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We report here a successful case of balloon angioplasty for a stenosis of the pulmonary artery after lung transplantation. A 49-year-old patient with end stage diffuse bronchiectasis with sinusitis underwent bilateral living donor lobar lung transplantation.
Our thoracic surgical team developed a set of patient-centered quality of care measures specific to patients undergoing pulmonary resection. Measures were chosen that demonstrated evidence-based preoperative assessment, adequate mediastinal staging, and interventions to prevent and expeditiously treat postoperative morbidity. Medical records of all patients undergoing pulmonary resection in 2005 were analyzed.
Primary pleomorphic adenoma of the lung is a rare occurrence. Clinical suspicion is normally low due to its rarity. We describe a case of a primary pleomorphic adenoma arising from the origin of the right main bronchus and include our management strategy.
Supplemental oxygenation is important in reversible pulmonary failure. To determine whether the peritoneal cavity can be used as a source of "extrapulmonary respiration," we perfused the peritoneal cavity with oxygenated red blood cells (RBCs) and saline, and measured the amount of oxygenation delivered through the peritoneum of dogs under controlled ventilation.
Pulmonary resections after pneumonectomy due to metastases or metachronous non-small cell lung cancer (NSCLC) are rare because of the high potential risk of the second procedure and uncertain long-term results.
Inhaled medication administered via a metered dose inhaler (MDI) is often used to treat asthma. Hydrofluoroalkane (HFA) has replaced chlorofluorocarbons (CFC) as the propellant and these new MDI may contain alcohol.
Pulmonary resection may cause inflammatory changes with subsequent injury to the remaining lung and deterioration in respiratory function. This study investigated the pattern of serum inflammatory markers and exhaled breath condensate (EBC) in patients undergoing major lung resection due to bronchial carcinoma compared with minimally invasive thoracic surgery.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200711-1731OC
Grain workers report adverse respiratory symptoms, due to exposures to grain dust and endotoxin. Studies have shown that biomarkers in exhaled breath condensate (EBC) vary with the severity of airway inflammation.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200804-595SO
Sphingolipids such as sphingosine-1-phosphate (S1P), ceramide or sphingomyelin are essential constituents of plasma membranes and regulate many (patho)physiological cellular responses inducing apoptosis and cell survival, vascular permeability, mast cell activation and airway smooth muscle functions.
The indication for chest physical therapy as an adjunct to the treatment of children hospitalised with acute pneumonia remains controversial and there is a lack of robust scientific evidence for the effectiveness of this modality in these patients.
Both unilateral and bilateral lung transplantation in chronic obstructive pulmonary disease (COPD) can improve pulmonary function, exercise capacity and quality of life; however, whether lung transplantation actually improves survival is debated.
Doctors can be pessimistic-especially when making a prognosis-and this in turn may influence clinical decisions. This study looked at the accuracy of the predicted outcome in patients with chronic obstructive pulmonary disease (COPD) and asthma with regard to admission to the intensive care unit (ITU).
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.
A Th1 predominant immune response has been shown in acute hypersensitivity pneumonitis. Predominance of Th2 appears to favour the development of pulmonary fibrosis through the profibrotic process and has been described as crucial in the progression of idiopathic pulmonary fibrosis.
The non-proportional Venn diagram explaining the components of chronic obstructive pulmonary disease (COPD) has been a graphical "COPD evergreen" along the Fletcher-Peto curve ever since it was proposed by Snider.
Chronic obstructive pulmonary disease (COPD) encompasses a group of disorders characterised by the presence of incompletely reversible airflow obstruction with overlapping subsets of different phenotypes including chronic bronchitis, emphysema or asthma.
The incremental shuttle walking test (ISWT) is used to assess exercise capacity in patients with 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 for the ISWT.
Pediatric Allergy and Immunology, Volume 19, Number 6, September 2008 , pp. 490-496(7)
Epidemiological evidence for an effect of breastfeeding on asthma continues to be inconclusive. The present prospective study examined the relationship between breastfeeding and the risk of wheeze and asthma in Japanese infants.
