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American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1276-1284, (2008)
Our previous studies found that Na+/H+ exchanger (NHE) activity played an essential role in pulmonary artery smooth muscle cell (PASMC) proliferation and in the development of hypoxia-induced pulmonary hypertension and vascular remodeling.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 738-743, 2008
Post-translational sulfation of tyrosines affects the affinity and binding of at least some chemokine receptors to their ligand(s) and has been hypothesized to be a feature in all chemokine receptors. This binding initiates downstream signaling cascades.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 744-749, 2008
The initial bronchoconstrictor response of the asthmatic airway depends on airway smooth muscle (ASM) contraction. Intracellular calcium is a key signaling molecule, mediating a number of responses, including proliferation, gene expression, and contraction of ASM. Ca2+ influx through receptor-operated calcium (ROC) or store-operated calcium (SOC) channels is believed to mediate longer term signals.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 750-758, 2008
The transcription factor (TF) Foxp2 has been shown to partially repress surfactant protein C (SP-C) transcription, presumably through interaction of an independent repressor domain with a conserved Foxp2 consensus site in the SP-C promoter.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 715-723, 2008
The dissociation of iron from heme is a major factor in iron metabolism and the cellular concentrations of the metal correlate with heme degradation. We tested the hypotheses that (1) exposure to a product of heme catabolism, carbon monoxide (CO), alters iron homeostasis in the lung and in cultured respiratory epithelial cells; (2) this response includes both decreased uptake and increased release of cell metal; and (3) the effects of CO on cell function track changes in metal homeostasis.
In their review of airway hygiene, Jelic and colleagues highlighted that colonization or infection of the upper airway precedes the development of ventilator-associated pneumonia.
Clinical Pulmonary Medicine. 15(3):161-166, May 2008
Pulmonary arterial hypertension is an increasingly recognized condition that occurs sporadically or in association with various diseases. Currently, 6 Food and Drug Administration-approved therapies for this pulmonary vascular disease exist. Patients with pulmonary arterial hypertension can develop right ventricular failure as a result of the natural history of this condition or from an intercurrent illness.
Clinical Pulmonary Medicine. 15(3):182-183, May 2008
In patients from the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) study, the presence of enlargement of the right ventricle (RV) without hemodynamic shock or respiratory failure was not associated with an increased risk of death.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1262-1267, (2008)
The relative contribution of body proportion and social exposures to ethnic differences in lung function has not previously been reported in the United Kingdom.
Clinical Pulmonary Medicine. 15(3):167-172, May 2008
Lung infections continue to represent a significant burden to the healthcare system and improved antibiotic therapy may serve as a means to improve patient outcomes. Time-dependent antibiotics such as [beta]-lactams and glycopeptides are commonly used as therapy for lung infections, and the emerging data suggest that administration by continuous infusion may result in improved patient outcomes.
Clinical Pulmonary Medicine. 15(3):177-180, May 2008
Patients with cardiac disease are described as high risk for complications, including death, when performing flexible bronchoscopy. Practitioners may, therefore, be reluctant to offer this procedure based on this perceived risk. We review the literature regarding the safety of bronchoscopy in adult patients with cardiac disease.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1248-1254, (2008)
In interstitial lung disease complicating systemic sclerosis (SSc-ILD), the optimal prognostic use of baseline pulmonary function tests (PFTs) and high-resolution computed tomography (HRCT) is uncertain.
Clinical Pulmonary Medicine. 15(3):185-188, May 2008
Pulmonary Kaposi sarcoma (KS) is a potentially fatal complication of AIDS/HIV infection. With the development of highly active antiretroviral therapy (HAART), the morbidity and mortality associated with AIDS/HIV have decreased significantly. However, a small number of patients started on HAART develop a severe inflammatory response to preexisting pathogens or antigens, known as immune reconstitution inflammatory syndrome.
Clinical Pulmonary Medicine. 15(3):181-182, May 2008
Use of bosentan in patients with idiopathic pulmonary fibrosis demonstrated no improvement in exercise tolerance; however, there was a suggestion of delayed time to death or disease progression.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1242-1247, (2008)
Survivors of hospitalization for community-acquired pneumonia (CAP) are at increased risk of cardiovascular events, repeat infections, and death in the following months but the cause is unknown.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1268-1275, (2008)
Circulating microparticles (MPs) are submicron membrane fragments shed from damaged or activated vascular cells. Endothelial MPs are a biological marker of dysfunctional endothelium. Vascular remodeling and endothelial dysfunction are involved in pulmonary hypertension (PH).
Clinical Pulmonary Medicine. 15(3):173-176, May 2008
Actinomycosis is an old disease, which was first described in the 19th century; it is one of the most misdiagnosed diseases, even among experienced clinicians. Actinomycosis is a chronic, suppurative granulomatous infection, which is usually caused by Actinomyces israelii. The pulmonary form is slowly progressive, showing nonspecific symptoms at the initial presentation.
Clinical Pulmonary Medicine. 15(3):183-184, May 2008
Low-dose hydrocortisone therapy does not decrease mortality in patients who did or did not have a response to corticotropin, which is a reversal of previous study outcomes. Hydrocortisone does reverse shock faster but there may be an associated increase in secondary infections.
Sarcoidosis is a multisystemic granulomatous disorder of unknown etiology. The unpredictable clinical course of the disease has prompted research into biomarkers useful for predicting outcome.
Severe endobronchial papillomatosis is associated with recurrent respiratory infections and airway obstruction. Current management includes treatment with antiviral and cytotoxic agents to slow papilloma growth and endobronchial therapies to excise the lesions.
Beta lactam antibiotics were very effective against Streptococcus pneumoniae. However, resistance to this class of antibiotics has become an increasing problem. Reports of penicillin resistant and multidrug resistant strains are being made in many parts of the world.
The European Journal of Health Economics 1618-7598 (Print) 10.1007/s10198-008-0098-1
In Germany the heptavalent pneumococcal conjugate vaccine (PCV7) has been recommended as a general infant vaccination since 2006. Data from similar programmes in the USA have reported a reduction of pneumococcal diseases in both vaccinated and unvaccinated populations, suggesting herd immunity effects.
In a case series of 152 children aged from 2 to 132 months will pleural emphema from a paediatric tertiary hospital in Luanda, Angola between September 2004 and March 2005, the authors found a high prevalence of anaemia and malnutrition.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 707-714, 2008
Lung fibroblasts are a major source of several cytokines including CC chemokine eotaxin. We aimed to study the regulation of eotaxin-1/CCL11 production by dexamethasone and analyze its molecular mechanisms in human lung fibroblasts.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 679-688, 2008
This is the first report to describe a role for Lung Kruppel-like Factor (LKLF or KLF2) in inflammatory airways diseases. In the present study, we identify that LKLF is constitutively expressed in the small airways of normal lungs; however, its expression disappears in severe airway diseases, such as cystic fibrosis (CF) and chronic obstructive pulmonary disease.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1194-1200, (2008)
Independent replication of genetic associations in complex diseases, particularly in whole-genome association studies, is critical to confirm the association.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1180-1186, (2008)
Dendritic cells (DCs) are professional antigen-presenting cells responsible for immune homeostasis. In the lung's responses to tissue damage or infection, they initiate and orchestrate innate and adaptive immunity. There are immature and mature states and at least three phenotypic and functional subsets.
Acute lung injury (ALI), including its more severe subcategory, acute respiratory distress syndrome (ARDS), is a critical illness associated with considerable morbidity and mortality.
