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Indian Journal of Occupational and Environmental Medicine Year : 2007 Volume : 11 Issue : 3 Page : 108-112
occurrence of occupational lung diseases is decreasing due to improvements in occupational health in recent years; however, silicosis and its complications remain important occupational health problems. We have studied the role of emphysema and bullae as predictive factors of secondary spontaneous pneumothorax in acute and accelerated silicosis.
We studied the effect of antenatal corticosteroids on the incidence of respiratory disorders in singleton neonates born between 34 and 36 weeks of gestation.
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 620-627(8)
Updated asthma care guidelines have recently been released. This review will focus on several elements in the Expert Panel Report (EPR) 3 guidelines that reflect substantial differences compared with recommendations of the EPR2 guidelines, issued in 1997 and updated in 2002.
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 671-687(17)
Flunisolide (FLU) is a synthetic corticosteroid with potent topical anti-inflammatory activity. Its oral bioavailability is poor (6.7%). After gastrointestinal and lung absorption, the drug undergoes rapid and extensive first-pass metabolism by the liver to an inactive 6Beta-hydroxylated metabolite. Plasma half-life is estimated to be 3.9 to 4.6 hours.
Clinical Microbiology and Infection doi:10.1111/j.1469-0691.2007.01915.x
A 1-year retrospective multicentre study was performed to identify factors influencing hospital length of stay (LOS) and mortality of patients (n = 3233) admitted to hospital because of community-acquired pneumonia (CAP).
We assessed the rates of influenza vaccine acceptance and the reasons for acceptance or refusal among medical residents in different disciplines during the 2004-2005 influenza season.
Surveillance for ventilator-associated pneumonia (VAP) using standard Centers for Disease Control and Prevention (CDC) criteria is labor intensive and involves many subjective assessments. We sought to improve the efficiency and objectivity of VAP surveillance by adapting the CDC criteria to make them amenable to evaluation with electronic data.
Patients with heart failure or OSA (obstructive sleep apnoea) have reduced HF-HRV (high-frequency heart rate variability), indicating reduced cardiac vagal modulation, a marker of poor prognosis. CPAP (continuous positive airway pressure) abolishes OSA in patients with heart failure, but effects on daytime HF-HRV have not been determined.
Journal of the American Geriatrics Society doi:10.1111/j.1532-5415.2007.01562.x
To evaluate hospital readmission rates and mortality at 6-month follow-up in selected elderly patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).
Journal of Neurosurgery January 2008 Volume 108, Number 1
Previous studies have demonstrated that periods of low brain tissue oxygen tension (PbtO2) are associated with poor outcome after head trauma but have primarily focused on cerebral and hemodynamic factors as causes of low PbtO2.
Recent studies have suggested involvement of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism in the susceptibility to and severity of community-acquired pneumonia (CAP) in Asian populations. We have explored the hypothesis that the ACE I/D polymorphism affects the risk and outcome of CAP in a Dutch white population.
Hemoptysis of pulmonary arterial origin is a diagnostic challenge in patients admitted to a respiratory ICU (RICU) for treatment of hemoptysis. Its early accurate recognition and treatment reduce morbidity and prevent mortality. Multidetector row CT angiography (MDCTA) is an accurate method for imaging the systemic vascular network.
Systemic lupus erythematosus (SLE) is considered the archetypal systemic autoimmune disease. Clinically characterized by multisystem involvement and varied serologic abnormalities, no two patients present or have disease that evolves in exactly the same way.
Pulmonary arterial hypertension (PAH) is a progressive disease, with right-heart failure being the main cause of death. In patients refractory to conventional drug therapy, atrial septostomy can serve as palliative treatment or as a bridge to transplantation.
Although tobacco smoke is the main cause of COPD, relatively little attention has been paid to its potential damage to skeletal muscle. This article addresses the effect of smoking on skeletal muscle.
Airway smooth muscle (ASM) plays a central role in regulating bronchomotor tone in patients with asthma. New evidence, however, suggests that ASM may also orchestrate and perpetuate airway inflammation by promoting the recruitment, activation, and trafficking of inflammatory cells in the airways.
Aging plays a critical role in the pathophysiology of atrial fibrillation (AF). The left atrium (LA) and pulmonary veins (PVs) are essential components for the genesis and maintenance of AF. The purpose of this study was to investigate the effects of aging on the AF substrate and the initiator (PVs).
Fluid infusion may be lifesaving in patients with severe sepsis, especially in the earliest phases of treatment. Following initial resuscitation, however, fluid boluses often fail to augment perfusion and may be harmful.
