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Gastro-oesophageal reflux (GOR) is an important cause of chronic cough. There has been a lack of placebo-controlled trials treating GOR related chronic cough with antireflux therapy. The aim of this study was to determine the efficacy of omeprazole on GOR related chronic cough.After excluding other common causes of cough, oesophageal pH monitoring was performed on 48 patients with chronic cough. Twenty-nine patients found to have GOR were randomized in a double-blind fashion to receive omeprazole 40 mg o.d. or placebo for 8 weeks. After a 2-week washout period, patients were crossed over to the other treatment. Symptoms were recorded daily in a diary.Twenty-one patients completed both treatment periods. Cough (p=0.02) and gastric symptoms (p=0.003) improved significantly during the omeprazole treatment in twelve patients who received placebo during the first and omeprazole during the second 8-week period. In nine patients who received omeprazole during the first 8-week period, amelioration in cough reached statistical significance only after cessation of omeprazole. Gastric symptoms also remained minor during placebo in these nine patients.Omeprazole 40 mg o.d. seems to improve chronic cough in patients with gastrooesophageal reflux and the effect of omeprazole in ameliorating both cough and reflux symptoms continues after treatment ceases. Eur Respir J 2000; 16: 633±638.

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SUMMARY A controlled trial is reported on the effects of mild-to-moderate physical activity on serum lipoproteins. After two baseline examinations 100 asymptomatic middle-aged men were randomly assigned to exercise and control groups. The exercise group participated in a 4-month exercise program that consisted of 3-4 weekly sessions. The control group was advised to maintain their previous exercise habits. The success of the program was corroborated by the increase in VO2 in the training group, but not in the control group. Serum triglycerides decreased from 1.54 ± 0.10 to 1.27 ± 0.08 mmol/1 (p < 0.001) and high-density lipoprotein (HDL) cholesterol increased from 1.27 ± 0.04 to 1.41 ± 0.04 mmol/1 (p < 0.01) in the exercise group during the trial. No change was seen in the control group. As the concentration of apolipoprotein Al stayed constant in both groups, the ratio HDL cholesterol/apolipoprotein Al increased only in the exercise group. The level of low-density lipoprotein (LDL) cholesterol and apolipoprotein All decreased in both groups during the trial. The alterations in serum triglycerides and HDL cholesterol in the exercise group were not dependent on weight reduction; similar changes were also seen in subjects with constant body weight during the intervention.EPIDEMIOLOGIC STUDIES have suggested that high physical activity is associated with low incidence of coronary heart disease." 2 The mechanism by which physical exercise influences coronary risk factors is not known. Muscular activity may directly protect the cardiovascular system through neural and hemostatic mechanisms or by increasing the vascularity of myocardium. Alternatively, physical exercise may have beneficial effects on the risk factors of coronary heart disease, such as serum lipids and blood pressure.Although several associations between serum lipid levels and physical activity have been reported, it is not clear whether the changes in serum lipid concentrations are directly attributable to physical exercise itself. Subjects active at work or during leisure time tend to have lower serum cholesterol and triglyceride concentrations than those with a sedentary occupation or lifestyle, but the differences are not always evident when other factors known to affect serum lipids are controlled. and clinical studies are more difficult to explain, but may be due to confounding factors such as changes in the diet or body weight and seasonal variations in serum lipid concentrations.Considerable evidence has accumulated indicating that the serum level of high-density lipoproteins (HDL) is inversely related to the development of coronary heart disease.7-9 On the other hand, the concentration of HDL has been demonstrated to be high in subjects with very vigorous physical activity.10-12 We report here the results of a controlled study on the effects of mild-to-moderate physical exercise on HDL and other lipoproteins in asymptomatic middle-aged men. Methods SubjectsThe subjects were recruited from a group of 110 men, ages 40-45 years, who were contacte...

A specific member of the cytochrome P450 superfamily of enzymes, designated P450IA (including 2 isozymes, P450IA1 and P450IA2), which is involved in the metabolic activation of polycyclic aromatic hydrocarbons and aromatic amines, was studied in lung tissue from 25 lung cancer patients by immunohistochemistry. The pulmonary activity of a P450IA1-dependent enzyme, aryl hydrocarbon hydroxylase (AHH), from the same patients was also measured. Cytochrome P450IA was localized principally in the peripheral airways in alveolar epithelium of types I and II and in ciliated columnar and cuboidal bronchiolar epithelium. The amount of P450IA in the bronchial wall was minimal and was localized mainly in the capillary endothelium and the epithelium of the bronchial glands. Smoking was the most important factor related to the presence of P450IA and the AHH activity in lung tissue. None of the 10 ex-smokers, but all except I of the current smokers had detectable level of P450IA. The localization of the cancer was also correlated with the presence of cytochrome P450IA. Peripheral lung tissue stained positively in all patients with a peripheral adenocarcinoma who currently smoked (8/8) but in less than half of those with a bronchial cancer who were smokers (3/7). Our data suggest that the smokers who have an inducible cytochrome P450IA are especially at increased risk of developing lung cancer of the peripheral adenocarcinomatous type.