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Internal Medicine Journal Volume 38 Issue 5 Page 334-340, May 2008
Despite recent advances in the management of patients with chronic obstructive pulmonary disease (COPD), interventions to reduce hospitalization have had only modest success. The aim of this study was to report the outcomes of a novel, nurse-led 24-h telephone support line (hotline) for patients with COPD.
American Journal of Epidemiology 2008 167(8):998-1004
Chronic obstructive pulmonary disease mortality and risk factors were studied in a nationally representative sample of 169,871 Chinese men and women aged 40 years or older.
Tropical Medicine & International Health doi:10.1111/j.1365-3156.2008.02074.x
To explore the relationship of easy to collect handwashing indicators with socioeconomic status and reported respiratory disease among children <5 years of age.
Archives of Pathology and Laboratory Medicine: Vol. 132, No. 4, pp. 606-614
Diagnosing the range of pulmonary disorders caused by Aspergillus spp can be challenging. In instances of hypersensitivity responses to Aspergillus spp (ie, allergic bronchopulmonary aspergillosis, bronchocentric granulomatosis, and hypersensitivity pneumonitis), the surgical pathologist must be cognizant of their relationship to infection, as fungal organisms may be rare or absent from the biopsy specimens.
American Journal of Rhinology, Volume 22, Number 2, March/April 2008 , pp. 197-203(7)
Certain diseases affect both upper and lower airways. Aspirin-induced asthma (AIA) is a clinical entity characterized by asthma, nasal polyposis, and aspirin intolerance. To understand the response of the lower airway to surgical treatment of the sinuses, we examined asthma outcomes in AIA compared with a second group of aspirin-tolerant asthmatic (ATA) patients to establish if there were any differences between the two groups after endoscopic sinus surgery (ESS).
Asthma is associated with increased numbers of T-cells in the lung. CC chemokine receptor (CCR)5 and CXC chemokine receptor (CXCR)3 have been reported to play important roles in the lung T-cell homing pathway, and may be potential targets for asthma therapy.
Pediatric Allergy and Immunology, Volume 19, Number 3, May 2008 , pp. 219-226(8)
Rhinitis is common in asthmatic schoolchildren who are allergic to animal dander and constantly and indirectly exposed to these allergens in their everyday environment. As a patho-physiological linkage between nasal and bronchial inflammation has been proposed to exist, the primary objective of this study was to determine whether nasal administration of mometasone furoate (MSNF) can reduce bronchial inflammation, as reflected in the level of exhaled nitric oxide (FENO) in asthmatic schoolchildren with dander allergy and mild-to-moderate rhinitis.
Allergy, Volume 63, Number 5, May 2008 , pp. 570-574(5)
Asthma and obesity are associated disorders, but the contribution of obesity to difficult-to-treat asthma as well as the mechanisms responsible for this relationship are unclear.
What happens when a brain injury survivor is denied access with her service dog? She starts an organization and website. Learn the story of Canine and Abled, our April site of the month.
Optimal management of emphysematous patients who have lost the benefits achieved after lung volume reduction surgery is a clinical dilemma. We have hypothesized that in stringently selected instances, lung volume reduction reoperations might be considered as a salvage surgical treatment.
The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 5, May 2008 , pp. 467-479(13)
The pathogenesis of chronic obstructive pulmonary disease (COPD) is related to a chronic innate and adaptive inflammatory immune response to inhaled toxic particles and gases, primarily as a result of the tobacco smoking habit.
Management of recurrent malignant pleural effusion associated with trapped lung syndrome remains problematic. An alternative treatment using a pleural catheter has been advocated. Between August 1999 and August 2002, 127 patients underwent thoracoscopy for malignant pleural effusion.
Allergy, Volume 63, Number 5, May 2008 , pp. 492-505(14)
The aims of part II is to review the current recommended treatment of exercise-induced asthma (EIA), respiratory and allergic disorders in sports, to review the evidence on possible improvement of performance in sports by asthma drugs and to make recommendations for their treatment.
American Journal of Rhinology, Volume 22, Number 2, March/April 2008 , pp. 192-196(5)
In cystic fibrosis (CF) patients who are candidates for lung transplant, pretransplant sinus surgery has been advocated to avoid bacterial seeding of the transplanted lungs. This study reviews the 17-year experience of pretransplant sinus surgery among CF patients at a major transplant center.
We assessed the impact of free on-site influenza vaccination on childcare staff vaccination prevalence using 2 before-and-after studies. Vaccination was offered during the 2003-2004 and 2006-2007 influenza seasons.
Standing order programs (SOPs), which allow for vaccination without an individual physician order, are the most effective mechanism to achieve high vaccination rates. Among the suggested settings for the utilization of SOPs are hospital inpatient units, because they provide care for those most likely to benefit from vaccination.
Canadian Journal of Infectious Diseases & Medical Microbiology March/April 2008, Volume 19 Issue 2: 185-192
The presence of the highly pathogenic avian H5N1 virus in wild bird populations in several regions of the world, together with recurrent cases of H5N1 influenza arising primarily from direct contact with poultry, have highlighted the urgent need for preparedness and coordinated global strategies to effectively combat a potential influenza pandemic. The purpose of the present study was to evaluate the Canadian pandemic influenza preparedness plan.
The optimal length of stay (LOS) for patients with pulmonary embolism (PE) is unknown. Although reducing LOS is likely to save costs, the effects on patient safety are unclear. We sought to identify patient and hospital factors associated with LOS and assess whether LOS was associated with postdischarge mortality.
Certain Native American populations have high rates of invasive pneumococcal disease (IPD). We aimed to determine the disease spectrum and risk factors of White Mountain Apache adults (age, >18 years) with IPD and the use and effectiveness of pneumococcal polysaccharide vaccine (PPV) in this population.
Pediatric Allergy and Immunology, Volume 19, Number 3, May 2008 , pp. 248-254(7)
Data on the pathogenic mechanisms underlying the development of non-atopic asthma in children are scarce. Our aim was to evaluate the association and compare the atopic status, pulmonary functions, bronchial hyperresponsiveness and serum total immunoglobulin E (IgE) levels of parents of atopic and non-atopic asthmatic children by using objective methods.
The bronchial epithelium is an important physical barrier that regulates physiological processes including leukocyte trafficking. The aim of the present study was to elucidate the mechanisms whereby the bronchial epithelium, stimulated by epidermal growth factor (EGF) as part of a response to acute or chronic injury, could activate and chemoattract human neutrophils.
The biology of O2 is extremely complex and defies a comprehensive yet brief summary that showcases its roles across the entire animal and plant kingdom. This necessarily short introduction to the 2006 Taormina Lung Science Conference (Taormina, Italy) on hypoxia will examine key features of the biology of O2 only within mammalian cells, even that being a daunting task.
Cystic fibrosis (CF) is associated with a long preclinical state of abnormal glucose tolerance. The aim of this study was (i) to evaluate the profile of glucose tolerance in young adults with CF and (ii) to compare these results with those obtained by a continuous subcutaneous glucose monitoring (CGMS).
This study aimed at determining the protection factors (PFs) provided by N95 filtering facepiece respirators and surgical masks against particles representing bacterial and viral size ranges.
Pediatric Allergy and Immunology, Volume 19, Number 3, May 2008 , pp. 239-247(9)
Atopy is characterized by eosinophilic inflammation associated with recruitment of eosinophil/basophil (Eo/B) progenitors. We have previously shown that Eo/B progenitor phenotypes are altered in cord blood (CB) in infants at high risk of atopy/asthma, and respond to maternal dietary intervention during pregnancy.
Endobronchial path selection is important for the bronchoscopic diagnosis of focal lung lesions. Path selection typically involves mentally reconstructing a three-dimensional path by interpreting a stack of two-dimensional (2D) axial plane CT scan sections.
Interferon-{gamma} release assays for the diagnosis of tuberculosis (TB) can give indeterminate results. The prevalence of indeterminate test results (ITRs) among T-SPOTTM.TB tests was assessed.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 237 - 242
To study the respiratory and physical health of young men, 224 asthmatic and 668 non-asthmatic military conscripts were recruited from the intake groups of July 2004 and January 2005 in Kajaani, Finland. Factors affecting respiratory health were elicited by a questionnaire at the beginning of the service, and results of high sensitive C-reactive protein (hsCRP) determination, peak expiratory flow (PEF), and 12-minute running test were collected at the beginning and the end of the service.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 191 - 195
Reduced attention span and motor skills in children limit the practicability of bronchial provocation tests. To assess exhaled nitric oxide
(FeNO) as a surrogate for bronchial hyperresponsiveness (BHR) in children with possible reactive airway disease, FeNO was measured using the single-breath method in 169 successive outpatients 11 ± 5 years of age before lung function testing and subsequent bronchial provocation by exercise (n = 165) and methacholine (n = 134).