Nontuberculous mycobacteria (NTM) are increasingly associated with pulmonary disease. This is a worldwide phenomenon and one that is not related just to better diagnostic techniques or HIV infection. The mode of transmission of NTM is not well defined, but environmental exposure may be the major factor.
The role of chest ultrasonography (US) in the diagnosis of pneumothorax (PTX) has been established, but how it compares with lung CT scanning in the diagnosis of radiooccult PTX and in the determination of its topographic extension has not yet been completely evaluated.
The prognostic value of BAL fluid cell count differential in patients with idiopathic pulmonary fibrosis (IPF) is unknown. We hypothesized that baseline BAL fluid cell count differential (ie, elevated levels of neutrophils and eosinophils, or reduced levels of lymphocytes) would predict higher mortality among persons with IPF.
Fatty liver disease (FLD) is a highly prevalent condition in obese (Ob) children, who are at increased risk for obstructive sleep apnea (OSA). However, the contribution of OSA to FLD remains unknown.
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 614-619(6)
This article reviews the concept of airway remodeling, through various inflammatory cells, the roles of angiogenesis, vascular endothelial cell growth factor, respiratory syncytial virus, and other biomarkers, including exhaled nitric oxide. Control of allergic asthma using immunomodulation and other strategies is addressed.
Virchows Archiv, Volume 451, Number 4, October 2007 , pp. 793-803(11)
In airway remodeling that occurs in association with chronic obstructive pulmonary disease (COPD), the relationship between the subepithelium and structural changes of the bronchial epithelium is not well defined.
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 654-658(5)
It is commonly believed that young children are incapable of pollen sensitization; therefore, skin testing usually is not performed to these allergens. The purpose of this study was to identify the frequency of positive skin tests to outdoor allergens among younger children who have asthma. Patients who have asthma, aged 6 months to 10 years, were evaluated for pollen sensitization over a 10-year period.
The Internet Journal of Anesthesiology. 2008. Volume 15 Number 2
Cardiac disease is an important cause of maternal mortality and morbidity in obstetric patients. Rheumatic heart disease resulting in valvular dysfunction is still relatively common in underdeveloped countries. Involvement of multiple valves poses a significant risk to patients requiring cesarean section.
The Proceedings of the American Thoracic Society 5:119-126 (2008)
Proliferation, migration, and differentiation of smooth muscle (SM)-like lymphangioleiomyomatosis (LAM) cells in the lungs are pathologic manifestations of pulmonary LAM, a rare lung disease predominantly afflicting women and exacerbated by pregnancy. LAM cells form nodules throughout the lung without any predominant localization, but can also form small cell clusters dispersed within lung parenchyma.
The Proceedings of the American Thoracic Society 5:127-132 (2008)
Myofibroblasts are mesenchyme-derived cells responsible for tissue repair after injury. Resident populations of myofibroblasts are present throughout the lung. In addition, it is likely that myofibroblast progenitors (fibrocytes) can migrate to the lung from the circulation during injury.
Medicine & Science in Sports & Exercise. 40(1):3-8, January 2008
To determine the relative contributions of the Fick principle variables to impaired exercise tolerance in pulmonary arterial hypertension compared with pulmonary venous hypertension.
Critical Care Medicine. 36(1):131-144, January 2008
To assess the safety and efficacy of an early enteral pharmaconutrition supplement containing glutamine dipeptides, antioxidative vitamins and trace elements, and butyrate in critically ill, septic patients.
A survey that included questions about preferred methods of influenza prevention was completed by 513 registered nurses working on inpatient units. Vaccination was the preferred influenza prevention method among 83.0% of respondents.
We surveyed house staff who had participated in a trial that compared influenza vaccination strategies for inpatients. House staff who were exposed to computer-generated vaccination orders were more likely to report that they recommended vaccination to their inpatients and outpatients, compared with house staff who were not exposed to a vaccination intervention.
Journal of Burn Care & Research. 29(1):82-88, January/February 2008
Respiratory failure is associated with a high mortality rate in burned children. Recently, a specialized pulmonary enteral formula (SPEF) was commercially introduced as an adjunct intervention in acute lung injury management. SPEF contains condition-specific nutrients to modulate the inflammatory response. The study examined SPEF impact in critically ill, pediatric burn patients with respiratory failure.
Animal model studies and human epidemiological studies have shown that some infectious diseases develop primarily in individuals with an inherited predisposition. A heritable contribution to the development of severe influenza virus infection (i.e., that which results in death) has not previously been hypothesized or tested.
Human rhinovirus (HRV) causes the common cold. The most common acute infection in humans, HRV is a leading cause of exacerbations of asthma and chronic obstruction pulmonary disease because of its ability to exacerbate airway inflammation by altering epithelial cell biology upon binding to its receptor, ICAM-1. ICAM-1 regulates not only viral entry and replication but also signaling pathways that lead to inflammatory mediator production.
