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Despite asthma being primarily managed in general practice and primary care, there is little research into the issues and tools which may impact on managing poorly controlled asthma in this setting.
Community-acquired pneumonia (CAP) is the most frequent infection-related cause of death. The reference standard to diagnose CAP is a new infiltrate on chest radiograph in the presence of recently acquired respiratory signs and symptoms. This study aims to evaluate the diagnostic and prognostic accuracy of clinical signs and symptoms and laboratory biomarkers for CAP.
Skeletal muscle depletion is an important complication of chronic obstructive pulmonary disease (COPD) but little prospective data exists about the rate at which it occurs and the factors that promote its development.
Journal of Allergy and Clinical Immunology Volume 119, Issue 2 , February 2007, Pages 344-350
Combination therapy with long-acting β-agonists (LABAs)/inhaled corticosteroids
(ICSs) has become established as effective maintenance treatment for asthma.
Journal of Hypertension. 25(4):779-783, April 2007
Obstructive sleep apnoea (OSA) confers a risk of hypertension and cardiovascular complications. Both the renin-angiotensin-aldosterone system and OSA are important determinants of blood pressure, but it is not fully known how they interact.
The American Journal of Surgery Volume 193, Issue 3 , March 2007, Pages 364-367
Many patients undergoing bariatric surgery have severe comorbidities, including obstructive sleep apnea (OSA). We suspected that sleep apnea was underdiagnosed in our study population.
chronic obstructive pulmonary disease (COPD) prevalence steadily increases with age. However, the effectiveness of inhaled therapy in the elderly COPD population has rarely been formally evaluated.
The American Journal of Cardiology Volume 99, Issue 5 , 1 March 2007, Pages 636-641
Although chronic obstructive pulmonary disease (COPD) is common in patients with myocardial infarction (MI), its association with long-term mortality after MI is controversial and little is known about its influence on patients’ health status (symptoms, function, and quality of life).
To determine the utility and reliability of a respiratory polygraphy (RP) device with actigraphy (Apnoescreen II; Erich Jaeger GMBH & CoKg; Wuerzburg, Germany) in the diagnosis of sleep apnea-hypopnea syndrome (SAHS).
The clinical and physiologic features of respiratory bronchiolitis (RB)-interstitial lung disease (ILD) have been previously described; however, the natural history and outcome have not been systematically evaluated. The majority of published reports consider RB-ILD to be a nonprogressive ILD that clinically improves with smoking cessation and antiinflammatory treatment.
Pulmonary hypertension (PH) is commonly seen in patients with idiopathic pulmonary fibrosis (IPF). We sought to examine the relationship between pulmonary function tests (PFTs), including the percentage of predicted FVC (FVC%), percentage of predicted total lung capacity, percentage of predicted diffusing capacity of the lung for carbon monoxide (DLCO%), the composite physiologic index (CPI), and PH. The ability of FVC%, DLCO%, and FVC%/DLCO% ratio to predict underlying PH was assessed.
Pulmonary hypertension is a common finding in patients with idiopathic pulmonary fibrosis (IPF), and is associated with increased morbidity and mortality. Therapy with sildenafil has been shown to decrease pulmonary vascular resistance in patients with pulmonary fibrosis and may improve functional status. Patients with IPF and documented pulmonary hypertension were followed up in an open-label study of sildenafil.
Over the past decade, advances in the ventilatory management of acute lung injury (ALI) and ARDS have improved outcomes; however, until recently the search for other therapies has been less fruitful. Recently, the Acute Respiratory Distress Syndrome Network Fluid and Catheter Treatment Trial reported that a conservative fluid management strategy, compared with a fluid liberal strategy, increased the mean (± SE) number of ventilator-free days in patients with ALI (14.6 ± 0.5 vs 12.1 ± 0.5 days, respectively; p < 0.001).
Frequent exacerbations are associated with a faster decline in FEV1, impaired health status, and worse survival. Their impact and temporal relationship with other outcomes such as functional status, dyspnea, and the multidimensional body mass index, obstruction, dyspnea, exercise capacity (BODE) index remain unknown.
Percutaneous endoscopic gastrostomy (PEG) is generally used for long-term enteral nutrition. Patients who require PEG placement are often very sick, and postoperative complications, especially aspiration pneumonia, can be fatal.