Journal of Clinical Microbiology, August 2008, p. 2774-2777, Vol. 46, No. 8
Herbaspirillum species are not known to be human pathogens. We report on the identification of Herbaspirillum from cultures from 28 persons with cystic fibrosis (CF). Most isolates were initially identified as members of the Burkholderia cepacia complex.
There are no data describing how very preterm infants breathe spontaneously immediately after birth. We studied a convenience sample of spontaneously breathing infants <=32 wk' gestation treated with facemask continuous positive airway pressure at birth.
Journal of Clinical Microbiology, August 2008, p. 2535-2546, Vol. 46, No. 8
The accurate and rapid identification of bacteria isolated from the respiratory tract of patients with cystic fibrosis (CF) is critical in epidemiological studies, during intrahospital outbreaks, for patient treatment, and for determination of therapeutic options.
Journal of Thoracic Imaging. 23(3):216-226, August 2008
Although there has been an increasing interest in diagnosing cardiac and pericardial diseases using electrocardiogram-gated cardiac computed tomography (CT), radiologists tend to neglect or overlook many incidentally detected abnormalities on conventional, nongated chest CT.
Allergy and Asthma Proceedings, Volume 29, Number 4, July/August 2008 , pp. 365-370(6)
Bronchial thermoplasty (BT) is a novel experimental procedure involving the application of controlled heat from a radiofrequency source to the airway wall as a means to reduce airway smooth muscle in the airway wall.
Cardiovascular Engineering Volume 8, Number 1 / March, 2008 30-41
There is ample evidence to support the notion that chronic exposure to repetitive episodes of interrupted breathing during sleep can lead to systemic hypertension, heart failure, myocardial infarction and stroke.
Journal of Thoracic Imaging. 23(3):178-181, August 2008
Thymic hyperplasia occurs in a small proportion of patients receiving chemotherapy for various malignancies. It likely results from an immunologic rebound phenomenon. Fluorodeoxyglucose positron emission tomography-computed tomography is an important tool for staging malignant neoplasms.
Journal of Thoracic Imaging. 23(3):194-196, August 2008
A 65-year-old man with neurofibromatosis type 1 (NF-1) presented with a 3-month history of dyspnea and cough. The chest spiral computed tomography scan showed multiple neurofibromas in the larynx and tracheobronchial tree.
Journal of Thoracic Imaging. 23(3):197-201, August 2008
Mycotic pulmonary artery aneurysms are rare but potentially fatal complications of infective endocarditis. Three mycotic aneurysms developed in a 22-year-old female patient who had a history of intravenous drug use.
Journal of Thoracic Imaging. 23(3):191-193, August 2008
We report a case of a patient with inflammatory myofibroblastic tumor of the lung, which recurred after steroid treatment. The diagnosis of the tumor was confirmed by a core needle lung biopsy and pathology.
Journal of Thoracic Imaging. 23(3):188-190, August 2008
A 61-year-old woman presented with dyspnea and intense cough. Chest radiography showed opacity of the entire left hemithorax and computed tomography of the chest confirmed a solid heterogeneous mass extending from apex to base, with foci of calcification and areas of low attenuation.
Journal of Clinical Microbiology, August 2008, p. 2790-2793, Vol. 46, No. 8
Organisms within the Mycobacterium avium complex (MAC) may have differential virulence. We compared 33 subjects with MAC pulmonary disease to 75 subjects with a single positive culture without disease.
The advantages and limitations of MRI in lung infections in children have not been well established. This article illustrates the MRI findings in children with pneumonia caused by Mycoplasma pneumoniae, Streptococcus pneumoniae, and other pathogens.
Pediatric Pulmonology Published Online: 26 Aug 2008
An 8-week-old preterm boy experienced respiratory deterioration due to unilateral pleural effusion. Intra-abdominal extravasation of parenteral fluid with leakage into the pleural cavity was suspected based on biochemical analysis of the effluent.
Th1 cells are implicated in numerous pulmonary inflammatory disorders, and adoptive transfer of alloreactive Th1 cells mediates lung injury and inflammation in mice. In response to Th1-mediated immune injury, CXCR3 ligands IP10 and MIG are markedly induced. Because Th1 cells express high levels of CXCR3, their recruitment and activity may be influenced by CXCR3 ligands.