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 243 - 250
Cough variant asthma (CVA) is characterized by chronic cough without apparent wheezing; its pathophysiology is considered to be similar to that of classic asthma.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 183 - 189
Previous studies have suggested that asthmatics have an increased incidence of sleep disturbances. However, these studies have been limited by reliance on population surveys or small numbers of participants. Objectives. We sought to measure sleep quality and daytime sleepiness in a cohort of symptomatic asthmatics and to measure the effects of improved asthma control on sleep quality.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 173 - 181
Asthma in older adults is under-recognized and possibly associated with allergic triggers. We conducted a pooled analysis of omalizumab double-blind, placebo-controlled trials to evaluate efficacy in older adults.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 233 - 236
Current data from clinical studies show that patients with severe allergic asthma experience a significant improvement from omalizumab. The early and late allergic reactions are inhibited by formation of complexes with free circulating immunoglobulin E (IgE), independent of which antigen activates the allergic cascade.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 221 - 225
Correctly identifying asthma patients who need treatment for depression is part of comprehensive care. The objective of this study was to compare the prevalence of depressive symptoms measured by the short-form Center for Epidemiologic Studies Depression Scale (CESD-SF), which measures somatic and psychological symptoms, with the original and short-form Geriatric Depression Scale (GDS and GDS-SF), which measure only psychological symptoms.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 205 - 210
This study examined belief systems of Latino caregivers who have children with asthma from Puerto Rican and Dominican backgrounds who resided on the Island of PR and the Mainland.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 227 - 231
: Suboptimal medication treatment of asthma has been reported. More specifically, short-acting {beta}2-agonists are overused, while inhaled corticosteroids are underused. This can be related in part to poor adherence by patients to the prescribed regimen and to professionals' failure to comply with practice guidelines.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 201 - 203
The aim of this study was to explore possible interactions between a glucocorticosteroid (budesonide) and a long-acting {beta}2-agonist (formoterol) on pro-inflammatory cytokine release.
Journal of Asthma, Volume 45, Issue 3 April 2008 , pages 211 - 214
A survey was given to the parents of 80 children with asthma between the ages of 3 and 18 years at the Pediatric Pulmonology Clinics of three military treatment facilities to evaluate asthma management and outcomes for different racial groups. Results demonstrated that management practices for the three groups were similar and that there were no significant differences in emergency department visits, prescription of oral steroids, or in the number of hospitalizations across the three groups.
Clinical Microbiology and Infection doi:10.1111/j.1469-0691.2008.01987.x
A high incidence of respiratory infection, including influenza, has been reported at the Hajj in Mecca, Saudi Arabia. Reported rates of influenza have been higher among UK than among domestic pilgrims, but this could be explained by methodological differences among studies.
Clinical Microbiology and Infection doi:10.1111/j.1469-0691.2008.01998.x
This study determined the types of AmpC enzymes produced by Klebsiella pneumoniae isolates resistant to third-generation cephalosporins and the clonality of these isolates.
Tropical Medicine & International Health doi:10.1111/j.1365-3156.2008.02050.x
To determine the value of C-reactive protein (CRP) and procalcitonin in the evaluation of the efficacy of a pneumococcal conjugate vaccine in Gambian children.
American Journal of Clinical Nutrition, Vol. 87, No. 4, 1002-1008, April 2008
Most cured meats contain nitrites. Nitrites generate oxidative-nitrative stress and were shown in animal models to cause emphysema. Prospective epidemiologic data on cured meats and chronic obstructive pulmonary disease (COPD), however, are sparse.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 4, April 2008 , pp. 301-307(7)
Medicaid insurance has been associated with worse asthma outcomes, but the degree to which demographic factors contribute to this relationship has not been well explored.
The objectives of this study were (1) to determine the prevalence and risk factors of elevated pulmonary artery pressures in children with homozygous SS or S{beta}° thalassemia using Doppler echocardiography and (2) to determine a correlation between abnormal transcranial Doppler examinations and elevated pulmonary artery pressures.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 906-911, (2008)
Late-onset central hypoventilation syndrome (LO-CHS) is a rare disorder that may manifest as early as infancy or as late as during adulthood. The potential overlap of LO-CHS with congenital CHS is under debate, even though both disorders can result from heterozygous PHOX2B gene mutations.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 880-886, (2008)
The outcome of precancerous bronchial lesions is not well known, and their management is subject to controversy. Many molecular alterations are present in preinvasive lesions, but none has been assessed to predict the evolution of the lesions.
Diffusing capacity (DLCO), an independent predictor of morbidity after major lung resection, is not used routinely in preoperative evaluation because of a perceived lack of value in patients with normal spirometry. We evaluated the potential utility of measuring DLCO for assessment of operative risk in lung resection patients with normal spirometry.
Familial Mediterranean fever (FMF) is an autosomal recessive disease affecting predominantly populations surrounding the Mediterranean basin. It is the most prevalent hereditary periodic fever syndrome characterized mainly by recurrent and short attacks of fever and serositis (pleuritis, arthritis, peritonitis). Unilateral polymorphonuclear exudative pleuritis associated with fever has been reported as the solitary manifestation of the first FMF attack, in < 10% of patients.
{beta2}-adrenergic agonists cause a release of pulmonary surfactant into lung airways. The surfactant phospholipids maintain the patency of the conducting airways, but this function is inhibited by plasma proteins entering an inflamed airway.
{alpha}--Antitrypsin deficiency (AATD) is an autosomal-codominant genetic disorder that predisposes individuals to the development of liver and lung disease. AATD is greatly underrecognized and underdiagnosed. Early identification allows preventive measures to be taken, the most important of which is the avoidance of smoking (including the inhalation of second-hand smoke) and exposure to environmental pollutants.
Idiopathic Pulmonary Fibrosis (IPF) is a refractory and lethal interstitial lung disease characterized by loss of alveolar epithelial cells, fibroblast proliferation and extra-cellular matrix protein deposition. EBV, localised to alveolar epithelial cells of pulmonary fibrosis patients is associated with a poor prognosis.
Organic cation transporters (OCTs) have an important role in tissue distribution and elimination of cationic drugs. To assess airway disposal of cationic bronchodilators, human airway cells and tissues obtained from organ donors were evaluated for drug transporter expression by quantitative RT-PCR and immunofluorescence.
Vascular Health and Risk Management Issue: ON-LINE EARLY
Diagnosis of pulmonary embolism (PE) remains difficult and is often missed in the elderly due to nonspecific and atypical presentation. Diagnostic algorithms able to rule out PE and validated in young adult patients may have reduced applicability in elderly patients, which increases the number of diagnostic tools use and costs. The aim of the present study was to analyze the reported clinical presentation of PE in patients aged 65 and more.
Immune characteristics distinguishing tolerant lung transplant recipients (LTR) from patients with Bronchiolitis obliterans syndrome (BOS) are largely unknown. We compared the effect of dendritic cells (DC) on T-cell activation in healthy LTR (non BOS) and in BOS patients.
Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) are a major cause of acute respiratory failure in the critically ill patient. ALI and ARDS are characterized by the acute onset of severe hypoxemia and bilateral pulmonary infiltrates in the absence of clinical evidence for left atrial hypertension.
Asthma is disease characterized by a massive accumulation of eosinophils that release an array of tissue-damaging mediators. Respiratory viral infections are thought to be a leading cause of exacerbations of asthma.
The process of diagnosis and management of solitary pulmonary nodules (SPNs) between 1 and 3 cm is not standardized. This multicentre study investigated how diagnosis of newly discovered SPNs is managed in routine practice.
Archives of Pathology and Laboratory Medicine: Vol. 132, No. 4, pp. 539-547
Shirt-sleeve magnification (holding a slide over a white sleeve) and low-power magnification serve as useful adjuncts in the general categorization of noninfectious medical lung disease. This article divides medical lung disease into chronic and acute, where the temporality is determined first by clinical circumstances and then confirmed by histopathology.
The Proceedings of the American Thoracic Society 5:311-315 (2008)
Lung fibrosis is a recognized feature of many chronic lung diseases and is central to the pathogenesis of idiopathic pulmonary fibrosis, a disease that carries a prognosis worse than many cancers.
