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International Archives of Occupational and Environmental Health 0340-0131 (Print) 10.1007/s00420-008-0328-y
The purpose of this study was to test whether population mortality rates from heart, respiratory and kidney disease were higher as a function of levels of Appalachian coal mining after control for other disease risk factors.
Pneumomediastinum is a result of perforation of the tracheobronchial tree. When air enters the interstitial space, air diffuses along the perivascular sheaths toward the mediastinum.
Nasal glial heterotopia (nasal glioma) is a rare congenital malformation of neural origin. We present a newborn baby with life-threatening respiratory distress secondary to nasopharyngeal glial heterotopia that obstructed the nasopharyngeal or nasal airway.
Arch. Dis. Child. Fetal Neonatal Ed.. Published Online First: 7 May 2008
To determine the impact of maternal and fetal intrauterine inflammatory responses (chorioamnionitis and umbilical vasculitis) on the development of neonatal respiratory distress syndrome (RDS) in preterm infants.
The Journal of Infectious Diseases 2008;197:1511-1518
Nasopharyngeal carriage of Streptococcus pneumoniae is required for transmission of the bacteria and for invasive disease. There have been conflicting reports as to whether protection against carriage is serotype specific and which immune mechanisms drive carriage.
Journal of Intensive Care Medicine, Vol. 23, No. 3, 204-209 (2008)
The use of the central venous catheter may be complicated by air embolism when central venous pressure is subatmospheric and the catheter is open to the surrounding air.
Clinical & Experimental Immunology, Volume 152, Number 3, June 2008 , pp. 440-447(8)
CCR6 is expressed by multiple leucocyte subsets, including peripheral blood memory T cells, and mouse models implicate a role for this receptor in diverse inflammatory responses that include allergic airway disorders, inflammatory bowel disease and autoimmune encephalitis.
Journal of the Medical Association of Thailand Vol91 No.4 527 5731
Extended-spectrum beta-lactamases (ESBLs) are most prevalent in Klebsiella
pneumoniae. This organism is frequently isolated from clinical specimens and can cause septicemia, pneumonia or urinary tract infection. There were occasionally suspicious outbreaks of
ESBL-producing K. pneumoniae in patients’ wards. The objective is to determine whether the randomly amplified polymorphic DNA
(RAPD), which is a polymerase chain reaction (PCR)-based typing technique, can be used as a typing method for studying the molecular epidemiology of
ESBL-producing K. pneumoniae.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0187-5
Tongue retaining devices (TRDs) are one type of oral appliance used to treat sleep disordered breathing. Previous studies have evaluated customized TRDs in comparison to mandibular repositioner appliances.
Current Opinion in Pediatrics. 20(3):288-293, June 2008
With rapid advances in the understanding and treatment of pulmonary arterial hypertension, navigating the pediatric literature becomes challenging. A comprehensive review of the most recent literature over the past year on available and emerging novel therapies as well as an approach to target pediatric populations will provide insight into the current management of pediatric pulmonary hypertension patients.
Indian Journal of Otolaryngology and Head & Neck Surgery Volume 60, Number 1 / March, 2008 25-29
The purpose of this study is to assess the role of dynamic MR imaging in the evaluation of obstructive sleep apnea. In this prospective study, MRI was performed in 22 patients (eighteen male and four female, ranging in age from 26 to 70 years) suspected of having obstructive sleep aponea (OSA).
It is well known that homozygous deficiency of {alpha}1-antitrypsin, PiZZ, is associated with an increased risk of emphysema. However, studies evaluating associations between the heterozygous form PiMZ with emphysema and impaired lung function have provided conflicting results.
In patients with COPD, prognosis might be determined at least in part by the extent of cardiac stress induced by hypoxia and pulmonary arterial hypertension.
PEDIATRICS Vol. 121 No. 5 May 2008, pp. e1250-e1257
The optimal management of pediatric empyema is controversial. The purpose of this decision analysis was to assess the relative merits in terms of costs and clinical outcomes associated with competing treatment strategies.
Mycobacterium avium complex (MAC) is an increasingly recognized cause of pulmonary disease in immunocompetent individuals. An acute form of MAC lung disease, MAC-associated pneumonitis, has generally been associated with the use of hot tubs. There is controversy in the literature about whether MAC-associated pneumonitis is a classic hypersensitivity pneumonitis or is a direct manifestation of mycobacterial infection.
Journal of Intensive Care Medicine, Vol. 23, No. 3, 159-177 (2008)
Cystic fibrosis was previously thought to be a disease of childhood. With a better understanding of this condition along with improvements in therapy, patients with cystic fibrosis are now living well into adulthood.
Current Opinion in Pediatrics. 20(3):272-278, June 2008
In this review, we discuss recent advances in our understanding of the etiology, pathology and pathogenesis, clinical presentation, diagnosis, treatment, and outcome of bronchiolitis obliterans in the nontransplant, pediatric population.
Some studies have suggested that use of long-acting {beta}2-agonists (LABAs) leads to an increased risk for adverse events in patients with stable COPD. The purpose of this review was to assess the safety, and secondarily the efficacy of LABAs.
Matrix metalloproteinase (MMP)-7 was reported to be a key molecule in the pathogenesis of idiopathic pulmonary fibrosis (IPF) based on the result of microarray analysis and knockout mice. However, the role of MMP-7 has not been determined in other types of idiopathic interstitial pneumonia (IIP).
Epidemiological studies have demonstrated adverse health effects of environmental pollution. Diesel exhaust (DE) is a major contributor to particulate matter pollution. DE exposure has been shown to induce a pronounced inflammatory response in the airways, together with an enhanced epithelial expression of cytokines such as IL-8, Gro-alpha, IL-13 and activation of redox sensitive transcription factors (NFKB, AP-1), and MAP kinases (p38, JNK).
Alveolar volume measured according to the American Thoracic Society-European Respiratory Society (ATS-ERS) guidelines during the single breath diffusion test can be underestimated when there is maldistribution of ventilation.
The assessment of airway inflammation for the diagnosis of asthma or COPD is still uncommon in pneumology-specialized general practices. In this respect, the measurement of exhaled nitric oxide (NO), as a fast and simple methodology, is increasingly used. The indirect assessment of airway inflammation, however, does have its limits and therefore there will always be a need for methods enabling a direct evaluation of airway inflammatory cell composition. Sampling of spontaneous sputum is a well-known, simple, economic and non-invasive method to derive a qualitative cytology of airway cells and here we aimed to assess today's value of spontaneous sputum cytology in clinical practice.
To compare mechanical ventilation (MV) with phrenic nerve stimulation (PNS) for treatment of respiratory device-dependent (RDD) spinal cord-injured (SCI) patients.
Stem Cells Vol. 26 No. 4 April 2008, pp. 1017 -1026
Circulating endothelial progenitor cells (EPCs) contribute to neovascularization of ischemic tissues and repair of injured endothelium. The role of bone marrow-derived progenitor cells in hypoxia-induced pulmonary vascular remodeling and their tissue-engineering potential in pulmonary hypertension (PH) remain largely unknown.
Medical Microbiology and Immunology 0300-8584 (Print) 10.1007/s00430-008-0097-y
We here describe four proteins of Chlamydia pneumoniae, which might play a role in host-pathogen interaction. The hypothetical bacterial proteins CPn0708 and CPn0712 were detected in Chlamydia pneumoniae-infected host cells by indirect immunofluorescence tests with polyclonal antisera raised against the respective proteins.
European Radiology 0938-7994 (Print) 10.1007/s00330-008-1002-1
The present study aimed to assess the feasibility of four-dimensional (4D) chest computed tomography (CT) under tidal volume ventilation and the impact of respiratory motion on quantitative analysis of CT measurements.
ediatric Allergy and Immunology, Volume 19, Number 4, June 2008 , pp. 307-314(8)
This cross-sectional study of children aged 6-7-years and adolescents aged 13-14-years in Bogotá, Colombia, assessed the prevalence of asthma symptoms and their associations with dietary, health, and behavioral habits.
Pediatric Allergy and Immunology, Volume 19, Number 4, June 2008 , pp. 287-295(9)
T lymphocyte apoptosis is essential for maintaining immune system homeostasis. Experimental evidence suggests apoptosis control mechanisms may be impaired in inflammatory conditions, particularly airway Th2-type allergic diseases.
Current Opinion in Pediatrics. 20(3):279-287, June 2008
Sickle cell disease is one of the most prevalent genetic diseases, affecting 1 in 600 African-Americans. The lung is one of the major organs affected in sickle cell disease and the pulmonary complications of sickle cell disease result in significant morbidity and mortality in children.
PEDIATRICS Vol. 121 No. 5 May 2008, pp. e1160-e1166
More than 500000 adolescents with special health care needs age into adulthood each year in the United States, and there is growing recognition of the need for support of their transition to adult-oriented health care. Because of improved survival, cystic fibrosis has experienced this increasing transition need, and cystic fibrosis policy leaders responded by mandating the transition of adults with cystic fibrosis to adult-focused cystic fibrosis care programs by 2000.
The surfactant proteins B (SP-B) and C (SP-C) are important for the stability and function of the alveolar surfactant film. Their involvement and down-regulation in inflammatory processes has recently been proposed, but their level during neutrophilic human airway diseases are not yet known.
Currently, there is much interest in measuring fractional exhaled nitric oxide (FENO) in populations. We evaluated the reproducibility of FENO in healthy subjects and determined the number of subjects necessary to carry out a longitudinal survey of FENO in a population containing smokers and non-smokers, based on the assessed reproducibility.
All bronchoscopies performed on suspicion of lung malignancy in 2003 and 2004 were reviewed, and 363 patients with proven malignant lung disease were included in the study.
As supra-physiological intake of corticosteroids is a well known risk factor for the development of adrenal insufficiency, we investigated the function of the hypothalamic-pituitary-adrenal (HPA) axis during a 14-day course of systemic corticosteroids in patients with acute exacerbation of chronic obstructive pulmonary disease using clinical and laboratory measures.
