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Am J Physiol Lung Cell Mol Physiol 291: L1177-L1184, 2006
We previously reported the ability of isoprostanes to induce airway hyperresponsiveness (AHR). In this study, we examined the signaling mechanisms underlying that phenomenon with the standard muscle bath technique.
A 36-year-old asymptomatic female with Turner syndrome was referred for a 3-cm opacity of the left lung detected by routine chest X-ray. A computed tomography scan of the chest suggested a vascular lesion such as pulmonary arteriovenous malformation, and transcatheter embolotherapy was considered.
Critical Care Medicine. Improving the Quality of End-of-Life Care in the ICU. 34(11) Suppl:S355-S358, November 2006
Deaths occur frequently in the intensive care unit, yet clinicians in this unique practice environment are often untrained in the care of patients who are dying. Palliative care consultation in the intensive care unit may bridge the gaps between what should be done for dying patients and their families and what is often the default, that is, a prolonged death with inadequate symptom management and not enough family support.
Seminars in Dialysis, Volume 19, Number 6, November-December 2006, pp. 517-524(8)
The occurrence of acute respiratory distress syndrome (ARDS), is now common in intensive care units throughout the world. The diagnosis of ARDS is based on a definition that includes bilateral pulmonary infiltrates on chest radiographs, impaired oxygenation, and the absence of clinical evidence of elevated left atrial pressure.
Smokers who develop chronic obstructive pulmonary disease (COPD) have amplified inflammation within their lungs, involving selective tissue accumulation of neutrophils, macrophages and CD8+ T cells.
British Journal of Clinical Pharmacology, Volume 62, Number 4, October 2006, pp. 403-411(9)
To evaluate the speed of onset of bronchodilation following salbutamol administered via a metered-dose inhaler with a spacer (pMDI + Volumatic) and a dry-powder inhaler (Diskus), as well as the relative potencies of these devices in asthmatic patients with methacholine-induced bronchoconstriction.
To retrospectively compare a low kilovoltage scanning protocol with a reduced radiation dose with a standard high kilovoltage, moderate-dose protocol for the depiction of central and peripheral pulmonary arteries at single-detector spiral computed tomography (CT).
To compare parallel acquisition magnetic resonance (MR) imaging with thin-section helical computed tomography (CT) for depiction of pulmonary abnormalities suggestive of pneumonia in immunocompromised patients.
Journal of Thoracic Imaging. 21(4):259-264, November 2006
Avian influenza is caused by the H5N1 subtype of the influenza A virus. Human transmission is either directly through close contact with infected birds usually poultry or their secretions. To date 178 people throughout South East Asia have been infected with 85 deaths.
In inflammatory cells, the low Km cyclic adenosine monophosphate (cAMP)-specific phosphodiesterase (PDE) 4 subtype is predominant in terms of expression and function, although more recently it has been suggested that PDE 7 may also play a role in regulating inflammatory cell activity.
Obstructive sleep apnea (OSA) has a critical association with cardiovascular mortality and morbidity. Carotid intima-media thickness (IMT), flow-mediated dilatation (FMD) and aortic stiffness are early signs of atherosclerosis. The presence of subclinical atherosclerosis was assessed in OSA patients using these parameters.
Although certain studies report high levels of vascular endothelial growth factor (VEGF) in obstructive sleep apnea syndrome (OSAS), the effect of systemic hypoxia on circulating VEGF remains controversial.
None of the explanations proposed for the increase in paediatric asthma have been adequate. It is becoming apparent that the cause of the increase in asthma must be multi-factorial. Increasing attention has been focused on the role of lifestyle in the development of asthma.
Journal of Thoracic Imaging. 21(4):252-258, November 2006
Inhalational anthrax is a lethal infection acquired from the inhalation of Bacillus anthracis, a pathogen classified as a Category A bioterrorist agent by the Centers for Disease Control and Prevention. The recent 2001 attack in which weaponized spores were delivered by mail to several US cities exposed our vulnerability to bioterrorism, and taught us important lessons in the timely diagnosis of this devastating disease. It is clear that patient mortality is significantly decreased by early recognition and immediate administration of antibiotic therapy.
The non-selective phosphodiesterase inhibitor theophylline has bronchodilator/anti-inflammatory properties and is widely used in the treatment of airways diseases. We determined the effect of long-term theophylline treatment on airway inflammation in patients with chronic obstructive pulmonary disease (COPD).
Continuous positive airway pressure (CPAP) reduces daytime somnolence in the obstructive sleep apnea syndrome (OSAS) and may contribute to a reduction in the risk of motor vehicle accidents.