The Proceedings of the American Thoracic Society 5:328-333 (2008)
Bronchioles of the distal conducting airway are lined by a simple epithelium composed primarily of nonciliated secretory (Clara) cells and ciliated cells. These cells are long-lived in the normal lung; renewal is mediated by cells that constitute a nonclassical stem cell hierarchy.
The Proceedings of the American Thoracic Society 5:343-347 (2008)
Although much progress has been made in understanding the biology and clinical course of interstitial pneumonia, the etiology of this disease remains elusive. Epidemiologic studies have consistently identified cigarette smoke as an important exposure; however, most smokers do not develop interstitial pneumonia and many individuals with interstitial pneumonia do not smoke cigarettes.
The Proceedings of the American Thoracic Society 5:338-342 (2008)
Fibrosis of parenchymal organs is caused by prolonged injury, deregulation of the normal processes of wound healing, and extensive deposition of extracellular matrix (ECM) proteins.
The Proceedings of the American Thoracic Society 5:300-304 (2008)
The entire epithelium of the lung is generated from a small pool of undifferentiated progenitor cells. At least during the early stages of development these reside in the distal tips of the embryonic lung. They respond to multiple signals from the surrounding mesenchyme and play a critical role as morphogenetic organizing centers.
The Proceedings of the American Thoracic Society 5:323-327 (2008)
Although it has been many years since publication of the first peer-reviewed studies showing that bone marrow (BM)-derived cells can become mature-appearing epithelial cells, we still know very little regarding the mechanisms, kinetics, cells, and potential clinical utility or pathology associated with this phenomenon.
The Proceedings of the American Thoracic Society 5:334-337 (2008)
Despite their importance in fibrosis, the origin of fibroblasts and the genesis of the various subpopulations characterized by distinct phenotypes remain unclear. Various studies have described distinct and relatively stable phenotypes in fibroblasts isolated from lung tissue undergoing remodeling, which were not present in the normal intact tissue.
To investigate the value of C-reactive protein (CRP) as a marker of chronic obstructive pulmonary disease (COPD) exacerbations or specifically bacterial exacerbations and to evaluate a correlation between raised CRP levels and other markers of inflammation in patients with an acute exacerbation (AECOPD).
Telephone based asthma management has a clinically important effect on reducing hospital readmissions. The cost and benefits to the individual have yet to be reported. The authors sought to determine the effect of a telephone based asthma self management program in terms of quality of life, self efficacy, patient acceptance and cost effectiveness.
Expert Review of Cardiovascular Therapy April 2008, Vol. 6, No. 4, Pages 439-442
It is clearly established that morbidity and mortality from congestive heart failure (CHF) is related to the irreversible progression of left ventricular (LV) dysfunction. Regardless of the etiology of CHF, the associated deterioration in LV diastolic compliance and systolic function results in impaired ventricular filling and decreased tissue perfusion leading to the progression of the symptoms of fatigue, dyspnea on exertion and peripheral edema.
Expert Review of Cardiovascular Therapy April 2008, Vol. 6, No. 4, Pages 471-479
Summary
Expert Review of Cardiovascular Therapy
April 2008, Vol. 6, No. 4, Pages 471-479
Hypertension is a major cardiovascular risk factor but most patients remain asymptomatic for many years. Successful therapy not only needs to be effective, it also needs to be well tolerated.
The Proceedings of the American Thoracic Society 5:305-310 (2008)
There has been ongoing controversy related to what differentiates normal lung repair and fibrosis. For example, the current prevailing concept has been that idiopathic forms of pulmonary fibrosis are due only to epithelial injury in response to some unknown cause that results in persistent evolving fibrosis without preceding inflammation.
The Clinical Respiratory Journal Volume 2 Issue 2 Page 106-115, April 2008
The study has been performed with the approval of the Regional Committee of Medical Research Ethics. The study is in compliance with the Helsinki Declaration. Informed consent was obtained from each participant prior to the survey. The study was supported by the Royal Norwegian Council for Scientific and Industrial Research and the Norwegian Research Council.
In an era of increased emphasis on patient safety and competency-based education, demonstration of significant variability in the teaching of flexible bronchoscopy has led to initiatives for new standardized curricula and assessment tools.
Clinical Physiology and Functional Imaging, Volume 28, Number 3, May 2008 , pp. 182-188(7)
In healthy subjects, hypoxemia and exercise represent independent stressors promoting the exercise-induced cytokine response and oxidative stress. We hypothesized that hypoxemia in patients with chronic obstructive pulmonary disease (COPD) may affect the cytokine production and/or the changes in oxidant-antioxidant status in response to maximal exercise.
Clinical Physiology and Functional Imaging, Volume 28, Number 3, May 2008 , pp. 196-201(6)
The recent American Thoracic Society/European Respiratory Society spirometry guidelines harmonized quality criteria and included assessment of forced expiratory time
(FET) in bronchodilation testing when an isolated significant forced vital capacity
(FVC) bronchodilation effect is observed. No consensus exists on the criteria of accepted variability of
FET. Forced expiratory volume in 6 s (FEV6) has been suggested to replace
FVC, especially in primary care. We examined the variability of FET and FEV6 and its determinants in the general population.
The Clinical Respiratory Journal Volume 2 Issue 2 Page 116-122, April 2008
To evaluate the colonisation rate and type in different groups of patients with chronic lung diseases, bronchial lavage (BL) fluid was investigated for bacteria.
The Clinical Respiratory Journal Volume 2 Issue 2 Page 92-97, April 2008
We set out to observe the General Practitioner (GP) management of a cohort of asthma patients over a 2-year period by comparing asthma health status, spirometry, British Thoracic Society treatment step, inhaled medication uptake and psychological status. Changes in these parameters were assessed over the 2-year period.
The Clinical Respiratory Journal Volume 2 Issue 2 Page 86-91, April 2008
The term dysfunctional breathing (DB) has been introduced to describe patients who display a divergent breathing pattern and have breathing problems that cannot be attributed to a specific medical diagnosis such as asthma, chronic obstructive pulmonary disease or sensory hyper-reactivity.
Despite the fact that patients with obstructive sleep apnoea syndrome (OSAS) often have symptoms at the level of skeletal muscle such as fatigue, the question of whether the structural, cellular and functional properties of limb skeletal muscles are affected has not been fully examined.
Cancer Prevention Research, 10.1158/1940-6207.CAPR-07-0017
Cigarette smoke is the major cause of lung cancer and can interact in complex ways with drugs for lung cancer prevention or therapy. Molecular genetic research promises to elucidate the biological mechanisms underlying divergent drug effects in smokers versus nonsmokers and to help in developing new approaches for controlling lung cancer.
Allergy, Volume 63, Number 5, May 2008 , pp. 575-582(8)
It has been hypothesized that obesity and insulin resistance may play a role in the development of asthma and allergy. The aim of the study was to examine the association of obesity and insulin resistance with asthma and aeroallergen sensitization.
JNCI Journal of the National Cancer Institute, doi:10.1093/jnci/djn088
The dose intensity of chemotherapy can be increased to the highest possible level by early administration of multiple and sequential high-dose cycles supported by transfusion with peripheral blood progenitor cells (PBPCs).
Am J Physiol Lung Cell Mol Physiol 294: L686-L697, 2008
Increased pulmonary endothelial cGMP was shown to prevent endothelial barrier dysfunction through activation of protein kinase G (PKGI). Vasodilator-stimulated phosphoprotein (VASP) has been hypothesized to mediate PKGI barrier protection because VASP is a cytoskeletal phosphorylation target of PKGI expressed in cell-cell junctions.
Am J Physiol Lung Cell Mol Physiol 294: L724-L732, 2008. First published January 25, 2008
Depletion of alveolar macrophages (AM) leads to an increase in endogenous surfactant that lasts several days beyond the repletion of AM. Furthermore, impairment to the endogenous pulmonary surfactant system contributes to ventilation-induced lung injury.
Am J Physiol Lung Cell Mol Physiol 294: L698-L704, 2008
The signal transducers and activators of transcription (STAT) family of transcription factors regulates a variety of biological functions including cellular proliferation, transformation, apoptosis, and differentiation.
Am J Physiol Lung Cell Mol Physiol 294: L772-L777, 2008
Endothelin 1 (ET-1) is a potent pulmonary vasoconstrictor and mediator of lung diseases. Antagonism of the ET-1-mediated effects has become an important therapeutic approach. ET-1 (A and B) receptors are differentially distributed in the lung vasculature.
Am J Physiol Lung Cell Mol Physiol 294: L778-L786, 2008
Hepatocyte growth factor (HGF) is upregulated in response to lung injury and has been implicated in tissue repair through its antiapoptotic and proliferative activities. Cyclooxygenase-2 (COX-2) is an inducible enzyme in the biosynthetic pathway of prostaglandins, and its activation has been shown to play a role in cell growth.