In a previous study, the authors reported the development of an optimized model bilayer of endothelium with alveolar epithelium using A549 cells, and that neutrophil transendothelial migration across endotoxin (lipopolysaccharide [LPS])-activated endothelial cells was attenuated by the apposition of the epithelium.
Journal of Pediatric Orthopaedics. 28(6):665-668, September 2008
Pediatric patients with congenital thoracic scoliosis often have restrictive lung disease and low body weight for age. In other patients with respiratory disorders, the work of breathing can increase basal metabolic demands and predispose patients to cachexia.
Canadian Respiratory Journal July/August 2008, Volume 15 Issue 5: 237-239
Burkholderia pseudomallei is a pathogen identified with increasing frequency in the respiratory tracts of cystic fibrosis (CF) patients from endemic areas such as Southeast Asia and northern Australia. The following report describes the first known reported case in a CF patient from the Caribbean attending a North American CF clinic.
Nursing in Critical Care Volume 13 Issue 5, Pages 260 - 268
To discuss the development of the LoTrachTM system in light of current evidence around the prevention of ventilator-associated pneumonia (VAP) and its practical application in the intensive care setting.
Nursing in Critical Care Volume 13 Issue 5, Pages 241 - 248
Ventilator-associated pneumonia (VAP) has been identified as the most common nosocomial infection in intensive care units (ICUs) with associated health and financial costs. To date, more research has been carried out in adult ICUs than in paediatric units, thus prompting a review and investigation of the implications for paediatric practice.
Early nasal continuous positive airway pressure (nCPAP) or early surfactant therapy with early extubation onto nCPAP rather than continued mechanical ventilation has been adopted by many centres, particularly in Scandinavia, as part of the treatment of newborns with respiratory distress syndrome.
While sarcoidosis generally inflicts a greater morbidity on African-American compared with Caucasian patients, no studies have examined whether racial differences exist in the intensity of the histologic hallmark of sarcoidosis, noncaseating granulomas.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200711-1731OC
Grain workers report adverse respiratory symptoms, due to exposures to grain dust and endotoxin. Studies have shown that biomarkers in exhaled breath condensate (EBC) vary with the severity of airway inflammation.
American Journal of Industrial Medicine Published Online: 22 Aug 2008
Fish processing is a common economic activity in Southern Africa. The aim of this study was to determine the prevalence and host determinants of allergic symptoms, allergic sensitization, bronchial hyper-responsiveness and asthma among workers processing saltwater fish.
Journal of Research in Medical Sciences, Vol 13, No 4 (2008)
The intensivist should be avoided over or under sedation in mechanically ventilated patients. There are controversies in validity of bispectral index (BIS) in the management of intensive care unit (ICU) patients.
Annals of Tropical Paediatrics: International Child Health, Volume 28, Number 3, September 2008 , pp. 199-203(5)
The incidence of meconium aspiration syndrome (MAS), associated perinatal factors, morbidity and deaths varies widely. This study aimed to assess the perinatal attributes and morbidity associated with MAS.
Journal of Clinical Microbiology, July 2008, p. 2414-2417, Vol. 46, No. 7
In this prospective study we compared the use of pernasal flocked swab samples with the use of nasopharyngeal aspirate (NPA) samples for the detection of respiratory viruses from 455 children less than 5 years of age.
Clinical Nuclear Medicine. 33(9):635-637, September 2008
Antiangiogenic treatment is a new method for molecular-targeted therapy for solid tumors. In a 54-year-old man with stage IV lung adenocarcinoma, the success and limitations of antiangiogenic treatment were visually demonstrated by serial F-18 FDG PET scans on a Siemens ECAT EXACT HR+ system.
Pediatric Allergy and Immunology, Volume 19, Number 6, September 2008 , pp. 482-489(8)
Environmental exposures during early life have been suggested to have the greatest impact on childhood asthma. Our aim was to evaluate the risk factors associated with asthma at age 7-yr in a high-risk cohort that participated in a randomized controlled study on the primary prevention of asthma.