Acute lung injury is a common cause of morbidity and mortality following pulmonary or systemic infections. Surfactant protein-D is a member of the collectin family of proteins, which play important roles in innate host defense of the lung. In this study, the effect of exogenous recombinant human SP-D (rhSP-D) on protection of the adult mouse lung from lipopolysaccharide (LPS)-induced and lipoteichoic acid (LTA)-induced injury was assessed.
C-C chemokines such as CCL11, CCL5, and CCL3 are central mediators in the pathogenesis of asthma. They are mainly associated with the recruitment and the activation of specific inflammatory cells, such as eosinophils, lymphocytes, and neutrophils.
Patients with chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are associated with exercise intolerance. Whether exercise intolerance and reduced mechanical efficiency are due to inactivity alone or to disease related muscular abnormalities is not clear.
Adenoviruses are associated with sporadic infection and community and institutional outbreaks; they can cause especially severe disease in infants, young children, immunocompromised persons, and transplant recipients.
Medicine & Science in Sports & Exercise. 40(1):9-14, January 2008
Abnormal skeletal muscle function is well documented in chronic obstructive pulmonary disease, but there is no information about the activity of muscle metabosensitive afferents. In this study, we tested the hypothesis that patients with chronic obstructive pulmonary disease would have abnormal reflex responses to stimulation of metabosensitive afferents in skeletal muscle when compared with healthy, matched subjects.
To evaluate whether five days’ treatment with injectable ampicillin plus gentamicin compared with chloramphenicol reduces treatment failure in children aged 2-59 months with community acquired very severe pneumonia in low resource settings.
Annals of Allergy, Asthma and Immunology, Volume 99, Number 6, December 2007 , pp. 540-548(9)
To examine the long-term safety of levalbuterol hydrofluoroalkane (HFA) vs racemic albuterol HFA administered via metered-dose inhaler (MDI) in patients with stable asthma.
als of Allergy, Asthma and Immunology, Volume 99, Number 6, December 2007 , pp. 496-501(6)
To create a standardized universal health history camp application that includes an assessment of health-related quality of life using the Child Asthma Short Form; to test a newly validated tool, the Childhood Asthma Control Test (C-ACT), to assess asthma control in children; to provide a clinical snapshot of the overall status of children with asthma in the United States; and to determine the benefit of children's asthma camps.
Pneumocystis pneumonia has long been recognized as a cause of morbidity and mortality in immunocompromised populations, particularly those with HIV infection.
Lung transplantation activity is frustrated by donor lung availability. We sought to examine the effect of active donor management and hormone administration on pulmonary function and yield in cadaveric heart-beating potential lung donors.
PEComa (clear cell sugar tumor) of the lung is a rare benign tumor of the lung probably arising from the perivascular epithelioid cells (PECs). We report a case of pulmonary PEComa arising from the periphery of the right lobe of a 64-year-old male.
Allergy & Clinical Immunology International September 2007 , Vol 19 , No. 5
The extent of T-helper cell type 1/type 2 (Th1/Th2) balance during the neonatal period may be the key determinant of how the genetic predisposition to asthma is modulated and may be useful in predicting its subsequent development.
Clinical & Experimental Immunology, Volume 151, Number 2, February 2008 , pp. 251-259(9)
Tumour necrosis factor (TNF)-alpha, an important proinflammatory cytokine, has been implicated in the pathogenesis of sarcoidosis, a multi-systemic granulomatous disorder of unknown aetiology. Here, we report for the first time the association of TNF haplotypes and genotypes with sarcoidosis and its prognosis in the Indian population.
Clinical & Experimental Immunology, Volume 151, Number 2, February 2008 , pp. 359-366(8)
The annual epidemics of respiratory syncytial virus (RSV) infection are probably explained by poor herd immunity and the existence of a dormant reservoir of virus that is activated by an unknown trigger. The virus causes particular problems in infants, the elderly and patients with chronic obstructive airways disease (COPD).
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 688-690(3)
Abbreviated aerosol therapy has been suggested to increase compliance by delivering the same therapeutic dose, but more rapidly than traditional aerosol therapy. A new spacer mouth mask, which is recommended for use in abbreviated aerosol therapy, is now available in Italy.
This study was designed to establish the rates of treatment failure for community-acquired pneumonia that are acceptable to knowledgeable and experienced physicians, in order to facilitate the interpretation of existing studies and the design of new studies aimed at optimizing the duration of antibiotic therapy.