Clinical Microbiology & Infection, Volume 13, Number 2, February 2007, pp. 172-175(4)
This study investigated 41 infants, aged <4-months, who were hospitalised with symptoms compatible with pertussis. Of these, 16 had Bordetella pertussis infection confirmed by real-time PCR. For four of these 16 patients, the initial sample was PCR-negative, but samples collected 5-7 days after the onset of infection were PCR-positive.
Clinical Pulmonary Medicine. 14(2):82-92, March 2007
In September 2004 the American Thoracic Society released a revised set of guidelines for the clinical diagnosis of nonmalignant asbestos-related disease (Am J Resp Crit Care Med. 2004;170:691-715). The conditions of concern are asbestosis, pleural disorders, and chronic airways obstruction.
To detect dynamic hyperinflation (DH) by evaluating reduction in inspiratory capacity (IC) during metronome-paced hyperventilation (MPH) in patients with moderate-to-severe COPD, studied before and after treatment with tiotropium.
Variability of oxyhemoglobin saturation (SpO2) during sleep has been utilized as a diagnostic index for sleep apnea. Spectral analysis with its graphical presentation, the periodogram, is an approach for measuring such variability. This work examined the parameters on a smoothed periodogram created from series data for SpO2 obtained by pulse oximetry during a sleep study.
To ascertain if analysis of lung density histograms in thin-section CT was more reproducible than visual assessment of lung changes in systemic sclerosis (SSc), and if such density histogram parameters as mean lung attenuation (MLA), skewness, and kurtosis could more closely reflect pulmonary function as well as exercise and quality of life impairment.
Neurally adjusted ventilatory assist (NAVA) is a mode of mechanical ventilation in which the ventilator is controlled by the electrical activity of the diaphragm (EAdi). During maximal inspirations, the pressure delivered can theoretically reach extreme levels that may cause harm to the lungs. The aims of this study were to evaluate whether NAVA could efficiently unload the respiratory muscles during maximal inspiratory efforts, and if a high level of NAVA would suppress EAdi without increasing lung-distending pressures.
Digestive Diseases and Sciences, Volume 52, Number 2, February 2007, pp. 555-557(3)
Pulmonary hypertension and cor pulmonale due to tumor emboli causing pulmonary tumor thrombotic microangiopathy (PTTM) is rare and extremely difficult diagnosis to make prior to death.
Clinical Physiology and Functional Imaging, Volume 27, Number 2, March 2007, pp. 67-90(24)
This review addresses the physiological background and the current status of evidence regarding ventilator-induced lung injury and lung protective strategies. Lung protective ventilatory strategies have been shown to reduce mortality from adult respiratory distress syndrome (ARDS).
Clinical Physiology and Functional Imaging, Volume 27, Number 2, March 2007, pp. 116-121(6)
Dynamic hyperinflation is considered an important mechanism behind shortness of breath and reduced exercise capacity in chronic obstructive pulmonary disease (COPD) patients. Prevailing methods to assess dynamic hyperinflation are crude because of the large normal variation of both functional residual capacity and inspiratory capacity (IC).
Asthma is a heterogeneous disorder characterized by chronic airway inflammation, hyperresponsiveness and remodeling. Being the hallmark of asthma, airway inflammation has become the most important target for therapeutic agents. Consequently, during the past decade various semi-and non-invasive methods have been explored to sample the airway inflammation in asthma.
Community-acquired pneumonia (CAP) is a frequent cause for hospitalization and may result in a number of different renal and electrolyte complications. The purpose of this study was to describe the incidence of hyponatremia in CAP and to analyze risk factors for its occurrence.
Our objectives were (a) to determine which common mental disorders are associated with asthma in the general population after controlling for age and sex, and (b) to assess whether the associations of mental disorders with asthma are consistent across diverse countries.
To determine if thoracoscopic anterior scoliosis correction with instrumentation affected pulmonary function less than open thoracotomy approaches at 2 years follow-up.
Skeletal muscle depletion is an important complication of chronic obstructive pulmonary disease (COPD) but little prospective data exists about the rate at which it occurs and the factors that promote its development. We therefore prospectively investigated the impact of disease severity, exacerbation frequency and treatment with corticosteroids on change in body composition and maximum isometric quadriceps strength (QMVC) over one year.
