Category Archives: Pulmonary Function

The Effect of Radiation Therapy on Immune Function in Patients With Squamous Cell Lung Carcinoma – Discussion

In this study, we confirmed that the patients with lung cancer had decreased numbers of circulating lymphocytes and RT accentuated more cancer-associated lymphopenia. Previous studies of RT-induced immune alteration in patients with bronchogenic carcinoma and other malignant diseases’ also showed that RT led to a decrease in the number of lymphocytes and lymphocyte subsets. Schulof et al supposed that these changes might be related to the volume of blood or bone marrow encompassed within RT portal, and Benningoff et al suggested the sequestration of T lymphocytes into the thoracic duct as a cause of RT-induced lymphopenia. However, the exact mechanisms are still unknown. In contrast to the number of lymphocytes, the change in the ratio of CD4 to CD8 lymphocytes after RT has been reported to be varia-ble. canadianfamilypharmacy

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The Effect of Radiation Therapy on Immune Function in Patients With Squamous Cell Lung Carcinoma – Results

The Effect of Radiation Therapy on Immune Function in Patients With Squamous Cell Lung Carcinoma - ResultsChanges in the Number and Proportion of Lymphocyte Subsets by RT
The number of lymphocytes, CD3- and С 04-positive lymphocytes significantly decreased in peripheral blood of the patients with lung cancer before RT when compared with those of normal control subjects. However, the numbers of CD8-positive lymphocytes, NK cells, and В cells were not different from those of control group. The number of IL-2 receptor-positive lymphocytes was higher in patients before RT when compared with that of normal control group. After RT, peripheral blood lymphocytes and all of their subsets significantly decreased in number when compared with those before RT (Table 1). The percentages of lymphocytes and their subsets in peripheral blood were not different between normal control subjects and patients with lung cancer before or after RT. However, the percentage of IL-2 receptor-positive lymphocytes increased in patients with lung cancer before or after RT when compared with that of the normal control group (Table 2).
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The Effect of Radiation Therapy on Immune Function in Patients With Squamous Cell Lung Carcinoma – Statistics

Isolation of Peripheral Blood Mononuclear Cells
Prior and within 2 davs after the completion of RT, peripheral blood mononuclear cells (PBMC) were isolated by a modified method of Boy:auum.IM Briefly, venous blood was obtained in fixative-free heparin (10 U/ml) and then mononuclear cells were obtained bv centrifugation of buffy coating over Ficoll-Hypaque (specific gravitv of 1.077). and washed twice with phosphate-buffered saline solution (PBS, pH 7.4) and resuspended in RPMI 1640 (Gibco) supplemented with 1 percent nonessential amino acid, 20 mmol/L glutamine. 50 mmol/L 2-niercaptoethanol, and 50 mg/ml gentami-cin. The latter solution will be referred to as tissue culture medium. buy birth control

The proportion of lymphocytes expressing cell surface antigens was determined using indirect immunofluorescence staining method. Monoclonal antibodies (MoAb). CD3 (Leu-4). CD4 (Leu-За), CDS (Leu-2). NK cell (Leu-1 lb). В cell (anti-human IgM) and CD25 (anti-Tac) were obtained (Becton-Dickinson Co). Briefly, PBMC was mixed with 20 |il of primary MoAb or control MoAb of irrelevant specificity and incubated for 30 min at 4°C. The cell suspension was then yvashed twice in 1 ini of PBS by centrifugation at 300g for 5 min and incubated yvith 100 |i.l of PBS containing 5 ц1 of fluorescein isothiocvanate labeled goat antimouse immunoglobulin (Becton-Dickinson) for 30 min at 4°C: 2×104 cells xvere counted using a floyv cvtometer and analyzed by a program of consort 30 (FACScan, Becton-Dickinson).
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The Effect of Radiation Therapy on Immune Function in Patients With Squamous Cell Lung Carcinoma – Materials and Methods

The Effect of Radiation Therapy on Immune Function in Patients With Squamous Cell Lung Carcinoma - Materials and MethodsAn immune mechanism is associated with resistance of host against development and progression of numerous tumors in humans. The immune function is depressed and correlated with stage and predicted survival in patients with bronchogenic carcinoma. Also, cell-mediated immunity (CMI) has been known to be depressed in a variety of untreated malignant diseases. This attenuated CMI has been related to the decrease in delayed hypersensitivity skin reaction to common antigens and the defect in in vitro synthesis of protein by lymphocytes stimulated with phytohemagglutinin (PHA). The mechanisms behind this attenuated CMI have been suggested to be excessive production of prostaglandin E2 by suppressor monocytes, abnormal regulation of interleukin 2 (IL-2) production by lymphocytes, malignant transformation of immunocompetent cells inducing aberrations of immune function, serum factors inhibiting lymphocyte-proliferative reactions, and reflection of tumor burden. asthma inhalers

Radiation therapy (RT) produced a decrease in the total leukocyte and lymphocyte counts, in the number of T cells, and in the leukocyte transformation response to purified protein derivatives (PPD) in patients with lung carcinoma. Also, in patients with Hodgkin’s disease and esophageal cancer, RT was shown to decrease the number of circulating lymphocytes and the ratio of helper to suppressor cells and in vitro response of peripheral blood mononuclear cells (PBMC) to PHA and antibody-dependent cell-mediated cytotoxicity. These findings suggest that decrease in number of circulating lymphocytes and dysfunction of monocytes or lymphocytes led to immune suppression by RT. It is not clear, however, whether therapeutic irradiation to the chest decreases more the cancer-associated attenuation of CMI in patients with lung cancer.
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Medical Personnel’s Knowledge of and Ability to Use Inhaling Devices – Conclusion