Am J Physiol Lung Cell Mol Physiol 294: L764-L771, 2008
Proteoglycans (PG) are altered in the asthmatic airway wall. Because PGs are known to affect cell proliferation and apoptosis, we hypothesized that alterations in PG might influence the airway smooth muscle (ASM) hyperplasia observed in the asthmatic airway.
Am J Physiol Lung Cell Mol Physiol 294: L807-L814, 2008
Membrane-associated intercellular adhesion molecule-1 (mICAM-1; CD54) is constitutively expressed on the surface of type I alveolar epithelial cells (AEC). Soluble ICAM-1 (sICAM-1) may be produced by proteolytic cleavage of mICAM-1 or by alternative splicing of ICAM-1 mRNA.
Am J Physiol Lung Cell Mol Physiol 294: L797-L806, 2008
Myogenic tone in the pulmonary vasculature of normoxic adult animals is minimal or nonexistent. Whereas chronic hypoxia (CH) increases basal tone in pulmonary arteries, it is unclear if a portion of this elevated tone is due to development of myogenicity.
The American Journal of Gastroenterology, Volume 103, Number 3, March 2008 , pp. 720-728(9)
The prevalence of gastroesophageal reflux (GER) is high among infants with chronic lung disease (CLD), and the associated pathogenic mechanisms are not clear. The relationship of symptoms to the extent or duration of acid reflux events (AREs) is not well known in preterm or term infants.
Pediatric Allergy and Immunology, Volume 19, Number 3, May 2008 , pp. 255-263(9)
Recent studies suggest that psychosocial factors may contribute to asthma. We examined associations of stressful life events with asthma prevalence and morbidity among Chicago adolescents.
PEDIATRICS Vol. 121 No. 4 April 2008, pp. e900-e905
Providing asthma education in a primary care setting can be challenging because of time and resource constraints. The purpose of this work was to determine factors associated with the provision of different asthma self-management tools.
As the population of patients with prolonged neutropenia, those receiving hematopoietic stem cell transplantation or lung transplantation, or those with human immunodeficiency virus or acquired immunodeficiency syndrome continues to increase, the rising incidence of pulmonary aspergillosis is unlikely to diminish.
The incidence of death due to recurrent pulmonary embolism (PE) after a first-time idiopathic PE is not well defined.We conducted a retrospective study of patients age 18 to 56 years who had idiopathic PE between 1994-2001.
Journal of the American Geriatrics Society doi:10.1111/j.1532-5415.2008.01683.x
To identify clinical outcomes and variables associated with 6-month mortality in very elderly patients admitted for nonacidotic acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
The aim of the study was to determine the impact of tumor-infiltrating lymphocytes on survival in patients with malignant pleural mesothelioma treated with induction chemotherapy followed by extrapleural pneumonectomy.
One of the deficiencies of positron emission tomography for N staging in lung cancer is a false-positive result caused by concurrent lymphadenitis. Recently, diffusion-weighted magnetic resonance imaging has been reported to be able to image tumors of body organs.
Objective: Recent technologic developments in computed tomography have increased the incidence of surgical intervention for small-sized lung cancer. Although indications of a sublobar resection for early disease have been discussed, we occasionally encounter locally advanced small-sized lung cancer with node metastasis.
Pediatric Infectious Disease Journal. 27(4):292-295, April 2008
Upper respiratory tract infections (URI) likely lead to acute otitis media (AOM) by causing Eustachian tube dysfunction which creates negative middle ear pressure. Children younger than 2 years of age are at highest risk for AOM compared with older children and adults. There has been no published study comparing the middle ear status during URI in infants and young children by age group.
Thermal ablation is one of the most commonly used modalities to treat central airway obstruction. Both laser and argon plasma coagulation (APC) have been reported to cause gas emboli and cardiac arrest.
Asthma is a chronic inflammatory disease of the airway that requires long-term antiinflammatory therapy. Inhaled corticosteroids (ICSs) are recommended for first-line treatment of persistent disease, but not all patients achieve asthma control even when these agents are used in high doses and in combination with other medications, including a long-acting {beta}2-agonist or a leukotriene modifier.
POEMS syndrome is a monoclonal plasma cell disorder characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes. Rare reports of pulmonary manifestations of POEMS syndrome such as pulmonary hypertension exist; however, a comprehensive review of the pulmonary manifestations of POEMS syndrome is lacking.
The hypoxia test can be performed to identify potential hypoxia that might occur in an at-risk individual during air travel. In 2004, the British Thoracic Society increased the hypoxia test cutoff guideline from 85 to 90% in young children.
Anti-endothelial cell antibodies (AECA) are circulating antibodies that bind to endothelial antigens and induce endothelial cell damage. These antibodies have been detected in patients with collagen vascular disease and systemic vasculitis. Sarcoidosis is a multiple granulomatous disorder of unknown etiology, and its clinical presentation, organ involvement, and prognosis are highly diverse.
The success of NIV depends on patient–ventilator interactions. These interactions are evaluated with the subjective comfort score which is not always reliable. An objective evaluation is thus required. To evaluate these interactions, we use a statistical measure of the variability of a physiological signal, i.e the Shannon entropy.
Ventricular ectopy is frequent in heart failure (HF) patients with sleep apnea. A previous report indicated that in HF patients, ventricular premature beats (VPB) occurred more frequently during episodes of recurrent central sleep apnea (CSA) than during normal breathing, and their frequency was greater during hyperpnea than during apnea.
Medically unexplained dyspnea (MUD) refers to a condition characterized by a sensation of dyspnea and is typically applied to patients presenting with anxiety and hyperventilation without cardiopulmonary explanations for their dyspnea. The diagnosis is difficult. We investigated whether descriptors of dyspnea and associated symptoms of MUD are differentially diagnostic.
To evaluate the influence of respiratory muscle overload and right cardiac overload among the possible risk factors of hospital readmission in a 1-year follow-up of a cohort of patients with moderate-to-severe COPD.
A large number of patients with underlying pulmonary disease travel by air each year and are therefore at risk for significant cardiopulmonary effects of induced hypoxia at higher altitudes. The hypoxia altitude simulation test provides a simple way to identify those patients at risk by simulating conditions encountered at high altitude.
Despite remarkable advances in diagnosis and long-term management, asthma remains a serious public health concern. Newly updated expert guidelines emphasize the intra- and inter-individual variability of asthma and highlight the importance of periodic assessment of asthma control. These guidelines update recommendations for step-wise asthma treatment, address the burgeoning field of asthma diagnostics, and stress the importance of a patient and health care professional partnership, including written action plans and self monitoring.
Internal Medicine Journal doi:10.1111/j.1445-5994.2007.01585.x
The aim of the study was to study the effect of 6 months of continuous positive airway pressure (CPAP) in community heart failure (HF) patients with obstructive sleep apnoea (OSA).
Allergy, Volume 63, Number 5, May 2008 , pp. 583-591(9)
The clinical outcome of diisocyanate-induced asthma has been found to be poor despite cessation of exposure. Our aim was to study the outcome of diisocyanate-induced asthma after initiation of inhaled steroid treatment at a mean period of 7-months (range 2-60-months) after cessation of exposure by following up lung function and bronchial inflammation.
Journal of Cardiac Surgery doi:10.1111/j.1540-8191.2007.00542.x
A biatrial thrombus straddling a patent foramen ovale (PFO) is rare. The optimal management is controversial. This report offers an additional report and brief review of the literature. Case Report: A 72-year-old female presented with paroxysmal dyspnea.
Journal of Computer Assisted Tomography. 32(2):238-241, March/April 2008
Synovial sarcoma is the third most common histological type of extremity soft tissue sarcoma. However, primary mediastinal synovial sarcoma is extremely rare. We present 2 cases of unresectable primary mediastinal synovial sarcoma.
Am J Physiol Lung Cell Mol Physiol 294: L676-L685, 2008
The signaling mechanisms in vasculogenesis and/or angiogenesis remain poorly understood, limiting the ability to regulate growth of new blood vessels in vitro and in vivo. Cultured human lung microvascular endothelial cells align into tubular networks in the three-dimensional matrix, Matrigel. Overexpression of MAPK phosphatase-1 (MKP-1), an enzyme that inactivates the ERK, JNK, and p38 pathways, inhibited network formation of these cells.
