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Archives of Disease in Childhood - Fetal and Neonatal Edition 2008;93:F104-F107
Extracorporeal membrane oxygenation (ECMO) remains the mainstay of management in neonates with severe but potentially reversible respiratory failure. In the UK, ECMO is available only as a supraregional service at four centres.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.082974
In early childhood, the ability to mount protective immune responses in the airways is impaired, with increased risk of allergic sensitisation to inhaled allergens. Antigen-presenting cells (APC) and regulatory T cells (Tregs) are important modifiers of T-cell immunity, but little is known about their distribution in bronchial mucosa at this age.
Bronchoalveolar lavage fluid (BALF) offers a potential means to diagnose acute rejection and could provide insight into the immune mechanisms responsible for lung allograft rejection.
Severe sepsis and septic shock represent a major cause of mortality in critical care. Even in patients who survived, a clinical course complicated with multiple organ dysfunction leads to significant morbidity, costs, and use of already limited resources. That's why treatment of these patients requires timely mobilization of a logical and scientifically up-to-date plan.
Thorax. Published Online First: 11 April 2008. doi:10.1136/thx.2007.086454
To estimate the cost-effectiveness of using continuous positive airway pressure (CPAP) in the management of patients suffering from severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS), compared to no treatment, from the perspective of the UK's National Health Service (NHS).
Thorax. Published Online First: 23 August 2006. doi:10.1136/thx.2005.057935
Nitric oxide is released by immune, epithelial and endothelial cells, and plays important role in asthma pathophysiology. We sought to investigate the association of inducible NOS (NOS2A) gene repeat polymorphisms with asthma.
Journal of Epidemiology and Community Health 2008;62:398-401
Chronic obstructive pulmonary disease (COPD) is a progressive disabling condition, for which tobacco smoking, environmental pollution, inherited {alpha}-antitrypsin deficiency and their interactions are predisposing factors. We carried out a family study on COPD in order to address the role of heritable and environmental risk factors at a population level.
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.081208
The Incremental Shuttle Walking Test (ISWT) is used to assess exercise capacity in chronic obstructive pulmonary disease (COPD) and is employed as an outcome measure for pulmonary rehabilitation. This study was designed to establish the minimum clinically important difference (MCID) for the ISWT.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.090951
Influenza-like illness (ILI) among elderly living in residential care homes (RCHE) is a common cause for hospitalization. We examined the incidence, underlying aetiology, natural history and associated healthcare resource utilization related to ILI in the RCHE population.
Our objective was to test for evidence of regression to the mean in chronic obstructive pulmonary disease (COPD)-related health care utilization in a Colorado Medicaid population that met the criteria for, but were not participating in, a COPD disease management (DM) program.
Thorax. Published Online First: 1 February 2008. doi:10.1136/thx.2007.086785
Lack of response to treatment in community-acquired pneumonia (CAP) worsens outcome. We evaluated the systemic cytokine profile -TNF{alpha}, IL1, IL6, IL8 and IL10- C-reactive protein (CRP) and procalcitonin (PCT) in patients with CAP who had treatment failure.
Thorax. Published Online First: 31 May 2006. doi:10.1136/thx.2005.058156
Reactive nitrogen species (RNS) are thought to be one of the important factors in the pathogenesis of chronic obstructive pulmonary disease (COPD). In this study, we examined the effects of theophylline and fluticasone propionate (FP) on RNS production in COPD subjects.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.085993
This study examined the effects of inhaled furosemide on the ventilatory and perceptual response to high intensity, constant-load cycle exercise in chronic obstructive pulmonary disease (COPD).
Primary sarcoma of the pulmonary artery (PSPA) is extremely rare. Many cases are misdiagnosed as pulmonary arterial hypertension (PAH) because of chronic thromboembolic disease (CTD). Four cases of PSPA with the initial misdiagnosis are reported. The presence of a unique mass in the main pulmonary artery or proximal branches, rapidly progressive dyspnea, and constitutional symptoms should raise the suspicion of PSPA. The pathological diagnosis is usually confirmed during surgery, which is done along with adjuvant chemotherapy, the treatment of choice.
Thorax. Published Online First: 17 June 2005. doi:10.1136/thx.2005.047803
Current guidelines recommend the use of a combination of inhaled beta2-agonists and anticholinergics, particularly for patients with acute severe or life threatening asthma in the emergency setting. However, this statement is based on a relatively small number of randomised controlled trials and related systematic reviews.
Thorax. Published Online First: 14 March 2008. doi:10.1136/thx.2007.088583
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive disorder with a poor prognosis. Epithelial instability is a crucial step in the development and progression of the disease including neoplastic transformation. Few tissue markers regarding epithelial instability have been reported in IPF. Squamous cell carcinoma antigen (SCCA) is a serine protease inhibitor typically expressed by dysplastic and neoplastic cells of epithelial origin, more often in squamous cell tumours. At present no information is available on its expression in IPF.
Thorax. Published Online First: 15 February 2008. doi:10.1136/thx.2007.084251
To determine whether well-trained lay people could deliver asthma self-management education with comparable outcomes to that achieved by primary care-based practice nurses.
Primary Care Respiratory Journal Volume 17 Issue 2 June 2008
Asthma causes a substantial burden of morbidity and mortality, affecting 300 million people worldwide - a figure predicted to increase to 400 million by 2025. Despite the availability of a variety of treatment options and detailed treatment guidelines, many patients with asthma, and in particular those with severe persistent asthma, remain inadequately controlled.
Primary Care Respiratory Journal Volume 17 Issue 2 June 2008
Canada has a universal health care system funded by the government. All people are supposed to have unrestricted access to all essential health care in a timely fashion.
