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Canadian Respiratory Journal May/ June 2007, Volume 14, Number 4: 235-237
A case of pulmonary Langerhans cell histiocytosis, proved by both lung high-resolution computed tomography and lung biopsy, is described. Following smoking cessation, lung nodules and cysts gradually disappeared on serial computed tomography scans, with complete clearance of the lesions after 12 months. The role of tobacco smoking is discussed, in detail, against the background of the literature.
Canadian Respiratory Journal May/ June 2007, Volume 14, Number 4: 221-227
Airflow obstruction is relatively uncommon in young adults, and may indicate potential for the development of progressive disease. The objective of the present study was to enumerate and characterize airflow obstruction in a random sample of Canadians aged 20 to 44 years.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1506-1511
We aimed to study trends in gender-related differences in incidence, and prevalence for long-term oxygen therapy due to chronic obstructive pulmonary disease. Another aim was to study survival after onset of oxygen therapy.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1529-1536
Exercise in a cold environment has been reported to increase exercise-induced bronchoconstriction (EIB). However, the effect of a cold environment upon exercise capacity in subjects with EIB has, to our knowledge, not been previously reported.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1579-1584
Nitric oxide (NO) has a much stronger affinity for hemoglobin than carbon monoxide (CO); therefore, the DLNO (diffusing capacity for NO) is less influenced by changes in capillary blood volume than the DLCO (diffusing capacity for CO), and represents the true membrane diffusing capacity.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1470-1476
Smoking induces airway hyperresponsiveness (AHR). Bronchial provocation with mannitol is used to identify AHR in subjects with asthma. This study aimed to determine the prevalence of airway hyperresponsiveness to mannitol in asymptomatic smokers compared to non-smokers and to assess if airway responsiveness to mannitol changes after smoking cessation.
Postobstructive pulmonary edema is a well-recognized complication of upper airway obstruction. The mechanisms of edema formation are unclear and may be due to increased hydrostatic forces generated by high negative inspiratory pressure or by increased permeability of the alveolar capillary membrane.
The diagnostic yields with transbronchial needle aspiration (TBNA) for mediastinal nodes are highly variable. Nodal positions, as assessed on a breath-hold conventional CT scan, do not account for nodal motion. We studied nodal motion on four-dimensional (4D) CT scans.
Journal of Sleep Research, Volume 16, Number 2, June 2007 , pp. 213-216(4)
There have been limited studies of the validation of actigraphy for the determination of sleep and wake in children and in this study we aimed to compare wrist actigraphy with polysomnography (PSG).
Journal of the International Neuropsychological Society (2007), 13: 595-605 Cambridge University Press
Some critically ill patients have dramatic recollections of the intensive care unit (ICU), whereas 23–50% have little or no recollection of their ICU stay. In addition, cognitive impairments are common following critical illness and ICU treatment. Little is known regarding the relationship between cognitive sequelae and ICU recall.
Airway obstruction occurs in anesthetized children with obstructive sleep apnea syndrome (OSAS). The inspiratory attempts against the occluded airway lead to an increased sympathetic activity. Heart rate variability (HRV) analysis provides information about the autonomic nervous system. The low-frequency component/high-frequency component ratio of HRV is considered to be an index of sympatho-parasympathetic balance.
The development of allergic diseases, such as allergic asthma, depends upon the initiation and maintenance of T-helper cell type-2-skewed allergen-specific immune reactions. Although it is clear that susceptibility to this process is under genetic and environmental control, the fine-tuning and regulation of the type-2 T-helper cell immune response is not yet fully understood.
Paediatric & Perinatal Epidemiology, Volume 21, Number 4, July 2007 , pp. 347-353(7)
Although antenatal steroids reduce risk factors for bronchopulmonary dysplasia (BPD) in preterm infants, their effect on BPD is conflicting. We hypothesised that the lack of protective effect found in some studies could derive from over-adjustment during analysis, caused by controlling for factors intermediate in the causal pathway between treatment and outcome.
Interleukin (IL)-10 is a type-2 T-helper cell cytokine with a broad spectrum of anti-inflammatory actions. Inflammation plays an important role in the pathogenesis of chronic obstructive pulmonary disease.
Am J Physiol Lung Cell Mol Physiol 292: L1385-L1395, 2007
In human airway smooth muscle (HASM) cells, the expression of CD38, which synthesizes the calcium-mobilizing molecule cyclic ADP-ribose, is augmented by TNF-{alpha}, a cytokine implicated in asthma.
Am J Physiol Lung Cell Mol Physiol 292: L1414-L1421, 2007
Tumor necrosis factor (TNF)-{alpha} is a potent inflammatory cytokine implicated in the exacerbation of asthma. Chronic exposure to TNF-{alpha} has been reported to induce G protein-coupled receptor desensitization, but adenylyl cyclase sensitization, in airway smooth muscle cells by an unknown mechanism.
Am J Physiol Lung Cell Mol Physiol 292: L1352-L1360, 2007
The luminal airway surface is lined with epithelial cells that provide a protective barrier from the external environment and clear inhaled pathogens from the lung. To accomplish this important function, human bronchial epithelial (HBE) cells must be able to rapidly regenerate a mucociliary layer of cells following epithelial injury.
