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Journal of Perinatology 26 June 2008; doi: 10.1038/jp.2008.76
Term and near-term infants with pulmonary hypertension are frequently treated with inhaled nitric oxide. This therapy can be delivered with high-frequency ventilation, but there has been limited study of the relative effectiveness of high-frequency jet ventilation and high-frequency oscillatory ventilation.
Asthma is the most common chronic disease in childhood. Large variations exist concerning the number of children being treated by general practitioners and by specialists. Consequently, health related costs due to this disease vary as care by specialists is more expensive compared with care by general practitioners.
Meconium aspiration is believed to cause persistent pulmonary hypertension syndrome of the newborn (PPHN) via vasoconstriction, whereas meconium has a relaxant effect on rat tracheal muscle.
First Published on: 12 June 2008 DOI: 10.1080/00016480801968534
The reported prevalence of vestibulotoxicity (30.4%) in cystic fibrosis (CF) patients supports vestibulotoxicity screening in CF patients during or after tobramycin exposure. Prospective longitudinal investigation is required for a more specific evidence-based proposal. Objective. To investigate the prevalence of tobramycin-induced vestibulotoxicity in CF patients, as it had not been investigated before.
A 30-year-old man presented for evaluation of multiple, hypopigmented macules and erythematous papules on his upper and lower lips and upper extremities. He subsequently developed firm, non-tender, subcutaneous, mobile nodules on the left forearm, left calf, and right thigh.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200710-1557OC
A proportion of patients with asthma present with chronic airflow obstruction (CAO). We hypothesised that these effects may result from increased activity of circulating fibroblast-like progenitor cells (fibrocytes) that could home to the airway mucosal wall.
Abnormal plasma and lung iron mobilization is associated with the onset and progression of ARDS and is detectable in specific at-risk populations. Patients with ARDS also have pronounced oxidative and nitrosative stress that can be catalyzed and thereby aggravated by the bioavailability of redox active iron
Despite overwhelming data that cigarette smoking causes COPD, only a minority of long-term smokers are affected, strongly suggesting that genetic factors modify susceptibility to this disease.
Federal and state agencies are considering ICU performance assessment and public reporting; however, an accurate method for measuring performance must be selected. In this study, we determine whether a substantial variation in ICU mortality performance still exists in modern ICUs, and compare the predictive accuracy, reliability, and data burden of existing ICU risk-adjustment models.
Cystic fibrosis (CF) is an inherited multi-system disorder characterised by chronic airway infection with pathogens such as Pseudomonas aeruginosa. Acquisition of P. aeruginosa by patients with CF is usually from the environment, but recent studies have demonstrated patient to patient transmission of certain epidemic strains, possibly via an airborne route.
Respiratory infection by Pasteurella multocida is uncommon and usually occurs in patients with an underlying lung disease, advanced age and/or immunodepression. In this study, we describe the clinical and microbiological characteristics of a series of 14 patients in whom Pasteurella multocida was isolated from lower respiratory tract samples, over a period of 21 y (1986-2006). Differentiation between colonization and infection allows establishment of early antibiotic treatment.
Cochrane Database of Systematic Reviews, Issue 3, 2008
Chest physiotherapy (CPT) has been used in many neonatal nurseries around the world to improve airway clearance and treat lung collapse; however, the evidence to support its use has been conflicting. Despite the large number of studies there is very little evidence of sufficiently good quality on which to base current practice.
Cochrane Database of Systematic Reviews, Issue 3, 2008
Epidemiological evidence has suggested a link between beta-agonists and increases in asthma mortality. There has been much debate about possible causal links for this association, and whether regular (daily) long-acting beta2-agonists are safe.
Cheyne-Stokes respiration (CSR) and central sleep apnea (CSA) are common in patients with left-heart failure. We investigated the hypothesis that sleep-disordered breathing is also prevalent in patients with right ventricular dysfunction due to pulmonary hypertension (PH).
Limited data exist about the molecular types of methicillin-resistant Staphylococcus aureus (MRSA) strains found in children with cystic fibrosis (CF). We sought to characterize MRSA strains from these patients and compare them with MRSA strains from non-CF pediatric patients.
Serum levels of C-reactive protein (CRP) are increased in patients with COPD and correlate modestly with variables predictive of outcomes. In epidemiologic studies, CRP level is associated with all-cause mortality in patients with mild-to-moderate disease.
Thorax. Published Online First: 11 April 2008. doi:10.1136/thx.2007.086454
To estimate the cost-effectiveness of using continuous positive airway pressure (CPAP) in the management of patients suffering from severe obstructive sleep apnoea/hypopnoea syndrome (OSAHS), compared to no treatment, from the perspective of the UK's National Health Service (NHS).
A 19-year-old man presented with pneumonia, cough, and occasional dyspnea. Chest CT scan and bronchoscopy with biopsy revealed a typical carcinoid tumor obstructing the orifice of the right middle lobe, leading to lobar collapse.
ARDS secondary to blastomycosis is associated with a high mortality rate despite appropriate antifungal therapy. Corticosteroids are of proven benefit in the treatment of severe Pneumocystis jiroveci pneumonia and are recommended for the treatment of severe pulmonary infections with Histoplasma capsulatum.
In this study, our aim was to investigate the pleural and parenchymal changes and their frequency in patients with ankylosing spondylitis using high resolution computed tomography.
Pediatrics International doi:10.1111/j.1442-200X.2008.02630.x
Congenital lobar emphysema (CLE) is a rare anomaly of lung development that usually presents in the neonatal period with respirator distress and pulmonary lobar hyperinflation.
Pediatrics International doi:10.1111/j.1442-200X.2008.02631.x
he purpose of the present paper was to examine whether low birth size is associated with reduced pulmonary function and increased atopic sensitization in preadolescence.
The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 7, July 2008 , pp. 703-708(6)
To measure the prevalence of chronic obstructive pulmonary disease (COPD) and its risk factors, investigate variation in prevalence across countries and develop standardized methods that can be used in industrialized and developing countries.
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.081208
The Incremental Shuttle Walking Test (ISWT) is used to assess exercise capacity in chronic obstructive pulmonary disease (COPD) and is employed as an outcome measure for pulmonary rehabilitation. This study was designed to establish the minimum clinically important difference (MCID) for the ISWT.
Thorax. Published Online First: 11 April 2008. doi:10.1136/thx.2008.096388
Impaired development in utero is suggested to increase the risk of poor respiratory health in adulthood, although a consensus has not been reached. A possible explanation for discrepancies between previous studies is inconsistent controlling for potential confounding factors, particularly childhood infections.
Increased right ventricular afterload leads to left ventricular diastolic dysfunction due to ventricular interdependence. Increased right ventricular afterload is frequently present in patients with COPD. The purpose of this study was to determine whether left ventricular diastolic dysfunction could be detected in COPD patients with normal or elevated pulmonary artery pressure (PAP).