Primary Care Respiratory Journal Volume 17 Issue 2 June 2008
To assess whether exhaled nitric oxide (FENO) measurements improve management and clinician confidence in patients presenting with non-specific respiratory symptoms.
Primary Care Respiratory Journal Volume 17 Issue 2 June 2008
To compare the effectiveness of the long-acting anticholinergic, tiotropium with ipratropium/salbutamol in reducing the risk of exacerbations and COPD-related referrals in patients with COPD.
Primary Care Respiratory Journal Volume 17 Issue 2 June 2008
Chlorofluorocarbons (CFCs) have historically served as the propellants of choice in pressurised metered-dose asthma inhalers, but concern has been raised in recent decades regarding their damaging effect on the ozone layer.
Sarcoidosis is an idiopathic granulomatous disease with pathologic and immunologic features similar to tuberculosis. Routine histologic staining and culture fail to identify infectious agents.
Severe alpha1-antitrypsin (AAT) deficiency associated with low AAT blood concentrations is an established genetic COPD risk factor. Less is known about the respiratory health impact of variation in AAT serum concentrations in the general population.
The patient population receiving long-term oxygen therapy has increased with the rising morbidity of COPD. Although high-dose oxygen induces pulmonary edema and interstitial fibrosis, potential lung injury caused by long-term exposure to low-dose oxygen has not been fully analyzed.
To investigate vascular function in children with a neonatal history of generalised inflammation indicated by premature prolonged rupture of membranes (PPROM) and bronchopulmonary dysplasia (BPD).
Disease Management & Health Outcomes, Volume 16, Number 2, 2008 , pp. 95-105(11)
Asthma is one of the most common chronic diseases of adults and children in industrialized countries, and has had a marked increase in prevalence over the past 25 years. Asthma disproportionately affects under-represented minority populations, with African Americans and (some) Hispanics having higher rates than other groups. Racial and ethnic disparities in asthma prevalence and severity exist and are partially explained by environmental, social, cultural, and economic factors.
Available data on the etiology of community-acquired pneumonia (CAP) in Australia are very limited. Local treatment guidelines promote the use of combination therapy with agents such as penicillin or amoxycillin combined with either doxycycline or a
macrolide.
The aim of this study was to show that sequential intravenous and oral moxifloxacin monotherapy (400 mg once per day) is as efficacious and safe as a combination regimen (intravenous
ceftriaxone, 2 g once per day, plus sequential intravenous and oral
levofloxacin, 500 mg twice per day) in patients hospitalized with community-acquired pneumonia.
Mechanical ventilation in the prone position is used to improve oxygenation in patients with acute hypoxemic respiratory failure. We sought to determine the effect of mechanical ventilation in the prone position on mortality, oxygenation, duration of ventilation and adverse events in patients with acute hypoxemic respiratory failure.
Excessive production of airway mucus is a cardinal feature of bronchial asthma and chronic obstructive pulmonary disease (COPD) and contributes to morbidity and mortality in these diseases. IL-13, a Th2-type cytokine, is a central mediator in the pathogenesis of bronchial asthma, including mucus overproduction.
Current Medical Research and Opinion, Volume 24, Number 4, April 2008 , pp. 975-983(9)
Asthma is a major public health problem with considerable economic impact. The highest costs being observed in patients with severe asthma. Furthermore, despite the use of recommended therapies, asthma control can still be poor. Therefore, the objective of this study was to assess the extent of uncontrolled disease and associated medical costs in severe asthma.
Current Opinion in Pulmonary Medicine. 14(3):228-234, May 2008
Pneumocystis pneumonia remains the most prevalent opportunistic infection in patients with AIDS. It is also a common devastating infection in patients with other causes of altered immunity. Though scientific study of this fungal pathogen is challenging given the inability to propagate the organism outside of the host lung, studies utilizing advanced molecular techniques and genomic analysis have broadened our understanding of the epidemiology and pathogenesis of Pneumocystis and will be described herein.
Primary ciliary dyskinesia (PCD) is a rare recessive hereditary disorder characterized by dysmotility to immotility of ciliated and flagellated structures. Its main symptoms are respiratory, caused by defective ciliary beating in the epithelium of the upper airways (nose, bronchi and paranasal sinuses). Impairing the drainage of inhaled microorganisms and particles leads to recurrent infections and pulmonary complications.
Current Opinion in Pulmonary Medicine. 14(3):254-259, May 2008
The role of thoracic surgery in pulmonary tuberculosis, in either a diagnostic or a therapeutic role, is well established. This review aims to underline the current indications for lung resection, surgical strategy and outcomes associated with surgery.
Current Opinion in Pulmonary Medicine. 14(3):235-240, May 2008
Respiratory syncytial virus has increasingly been recognized as a clinically significant cause of respiratory tract infections in adults, especially among the elderly and the immunocompromised.
Current Opinion in Pulmonary Medicine. 14(3):248-253, May 2008
The main purpose of this review is to summarize the current research (2006-2007) concerning the development of novel anticoronaviral strategies and compounds.
Current Opinion in Pulmonary Medicine. 14(3):219-227, May 2008
Pulmonary infection by Nocardia spp. has been recognized for the past 100 years. The number of cases of pulmonary nocardiosis reported in the literature is increasing, and in some cases, a diagnosis is reached even postmortem.