Am J Physiol Lung Cell Mol Physiol 292: L1432-L1443, 2007
Salt and water absorption and secretion across the airway epithelium are important for maintaining the thin film of liquid lining the surface of the airway epithelium. Movement of Cl across the apical membrane involves the CFTR Cl channel; however, conductive pathways for Cl movement across the basolateral membrane have been little studied.
Current Opinion in Pharmacology Volume 7, Issue 3, June 2007, Pages 266-271
Infection with Chlamydophila pneumoniae or Mycoplasma pneumoniae has been linked to asthma. There is evidence to suggest that persistent infection with these organisms might lead to an increase in the severity of asthma. B-Lactam antibiotics have not been shown to be beneficial in the treatment of asthma but several studies have indicated that macrolides and related antibiotics might be useful both for the treatment of chronic asthma and for acute exacerbations.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1431-1438
Some studies have shown an association between lower maternal age at delivery and increased asthma in children and young adults. It is unclear whether this represents an effect of maternal ageing or a protective effect of siblings. In a North-European population based study, we investigated whether mother's age at delivery was associated with risk for asthma and hay fever in adult offspring, taking into account relevant confounders.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1398-1405
Tiotropium is a once-daily inhaled anticholinergic maintenance treatment with demonstrated effectiveness in chronic obstructive pulmonary disease (COPD).
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1383-1389
Induced sputum (IS) sampling is a safe and validated approach to study bronchial inflammation in chronic obstructive lung diseases. Although promising results have also been reported in various diffuse interstitial lung disorders, the potential use of IS in the assessment of connective tissue diseases (CTD)-related lung involvement has not yet been investigated.
Idiopathic spontaneous pneumothorax (ISP) results from rupture of blebs, bullas, or diseased alveolar walls. Initiating mechanisms may relate to increased transpulmonary pressure. The possible impact of changes in atmospheric pressure (Patm) on the occurrence of ISP remains uncertain.
Patients with COPD and chronic hypercapnic respiratory failure (CHRF) are at high risk, and noninvasive ventilation at home is increasingly being used. Knowledge of prognostic parameters under these conditions is limited but may be clinically helpful and highlight the role of noninvasive ventilation.
To address the major methodological issues of reverse causation and selection bias in epidemiologic studies of antibiotic use in early life and the development of asthma, we undertook a cohort study of this association in a complete population of children.
Metabolism Volume 56, Issue 7, July 2007, Pages 969-976
Increased circulating levels of plasminogen activator inhibitor 1 (PAI-1) have been associated with atherothrombosis. Plasminogen activator inhibitor 1 levels are elevated in obstructive sleep apnea (OSA) and in the metabolic syndrome, both of which confer excess coronary risk.
Journal of Infection Volume 55, Issue 1, July 2007, Pages 68-74
Prophylactic strategies against invasive pulmonary aspergillosis are often limited by drug interactions and toxicities. Targeted airway delivery of antifungals to the lungs may avoid these pitfalls. We evaluated the effectiveness of an aerosolized nanostructured formulation of itraconazole produced by spray freezing into liquid (SFL) as prophylaxis against invasive pulmonary aspergillosis caused by A. fumigatus.
Journal of Intensive Care Medicine, Vol. 22, No. 3, 157-165 (2007)
Emergency airway management outside the elective operating room presents considerable risks to the patient and significant challenges to the practitioner. Complications and adverse consequences are commonplace, yet they have not received their justified discussion or scrutiny in the literature.
Our 2005 and 2006 Northeast Center for Special Care respiratory conferences were a resounding success and highly rated by attendees. The 2007 conference will be packed with sessions that can benefit you. Whether you are a respiratory therapist, case manager, social worker, nurse, physician or clinician - there is important information that you can use. Join us in historic Kingston, New York on August 9, 2007.
Pediatric and Developmental Pathology Volume 10, Issue 3 (May-June 2007) Article: pp. 172-180
The recent availability of diagnostic polymerase chain reaction-based assays for the detection of viral pathogens has allowed us to identify the infectious agents present in a large percentage of culture-negative specimens. The information gained by these studies has led to a reassessment of the prevalence of individual viruses in lower respiratory tract infections in both normal and immunocompromised children.
Clinical Orthopaedics & Related Research. 459:118-121, June 2007
We prospectively studied 331 sarcoma patients treated between April 1999 and December 2004 to see if small, indeterminate pulmonary nodules are of prognostic significance. Seventy-one (21%) had indeterminate pulmonary nodules on initial spiral CCT. Twenty of 71 (28%) patients with indeterminate nodules progressed with metastatic disease. Metastatic disease developed in 18/20 (90%) in the area of the original indeterminate nodule.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1455-1461
Diagnosing asthma cannot be always easy. It is important to consider the validity of the diagnostic tests, and/or how much more commonly they are positive in patients with asthma compared to healthy subjects and, particularly, to patients with asthma-like symptoms.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1521-1528
Plasma levels of neutrophil elastase (NE) are elevated in several inflammatory diseases and thus this enzyme might be a critical inflammatory marker. However, the role of NE in the pathogenesis of pneumonia has not been determined. The association between the severity of pneumonia and blood levels of inflammatory markers could be relevant to developing a useful indicator of severity and new therapeutic strategies for pneumonia.
The 2003 Infectious Diseases Society of America guidelines for community-acquired pneumonia (CAP) recommend the initiation of antibiotic therapy within 4 h of hospitalization. This quality indicator has been linked to the incentive compensation of third-party payers to hospitals. We evaluated the impact of this recommendation on the diagnosis of CAP and the utilization of antibiotics.