COPD is associated with an increased risk of peptic ulcer disease, but limited data exist on whether COPD influences short-term mortality among patients with bleeding and a perforated peptic ulcer. We examined the association between COPD and 30-day mortality following bleeding and perforation of a peptic ulcer.
Sang Thrombose Vaisseaux. Volume 20, Number 5, 245-52, mai 2008, Mini-revue
Considerable evidence is available supporting an independent association between obstructive sleep apnea syndrome (OSAS) and cardiovascular diseases, especially hypertension, ischaemic heart disease, stroke, heart failure, atrial fibrillation and cardiac sudden death.
Antimicrobial Agents and Chemotherapy, July 2008, p. 2395-2402, Vol. 52, No. 7
Bacterial alveolar invasion is followed by an inflammatory response. A systemic extension of the compartmentalized immune response has been described in patients with severe pneumonia. The data suggest that some antimicrobials may induce a differential release of cytokines.
Journal of Medical Systems 0148-5598 (Print) 10.1007/s10916-008-9155-7
Artificial Immune Recognition System (AIRS) classifier algorithm is robust and effective in medical dataset classification applications such as breast cancer, heart disease, diabetes diagnosis etc. In our previous work, we have proposed a new resource allocation mechanism called fuzzy resource allocation in AIRS algorithm both to improve the classification accuracy and to decrease the computation time in classification process.
Thorax. Published Online First: 27 May 2008. doi:10.1136/thx.2007.093724
Little is known on the long term outcomes of individuals with mild COPD, as defined by the Global Initiative for Chronic Obstructive Lung Disease (GOLD).
Obstructive sleep apnea (OSA) is closely related to systemic inflammation. Resistin is an adipocyte-derived cytokine (adipokine) that may link obesity with inflammation.
Air trapping evaluated in high-resolution computed tomography (HRCT) reflects changes in small bronchi. We simultaneously evaluated focal and diffuse air trapping in asthmatic patients.
Recognition of a pivotal role for eicosanoids in both normal and pathologic fibroproliferation is long overdue. These lipid mediators have the ability to regulate all cell types and nearly all pathways relevant to fibrotic lung disorders
Secondhand smoke triggers childhood asthma. Understanding sources of exposure, parental beliefs about exposure, and readiness to change that exposure are important for designing smoke exposure reduction interventions.
Chyle is a noninflammatory, lymphocyte-predominant fluid that may cause a pleural effusion as a consequence of thoracic duct leakage into the pleural space. Although chyle is reported to have protein concentrations in the transudative range, chylous effusions are typically exudative, as defined by the standard criteria.
British Journal of Clinical Pharmacology, Volume 66, Number 1, July 2008 , pp. 82-87(6)
number of factors have been hypothesized to increase the risk of amiodarone-induced pulmonary toxicity (AIPT), although there remains some controversy in the literature as to their relative significance.
Antimicrobial Agents and Chemotherapy, July 2008, p. 2639-2643, Vol. 52, No. 7
Of 393 isolates of Streptococcus pneumoniae from U.S. children collected in 2005-2006, nonvaccine serotypes accounted for 89.1%, with serotype 19A the most prevalent, representing 30.5% of all isolates.
Pulmonary vasoconstriction in response to hypoxia is unusual inasmuch as local exposure of nonpulmonary vasculature to hypoxia results in vasodilation.
Thorax. Published Online First: 20 May 2008. doi:10.1136/thx.2007.090167
Respiratory muscle unloading during exercise could improve locomotor muscle oxygenation due to increased systemic oxygen delivery (higher cardiac output and/or CaO2) in patients with chronic obstructive pulmonary disease (COPD).
Bronchopulmonary fistula (BPF) is associated with high morbidity and mortality. It occurs as an uncommon but often severe complication of pneumonectomy. BPF may be treated by a range of surgical and medical techniques, including chest drain, Eloesser muscle flap, omental flap, transsternal bronchial closure, thoracoplasty, and prolonged therapy with antibiotic regimens.
To evaluate the feasibility of combined oximetry (pulse oximetric saturation [SpO2]) and cutaneous capnography (transcutaneous carbon dioxide tension [PtcCO2]) for oxygen titration in patients requiring long-term oxygen therapy.
The clinical significance of pulmonary nodular ground-glass opacities (NGGOs) in patients with extrapulmonary cancers is not known, although there is an urgent need for study on this topic.
Specialists in pulmonary and critical care medicine frequently perform invasive procedures that may require sedation or anesthesia for patient comfort. The number and complexities of interventional pulmonary procedures that can be performed in the bronchoscopy suite or critical care unit continues to expand.
The airways in patients with cystic fibrosis (CF) are characterized by the accumulation of tenacious, dehydrated mucus that is a precursor for chronic infection, inflammation, and tissue destruction. The clearance of mucus is an integral component of daily therapy. Inhaled mannitol is an osmotic agent that increases the water content of the airway surface liquid, and improves the clearance of mucus with the potential to improve lung function and respiratory health.
Sleep Medicine Volume 9, Issue 5, Pages 583-585 (July 2008)
Although decrease in myocardial iodine-123 metaiodobenzylguanidine (123I-MIBG) radioactivity has been reported in patients with rapid eye movement (REM) sleep behavior disorder (RBD), its pathophysiology has not been thoroughly disclosed.
Sleep Medicine Volume 9, Issue 5, Pages 572-574 (July 2008)
Augmentation is a major problem with dopaminergic therapy for restless legs syndrome (RLS), and predictors of augmentation have not yet been identified. We aimed to analyze the relationship between baseline ferritin level and occurrence of augmentation in a retrospective analysis of a prospective double-blind trial of cabergoline versus levodopa on augmentation in RLS.
Sleep Medicine Volume 9, Issue 5, Pages 549-554 (July 2008)
The pathophysiology of obstructive sleep apnea (OSA) and recurrent otitis media (ROM) is intimately associated with the presence of adenotonsillar hypertrophy in children. However, it remains unclear whether habitually snoring children have a higher prevalence of ROM and whether they require tympanostomy tube placement more frequently.
Sleep Medicine Volume 9, Issue 5, Pages 537-541 (July 2008)
To demonstrate the long-term efficacy and safety of pramipexole for Restless Legs Syndrome (RLS) using physician and patient RLS ratings, along with subjective assays of sleep parameters, in a 26-week, open-label trial.
Sleep Medicine Volume 9, Issue 5, Pages 511-516 (July 2008)
Despite correct treatment with positive airway pressure (PAP), obstructive sleep apnea (OSA) patients sometimes remain subjectively somnolent. The reliability of the Epworth Sleepiness Scale (ESS) has been established for healthy subjects and patients under stable conditions; the ESS may eventually vary among treated OSA patients, biasing the results of a cross-sectional analysis of persisting sleepiness.