Indian Journal of Occupational and Environmental Medicine Year : 2007 Volume : 11 Issue : 3 Page : 95-96
Pneumoconiosis is resulting from exposure to free silica may be the commonest and most extensively studied occupational disease of the lung and even today, it continues to be among the most serious occupational diseases. The problem of silicosis is confined not only to the developing nations, but is also not uncommon in industrialized nations.
Indian Journal of Occupational and Environmental Medicine Year : 2007 Volume : 11 Issue : 3 Page : 97-102
This mini-review describes the toxic effects of vanadium pentoxide inhalation principally in the workplace and associated complications with breathing and respiration. Although there are some material safety data sheets available detailing the handling, hazards and toxicity of vanadium pentoxide, there are only two reviews listed in PubMed detailing its toxicity.
Tobacco smoke and genetic susceptibility are risk factors for asthma and wheezing. The aim of this study was to investigate whether there is a combined effect of interleukin-13 gene (IL13) polymorphisms and tobacco smoke on persistent childhood wheezing and asthma.
Both acute thoracic aortic disease and pulmonary embolism carry high mortality rates. Imaging is central to the diagnosis of both. Acute dissection, intramural haematoma (IMH) and penetrating artheromatous ulcers (PAU) comprise the "acute aortic syndrome", where each can arise de novo or by a process of evolution.
Following a brief account of anatomy and imaging techniques, this article will provide an overview of the imaging findings of some of the more common abnormalities affecting the trachea, main bronchi and small airways.
Joint Commission Perspectives on Patient Safety, Volume 8, Number 1, January 2008 , pp. 8-13(6)
Communicable respiratory threats like influenza, tuberculosis (TB), and emergent respiratory threats represent a serious public health risk in emergency departments (EDs). Respiratory illnesses are a hazard not only for patients, but for visitors and staff as well.
The impact of short-term preoperative pulmonary rehabilitation on exercise capacity of patients with chronic obstructive pulmonary disease undergoing lobectomy for non-small cell lung cancer is evaluated.
Secretory phospholipases A2 (sPLA2) have functions relevant to asthmatic inflammation, including eicosanoid synthesis and effects on dendritic cells and T cells. The aim of this study was to measure sPLA2 activity in patients with stable and acute asthma and to assess potential associations with body mass index (BMI), and plasma cholesterol and vitamin C concentrations.
The purpose of this study was to evaluate the feasibility of integrating an artificial, pumpless extracorporeal membrane ventilator (Novalung) to near static mechanical ventilation and its efficacy in patients with severe postresectional acute respiratory distress syndrome (ARDS) unresponsive to optimal conventional treatment.
Inflammation & Allergy - Drug Targets (Formerly Current Drug Targets - Inflammation & Allergy), Volume 6, Number 4, December 2007 , pp. 201-209(9)
Understanding mechanisms that underlie lung disorders is crucial to achieving optimum care and improved outcomes in pulmonary medicine. Extensive investigations have revealed that inflammation displays an active role in the pathogenesis of these diseases. The byproduct of these inflammatory reactions has been shown to propagate pulmonary disease in consonance with alteration in haemostatic balance.
The goal was to evaluate whether changes in neonatal intensive care have improved outcomes for children with bronchopulmonary dysplasia (oxygen dependence at corrected age of 36 weeks).
Allergy and Asthma Proceedings, Volume 28, Number 6, November/December 2007 , pp. 628-633(6)
The purpose of this article is to review the recommendations for pharmacotherapy in the new National Asthma Education and Prevention Program (NAEPP) guidelines.
Lung transplantation is the only treatment modality that provides a survival advantage in pulmonary fibrosis, but many patients deemed suitable will die awaiting lung transplantation.
The external intercostal muscles are chronically exposed to increased inspiratory loading and to continuous hypoxia-reoxygenation cycles in patients with obstructive sleep apnoea syndrome (OSAS). It was therefore hypothesised that oxidative stress levels would be increased in these muscles, and that treatment with continuous positive airway pressure (CPAP) would modify the oxidative stress levels and improve muscle dysfunction.
An integrated breathing and relaxation technique known as the Papworth method has been implemented by physiotherapists since the 1960s for patients with asthma and dysfunctional breathing, but no controlled trials have been reported. This study evaluated the effectiveness of the Papworth method in a randomised controlled trial.
The relationship between airway structural changes and inflammation is unclear in early cystic fibrosis (CF) lung disease. A study was undertaken to determine changes in airway remodelling in children with CF compared with appropriate disease and healthy controls.
A special regulatory role for prostaglandin E2 has been postulated in aspirin-induced asthma. A study was undertaken to investigate the effects of aspirin on the systemic production of prostaglandin E2 and cysteinyl leucotrienes in patients with asthma.