The resolution of inflammatory responses in the lung has not been described in detail and the role of specific cytokines influencing the resolution process is largely unknown. Methods: The present study was designed to describe the resolution of inflammation from 3 h through 90 d following an acute injury by a single intratracheal instillation of F344/N rats with LPS. We documented the inflammatory cell types and cytokines found in the bronchoalveolar lavage fluid (BALF), and epithelial changes in the axial airway and investigated whether IL-18 may play a role in the resolution process by reducing its levels with anti-IL-18 antibodies.
Exposure to cigarette smoke is considered a major risk factor for the development of lung diseases, since its causative role has been assessed in the induction and maintenance of an inflamed state in the airways. Lung fibroblasts can contribute to these processes, due to their ability to produce proinflammatory chemotactic molecules and extracellular matrix remodelling proteinases.
The interleukin-1 receptor antagonist (IL1RN) is a potent anti-inflammatory cytokine. In the present study, association of the human IL1RN gene polymorphisms with asthma, bronchial hyperresponsiveness and forced expiratory volume in one second/forced vital capacity ratio was tested and the data was stratified by environmental tobacco smoke exposure in order to investigate a gene-smoking interaction.
Critical Care Medicine. 35(1):96-105, January 2007
To evaluate the utility of serial measurements of plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) to detect acute cardiac dysfunction during weaning failure in difficult to wean patients with chronic obstructive pulmonary disease.
The Journal of Heart and Lung Transplantation Volume 25, Issue 12 , December 2006, Pages 1467-1473
High ventilation and perfusion pressures after lung transplantation may have deleterious effects. We hypothesized that using combined protective approaches for ventilation and perfusion would be optimal for reducing injury and improving function after ischemia-reperfusion.
Montelukast and ketotifen are oral anti-allergy medications in asthmatic children. This study investigates the modulation effect of montelukast and ketotifen on children with intermittent to mild persistent asthma as demonstrated by the levels of peak expiratory flow (PEF), asthma scores (AS), exhaled nitric oxide (eNO) and plasma stromal cell-derived factor-1 (SDF-1) concentration in a randomized, prospective study.
Smoking, the most prominent nongenetic factor contributing to mortality, remains the major public health problem throughout the world. There are nearly 1.1 billion users of nicotine and tobacco products worldwide while approximately one third to half of them will die from smoking-related disease.
Capsazepine is known as a transient receptor potential channel vanilloid subfamily 1 (TRPV1) antagonist that inhibits bronchoconstriction evoked in animals by TRPV1 agonists. In this study, effects of capsazepine and chemically related analogues, so called capsazepinoids, were examined in vitro on contractile effects in human small airway preparations.
Journal of Thoracic Imaging. 22(1):49-55, February 2007
The evaluation of patients presenting with chest pain to the emergency department remains a significant challenge. The primary goal is to distinguish clinically insignificant etiologies from life-threatening causes such as myocardial ischemia, aortic dissection, and pulmonary embolism.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 570-576, (2007)
Allelic substitutions in IL4R are associated with asthma exacerbations, lower lung function, and tissue inflammation, in particular to mast cells and IgE.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 577-586, (2007)
To assess the expression of genes involved in oxidative stress responses in the bronchial epithelium of smokers with or without COPD and in relation to disease severity.
Community-acquired pneumonia (CAP) is the most frequent infection-related cause of death. The reference standard to diagnose CAP is a new infiltrate on chest radiograph in the presence of recently acquired respiratory signs and symptoms. This study aims to evaluate the diagnostic and prognostic accuracy of clinical signs and symptoms and laboratory biomarkers for CAP.
We describe the application of an optical flow method to inspiratory and expiratory high-resolution volumetric lung MDCT for the assessment of regional air trapping.
Telemedicine and e-Health Dec 2006, Vol. 12, No. 6 : 698 -701
To develop a simple and portable home screening monitor for sleep-disordered breathing (SDB) in children. In such a system, identifying the respiratory events and occurrences of motional artifacts are two essential elements that can affect the accuracy of the study.