Sleep Medicine Volume 9, Issue 5, Pages 506-510 (July 2008)
Norepinephrine reuptake inhibitors such as protriptyline have been shown to improve sleepiness in sleep apnea, with or without improvement in the respiratory disturbance index (RDI).
Sleep Medicine Volume 9, Issue 5, Pages 500-505 (July 2008)
Restless legs syndrome (RLS) is a common sensorimotor disorder that peaks in severity during the night and comes on with rest. As a result, this condition often results in significant chronic sleep loss, especially for those with severe disease. Chronic partial sleep restriction has been associated with conditions such as depression, anxiety, chronic pain, and decline in cognitive function.
Sleep Medicine Volume 9, Issue 5, Pages 494-499 (July 2008)
Obstructive sleep apnea (OSA) and asthma are common and share similar nocturnal symptoms. We hypothesized that the prevalence of OSA symptoms would be greater in asthmatics compared to a general internal medicine population.
Sleep Medicine Volume 9, Issue 5, Pages 481-487 (July 2008)
Sleep disturbance is a common subjective complaint of minor traumatic brain-injured (mTBI) patients, but little is known about the characteristics of sleep disturbance in adults years after the injury.
Sleep Medicine Volume 9, Issue 5, Pages 475-480 (July 2008)
Nocturnal cardiac arrhythmias occur in patients with obstructive sleep apnea (OSA), reportedly as a consequence of the autonomic effects of recurrent apnea with subsequent oxygen desaturation. We have investigated whether different patterns of OSA are associated with specific arrhythmia during sleep.
Pediatrics International doi:10.1111/j.1442-200X.2008.02636.x
Bronchial asthma-like symptoms such as wheezing are commonly associated with respiratory tract infection including respiratory syncytial virus (RSV) infection in infants. No study on the association of wheezing with cytomegalovirus (CMV) infection in infancy has been reported, although CMV infection has been observed to play some role in prolonged and intractable wheezing in limited cases.
International Archives of Occupational and Environmental Health 0340-0131 (Print) 10.1007/s00420-008-0338-9
Due to new legal requirements in Germany, the employer must request preventive medical check-ups for activities involving exposure to dust from experimental animals in the rooms in which the animals are kept. The objective is to report our first experiences with these medical check-ups in the context of academic research.
Pediatric Surgery International 0179-0358 (Print) 10.1007/s00383-008-2187-8
Bronchogenic cyst (BC), which develops from abnormal budding of the tracheal diverticulum or ventral foregut, is a congenital bronchopulmonary malformation. Localization of the BC varies depending on the level of the abnormal budding. Thoracic or abdominal-sited diaphragmatic lesions are the rarest presentations of the BC.
We compared conventional treatment with pumpless extracorporeal lung membrane (Interventional Lung Assist [iLA] Novalung; Novalung GmbH, Hechingen, Germany) support in a pig model of postpneumonectomy severe acute respiratory distress syndrome.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 97-104, 2008
4-Hydroxy-2-nonenal (HNE), a major lipid peroxidation product, is toxic at high concentrations, but at near-physiological concentrations it induces detoxifying enzymes.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 68-76, 2008
We have reported previously that myristoylated alanine-rich C kinase substrate (MARCKS) is a key regulatory molecule controlling mucin secretion by airway epithelial cells in vitro and in vivo.
Host: Rick Soshensky, MA, MT-BC, NRMT, Director of the Fine and Performing Arts Program, Northeast Center for Special Care
Guest: Kimberly Carnevale, founder: Canine and Abled
Time: 27:43
Synopsis: Kimberly Carnevale is a traumatic brain injury survivor. Because of seizures and ambulation issues Ms. Carnevale partners with a service dog. After a number of experiences of access denial with her service dog in public areas she started an organization called Canine and Abled.
Ms. Carnevale discusses service dogs, issues around discrimination, the Americans with Disabilities Act, and the outreach she does through Canine and Abled.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 105-112, 2008
Endothelial cells are subjected to mechanical forces in the form of cyclic stretch resulting from blood pulsatility. Pulmonary artery endothelial cells (PAECs) produce factors that stimulate and inhibit pulmonary artery smooth muscle cell (PASMC) growth.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0198-2
Obstructive sleep apnea (OSA) can have adverse effects on cognitive functioning, mood, and cardiovascular functioning. OSA brings with it disturbances in sleep architecture, oxygenation, sympathetic nervous system function, and inflammatory processes. It is not clear which of these mechanisms is linked to the decrease in cognitive functioning.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0199-1
Continuous positive airway pressure (CPAP) devices with the option of flexible pressure delivery (e.g., C-Flex) are thought to provide an improved degree of comfort and result in better therapeutic adherence while maintaining standard CPAP efficacy.
In recent decades international and national guidelines have been formulated to ensure that patients suffering from specific diseases receive evidence-based care.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200803-419OC
Microvascular injury, inflammation and coagulation play critical roles in the pathogenesis of acute lung injury. Plasma protein C levels are decreased in patients with acute lung injury and are associated with higher mortality and fewer ventilator free days.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200802-235OC
Growth-differentiation factor-15 (GDF-15) is a stress-responsive, transforming growth factor-{beta}-related cytokine. Circulating levels of GDF-15 provide independent prognostic information in patients with acute pulmonary embolism and chronic left-sided heart failure.
Thorax. Published Online First: 15 February 2008. doi:10.1136/thx.2007.084251
To determine whether well-trained lay people could deliver asthma self-management education with comparable outcomes to that achieved by primary care-based practice nurses.
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.090324
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an accurate tool for lymph node staging of non-small lung cancer (NSCLC). The majority of NSCLC patients require systemic chemotherapy during their treatment, with relatively poor responses. If one could predict chemotherapy response, ideally at the time of initial bronchoscopic examination, one could maximize therapeutic benefit while limiting toxicity.
An epidemiological link between respiratory infection and acute myocardial infarction (AMI) has been suggested, and recent data indicate that there is an association between AMI and pneumococcal community-acquired pneumonia (CAP) in hospitalized patients.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200803-384OC
Beta-blocker use is associated with improved health outcomes in patients with cardiovascular disease. There is a general reluctance to prescribe beta-blockers in patients with chronic obstructive pulmonary disease (COPD) as they may worsen symptoms.
The treatment of fibrocavitatory pulmonary infection due to Mycobacterium avium complex and Mycobacterium malmoense poses a challenge. This study assessed microbial, inflammatory, radiographic, and clinical outcomes for a standardized 24-month triple-drug regime.
Alpha-1-antitrypsin deficiency (AATD) is a genetic disorder that manifests as pulmonary emphysema, liver cirrhosis and, rarely, as the skin disease panniculitis, and is characterized by low serum levels of AAT, the main protease inhibitor (PI) in human serum.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.082974
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 (Tregs) are important modifiers of T-cell immunity, but little is known about their distribution in bronchial mucosa at this age.
