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Pulmonary embolism (PE) is a potentially lethal condition that presents in patients with chest pain or shortness of breath. Although electrocardiograms (ECGs) typically demonstrate abnormalities associated with PE, ST-segment elevation, which can indicate anteroseptal acute myocardial infarction (AMI), has-on rare occasions-been noted on ECGs of patients with acute PE.
Clinical efficacy of aerosol therapy in premature newborns depends on the efficiency of delivery of aerosolized drug to the bronchial tree. To study the influence of various anatomical, physical, and physiological factors on aerosol delivery in preterm newborns, it is crucial to have appropriate in vitro models, which are currently not available.
Current Opinion in Pulmonary Medicine. 14(5):434-439, September 2008
Increased familial occurrences as well as different disease modes in different ethnic groups suggest a genetic influence in sarcoidosis. Also, genetic analyses have revealed a number of chromosomal regions and specific genes associated with sarcoidosis. This review brings up some recent discoveries on the genetic contribution to sarcoidosis.
Inflammation & Allergy - Drug Targets (Formerly Current Drug Targets - Inflammation & Allergy), Volume 7, Number 2, June 2008 , pp. 85-93(9)
Leukocyte migration into the tissues represents a key process in the pathogenesis of inflammatory diseases. Data obtained in clinical trials have convincingly shown that inhibition of leukocyte migration into the target organs represents an effective therapeutic approach for diseases in which inflammation has a noxious effect.
Annals of Allergy, Asthma and Immunology, Volume 101, Number 2, August 2008 , pp. 144-152(9)
Asthma guidelines recommend routine evaluation of asthma control, which includes measurements of impairment and risk. It is unclear whether rigorous asthma control changes risk of asthma morbidity.
Am J Physiol Lung Cell Mol Physiol 295: L235-L237, 2008
Current emphasis on translational application of genetic models of lung disease has renewed interest in the measurement of the gravimetric filtration coefficient (Kf) as a means to assess vascular permeability changes in isolated perfused lungs.
Am J Physiol Lung Cell Mol Physiol 295: L272-L284, 2008
Pulmonary hypoxia is a common complication of chronic lung diseases leading to the development of pulmonary hypertension. The underlying sustained increase in vascular resistance in hypoxia is a response unique to the lung.
Am J Physiol Lung Cell Mol Physiol 295: L293-L302, 2008
As part of the innate immune defense, the polarized conducting lung epithelium acts as a barrier to keep particulates carried in respiration from underlying tissue. Arsenic is a metalloid toxicant that can affect the lung via inhalation or ingestion.
We describe an 11-year-old girl with severe obstruction of the main pulmonary arteries caused by invasive aspergillosis and managed with combined pulmonary endarterectomy and antimycotic treatment.
The Carney complex is a multiple neoplasia syndrome characterized by myxomas, schwannomas, mucocutaneous spotty pigmentations, and endocrine overactivity with or without endocrine tumors.
Current Opinion in Pulmonary Medicine. 14(5):389-396, September 2008
Venous thromboembolism is an important cause of morbidity and mortality after stroke. Its potential for prevention is substantial with the use of antithrombotic agents, but there is no agreement on the relative advantages and disadvantages of various available prophylactic drugs. There have been recent publications that clarify some of these issues.
There is increasing evidence that patients with low-risk community acquired pneumonia (CAP) can be effectively treated as outpatients. This study aimed to explore patients' experiences of having pneumonia and seeking health care; their perceptions of the information provided by health professionals; how they self managed at home; their information and support needs; and their beliefs and preferences regarding site of care.
Inflammation & Allergy - Drug Targets (Formerly Current Drug Targets - Inflammation & Allergy), Volume 7, Number 2, June 2008 , pp. 119-128(10)
Asthma is a chronic disease characterised by airways hyperresponsiveness, airways inflammation, airways remodelling and reversible airways obstruction. Airway structural cells, recruited inflammatory cells and many mediators such as cytokines, chemokines and adhesion molecules are involved in the pathogenesis of asthma.
Pediatric Pulmonology Published Online: 21 Jul 2008
Obstruction, infection, and inflammation lead to progressive and irreversible lung destruction in cystic fibrosis (CF). Neutrophil-derived DNA contributes to thick, viscous secretions. Dornase alfa hydrolyzes DNA, reducing the viscosity of CF sputum.
Current Opinion in Pulmonary Medicine. 14(5):427-433, September 2008
To examine recent advancements in the clinical characteristics, treatment and prognosis of diffuse parenchymal disease and pulmonary hypertension due to idiopathic pulmonary fibrosis, scleroderma and sarcoidosis.
Current Opinion in Pulmonary Medicine. 14(5):381-388, September 2008
To demonstrate that venous thromboembolism is an important and common problem in hospitalized medical patients; to outline anticoagulant prophylaxis management options and the evidence for efficacy and safety; and to identify medical patients in whom anticoagulant prophylaxis should be considered.
Current Opinion in Pulmonary Medicine. 14(5):414-421, September 2008
This paper reviews recently described prognostic prediction rules (the Geneva score, the Pulmonary Embolism Severity Index, the Spanish score, the Davies criteria, and the HOme Management Exclusion criteria) for patients with acute symptomatic pulmonary embolism, and discusses their usefulness in decision-making regarding the appropriate initial therapy and treatment setting.
Current Opinion in Pulmonary Medicine. 14(5):422-426, September 2008
Acute pulmonary embolism is a common, life-threatening, cardiopulmonary disorder with a high mortality rate within the first 3 months of diagnosis. As prompt anticoagulation is the mainstay of therapy in patients with pulmonary embolism, the clinical utility and cost effectiveness of systemic thrombolysis is debated.
We evaluated regional variation and trends in invasive pneumococcal infections (IPI) in Finland by using data from national, population-based laboratory surveillance and number of blood and cerebrospinal fluid (CSF) cultures performed by all microbiology laboratories during 1995-2002.
A 31-day-old girl with right atrial isomerism, a single atrium, a single right ventricle, pulmonary atresia, patent ductus arteriosus, coarctation of the pulmonary artery, infracardiac total anomalous pulmonary venous connection, and a large hiatal hernia was referred to our institution.
Air leaks remain the most common pulmonary complication after elective pulmonary resection, yet their assessment, unlike other clinical bedside indicators, remains analogue and not digital.
Pulmonary surfactant protein-D (SP-D) is a multifunctional, pattern recognition molecule involved in resistance to allergen challenge and pulmonary inflammation.
Journal of Intensive Care Medicine, Vol. 23, No. 4, 219-235 (2008)
Despite the ever-present risk of mass-casualty incidents (MCIs) in all geographical regions, there is a limited body of literature detailing specifically how an intensive care unit (ICU) prepares for such an event.
