The American review of respiratory disease
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Am. Rev. Respir. Dis. · Jan 1989
Randomized Controlled Trial Clinical TrialCan mild bronchospasm reduce gastroesophageal reflux?
During attacks of asthma, changes in the transdiaphragmatic pressure gradient may impair the antireflux barrier and provoke gastroesophageal reflux (GER). If GER triggers asthma and asthma causes GER, a vicious circle could arise with an increase in the severity of asthma symptoms. The aim of this investigation was to determine whether postprandial reflux in asthmatics with GER disease is increased during histamine-induced bronchospasm and also if theophylline increases GER during provoked episodes of bronchospasm. ⋯ GER was not more pronounced during the provoked bronchospasm period irrespective of theophylline treatment or not. It seems unlikely that mild bronchospasm provokes reflux in patients with asthma and GER. It would appear that mild bronchospasm is rather protective against gastroesophageal reflux.
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Am. Rev. Respir. Dis. · Jan 1989
Long-term follow-up of symptoms, pulmonary function, respiratory muscle strength, and exercise performance after botulism.
Respiratory muscle weakness occurs commonly at presentation in patients with botulism. Although clinical improvement occurs over several months, symptoms such as fatigue and dyspnea persist in many patients in the long term. To determine whether continued respiratory muscle weakness might contribute to these symptoms, we compared lung function tests, respiratory muscle strength, and exercise performance in 13 patients 2 years after type B botulism. ⋯ During exercise, botulism patients had a more rapid and shallow breathing pattern and a higher dyspnea score at a given minute ventilation in comparison to control subjects. Reasons for premature exercise termination in botulism patients were multifactorial. Although respiratory muscle weakness may have been contributory in some patients, most appeared to be limited by reduced cardiovascular fitness, leg fatigue, or reduced motivation.
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Am. Rev. Respir. Dis. · Jan 1989
Case ReportsDyspnea on immersion: mechanisms in patients with bilateral diaphragm paralysis.
Patients with bilateral diaphragm paralysis are able to inflate their lungs by two mechanisms: relaxing the abdominal wall or expanding the rib cage. Each maneuver promotes lung expansion by shifting support of the abdominal contents from the abdominal wall to the diaphragm. We describe a patient with bilateral diaphragm paralysis who experienced acute dyspnea when immersed in water to the level of the abdomen and discuss the precipitation of dyspnea in the context of the strategies available to these patients for lung inflation.
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Am. Rev. Respir. Dis. · Jan 1989
Case ReportsAcute eosinophilic pneumonia: a hypersensitivity phenomenon?
A previously healthy young man presented with acute respiratory distress and diffuse bilateral infiltrates on chest radiograph. Eosinophilic pneumonia was diagnosed by bronchoalveolar lavage and confirmed by transbronchial lung biopsy. ⋯ The case presented here was acute in onset, suggesting a hypersensitivity reaction. High levels of bronchoalveolar lavage eosinophils indicate the diagnosis but not the etiology of eosinophilic pneumonia.