To examine the association of changes in current negative mood and long-term daily hassles with changes in lung function and airway inflammation in patients suffering from asthma and in healthy controls. Associations between psychological factors and asthma symptoms have been documented, but the relationship between airway inflammation and psychological factors has been largely unexplored.
Journal of Medical Systems Volume 32, Number 3 / June, 2008 243-250
In this paper, we have compared the classifier algorithms including C4.5 decision tree, le artificial neural network (ANN), artificial immune recognition system (AIRS), and adaptive neuro-fuzzy inference system (ANFIS) in the diagnosis of obstructive sleep apnea syndrome (OSAS), which is an important disease that affects both the right and the left cardiac ventricle.
Diabetes, Obesity and Metabolism Volume 10 Issue 6 Page 468-475, June 2008
To determine the association between sleep-disordered breathing (SDB) and obesity, diabetes and glucose intolerance among middle-aged men and women in Finland.
The purpose of this study is to evaluate the correlation of the perfusion parameters of 3-dimensional, contrast-enhanced magnetic resonance (MR) imaging (3D CEMRI) with pulmonary function test (PFT) and quantitative computed tomography (CT) parameters in patients with chronic obstructive pulmonary disease (COPD).
The clinical feasibility of oxygen-enhanced magnetic resonance imaging (MRI) of the lung may benefit from the use of a simple gas delivery method. In this study, the oxygen-induced T1 change of the lung obtained using a closed O2 delivery system was compared with that obtained by a conventional nontight face mask.
To assess susceptibility related signal decay in lung tissue and to measure the influence of body positioning, together with inspiration and expiration, as well as oxygen inhalation. T2* maps and line shape maps of lung parenchyma were derived from datasets acquired at 0.2 T and compared with findings at 1.5 T. The line shape maps allow for a visualization of the intravoxel frequency distribution of lung parenchyma.
To prospectively determine whether the regional distribution of air trapping in patients with suspected or overt bronchiolitis is heterogeneous, and to determine the effect that a simulated reduction of computed tomographic (CT) sections and of scanned anatomic regions would have on the assessment of the extent of air trapping.
Congenital lung anomalies vary widely in their clinical manifestation and imaging appearance. Although radiographs play a role in the incidental detection and initial imaging evaluation in patients with clinical suspicion of congenital lung anomalies, cross-sectional imaging such as computer tomography (CT) is frequently required for confirmation of diagnosis, further characterization, and preoperative evaluation in the case of surgical lesions.
To retrospectively evaluate effectiveness, follow-up imaging features, and safety of microwave ablation in 50 patients with intraparenchymal pulmonary malignancies.
To prospectively determine management strategies used by international thoracic radiologists in evaluation of small (3–5-mm) pulmonary nodules at chest computed tomography (CT).
To prospectively evaluate (a) the diagnostic performance of D-dimer assay for pulmonary embolism (PE) in an oncologic population by using computed tomographic (CT) pulmonary angiography as the reference standard, (b) the association between PE location and assay sensitivity, and (c) the association between assay results and clinical factors that raise suspicion of PE.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1215-1222, (2008)
In a clinical trial by the Acute Respiratory Distress Syndrome Network (ARDSNet), mechanical ventilation with tidal volumes of 6 ml/kg decreased mortality from acute lung injury. However, interpretations of these results generated controversy and it was unclear if this trial would change usual-care practices.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1223-1232, (2008)
Ventilator-induced lung injury (VILI) leads to an unacceptably high mortality. In this regard, the antiinflammatory properties of inhaled carbon monoxide (CO) may provide a therapeutic option.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1201-1206, (2008)
Computed tomography (CT) has been shown to reliably measure the airway wall dimensions of medium to large airways. Optical coherence tomography (OCT) is a promising new micron-scale resolution imaging technique that can image small airways 2 mm in diameter or less.
To develop a system for texture-based quantification of emphysema on high-resolution computed tomography (HRCT) and to compare it with density-based quantification in correlation with pulmonary function test (PFT).
Dynamic ventilation 3He-MRI is a new method to assess pulmonary gas inflow. As differing airway diameters throughout the ventilatory cycle can influence gas inflow this study intends to investigate the influence of volume and timing of a 3He gas bolus with respect to the beginning of the tidal volume on inspiratory gas distribution.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0188-4
Obstructive sleep apnea syndrome (OSAS) is characterized by repeated cessations of breathing during sleep. Major symptoms of this disease are excessive daytime sleepiness, snoring, and witnessed apnea.
Lung transplantation is an important option to treat patients with advanced Cystic Fibrosis (CF) lung disease. We report the outcomes of a large UK cohort of CF lung transplantation recipients.
Migraine is a common neurological disorder with a great impact on the quality of life and social activities. Pulmonary arteriovenous malformations (PAVMs) are mostly congenital, with a prevalence of 5-50% in patients with hereditary hemorrhagic telangiectasia (HHT).
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.
Clinical Pulmonary Medicine. 15(3):153-160, May 2008
Receiving care in an intensive care unit (ICU) can greatly influence patients' survival and quality of life. The benefit achieved in terms of improved survival rates is particularly attributed to the favorable changes in supportive care made over the past decades. The improved acute phase survival, however, was associated with a growing number of long-term ICU residents at high risk for infection, especially when orally intubated.
Clinical Pulmonary Medicine. 15(3):138-144, May 2008
Exposure to microbial aerosols from indoor hot tubs and therapy pools can cause granulomatous lung disease. However, the clinical presentation, causative antigen, and factors affecting outcome remain poorly understood.
Clinical Pulmonary Medicine. 15(3):132-137, May 2008
Detection of herpes simplex virus (HSV) in the upper and lower respiratory tracts has been well described. In the throat, the viral reactivation is probably because of the immunoparalysis observed in such patients and/or as a result of microtrauma.
Clinical Pulmonary Medicine. 15(3):127-131, May 2008
Chronic obstructive pulmonary disease (COPD) remains a major cause of morbidity in the Western world. Patients with COPD are prone to acute exacerbation that may cause a substantial decline in functional status, hospitalization, and even death.
COPD is characterised by loss of alveolar elastic fibers and by lack of effective repair. Elastic fibers are assembled at cell surfaces by elastin binding protein (EBP), a molecular chaperone whose function can be reversibility inhibited by chondroitin sulphate of matrix proteoglycans such as versican.
Active smoking increases asthma severity and is related to diminished treatment efficacy. Animal models in which inhalation of both allergen and mainstream cigarette smoke are combined can help us to understand the complex interaction between both agents. We have recently shown that, in allergic mice, the airway inflammation can be cleared by repeated allergen challenge, resulting in the establishment of a state of inhalational tolerance.
Sleep Medicine Volume 9, Issue 3, Pages 273-282 (March 2008)
The neurotensin gene (NTS), a known dopamine modulator, is located within the candidate region for the first genetic locus of restless legs syndrome (RLS1) on chromosome 12q. Though no causative mutation was found in selected patients in a previous mutation analysis, the involvement of NTS in RLS cannot be completely excluded as a potential positional and functional candidate gene.
Sleep medicine Volume 9, Issue 3, Pages 283-289 (March 2008)
Because the diagnosis of restless legs syndrome (RLS) depends on clinical features ascertained by interview, it is important to have structured diagnostic instruments that can guide a diagnostician to an accurate diagnosis.
Sleep Medicine Volume 9, Issue 3, Pages 290-296 (March 2008)
Risk factors and correlates of snoring and observed apnea in the population are not well known. This study aimed to assess risk factors and correlates of snoring and observed apnea.
Sleep Medicine Volume 9, Issue 3, Pages 260-265 (March 2008)
Although several studies have reported an association between obstructive sleep apnea (OSA) and the chromosomal region containing the Apolipoprotein E (ApoE) gene, findings about the exact location in the ApoE gene have been inconsistent.
