Airway and cardio vascular responses to nebulized glyceryl trinitrate in normal subjects

Glyceryl Trinitrate [GTN] is a potent smooth muscle relaxant and vasodilator. There are conflicting reports regarding its efficacy as a bronchodilator. The aim of this study was to examine the effect of nebulized GTN on airway calibare and cardio vascular system in normal subjects. We studied 24 normal subjects [6 female] on two occasions, administering either nebulized GTN 6 mg or placebo in a double-blind, randomized, crossover fashion. Bronchial response was assessed by measurement of FEV1. A systemic effect of this dose of GTN was demonstrated by a supine to erect increase in heart rate of 36.0 [8.6%] mean [95% CI] after GTN compared with 16.2 [6.1%] after placebo. Systolic Blood Pressure [BP] decreased by 8.0 [3.8%] after GTN compared with 1.4 [2.8%] after placebo. Diastolic BP did not change. Baseline FEV1 did not differ on the two study days. There was no acute bronchodilator effect. Nebulized GTN has cardio vascular effects but does not have any bronchodilator effect in normal subjects. Further investigation in airways disease is justified

Tracheobronchial straight metallic pin aspiration in young Jordanian females

To define the clinical spectrum of tracheobronchial straight metallic pin aspiration in adults, assess predisposing conditions, evaluate the efficacy of bronchoscopy, and determine the outcome and complications at the largest 2 hospitals in Jordan. Retrospective analysis of 60 consecutive clinical cases from 2 referrAl based medical centers [32 patients at King Hussein Medical Center [KHMC] and 28 patients at Al Basheer Hospital]. Medical records of adult patients [>13 years of age] who presented with history of straight metallic pin aspiration over 6-year period [July 2000 and July 2006] were analyzed. Clinico-radiological features and location of the pins were studied. The flexible fiberoptic bronchoscopy [FFB] was used for foreign body [FB] identification and removal in all KHMC patients; video assisted rigid bronchoscope under general anesthesia was used at Al Basheer Hospital. All patients were females<28 years of age. Fifty-six patients [93%] presented within the first 24 hours after aspiration. Medical history was suggestive of FB aspiration in all patients. Chest x-rays demonstrated the radio opaque pins in all patients. At bronchoscopy, the intermediate bronchus was the most common site of FB lodgment [62%]. Ninety-two percent of patients were discharged on the same day of the procedure. Tracheobronchial straight metallic pins are relatively frequent FB in Jordanian young females and can occur in a very specific clinical setting. Removal of these FBs can usually be accomplished successfully by FFB