The haemodynamic effects of intravenous verapamil at rest, during hypoxaemia, and during progressive exercise were evaluated in 10 patients with chronic obstructive lung disease. Verapamil produced significant decreases in the peak heart rate and systemic blood pressure during exercise but exercise capacity and pulmonary gas exchange at exhaustion were unaffected. There were no significant changes in pulmonary artery pressure or total pulmonary vascular resistance during exercise or during the breathing of either air or a hypoxic gas mixture at rest. No clinically useful benefit was found with verapamil in the dosage used in this group of patients and the value of calcium antagonists in the treatment of patients with chronic obstructive lung disease requires further clarification. chronic bronchitis and emphysema were included. Patients with known left ventricular disease and those taking beta adrenergic blocking agents, antiarrhythmics, or digitalis were excluded. All patients were taking long acting theophylline compounds and nebulised metaproterenol. These agents were last administered about one hour before the study began. Study protocol Catheters were placed in the radial and pulmonary arteries. Mean pulmonary artery pressure (PAP) was measured with patients seated breathing room air and the measurements were repeated while they breathed a hypoxic gas mixture. sGaw (s-' cmH2O-1) 0-06 (0-03) 0-03-0-13 FVC-forced vital capacity; TLco-diffusing capacity (transfer factor); TLC-total lung capacity; FRC-functional residual capacity; RV-residual volume; sGaw-specific conductance (conversion to s-kPa-I x 10).
Background Up to 26% of urogenital Chlamydia trachomatis infections spontaneously resolve between detection and treatment. Mechanisms governing natural resolution are unknown. We examined whether bacterial vaginosis (BV) was associated with greater chlamydia persistence versus spontaneous clearance in a large, longitudinal study. Methods Between 1999-2003, the Longitudinal Study of Vaginal Flora followed reproductive-age women quarterly for one year. Baseline chlamydia screening and treatment were initiated after ligase chain reaction testing became available mid-study, and unscreened endocervical samples were tested after study completion. Chlamydia clearance and persistence were defined between consecutive visits without chlamydia-active antibiotics (N = 320 persistence/N = 310 clearance). Associations between Nugent score (0-3, no BV; 4-10, intermediate/BV), Amsel-BV, and chlamydia persistence versus clearance were modeled with alternating and conditional logistic regression. Results 48% of chlamydia cases spontaneously cleared by the next visit (310/630). Nugent-Intermediate/BV was associated with higher odds of chlamydia persistence (aOR = 1.89, 95% CI:1.30-2.74), and the findings were similar for Amsel-BV (aOR 1.39, 95% CI:0.99-1.96). The association between Nugent-Intermediate/BV and chlamydia persistence was stronger in a within-participant analysis of 67 participants with both clearance/persistence intervals (aOR = 4.77, 95% CI:1.39-16.35). BV symptoms did not affect any results. Conclusions BV is associated with greater chlamydia persistence. Optimizing the vaginal microbiome may promote chlamydia clearance.
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