Annals of Allergy, Asthma and Immunology, Volume 101, Number 2, August 2008 , pp. 137-143(7)
Concerns regarding potential harmful effect of medications on fetuses often result in inadequate treatment of asthma in pregnancy, whereas risks posed by poorly controlled maternal asthma are often underestimated.
Annals of Allergy, Asthma and Immunology, Volume 101, Number 2, August 2008 , pp. 200-205(6)
Baker's asthma is a frequent IgE-mediated occupational disorder mainly provoked by inhalation of cereal flour. Allergy to kiwifruit has being increasingly reported in the past few years. No association between both allergic disorders has been described so far.
Journal of Computer Assisted Tomography. 32(4):576-582, July/August 2008
To prospectively evaluate the use of minimum-intensity projection (minIP) imaging, high-resolution (HR) computed tomography (CT), and pulmonary function tests for quantifying emphysema with histopathologic examination.
European Radiology 0938-7994 (Print) 10.1007/s00330-008-1105-8
Negative pressure ventilation via an external device (‘iron lung’) has the potential to provide better oxygenation with reduced barotrauma in patients with
ARDS.
Journal of Computer Assisted Tomography. 32(4):562-569, July/August 2008
To assess the feasibility of volumetric and densitometric software to localize and quantify signs of regional air trapping after methacholine bronchoprovocations in asthma.
Pediatric Pulmonology Published Online: 21 Jul 2008
Chronic airways infection is associated with the greatest morbidity and mortality of patients with cystic fibrosis (CF). The CF airways become infected early in life and once established, the infection is difficult, if not impossible, to eradicate, with Pseudomonas aeruginosa becoming the predominant organism over time.
Pulmonary rehabilitation is successful in improving exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD). However, training effects diminish over time.
Congenital Heart Disease, Volume 3, Number 4, July/August 2008 , pp. 284-287(4)
An infant was referred to us for persistent cough and recurrent wheezing. Chest X-ray showed an abnormal shadow in the right lower lobe. A volumetric contrast-enhanced computerized tomography (CT) scan of the chest revealed an abnormal blood vessel extending from the descending aorta to the right lower lobe and anomalous venous drainage from the right lower lobe into inferior vena cava.
he objective of our study was to investigate the difference of perceptible artifacts between the lungs and the chest wall and mediastinum in Joint Photographic Experts Group (JPEG) 2000-compressed low-dose chest CT images and to show that a perceptual image quality metric-the High-Dynamic Range Visual Difference Predictor (HDR-VDP)-can reproduce this regional difference.
A cutoff standard uptake value (SUV) of 2.5 has been commonly adopted for 18F-FDG PET to evaluate pulmonary lesions, but false results can occur. Studies have shown the usefulness of delayed PET for improving accuracy.
Pediatric Pulmonology Published Online: 21 Jul 2008
Cystic fibrosis (CF) provides an extreme example of the consequences of failed host defense of the lung. Investigation into the nature of the CF defect has revealed that abnormal ion transport activities lead to dehydration of airway surfaces and defective mucus clearance.
Future Microbiology, Volume 3, Number 4, August 2008 , pp. 397-404(8)
Secondary bacterial pneumonia following influenza is an old problem, which is re-emerging. Despite rapid advances in our armamentarium of antimicrobials, the case-fatality rate for this frequent complication of influenza remains high.
The objective of our study was to evaluate whether diffusion-weighted imaging (DWI) with a high b factor can be used to differentiate malignancies from benign pulmonary nodules.
The authors present the case of a 31-year-old woman with a massive anterior mediastinal tumor who presented with respiratory failure. A thoracic computed tomographic scan suggested a mediastinal lipomatous mass, and an operation was performed.
Occasionally pulmonary artery banding is necessary to reduce pulmonary arterial blood flow and pressure in patients who cannot be repaired in a single stage. Traditional extraluminal PAB can be associated with significant morbidity.
We describe a new technique for coronary transfer in the repair of anomalous origin of the left coronary artery from the pulmonary artery. The left coronary artery is elongated with the native pulmonary artery wall to form a spiral-shaped coronary cuff to construct an unstretched new left coronary artery system from the ascending aorta.
Pneumothorax is a common clinical entity that may present to a wide variety of medical specialties. Primary pneumothorax (in the presence of no known underlying lung disease) and secondary pneumothorax (in known lung disease) are distinct entities with varied etiology, treatment, and prognosis.
Recent years have witnessed the refinement and significant growth of several new, minimally invasive approaches for the nonsurgical treatment of primary lung malignancies.
Cross-sectional imaging of the chest with computed tomography (CT), magnetic resonance imaging, and at times, ultrasonography exquisitely delineates mediastinal, hilar, and pleural pathologies.
Epidemiological studies have shown increased prevalence of asthma over the last decades and a considerable variation in these rates between different countries, mainly developed.
Patients face increasing insurance restrictions on prescription drugs, including generic-only coverage. There are no generic inhaled corticosteroids (ICS), which are a mainstay of asthma therapy, and patients pay the full price for these drugs under generic-only policies.
Current Opinion in Pulmonary Medicine. 14(5):440-454, September 2008
Hypersensitity pneumonitis, caused by inhalation of various antigens, is characterized by interstitial mononuclear cell infiltration, nonnecrotizing granulomas, cellular bronchiolitis, and fibrosis.
Current Opinion in Pulmonary Medicine. 14(5):488-492, September 2008
Diffuse pulmonary ossification is a rare disease characterized by diffuse small bone fragments in the lung tissue. It can be idiopathic or associated with underlying chronic pulmonary or heart diseases.
Am J Physiol Lung Cell Mol Physiol 295: L348-L355, 2008
Prolonged hyperoxic exposure contributes to neonatal lung injury, and airway hyperreactivity is characterized by enhanced contraction and impaired relaxation of airway smooth muscle.
Am J Physiol Lung Cell Mol Physiol 295: L370-L377, 2008
Previously, we have reported that endothelial nitric oxide synthase (eNOS) promoter activity is decreased in pulmonary arterial endothelial cells (PAECs) in response to hydrogen peroxide (H2O2).
Am J Physiol Lung Cell Mol Physiol 295: L326-L335, 2008. First published May 23, 2008
Cytosolic phospholipase A2{alpha} (cPLA2{alpha}) activation is a regulatory step in the control of arachidonic acid (AA) liberation for eicosanoid formation. Sphingosine 1-phosphate (S1P) is a bioactive lipid mediator involved in the regulation of many important proinflammatory processes and has been found in the airways of asthmatic subjects.
Am J Physiol Lung Cell Mol Physiol 295: L363-L369, 2008
Activation of the Rho GTPase Cdc42 has been shown in endothelial cell monolayers to prevent disassembly of interendothelial junctions and the increase in endothelial permeability.