Am J Physiol Lung Cell Mol Physiol 292: L625-L631, 2007
Ischemia-reperfusion not only damages the affected organ but also leads to remote organ injuries. Hepatic inflow interruption usually occurs during hepatic surgery. To investigate the influence of liver ischemia-reperfusion on lung injury and to determine the contribution of tidal volume settings on liver ischemia-reperfusion-induced lung injury, we studied anesthetized and mechanically ventilated rats in which the hepatic inflow was transiently interrupted twice for 15 min.
Most previous studies on the association between moisture damage and asthma have been cross-sectional and relied on self-reported exposure and health. The present authors studied the association by carrying out careful home inspections among new, clinically determined cases of asthma and controls.
Increase in pulmonary artery pressure (PAP), which is common in severe chronic obstructive pulmonary disease (COPD), is a predictor of mortality independent of airflow limitation.
Acute lung injury (ALI) and its presentation with more severe hypoxemia, the ARDS, is a challenging entity for clinical investigation because, like many critical illness syndromes, it lacks an accepted diagnostic test and relies on a constellation of clinical findings for diagnosis.
Am J Physiol Lung Cell Mol Physiol 292: L788-L798, 2007
Human lung fibroblasts express proteinase-activated receptor-1 (PAR1), PAR2 and PAR3, but not PAR4. Because PAR2 has inflammatory effects on human primary bronchial fibroblasts (HPBF), we asked 1) whether the inflammatory mediators TNFa- and LPS could modify HPBF PAR expression and 2) whether modified PAR expression altered HPBF responsiveness to PAR agonists in terms of calcium signaling and cell growth.
Chloroquine and hydroxychloroquine (HCQ) are commonly prescribed antimalarial agents used for a variety of systemic diseases. HCQ neuromyotoxicity is a rare complication characterized by proximal muscle weakness, normal creatinine kinase levels, and characteristic ultrastructural changes on muscle biopsy of curvilinear body formation.
Churg-Strauss syndrome (CSS) is an uncommon systemic vasculitis with an increase in the number of eosinophils in the peripheral blood and tissues. Its pathogenesis is unknown, and there is no evidence that genetic factors influence susceptibility to this disease.
Castleman disease (CD) is an uncommon benign lymphoid hyperplasia with several clinical and morphologic variants associated with distinct outcomes. Pulmonary CD has been reported as a rare extranodal manifestation in the literature. However, CD presenting as an obstructive mass in the airway has not been documented.
ANZ Journal of Surgery, Volume 77, Number 3, March 2007, pp. 135-141(7)
Pulmonary complications are the most frequent cause of postoperative morbidity and mortality in upper abdominal surgery (UAS). We aimed to examine the influence of possible preoperative, operative and postoperative risk factors on the development of early postoperative pulmonary complications (POPC) after UAS.
Respiratory infection with the neurovirulent vaccinia virus (VV) strain Western Reserve (WR) results in an acute infection of the lung followed by dissemination of the virus to other organs and causes lethality in mice. The mechanisms of lethality are not well-understood. In this study, we analyzed virus replication and host immune responses after intranasal infection with lethal and non-lethal doses of VV using the WR strain and the less virulent Wyeth strain.
Lung ultrasound can be routinely performed at the bedside by intensive care unit physicians and may provide accurate information on lung status with diagnostic and therapeutic relevance. This article reviews the performance of bedside lung ultrasound for diagnosing pleural effusion, pneumothorax, alveolar-interstitial syndrome, lung consolidation, pulmonary abscess and lung recruitment/derecruitment in critically ill patients with acute lung injury.
The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 3, March 2007, pp. 251-257(7)
This review critically evaluates the recent scientific literature relevant to occupational risk factors for chronic obstructive pulmonary disease (COPD) and chronic bronchitis. The 2003 American Thoracic Society statement on the occupational contribution to the burden of airway disease synthesized relevant data on this topic through 1999.
Inhaled corticosteroids (ICS) and long-acting B-agonists (LABA) are currently used in the management of asthma and chronic obstructive pulmonary disease (COPD). Localized targeted delivery of these drugs into the lungs is achieved by means of two types of inhalation devices; pressurized metered-dose inhalers (pMDIs) and dry powder-inhalers (DPIs).
There is growing epidemiological evidence that short-term and long-term exposure to high levels of air pollution may increase cardiovascular morbidity and mortality. In addition, epidemiological studies have shown an association between air pollution exposure and respiratory health.