Clinical Endocrinology, Volume 69, Number 3, September 2008 , pp. 374-381(8)
Cystic fibrosis (CF) patients have chronic pancreatic insufficiency leading to malabsorption of fat-soluble vitamins, including vitamin D which can contribute to poor skeletal health and respiratory function.
Pediatric Emergency Care. 24(8):505-510, August 2008
Cross-sectional study of subjects from a prospectively enrolled cohort of children aged 0 to 18 years with physician-diagnosed asthma in the ED Allies Tracking System. Demographics and data on quality of life, health care utilization, environmental factors, chronic asthma severity, and ED management were collected. Emergency department revisits for acute asthma within 7 days of a prior visit resulting in discharge were compared with those without a revisit, using [chi]2 and t tests and logistic regression.
VACTERL association is an acronym made of associated defects including vertebral anomalies, anal atresia, cardiac, tracheal-esophageal fistula, and renal/radial limb anomalies. Tracheal bronchus is a condition characterized by ectopic location of the right upper lobe bronchus at the mid to distal trachea.
Canadian Respiratory Journal July/August 2008, Volume 15 Issue 5: 263-269
The aims of the present study were to estimate the prevalence of second-hand smoke exposure in Canada, to identify sociodemographic risk factors for second-hand smoke exposure, and to examine the relationship between second-hand smoke exposure and respiratory and cardiovascular diseases.
The aim of the present prospective multicenter cohort study was to examine the prevalence of sleep disturbance and its relation to the patient's reported health-related quality of life after intensive care. We also assessed the possible underlying causes of sleep disturbance, including factors related to the critical illness.
Pediatric Allergy and Immunology, Volume 19, Number 6, September 2008 , pp. 541-543(3)
The association between high birth weight and asthma has been suggested. The Northern Finland Birth Cohort 1986, a longitudinal cohort originally including 9479 participants, has been followed up since birth until the age of 16yr.
Despite the widespread use of airway clearance (AC) techniques to clear excessive secretions and improve lung function, little is known about their efficacy following lung transplantation (LTx). This study compared the effects of two AC strategies (proactive vs reactive) on a range of clinical outcomes following LTx.
Sarcoidosis is a systemic granulomatous disorder of unknown aetiology involving multiple organs and often associated with non-granulomatous microangiopathic lesions in various organs. Increased angiogenesis-inducing ability of activated alveolar macrophages was found in bronchoalveolar specimens from patients with pulmonary sarcoidosis and from patients with extrapulmonary involvement.
Canadian Respiratory Journal July/August 2008, Volume 15 Issue 5: 259-262
Inhaled tobramycin has been shown to improve lung function in cystic fibrosis (CF) patients chronically infected with Pseudomonas aeruginosa. However, to date no comparative data are available for different dose regimens used in clinical practice.
Journal of Digital Imaging 0897-1889 (Print) 10.1007/s10278-008-9147-7
The motivation is to introduce new shape features and optimize the classifier to improve performance of differentiating obstructive lung diseases, based on high-resolution computerized tomography (HRCT) images.
Epoxy resins (ERs) are used in paints and other protective coatings, including flooring materials. Bisphenol A diglycidyl ether (BADGE) ERs (BADGE ERs) account for about 75% of the ERs used world-wide.
PEDIATRICS Vol. 122 No. 2 August 2008, pp. e402-e410
Upper respiratory tract infections are the most common childhood illness. Panax quinquefolius (American ginseng root extract) standardized to contain 80% poly-furanosyl-pyranosyl-saccharides is purported to be effective in adult upper respiratory tract infection but has not been evaluated yet in a pediatric population.
In this rare case a non-immunocompromised patient with old Tuberculosis on low dose of steroids presents with oppurtunistic infection of a weakly aerobic gram positive acid fast, filamentous bacteria called Nocardia.
Health and Quality of Life Outcomes 2008, 6:65doi:10.1186/1477-7525-6-6
Pulmonary Hypertension is a severe and incurable disease with poor prognosis. A suite of new disease-specific measures - the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) - was recently developed for use in this condition. The purpose of this study was to develop and validate a preference based measure from the CAMPHOR that could be used in cost-utility analyses.
