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Clinical Microbiology and Infection doi:10.1111/j.1469-0691.2007.01842.x
This study evaluated the capacity of 23 multidrug-resistant (MDR) clinical isolates of Acinetobacter baumannii to adhere to respiratory epithelial cell surfaces and to form biofilm on a polystyrene surface.
No country is fully prepared for a 1918-like pandemic influenza. Averting a pandemic of H5N1 influenza virus depends on the successful control of its endemicity, outbreaks in poultry and occasional spillage into human which carries a case-fatality rate of over 50%. The use of perimetric depopulation and vaccination has failed to halt the spread of the epidemic.
Allergy and Asthma Proceedings, Volume 28, Number 5, September/October 2007 , pp. 540-543(4)
Atopic dermatitis (AD), a chronic inflammatory skin disease, frequently associated with respiratory allergy, is one of the most common skin disorders observed in children. The prevalence of AD and other allergic diseases is increasing in industrialized countries, representing a major burden on health care cost.
Pediatric and Developmental Pathology Volume 10, Issue 6 (November-December 2007) Article: pp. 419-435
The airway epithelium of human and animal lungs contains highly specialized pulmonary neuroendocrine cells (PNEC), distributed as solitary cells and as innervated clusters, neuroepithelial bodies (NEB). The designation "PNEC system" stems from the expression of both neural and endocrine cell phenotypes, including the synthesis and release of amine (serotonin, 5-HT) and a variety of neuropeptides (that is, bombesin).
Allergy, Volume 62, Number 12, December 2007 , pp. 1451-1455(5)
Chronic sinusitis (CS) with asthma generally exhibits a high degree of sinus tissue eosinophilia and recurrence often occurs even after surgical therapy. However, the cause has not yet been fully clarified.
Detailed deposition patterns of inhaled wood dust in an anatomically accurate nasal cavity were investigated using computational fluid dynamics (CFD) techniques. Three wood dusts, pine dust, heavy oak dust, and light oak dust, with a particle size distribution generated by machining (Chung et al., 2000), were simulated at an inhalation flow rate of 10 L/min. It was found that the major particle deposition sites were the nasal valve region and anterior section of the middle turbinate.
Internal Medicine Journal doi:10.1111/j.1445-5994.2007.01497.x
The aim of the study was to describe the oral antibiotics prescribed as step-down therapy for patients hospitalized for community-acquired pneumonia (CAP).
Despite current regulations, which limit the levels of certain air pollutants, there are still a number of adverse health effects that result from exposure to these agents. Numerous epidemiological studies have noted an association between the levels of air pollution and hospital admissions for a variety of different health reasons, including a number of respiratory diseases, as well as increased morbidity and mortality associated with various respiratory conditions and diseases.
The clinical course of patients with idiopathic pulmonary fibrosis (IPF) is generally marked by a decline in pulmonary function over time. Increasingly, patients have been recognized as having an acute, and often fatal, clinical deterioration, termed an acute exacerbation of IPF (AE-IPF).
The longer the duration of symptoms of occupational asthma (OA) before diagnosis, the poorer the outcome. Physicians can play a key role in the early recognition of occupational lung diseases (OLDs), including OA. Our objective was to document and compare the practice patterns, barriers, and needs for early diagnosis of OA among pulmonologists and family physicians.
The current recommendations of 8 to 12 min for the optimal targeted duration of symptom-limited maximal cardiopulmonary exercise testing (CPET) to attain maximal oxygen consumption are based on results from healthy individuals and may not be applicable to patients with severe COPD.
The Internet Journal of Pulmonary Medicine. 2007. Volume 8 Number 1
Septic emboli (SPE) is a rare disorder that is associated with bone infections, infective endocarditis, sinusitis, orbital cellulitis, femoral thrombophlebitis, urinary tract infections, central venous catheter infections, prosthetic cardiac valve infections and pacemaker infections. Some of the causative organisms include Klebsiella.
Though asthma is an airway inflammatory disease, the assessment of treatment efficacy is mainly based on symptom monitoring and the evaluation of lung function parameters. This study was aimed to evaluate the feasibility of exhaled nitric oxide monitoring in allergic asthmatic children who were exposed to relevant allergens in their homes.