Am J Physiol Lung Cell Mol Physiol 295: L303-L313, 2008
The pathophysiology of cystic fibrosis (CF) inflammatory lung disease is not well understood. CF airway epithelial cells respond to inflammatory stimuli with increased production of proinflammatory cytokines as a result of increased NF-{kappa}B activation.
Pediatric Pulmonology Published Online: 21 Jul 2008
Aerosolized drugs are universally used for treatment of cystic fibrosis airway disease. Inhalation can increase topical efficacy and reduce systemic exposure and toxicity of many drugs.
Several surgical, medical, irradiative, and image-guided focal ablative therapies are available for patients with primary non-small-cell lung cancer (NSCLC) or pulmonary metastases.
Current Opinion in Pulmonary Medicine. 14(5):374-380, September 2008
Venous ultrasound is a major tool in both routine clinical care and clinical research. Since the last review, major attempts have been made to improve its methodological strength, and therefore, its value in assessing diagnostic criteria, risks, and outcomes in venous thromboembolism.
Current Opinion in Pulmonary Medicine. 14(5):462-469, September 2008
To examine recent advances in the understanding of the prevalence, pathophysiology, natural history, diagnosis, and treatment of pulmonary hypertension associated with interstitial lung disease.
As the prevalence of obesity increases in both the developed and the developing world, the respiratory consequences are often underappreciated. This review discusses the presentation, pathogenesis, diagnosis and management of the obstructive sleep apnoea, overlap and obesity hypoventilation syndromes.
Admission blood pressure (BP) assessment is a central component of severity assessment for community acquired pneumonia. The aim of this study was to establish which readily available haemodynamic measure on admission is most useful for predicting severity in patients admitted with community acquired pneumonia.
Idiopathic pulmonary fibrosis (IPF) is a progressive lung disorder of unknown aetiology that leads to death in the majority of patients within 3-5 years of diagnosis.
The study by Aubin et al1 published in this issue is significant in that it is the first head-to-head comparison of the two smoking cessation pharmacotherapies: varenicline and nicotine replacement therapy (NRT).
Frank et al have elegantly demonstrated in animal models of ventilator associated lung injury (VALI) that interleukin 1{beta} (IL1{beta}) may play a role in the development of alveolar barrier dysfunction.
I read with interest the article by Aaron et al.1 In this paper, data from the Optimal Trial2 were reanalysed for the purpose of examining the effect of differences in counting and analysing exacerbation rates on estimated treatment effects in chronic obstructive pulmonary disease (COPD).
In early childhood, the ability to mount protective immune responses in the airways is impaired, with increased risk of allergic sensitisation to inhaled allergens. Antigen presenting cells (APC) and regulatory T cells (Treg) are important modifiers of T cell immunity but little is known about their distribution in bronchial mucosa at this age.
There is limited evidence for the role of air pollution in the development and triggering of wheezing symptoms in young children. A study was undertaken to examine the effect of exposure to air pollution on wheezing symptoms in children under the age of 3 years with genetic susceptibility to asthma.
The differential diagnosis for pulmonary infiltrates in the immunocompromised host includes opportunistic infections, drug toxicity, alveolar haemorrhage and progression of the primary disease.
Interleukin (IL)6 production by antigen-presenting dendritic cells (DCs) is integral to the differentiation of T helper cells into T helper type Th1, Th2 and Th17 subsets. However, molecular mechanisms that regulate IL6 production in DCs are yet to be elucidated.
Progressive lung disease is an important cause of mortality and morbidity in patients with cystic fibrosis (CF). The severity and progression of lung disease, which has a poor correlation with CF transmembrane conductance regulator (CFTR) genotype, is thought to be modulated by secondary genetic factors known as CF modifiers.
This study investigated the clinical value of chest radiographs during the 4-week period after diagnosis of severe community acquired pneumonia (CAP) in immune competent hospitalised patients.
A 74-year-old man of Jamaican origin residing in the USA for 20 years presented to the hospital with progressively increasing shortness of breath and low-grade fever for 3 weeks. He had been diagnosed with
non-Hodgkin’s lymphoma 6 months prior to admission and started on chemotherapy with
cyclophosphamide, doxorubicin, vincristine and prednisolone, with the last dose 12 days before presentation. In the hospital he was found to be hypoxic (82% saturation on room air) and required intubation and mechanical ventilation in the next 24 h.
A 42-year-old Caucasian woman presented with dyspnoea and expectoration of white stringy phlegm with a consistency between goat’s cheese and chewing gum.
In this issue of Thorax Aubin and colleagues1 report a further trial from the Varenicline Phase III Programme (see page 717). The trials supporting registration contrasted bupropion with varenicline in a double placebo design.
We probably all acknowledge that regular spontaneous physical activity plays a large role in maintaining health and physical fitness. In health, the promotion of regular physical activity has been a feature of active living since at least the time of Ancient Greece. In more modern times we have continued this tradition by encouraging our children to play sport and sustaining recreational physical activity through to old age.
According to a widespread consensus reflected in all authoritative guidelines, assessment of severity is the key step in the management of patients with community acquired pneumonia (CAP).
Lung transplantation is an important option to treat patients with advanced cystic fibrosis (CF) lung disease. The outcomes of a large UK cohort of CF lung transplantation recipients is reported.
Infection with Burkholderia cepacia complex (BCC) is a life threatening complication of cystic fibrosis (CF), often seen as a contraindication for lung transplantation.
Patients with chronic obstructive pulmonary disease (COPD) walk less than healthy older people and their self-reported activity predicts exacerbation risk. The relationship between lower limb activity and total daily activity is not known, nor are there any data which relate objectively assessed daily activity to laboratory assessments made before and after rehabilitation.
Epidemiological studies first demonstrated the association between obesity and asthma and they have begun to provide additional evidence to support causality: a dose-effect relationship, consistency across studies (especially among women) and the correct temporal order (ie, obesity before asthma).
There has been some concern that leucotriene receptor antagonists might precipitate the onset of Churg-Strauss syndrome (CSS). A study was undertaken to investigate the relationship between the leucotriene receptor antagonist montelukast and the onset of CSS.
The 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for persons aged 65 years or less with chronic medical conditions. We evaluated the risk and mortality from invasive pneumococcal disease (IPD) among persons with and without the underlying medical conditions which are considered PPV23 indications.
Despite recent advances in the perinatal management of neonatal respiratory distress syndrome (RDS), controversies still exist. We report the recommendations of a European panel of expert neonatologists who developed consensus guidelines after critical examination of the most up-to-date evidence in 2007.
