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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.
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