Using flexible bronchoscopy, 82 SEMAS (67% Ultraflex, 33% Wallstent) were placed in 35 patients with inoperable lesions, many with significant medical comorbidities (88%). 68% of stents were tracheal, and 83% of patients showed immediate symptomatic improvement. Reversible complications developed in 9% of patients within 24 hrs of stent placement. Late complications (>24hrs) occurred in 77% of patients, of which 37% were clinically significant or required an interventional procedure.
International Journal of COPD Issue: ON-LINE EARLY
Static lung hyperinflation has important clinical consequences in patients with chronic obstructive pulmonary disease (COPD). Given that most of these patients have respiratory and peripheral muscle weakness, dyspnea and functional exercise capacity may improve as a result of inspiratory muscle training (IMT).
Involuntary coughing such as that evoked from the larynx, the laryngeal cough reflex (LCR), triggers a coordinated contraction of the thoracic, abdominal and pelvic muscles, which increases intra-abdominal pressure (IAP), displaces the diaphragm upwards and generates the expiratory force for cough and airway clearance.
Can Fam Physician Vol. 54, No. 5, May 2008, pp.740 - 741
Does treatment with salmeterol and fluticasone propionate combination (SFPC) reduce all-cause mortality compared with placebo (PL) in patients with chronic obstructive pulmonary disease (COPD)?
The outcome of patients with bronchiectasis during and after their stay in the intensive care unit (ICU) has seldom been reported in the literature. Managing these patients in the ICU can be challenging because of the complex nature of their disease. This study aims to identify the in-hospital and long-term outcome of patients with bronchiectasis and respiratory failure (RF) in ICU.
In the management of asthma, features of care important to patients may not be fully appreciated. This study quantifies the importance of different features of asthma management from the patient perspective. This may assist in the development of personalised management strategies.
Can Fam Physician Vol. 54, No. 5, May 2008, pp.742 - 743
Bronchiolitis is the most common lower respiratory tract infection in infants. It is the leading cause of hospitalization of infants younger than age 1, and more than 80% of children hospitalized are younger than 6 months of age.
International Journal of COPD Issue: ON-LINE EARLY
Although medical treatment of COPD has advanced, nonadherence to medication regimens poses a significant barrier to optimal management. Underuse, overuse, and improper use continue to be the most common causes of poor adherence to therapy.
International Journal of COPD Issue: ON-LINE EARLY
Dyspnea in patients with known chronic obstructive pulmonary disease (COPD) can be a clinical challenge due to the nonspecific nature of atypical presentations. Typical features of fever, productive cough, and wheezing on presentation support COPD exacerbation, while absence of such findings may warrant further evaluation for underlying etiologies, including pulmonary embolism (PE).
We previously demonstrated that chronic pulmonary infection with Cryptococcus neoformans results in enhanced allergic inflammation and airway hyperreactivity in a rat model. Because the cell wall of C. neoformans consists of chitin, and since acidic mammalian chitinase (AMCase) has recently been implicated as a novel mediator of asthma, we sought to determine whether such infection induces chitinase activity and expression of AMCase in the rat.
Vascular Health and Risk Management Issue:ON-LINE EARLY
Treprostinil is a stable, long-acting prostacyclin analogue which can be administered as a continuous subcutaneous infusion using a portable miniature delivery system. Subcutaneous treprostinil has been shown in a large multicenter randomized controlled trial to improve exercise capacity, clinical state, functional class, pulmonary hemodynamics, and quality of life in patients with pulmonary arterial hypertension, an uncommon disease of poor prognosis.
Clinical & Experimental Allergy, Volume 38, Number 5, May 2008 , pp. 767-773(7)
Early wheezing in infants is a potential risk factor for persistence of asthma into adulthood. Moreover, a personal or familial history of atopy are risk factors associated with persistence of pre-existing wheezing during childhood. However, their relative importance remains unclear.
Clinical & Experimental Allergy, Volume 38, Number 5, May 2008 , pp. 774-780(7)
TNF-{alpha} and IL-13, two pivotal pro-inflammatory cytokines, are increased in asthmatic airways and may be linked to asthma susceptibility and/or bronchial hyperresponsiveness (BHR).
The Proceedings of the American Thoracic Society 5:381-384 (2008)
The National Emphysema Treatment Trial (NETT) was a multicenter, randomized, controlled clinical trial, comparing the efficacy of lung volume reduction surgery (LVRS) plus medical management with rehabilitation to medical management with rehabilitation in 1,218 patients with severe emphysema.
Fatigue is a common complaint in patients with sarcoidosis. We studied the effectiveness of dexmethylphenidate hydrochloride (d-MPH) in treating sarcoidosis-associated fatigue.
CardioVascular and Interventional Radiology 0174-1551 (Print) 10.1007/s00270-008-9339-z
Introducing gas to the circulation is a largely iatrogenic problem which can result in serious morbidity and even death. We report a case of CT-guided needle biopsy of a pulmonary lesion complicated by acute stroke.
The Proceedings of the American Thoracic Society 5:393-405 (2008)
The National Emphysema Treatment Trial (NETT) has published many articles reporting the various outcomes of lung volume reduction surgery versus medical treatment for patients with severe emphysema.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1090-1094, (2008)
Impaired skeletal muscle function contributes to exercise limitation in patients with chronic obstructive pulmonary disease (COPD). This is characterized by reduced mitochondrial adenosine triphosphate generation, and greater reliance on nonmitochondrial energy production.
Pediatric and Developmental Pathology Volume 11, Issue 2 (March-April 2008)
Lung transplantation offers life-saving and life-extending treatment for children and adolescents with congenital and acquired forms of pulmonary and pulmonary vascular disease, for whom medical therapy is ineffective or insufficient for sustained response.
Current Respiratory Medicine Reviews, Volume 4, Number 2, May 2008 , pp. 85-89(5)
Orexins (orexin-A and orexin-B) are produced in the lateral hypothalamic area, also known as the feeding center, have been implicated to play a critical role in central regulation and maintenance of sleep and wakefulness state, feeding and energy homeostasis by acing upon its receptors (orexin receptor 1 and orexin receptor 2) respectively.
Current Respiratory Medicine Reviews, Volume 4, Number 2, May 2008 , pp. 95-99(5)
Obesity trends continue to rise in alarming proportions worldwide. Obstructive sleep apnea, an increasingly commonly recognized disorder, is characterized by recurrent episodes of upper airway closure during sleep, and obesity is proposed to be its strongest risk factor.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1082-1089, (2008)
The common cold virus, human rhinovirus (HRV), is the most frequent cause of asthma exacerbations. However, a possible contribution of HRV to the pathogenesis of chronic, persistent asthma has not been defined.
Surgical Endoscopy, Volume 22, Number 3, March 2008 , pp. 679-682(4)
This study aimed to determine the possible cause for an unacceptable frequency of postresectional pneumothorax in cases of ultrasonic scalpel use without a further reinforcing maneuver in lung biopsy during video-assisted thoracic surgery (VATS).
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1095-1102, (2008)
Oxygen-enhanced magnetic resonance imaging (MRI) has been proposed as a useful tool for assessing regional morphological and functional changes in chronic obstructive pulmonary disease (COPD).
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1074-1081, (2008)
Despite increasing recognition of bone morphogenetic protein (BMP) signaling in tissue remodeling, the expression pattern of ligands and signaling pathways remain undefined in the asthmatic airway.
Current Opinion in Pediatrics. 20(3):261-265, June 2008
Novel therapies, such as a heliox gaseous mixture and noninvasive bilevel positive pressure ventilation, are being utilized in the treatment of the patient with severe asthma who is unresponsive to conventional medical management. Aggressive treatment may prevent intubation and its untoward complications.
Current Opinion in Pediatrics. 20(3):266-271, June 2008
To summarize the current state of the art in upper-airway evaluation, focusing on endoscopic techniques, and especially to make a comparison between rigid and flexible instrumentation.
European Archives of Oto-Rhino-Laryngology 0937-4477 (Print) 10.1007/s00405-008-0688-7
This study aimed to evaluate the efficacy and safety of single-session radiofrequency tongue base reduction (RTBR) combined with uvulopalatopharyngoplasty (UPPP) for the treatment of obstructive sleep apnea syndrome (OSAS).
European Archives of Oto-Rhino-Laryngology 0937-4477 (Print) 10.1007/s00405-008-0673-1
Snorers represent a heterogeneous group that requires adequate assessment before recommending surgical treatment. Most studies of the pathophysiology of snoring and obstructive sleep apnea have emphasized anatomical abnormalities in the oropharyngeal and hypopharyngeal airways.
The 27-kDa heat shock protein (Hps27) is phosphorylated in a way that appears to regulate antioxidant defenses by mitogen-activated protein kinase (MAPK)-activated protein kinase 2 (MK2), a component of the p38MAPK pathway.
A cluster randomised trial was conducted to determine the effectiveness of locally adapted practice guidelines and education about paediatric asthma management, delivered to general practitioners (GPs) in small group interactive workshops.
European Spine Journal 0940-6719 (Print) 10.1007/s00586-008-0668-z
Patients undergoing spinal surgery are at risk of developing thromboembolic complications even though lower incidences have been reported as compared to joint arthroplasty surgery.
Tracheobronchopathia osteochondroplastica (TO) is a rare benign disease of the endobronchial system with nonspecific symptoms and different treatment approaches.
Global Initiative on Chronic Obstructive Lung Disease (GOLD) guidelines recently removed stage 0, a group with symptoms but without airways obstruction, from their severity staging. However, in practice this group may still be diagnosed and medically managed.
While patients with interstitial lung disease (ILD) may be particularly susceptible to ventilator-induced lung injury, ventilator strategies have not been studied in this group of patients.
Air travel may pose risks to ex-preterm neonates due to the low oxygen environment encountered during flights. We aimed to study the utility of the preflight hypoxia challenge test (HCT) to detect in-flight hypoxia in such infants.
Strategies for ordering bedside chest radiographs (CXRs) have substantial logistic and financial consequences in the ICU. Many of the indications for CXRs in the ICU are controversial, such as the ordering of daily routine CXRs for intubated patients.
