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Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 429 - 432
Scientific evidence suggests that lycopene and antioxidant vitamins have significant antioxidant and protective effects. Methods: This case-control study included 96 subjects (40 asthmatics, 56 healthy control subjects). Baseline blood samples, pulmonary function tests, and clinical and alimentary histories were collected. All subjects were grouped by age, sex, cigarette smoking habit, body mass index, alimentary intake, and atopic status.
nal of Asthma, Volume 44, Issue 6 July 2007 , pages 437 - 441
The objective of this study was to investigate initial maintenance treatment with salmeterol/fluticasone propionate (Seretide) 50/250 g twice daily (SFC) compared with fluticasone propionate (Flixotide) 250 g twice daily (FP) (both via Diskus inhaler, GlaxoSmithKline, Greenford, UK) in patients with moderate persistent asthma currently only treated with inhaled short-acting B2-agonists.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 479 - 483
Healthcare costs were determined for mild persistent asthma patients (n = 796) who used inhaled corticosteroids infrequently (0 to 2 claims) or consistently (3 or more claims). Study patients, selected from a privately insured claims database (1999-2003), had at least one asthma diagnosis, no diagnosis of chronic obstructive pulmonary disease (COPD), and mild persistent asthma as defined by the 2005 Health Plan Employer Data and Information Set (HEDIS), Leidy's reliever and oral steroid methods, and the 2004 Global Initiative for Asthma (GINA) guidelines.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 433 - 436
The purpose of this study was to estimate the prevalence of asthma in German adults. Methods. This analysis used data of 8,318 German adults 18 years of age and older who had participated in the German National Telephone Survey, a nationally representative cross-sectional study.
Elevated pulmonary levels of CCL18 have been associated with influx of T lymphocytes, collagen accumulation, and a decline in lung function in pulmonary fibrosis patients. We previously reported that overexpression of CCL18 in mouse lungs triggers selective infiltration of T lymphocytes and moderate lymphocyte-dependent collagen accumulation.
Pulmonary surfactant is essential to maintain alveolar patency, and invariably fatal neonatal lung disease has been recognized to involve mutations in the genes encoding surfactant protein-B or ATP-binding cassette transporter family member ABCA3.
Allergy, Volume 62, Number 8, August 2007 , pp. 943-948(6)
3-year subcutaneous specific immunotherapy (SIT) in children with seasonal allergic rhinoconjunctivitis reduced the risk of developing asthma during treatment and 2 years after discontinuation of SIT (5-year follow-up) indicating long-term preventive effect of SIT.
An estimated 150 000 patients develop a pleural effusion each year in the UK. Establishing the aetiology of pleural effusions can be challenging as they can be associated with over 50 systemic or pulmonary disorders.
We report a case of calcified endobronchial leiomyoma in the left main bronchus. Leiomyoma of the airways is a rare benign tumour, usually described as a solitary lesion and located in the membranous portion of the lower third of the trachea and rarely in the bronchi. Chest CT showed a well-defined, calcified, polypoid endobronchial mass with a broad stalk in the left main bronchus.
An increase in levels of C-reactive protein (CRP), a marker of systemic inflammation, is associated with reduced forced expiratory volume in 1 s (FEV1), supporting the hypothesis that the pathophysiology of chronic obstructive pulmonary disease has a systemic inflammatory component. However, few large studies have assessed the relationship between systemic inflammation as measured by CRP and decline in lung function prospectively in a randomly selected population.
A 69-year-old male non-smoker with a history of atopic asthma of >30 years had recently been diagnosed with pulmonary emphysema (chronic obstructive pulmonary disease, COPD) because of exertional dyspnoea and chronic airflow limitation without bronchodilator responsiveness.
High resolution CT (HRCT) scanning has contributed significantly to the evaluation of patients with interstitial lung disease and is particularly useful in the diagnosis of idiopathic pulmonary fibrosis (IPF). The characteristic radiographic features of the idiopathic interstitial pneumonias on HRCT scans have been increasingly analysed and are now fairly well described. Based on current data, HRCT scanning can provide a confident, highly specific diagnosis of IPF in many patients with diffuse lung disease. This article reviews an organised approach to HRCT scanning and identifies the features that allow an accurate diagnosis of the idiopathic interstitial pneumonias to be made. The role of surgical lung biopsy is discussed in the diagnosis of cases when a definite HRCT diagnosis cannot be made.
The impact of human enterovirus (HEV) and human rhinovirus (HRV) respiratory tract infections in adult patients with hematological malignancies has been infrequently reported. We retrospectively studied 31 patients with an upper or lower respiratory tract infection.
Allergy and Asthma Proceedings, Number 3, 5/6 2007 , pp. 375-381(7)
Suboptimal asthma control may be caused by a combination of factors, such as nonadherence to guidelines, lack of compliance, and poor asthma education. The aim was to assess patients' knowledge of asthma and different management strategies, including patients' attitudes toward involvement in treatment decisions.
American Journal of Public Health 1376-1382 August 2007, Vol 97, No. 8
There is mounting evidence that documents the dangers of exposure to secondhand smoke, including in the workplace. In states that permit workplace smoking, employers face significant legal risks from employees who are exposed to secondhand smoke on the job. Employers have been held liable for employee exposure to secondhand smoke in numerous cases, including those based on workers' compensation, state and federal disability law, and the duty to provide a safe workplace. Given this liability risk, employers should voluntarily adopt smoke-free workplace policies. Such policies do more than fulfill an employer's legal obligation to provide a safe workplace; they also reduce the risk of litigation, potentially reduce
workers' compensation premiums, and protect employees from harm.
The use of administrative databases to perform epidemiological studies in asthma has increased in recent years. The absence of clinical parameters to measure the level of asthma severity and control is a major limitation of database studies. A study was undertaken to develop and validate two database indexes to measure the control and severity of asthma.