A consensus panel convened by the American College of Chest Physicians developed guidelines for the treatment of pulmonary arterial hypertension (PAH) that were published in 2004. Subsequently, several important clinical trials have been published, and new treatments have received regulatory approval. In addition, add-on and combination therapy are being explored, which promise to open new therapeutic avenues.
High C-reactive protein (CRP) and homocysteine levels are risk factors for cardiovascular disease. Some, but not all, previous studies have reported increased levels of CRP and homocysteine in patients with obstructive sleep apnoea syndrome (OSAS). A study was undertaken to investigate the levels of these factors in carefully selected patients with OSAS and matched normal controls.
High resolution CT (HRCT) scanning has contributed significantly to the evaluation of patients with interstitial lung disease and is particularly useful in the diagnosis of idiopathic pulmonary fibrosis (IPF). The characteristic radiographic features of the idiopathic interstitial pneumonias on HRCT scans have been increasingly analysed and are now fairly well described. Based on current data, HRCT scanning can provide a confident, highly specific diagnosis of IPF in many patients with diffuse lung disease.
To quantify the incidence of unsuspected pulmonary emboli (PE) in an unselected inpatient population undergoing contrast enhanced multidetector CT (MDCT) scanning of the thorax and to assess aetiological factors in their development.
Monitoring of respiratory function is important in the diagnosis and management of respiratory disease. The forced oscillation technique requires minimal patient cooperation and is ideal for the determination of respiratory function in young children. This study aimed to develop reference ranges and to document the repeatability in healthy young children using commercially available forced oscillation equipment.
A 24-year-old Indian doctor presented to the ophthalmology department complaining of bright lights in his field of vision during the preceding 6 months. He had previously been diagnosed with inferior branch retinal vein occlusion in his right eye and undergone laser treatment.
Although several studies have investigated the influence of diet on asthma in schoolchildren, none of them has evaluated how obesity can modify this effect. A study was undertaken to evaluate the association of various foods and a Mediterranean diet with the prevalence of asthma and rhinoconjunctivitis, adjusting for obesity and exercise.
Epidemiological evidence from observational studies has suggested that blood levels and dietary intake of selenium of adults with asthma are lower than those of controls. The only previous trial of selenium supplementation in adults with asthma found no objective evidence of benefit but involved only 24 participants.
Despite national disease management plans, optimal asthma management remains a challenge in Australia. Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of best practice. The impact of the Pharmacy Asthma Care Program (PACP) on asthma control was assessed using a multi-site randomised intervention versus control repeated measures study design.
Acid reflux may aggravate airway disease including asthma and chronic cough. One postulated mechanism concerns a vagally-mediated oesophageal-tracheobronchial reflex with airway sensory nerve activation and tachykinin release.
A study was undertaken to test the hypothesis that severe exacerbations of asthma are characterised by increased bronchial mucosal neutrophilia associated with upregulation of neutrophil chemoattractant ligands and their specific cell surface receptors.
Am J Physiol Lung Cell Mol Physiol 292: L1572-L1579, 2007
Neutrophils are the primary inflammatory cell in smokers' lungs, but little is known about the ability of cigarette smoke to modulate neutrophil function. Neutrophils undergo caspase-3-dependent spontaneous, as well as
phagocytosis-induced, apoptosis. This study investigated the ability of cigarette smoke extract
(CSE) to alter neutrophil caspase-3 activity, apoptosis, and
phagocytosis.
Am J Physiol Lung Cell Mol Physiol 292: L1598-L1608, 2007
Reactive oxygen species (ROS) generated from NADPH oxidases and mitochondria have been implicated as key messengers for pulmonary vasoconstriction and vascular remodeling induced by agonists and hypoxia. Since Ca2+ mobilization is essential for vasoconstriction and cell proliferation, we sought to characterize the Ca2+ response and to delineate the Ca2+ pathways activated by hydrogen peroxide (H2O2) in rat intralobar pulmonary arterial smooth muscle cells (PASMCs).
Medicine & Science in Sports & Exercise. 39(6):918-925, June 2007
Hyperpnea and hyperinflation have been proposed as contributors to exaggerated energy demands in chronic obstructive pulmonary disease (COPD), yet there are incomplete data on exercise requirements
It has been suggested that early childhood exposure to microbial agents decreases the risk of allergies in children. The current authors studied the association between microbial agents in house dust and allergic sensitisation in children aged 2-4 yrs.
Modern Rheumatology, Volume 17, Number 2, April 2007 , pp. 123-130(8)
Corticosteroids (CS) are the standard initial treatment for interstitial pneumonia (IP) associated with dermatomyositis (DM)/polymyositis (PM). However, many patients fail to respond and have significantly high mortality even if immunosuppressive drugs (ISDs) are subsequently added, while a more intensive initial approach using ISDs is suggested to improve their survival.
Physician adherence to key recommendations of guidelines for community-acquired pneumonia (CAP) is often not optimal. A better understanding of factors influencing optimal performance is needed to plan effective change.
