Antiinflammatory therapy with inhaled budesonide is an effective first-line treatment for patients with newly detected, mild asthma, and it is superior to the use of terbutaline in such patients.

Twenty-one adult asthmatic patients participated in a trial to compare the clinical equivalence of a single dose of salbutamol inhaled either from a novel multiple dose powder inhaler (MDPI), Easyhaler®, or from a conventional metered dose inhaler (MDI). The trial was carried out as a randomized, double-blind, crossover study. The study involved 2 study days with a 6-hour follow-up period of spirometric indices. In addition, blood pressure and heart rate were measured immediately before each lung function test. Our data indicate that salbutamol treatment with the MDPI achieves values which are equivalent to those achieved with the conventional pressurized MDI as regards improving pulmonary function and tolerability. The mean maximum forced expiratory volume in 1 s (FEV₁) after the powder dose was 2.44 ± 0.96 liters and after the aerosol dose 2.45 ± 0.93 liters. The mean area under the curve of absolute FEV₁ values was 822 ± 340 and 829 ± 335, respectively. The mean percent change from the baseline in FEV₁, forced vital capacity and peak expiratory flow following administration of the preparations was of equal magnitude in both cases. The treatments tested had no effect on blood pressure or heart rate and were well tolerated. A further important finding was that most patients found the MDPI easier or no more difficult to use than the conventional MDI and this probably facilitates the transition from pressurized MDIs to the novel MDPI

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In 32 patients with sleep apnea syndrome (SAS), pulmonary function, blood gases and the ventilatory response to CO2 (CO2 VR) were studied before and 6 months after uvulopalatopharyngoplasty. Nine of the SAS patients had airway obstruction (AO-SAS), defined as FEV1.0 < or = 72% of the predicted value. They had a significantly higher PaCO2, lower PaO2 and a lower CO2 VR than the remaining SAS patients. Preoperatively 4 SAS patients were hypercapnic (PaCO2 > 5.8 kPa) and compared with the normocapnic ones they were more obese; in 3 of them FEV1.0 was < or = 72%. The hypercapnic SAS patients had a significantly lower CO2 VR. The CO2 VR was significantly correlated to AO and the degree of oxygen desaturation during sleep, but not to the number of episodes of apnea and hypopnea nor their length. The VR to CO2 did not predict the postoperative outcome. Postoperatively 2 hypercapnic obese AO-SAS patients showed a large decrease in episodes of apnea and hypopnea and an increase in CO2 VR, and became normocapnic. Other patients showed no consistent changes in CO2 VR postoperatively.