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Parapneumonic empyema continues to be a disease of significant morbidity and mortality among children despite recent advances in medical management. To date, only a limited number of studies have assessed the burden of empyema in Asia
Scandinavian Journal of Infectious Diseases First Published on: 11 July 2008
Human metapneumovirus (hMPV) is a newly identified paramyxovirus causing lower respiratory tract infections (LRTI). Current knowledge on hMPV is mainly based on retrospective studies performed in stored respiratory and serum samples.
Allergy, Volume 63, Number 8, August 2008 , pp. 1054-1060(7)
Limited information is available regarding the prevalence of severe asthma in children. The present study aimed at investigating the prevalence of severe asthma in an urban child population; secondarily evaluating the applicability of the chosen definition by clinical characteristics.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0200-z
In 70 consecutive male patients with obstructive sleep apnea (OSA) diagnosed at the Northport VA Medical Center Sleep Disorders Center, we have characterized the association between obesity, OSA, and pulmonary hypertension (PH).
Postpneumonectomy empyema remains a clinical challenge. We proposed an accelerated therapy without an open chest window 5 years ago. This concept was evaluated on a larger scale in 2 centers in 2 different countries.
Pediatric Allergy and Immunology, Volume 19, Number 4, June 2008 , pp. 355-362(8)
Allergen avoidance has been a major component of most programs for primary prevention of asthma and allergic diseases in childhood. As a part of the Childhood Asthma Prevention Study, families were provided with written and oral information on measures considered to be helpful in the primary prevention of allergic disease in high-risk infants.
Isocyanates in the workplace atmosphere are typically present both in gas and particle phase. The health effects of exposure to isocyanates in gas phase and different particle size fractions are likely to be different due to their ability to reach different parts in the respiratory system.
Allergy, Volume 63, Number 8, August 2008 , pp. 969-980(12)
The present document is the result of a consensus reached by a panel of experts from European and nonEuropean countries on Occupational Rhinitis (OR), a disease of emerging relevance, which has received little attention in comparison to occupational asthma.
Pulmonary hypertension is a common but underdiagnosed complication of systemic lupus erythematosus, which can be associated with significant morbidity and early mortality.
The Proceedings of the American Thoracic Society 5:610-616 (2008)
This article elaborates on the phases of drug development and trial design for pulmonary arterial hypertension, emphasizing the need for learning trials to assess efficacy signals before confirming trials.
The Proceedings of the American Thoracic Society 5:617-622 (2008)
Pulmonary arterial hypertension is a rare and often devastating disease, although various effective therapies are now available. Clinical trials have used hemodynamic, cardiac imaging, laboratory, and exercise measurements as surrogate and intermediate end points in pulmonary arterial hypertension.
The Proceedings of the American Thoracic Society 5:623-630 (2008)
Advances in our understanding of the basic pathophysiology of pulmonary arterial hypertension (PAH) has led to an expanding number of therapeutic options. The ultimate goals of therapy are to lengthen survival while improving symptoms and quality of life.
Clinical Pulmonary Medicine. 15(4):218-225, July 2008
Ewing sarcoma family of tumors (ESFTs) includes extraosseous ES, adult neuroblastoma, Askin's tumor, paravertebral small-cell tumor, and atypical ES. ESFTs affects young people between ages 10 and 20 years and can develop in almost any bone or soft tissue but is most common in the flat and long flat bones.
Clinical Pulmonary Medicine. 15(4):232-233, July 2008
The addition of a spontaneous awakening trial to ventilated patients resulted in more ventilator-free days, faster discharge, and increased overall survival.
The addition of active screening for methicillin-resistant Staphylococcus aureus did not affect the occurrence of methicillin-resistant S. aureus infections in a surgical population.
The Proceedings of the American Thoracic Society 5:631-635 (2008)
Randomized clinical trials (RCTs) conducted during the past decade have shown that several therapies produce improvements in surrogate endpoints for patients with pulmonary arterial hypertension (PAH). Whether these therapies also influence clinical outcomes remains uncertain.
Clinical Pulmonary Medicine. 15(4):201-209, July 2008
The clinical evaluation of a patient with suspected interstitial lung disease is complex and often requires pulmonologists to consider the use of surgical lung biopsy as an option to achieve a more definitive diagnosis.
Asthma is the most common chronic illness among children and accounts for 1 in 5 of all child GP consultations. This paper reviews and discusses recent literature outlining the growing problem of physical inactivity among young people with asthma and explores the psychosocial dimensions that may explain inactivity levels and potentially relevant interventions and strategies, and the principles that should underpin them.
Several concepts of treatment in neonatal ARDS have been proposed in the last years. The present study compared the effects of open lung concept positive pressure ventilation (PPVOLC) with a conventional ventilation strategy combined with administration of two different surfactant preparations on lung function and surfactant homoeostasis.
Clinical Pulmonary Medicine. 15(4):210-217, July 2008
Conventional modes of mechanical ventilation often cause patient-ventilatory asynchrony and may fail to assure adequate gas exchange while attempting to adhere to lung protective ventilatory strategies. Airway pressure release ventilation, partial liquid ventilation, and high-frequency ventilation are alternative ventilatory strategies used for acute respiratory distress syndrome that aim to protect the lung while providing adequate gas exchange.
Clinical Pulmonary Medicine. 15(4):235-237, July 2008
Birt-Hogg-Dube (BHD) is a familial syndrome that leads to the development of lung cysts and carries a significantly increased risk of spontaneous pneumothorax. Other manifestations are benign hair follicle tumors and a high incidence of renal cancers.
Clinical Pulmonary Medicine. 15(4):197-200, July 2008
Streptococcus pneumoniae is one of the major bacterial causes of invasive disease with significant morbidity and mortality. The ability of pneumococci to cause disease is directly related to the production of a capsule that promotes evasion of the host immune system of the patient.
Clinical Pulmonary Medicine. 15(4):226-231, July 2008
Over the past 25 years, there has been an increased understanding of pediatric obstructive sleep apnea (OSA). The initial descriptions of children presenting with cor pulmonale and other serious physiological consequences of OSA have been augmented by descriptions of the effects of OSA on more subtle outcomes such as cognitive abilities and behavior.
Clinical Pulmonary Medicine. 15(4):233-234, July 2008
In a multicenter trial, monotherapy with meropenem was as good as combination therapy with meropenem and ciprofloxacin for ventilator-associated pneumonia (VAP) in patients at low risk for multidrug resistant organisms.
Clinical Pulmonary Medicine. 15(4):189-196, July 2008
Cough is the most common complaint for which patients seek medical attention, and chronic cough is an especially important clinical problem. Guidelines for the diagnosis and treatment of cough have been published from several countries.