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.088930
The clinical impact of nocturnal desaturation on health-related quality of life (HRQL) and sleep in COPD has been little studied. We aimed to evaluate the prevalence and clinical impact of nocturnal desaturation in a typical outpatient population with COPD.
Thorax. Published Online First: 14 March 2008. doi:10.1136/thx.2007.088583
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive disorder with a poor prognosis. Epithelial instability is a crucial step in the development and progression of the disease including neoplastic transformation. Few tissue markers regarding epithelial instability have been reported in IPF. Squamous cell carcinoma antigen (SCCA) is a serine protease inhibitor typically expressed by dysplastic and neoplastic cells of epithelial origin, more often in squamous cell tumours. At present no information is available on its expression in IPF.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200802-301OC
Both obesity and asthma are common conditions, and both are characterised by the presence of inflammation. Animal studies suggest that the development of airway hyper-responsiveness with antigen challenge is exaggerated with obesity.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200802-309OC
Virus-induced wheezing episodes in infancy often precede the development of asthma. Whether infections with specific viral pathogens confer differential future asthma risk is incompletely understood.
Thorax. Published Online First: 11 April 2008. doi:10.1136/thx.2007.091538
Breathlessness is a common and difficult symptom to treat in patients with cancer. Case reports suggest that nebulised furosemide can relieve breathlessness in such patients but few data are available.
Thorax. Published Online First: 14 February 2008. doi:10.1136/thx.2007.086074
A Th1 predominant immune response has been shown in acute hypersensitivity pneumonitis. A Th2 predominance appears to favor the development of pulmonary fibrosis through the profibrotic process, and has been described as crucial in the progression of idiopathic pulmonary fibrosis (IPF). Chronic bird fancier's lung (cBFL) can present a histological pattern of usual interstitial pneumonia (UIP)-like lesions. Little is known about the Th1/Th2 balance in the pathogenesis of cBFL.
Thorax. Published Online First: 5 June 2008. doi:10.1136/thx.2007.093740
Excessive daytime sleepiness (EDS), obesity and insulin resistance (IR) occur frequently in patients with obstructive sleep apnea (OSAS). We hypothesized that in these patients EDS is a marker of IR, independently of obesity.
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.081877
The obstructive sleep apnea/hypopnea syndrome (OSAHS) is associated with hypertension and increased cardiovascular risk, particularly when accompanied by marked nocturnal hypoxemia. The mechanisms of these associations are unclear. We hypothesised that OSAHS combined with severe nocturnal hypoxemia causes impaired vascular function that can be reversed by continuous positive airways pressure (CPAP) therapy.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.087999
The management of pulmonary disease caused by opportunist mycobacteria is bedevilled by a lack of randomized trials to provide an evidence-base for treatment. Rifampicin (R) and ethambutol (E) are the mainstay of treatment but the roles of macrolides and quinolones are not clear.
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.090803
The association of murine asthma with adiposity may be mediated by adiponectin, an anti-inflammatory adipokine with reduced serum concentrations in the obese. We studied whether serum adiponectin concentration was associated with human asthma and explained the association between adiposity and asthma, particularly in women and in pre-menopausal women.
Thorax. Published Online First: 3 April 2008. doi:10.1136/thx.2007.091132
Childhood obstructive sleep apnoea (OSA) is increasingly being recognized. Its effect on blood pressure (BP) elevation and hypertension is still controversial.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.088559
Neutrophil elastase (NE) activity is increased in lung diseases such as alpha-1-antitrypsin (A1AT) deficiency and pneumonia. We have recently demonstrated that NE can induce expression of cathepsin B and MMP 2 in vitro and in a mouse model. We postulated that increased Cathepsin B and MMP-2 in acute and chronic lung diseases are due to the presence of high levels of extracellular NE and that expression of these proteases could be inhibited by A1AT augmentation therapy.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 86-96, 2008
Chronic pulmonary inflammation in patients affected by cystic fibrosis (CF) is characterized by massive bronchial infiltrates of neutrophils, which is sustained by the interaction of pathogens (e.g., Pseudomonas aeruginosa) with surface bronchial cells.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 77-85, 2008
Human endothelial cells (EC) are typically resistant to the apoptotic effects of stimuli associated with lung disease. The determinants of this resistance remain incompletely understood. Macrophage migration inhibitory factor (MIF) is a proinflammatory cytokine produced by human pulmonary artery EC (HPAEC).
J Am Coll Cardiol, 2008; 52:52-59, doi:10.1016/j.jacc.2008.03.034
We sought to determine whether the type of shunt used at stage one palliation (S1P) affected the survival and the perioperative course through Fontan completion.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200708-1286OC
Recent epidemiologic studies have shown that homocysteine, a sulfur-containing amino acid formed during the metabolism of methionine, is a risk factor of atherosclerosis, myocardial infarction, stroke, and thrombosis.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200707-1104OC
Secretoglobin (SCGB) 3A2 was originally identified as a downstream target in lung for the homeodomain transcription factor NKX2-1, whose null mutation resulted in severely hypoplastic lungs. A very low level of SCGB3A2 is expressed in lungs at embryonic day (E) 11.5 during mouse development, which markedly increases by E16.5, the time when lung undergoes dramatic morphological changes, suggesting that SCGB3A2 may be involved in lung development in addition to a known role in lung inflammation.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200802-239OC
Pseudomonas aeruginosa is one of the leading causes of Gram negative ventilator-associated pneumonia (VAP) associated with a mortality rate of 34% to 68%. Recent evidence suggests that P. aeruginosa in patients with VAP may persist in the alveolar space despite adequate antimicrobial therapy.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1818OC
Epidemiological studies have shown that in atopic children wheezing is more likely to persist into adulthood, eventually becoming asthma, while it appears to resolve by adolescence in non-atopic children.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200706-929OC
Fibroblasts are believed to be the major cells responsible for the production and maintenance of extracellular matrix. Alterations in fibroblast functional capacity, therefore, could play a role in the pathogenesis of pulmonary emphysema, which is characterized by inadequate maintenance of tissue structure.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200709-1383OC
The predictive value of longitudinal change in BODE has received limited attention. We hypothesized that decrease in a modified BODE (mBODE) would predict survival in National Emphysema Treatment Trial (NETT) patients.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200801-090OC
American Thoracic Society guidelines state that a >10% intersession change in diffusing capacity of the lung (DLCO) should be considered clinically significant. However, little is known about the short-term intersession variability in DLCO in untrained subjects or how variability is affected by rigorous external quality control.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200711-1648OC
Pulmonary complications of hematopoietic stem cell transplantation include infections and graft-versus-host diseases, such as idiopathic pneumonia syndrome (IPS). Conflicting data exist regarding the role of the interferon-gamma-producing Th1 CD4+ T-cell subset and IL-17A in IPS.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200710-1486O
Emphysema is mainly known for the complex inflammatory processes associated with its development. In addition to lung inflammation, it is now accepted that increased alveolar cell apoptosis is also part of emphysema pathophysiology. However, little is known about the mechanisms involved in alveolar apoptosis.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200711-1754OC
Heterogeneity in asthma expression is multidimensional, including variability in clinical, physiological and pathological parameters. Classification requires consideration of these disparate domains in a unified model.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1829OC
ICU-acquired paresis (ICUAP) is common in survivors of critical illness. There is significant associated morbidity, including prolonged time on the ventilator and longer hospital stay.