Journal of Public Health Management & Practice. 13(6):567-571, November/December 2007
Despite longstanding national guidelines, many children with asthma do not receive annual influenza vaccinations. Information from Medicaid-administrative claims data was integrated into the Michigan Care Improvement Registry (MCIR) to prompt providers regarding influenza vaccination among children with high-risk conditions such as asthma. The attitudes of pediatric primary care providers regarding the implementation of this system were assessed.
Allergy and Asthma Proceedings, Volume 28, Number 5, September/October 2007 , pp. 514-516(3)
Compliance and noncompliance are big issues in asthma management. It has been well established that compliant patients experience less exacerbations than less compliant patients and that compliance rates often are <50%.
Archives of Pathology and Laboratory Medicine: Vol. 131, No. 11, pp. 1700-1708
Cytologic examination of the respiratory tract has been a useful diagnostic tool when evaluating neoplastic lesions of the respiratory tract. However, we have limited experience in the application of this technique in the management of nonneoplastic occupational and environmental diseases of the lung and pleura.
Poverty is a major social problem in the United States and throughout much of the world. Poverty and the broader term socioeconomic status (SES) are important determinants of overall health status and many pulmonary diseases.
New England Journal of Medicine Volume 357:2016-2027 November 15, 2007 Number 20
The evolutionarily conserved 18-glycosyl-hydrolase family contains true chitinases and chitinase-like proteins that lack enzymatic activity. Acidic mammalian chitinase has recently been associated with animal models of asthma. The related chitinase-like protein, YKL-40 (also called human cartilage glycoprotein 39 [HCgp-39] and chitinase 3-like 1), can be readily measured in the serum. However, its relationship to asthma has not been evaluated.
We have previously shown that exposure of respiratory epithelial cells to diesel exhaust (DE) enhances susceptibility to influenza infection and increases the production of interleukin (IL)-6 and interferon (IFN)-Beta.
We measured noise intensity and perceived noisiness during continuous positive airway pressure (CPAP) performed with two interfaces (face-mask, helmet) and four delivery systems.
Gastroesophageal reflux has been suggested as an underlying cause of chronic lung disease. The aim of this study was to assess the value of pepsin and bile acids, both components of GI secretions, in the lungs of children with chronic lung diseases as possible markers for gastroesophageal reflux disease and their relation to oxidation and inflammation.
Clinical Pulmonary Medicine. 14(6):365, November 2007
The use of supplemental oxygen for patients with chronic obstructive pulmonary disease who desaturate with exercise produced a short-term improvement in exercise capacity but had no effect on quality of life or functional status.
Preoperative pulmonary evaluation is important in the management of patients with lung disease who are undergoing elective cardiothoracic or noncardiothoracic surgery. In some instances, preoperative pulmonary evaluations may also contribute to the management of patients being considered for urgent surgery.
Clinical Pulmonary Medicine. 14(6):338-345, November 2007
Alternative medicine and complementary therapies are being increasingly used in the United States for treatment or prevention of a variety of diseases. The lack of side effects and likely lower costs compared with conventional medications are major attractions to these treatments.
Exercise-induced hypoxemia is frequent in patients with lymphangioleiomyomatosis (LAM) and could be associated with pulmonary hypertension. The aims of this study were to determine the prevalence of pulmonary hypertension in patients with LAM, to identify physiologic parameters associated with its occurrence, and to evaluate the effect of oxygen on response to exercise.
Clinical Pulmonary Medicine. 14(6):330-337, November 2007
Lung damage may take place after a single exposure to an irritant gas, fume, or vapor. It is surprising that, although thousands of persons experience accidental high-level irritant exposure each year and seek medical care, a majority recover and few persons die.
Clinical Pulmonary Medicine. 14(6):366, November 2007
Empiric antibiotics are frequently used in the intensive care unit (ICU) in the absence of confirmed infections and, in these cases, prolonged use is not helpful and may be harmful.
Clinical Pulmonary Medicine. 14(6):315-320, November 2007
Occupational asthma (OA) is an important cause of adult onset asthma and may contribute particularly to severe asthma. There are two major forms of OA: (1) OA with latency that develops after sensitization to workplace antigens and (2) irritant-induced asthma that develops from direct effects of an irritant on the airway. A number of host and environmental factors will determine whether an individual develops OA.
Smoking activates and recruits inflammatory cells and proteases to the airways. Matrix metalloproteinase (MMP)-12 may be a key mediator in smoke induced emphysema. However, the influence of smoking and its cessation on airway inflammation and MMP-12 expression during COPD is still unknown.