Bronchial asthma and allergic rhinitis often co-exist, and rhinitis is a major risk factor for the development of asthma. However, the reported incidence of allergic rhinitis in asthmatic children varies widely.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1835OC
Sepsis is an archetypal condition with molecular links between inflammation and coagulation. Both events can be orchestrated by the interaction between circulating and vascular cells that under activation release microparticles.
Canadian Respiratory Journal July/August 2008, Volume 15 Issue 5: 255-258
Empyema complicates tube thoracostomy following trauma in up to 10% of cases. Studies of potential risk factors of empyema have included use of antibiotics, site of injury and technique of chest tube placement. Residual fluid has also been cited as a risk factor for empyema, although the imaging technique to identify this varies.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200801-145OC
Frequent COPD exacerbations are a major cause of hospital admission and mortality and are associated with increased airway inflammation. Macrolides have airway anti-inflammatory actions and may reduce the incidence of COPD exacerbations.
Respiratory Research 2008 9:63doi:10.1186/1465-9921-9-63
To our knowledge, no studies of the possible association of early life environment with snoring in adulthood have been published. We aimed to investigate whether early life environment is associated with snoring later in life.
American Journal of Industrial Medicine Published Online: 13 Aug 2008
We studied the relationship between behaviors promoted through the US Environmental Protection Agency Worker Protection Standard (WPS) and other programs and agricultural pesticide exposures in 73 strawberry fieldworkers employed in Monterey County, California.
Secretory leukoproteinase inhibitor (SLPI) is an important inhibitor of neutrophil elastase (NE), a proteinase implicated in the pathogenesis of lung diseases such as COPD. SLPI also has antimicrobial and anti-inflammatory properties, but the concentration of SLPI in lung secretions in COPD varies inversely with infection and the concentration of NE.
Journal of Cardiovascular Electrophysiology Published Online: 26 Mar 2008
Obstructive sleep apnea (OSA) is a sleep-related breathing disorder with important cardiovascular consequences, including arrhythmogenesis. The unique pathophysiology of OSA results in multiple intermediate mechanisms that may promote atrial fibrillation, ventricular arrhythmias, and sudden cardiac death.
The lung is divided into two major compartments: the alveolar space and the parenchyma. The alveolar macrophages are the first line of leukocytes in the lung taking up incoming microbes or microbial antigens whereas the parenchymal dendritic cells (DCs) are believed to be the sole potent antigen presenting cells (APCs) in the lung.
The Clinical Respiratory Journal Published Online: 28 Jun 2008
We describe a new case in a 73 year-old man. As the patient was obese, complained of snoring and was treated for hypertension, we looked for a morbid association with an obstructive sleep apnea syndrome (OSAS).
Invasive pulmonary aspergillosis (IPA) is a rapid, progressive, fatal disease that occurs mostly in immunocompromised patients. Patients with severe liver disease are at a heightened risk for infections. Little is known about the clinical presentation including predisposing factors and treatment of IPA in patients with hepatic failure.
Based on the results of a multicentre collaborative survey of hospital-acquired pneumonia (HAP) conducted in Japan, the severity rating and classification of pneumonia in the Japanese Respiratory Society guidelines for management of HAP were examined.
Pediatric Pulmonology Published Online: 13 Aug 2008
Acute lung injury (ALI), including its most serious form called acute respiratory distress syndrome (ARDS), is a devastating disease that can occur at any age. ALI/ARDS accounts for only 5-8% of admissions to pediatric intensive care units (PICUs) but is fatal in 30-60% of cases.
The Clinical Respiratory Journal Published Online: 16 Apr 2008
Some patients cannot perform forced vital capacity (FVC). We conducted a study to answer three questions: Can the ability to perform components of spirometry be predicted by the Mini Mental State Examination (MMSE)? What proportion of subjects can perform forced expiratory volume in 3 s (FEV3) but not FVC? Does the forced expiratory volume in 1 s (FEV1)/FEV3 ratio concord with FEV1/FVC ratio in patients with airflow obstruction?