Cigarette smoke has both pro- inflammatory and immunosuppressive effects. Both active and passive cigarette smoke exposure are linked to an increased incidence and severity of respiratory virus infections, but underlying mechanisms are not well defined. We hypothesized, based on prior gene expression profiling studies, that upregulation of pro-inflammatory mediators by short term smoke exposure would be protective against a subsequent influenza infection.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200701-013OC
Repeated antigen-driven proliferations cause CD28 on T-cells to downregulate. We hypothesized alloantigen-induced proliferations could cause CD28 downregulation in lung transplant recipients.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200709-1363OC
Rationale: Inhaled {beta} agonists are one of the most widely used classes of drugs for the treatment of asthma. However, a substantial proportion of asthmatics do not have a favorable response to these drugs, and identifying genetic determinants of drug response may aid in tailoring treatment for individual patients.
In a cohort study of 36 patients with community-onset extended-spectrum {beta}-lactamase (ESBL)-producing Escherichia coli or Klebsiella pneumoniae bloodstream infections, we found that predictors of mortality were community-onset infection with ESBL-producing K. pneumoniae pathogens (P = .02) and failure to receive an initial empirical regimen that included either {beta}-lactam and [beta}-lactamase-inhibitors or a carbapenem (P = .04).
We report three patients with partial atrioventricular septal defect who presented in the neonatal period with excessive left to right shunting and progressive pulmonary hypertension.
Journal of Pediatric Hematology/Oncology. 30(7):507-512, July 2008
The purpose of this study was to determine whether a correlation exists between tumor cyclooxygenase (COX)-2 expression and disease-specific survival in patients with osteosarcoma lung metastases. Thirty-six patients diagnosed with osteosarcoma lung metastases between the years 1990 and 2001 were included in this retrospective study.
Cancer Prevention Research 1, 112-118, July 1, 2008
Cigarette smoke is the major cause of lung cancer and can interact in complex ways with drugs for lung cancer prevention or therapy. Molecular genetic research promises to elucidate the biological mechanisms underlying divergent drug effects in smokers versus nonsmokers and to help in developing new approaches for controlling lung cancer.
Allergy, Volume 63, Number 8, August 2008 , pp. 1046-1053(8)
Leukotrienes (LTs) have been identified as central mediators in asthma and allergy. Pharmacological inhibition of cysteinyl-LT activity improves asthma symptoms and control. Accumulating evidence suggests a role for the dihydroxy leukotriene LTB4 in airway disease.
Allergy, Volume 63, Number 8, August 2008 , pp. 1015-1030(16)
Asthma represents a serious global health problem. People of all ages in countries throughout the world are affected by this chronic airway disorder that, when uncontrolled, can place severe limits on daily life and can even be fatal.
Allergy, Volume 63, Number 8, August 2008 , pp. 1054-1060(7)
Limited information is available regarding the prevalence of severe asthma in children. The present study aimed at investigating the prevalence of severe asthma in an urban child population; secondarily evaluating the applicability of the chosen definition by clinical characteristics.
Allergy, Volume 63, Number 8, August 2008 , pp. 1031-1039(9)
Asthma is a complex disease resulting from interactions between multiple genes and environmental factors. Study of gene-gene interactions could provide insight into the pathophysiology of asthma.
Allergy, Volume 63, Number 8, August 2008 , pp. 1040-1045(6)
The occurrence of asthma has geographic variations and is lower in developing compared with industrialized countries. Both environmental and genetic factors may influence its prevalence. We aimed to evaluate the importance and effect of immigration (country of birth and age at immigration to Israel) on the prevalence of asthma in a large group of Israeli adolescents.
Allergy, Volume 63, Number 8, August 2008 , pp. 969-980(12)
The present document is the result of a consensus reached by a panel of experts from European and nonEuropean countries on Occupational Rhinitis (OR), a disease of emerging relevance, which has received little attention in comparison to occupational asthma.
Allergy, Volume 63, Number 8, August 2008 , pp. 962-968(7)
China is going to host the Games of the XXIX Olympiad from 8-24 August 2008 in Beijing. The number of athletes and accompanying individuals expected to arrive at China for the Beijing Olympics is estimated at over 10,000 and among them at least 2,000 (20%) are suspected to suffer from respiratory allergies.
Studies focusing on serum sodium disorders in children with community-acquired-pneumonia (CAP) are nearly entirely lacking, though clinical experience suggests that at least hyponatremia (HN) might be rather common.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200804-613OC
Portopulmonary hypertension can be defined as elevation of pulmonary arterial pressure and pulmonary vascular resistance in the setting of portal hypertension. Survival results in portopulmonary hypertension are contrasting and prognostic factors need to be identified.
Fluticasone/salmeterol combination therapy was considered to be costeffective compared with ipratropium alone because it achieved better clinical outcomes with similar or lower treatment costs.
Genetic variation may underlie phenotypic variation in chronic obstructive pulmonary disease (COPD) in subjects with and without alpha 1 antitrypsin deficiency (AATD). Genotype specific sub-phenotypes are likely and may underlie the poor replication of previous genetic studies. This study investigated subjects with AATD to determine the relationship between specific phenotypes and TNFalpha polymorphisms.
Airway foreign bodies may be discovered after aspiration, or less commonly, after erosion into the airway. Surgical pledgets may erode into neighboring anatomic structures, often many years after the original surgery.
An 82-year-old man presented with cough and wheeze. Chest x-ray and computed tomography of the chest revealed a right upper lobe mass that occupied the middle lung field when the patient was in upright position and moved cephalad when he was supine.
Bronchial stenosis due to pill aspiration has been rarely described. The case reports describe "iron pill aspiration syndrome," as no foreign body was observed and the diagnosis was made based on history and bronchoscopic findings.
Cardiac operations may be performed in a conscious, spontaneously breathing patient, but it is difficult to justify an awake technique in patients undergoing coronary artery procedures with low operative risk.
We describe a case of "topsy-turvy heart" that necessitated simultaneous left tracheobronchial repair, aortic arch reconstruction, and bronchial stenting in an 11-month-old girl. This case highlights the significant therapeutic dilemmas clinicians are faced with when dealing with conditions having an unknown natural history and unpredictable surgical outcomes, and reinforces the need for these patients to be managed by a multidisciplinary team approach.
Reconstruction of the right ventricular outflow tract is a frequently encountered component of many congenital cardiac repairs. We sought to tissue engineer pulmonary artery augmentation patches from retrovirally labeled endothelial progenitor and mesenchymal stem cells and determine the persistence of the seeded cells in vivo.
For patients with end-stage emphysema undergoing lung volume reduction surgery (LVRS), we have preferred a bilateral (BLVRS) approach to achieve maximum benefit with a single procedure. A unilateral (ULVRS) approach has been used in certain patients in whom BLVRS is contraindicated.
We aimed to develop and validate a scoring system to predict intensive care unit (ICU) admission for complications after major lung resection for purposes of optimizing planning of resources for patient care.