COPD is highly prevalent and will continue to be an increasing cause of morbidity and mortality worldwide. COPD is now viewed under a new paradigm as preventable and treatable. In addition, it has become accepted that COPD is not solely a pulmonary disease but also one with important measurable systemic consequences.
This study describes an unusual patient with X-linked Alport syndrome (XLAS) in whom diffuse alveolar hemorrhage (DAH) developed as a complication of alemtuzumab therapy following renal transplantation.
American Journal of Respiratory and Critical Care Medicine Vol 178. pp. 7-12, (2008)
Panic attacks are common in chronic obstructive pulmonary disease (COPD), and the prevalence of panic disorder is at least 10 times higher than in the general population.
American Journal of Respiratory and Critical Care Medicine Vol 178. pp. 42-49, (2008)
After recent standardization of forced expiratory maneuvers for both infants and preschool children, longitudinal measurements are now possible from birth.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200803-381OC
Serial smear analysis to guide respiratory isolation (RI) of tuberculosis (TB) suspects, the majority of whom will be found not to not have TB, leads to expensive and unnecessary isolation, and may potentially result in decreased vigilance of subjects with respiratory compromise.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1826OC
Lung volume reduction surgery is inconsistently reported to improve arterial oxygenation in COPD patients. We studied the effects of surgery on oxygenation in a large cohort and identified predictors of postoperative oxygenation improvement.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1869OC
Chronic obstructive pulmonary disease (COPD) is characterized by an accelerated decline in lung function. No drug has been shown conclusively to reduce this decline.
Congestive heart failure (HF), an exceedingly common and costly disease, is frequently seen in association with central sleep apnea (CSA), which often manifests as a periodic breathing rhythm referred to as Cheyne-Stokes respiration.
Three cases are presented in which patients were using opioids as required for nonmalignant pain management and significant central sleep apnea developed. Patients in the first two cases had no evidence of sleep-related breathing disorders on polysomnography until they ingested an opioid for treatment of chronic pain during the night and severe central sleep apnea developed.
Asthma is a multifactorial disease, in which the intricate interplay between genetic and environmental factors underlies the overall phenotype of the disease.
Allergy, Volume 63, Number 7, July 2008 , pp. 932-938(7)
Uncontrolled asthma is characterized by variability. Current asthma guidelines recommend focussing on the achievement and maintenance of control but few studies have examined in detail, using composite measures of control, the stability and potential duration of control once achieved.
Allergy, Volume 63, Number 7, July 2008 , pp. 917-923(7)
The traditional Mediterranean diet is claimed to possess antioxidant and immune-regulatory properties in several chronic diseases. Typical Mediterranean foods have recently been associated with improvement of symptoms of asthma and rhinitis in children. However the effect of adherence to Mediterranean diet on adult asthma outcomes is unknown. We aimed to investigate the association between adherence to Mediterranean diet and asthma control.
Journal of Cardiovascular Electrophysiology doi:10.1111/j.1540-8167.2008.01141.x
We report a case of a 56-year-old man with paroxysmal atrial fibrillation who underwent segmental, ostial pulmonary vein (PV) isolation while in arrhythmia. During isolation of the left superior PV (LSPV), organized electrical activity was seen within the vein, suggestive of a PV tachycardia with a cycle length of 90 ms.
Journal of Cardiovascular Electrophysiology doi:10.1111/j.1540-8167.2008.01118.x
Obesity and obstructive sleep apnea (OSA) are associated with atrial fibrillation (AF). The effects of a large body mass index (BMI) and OSA on the results of radiofrequency catheter ablation (RFA) of AF are unclear.
European Journal of Clinical Investigation, Volume 38, Number 7, July 2008 , pp. 462-468(7)
Several studies have suggested an association between Chlamydophila pneumoniae (Cp) infection and atherosclerosis. A recent study detected Cp DNA in the saphenous vein of 12% of all patients before bypass grafting and in 38% of failed grafts. We used a system in which human veins were perfused with autologous blood under arterial pressure.
Streptococcus pneumoniae is a major cause of morbidity and mortality worldwide, but also a common colonizer of the upper respiratory tract. The emergence and spread of antibiotic resistant pneumococcal strains has threatened effective therapy.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200711-1661OC
Efficient removal of apoptotic cells is essential for the resolution of acute pulmonary inflammation. Alveolar macrophages ingest apoptotic cells less avidly than other professional phagocytes at rest but overcome this defect during acute inflammation. Surfactant protein-A (SP-A) and surfactant protein-D (SP-D) are potent modulators of macrophage function and may influence clearance of apoptotic cells through activation of the transmembrane receptor SIRP{alpha}.
Thorax. Published Online First: 17 June 2008. doi:10.1136/thx.2008.097311
Antibiotic treatment is not recommended for acute bronchitis in immunocompetent patients in industrialized countries. Whether these recommendations are relevant to the developing world and to immunocompromised patients is unknown.
Thorax. Published Online First: 11 April 2008. doi:10.1136/thx.2007.089458
Infection with Burkholderia cepacia complex (BCC) is a life-threatening complication of cystic fibrosis (CF) often seen as a contraindication for lung transplantation.
Thorax. Published Online First: 17 June 2008. doi:10.1136/thx.2007.091181
Oxidative stress, resulting from increased oxidative burden and decreased level of anti-oxidant proteins, plays a role in the pathophysiology of smoking-related pulmonary emphysema. Expression of several antioxidant proteins, such as heme oxygenase-1 (HO-1), glutathione peroxidase2 (GPX2) and NAD(P)H:quinone oxidoreductase1 (NQO1), results from an equilibrium created by positive or negative regulation by the transcription factors Nrf2, Keap1 and Bach1 respectively.
Am. J. Respir. Crit. Care Med., Volume 178, Number 1, July 2008, 81-88
Platelet-derived growth factor (PDGF) promotes the proliferation and migration of pulmonary artery smooth muscle cells (PASMC), and may play a role in the progression of pulmonary arterial hypertension (PAH), a condition characterized by proliferation of PASMC resulting in the obstruction of small pulmonary arteries. Objectives: To analyze the expression and pathogenic role of PDGF in idiopathic PAH.