Asthmatics treated with long-acting beta-agonists have a reduced bronchodilator response to moderate doses of short acting beta-agonists during acute bronchoconstriction. It is unknown if the response to high doses of beta-agonists or other bronchodilators is impaired.
Acute exposure to chlorine (Cl2) gas causes epithelial injury and airway dysfunction. Gamma delta T cells are present in the mucosal surface of the airways and may contribute to the injury/repair response of the epithelium.
Several studies have indicated that one of the most potent mediators involved in pulmonary vascular remodeling is vascular endothelial growth factor (VEGF). This study was designed to determine whether airway VEGF level reflects pulmonary vascular remodeling in patients with bronchitis-type of COPD.
We had shown that COPD women expressed more dyspnea than men for the same degree of airway obstruction. Objectives: Evaluate gender differences in respiratory factors associated with dyspnea in COPD patients.
The Annals of Pharmacotherapy: Vol. 41, No. 2, pp. 216-221
To determine whether a computer-based tutorial on inhaler technique could improve patients' knowledge and ability to correctly demonstrate inhaler technique.
We report a rare case of airway erosion resulting from the migration of an epicardial defibrillator patch. The patient is a middle age gentleman who had multiple implantable cardiac defibrillators placed for management of ventricular arrhythmias secondary to nonischemic cardiomyopathy.
Fungal lung abscesses are rare but life threatening, especially in immunocompromised patients. We describe a case of a fungal hilar abscess resulting from invasive pulmonary aspergillosis. Endoscopic drainage was performed which resulted in clinical improvement.
Annals of Allergy, Asthma and Immunology, Volume 98, Supplement 2, February 2007, pp. 7-15(9)
Inhaled corticosteroids (ICSs) continue to be the cornerstone of treatment for asthma, and a number of ICSs are currently available, with others in the latter stages of development. The degree of pulmonary targeting and selectivity achieved by inhalation therapy depends on a number of pharmacokinetic and pharmacodynamic (PK/PD) properties, which vary for each drug, and on the efficiency of the inhalation device used for delivery.
Pulmonary arterial hypertension (PAH) is a disease of the small vessels in which there is a substantial increase in pulmonary vascular resistance leading to right ventricle failure and death. Invasive haemodynamic evaluation is mandatory not only for diagnosis confirmation but also to address prognosis and eligibility for the use of calcium-channel blockers through an acute vasodilator challenge. Noninvasive surrogate response markers to the acute vasodilator test have been sought.
Exhaled breath condensate (EBC) pH is considered to reflect the acid-base balance of the airways. Current pH measurements do not take into account the effect of CO2. The aim of the present study was to determine the effect of condensate CO2 partial pressure on pH and to provide a more precise mode of EBC pH determination.
Self-management programmes for chronic disease are a high priority for healthcare providers. The content and method of delivery of self-management should give consideration to the specific requirements of the disease population. The aims of the present study were to assess the physical and psychosocial impact of bronchiectasis, to determine whether patients with bronchiectasis are receptive to self-management and to identify any obstacles or sources of support for a disease-specific self-management programme.
Respiratory Medicine Volume 101, Issue 3 , March 2007, Pages 595-600
The aim of the study was to evaluate the quality of asthma-related referral letters at the launch of the Asthma Programme in 1994 and 7 years later in 2001.
Respiratory Medicine Volume 101, Issue 3 , March 2007, Pages 531-538
To study the relationship between respiratory/allergic disorders and chronic environmental tobacco smoke (ETS) exposure to husband or at workplace among non-smoking women of a general population in Italy.
Injury Volume 38, Issue 1 , January 2007, Pages 27-33
Obtaining a patent airway can be difficult in patients with traumatic airway injuries (TAI). There is a paucity of data available about the incidence of airway compromise and techniques used in these patients.
Respiratory Medicine Volume 101, Issue 3 , March 2007, Pages 510-515
The value of elevated serum angiotensin-converting enzyme (ACE) activity in the diagnosis and follow-up in sarcoidosis is a matter of ongoing debate. This may be at least related to the insertion (I)/deletion (D) polymorphism in the ACE gene (ACE I/D). ACE activity is influenced by the ACE I/D polymorphism. As a consequence, the use of one reference interval instead of three genotype-specific reference intervals for ACE activity may lead to a less precise interpretation of ACE activity.
