Stress-induced cardiomyopathy, also known as 'broken heart syndrome' or Takotsubo cardiomyopathy, is characterized by transient systolic dysfunction of the apical and/or mid segments of the left ventricle, in the absence of significant coronary artery disease. We report the case of a 56-year-old male patient with chronic obstructive pulmonary disease (COPD), with stress-induced cardiomyopathy a...

Preclinical studies with Ba 679 Br have demonstrated a significantly longer duration of action than ipratropium bromide. Following inhalation of single doses, no systemic antimuscarinic effects were noted at doses likely to be bronchodilating in man. The objective of the present pilot-study of Ba 679 Br was to establish the dose-range for its bronchodilatory activity in a small number of chroni...

BACKGROUND The aim of this study was to evaluate the responsiveness of the 3-minute constant rate step test (3-MST) to detect the relief of exertional dyspnea (respiratory discomfort) after acute bronchodilation in COPD patients. PATIENTS AND METHODS A total of 40 patients with moderate-to-severe COPD (mean forced expiratory volume in 1 second: 45.7 (±14.7), % predicted) performed four 3-MSTs...

BACKGROUND Medications are frequently combined in the nebulizer cup, so it is important to determine their chemical and physical compatibility. OBJECTIVE To determine the chemical and physical compatibility of levalbuterol with ipratropium bromide, cromolyn sodium, acetylcysteine sodium, and budesonide. METHODS We mixed one dose of levalbuterol inhalation solution concentrate (1.25 mg/0.5 m...

A double-blind crossover placebo controlled study was performed on 20 patients with stable chronic asthma, in order to obtain dose response data to ipratropium bromide (40, 80, 200 micrograms) given by metered dose inhaler. The use of the 200 micrograms dose gave a significantly greater peak effect and duration of action than the recommended standard therapeutic dose of 40 micrograms. There wer...

Unilateral fixed mydriasis can be an ominous sign; however in many cases, it is benign and represents pharmacologic mediated action on the iris dilator or sphincter. Differentiation between pharmacologic mediated anisocoria and physiologic anisocoria can be challenging but may save on costly imaging. An 83 year-old woman was admitted with critical limb ischemia and subsequently developed respir...