Irish Journal of Medical Science Volume 173, Number 2 / April, 2004 96-98
Patients with cystic fibrosis (CF) are at high risk from atypical mycobacterial infections. There have been few attempts to delineate the intensity of mycobacterial infection in CF patients in Ireland.
European Journal of Pediatrics 0340-6199 (Print) 10.1007/s00431-008-0777-z
Gastric malrotation is defined as a torsion of stomach around its short or long axis. It is a rare disease in childhood. Gastric malrotation may present either as a surgical emergency or as chronic abdominal symptoms.
30-80% of outgrown asthma subjects develop symptoms again later in life. We investigated inflammation and function of lower airway in adolescents with former asthma.
Exhaled nitric oxide (eNO) is a useful marker of eosinophilic airway inflammation in asthmatics. There have been no studies to show the relationship between eNO measured by offline methods and the degree of bronchial hyperresponsiveness in asthmatic patients treated with inhaled corticosteroids.
We report a case of hypersensitivity pneumonitis and asthma attacks caused by environmental fungi in a 75-year-old man. The diagnosis was established by inhalation challenge with Bjerkandera adusta and Aspergillus fumigatus.
To evaluate whether hydrofluoroalkane-beclomethasone dipropionate (HFA-BDP) controls eosinophilic inflammation, including that in the distal airways, more effectively than fluticasone propionate (FP) Diskus.
Therapeutic lung lavage is an emerging treatment for meconium aspiration syndrome (MAS), but the ideal fluid volume and lavage technique remain unclear.
A long-standing undiagnosed denture in the bronchus is not unknown, yet it is rare. We report a case in which a denture was lodged in the left main bronchus for 15 years. Bronchial asthma and other misleading factors delayed the diagnosis. Hemoptysis warranted bronchoscopy, which led to the diagnosis of foreign body aspiration and its removal.
Bronchial arteriovenous malformation is a rare disease in which there is an abnormal communication between a bronchial artery and pulmonary artery or vein.
Traditional palliation of infants with biventricular hearts and inadequate pulmonary blood flow is a modified Blalock-Taussig shunt. The aim of this report is to assess the results of an alternative, right ventricle-to-pulmonary artery (RV-PA) shunt.
Pulmonary dysfunction presumably linked to an inflammatory response is frequent after cardiac operations using cardiopulmonary bypass (CPB) and pulmonary hypoperfusion.
PEDIATRICS Vol. 122 No. 1 July 2008, pp. e195-e201
Although asthma is often inappropriately treated in children, little is known about what information pediatricians use to adjust asthma therapy. The purpose of this work was to assess the importance of various dimensions of patient asthma status as the basis of pediatrician treatment decisions.
Systemic postnatal dexamethasone treatment reduces the risk of chronic lung disease in preterm infants but also may be associated with increased risk of neurodevelopmental impairment. Because it is not known whether these effects are modulated by the cumulative dexamethasone dose, we systematically reviewed the available randomized evidence on the effects of lower versus higher cumulative dexamethasone doses, in terms of death, pulmonary morbidity, and neurodevelopmental outcomes, in preterm infants.
Archives of Pathology and Laboratory Medicine: Vol. 132, No. 7, pp. 1171-1181
Pulmonary Langerhans cell histiocytosis is the most common and best known pulmonary histocytic lesion; however, the realm of pulmonary histiocytic lesions also includes an assortment of uncommon diseases that may exhibit pulmonary involvement.
Archives of Pathology and Laboratory Medicine: Vol. 132, No. 7, pp. 1073-1078
Improved screening techniques for lung cancer have resulted in detection of lesions that are considered to represent precursors of invasive lung carcinomas. These lesions may cause a diagnostic dilemma particularly on small biopsy or cytology specimens. Ancillary studies are usually not helpful, and diagnosis is based on morphology alone. Recognition of these lesions is very important to prevent potential diagnostic mistakes that may result in inadequate patient management. Future molecular studies may provide clinically useful diagnostic and prognostic gene markers.
Bronchopleural and alveolopleural fistulae from surgical and nonsurgical causes present unique management issues. A myriad of strategies have been employed to diminish airflow through the fistulous tracts.
Journal of Pediatric Hematology/Oncology. 30(7):522-526, July 2008
We evaluated the frequency, etiologic factors, outcome, and the comorbid conditions affecting the morbidity and mortality of pulmonary complications in acute childhood leukemia. Sixty-six (40.4%) out of 163 patients developed 79 pulmonary complications.
The goals were to estimate the year-round burden of health care visits attributable to bronchiolitis and to identify risk factors for bronchiolitis in term healthy infants.
Previous studies have demonstrated that poultry house workers are exposed to very high levels of organic dust and consequently have an increased prevalence of adverse respiratory symptoms.
The Journal of Experimental Medicine, Vol. 205, No. 7, 1659-1672
Idiopathic pulmonary fibrosis (IPF) is a relentlessly progressive lung disease in which fibroblasts accumulate in the alveolar wall within a type I collagen–rich matrix. Although lung fibroblasts derived from patients with IPF display durable pathological alterations in proliferative function, the molecular mechanisms differentiating IPF fibroblasts from their normal counterparts remain unknown.
American Journal of Clinical Nutrition, Vol. 88, No. 1, 167-175, July 2008
Evidence suggests that asthma is rooted in the intrauterine environment and that intake of marine n-3 polyunsaturated fatty acids (n-3 PUFAs) in pregnancy may have immunomodulatory effects on the child.
Am J Physiol Lung Cell Mol Physiol 295: L44-L53, 2008
The molecular events leading to emphysema development include generation of oxidative stress and alveolar cell apoptosis. Oxidative stress upregulates ceramides, proapoptotic signaling sphingolipids that trigger further oxidative stress and alveolar space enlargement, as shown in an experimental model of emphysema due to VEGF blockade.
Am J Physiol Lung Cell Mol Physiol 295: L79-L85, 2008
Epidemiologic and animal studies have shown that exposure to particulate matter air pollution (PM) is a risk factor for the development of atherosclerosis. Whether PM-induced lung and systemic inflammation is involved in this process is not clear.
Systemic corticosteroids are known to induce osteoporosis and increase the risk for fractures in adults and children. Inhaled corticosteroids have been shown to increase the risk for osteoporosis and fractures in adults at risk; however, long-term prospective studies of children to assess risks of multiple short courses of oral corticosteroids and chronic inhaled corticosteroids have not been performed.
Meconium aspiration is believed to cause persistent pulmonary hypertension syndrome of the newborn (PPHN) via vasoconstriction, whereas meconium has a relaxant effect on rat tracheal muscle.
The pathogenesis of congenital cystic adenomatoid malformation (CCAM) is unknown and its natural history is unpredictable. Fatty acid binding protein-7 (FABP-7) has been previously described in brain and breast development, but never before in the lung.