Over the last decade, several studies have suggested that survival rates for patients with acute lung injury (ALI) or ARDS may have improved. We performed a systematic analysis of the ALI/ARDS literature to document possible trends in mortality between 1994 and 2006.
Autosomal dominant polycystic kidney disease (ADPKD) is a common disease with several known extrarenal manifestations, although no known pulmonary features. The formation of renal cysts in ADPKD has been attributed to dysfunction of primary cilia and the primary cilia-related proteins polycystin-1 (in 85% of cases) and polycystin-2 in renal epithelial cells. The goals of this study were to characterize the normal expression of polycystin-1 in the motile cilia of airway epithelial cells and to evaluate lung structure in ADPKD patients.
The combined measurement of diffusing capacity of the lung for nitric oxide (DLNO) and diffusing capacity of the lung for carbon monoxide (DLCO) is a simple, noninvasive tool, but methodologic factors might influence results and reproducibility. We thus quantified the influence of breath-hold time on DLCO and DLNO in subjects with or without airway disease.
Infection Volume 36, Number 2 / April, 2008 163-166
The induction of C-reactive Protein (CRP) may be attenuated by corticosteroids, whereas Procalcitonin (PCT) appears to be unaltered. We investigated, whether in community-acquired pneumonia (CAP) a combined antibiotic-corticosteroid therapy may actually lead to different slopes of decline of these inflammatory markers.
European Archives of Oto-Rhino-Laryngology 0937-4477 (Print) 10.1007/s00405-008-0685-x
ApneaGraph relies on measuring pressure and airflow simultaneously at different levels in the pharynx identifying the segment of airway obstruction and providing baseline respiratory parameters.
The protocol used for the 6-min walk test (6MWT) influences its results. The only study to examine the effect of modifying track layout performed a retrospective analysis and concluded that institutions using continuous tracks yield greater distances than those using straight tracks. Agreement between the distances measured on different tracks could not be examined. We evaluated the effect of modifying track layout on walk distance and examined the agreement and repeatability of distances measured on different tracks.
Depressive conditions in asthma patients have been described mostly from patient reports and less often from physician reports. While patient reports can encompass multiple symptoms, physician assessments can attribute symptoms to a mental health etiology. Our objectives were to identify associations between patient- and physician-reported depressive conditions and asthma severity and control.
Obstructive sleep apnea (OSA) is associated with increased perioperative risk, but the incidence of postoperative complications and the severity of OSA associated with increased risk have not been established.
Can Fam Physician Vol. 54, No. 5, May 2008, pp.706 - 711
Chronic obstructive pulmonary disease (COPD) is a systemic disorder caused mainly by smoking and is characterized by progressive irreversible, or partially reversible, airflow obstruction; systemic manifestations; and recurrent exacerbations.
Approximately one third of patients with sickle cell disease (SCD) have pulmonary hypertension (PH), which increases their risk of death. Endothelin (ET)-1 is elevated in SCD and appears to play a key role in many of the pathologic processes in this disease, including PH, suggesting that endothelin receptor antagonists such as bosentan may be effective in treating patients with SCD, particularly those with PH.
Oral appliances (OAs) are first-line therapy for mild-to-moderate obstructive sleep apnea (OSA) and are being used with increasing frequency. Additionally, best practice of OA titration is unknown. We describe the experience of patients treated with an OA, identify factors that predict treatment success with an OA, and offer a protocol for OA titration.
Acute eosinophilic pneumonia (AEP) is characterized by a febrile illness, diffuse pulmonary infiltrates, and pulmonary eosinophilia. The etiology of AEP remains unknown, but several studies have proposed a relationship between cigarette smoking and AEP. However, most studies showing this possibility are single-case reports, and cigarette smoke has not been fully validated as a causative agent of AEP in a large series of patients. The present study was conducted to clarify the etiologic role of cigarette smoking in AEP, with special reference to alterations in smoking habits.
The Proceedings of the American Thoracic Society 5:524-529 (2008)
Pulmonary rehabilitation is an established treatment for patients with chronic lung disease. Benefits include improvement in exercise tolerance, symptoms, and quality of life, with a reduction in the use of health care resources.
Although long recognized as a nosocomial organism, methicillin-resistant Staphylococcus aureus (MRSA) has been noted to have an increasing incidence in both immunocompromised and otherwise healthy people in the community.
We present a case of bronchial disruption after blunt chest trauma, which is unusual because the pneumomediastinum on the chest radiograph was detected 7 days after the injury.
International Journal of Clinical Practice doi:10.1111/j.1742-1241.2008.01731.x
Statins have diverse anti-inflammatory effects in addition to their lipid-lowering ability. This study assesses the rate of chronic obstructive pulmonary disease (COPD) exacerbation and intubations in patients taking statins.
Am J Physiol Lung Cell Mol Physiol 294: L817-L829, 2008
Combustion-derived and synthetic nano-sized particles (NSP) have gained considerable interest among pulmonary researchers and clinicians for two main reasons. 1) Inhalation exposure to combustion-derived NSP was associated with increased pulmonary and cardiovascular morbidity and mortality as suggested by epidemiological studies.
Cardiac arrest causes devastating neurologic morbidity and mortality. The preservation of the brain function is the final goal of resuscitation. Therapeutic hypothermia (TH) has been considered as an effective method for reducing ischemic injury of the brain.
A 66-year-old woman was cared for at two referral institutions following a witnessed cardiac arrest in a local emergency department. Despite aggressive initial care, she failed to regain consciousness during a 28-day course.
Current Respiratory Medicine Reviews, Volume 4, Number 2, May 2008 , pp. 90-94(5)
Obesity affects pulmonary function profoundly. Lung pathology is rarely found in obese people. Thus the functional abnormalities often observed in obese people (e.g., reduced lung volumes, increased airway resistance, hypoxemia and hypercapnia) are a consequence of the added load presented by chest wall adiposity to the respiratory system.
The Proceedings of the American Thoracic Society 5:421-426 (2008)
Delineating the extent and distribution of emphysema is an essential component of the evaluation of candidates for lung volume reduction surgery (LVRS). Imaging also may identify contraindications to LVRS, including bronchiectasis and pleural scarring.
The Proceedings of the American Thoracic Society 5:412-415 (2008)
The National Emphysema Treatment Trial (NETT) required the coordinated evaluation and treatment of thousands of patients with emphysema simultaneous with data collection to evaluate the safety and efficacy of surgery versus medical treatment for emphysema.
Exacerbation of chronic obstructive pulmonary disease (COPD) is an important cause of morbidity and mortality, but the effect of metabolic compensation of respiratory acidosis (RA) on mortality is not fully understood.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1128-1134, (2008)
Pulmonary arterial hypertension (PAH) may be classified as idiopathic (IPAH) or familial (FPAH) or associated with various conditions and exposures such as dexfenfluramine intake (Dex-PAH) or systemic sclerosis (SSc-PAH).
When severe COPD and obstructive hypertrophic cardiomyopathy (HCM) coexist, management is challenging and complex. Drug contraindications limit pharmacologic options. Patients may not be candidates for surgical septal myectomy due to severe pulmonary disease.
Current Respiratory Medicine Reviews, Volume 4, Number 2, May 2008 , pp. 105-109(5)
In the last few decades, obesity has captured the attention of the medical community, as well as the general public. Obesity has been shown to be a direct cause or a contributor to the development of various chronic diseases.
Nocturnal noninvasive ventilation (NNV), the provision of ventilatory assistance via a noninvasive interface mainly during sleep, has assumed an important role in the management of chronic hypoventilatory syndromes. This review focuses on recent developments related to the use of NNV to treat various forms of chronic respiratory failure or insufficiency.
This review discusses the usefulness of bedside lung ultrasound in the diagnostic distinction between different causes of acute dyspnea in the emergency setting, particularly focusing on differential diagnosis of pulmonary edema and exacerbation of chronic obstructive pulmonary disease (COPD).
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1150-1155, (2008)
Epidemiologic studies on the consequences of sleep-disordered breathing invariably use the apnea-hypopnea index as the primary measure of disease severity. Although hypopneas constitute a majority of disordered breathing events, significant controversy remains about the best criteria used to define these events.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1122-1127, (2008)
The management of chronic thromboembolic pulmonary hypertension (CTEPH) has changed over recent years with the growth of pulmonary endarterectomy surgery and the availability of disease-modifying therapies.
The measurement of the fractional concentration of exhaled nitric oxide (FeNO) is a convenient, noninvasive, point-of-service office test for airway inflammation. The first half of this practice management review presents the methodological, interpretative, and clinical applications of FeNO.
Acute febrile respiratory illness (FRI) leading to respiratory failure is a common reason for admission to the ICU. Viral pneumonia constitutes a portion of these cases, and often the viral etiology goes undiagnosed. Emerging viral infectious diseases such as severe acute respiratory syndrome and avian influenza present with acute FRIs progressing to respiratory failure and ARDS.
The Proceedings of the American Thoracic Society 5:416-420 (2008)
It is not readily apparent how pulmonary function could be improved by resecting portions of the lung in patients with emphysema. In emphysema, elevation in residual volume relative to total lung capacity reduces forced expiratory volumes, increases inspiratory effort, and impairs inspiratory muscle mechanics.
Current Respiratory Medicine Reviews, Volume 4, Number 2, May 2008 , pp. 110-115(6)
We review studies examining the impact of obesity on survival, morbidity, and respiratory failure in critical illness. Given the increasing rates of overweight and obesity, there is a surprising lack of well-conducted clinical trials addressing its interaction with critical illness.
The Proceedings of the American Thoracic Society 5:406-411 (2008)
Lung volume reduction surgery (LVRS) is a costly procedure that can improve quality and quantity of life. Given the prevalence of emphysema, the costs involved with its management, and resource constraints on all health care delivery systems, evaluating the cost-effectiveness of LVRS is important.