Southern Medical Journal. 100(6):579-587, June 2007
Interstitial lung disease (ILD) is a final common pathway for a large number of lung insults. It is characterized by progressive scarring of the lung leading to restriction and diminished oxygen transfer. Clinically, the presenting symptoms of ILD are nonspecific (cough and progressive dyspnea on exertion) and are often attributed to other diseases, thus delaying diagnosis and timely therapy.
The American Journal of Emergency Medicine Volume 25, Issue 5, June 2007, Pages 515-522
There is limited information about factors associated with mortality of patients with chronic obstructive pulmonary disease (COPD) admitted to hospital because of an acute exacerbation.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1462-1469
An integrated care intervention including education, coordination among levels of care, and improved accessibility, reduced hospital readmissions in chronic obstructive pulmonary disease (COPD) after 1 year. This study analyses the effectiveness of this intervention in terms of clinical and functional status, quality of life, lifestyle, and self-management, under the hypothesis that changes in these factors could explain the observed reduction in readmissions.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1549-1555
Increased concentrations of exhaled nitric oxide (NO) have been detected in inflammatory lung diseases including asthma and have been attributed to increased expression and activity of inducible nitric oxide synthase (iNOS) within the airways.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1537-1542
To assess the frequency, clinical presentation and outcome associated with saddle pulmonary embolism (PE) diagnosed by computed tomographic angiography (CTA).
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1572-1578
We studied whether prophylactic use of noninvasive pressure support ventilation (NIPSV) administered pre- and postoperatively may reduce the postoperative pulmonary function impairment.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1585-1593
Beclometasone dipropionate (BDP) extrafine is a hydrofluoroalkane-based, chlorofluorocarbon (CFC)-free inhalation aerosol. This study was conducted to determine whether BDP extrafine and CFC-fluticasone proprionate (FP) aerosols were equivalent in terms of efficacy and tolerability in children with symptomatic mild-to-moderate asthma.
After focusing last month on the pathophysiology of sepsis and early goal-directed therapy (EGDT), this month I think it's worth considering traditional methods (antibiotics) and looking at the implementation of EGDT in a community ED. A very aggressive approach is required for a patient who is anywhere in the spectrum of sepsis, from SIRS to septic shock. Managing a septic patient obviously includes antibiotic administration, and EGDT assumes proper and timely antibiotic administration.
ournal of Paediatrics and Child Health, Volume 43, Number 6, June 2007 , pp. 469-475(7)
In Australian hospitals: (i) to identify current practices in the initial oxygen management of infants with respiratory distress; (ii) to identify factors important in deciding to transfer an infant; and (iii) to identify thresholds for transfer.
Am J Physiol Lung Cell Mol Physiol 292: L1452-L1458, 2007
We investigated the nonlinear dynamics of the pressure vs. hydraulic conductivity (Lp) relationship in lung microvascular endothelial cells and demonstrate that heparan sulfates, an important component of the endothelial glycocalyx, participate in pressure-sensitive mechanotransduction that results in barrier dysfunction.
Of late, obstructive sleep apnea (OSA) has been suggested to be a risk factor for atherosclerotic artery disease. In the present study, we analyzed the prevalence of atherosclerosis in stroke patients with and without OSA.
We describe the use of non-invasive positive pressure ventilation combined with spinal anaesthesia to allow the insertion of a dynamic hip screw in an obese patient with advanced chronic obstructive pulmonary disease. The technique avoided the hazards of intubation and general anaesthesia in this high-risk patient.
In patients with bilateral bullous disease and empyema in one lung, controlled ventilation may be hazardous and result in severe hypoxia. A 50-year-old man with bullous disease and thoracic empyema on the left side was operated on under general anesthesia with spontaneous respiration using differential lung ventilation.
Journal of Thoracic Imaging. 22(2):176-179, May 2007
A 4-year old boy was admitted to hospital with progressive respiratory failure. A chest roentgenogram revealed hyperinflated lungs and a diffuse reticular pattern. There was no smoking history in the family environment. A thin slice computed tomography of the lungs exhibited extended and diffuse cystic lung disease with no zonal predominance. An open lung biopsy showed pulmonary Langerhans cell histiocytosis.
Journal of Thoracic Imaging. 22(2):182-184, May 2007
Gemella morbillorum and Gemella haemolysans are normal oral flora that can also be pathogenic. We report 2 cases of adolescents with osteosarcoma who developed multiple pulmonary nodules associated with Gemella bacteremia. These nodules mimicked metastatic disease. To our knowledge, this manifestation of Gemella infection has not been previously reported. In the setting of malignancy, infectious pulmonary nodules must be distinguished from metastatic nodules in order to treat appropriately.
Journal of Thoracic Imaging. 22(2):166-168, May 2007
Symptomatic extralobar pulmonary sequestration in adults is thought to be extremely rare. We present a case of an extralobar pulmonary sequestration, with infarct, in a 28-year-old woman who complained abrupt onset of chest pain. Chest computed tomography and magnetic resonance imaging showed a mass in the left paraspinal area, medial to the left lower lobe, and serial chest radiographs revealed increasing pleural effusion. This was histopathologically confirmed to be a hemorrhagic infarct of the extralobar pulmonary sequestration.
Journal of Thoracic Imaging. 22(2):172-175, May 2007
[18F]-fluoro-2-deoxy-D-glucose positron emission tomography computed tomography is a useful tool to suggest the diagnosis of malignant processes. However, false positive results are known to occur in benign lesions that have a high metabolic activity. Here we describe the unusual diagnosis of a pulmonary endometrioma in a 47-year-old woman, presenting as a cavitary lung mass with intense 18F-FDG uptake on PET-CT.