Very preterm neonates are at risk of hypothyroxinemia because of prematurity as well as because of neonatal disease. Hypothyroxinemia is associated with impaired developmental outcome. Preterm infants who cannot be weaned from the ventilator can be treated with dexamethasone.
The construction of manual ventilators by Hunter, Chaussier, and Gorcy seemed to set the stage for artificial ventilation of the neonate at the end of the 18th century
Am J Physiol Lung Cell Mol Physiol 295: L123-L133, 2008
Transforming growth factor (TGF)-{beta}1 has been reported to cause endothelial cell apoptosis. However, conflicting data have also demonstrated that TGF-{beta}1 promotes endothelial cell survival.
Am J Physiol Lung Cell Mol Physiol 295: L194-L200, 2008
Recognition of temperature is a critical element of sensory perception and allows mammals to evaluate both their external environment and internal status. The respiratory epithelium is constantly exposed to the external environment, and prolonged inhalation of cold air is detrimental to human airways.
Am J Physiol Lung Cell Mol Physiol 295: L186-L193, 2008
The enzymatic activity of CD38, ADP-ribosyl cyclase, synthesizes the calcium mobilizing molecule cyclic ADP-ribose from {beta}-NAD. In human airway smooth muscle (HASM) cells, CD38 expression is augmented by the inflammatory cytokine, TNF-{alpha}, causing increased intracellular calcium response to agonists.
To determine the effect of initial procedure type on the length of hospital stay (LOS) and on the requirement for additional pleural fluid drainage procedures in a large multicenter cohort of children with pneumonia complicated by pleural effusion.
Noninvasive ventilation (continuous positive airway pressure [CPAP] or noninvasive intermittent positive-pressure ventilation [NIPPV]) appears to be of benefit in the immediate treatment of patients with acute cardiogenic pulmonary edema and may reduce mortality. We conducted a study to determine whether noninvasive ventilation reduces mortality and whether there are important differences in outcome associated with the method of treatment (CPAP or NIPPV).
American Journal of Clinical Nutrition, Vol. 88, No. 1, 161-166, July 2008
In 2005, the Cystic Fibrosis Foundation (CFF) revised the nutrition classification guidelines to eliminate the use of percentage of ideal body weight (%IBW) to define "nutritional failure"; the CFF also recommended that children with cystic fibrosis maintain a body mass index percentile (BMIp) > 50th.
BMC Pulmonary Medicine 2008, 8:9doi:10.1186/1471-2466-8-9
Hypertonic saline (HTS) reduces the severity of lung injury in ischemia-reperfusion, endotoxin-induced and ventilation-induced lung injury. However, the potential for HTS to modulate the resolution of lung injury is not known. We investigated the potential for hypertonic saline to modulate the evolution and resolution of oleic acid induced lung injury.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 479 - 483
Subjects with bronchial asthmatic symptoms, forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity [FVC] > 80% could show a positive reversibility test with salbutamol in about 25% of the cases.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 453 - 458
Abstract
Knowing about spontaneous variations in the fractional concentration of exhaled nitric oxide (FENO) could improve monitoring of airway inflammation in asthmatic children.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 513 - 517
NHLBI guidelines classify asthma in children as intermittent, mild persistent, moderate persistent, and severe persistent asthma based on baseline symptoms and pulmonary function. However, this may not capture the spectrum of asthma in children, since even mild baseline disease can have significant effects on quality of life.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 485 - 487
Previously we reported that patients sensitized to pollen-allergens who had seasonal allergic rhinitis and seasonal asthma may show increased plasma levels of platelet activation markers during grass pollen season.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 445 - 451
Inhaled corticosteroids (ICSs) are the most effective anti-inflammatory drugs for adult asthma and can improve not only clinical symptoms but also bronchial hyperresponsiveness (BHR). However, the prognosis of adult asthma has not been well studied, and it remains to be elucidated precisely how long treatment with ICSs should be continued once clinical remission is achieved.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 519 - 522
To investigate the extent of inhaled glucocorticoid (IGC) treatment in general and to what extent general practitioners (GPs) manage the risk of glucocorticoid-induced osteoporosis.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 465 - 472
Asthma is the most common chronic illness of childhood, affecting up to 14% of children. Poor asthma management and non-adherence to treatment regimens are a pervasive problem in this population and are related to exacerbation of symptoms.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 437 - 443
Asthma is an important health condition in sub-Saharan Africa, with major gaps in clinical care. The aim of this project was to implement nurse-led care for asthma in rural Cameroon.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 489 - 493
To use representative population chronic disease and risk factor data to investigate the relationship between asthma and social factors in school-age children.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 501 - 505
To determine if patterns of predominant asthma disease activity are more closely related than baseline asthma severity to measures of morbidity (acute asthma attack, emergency room visit/hospitalization, missed school days, and/or steroid burst). Retrospective analysis was performed for inner-city Los Angeles asthmatic children (3 to 18 years of age) during their first year of enrollment in an asthma-specific disease management program.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 459 - 464
This article reviews an emerging area of research on patients with asthma: namely, illness perceptions and their relationships with various aspects of outcome.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 507 - 511
Asthma is a variable disease, and therapy should be tailored accordingly. The aim of this study was to explore patterns of self-management in response to disease variability in adult asthmatics.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 473 - 477
Our objective was to characterize the association between body mass index (BMI) and childhood asthma while adjusting for individual and neighborhood socioeconomic factors. Data were obtained from 3,804 students 10 to 11 years of age in Nova Scotia, Canada. Asthma was defined as parent-reported doctor-diagnosed asthma or bronchitis.
Journal of Asthma, Volume 45, Issue 6 August 2008 , pages 429 - 436
Traditionally, practice guidelines have recommended a step-wise approach to treatment based on asthma severity and lung function. However, increasing evidence suggests that asthma may not be adequately controlled in many patients with moderate-to-severe disease despite aggressive therapy, and that regularly evaluating the level of asthma control achieved in individual patients may be more effective than disease severity in guiding treatment decisions.
Although parenchyma-saving resection makes it possible to preserve the lung parenchyma, most surgeons are reluctant to perform it for congenital cystic adenomatoid malformation (CCAM) because it could also result in recurrent pulmonary infection or residual lesion. This study compared the early and late postoperative outcomes according to the extent of resection in CCAM patients to determine if the extent of resection would influence the short- and long-term results.
Exercise tests are increasingly used during preoperative evaluation before lung resection. This study assessed the association between performance at the symptom-limited stair-climbing test and postoperative cardiopulmonary morbidity, mortality, and costs after major lung resections.
Primary graft dysfunction (PGD) in the immediate post-lung transplant period strongly increases the risk of chronic rejection (broncholitis obliterans syndrome). Here, we hypothesized that PGD-induced inflammation augments alloimmunity, thereby predisposing to broncholitis obliterans syndrome.