Current Opinion in Pulmonary Medicine. 14(3):260-265, May 2008
Pneumonia and sepsis are major causes of morbidity and mortality. Lung defense against pathogens involves innate and acquired immune responses. In this review, we focus on lung pathogens associated with sepsis and the innate immune response to them. In addition to discussing typical lung pathogens, the structural defenses, antimicrobial particles, complement, and cellular components of the immune response against these pathogens are also explored.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 197-204(8)
Treatment with common household bleach containing hypochlorite destroys dust mites and denatures protein allergens. The purpose of this study was to determine if home use of hypochlorite products results in lowered exposure to bacteria, fungi, and protein allergens and improved quality of life (QOL) for asthmatic persons in the home.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 103-108(6)
The combination of long-acting beta-agonist (LABA) bronchodilators with inhaled corticosteroids (ICSs) has been shown to be an extremely effective treatment for asthma. Use of LABA as monotherapy for asthma is associated with increased adverse events including exacerbations and asthma deaths.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 189-196(8)
Current guidelines for asthma treatment do not recommend daily maintenance therapy in patients with mild intermittent (step 1) asthma. However, because there is increasing evidence that airway inflammation is present even in this patient group, maintenance anti-inflammatory therapy may be considered.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 161-165(5)
Transient wheezing in young children has been reported to be independent of atopy. Although persistence of early wheezing has been associated with factors related to allergy in multiple studies, transient wheezing has not been similarly studied.
llergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 166-170(5)
The prevalence of allergic diseases such as asthma, hay fever, and atopic dermatitis has increased over the past few decades, especially in developed countries. They are characterized by a chronic inflammatory reaction mediated by T helper 2 (Th2) cells. Two common chronic diseases of childhood-an autoimmune disease, type 1 diabetes mellitus (DM), and a chronic viral infection, hepatitis B virus (HBV) carriers-are associated with a Th1-dominant and Th1-insufficient cytokine profile, respectively.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 109-122(14)
Asthma affects 20 million Americans and causes a substantial loss of productivity. Medications help to increase symptom-free days and improve quality of life. Examining the cost-effectiveness of different treatments, in addition to their clinical efficacy, allows us to choose the optimal strategy in managing patients.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 177-181(5)
The burden of asthma is sufficient to warrant its recognition as a high-priority disorder in governmental health strategies in many countries. However, the components of the total health care costs for patients with asthma have not been well studied, and an overall understanding of health care utilization patterns in this population is lacking in Taiwan. We evaluated 95,110 patients aged 18-55 years who were enrolled in the National Health Insurance Research Database from January 1 to December 31, 2002.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 123-129(7)
Beginning in 1916 Harmonia axyridis, an orange/red lady beetle with variable black spotting, was imported into the United States from Asia. This agricultural pest-control predator established independent feral populations in North America by 1988. Subsequently, Harmonia axyridis has become a pest to homeowners and various horticultural enterprises. Seeking winter hibernation sites, ladybug swarms invade human homes/habitats primarily in the fall.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 171-176(6)
The time required for fractional excretion of nitric oxide (FENO) measurements to acutely change after systemic corticosteroids is unknown, limiting the usefulness of this biomarker in hospital treatment and discharge decisions. The purpose of this study was to follow FENO measurements of hospitalized adult patients with asthma receiving therapy and to correlate FENO with forced expiratory volume in 1 second percent predicted (FEV1%). Ten acute asthmatic patients who required hospitalization were recruited and treated with standard therapy.
Although vascular anomalies have been reported to cause extrinsic compression of the trachea leading to respiratory distress, achalasia has been less frequently associated with airway compromise. Here, we report the case of a 56-year-old woman with symptomatic tracheal compression between a megaesophagus and a normal innominate artery. Diagnosis of tracheal obstruction was made by direct visualization with flexible bronchoscopy and confirmed by computed tomography scan imaging.
Transplantation. Workshop on Cancer Risk After Solid Organ Transplantation. 85(8S) Supplement:S69-S71, April 27, 2008
We present here new molecular tools such as gene expression microarrays as promising biomarkers for diagnosis and prognosis in lung cancer as well as for an early diagnosis of malignancy after lung transplantation.
Pleural tuberculosis (TB) remains difficult to diagnose despite numerous diagnostic tools. Recently, in vitro interferon (IFN)-gamma-based assays have been introduced in the diagnosis of latent TB, but these techniques have not been established in the diagnosis of active TB disease, including pleural TB.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 959-969, (2008)
: Nuclear factor (NF)-{kappa}B is a prominent proinflammatory transcription factor that plays a critical role in allergic airway disease. Previous studies demonstrated that inhibition of NF-{kappa}B in airway epithelium causes attenuation of allergic inflammation.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1002-1011, (2008)
Occupational exposure to beryllium (Be) can result in chronic granulomatous inflammation characterized by the presence of Be-specific CD4+ T cells. Studies show that oxidative stress plays a role in the pathogenesis of chronic inflammatory disorders.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 983-988, (2008)
Monocytes are central to the initiation of the inflammatory response in sepsis, with caspase-1 activation playing a key role. Monocyte deactivation during sepsis has been linked to poor outcomes.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 952-958, (2008)
The drug product TPI ASM8 contains two modified phosphorothioate antisense oligonucleotides designed to inhibit allergic inflammation by down-regulating human CCR3 and the common beta chain ({beta}c) of IL-3, IL-5, and granulocyte-macrophage colony-stimulating factor receptors.
Pulmonary venous aneurysms are uncommon. They usually present as mediastinal mass, and little is known about their etiology and pathogenesis. Association with mitral regurgitation has been described. Pulmonary venous aneurysm presenting as a peripheral pulmonary nodule is rare.