Am. J. Respir. Crit. Care Med., Volume 178, Number 1, July 2008, 34-41
Recognition of 'pathogen-associated-molecular-patterns' by Toll-like receptors (TLRs) is considered to be important for an appropriate immune response against pathogens that enter the lower airways.
Delayed time to antibiotic administration has been linked with higher mortality for patients with community-acquired pneumonia, but the impact of antibiotic resistance on clinical outcomes has been controversial. In the current study we assess the combined impact of antibiotic resistance and antibiotic timing on outcomes, including inhospital mortality, complications, length of stay, and time to stability, for patients hospitalized with community-acquired bacteremic pneumococcal pneumonia.
Pediatrics International Volume 50 Issue 3 Page 352-355, June 2008
The aim of this study was to develop a clinical prediction model that identifies respiratory syncytial virus (RSV) infection in infants and young children.
The latest links to journal article abstracts on Respiratory, Pulmonary, COPD, Mechanical Ventilation, Ventilator Weaning, Respiratory Therapy, Asthma, Cardio-Vascular, Sleep Apnea, CPAP, BiPAP, and other related clinical topics
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Thorax. Published Online First: 14 February 2008. doi:10.1136/thx.2007.088195
The indication of chest physical therapy as an adjunct to treatment of children hospitalized with acute pneumonia remains controversial and there is lack of robust scientific evidence on effectiveness of this modality in these patients.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200709-1365OC
The purpose of this study was to evaluate the parenchymal abnormalities and prognosis using high-resolution computed tomography (HRCT) in acute exacerbation of IPF.
Thorax. Published Online First: 1 February 2008. doi:10.1136/thx.2007.086314
We report a randomised double-blind placebo-controlled parallel group trial of etanercept (an IgG1-TNF p75 receptor fusion protein), administered once weekly for 12 weeks in 39 patients with symptomatic corticosteroid refractory asthma
Am. J. Respir. Crit. Care Med., Volume 178, Number 1, July 2008, 89-95
In adult rats, bilateral ablation of preBotzinger Complex(preBotC) neurokinin 1 expressing (NK1R) neurons leads to a progressive and irreversible disruption in breathing pattern, initially during sleep, eventually resulting in an ataxic breathing pattern during wakefulness.
Thorax. Published Online First: 20 May 2008. doi:10.1136/thx.2007.093955
Churg Strauss Syndrome (CSS) is a rare granulomatous small vessel vasculitis that occurs against a background of long-standing asthma. Leukotriene antagonists (LTAs) are used in the management of asthma and may facilitate a reduction in steroid dosage. Reports of the development of CSS in asthmatic patients following the initiation of LTA therapy suggest either a causal association or an unmasking of latent CSS as steroid doses fall. We have undertaken a systematic review to establish whether evidence of a drug induced syndrome exists.
To identify the predominant radiological abnormalities in the lungs of patients with early rheumatoid arthritis (RA) and in those with longstanding RA.
Legionella is an important cause of nosocomial and community-acquired pneumonia in both immunocompetent and immunosuppressed patients worldwide; however, the clinical course and optimal antibiotic therapy of Legionella pneumonia (LP) in patients with cancer is uncertain.
Allergy, Volume 63, Number 7, July 2008 , pp. 865-871(7)
There is evidence that selenium levels are relatively low in Europe and may be falling. Low levels of selenium or low activity of some of the enzymes dependent on selenium have been associated with asthma.
The Internet Journal of Thoracic and Cardiovascular Surgery. 2008. Volume 11 Number 2
Pulmonary balloon dilation has almost replaced surgical therapy. After this intervention the restenosis rate might seen as 6-6.7%.
In this study, we report a case with pulmonary restenosis. He had been performed a pulmonary balloon dilatation 2 years ago at another health facility with a diagnosis of supravalvular pulmonary stenosis.
European Journal of Pediatrics 0340-6199 (Print) 10.1007/s00431-008-0753-7
The etiology of secretory diarrhea in early life is often unclear. We report a Japanese boy who survived until 3 years of age, despite intractable diarrhea commencing soon after birth.
The primary aim of this study was to investigate whether IMA levels are helpful in the diagnosis of pulmonary embolism (PE). The secondary aim was to determine whether IMA was more effective alone or in combination with clinical probability scores in the diagnosis of PE.
Thorax. Published Online First: 14 February 2008. doi:10.1136/thx.2007.087825
There has been some concern that leukotriene-receptor antagonists might precipitate the onset of Churg-Strauss syndrome (CSS). Objective: To investigate the relationship between the leukotriene-receptor antagonist montelukast and CSS onset.
Am. J. Respir. Crit. Care Med., Volume 178, Number 1, July 2008, 13-19
Smoking induced oxidative stress contributes to COPD, a lung disease characterized by low lung function and increasing mortality worldwide. The counterbalance for this effect may be provided by e.g. increased intake of the antioxidant vitamin C or endogenously acting antioxidant enzymes like glutamate cysteine ligase (GCL) that is responsible for glutathione biosynthesis.
International Archives of Occupational and Environmental Health 0340-0131 (Print) 10.1007/s00420-008-0337-x
To perform a critical review of a series of journal articles and Health Hazard Evaluation Reports (HHER) by the National Institute for Occupational Safety and Health (NIOSH), where they have described the incidence of fixed obstructive pulmonary disease in a population of workers exposed to butter flavorings.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200802-207OC
Clinical probability assessment is a fundamental step in the diagnosis of pulmonary embolism. Objective: To develop a predictive model for pulmonary embolism based on clinical symptoms, signs, and the interpretation of the electrocardiogram.
Thorax. Published Online First: 1 February 2008. doi:10.1136/thx.2007.087213
The combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide (TIO) are commonly used treatments in COPD but there is little data on their effectiveness when used together. We compared the effects of SFC 50/500mcg bd plus TIO 18mcg od with the individual treatments alone.
Thorax. Published Online First: 17 June 2008. doi:10.1136/thx.2007.087387
Angiopoietin-2 and vascular endothelial growth factor (VEGF) may impair vascular barrier function, while angiopoietin-1 may protect. We hypothesised that circulating angiopoietin-2 is associated with pulmonary permeability oedema and severity of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) during septic or non-septic critical illness.
Independent lung ventilation is a form of protective ventilation strategy used in adult asymmetric acute lung injury, where the application of conventional mechanical ventilation can produce ventilator induced lung injury and ventilation-perfusion mismatch. Only few small experiences with independent lung ventilation are available at the moment on newborn patients.
Congenital Heart Disease, Volume 3, Number 3, May/June 2008 , pp. 223-225(3)
Congenital pulmonary venous stenosis is a rare condition leads to progressive pulmonary hypertension and heart failure. It may be isolated or associated with other cardiac malformations. The condition ranges from hypoplasia of individual pulmonary veins to constriction of the intima of the venoatrial junction. We present a case of congenital PVS involving 4 pulmonary veins combined with severe valvular and subvalvular aortic stenoses.