Predicting school-age asthma from obstructive airways disease (OAD) in early life is difficult, even when parental and children’s atopic manifestations are taken into consideration.
In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia.
Ectopic acromegaly due to growth hormone-releasing hormone secretion by a bronchial carcinoid is rare. We report a case of bronchial carcinoid presenting with acromegaly due to ectopic growth hormone production. The patient was treated successfully with right pneumonectomy.
Imaging has a pivotal role in the assessment of the patient brought to the emergency department, whether the admission is due to trauma or a medical condition.
Microsomal epoxide hydrolase (EPHX1) metabolises xenobiotics including polyaromatic hydrocarbons (PAHs). Functional variants at this locus have been associated with respiratory diseases.
Recent studies have indicated long-term effects on mortality of particulate and sulphur dioxide (SO2) pollution, but uncertainties remain over the size of any effects, potential latency and generalisability.
The Annals of Pharmacotherapy: Vol. 42, No. 1, pp. 80-90
To review the literature concerning the in vitro activity, pharmacokinetic properties, in vivo efficacy, and adverse events associated with a new penem antibiotic, faropenem medoxomil.
Clinical Cancer Research 14, 149-154, January 1, 2008
The histologic distinction between low-grade typical and intermediate-grade atypical bronchopulmonary carcinoids basically lies on cellular differentiation, mitotic activity, and presence of "neoplastic" necrosis; at single patient level, however, none of these features enables a reliable prediction of the clinicopathologic outcome.
Cannabis is the most widely used illegal drug worldwide. Long-term use of cannabis is known to cause chronic bronchitis and airflow obstruction, but the prevalence of macroscopic emphysema, the dose-response relationship and the dose equivalence of cannabis with tobacco has not been determined.
To ascertain whether therapeutic equivalence exists for the treatment of paediatric community acquired pneumonia by the oral and intravenous (IV) routes.
Roflumilast is a targeted oral once-daily administered phosphodiesterase 4 (PDE4) inhibitor with clinical efficacy in chronic obstructive pulmonary disease (COPD). Results from in vitro studies with roflumilast indicate that it has anti-inflammatory properties that may be applicable for the treatment of COPD.
Clara cells are the epithelial progenitor cell of the small airways, a location known to be important in many lung disorders. Although migration of alveolar type II and bronchiolar ciliated epithelial cells has been examined, the migratory response of Clara cells has received little attention.
The clinical benefits of domiciliary non-invasive positive pressure ventilation (NIV) have not been established in cystic fibrosis (CF). We studied the effects of nocturnal NIV on quality of life (QoL), functional and physiological outcomes in CF subjects with awake hypercapnia (arterial carbon dioxide pressure PaCO2>45 mm Hg).
The facilities which should be available to physicians offering specialist occupational asthma services have recently been agreed upon by a UK panel of experts.
Eosinophilic inflammation is a characteristic feature of asthma. Integrins are highly versatile cellular receptors that regulate extravasation of eosinophils from the postcapillary segment of the bronchial circulation to the airway wall and airspace.
Non-univocal conclusions have been published regarding the definition of oxygen desaturation in relation to postoperative outcome. We aimed to verify whether oxygen desaturation during a maximal stair-climbing test was associated with postoperative cardiopulmonary complications and to assess which definition of oxygen desaturation (oxygen saturation <90% or desaturation >4% with respect to rest level) discriminated better between complicated and uncomplicated patients.
The Journal of Experimental Medicine, Vol. 204, No. 13, 3173-3181
Asthma and chronic obstructive pulmonary disease (COPD) are characterized by different patterns of airway remodeling, which all include an increased mass of bronchial smooth muscle (BSM).
Allergology International doi:10.2332/allergolint.R-07-152
Asthma is a chronic inflammatory disease characterized by reversible airflow limitation and airway hyperresponsiveness. Persistent inflammation in airway tissues may lead to structural changes known as airway remodeling and consequently airway obstruction that is not fully reversible and progressive loss of lung function over time.
The case history is presented of a male infant who was thought to have idiopathic pulmonary arterial hypertension (PAH) at 3 months of age. Subsequently the PAH decreased unexpectedly and diffuse pulmonary arteriovenous malformations (PAVMs) were seen at 6.9 years of age for the first time.
Allergology International doi:10.2332/allergolint.R-07-151
Airway remodeling in asthma is characterized by goblet cell hyperplasia, subepithelial fibrosis, and hyperplasia and hypertrophy of airway smooth muscle cells.
Acute lung injury is a common complication in critically ill patients. The present study examined possible immunomodulating effects of the volatile anaesthetic sevoflurane on lipopolysaccharide (LPS)-stimulated alveolar epithelial cells (AEC) in vitro.