Among the nocardial species, Nocardia otitidiscaviarum (formerly Nocardia caviae) as causative agent of pulmonary disease is rarely reported even in immunocompromised individuals. We report 2 renal transplant recipients presenting with pleural effusion and acute respiratory distress syndrome owing to N. otitidiscaviarum. Culture of bronchial washings led to the diagnosis in both the cases and established importance of early bronchoscopy in diagnosing opportunistic pulmonary infections in immunocompromised individuals.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1026-1032, (2008)
The subjective perception of dyspnea, which is an impairing symptom in various cardiopulmonary diseases, consists of sensory (intensity) and affective aspects (unpleasantness). However, little is known about the cortical processing of the perception of dyspnea.
A patient was referred for a focal wheeze on his right chest and blood-tinged sputum for 7 days. After the discontinuation of clopidogrel, flexible bronchoscopy was performed and it showed petechias throughout the airway. We have observed similar changes in other patients on clopidogrel. The "clopidogrel airway" should be recognized by clinicians evaluating patients with cardiovascular disease to better determine the need of additional testing and therapies.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 989-994, (2008)
Although several studies have investigated volume-outcome relationships for surgical procedures, there has been no such study of intensive care unit (ICU) patients admitted for pneumonia.
Allergy and Asthma Proceedings, Volume 29, Number 2, March/April 2008 , pp. 99-102(4)
Childhood asthma poses a number of challenges. In many asthmatic patients, the disease begins in infancy or early childhood and aeroallergen sensitization in the first 3 years of life appears to dictate later outcomes. The airway manifestations of asthma in childhood differ from those in adults and require different therapeutic approaches. Importantly, corticosteroid treatment of childhood asthma appears to have little impact on the progressive loss of lung function in a subset of patients.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1012-1017, (2008)
Between 1948 and 1969, cases of community-acquired chronic beryllium disease (CA-CBD) were reported in neighborhoods surrounding beryllium facilities. Further surveillance was not performed in these communities, and additional cases have not been reported.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1018-1025, (2008)
Growth differentiation factor (GDF)-15 is a cytokine induced in the heart after ischemia or pressure overload. Circulating levels of GDF-15 provide independent prognostic information in patients with acute coronary syndromes or heart failure.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 970-975, (2008)
Symptoms and respiratory function tests may be difficult to assess and interpret in obese patients with asthma, particularly if the asthma is severe. It is unclear whether the dynamic changes that occur during bronchoconstriction differ between obese versus nonobese patients with asthma.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 995-1001, (2008)
Pulmonary infection in cystic fibrosis (CF) is polymicrobial and it is possible that anaerobic bacteria, not detected by routine aerobic culture methods, reside within infected anaerobic airway mucus.
Current Opinion in Pulmonary Medicine. 14(3):168-175, May 2008
Nosocomial infections are common and are associated with considerable morbidity and mortality. The continuing evolution of multidrug resistant pathogens and ineffective therapy for the infections they cause has stimulated interest in the potential of probiotic products to prevent nosocomial infections. Probiotics are viable microorganisms that colonize the host and exert antibacterial and immunomodulatory effects.
Current Opinion in Pulmonary Medicine. 14(3):203-210, May 2008
Pulmonary disease caused by nontuberculous mycobacteria is occurring with greater frequency, and previously unrecognized manifestations of nontuberculous mycobacteria are being identified. Paralleling this increase, improvements in laboratory techniques now allow for more precise identification of nontuberculous mycobacteria and recognition of new species.
Current Opinion in Pulmonary Medicine. 14(3):176-182, May 2008
Respiratory tract infections are a common reason for prescribing antibiotics, although not all of these infections require such therapy. Rapid diagnosis of etiology using point-of-care tests is a potentially useful way of reducing prescriptions of both unnecessary and unnecessarily broad-spectrum antibiotics. This can also lead to the facilitation of appropriate infection control measures to prevent spread of respiratory viruses within institutions.
Current Opinion in Pulmonary Medicine. 14(3):183-194, May 2008
This review provides clinicians with an overview of the clinical features of the atypical pneumonias. Atypical community-acquired pneumonia pathogens cause systemic infections with pneumonia. The key to the clinical diagnosis of atypical pneumonias depends on recognizing the characteristic pattern of extrapulmonary organ involvement different for each pathogen.
Current Opinion in Pulmonary Medicine. 14(3):195-202, May 2008
Infective causes of severe haemoptysis have progressively shifted to causes related to chronic inflammatory lung diseases. Physicians should, however, recognize the most common of them, for example necrotizing parenchymal infections, tuberculosis and mycetoma.
Particularly in small brain biopsies, it might be difficult to distinguish reactive astrogliosis from low-grade or infiltration zones of high-grade astrocytomas.
Lewy bodies (LBs) and Lewy neurites (LNs) are the hallmarks of Parkinson's disease (PD). Although LBs and LNs, frequently coexistent, share some histological properties, their appearances are quite different under conventional two-dimensional observation.
The role of endogenous dopamine in severe Parkinson's disease is often underestimated. We report on a case of acute general motor worsening induced by the ingestion of fluphenazine in a parkinsonian patient successfully treated with STN DBS.
The management of cerebral arteriovenous malformations (AVMs) continues to present a challenge to neurosurgeons. The natural history of this condition, as well as the morbidity and mortality of therapeutic interventions, remains incompletely elucidated.
The Department of Veterans Affairs (VA) Cooperative Studies Program has established a National Registry of Veterans with Amyotrophic Lateral Sclerosis (ALS).
Recent reports of a potentially increased risk of amyotrophic lateral sclerosis (ALS) for veterans deployed to the 1990-1991 Persian Gulf War prompted the Department of Veterans Affairs to establish a National Registry of Veterans with ALS, charged with the goal of enrolling all US veterans with a neurologist-confirmed diagnosis of ALS.