Scandinavian Journal of Infectious Diseases First Published on: 02 June 2008
It is well documented that antiphospholipid antibodies are increased in patients with HIV-1 infection and these are most commonly seen in those with Pneumocystis jirovecii pneumonia. Therefore it has been proposed that this could be the cause of its presence.
American Journal of Epidemiology 2008 168(2):170-178
The aim of the study was to assess whether perinatal factors are associated with the risk of asthma in childhood in a register-based, nested case-control study in Finland. All children born between January 1, 1996, and April 30, 2004, who were entitled to a special reimbursement for antiasthmatic drugs (i.e., had diagnosed asthma by 2006 and had purchased inhaled corticosteroids or montelukast at least once), were identified (n = 21,038). For each case, one matched control child was selected.
Endotracheal tube (ETT) suction is the most frequently performed invasive procedure in ventilated newborn infants and is associated with adverse effects related to negative tracheal pressure. We aimed to measure suction catheter gas flow and intratracheal pressure during ETT suction of a test lung and develop a mathematical model to predict tracheal pressure from catheter and ETT dimensions and applied pressure.
Cochrane Database of Systematic Reviews 2008, Issue 2
Pleural effusions and empyema may complicate lower respiratory tract infections. Treatment of these collections of pus includes surgical drainage and the use of intra-pleural fibrinolysis to break down fibrin bands that may cause loculation.
Cochrane Database of Systematic Reviews 2008, Issue 2
Post-extubation stridor may prolong length of stay in the intensive care unit, particularly if airway obstruction is severe and re-intubation proves necessary. Corticosteroids, however, may be associated with adverse effects ranging from hypertension to hyperglycemia, and a more systematic assessment of the efficacy of this therapy is indicated prior to widespread adoption of this practice.
Pediatric Infectious Disease Journal. 27(7):660-661, July 2008
Palivizumab has proved effective in reducing hospitalization rates because of respiratory syncytial virus in vulnerable groups. In Argentina its administration is not universal because of high costs.
Pulmonary talc granulomatosis is a rare disorder characterized by the development of foreign body granuloma secondary to talc exposure. Previous case reports have documented the illness in current intravenous drug users who inject medications intended for oral use.
We present a case of a 45-year-old woman, postbilateral lung transplantation performed for cystic fibrosis who presented fever, productive cough, and multiple constitutional symptoms. Computed tomography scan of the chest showed multiple diverticula involving the posterior tracheal wall. Bronchoscopy revealed moderate amount of mucopurulent secretions, tracheomalacia, and multiple pinhole openings at the location of these diverticula.
The Internet Journal of Pulmonary Medicine. 2008. Volume 10 Number 1
The purpose of the study was to assess the outpatient management of adult patients admitted with asthma and compare the results obtained to a similar series studied five years earlier.
Clinical Reviews in Allergy and Immunology 1080-0549 (Print) 10.1007/s12016-008-8080-3
Cystic Fibrosis (CF) is an autosomal recessive disorder due to mutations in the CF transmembrane conductance regulator (CFTR) gene that lead to defective ion transport in the conducting pulmonary airways and exocrine glands.
Interpretation of the Hospital Anxiety and Depression Scale (HADS), commonly used to assess anxiety and depression in COPD patients, is unclear. Since its minimal important difference has never been established, our aim was to determine it using several approaches.
Local inflammation in airway diseases is well recognised, but less is known about the association between low-grade systemic inflammatory processes and lung function. The aim of the present study was to assess the association between inflammatory markers and lung function, taking into account polymorphisms in genes coding for inflammatory markers.
Clock genes regulate mammalian circadian rhythms, and dysfunction of clock genes can contribute to various disorders. To investigate whether obstructive sleep apnoea syndrome (OSAS) influences clock gene function, the present authors examined Period1 (Per1) mRNA expression in vitro and in vivo.
Granulocyte-macrophage colony-stimulating factor (CSF), also known as CSF2, and granulocyte CSF, also known as CSF3, are important survival and proliferation factors for neutrophils and macrophages. The objective of the present study was to determine whether single nucleotide polymorphisms (SNPs) of CSF2 and CSF3 are associated with lung function in smoking-induced chronic obstructive pulmonary disease.
Annals of Allergy, Asthma and Immunology, Volume 101, Number 1, July 2008 , pp. 74-81(8)
The relative efficacy of various inhaled corticosteroids (ICSs) for oral corticosteroid (OCS)-sparing effect in asthma is not known. To our knowledge, no randomized controlled trial directly comparing 2 ICSs has been reported, but several randomized controlled trials have reported comparison of various ICSs with placebo.
Annals of Allergy, Asthma and Immunology, Volume 101, Number 1, July 2008 , pp. 90-95(6)
Indacaterol is a novel once-daily inhaled {beta}2-agonist in development for the treatment of patients with asthma or chronic obstructive pulmonary disease.
Enteral tube feeding is routinely used in many cystic fibrosis centres when weight for height percentage is less than 85%, when there has been weight loss for longer than a two-month period or when there has been no weight gain for two to three months (under five years old) or for six months (over five years old).
Cochrane Database of Systematic Reviews 2008, Issue 2
Non-specific cough is defined as non-productive cough in the absence of identifiable respiratory disease or known aetiology. It is commonly seen in paediatric practice. These children are treated with a variety of therapies including anti-histamines. Also, anti-histamines are advocated as an empirical treatment in adults with chronic cough.
The goal was to establish whether reduced amounts of pulmonary surfactant contribute to postextubation respiratory failure in preterm infants recovering from respiratory distress syndrome.
The extensive pulmonary vasculature results in the lungs being intimately exposed to circulating blood. As increased serum osmolality may be associated with an increase in pro-inflammatory activity, this has the potential to result in damage to the lungs and reduced lung function.
The Internet Journal of Pulmonary Medicine. 2008. Volume 10 Number 1
Chronic obstructive pulmonary disease (COPD) is defined as set of breathing related problems i.e. chronic bronchitis, expectoration and exertional dyspnea characterized by presence of airflow obstruction that is not fully reversible.
Existing severity assessment tools, such as the pneumonia severity index (PSI) and CURB-65 (tool based on confusion, urea level, respiratory rate, blood pressure, and age >65 years), predict 30-day mortality in community-acquired pneumonia (CAP) and have limited ability to predict which patients will require intensive respiratory or vasopressor support (IRVS).
Each year, Bordetella pertussis infection causes an estimated 294,000 deaths worldwide, primarily among young, nonvaccinated children. Approximately 90% of all deaths due to pertussis in the Unites States occur in young infants.
Cochrane Database of Systematic Reviews, Issue 2, 2008
Failure of extubation and subsequent reintubation may result in additional stress and trauma to the premature infant. Treating infants about to be extubated with a period of endotracheal CPAP has been suggested as a method of preparing for extubation. However, this process has been criticized as increasing the neonate's work of breathing and perhaps increasing the likelihood of extubation failure.