The Journal of Infectious Diseases 2008;198:553-560
Asthma, a serious health problem worldwide, is becoming more common. Colonization with Helicobacter pylori, a major human indigenous (commensal) microbe, during early life may be relevant to the risk of childhood asthma.
Pharmacotherapy in patients with idiopathic pulmonary fibrosis
Based on the recognition of idiopathic pulmonary fibrosis as a fibroproliferative disease with the usual interstitial pneumonia histology, pharmacotherapies should be reconsidered.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200805-670OC
Human rhinovirus infections cause colds and trigger exacerbations of lower airway diseases. Objectives: To define changes in gene expression profiles during in vivo rhinovirus infections.
Antimicrobial Agents and Chemotherapy, August 2008, p. 2831-2835, Vol. 52, No. 8
Tibotec Medicinal Compound 207 (TMC207) is a novel diarylquinoline with a unique mode of action that targets mycobacterial ATP synthase. TMC207 exhibits high in vitro activity against mycobacterial strains either susceptible or resistant to all first-line and many second-line drugs, including fluoroquinolones, and has shown exceptional in vivo activity against several mycobacterial species in different animal models.
In this study, we tested the hypothesis that 17[beta]-estradiol (E2) administration after trauma-hemorrhage reduces lung injury through a mechanism involving estrogen receptor (ER)-dependent activation of the endothelial nitric oxide (NO) synthase (eNOS)/protein kinase G (PKG)/vasodilator-stimulated phosphoprotein (VASP) pathway.
Respiratory Research 2008, 9:56doi:10.1186/1465-9921-9-56
CPAP titration may be completed by automatic apparatus. However, differences in pressure behaviour could interfere with the reliability of pressure recommendations. Our objective was to compare pressure behaviour and effective pressure recommendations between three Automatic CPAP machines.
Achalasia is a rare motility disorder of the esophagus which results from lack of enervation of the lower sphincter muscles and leads to dilatation of the proximal esophagus.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1822OC
We previously demonstrated pre-B cell colony enhancing factor (PBEF) as a biomarker in sepsis and sepsis-induced acute lung injury (ALI) with genetic variants conferring ALI susceptibility.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1894OC
High-mobility group box 1 (HMGB1) is a potent inflammatory mediator elevated in sepsis and rheumatoid arthritis, although its role in cystic fibrosis (CF) lung disease is unknown.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200805-717OC
Moderate-severe obstructive sleep apnea (OSA) is associated with endothelial dysfunction, increased arterial stiffness and hypertension. It is not known if minimally symptomatic OSA is also associated with impaired vascular function.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200804-606OC
Children with congenital or late-onset central hypoventilation syndrome (CHS) hypoventilate during sleep, although they generally breathe adequately during wakefulness.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200802-321OC
Rationale An association between neurocognitive deficits and pediatric sleep disordered breathing has been suggested; however, weak correlations between disease severity and functional outcomes underscore the lack of knowledge regarding factors modulating cognitive morbidity of sleep disordered breathing.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1895OC
The purpose of this study was to examine the changes in protein expression in the bronchoalveolar lavage fluid (BALF) of patients during the course of the acute respiratory distress syndrome (ARDS). Methods: Using two dimensional difference gel electrophoresis (DIGE), the expression of proteins in the BALF from patients on days 1 (n=7), 3 (n=8), and 7 (n=5) of ARDS were compared to findings in normal volunteers (n=9).
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1804OC
The effectiveness and safety of aztreonam lysine for inhalation (AZLI) in patients with cystic fibrosis (CF) on maintenance treatment for Pseudomonas aeruginosa (PA) airway infection was evaluated in this randomized, double-blind, placebo-controlled study.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200711-1657OC
Human Metapneumovirus is a newly described virus isolated in 2001 from children with acute respiratory infection. It has subsequently been reported globally although there is limited data in lung transplant recipients.
Neurologists should be able to anticipate and recognise the onset of respiratory failure in patients with neuromuscular disorders. Symptoms will differ depending on the speed of onset of the respiratory muscle weakness.
Prior to the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7), the rate of invasive pneumococcal disease (IPD) was 8-fold higher among White Mountain Apache persons of all ages than it was among the general US population.
The purpose of our study was to show the difference of Joint Photographic Experts Group (JPEG) 2000 compression artifacts in the lung between thin- and thick-section CT images.
European Radiology 0938-7994 (Print) 10.1007/s00330-008-1089-4
Quantitative assessment of airway-wall dimensions by computed tomography (CT) has proven to be a marker of airway-wall remodelling in chronic obstructive pulmonary disease (COPD) patients.
Prevalence of asthma has increased considerably in recent decades throughout the world especially in developed countries. Airway inflammation is thought to be prime cause for repeated episodes of airway obstruction in asthmatics. Several studies have shown that reactive oxygen species (ROS) play a key role in initiation as well as amplification of inflammation in asthmatic airways.
The modulation of gap junctional communication between tumor cells and between tumor and vascular endothelial cells during tumorigenesis and metastasis is complex. The notion of a role for loss of gap junctional intercellular communication in tumorigenesis and metastasis has been controversial.
Previous studies have shown associations between low mannose-binding lectin (MBL) level or variant MBL2 genotype and sepsis susceptibility. However, MBL deficiency has not been rigorously defined, and associations with sepsis outcomes have not been subjected to multivariable analysis.
Pediatric Pulmonology Published Online: 21 Jul 2008
Aggressive treatment of CF lung disease has markedly increased survival of CF patients and intense research efforts over the last decades have led to new treatment strategies, many of which target the lower airways directly via aerosol.
Formoterol fumarate is a long-acting {beta}2-agonist that is an effective bronchodilator for the maintenance management of patients with chronic obstructive pulmonary disease.
Pulmonary arterial hypertension (PAH) is characterized by vasoconstriction, in situ thrombosis, and vascular remodeling of small pulmonary arteries inducing increased pulmonary arterial resistance. Conventional treatment is based on life style modification and nonspecific treatment (warfarine, diuretics, oxygen).
Smoking is associated with an increased risk of respiratory tract infection in adults likely because components in the smoke might alter properties of the epithelial cell surface. In studies with smokers suffering from acute exacerbations of COPD (AECOPD), the most common bacterial pathogens found were mainly Haemophilus influenzae, but also Streptococcus pneumoniae, Staphylococcus aureus, and Moraxella catarrhalis.
Chlorobenzene is a volatile organic compound that is used as a solvent in many industrial settings and has been shown to be related with irritations of the respiratory tract. Exposure to chlorobenzene induces the release of monocyte chemoattractant protein 1 (MCP-1) by lung epithelial cells, a chemokine involved in inflammatory reactions.