Heart failure is a growing problem, placing an increasing burden on public health resources and continuing to exert a high toll in mortality and morbidity. Sleep disordered breathing (SDB) is also a major public health problem and is associated with an increased risk of fatal and non-fatal cardiovascular events.
American Journal of Epidemiology 2008 168(1):58-65
With few exceptions, studies of short-term health effects of air pollution use pollutant concentrations that are averaged citywide as exposure indicators.
In Brazil, serotype 1 Streptococcus pneumoniae is one of the most prevalent causes of severe infection. This study investigated the genetic relatedness of 134 serotype 1 isolates obtained from invasive diseases during the period 1977-2005. Molecular typing by PFGE revealed two major lineages using visual inspection and computer analysis.
A highly sensitive immunochromatography test kit, ODK0501, was developed using specific polyclonal antibodies against the C-polysaccharide moiety of Streptococcus pneumoniae for the rapid detection of S. pneumoniae antigen in sputum samples.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 53-60, 2008
Mechanical ventilation, often required to maintain normal gas exchange in critically ill patients, may itself cause lung injury. Lung-protective ventilatory strategies with low tidal volume have been a major success in the management of acute respiratory distress syndrome (ARDS).
A prescription-sized asthma educational tool (AET) was used to identify, assess, and educate pediatric asthma patients during a 2-year period. A Patient Electronic Care System (PECS) was used to register these patients over 2 influenza vaccination seasons to determine whether influenza vaccination rates could be improved among these pediatric asthmatics by use of the asthma educational tool.
Two severely compromised children developed bowel necrosis in the context of severe pneumonia, presumably secondary to ischemia. No other obvious etiology for the abdominal pathology could be ascertained.
The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 7, July 2008 , pp. 713-717(5)
Chronic obstructive pulmonary disease (COPD) is a global health problem that poses a heavy burden on most countries in the Asia-Pacific region. When compared to industrialised Western countries, the COPD burden in the Asia-Pacific region is higher in terms of the number of deaths, years spent living with disability and years of life lost.
Thorax. Published Online First: 20 May 2008. doi:10.1136/thx.2008.095562
Admission blood pressure 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.
American Journal of Respiratory Cell and Molecular Biology. Vol. 39, pp. 61-67, 2008
Structural changes to the lung are associated with chronic asthma. In addition to alterations to the airway wall, asthma is associated with vascular modifications, although this aspect of remodeling is poorly understood.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200703-409OC
Markers of inflammatory activity are important for assessment and management of many respiratory diseases. Markers currently unrecognised may be more valuable than those presently thought useful.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200801-059OC
It is unclear whether airway wall thickening and emphysema make independent contributions to airflow limitation in chronic obstructive pulmonary disease (COPD) and whether these phenotypes cluster within families.
Thorax. Published Online First: 20 May 2008. doi:10.1136/thx.2007.094250
The incidence of empyema is increasing worldwide in children. While there are emerging data for the best treatment options, there is little evidence to support the imaging modalities used to guide treatment particularly with regard to the role of routine computed tomography (CT). The aims of this study were to develop a radiological scoring system for paediatric empyema and to assess the utility of routine CT scanning in this disease.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.090951
Influenza-like illness (ILI) among elderly living in residential care homes (RCHE) is a common cause for hospitalization. We examined the incidence, underlying aetiology, natural history and associated healthcare resource utilization related to ILI in the RCHE population.
Thorax. Published Online First: 20 May 2008. doi:10.1136/thx.2007.090027
About 5-10% of patients with asthma suffer from poorly-controlled disease despite corticosteroid (CS) therapy, which may indicate the presence of CS insensitivity. We determined whether relative CS insensitivity is present in alveolar macrophages (AMs) from severe asthma patients and its association with p38 mitogen-activated protein kinase (MAPK) activation and MAPK phosphatase-1 (MKP-1).
Thorax. Published Online First: 16 May 2008. doi:10.1136/thx.2007.087130
Patients with 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 is there data relating objectively assessed daily activity to laboratory assessments made before and after rehabilitation.
Although the BTS-SIGN asthma guideline is one of the most well known and widely respected guidelines in the world, implementation in UK primary care remains patchy. Building on extensive earlier descriptive work, we sought to explore the way teamwork and inter-professional relationships impact on the implementation of the BTS-SIGN guideline on asthma in general practice.
Heart. Published Online First: 11 October 2007. doi:10.1136/hrt.2006.114660
To examine the outcomes in patients with moderate or severe pulmonary arterial hypertension (PAH) undergoing percutaneous atrial septal defect (ASD) closure.
ANZ Journal of Surgery, Volume 78, Number 6, June 2008 , pp. 445-448(4)
Although elderly patients with thoracic disease were considered to be poor candidates for thoracotomy before, recent advances in preoperative and postoperative care as well as surgical techniques have improved outcomes of thoracotomies in this patient group. The aim of this study was to investigate surgical risk factors and results in elderly patients (aged ≥70 years) with thoracic
empyema.
Pediatrics International doi:10.1111/j.1442-200X.2008.02617.x
Continuous positive airway pressure (CPAP) is a widely accepted method of respiratory support used in the care of preterm infants. It remains unknown as to what is the best strategy for the withdrawal of CPAP once it has been commenced.
Pediatrics International doi:10.1111/j.1442-200X.2008.02620.x
Characteristics related to decreased lung function and increased bronchial responsiveness after early childhood wheezing requiring hospitalization are not fully established.
Pediatrics International doi:10.1111/j.1442-200X.2008.02580.x
During the follow-up period in surviving patients with severe congenital diaphragmatic hernia (CDH), respiratory complications, such as recurrence of CDH or chronic lung disease, have been reported to occur as a late complication.
The Internet Journal of Thoracic and Cardiovascular Surgery. 2008. Volume 11 Number 2
We report the case of an 85 year old female patient who presented a mediastinal myelolipoma associated with hemorrhagic pleural effusion and anemia. Pathologic examination identified zones of acute and old intratumoral hemorrhage.
Journal of Paediatrics and Child Health doi:10.1111/j.1440-1754.2008.01326.x
A high rate (48.6%) of extended spectrum beta-lactamase production among Klebsiella pneumoniae (ESBL-KP) clinical isolates in the paediatric wards of our hospital prompted the introduction of enhanced infection control measures, and after the implementation of these measures, we instituted a prospective surveillance programme, with a nested case-control study to determine the risk factors for rectal colonisation by ESBL-KP.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200803-459OC
The potential role of elevated B-type natriuretic peptides in the differentiation of patients suffering from acute pulmonary embolism at risk for adverse clinical outcome has not been fully established.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200710-1589OC
Lung injury due to ventilator results from un-physiological lung stress (transpulmonary pressure) and strain (inflated volume to functional residual capacity ratio).
