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Primary immune deficiencies (PID) comprise a heterogeneous group of genetically determined disorders that affect development and/or function of innate or adaptive immunity. Consequently, patients with PID suffer from recurrent and/or severe infections that frequently involve the lung.
Journal of Asthma, Volume 44, Issue 3 April 2007 , pages 219 - 241
Research highlights psychosocial factors associated with adverse asthma events. This systematic review therefore examined whether psycho-educational interventions improve health and self-management outcomes in adults with severe or difficult asthma. Seventeen controlled studies were included. Characteristics and content of interventions varied even within broad types. Study quality was generally poor and several studies were small.
New England Journal of Medicine Volume 356:2156-2164 May 24, 2007 Number 21
Respiratory distress is a common symptom of patients transported to hospitals by emergency medical services (EMS) personnel. The benefit of advanced life support for such patients has not been established.
Critical Care Medicine. 35(6):1500-1508, June 2007
In acute respiratory distress syndrome (ARDS), high-frequency oscillation (HFO) improves oxygenation relative to conventional mechanical ventilation (CMV). Alveolar ventilation is improved by adding tracheal gas insufflation (TGI) to CMV. We hypothesized that combined HFO and TGI (HFO-TGI) might result in improved gas exchange relative to both standard HFO and CMV according to the ARDS Network protocol.
The peripheral chemoreceptors are the dominant reflex mechanism responsible for the rise in ventilation and muscle sympathetic nerve activity (MSNA) in response to hypoxia. Animal studies have suggested that endothelin (ET) plays an important role in chemosensitivity. Moreover, several human clinical conditions in which circulating ET levels are increased are accompanied by enhanced chemoreflex sensitivity. Whether ET plays a role in normal human chemosensitivity is unknown.
Toll-like receptors (TLRs) are pivotal in human response to microbial stimuli. Their activation and signaling underpin much of the observed epidemiologic data generated by the hygiene hypothesis, and their contribution to infectious exacerbations of airways disease is likely to be highly important. Our growing knowledge in this field will have a significant impact on the understanding of the pathogenesis of inflammatory diseases, and TLR-based therapies are already in early clinical trials to modify atopic disease severity.
Journal of Thoracic Imaging. 22(2):125-129, May 2007
To test the hypothesis that a transient interruption of contrast is the result of an increase in flow of unopacified blood from the inferior vena cava (IVC) by comparing the relative IVC contribution to the right side of the heart in cases and age-matched and sex-matched controls.
Journal of Thoracic Imaging. 22(2):199-206, May 2007
The aim of this manuscript is to summarize an approach to the differential diagnosis of the pulmonary complications of illicit drug use based on the computed tomography findings.
Journal of Thoracic Imaging. 22(2):136-142, May 2007
To evaluate the accuracy of multidetector row computed tomography (MDCT) compared with bronchoscopy in the assessment of airway complications related to endotracheal and tracheostomy tubes.
Journal of Thoracic Imaging. 22(2):149-153, May 2007
Congenital pulmonary airway malformation (CPAM) is classified into 5 subtypes (types 0 to 4). We attempted to correlate computed tomography (CT) findings with those of pathologic examination and evaluated the predictability of the CPAM subtype.
Pediatrics International, Volume 49, Number 3, June 2007, pp. 363-367(5)
The purpose of the present paper was to evaluate the clinical and chest radiographic features of pediatric patients with serologically proven Mycoplasma pneumoniae pneumonia (mycoplasma pneumonia).
Journal of Paediatrics and Child Health, Volume 43, Number 6, June 2007, pp. 438-442(5)
Intermittent wheezing illnesses, which include viral-associated wheeze and asthma, are among the most common reasons for children to present urgently to a doctor. The objectives of this systematic review were to assess the benefits and harmful effects of parent-initiated oral corticosteroids (PIOCS) in the management of intermittent wheezing illness in children.
European Journal of Internal Medicine Volume 18, Issue 3, May 2007, Pages 230-234
Continuous positive airway pressure (CPAP) is the main treatment for obstructive sleep apnea-hypopnea syndrome (OSAHS). Polysomnography (PSG) is the gold standard for CPAP titration. However, alternative methods have been sought to titrate CPAP at less expense in terms of time and resources. The aim of this study was to analyze CPAP success in controlling OSAHS symptoms and adverse effects by two titration methods.