As excess mucin expression can contribute to the exacerbation of asthma, the present authors hypothesised that Mycoplasma pneumoniae significantly induces MUC5AC (the major airway mucin) expression in airway epithelial cells isolated directly from asthmatic subjects.
Inspiratory muscle strength monitoring is crucial in patients with neuromuscular disorders. The sniff nasal inspiratory pressure (SNIP) and maximal inspiratory pressure (PI,max) are usually measured. The present study investigated whether the test yielding the best value at baseline continued to yield the best value during follow-up.
Inflammation, oxidative stress and apoptosis, which are involved in chronic obstructive pulmonary disease (COPD) pathogenesis, may activate the p38 subgroup of mitogen-activated protein kinases (MAPKs). Therefore, the aim of the present study was to evaluate the expression of the phosphorylated, active form of p38 MAPK (phospho-p38) in the lungs of COPD patients.
Since 1995, the German Cystic Fibrosis Quality Assessment project has collected demographic data and outcome parameters. It aims to develop tools for quality management.
The pathogenesis of idiopathic pulmonary arterial hypertension (PAH) remains poorly understood. The present authors recently reported that mice with vasoactive intestinal peptide (VIP) gene disruption show a spontaneous phenotype of PAH, with pulmonary vascular remodelling and lung inflammation.
Erythropoietin (EPO) mobilises endothelial progenitor cells and promotes neovascularisation in heart failure. The present authors studied the effects of EPO on pulmonary vascular and cardiac remodelling in a model for flow-associated pulmonary arterial hypertension (PAH).
Infection and Immunity, January 2008, p. 189-197, Vol. 76, No. 1
Excessive inflammation contributes to the pathogenesis of bacterial meningitis, which remains a serious disease despite treatment with antibiotics. Therefore, anti-inflammatory drugs have important therapeutic potential, and clinical trials have revealed that early treatment with dexamethasone significantly reduces mortality and morbidity from bacterial meningitis.
We performed an historical cohort study of appropriately sized, preterm infants without congenital anomalies who were born between January 2001 and June 2002 (pre-early management practice change group; n = 87) and between July 2004 and December 2005 (post-early management practice change group; n = 76).
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.
Forced expiratory volume in 6 s (FEV6) has been proposed as a more easily measurable parameter than forced vital capacity (FVC) to diagnose airway disease using spirometry. A study was undertaken to estimate FEV6 repeatability, to identify correlates of a good quality FEV6 measurement and of volumetric differences between FEV6 and FVC in elderly patients.
In adults, viral causes of community-acquired pneumonia (CAP) are poorly characterised. The aims of this study were to characterise the viral aetiology of CAP in adults by using an extensive array of viral diagnostic tests and to compare the characteristics of viral pneumonia with those of pneumococcal pneumonia.
A multicentre retrospective study was undertaken to examine patients with interstitial lung disease (ILD) with the initial clinical manifestation of an anti-synthetase syndrome (anti-Jo-1 antibodies), and to analyse the characteristics and long-term outcome of these patients according to their clinical presentation (acute or gradual onset), treatment and adverse events related to treatment.
The presence of chronic bronchitis predicts a more rapid decline of forced expiratory volume in one second (FEV1) in patients with chronic obstructive pulmonary disease (COPD). The hallmark of COPD is airway inflammation.
Granulomatous inflammation in lung biopsies is a relatively non-specific finding that can occur in a range of inflammatory and neoplastic conditions. This review focuses on the patterns of granulomatous inflammation that can cause diffuse lung disease, highlighting histopathological features helpful in differential diagnosis.
The role of tumour markers such as carbohydrate antigen (CA) 125, CA 15-3, CA 19-9 and CYFRA 21-1 (a fragment of cytokeratin 19) in differentiating malignant pleural effusions (MPE) from benign effusions is not yet clear.
The goal was to estimate the influenza disease burden among children with asthma and among healthy children by using active, laboratory-confirmed, population-based surveillance.
PEDIATRICS Vol. 121 No. 1 January 2008, pp. e146-e149
Neonatal respiratory distress syndrome is associated with intrahepatic cholestasis of pregnancy, and bile acids may play a major role in neonatal bile acid pneumonia. Our aim was to demonstrate the bile acid presence in the bronchoalveolar lavage fluid of neonates affected by respiratory distress syndrome who were born from intrahepatic cholestasis of pregnancy and to investigate bile acid mechanisms of action in acute lung injury.
To retrospectively determine if the interval increase of right ventricular–left ventricular (RV/LV) diameter ratio from negative prior to positive current computed tomographic (CT) examination findings for pulmonary embolism (PE) is more accurate for predicting 30-day mortality than positive CT ratio alone, by using patient 30-day mortality as reference standard.