Pediatrics International doi:10.1111/j.1442-200X.2008.02591.x
Invasive Haemophilus influenzae type b (Hib) infection has a high morbidity among young children, but the burden of disease and rate of Hib are different in different regions. The aim of the present study was to investigate the levels of Hib antibodies and the oropharyngeal Hib prevalence in young children.
Upper airways in patients with obstructive sleep apnea syndrome (OSAS) are more likely narrower than those of normal subjects, a factor in increasing the work of breathing (WOB) in these individuals.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 5, Issue 3 June 2008 , pages 187 - 200
Mortality due to chronic obstructive pulmonary disease continues to rise, whereas mortality rates related to cardiovascular disease appear to be slowing, or even declining. This is due at least in part to more widespread use of preventative therapies that have been shown to reduce cardiovascular mortality, raising the question of whether appropriate use of therapies for chronic obstructive pulmonary disease which potentially reduce mortality could have a similar impact.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200711-1629OC
Puerto Ricans have the highest prevalence of and morbidity from asthma of all ethnic groups in the U.S. One potential contributor to the high burden of asthma in Puerto Rican children is exposure to stress and violence.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200709-1369PP
The plexiform lesions of severe pulmonary arterial hypertension (PAH) are similar in histologic appearance, whether the disease is idiopathic or secondary. Both forms of the disease show actively proliferating endothelial cells without evidence of apoptosis.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200707-1046OC
Airway remodeling in asthma involves accumulation of airway smooth muscle (ASM) and increased vascularity due to angiogenesis. Bronchial blood vessels and ASM are found in close proximity, and ASM releases multiple proinflammatory mediators including vascular endothelial growth factor (VEGF).
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1135-1141, (2008)
The intermittent hypoxia (IH) that characterizes sleep-disordered breathing impairs spatial learning and increases NADPH oxidase activity and oxidative stress in rodents.
Am J Physiol Heart Circ Physiol 294: H2465-H2472, 2008
Blood flow requirements of the respiratory muscles (RM) increase markedly during exercise in chronic heart failure (CHF). We reasoned that if the RM could subtract a fraction of the limited cardiac output (QT) from the peripheral muscles, RM unloading would improve locomotor muscle perfusion.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200707-1022OC
The low efficiency of conventional therapies in achieving long-term survival of lung cancer patients calls for the development of novel therapeutic options. Recent advances in aerosol-mediated gene delivery have provided the possibility of an alternative for the safe and effective treatment of lung cancer.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200705-701OC
There are limited longitudinal data about respiratory morbidity and lung function following preterm birth into adulthood. Objectives To determine the evolution of respiratory symptoms, spirometry and airway hyperresponsiveness of ex-preterm subjects from childhood into adulthood.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200608-1240OC
Preterm infants exposed to mechanical ventilation and oxygen are at risk for bronchopulmonary dysplasia (BPD), a multifactorial chronic lung disorder characterized by arrested alveolar development. Recent studies have described disruption of microvascular development in BPD, characterized by primitive angioarchitectural patterns reminiscent of the canalicular/saccular stages of lung development.
Am. J. Respir. Crit. Care Med. 2007, doi:10.1164/rccm.200701-114OC
Background The efficacy of immediate adaptation of mandibular advancement devices made of thermoplastic material as a treatment option for sleep disordered breathing (SDB) has been demonstrated in clinical studies.
Although life saving, mechanical ventilation can cause complications such as ventilator-induced lung injury and bronchopulmonary dysplasia in very preterm babies. The ventilator-induced lung injury is multi-factorial. There has been an introduction of a number of newer forms of mechanical ventilation, which are aimed to reduce such complications. These are based on sound physiologic principles and clinicians should familiarize themselves with these advances.
Obesity Reviews, Volume 9, Number 4, July 2008 , pp. 340-354(15)
Obstructive sleep apnea-hypopnea syndrome involves recurring episodes of total obstruction (apnea) or partial obstruction (hypopnea) of airways during sleep. Obstructive sleep apnea-hypopnea syndrome affects mainly obese individuals and it is defined by an apnea-hypopnea index of five or more episodes per hour associated with daytime somnolence.
Tracheobronchial obstruction is infrequent in the pediatric age group but it is associated with significant morbidity and mortality. The purpose of this study is to review the results of a single institution experience with endoscopic stent placement in children with benign tracheobronchial obstruction, and with special concern on safety and clinical effectiveness.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200710-1513OC
Aminobiphosphonates, such as zoledronic acid (ZA), exert potent indirect anti-tumor effects and are currently tested against human solid tumors. The anti-tumor actions of aminobiphosphonates, including angiostasis, are relevant to the pathogenesis of malignant pleural effusion (MPE), but no study has addressed the efficacy of these compounds against malignant pleural disease.
Journal of Nervous & Mental Disease. 196(5):429-431, May 2008
The Epworth sleepiness scale (ESS) is often used clinically to screen for the manifestations of the behavioral morbidity associated to obstructive sleep apnea (OSA). The purpose of this study was to assess the sensitivity of the ESS in the identification of OSA, as defined by an elevated apnea-hypopnea index. A retrospective chart review of 268 consecutive patients diagnosed with OSA at a multidisciplinary sleep medicine clinic was conducted.
Thorax. Published Online First: 3 April 2008. doi:10.1136/thx.2007.088096
OSA is associated with high cardiovascular morbidity and mortality. Randomised controlled trials have shown that on average CPAP treatment of OSA reduces blood pressure by about 3 to 5mmHg, although with considerable inter-individual variation. No predictors of BP change with CPAP have been convincingly identified. This prospective study aimed to determine predictors of BP change, which might provide insight into the aetiology of the raised blood pressure seen in untreated OSA.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.085993
This study examined the effects of inhaled furosemide on the ventilatory and perceptual response to high intensity, constant-load cycle exercise in chronic obstructive pulmonary disease (COPD).
Thorax. Published Online First: 5 June 2008. doi:10.1136/thx.2008.095786
Respiratory failure remains the leading indication for intensive care unit admission and a leading cause of death for HIV-infected patients in spite of overall improvements in ICU mortality. It is unclear if these improvements are due to combination antiretroviral therapy, low tidal-volume ventilation for acute lung injury, or both.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200710-1544OC
Maternal diet during pregnancy has the potential to affect airway development, and to promote Th2-cell responses during fetal life. This might increase the risk of developing childhood asthma or allergy.
Am. J. Respir. Crit. Care Med. 2008, doi:10.1164/rccm.200712-1834OC
Lung transplantation offers the only survival option for cystic fibrosis (CF) patients with end-stage pulmonary disease. Infection with Burkholderia species is typically considered a contraindication to transplantation in CF.
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