Sleep Medicine Volume 9, Issue 3, Pages 254-259 (March 2008)
Obstructive sleep apnea (OSA) has been associated with increased systemic inflammatory responses that may contribute to an increased risk for end-organ morbidity. The changes in levels of pro-inflammatory cytokine IL-6 , and the anti-inflammatory cytokine IL-10, both of which play a major role in atherogenesis, a major consequence of OSA, have not specifically been assessed in pediatric patients.
Sleep Medicine Volume 9, Issue 3, Pages 247-253 (March 2008)
Sleep apnea syndrome is an important risk factor for atherosclerosis and cardiovascular morbidity and so is cigarette smoking. In both atherosclerosis and cardiovascular disease, oxidative stress and inflammation have been implicated as underlying pathophysiologic mechanisms. We investigated oxidative stress and inflammatory markers in 70 non-smoking and smoking patients with sleep apnea.
Sleep Medicine Volume 9, Issue 3, Pages 228-239 (March 2008)
In a pilot placebo-controlled study, low dosages of 0.5-2mg/24h rotigotine showed a dose-dependent beneficial effect in restless legs syndrome (RLS) patients.
Sleep Medicine Volume 9, Issue 3, Pages 221-227 (March 2008)
There was an independent association between abnormal sleeping times and type 2 diabetes in middle-aged women. Even after adjustments for age, body mass index, sleep apnea probability, smoking, physical activity, and central nervous system-affecting medication, sleep duration of 6h or less or 8h or longer was independently associated with type 2 diabetes. There was no increase in the prevalence of diabetes in middle-aged men with abnormal sleeping times.
Many authors have hypothesized that inhaled nitric oxide (iNO) might acutely improve oxygenation in preterm neonates with infant respiratory distress syndrome (iRDS) and decrease the risk of bronchopulmonary dysplasia.
Clinical & Experimental Allergy, Volume 38, Number 4, April 2008 , pp. 594-601(8)
IL-13 plays a key regulatory role in asthmatic responses and immunity to parasitic infection. In vivo, IL-13R-a2 is a critical modulator of IL-13 bioactivity. When inducibly expressed on the surface of fibroblasts and other cell types under inflammatory conditions, IL-13R-a2 contributes to resolution of IL-13 responses.
Lung transplantation is the treatment option for a variety of end-stage pulmonary diseases. Posttransplant development of Abs against donor HLA and non-HLA Ags have been associated with acute and chronic rejection of transplanted organs.
The purpose of our study was to evaluate the utility of 3-T MRI of the lung for differentiating inflammation- and fibrosis-predominant lesions in the usual and nonspecific types of interstitial pneumonia.
Airway obstruction in children is a rare, but difficult clinical problem, with no clear agreement on optimal therapeutic approach. Stenting of the airway has been used successfully in adults, and is an attractive alternative in children. Fundamental differences of pediatric compared to adult use include the benign nature of most stenoses, the narrow and soft airways of children, the required long-term tolerance and adaptation to growth.
The aim of the present study was to examine the modification of initial empirical treatment based on the microbiological results of bronchoscopic techniques after comparing the diagnostic yield of protected specimen brush (PSB) and bronchoalveolar lavage (BAL) in the immunocompetent patient with community acquired pneumonia (CAP) with results obtained from conventional sputum cultures.
Surgical Infections. February 1, 2008, 9(1): 99-104
Invasive pulmonary aspergillosis is a rare, but severe and potentially fatal, complication after liver transplantation. There is no therapeutic regimen accepted worldwide for both initial and continuation therapy; nevertheless, several options have been proposed.
To determine the frequency of pertussis in children le16 y who had prolonged cough (ge14 d), a prospective study was conducted at an outpatient clinic of a paediatric hospital. Nasopharyngeal swabs were taken for culture and nucleic acid testing by polymerase chain reaction (PCR) for Bordetella pertussis.
Plasma levels of high mobility group box chromosomal protein-1 (HMGB-1), as well as of other inflammatory molecules such as interleukin-6 (IL-6), regulated on activation normal T-cell expressed and secreted (RANTES), and soluble intercellular adhesion molecule-1 (sICAM-1), were determined in patients with bacterial pneumonia coinfected with influenza virus.
Pneumonia severity assessment systems such as the pneumonia severity index (PSI) and CURB-65 were designed to direct appropriate site of care based on 30-d mortality. Increasingly they are being used to guide empirical antibiotic therapy and also possibly to detect patients who will require admission to the intensive care unit (ICU).
Previous population-based studies have reported a temporal association between respiratory syncytial virus (RSV) infection and invasive pneumococcal disease (IPD). We examined this association at an individual level in the Danish population.
The manuscript presents definitive studies of surfactant protein D (SP-D) in the context of inflammatory lung fluids. The extent of SP-D depletion in bronchoalveolar lavage fluid (BALF) of children affected with cystic fibrosis (CF) is demonstrated to correlate best with the presence of the active neutrophil serine protease (NSP) elastase.
S100A7 is a calcium-binding protein with chemotactic and antimicrobial properties. S100A7 protein levels are decreased in nasal lavage fluid from individuals with ongoing allergic rhinitis, suggesting a role for S100A7 in allergic airway inflammation. The aims of this study were to describe genetic variation in S100A7 and search for associations between this variation and allergic rhinitis.
Lung ischemia-reperfusion injury (LIRI) is suggested to be a major risk factor for development of primary acute graft failure (PAGF) following lung transplantation, although other factors have been found to interplay with LIRI.
High altitude pulmonary oedema (HAPE) is a well-known potential hazard of activities at high altitudes but not a common disease presentation that most emergency physicians have experience treating.
Clinical Pulmonary Medicine. 15(2):81-96, March 2008
The increasing number and variety of patients with compromised immune systems poses a diagnostic challenge for the chest physician. Manifestations of pulmonary disease on imaging studies are diverse, with substantial overlap possible between entities.
Clinical Pulmonary Medicine. 15(2):63-70, March 2008
Ventilator-associated pneumonia (VAP) continues to be an important cause of morbidity and mortality in critically ill patients. Despite the numerous contributions in the field of the prevention of VAP in the last decade, the majority of issues related to the prevention of VAP remain unresolved and are subject to controversy.
Clinical Pulmonary Medicine. 15(2):55-62, March 2008
The systemic effects of chronic obstructive pulmonary disease (COPD) are becoming increasingly apparent. Systemic inflammatory markers are of interest in mediating these systemic effects, and studies have shown that increased levels of inflammatory markers such as fibrinogen and C-reactive protein are associated not only with COPD severity, but also with the risk of cardiovascular morbidity and mortality.
Pediatrics International Volume 50 Issue 2 Page 184-188, April 2008
Funisitis is a manifestation of the fetal inflammatory response syndrome, and intrauterine inflammation is involved in the pathogenesis of lung injury in premature infants. The aim of the present paper was to examine the relationship between funisitis and lung injury in premature infants born at <28 weeks gestation. The present study focuses on the number of macrophages in tracheobronchial aspirate fluid (TAF).
Journal of Intensive Care Medicine, Vol. 23, No. 2, 128-135 (2008)
The aim of this study is to analyze neonatal outcome of isolated congenital diaphragmatic hernia and to identify prenatal and postnatal prognosis-related factors. A retrospective single institution series from January 2000 to November 2005 of isolated congenital diaphragmatic hernia neonates was reviewed. Respiratory-care strategy was early high-frequency oscillatory ventilation, nitric oxide in pulmonary hypertension, and delayed surgery after respiratory and hemodynamic stabilization.