Upper airway obstruction secondary to a carotid mycotic aneurysm has not been previously reported. We describe a patient with a mycotic aneurysm associated with a deep neck infection and presenting with acute tracheal obstruction.
We present an extremely rare case of extralobar pulmonary sequestration in the right upper thoracic region, with a wide tracheal communication and a right subclavian arterial blood supply.
Airway remodelling refers to changes in the airway structure and includes subepithelial fibrosis, increased smooth muscle mass, submucosal gland enlargement, neovascularisation and epithelial alterations. Remodelling is observed in response to chronic injury and is seen not only in asthma but in all airway diseases.
Indacaterol is a novel B2-adrenoceptor agonist in development for the once-daily treatment of asthma and chronic obstructive pulmonary disease. The present study evaluated the relaxant effect of indacaterol on isolated human bronchi obtained from lungs of patients undergoing surgery for lung carcinoma.
Clinical trials have recently demonstrated that using a budesonide/formoterol combination inhaler as regular maintenance treatment twice daily but also as a rescue therapy for breakthrough symptoms can provide more effective control of asthma, particularly in reducing exacerbations, than using a short-acting B2-agonist or formoterol as rescue therapy.
The intrapulmonary renin' angiotensin system via tissue concentration of angiotensin II or bradykinin may have multiple effects on pulmonary pathophysiology. Therefore, it was investigated whether the presence of the D allele of the angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism or the A allele of angiotensinogen (AGT) promoter polymorphism (-6)A/G are independent risk factors for 30-day survival in acute respiratory distress syndrome (ARDS) patients.
The aim of the present study was to examine the genetic and environmental contributions to the individual differences in susceptibility to asthma, eczema and rhinitis in childhood and their role in the association among these conditions.
We investigated the pathogenic roles of CC chemokine ligand (CCL)3 and its receptors, CC chemokine receptor (CCR)1 and CCR5, in bleomycin (BLM)-induced pulmonary fibrosis (PF). An intratracheal injection of BLM into wild-type (WT) mice caused a massive infiltration of granulocytes and macrophages, followed by the development of diffuse PF with fibrocyte accumulation.
Respirology, Volume 12, Number 2, March 2007, pp. 220-226(7)
Reattendance rates at hospitals and emergency departments (ED) can provide a valuable marker of the quality and effectiveness of clinical care. Linked hospital and ED data from New South Wales and Victoria, Australia, were used to examine reattendances for asthma.
Respirology, Volume 12, Number 2, March 2007, pp. 212-219(8)
Asthma is a high-burden disease for which effective treatment is available. In Australia, there has been a public health campaign directed at increasing the implementation of effective management with the aim of improving asthma outcomes. The aim of this study was to assess the burden of asthma and describe current asthma management in Australia.
To retrospectively determine whether three computed tomographic (CT) findings ventricular septal bowing (VSB), ratio between the diameters of right ventricle (RV) and left ventricle (LV), and embolic burden are associated with short-term death, defined as in-hospital death or death within 30 days of CT, whichever was longer, due to acute pulmonary embolism (PE).
Allergy and Asthma Proceedings, Volume 28, Number 1, January-February 2007, pp. 25-27(3)
Hypersensitivity pneumonitis (HP) appears to be an underdiagnosed condition. It may masquerade as recurrent pneumonia, idiopathic pulmonary fibrosis, Haman-Rich disease, or interstitial pneumonitis.
Allergy and Asthma Proceedings, Volume 28, Number 1, January-February 2007, pp. 28-34(7)
New emerging infectious diseases include "severe acute respiratory distress syndrome" (SARS) and avian influenza A H5N1. First cases of SARS, induced by a new strain of coronavirus, were described in China in 2002 and by May 2003 8360 cases and 764 deaths were reported by the World Health Organization.
Chronic obstructive pulmonary disease (COPD) exacerbations are associated with increased airway and systemic inflammation, though relationships between exacerbation recovery, recurrent exacerbation and inflammation have not been previously reported. In the present study, inflammatory changes at COPD exacerbations were related to clinical nonrecovery and recurrent exacerbations within 50 days.