Current Respiratory Medicine Reviews, Volume 4, Number 2, May 2008 , pp. 100-104(5)
The obesity hypoventilation syndrome (OHS) characterized by persistent hypercapnia with obesity has many causes. Probably the most common cause is the obstructive sleep apnea syndrome and related conditions, but some cases may occur along with depressed chemosensitivity and few apneas during sleep.
To summarize the current literature on mechanical ventilation of patients with chronic obstructive pulmonary disease (COPD) using published data to augment commonly accepted principles of clinical practice.
Digestive Diseases and Sciences 0163-2116 (Print) 10.1007/s10620-008-0265-3
It is a commonly held notion that patients with cirrhosis do not suffer from deep vein thrombosis (DVT) or pulmonary embolism (PE) because they are naturally anticoagulated. However, to date, no studies have been carried out that objectively address this issue.
Archives of Dermatological Research 0340-3696 (Print) 10.1007/s00403-008-0859-9
Several reports have demonstrated an association between psoriasis and cardiovascular diseases such as hypertension, valvular disease and arrhythmia. However, the data is scarce.
Am J Physiol Lung Cell Mol Physiol 294: L942-L954, 2008
These data therefore 1) confirm that H441 cells can express selective or nonselective GNa (14, 48), 2) show that these conductances are both induced by glucocorticoids/SGK1 and subject to PI3K-dependent regulation, and 3) establish that cell-cell contact is vitally important to the development of Na+ selectivity and amiloride sensitivity.
Am J Physiol Lung Cell Mol Physiol 294: L921-L931, 2008
Cigarette smoke is a major environmental air pollutant that injures airway epithelium and incites subsequent diseases including chronic obstructive pulmonary disease. The lesion that smoke induces in airway epithelium is still incompletely understood.
Am J Physiol Lung Cell Mol Physiol 294: L932-L941, 2008
Airway surface liquid (ASL) absorption is initiated by Na+ entry via epithelial Na+ channels (ENaC), which establishes an osmotic gradient that drives fluid from the luminal to serosal airway surface.
Am J Physiol Lung Cell Mol Physiol 294: L902-L911, 2008
Reactive oxygen species (ROS) signal vital physiological processes including cell growth, angiogenesis, contraction, and relaxation of vascular smooth muscle. Because cytochrome P-450 family 4 (CYP4)/20-hydroxyeicosatetraenoic acid (20-HETE) has been reported to enhance angiogenesis, pulmonary vascular tone, and endothelial nitric oxide synthase function, we explored the potential of this system to stimulate bovine pulmonary artery endothelial cell (BPAEC) ROS production.
Eosinophilic bronchitis without asthma causes chronic coughs without the physiologic features of asthma. The aim of this study was to review the clinical features, pathogenesis, diagnosis, treatment and prognosis of this condition.
International Archives of Occupational and Environmental Health 0340-0131 (Print) 10.1007/s00420-008-0322-4
To study the predictive power of respiratory screening examinations a cohort of asbestos workers was followed from active work in an asbestos cement plant until death.
Lung herniation, defined as a protrusion of the lung parenchyma with pleural membranes through a defect of the thoracic wall, is a rare entity. As minimally invasive cardiac procedures evolve, different complications may be evident such as lung herniation.
The Proceedings of the American Thoracic Society 5:561-566 (2008)
Patients with emphysema may experience reduced health-related quality of life (HRQOL). HRQOL measures have evolved from two different measurement traditions: psychometric theory and decision theory.
The Proceedings of the American Thoracic Society 5:556-560 (2008)
Various psychological and cognitive difficulties have been documented in patients with emphysema. The aim of this article is to review prior literature on the prevalence of these difficulties in emphysema, as well as identify specific studies demonstrating improvement in these areas after therapy.
Thorax. Published Online First: 3 April 2008. doi:10.1136/thx.2007.088096
OSA is associated with high cardiovascular morbidity and mortality. Randomised controlled trials have shown that on average CPAP treatment of OSA reduces blood pressure by about 3 to 5mmHg, although with considerable inter-individual variation. No predictors of BP change with CPAP have been convincingly identified. This prospective study aimed to determine predictors of BP change, which might provide insight into the aetiology of the raised blood pressure seen in untreated OSA.
Thorax. Published Online First: 11 April 2008. doi:10.1136/thx.2008.096388
Impaired development in utero is suggested to increase the risk of poor respiratory health in adulthood, although a consensus has not been reached. A possible explanation for discrepancies between previous studies is inconsistent controlling for potential confounding factors, particularly childhood infections. Also, little is known regarding the relative importance of factors operating at different stages of the lifecourse. We have used detailed longitudinal data from the Newcastle Thousand Families cohort to assess the impact of birth weight, and various other factors acting throughout the lifecourse, on predicting forced expiratory volume in one second (FEV1).
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.081877
The obstructive sleep apnea/hypopnea syndrome (OSAHS) is associated with hypertension and increased cardiovascular risk, particularly when accompanied by marked nocturnal hypoxemia. The mechanisms of these associations are unclear. We hypothesised that OSAHS combined with severe nocturnal hypoxemia causes impaired vascular function that can be reversed by continuous positive airways pressure (CPAP) therapy.
The Proceedings of the American Thoracic Society 5:536-542 (2008)
Sleep abnormalities are common in severe emphysema, and include poor sleep quality, the development of nocturnal oxygen desaturation, and the presence of coexistent obstructive sleep apnea.
The Proceedings of the American Thoracic Society 5:513-518 (2008)
Since the introduction of oxygen as a therapeutic agent 70 years ago, much has been learned regarding the detrimental effects of hypoxemia and the beneficial impact of oxygen therapy.
The Proceedings of the American Thoracic Society 5:519-523 (2008)
It is clear that being underweight is a poor prognostic sign in chronic obstructive pulmonary disease (COPD). It is also clear that undernutrition is at least in part associated with the severity of airflow obstruction.
The Proceedings of the American Thoracic Society 5:506-512 (2008)
Systemic and local inflammation is central to the pathophysiology of chronic obstructive pulmonary disease (COPD). Increased levels of inflammation have been linked to a more progressive course in COPD and have been shown to be present during an exacerbation.
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.088930
The clinical impact of nocturnal desaturation on health-related quality of life (HRQL) and sleep in COPD has been little studied. We aimed to evaluate the prevalence and clinical impact of nocturnal desaturation in a typical outpatient population with COPD.
Thorax. Published Online First: 11 April 2008. doi:10.1136/thx.2007.089458
Infection with Burkholderia cepacia complex (BCC) is a life-threatening complication of cystic fibrosis (CF) often seen as a contraindication for lung transplantation.
The Proceedings of the American Thoracic Society 5:567-571 (2008)
The National Emphysema Treatment Trial used a multidisciplinary team approach to implement the maximum medical care protocol, including adjustment of medications and outpatient pulmonary rehabilitation for all patients and nutritional and psychological counseling as needed.
Thorax. Published Online First: 4 April 2008. doi:10.1136/thx.2007.090803
The association of murine asthma with adiposity may be mediated by adiponectin, an anti-inflammatory adipokine with reduced serum concentrations in the obese. We studied whether serum adiponectin concentration was associated with human asthma and explained the association between adiposity and asthma, particularly in women and in pre-menopausal women.
The Proceedings of the American Thoracic Society 5:524-529 (2008)
Pulmonary rehabilitation is an established treatment for patients with chronic lung disease. Benefits include improvement in exercise tolerance, symptoms, and quality of life, with a reduction in the use of health care resources.
The Proceedings of the American Thoracic Society 5:530-535 (2008)
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) describe the phenomenon of sudden worsening in airway function and respiratory symptoms in patients with COPD.
The Proceedings of the American Thoracic Society 5:549-555 (2008)
Comorbidities such as cardiac disease, diabetes mellitus, hypertension, osteoporosis, and psychological disorders are commonly reported in patients with chronic obstructive pulmonary disease (COPD) but with great variability in reported prevalence.
The Proceedings of the American Thoracic Society 5:501-505 (2008)
The treatment objectives for chronic obstructive pulmonary disease (COPD) include relieving symptoms such as dyspnea and cough, slowing the accelerated decline in lung function, decreasing exacerbations, and improving quality of life.
Canadian Journal of Cardiology May 2008, Volume 24 Issue 5: 369-372
It is thought that emphysema patients are at a higher risk of coronary artery disease. The present study is one of very few that evaluated the prevalence of significant coronary artery disease in emphysema patients using coronary artery calcification measured by electron beam computed tomography.
The Proceedings of the American Thoracic Society 5:543-548 (2008)
The cardiac manifestations of chronic obstructive pulmonary disease (COPD) are numerous. Impairments of right ventricular dysfunction and pulmonary vascular disease are well known to complicate the clinical course of COPD and correlate inversely with survival.
The Proceedings of the American Thoracic Society 5:494-500 (2008)
Definitions of types of emphysema within the framework of chronic obstructive pulmonary disease are given. The classic findings on the chest radiograph are described, and the advances in sensitivity and specificity achieved with computed tomography (CT) scanning are noted.
Lung volume reduction (LVR) is an effective therapy for end-stage emphysema. Preliminary and postprocedure imaging is usually limited to CT for anatomic delineation of the location and severity of the most acutely affected lung zones.
The Proceedings of the American Thoracic Society 5:486-493 (2008)
Although a hereditary contribution to emphysema has been long suspected, severe {alpha}1-antitrypsin deficiency remains the only conclusively proven genetic risk factor for chronic obstructive pulmonary disease (COPD).
Canadian Journal of Cardiology May 2008, Volume 24 Issue 5: 369-372
It is thought that emphysema patients are at a higher risk of coronary artery disease. The present study is one of very few that evaluated the prevalence of significant coronary artery disease in emphysema patients using coronary artery calcification measured by electron beam computed tomography.
Nine carbapenem-resistant Escherichia coli isolates harboring Klebsiella pneumoniae carbapenemase
(KPC)–2 or KPC-3 enzymes were identified in patients residing in 7 distinct long-term care facilities.