PEDIATRICS Vol. 122 No. 1 July 2008, pp. e149-e155
Intranasal corticosteroids have been advanced as a nonsurgical therapeutic alternative for pediatric obstructive sleep apnea syndrome, particularly for patients with mild disease, and aims at reducing the size of hypertrophic adenotonsillar tissue.
PEDIATRICS Vol. 122 No. 1 July 2008, pp. e217-e222
The purpose of this work was to estimate asthma prevalence among US children in racial minority subgroups who have been historically underrepresented in the pediatric asthma literature. These subgroups include American Indian/Alaska Native, Chinese, Filipino, and Asian Indian children.
A 72-year-old man was discovered to have a large right upper lobe mass on computerized tomography scan of the chest. The patient underwent diagnostic bronchoscopy in which endobronchial ultrasound (EBUS) was used to assist in biopsy. With the use of EBUS, we were able to clearly visualize tumor invasion directly into the right pulmonary artery and vein. EBUS, a new technology, is primarily used to aid in biopsy of mediastinal and hilar lymph nodes.
Acute foreign body aspiration can occur in the setting of oropharyngeal procedures, especially if conscious sedation is used. We report a case of a patient undergoing esophagogastroduodenoscopy with band ligation complicated by aspiration of the handle and ligator located at the tip of the endoscope.
Adenocarcinoma is one of the most common histologic types of lung cancer; which seldom cavitates. We report a case of cavitating adenocarcinoma with a large communication between the tumor cavity and the central airway, allowing passage of the flexible bronchoscope directly into the tumor.
A number of genome-wide linkage analyses have identified the 2q33.3-2q37.2 region as the most likely to contain the genes that contribute to the susceptibility to chronic obstructive pulmonary disease (COPD).
Hughes-Stovin syndrome is an exceedingly rare disorder of unknown etiology, and it is characterized by multiple pulmonary artery aneurysms and peripheral venous thrombosis.
Most fatalities from fires are not due to burns, but are a result of inhalation of toxic gases produced during combustion. Fire produces a complex toxic environment involving flame, heat, oxygen depletion, smoke and toxic gases. As a wide variety of synthetic materials is used in buildings (insulation, furniture, carpeting, and decorative items) the potential for severe health impacts from inhalation of products of combustion during building fires is continuously increasing.
Annals of Allergy, Asthma and Immunology, Volume 101, Number 1, July 2008 , pp. 42-46(5)
A remarkable relationship exists between the upper and lower airways. Bronchial obstruction is a paramount feature of asthma, and its reversibility is considered a main step in asthma diagnosis.
Am J Physiol Lung Cell Mol Physiol 295: L152-L161, 2008
Magnetic resonance imaging (MRI) and metabolic nuclear magnetic resonance (NMR) spectroscopy are clinically available but have had little application in the quantification of experimental lung injury.
European Radiology 0938-7994 (Print) 10.1007/s00330-008-1065-z
Automated lobar quantification of emphysema has not yet been evaluated. Unenhanced 64-slice MDCT was performed in 47 patients evaluated before bronchoscopic lung-volume reduction.
The Internet Journal of Pulmonary Medicine. 2008. Volume 10 Number 1
There are reports of misdiagnosis of COPD in elderly asthmatics in industrialized countries. In this region, COPD is frequently encountered in middle-aged subjects. We studied the proportions of asthma among 35-69 years-old-patients with COPD.
Annals of Allergy, Asthma and Immunology, Volume 101, Number 1, July 2008 , pp. 1-11(11)
To review the concept that asthma comprises distinct heterogeneous inflammatory disorders characterized by patients showing different phenotypes with distinct genetic components, environmental causes, and immunopathologic signatures.
Archives of Pathology and Laboratory Medicine: Vol. 132, No. 7, pp. 1133-1148
Benign tumors and tumorlike conditions of the lung are encountered in the pathologic evaluation of asymptomatic and symptomatic lung nodules. Since many of these lesions are uncommon, they can be diagnostically challenging.
The Internet Journal of Pulmonary Medicine. 2008. Volume 10 Number 1
Chylothorax is a rare cause of pleural effusion seen in approximately 2% of pleural effusions in adults and is associated with a 10% morbidity and mortality rate. Non-traumatic chylothorax in the adult is highly suggestive of malignancy, mainly lymphoma and metastatic carcinoma.
The aim of this study is to evaluate the long-term respiratory outcome of patients who underwent pneumonectomy for non-small cell lung cancer (NSCLC), analysing functional tests.
Residual air spaces on chest radiographs after pneumothorax surgery are not uncommon. We aimed to study their incidence and impact on surgical outcomes.
The current surgical technique for pulmonary endarterectomy (PEA) involves the use of deep hypothermia and circulatory arrest at 18 °C (DHCA). Our experience started in 2004 when we decided to use an original alternative strategy which consists of avoiding deep hypothermia and subsequent circulatory arrest by using moderate hypothermia at 26 °C, and maintaining a bloodless field.
American Journal of Surgical Pathology. 32(7):1095-1100, July 2008
Neonatal cystic disorders of the lungs are a heterogeneous malformative group including giant lobar hyperinflation, congenital pulmonary airway malformations, intralobar pulmonary sequestration, and bronchogenic cyst. Here, we describe a giant cystic pulmonary malformation in a 5-year-old girl, morphologically characterized by a highly disorganized proliferation of numerous cartilage islands, abundant mesenchymal tissue with abundant adipose differentiation, and epithelium-lined cysts.
Pulmonary arterial compliance (C) is increasingly being recognized as an important contributor to right ventricular afterload, but for monitoring of treatment of pulmonary hypertension (PH) most often still only pulmonary vascular resistance (R) is used.
Recent studies have suggested an emerging link between sleep apnoea and atrial fibrillation (AF). These studies included patients with reduced left ventricular (LV) function which may cause both AF and sleep disordered breathing
(SDB).
Pediatric Surgery International 0179-0358 (Print) 10.1007/s00383-008-2192-y
H-type tracheoesophageal fistula (TEF) may lead to chronic respiratory disease if the diagnosis is delayed. Long-standing fistula causes esophageal distention which is named as pneumoesophagus or megaesophagus and possibly affects the motility of the esophageal body which may also be encountered as a part of tracheoesophageal anomalies.
Inhaled human insulin (Exubera® (human insulin of rDNA origin) Inhalation Powder) causes small, early and reversible changes in pulmonary function in subjects with diabetes mellitus.
In recent decades international and national guidelines have been formulated to ensure that patients suffering from specific diseases receive evidence-based care. In 2004 the National Swedish Board of Health and Welfare (SoS) published guidelines concerning the management of patients with asthma and
COPD.
Detection of bullae is usually performed during lung inflation with an inspiratory hold in collaboration with anesthetists (conventional method). One cause leading to recurrent pneumothorax is failure to detect the position and extent of bullae under the conventional method. We herein present a novel method for detecting bullae under negative intrathoracic pressure, enabling exploration in the narrow cupola space without lung inflation.