Rheumatology International, Volume 27, Number 7, May 2007, pp. 675-677(3)
A 40-year-old woman with known systemic sclerosis presented with dyspnea. She had been treated for pneumonia, 2 months prior to the present admission and at this time presented with sudden dyspnea and was found to have a spontaneous pneumomediastinum and subcutaneous emphysema. Pneumomediastinum is an extremely rare complication in patients with systemic sclerosis.
Pediatric Infectious Disease Journal. 26(6):485-491, June 2007
Respiratory syncytial virus (RSV) infection is an important cause of viral respiratory tract infection in children. In contrast to other confirmed risk factors that predispose to a higher morbidity and mortality, the particular risk of a preexisting neuromuscular impairment (NMI) in hospitalized children with RSV infection has not been prospectively studied in a multicenter trial.
The Journal of Pediatrics Volume 150, Issue 6, June 2007, Pages 649-653.e1
Genetic abnormalities of pulmonary surfactant were identified by DNA sequence analysis in 14 (12 full-term, 2 preterm) of 17 newborn infants with fatal respiratory distress of unknown etiology. Deficiency of adenosine triphosphate-binding cassette protein, member A3 (n = 12) was a more frequent cause of this phenotype than deficiency of surfactant protein B (n = 2).
Measles virus infection may progress to a chronic obstructive process including bronchiolitis obliterans (BO). This study investigates pulmonary cellular profiles and interleukin (IL)-8 levels in patients with BO following the measles.
European Journal of Internal Medicine Volume 18, Issue 3, May 2007, Pages 209-214
Despite the wide distribution of different severity scoring systems for community-acquired pneumonia (CAP) patients, low-risk patients are frequently hospitalized, contrary to current recommendations. The aim of our study was to determine the rate, clinical characteristics, and outcome of low-risk patients with CAP admitted to our institution.
To evaluate the data quality of ventilator settings recorded by respiratory therapists using a computer charting application and assess the impact of incorrect data on computerized ventilator management protocols.
The American Journal of Emergency Medicine Volume 25, Issue 4, May 2007, Pages 425-429
We sought to determine the association of select clinical measures of asthma severity with percent predicted forced expiratory volume in one-second (%FEV1).
Journal of Thoracic Imaging. 22(2):160-165, May 2007
To establish whether a relationship exists between computed tomography features of lung opacities in severely neutropenic patients and their Aspergillus or bacterial etiology.
Aspergillus spp may cause a variety of pulmonary diseases, depending on immune status and the presence of underlying lung disease. These manifestations range from invasive pulmonary aspergillosis in severely immunocompromised patients, to chronic necrotizing aspergillosis in patients with chronic lung disease and/or mildly compromised immune systems.
Esophageal perforation is a rare cause of pleural effusions that carries with it a high mortality rate if diagnosis is delayed. The chemical characteristics of the pleural effusion include high amylase and low pH levels. However, these variables are nonspecific.
Journal of Infection Volume 54, Issue 5, May 2007, Pages 446-453
Community Acquired Pneumonia (CAP) is a frequent and potentially fatal infectious disease which, in the majority of cases, needs an antibiotic intervention.
Clinical Oral Implants Research, Volume 18, Number 3, June 2007, pp. 383-387(5)
Mandibular repositioning appliances (MRAs) are a viable treatment alternative in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Because these appliances require retention in the patient's dentition, edentelous patients generally do not qualify for this treatment. This study describes our experiences with an implant-retained MRA in the treatment of edentulous OSAHS patients.
Journal of Asthma, Volume 44, Issue 3 April 2007 , pages 203 - 207
We studied the relationship between the intensity of dyspnea and psychopathological and personality dimensions in 74 women and 38 men (mean age 49.7 years) with asthma. The women had higher values for the following variables: depression, anxiety-trait, and neuroticism, and they proved to have a greater external control location than the men.
Allergy, Volume 62, Number 6, June 2007, pp. 611-619(9)
Achieving and maintaining optimal asthma control is a major asthma management goal advocated by the Global Initiative for Asthma (GINA). Recent evidence suggests that while asthma control is clearly achievable in most asthmatics, not all asthmatics attain optimal asthma control. The difficulty is compounded further because patients, physicians and regulatory bodies have different perceptions of what is meant by asthma control.
Critical Care Medicine. 35(6):1522-1529, June 2007
Characterize how ventilator and patient variables affect tidal volume during high-frequency oscillatory ventilation; and measure tidal volumes in adults with acute respiratory distress syndrome during high-frequency oscillatory ventilation.