Studies describing predictors of mortality in patients with acute lung injury were primarily derived from selected academic centers. We sought to determine the predictors of mortality in a population-based cohort of patients with acute lung injury and to characterize the performance of current severity of illness scores in this population.
To determine the steady-state serum and alveolar concentrations of piperacillin/tazobactam administered in continuous infusion to critically ill patients with ventilator-associated pneumonia and various degrees of renal failure.
The Proceedings of the American Thoracic Society 5:427-431 (2008)
Potential candidates for lung volume reduction surgery should undergo extensive evaluation and preparation to minimize perioperative risks and optimize surgical outcomes. Initial screening includes spirometry, diffusion capacity, lung volumes by body plethysmography, and high-resolution computerized tomography scanning.
The Proceedings of the American Thoracic Society 5:438-441 (2008)
This article reviews management strategies that may improve the outcome of thoracic surgery and particularly lung volume reduction surgery (LVRS) in patients with severe emphysema. Maximal preoperative pharmacologic therapy includes bronchodilators and inhaled corticosteroids to attain peak lung function at the time of surgery.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1156-1163, (2008)
Although chronic obstructive pulmonary disease is the first indication for lung transplantation, the benefit of the procedure in terms of survival remains debated.
The Proceedings of the American Thoracic Society 5:447-453 (2008)
Lung transplantation and lung volume reduction surgery are surgical options for patients with advanced chronic obstructive pulmonary disease that is refractory to medical treatment. In this review, we discuss the differential indications for each procedure, as well as compare their risks and benefits.
To identify factors that affect operative mortality and morbidity and long-term survival after completion pneumonectomy. Methods: We retrospectively reviewed the charts of consecutive patients who underwent completion pneumonectomy at our cardiothoracic surgery department from January 1996 to December 2005.
The Proceedings of the American Thoracic Society 5:475-477 (2008)
Chronic obstructive pulmonary disease (COPD) is characterized physiologically by expiratory flow limitation and pathologically by alveolar destruction and enlargement and small and large airway inflammation and remodeling.
The Proceedings of the American Thoracic Society 5:454-460 (2008)
Lung volume reduction surgery (LVRS) produces physiological, symptomatic, and survival benefits in selected patients with advanced emphysema. Because it is associated with significant morbidity, mortality, and cost, nonsurgical alternatives for achieving volume reduction have been developed.
Am J Physiol Lung Cell Mol Physiol 294: L830-L840, 2008
In addition to its critical role in purine metabolism, xanthine oxidoreductase (XOR) has been implicated in the development of tissue oxidative damage in a wide variety of respiratory and cardiovascular disorders such as acute lung injury, ischemia-reperfusion injury, atherosclerosis, heart failure, and arterial hypertension.
The Proceedings of the American Thoracic Society 5:442-446 (2008)
The objective of lung volume reduction surgery (LVRS) is the safe, effective, and durable palliation of dyspnea in appropriately selected patients with moderate to severe emphysema. Appropriate patient selection and preoperative preparation are prerequisites for successful LVRS.
The Proceedings of the American Thoracic Society 5:432-437 (2008)
The administration of anesthesia to patients undergoing lung volume reduction surgery (LVRS) requires a complete understanding of the pathophysiology of severe chronic obstructive pulmonary disease, the planned surgical procedure, and the anticipated postoperative course for this group of patients.
American Journal of Respiratory and Critical Care Medicine Vol 177. pp. 1142-1149, (2008)
Obstructive sleep apnea (OSA) has been associated with a higher prevalence and severity of the metabolic syndrome in adult patients, even after controlling for obesity. In contrast, OSA in prepubertal children does not appear to correlate with the magnitude of such metabolic derangements.
Current Respiratory Medicine Reviews, Volume 4, Number 2, May 2008 , pp. 116-121(6)
The aging lung is characterized by changes that result in both loss of elasticity and muscle strength, causing alterations in lung volumes, such as decreased vital capacity. Obesity compounds these changes.
The Proceedings of the American Thoracic Society 5:468-474 (2008)
Chronic obstructive pulmonary disease (COPD) is a progressive disease with studies of disease progression generally focusing on measures of airflow and mortality. In nonsmokers, maximal lung function is attained around age 15 to 25 years, and after a variable plateau phase, subsequently declines at approximately 20 to 25 ml/year.
Current Respiratory Medicine Reviews, Volume 4, Number 2, May 2008 , pp. 131-136(6)
Bariatric surgery for morbid obesity is an effective approach to weight loss in selected obese patients. The candidate for surgery must be massively obese and have failed to lose appreciable weight with diet, drugs, and exercise.
The Proceedings of the American Thoracic Society 5:478-485 (2008)
Chronic obstructive pulmonary disease (COPD) is characterized by an abnormal persistent inflammatory response to cigarette smoke. This noxious insult leads to emphysema and airway remodeling, manifested by squamous and mucous metaplasia of the epithelium, smooth muscle hypertrophy, and airway wall fibrosis.
PEDIATRICS Vol. 121 No. 5 May 2008, pp. e1208-e1214
Habitual snoring and obstructive sleep apnea have been associated with bed-wetting in children, and effective obstructive sleep apnea treatment may improve enuresis.
A novel, commercially available reverse hybridization assay [GenoType Mycobacteria Direct (GTMD), version 2.0; Hain Lifescience] was evaluated for the direct detection of five clinically relevant mycobacterial species [Mycobacterium tuberculosis complex (MTBC), Mycobacterium avium, Mycobacterium malmoense, Mycobacterium kansasii and Mycobacterium intracellulare] from 54 smear-positive respiratory specimens and the findings were compared with culture results.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 5, May 2008 , pp. 433-438(6)
Despite the high co-occurrence between depression and asthma, few studies have addressed methods assessing the severity of depressive symptoms among patients with asthma.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 5, May 2008 , pp. 426-432(7)
Anecdotal accounts have identified hyperventilation as one route through which psychological factors can trigger bronchoconstriction. However, little is known about the empirical association between psychological and other trigger factors and hyperventilation in asthma exacerbations.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 5, May 2008 , pp. 420-425(6)
A definitive diagnosis of aspirin-exacerbated respiratory disease (AERD) requires a positive oral aspirin challenge (OAC), but predicting which patients will have positive challenges is often difficult.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 5, May 2008 , pp. 457-462(6)
Late asthmatic response (LAR) to allergen challenge is a validated method for studying the pathogenesis of and new treatments for asthma in the laboratory.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 5, May 2008 , pp. 415-419(5)
Fraction of exhaled nitric oxide (FENO) measurements performed on patients with acute asthma in the emergency department (ED) have previously shown poor reproducibility.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 5, May 2008 , pp. 439-446(8)
Evidence of a respiratory diseases and suicidal ideation and suicide attempts link exists. To improve our understanding of the mechanism underlying these links, there is a need for examination of the relationship between specific respiratory disease, such as asthma, and suicidal ideation and behavior. In addition, studies need to examine many common risk factors that may play a role in the association between asthma and suicidal ideation and suicide behavior.
Annals of Allergy, Asthma and Immunology, Volume 100, Number 5, May 2008 , pp. 447-451(5)
The prevalence of obesity and asthma in the United States has increased in past decades. Numerous studies have focused on the relationship between the 2 factors. However, to our knowledge, this association in Asian Americans has not been extensively studied.
PEDIATRICS Vol. 121 No. 5 May 2008, pp. e1032-e1038
Our objective was to compare the pulmonary function (respiratory compliance) of infants who were <32 weeks' gestation and delivered >7 days after a single course of antenatal steroids versus infants who were delivered 1 to 7 days after a single course of antenatal steroids.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0169-7
Previous studies have indicated that high levels of urinary albumin excretion (UAE) are associated with an increased incidence of cardiovascular morbidity and mortality. This study examined the association between UAE and obstructive sleep apnea syndrome (OSAS).
Thorax. Published Online First: 14 February 2008. doi:10.1136/thx.2007.087825
There has been some concern that leukotriene-receptor antagonists might precipitate the onset of Churg-Strauss syndrome (CSS). Objective: To investigate the relationship between the leukotriene-receptor antagonist montelukast and CSS onset.
Chronic inhalation of spores may cause respiratory symptoms such as productive cough and sputum. The purpose of this study was to determine the clinical pathophysiology of airway inflammation caused by bunashimeji spores and to investigate whether the spores have direct toxic inflammatory effects.
Thorax. Published Online First: 14 February 2008. doi:10.1136/thx.2007.086074
A Th1 predominant immune response has been shown in acute hypersensitivity pneumonitis. A Th2 predominance appears to favor the development of pulmonary fibrosis through the profibrotic process, and has been described as crucial in the progression of idiopathic pulmonary fibrosis (IPF). Chronic bird fancier's lung (cBFL) can present a histological pattern of usual interstitial pneumonia (UIP)-like lesions. Little is known about the Th1/Th2 balance in the pathogenesis of cBFL.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.088559
Neutrophil elastase (NE) activity is increased in lung diseases such as alpha-1-antitrypsin (A1AT) deficiency and pneumonia. We have recently demonstrated that NE can induce expression of cathepsin B and MMP 2 in vitro and in a mouse model. We postulated that increased Cathepsin B and MMP-2 in acute and chronic lung diseases are due to the presence of high levels of extracellular NE and that expression of these proteases could be inhibited by A1AT augmentation therapy.
Cathepsin S is involved in the pathogenesis of COPD in murine models overexpressing interferon (IFN)-y and IL-13. It is widely accepted that genetic factors partly influence susceptibility to COPD; however, the association of genetic polymorphisms in the cathepsin S gene with COPD has not been reported previously.
Am J Physiol Lung Cell Mol Physiol 294: L974-L983, 2008
Lung injury due to mechanical ventilation is associated with an impairment of endogenous surfactant. It is unknown whether this impairment is a consequence of or an active contributor to the development and progression of lung injury.