Am J Physiol Lung Cell Mol Physiol 294: L644-L653, 2008
Exogenous carbon monoxide (CO) has anti-inflammatory and cytoprotective properties that show promise in the treatment of numerous pulmonary diseases. However, the effectiveness of CO in acute pulmonary injury associated with direct lung insult has not been shown conclusively.
Am J Physiol Lung Cell Mol Physiol 294: L665-L675, 2008
Congenital diaphragmatic hernia (CDH) is a frequently occurring birth defect and a source of potentially fatal neonatal respiratory distress. Recently, through the application of detailed karyotyping methods, several CDH-critical regions within the human genome have been identified.
Am J Physiol Lung Cell Mol Physiol 294: L654-L664, 2008
FXYD5, also known as dysadherin, belongs to a family of tissue-specific regulators of the Na+-K+-ATPase. We determined the kinetic effects of FXYD5 on Na+-K+-ATPase pump activity in stably transfected Madin-Darby canine kidney cells.
Apoptosis and other forms of programmed cell death are important contributors to lung pathophysiology. In this brief review, we discuss some of the implications of finding apoptotic cells in the lung and methods for their detection.
The chitinase-like protein YKL-40 is involved in inflammation and tissue remodeling. We recently showed that serum YKL-40 levels were elevated in patients with asthma and were correlated with severity, thickening of the subepithelial basement membrane, and pulmonary function. We hypothesized that single-nucleotide polymorphisms (SNPs) that affect YKL-40 levels also influence asthma status and lung function.
Clinical and Experimental Hypertension, Volume 30, Issue 2 February 2008 , pages 143 - 150
Sleep apnea is a very common condition, particularly in patients with arterial hypertension. A precise diagnosis, however, requires the performance of a sleep study. Clinical surrogate markers for significant apnea could be useful in guiding decisions to perform sleep studies.
Geriatrics & Aging Volume 11, Number 2, March 2008, Pages 111-115
Among older adults, aspiration pneumonia is associated with higher rates of morbidity and mortality than community-acquired pneumonia. Individuals admitted to acute care from continuing care facilities are at increased risk for aspiration pneumonia.
Low tidal volume (VT) ventilation for ARDS is a well-accepted concept. However, controversy persists regarding the optimal ventilator settings for patients without ARDS receiving mechanical ventilation. This study tested the hypothesis that ventilator settings influence the development of new ARDS.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) can reliably sample enlarged mediastinal lymph nodes in patients with non-small cell lung cancer (NSCLC), and in practice is mostly used to sample nodes visible on CT or positron emission tomography (PET).
Published criteria for the diagnosis of Mycobacterium kansasii lung disease require the presence of clinical symptoms, positive microbiologic results, and radiographic abnormalities. In patients with HIV infection, the radiographic findings of M kansasii lung disease are not well described.
Lung cancer is one of the leading causes of cancer-related deaths worldwide. Accurate staging is important for patient management and clinical research. The recognition of chest wall involvement preoperatively is important for staging and surgical planning. Multiple modalities are available to assess the chest wall involvement preoperatively, including CT scanning, MRI, and ultrasound (US) examination.
The fraction of exhaled NO (FeNO) is valuable for the follow-up of asthmatic patients. However, its usefulness as a screening tool for asthma is not established.
The use of antiplatelet therapy in combination with oral anticoagulants remains controversial. The objective of this study was to estimate and compare the incidence of adverse and coronary event rates between patients receiving warfarin monotherapy or warfarin and antiplatelet combination therapy.
Obstructive sleep apnea (OSA) is associated with coronary risk factors, but it is unknown if OSA is associated with development of coronary disease. We evaluated the association between OSA and the presence of subclinical coronary disease assessed by coronary artery calcification (CAC).
Ischemia-reperfusion injuries, fluid overload, and cardiac insufficiency may all contribute to alveolar and interstitial lung edema. We hypothesized that aerosolized salbutamol would reduce extravascular lung water and improve oxygenation after lung resection by stimulating epithelial fluid clearance and cardiovascular function.
Limited data are available comparing air travel with the hypoxia inhalation test (HIT) in passengers with COPD. The aim of this study was to assess the predictive capability of the HIT to in-flight hypoxemia in passengers with COPD.
The Competence Network for Community Acquired Pneumonia (CAPNETZ) offers a unique opportunity to study the epidemiology of legionellosis throughout Germany, applying sophisticated diagnostic tools.
Invasive pulmonary aspergillosis (IPA) is a significant problem in patients with chemotherapy-induced prolonged neutropenia. Because pulmonary deposition of conidia is the first step in developing IPA, we hypothesized that inhalation of liposomal amphotericin B would prevent IPA.
The first phase of national surveillance for avian influenza (H5N1) human disease in Thailand occurred over a 4-month period that began on 1 December 2003. Subsequently, a nationally coordinated laboratory system (NCLS) for avian influenza (H5N1) was created to assess population-based surveillance, specimen procurement, case detection, and reporting at the national level
Allergy, Volume 63, Number 5, May 2008 , pp. 527-532(6)
Airway hyperresponsiveness (AHR) can be studied by bronchoprovocation test (BPT) using direct (methacholine - MCh) or indirect (adenosine 5'-monophosphate - AMP) stimuli. These two substances have not been compared in cough variant asthma (CVA).
Allergy, Volume 63, Number 5, May 2008 , pp. 564-569(6)
Retrospective studies provide evidence that rhinitis is associated with more severe asthma. The aim of this study was to evaluate prospectively whether rhinitis is a predictor of increased asthma severity.
Allergy, Volume 63, Number 5, May 2008 , pp. 533-541(9)
Severe asthma may involve an irreversible obstructive pattern, and structural changes in bronchial airways are believed to play a key role in this context. The aim of the present study was to compare airway remodeling in severe asthmatic children with or without obstructive pattern.
The role of corticosteroid in severe bronchopulmonary dyplasia (BPD) is still debated. Scanty data are available on the corticosteroids effect on surfactant metabolism.
PEDIATRICS Vol. 121 No. 4 April 2008, pp. e892-e899
Pulmonary arterial hypertension has been reported to be observed in association with acquired portal hypertension. However, the contribution of congenital anomalies occurring in the portal system to the development of pulmonary arterial hypertension remains to be elucidated.
The use of antibiotics in infancy and subsequent changes in the intestinal bacterial flora have been discussed as risk factors for the development of asthma. However, it has been difficult to exclude the possibility that antibiotics have been given in early episodes of wheezing. As a result, there has been a risk of reverse causation. To minimize the risk of reverse causation, we have focused on the effect of antibiotics that are already administered on the neonatal ward.
The controversial discussion about the role of Chlamydia pneumoniae in atherosclerosis cannot be solved without a reliable diagnosis that allows discrimination between past and persistent infections.
Cryptococcosis is a common opportunistic infection in acquired immunodeficiency syndrome (AIDS) patients, also occurring in other immunosuppressed patients and occasionally those with no apparent immunocompromise.
Although chronic thromboembolic pulmonary hypertension (CTEPH) is characterised by the persistence of organised thrombus, few pro-thrombotic risk factors have been identified in subjects with the disease. The aim of the present study was to compare the prevalence of eight functionally relevant haemostatic polymorphisms between CTEPH subjects and healthy controls.
PEDIATRICS Vol. 121 No. 4 April 2008, pp. e754-e758
Although nasal continuous positive airway pressure is widely used in neonatal units, its use in neonatal transport is not yet established. Previous reports have been limited to small numbers of primary road transports and larger numbers of return transports while its use in air transportation has not been reported.
PEDIATRICS Vol. 121 No. 4 April 2008, pp. e870-e878
To compare long-term effects of neonatal treatment with dexamethasone or hydrocortisone for chronic lung disease of prematurity on the hypothalamus-pituitary-adrenal axis and the immune response in children at school age.
The Clinical Respiratory Journal Volume 2 Issue 2 Page 80-85, April 2008
Malignant pleural mesothelioma (MPM) has a poor prognosis and there is limited effect of treatment. Lately, pemetrexed and cisplatin have been established as the standard treatment.
There are conflicting data on the effect of adding a heated humidifier to nasal continuous positive airway pressure (CPAP) therapy for patients with obstructive sleep apnoea syndrome (OSAS). The effects of heated humidification on sleep quality and treatment side-effects for patients who prefer a cold bedroom environment have not been studied.
The Clinical Respiratory Journal doi:10.1111/j.1752-699X.2008.00054.x
The addition of a long-acting {beta}2 agonist (LABA) to inhaled corticosteroid (ICS) may control asthma better than ICS alone. Eosinophil markers may predict symptom severity in asthma.