Previous reports suggest that sarcoidosis occurs with abnormally high frequency in firefighters. We sought to determine whether exposure to World Trade Center (WTC) "dust" during the collapse and rescue/recovery effort increased the incidence of sarcoidosis or "sarcoid-like" granulomatous pulmonary disease (SLGPD).
Observational studies of patients receiving prolonged mechanical ventilation and other forms of critical care support have determined acquired neuromuscular disorders to be extremely common. Early studies used electrophysiologic investigations to diagnose critical illness polyneuropathy (CIP) and muscle biopsy to confirm critical illness myopathy (CIM). More recent approaches seek to obviate these invasive techniques and build on a standardized bedside neuromuscular examination to identify patients with acquired weakness syndromes.
Sleep Medicine Volume 8, Issue 4, June 2007, Pages 400-426
Sleep apnea syndrome (SAS), a common disorder, is characterized by repetitive episodes of cessation of breathing during sleep, resulting in hypoxemia and sleep disruption. The consequences of the abnormal breathing during sleep include daytime sleepiness, neurocognitive dysfunction, development of cardiovascular disorders, metabolic dysfunction, and impaired quality of life.
Sleep Medicine Volume 8, Issue 4, June 2007, Pages 441-452
This chapter addresses the use of long-term non-invasive positive pressure ventilation (NIPPV) (to the exclusion of continuous positive airway pressure) in the different clinical settings in which it is currently proposed: principally in diseases responsible for hypoventilation characterized by elevated PaCO2. Nasal masks are predominantly used, followed by nasal pillow and facial masks. Mouthpieces are essentially indicated in case daytime ventilation is needed.
Surfactant replacement therapy (SRT) has a proven role in the treatment of neonatal respiratory distress syndrome and severe meconium aspiration syndrome in infants, and may have a role in the treatment of pediatric patients with ARDS. Although newer delivery mechanisms and strategies are being studied, the classic surfactant administration paradigm consists of endotracheal intubation, surfactant instillation into the lung, and stabilization with mechanical ventilation followed by extubation when stable on low respiratory support. Currently, this surfactant administration procedure is bundled into Current Procedural Terminology (CPT) codes used when providing intensive care.
CardioVascular and Interventional Radiology, Volume 30, Number 3, June 2007, pp. 531-533(3)
A case of tension pneumothorax developed after placement of a tunneled pleural catheter for treatment of malignant pleural effusion in a patient with advanced lung cancer. The catheter placement was carried out by an experienced operator under direct ultrasound guidance, and the patient showed immediate symptomatic improvement with acute decompensation occurring several hours later. Possible mechanisms for this serious complication of tunneled pleural catheter placement are described, and potential strategies to avoid or prevent it in future are discussed.
Clinical Pulmonary Medicine. 14(3):127-139, May 2007
Diagnosing sepsis and differentiating bacterial infections from other causes of inflammation constitute a challenge for clinical practice, especially in the intensive care unit. Many laboratory markers have been evaluated as diagnostic tests of bacterial infections and sepsis, but C-reactive protein (CRP) and procalcitonin (PCT) are at present the most studied and used indicators.
Antiviral Research Volume 75, Issue 2, August 2007, Pages 173-176
The adamantanes (amantadine and rimantadine) were the first antivirals licensed for use against influenza A viruses and have been used in some countries to control seasonal influenza. While increasing resistance of A(H3) viruses to this class of drug has been reported in recent years, only low levels of resistance were seen with A(H1) viruses until the 2005-2006 influenza season in the USA.
Hyperpolarized 3He magnetic resonance imaging (3He MRI) at 3.0 Tesla of healthy volunteers and chronic obstructive pulmonary disease (COPD) patients was performed for quantitative evaluation of ventilation defects and apparent diffusion coefficients (ADC) and for comparison to published results acquired at 1.5 Tesla. The reproducibility of 3He ADC and ventilation defects was also assessed in subjects scanned 3 times, twice within 10 minutes, and again within 7 +/- 2 days of the first MRI visit.
Clinical Radiology Volume 62, Issue 6, June 2007, Pages 587-595
To document the pulmonary vascular changes on thin-section computed tomography (CT) in patients with Eisenmenger syndrome and idiopathic pulmonary arterial hypertension, and to determine whether there is any correlation with pulmonary arterial pressures or the aetiology of pulmonary hypertension.
Obstructive sleep apnea (OSA) and hypertension are independently associated with increased stiffness of large arteries that may contribute to left ventricular (LV) remodeling. We sought to investigate the impact of OSA, hypertension, and their association with arterial stiffness and heart structure.