To retrospectively assess the accuracy of thin-section computed tomography (CT) in distinguishing chronic hypersensitivity pneumonitis (HP) from idiopathic pulmonary fibrosis (IPF) and nonspecific interstitial pneumonia (NSIP), with histologic results as the reference standard.
Birth depression unresponsive to conventional resuscitative measures merits careful consideration. The case of a term infant with primary respiratory failure at birth despite extensive intervention is presented.
Allergology International doi:10.2332/allergolint.R-07-153
Airway remodeling can be defined as changes in the composition, content, and organization of the cellular and molecular constituents of the airway wall. Airway remodeling is a characteristic feature of asthma, and has important functional implications.
The Internet Journal of Pulmonary Medicine. 2007. Volume 9 Number 1
Haemoptysis is a common symptom that can occur in a variety of respiratory and cardiovascular diseases. Here we describe an interesting case of haemoptysis who was first mistook as pulmonary tuberculosis and then as bronchogenic carcinoma before being referred to us and was ultimately found to have aortic dissection.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 17(6):562-564, December 2007
In terms of perioperative management, it is extremely difficult to perform a video-assisted thoracic surgery lobectomy for primary lung cancer in patients previously undergoing a contralateral pneumonectomy.
To determine whether extravascular lung water predicts survival in patients with early acute respiratory distress syndrome, to determine the relationship between extravascular lung water and other markers of lung injury, and to examine if indexing extravascular lung water with predicted body weight (EVLWp) strengthens its discriminative power.
Clinical and Experimental Nephrology, Volume 11, Number 3, September 2007 , pp. 230-234(5)
A 66-year-old woman was admitted to our hospital because of vomiting and appetite loss. For the 2 days prior to admission, she had a cold, which had developed into acute viral bronchitis on admission. Because laboratory data on admission showed hyponatremia, intravenous infusion of Ringer's lactate solution was started. However, generalized seizures appeared, and she developed a coma on the day of admission.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 184-189, (2008)
Although the association between mortality and particles is well established, fewer studies have been reported with ozone. The harvesting hypothesis posits that the deaths associated with an exposure are occurring in people who are dying already, and the effect of exposure is merely to move the death from one day to an earlier day, and has no other effects that would influence deaths.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 170-177, (2008)
Recent literature in mechanical ventilation includes strong evidence from randomized trials. Little information is available regarding the influence of these trials on usual clinical practice.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 208-218, (2008)
Severe respiratory syncytial virus (RSV) bronchiolitis has been associated with deficient IFN- production in humans, but the role of this cytokine in determining the outcome of reinfection is unknown.
Although nasal surgery has limited efficacy in obstructive sleep apnoea (OSA) treatment, some patients experience improvement. The present study tested the hypothesis that post-surgery improvement is associated with increased nasal breathing epochs.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 202-207, (2008)
Thrombus formation and inflammation are involved in the pathogenesis of pulmonary arterial hypertension (PAH), and LIGHT (Lymphotoxin-like Inducible protein that competes with Glycoprotein D for Herpesvirus entry mediator on T lymphocytes) has been shown to promote vascular inflammation.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 190-194, (2008)
The pathogenic importance of smoking status in idiopathic pulmonary fibrosis (IPF) is uncertain. In theory, increased oxidative stress in current and former smokers might promote disease progression. However, better survival has been reported for current smokers with IPF, although this might reflect less severe disease at presentation (a "healthy smoker effect").
The diagnosis of allergic bronchopulmonary aspergillosis (ABPA) in cystic fibrosis (CF) is a challenge. Thymus- and activation-regulated chemokine (TARC) has recently been reported to play a role in ABPA.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 164-169, (2008)
Lung volume reduction surgery (LVRS) has been demonstrated to provide a functional and mortality benefit to a select group of subjects with chronic obstructive pulmonary disease (COPD). The effect of LVRS on COPD exacerbations has not been as extensively studied, and whether improvement in postoperative lung function alters the risk of disease exacerbations is not known.
Primary care spirometry is a uniquely valuable tool in the evaluation of patients with respiratory symptoms, allowing the general practitioner to diagnose or exclude chronic obstructive pulmonary disease (COPD), sometimes to confirm asthma, to determine the efficacy of asthma treatment and to correctly stage patients with COPD.
The Proceedings of the American Thoracic Society 5:58-61 (2008)
A novel physical perspective of molecular interactions within the cytoskeleton of the airway smooth muscle cell may help to explain why the most efficacious of all known bronchodilatory agencies-a simple deep inspiration-becomes abrogated during the spontaneous asthma attack and leads thereby to excessive airway narrowing.