Ingestion of milk powder is a known cause of allergies in children, but the risks to respiratory health from exposure to inhaled milk powder have not been studied previously. The aim of the present study was to assess the effects of occupational exposures in a milk powder factory on respiratory symptoms and lung function.
DISASTER MEDICINE AND PUBLIC HEALTH PREPAREDNESS - 2(1): 33-39 2008
Inhaled corticosteroids (ICS) are the most effective anti-inflammatory treatment for asthmatics. This trial evaluated the effects of prophylactic ICS in firefighters exposed to the World Trade Center disaster.
Zygomycosis has emerged as an increasingly common infection in immunocompromised patients. Although the majority of these cases are community acquired, hospital outbreaks have been described, linked to the use of contaminated products.
Pneumocystis is an opportunistic fungus that is a major cause of morbidity and mortality in immunocompromised hosts. Despite a decline in incidence with the advent of highly active antiretroviral therapy (HAART), Pneumocystis remains the most common opportunistic infection in patients with the acquired immunodeficiency syndrome (AIDS) and is an increasing cause of disease in patients with other forms of immunosuppression.
Allergy, Volume 63, Number 5, May 2008 , pp. 542-546(5)
Reports on air pollution and asthma exacerbations have been inconsistent, although effects of airborne allergen can be spectacular. With no generalized test for allergen in air, it is not known how far allergen is responsible for nonepidemic exacerbations of the disease.
Allergy, Volume 63, Number 5, May 2008 , pp. 547-554(8)
Health-related quality-of-life (HRQL) has been poorly studied in large samples of asthmatics from the general population. HRQL and its relationship to asthma-severity were assessed among 900 asthmatics enrolled in the European Community Respiratory Health Survey.
Allergy, Volume 63, Number 5, May 2008 , pp. 592-596(5)
Omalizumab is efficacious in the treatment of moderate-to-severe and severe persistent allergic (immunoglobulin E-mediated) asthma, reducing exacerbations, emergency visits and improving quality of life (QoL). However, as exacerbations are relatively infrequent, assessment of efficacy on day-to-day symptoms is warranted.
The American Journal of Managed Care Volume 14:206-211 April 2008 Number 4
To identify an optimal cut-point score on the Mini-Asthma Quality of Life Questionnaire (mini-AQLQ) to predict subsequent asthma exacerbations, and to determine the additional risk conferred by a prior history of acute episodes.
Pulmonary artery sarcomas are exceedingly rare and the prognosis for patients with pulmonary artery sarcoma is very poor. We retrospectively reviewed the early and late outcomes after treatment for pulmonary artery sarcoma, and the purpose of this study is to report our surgical experience with this fatal disease.
Percutaneous pulmonary valve insertion (PPVI) is an evolving alternative to surgical pulmonary valve insertion. The aim of this study is to review the acute complications of PPVI requiring emergency rescue surgery.
Asthma accounts for considerable burden on health care, but in most cases, asthma can be controlled. Quality-of-care indicators would aid in monitoring asthma management. We describe the quality of asthma care using a set of proposed quality indicators.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 4, April 2008 , pp. 314-322(9)
Recent evidence suggests that regulatory T cells (Treg cells) and immunosuppressive cytokines, such as transforming growth factor {beta}1 (TGF-{beta}1) and interleukin 10 (IL-10), may have a role in clinically effective allergen specific immunotherapy (SIT).
We aimed to determine the effects of adenoidectomy and/or tonsillectomy (AT) on cardiac functions in children with adenoid and/or tonsillary hypertrophy and obstructive sleep apnea syndrome (OSAS) by using echocardiography with tissue Doppler imaging facility (TDI).
Antimicrobial Agents and Chemotherapy, April 2008, p. 1567-1569, Vol. 52, No. 4
Among 48 erythromycin-resistant group D streptococci (GDS), 36 had the erm(T) resistance gene. erm(T) was also found in 4 of 31 erythromycin-resistant Enterococcus faecium isolates. This is the first report of the erm(T) gene in U.S. GDS isolates and the first report of the erm(T) gene in enterococci.
PEDIATRICS Vol. 121 No. 4 April 2008, pp. e879-e884
The lipid-laden macrophage index has been used to evaluate for gastroesophageal reflux-related respiratory disease, but the relationship between reflux detected by pH probe and the lipid-laden macrophage index is uncertain despite widespread use of the lipid-laden macrophage index in clinical decision-making. It was the aim of this study to correlate reflux as detected by multichannel intraluminal impedance with the lipid-laden macrophage index.
Bronchopleural fistula remains a significant source of morbidity and mortality after right pneumonectomy. We reviewed our initial experience with a novel "carinaplasty" airway closure technique aimed at reducing the risks of bronchopleural fistula.
The Journal of Infectious Diseases 2008;197:1094-1102
It is unclear whether reducing antibiotic prescriptions can reduce rates of resistance once resistance becomes prevalent. We attempted to determine whether reduced antibiotic consumption, which is observed yearly in children during the warm season, is associated with a reduction in antibiotic resistance in pneumococcal acute otitis media (AOM).
The Journal of Infectious Diseases 2008;197:1185-1188
Development of effective and immunogenic vaccines against highly pathogenic avian influenza H5N1 viruses with the potential to cause a pandemic is a public health priority. The global demand for a vaccine cannot be met in the event of an influenza pandemic because of the limited capacity to manufacture egg-derived vaccines as well as potential problems with the availability of embryonated eggs.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 896-905, (2008)
Pulmonary arterial hypertension is a progressive disease characterized by an elevation in the mean pulmonary artery pressure leading to right heart failure and a significant risk of death. Alterations in two transforming growth factor (TGF) signaling pathways, bone morphogenetic protein receptor II and the TGF-{beta} receptor I, Alk1, have been implicated in the pathogenesis of pulmonary hypertension (PH). However, the role of TGF-{beta} family signaling in PH and pulmonary vascular remodeling remains unclear.
A 38-year-old woman with bronchioloalveolar carcinoma (BAC) had a slow-growing cavitary nodule for nearly a decade. When she was hospitalized because of pneumonia 9 years earlier, a chest computed tomography scan showed a 1.5-cm cavitary right upper lobe nodule.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 853-860, (2008)
Pseudomonas aeruginosa is isolated from adults with chronic obstructive pulmonary disease (COPD) in cross-sectional studies. However, patterns of carriage and the role of P. aeruginosa in COPD are unknown.
Progress in computer simulation technology offers new possibilities for modern medicine. On one hand - virtual organs can help to create animal or human models for research, on the other hand - e-learning or distant learning through Internet is now possible.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 861-870, (2008)
Abnormal inflammation and accelerated decline in lung function occur in patients with chronic obstructive pulmonary disease (COPD). Human sirtuin (SIRT1), an antiaging and antiinflammatory protein, is a metabolic NAD+-dependent protein/histone deacetylase that regulates proinflammatory mediators by deacetylating histone and nonhistone proteins.
From a total of 1211 adult & paediatric patients receiving home ventilation (HV) supervised by Royal Brompton Hospital between 1/1/06 and 30/6/06 the respiratory support team received an average of 528 daytime calls/month and 14/month out of hours calls to a telephone helpline.
The burden of asthma has been steadily increasing over the past three decades. In 1970, approximately 3% of the population had asthma, compared with 5.5% and 7.7% in 1995 and 2005, respectively.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 4, April 2008 , pp. 370-376(7)
High repeated doses of inhaled corticosteroids (ICSs) are recognized as having a more rapid improvement of outcomes than a single dose of ICS in severe acute asthma. However, to our knowledge, there has been no direct comparison of the early effects of single or repeated administration of the same total dosage of ICS in children with moderate to severe exacerbations of asthma.
The purpose of this study was to determine how much double lung transplantation improves lung function over single lung transplantation and to identify predictors of lung function after transplantation.
Factors associated with increased risk of major complications after extrapleural pneumonectomy (EPP) for malignant pleural mesothelioma are not well characterized; in particular, the risks of induction chemotherapy and red blood cell (RBC) transfusion have not been well defined.
Mexico City children are chronically exposed to significant concentrations of air pollutants and exhibit chronic respiratory-tract inflammation. Epidemiological, controlled human exposures, laboratory-based animal models, and in vitro/in vivo studies have shown that inflammatory, endothelial dysfunction, and endothelial damage mediators are upregulated upon exposure to particulate matter (PM). Endothelial dysfunction is a critical event in cardiovascular disease.
Whole-lung dosimetry codes and computational fluid dynamics (CFD) techniques have been used extensively to predict particle deposition in the respiratory tract of animals and humans. Although these predictions implement three well-known deposition mechanisms (impaction, sedimentation, and diffusion), validation of deposition due to each deposition mechanism in isolation has been difficult.