Community-acquired pneumonia remains a major cause of mortality in developed countries. There is much discrepancy in the literature regarding factors influencing the outcome in the elderly population.
There is an intimate relationship between the extracellular matrix (ECM) and smooth muscle cells within the airways. Few studies have comprehensively assessed the composition of different ECM components and its regulators within the airway smooth muscle (ASM) in asthma.
Cochrane Database of Systematic Reviews, Issue 2, 2008
Preterm infants being extubated following a period of intermittent positive pressure ventilation via an endotracheal tube are at risk of developing respiratory failure as a result of apnea, respiratory acidosis and hypoxia. Nasal continuous positive airway pressure appears to stabilise the upper airway, improve lung function and reduce apnea and may therefore have a role in facilitating extubation in this population.
Pediatric Infectious Disease Journal. 27(7):589-594, July 2008
Respiratory viruses are the main cause of acute respiratory tract infection (ARI) in children. Real-time polymerase chain reaction (PCR) technology is highly practicable for the rapid detection of viral pathogens. The simultaneous detection of a broad spectrum of viruses enables the diagnosis and evaluation of viral coinfection in
ARI.
The term "amyloidoma" has been used to describe localized pulmonary nodular amyloidosis when it is a solitary lesion. Amyloidoma is an uncommon and infrequently reported cause of benign pulmonary lesions.
Interpretation of the Hospital Anxiety and Depression Scale (HADS), commonly used to assess anxiety and depression in COPD patients, is unclear. Since its minimal important difference has never been established, our aim was to determine it using several approaches.
Human airway epithelium, the defence at the forefront of protecting the respiratory tract, evacuates inhaled particles by a permanent beating of epithelial cell cilia.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0207-5
The aim of this study was to evaluate (1) the prevalence of periodic leg movements during sleep (PLMs) in a consecutive sample of congestive heart failure (CHF) outpatients; (2) the presence of correlation between PLMs, subjective daytime sleepiness, and sleep architecture; and (3) the heart rate response to PLMs in
CHF.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0206-6
The recognition of the role of craniofacial abnormalities in the development of obstructive sleep apnea (OSAS) has led to several treatment strategies to correct or improve craniofacial structures.
Severity of oxygen desaturation is predictive of early atherosclerosis in obstructive sleep apnoea (OSA). Leukotriene (LT)B4 is a lipid mediator involved in atherogenesis.
Increasing evidence supports the use of embolisation to treat pulmonary arteriovenous malformations (AVMs). Most pulmonary AVM patients have hereditary haemorrhagic telangiectasia (HHT), a condition that may be associated with pulmonary hypertension.
Recent research has suggested an association between circulating C-reactive protein (CRP) and adult asthma, confined to those without evidence of allergic predisposition. The current authors investigated the role of smoking and obesity as possible explanations for this relationship.
Chronic obstructive pulmonary disease is associated with exacerbations. Some patients are prone to frequent exacerbations and these individuals have a worse quality of life, greater limitation of their daily activity and faster disease progression than patients with less frequent exacerbations.
Airway hyperresponsiveness (AHR) is a characteristic feature of asthma, but it is unclear whether asymptomatic AHR is associated with a higher risk of asthma.
The causes of chronic cough in elderly patients have not been specifically investigated. Therefore, it remains to be determined whether chronic cough differs between elderly and non-elderly patients.
To evaluate the prognostic implications of computed tomography (CT) findings in assessing responses to treatment in Mycobacterium avium complex (MAC) pulmonary disease without underlying lung disease, high-resolution (HR)CT findings were correlated based on the results of sputum conversion after anti-MAC therapy.
Although children commonly travel to high altitudes, their respiratory adaptation to hypoxia remains elusive. Therefore, in the present study respiratory inductive plethysmography, pulse oximetry (Sp,O2) and end-tidal CO2 tension (PET,CO2) were recorded in 20 pre-pubertal children (aged 9-12 yrs) and their fathers during 1 night in Zurich (490 m) and 2 nights at the Swiss Jungfrau-Joch research station.
Large airway stenosis, and/or bronchomalacia will occur in a subset of lung transplant recipients. We report clinical observations in patients requiring interventional bronchoscopic treatment from the first 150 lung transplant recipients at our institution.
The present study investigated how end-expiratory ribcage and abdominal volume regulation during exercise is related to the degree of dynamic chest wall hyperinflation in patients with different spirometric severity of chronic obstructive pulmonary disease (COPD) based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification.
The pulmonary vascular bed is both a source of and target for a number of vasoactive factors. Among the most important for pulmonary vascular homeostasis are factors that utilise cyclic guanosine monophosphate (cGMP) as an intracellular second messenger.
Topical lidocaine is commonly used to obtain airway mucosal anesthesia during flexible bronchoscopy. Although its safety profile is excellent and there are few reports of adverse effects and allergies, precautions are necessary to avoid using lidocaine inappropriately and to avoid excess administration in patients at risk for lidocaine-related adverse events.
Children with chronic lung diseases are vulnerable to develop bacterial colonization of their distal airways. The aim of this study was to assess role of flexible bronchoscopy to determine distal airway microbial colonization and inflammation in children with chronic lung diseases compared with conventional methods.
The mainstays of treatment for pulmonary disease caused by opportunist mycobacteria are rifampicin (R) and ethambutol (E). The role of
macrolides, quinolones and immunotherapy with Mycobacterium vaccae is not clear.
The obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is associated with hypertension and increased cardiovascular risk, particularly when accompanied by marked nocturnal
hypoxaemia.
Obesity is the most common metabolic disease in the world and its prevalence has been increasing over several decades. The World Health Organization (WHO) predicts that, by 2015, around 700 million adults will be obese (at least 10% of the projected global population).
The article by Jennings and colleagues described interesting findings regarding the common nature of mixed viral/bacterial aetiology in patients with community acquired pneumonia (CAP) and the association between mixed
rhinovirus/pneumococcal infection and severe disease.
Cystic fibrosis (CF) is an autosomal recessive "channelopathy" characterised by aberrant CFTR and ENaC function resulting in widespread epithelial cell dysfunction and persistent airway infection.
Taylor and colleagues demonstrated a significant association between asthma severity and obesity. However, the mechanisms underlying this association are not fully understood. We suggest that the increase in asthma severity in obese patients might also be related to a defective function of regulatory T cells
(Tregs).
Sleep apnoea has been associated with increased mortality following stroke, but not independently of potential confounding factors. This is the first study to distinguish between obstructive and centrally mediated sleep apnoea following a stroke and to investigate the influence of each on mortality.