Pediatric Infectious Disease Journal. 26(8):733-739, August 2007
The relation between early respiratory syncytial virus (RSV) infection and later emergence of episodes of wheezing/asthma remains a subject of debate. We carried out a systematic review of studies of the association between RSV infection in the first 36 months of life and the subsequent development of asthma/bronchial hyperreactivity.
A short cut review was carried out to establish whether ultrasonography is as sensitive and specific as chest x ray or computed tomography (CT) scan in detecting haemothorax after chest trauma. Thirty-nine papers were found using the reported searches, of which six presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are shown in table 3. It is concluded that ultrasonography is more sensitive and as specific as chest x ray at detecting haemothorax in patients with chest trauma.
Pneumonia is a major cause of morbidity and mortality after stroke. We aimed to determine key characteristics that would allow prediction of those patients who are at highest risk for poststroke pneumonia.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 443 - 448
A single deep inspiration (DI) is known to be a potent bronchodilator but it is not known if repeated DI can accelerate sustained recovery from bronchoconstriction. Methods. We induced sustained bronchoconstriction using increasing concentrations of nebulized methacholine (Mch) during tidal breathing and assessed airway narrowing by measuring respiratory resistance (Rrs) using forced oscillation in six healthy subjects.
International Archives of Occupational and Environmental Health, Volume 80, Number 7, July 2007 , pp. 649-652(4)
Organic waste workers are exposed to high endotoxin levels that may result in respiratory health effects. This study describes changes in lung function and methacholine airway responsiveness over a workweek in household organic waste loaders.
Inhaled asbestos fibres can cause inflammation and fibrosis in the lungs called asbestosis. However, there are no non-invasive means to assess and follow the severity of the inflammation. Exhaled nitric oxide (NO) measured at multiple exhalation flow rates can be used to assess the alveolar NO concentration and bronchial NO flux, which reflect inflammation in the lung parenchyma and airways, respectively. The aim of the present study was to investigate whether exhaled NO or markers in exhaled breath condensate could be used to assess inflammation in asbestosis.
American Journal of Reproductive Immunology, Volume 58, Number 2, August 2007 , pp. 120-128(9)
Asthma has its origins in early-life. Maternal, not paternal asthma is an important risk factor, but the mechanisms and the duration of the maternal effect are unknown.
American Journal of Medical Quality, Vol. 22, No. 4, 259-264 (2007)
In this study, we compared large urban teaching hospitals (group 1) with small nonurban nonteaching hospitals (group 2) in terms of administering antibiotics to patients admitted with pneumonia within 4 hours of hospital arrival. The following 2 independent data sets were used: hospital-reported data (comprising 22 193 patients with pneumonia discharged from Michigan hospitals in 2003) and hospital surveillance data (comprising 1053 randomly selected patients with pneumonia in Michigan from 2002 to 2004, reviewed by a central data abstraction center).
urnal of Asthma, Volume 44, Issue 6 July 2007 , pages 423 - 427
The purposes of this study were to examine relationship between depression and resilience in children with asthma and identify factors associated with depression. Data were collected from 86 children who ranged in age from 10 to 15 years and who had been diagnosed with asthma for over 6 months.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 475 - 478
The relationship between exhaled nitric oxide (eNO) and bronchial hyperresponsiveness (BHR) should be clarified. The aim of this study was to determine the relationship between eNO and exercise-induced bronchospasm (EIB) by estimation of the each lung parameter in asthmatic children who performed a bicycle ergometer exercise test.
Current Opinion in Pulmonary Medicine. 13(5):384-388, September 2007
This review describes the accuracy of multidetector contrast-enhanced computed tomography (CT) for the diagnosis of acute pulmonary embolism, the role of clinical assessment and of venous phase imaging in combination with it, and the approach to the diagnosis.
Bronchiectasis continues to be a major cause of morbidity and mortality in developing countries. The purpose of this study was to present the results of our 14 years of surgical experience to re-evaluate our indications for using surgical therapy and to analyze several factors that might affect the outcome and postoperative complications of this disease.
Pediatric Critical Care Medicine. 8(4):317-323, July 2007
Acute lung injury (ALI) is poorly defined in children. The objective of this prospective study was to clarify the incidence, demographics, management strategies, outcome, and mortality predictors of ALI in children in Australia and New Zealand.
Epidemiological evidence from observational studies has suggested that blood levels and dietary intake of selenium of adults with asthma are lower than those of controls. The only previous trial of selenium supplementation in adults with asthma found no objective evidence of benefit but involved only 24 participants.
Despite national disease management plans, optimal asthma management remains a challenge in Australia. Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of best practice. The impact of the Pharmacy Asthma Care Program (PACP) on asthma control was assessed using a multi-site randomised intervention versus control repeated measures study design.
Acid reflux may aggravate airway disease including asthma and chronic cough. One postulated mechanism concerns a vagally-mediated oesophageal-tracheobronchial reflex with airway sensory nerve activation and tachykinin release.
Clinical & Experimental Immunology, Volume 149, Number 2, August 2007 , pp. 295-302(8)
Specific anti-polysaccharide antibody deficiency (SPAD) is an immune disorder. Diagnostic criteria have not yet been defined clearly. One hundred and seventy-six children evaluated for recurrent respiratory tract infections were analysed retrospectively.
Alterations to pulmonary surfactant composition have been encountered in the Acute Respiratory Distress Syndrome (ARDS). However, only few data are available regarding the time-course and duration of surfactant changes in ARDS patients, although this information may largely influence the optimum design of clinical trials addressing surfactant replacement therapy. We therefore examined the time-course of surfactant changes in 15 patients with direct ARDS (pneumonia, aspiration) over the first 8 days after onset of mechanical ventilation.
Rapidly growing mycobacteria (RGM) are ubiquitous in the environment but cause lung disease in only a fraction of exposed individuals. This variable susceptibility to disease implies vulnerability to RGM infection due to weakness in host defense. Since most persons who contract RGM lung disease have no known host defense defect, it is likely that uncharacterized host deficiencies exist that predispose to RGM infection.