Acinetobacter baumannii is increasingly recognized as being a significant pathogen associated with nosocomial outbreaks in both civilian and military treatment facilities. Current analyses of these outbreaks frequently describe patient-to-patient transmission.
Journal of Human Nutrition & Dietetics, Volume 21, Number 4, August 2008 , pp. 381-382(2)
Clinical trials have shown that pulmonary rehabilitation can improve the functional status and quality of life of chronic obstructive pulmonary disease (COPD) patients (Lacasse, 2006) but there is no research examining the efficacy of group dietetic intervention during standard 8-week rehabilitation courses. Current input is usually limited to a 1-h nutrition education session.
The objective of our study was to illustrate the potential for phrenic nerve injury during percutaneous lung ablation, to discuss the importance of this complication, and to review the expected location of the phrenic nerve on chest CT.
Cigarettes with candy, fruit and alcohol flavors have been introduced in recent years as extensions to popular cigarette brands, raising concerns in the public health community that the enticing names, creative packaging, and intense flavorings of these products may be especially appealing to youth.
Compared to men, women may be at greater risk for smoking-related diseases and have greater difficulty quitting smoking. Sex differences in medication response could guide treatment for smoking cessation to improve women's quit rates.
In a general population sample from the Detroit site of the Collaborative Genetic Study of Nicotine Dependence (COGEND), we tested Black-White differences in nicotine dependence, measured by "how soon after wake-up the smokers smoked their first cigarette (time to first cigarette TTFC)", and its relationship with number of cigarettes per day (CPD).
Tobacco withdrawal symptoms have been shown to play a significant role in mediating relapse to smoking in adult smokers; however, few prospective studies have examined the course of tobacco withdrawal symptoms over time and their connection to lapse in adolescent smokers.
Small interfering RNA (siRNA) against alpha-ENaC (alpha-subunit of the epithelial Na channel) and CFTR (cystic fibrosis transmembrane conductance regulator) was used to explore ENaC and CTFR function in newborn rat lungs.
CPAP titration may be completed by automatic apparatus. However, differences in pressure behaviour could interfere with the reliability of pressure recommendations.
In computed tomographic (CT) examinations of the lung, accurate visualization of the natural contrast between the low attenuation of air and the relatively higher attenuation of vessels, airways, and interstitial structures requires cooperative and coordinated respiratory maneuvers by the patient.
European Journal of Pediatrics 0340-6199 (Print) 10.1007/s00431-008-0761-7
The aim of this paper is to quantitatively summarize the original articles on the relationship between environmental hazards and respiratory health in young children.
Diaphragmatic rupture due to trauma is both well recognised and uncommon. The difficulties in diagnosing traumatic diaphragmatic rupture at the first admission are the most common causes of latent morbidity and mortality. Herniation of the abdominal viscera is the most common sequel with strangulation and perforation the most serious complication.
Cochrane Database of Systematic Reviews, Issue 3, 2008
Non-invasive positivepressure ventilation (NPPV) has been widely used to alleviate signs and symptoms of respiratory distress due to cardiogenic pulmonary edema. NPPV prevents alveolar collapse and helps redistribute intra-alveolar fluid, improving pulmonary compliance and reducing the pressure of breathing.
Intensive Care Medicine 0342-4642 (Print) 10.1007/s00134-008-1208-3
Neurally adjusted ventilatory assist (NAVA) is a new mode wherein the assistance is provided in proportion to diaphragm electrical activity (EAdi). We assessed the physiologic response to varying levels of NAVA and pressure support ventilation (PSV).
Intensive Care Medicine 0342-4642 (Print) 10.1007/s00134-008-1214-5
Patients with pulmonary embolism (PE) have a high risk of death, and it is important to recognize factors associated with higher mortality. Recently, several biomarkers have been studied for risk stratification in patients with PE.
The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 8, August 2008 , pp. 962-966(5)
Mycobacterium tuberculosis infection has been shown to be associated with anthracotic bronchitis. However, the typical manifestation of infection is not usually present in infected patients, which raises the question of whether a particular strain of M. tuberculosis is associated with this group of patients.
The World Health Organizationas (WHO) case definition for childhood pneumonia, composed of simple clinical signs of cough, difficult breathing and fast breathing, is widely used in resource poor settings to guide management of acute respiratory infections. The definition is also commonly used as an entry criteria or endpoint in different intervention and disease burden studies.
Washed human erythrocytes were incubated with titanium dioxide (TiO2) particles at 37°C for 1 hr and hemolysis was determined by the percentage of hemoglobin released (optical density at 540 nm; OD540) from the cells. Effects of TiO2 on OD540 were corrected and dose-response curves were analyzed by the Hill plot. Judging from the estimated dose to cause 50% hemolysis, the anatase form of micron-scale (<5000 nm) particles was 73 and 11 times more potent than the amorphous (<50 nm) and rutile (<5000 nm) forms, respectively, whereas it was 1.3 times more potent than the nano-scale (<25 nm) anatase particles.
Dyspnea is the hallmark symptom of some respiratory diseases such as chronic obstructive pulmonary disease and bronchiolitis and is a major reason for which these patients seek medical attention. We performed a randomized triple-blind controlled crossover clinical trial in which we compared the efficacy of inhaled furosemide (4 ml equal to 40 mg in 10 min) with placebo (4 ml of 0.9% saline solution) in 41 mustard gas-exposed patients.
Pesticides may contribute to adverse respiratory health effects among farmers and have been considered one causal factor for the rise in asthma prevalence. This cross-sectional study was conducted to evaluate potential respiratory function abnormalities following long-term pesticide exposure by means of a complete pulmonary function testing, including spirometry, lung volumes, and diffusing capacity for carbon monoxide.
Neurologists should be able to anticipate and recognise the onset of respiratory failure in patients with neuromuscular disorders. Symptoms will differ depending on the speed of onset of the respiratory muscle weakness.
Pigeon fanciers lung, a form of hypersensitivity pneumonitis, is an unusual but important occupational and recreational cause of severe and debilitating breathlessness.
A 15-year-old girl was referred with a 2-year history of perennial non-productive cough, which had been preceded by Mycoplasma pneumoniae pneumonia and subsequent asthma. Symptoms were only partially responsive to anti-asthma treatment including an inhaled corticosteroid and a leukotriene receptor antagonist.
During the past two decades, there has been considerable progress in developing particle size-selective criteria for aerosol sampling and exposure assessment that relate more realistically to actual human exposures than previously.
This study presents temporal trends of styrene exposure for workers in the European glass fibre-reinforced plastics (GRP) industry during the period 1966-2002.