Current standards for spirometry require daily calibration checks to come within 3.5% of the inserted volume but do not require evaluation of trends over time. We examined the current guidelines and candidate quality control rules to determine the best method for identifying spirometers with suboptimal performance.
Solitary pulmonary nodule (SPN) evaluation based on analyses of combined wash-in (WI) and washout (WO) values obtained by helical dynamic CT (HDCT) scanning is useful for malignant SPN characterization, because this method has higher specificity and accuracy than that based on analyses of WI values only. However, increased specificity results in reduced sensitivity and the missing of malignant SPNs. Thus, the purpose of this study was to seek the most effective method for SPN characterization during HDCT scanning.
Clinical Pulmonary Medicine. 14(3):184-185, May 2007
Measurements of serum procalcitonin at admission to the hospital on utilization of a treatment guideline based on results allows for decreased use of antibiotic therapy for acute exacerbations of chronic obstructive pulmonary disease.
Cardiovascular Drugs and Therapy, Volume 21, Number 1, February 2007, pp. 63-67(5)
Amiodarone is a very effective antiarrhytmic drug. However its use may be accompanied by side effects. Hyperglobulinemia was not described in association with amiodarone treatment.
Journal of Asthma, Volume 44, Issue 3 April 2007 , pages 189 - 194
In asthma, healthcare utilization is frequently an outcome measure and can come from several sources. Asthma-related hospitalizations, emergency department (ED) visits, oral steroid bursts, and outpatient visits were compared between caregiver report and administrative data over 2 years.
Allergy, Volume 62, Number 6, June 2007, pp. 635-640(6)
Asthma is a chronic inflammatory disease, characterized by airway inflammation, bronchial hyper-responsiveness, and airway obstruction. Although asthma induces partially reversible airway obstruction, obstruction can sometimes become irreversible. This may be a consequence of airway remodeling, which includes a number of structural changes, such as epithelial detachment, basement membrane (BM) thickening, smooth muscle hypertrophy, and new vessel formation. This study evaluated children with asthma for the presence of BM thickening.
Journal of Asthma, Volume 44, Issue 3 April 2007 , pages 209 - 212
The In-Check-Dial (Alliance Tech Medical, Granburg, TX) was used to determine adequacy of inhalation techniques and teaching of two different devices. Retention of adequate techniques, was assessed in 234 moderate to severe asthmatics. Inhalation techniques were assessed at periodic follow-ups divided into less than 1 month return visit, between 1 and 3 months, 3 to less than 6 months, and 6 months to less than 1 year.
American Journal of Respiratory and Critical Care Medicine Vol 175. pp. 1173-1180, (2007)
Ventilation-perfusion scintigraphy is highly sensitive for pulmonary embolism (PE), but its clinical usefulness is limited by its nondiagnostic rate. Objective analysis of single photon emission computed tomography (SPECT) three-dimensional scintigraphy may improve its diagnostic performance compared with subjective interpretation.
Although more than 100 Chlamydia pneumoniae hypothetical proteins have been predicted to be inclusion membrane proteins, only a few have been experimentally demonstrated to be in the inclusion membrane. Using antibodies raised with fusion proteins, we characterized four such hypothetical proteins encoded by two gene clusters (Cpn0146-147 and Cpn0284-285) in the C. pneumoniae genome.
European Heart Journal Volume 28, Number 10 Pp. 1221-1227
Obstructive sleep apnoea (OSA) is highly prevalent in patients with chronic heart failure (CHF) and may contribute to CHF progression. We aimed to determine whether treatment of OSA with continuous positive airway pressure (CPAP) would improve subjective and objective measures of heart failure severity in patients with CHF and OSA.
Current Opinion in Pediatrics. 19(3):328-332, June 2007
Pneumonia in children is frequently complicated by pleural effusions, which rarely progress to empyema. Appropriate clinical management depends on correctly diagnosing the stage of the disease process. Recently, increasing use of video-assisted thoracic debridement has altered the traditional management of pleural effusions and empyema in children, resulting in decreasing reliance on thoracentesis and earlier surgical intervention.
European Journal of Heart Failure Volume 9, Issues 6-7, June-July 2007, Pages 651-659
To compare the ability of different B-type natriuretic peptide (BNP) assays to identify heart failure in stable elderly patients with a diagnosis of chronic obstructive pulmonary disease (COPD).
The ability to recognize, understand, and treat pleural effusions in the pediatric population is important for pediatric health care providers. The topic of pleural effusions has been extensively studied in the adult population. In recent years, these studies have extended into the pediatric population.