European Journal of Cardiovascular Prevention & Rehabilitation. 15(2):230-233, April 2008
Currently little data exist on the development of quality of life over time in patients suffering from stroke, in particular using instruments that can be adapted in economic studies. The purpose of the study was to assess the utility loss and indirect costs following a stroke in Sweden.
Epileptic Disorders. Volume 10, Number 1, 35-8, march 2008
Auditory aura is a rare symptom in focal epilepsy. It has been described in autosomal dominant partial epilepsy with auditory features, but is, in general, poorly documented. We report on a 7-year-old, right-handed boy, who suffered seizures characterized by positive auditory illusions with verbal and gestural automatisms and noticeable attempts at covering his ears. Clinical evaluation and video-recording of the seizures, confirmed that most of the ictal behavior was deliberately directed at trying to prevent the unpleasant sensations reaching his ears.
Epileptic Disorders. Volume 10, Number 1, 49-52, march 2008
The most frequent precipitants of photic- or pattern-induced seizures are television and discotheque lighting effects. Seizure induction by reflection of bright sunlight on water surfaces has also been reported. We report a patient with seizures induced by the sight of moving water in the absence of bright sunlight.
Epileptic Disorders. Volume 10, Number 1, 22-30, march 2008
Purpose. To study clinical, EEG, neuropsychological and behavioural evolution of three patients presenting with epileptic activity triggered by eye closure (EC) over a mean 10-year follow-up period.
Epileptic Disorders. Volume 10, Number 1, 53-5, march 2008
Absence seizures are one of the features of idiopathic generalised epilepsy (IGE) and occur as component of many different syndromes. They are commonly associated with various clinical features such as mild clonic components, change in postural tone, automatisms and autonomic phenomena. Childhood absence epilepsy (CAE) is the prototype IGE with typical absence seizures. We report a child who had prominent ictal hiccups during an absence seizure, and discuss the possible mechanisms.
Epileptic Disorders. Volume 10, Number 1, 39-44, march 2008
Events of ictal bradycardia or asystole may be of relevance in epilepsy patients presenting with ictal falls, and are a potential contributor to SUDEP. The literature on ictal bradycardia or asystole is anecdotal and consists of case reports and small case series.
Epileptic Disorders. Volume 10, Number 1, 45-8, march 2008
We present the case report of a 13-month-old Caucasian toddler with symptoms of loss of consciousness, central cyanosis and uncontrolled movements of the upper limbs while taking a warm bath. The diagnosis of hot water epilepsy was supported by an ictal EEG. Hot water epilepsy, also known as bathing epilepsy or water-immersion epilepsy is, in the Caucasian population, a rare form of benign epilepsy, where seizures are provoked by immersion in a hot or even just a warm bath. This is the first comprehensive video publication of a seizure provoked by water-immersion in a Caucasian child.
Epileptic Disorders. Volume 10, Number 1, 8-12, march 2008
The substantia nigra pars reticulata (SNR) controls seizures in a sex-specific manner. At postnatal day 15 (P15), SNR infusion of GABA A receptor agonist muscimol have proconvulsant effects in males but not in females. In males, administration of an androgen receptor antagonist flutamide between P0-P2 led to the disappearance of the proconvulsant muscimol effects at P15. Thus, activation of androgen receptors is important for the presence of proconvulsant SNR muscimol responses.
The search for new drugs and treatment approaches is of particular importance for glioblastomas (GBMs), as with other types of malignant gliomas, as they are lethal without the available medical care.
To determine whether multisequence MRI of the brain can show thalamic alterations and establish pathoradiologic correlations in a patient with familial fatal insomnia.
Brain abnormalities in neuromyelitis optica (NMO) attracted much attention. Our study was to identify the brain magnetic resonance imaging (MRI) abnormalities in Chinese NMO patients.
Positron emission tomography with 11C-PiB and magnetic resonance imaging were performed for 2 patients, 49-year-old and 60-year-old siblings with APP locus duplication, with hereditary Alzheimer disease and cerebral amyloid angiopathy.
New insights into the biology of neural stem cells (NSCs) have raised expectations for their use in the treatment of neurologic diseases. Originally, NSC transplantation was proposed as a means of replacing cells in central nervous system diseases that result in cell loss.
A large British kindred (DRC255) with a PGRN mutation was assessed. Affected individuals presented with a mean age of 57.8 years (range, 54-67 years) and a mean disease duration of 6.1 years (range, 2-11 years).
Severe gait disturbances and freezing episodes (frequently resistant to optimal dopaminergic treatment) often appear in advanced Parkinson disease (PD). Even several years after initiation, high-frequency subthalamic nucleus deep brain stimulation (STN-DBS) is still very effective for controlling segmental symptoms. However, there are no long-term data on the management of gait disorders and freezing in STN-DBS.
The natural history of patients with pathologically proven frontotemporal lobar degeneration (FTLD) is important from clinical and biologic perspectives, but is not well documented quantitatively.
Epileptic Disorders. Volume 10, Number 1, 3-7, march 2008
Epilepsia partialis continua (EPC) is a rare form of focal status epilepticus. It may have vascular, immune-mediated, neoplastic or metabolic-toxic causes. The origin of EPC has been linked with the motor cortex. This has been solidly supported by sophisticated electrophysiological studies.
Patients who survive after subarachnoid hemorrhage (SAH) are at risk for a recurrence despite successful treatment of the ruptured aneurysm and may therefore benefit from screening for new aneurysms.