Respiratory disability induced by dust exposure in coal workers is assessed by pulmonary function tests and radiological evidence of pneumoconiosis. High-resolution computed tomography (HR-CT) improves the visibility of tissue changes, but the value of the findings for the clinical evaluation is controversial.
Whether sputum microbiological examination should be performed systematically in hospitalized patients with chronic obstructive pulmonary disease (COPD) exacerbations remains unclear.
Although results from a few meta-analyses were most uniformly supportive of the beneficial effect of combination therapy on lung function, there were inconsistent results on other endpoints such as asthma exacerbation.
Most fungi enter the human body via inhalation; however, endobronchial fungal infection (EBFI) seems to be a rare manifestation compared to pulmonary or systemic disease. This presentation seems to be related to environmental factors as well as to the host status.
Mutations of the caspase-activating recruitment domain 15 (CARD15) gene on chromosome 16 are associated with chronic inflammatory granulomatous bowel disease (Crohn's disease). Sarcoidosis is a systemic granulomatous disease with unknown etiology, which shares histological features with Crohn's disease.
American Journal of Respiratory and Critical Care Medicine Vol 174. pp. 1101-1109, (2006)
To identify ADRB2 polymorphisms and haplotype structure in white and African American subjects and to test for genotype and haplotype association with asthma phenotypes.
3-Nitrotyrosine (3-NT) is considered as a marker of oxidative stress, which occurs during inflammation. Since 3-NT levels in exhaled breath condensate (EBC) are very low, we applied a specific and sensitive gas chromatography-negative ion chemical ionization-mass spectrometry (GC-NICI-MS) method and high performance liquid chromatography (HPLC) with electrochemical detection for the analysis of free 3-NT in EBC.
Current Respiratory Medicine Reviews, Volume 2, Number 4, November 2006, pp. 393-396(4)
In the last three decades studies of respiration have embarked on a new phase eliciting exciting new areas of investigation. At this juncture we are happy to contribute a brief article honoring NS Cherniack.
The authors examine which clinical factors contribute to the clinician suspicion of pneumonia, as well as the relationship between clinical factors, clinician suspicion of pneumonia, and ordering chest X-rays (CXR).
Current Respiratory Medicine Reviews, Volume 2, Number 4, November 2006, pp. 397-403(7)
The structure of several respiratory models are reviewed and the physiological foundations of salient features are explained. The models reviewed include an early model of Cheyne-Stokes breathing, the gas stores of the body following alterations in ventilation, sleep apnea considered as instability in the respiratory control system, a neurochemical model describing effects of neural drives on breathing in respiratory control of awake people, and inclusion in the neurochemical control system a respiratory pattern generator, as a potential source of apneas.
Current Respiratory Medicine Reviews, Volume 2, Number 4, November 2006, pp. 373-381(9)
Cyclic GMP-dependent protein kinase (PKG) plays a central role in the responses of the pulmonary vasculature to nitric oxide, nitrovasodilators, and natriuretic peptides.
Current Respiratory Medicine Reviews, Volume 2, Number 4, November 2006, pp. 383-391(9)
Our understanding of mechanisms involved in worsening of airway function during sleep is incomplete. Therefore, this work is aimed to link central neuronal structures alternating wakefulness and sleep with the neuronal network regulating the activity of airway-related vagal preganglionic neurons (AVPNs).
Chronic eosinophilic pneumonia (CEP) is an idiopathic pulmonary disease. As the lung is in direct communication with the environment, inhaled antigen may activate immune mechanisms in the airway that may participate in the pathogenesis of idiopathic pulmonary diseases.
Continuous positive airway pressure (CPAP) is considered as the standard therapy for obstructive sleep apnea syndrome (OSAS), but some patients with OSAS are unable to accept CPAP due to nasal obstruction and poor nasal airflow.
Clinical Cancer Research Vol. 12, 6730-6736, November 15, 2006
Because both emphysema and lung cancer can arise from biological damage caused by cigarette smoking, we investigated if the development of emphysema is associated with the clinical features of smoker's lung cancer.
Journal of Medical Systems, Volume 30, Number 5, October 2006, pp. 395-403(9)
This study aims at exploring the variance in resources used for management and treatment of asthma disease and analyzing the impact of patient and physician characteristics on total test expenditures and the number of drugs prescribed as resource utilization variables.
Leukotrienes are increased locally in idiopathic pulmonary fibrosis. Furthermore, a role for these arachidonic acid metabolites has been thoroughly characterized in the animal bleomycin model of lung fibrosis by using different gene knock-out settings.