Pregnancy in Type 1 diabetic patients is a precarious condition, both for mother and fetus with increased the risk of prematurity and, immediately after delivery with risk of respiratory distress syndrome and hypoglycaemia in newborns.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 133-141, 2008
Inherited mutations in the human {alpha}1-antitrypsin (AAT) gene lead to deficient circulating levels of AAT protein and a predisposition to developing emphysema. Gene therapy for individuals deficient in AAT is an attractive goal, because transfer of a normal AAT gene into any cell type able to secrete AAT should reverse deficient AAT levels and attenuate progression of lung disease.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 127-132, 2008
Cyclic adenosine monophosphate (cAMP) was the original "second messenger" to be discovered. Its formation is promoted by adenylyl cyclase activation after ligation of G protein-coupled receptors by ligands including hormones, autocoids, prostaglandins, and pharmacologic agents.
What you need to know when you are considering a program for ventilator care and weaning and pulmonary rehabilitation. A handy, printable guide for what to look for in a respiratory program.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 142-149, 2008
Amiodarone interferes with the endocytic pathway, inhibits proteolysis, and causes the formation of vacuoles, but uptake and intracellular distribution of the drug, origin of vacuoles, and functional consequences of amiodarone accumulation remain unclear.
Pediatric Pulmonology Published Online: 9 Jul 2008
Cysteinyl leukotrienes promote airway inflammation, bronchoconstriction and mucus hypersecretion. Cigarette smoking and respiratory syncytial virus (RSV) bronchiolitis are known to increase urinary cysteinyl leukotriene E4 (uLTE4), the end product of the cysteinyl leukotriene biosynthetic pathway.
Pediatric Pulmonology Published Online: 10 Jul 2008
A 20-day-old female child presented with mild respiratory distress since first week of life. On examination there was an ejection systolic murmur at left sternal border. Chest x-ray revealed well-defined mass in the left lung. Echocardiogram showed features suggestive tetrology of fallot with absent pulmonary valve with massively dilated main and left pulmonary artery.
Inflammatory diseases of the lung such as asthma and COPD represent a major worldwide health problem. There are potent antiinflammatory drugs available to treat asthma, such as the glucocorticoids, but these produce unwanted side effects and exhibit limited efficacy in the treatment of COPD.
Rural management of acute cardiogenic pulmonary edema should be based on avoidance of adverse outcomes such as in-hospital mortality, the need for intensive care unit care, and the need for intubation and mechanical ventilation.
Pediatric Pulmonology Published Online: 10 Jul 2008
A 2-month-old female infant was admitted with progressive respiratory distress, fever, and diagnosed with acute respiratory distress syndrome (ARDS). The primary pulmonary pathogen was proven to be cytomegalovirus (CMV) from bronchoalveolar lavage fluid, urine, and blood specimens. Other immunologic findings were normal. CMV-induced ARDS has not been reported previously in immunocompetent infants.
A patient admitted to the medical step-down unit experienced severe hypoglycemia due to an infusion of a higher-than-ordered insulin dose. The event could have been prevented if the insulin syringe pump was checked during the nursing shift handoff.
Pulmonary arterial hypertension (PAH) is the most common cause of scleroderma-related deaths. New medications for PAH patients make it necessary to identify patients with high risk factors for PAH. This study looks at the use of an exercise echocardiogram in identifying patients who may have PAH and may be candidates for early therapeutic intervention.
Many acute infectious pulmonary diseases have incubation periods that are long enough for travelers to have symptoms after returning home to a health-care system that is not familiar with "foreign" infections. Respiratory infections have a relatively limited repertoire of clinical manifestations, so that there is often nothing characteristic enough about a specific infection to make the diagnosis obvious.
Asthma and COPD can significantly affect patients and pose a substantial economic burden for both patients and managed-care plans. This study compares utilization outcomes in patients with asthma, COPD, or co-occurring asthma and COPD in a Medicaid population, and assesses the incremental burden of COPD in patients with asthma.
Pulmonary emphysema is associated with cachexia and disregulation of the hormones regulating the glycolipid metabolism, insulin resistance, and altered substrate utilization. This study aimed at identifying the effects of lung volume reduction surgery (LVRS) on glycolipidic hormones compared to respiratory rehabilitation (RR).
Histopathologic evidence of fibrosis on surgical lung biopsy has been associated with reduced survival in patients with hypersensitivity pneumonitis (HP). Changes of pulmonary fibrosis detected on CT may also correlate with prognosis in patients with HP.
Treprostinil, a long-acting prostacyclin analog, diminished the symptoms of pulmonary arterial hypertension (PAH) in controlled 12-week clinical efficacy studies. This retrospective, single-center, open-label study was designed to assess the efficacy of long-term, subcutaneously administered, treprostinil-based therapy alone or in combination with bosentan for the treatment of moderate-to-severe PAH.
The Proceedings of the American Thoracic Society 5:577-590 (2008)
Globally, about 50% of all households and 90% of rural households use solid fuels (coal and biomass) as the main domestic source of energy, thus exposing approximately 50% of the world population-close to 3 billion people-to the harmful effects of these combustion products. There is strong evidence that acute respiratory infections in children and chronic obstructive pulmonary disease in women are associated with indoor biomass smoke.
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. 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. 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. 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.
Journal of General Internal Medicine 0884-8734 (Print) 10.1007/s11606-008-0707-9
Overuse of antibiotics in the treatment of acute respiratory tract infection (ARI) contributes to the growing problem of antibiotic-resistant infections.
Surgical Endoscopy 0930-2794 (Print)
DOI 10.1007/s00464-008-0071-1
Minimally invasive techniques continue to expand in pediatric surgery; however, there has been some debate over the appropriate operative technique for the management of congenital diaphragmatic hernias in neonates [1-3]. We present a video of a thoracoscopic patch repair of a right-sided Bochdalek congenital diaphragmatic hernia (CDH) in a 3-day-old male.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 208-217, 2008
The mechanisms by which corticosteroids reduce airway inflammation are not completely understood. Traditionally, corticosteroids were thought to inhibit cytokines exclusively at the transcriptional level.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 190-197, 2008
Adenosine (ADO) signaling is altered in both asthma and chronic obstructive pulmonary disease, and the A2B adenosine receptor (A2B-R) may drive pulmonary inflammation. Accordingly, it has been proposed that specific inhibition of the A2B-R could treat inflammatory lung diseases.
Pediatric Pulmonology Published Online: 10 Jul 2008
This study presents reference equations for spirometric parameters in 6-year-old children and evaluates the ability of spirometry to discriminate healthy children from children with asthma. Baseline spirometry and respiratory symptoms were assessed in 404 children participating in a longitudinal birth cohort study.
Pediatric Pulmonology Published Online: 9 Jul 2008
The objective of this study was to evaluate the association between socioeconomic factors and asthma control in children, as defined by the Canadian Pediatric Asthma Consensus Guidelines.