International Archives of Occupational and Environmental Health, Volume 80, Number 7, July 2007 , pp. 627-633(7)
Exposure to aluminium compounds, such as fluorides in gaseous and particulate form, places people who work in potrooms at risk for respiratory symptoms. Workers in potrooms, however, also are exposed to a number of other air contaminants.
Although pulmonary endarterectomy (PEA) is potentially curative in chronic thromboembolic pulmonary hypertension (CTEPH), some patients have distally distributed disease that is not amenable to surgery. The aetiology and characteristics of this patient group are currently not well understood.
Bronchiolocentric fibrosis is essentially represented by the pathological pattern of constrictive fibrotic bronchiolitis obliterans. The corresponding clinical condition (obliterative bronchiolitis) is characterised by dyspnoea, airflow obstruction at lung function testing and air trapping with characteristic mosaic features on expiratory high resolution CT scans. Bronchiolitis obliterans may result from many causes including acute diffuse bronchiolar damage after inhalation of toxic gases or fumes, alloimmune chronic processes after lung or haematopoietic stem cell transplantation, or connective tissue disease (especially rheumatoid arthritis). Airway-centred interstitial fibrosis and bronchiolar metaplasia are other features of bronchiolocentric fibrosis
Background: Right ventricular (RV) dysfunction is associated with increased morbidity and mortality in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who undergo pulmonary endarterectomy (PEA). We studied whether plasma brain natriuretic peptide (BNP) levels can be used to identify RV dysfunction in CTEPH patients. Therefore, plasma BNP levels were studied in relation to cardiac remodeling and function as determined by cardiac magnetic resonance imaging (MRI).
Allergy and Asthma Proceedings, Volume 28, Number 3, 5/6 2007 , pp. 353-361(9)
Despite long-term studies, still not much is known about the asthma triggering factors and its sometimes controversial results. Probably one of the major problems of controversy is the lack of specific and accurate diagnosis of this disease.
Allergy and Asthma Proceedings, Volume 28, Number 3, 5/6 2007 , pp. 362-367(6)
Allergy is considered to be caused by complex interactions between genetic and environmental factors. Socioeconomic status (SES) may be the most important environmental determinant of allergy because it determines the living environment, but few studies have addressed the causal role of SES in allergy.
PharmacoEconomics, Volume 25, Number 8, 2007 , pp. 665-676(12)
To evaluate the healthcare resource use and costs associated with adding montelukast to therapy in patients with mild to moderate persistent asthma and co-morbid seasonal allergic rhinitis whose asthma is inadequately controlled by their current asthma therapy.
Although there is now substantial evidence that pulmonary artery (PA) catheterization does not reduce mortality in critically ill patients, it is unknown whether national utilization has decreased in response.
Allergy and Asthma Proceedings, Volume 28, Number 3, 5/6 2007 , pp. 348-352(5)
Exercise-induced bronchospasm (EIB) is a clinical syndrome that affects 8-20% of the general population and 11-50% of athletes. Although a variety of testing protocols for the diagnosis of EIB have been pursued, the optimal algorithm still is lacking.
Monitoring of respiratory function is important in the diagnosis and management of respiratory disease. The forced oscillation technique requires minimal patient cooperation and is ideal for the determination of respiratory function in young children. This study aimed to develop reference ranges and to document the repeatability in healthy young children using commercially available forced oscillation equipment.
A study was undertaken to test the hypothesis that severe exacerbations of asthma are characterised by increased bronchial mucosal neutrophilia associated with upregulation of neutrophil chemoattractant ligands and their specific cell surface receptors.
The aim of our study was to review retrospectively the imaging findings on tracheobronchial leiomyoma and to compare them with the pathologic findings.
Pediatric Critical Care Medicine. 8(4):372-377, July 2007
To evaluate the association between deadspace/tidal volume ratio (Vd/Vt) and gas exchange variables: Pao2, Paco2, Pao2/Fio2, arterial/alveolar oxygen tension ratio (Pao2/PAo2), alveolar-arterial oxygen tension difference/arterial oxygen tension ratio (P(A-a)o2/Pao2), carbon dioxide production ([latin capital V with dot above]co2), ventilation index ([Paco2 x peak inspiratory pressure x mechanical respiratory rate]/1000), and oxygenation index ([mean airway pressure x Fio2 x 100]/Pao2), all measured at an early stage in children with obstructive acute respiratory failure.
Pneumocystis jirovecii, formerly carinii, pneumonia (PCP) poses a life-threatening risk to oncology patients. The use of trimethoprim-sulfamethoxazole (TMP-SMZ) prophylaxis virtually eliminates the risk of infection; however, many patients cannot tolerate TMP-SMZ. We performed a retrospective analysis to determine the PCP breakthrough rate in pediatric oncology patients receiving intravenous pentamidine as second line PCP prophylaxis.
Respirology, Volume 12, Number 4, July 2007 , pp. 543-550(8)
Patients with expiratory central airway collapse present with various symptoms, aetiologies, morphologies, extent and severity of airway collapse. The aim of this study was to delineate a multidimensional classification system and common language for evaluating patients with expiratory central airway collapse.
A 45-year-old man presented to the emergency room after three syncopes. ECG showed sinus rhythm with complete right bundle branch block and left anterior fascicle block. Echocardiography and 24 h ECG monitoring were normal. Chest radiography showed small patchy infiltrations and spiro-ergometry tests showed normal carbon monoxide transfer factor but a reduction in physical capacity (maximum oxygen consumption 70%) associated with an effort-related grade II atrioventricular block. An MRI scan of the heart using gadolinium showed enhancement at the anteroseptal level (fig 1A), and 18F-FDG positron emission tomography (PET) showed focal uptake at exactly the same location (fig 1B). Transbronchial biopsy specimens showed typical granulomas and bronchoalveolar lavage revealed lymphocytosis of 26% and a CD4/CD8 quotient of 7.5, both compatible with sarcoidosis.