Journal of the American Society of Nephrology November 2, 2006
Sleep-disordered breathing (SDB) has been noted commonly in hemodialysis (HD) patients, but it is not known whether this is related directly to the treatment of kidney failure with HD or to the higher prevalence of obesity and older age.
American Journal of Respiratory and Critical Care Medicine Vol 174. pp. 1088-1093, (2006)
Puerto Ricans, an admixed population of African, European, and Native American ancestries, have the highest asthma prevalence, morbidity, and mortality rates of any United States' population. Although socioeconomic status (SES) is negatively correlated with asthma incidence in most populations, no such relationship has been identified among Puerto Ricans.
American Journal of Respiratory Cell and Molecular Biology. Vol. 35, pp. 628-638, 2006
Mechanical stimulation of the airway epithelium, as would occur during bronchoconstriction, is a potent stimulus and can activate profibrotic pathways. We used DNA microarray technology to examine gene expression in compressed normal human bronchial epithelial cells (NHBE).
Acute exposure to ozone has been related to a wide spectrum of health effects in susceptible individuals. Genetic factors may influence interindividual variation in ozone response.
American Journal of Respiratory Cell and Molecular Biology. Vol. 35, pp. 651-661, 2006
A description of the transcriptome of human bronchial epithelium should provide a basis for studying lung diseases, including cancer. We have deduced global gene expression profiles of bronchial epithelium and lung parenchyma, based on a vast dataset of nearly two million sequence tags from 21 serial analysis of gene expression (SAGE) libraries from individuals with a history of smoking.
Journal of Sleep Research, Volume 15, Number 4, December 2006, pp. 430-436(7)
To study dream content in patients with severe obstructive sleep apnea syndrome (OSAS) and its modification with Continuous Positive Airway Pressure (CPAP) therapy. We assessed twenty consecutive patients with severe OSAS and 17 healthy controls.
Anticoagulation management by a dedicated anticoagulation clinic improves patient outcomes compared to routine medical care. Telephone-based anticoagulation management has been described but has not been compared to management with traditional office-based visits.
Exhaled breath condensate collection is not yet standardised and biomarker measurements are often close to lower detection limits. In the current study, it was hypothesised that adhesive properties of different condenser coatings interfere with measurements of eicosanoids and proteins in breath condensate.
American Journal of Respiratory Cell and Molecular Biology. Vol. 35, pp. 681-688, 2006
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States, and cigarette smoking is the major risk factor for COPD. Fibroblasts play an important role in repair and lung homeostasis. Recent studies have demonstrated a reduced growth rate for lung fibroblasts in patients with COPD. In this study we examined the effect of cigarette smoke extract (CSE) on fibroblast proliferative capacity.
The fraction of exhaled nitric oxide (FENO) is elevated in subjects with asthma and atopy, and it has been proposed to be a noninvasive marker of airway inflammation. In addition to asthma and atopy, there is limited information about the determinants of FENO in a general population.
Neonatal dexamethasone (DEX) for chronic lung disease is associated with adverse outcome. We compared behavioral and motor development at school age of children who neonatally received DEX to children neonatally treated with hydrocortisone (HC) in a retrospective matched cohort study.
British Journal of Haematology, Volume 135, Number 2, October 2006, pp. 220-227(8)
Haemostatic changes in septic patients are complex, with both procoagulant and anticoagulant changes. Thirty-eight patients with severe sepsis and 32 controls were investigated by coagulation screens, individual factor assays, calibrated automated thrombography (CAT), whole blood low-dose-tissue factor activated (LD-TFA) Rotem and LD-TFA waveform analysis.
Wound Repair and Regeneration, Volume 14, Number 5, September-October 2006, pp. 548-557(10)
This study examined the diagnostic validity of three different swab techniques in identifying chronic wound infection. Concurrent swab specimens of chronic wounds were obtained using wound exudate, the Z-technique, and the Levine technique, along with a specimen of viable wound tissue. Swab and tissue specimens were cultured using quantitative and qualitative laboratory procedures.
Clinical Pulmonary Medicine. 13(6):321-323, November 2006
Lipoid pneumonia is an uncommon and often underrecognized form of pneumonia. It results from accumulation of lipid material in the lung. Based on the source of the lipid, lipoid pneumonia may be classified as either exogenous or endogenous.
Studies of acute myocardial infarction, trauma, and stroke have been translated into improved outcomes by earlier diagnosis and application of therapy at the most proximal stage of hospital presentation. Most therapies for these diseases are instituted prior to admission to an ICU; this approach to the sepsis patient has been lacking.