In patients with community-acquired pneumonia (CAP), bacterial-cell-wall-derived fragments may induce the coagulation cascade. To contribute to the knowledge of underlying mechanisms, we have studied the fibrinolytic activity in children with CAP and parapneumonic effusions.
HIV Medicine, Volume 9, Number 4, April 2008 , pp. 203-207(5)
To ascertain the relationship between periods of various antiretroviral therapies and the incidence of first community-acquired pneumococcal pneumonia (CAPP) among HIV-1 infected patients.
Intravenous continuous infusion of betalactam (CIBL) antibiotic and high dose extended interval (HDEI) aminoglycoside therapy theoretically maximize bacterial killing in treatment of Pseudomonas aeruginosa (PsA) in pulmonary exacerbations of cystic fibrosis (CF).
We assessed the relationship between particle air pollution and changes in lung function in children as measured by spirometry over time. Data were collected from air pollution and family health examinations of 181 subjects, aged 9-19 years, in a Korean community.
Primary ciliary dyskinesia (PCD) is an autosomal recessive disease in which ciliary dysfunction leads to chronic lung, sinus, and middle ear disease. PCD is often not diagnosed until late childhood due to its presumed rarity and the technical expertise necessary for diagnosis; as such, little is known about lung disease in young children with PCD.
Pulmonary manifestations of histoplasmosis were last reviewed in Seminars in 2004. This review highlights the management of the most common clinical syndromes, emphasizing recognition, diagnosis, and treatment.
Journal of Cardiopulmonary Rehabilitation & Prevention. 28(2):79-91, March/April 2008
Exercise training comprises a variety of modalities in patients with chronic obstructive pulmonary disease (COPD). In the last 10 years, neuromuscular electrical stimulation (NMES) has attracted the interests of clinicians as a novel rehabilitative approach.
Clinical Pulmonary Medicine. 15(2):113-117, March 2008
Panniculitis is defined as inflammation of the subcutis. Alpha-1 antitrypsin deficiency (AATD) is clearly, although uncommonly, associated with panniculitis. Clinical manifestations of panniculitis associated with AATD include red, painful nodular lesions that often weep with an oily discharge and commonly occur on the thighs, buttocks, and areas of physical trauma.
Clinical Pulmonary Medicine. 15(2):120-121, March 2008
The institution of a rapid response team produced faster initiation of important therapeutic interventions and reduced mortality for patients who develop shock.
Clinical Pulmonary Medicine. 15(2):122-125, March 2008
Bronchial atresia is a rare congenital anomaly of the airways associated with regional airway hyperinflation and bronchial mucocele formation. It is often found incidentally during chest radiography performed in young adults. Most patients are asymptomatic but some report dyspnea or frequent respiratory infections.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 752-762, (2008)
Acquired pulmonary alveolar proteinosis (PAP) is a syndrome characterized by pulmonary surfactant accumulation occurring in association with granulocyte/macrophage colony-stimulating factor autoantibodies (autoimmune PAP) or as a consequence of another disease (secondary PAP). Because PAP is rare, prior reports were based on limited patient numbers or a synthesis of historical data.
To retrospectively assess the change in disease pattern of nonspecific interstitial pneumonia (NSIP) and idiopathic pulmonary fibrosis (IPF) findings seen at thin-section computed tomography (CT) at long-term follow-up and to compare the same with initial findings at CT.
Chemical warfare agents (CWA) including sulfur mustard (SM) were commonly used in Iran-Iraq war. Respiratory problems are the greatest cause of long-term disability among people who had combat exposure to SM. High-resolution computed tomography (HRCT) has been accepted as the imaging modality of choice in these patients.
Data suggest that obstructive sleep apnea syndrome (OSA) results in sympathetic stimulation, brady/tachycardia and cardiac stress. Heart rate variability, but not baseline heart rate, is known to be elevated in pediatric OSA. Our patients with moderate to severe OSA (McGill Oximetry Scores of 3 or 4) have been re-evaluated with pulse oximetry after adenotonsillectomy (T&A). We hypothesized that pulse rate (PR) and pulse rate variability (PRV) would decrease after treatment of OSA with T&A.
Clinical Pulmonary Medicine. 15(2):71-80, March 2008
Pulmonary complications in patients with hematologic malignancies is commonly encountered by clinicians. Some of these complications are believed to be related to direct toxicity of the drug itself. Novel antineoplastic agents with activity against hematologic malignancies are constantly being introduced into practice and clinical trials.
Clinical Pulmonary Medicine. 15(2):97-105, March 2008
Obesity represents a growing epidemic in the United States. As the population ages and prevalence of obesity increases, the number of obese people admitted to the medical intensive care unit (MICU) will likely increase.
The goal of this research was to begin the process of evaluating acceptability of infection control (IC) recommendations to CF patients and their families, determine whether compliance with IC guidelines differs from compliance with traditional CF medical treatment with respect to the variables predictive of compliance, and assess which patients are most likely to comply with IC recommendations.
The Streptococcus milleri group (SMG) is increasingly recognized for their role in pyogenic infections including empyema and solid organ abscesses. However, SMG disease has rarely been identified in cystic fibrosis (CF). Inherent difficulties in both growing the organisms and distinguishing SMG from less virulent oropharyngeal viridans streptococci may have led to a decreased recognition of this as a CF pathogen.
Journal of the Neurological Sciences Volume 268, Issue 1, Pages 193-194 (15 May 2008)
Patent foramen ovale is a defect in the interatrial septum associated with cryptogenic stroke. The presumed mechanism of cryptogenic stroke due to a patent foramen ovale is the migration of thrombus from the venous side of the circulation to the left atrium with subsequent systematic embolism, called paradoxical embolization.
Appropriate parameters are needed for the monitoring of children with pulmonary arterial hypertension (PAH). Various biologic markers seem to be of use in adults with PAH. No data are available on their value in children with PAH.
Inhaled corticosteroids (ICS) are the mainstay of long-term treatment of asthma. In moderate and severe persistent asthma, long acting beta-2 agonists (LABA) such as salmeterol and formoterol are added to ICS.
Am J Physiol Lung Cell Mol Physiol 294: L431-L439, 2008
Pulmonary microvascular endothelial cells (PMVECs) are enriched with progenitor cells that underlie their rapid proliferation and vasculogenic capacity. However, the molecular basis for such an enhanced growth potential is unknown.
Am J Physiol Lung Cell Mol Physiol 294: L419-L430, 2008
Endothelial progenitor cells (EPCs) have been isolated postnatally from bone marrow, blood, and both the intima and adventitia of conduit vessels. However, it is unknown whether EPCs can be isolated from the lung microcirculation.
Clinical & Experimental Immunology, Volume 152, Number 1, April 2008 , pp. 95-101(7)
The aetiology of idiopathic bronchiectasis, a lung disease where chronic inflammation and bacterial infection leads to progressive lung damage, is unknown. A possible role for natural killer cells has been highlighted previously. However, a role for adaptive immunity is suggested by the presence of CD4 and CD8 T cells in diseased lung tissue.
We report a 5-year-old girl who presented to our emergency room with respiratory arrest and limb deformities and was subsequently diagnosed with X-linked hypophosphatemic rickets.
Journal of Cardiopulmonary Rehabilitation & Prevention. 28(2):128-141, March/April 2008
To determine the effect of inspiratory muscle training (IMT) (alone or combined with exercise and/or pulmonary rehabilitation) and compare with other rehabilitation interventions among adults with chronic obstructive pulmonary disease (COPD).
