RESUMO
An EEC Working Party has investigated death certification of respiratory disease in eight EEC countries by sending ten standard case histories to a sample of certifying doctors in each country. Results of interest to clinicians with reference to certification of farmer's lung, and of obstructive airway diseases, are presented. For a case of farmer's lung, a majority of certifying doctors in all countries certified an interstitial lung disease, but the proportion certifying farmer's lung ranged from 70% to 0% (overall 26%). Rural doctors certified farmer's lung more frequently than others only in some countries. For four cases of different types of airways disease (chronic obstructive bronchitis, emphysema or asthma) there were wide differences between countries of certification of these conditions or of unspecified chronic airways obstruction. Some countries certify more emphysema, and others, particularly younger doctors in English speaking countries, more unspecified chronic airways obstruction. There are also large differences in the certification of asthma. The differences are presumed to be attributable to differences of medical education. Epidemiological studies and patient care might be helped by more uniformity of diagnostic criteria within the EEC.
Assuntos
Atestado de Óbito , União Europeia , Pulmão de Fazendeiro/mortalidade , Pneumopatias Obstrutivas/mortalidade , Fatores Etários , Medicina de Família e Comunidade , Humanos , Cooperação Internacional , Masculino , População Rural , População UrbanaRESUMO
A placebo-controlled double-blind clinical trial was conducted to determine whether propranolol helps cigarette smokers to stop smoking; 73 subjects entered the trial but at the end of eight weeks only six had stopped smoking, three in the propranolol and three in the placebo group. There was no evidence of any helpful effect of propranolol in subjects trying to stop smoking.
Assuntos
Propranolol/uso terapêutico , Fumar/tratamento farmacológico , Adulto , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Relations between expiratory reserve volume (ERV), closing volume (CV) as a percentage of vital capacity (CV/VC%), and pulmonary gas exchange have been investigated in the sitting and supine postures in eight severely obese subjects before and after substantial weight loss. CV/VC% exceeded predicted values but did not change with posture or weight loss; the increase could have been owing to the smoking habits of the subjects. Arterial oxygen pressure (PaO(2)) was significantly less in the supine than in the sitting posture and improved after weight loss in six subjects. The reduction in PaO(2) was correlated with the extent to which dependent airways were closed within the range of tidal breathing, shown by increasing negativity of ERV-CV as a percentage of VC. A good correlation was also found between PaO(2) and ERV, an easier measurement for routine use. Improvement of pulmonary gas exchange occurred only in those patients who lost weight to within 30% in excess of ideal.
