Shunt effect of gas compression inside pneumotachographs during forced oscillations

Determination of the frequency response of pneumotachographs is needed whenever they are used to measure high-frequency flows, such as in the forced oscillation method. When screen and capillary pneumotachographs are calibrated using an adiabatic compression in a closed box as a reference impedance, they can be adequately described by a series of inertial-resistive elements. However, this type of reference impedance strongly differs from the actual respiratory impedance (ZL). We studied the frequency response of pneumotachographs up to 250 Hz in reference to the impedance of a compressible gas oscillating in a long tube, taken as a more generalizable model of actual ZL. We found that, with this device, the series resistance-inertance models fail to describe the frequency response of the pneumotachograph. However, when compressible effects in the pneumotachograph are taken into account by adding to the resistive models a compliance (Cpn) corresponding to the compression in half of the inner volume of the pneumotachograph, the agreement with experiments becomes satisfactory. Gas compression-related phenomena were demonstrated to be negligible only when the parameter omega Cpn magnitude of ZL is much smaller than 1 (omega pulsation). Results obtained in normal humans have shown that such a correction is required above 100 Hz. Similar correction at lower frequency might also be necessary in cases of large respiratory impedance (e.g., babies, subjects with pathological lungs, and intubated subjects).     

Influence of tidal volume on histamine-induced bronchoconstriction in guinea pigs

The effects of tidal volume amplitude on bronchopulmonary reactivity were investigated in three groups of 14 anesthetized paralyzed mechanically ventilated guinea pigs. Animals of group 1 served as control; in animals of group 2, both the sympathetic and parasympathetic nervous systems were blocked; in animals of group 3, only the parasympathetic system was blocked. In each group, the animals were randomly divided into two subgroups characterized by their ventilatory pattern: rate of 60/min with a 6-ml/kg tidal volume or rate of 40/min with a 9-ml/kg tidal volume. Bronchopulmonary reactivity to infused histamine was assessed by the respiratory compliance and conductance values measured during bronchoconstriction and expressed as a percentage of the corresponding basal values. In group 1 the animals ventilated with a 9-ml/kg tidal volume were found significantly less reactive than those ventilated with a 6-ml/kg tidal volume. This difference was abolished in groups 2 and 3. These results demonstrate that the effects of increased tidal volume on bronchopulmonary reactivity are vagally mediated and suggest that the decrease observed in histamine-induced bronchoconstriction is mainly due to reflex effects evoked by stretch receptor stimulation.     

IgM anti-hepatitis C virus in patients with chronic non-A, non-B hepatitis and their relationship to viral replication

Patients with hepatitis C virus (HCV) infection may have different patterns of antibody response to various structural and non-structural viral antigens. We have correlated the serological patterns to the clinical features of chronic infection and to viral replication in 68 HCV-Ab-positive patients with chronic liver disease at different stages (19 with cirrhosis-hepatocellular carcinoma, 38 with chronic active hepatitis and 11 with chronic persistent hepatitis). Serum samples from each patient were assayed for HCV-IgM by enzyme immunoassay and for HCV-RNA by the polymerase chain reaction using primer sets derived from the 5'-non-coding region. The prevalence of HCV-IgM was high (54 patients (79.4%)) and the study showed a good correlation between high values of anti-HCV-IgM and the presence of HCV-RNA in serum, since HCV-RNA was detected in 35 of the 54 IgM-positive patients (64.8%) and notably in 19 of the 20 subjects with high levels of specific IgM. Conversely, all the 35 sera containing HCV-RNA were also reactive for HCV-IgM, while none of the HCV-IgM-negative sera was HCV-RNA reactive. Positivity rates for both HCV-RNA and IgM anti-HCV were higher in the more advanced stages of disease; thus, the clinical pattern of HCV chronic hepatitis seems to be strictly related to the serological pattern and the presence of HCV-RNA.     

The effects of caffeine on athletic agility

Caffeine has been shown to improve sprint time, anaerobic power, and reaction time, all integral aspects of agility. The purpose of this study was to determine whether an acute caffeine dose would enhance agility and anaerobic power. Sixteen subjects participated in a randomized, double-blind experiment and performed the proagility run and the 30-second Wingate test 60 minutes after ingestion of caffeine (6 mg.kg(-1)) or placebo. No significant change was observed in the proagility run after caffeine ingestion compared with placebo. Also, no significant change was observed in peak power, mean power, or percent power decrease. Agility is an integral component of athletic skill and any reasonable method for enhancing agility would benefit active individuals. However, results from this study indicate that a 6 mg.kg(-1) dose of caffeine does not impact agility as measured by the proagility run test or power output as measured by the 30-second Wingate test in recreationally active young adult males who are not habituated to caffeine.     