It has been suggested that pulmonary embolism (PE) is an under-recognized cause of pleural effusion. This study aimed to (i) establish the incidence and clinical relevance of pleural effusion in patients with pulmonary emboli; and (ii) determine if there is a relationship between development of pleural effusions and the location of emboli and number of pulmonary arteries involved.
We present the case of a 70 year-old man with carbon monoxide poisoning following a house fire. A significant smoking history and likely underlying chronic lung pathology complicated treatment, as due to symptomatic retention of carbon dioxide we were unable to use high-flow oxygen to facilitate the elimination of carbon monoxide.
Niemann-Pick disease is a rare inherited autosomal recessive disorder, currently classified into six subtypes and characterized by the intracellular accumulation of sphingomyelin in the liver, spleen, lungs, bone marrow or brain.
This report describes a case of isolated congenital spleen agenesis complicated by chronic thromboembolic pulmonary hypertension (CTPH) in a 44-year-old female patient. The patient had increasing exertional dyspnoea and thrombocytosis.
Cytotoxic T-lymphocyte antigen 4 (CTLA-4) signalling of regulatory T cells regulates mucosal lymphocyte tolerance and differentiation, and may therefore have a beneficial effect in allergic diseases such as asthma.
Fistula formation between the bronchi and peritoneal cavity is extremely rare. In previous reports, fistulas have occurred secondary to thoraco-abdominal trauma, subphrenic abscess, suppurative biliary tract obstruction, malignancy and iatrogenically through procedures such as biliary surgery or percutaneous biliary drainage.
The pattern and the degree of mechanical stimuli may determine cellular responses, but little is known about how low magnitude stimuli are converted into biochemical signals in alveolar epithelial cells (AEC).
Journal of Internal Medicine Published Online: 5 Jun 2008
Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study a possible relationship between right and left ventricular function and pulmonary function.
The Clinical Respiratory Journal Published Online: 1 Aug 2008
To test whether different degrees of immunologic and fibrotic airway remodeling processes occur in idiopathic interstitial pneumonias (IIPs), with impact on functional tests and survival, we studied the collagen/elastic system and immune cell density in the bronchiolar interstitium of lungs with the major types of IIPs.
The Clinical Respiratory Journal Published Online: 22 May 2008
Baseline clinical and physiological variables have been described as relevant predictors of survival among patients with idiopathic pulmonary fibrosis (IPF). However, substantial heterogeneity in both survival time and mortality has been observed with many of these predictive factors. The incidence and mortality rates of IPF vary from country to country, with race potentially contributing to such variations.
Iodine-123 metaiodobenzylguanidine (123I-MIBG) uptake in the lungs is a potentially suitable marker of pulmonary endothelial function because MIBG behaviour in the pulmonary circulation is quantitatively similar to that of norepinephrine.
Pediatric Pulmonology Published Online: 30 Jul 2008
Pulmonary sequestration is a rare anomaly and is conventionally treated with surgical excision. This report describes the successful occlusion of a large aberrant artery to an intralobar pulmonary sequestration using an Amplatzer Vascular Plug.
To explore how hyponatremia is associated with outcomes in hospitalized patients with pneumonia, we analyzed a large administrative database with laboratory component from January 2004 to December 2005.
Worsening gas exchange during exercise and during exacerbations of COPD contributes to systemic hypoxaemia and reduces quality of life. However, pulmonary haemodynamic changes under such conditions are not well understood.
It was previously reported that visual scores of the lung opacities were associated with lung function in patients with sarcoidosis. However, there are no reports on the evaluation of airway dimensions or lung density by computed tomography (CT) in sarcoidosis patients.
Solitary fibrous tumor of the pleura is a rarely encountered clinical entity which may have different clinical pictures. Although the majority of these neoplasms have a benign course, the malignant form has also been reported.
Episodic angioedema with eosinophilia is characterized by recurrent angioedema, peripheral eosinophilia, fever, weight gain, elevated serum immunoglobulin M (IgM), and a benign course lacking any internal organ involvement.