The addition of theophylline or montelukast does not add anything to improve asthma control in poorly controlled asthmatics; however, in those patients not using inhaled corticosteroids, there is benefit to adding theophylline.
Clinical Pulmonary Medicine. 14(3):157-165, May 2007
Multidetector computed tomography (MDCT), with its ability to rapidly acquire very thin sections, has become the cornerstone of imaging of pulmonary embolism (PE). Its availability, speed, and high negative predictive value (95-99%) make it an ideal modality for the evaluation of PE. MDCT also allows the concurrent evaluation of a wide variety of other thoracic disorders, including pulmonary parenchymal diseases, aortic dissection, and coronary artery disease.
Clinical Pulmonary Medicine. 14(3):148-156, May 2007
Bronchoalveolar lavage (BAL) is a simple and safe procedure that can retrieve cells and acellular components from airspaces of the distal lung parenchyma. Analysis of BAL fluid and determination of white blood cell patterns may provide important information, which can assist in the diagnosis of interstitial lung disease when combined with a thorough clinical evaluation of the patient and accurately interpreted high-resolution computed tomography of the thorax.
To determine, in patients who had successful outcomes in spontaneous breathing trials (SBTs), whether the analysis of the minute ventilation (VE) recovery time obtained by minute-by-minute sequential monitoring after placing the patient back on mechanical ventilation (MV) may be useful in predicting extubation outcome.
A strong association between obstructive sleep apnea (OSA) and the risk for cardiovascular and cerebrovascular diseases has been reported. Continuous positive airway pressure (CPAP) is the first-line therapy for OSA, able not only to reduce daytime sleepiness but also to improve cardiovascular and metabolic outcomes.
The majority of asthmatic patients achieve control of their illness; others do not. It is therefore crucial to validate/develop strategies that help the clinician monitor the disease, improving the response to treatment.
APLAR Journal of Rheumatology, Volume 10, Number 2, June 2007, pp. 160-163(4)
We experienced a case of transient dermatomyositis with interstitial pneumonia, which was diagnosed on the basis of clinical manifestation and histology. The patient's symptoms, including both dermatomyositis and interstitial pneumonia, improved without pharmacological treatment.
To retrospectively determine if controlled apnea improves the image quality of contrast material-enhanced magnetic resonance (MR) angiography of the chest and abdomen in children.
International Archives of Occupational and Environmental Health, Volume 80, Number 5, April 2007, pp. 388-395(8)
In a cross-sectional study, 150 employees of a cotton spinning mill underwent lung function testing. Furthermore, in a random subset of 75 textile workers cross-shift lung function test and methacholine challenges were performed.
Patient Education and Counseling Volume 66, Issue 2, May 2007, Pages 162-166
The aims of this study were to identify prospective determinants of smoking cessation in COPD patients, and to assess whether prospective determinants vary between two different cessation interventions.
ANZ Journal of Surgery, Volume 77, Number 5, May 2007, pp. 344-346(3)
The collection of pleural fluid and thickened pleura restrict the movement and expansion of lung. The main treatment strategy is lung decortication for the thickened pleura. The aim of this study was to investigate lung functions before and after pleural decortication in young adults.
Annals of Allergy, Asthma and Immunology, Volume 98, Number 5, May 2007, pp. 455-463(9)
To investigate associations between traffic and outdoor air pollution levels near residences and poorly controlled asthma among adults diagnosed as having asthma in Los Angeles and San Diego counties, California.
Airflow limitation in COPD is due to a variable combination of small airway obstruction and centrilobular emphysema (CLE) and/or panlobular emphysema (PLE), but the relationship between these three different phenotypes is poorly understood.
Sympathetic nerve activity is increased in awake and regularly breathing patients with obstructive sleep apnea (OSA). Over time, repetitive hypoxic stress could alter sympathetic chemoreflex function in OSA.
Clinical Pulmonary Medicine. 14(3):179-182, May 2007
Wegener granulomatosis (WG) is the most common antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. Diagnosis often relies on a combination of clinical and histologic findings, with open lung biopsy considered the gold standard for confirmation of pulmonary involvement.
The safety of sputum induction (SI) is well described in stable asthma, but the safety of SI in exercise-induced bronchoconstriction (EIB) has not been established.