The description of neuroglia by Virchow in 1848 may be considered the starting point of our understanding of primary brain tumors. At the beginning of the 20th century, surgical removal of primary brain tumors became possible, and therefore, tissue for microscopic analysis and clinical data on survival became available.
Cytologic pleomorphism has been described in a limited number of benign pineal tumors, namely pineocytoma (PC) and pineal parenchymal tumors (PPTs) of intermediate differentiation (PPTID).
Most human gliomas are characterized by diffuse infiltrative growth in the brain parenchyma. Partly because of this characteristic growth pattern, gliomas are notorious for their poor response to current therapies. Many animal models for human gliomas, however, do not display this diffuse infiltrative growth pattern.
We report a case of glioblastoma (GBM) occurring 8 years after radiation therapy for a medulloblastoma. A 15-year-old boy underwent surgery and radiotherapy for a medulloblastoma and 8 years later he developed a second tumor at the same site.
Journal of Magnetic Resonance Imaging Volume 27, Issue 4 , Pages 718 - 725
To examine the relationship between apparent diffusion coefficients (ADC) from diffusion weighted imaging (DWI) and choline levels from proton magnetic resonance spectroscopic imaging (MRSI) in newly diagnosed Grade II and IV gliomas within distinct anatomic regions.
Wind turbines are known to produce shadow flicker by interruption of sunlight by the turbine blades. Known parameters of the seizure provoking effect of flicker, i.e., contrast, frequency, mark-space ratio, retinal area stimulated and percentage of visual cortex involved were applied to wind turbine features.
As reported by several authors, angiotensin II (AngII) is a proinflammatory molecule that stimulates the release of inflammatory cytokines and activates nuclear factor kB (NFkB), being also associated with the increase of cellular oxidative stress.
PDE4D was identified as the first novel gene associated with ischemic stroke risk. Replication studies have produced conflicting results, but many have been small and underpowered. Meta-analysis provides a method to combine this data and determine in a larger sample size whether the association with PDE4D can be replicated.
To determine whether neurophysiological effects of levetiracetam (LEV) outlast its serum half-life of approximately 7 h. Demonstration of prolonged effects would help to explain the efficacy of LEV at conventional dosing intervals that are longer than the serum half-life.
Diabetes and hypertension impart approximately the same increased relative risk for stroke, although hypertension has a larger population-attributable risk because of its higher population prevalence.
To determine the effects of high-frequency electrical stimulation on electrographic seizure activity during and after stimulation (ON-effect and OFF-effect).
Although no randomized studies have demonstrated a positive impact of therapeutic drug monitoring (TDM) on clinical outcome in epilepsy, evidence from nonrandomized studies and everyday clinical experience does indicate that measuring serum concentrations of old and new generation antiepileptic drugs (AEDs) can have a valuable role in guiding patient management provided that concentrations are measured with a clear indication and are interpreted critically, taking into account the whole clinical context.
Cerebral vasospasm continues to be a major cause of poor outcome in patients with ruptured aneurysms. Prophylactic Transluminal Balloon Angioplasty (pTBA) appeared to prevent delayed ischemic neurological deficit in a pilot study. A phase II multicenter randomized clinical trial was subsequently designed.
Cochrane Database of Systematic Reviews 2008 Issue 2
Dopamine agonists are being used increasingly as first line treatment for Parkinson's disease, but there remains uncertainty about their clinical and cost-effectiveness relative to levodopa.
The management of stroke in rural and regional areas is variable in both the developed and developing world. Informed by best-practice guidelines and recommendations for systems of stroke care, adaptable models of care that are appropriate for local needs should be devised for rural and regional settings.
Dural arteriovenous shunts with cortical venous reflux or drainage may cause neurological symptoms and death with or without intracranial hemorrhage. Present knowledge about the natural history of these lesions is limited, however. We investigated the incidences of intracranial hemorrhage, progressive dementia syndrome, and death in patients diagnosed in our neurovascular center.
Central retinal artery occlusion results in acute visual loss with poor spontaneous recovery. Current standard therapies do not alter the natural history of disease. Several open-label clinical studies using continuous infusion of thrombolytic agents have suggested that local intraarterial fibrinolysis (LIF) is efficacious in the treatment of central retinal artery occlusion.
Intracranial angioplasty and stenting are therapeutic options for patients with symptomatic intracranial arterial stenoses intractable to medical therapy. However, the long-term safety and clinical efficacy of these techniques are unknown. We sought to assess the long-term outcome and efficacy of these techniques.
There is a well-described association between the occurrence of developmental tumors and the presence of cortical dysplasia in the neighboring brain tissue. The main surgical approaches in the treatment of medically refractory epilepsy related to such developmental tumors include a lesionectomy versus a tailored cortical resection, often guided by an invasive evaluation.
To use Diffusion Tensor Imaging (DTI) to explore structural integrity and connectivity of the uncinate fasciculus (UF) in patients with temporal lobe epilepsy (TLE) and its relationship to memory performance.
Hypothalamic hamartomas (HHs), rare developmental abnormalities of the inferior hypothalamus, often cause refractory, symptomatic, mixed epilepsy, including gelastic seizures. We present 37 patients with HH who underwent transcortical transventricular endoscopic resection.
Measurement of sympathetic effector organ responses to selective activation of muscle and skin nociceptors below lesion in spinal cord-injured (SCI) subjects.
The relationship between stroke risk and cognitive function has not previously been examined in a large community living sample other than the Framingham cohort. The objective of this study was to examine the relationship between 10-year risk for incident stroke and cognitive function in a large population-based sample.