To review and analyse the literature regarding out-of-hospital external chest compressions (ECC) in severe asthma and status asthmaticus. To compare which ambulance services in Australia and New Zealand actively use ECC in their clinical practice guidelines for severe asthma.
As part of recertification, the American Board of Internal Medicine requires its diplomats to complete at least 1 practice improvement module (PIM). We assessed whether completing an asthma-specific PIM resulted in improved patient outcomes.
Critical Care Medicine. 35(11):2547-2552, November 2007
During pressure support ventilation, ventilator inspiration ends when inspiratory flow drops to a given percentage of the peak inspiratory flow cycling-off criteria. This study evaluated the effect of two different cycling-off criteria on breathing pattern, respiratory effort, and gas exchange in patients with chronic obstructive pulmonary disease.
Noninvasive positive-pressure ventilation is a type of mechanical ventilation that does not require an artificial airway. Studies published in the 1990s that evaluated the efficacy of this technique for the treatment of diseases as chronic obstructive pulmonary disease, congestive heart failure and acute respiratory failure have generalized its use in recent years.
Pediatric Critical Care Medicine. 8(6):519-523, November 2007
Objective: 1) To alert the clinician that increasing rate and depth of breathing during treatment of acute asthma may be a manifestation of metabolic acidosis with hyperventilation rather than worsening airway obstruction; and 2) to describe the frequency of metabolic acidosis with hyperventilation in children with severe acute asthma admitted to our pediatric intensive care unit.
Dyspnea is the primary symptom limiting exercise in patients with COPD. Recent research has demonstrated that psychological factors can substantially influence the perception of dyspnea, but little is known about the modulation of perceived intensity or unpleasantness of dyspnea by attentional distraction.
This article reviews the research on the relation between indoor air pollution exposure and acute respiratory infection (ARI) in children in developing countries. ARI is a cause of death globally, causing approximately 19% of all deaths before the age of 5 years, according to a World Health Organization estimate.
It has been postulated that right ventricular (RV) function may improve after lung volume reduction surgery (LVRS) for severe emphysema due to improvement in lung elastic recoil. Improved lung elastic recoil after LVRS is hypothesized to "tether" open extraalveolar vessels, thereby leading to a decrease in pulmonary vascular resistance (PVR) and improved RV function.
Obstructive sleep apnea (OSA) is a common disorder associated with serious health consequences, increased health-care utilization, and economic burden. With greater public and medical attention to sleep disorders, the volume of referrals for sleep studies over the last decade has increased by approximately 12-fold. Despite the steep growth of infrastructure to diagnose and treat OSA, access to such services remains a sizeable problem, and demand overwhelms capacity.
The use of portable monitors (PM) devices has been demonstrated in a wide variety of investigational settings with varying results. While most devices correlate very well with in-laboratory polysomnography, some still misclassify a significant numbers of patients and have lower sensitivity.
Combining bronchodilators has been shown to be beneficial in patients with COPD. The additive effects of short-acting bronchodilators added to maintenance tiotropium therapy, however, are unknown.
Medicine & Science in Sports & Exercise. 39(11):1891-1895, November 2007
Very little information is known about patients with chronic obstructive pulmonary disease who travel to high altitude for work or pleasure. Even less is known about the outcomes at high altitude for patients with severe bullous lung disease.
Scandinavian Journal of Medicine & Science in Sports doi:10.1111/j.1600-0838.2006.00598.x
The objective of this study was to determine the prevalence of asthma and use of asthma medications in elite athletes compared with an age-matched non-athlete population.
The number of children on home mechanical ventilation (HMV) has increased markedly in Europe and North America but little is known about the HMV use and outcomes in children in Turkey.
PEDIATRICS Vol. 120 No. 5 November 2007, pp. e1174-e1181
Factors predictive of future asthma must be identified among young inner-city children, who suffer disproportionately from asthma. We investigated whether current asthma control predicts future asthma-related health care use among inner-city preschool-aged children with asthma.
Guidelines recommend daily controller therapy for mild persistent asthma. Montelukast has demonstrated consistent benefit in controlling symptoms of asthma and may be an alternative, orally administered, nonsteroidal agent for treating mild asthma.
Journal of Bronchology. 14(4):289-292, October 2007
Cho Ray Hospital is one of 3 large hospitals in Ho Chi Minh City (formerly known as Saigon), Vietnam. Despite limited resources and equipment, more than 3000 flexible bronchoscopies are performed there each year, usually for diagnosis of infection, lung cancer, and airway stenosis.