The aim of the present study was to elucidate whether the culture of cells recovered from induced sputum may represent a suitable model to evaluate cytokine and chemokine production by airway inflammatory cells.
The comparative effectiveness and safety of carbapenems with other B-lactams and fluoroquinolones for the empirical treatment of patients with hospital-acquired pneumonia remains controversial.
Digestive Diseases and Sciences, Volume 52, Number 2, February 2007, pp. 329-335(7)
We conducted a study to examine the relation of asthma and its treatment to irritable bowel syndrome (IBS). We identified cohorts of members with and without asthma from January 1996 though June 2002 and calculated rates of IBS in both cohorts.
Transient interruption of the contrast bolus has been described as a physiologic artifact that can sometimes result in poor opacification of the pulmonary arteries on pulmonary CT angiographic studies. To better understand the mechanism underlying this artifact, we used velocity-encoded cine MRI to measure flow in the inferior vena cava (IVC) and superior vena cava (SVC) during respiratory maneuvers.
Allergy and Asthma Proceedings, Volume 28, Number 1, January-February 2007, pp. 58-63(6)
This study was undertaken to investigate the association of Chlamydophila pneumoniae infection (CPI) with asthma and allergy. One hundred forty-one patients with asthma aged 3-21 years, 125 healthy controls aged 3-21 years, and 62 allergic but nonasthmatic patients aged 4-20 years participated in this study. C. pneumoniae-specific antibodies were measured by ELISA.
New England Journal of Medicine Volume 356:775-789 February 22, 2007 Number 8
Long-acting beta-agonists and inhaled corticosteroids are used to treat chronic obstructive pulmonary disease (COPD), but their effect on survival is unknown.
Sleep Medicine Volume 8, Issue 2 , March 2007, Pages 149-155
Autonomic dysfunction has been theorized to be responsible for the increased risk of cardiovascular disease in obstructive sleep apnea (OSA). Previous studies did not control for the presence of impaired glucose regulation (IGR, comprising impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes) which is also associated with abnormalities in autonomic function.
Sleep Medicine Volume 8, Issue 2 , March 2007, Pages 135-143
The pressures generated within the upper esophageal sphincter (PUES) and lower esophageal sphincter (PLES) reflect the integrity of these barriers to gastroesophageal and pharyngoesophageal reflux, respectively. This study sought to describe the effects of sleep, respiration and posture on the function of the UES and the LES and the pressure differentials developed across them.
Mast cell-derived prostaglandin D2 (PGD2), may contribute to eosinophilic inflammation and mucus production in allergic asthma. Chemoattractant receptor homologous molecule expressed on TH2 cells (CRTH2), a high affinity receptor for prostaglandin D2, mediates trafficking of TH2-cells, mast cells, and eosinophils to inflammatory sites, and has recently attracted interest as target for treatment of allergic airway diseases.
Respirology, Volume 12, Number 2, March 2007, pp. 283-287(5)
Acute exacerbations of COPD (AECOPD) are commonly observed in community-based patients worldwide. The factors causing exacerbation are largely unknown. This study was undertaken to determine the predominant bacterial pathogens cultured from sputum in community-based patients with AECOPD, to assess the risk factors associated with exacerbations and to compare these findings with published studies.
The association between body mass index (BMI) and outcomes in critically ill patients is unclear. Our objective was to determine the association between BMI and outcomes in a population-based cohort of patients with acute lung injury (ALI).
Central sleep apnea (CSA) is characterized by a lack of drive to breathe during sleep, resulting in repetitive periods of insufficient ventilation and compromised gas exchange. These nighttime breathing disturbances can lead to important comorbidity and increased risk of adverse cardiovascular outcomes.
Pulmonary arterial hypertension of variable degree is commonly associated with adult congenital heart disease. Depending on size and location of the underlying cardiac defect as well as on repair status, pulmonary arterial hypertension may present with or without reversed shunting and associated cyanosis (ie, Eisenmenger syndrome).
European Journal of Pediatrics, Volume 166, Number 2, February 2007, pp. 185-186(2)
The duration of fervescence (24 hours in children or 30 hours in adults) was shorter in the oseltamivir group than in the placebo group. According to a Japanese law enacted before oseltamivir therapy became available, schoolchildren with influenza must be isolated 48 hours after defervescence.