Birth Defects Research Part C: Embryo Today: Reviews Volume 84, Issue 1 , Pages 54 - 60
Exposure to environmental tobacco smoke (ETS) during fetal development and early postnatal life is perhaps the most ubiquitous and hazardous of children's environmental exposures. The developing lung is highly susceptible to ETS.
Cochrane Database of Systematic Reviews 2008 Issue 2
The measurement of severity and control of asthma in both children and adults can be based on subjective or objective measures. It has been advocated that fractional exhaled nitric oxide (FeNO) can be used to monitor airway inflammation as it correlates with some markers of asthma. Interventions for asthma therapies have been traditionally based on symptoms and/or spirometry.
Cochrane Database of Systematic Reviews, Issue 2, 2008
Pneumonia is the leading cause of mortality in children under five years of age. Treatment of pneumonia requires an effective antibiotic used in adequate doses for an appropriate duration. Recommended duration of treatment ranges between 7 and 14 days, but this is not based on any empirical evidence.
To report a case where combined whole-body Fluorine-18 fluorodeoxyglucose (FDG) PET-CT scanning was used to aid in the diagnosis of a patient with occult sarcoidosis.
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are important causes of morbidity and mortality, with mortality rates approaching 62%. HAP and VAP are the second most common cause of nosocomial infection overall, but are the most common cause documented in the intensive care unit setting.
Necrotizing fasciitis due to Streptococcus pneumoniae is a rare and grave condition, and only a few cases have been reported. Suggested risk factors include minor trauma, systemic lupus erythematosus, immunosuppression secondary to medication, use of intramuscular anti-inflammatories and alcoholism.
Cochrane Database of Systematic Reviews, Issue 2, 2008
In the late 1960's and 1970's, pulmonary hemorrhage (PH) occurred mainly in full term infants with severe pre-existing illness. The incidence of PH was quoted as 1.3 per 1,000 live births. In the older medical literature, the risk factors associated with PH included the severity of the associated illness, intrauterine growth restriction, patent ductus arteriosus (PDA), coagulopathy, and the need for assisted ventilation.
Cochrane Database of Systematic Reviews 2008 Issue 2
Inhaled corticosteroids (ICS) are an integral part of asthma management, and act as an anti-inflammatory agent in the airways of the lung. These agents confer both significant benefit in terms of symptom management and improvement in lung function, but may also cause harm in terms of local and systemic side-effects. Ciclesonide is a novel steroid that is metabolised to its active component in the lung, making it a potentially useful for reducing local side effects.
A 77-year-old man experienced sudden onset of dysphagia. An MRI revealed a left lateral medullary infarction. Portable polysomnography showed Cheyne-Stokes-like breathing with marked desaturation (lowest SaO2 74%) associated with apnoea.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 532-540, 2008
Combustion-generated radicals interact to form polynuclear aromatic hydrocarbons (PAHs), including carcinogens. PAHs aggregate into 20- to 50-nm particles, which extend into branched-chain structures (soots). Incomplete combustion yields black soot particles and black smoke. Many PAHs, including those in soots, fluoresce upon excitation.
A cost analysis of nocturnal non-invasive ventilation (NNV) in stable chronic obstructive pulmonary disease (COPD) patients would be helpful in decision making, when the balance between the increased demand and the availability of resources should be checked.
The beta2-adrenergic receptor (beta2AR) is a primary target for medications used to treat asthma. Due to the low abundance of beta2AR, very few studies have reported its localization in tissues.
Indian Journal of Radiology and Imaging Year : 2008 Volume : 18 Issue : 2 Page : 124-125
Left pulmonary artery sling (LPAS) is a rare vascular anomaly in which the left pulmonary artery (LPA) arises from the right pulmonary artery (RPA) and enters the left hilum after passing between the trachea and the esophagus; it can cause respiratory distress.
Bronchial artery aneurysm is a rare entity, detected in less than 1% of all patients undergoing selective bronchial arteriograms. Approximately 50 cases have been reported so far. Computed tomography (CT) reports of mediastinal bronchial artery aneurysms are rare. We report a case of a bronchial artery aneurysm in an 84-year-old male patient, which had been misdiagnosed as lung cancer for 6 years.
Pediatric Allergy and Immunology, Volume 19, Number 3, May 2008 , pp. 227-232(6)
The aim of this study was to investigate repeatability of cysteinyl-leukotrienes (cys-LT) measurements in nasal lavage fluid (NLF) and to determine if cys-LT levels in NLF are related to asthma severity in children.
Recently, the dual-side readout technique has been introduced in computed radiography, leading to an increase in detective quantum efficiency (DQE) compared with the single-side readout technique.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 5, Issue 2 April 2008 , pages 105 - 116
This study reports the costs associated with rehabilitation among participants in the National Emphysema Treatment Trial (NETT), and evaluates factors associated with adherence to rehabilitation.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 5, Issue 2 April 2008 , pages 75 - 84
Peripheral muscle wasting is a feature of chronic obstructive pulmonary disease (COPD). Potent therapeutic strategies are needed to improve peripheral muscle mass in these patients.
The Clinical Respiratory Journal Volume 2 Issue 2 Page 98-105, April 2008
Despite efforts to improve the management of asthma worldwide, few options exist for evaluating the specific needs or the success of these activities in a manner free from bias.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 5, Issue 2 April 2008 , pages 97 - 104
A beneficial effect of long-term corticosteroid treatment in patients with COPD may be linked to suppressing inflammation, in particular neutrophilic inflammation.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 5, Issue 2 April 2008 , pages 117 - 124
Six-minute walk testing (6MWT) and cardiopulmonary exercise testing (CPX) are used to evaluate impairment in emphysema. However, the extent of impairment in these tests as well as the correlation of these tests with each other and lung function in advanced emphysema is not well characterized.