Smoking is one of the major lifestyle factors influencing the health of human beings. Life-long cigarette smokers have a higher prevalence of common diseases such as atherosclerosis and COPD with significant systemic impact. The present review evaluates current knowledge concerning possible pathways through which cigarette smoking can affect human health, with special focus on extrapulmonary effects. Long-term smoke exposure can result in systemic oxidants-antioxidants imbalance as reflected by increased products of lipid peroxidation and depleted levels of antioxidants like vitamins A and C in plasma of smokers.
Lenalidomide is an immunomodulatory agent approved for use in patients with myelodysplastic syndrome, and in combination with dexamethasone for refractory or relapsed multiple myeloma. Pulmonary toxicity is believed to be uncommon. In this report, we describe a patient receiving lenalidomide in whom dyspnea, fever, hypoxia, and diffuse pulmonary infiltrates developed. BAL demonstrated a significant lymphocytic alveolitis typical for hypersensitivity pneumonitis.
Puerto Ricans have the highest prevalence of asthma among all ethnic groups in the United States. There have been no studies that directly compare the burden of asthma between Puerto Ricans living in Puerto Rico and those living in the mainland United States.
This study aimed to assess the association of anxiety and depression with psychosocial and asthma-related functional impairment in a large-population-based sample of adolescents with asthma.
Allergy, Volume 62, Number 6, June 2007, pp. 591-604(14)
This review is the synthesis of a working group on mild asthma. Mild asthma includes intermittent and persistent mild asthma according to the Global Initiative for Asthma (GINA) classification, and affects between 50% and 75% of asthmatic patients.
Allergy, Volume 62, Number 6, June 2007, pp. 655-660(6)
Clinical tools for predicting poor outcomes in asthma patients are lacking. This study investigated the association of asthma control and subsequent severe asthma-related healthcare events in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study.
Allergy, Volume 62, Number 6, June 2007, pp. 661-667(7)
Extra-fine particle formulations of hydrofluoroalkane-134a beclometasone dipropionate (HFA-BDP) exhibit clinical effects comparable with conventional particle formulations of chlorofluorocarbon beclometasone dipropionate (CFC-BDP) at half the dose. There is little data comparing their effects on inflammation. We have evaluated the effects of HFA-BDP and CFC-BDP on pulmonary and systemic markers of asthmatic inflammation.
Allergy, Volume 62, Number 6, June 2007, pp. 668-674(7)
The Global Asthma Physician and Patient (GAPP) Survey is the first global quantitative survey designed to uncover asthma attitudes and treatment practices among separate groups of physicians and patients, with the goal of identifying barriers to optimal management.
To evaluate the influence of physical training with or without noninvasive ventilation at 2 levels of pressure in the airways
(BiPAP) in patients with chronic obstructive pulmonary disease.
To evaluate the technical feasibility of high spatial resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with highly accelerated parallel acquisition at 3.0 T using a 32-channel phased array coil, and a high relaxivity contrast agent.
Recently, the use of proton pump inhibitors (PPIs) has been associated with an increased risk of pneumonia. We aimed to confirm this association and to identify the risk factors.
New England Journal of Medicine Volume 356:2027-2039 May 17, 20007 Number 20
Treatment guidelines recommend the use of inhaled corticosteroids in patients with asthma who have persistent symptoms and the "stepping down" of therapy to the minimum needed to maintain control of asthma. Whether patients with asthma that is well controlled with the use of inhaled corticosteroids twice daily can receive a step-down treatment with once-daily montelukast (our primary hypothesis) or once-daily fluticasone propionate plus salmeterol (our secondary hypothesis) has not yet been determined.
New England Journal of Medicine Volume 356:2040-2052 May 17, 2007 Number 20
Treatment guidelines recommend the regular use of inhaled corticosteroids for patients with mild persistent asthma. We investigated whether the symptom-driven use of a combination of beclomethasone dipropionate and albuterol (also known as salbutamol) in a single inhaler would be as effective as the regular use of inhaled beclomethasone and superior to the as-needed use of inhaled albuterol.
New England Journal of Medicine Volume 356:2083-2091 May 17, 2007 Number 20
A 20-year-old woman with asthma was taken to the emergency room of another hospital because of cardiorespiratory arrest. The patient had had severe asthma since childhood. She was born after a normal pregnancy and delivery to a teenaged, single mother, who smoked three packs of cigarettes per day during pregnancy and during the patient's childhood.
New England Journal of Medicine Volume 356:2096-2100 May 17, 2007, Number 20
You are consulted by a 30-year-old white woman, who holds an administrative position in an office and has a lifelong history of asthma, about the treatment of her condition. In childhood, the patient visited her local hospital for treatment of acute asthma, but she was never admitted overnight and was discharged from the emergency department after a few "breathing treatments."