Because clarithromycin provided beneficiary nonantibiotic effects in experimental studies, its efficacy was tested in patients with sepsis and ventilator-associated pneumonia (VAP).
The purpose of our study was to evaluate contrast-enhanced MR angiography (CE-MRA) as a screening procedure for the detection of pulmonary arteriovenous malformations (AVMs) in patients with hereditary hemorrhagic telangiectasia (HTT).
We present a case of prominent glossopharyngeal muscles causing severe obstructive symptoms in a 3-month-old child. Preoperative sleep studies and dynamic microdirect laryngoscopy were used in evaluation of the patient.
A number of emergency departments have introduced non-invasive positive pressure ventilation (NIV) and continuous positive airway pressure (CPAP) for patients presenting with acute respiratory failure. It is thought that early non-invasive respiratory support will avoid the need for invasive ventilation in many cases.
Brain abscesses and ischaemic strokes complicate pulmonary arteriovenous malformations (PAVMs). At risk individuals are poorly recognised. Stroke/abscess risk factors have not been defined.
Acute lung injury is an important cause of respiratory failure in the critically ill patient. It is caused by damage to the alveolar barrier with subsequent alveolar flooding leading to the development of refractory hypoxaemia.
Improved survival from idiopathic pulmonary fibrosis (IPF) is dependent on better understanding of the epidemiology of the disease, its diagnostic spectrum in global terms and an analysis of outcomes from emerging therapies at a significant level.
The immune response to bacterial antigens on mucosal surfaces may be modified in individuals allergic to aeroallergens due to a maturational or genetic difference or from the interaction between inhaled allergens and bacteria at the mucosa.
The spectrum of diseases collectively known as pulmonary fibrosis does not have reliable therapeutic options. Many treatment protocols have been the subject of clinical trials, resulting in few significant improvements in outcome.
Bronchiectasis unrelated to cystic fibrosis (CF) is increasingly recognised as an important and major primary respiratory disease in developing countries.
Pediatric Transplantation, Volume 12, Number 2, March 2008 , pp. 129-136(8)
In their provocative paper, "Lung transplantation and survival in children with cystic fibrosis," Liou and colleagues state that "Prolongation of life by means of lung transplantation should not be expected in children with cystic fibrosis. A prospective, randomized trial is needed to clarify whether and when patients derive a survival and quality of life benefit from lung transplantation."
We report on a sarcoma of the central pulmonary arteries. Surgical therapy consisted in replacing both main pulmonary arteries and the pulmonary trunk including the pulmonary valve. Six months later a left-sided pneumonectomy had to be performed due to an intravascular tumor.
The purpose of this article is to describe abnormalities seen on MDCT of the airways and lung parenchyma that are caused by the aspiration of solid foreign bodies and liquid material.
Patients often present to the emergency department following a generalized tonic-clonic seizure, particularly of new onset. Complications associated with seizures usually arise from injuries sustained from loss of consciousness or during convulsive activity.
The Journal of Infectious Diseases 2008;197:1000-1005
Nasopharyngeal colonization with Streptococcus pneumoniae precedes invasive pneumococcal disease. Human immunodeficiency virus (HIV) infection increases rates of invasive pneumococcal disease, and its effect on colonization is unknown.
European Journal of Endocrinology, Vol 158, Issue 4, 459-465
To determine the prevalence of sleep apnea (SA) and SA syndrome (SAS) in patients with acromegaly and correlate SA with clinical, laboratory, and cephalometric parameters.
Somatostatin analogues may have antifibrotic properties in the lung. The aim of this study was to evaluate the expression of the five somatostatin receptors sst1 to sst5 in normal and fibrotic mouse lung and the action of SOM230 (pasireotide), a new somatostatin analogue with a long half-life, in bleomycin induced lung fibrosis and in human lung fibroblasts in vitro.
Chronic obstructive pulmonary disease (COPD) is an insidiously starting disease. Early detection has high priority because of the possibility of early implementation of smoking cessation interventions. An evidence based model for case finding of COPD is not yet available.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 793-797, (2008)
The diagnosis of Mycobacterium avium-complex pulmonary disease (MAC-PD) and/or its discrimination from pulmonary tuberculosis (TB) is sometimes complicated and time consuming.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 743-751, (2008)
Physical activity is reduced in patients with chronic obstructive pulmonary disease (COPD). COPD has a systemic component that includes significant extrapulmonary effects that may contribute to its severity in individual patients.
There is much debate about the effect on interpretation of results caused by the funding of studies by the pharmaceutical industry. This paper attempts to look for objective differences in results depending on the source of funding for studies on the adverse effects of inhaled corticosteroids.
When Pneumocystis DNA is recovered from respiratory specimens of patients without Pneumocystis pneumonia (PCP), patients are said to be colonised with Pneumocystis, although the significance of this state is unknown. Understanding risk factors for and outcomes of colonisation may provide insights into the life cycle and transmission dynamics of Pneumocystis jirovecii.
The lack of effect on this primary end point in the presence of highly significant effects on medication use and symptoms-even after 12 months-simply illustrates once again that PEF is too insensitive to contribute meaningfully to the interpretation of our therapeutic interventions.
The authors did not demonstrate an improvement in insulin sensitivity and glycaemic control in obese patients after 3 months of therapeutic CPAP compared with placebo CPAP.
This is the first study to evaluate the pathogenic role of the novel chitinase-like protein YKL-40 in asthma. In experimental models, YKL-40 and chitinases promoted airway inflammation through type 2 helper T cells.
A 75-year-old man was admitted with a non-productive cough and chest discomfort. He had been admitted 2 months previously with left lower lobe (LLL) consolidation for which he received intravenous antibiotics. He had no weight loss or constitutional symptoms. The chest radiograph (fig 1) revealed persistent consolidation and he was urgently referred to the chest clinic for review.
A 26-year-old female presented with progressive cough and breathlessness for 4 months. At her initial visit she was 6 weeks’ pregnant and reported that she could only climb 10 steps before becoming short of breath.
Previous reports regarding the mutations in ABCA3 were derived primarily from the analysis of term infants presenting with severe respiratory failure in the neonatal period.
Cardiovascular disease is a major cause of death in patients with chronic obstructive pulmonary disease (COPD) and predicts hospitalisation for acute exacerbation, in-hospital death and post-discharge mortality.
Chronic obstructive pulmonary disease (COPD) is associated with a 2-3-fold increase in the risk of ischaemic heart disease, stroke and sudden death. The mechanisms responsible for this association are not clear and appear to be independent of smoking history.
Tracheal fistulas represent a challenging management problem. The standard treatment in most cases is based on surgical procedures. Various endoscopic treatment modalities have been proposed in patients at high surgical risk but the results are often unsatisfactory.
Bronchial hyperresponsiveness (BHR) and variation in glutathione S-transferase (GST) genes have been associated with asthma risk. The relationship of these two risk factors with adult onset asthma in the general population was investigated.
The purpose of this study was to describe and explain the basis for the lateral chest radiographic finding of a pseudolesion simulating a sclerotic vertebral lesion.
The forkhead box m1 (Foxm1 or Foxm1b) protein (previously called HFH-11B, Trident, Win or MPP2) is abundantly expressed in human non-small cell lung cancers where it transcriptionally induces expression of genes essential for proliferation of tumor cells.
Am J Physiol Lung Cell Mol Physiol 294: L489-L497, 2008
Competition between nitric oxide synthases (NOSs) and arginases for their common substrate L-arginine could be involved in the regulation of cholinergic airway reactivity and subsequent airway remodeling.
