighted hyperintense lesions and had been on medical therapy an average of 3 days (excluding one outlier). Ten (37%) patients had T2-weighted isointense lesions and had received medical therapy an average of 61 days. Seven (26%) patients had lesions with mixed signal on T2-weighted images and had been on treatment an average of 6 days. Analysis of autopsy material from the four additional patients revealed the presence of organizing abscesses in three and necrotizing encephalitis in one, while the patient who had a brain biopsy demonstrated both types of pathologic lesions. In both cases having postmortem MRI, organizing abscesses appeared isointense to hypointense on T2-weighted images. CONCLUSION: There is a definite variation in the appearance of lesions of Toxoplasma encephalitis on T2-weighted images that precludes a definitive diagnosis based on signal characteristics alone. Pathologically, our data suggest that T2-weighted hyperintensity correlates with necrotizing encephalitis and T2-weighted isointensity with organizing abscesses. Furthermore, in patients on medical therapy the T2-weighted MR appearance may be a transition from hyperintensity to isointensity as a function of a positive response to antibiotic treatment, indicating that the signal change might be used to gauge the effectiveness of medical therapy.     

Pulsus paradoxus in the bedside assessment of patients with bronchial asthma

Pulsus paradoxus (PP) was measured in 35 patients with bronchial asthma. The presence and degree of PP correlated well with the clinical conditions of the patient and with peak expiratory flow rate (PEF). PP and PEF are useful bedside measurements in the assessment and management of patients with bronchial asthma. Although the degree of PP is usually directly related to the severity of the attack of asthma, it was absent in the one patient who remained severly ill with unreleived bronchospam when he became exhausted. Our experience with this patient, and with previous patients who are not included in the present analysis, emphasises the fact that PP must not be considered in isolation but in conjunction with the patient's clinical state and with other indices of the severity of the astmatic attack.     

Aevit and glutamic acid in the treatment of patients with bronchial asthma

To elucidate the effect of antioxidants aevit and glutaminic acid on the course of bronchial asthma (BA) and free radical processes in this disease, 54 BA patients were divided into 2 groups: glucocorticoid-untreated and glucocorticoid-treated. Each of two subgroups made of these groups either received antioxidants (AO) or not. The response was assessed by clinical BA symptoms and free radical processes reflecting production of active oxygen forms by leukocytes (PAOFL) and free radical peroxidation (FRPO). PAOFL was studied using luminol-dependent chemiluminescence (CL). CL basal and stimulated values were calculated. FRPO was measured by plasma levels of malonic dialdehyde. Aevit and glutaminic acid treated BA patients improved clinically and exhibited reduced CL of PAOFL and malonic dialdehyde in plasma compared to BA patients on conventional therapy or conventional therapy plus glucocorticoids. Aevit and glutaminic acid are recommended for BA patients.     

The clinico-immunological parallels of hemosorption using different sorbents in the treatment of bronchial asthma patients

A comprehensive clinical and functional and allergo-immunological comparative evaluation was done of hemosorption involving the KAU, SKN hemosorbents, "Gemosfer" and a DNA-containing sorbent in 341 patient with bronchial asthma. SKN sorbent were found out to have a more pronounced positive effect on clinical signs and functional activity of immunocompetent cells. The above sorbents appeared to significantly enhance sensitivity of bronchial beta-adrenoreceptors; besides, they allow the dosages of systemic corticosteroids to be substantially brought down. The KAU and "Gemosfer" hemosorbents caused, to a certain degree, a blockade of the phagocyte system of blood, and, to a considerably lesser extent, affected the level of autoimmune processes. Thus, hemosorption should involve SKN sorbents or an SKN-based DNA-containing sorbent.     

The effect of kavinton on bronchial tonus in bronchial asthma patients

Intravenous cavinton given in a dose of 10 mg for 3 days was studied for its effects on bronchial tone in 40 patients with bronchial asthma. Respiratory parameters were pneumotaxometrically determined and cerebral circulatory parameters were rheographically measured prior to and following the drug injection. The findings have demonstrated that cavinton significantly decreased bronchial tone improved cerebral circulation, particularly in patients with bronchial asthma and chronic cerebral circulatory disorders.     

Effects of becotide and becodisk glucocorticoid drugs on bronchial reactivity in patients with bronchial asthma

Efficacy of inhalation corticosteroids becotide and becodisk was compared in 24 patients with bronchial asthma. Becodisk has the advantage of not containing freon which irritates upper airways and bronchial mucosa. Clinical, allergological, bronchial resistance, provocative carbacholine tests, external respiration tests, peakflowmetry demonstrated that becodisk reduced the number of asthma attacks, lowered the need in inhalation sympathomimetics, improved external respiration function, decreased bronchial sensitivity to carbacholine. Determination of specific and nonspecific bronchial reactivity is thought essential in comparing efficacy of asthma chemotherapy. Becodisk significantly reduces bronchial reactivity to nonspecific mediator substances, is simple in use and well tolerated. It is recommended for basic therapy in various bronchial asthma forms managed with local corticosteroids.     

The effect of the liposomal form of hydrocortisone on the status of cellular and humoral immunity in patients with steroid-dependent bronchial asthma

Skin injury alive produces quick and distinct increase of free histamine and serotonin. A fluorimetric method for detection of these compounds in tissues has been the only one described in the literature up to now but it needed a time consuming extraction and big amount of primary material (about 3 g of skin devoid of subcutaneous fat tissue) as well. The authors succeeded in substituting the method and developed a voltametric detection of histamine and serotonin using the computerized ECO-TRIBO-Polarograph. It enabled to omit the extraction of skin compounds and to decreased the amount of primary tissue to a quarter. The detection of free histamine and serotonin levels is presumed to enable a more accurate determination of the time of injury, particulary in short interval before death; it presents, with a simultaneous of glycophorin, a convenient complementation of immunohistochemical investigation of fibronectin.     