Medical Personnel’s Knowledge of and Ability to Use Inhaling Devices - ConclusionUnlike previous studies, we have addressed the required technique for taking multiple puffs from an inhaler. Many medications are prescribed in dosages of more than a single puff and this increases the likelihood of making an error. For example, failure to wait an appropriate interval between actuations with an MDI may result in a little or no medication being delivered with the second actuation. In the case of the Turbuhaler, patients may actuate the dry powder device twice before inhalation, a technique that wastes a dose of drug as the dry powder reservoir rotates out of the inhalation chamber. Such errors, we suspect, are commonly overlooked in clinical practice and have not generally been the subject of published MDI usage studies. buy claritin online

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Medical Personnel’s Knowledge of and Ability to Use Inhaling Devices – Discussion

During the last few years, emphasis has been made on the important role played by medical professionals in repeatedly instructing and monitoring patients for the optimal use of inhaled medication delivery devices. However, our data show that many of these medical personnel lack rudimentary skills with these devices and many lack elementary theoretic knowledge about their use. Of the medical and paramedical groups tested, house staff and nurses seem least likely to use inhaling devices correctly and this may reflect their lack of formal training in professional schools or postgraduate training programs. Our data also show that newer inhaling devices may be less optimally used than devices that have been in common usage for several years.
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Medical Personnel’s Knowledge of and Ability to Use Inhaling Devices – Results

Medical Personnel’s Knowledge of and Ability to Use Inhaling Devices - ResultsPercent mean scores ± SD for each group and each device are listed in Table 3.  The percent mean demonstration score for RTs (85 ± 21 percent) for all devices tested was significantly higher than that achieved by either RNs (57 ± 39 percent) or MDs (49 ± 25 percent) (for all p < 0.0001). Mean demonstration scores for each of the three tested devices were significantly higher for RTs than either RN or MD groups (for all p < 0.0001). Mean demonstration scores for RNs and MDs for all devices combined were not statistically different (p = 0.12). However demonstration scores for the MDI and the Aerochamber were statistically higher for RNs than for MDs (p = 0.01 and 0.003, respectively). The practical skills for these devices were roughly proportional to the length of time the device had been in clinical use. For all medical personnel, Turbuhaler demonstration scores (30.9 percent) tended to be lower than either MDI (82.7 percent) or Aerochamber (77.6 percent) scores (p = 0.05 and p = 0.09, respectively). buy antibiotics online

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Medical Personnel’s Knowledge of and Ability to Use Inhaling Devices – Protocol

All participants were interviewed by one of two research assistants who were trained to use placebo devices and to assess device usage by means of a written criteria for each device (Table 1). Prior to the study, the research assistants monitored patient performance simultaneously on a trial basis until their demonstration scores were in agreement ( ± 1/11). The interview comprised three sections. In the first section, background information was recorded, including age, year of graduation, and the method of acquiring inhaler skills. A knowledge score was derived by asking each participant to answer 11 clinically relevant questions related to the use and maintenance of the devices tested (Table 2). there

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Medical Personnel’s Knowledge of and Ability to Use Inhaling Devices – Methods

Medical Personnel’s Knowledge of and Ability to Use Inhaling Devices - MethodsCurrent treatment strategies for asthma and chronic obstructive pulmonary disease (COPD) emphasize the role of self-administered inhalation therapy. The regular use of inhaled anti-inflammatory agents with inhaled 6-agonists for rescue is now considered to be the cornerstone for the optimal long-term asthma therapy. Similarly in COPD, inhaled therapy appears to offer greater benefit with less risk of side effects than oral therapy. The use of hand-held inhalation devices provides a rapid, cost-effective, and safe method of delivering drugs to the lung. Successful therapy is dependent on the proper deposition of the drug in the lung, although some effects can arise from drug either deposited in the oropharynx and absorbed locally or swallowed and absorbed from the gastrointestinal tract. Metered-dose inhalers (MDI) are the devices most commonly used for aerosolized drug delivery. Even with the best inhalation technique, only 10 to 15 percent of the aerosol actually reaches the lung. Clinically important problems arise when patients fail to use the MDI properly often mistiming inhalation and canister actuation. Several studies have shown that 24 to 89 percent of patients have poor technique when using the MDI. To remedy this problem, patient education by medical personnel has been recommended, a variety of alternate easy-to-use inhalation devices have been developed, and several teaching tools including videotapes and pamphlets have been introduced. However, few studies have assessed the ability of medical personnel to use MDI and available data are discouraging. No study has assessed the ability of medical personnel to use die newer inhalation devices. We, therefore, undertook the following study to survey three groups of medical personnel to assess their knowledge of and ability to use three different commonly used inhaling devices. canadian neighbor pharmacy

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The Effects of Inhalation of Grain Dust Extract and Endotoxin on Upper and Lower Airways: Finally

Although crude, these parameters suggest a different metabolic response to the inhaled com dust extract than to the soybean dust extract. The physiologic effects of soybean dust extract were less pronounced than those of the com dust extract, and by several parameters, it was less biologically active than the endotoxin solution. As these subjects were nonsmokers, had never been exposed to soybean dust, and had no history of atopy, this supports the hypothesis that senitization must occur to exhibit the acute, severe airflow obstruction that has been seen in Barcelona and other European cities.
These observations regarding the differences between the various endotoxin containing substances in our study must be viewed with caution. Our randomization procedure resulted in all subjects receiving corn dust extract as one of the first two substances inhaled, and all but one of the subjects were exposed to the endotoxin solution as one of the last two substances. Thus, the most severe effects observed following inhalation of com dust extract may have resulted from the sequence in which these solutions were inhaled. However, the order of administration does not appear to account for the differences we observed between the mild effects of soybean dust extract and the more severe effects of the endotoxin.
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