Annals of Tropical Paediatrics: International Child Health, Volume 27, Number 2, June 2007 , pp. 107-113(7)
Meconium aspiration syndrome (MAS) is a major cause of severe respiratory distress in newborns and the role of antibiotics in its management is not well defined.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1512-1520
The role of computerised tomography (CT) lung density measurements in objective quantification of emphysema is uncertain. The aim of this study was to determine normal reference values for CT lung density measurements and investigate their utility in identifying subjects with clinical emphysema.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1483-1492
Omalizumab is a monoclonal antibody indicated for treatment of severe persistent allergic asthma inadequately controlled despite optimal controller therapy. We investigated whether patient selection could be targeted further.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1477-1482
Asthma patients exhibit an increased rate of loss of lung function. Determinants to such decline are largely unknown and the modifying effect of steroid therapy is disputed. This cross-sectional study aimed to elucidate factors contributing to such decline and the possible modifying effect of steroid treatment.
Respiratory Medicine Volume 101, Issue 7, July 2007, Pages 1543-1548
The use of sputum induction by inhalation of hypertonic saline to study the cellular and biochemical composition of the airways allows noninvasive sampling of the airways content and identification of markers of airways inflammation.
International Journal of Medical Informatics Volume 76, Issue 7, July 2007, Pages 557-564
Asthma is a common pediatric chronic disease and is estimated to account for more than 2 million emergency department visits per year. Asthma guidelines have demonstrated improved outcomes, but remain underutilized due to several barriers. Computerized methods to automatically identify asthma exacerbations may be beneficial to initiate guideline recommended treatment, but have not been described.
Future Rheumatology, Volume 2, Number 3, June 2007 , pp. 279-286(8)
Over recent decades, advances in renal-targeted therapies in systemic sclerosis have caused a shift in the leading causes of scleroderma-related morbidity and mortality. Pulmonary arterial hypertension now confers the worst prognosis in this patient group and a large amount of time and resource is being put into developing diagnostic and therapeutic tools to improve patient outcome. Here we outline the most up-to-date evidence in this area in an attempt to improve current practice.
Pulmonary arterial hypertension (PAH) in patients with systemic lupus erythematosus (SLE) is uncommon but is associated with poor survival. This study aimed to examine the long-term effects of bosentan, a dual endothelin-1 receptor antagonist, on symptomatology, haemodynamics and quality of life measures in SLE patients with symptomatic PAH. Four local patients had been followed up prospectively with pre-defined protocol during 12-months of bosentan treatment.
Current Opinion in Pulmonary Medicine. 13(4):324-327, July 2007
Numerous case reports have described pleural effusions in conjunction with the superior vena cava syndrome. Recent data suggest that these effusions occur in 60% of superior vena cava syndrome cases. The effusions are small, usually occupying less than half the affected hemi-thorax, and occur about equally on either side or bilaterally.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1151-1157, (2007)
Alveolar macrophages are inflammatory cells that may contribute to the pathogenesis of idiopathic pulmonary fibrosis (IPF), which is characterized by excessive alveolar aggregation of cells and extracellular matrix proteins.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1109-1116, (2007)
Urokinase plasminogen activator (uPA) interacts with its receptor on inflammatory and migrating cells to regulate extracellular matrix degradation, cell adhesion, and inflammatory cell activation. It is necessary for the development of an appropriate immune response and is involved in tissue remodeling. The PLAU gene codes for this enzyme, and is located on 10q24. This region has demonstrated evidence for linkage in a genome scan for asthma in a sample from northeastern Quebec. Here, we hypothesized that uPA may function as a regulator of asthma susceptibility.
Journal of Computer Assisted Tomography. 31(3):384-389, May/June 2007
We examined the hypothesis that paired inspiratory/expiratory computed tomography (CT) scans in a limited-lung area that excludes emphysema may provide a more accurate evaluation of peripheral airway obstruction in patients with chronic obstructive pulmonary disease (COPD) with emphysema.
Bronchoconstriction in asthma results in patchy ventilation forming ventilation defects (VDefs). Patchy ventilation is clinically important because it affects obstructive symptoms and impairs both gas exchange and the distribution of inhaled medications. The current study combined functional imaging, oscillatory mechanics and theoretical modelling to test whether the degrees of constriction of airways feeding those units outside VDefs were related to the extent of VDefs in bronchoconstricted asthmatic subjects.
Canadian Respiratory Journal May/ June 2007, Volume 14, Number 4: 212-216
To determine the factors that allow patients with community-acquired pneumonia who are at high risk of mortality (risk classes IV and V) to be treated at home.
Canadian Respiratory Journal May/ June 2007, Volume 14, Number 4: 229-234
Surveys of Canadian patients with asthma and their physicians consistently report satisfaction with asthma management; however, when objective indicators are used, these same surveys also observe very poor levels of asthma control.
Approximately half of all asthmatics become refractory to exercise-induced bronchoconstriction (EIB) with repeated challenges. Exercise refractoriness has been utilized by asthmatic athletes to reduce the bronchoconstrictor response to exercise prior to competition, and this has led to the observation that some asthmatic athletes can "run through" their asthma.