Tire and brake wear particles contain transition metals, and contribute to near-road PM. We hypothesized that acute cardiopulmonary injury from respirable tire particles (TP) will depend on the amount of soluble metals.
Coccidioidal infection can manifest as pulmonary or extrapulmonary disease. Pulmonary coccidioidomycosis occurs in 95% of all cases and can be divided into three main categories: primary, complicated, and residual pulmonary coccidioidomycosis.
Journal of Thoracic Oncology. 3(4):428-429, April 2008
We describe a case of known lung malignancy presenting acutely with bronchial obstruction. A piece of tumor from the left main bronchus (occluded by primary tumor) had been aspirated into the previously patent right main bronchus, leading to acute respiratory distress. The obstruction was cleared before intervention by expectoration.
Journal of Thoracic Oncology. 3(4):444-446, April 2008
A 18-year-old man presented to a local hospital with muscle weakness, facial edema, and a 6 kg weight gain over 2 months. After a complete work-up, he was diagnosed with pituitary Cushing syndrome and treated with a bilateral adrenalectomy for Cushing syndrome and pituitary radiotherapy for Nelson syndrome.
Ventilator-associated pneumonia (VAP) rates are advocated as a measure of hospitals’ quality of care for critically ill patients. The standard definition used to measure VAP rates, however, is constructed of nonspecific clinical signs common to many common complications of critical care.
Journal of Emergency Primary Health Care 2008; Volume 6 : Issue 1 Article Number: 990280
Perpetual debate continues regarding the amount of oxygen that should delivered by paramedics to patients with acute exacerbations of chronic obstructive pulmonary disease (COPD). A number of studies argue that providing excessive levels of oxygen in COPD patients results in hypercapnic respiratory failure. Despite the prevalence of COPD there continues to be a paucity of prehospital literature on this topic.
Critical Care Medicine. 36(4):1119-1124, April 2008
Ambulation of patients with acute respiratory failure may be unnecessarily limited in the acute intensive care setting. We hypothesized that ambulation of patients with acute respiratory failure would increase with transfer to an intensive care unit where activity is a key component of patient care.
The aim of this study was to investigate the relationship between respiratory muscle strength, functional capacity, physical activity, and quality of life in preoperative cardiac surgery patients.
Journal of Thoracic Oncology. 3(4):358-364, April 2008
Recent developments of diffusion-weighted magnetic resonance imaging (DWI) make it possible to image malignant tumors to provide tissue contrast based on difference in the diffusion of water molecules among tissues, which can be measured by apparent diffusion coefficient (ADC) value. The aim of this study is to examine the usefulness of DWI for benign/malignant discrimination of pulmonary nodules/masses compared with 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET
Upper airway compromise due to tracheobronchial stenosis commonly occurs in patients with Wegener's Granulomatosis (WG). There is at present no consensus on the optimal management of this life-threatening condition.
Immunoglobulin E (IgE) is central to the development of allergic diseases. Cross-linking of cell-bound IgE by the allergen leads to the initiation of the inflammatory cascade. Omalizumab, an anti-IgE antibody, forms complexes with free IgE, thereby inhibiting the allergic reaction before its commencement.
In developed countries, it is very difficult to demonstrate the effectiveness of pneumococcal vaccines because the incidence of pneumococcal pneumonia is very low.
There is limited information on lung function and exhaled nitric oxide fraction (FeNO) in infants with recurrent lower respiratory tract symptoms. In 2000-2003, 201 recurrently symptomatic infants were referred to a tertiary center for further investigation.
Expert Review of Cardiovascular Therapy March 2008, Vol. 6, No. 3, Pages 411-418
The advances in pediatric tertiary care have resulted in a decrease in the mortality of children with serious underlying conditions. Consequently, there has been an increase in previously rare complications of therapy in children, including venous thrombosis.
Lung function at the end of life depends on its peak and subsequent decline. Because obesity is epidemic in young adulthood, we quantified age-related changes in lung function relative to body mass index (BMI).
Following influenza, the elderly and those with chronic heart/lung diseases are often affected by bacterial complications such as pneumonia. Whether neutrophil and monocyte functions are affected differently in patients with or without complications is less well known.
There is little information on nasopharyngeal (NP) flora or bacteremia in HIV-infected children. Our aim was to describe the organisms and antimicrobial resistance patterns in children enrolled in a prospective study comparing daily and three times weekly trimethoprim-sulfamethoxazole (TMP-SMX) and isoniazid (INH) or placebo prophylaxis.
Child: Care, Health and Development doi:10.1111/j.1365-2214.2007.00804.x
Cystic fibrosis is a chronic, life-threatening illness. Coping, vicarious hope and vicarious despair are constructs that may explain why some children and parents adjust well to cystic fibrosis, while others adjust poorly.
Pediatric Infectious Disease Journal. 27(4):358-360, April 2008
The main objective of our study was to determine the frequency of human bocavirus (HBoV) detection in asymptomatic children and to compare it with that in children hospitalized because of respiratory infection.
Pediatric Infectious Disease Journal. 27(4):341-346, April 2008
In the United States, diphtheria-tetanus-acellular pertussis (DTaP) and inactivated poliovirus (IPV) booster vaccinations are recommended for children 4-6 years of age. A combined DTaP-IPV vaccine is being developed, which would reduce by one the number of injections in this age group.
The frequency and diversity of serious fungal infections are increasing. Persons who are severely immunocompromised are particularly vulnerable to infection from unusual molds and yeasts that are often found naturally in the environment.
Critical Care Medicine. 36(4):1290-1296, April 2008
Prolonged erythrocyte storage time might reduce the efficacy of transfusion. In this study, the effects of transfusion of erythrocytes with four different storage periods (<10 days, n = 18; 10-14 days, n = 15; 15-19 days, n = 17; and >19 days, n = 16 patients) on brain tissue oxygen tension (Ptio2) in stable male patients with severe traumatic brain injury were investigated during a 24-hr follow-up period.
Critical Care Medicine. 36(4):1089-1096, April 2008
Doripenem is an investigational carbapenem with broad-spectrum activity against Gram-negative and Gram-positive pathogens, including multidrug-resistant strains, commonly responsible for ventilator-associated pneumonia (VAP). This large, phase III study compared doripenem with imipenem for the treatment of ventilator-associated pneumonia.
In chronic obstructive pulmonary disease (COPD) patients, stroke volume response to exercise is impaired. The aim of the present study was to investigate whether 3 months of sildenafil treatment improves stroke volume and, if so, whether this improvement is related to the pulmonary artery pressure and translated into an improved exercise capacity.
Factors influencing nasal versus oral breathing in asthmatics are not well understood. The current authors hypothesised that asthmatic subjects have enhanced perception of nasal threshold loads, and switch from nasal to oral breathing at a lower load than healthy subjects.
Brachytherapy is a modality of treatment available for lung cancer with tracheal involvement. Correct positioning of the brachytherapy catheter is vital to the optimisation of treatment effect and reduction of complications. Normal airway anatomy and tumour location can make this positioning difficult.
The source of acquisition of Pseudomonas aeruginosa in cystic fibrosis (CF) patients remains unknown. Patient-to-patient transmission has been well documented but the role of the environment as a source of initial infection is as yet unclear.
The degree of acute improvement in spirometric indices after bronchodilator inhalation varies among chronic obstructive pulmonary disease (COPD) patients, and depends upon the type and dose of bronchodilator and the timing of administration.
There is no mechanical device available to support patients with end-stage lung failure for weeks and months until appropriate donor organs for lung transplantation are available.
The Clinical Respiratory Journal doi:10.1111/j.1752-699X.2007.00045.x
Elevated fractional exhaled nitric oxide (FENO) associates positively with symptomatic atopy among asthmatics and in the general population. It is, however, unclear whether sensitization to common allergens per se - as verified with positive skin prick tests - affects FENO in healthy individuals.
Pediatric Infectious Disease Journal. 27(4):335-340, April 2008
The impact of heptavalent pneumococcal conjugate vaccine (PCV7) on transmission of antimicrobial-resistant Streptococcus pneumoniae is an important concern for countries considering PCV7 introduction.
Bronchiolitis is the leading cause of hospitalization for infants. Our objective was to identify factors associated with safe discharge to home from the emergency department.
Clinical Cancer Research 14, 2006-2011, April 1, 2008
Optical coherence tomography (OCT) is an optical imaging method that can visualize cellular and extracellular structures at and below tissue surface. The objective of the study was to determine if OCT could characterize preneoplastic changes in the bronchial epithelium identified by autofluorescence bronchoscopy.