Pediatric Pulmonology Published Online: 9 Jul 2008
Inflammatory myofibroblastic tumors (IMTs) are relatively rare entities of a distinct histologic appearance and benign clinical course. Although these lesions have been described in virtually every anatomic location, there are few documented reports with tracheal localization.
Clinical & Experimental Allergy, Volume 38, Number 7, July 2008 , pp. 1100-1107(8)
Cough is one of the most common symptoms of asthma. However, studies using capsaicin, citric acid, or tartaric acid to document cough threshold have repeatedly failed to show statistically significant differences between asthmatic and healthy subjects. The studies using hypertonic aerosols as the cough stimulant have suggested an enhanced sensitivity in asthmatic subjects but the induced bronchoconstriction has made the interpretation of the results difficult.
Clinical & Experimental Allergy, Volume 38, Number 7, July 2008 , pp. 1117-1123(7)
Atrial natriuretic peptide (ANP) plays an important role in the lung and in augmenting allergic inflammation in asthma. The gene encoding ANP, NPPA, is located on chromosome 1p36, a region that has been linked to asthma.
Many diverse and frequently idiopathic disorders cause interstitial lung disease (ILD) in children. Although the histologic patterns of ILD in children and adults share similar features, important differences exist in etiology, clinical manifestations, and outcome.
Sleep-disordered breathing (SDB) and especially obstructive sleep apnea (OSA) are associated with daytime sleepiness and an increased risk for motor vehicle crashes. Previous studies have assessed the prevalence of OSA among professional drivers, but no study so far has focused on railway drivers.
Heart failure (HF) is often associated with interstitial pulmonary edema and structural changes, resulting in thickening of the alveolar-capillary membrane and reductions in diffusing capacity of the lung for carbon monoxide (DLCO). Reduced DLCO reflects an impaired efficiency of gas exchange, which may increase plant gain, influence ventilatory control stability, and result in central sleep apnea (CSA). In this study, we test the hypothesis that reductions in DLCO would be associated with increased apnea-hypopnea index (AHI) in patients with CSA.
Macrolide antibiotics have been shown to have a beneficial effect in a number of pulmonary conditions that are characterized by inflammation, including cystic fibrosis, asthma, and cryptogenic organizing pneumonia. We report the first case of desquamative interstitial pneumonia (DIP) showing a favorable response to treatment with clarithromycin. If confirmed, this observation would add DIP to the list of pulmonary disorders that are amenable to the beneficial antiinflammatory effects of macrolides.
Lung fibrosis is a devastating pulmonary disorder characterized by alveolar epithelial injury, deposition of extracellular matrix and scar tissue formation. Due to its potent collagenolytic activity, cathepsin K, a lysosomal cysteine protease is an interesting target molecule with therapeutic potential to attenuate bleomycin-induced pulmonary fibrosis in mice.
The ketolide antibiotic telithromycin (TEL) exerts immunomodulatory and antiinflammatory effects in vitro and in a mouse model of septic shock. We studied the antiinflammatory activity of TEL in in vitro and in vivo models of airway inflammation induced by lipopolysaccharide (LPS).
Treatment with continuous positive airway pressure (CPAP) improves cardiac function in chronic heart failure (CHF) patients with central sleep apnea (CSA)-Cheyne-Stokes respiration (CSR) by stabilizing ventilation, but frequently central apneas and hypopneas persist. Our objective was to test the hypothesis that flow-targeted dynamic bilevel positive airway pressure (BPAP) support (BiPAP autoSV; Respironics; Murrysville, PA) effectively suppresses CSR-CSA in CHF patients.
Central venous pressure (CVP) is used almost universally to guide fluid therapy in hospitalized patients. Both historical and recent data suggest that this approach may be flawed.
Pediatric Pulmonology Published Online: 8 Jul 2008
Patients with cystic fibrosis spend as much 30 min a day inhaling tobramycin. Could a new rapid system deposit the equivalent amount of tobramycin faster?
Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support for patients experiencing both pulmonary and cardiac failure by maintaining oxygenation and perfusion until native organ function is restored. ECMO is used routinely at many specialized hospitals for infants and less commonly for children with respiratory or cardiac failure from a variety of causes.
Studies indicate that not all physicians in clinical practice use spirometry routinely in the diagnosis of COPD. Understanding the patterns of spirometry use across geographic regions in patients with newly diagnosed COPD may help to identify the factors associated with the use of spirometry and to improve the quality of COPD care. The objective of this study was to characterize the regional variation in spirometry use for patients with newly diagnosed COPD using the Healthcare Effectiveness Data and Information Set (HEDIS) 2006 spirometry performance measure.
We investigated the role of the clinical pulmonary infection score (CPIS), serum levels of procalcitonin (PCT), C-reactive protein (CRP), and serum amyloid A (SAA) in the detection of patients with early ventilator-associated pneumonia (VAP).
Obstructive sleep apnea (OSA) is associated with increased BP and other cardiometabolic risk factors. The aim of the present study was to determine whether arterial stiffness and central BP (two important cardiovascular risk factors) would change, independent of peripheral BP following either the initiation of or withdrawal from nasal continuous positive airway pressure (CPAP) treatment in subjects with OSA.
Massive angiographic pulmonary embolism (PE) with right ventricular dysfunction (RVD) is associated with a high early mortality rate. The therapeutic alternatives for this condition include thrombolysis, surgical embolectomy, or percutaneous mechanical thrombectomy (PMT).
Lung biopsy has been proposed as a criterion for diagnosis of chronic hypersensitivity pneumonia (HP), especially in patients without proven antigen exposure. Histologic findings in some suspected HP patients overlap with usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP).
Respiratory tract infections are a frequent complication of COPD, but little is known about the incidence, association, and risk of infectious diseases related to impaired lung function.
Annals of Thoracic Medicine Year : 2008 Volume : 3 Issue : 3 Page : 106-107
A 12-hour-old male infant presented with prolapsed abdominal content through a defect on left side of chest wall with respiratory distress. A thorough clinical examination suggested absence of ectopia cordis, abdominal wall defect, and any bony anomaly. The child expired after 6 hours of admission because of respiratory distress and electrolyte imbalance.
Annals of Thoracic Medicine Year : 2008 Volume : 3 Issue : 3 Page : 104-105
Spontaneous pneumothorax complicating pregnancy is rare. Only 55 cases have been reported till now. We describe a case of a 30-year-old Indian woman with spontaneous pneumothorax during her 28 th week of pregnancy.