Inflammation & Allergy - Drug Targets (Formerly Current Drug Targets - Inflammation & Allergy), Volume 6, Number 2, June 2007 , pp. 127-132(6)
Over the past number of decades there has been considerable interest in the role of neurogenic inflammation in asthma with the identification of many biologically active neuropeptides in the lung. Whilst there is convincing evidence of neurogenic inflammation in various animal models of asthma, the evidence in humans is less clear and replicating the experimental approaches in humans has proven difficult with different studies producing conflicting results.
Child: Care, Health and Development, Volume 33, Number 4, July 2007 , pp. 360-367(8)
Previous research suggests that children dealing with the asthma are at a greater risk for experiencing psychological maladjustment than children without asthma. Research also suggests that coping is a factor in psychological adaptation to chronic stressors such as physical illnesses.
PEDIATRICS Vol. 119 No. 6 June 2007, pp. e1361-e1370
The benefits of exogenous surfactants for prevention or treatment of respiratory distress syndrome are well established, but there is a paucity of long-term follow-up data from surfactant-comparison trials.
PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1095-1103
Irritant gases and aerosols contaminating the air of indoor swimming pools can affect the lung epithelium and increase asthma risk in children. We evaluated the impact of infant swimming practice on allergic status and respiratory health later in childhood.
Idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP) is the severest form of idiopathic interstitial pneumonia for which therapeutic targets are needed. Surgical lung biopsy specimens from IPF/UIP patients exhibit focal expression of CC chemokine receptor (CCR) 7, but the identity of these CCR7-positive cells is unknown.
Current Anaesthesia & Critical Care Volume 17, Issue 6, 2006, Pages 329-332
Non-invasive ventilation (NIV) is a technique developed to assist patients with acute respiratory failure (ARF) of different origins, which avoids endotracheal intubation. NIV has already been demonstrated to be a useful alternative to invasive mechanical ventilation in patients with acute exacerbation of COPD, cardiogenic pulmonary oedema and other causes of hypoxemic ARF, avoiding several complications directly related to the presence of an endotracheal tube, such as the increased risk for nosocomial pneumonia.
Journal of Cardiac Surgery, Volume 22, Number 3, May/June 2007 , pp. 180-184(5)
Despite recent advances in critical care management, the mortality of acute respiratory distress syndrome (ARDS) remains high. The final rescue therapy for patients with severe hypoxia refractory to conventional therapy modalities is the extracorporeal gas exchange.
Allergy, Volume 62, Number 6, June 2007 , pp. 648-654(7)
Case reports of occupational asthma in dental personnel have been published, but there is little data on the risk of respiratory disorders related to occupational exposure to methacrylates in dental assistants. The objective of this study was to investigate the relation of exposure to methacrylates to occurrence of respiratory symptoms and diseases among dental assistants.
The overall safety of surgical lung biopsy in patients with idiopathic interstitial pneumonia (IIP) remains controversial. This study was performed to investigate the mortality and complication rate and identify the risk factors for surgical lung biopsy in patients with IIP.
Annals of Allergy, Asthma and Immunology, Volume 98, Number 6, June 2007 , pp. 546-552(7)
Clinical validity of impulse oscillometry (IOS) for the evaluation of airway obstruction and bronchodilation is a controversial issue in adults with asthma.
PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1104-1112
Our goal was to determine whether maternal asthma and maternal smoking during pregnancy are associated with the incidence and severity of clinically significant bronchiolitis in term, otherwise healthy infants without the confounding factors of small lung size or underlying cardiac or pulmonary disease.
In seriously ill patients, etomidate gives cardiovascular stability at induction of anaesthesia, but there is concern over possible adrenal suppression. Etomidate could reduce steroid synthesis and increase the need for vasopressor and steroid therapy. The outcome could be worse than in patients given other induction agents.
Chemokines play important roles in inflammation and antiviral action. We examined whether polymorphisms of RANTES, IP-10 and Mig affect the susceptibility to and outcome of severe acute respiratory syndrome (SARS).
Studies from the USA have reported that sleep apnoea is common in congestive heart failure
(CHF), with Cheyne–Stokes respiration (CSR) being the most frequent type of sleep-disordered breathing
(SDB) in these patients. Within the present study, the authors sought to assess the prevalence and type of SDB among CHF patients in Germany.
Pediatric Radiology Volume 37, Number 4 / April, 2007 345-350
Idiopathic pulmonary arterial hypertension (IPAH) is a rare disease in children. By definition it is a diagnosis of exclusion, and CT of the chest is primarily performed to exclude other causes. Previous studies have defined CT features suggestive of the diagnosis of IPAH, but these have all been limited to the adult population.
Current Opinion in Pulmonary Medicine. 13(4):305-311, July 2007
Pleural effusions are rare except in hydropic neonates. Elevated pleural fluid/serum immunoglobulin G ratio may be a diagnostic marker for congenital chylothorax in utero. Chylothorax may be congenital or acquired. Hydrothoraces may appear at any time during the neonatal period and are related to infectious and noninfectious aetiologies.
Pharmacogenetic approaches provide the opportunity to improve prescribing for asthmatic patients in order to optimise efficacy and prevent side-effects. Currently, there are comprehensive data available on the extent of genetic variation in the human genome that will further this area of research.
The present study prospectively evaluated the diagnostic yield and safety of electromagnetic navigation-guided bronchoscopy biopsy, for small peripheral lung lesions in patients where standard techniques were nondiagnostic.