Bronchial asthma can be characterized by some significant changes in airway blood vessels, which may contribute to airway remodelling. Despite the clinical and functional consequences of bronchial microvascular remodelling in asthma, up to now, little data have been published on the therapeutic approach to this phenomenon.
Clinical Pulmonary Medicine. 13(6):324-327, November 2006
Focal cryptogenic organizing pneumonia (COP) usually presents as a peripheral, upper lobe solitary nodular or mass-type lesion, which is diagnosed by routine chest radiography. On computed tomography scans, lesions may present as peripheral masses with irregular spiculated margins and cavitation, making them difficult to distinguish from bronchioloalveolar or other pathologic subtypes of adenocarcinoma.
Current Respiratory Medicine Reviews, Volume 2, Number 4, November 2006, pp. 419-426(8)
The Global Initiative for Chronic Obstructive Lung Disease guidelines stated that COPD is a disease of airflow limitation that is associated with abnormal inflammatory response.
The American Association of Critical-Care Nurses (AACN) Standards for Establishing and Sustaining Healthy Work Environments and the American College of Chest Physicians (ACCP) Patient-Focused Care Project are complementary initiatives that provide a road map for creating practice environments where interdisciplinary, patient-focused care can thrive.
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 1925-1931
Recurrent respiratory papillomatosis in children is an uncommon but potentially life-threatening benign tumor of the respiratory tract with laryngeal predilection. The diagnosis of recurrent respiratory papillomatosis may be challenging unless there is a high index of suspicion and awareness of the variable presentations.
Sleep apnea-hypopnea syndrome (SAHS) is a cardiovascular risk factor. The aim of this study was to evaluate sleep disorders using polysomnography on a non-selected population of patients on maintenance hemodialysis.
NEJM Volume 355:2125-2130 November 16, 2006 Number 20
A 40-year-old man with no underlying lung disease has a 7-day history of mild shortness of breath with exertion, as well as cough that is now productive of purulent sputum.
American Journal of Respiratory Cell and Molecular Biology. Vol. 35, pp. 722-729
Enhanced proliferation of smooth muscle cells contributes to airway remodeling of bronchial asthma. Recently,
statins, inhibitors of 3-hydroxy-3-methylglutaryl–coenzyme A
reductase, have been shown to inhibit proliferation of both vascular and airway smooth muscle cells independently of lowering cholesterol. However, the mechanisms remain to be elucidated.
American Journal of Respiratory and Critical Care Medicine Vol 174. pp. 1179-1188
To examine expression of the chemokine receptor, CC chemokine receptor (CCR) 7, in vivo by ASM in patients with asthma and healthy control subjects, and by primary cultures of ASM and fibroblasts; to define expression of its ligands, CC chemokine ligand (CCL) 19 and CCL21, in bronchial biopsies, and primary cultures of ASM and mast cells; and to investigate CCR7's role in ASM migration and repair.
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2032-2037
Children 9 years of age do not respond optimally to a first dose of trivalent inactivated influenza vaccine, and so 2 doses of trivalent inactivated influenza vaccine are recommended for children 9 years of age who are being vaccinated for the first time. We conducted a population-based retrospective cohort study to evaluate compliance with the 2-dose trivalent inactivated influenza vaccine recommendations.
British Journal of Clinical Pharmacology, Volume 62, Number 4, October 2006, pp. 383-390(8)
To investigate the dosage and duration of inhaled steroids prescribed to children and to compare the prescribed doses with recommended doses for the treatment of asthma in children.
Patients with obstructive sleep apnea (OSA) are characterized by deranged cardiovascular variability, a well-established marker of cardiovascular risk. While long-term treatment with continuous positive airway pressure leads to a significant improvement of cardiovascular variability, little is known of the possibility of achieving the same results with other therapeutic approaches.
Standard treatment for persistent bronchopleural fistulas involves thoracotomy with primary closure and transposition of a vascularized muscle flap to the bronchial leak site. This major operation may be ineffective or medically contraindicated.
Inflammation is considered to be of primary pathogenic importance in COPD but the evidence on which current understanding is based does not distinguish between cause and effect and no single mechanism can account for the complex pathology. We performed a prospective longitudinal study of subjects with COPD that related markers of sputum inflammation at baseline to subsequent disease progression.
Whereas most studies focus on laboratory and clinical research, little is known about the causes of death and risk factors for death in critically ill patients.