Annals of Thoracic Medicine Year : 2008 Volume : 3 Issue : 3 Page : 108-109
We report a 28-year-old woman, pregnant, at 24 weeks, with 3-day history of right-sided chest pain and shortness of breath. Few hours after admission, she delivered a dead baby. She had a history of right partial hepatic lobotomy and cholecystectomy at UK on May 2004 because of multiple pyogenic liver abscesses. Chest examination revealed signs of hydrothorax on the right side. Chest X-ray showed pleural effusion on the right side.
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.
Pediatric Allergy and Immunology, Volume 19, Number 4, June 2008 , pp. 307-314(8)
This cross-sectional study of children aged 6-7-years and adolescents aged 13-14-years in Bogota, Colombia, assessed the prevalence of asthma symptoms and their associations with dietary, health, and behavioral habits.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200803-462OC
Polymorphisms affecting toll-like receptor (TLR)-mediated responses could predispose to excessive inflammation during an infection and contribute to an increased risk for poor outcomes in patients with sepsis.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200804-550OC
Heterozygous mutations in the coding regions of the telomerase genes, TERT and TERC, have been found in familial and sporadic cases of idiopathic interstitial pneumonia.
American Journal of Kidney Diseases August 2008 Volume 52 Number 2
Microalbuminuria reflects a state of widespread vascular dysfunction, whereas obstructive sleep apnea (OSA) further promotes atherosclerotic damage in hypertension.
Cochrane Database of Systematic Reviews, Issue 3, 2008
Dyspnoea, or distressing breathing, is often a severe subjective symptom in terminal illness and may be difficult to control. Oxygen therapy is currently one of the interventions used to treat it. This review aimed to identify all randomised controlled studies (RCTs) in which oxygen therapy was used as a treatment to relieve dyspnoea in chronic terminal illness, and to synthesize the findings into a conclusion regarding the overall effectiveness of oxygen therapy for the palliation of dyspnoea in chronic terminal illness.
To evaluate the prevalence of proximal reflux and esophago-bronchial reflex (EBR) in patients with asthma, and to compare the symptom spectrum, esophageal acid sensitivity, pH monitoring, and the endoscopic and manometric parameters of EBR-positive and -negative patients with asthma
Pediatric Pulmonology Published Online: 8 Jul 2008
Respiratory signs and symptoms (cough, sputum production, or crackles) are considered bellwethers of underlying cystic fibrosis (CF) lung disease. If respiratory signs and symptoms predict future lung function loss, then improvements in population lung function over the past decade should have been paralleled by a decrease in the prevalence of these variables in the same population.
Pediatric Pulmonology Published Online: 10 Jul 2008
To investigate the effect of position on the strength of the Hering-Breuer reflex in prematurely born infants and determine whether any differences seen were related to differences in lung or tidal volume between positions.
Pediatric Pulmonology Published Online: 8 Jul 2008
To describe an educational program and timeline for the discharge of children with a new tracheostomy and identify common impediments to the education and discharge process.
Pediatric Pulmonology Published Online: 9 Jul 2008
The aim of the present study was to determine the relationship between bronchodilator response, assessed by interrupter resistance (Rint), and bronchial reactivity in preschool children with chronic cough. Thirty-eight children coughers (median age 5.0 years, range 2.8-6.4) were tested.
Pediatric Pulmonology Published Online: 10 Jul 2008
Inert gas multiple breath washout (MBW) for measuring Lung Clearance Index using mass spectrometry and 4% sulfur hexafluoride (SF6) as the tracer gas has been shown to be sensitive for detecting early Cystic Fibrosis (CF) lung disease. However, mass spectrometry requires bulky equipment and is expensive to buy and maintain.
Pediatric Pulmonology Published Online: 10 Jul 2008
Systemic and inhalation therapy of granulocyte-macrophage colony-stimulating factor (GM-CSF) is usually effective in controlling autoimmune pulmonary alveolar proteinosis (PAP), but some cases are refractory to GM-CSF therapy and subjected to whole lung lavage (WLL). A 9-year-old girl developed severe respiratory failure due to autoimmune PAP was treated with inhalational 250 µg of GM-CSF daily, however, it was ineffective.
Pediatric Allergy and Immunology, Volume 19, Number 4, June 2008 , pp. 287-295(9)
T lymphocyte apoptosis is essential for maintaining immune system homeostasis. Experimental evidence suggests apoptosis control mechanisms may be impaired in inflammatory conditions, particularly airway Th2-type allergic diseases.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200801-076OC
Obesity may alter glucocorticoid (GC) response in asthma. Objective: To evaluate the relationship between body mass index (BMI, kg/m2) and GC response in subjects with and without asthma.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200802-336OC
To report findings from initial and one-year repeat screening low-radiation-dose computed tomography (CT) of the chest and three-year outcomes for 50 to 79 year-old current and ex-smokers in the Pittsburgh Lung Screening Study (PLuSS).
Allergy, Volume 63, Number 8, August 2008 , pp. 997-1004(8)
Asthma is one of the most common chronic airways diseases worldwide, and its prevalence is increasing. Family doctors (sometimes called `primary care physicians' or 'general practitioners') are frequently an asthma patient's first point of contact with healthcare systems.
Cochrane Database of Systematic Reviews, Issue 3, 2008
Combination therapies are frequently recommended as maintenance therapy for people with asthma, whose disease is not adequately controlled with inhaled steroids. Fluticasone/salmeterol (FP/SAL) and budesonide/formoterol (BUD/F) have been assessed against their respective monocomponents, but there is a need to compare these two therapies on a head-to-head basis.
Annals of Thoracic Medicine Year : 2008 Volume : 3 Issue : 3 Page : 87-93
During the last few decades, high-resolution computed tomography (HRCT) has come up as a new diagnostic modality to diagnose emphysematous and chronic bronchitis components of chronic obstructive pulmonary disease (COPD).
Annals of Thoracic Medicine Year : 2008 Volume : 3 Issue : 3 Page : 100-103
The current mortality rate of patients suffering from acute respiratory distress syndrome (ARDS) is between 45% and 92%, with most dying within the first two weeks of the illness. In an effort to combat such an alarmingly high mortality rate, various treatment therapies such as low tidal volume ventilation strategies, corticosteroid therapy, and use of nitric oxide (NO) have been attempted in the management of patients with ARDS.
Annals of Thoracic Medicine Year : 2008 Volume : 3 Issue : 3 Page : 82-86
High resolution CT scan (HRCT) and its score have an important role in delineating pathological changes and pulmonary functional impairment in patients with bronchiectasis.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200710-1542OC
As the sole nitrogen donor in nitric oxide (NO) synthesis and key intermediate in the urea cycle, arginine and its metabolic pathways are integrally linked to cellular respiration, metabolism and inflammation.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200804-582OC
Surfactant Protein D (SP-D) is a member of the collectin family of soluble, innate host defense molecules with demonstrated immunomodulatory properties in vitro.
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