Childhood farm contact is associated with a lower prevalence of sensitisation and allergic rhinitis. Findings have been contradictory for asthma. The aim of the present study was to investigate the differences between farm and nonfarm subjects using objective measurements.
Pulmonary thromboendarterectomy is a curative surgical procedure for chronic thromboembolic pulmonary hypertension. The aim of this study was to clarify whether severe hemodynamic compromise affects surgical outcome.
Azithromycin reduces the severity of illness in patients with inflammatory lung disease such as cystic fibrosis and diffuse panbronchiolitis. Bronchopulmonary dysplasia (BPD) is a pulmonary disorder which causes significant morbidity and mortality in premature infants.
PEDIATRICS Vol. 119 No. 6 June 2007, pp. 1120-1130
The quantified effect of zinc supplementation to prevent childhood diarrhea and respiratory illnesses is unclear. We conducted a meta-analysis of randomized, controlled trials on the subject.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1186-1191, (2007)
Patients with obstructive sleep apnea (OSA) are at increased risk for cardiovascular diseases. Injury of endothelial cells has been advanced as an initial trigger to atherosclerosis.
Journal of Asthma, Volume 44, Issue 4 May 2007 , pages 273 - 279
There is a wide variability in clinical practice for treating acute asthma (AA) in the emergency department (ED), interfering in the quality of care. The purpose of this study was to evaluate the impact of a clinical pathway on the management of AA in the ED.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1266-1271, (2007)
In patients with neuromuscular diseases, a chest infection is associated with a reduction in respiratory muscle function that may result in decreased cough effectiveness.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1272-1279, (2007)
Although pulmonary hypertension (PH) is a common complication of sickle cell disease (SCD) associated with high mortality, there exist few data characterizing hemodynamics and cardiopulmonary function in this population.
Asthma is common in urban centres in Latin America, but atopic asthma may not be the main phenotype among children. Helminth infections are highly prevalent in poor populations, and it was hypothesised that they attenuate allergic asthma, whereas other factors are related to the expression of a nonatopic wheeze/asthma phenotype.
The aim of the current study was to assess the safety of bronchoscopy-guided radiofrequency ablation (RFA) and compare the effectiveness between new internal cooled-RFA and standard noncooled-RFA.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1233-1240, (2007)
Inspiratory muscle weakness in patients with chronic obstructive pulmonary disease (COPD) is of major clinical relevance; maximum inspiratory pressure generation is an independent determinant of survival in severe COPD. Traditionally, inspiratory muscle weakness has been ascribed to hyperinflation-induced diaphragm shortening.
Primary ciliary dyskinesia (PCD) is a genetically heterogeneous disorder reflecting abnormalities in the structure and function of motile cilia and flagella, causing impairment of mucociliary clearance, left-right body asymmetry, and sperm motility. Clinical manifestations include respiratory distress in term neonates, recurrent otosinopulmonary infections, bronchiectasis, situs inversus and/or heterotaxy, and male infertility.
Journal of Asthma, Volume 44, Issue 4 May 2007 , pages 341 - 345
The purpose of this study was to identify determinants of asthma control. Questionnaires were completed by a random sample of 570 members of a large managed care organization who were >35 years of age with utilization suggestive of active asthma.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1298-1303, (2007)
Human lung transplantation is a therapeutic option for selected patients with advanced cardiopulmonary disease, but long-term survival is limited by chronic rejection. Persistent acute rejection and gastric aspiration have been implicated as risk factors but there is little or no evidence to date that they are associated.
Current Opinion in Pulmonary Medicine. 13(4):312-318, July 2007
Therapeutic thoracentesis is one of the most commonly performed medical procedures. The availability of handheld ultrasound machines has greatly enhanced the evaluation and management of patients with pleural effusions, with advantages including the absence of radiation, ease of use, portability and real-time/dynamic imaging.
Exacerbations of chronic obstructive pulmonary disease are of major importance in terms of their prolonged detrimental effects on patients, the acceleration in disease progression and high healthcare costs.
The prevalence of obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is underestimated and its diagnosis is costly and restricted to specialised sleep laboratories. The frequency component of interbeat interval increment (III) has been proposed as a simple and inexpensive diagnostic tool in OSAHS.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1259-1265, (2007)
Chronic obstructive pulmonary disease (COPD) is associated with an increased risk of cardiovascular events and osteoporosis. Increased arterial stiffness is an independent predictor of cardiovascular disease.
Repeated bronchoalveolar lavage (BAL) has been used in animals to induce surfactant depletion and to study therapeutical interventions of subsequent respiratory insufficiency. Intratracheal administration of surface active agents such as perfluorocarbons (PFC) can prevent the alveolar collapse in surfactant depleted lungs. However, it is not known how BAL or subsequent PFC administration affect the intracellular and intraalveolar surfactant pool.
Mucin hypersecretion and mucus plugging in the airways are characteristic features of chronic respiratory diseases like cystic fibrosis (CF) and contribute to morbidity and mortality. In CF, Pseudomonas aeruginosa superinfections in the lung exacerbate inflammation and alter mucus properties.