Critical Care Medicine. Improving the Quality of End-of-Life Care in the ICU. 34(11) Suppl:S364-S372, November 2006
Critical care clinicians no longer consider family members as visitors in the intensive care unit. Family-centered care has emerged from the results of qualitative and quantitative studies evaluating the specific needs of families of patients dying in the intensive care unit. In addition, interventional studies have established that intensive and proactive communication empowers family members of dying patients, helping them to share in discussions and decisions, if they so wish. In addition to intensive communication, interventional studies have highlighted the role of nurses, social workers, and palliative care teams in reducing family burden, avoiding futile life-sustaining therapies, and providing effective comfort care.
Obstructive sleep apnoea (OSA) is a cardio-metabolic disorder. Whether metabolic syndrome (MS), insulin resistance (IR) and albuminuria are independently associated with OSA is unclear, but defining the interactions between OSA and various cardiovascular (CV) risk factors independent of obesity facilitates the development of therapeutic strategies to mitigate their increased CV risks.
Journal of Bronchology. 13(4):216-217, October 2006
A complex anatomic variant involving the right lung and characterized by upper lobe agenesis and left vascular isomerism is extensively demonstrated through the correlation of bronchoscopic, computed-tomographic, and surgical findings.
Gastroesophageal reflux (GER) may underlie respiratory manifestations via vagally mediated airway hyperresponsiveness or microaspiration, and intraesophageal pH monitoring is generally used to identify GER in patients with such manifestations. We aimed to establish the frequency of retrograde pulmonary aspiration in patients with unexplained respiratory manifestations.
Journal of Thoracic Imaging. 21(4):276-283, November 2006
Severe acute respiratory distress syndrome (SARS) caused by SARS-associated coronavirus (SARS-CoV) is a systemic infection that clinically manifests as progressive pneumonia. During the initial phases of infection the virus causes pauci-inflammatory alveolar and interstitial edema that result in imaging abnormalities dominated by ground glass opacities (GGO).
Pertussis, a highly contagious disease caused by Bordetella pertussis, is making a comeback globally despite good immunization coverage. The developed countries have also shown a shift in the epidemiology of the disease to the adolescent and the adult age group, leading to a revision of their vaccination policies.
Species within the Burkholderia cepacia complex (Bcc) can contaminate medications and disinfectants and cause severe pneumonia in critically ill patients or persons with cystic fibrosis. In March 2004, we investigated a hospital outbreak of Bcc possibly associated with a contaminated nasal spray.
Assessing airway and lung inflammation is important for investigating the underlying mechanisms of asthma and COPD. Yet these cannot be measured directly in clinical research and practice because of the difficulties in monitoring inflammation. Noninvasive monitoring may assist in early recognition of asthma and COPD, assessment of its severity, and response to treatment, especially during disease exacerbations.]
In order to develop efficient therapeutic regimes for chronic obstructive pulmonary disease (COPD), N-acetylcysteine (NAC) has been tested as a medication which can suppress various pathogenic processes in this disease. Besides its well-known and efficient mucolytic action, NAC meets these needs by virtue of its antioxidant and anti-inflammatory modes of action.
Tracheopulmonary intubation is the most common misplacement site for narrow-bore feeding tube and it might be associated with severe pleuro-pulmonary complications.
Journal of Bronchology. 13(4):210-211, October 2006
Endobronchial telangiectasias are a rare cause of hemoptysis. Endobronchial telangiectasias have been reported in association with scleroderma, CREST, and hereditary hemorrhagic telangiectasia. We present a case of a patient with hemoptysis and bronchial telangiectasias successfully treated with electrocautery. The patient likely had a "forme fruste" of CREST.
Annals of Allergy, Asthma and Immunology, Volume 97, Number 5, November 2006, pp. 672-680(9)
To evaluate the efficacy and safety of 2 dosing regimens of mometasone furoate DPI in the treatment of mild-to-moderate persistent asthma in children previously using inhaled corticosteroids (ICSs).
Obstructive sleep-disordered breathing is accompanied by episodic increases in left ventricle afterload due to large negative swings in intrathoracic pressure and repetitive surges in arterial pressure. Brain natriuretic peptide (BNP) is released by ventricular myocytes in response to pressure and volume overload. It was hypothesized that in children with snoring, overnight change in BNP levels is correlated with severity of disturbance in respiration.
Anaesthesia, Volume 61, Number 12, December 2006, pp. 1149-1154(6)
Bronchial hyperactivity, a key feature of active asthma in children, is a risk factor for respiratory adverse events in the peri-operative period. The presence of activated eosinophils in the lungs and mast cell degranulation can contribute to bronchial hyperreactivity.
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