American Journal of Health-System Pharmacy, Vol. 64, Issue 10, 1054-1061
To evaluate the effectiveness of budesonide inhalation suspension relative to other common asthma therapies in a high-risk population, a study was conducted to compare the risk of having a repeat asthma-related hospitalization or emergency department (ED) visit in a Medicaid population of children; the relationship between asthma medication adherence level and repeat asthma hospitalizations or ED visits was also evaluated.
Despite growing recognition that asthma is an important cause of morbidity among American Indians, there has been no systematic study of this disease in older adults who are likely to be at high risk of complications related to asthma. Characterization of the impact of asthma among American Indian adults is necessary in order to design appropriate clinical and preventive measures.
To determine whether the detection of pneumococcal antigen in pleural fluid augments conventional microbiological methods used for the etiologic diagnosis of pneumonia.
Clinical Pulmonary Medicine. 14(3):117-126, May 2007
Respiratory muscles are responsible for alveolar ventilation. In chronic obstructive pulmonary disease (COPD), the function of these and other muscles is impaired as a result of different factors, including geometrical changes occurring in the thorax, metabolic mismatching, oxidative stress, and inflammation.
Clinical Pulmonary Medicine. 14(3):171-178, May 2007
Given its high prevalence and propensity to cause disabling disease, it is not surprising that COPD represents the most common indication worldwide for lung transplantation, accounting for nearly half of all lung transplant procedures. Despite over 4 decades of experience with this procedure in the COPD population, a number of important clinical issues remain unresolved.
We hypothesized that intermittent hypoxia might influence serum substance P levels, and that this effect might in turn contribute in excessive daytime sleepiness (EDS) in patients with obstructive sleep apnea syndrome (OSAS).
Rhinitis and asthma represent the manifestation of one syndrome. Our hypothesis is that in patients with symptoms of persistent rhinitis, lower airway inflammation, lower respiratory symptoms, and lung function abnormalities compatible with asthma are more frequently associated with the diagnosis of allergic rhinitis (AR) and chronic rhinosinusitis (CRS) than with nonallergic rhinitis (NAR).
The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 6, June 2007, pp. 695-702(8)
Comparable population-based data exist at the European level for asthma but not for chronic obstructive pulmonary disease. Data from the World Health Organization's Large Analysis and Review of European Housing and Health Status Study conducted in random samples from eight European cities were used 1) to describe the prevalence of chronic bronchitis and emphysema (CBE) and asthma according to socio-demography, addictions, physical activities and body mass index; and 2) to identify the co-morbidities of these respiratory diseases.
International Archives of Allergy and Immunology 2007;144:91-94
Chemokines and their receptors are involved in many aspects of immunity. Chemokine CX3CL1, acting via its receptor CX3CR1, regulates monocyte migration and macrophage differentiation as well as T cell-dependent inflammation.
Intracavitary cardiac metastasis is rare. Apart from causing intracardiac obstruction, this type of metastasis can present as pulmonary emboli. It is important to suspect this diagnosis in an oncology patient with recurrent pulmonary emboli, particularly in the setting of a negative venous Doppler ultrasound of the lower limbs and pelvis.
Acta Tropica Volume 101, Issue 3, March 2007, Pages 217-224
Pneumonia is one of the major killers of children under 5 years. Prompt and appropriate management is crucial; yet, the care a sick child receives depends on caretakers' perception of illness and action taken. Hence, understanding of local illness concepts on pneumonia and caretakers' response is crucial for interventions aimed at improved management.
Current Opinion in Pediatrics. 19(3):281-287, June 2007
The prevalence of severe asthma in children has risen in the past few decades. The present review explores our current understanding of epidemiology, pathophysiology and treatment of status asthmaticus in children.
International Journal of Pediatric Otorhinolaryngology Volume 71, Issue 4, April 2007, Pages 615-621
A link between the upper and lower airways has been convincingly demonstrated both in health and disease. To what extent the nose may be involved in children's asthma, has so far not been thoroughly investigated. In this study, we compared symptoms and signs from the upper airways in children with asthma and in children without to find out more about this.
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1123-1131
We studied the prevalence of asthma and allergy in non-elite marathon runners and investigated the effects of probiotic supplementation on allergic inflammatory markers.
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1183-1190
Wheeze and chest tightness has traditionally been associated with enhanced bronchial responsiveness. However, no community studies are available on the associations between bronchodilator response and respiratory symptoms among adults.