A bronchoscopic aid in the therapy of bronchial asthma patients with a severe course

The body's immunological responses were examined in thyroid damage caused by the incorporation of varying 131I doses. The in-take of 131I in doses of 37, 74, and 148 KBc/g body weight caused reductions in the murine blood concentrations of thyroxin following 30, 60, and 180 days. The blood levels of triiodothyronine decreased 180 days after administration of 131I in a dose of 74 KBc/g body weight and 30, 60, and 180 days after incorporation of the radioisotope in a dose of 148 KBk/g body weight. Decreased concentrations of the both hormones were followed by the suppression of a humoral immune response to sheep red blood cells, diminished cell-mediated immunity in the mixed culture of lymphocytes. The inhibition of immune responses was correlated with the changes in the level of triiodothyronine.     

Specific bronchial provocation tests with flour in the diagnosis of occupational bronchial asthma

The gold standard in the diagnosis of occupational asthma is the specific bronchial provocation test (sBPT), but other diagnostic criteria have been proven to have a similar sensitivity, mainly in asthma due to high molecular weight compounds. In order to assess wether some clinical findings can predict the positive response to sBPT, we studied 37 subjects (14 millers and 23 bakers) with suspected occupational asthma who underwent sBPT with wheat flour dust (dust exposure in a small cabin: geometric mean 12.1 mg/m3 for up to 30 min). A positive response to sBPT (FEV1 > 20%) was elicited in 20 subjects (11 early, 4 late, and 5 dual responses). There was no significant difference between subjects with positive or negative sBPT as regards mean age, smoking, length of employment, duration of symptoms, atopy (skin positivity to one or more common allergens) and PD20FEV1 methacholine. The percentage of subjects with work-related symptoms was significantly higher in subjects with positive sBPT with respect to subjects with negative sBPT (81% versus 41.2%, p < 0.01 by chi 2 test); furthermore, FEV1 was significantly lower in subjects with positive sBPT. The percentage of positive skin response to wheat flour extract (mean wheal diameter > or = 3 mm) was mildly but not significantly higher in subjects with positive sBPT (68.4% versus 41.2%). None of the following clinical factors (age < 35 years, asthma symptoms pre-existing occupational exposure, non smokers, atopy and bronchial hyperresponsiveness to methacholine), alone or in combination, were associated with higher prevalence of positive sBPT. We conclude that the response to sBPT in subjects with suspected occupational asthma due to flour dust can not be adequately predicted by other clinical, allergologic and functional data. Therefore, sBPT with flour dust should always be performed in subjects with suspected occupational asthma.     

Long-term therapy of bronchial asthma with ingacort

To study the effectiveness of ACE-inhibitors in diabetic nephropathy (DN) 12 male and 16 female patients aged 13-21 years with DN having normal blood pressure (BP) were given ramipril (tritace) in a dose 2.5-5 mg/day in the course of 12-24 weeks. Efficacy and safety of the treatment were assessed by changes in albuminuria and proteinuria, BP. Reduction of albuminuria occurred in 19(79.1%) out of 24 patients with microalbuminuria, in 13(54.1%) of them urine excretion of albumin returned to normal levels. All the patients with proteinuria and macroalbuminuria benefited from ramipril therapy because their proteinuria diminished or even disappeared (2 cases). The persistence of the antiproteinuria effect on posttreatment week 12 was 66.6%. Ramipril effect on BP was minimal. It is inferred that ramipril is effective in the treatment of DN at the stage of microalbuminuria and proteinuria in patients with normal BP.     

Candida albicans sensitization in patients with atopic bronchial asthma and atopic dermatitis

Candida albicans, a component of normal human microflora, can induce synthesis of specific IgE-antibodies in patients with atopic bronchial asthma and atopic dermatitis. The study included 25 patients with atopic dermatitis sensitized to C.albicans and 23 patients with atopic dermatitis non-sensitized to C.albicans. The sensitization was determined by the skin test and enzyme immunoassay. The patients had the history of atopic dermatitis exacerbation after taking food containing baking yeasts. Atopic dermatitis with sensitization to C.albicans is characterized by severe course correlating with the following indices: high total IgE (r = 0.6), level of IgE antibodies to C.albicans (r = 0.6), level of serum IgG (r = 0.46) and IgA (r = 0.33). Contrary to adults, children with sensitization to C.albicans had decreased relative number of CD4+, CD8+ and CD72+ of lymphocyte subpopulations. Thus, sensitization to C.albicans manifests in severe atopic dermatitis which in children is often associated with immune deficiency.     

Sex hormone metabolism in middle-aged and old patients with bronchial asthma]

Tests were conducted with two groups of growing albino rats kept on a ration with hydrogenated fat containing 62 and 26 per cent of non-saturated fatty acids transisomers. The latter were found to accumulate in the lipids of the animal organs and tissues reaching their maximum level by the 4th week of the experiments. On switching the rats to a ration containing no transisomers their exponential fall in the lipids of the organs and tissues was recorded. From these investigations it follows that the non-saturated fatty acids transisomers taken up by the organism together with edible fats become involved in metabolic processes and are utilized by the organism alongside with other fatty acids.