Allergy, Volume 63, Number 6, June 2008 , pp. 685-694(10)
Athletes' symptoms may only occur in extreme conditions, which are far from normal. Exercise may increase ventilation up to 200 l/min for short periods in speed and power athletes, and for longer periods in endurance athletes such as swimmers and cross-country skiers. Increasing proportions of young athletes are
atopic, i.e. they show signs of IgE-mediated allergy which is, along with the sport event (endurance sport), a major risk factor for asthma and respiratory symptoms.
Allergy, Volume 63, Number 6, June 2008 , pp. 646-659(14)
The major allergen in house dust comes from mites. We performed a systematic review of the randomized trials that had assessed the effects of reducing exposure to house dust mite antigens in the homes of people with mite-sensitive asthma, and had compared active interventions with placebo or no treatment. Fifty-four trials (3002 patients) were included.
Thorax. Published Online First: 13 March 2008. doi:10.1136/thx.2007.091447
Randomised data in men showed a small but significant reduction in risk of adult-onset asthma among those assigned to aspirin. Results from an observational study in women suggest that frequent use of aspirin decreased the risk of adult-onset asthma. Randomised data in women are lacking.
Thorax. Published Online First: 14 February 2008. doi:10.1136/thx.2007.088195
The indication of chest physical therapy as an adjunct to treatment of children hospitalized with acute pneumonia remains controversial and there is lack of robust scientific evidence on effectiveness of this modality in these patients.
Thorax. Published Online First: 11 February 2008. doi:10.1136/thx.2007.091371
There is little previous information of the effects of size-fractioned particulate air pollution and source-specific fine particles (PM2.5; <2.5 µm) on asthma and COPD among children, adults, and the elderly.
A new interpretative strategy for pulmonary function tests (PFT) has been proposed by the American Thoracic Society/European Respiratory Society (ATS/ERS) Task Force. To assess the accuracy of this strategy, clinical diagnosis was compared with the PFT interpretation in patients showing concomitant decreases in FEV1 and FVC.
Sleep and Breathing 1520-9512 (Print) 10.1007/s11325-008-0186-6
Most obstructive sleep apnea (OSA) patients are overweight, and OSA is substantially more common in obese individuals. In morbidly obese patients, at least 70% suffer from OSA. However, the exact mechanism by which obesity causes OSA is unclear.
Thorax. Published Online First: 4 February 2008. doi:10.1136/thx.2007.087999
The management of pulmonary disease caused by opportunist mycobacteria is bedevilled by a lack of randomized trials to provide an evidence-base for treatment. Rifampicin (R) and ethambutol (E) are the mainstay of treatment but the roles of macrolides and quinolones are not clear.
It has been suggested that the rapid increase in asthma prevalence may in part be due to a decrease in the intake of dietary antioxidants, including vitamin C, vitamin E and {beta}-carotene. Epidemiological studies investigating the association between dietary antioxidant intake and asthma have generated inconsistent results.
Neutrophil elastase (NE) may play a key role in the development of acute lung injury (ALI) or ARDS. NE activity (NEA) was measured in patients with ALI treated with a selective NE inhibitor.
ARDS is life-threatening acute respiratory failure, and pneumonia is one of the most common causes of direct ARDS. Procalcitonin (PCT) has been evaluated for its utility in determining the aetiology of community-acquired pneumonia (CAP), choice of antibiotics and prediction of outcome. This study evaluated the role of PCT in predicting the outcome of patients with ARDS caused by severe CAP.
Thorax. Published Online First: 1 February 2008. doi:10.1136/thx.2007.087213
The combination of salmeterol and fluticasone propionate (SFC) and tiotropium bromide (TIO) are commonly used treatments in COPD but there is little data on their effectiveness when used together. We compared the effects of SFC 50/500mcg bd plus TIO 18mcg od with the individual treatments alone.
Acute respiratory failure (ARF) in patients over 65 years is common in emergency departments (EDs) and is one of the key symptoms of congestive heart failure (CHF) and respiratory disorders.
Thorax. Published Online First: 1 February 2008. doi:10.1136/thx.2007.088070
Interstitial lung disease (ILD) is characterised by exertional dyspnoea, exercise limitation and reduced quality of life. The role of exercise training in this diverse patient group is unclear. The aims of this study were to establish the safety of exercise training in ILD; its effects on exercise capacity, dyspnoea and quality of life; and whether patients with idiopathic pulmonary fibrosis (IPF) had similar responses to those with other types of ILD.
Arch Dis Child. Published Online First: 12 March 2008. doi:10.1136/adc.2007.134569
Asthma is a common condition characterised by wheeze. Many different respiratory sounds are interpreted by parents as "wheeze" in young children. The primary aim of the present study was to relate different respiratory sounds reported as wheeze in two year olds to wheeze at age five years.
All-trans retinoic acid (ATRA) can induce acute respiratory distress syndrome in patients with acute promyelocytic leukaemia (APL). The current study investigated the role of monocyte chemotactic protein (MCP)-1 in the chemotactic transmigration of ATRA-treated NB4 (ATRA-NB4) APL cells toward A549 alveolar epithelial cells.
Cosmetic filler injections are now a very common procedure for aesthetic purposes. Today no contra-indication is given anymore to any patient for an intradermal filling.
Whether sleep-disordered breathing (SDB) is a risk factor for left ventricular (LV) hypertrophy and dysfunction is controversial. We assessed the relation of SDB to LV morphology and systolic function in a community-based sample of middle-aged and older adults.
We report the case of a 63-year-old female with hepatic cirrhosis due to chronic hepatitis C, successfully treated for refractory nonmalignant hepatic hydrothorax by using a long-term pleurovenous shunt (PVS).
Thorax. Published Online First: 3 April 2008. doi:10.1136/thx.2007.091132
Childhood obstructive sleep apnoea (OSA) is increasingly being recognized. Its effect on blood pressure (BP) elevation and hypertension is still controversial.
The use of exhaled breath condensate (EBC) as a tool for noninvasive assessment of lung inflammation is becoming commonplace. Many authors use commercial ELISA kits to measure inflammatory mediators within EBC.
High re-attendance rates are common after asthma emergency department (ED) care. Inadequate patient education has been cited as a potential cause of re-attendance and the optimal format of education is uncertain. The present study aimed to compare the effectiveness of patient-centred education (PCE) and standard asthma patient education on ED re-attendance.
The recent Towards a Revolution in COPD Health (TORCH) randomised trial replicated the findings of previous trials in chronic obstructive pulmonary disease (COPD) on the apparent effectiveness of inhaled corticosteroids (ICS) in reducing exacerbation rates, but not so for mortality.
Purinergic signalling regulates airway defence mechanisms, suggesting that extracellular purines could serve as airway inflammation biomarkers in cystic fibrosis (CF).
Optimal collection and analysis of exhaled breath condensate (EBC) are prerequisites for standardisation and reproducibility of assessments. The present study aimed to assess reproducibility of EBC volume, hydrogen peroxide (H2O2), 8-isoprostane and cytokine measurements using different condensers, including a newly developed glass condenser.
The effect of dog ownership during childhood on the development of allergy has been investigated in few studies with conflicting results. The association between dog contact and indoor endotoxin exposure during infancy and the development of allergic sensitisation and atopic disease up to age 6 yrs was investigated.
Airway disease in childhood comprises a heterogeneous group of disorders. Attempts to distinguish different phenotypes have generally considered few disease dimensions. The present study examines phenotypes of childhood wheeze and chronic cough, by fitting a statistical model to data representing multiple disease dimensions.
Use of small bore chest drains (<14F), inserted via the Seldinger technique, has increased globally over the last few years. They are now used as first line interventions in most acute medical situations when thoracostomy is required. Limited data are available on the associated complications. In this study, the frequency of complications associated with 12F chest drains, inserted using the Seldinger technique, was quantified.
Allergy, Volume 63, Number 6, June 2008 , pp. 670-684(15)
Omalizumab is the first licensed anti-immunoglobulin (Ig) E antibody shown to be effective for treatment of allergic (IgE-mediated) asthma. Recent international guidelines recommend omalizumab as add-on treatment to fixed dose inhaled corticosteroid (ICS) and long-acting {beta}2-agonist (LABA) combination therapy.
The aim of the present study was to assess associations between obstructive sleep apnoea and insulin sensitivity in a population-based sample of females.
Community-acquired pneumonia (CAP) has a high incidence and involves an important consumption of healthcare resources. The present authors analysed the influence of comorbidity, initial severity and complications upon the direct costs associated with hospitalised CAP patients.
Antioxidant counteraction of oxidative stress has been poorly explored in obstructive sleep apnoea (OSA). Serum albumin is a major antioxidant agent and structural modifications induced by glucose or free radicals impair its antioxidant properties.
Stent implantation has been reported to facilitate liberation from mechanical ventilation in patients with respiratory failure due to central airway disease. The present retrospective cohort study sought to evaluate the risk and benefit of stent implantation via bronchoscopy without fluoroscopic guidance in mechanically ventilated patients.
The aim of the present study was to compare the effectiveness, safety and health economics of budesonide/formoterol maintenance and a novel reliever therapy with conventional best practice in patients with persistent asthma in Canada.
Small airways are the major site of airflow obstruction in chronic obstructive pulmonary disease (COPD). This is attributed to loss of elastin in alveoli and fibrosis in small airways. In the present study, it was hypothesised that changes to elastic fibres in alveoli might be paralleled by a similar reduction in elastic fibres in small airways.
Adherence with preventive asthma medication by young children is an important factor when evaluating a suboptimal response to treatment. However, few data exist regarding the accuracy of subjective measures of adherence and factors associated with adherence in young children.
Systemic effects of COPD include skeletal muscle dysfunction; the lactate threshold (LT) is an index of such dysfunction. However, it is not feasible in daily clinical practice to accurately determine the LT in all patients with COPD.
Conventional tests are not always helpful in making a diagnosis of malignant pleural effusion (MPE). Many studies have investigated the utility of pleural carcinoembryonic antigen (CEA) in the early diagnosis of MPE. The present meta-analysis determined the accuracy of CEA measurement in the diagnosis of MPE.
Untreated, obesity hypoventilation is associated with significant use of health care resources and high mortality. It remains unclear whether continuous positive airway pressure (CPAP) or bilevel ventilatory support (BVS) should be used as initial management.