Macrolide resistance genotypes and phenotypes among erythromycin-resistant clinical isolates of Staphylococcus aureus and coagulase-negative staphylococci, Italy

One hundred macrolide-resistant staphylococcal isolates from clinically relevant infections in Italy during a 19-month period were studied. Four distinct resistance phenotypes were observed using the triple-disk induction test (erythromycin, clindamycin, telithromycin): the cMLS_B phenotype (24 isolates); the iMLS_B phenotype (41 isolates); the MS phenotype (three isolates); and the iMTS phenotype (erythromycin-induced telithromycin resistance) (32 isolates). ermC and ermA genes predominated within erythromycin-resistant Staphylococcus aureus isolates with iMLS_B phenotype and cMLS_B phenotype, respectively. Among erythromycin-resistant CoNS isolates, half of the strains showed the iMTS or MS/ msrA association, and ermC gene predominated among isolates with MLS_B phenotype. By pulsed-field gel electrophoresis, high genetic heterogeneity was observed among the isolates studied. Both independent acquisition of macrolide resistance genes and spread of specific resistant clones were observed. Association between certain clonal types and specific types of infection could be detected. To our knowledge, this is the first report on characterization of erythromycin-resistant staphylococci in Italy.     

Antibiotic resistance and genotypic characterization by PFGE of clinical and environmental isolates of enterococci

Fifty-four Enterococcus faecalis and 20 Enterococcus faecium isolates from clinical and non-human sources in Rome, Italy, were characterized by antibiotic resistance and pulsed field gel electrophoresis (PFGE). Resistance to vancomycin, teicoplanin, ampicillin, and ciprofloxacin was more frequent in E. faecium than in E. faecalis, whereas high-level resistance to aminoglycoside was found primarily in E. faecalis. Multi-resistance was found primarily among clinical isolates, but was also observed among environmental isolates. Common genotypes shared among clinical and environmental isolates were observed, however, the majority of isolates occurred as unique, source-specific clones. Several PFGE types were associated with shared features in their antibiotic resistance patterns; evidences of clonal spread between and within wards were also noted. This is the first report indicating clonal relatedness between human and environmental enterococci isolated in Italy.     

Heavy snoring with upper airway resistance syndrome may induce intrinsic positive end-expiratory pressure

We studied eightheavy snorers with upper airway resistance syndrome to investigatepotential effects of sleep on expiratory airway and lungresistance, intrinsic positive end-expiratory pressure,hyperinflation, and elastic inspiratory work of breathing (WOB).Wakefulness and non-rapid-eye-movement sleep with high- and withlow-resistance inspiratory effort (H-RIE and L-RIE, respectively) werecompared. No differences in breathing pattern were seen across thethree conditions. In contrast, we found increases in expiratory airwayand lung resistance during H-RIE compared with L-RIE and wakefulness(56 ± 24, 16 ± 4, and 11 ± 4 cmH₂O · l¹ · s,respectively), with attendant increases in intrinsic positive end-expiratory pressure (5.4 ± 1.8, 1.4 ± 0.5, and 1.3 ± 1.3 cmH₂O, respectively) andelastic WOB (6.1 ± 2.2, 3.7 ± 1.2, and 3.4 ± 0.7 J/min, respectively). The increase in WOB during H-RIE is partly causedby the effects of dynamic pulmonary hyperinflation produced by theincreased expiratory resistance. Contrary to the Starling model, amultiple-element compliance model that takes into account theheterogeneity of the pharynx may explain flow limitation duringexpiration.

     

Influence of body temperature on histamine-induced bronchoconstriction in guinea pigs

The effects of body temperature on histamine-induced bronchoconstriction were investigated in anesthetized, paralyzed, and mechanically ventilated guinea pigs. Four groups of guinea pigs were studied with constant body temperatures of 40, 38, 35, and 32 degrees C, respectively. Histamine was infused for 5 min at a rate of 50 ng.kg-1.s-1. Body cooling from 40 to 32 degrees C augmented the bronchomotor responses to histamine, which eventually rose almost fourfold. The enhancement of histamine-induced bronchoconstriction induced by body cooling was not suppressed by pretreating guinea pigs with 5 mg/kg hexamethonium or 5 mg/kg hexamethonium plus 3 mg/kg atropine; neither was the enhancement of histamine-induced bronchoconstriction suppressed in pithed guinea pigs, demonstrating that the autonomic nervous system is not involved in potentiating bronchoconstriction at low body temperatures. These results suggest that, at low body temperatures, increased airway responsiveness to histamine may be because of some direct effect of temperature on bronchial airway smooth muscle.