To quantify the incidence of unsuspected pulmonary emboli (PE) in an unselected inpatient population undergoing contrast enhanced multidetector CT (MDCT) scanning of the thorax and to assess aetiological factors in their development.
Clinical Pulmonary Medicine. 14(4):212-216, July 2007
H5N1 influenza has recently appeared as a predominantly avian infection that can be transmitted to humans following exposure to infected birds. Should this virus mutate to become a human virus, the health and economic impact would be considerable. This review discusses options with regard to vaccine, antivirals, and interventions within the community and stresses the need for preparation at all levels of society.
High C-reactive protein (CRP) and homocysteine levels are risk factors for cardiovascular disease. Some, but not all, previous studies have reported increased levels of CRP and homocysteine in patients with obstructive sleep apnoea syndrome (OSAS). A study was undertaken to investigate the levels of these factors in carefully selected patients with OSAS and matched normal controls.
USAN approved name, a new topically active glucocorticoid has been recently identified. The aim of this study was to characterise the binding affinity of this compound to the human lung glucocorticoid receptor in relation to other glucocorticoids.
Clinical Pulmonary Medicine. 14(4):197-205, July 2007
Invasive aspergillosis (IA) typically develops in patients with compromised immune status and/or severe neutropenia. The clinical manifestations are not specific, but there are suggestive radiographic appearances.
Respirology, Volume 12, Number 4, July 2007 , pp. 531-542(12)
The temporal importance of prognostic indicators for severe acute respiratory syndrome (SARS) has not been studied. This study identified the various clinical prognostic factors for SARS and described the temporal evolution of these factors in the course of the SARS illness in Hong Kong in 2003.
Respirology, Volume 12, Number 4, July 2007 , pp. 585-590(6)
Glucocorticoids have been shown to improve survival when used in patients with septic shock. The aim of this study was to analyse the role of glucocorticoids in decreasing mortality in acute respiratory distress syndrome (ARDS) both in the acute and the fibroproliferative phases.
PharmacoEconomics, Volume 25, Number 8, 2007 , pp. 695-711(17)
Roflumilast is an oral, once-daily phosphodiesterase IV (PDE4) inhibitor under investigation for chronic obstructive pulmonary disease (COPD). This study investigated the cost effectiveness of roflumilast in patients with severe to very severe COPD from the perspective of the UK society and UK NHS.
Clinical Pulmonary Medicine. 14(4):225-231, July 2007
Obstructive sleep apnea (OSA), a widely prevalent disease, is the most frequent form of sleep-disordered breathing encountered by adults of all age groups and is associated with serious medical, public health, and economic sequelae.
PharmacoEconomics, Volume 25, Number 8, 2007 , pp. 677-683(7)
Antibacterial cost-containment programmes emphasise the use of narrow-spectrum generic agents whenever possible. The use of these agents is driven by their lower purchase prices; the consequences of treatment failure are rarely considered. This study was conducted to identify the costs of treating patients hospitalised with community-acquired pneumonia (CAP) associated with Streptococcus pneumoniae following failure to respond to outpatient treatment with macrolide antibacterials.
Clinical Pulmonary Medicine. 14(4):232-239, July 2007
Step-up management algorithms are recommended by recently published clinical guidelines for use in pulmonary arterial hypertension (PAH). Decisions regarding when and which treatment should be introduced as well as whether and when to escalate the treatment by augmenting the dose, switching to or adding another drug, changing the administration route or progressing to interventional therapy require monitoring of the severity of disease and assessment of its response to applied treatment.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 224-230, (2007)
Recent advances in imaging offer exciting opportunities to develop and validate lung-specific biomarkers as valuable adjuncts to diagnosis, tests of treatment efficacy, and/or treatment monitoring. State-of-the-art structural, functional, and molecular imaging methods allow the lungs to be visualized noninvasively in vivo at submillimeter and subsecond spatial and temporal scales.
The addition of bronchoscopy in the management of patients with ventilator-associated pneumonia (VAP) does not have any beneficial effect on clinical outcomes.
Clinical Pulmonary Medicine. 14(4):242-243, July 2007
The addition of inhaled iloprost in patients with pulmonary arterial hypertension with reduced exercise capacity already on bosentan monotherapy is safe and efficacious.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 261-269, (2007)
The molecular mechanisms of muscle atrophy in chronic obstructive pulmonary disease (COPD) are poorly understood. In wasted animals, muscle mass is regulated by several AKT-related signaling pathways.
The purpose of this study was to evaluate the clinical applicability and feasibility of deep-inspiratory breath-hold (DIBrH) perfusion SPECT for improving adverse respiratory motion effects and for accuracy of SPECT/CT image fusion.
European Journal of Emergency Medicine. 14(4):207-211, August 2007
We compared the usefulness of plasma N-terminal-pro B-type natriuretic peptide and troponin I levels for risk stratification of patients with pulmonary embolism.
Clinical Pulmonary Medicine. 14(4):240-242, July 2007
Elderly patients with clinically suspected idiopathic pulmonary hypertension (IPAH) often fail to meet usual hemodynamic criteria because of elevated pulmonary capillary wedge pressures (PCWP). Those with normal PCWP by current criteria for diagnosing PAH had worse survival than those with elevated PCWP.
Lung, Volume 185, Number 3, May 2007 , pp. 139-144(6)
Diffuse lung diseases (DLD) are a heterogeneous group of diseases with different etiopathogenesis, clinical course, and prognosis. It has been demonstrated that oxidative stress can contribute to the pathogenesis of these diseases.
Clinical & Experimental Allergy, Volume 37, Number 7, July 2007 , pp. 1023-1032(10)
Asthma is characterized by increases in mature eosinophils and their progenitors within the bronchus and bone marrow. IL-5 plays a key role in eosinophil development in the bone marrow and at the site of allergic inflammation. We therefore studied the effects of nebulized IL-5 on eosinophils, their progenitors and in situ haemopoiesis within the airway and bone marrow.