The Proceedings of the American Thoracic Society 5:32-39 (2008)
The ability of airway smooth muscle to alter its stiffness and contractility in response to mechanical oscillation and stretch is critically important for the regulation of normal airway responsiveness during breathing. The properties of mechanical adaptation in airway smooth muscle are proposed to result from dynamic cytoskeletal processes outside of the actomyosin interaction.
The Proceedings of the American Thoracic Society 5:68-72 (2008)
Superimposition of force fluctuations on contracted tracheal smooth muscle (TSM) has been used to simulate normal breathing. Breathing has been shown to reverse lung resistance of individuals without asthma and animals given methacholine to contract their airways; computed tomography scans also demonstrated bronchial dilation after a deep inhalation in normal volunteers.
The Proceedings of the American Thoracic Society 5:15-22 (2008)
Contractility of airway smooth muscle requires elevation of intracellular calcium concentration. Under resting conditions, airway smooth muscle cells maintain a relatively low intracellular calcium concentration, and activation of the surface receptors by contractile agonists results in an elevation of intracellular calcium, culminating in contraction of the cell.
The Proceedings of the American Thoracic Society 5:106-112 (2008)
The present article will describe the potential role of airway smooth muscle (ASM) in mediating both deleterious/beneficial effects of interferons (IFNs) in asthma. First described as beneficial in treating the main features of asthma, the interplay between IFNs and ASM could explain their deleterious actions recently described in a number of different studies.
This is the first report describing the use of robotic technology for the treatment of chylothorax. We present a 22-year-old with mixed embryonal cell and seminoma germ cell cancer refractory to medical and surgical treatment. The patient had rising markers and a growing left lower lung lobe metastasis. After left lower lobectomy, left-sided chylothorax developed. Conservative management failed, and a robotic right-sided thoracic duct ligation was performed. Other treatment options are reviewed.
We report on the very rare case of a 49-year-old man with a large solitary pulmonary lymphangioma. Rapid growth of the tumor led to dyspnea and pain. A chest roentgenogram and computed tomography scan revealed a large 18 x 12-cm space-occupying cystic lesion in the posterior mediastinum. The tumor was resected by lateral thoracotomy. Histopathology revealed a pulmonary cystic lymphangioma.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 132-141, (2008)
Dithiothreitol (DTT) is commonly used to liquefy induced sputum samples before assessment of cytology, but causes reduction of disulfide bonds and denaturation of proteins.
Antimicrobial Agents and Chemotherapy, January 2008, p. 348-350, Vol. 52, No. 1
Among 380 Mycoplasma pneumoniae isolates from 3,678 pediatric patients with community-acquired pneumonia, 50 macrolide-resistant strains had an A2063G transition in domain V of the 23S rRNA, whereas 5 had an A2064G transition.
The aim of the present study was to investigate whether imprint cytology can improve the diagnostic accuracy of computed tomography-guided transthoracic core biopsy.
In patients with interstitial lung disease (ILD), the diagnosis of idiopathic interstitial pneumonia is usually made after excluding, among other conditions, connective tissue diseases (CTDs).
The present study assessed the impact of computerised spirometry interpretation expert support on the diagnostic achievements of general practitioners (GPs), and on GPs' decision making in diagnosing chronic respiratory disease.
The thorax is the most frequent extrapelvic location of endometriosis. Thoracic endometriosis is probably responsible for the high rate of recurrent pneumothoraces in females.
Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services.
Dry powder inhalers (DPIs) are increasingly replacing metered dose inhalers in elderly chronic obstructive pulmonary disease (COPD) patients. However, most DPIs are dependent on inspiratory flow, which is compromised by the ageing process itself.
Polymyositis and interstitial lung diseases, predominantly nonspecific interstitial pneumonia (NSIP), are known to be frequent in antisynthetase syndrome, where anti-aminoacyl-tRNA synthetase antibodies are often identified.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 148-155, (2008)
Patients with refractory asthma have persistent symptoms despite maximal treatment with inhaled corticosteroids and long-acting bronchodilators. The availability of add-on therapies is limited, and effective add-on therapies that target noneosinophilic airway inflammation are needed. Macrolide antibiotics, such as clarithromycin, have in vitro efficacy against IL-8 and neutrophils, key inflammatory mediators in noneosinophilic asthma.
Chronic obstructive pulmonary disease (COPD) is defined by fixed airflow limitation associated with an abnormal pulmonary and systemic inflammatory response of the lungs to cigarette smoke.
The precise pathophysiologic processes underlying the prothrombotic or hypercoagulable state in patients with atrial fibrillation (AF) remain uncertain.
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