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1106-1112
B2-Agonists may exert mast cell stabilizing and anti-plasma exudation effects. While available data suggest no or only marginal effects of B2-agonists on symptoms of allergic rhinitis, little is known about whether these drugs may add to the efficacy of anti-rhinitis drugs.
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1191-1195
Long-term nocturnal non-invasive mechanical ventilation (NIMV) is an effective treatment for obesity-hypoventilation syndrome (OHS), improving central carbon dioxide (CO2) sensitivity. Leptin might contribute to sustain adequate ventilation in obesity. The aim of the study was to investigate the role of leptin in the OHS pathogenesis looking at its relationship to CO2 sensitivity before and after NIMV in OHS patients.
Obesity, hypertension, dyslipidemia, and hyperglycemia are prevalent in obstructive sleep apnea syndrome (OSAS). Metabolic syndrome, however, is defined by visceral fat obesity plus at least two of these factors. However, whether OSAS contributes to the development of metabolic syndrome has not been defined. We investigated whether the components of metabolic syndrome were associated with OSAS in nonobese patients.
Pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis (PCH) are two unusual idiopathic disorders that almost uniformly manifest to the clinician as pulmonary arterial hypertension (PAH). Impressive clinical signs and symptoms often obscure the true underlying capillary or postcapillary disorder, thus severely compromising timely and appropriately directed therapy.
Journal of Hospital Infection Volume 65, Issue 4, April 2007, Pages 285-291
The Dutch Working Party on Infection Prevention (WIP) aimed to determine whether certain humidification policies are better than others in terms of prevention of ventilator-associated pneumonia (VAP) in mechanically ventilated intensive care unit (ICU) patients.
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1313-1320
COPD is a heterogeneous disease comprising a wide range of clinical phenotypes, depending on the degree to which emphysema, chronic bronchitis, reversible bronchospasm and small airways inflammation are present. Not all of these phenotypes may be represented among the subjects included in randomized controlled drug trials (RCTs) in COPD, making it difficult for doctors to know to what extent RCT evidence applies to individual patients.
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1291-1298
The aim of this study was to investigate the relative burden of rhinitis and asthma on health-related quality of life (HRQL) as a function of gender and age in the general population.
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1155-1162
Atmospheric particulate matter (PM), an ingredient of urban pollution matter, is a mixture of solid and liquid particles differing in origin, dimension and composition. There is big concern about inhaled PM in urban areas, especially due to its adverse effects on the respiratory system.
Journal of Trauma-Injury Infection & Critical Care. 62(5):1201-1206, May 2007
To compare the effectiveness of supine versus prone kinetic therapy in mechanically ventilated trauma and surgical patients with acute lung injury (ALI) and adult respiratory distress syndrome (ARDS).
Journal of Hospital Infection Volume 65, Issue 4, April 2007, Pages 361-367
Initial antibiotic therapy is an important determinant of clinical outcomes in ventilator-associated pneumonia (VAP). Several studies have investigated this issue, with conflicting results. This study investigated risk factors of inadequate empirical antimicrobial therapy and its impact on outcomes for patients with a clinical diagnosis of VAP.
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1236-1243
To determine the structural and functional consequences of high-frequency neuromuscular electrical stimulation (hf-NMES) in a group of moderately impaired outpatients with chronic obstructive pulmonary disease (COPD).
Respiratory Medicine Volume 101, Issue 6, June 2007, Pages 1196-1204
The aim of this study was to compare the effects of interval training (3-min intervals) with continuous training on peak exercise capacity (W peak), physiological response, functional capacity, dyspnoea, mental health and health-related quality of life (HRQoL) in patients with moderate or severe COPD.
There is no recognized medical treatment for chronic pulmonary aspergillosis (CPA) apart from surgery in patients with simple aspergilloma. To evaluate the efficacy of voriconazole in this setting, we conducted a retrospective multicenter study over a 3-year period.
Application of mass spectrometry (MS) for direct measurements of desmosine (D) and isodesmosine (I) in urine, plasma, and sputum as markers of elastin degradation in patients with {alpha}1-antitrypsin deficiency (AATD) and non-AATD-related COPD.
Developing strategies for controlling the severity of pandemic influenza is a global public health priority. In the event of a pandemic there may be a place for inexpensive, readily available, effective adjunctive therapies to support containment strategies such as prescription antivirals, vaccines, quarantine and restrictions on travel. Inactivation of virus in the intranasal environment is one possible approach.
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