Clinical Pulmonary Medicine. 14(4):191-196, July 2007
Osteoporosis is a disease that is increasingly prevalent worldwide, affecting aging individuals especially. Likewise, the use of medications such as corticosteroids and the constant rise in the survival of patients suffering from chronic medical diseases has placed more patients at risk for osteoporosis than in the past. Chronic obstructive pulmonary disease (COPD) is a chronic condition characterized by progressive dyspnea and frequent exacerbation that often leads to hospital admission.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 479 - 483
Healthcare costs were determined for mild persistent asthma patients (n = 796) who used inhaled corticosteroids infrequently (0 to 2 claims) or consistently (3 or more claims). Study patients, selected from a privately insured claims database (1999-2003), had at least one asthma diagnosis, no diagnosis of chronic obstructive pulmonary disease (COPD), and mild persistent asthma as defined by the 2005 Health Plan Employer Data and Information Set (HEDIS), Leidy's reliever and oral steroid methods, and the 2004 Global Initiative for Asthma (GINA) guidelines.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 411 - 422
Inhaled corticosteroids, long-acting B2-adrenoceptor agonists, and leukotriene receptor antagonists are widely used for treatment of asthma. Inhaled corticosteroids are recommended as first-line therapy, whereas long-acting B2-adrenoceptor agonists and leukotriene receptor antagonists are indicated as add-on therapy in patients not adequately controlled with corticosteroids alone.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 449 - 453
Abstract
Over 3 years, 972 families participated in an after-school asthma program at their child's school. Parents and children attended concurrent 21/2 -hour workshops. Parents were 74% Latino; 45% non-English speaking, with 77% of children on Medicaid. Asthma symptoms were significantly reduced, from multiple times per week to less than once per week on average.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 433 - 436
The purpose of this study was to estimate the prevalence of asthma in German adults. Methods. This analysis used data of 8,318 German adults 18 years of age and older who had participated in the German National Telephone Survey, a nationally representative cross-sectional study.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 429 - 432
Scientific evidence suggests that lycopene and antioxidant vitamins have significant antioxidant and protective effects. Methods: This case-control study included 96 subjects (40 asthmatics, 56 healthy control subjects).
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 423 - 427
The purposes of this study were to examine relationship between depression and resilience in children with asthma and identify factors associated with depression. Data were collected from 86 children who ranged in age from 10 to 15 years and who had been diagnosed with asthma for over 6 months.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 475 - 478
The relationship between exhaled nitric oxide (eNO) and bronchial hyperresponsiveness (BHR) should be clarified. The aim of this study was to determine the relationship between eNO and exercise-induced bronchospasm (EIB) by estimation of the each lung parameter in asthmatic children who performed a bicycle ergometer exercise test.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 455 - 460
The efficacy of residential interventions to reduce cockroach allergens in public housing developments was evaluated over months of follow-up. Repeated measurements were collected from 39 apartments, with longitudinal analyses used to evaluate changes over time. Bla g 1 kitchen concentrations were reduced 71% and bed concentrations 53% (86% and 70% for Bla g 2, respectively) by 6 months post-intervention, after which concentrations began to increase.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 443 - 448
A single deep inspiration (DI) is known to be a potent bronchodilator but it is not known if repeated DI can accelerate sustained recovery from bronchoconstriction.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 461 - 467
The aim of this study was to determine the level of asthma control and the concordance between physicians' and patients' opinions and the real patients' situation. A total of 777 subjects (55% female) with asthma were recruited. The study comprised a 4-week follow-up period, during which subjects completed a diary recording peak expiratory flow (PEF), symptoms, and use of rescue medication.
Journal of Asthma, Volume 44, Issue 6 July 2007 , pages 469 - 473
Obesity is well recognized as a state of increased insulin resistance and has been implicated as a significant risk factor for both asthma prevalence and asthma severity in children and adolescents. However, little is known about the specific factors that relate asthma and obesity.
The Journal of the American Board of Family Medicine 20 (4): 392-398 (2007)
This paper presents data evidence supporting the value of diagnosing and treating obstructive sleep apnea (OSA) in reducing morbidity and mortality, improving comorbid disease processes, and improving patient quality of life.
Pediatric Critical Care Medicine. 8(4):378-382, July 2007
The histopathologic pattern of acute fibrinous and organizing pneumonia (AFOP) has been described recently in cases of acute respiratory distress syndrome (ARDS) in adults and differs from the well-recognized pattern of classic diffuse alveolar damage (DAD). The objective of this study was to determine whether similar appearances can be seen in infant ARDS.
Respirology, Volume 12, Number 4, July 2007 , pp. 619-621(3)
The aim of the present study was to determine the incidence of Q fever in patients with an acute exacerbation of a chronic lower respiratory tract infection. Eighty patients treated for acute exacerbation of chronic lower respiratory tract infections during a 30-month period were studied. Q fever was diagnosed by ELISA. Two elderly woman with pre-existing bronchiectasis (2.5%) were diagnosed as having an acute infection by Coxiella burnetii.
Pediatric Critical Care Medicine. 8(4):383-385, July 2007
The patient was initially placed on a conventional ventilator in a pressure-regulated volume-control mode but needed higher-than-normal pressures to maintain adequate ventilation. A decision was made to switch the patient to a pressure-control/pressure-support mode. At the end of the third day of pressure-control/pressure-support mode, a decision was made to attempt airway pressure-release ventilation.
Respirology, Volume 12, Number 4, July 2007 , pp. 614-616(3)
Several cases of non-traumatic pulmonary haematoma have been reported in the literature. However, very few of them are related to anticoagulation therapy. The authors report two cases of pulmonary haematoma caused by oral anticoagulant therapy without any underlying pathological lesion.
Respirology, Volume 12, Number 4, July 2007 , pp. 610-613(4)
We report a patient methicillin-resistant Staphylococcus aureus pneumonia who developed fluid collections in three spaces in the thorax, the pleural space, the pericardial space, and a pre-existing bulla, in addition to mediastinal oedema.