Community acquired pneumonia (CAP) is caused by a variety of microorganisms. By identifying patients at risk for failure of pathogen identification, it is possible to make an early decision on the extent of diagnostic procedures to be performed.
The Clinical Respiratory Journal Published Online: 5 May 2008
Chronic obstructive pulmonary disease (COPD) is suspected if the ratio between forced expired volume in 1 s (FEV1) and forced vital capacity is below 0.7 after bronchodilatation, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD).
Streptococcus pneumoniae is a common cause of sporadic invasive infections, but outbreaks of invasive pneumococcal disease are infrequent. In August 2006, a sudden increase in the number of patients presenting with invasive pneumococcal disease was noted at St. Paul's Hospital (Vancouver, Canada).
The majority of patients (80%) were women and the mean age was 37 years. Three patients had a family history of TSC. The radiological findings were small multiple nodular shadows with ground-glass opacity randomly distributed in the bilateral whole-lung fields in most patients.
Pediatric Pulmonology Published Online: 31 Jul 2008
Lung disease is a major cause of morbidity in children with sickle cell disease (SCD). Asthma in children with SCD is associated with a twice greater rate of pain and acute chest syndrome (ACS) episodes when compared to children with SCD but without asthma.
To analyze the relationship between airflow limitation and airway dimensions from the third to the fifth generation of bronchi in patients with chronic obstructive pulmonary disease (COPD) by using inspiratory and expiratory multisection computed tomography (CT).
Lymphoid granulomatosis is a rare form of pulmonary angiitis. This case report presents a patient with lymphoid granulomatosis in whom the clinical presentation, radiological features and the partial response to corticosteroid therapy mimicked interstitial lung disease. Lymphoid granulomatosis was only diagnosed at post-mortem examination. The range of reported clinical presentations, diagnostic approaches and outcomes are described.
Background and objective: Impulse oscillometry (IOS) measures respiratory function during normal breathing by transmitting mixed frequency rectangular pressure impulses down the airways and measuring the resultant pressure and flow relationships, which describe the mechanical parameters of the lungs.
Primary Care Respiratory Journal Volume 17 Issue 2 June 2008 Pages 62-72
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 Pages 111-113
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.
Current clinical guidelines for COPD indicate that health care professionals must ensure that COPD is diagnosed accurately at an early stage so that people with COPD are treated effectively. Difficulties in making the diagnosis and assessing severity using spirometry may also affect management decisions. We evaluated the diagnosis and management of COPD in primary care practices in Devon.
International Clinical Psychopharmacology. 23(5):263-268, September 2008
To determine the association between fatal pulmonary embolism and use of antipsychotic drugs in a Swedish medicolegal autopsy series. Persons aged 18-65 years and subjected to a medicolegal autopsy in 1992-2005 were selected.
Journal of Sleep Research Published Online: 15 May 2008
In recent years, special interest has been focused on impairments of executive functions in patients with obstructive sleep apnoea syndrome (OSAS). However, the majority of studies have not clearly separated deficits in executive functions from impairments in other cognitive processes involved in task solving.
Journal of Sleep Research Published Online: 22 Jul 2008
Obstructive sleep apnoea syndrome (OSA) increases the risk of motor vehicle crashes, and of all medical disorders, has greatest risk in this respect. There is no consistency in the way OSA is considered by the national 'Physical Fitness to Drive' legislations within the 27 member countries of the European Union (EU), and most ignore OSA.
Journal of Sleep Research Published Online: 15 Aug 2008
Whether nasal congestion promotes obstructive sleep apnea is controversial. Therefore, we performed a randomized placebo-controlled cross-over trial on the effects of topical nasal decongestion in patients with obstructive sleep apnea syndrome (OSA) and nasal congestion.
Journal of Sleep Research Published Online: 28 Jun 2008
he goal of this study was to test the hypothesis that spectral indices of heart rate variability, such as high-frequency power (HFP), low-to-high frequency power (LHR), and their respiration-adjusted counterparts (HFPra, LHRra) are correlated with severity of sleep-disordered breathing (SDB), as quantified by the respiratory disturbance index (RDI).