Modern Rheumatology, Volume 17, Number 2, April 2007, pp. 131-136(6)
The availability of intravenous cyclophosphamide (CYC) pulse therapy for collagen vascular diseases (CVD)-associated interstitial lung disease (ILD) has been indicated. However, the standard protocol concerning the dosage and the interval of CYC infusion has not yet been established.
Journal of Paediatrics and Child Health, Volume 43, Number 6, June 2007, pp. 443-445(3)
To determine (i) the proportion of doctors who recommend parent-initiated oral corticosteroids (PIOCS) for acute asthma; and (ii) the proportion of parents who have received this advice.
European Journal of Clinical Investigation, Volume 37, Number 6, June 2007, pp. 522-527(6)
The direct causal relationship between skin sensitization and asthma are controversial until now and remains to be further researched. Our aim is to analyse the role of parental asthma in the development of skin sensitization in offspring.
Noninvasive positive-pressure ventilation (NPPV) is commonly used to improve ventilation and oxygenation in patients with acute respiratory failure (ARF). Mask leak and intolerance due to facial discomfort or claustrophobia often occur with NPPV and are frequently cited reasons for treatment failure.
Journal of Asthma, Volume 44, Issue 4 May 2007 , pages 267 - 271
To explore the use of oscillometry as a measure of airway responsiveness, 69 asthmatic children underwent histamine and methacholine bronchoprovocation using dosimeter-MedicAid (Jaeger Co.; Germany) and DeVilbiss nebulizers (DeVilbiss, Bornemouth; England).
Current Opinion in Pulmonary Medicine. 13(4):319-323, July 2007
The bacteriology of complicated parapneumonic effusions has changed in recent decades, but the causative organisms often remain obscure in up to 40% of cases. Recently, new molecular methods have become available which might help clinical management and improve our understanding of this condition.
Current Opinion in Pulmonary Medicine. 13(4):328-333, July 2007
Malignant pleural effusion is a common complication in advanced malignancy that causes debilitating symptoms which result in impaired quality of life. The primary therapeutic goal in malignant pleural effusion management is effective palliation of the associated respiratory symptoms. Pleurodesis by chest tube or thoracoscopy is widely accepted as the gold standard treatment, although these treatments are not without problems.
Current Opinion in Pulmonary Medicine. 13(4):278-283, July 2007
: Airway stenting is a valuable adjunct to therapeutic bronchoscopy to relieve malignant airway obstruction. Over 80% of patients with obstructing lesions who were treated by airway stenting presented immediate symptom improvement in recent series. Stenting may also function as a bridge until further curative treatment can be used.
Journal of Asthma, Volume 44, Issue 4 May 2007 , pages 291 - 295
The authors tested the hypothesis that short stature predicts adult-onset asthma independent of obesity among women in the Nurses' Health Study. Height, weight, and physician-diagnosed asthma were assessed with validated questionnaire items.
International Archives of Allergy and Immunology 2007;144:162-170
Pollen allergy has been found in 80-90% of childhood asthmatics and 40-50% of adult-onset asthmatics. Despite the high prevalence of atopy in asthmatics, a causal relationship between the allergic response and asthma has not been clearly established.
. Autoantibodies directed against the aminoacyl tRNA synthetases are associated with myositis, arthritis, Raynaud's phenomenon, mechanic's hands, fever and interstitial pneumonia, clinically referred to as the anti-synthetase syndrome (ASS).
Journal of Paediatrics and Child Health, Volume 43, Number 6, June 2007, pp. 451-457(7)
To investigate temporal trends in admission rates for acute lower respiratory infections (ALRI) in a total population birth cohort of non-Aboriginal and Aboriginal children.
Inappropriate antibiotic use promotes resistance. Antibiotics are generally not indicated for upper respiratory infections (URIs). Our objectives were to describe patterns of URI treatment and to identify patient and provider factors associated with antibiotic use for URIs.
Journal of Asthma, Volume 44, Issue 4 May 2007 , pages 285 - 289
Factors resulting in intensive care unit (ICU) admissions for asthma exacerbations remain largely unclear. We compared ICU and general pediatric ward admissions for asthma exacerbations.
Journal of Asthma, Volume 44, Issue 4 May 2007 , pages 333 - 340
Although prudent exercise is recommended for most patients with well-controlled asthma, many patients avoid exercise and physical activity because they are concerned about triggering asthma.
Epidemiological studies have indicated that chronic obstructive pulmonary disease (COPD) may be associated with an increased incidence of ischaemic cardiac events.
The comparative effectiveness and safety of macrolides, quinolones and amoxicillin/clavulanate (A/C) for the treatment of patients with acute bacterial exacerbation of chronic bronchitis (ABECB) was evaluated in the present study.
The present authors have previously reported the usefulness of a serodiagnostic test to detect serum glycopeptidolipid (GPL) core antibody in diagnosing Mycobacterium avium complex (MAC) lung disease in immunocompetent patients. The aim of the present study was to investigate correlations between the levels of antibody against GPL core and chest computed tomography (CCT) findings in patients with MAC lung disease.
To explore if change in the extent of emphysema correlated with change in lung function, the effect of resection of emphysematous tissue was studied by computed tomography (CT) densitometry. In addition, the current authors studied how surgery-induced change in emphysema related to lung density in control subjects.
Pulmonary thromboendarterectomy is a curative surgical procedure for chronic thromboembolic pulmonary hypertension. The aim of this study was to clarify whether severe hemodynamic compromise affects surgical outcome.
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