Clinical and Applied Thrombosis/Hemostasis, Vol. 14, No. 2, 159-167 (2008)
Pulmonary embolism, though treatable, is a devastating disease and an important cause of morbidity and mortality among hospitalized patients. In all, 1000 autopsies were reviewed in adult medical patients.
Am J Physiol Endocrinol Metab 294: E778-E784, 2008
Previous reports demonstrated that adiponectin has antiatherosclerotic properties. Obstructive sleep apnea-hypopnea syndrome (OSAHS) is reported to exacerbate atherosclerotic diseases.
The plasma ammonia response to exercise in chronic obstructive pulmonary disease (COPD) was examined and the relationship between plasma ammonia concentration and muscle adenine nucleotide metabolism was explored.
Mast cells are thought to contribute to allergic airway disease. However, the role of mast cell-produced mediators, such as tumour necrosis factor (TNF), for the development of allergic airway disease is unclear.
Critical Care Medicine. 36(4):1083-1088, April 2008
The use of sedatives, opioids, and neuromuscular blocking agents (NMBAs) may delay weaning and prolong intensive care unit length of stay. We hypothesized that in patients on higher positive end-expiratory pressure (PEEP), sedatives, opioids, and NMBAs are used in a higher proportion of patients and in higher doses and that the use of these medications is associated with prolongation of weaning and mortality.
Lung carcinoma with a basaloid pattern (BC) is classified as either a basaloid variant of squamous cell carcinoma (SCC) or as variant of large cell carcinoma (LCC) depending on the presence of a squamous component. In a previous study of 37 cases, the present authors showed that BC presented with a shorter median and overall survival.
The need for updated spirometric reference values to be used on European populations is widely acknowledged, especially for subjects aged >70 yrs. Their reference values are generally based on extrapolations.
Bronchiectasis is characterised by hypersecretion and impaired clearance of mucus. A 400-mg dose of inhaled mannitol improves mucus clearance however, the effect of other doses is unknown.
Acid gastro-oesophageal reflux (GOR) and gastric aspiration have been labelled as risk factors for chronic rejection bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTx). The present study aimed to further characterise GOR (both acid and nonacid) and the degree of gastric aspiration in LTx recipients both with and without BOS.
Bacterial infections are a cause of exacerbation of airway disease. Airway smooth muscle cells (ASMC) are a source of inflammatory cytokines/chemokines that may propagate local airway inflammatory responses. We hypothesize that bacteria and bacterial products could induce cytokine/chemokine release from ASMC.
Future Microbiology, Volume 3, Number 2, April 2008 , pp. 205-221(17)
Streptococcus pneumoniae (the pneumococcus) is a major global cause of human disease. Since the publication of the entire sequence of TIGR4 in 2001, our understanding of this human pathogen has increased significantly.
Future Microbiology, Volume 3, Number 2, April 2008 , pp. 191-203(13)
Pseudomonas aeruginosa is a Gram-negative bacterium that is ubiquitously found in the environment. It is an important opportunistic pathogen in immunocompromised patients and causes life-threatening lung infections in individuals with cystic fibrosis. A prominent virulence factor for many Gram-negative bacteria, including P.aeruginosa, is lipopolysaccharide (LPS), which is an immunodominant antigen located in the outer portion of the outer membrane.
American Journal of Rhinology, Volume 22, Number 1, January-February 2008 , pp. 59-63(5)
The purpose of this study was to evaluate the effects of nasal surgery on nasal resistance, sleep apnea, and sleep quality in adult male patients with obstructive sleep apnea syndrome (OSAS). A prospective study was performed in OSAS patients who underwent isolated nasal surgery in a tertiary referral center.
Single-lung transplantation is an accepted treatment for end-stage lung disease caused by chronic obstructive pulmonary disease. A complication unique to single-lung transplantation for chronic obstructive pulmonary disease is graft dysfunction due to compression caused by native lung hyperinflation.
Chronic mucoid Pseudomonas aeruginosa within the airway in cystic fibrosis (CF) patients can determine prognosis. Understanding the risk factors of mucoid P. aeruginosa acquisition may change how we deliver care.
everal studies have suggested that after regular use of short acting {beta}2-agonists the bronchodilator effect of the drug may decline and this condition would be related to polymorphisms of the {beta}{beta}2-adrenergic receptor ({beta}2-AR).
o investigate the nasopharyngeal carriage and antimicrobial susceptibility of H. influenzae among children younger than 5 years old and to assess antibiotics usage patterns in the outpatient department of Beijing Children's Hospital from 2000 to 2004.
Journal of Intensive Care Medicine, Vol. 23, No. 2, 109-121 (2008)
Transfusion-related acute lung injury (TRALI) refers to a clinical syndrome of acute lung injury that occurs in a temporal relationship with the transfusion of blood products.
Infants with bronchopulmonary dysplasia (BPD) are known to have developmental delays, but a direct link between oxygen (O2) exposure and brain growth has not been explored.
Annals of Internal Medicine 1 April 2008 Volume 148 Issue 7 Pages 535-543
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. Fewer than half of the estimated 24 million Americans with airflow obstruction have received a COPD diagnosis, and diagnosis often occurs in advanced stages of the disease.
Annals of Internal Medicine 1 April 2008 Volume 148 Issue 7 Pages 509-518
Aspiration pneumonia is common among frail elderly persons with dysphagia. Although interventions to prevent aspiration are routinely used in these patients, little is known about the effectiveness of those interventions.
Patients receiving mechanical ventilation through an endotracheal tube are at increased risk for pneumonia. Because microaspiration of contaminated supraglottic secretions past the endotracheal tube cuff is considered to be central in the pathogenesis of ventilator-associated and postoperative pneumonia, better sealing of the upper trachea by the endotracheal tube cuff could possibly reduce this risk.
Journal of Intensive Care Medicine, Vol. 23, No. 2, 143-145 (2008)
Percutaneous declotting of a thrombosed fistula or graft is standard of care and is a safe procedure. Subclinical pulmonary embolism (PE) during this procedure occurs commonly, but symptomatic PE is extremely rare.
Children with orphan lung diseases (defined as a prevalence of <1 in 2000) receive suboptimal care due to a lack of understanding of pathophysiology and management.
Blastomycosis is a rare but important fungal infection diagnosed primarily in the south central and midwestern United States but also in the American and Canadian borders of the Great Lakes.
Telemedicine and e-Health. March 1, 2008, 14(2): 138-146
Four hospitals took part in a nonrandomized controlled multicenter COPD study to determine the effect of homebased telemonitoring using the Health Buddy (HB) and health-related quality-of-life as measured by the Clinical COPD Questionnaire.
Critical Care Medicine. 36(4):1043-1048, April 2008
To assess the feasibility of using respiratory frequencies up to 15 Hz during high-frequency oscillatory ventilation (HFO) of adults with acute respiratory distress syndrome (ARDS).
The aim of this study was to test the hypothesis that diabetes is independently associated with reduced lung function, both cross-sectionally and longitudinally.
Education on optimal medication use is an essential strategy to improve asthma control. The current authors investigated whether pharmacist interventions, focused on appropriate use of asthma medication and tailor-made to the patient's current asthma control, would improve asthma control in adult patients.
Airway nitric oxide production is decreased in cystic fibrosis. As growth hormone therapy has been shown to increase nitric oxide production in growth hormone-deficient patients, it may also affect nitric oxide production in patients with cystic fibrosis. The objective of the present study was to investigate the effect of growth hormone therapy on systemic and airway nitric oxide formation in patients with cystic fibrosis.
Prostacyclin and its analogues (prostanoids) are potent vasodilators and possess antithrombotic, antiproliferative and anti-inflammatory properties. Pulmonary hypertension (PH) is associated with vasoconstriction, thrombosis and proliferation, and the lack of endogenous prostacyclin may considerably contribute to this condition.
The aim of the present study was to determine the impact of various pleurodesis procedures on post-operative morbidity and late recurrence rate after surgical treatment of Vanderschueren’s stage III primary spontaneous
pneumothorax.
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease and not well understood. The forced expiratory volume in one second is used for the diagnosis and staging of COPD, but there is wide acceptance that it is a crude measure and insensitive to change over shorter periods of time.
It was hypothesised that, apart from right ventricular (RV) dysfunction, patients with idiopathic pulmonary fibrosis (IPF) also exhibit left ventricular (LV) impairment, which may affect disease progression and prognosis. The aim of the present study was to evaluate LV performance in a cohort of IPF patients using conventional and tissue Doppler ECG.
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