Bronchopulmonary dysplasia, resulting from damage to the lungs caused by ventilation, remains a major cause of mortality in preterm infants. In this international multicentre study the investigators compared continuous positive airway pressure
(CPAP) with intubation in preterm infants (infants born at 25-28 weeks’ gestation) to assess whether avoidance of ventilation reduced the incidence of bronchopulmonary
dysplasia.
A 65-year-old female non-smoker had a 3-month history of productive cough and intermittent haemoptysis for 1 month. Plain chest radiography showed a mass-like shadow at the medial side of the left lower lung field .
Malignant pleural effusion accounts for 22% of all pleural effusions, and affects about 300 000 patients annually (UK and USA). Approximately 50% of patients with breast cancer, 25% of those with lung cancer and >90% with pleural mesothelioma develop a symptomatic malignant pleural effusion.
There is convincing scientific evidence showing that ambient particulate matter (PM) is related to both short and long term health effects. Increased mortality and hospitalisation for cardiopulmonary causes have been noted in several studies evaluating the effects of PM10 or PM2.5 (PM <10 or 2.5 µm in diameter).
Asthma that is refractory to treatment with inhaled corticosteroids affects 5-10% of patients with asthma; it is an important health and economic problem in the UK and most industrialised nations.
The combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide
(TIO) are commonly used treatments in chronic obstructive pulmonary disease
(COPD) but there are few data on their effectiveness when used together. We compared the effects of SFC 50/500 µg twice daily in addition to TIO 18 µg once daily with the individual treatments alone.
This study examined the effects of inhaled furosemide on the ventilatory and perceptual response to high-intensity constant-load cycle exercise in chronic obstructive pulmonary disease
(COPD).
Anthracofibrosis, defined as bronchial luminal narrowing with black pigmentation of the overlying mucosa, has been attributed to tuberculosis. Three patients with anthracofibrosis without mycobacterial infection are described who had previous occupational exposure to mixed dusts.
There is little previous information of the effects of size fractioned particulate air pollution and source specific fine particles (PM2.5; <2.5
µm) on asthma and chronic obstructive pulmonary disease (COPD) among children, adults and the elderly.
As Berry and Pavord point out in their editorial in this month's Thorax, asthma refractory to treatment with inhaled corticosteroids is an important health and economic problem and unmet clinical need.
Neutrophil elastase (NE) activity is increased in lung diseases such as 1-antitrypsin (A1AT) deficiency and pneumonia. It has recently been shown to induce expression of cathepsin B and matrix metalloprotease 2 (MMP-2) in vitro and in a mouse model. It is postulated that increased cathepsin B and MMP-2 in acute and chronic lung diseases result from high levels of extracellular NE and that expression of these proteases could be inhibited by A1AT augmentation therapy.
Lobectomies using video-assisted thoracoscopic surgery (VATS) are becoming more and more accepted since several recent studies have demonstrated their safety and efficacy for stage I lung cancer. However, "video-assisted thoracoscopic surgery
lobectomy" usually means that a utility incision or a
mini-thoracotomy is used for insertion of conventional instruments.
Primary repair of infracardiac total anomalous pulmonary venous connection is associated with a significant risk of recurrent pulmonary venous obstruction. Herein we describe a technique of primary repair in which a modified sutureless anastomosis is constructed by suturing the left atrium to the posterior mediastinal pleura that surrounds the pulmonary venous confluence.
The aim of this study is to investigate the relationship between16-slice spiral CT perfusion imaging and tumor angiogenesis and VEGF (vascular endothelial growth factor) expression in patients with benign and malignant pulmonary nodules, and differential diagnosis between benign and malignant pulmonary nodules.
Although favourable prognosis following aggressive treatment of extrahepatic metastases from hepatocellular carcinoma
(HCC) has been reported, surgical outcomes for pulmonary metastases are unclear.
Fast track programs, multimodal therapy strategies, have been introduced in many surgical fields to minimize postoperative morbidity and mortality. In terms of lung resections no randomized controlled trials exist to evaluate such patient care programs.
Lymphangioleiomyomatosis (LAM) is a rare, idiopathic disease affecting young women often complicated by refractory and difficult to manage
chylothorax. We report one case of a patient who received a bilateral lung transplantation for LAM presenting a refractory
chylothorax. The instillation of povidone iodine in the pleural space was effective in inducing
pleurodesis.
Cochrane Database of Systematic Reviews 2008 Issue 2
Influenza vaccination is recommended for asthmatic patients in many countries as observational studies have shown that influenza infection can be associated with asthma exacerbations, but influenza vaccination itself has the potential to adversely affect pulmonary function. A recent overview concluded that there was no clear benefit of influenza vaccination in patients with asthma but this conclusion was not based on a systematic search of the literature.
Cochrane Database of Systematic Reviews 2008 Issue 2
The major allergen in house dust comes from mites. Chemical, physical and combined methods of reducing mite allergen levels are intended to reduce asthma symptoms in people who are sensitive to house dust mites.
European Radiology 0938-7994 (Print) 10.1007/s00330-008-1061-3
The purpose of this study was to describe the findings of CT performed on denim sandblasters with silicosis. Fifty consecutive male patients with silicosis were evaluated. Their clinical data and pulmonary function tests
(PFT) were obtained. The CT findings were recorded and the correlations between CT nodular profusion score and the other parameters were
assessed.
Bronchial artery aneurysms occur rarely, but they are potentially life threatening and require treatment to avoid rupture and other complications. A 37-year-old man, who was otherwise healthy, presented with chest discomfort and was found to have a large right bronchial artery aneurysm.
A case of tracheobronchopathia osteochondroplastic (TPO) was diagnosed in a 69-year old male with prolonged cough. TPO is a rare condition of unknown cause and only sporadic cases have been reported.
The transcription factor complex hypoxia-inducible factor (HIF)-1 controls the expression of most genes involved in adaptation to hypoxic conditions. HIF-1 is a heterodimer composed of oxygen-labile
HIF-{alpha} and constitutively expressed HIF-{beta} subunits.
Postpneumonectomy syndrome is a rare syndrome of dynamic airway obstruction caused by extreme rotation and shift of the mediastinum after
pneumonectomy, resulting in symptomatic central airway compression.
Epidemiological studies report an association between exposure to biomass smoke and cardiopulmonary morbidity. The mechanisms for this association are unclear. The aim of the present study was to characterise the acute pulmonary and systemic inflammatory effects of exposure to forest fire smoke.
The platelet-derived growth factor receptor inhibitor imatinib has demonstrated clinical and haemodynamical improvement in both animal models of pulmonary hypertension (PH) and patients with PH. It has been suggested that
anti-proliferative effects on pulmonary vascular smooth muscle cells are responsible for these beneficial effects.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0196-4
Individuals with moderate to severe chronic obstructive pulmonary disease (COPD) have poor sleep quality. This study evaluated the effects of
ramelteon, an MT1/MT2 melatonin receptor agonist indicated for insomnia treatment on respiration in this population.
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