Chronic lung diseases are increasingly recognised complications of the human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS).
Lack of response to treatment in community acquired pneumonia (CAP) worsens outcome. We evaluated the systemic cytokine profile (tumour necrosis factor , interleukin (IL)1, IL6, IL8 and IL10), C reactive protein (CRP) and procalcitonin (PCT) in patients with CAP who had treatment failure.
It has been suggested that patients with chronic bronchitis are more likely to snore during sleep. The authors studied 5015 people in Korea aged 40-69 years who all participated in a comprehensive health examination and on-site interview.
Activation of CD23, a low affinity IgE receptor, results in downregulation of IgE-mediated immune responses. CD23 is encoded for by the Fc fragment of IgE low affinity II receptor (FCER2) gene.
A 17-year-old man, a non-smoker, presented with a 4-day history of chest pain and dyspnoea. The symptoms had begun immediately after an episode of aspiration, which occurred whilst learning to be a fire eater. The patient was on holiday abroad at the time of the incident and attended the emergency department 3 days after returning home because his symptoms had persisted. There was no previous medical history.
Lung transplantation is a common procedure with significant risks undertaken in children with cystic fibrosis. This retrospective study investigates the effect of lung transplantation on survival.
Respiratory muscle weakness in patients with Duchenne muscular dystrophy (DMD) leads to respiratory failure for which non-invasive positive pressure ventilation (NIPPV) is an effective treatment.
A 48-year-old Chinese male henhouse keeper was admitted with dyspnoea. A plain chest radiograph and CT scan indicated a solitary right lung mass with invasion to the trachea.
Early life exposure to respiratory diseases is associated with lung impairment in adulthood. The objective of this study was to investigate morbidity, and respiratory and other cause specific mortality, among people who reported a medical history of bronchitis, pneumonia and asthma early in life.
Antibiotics are commonly prescribed empirically for lower respiratory infections. Infections of the airway mucosa are much more common than pneumonia and the illness they cause is less severe because the infection is superficial, most of the bacteria being found associated with mucus in the lumen.
Investigators from Tasmania, an island state of Australia (famous for its marsupial devils), have demonstrated, in this issue of Thorax,1 that both the quantity and quality of spirometry tests provided by nurses visiting general practitioner (GP) offices were much better than when GPs were given a spirometer and taught when and how to use it .
The BTS took over the entire Queen Elizabeth II Conference Centre in London again this year to host its Silver Jubilee year Winter Meeting. This, the biggest and most comprehensive meeting so far, was also the first to accommodate an additional day for allied health professionals, held in conjunction with the Association of Chartered Physiotherapists in Respiratory Care (ACPRC).
A study was undertaken to determine whether a short course of antibiotic treatment (5 days) is as effective as the conventional longer treatment in acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD).
Chronic obstructive pulmonary disease (COPD) is a common disease with a steadily increasing prevalence and mortality. However, recent epidemiological estimates differ depending on the population studied and methods used.
To increase recognition of airflow obstruction in primary care, we compared two models of spirometry delivery in a target group at risk of chronic obstructive pulmonary disease (COPD).
We report the simultaneous occurrence of lymphocytic interstitial pneumonitis and pulmonary embolism in a patient with tetralogy of Fallot and common variable immunodeficiency. An explanation based on the pathogenesis of these diseases is proposed to explain this "unfortunate coincidence".
To systematically review the evidence for the medium to long term benefits and risks of montelukast as add-on therapy to inhaled corticosteroids (ICS) in comparison with placebo and active controls in mild to moderate asthma.
Legionella pneumophila pneumonia often exacerbates acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Apoptosis of alveolar epithelial cells is considered to play an important role in the pathogenesis of ALI and ARDS.
In patients with hematological malignancy (HM) developing acute respiratory failure (ARF) bronchoalveolar lavage (BAL) is considered as a major diagnostic tool. However, the benefit/risk ratio of this invasive procedure is probably lower in the subset of patients with acute myeloid leukemia (AML).
Journal of Public Health, doi:10.1093/pubmed/fdn023
Severe Acute Respiratory Syndrome (SARS) was first reported in November 2002 in China, and spreads to about 30 countries over the next few months. While the characteristics of epidemic transmission are individually assessed, there are also important implicit associations between them.
Occupational and Environmental Medicine 2008;65:306-310
Long-term occupational exposure to mineral dusts including quartz is known to cause pneumoconiosis but little is known about the effects of such exposure during the period of lung development in childhood. The objective of this study was to investigate the effects on young people of exposure to mineral dusts.
The main objective of this study is to describe the presence of infections in patients with pulmonary haemorrhage and systemic lupus erythematosus. Patients with systemic lupus erythematosus and pulmonary haemorrhage were thoroughly evaluated in the first 48 hours with imaging plus bronchoscopy and bronchoalveolar fluid analysis.
Occupational and Environmental Medicine 2008;65:319-324
Particulate air pollution affects cardiovascular and pulmonary disease and mortality. A main hypothesis about the mechanisms involved is that particles induce inflammation in lower airways, systemic inflammation and oxidative stress.
Occupational and Environmental Medicine 2008;65:261-267
The aim of this longitudinal study was to investigate the effects on respiratory health of talc dust, free of asbestiform fibres, at or below airborne concentrations of 2 mg/m3.
To characterize the association between sleep-disordered breathing (SDB) and impaired fasting glucose (IFG), impaired glucose tolerance (IGT), combined IFG and IGT, and occult diabetes in individuals of different body habitus.
Sleep and Breathing 1520-9512 (Print) Thursday, January 31, 2008
Diagnosed obstructive sleep apnea affects 2–4% of middle aged Americans and represents a substantial health care burden. Despite its prevalence, little is known about the demographic characteristics or clinical management of sleep apnea patients hospitalized for other comorbidities and surgeries.
Sleep and Breathing 1520-9512 (Print) Wednesday, April 09, 2008
Obstructive sleep apnea is a commonly undiagnosed chronic disease. While dentists represent an important resource for identifying people at risk for primary snoring and sleep apnea, less than 50% of dentists are capable of identifying the common signs and symptoms of sleep disordered breathing.
Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation of the airways. In the majority of cases, the inflammation is triggered by tobacco smoke. Smoking also affects the pathogenesis of inflammatory bowel disease
(IBD), protecting against ulcerative colitis (UC) and promoting development of Crohn’s disease (CD).
In both chronic obstructive pulmonary disease (COPD) and multiple sclerosis (MS), combinations of environmental and genetic factors are likely to increase the vulnerability to acquire disease.
Lung 0341-2040 (Print) Volume 186, Number 2 / April, 2008
Reactive oxygen species (ROS) play an important role in the pathogenesis of numerous pulmonary diseases. Various mainly membrane-bound ROS-generating processes exist in alveolar cells.
Sleep and Breathing 1520-9512 (Print) Wednesday, April 09, 2008
Patients with obstructive sleep apnea (OSA) are at increased risk of atherothrombosis independent of the Framingham risk factors. Studies on hemostasis factors in OSA are scarce and inconsistent.
Sleep and Breathing 1520-9512 (Print) Wednesday, January 30, 2008
The aim of this study was to establish cardiac damage related to nocturnal ischemia using heart type fatty acid binding protein (h-fabp), which reaches detectable levels in plasma after being released from myocytes in case of ischemia in obstructive sleep apnea syndrome (OSAS) patients without coronary artery disease (CAD).
Sleep and Breathing 1520-9512 (Print) Tuesday, February 05, 2008
The evidence for a role of sleep-disordered breathing (SDB) in cardiovascular disease (CVD) is inconclusive and limited to clinic-based studies or population-based studies using historical CVD data.
Obstructive sleep apnea syndrome (OSAS) is an important risk factor in cardiovascular disorders. Although the precise mechanism remains to be described, hypercoagulability seems to be involved.
Lung 0341-2040 (Print) Volume 186, Number 2 / April, 2008
Among the possible mechanisms explaining the worsening of asthma due to gastroesophageal reflux disease (GERD) is the increase in bronchial hyperresponsiveness. The effects of GERD on bronchial hyperresponsiveness in patients with bronchial asthma have yet to be studied in significant detail.
The severity of chronic obstructive pulmonary disease (COPD) is evaluated not only by airflow limitation but also by factors such as exercise capacity and body mass index.
Sleep and Breathing 1520-9512 (Print) Friday, April 18, 2008
Asthma has been identified as a possible risk factor for Obstructive Sleep Apnea (OSA) in children. It is not known whether parent-reported asthma increases the likelihood of the diagnosis of OSA in snoring children. We hypothesized that snoring children with asthma are more likely to have OSA than snoring children without asthma.
Continuous positive airway pressure (CPAP) is the standard treatment for obstructive sleep apnea syndrome (OSAS). However, the impact of CPAP on quality of life (QOL) is controversial.
To validate the technique of the Muller maneuver (MM) using videoendoscopy and to quantify the correlation between its clinical results and variables of polysomnography.
Congenital diaphragmatic hernia (CDH) continues to be a devastating disease in the newborn population, with well-documented morbidity and mortality. Bronchopulmonary sequestration is a separate congenital defect that has been associated with CDH.
Many studies have been conducted to try and find interventions to treat patients with severe sepsis, but with little success. In several cases, initial apparent beneficial effects have not been confirmed in later trials.
Trends of occupational asthma (OA) differ between regions depending on local industries, provisions for health and safety at the workplace and the availability of a reporting scheme to help in data collection and interpretation.
The study of particle transport and deposition in the human lung is critical in health risk assessment of air pollutants and in pharmaceutical drug delivery. Several computational fluid dynamics (CFD) studies have investigated particle deposition in the lung for simplified airflow scenarios.
Increased circulating endothelial cells (CECs) have been observed in patients with vascular injury associated with acute myocardial infarction, pulmonary hypertension, and congestive heart failure.