American Journal of the Medical Sciences. 335(4):260-265, April 2008
During the last 3 decades, asthma prevalence and morbidity in the United States have dramatically increased. The impact of this chronic respiratory disease has been disproportionately high among inner city residents, particularly lower socioeconomic groups, ethnic minorities, and children.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 5, Issue 2 April 2008 , pages 125 - 131
Chronic obstructive pulmonary disease (COPD) is a highly prevalent condition that has frequent morbidity and mortality, with associated costs of US $ 2.5 billion annually and nearly 14,000 deaths each year. In the most advanced stages it causes debilitating breathlessness which is not improved despite maximal medical therapy including smoking cessation, bronchodilators, steroids and supplemental oxygen.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 5, Issue 2 April 2008 , pages 133 - 138
Chronic obstructive pulmonary disease (COPD) represents an important and increasing burden throughout the world. Classically, COPD has been considered a respiratory condition only, mainly caused by tobacco smoking. However, COPD has important manifestations beyond the lungs, the so-called systemic effects.
International Journal of Surgical Pathology, Vol. 16, No. 2, 230-232 (2008)
The gross and microscopic findings from 2 fatal cases of plastic bronchitis (PB) in children, a rare entity characterized by the formation of large mucous casts in the bronchial tree, are presented.
Our aim was to describe the incidence, clinical characteristics and outcome of community acquired pneumonia (CAP) caused by Escherichia coli through the analysis of a cohort of patients with this condition.
Nuclear factor kB (NF-kB) overactivation plays a crucial role in T-helper 2 (Th2)-biased allergic airway inflammation by increased activation and decreased apoptosis of CD4+ T cells.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 591-599, 2008
Particulate matter air pollution (PM) has been linked with chronic respiratory diseases. Real-life exposures are likely to involve a mixture of chemical and microbial stimuli, yet little attention has been paid to the potential interactions between PM components (e.g., Ni) and microbial agents on the development of inflammatory-like conditions in the lung.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 609-617, 2008
The acute phase reactant and protease inhibitor {alpha}1-antichymotrypsin is considered to play a protective role in the airways, but whether it interacts with respiratory bacteria is not known.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 600-608, 2008
Mast cells are central in the development of several allergic diseases and contain a number of pre-formed mediators. {beta}-tryptase, the most abundant mast cell product, is increasingly recognized as a key inflammatory mediator, as it causes the release of cytokines, particularly the chemokine IL-8, from both inflammatory and structural cells.
NEJM Volume 358:1682-1691 April 17, 2008 Number 16
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.
Journal of Thoracic Oncology. 3(4):380-385, April 2008
Treatment options are limited in patients with advanced or refractory non-small cell lung cancer and lead to suboptimal outcome and/or benefit. The epidermal growth factor tyrosine kinase inhibitor gefitinib (IRESSA) has been approved in many countries. Increased responsiveness to gefitinib has been demonstrated in particular subsets of patients, for example never smokers and patients of Asian origin.
There is strong controversy as to whether to use filters temporarily in the inferior vena cava (IVC) during endovascular therapies for deep venous thrombosis (DVT) in the lower extremity.
Cochrane Database of Systematic Reviews 2008 Issue 2
Strong evidence supports the use of metered-dose inhalers combined with a spacer for delivering rapid-acting inhaled beta-2 agonists in the treatment of acute exacerbations of asthma in children. The high cost and lack of availability of commercially produced spacers however, have limited their use in developing countries.
Indirect evidence implicates endothelial dysfunction in the pathogenesis of vascular diseases associated with obstructive sleep apnea (OSA). We investigated directly whether dysfunction and inflammation occur in vivo in the vascular endothelium of patients with OSA. The effects of continuous positive airway pressure (CPAP) therapy on endothelial function and repair capacity were assessed.
Significant advances in the treatment of pulmonary arterial hypertension (PAH) have occurred over the last 10 years, starting with the approval of epoprostenol in 1998. Subsequently, multiple additional medications have received approval, including a subcutaneous prostacyclin, an inhaled prostacyclin, and oral medications in 2 separate classes.
The high prevalence of cigarette smoking in patients with respiratory disease puts them at risk of developing clinically important drug interactions. Cigarette smoking reduces the therapeutic response to certain drugs such as theophyllines through the induction of hepatic cytochrome P450 isoenzymes.
A subset of patients with chronic obstructive pulmonary disease (COPD) may respond more favorably to inhaled corticosteroids (ICS), but no simple method is currently utilized to predict the presence or absence of ICS responses in patients with COPD.
The syndrome of pulmonary hypertension (PHT) in end-stage renal disease (ESRD) has been described in patients on chronic hemodialysis (HD) therapy via arterial-venous (A-V) access. However, the exact timing for the development of the PHT is unknown. This study was designed to evaluate changes in pulmonary artery pressure (PAP) following creation of the vascular access.
Concerns have been raised regarding the safety of extended use of long-acting {beta}2-agonists
(LABAs). The safety of arformoterol (50 µg QD), and salmeterol (42 µg BID), was assessed over 12 months in subjects with
COPD. The study also examined the occurrence of tolerance with these agents, i.e. whether improvement in airway function diminished or frequency of exacerbations increased with 12-months of use.
Idiopathic pulmonary "brosis (IPF) is the most frequent idiopathic interstitial pneumonia with a prevalence ranging from 5 to 15 per 100,000 persons, and above 175 per 100,000 in the older population. IPF is a relentlessly progressive "brotic lung disorder leading to death within a median duration of 3 years.
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