Current Respiratory Medicine Reviews, Volume 3, Number 1, February 2007, pp. 49-51(3)
The expression of Panton-Valentine leukocidin (PVL) has been implicated as a virulence factor for communityacquired Staphylococcus aureus pneumonia with most reported cases involving methicillin-resistant strains.
Toxic, nonallergic reactions to lidocaine and other local anesthetics are marked by high serum concentrations that cause central nervous system (CNS) or cardiovascular system toxic effects. Excessive blood concentrations can result from direct intravascular injection or from injection of an excessive dose into the correct tissue space with subsequent vascular absorption.
Sleep Medicine Volume 8, Issue 2 , March 2007, Pages 169-175
The etiology of obstructive sleep apnea (OSA) is multifactorial, consisting of a complex interplay between anatomic and neuromuscular factors and an underlying genetic predisposition toward this disease.
Urology Volume 69, Issue 2 , February 2007, Pages 384.e1-384.e3
A percutaneous approach to cryoablation of renal masses is not without a risk of complications. We describe a case in which selective, single lung intubation of an obese patient with an upper pole left renal mass allowed for percutaneous cryoablation with avoidance of pleural and pulmonary injury. We accomplished this by minimizing the ventilation-induced renal motion and collapsing the ipsilateral lung so that it remained out of harm's way.
Current Respiratory Medicine Reviews, Volume 3, Number 1, February 2007, pp. 53-56(4)
We report a case of extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT) that presented as multiple pulmonary nodules and masses.
Current Respiratory Medicine Reviews, Volume 3, Number 1, February 2007, pp. 3-6(4)
The observation that non-chemically mediated respiratory load compensation is dependent on a state of wakefulness suggested that the perception of the load or the conscious appreciation of the ventilatory consequences of the loading is required for respiratory motor output to increase.
Journal of the American Society of Echocardiography Volume 20, Issue 2 , February 2007, Pages 198.e6-198.e10
We present right ventricular tissue Doppler findings in a 41-year-old man with pelvic fracture who had a near-fatal pulmonary embolus. We found small early systolic lengthening and reduced delayed systolic shortening using strain and strain rate imaging. There were also delayed and fused diastolic waves. Normal systolic tricuspid annular velocities were absent and there was only one late tricuspid annular ascent velocity. Strain, strain rate, and tricuspid annular velocities were normalized early after surgical embolectomy.
Several studies have implicated the role of inflammation in the pathogenesis of lung damage in idiopathic interstitial pneumonias (IIPs). Investigations of inflammatory cells in IIP have show that eosinophils, neutrophils and T cells may be associated with a poorer prognosis.
Rapid influenza testing decreases antibiotic and ancillary test use in febrile children, yet its effect on the care of hospitalized adults is unexplored. We compared the clinical management of patients with influenza whose rapid antigen test result was positive (Ag+) with the management of those whose rapid antigen test result was negative or the test was not performed (Ag0).
Sleep Medicine Reviews Volume 11, Issue 1 , February 2007, Pages 35-46
Opioid use whether acute or chronic, illicit or therapeutic is prevalent in Western societies. Opioid receptors are located in the same nuclei that are active in sleep regulation and opioid peptides are suggested to be involved in the induction and maintenance of the sleep state.
Smoking is the leading cause of preventable death worldwide. Hundreds of millions of individuals still smoke, affecting their health as well as that of their peers, family and offspring. Smoking is a well-established prime risk factor for chronic obstructive pulmonary disease and hampers the response to treatment in asthma and chronic obstructive pulmonary disease.
High-resolution computed tomography (HRCT) findings in patients with respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) are varied and nonspecific. There is no known report of changes in HRCT findings and respiratory function test results for RB-ILD patients following the cessation of smoking.
Combination therapy has been recommended for the treatment of pulmonary arterial hypertension (PAH). However, there is scant information on combination therapy after failure of monotherapy, particularly in patients with scleroderma-associated PAH (PAH-SSD).
The 6-min walking distance (6MWD) test is used in clinical practice and research into patients with chronic obstructive pulmonary disease (COPD). However, little is known about natural long-term change in this parameter.
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