Am J Physiol Lung Cell Mol Physiol 294: L478-L488, 2008
Nuclear erythroid-related factor 2 (Nrf2), a redox-sensitive transcription factor, is involved in transcriptional regulation of many antioxidant genes, including glutamate-cysteine ligase (GCL).
Am J Physiol Lung Cell Mol Physiol 294: L582-L591, 2008
In this study, we explore the roles of the delta isoform of PKC (PKC{delta}) in the regulation of endothelial nitric oxide synthase (eNOS) activity in pulmonary arterial endothelial cells isolated from fetal lambs (FPAECs).
Am J Physiol Lung Cell Mol Physiol 294: L469-L477, 2008
In inflammatory diseases of the airway, a high level (estimated to be as high as 8 mM) of HOCl can be generated through a reaction catalyzed by the leukocyte granule enzyme myeloperoxidase (MPO). HOCl, a potent oxidative agent, causes extensive tissue injury through its reaction with various cellular substances, including thiols, nucleotides, and amines.
Am J Physiol Lung Cell Mol Physiol 294: L523-L534, 2008
Neuropeptide tachykinins (substance P, neurokinin A, and neurokinin B) are present in peripheral terminals of sensory nerve fibers within the respiratory tract and cause airway contractile responses and hyperresponsiveness in humans and most mammalian species.
Am J Physiol Lung Cell Mol Physiol 294: L498-L504, 2008
Arginases compete with nitric oxide (NO) synthases for L-arginine as common substrate. Pulmonary vascular and airway diseases in which arginase activity is increased are associated with decreased NO production and reduced smooth muscle relaxation.
The Journal of Infectious Diseases 2008;197:1016-1027
Serotype 19A invasive pneumococcal disease (IPD) increased annually in the United States after the introduction of the 7-valent conjugate vaccine (PCV7). To understand this increase, we characterized serotype 19A isolates recovered during 2005.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 491-497, 2008
Unique among the vascular beds, loss of endothelial integrity in the pulmonary microcirculation due to injury can lead to rapidly fatal hypoxemia. The ability to regain confluence and re-establish barrier function is central to restoring proper gas exchange.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 423-434, 2008
In cystic fibrosis (CF), the absence of functional CFTR leads to dysregulated Na+ absorption across airway epithelia. We established an in vitro model of dysregulated Na+ absorption by treating polarized normal human bronchial epithelial cells (HBEs) with nystatin (Nys), a polyene antibiotic that enables monovalent cations to permeate biological membranes.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 473-482, 2008
Expression of pulmonary surfactant, a complex mixture of lipids and proteins that acts to reduce alveolar surface tension, is developmentally regulated and restricted to lung alveolar type II cells.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 463-472, 2008
We have previously shown that long-term treatment of airway smooth muscle (ASM) cells with a combination of TNF-{alpha} and IFN-{gamma} impaired steroid anti-inflammatory action through the up-regulation of glucocorticoid receptor beta isoform (GR-{beta}) (Mol Pharmacol 2006;69:588-596).
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 414-422, 2008
The glucocorticoid receptor (GR) is a major control factor for proliferation, differentiation, and inflammation. Our knowledge about the GR is focused on its function as a transcription regulator.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 435-445, 2008
Development of the extracellular matrix is a critical feature of alveolar formation and actively involves pulmonary interstitial fibroblasts. The elastic fiber network is an interconnected system of load-bearing fibers that also influences the behavior of adjacent cells, particularly the interstitial lung fibroblasts (LF).
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 446-454, 2008
Chronic obstructive pulmonary disease (COPD), a global public health problem, is characterized by progressive difficulty in breathing, with increased mucin production, especially in the small airways.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 483-490, 2008
Heme oxygenase-1 (HO-1) catalyzes the rate limiting reaction of heme metabolism and plays critical roles in resistance to oxidative stress and other cellular functions. It is well known that HO-1 is induced in response to various stresses; however, the signaling pathways involved remain incompletely elucidated.
American Journal of Respiratory Cell and Molecular Biology. Vol. 38, pp. 407-413, 2008
In response to mechanical stretch, airway smooth muscle exhibits various cellular functions such as contraction, proliferation, and cytoskeletal remodeling, all of which are implicated in the pathophysiology of asthma.
Clinical & Experimental Allergy, Volume 38, Number 4, April 2008 , pp. 629-633(5)
Children born by Caesarean section have modified intestinal bacterial colonization and consequently may have an increased risk of developing asthma under the hygiene hypothesis. The results of previous studies that have investigated the association between Caesarean section and asthma have been conflicting.
Pulmonary sequestration (PS) is a rare congenital malformation of the lower respiratory tract. The exact natural course of PS is not well understood and there are no well-established treatment guidelines for antenatally diagnosed PS.
American Journal of Industrial Medicine Volume 51, Issue 4 , Pages 296 - 306
In the smelting industry airborne pollutants are emitted into the workplace atmosphere during the production process. Our aim in this study was to investigate the relationship between production and lung function among employees at Norwegian smelters.
Pediatrics International Volume 50 Issue 1 Page 92-94, February 2008
To characterize adenoviral (ADV) infection, the clinical symptoms, laboratory findings and serum cytokine concentrations were evaluated in ADV patients and compared with those in patients with respiratory syncytial virus (RSV) infections.
Effects of daclizumab and antithymocyte globulin induction on acute rejection, bronchiolitis obliterans syndrome, and survival after lung transplantation are unknown. We hypothesized that daclizumab results in less acute rejection and bronchiolitis obliterans and better survival than antithymocyte globulin.
The Journal of Infectious Diseases 2008;197:888-896
Pilus components of Streptococcus pneumoniae encoded by rlrA were recently shown to elicit protection in an animal model of infection. Limited data are available on the prevalence of the rlrA operon in pneumococci; therefore, we investigated its distribution and its antigenic variation among disease-causing strains.
The aim of this study is to evaluate psychological aspects of childhood asthma and the connections between the illness and behavioral disturbances in asthmatic children.
Clinical & Experimental Allergy, Volume 38, Number 4, April 2008 , pp. 557-565(9)
Exhaled breath condensate (EBC) analysis, a rather appealing and promising method, can be used to evaluate conveniently and non-invasively a wide range of molecules from the respiratory tract, and to understand better the pathways propagating airway inflammation.
Journal of the Medical Association of Thailand Vol91 No.2 196 2624
Pulmonary Arterial Hypertension (PAH) plays a significant role in morbidity and mortality of patients with congenital heart disease (CHD). Bosentan, a dual endothelin receptor antagonist has been approved for PAH patients with Eisenmenger physiology (EP). The authors retrospectively reviewed the efficacy and safety of bosentan in Thai PAH patients associated with CHD.
Am J Physiol Lung Cell Mol Physiol 294: L442-L448, 2008
Activation of the type 1 histamine (H1) or the type 2 protease-activated (PAR-2) G protein-coupled receptors interrupts E-cadherin adhesion and decreases the transepithelial resistance (TER) of epithelium.
The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 4, April 2008 , pp. 458-464(7)
To bring together all deaths of respiratory origin, whether concentrated under Group J of the International Classification of Diseases (ICD-10) or in other codes, and including the upper and lower airways and thorax, for a more accurate assessment of the public importance of respiratory diseases.
Canadian Respiratory Journal March 2008, Volume 15 Issue 2: 85-89
Empyema is a suppurative infection of the pleural space. Without prompt treatment, it can result in significant hospital stays, more invasive treatments as it progresses, and substantial morbidity and mortality.
Canadian Respiratory Journal March 2008, Volume 15 Issue 2: 91-98
Allergic rhinitis and asthma are both chronic heterogeneous disorders, with an overlapping epidemiology of prevalence, health care costs and social costs in quality of life. Both are inflammatory disorders with a similar pathophysiology, and both share some treatment approaches.