The aim of this study was to retrospectively evaluate 140 patients with severe (97 massive, 43 moderate) haemoptysis treated by bronchial artery embolisation.
Southern Medical Journal. 100(7):669-676, July 2007
The aims of this study are to define the length of the respiratory syncytial virus (RSV) season throughout Florida and evaluate the American Academy of Pediatrics (AAP) guidelines on the administration of palivizumab in light of the Florida data.
To retrospectively compare in patients with chronic hypersensitivity pneumonitis (HP) the computed tomographic (CT) imaging features suggestive of fibrosis with pathologic evidence of fibrosis at surgical lung biopsy and to compare a usual interstitial pneumonia (UIP) pattern at CT with survival.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 231-237, (2007)
Current asthma guidelines recommend adjusting antiinflammatory treatment on the basis of the results of lung function tests and symptom assessment, neither of which are closely associated with airway inflammation.
To evaluate the safety of inferior vena cava (IVC) filter retrieval in therapeutically anticoagulated patients in comparison to prophylactically or not therapeutically anticoagulated patients with respect to retrieval-related hemorrhagic complications.
Respirology, Volume 12, Number 4, July 2007 , pp. 573-580(8)
Inhaled corticosteroids are recognized as first-line therapy in the management of asthma; however, their use may be limited by systemic and local side-effects. Ciclesonide, a novel pro-drug inhaled corticosteroid, is activated in the lungs and is expected to have less systemic and local side-effects.
This study investigated whether right ventricular (RV) diastolic function is impaired in pulmonary hypertension (PH) patients, and whether it is related to RV mass and afterload. In addition, the effects of an acute reduction of RV afterload by the oral intake of sildenafil were studied. Finally, we assessed whether diastolic function is related to cardiac parameters of disease severity.
Obstructive sleep apnea (OSA) in children is associated with severity-dependent changes in neurocognitive functioning. However, the severity of OSA accounts for only approximately 40% of the variance in cognitive performance. Thus, genetic determinants of individual susceptibility may also contribute to the morbidity of OSA. Considering the unique susceptibility of apolipoprotein E (ApoE) knock-out mice to an experimental model of OSA, we examined whether the APOE e4 allele contributes to increased neurocognitive morbidity in pediatric OSA.
Pediatric Critical Care Medicine. 8(4):324-330, July 2007
To describe the changes that have occurred in mechanical ventilation in children with acute lung injury in our institution over the last 10-15 yrs and to examine the impact of these changes, in particular of the delivered tidal volume on mortality.
Respirology, Volume 12, Number 4, July 2007 , pp. 551-559(9)
Non-invasive positive pressure ventilation (NPPV) is an established treatment in restrictive thoracic disorders (RTD) with chronic hypercapnic respiratory failure. The aim of this study was to identify predictors of long-term survival for patients on NPPV therapy.
Respirology, Volume 12, Number 4, July 2007 , pp. 516-522(7)
BHR is a clinical feature of asthma and factors crucial to the development of BHR remain to be elucidated. Asymptomatic BHR also occurs in the general population. This study examined the prevalence of asymptomatic BHR in a population of young Japanese atopic individuals to identify whether airway inflammation is present in asthmatic patients but not in asymptomatic subjects with BHR.
Adiponectin is an adipose tissue-derived specific protein that has antiinflammatory as well as antiatherosclerotic effects. In the United States, many patients with COPD are obese and die of cardiovascular diseases. However, in Japan, patients with COPD are frequently cachexic and die of respiratory failure. This study was designed to investigate the role of adiponectin in these differences in characteristics of COPD.
Respirology, Volume 12, Number 4, July 2007 , pp. 560-565(6)
Fourteen day re-admission rates are deemed to be an important indicator of the quality of medical care for COPD in Taiwan. This study identified the characteristics of patients with COPD who required short-term re-admission and analysed the risk factors for 1-year mortality.
Obstructive sleep apnea (OSA) is a highly prevalent disease characterized by recurrent episodes of upper airway obstruction that result in recurrent arousals and episodic oxyhemoglobin desaturations during sleep. Significant clinical consequences of the disorder cover a wide spectrum, including daytime hypersomnolence, neurocognitive dysfunction, cardiovascular disease, metabolic dysfunction, and cor pulmonale.
Chronic cough (CC) can be refractory to medical treatment and newer strategies are required for these patients. Behaviour modification therapies are a potential approach for management of cough that does not respond to medical management. Behaviour modification therapy for CC involves an individually tailored programme teaching individuals to increase control over cough symptoms and includes education, specific strategies to suppress the cough, vocal hygiene training and psychoeducational counselling.
Cytochrome P-450 2J2 (CYP2J2) has recently been shown to be an important enzyme in the metabolism of epoxygenase-derived eicosanoids that play important functional roles in pulmonary physiology and may contribute to the pathogenesis of asthma.
Respirology, Volume 12, Number 4, July 2007 , pp. 566-572(7)
Inhaled corticosteroids are recommended as first-line therapy for the management of asthma, although side-effects may limit their use. Ciclesonide, a novel pro-drug inhaled corticosteroid, exerts potent and prolonged local anti-inflammatory effects in the lungs, and is considered to have an improved safety and tolerability profile. The aim of this study was to evaluate the efficacy and safety of ciclesonide in adult patients with mild to moderate asthma.
Clinical & Experimental Allergy, Volume 37, Number 7, July 2007 , pp. 1083-1089(7)
We examined the effects of suplatast tosilate, which prevents T-helper type 2 responses, on the differentiation and function of monocyte-derived DCs (moDCs).