Particle transport and deposition within a model alveolus, represented by a rhythmically expanding and contracting hemisphere, was modeled by a three-dimensional analytical model for the time-dependent air velocity field as a superposition of uniform and radial flow components, satisfying both the mass and momentum conservation equations.
Patients with acute respiratory distress syndrome and high-altitude pulmonary oedema build up excess lung fluid, which leads to alveolar hypoxia. In patients with acute respiratory distress syndrome and hypoxia, there is a decrease in oedema fluid clearance, due in part to the downregulation of plasma membrane sodium-potassium adenosine triphosphatase (Na,K-ATPase).
Lymphangioleiomyomatosis (LAM) is a rare multisystemic disease of women of child-bearing age and affects mainly the lungs, promoting cystic destruction of lung parenchyma or leading to abdominal tumor formation (e.g., angiomyolipomas, lymphangioleiomyomas).
Chronic cough is a common condition that presents to both primary and secondary care. Assessment and management are hampered by the absence of well-validated outcome measures.
Envirox is a scientifically and commercially proven diesel fuel combustion catalyst based on nanoparticulate cerium oxide and has been demonstrated to reduce fuel consumption, greenhouse gas emissions (CO2), and particulate emissions when added to diesel at levels of 5 mg/L. Studies have confirmed the adverse effects of particulates on respiratory and cardiac health, and while the use of Envirox contributes to a reduction in the particulate content in the air, it is necessary to demonstrate that the addition of Envirox does not alter the intrinsic toxicity of particles emitted in the exhaust.
Adult volunteers (17 healthy, 14 asthmatic) were exposed in a controlled environmental chamber to concentrated ultrafine particles (UFP) collected in a Los Angeles suburb with substantial motor vehicle pollution. Exposures lasted 2 h with intermittent exercise. Inhaled particle counts (mean 145,000/cm3, range 39,000-312,000) were typically 7-8 times higher than ambient levels.
The aim of the present study was to systematically compare outcomes between antibiotic classes in treating outpatient community-acquired pneumonia, with regard to antibacterials active against atypical organisms, as well as between various antibacterial classes with similar atypical coverage.
Platinum salt sensitivity (PSS) is well recognized following occupational exposure to platinum salts, though specific platinum compounds have been suggested to be non-allergenic.
Exhaled breath condensate analysis is a developing method for investigating airway pathology. Impact of food and drink on breath condensate composition has not been systematically addressed.
A population-based molecular epidemiology investigation has been undertaken to evaluate tuberculosis transmission and control in the Brussels-Capital Region (Belgium).
Immunocompromised patients with acid-fast bacilli (AFB) smear-negative active pulmonary tuberculosis (pTB) often present with nonspecific clinical symptoms and findings. T-cell interferon-{gamma} release assays (TIGRA) performed on whole blood (using ELISA) or peripheral blood mononuclear cells (using enzyme-linked immunospot assay (ELISPOT)) are more sensitive for the diagnosis of Mycobacterium tuberculosis (MTB) infection than the tuberculin skin test (TST), but cannot distinguish active from latent MTB infection.
Airway colonisation with Pseudomonads, especially Pseudomonas aeruginosa, is common in lung transplant (LTx) recipients. The current authors investigated whether pseudomonal colonisation affects the prevalence of bronchiolitis obliterans syndrome (BOS) after lung transplantation.
Heart-type fatty acid-binding protein (H-FABP) is a reliable marker of myocardial injury and was recently identified as a predictor of outcome in acute pulmonary embolism. The aim of the present study was to investigate the prognostic value of H-FABP in chronic thromboembolic pulmonary hypertension (CTEPH).
Bridging bronchus (BB) is a rare, congenital bronchial anomaly that is frequently associated with congenital cardiac malformations, especially left pulmonary artery sling. It represents an anomalous bronchus to the right originating from the left main bronchus.
Many patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) are incapable of using continuous positive airway pressure. These patients therefore turn to surgical options as a salvage treatment. Early studies and reviews focused on the efficacy of uvulopalatopharyngoplasty, a single-level procedure for the treatment of OSAHS.
The effects of intensive 3-week outpatient pulmonary rehabilitation (PR) on exercise capacity, dyspnea, and health-related quality of life (HRQL) were investigated in patients with COPD.
Access to comprehensive guidelines on the management of chronic obstructive pulmonary disease (COPD) is now available, and several treatment goals of therapy have been identified from these guidelines, which have since been studied in clinical trials.
PEDIATRICS Vol. 121 No. 5 May 2008, pp. e1310-e1318
Budesonide is an inhaled steroid with a strong topical effect but with minimal systemic effects; it has been effectively delivered to animal lungs using surfactant as a vehicle. The purposes of this study were to determine whether early intratracheal instillation of budesonide using surfactant as a vehicle would improve pulmonary status, reduce mortality, and reduce chronic lung disease morbidity.
Sleep and Breathing 1520-9512 (Print) Friday, March 28, 2008
More than two thirds of stroke patients suffer from sleep apnea. A recent study showed that mirtazapine reduced the respiratory disturbance index (RDI) of a stroke patient by 80%.
Sleep and Breathing 1520-9512 (Print) Friday, March 28, 2008
Obstructive sleep apnea (OSA) remains under-recognized in women possibly due to differences in clinical presentation, difference in tolerance to symptoms, and rate of usage and referral to sleep services.
Sleep and Breathing 1520-9512 (Print) Saturday, March 01, 2008
The purpose of this study was to determine the objective short-term influence of nasal continuous positive airway pressure (nCPAP) therapy, nasal mask leak (NML) and heated humidifiers (HH) to nasal conditioning of spontaneously breathing subjects.
Am J Physiol Lung Cell Mol Physiol 294: L998-L1006, 2008
Elevated level of oxygen (hyperoxia) is widely used in critical care units and in respiratory insufficiencies. In addition, hyperoxia has been implicated in many diseases such as bronchopulmonary dysplasia or acute respiratory distress syndrome.
Am J Physiol Lung Cell Mol Physiol 294: L984-L990, 2008
Reactive species of oxygen and nitrogen have been collectively implicated in pulmonary oxygen toxicity, but the contributions of specific molecules are unknown. Therefore, we assessed the roles of several reactive species, particularly nitric oxide, in pulmonary injury by exposing wild-type mice and seven groups of genetically altered mice to >98% O2 at 1, 3, or 4 atmospheres absolute.
Sleep and Breathing 1520-9512 (Print) Saturday, March 08, 2008
Obstructive sleep apnea (OSA) is associated with cardiovascular diseases, yet available data suggests cardiologists underreport
OSA. This study assessed whether cardiologists’ knowledge and attitudes about OSA contribute to this finding.
The objective of our study was to evaluate the potential of the sonographic fetal lung volume-body weight ratio to predict neonatal deaths and pulmonary hypoplasia in fetuses with isolated congenital diaphragmatic hernia (CDH).
Thoracic empyema caused by rapidly growing mycobacteria (RGM) and complicated with bronchopleural fistula is rarely reported, especially in immunocompetent patients.
Am J Physiol Lung Cell Mol Physiol 294: L1007-L1012, 2008
We assessed the roles of the protein kinase C (PKC) and the tyrosine kinase (TK) signaling pathways in regulating capacitative calcium entry (CCE) in human pulmonary artery smooth muscle cells (PASMCs) and investigated the effects of intravenous anesthetics (midazolam, propofol, thiopental, ketamine, etomidate, morphine, and fentanyl) on CCE in human PASMCs.
Sleep and Breathing 1520-9512 (Print) Thursday, March 27, 2008
To assess the accuracy of a single channel portable monitoring device (RUSleeping RTS, Respironics, Murrysville, PA) that measures nasal pressure (a surrogate for airflow) to detect sleep disordered breathing (SDB). Twenty-five adult patients referred to a community sleep laboratory with suspected obstructive sleep apnea (OSA) participated in this investigation.
Thorax. Published Online First: 18 January 2008. doi:10.1136/thx.2007.086371
COPD is often associated with other chronic diseases. These patients are often admitted to hospital-based rehabilitation programs. Objectives. To determine the prevalence of chronic comorbidities in COPD patients undergoing pulmonary rehabilitation (PR) and to assess their influence on the outcomes.
American Journal of Critical Care. 2008;17: 246-253
Despite the overall negative impact of chronic rejection on quality of life and survival after lung transplant, the specific clinical indicators of deterioration have not been identified.
To systematically review the efficacy of steroids in the prevention of acute respiratory distress syndrome (ARDS) in critically ill adults, and treatment for established ARDS.
Although the management of spontaneous pneumothorax through a thoracotomy traditionally included apical pleurectomy, thoracoscopic treatment of this problem does not generally include pleurectomy. Thoracoscopy in fact allows excellent exposure to perform total parietal pleurectomy, and we hypothesize that including total pleurectomy will reduce recurrences. We describe here the technique of thoracoscopic total parietal pleurectomy and the early outcomes afterward.
Thorax. Published Online First: 30 January 2008. doi:10.1136/thx.2007.085464
Obstructive sleep apnea hypopnea (OSAH) appears to be associated with an increased risk of motor vehicle crashes (MVC). However, its impact on crash patterns and particularly the severity of crashes has not been well described. We sought to determine whether OSAH severity influenced crash severity in patients referred for investigation of suspected sleep-disordered breathing.
Thorax. Published Online First: 5 December 2007. doi:10.1136/thx.2007.086751
Measurements of pulmonary biomarkers can be used to monitor airway inflammation in COPD but the variability of sampled biomarkers and their inter relationships are poorly understood.
The Clinical Respiratory Journal doi:10.1111/j.1752-699X.2008.00057.x
he study was approved by the local ethics committee (Karolinska Institute Nord, D-nr 01-359) and performed in accordance with the ethical principles of the WMA Declaration of Helsinki 2000. All the subjects were included in the study after written informed consent from their parents.
The Clinical Respiratory Journal doi:10.1111/j.1752-699X.2008.00061.x
Diffuse pulmonary haemorrhage is a potentially life-threatening complication of a variety of conditions. Tumours, including angiosarcoma lung metastases, are an unusual cause of pulmonary haemorrhage.
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