Current Opinion in Pulmonary Medicine. 14(2):122-127, March 2008
The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.
The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 4, April 2008 , pp. 368-374(7)
Chronic obstructive pulmonary disease (COPD) represents a serious global health problem that affects the aged. This State of the Art article summarises previous studies on oxidative-antioxidative imbalance in patients with stable COPD or in acute exacerbations.
Current Opinion in Pulmonary Medicine. 14(2):95-100, March 2008
A bacterial cause is found in about half of all severe chronic obstructive pulmonary disease exacerbations. The aim of this review is to discuss recent findings regarding prevalence, risk factors and outcome of severe chronic obstructive pulmonary disease exacerbations caused by multidrug-resistant bacteria.
Canadian Respiratory Journal March 2008, Volume 15 Issue 2: 99-106
Asthma is an inflammatory disease of the airways, for which many therapeutic options are available. Guidelines for the management of asthma suggest a stepwise approach to pharmacotherapy based on assessment of asthma severity and control.
Current Opinion in Pulmonary Medicine. 14(2):135-140, March 2008
Dust-induced occupational lung diseases comprise a vast variety of causative agents. These largely preventable illnesses not only afflict lung parenchyma but also bronchi, bronchioles, as well as mediastinal and pleural structures. Chest radiography undisputedly has value in screening thoracic manifestations of occupational diseases, but also has its limitations.
Scandinavian Journal of Medicine & Science in Sports doi:10.1111/j.1600-0838.2007.00753.x
The objective was to determine the prevalence of asthma-like symptoms and asthma and the use of asthma medication in Danish elite athletes. A cross-sectional questionnaire survey of Danish elite athletes was conducted in 2006.
A 10-year invasive pneumococcal disease (IPD) enhanced surveillance project in the Oxfordshire region of the UK between 1996 and 2005 identified a total of 2691 Streptococcus pneumoniae isolates from all ages that provided a comprehensive description of pneumococcal epidemiology.
Several public health strategic interventions are required for effective prevention and control of avian influenza (AI) and it is necessary to create a communication plan to keep families adequately informed on how to avoid or reduce exposure. This investigation determined the knowledge, attitudes, and behaviors relating to AI among an adult population in Italy.
Canadian Respiratory Journal March 2008, Volume 15 Issue 2: 77-83
The Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) is the first disease-specific instrument for assessing patient-reported symptoms, functioning and quality of life (QoL) in pulmonary arterial hypertension (PAH).
Despite many clinical examples of exemplary end-of-life care, a number of studies highlight significant shortcomings in the quality of end-of-life care that the majority of patients receive. In part, this stems from inconsistencies in training and supporting clinicians in delivering end-of-life care.
Families of ICU patients may be at risk for increased psychological morbidity due to end-of-life decision making. The identification of chart-based quality indicators of palliative care that predict family satisfaction with decision making may help to guide interventions to improve decision making and family outcomes.
Obesity is a risk factor for obstructive sleep apnea-hypopnea syndrome (OSAHS) in adults. However, the prevalence of OSAHS in children is not clear, and the relationship between obesity and OSAHS remains controversial.
Severe emphysema developed in a white woman with a 26–pack-year history of tobacco use. Serum {alpha}1-antitrypsin levels were normal. A history of autoimmune hemolytic anemia,
angioedema, low complement, and recurrent urticaria prompted an immunologic workup that ultimately led to a diagnosis of hypocomplementemic urticarial vasculitis syndrome.
Journal of Thoracic Imaging. 23(1):47-49, February 2008
Diffuse pulmonary ossification most commonly occurs in men in their fifth and sixth decades of life and is usually associated with diffuse and chronic lung disease, cardiac disease, or other systemic disorders. In this report, we describe a case of dendriform pulmonary ossification with a past history of giant cell tumor in the femur that occurred 8 years before.
Pediatrics International Volume 50 Issue 1 Page 99-102, February 2008
T-helper (Th) 2 cytokines are thought to mediate most of the allergic inflammatory responses associated with atopic asthma. But the Th1-related chemokine, interferon-inducible protein 10 (IP-10)/CXCL10, was the predominant chemokine measured during human allergic pulmonary late-phase reaction.
During lung transplantation, cells in the pulmonary parenchyma are subjected to ischemia, hypothermic storage, and reperfusion injury. Platelets, whose granular contents include adhesion receptors, chemokines, and coactivating substances that activate inflammatory and coagulant cascades, likely play a critical role in the lung allograft response to ischemia and reperfusion.
PEDIATRICS Vol. 121 No. 3 March 2008, pp. e533-e538
Hypoalbuminemia is a common finding in children with massive parapneumonic pleural effusion; however, its incidence and pathogenesis are unclear. The objective of this study was to assess the presence and severity of hypoalbuminemia in children with parapneumonic pleural effusion and to propose a possible pathophysiologic mechanism.
Journal of Thoracic Imaging. 23(1):39-43, February 2008
Organizing pneumonia (OP) is a nonspecific response to various forms of lung injury. Although patients with human immunodeficiency virus (HIV) infection tend to develop several respiratory disorders, especially infections and malignances, the association of HIV infection and OP is unusual.
Inflammatory cytokines (e.g. IL-13) and mechanical perturbations (e.g. scrape injury) to the epithelium release profibrotic factors such as TGF-beta2, which may, in turn, stimulate subepithelial fibrosis in asthma. We hypothesized that prolonged IL-13 exposure creates a plastic epithelial phenotype that is profibrotic through continuous secretion of soluble mediators at levels that stimulate subepithelial fibrosis.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 149 - 154
Exhaled nitric oxide and induced sputum eosinophils are well established as direct markers of inflammation/oxidative stress in asthma. Recently, it has been proposed that sputum 8-isoprostane concentrations may present a reliable index for measuring oxidative stress in asthmatic patients.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 101 - 107
Laboratory animal allergy (LAA) may cause eosinophilic airway inflammation, for which exhaled nitric oxide (FENO) measurements are sensitive and specific.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 95 - 99
The aim of this study was to investigate the effects of leukotriene receptor antagonists (LTRAs) on the premenstrual exacerbation of asthma (PMA). Twenty-four female patients with mild asthma were enrolled in the study.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 109 - 113
Patient-related factors are a significant component in the serious public health problem of poor asthma control, yet they have not been extensively studied.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 135 - 139
Debate exists within the literature concerning whether asthma and obesity are linked as comorbid conditions. Further study is required to understand the relationship between asthma and overweight status, and developmental considerations are an important priority area.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 141 - 147
There is evidence that prevalence and severity of asthma in children has risen. Risk factors for severe asthma have been studied extensively in children living in developed countries, but little is known about factors determining the severity of asthma in Latin American countries.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 165 - 170
This pilot study explores the reported symptoms in African Americans and Caucasians with asthma. Methods. Asthma patients in an inner-city pulmonary clinic were given a brief questionnaire of asthma symptoms and the BORG scale, followed by spirometry.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 115 - 116
Omalizumab is a new anti-IgE treatment for severe-persistent allergic asthma. In this case presentation, we report the clinical features of a patient with Churg-Strauss syndrome (CSS) diagnosed after five months of omalizumab treatment.
Journal of Asthma, Volume 45, Issue 2 March 2008 , pages 81 - 94
The commonly used research approach to asthma self-management is based on black box theory where emphasis is placed on input (manipulation of independent variables) and output (the assessment of dependent variables). In this paradigm, little attention is paid to the behavioral and cognitive processes that occur between input and output.