Journal of Bronchology. 14(4):286-288, October 2007
An 86-year-old woman with a 30-year history of goiter was hospitalized with severe stridor and progressive dyspnea on exertion that had worsened over the past year. The trachea was severely compressed by a huge mass, measuring 15 cm in diameter, on the left side of her neck. For the prevention of postoperative instability, a Dumon stent was placed in the trachea for 3 days.
Critical Care Medicine. 35(11):2509-2514, November 2007
Practice guidelines suggest processes of care such as timely oxygenation assessment and antibiotic therapy as quality indicators for the management of community-acquired pneumonia. The objective of this study was to determine whether postponed oxygenation assessment (either by pulse oximetry monitoring or arterial blood gas analysis) delays initiation of antibiotic therapy and adversely affects intensive care unit survival in patients with severe community-acquired pneumonia.
Journal of Bronchology. 14(4):255-260, October 2007
Endobronchial inflammatory pseudotumor (EIP) is an uncommon, benign entity in the central airways, frequently causing acute respiratory insufficiency by occluding the trachea or main-stem bronchi. Surgical resection of the tumor is a treatment option; however, it is associated with high morbidity.
Journal of Bronchology. 14(4):281-283, October 2007
Foreign body aspiration is a common problem necessitating prompt recognition and early treatment. Very rarely, foreign bodies left in situ after surgical interventions in the lung or other sites can migrate into the bronchial tree and cause symptoms. We report a case of chronic cough and hemoptysis 7 years after mitral valve replacement in whom bronchoscopy revealed an endobronchial suture, which presumably migrated from its original site in the heart. Removal of the suture was followed by prompt resolution of symptoms.
Journal of Bronchology. 14(4):284-285, October 2007
We report the placement of a silicone-coated polyester stent (Polyflex; Boston Scientific-Watertown, MA) for long-term control of a tracheo-gastric conduit fistula in a 75-year-old man who underwent tri-incisional esophagectomy for T1N0 adenocarcinoma in the setting of Barrett esophagus with high-grade dysplasia.
Journal of Bronchology. 14(4):269-271, October 2007
Granular cell tumors (GCT) are uncommon, usually benign, neoplasms that most frequently originate from tongue, skin, and breast. Since the first case of GCT from the trachea and bronchus was described in the late 1930s, fewer than 100 cases have been reported as originating from the tracheobronchial tree, most of which were benign.
Journal of Bronchology. 14(4):261-263, October 2007
Massive hemoptysis is a life-threatening emergency encountered by bronchoscopists. Oftentimes stabilizing these patients requires use of selective lung intubation.
Journal of Bronchology. 14(4):272-274, October 2007
A 15-year-old nonsmoking adolescent visited our hospital with complaints of cough and hemoptysis. Chest imaging detected a dense consolidation located in right middle and lower lobes. Bronchoscopy revealed a bulging mass into the right main bronchus. Biopsies of the lesion were diagnostic for Langerhans' cell histiocytosis. There were no features of interstitial lung disease.
Journal of Bronchology. 14(4):267-268, October 2007
High tracheostomy is defined as tracheostomy through the cricothyroid membrane. High tracheostomy through the cricothyroid membrane is the procedure of choice for short-term emergent situations. However, its long-term use is associated with severe complications. For technical reasons, it is contraindicated in obese individuals. Here, we demonstrate long-term sequelae of a high tracheostomy inadvertently placed through the laryngeal cartilage in a morbidly obese individual.
Journal of Pediatric Health Care, Volume 21, Issue 6, Pages 361-371
This study explored Latino family experiences, issues, and needs in caring for a child with asthma as expressed by Latino parents of children with asthma.
Internal Medicine Journal Volume 37 Issue 10 Page 687-692, October 2007
The aim of the study was to review all cases of Pneumocystis carinii pneumonia (PCP) in patients seen by the Christchurch Hospital Rheumatology service over a 5-year period and to determine the annual incidence of PCP.
To investigate the effectiveness of passive antibody treatment as post-exposure therapy for ricin, we had developed an oropharyngeal aspiration model for ricin lethal challenge and antibody administration.
