The effect of positive expiratory pressure (PEP) and inhaled terbutaline was evaluated in ten patients with chronic obstructive pulmonary disease in a randomized cross-over study with three 2 weeks periods. In one period 5 mg terbutaline was inhaled 3 times daily from a nebulizer combined with PEP. In a second period 5 mg terbutaline was inhaled similarly but without PEP and in a third period placebo inhalations were combined with PEP. Symptom score and peak expiratory flow (PEF) measured before and after each inhalation was noted in a diary. The treatment with nebulized terbutaline combined with PEP gave the best relief in symptoms. All treatments increased PEF significantly. PEP alone gave the least increase in PEF (25 1/min), and there was no difference between the increase in PEF after terbutaline inhaled with PEP (28 1/min) compared to terbutaline alone (29 1/min).
The serum concentrations of IgG, IgA, IgE, C3 (B1A), C4 and alpha 1 AT were measured in 8 farmers with chronic pneumopathy, who showed precipitins against M. faeni or T. vulgaris in the serum. A group of 8 precipitins negative farmers who had worked in barn and 28 normal subjects served as control. IgG were elevated in the patients with detectable precipitins; levels of serum IgA in patients with precipitating antibody were lower than in the subjects without them. The mean levels of C3 were significantly lower in the farmers with detectable precipitins than in the farmers without precipitating antibody and in the control group.
Respiratory function (FVC, FEV1, FMF and FEF200-1200) was measured before and after nebulized distilled water in 68 subjects divided in the five following groups: a) 21 healthy children (age range 7 to 15 years); b) 10 children with asthma (age range 6 to 11 years); c) 10 children with cystic fibrosis (age from 5 to 15 years); d) 7 children with different diseases of the respiratory system (age range from 6 to 11 years); e) 20 healthy adults (aged from 18 to 33 years). The only statistically significant changes were noted in the asthmatic children group. We conclude that a specifically induced bronchoconstriction by nebulized distilled water is a good mean of assessing bronchial lability.
Portugal is one of the European countries with the highest mortality from Chronic Bronchitis (CB). This constitutes a severe problem as CB is one of the main causes of absenteeism and incapacity. To determine the prevalence of this disease, an epidemiological study was planned. The first part of this study involved the children of Lisbon because of the large number of children attending chest clinics for respiratory symptoms, because a similar study is being carried out in Europe by WHO in children from 8 to 10 years of age and because of the importance that this type of study in children may have in the prediction of the development of CB in adults. The study consisted in a standard questionnaire (WHO), a physical examination based on the CECA questionnaire, an ENT examination, a simple respiratory function test and a 70 mm microradiograph of the chest. 4148 children of both sexes, whose ages ranged from 6 to 14 were studied. The operational diagnosis of CB was based on the presence of chronic cough for the past 2 years, for at least 3 months and nearly every day during the Autumn and Winter months. The prevalence of CB in the overall population was 4.9%. The global analysis of the data collected seems to show the following: - Measles and whooping cough contribute to the incidence of CB. --Socio-economic conditions probably contribute to the increase in the incidence of CB. --A high incidence of ENT pathology was found in CB. --Atmospheric pollution does not appear to influence the incidence of CB.
In a prospective study in our department, 63 consecutive patients with suspected sarcoidosis underwent combined bronchial and transbronchial biopsy during bronchoscopy with rigid instruments under general anaesthesia. Lung tissue was obtained in all cases. In 19 cases noncaseous granulomas were found only by transbronchial lung biopsy. In 9 cases they were found only by bronchial biopsy. In 30 patients noncaseating granulomas were found by both technics, that is, the lesions were found in both lung parenchyma and bronchial wall. In 5 patients, diagnosis of sarcoidosis could not be confirmed by bronchological methods, but was obtained by other biopsy procedures. From our findings, we conclude that the combination of bronchial and transbronchial biopsies during bronchoscopy with rigid instruments is a valuable procedure for establishing the diagnosis of sarcoidosis and that the bronchological methods could replace mediastinoscopy in most cases of sarcoidosis.