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 169-185, 2007
When cultured at an air liquid interface (ALI) in the appropriate medium, primary human airway epithelial cells form a polarized, pseudostratified epithelium composed of ciliated and mucus-secreting cells. This culture system provides a useful tool for the in vitro study of airway epithelial biology and differentiation. We have performed microarray analysis on ALI cultures of human bronchial epithelial cells
(HBECs) grown over a 28-d period to identify genes involved in mucociliary differentiation.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 202-209, 2007
IL-9 overexpression protects against alveolar fibrosis induced by crystalline silica particles. This cytokine is also involved in allergic asthma. In the present study, we examined the effect of IL-9 overexpression on the subepithelial fibrotic response, a feature of asthmatic remodeling, induced by chronic exposure to Alternaria alternata extract.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 193-201, 2007
Idiopathic pulmonary fibrosis (IPF) is a progressive, scarring lung disease characterized by fibroblast accumulation and deposition of collagen. Factors that promote growth and/or survival of fibroblasts are potential therapeutic targets.
To assess speech results and rate of obstructive sleep apnea using a modified, superiorly based pharyngeal flap performed after staged adenotonsillectomy in a group with velopharyngeal insufficiency.
Women with asthma have greater mortality and morbidity than men in the United States. To date, there has been no rigorous evaluation of an intervention focused on the particular problems in asthma management faced by women. This study was a randomized clinical trial of a self-regulation, telephone counseling intervention emphasizing women’s concerns, and sex and gender role factors in their management of asthma.
Continuing Education in Anaesthesia, Critical Care & Pain 2007 7(4):131-134
Respiratory failure is perhaps the single most common reason for the emergency admission of patients to Intensive Care. It can be defined as the failure of the respiratory system to deliver adequate oxygen to, and remove adequate carbon dioxide from, the arterial blood, to a degree that causes a threat to life.
Anaesthesia, Volume 62, Number 8, August 2007 , pp. 769-773(5)
During apnoea following induction of anaesthesia, morbidly obese patients may suffer a rapid decrease in oxygen saturation. This study compares pre-oxygenation alone with pre-oxygenation followed by nasopharyngeal oxygen insufflation on the onset of desaturation occurring during the subsequent apnoea. A randomised controlled trial was performed in 34 morbidly obese patients undergoing gastric bypass or gastric band surgery.
The diagnosis of ventilator-associated pneumonia (VAP) can be difficult. Soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) has been reported to be elevated in BAL fluid from patients with VAP.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 2 April 2007 , pages 163 - 166
Epidemiologic studies suggest that as many as 75% of patients with COPD have concomitant nasal symptoms and more than 1/3 of patients with sinusitis also have lower airway symptoms of asthma or COPD. Because the inflammatory response of the upper and lower airways are similar, and both sites have a similar exposure to allergens and irritants, it is not surprising that rhinitis or sinusitis would coexist with COPD.
Cardiac index is an important determinant of outcome in patients with idiopathic pulmonary artery hypertension (IPAH). An implantable hemodynamic monitor (IHM) [Chronicle; Medtronic; Minneapolis, MN; a system limited to investigational use only] that records right ventricular (RV) pressure waveforms continuously may increase our understanding of IPAH and improve therapeutic selections and outcomes.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 167-173, (2007)
Chronic obstructive pulmonary disease (COPD) is a complex disease influenced by multiple genes and environmental factors. A region on chromosome 2q has been shown to be linked to COPD. A positional candidate gene from the chromosome 2q region SERPINE2 (Serpin peptidase inhibitor, clade E [nexin, plasminogen activator inhibitor type 1], member 2), was previously evaluated as a susceptibility gene for COPD in two association studies, but the results were contradictory.
Lung, Volume 185, Number 3, May 2007 , pp. 145-149(5)
The aim of this study was to compare the frequency of the HLA-DRB1 and HLA-DQB1 alleles in Korean patients with idiopathic pulmonary arterial hypertension (IPAH) and in normal controls and to determine any association that may exist between clinical characteristics of IPAH and specific HLA alleles.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 2 April 2007 , pages 107 - 112
There is increasing interest in the objective measurement of physical activity in chronic obstructive pulmonary disease (COPD) patients due to the close relationship between physical activity level, health, disability and mortality. We aimed to (a) determine the validity and reproducibility of an activity monitor that integrates accelerometry with multiple physiologic sensors in the determination of energy expenditure in COPD subjects and (b) to document the independent contribution of the additional physiologic sensors to accelerometry measures in improving true energy expenditure determination.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 2 April 2007 , pages 113 - 120
The aim of this study was to describe the impact of using bronchodilators on the prevalence of Chronic Obstructive Pulmonary Disease in a population-based survey (Platino study). A cluster sampling of subjects 40 years of age or older, representative of the metropolitan areas of 5 Latin American cities (Sao Paulo, Mexico, Montevideo, Santiago and Caracas) was chosen. Spirometry according to ATS standards was done before and after inhalation of 200 micrograms of salbutamol in 5183 subjects. Prevalences of airflow obstruction were estimated using different criteria, in tests done before and after bronchodilator use, and with reference values for pre- or post-bronchodilator use.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 2 April 2007 , pages 121 - 126
Chronic obstructive pulmonary disease (COPD) is associated with a continuous systemic inflammatory response. Furthermore, COPD is associated with an excess risk for cardiovascular disease and type II diabetes. Systemic inflammation in other populations is a factor in atherogenesis and has been associated with insulin resistance. We assessed the association between systemic inflammation and insulin resistance in non-hypoxaemic patients with COPD.
Pediatric Allergy and Immunology, Volume 18, Number 4, June 2007 , pp. 293-297(5)
Brain-derived neurotrophic factor (BDNF) has been described to modulate airway hyper-responsiveness and inflammation and was involved in late allergic reaction in asthma and higher levels of circulating BDNF were present in allergic asthmatics.
PD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 2 April 2007 , pages 127 - 134
Recent retrospective studies have suggested that use of inhaled corticosteroids (ICS) may improve survival in chronic obstructive pulmonary disease (COPD), particularly when combined with a long-acting beta-agonist (LABA). However, the study methodologies have been questioned, and no study has examined the survival effect of the newer combination ICS/LABA inhalers.