Infectious Disease Clinics of North America, Volume 21, Issue 3, Pages 673-695
Chronic lung diseases are prevalent worldwide and cause significant mortality and suffering. This article discusses infections that occur in three chronic lung diseases: chronic obstructive pulmonary disease, bronchiectasis, and cystic fibrosis. Rather than discussing the role of infections as etiology of these diseases, this article focuses on infections that occur in the background of established chronic lung disease.
Clinical and Vaccine Immunology, November 2007, p. 1433-1436, Vol. 14, No. 11
An indirect immunofluorescent assay (Euroimmun AG, Luebeck, Germany) was used to investigate the avidity of immunoglobulin G (IgG), IgM, IgA, and total Ig (IgGAM) antibody responses to severe acute respiratory syndrome coronavirus (SARS CoV) infections.
Scandinavian Journal of Infectious Diseases 08 November 2007
Our aim was to describe the incidence, clinical characteristics and outcome of community acquired pneumonia (CAP) caused by Escherichia coli through the analysis of a cohort of patients with this condition. This study includes all the patients who were admitted to our hospitals because of CAP caused by E. coli, diagnosed with highly reliable microbiological techniques, such as blood culture, bronchoscopic protected specimen brush (PSB) or transthoracic needle aspiration (TNA).
Interferons play a critical role in regulating both the innate and adaptive immune responses. Previous reports have shown increased levels of IFN-gamma, IFN-gamma-inducing IL-12 and IFN-gamma-inducible chemokine IP-10 in patients with chronic obstructive pulmonary disease (COPD).
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 723 - 728
Tobacco smoke (TS) exposure exacerbates asthma and may induce airway hyperresponsiveness in asymptomatic individuals. We hypothesized that TS exposure is an adjuvant to airway responsiveness.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 705 - 710
Individuals with asthma must often make management decisions without the support of asthma care providers. A toll-free asthma helpline is one solution for an easily accessible, community-based service to support individuals with management dilemmas. The study evaluated a toll-free asthma helpline staffed by Certified Asthma Educators (CAEs).
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 753 - 758
Abstract
We assessed timeliness of diagnosis of asthma before and after the inception of electronic medical record (EMR). The proportions of children with a delay in diagnosis of asthma before and after the inception of EMR were 67.8% and 56.8%, respectively (p = 0.088). A significant proportion of children have delayed diagnosis of asthma, and availability of EMR plays a minimal role in reducing delays in diagnosis of asthma.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 769 - 773
This study determined retention by children of drug delivery device technique between visits. Patients had asthma requiring the daily use of at least one medication delivery device.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 747 - 751
To study quality of life and asthma control in primary care. A total of 1,477 patients 15 to 45 years of age received questionnaires regarding asthma control (77% responded) and quality of life, Mini Asthma Quality of Life Questionnaire (MiniAQLQ), (74% responded).
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 699 - 704
The aims of this study were to compare the efficacy of 1-year peak expiratory flow (PEF)-based self-management of asthma against conventional treatment and to analyze the long-term effectiveness of self-management. Eighty adult patients with persistent asthma (group B).
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 789 - 793
We report a case of mucous gland adenoma arising in the left main bronchus which was initially misdiagnosed as asthma and review the previous reported cases of this rare tumor published in the available literature.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 765 - 768
We evaluated residents regarding maintenance treatment of asthma and the technique for using metered dose inhalers. Methods. Residents were asked to prescribe a treatment for a patient with poorly controlled persistent asthma and to demonstrate the use of metered dose inhaler (MDI) medication.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 739 - 745
Few child asthma studies address the specific content and techniques needed to enhance child communication during asthma preventive care visits. This study examined the content of child and parent communications regarding their asthma management during a medical encounter with their primary care provider (PCP).
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 685 - 698
Asthma is a condition, often chronic, characterized by respiratory symptoms, variable airflow limitation and/or airway hyper-reactivity with symptoms causally related to family history, environmental influences, exposure to viruses and allergens as examples.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 735 - 738
The effect of common indoor combustion heating sources on childhood asthma is not well described. The objective was to determine if the use of woodstoves in the home or other factors such as environmental tobacco smoke exposure were associated with the frequency of asthma-related symptoms among children in a rural community.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 759 - 763
This prospective exploratory story examined diurnal variations in pulmonary function and their association with sleep and quality of life (QOL) in 20 adult asthmatics. Peak expiratory flow (PEF) was assessed for 7 days, before bedtime and upon awakening.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 775 - 782
Asthma is a disease of significant social magnitude that disproportionately affects children from minority and low-income backgrounds. Poor asthma management is one of the leading causes for high morbidity and mortality rates.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 711 - 715
National guidelines recommend the use of clinical history and spirometry to determine asthma severity. We examined the usefulness of the six guideline-recommended clinical questions in determining asthma severity and then compared guideline-determined severity to clinician-reported and spirometry-determined severity in a cross-sectional study of 201 children with asthma who were not receiving controller therapy.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 783 - 787
The objective of this paper is to study patterns in children's asthma hospitalizations along the Texas-Mexico border. Data for analysis were obtained from the State of Texas and the US Bureau of the Census. Estimated hospitalization rates are compared for border and off-border sociodemographic groups.