Surgical Practice, Volume 12, Number 1, February 2008 , pp. 20-22(3)
We report the case of a 6-year-old child who fell from a height of almost 10-metres. He had a large wound in the anterior chest wall with herniation of the lung through a defect produced by dysjunction of costo-chondral/sterno-chondral cartilages of the second to the fifth right ribs.
Human immunodeficiency virus (HIV)-infected persons have a high incidence of pneumonia and pneumococcal disease. Benefits of vaccination with the 23-valent pneumococcal polysaccharide vaccine (PPV) among these patients continue to be debated.
High functional antibody responses, establishment of immunologic memory, and unambiguous efficacy in infants suggest that an initial dose of conjugated pneumococcal polysaccharide (PnC) vaccine may be of value in a comprehensive adult immunization strategy.
Pediatrics International Volume 50 Issue 1 Page 12-16, February 2008
The inflammatory marker, high-sensitivity C-reactive protein (HsCRP), is known to be related to non-allergic asthma, obesity, cardiovascular disease and smoking in adults. The aim of the present study was to determine whether HsCRP is related to respiratory symptoms and pulmonary function test findings in asthmatic children.
To compare airway function in early adulthood in subjects with wheezing in infancy with age-matched controls and to analyze what accounts for a possible difference.
Pediatric Infectious Disease Journal. 27(3):213-217, March 2008
Bronchiolitis is a major cause of morbidity and mortality in early childhood worldwide. The presence of more than one pathogen may influence the natural history of acute bronchiolitis in infants.
Bird fancier's lung (BFL) is one of the most common types of hypersensitivity pneumonitis. Nevertheless, the criteria for diagnosing this condition are not standardized. The current study is an in-depth investigation into the clinical characteristics of BFL in the largest series examined for this purpose by a single group, to our knowledge, taking into account the acute, subacute, or chronic clinical presentation.
Pulmonary arterial hypertension (PAH) and morbid obesity both dramatically impair functional capacity. New therapies have emerged for both conditions, including pharmaceutical agents for the former and bariatric surgery for the latter.
Current Opinion in Cardiology. 23(2):121-126, March 2008
As heart failure continues to carry significant morbidity and mortality it is crucial to pursue new lines of therapy. Addressing sleep apnea, which is highly prevalent in these patients, offers just such an avenue.
Investigative Ophthalmology and Visual Science. 2008;49:934-940
Several reports have demonstrated an association between glaucoma and obstructive sleep apnea (OSA), though the origin of this association remains unknown. In the present study, the influence of OSA and continuous positive airway pressure (CPAP) therapy on intraocular pressure (IOP) and ocular perfusion pressure (OPP) was examined.
Current Opinion in Pulmonary Medicine. 14(2):89-94, March 2008
Chronic obstructive pulmonary disease is a major cause of morbidity and mortality worldwide. There is increasing evidence that implicates viral infections as a major risk factor for exacerbations of chronic obstructive pulmonary disease.
Current Opinion in Pulmonary Medicine. 14(2):115-121, March 2008
Cardiovascular disease and cancer are the two leading causes of morbidity and mortality in patients with chronic obstructive pulmonary disease. The epidemiological and mechanistic evidence linking these disorders, however, is uncertain.
Journal of Thoracic Imaging. 23(1):7-12, February 2008
To evaluate the diagnostic accuracy of percutaneous computed tomography (CT)-guided coaxial core needle biopsy in patients with nonresolving pulmonary focal air space consolidations and negative fiberoptic bronchoscopy results.
Current Opinion in Pulmonary Medicine. 14(2):110-114, March 2008
There is increasing interest in using multichannel computed-tomography scanning in the characterization of subjects with chronic obstructive pulmonary disease. Three distinct components - emphysema, large-airway inflammation and small-airway abnormality - have been evaluated using qualitative and quantitative approaches. Here we highlight computed-tomography findings of chronic obstructive pulmonary disease and correlation with spirometric values.
Journal of the Medical Association of Thailand Vol91 No.2 166 3679
Study the clinical features of pulmonary arterial hypertension (PAH) in Thai patients with systemic sclerosis (SSc), and compare these features between those with limited (lc) SSc and diffuse (dc) SSc.
Pediatrics International Volume 50 Issue 1 Page 103-108, February 2008
For the treatment of bronchial asthma, two types of fluticasone inhaler devices are available, namely, metered-dose inhaler with spacer (MDI-S) and the dry powder inhaler (DPI). The former is recommended for young children with a low peak inspiratory flow (PIF) and the latter for adolescents and adults. But the difference in the therapeutic efficacy between them has been studied only rarely in adolescent patients.
Journal of Paediatrics and Child Health, Volume 44, Number 3, March 2008 , pp. 129-133(5)
To delineate the predisposing factors, clinical, radiological features and outcomes of bronchiolitis obliterans (BO) in children for minimising morbidity and mortality.
We analyzed polymorphisms of IL-10 -1082 G/A, IL-18 -137 G/C, TLR4 +896 A/G, and IFNG +874 T/A in 139 infants under 6 months of age hospitalized with bronchiolitis and 400 unselected blood donors. Causative viruses were determined by PCR. Infants with bronchiolitis associated with a virus other than respiratory syncytial virus (N = 18), were more often IL-10 -1082 allele G non-carriers, that is, homozygous for allele A (AA) than controls (66.7% vs. 28.0%, P < 0.0001).
Post-infectious bronchiolitis obliterans (PBO) is a rare form of chronic obstructive lung disease in children with few data on the pulmonary function outcome and underlying inflammatory process. The aim of this study was to determine the change in lung function over time and to investigate by bronchoalveolar lavage (BAL) the inflammatory characteristics of pulmonary involvement.
Clinical & Experimental Allergy, Volume 38, Number 4, April 2008 , pp. 586-593(8)
Although methylene diphenyl diisocyanate (MDI) is widely used in many industries, there have been few immunological studies of MDI-induced occupational asthma.
American Journal of the Medical Sciences. 335(3):192-197, March 2008
Highly active antiretroviral therapy (HAART) has decreased the morbidity and mortality of opportunistic infections including Pneumocystis jiroveci pneumonia (PCP) among HIV-infected individuals.
The International Journal of Tuberculosis and Lung Disease, Volume 12, Number 4, April 2008 , pp. 375-380(6)
Chronic obstructive pulmonary disease (COPD) is mostly caused by cigarette smoking and affects up to 25% of smokers. Air pollution and occupational exposure to dust and fumes can also induce COPD. COPD is characterised by airflow limitation that is not fully reversible and chronic inflammation of the lung.
Current Opinion in Pulmonary Medicine. 14(2):128-134, March 2008
Despite its widespread use, the role of noninvasive home mechanical ventilation for the management of severe chronic obstructive pulmonary disease and chronic hypercapnic respiratory failure is still controversial. The majority of randomized controlled trials show methodological weaknesses, including issues of patient selection, insufficient pressure support and poor adherence to therapy.
Current Opinion in Pulmonary Medicine. 14(2):141-146, March 2008
Medical and environmental surveys at microwave popcorn plants and flavoring production plants have revealed a risk for bronchiolitis obliterans in workers exposed to flavoring chemicals. Workers in other food industries may also be at risk. This review summarizes the available information on disease characteristics and natural history and provides information on workplace characteristics associated with disease development.
Current Opinion in Pulmonary Medicine. 14(2):101-104, March 2008
In patients with chronic obstructive pulmonary disease, nasal inflammation often coexists with lower respiratory disease. We review the current understanding of the relationship between upper and lower airway disease, particularly in chronic obstructive pulmonary disease, including therapeutic implications.
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