Untreated pulmonary arteriovenous malformations (PAVMs) can present with life-threatening complications. Agitated saline solution transthoracic contrast echocardiography (TTCE) has been recommended as the screening test of choice for PAVMs in hereditary hemorrhagic telangiectasia (HHT). A TTCE grading system has been proposed but not validated. The aim of this study was to determine the positive predictive value (PPV) of TTCE grades for the presence of PAVMs on CT.
Internet and short message service are emerging tools for chronic disease management in adolescents, but few data exist on the barriers to and benefits of internet-based asthma self-management. Our objective was to reveal the barriers and benefits perceived by adolescents with well-controlled and poorly controlled asthma to current and internet-based asthma management.
The aim of this study was to determine whether the severity of sleep-disordered breathing (SDB) was associated with increased levels of uric acid (UA), both in serum and in urine, as a marker of tissue hypoxia, in a sample of overweight and obese subjects, irrespective of indexes of adiposity.
Psychiatric disorders are highly prevalent in patients with COPD. In general, psychiatric disorders are more common in women than in men. The extent to which women with COPD suffer from greater psychiatric and psychological morbidity is not known. The present cross-sectional study evaluated the prevalence of mood and anxiety disorders, levels of psychological distress, and quality of life in 62 women and 54 men with documented, stable COPD.
Lung, Volume 185, Number 3, May 2007 , pp. 161-171(11)
The aim of this study was to test the hypothesis that systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) is accompanied by enhanced interleukin 18 (IL-18) expression in skeletal muscle, which may precede muscle weight loss.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 2 April 2007 , pages 143 - 161
Chronic obstructive pulmonary disease (COPD) is divided into pulmonary emphysema and chronic bronchitis (CB). Emphysema is defined patho-anatomically as "permanent enlargement of airspaces distal to the terminal bronchiole, accompanied by the destruction of their walls, and without obvious fibrosis" (1). These lesions are readily identified and quantitated using computed tomography (CT), whereas the accompanying hyperinflation is best detected on plain chest X-ray, especially in advanced disease.
A significant proportion of individuals who have no symptoms of asthma or other respiratory diseases show bronchial hyperresponsiveness (BHR). BHR is usually assessed by measuring the provocative concentration of methacholine causing a 20% fall in FEV1 (PC20).
COPD primarily affects the lungs but also produces systemic consequences that are not reflected by the recent staging according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Body mass index (BMI) and fat-free mass index (FFMI) represent different aspects of nutrition abnormalities in COPD. We investigated whether BMI and FFMI could be related to parameters expressing airflow obstruction and limitation, exercise capacity, airway inflammation, and quality of life, and whether they would reflect the GOLD staging of the disease.
Several studies in the past few decades have shown that very intense and repeated exercise, particularly when performed over many years, could cause respiratory health problems.
Pneumococcal disease is a serious condition that may result in considerable morbidity causing pneumonia, bacteremia, or meningitis. It is known to kill more people in the U.S. each year than all other vaccine-preventable diseases combined.
Understanding of the underlying pathophysiology of asthma will allow the pharmacist to better evaluate drug therapy for appropriateness. Current drug therapies target the two basic components of asthma: airway inflammation and bronchoconstriction. Chronic inflammation plays a key role in the changes that occur in patients.
House dust mites (HDM) have been shown to be important sources of indoor allergens associated with asthma and other allergic conditions. While exogenous proteases from allergens have a direct proinflammatory role in the respiratory tract, the precise mechanisms underlying the release of cytokines from the respiratory epithelium are unclear.
Chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity and mortality in the United States. In fact, 11.4 million Americans ages 18 and older were reported to suffer from COPD in 2004; however, an estimated 24 million Americans have evidence of lung dysfunction, indicating an underdiagnosis of the condition.
Obstructive sleep apnoea is caused by collapse of the upper airway. The presence of CO2 in the upper airway lumen evokes a number of reflexes which favour upper airway re-opening, and we have proposed previously that CO2 would build up in the upper airway following airway collapse and that this would contribute to reflex airway re-opening.
The role of neutrophils in exacerbations of asthma is poorly understood. We examined the effect of withdrawal of inhaled corticosteroids on sputum inflammatory indexes in a double-blind study in patients with moderate, stable asthma.
Infants diagnosed with pulmonary atresia postnatally were more hypoxic at birth than their counterparts diagnosed while in utero. Infants diagnosed postnatally presented on day 1 and prostaglandin E therapy was initiated within a median of 3 hours. As a result of such prompt diagnosis and treatment, postnatal diagnosis was not related to greater neonatal morbidity and mortality.
Pulmonary embolism in the critically ill requires considerations beyond anticoagulant therapy. Measurements of chamber size by echocardiography and CT and of circulating biomarkers identify higher-risk patients with moderate accuracy and may aid determination of patient acuity. Preserving right ventricular function requires judicious use of volume administration, vasopressor, and perhaps vasodilator therapies.
Diffuse alveolar damage (DAD) is a relatively common histopathologic finding at autopsy, particularly in patients dying with ARDS, and can result from a variety of causes. The spectrum of causes and associated prognostic implications for DAD diagnosed by surgical lung biopsy are unclear.
Childhood interstitial lung disease (ILD) is a spectrum of diseases including many different rare lung conditions. We present a family with an unusual presentation of ILD in association with rheumatologic and immunologic abnormalities.
Patients with bronchitis type of chronic obstructive pulmonary disease (COPD) have raised vascular endothelial growth factor (VEGF) levels in induced sputum. This has been associated with the pathogenesis of COPD through apoptotic and oxidative stress mechanisms. Since, chronic airway inflammation is an important pathological feature of COPD mainly initiated by cigarette smoking, aim of this study was to assess smoking as a potential cause of raised airway VEGF levels in bronchitis type COPD and to test the association between VEGF levels in induced sputum and airway inflammation in these patients.
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