Journal of Asthma, Volume 44, Issue 9 November 2007 , pages 729 - 733
Exercise-induced bronchospasm (EIB) affects up to 90% of all patients with asthma. Objective. This study evaluated the ability of levalbuterol hydrofluoroalkane (HFA) 90 g (two actuations of 45 g) administered via metered dose inhaler (MDI) to protect against EIB in mild-to-moderate asthmatics.
Emergency Medicine News:Volume 29(11)November 2007p 25
Most patients who survived severe acute respiratory syndrome (SARS) had good physical recovery, but they or their caregivers often reported a decline in mental health one year later, according to a study in the June 25 Archives of Internal Medicine.
Travel Medicine and Infectious Disease, Volume 5, Issue 6, Pages 411-411
Since January 2006, the range of H5N1 viruses has greatly extended from being mostly confined to East and South East Asia to outbreaks spreading into Europe, the Middle East and Africa meaning that travelers will be increasingly likely to enter into an affected region. Travelers need reassurance that they can be protected from developing this life-threatening disease if exposed.
Ultrasound in Obstetrics and Gynecology, Volume 30, Number 6, November 2007 , pp. 855-860(6)
To prospectively examine the relationship between contralateral lung area measured by two-dimensional (2D) ultrasound examination and contralateral and total fetal lung volume (FLV) estimated by magnetic resonance imaging (MRI) in the assessment of fetuses with congenital diaphragmatic hernia (CDH).
European Journal of Emergency Medicine. 14(6):351-353, December 2007
Constipation with faecal impaction is a common condition, which may lead to serious potential complications. Among such complications, stercoral perforation has been rarely reported in the literature. We report a single case of 75-year-old woman, with a massive faecal impaction, which resulted in a rectum perforation, presented as a pneumoperitoneum, pneumomediastinum and subcutaneous emphysema.
The Internet Journal of Anesthesiology. 2007. Volume 14 Number 2
Anaesthesiologists are usually conservative in accepting children with URI (Upper Respiratory Tract Infection) for surgery and cases are scheduled for a later symptom free date. This is for fear of aiway hyper-reactivity and its associated complications which are a major concern to the anaesthesiologist. It is for this reason that we conducted the present study to see if children with mild URI or those diagnosed by the pediatrician as having allergic rhinitis (with out any symptoms of viral URI or LRTI) can be taken up for surgery with extra vigilance and whether LMA could serve as an appropriate substitute in minimizing the adverse respiratory events associated with URI.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 974-982, (2007)
Asthma is characterized by increases in airway resistance, pulmonary remodeling, and lung inflammation. The cytokine transforming growth factor (TGF)- has been shown to have a central role in asthma pathogenesis and in mouse models of allergic airway disease.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 1041-1047, (2007)
Inflammatory cytokines may affect pulmonary vascular remodeling in idiopathic pulmonary arterial hypertension (IPAH). CC chemokine ligand 2 (CCL2) is synthesized by vascular cells and can stimulate monocyte/macrophage migration and smooth muscle cell (SMC) proliferation.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 1007-1014, (2007)
There is growing evidence that resident cells, such as fibroblasts and epithelial cells, can drive the persistent accumulation of dendritic cells (DCs) in chronically inflamed tissue, leading to the organization and the maintenance of ectopic lymphoid aggregates. This phenomenon, occurring through a chemokine-mediated retention mechanism, has been documented in various disorders, but not in fibrotic interstitial lung disorders in which the presence of organized lymphoid follicles has been documented.
Journal of Bronchology. 14(4):275-277, October 2007
Numerous well-recognized manifestations of amiodarone pulmonary toxicity have been described since the advent of this medication for the treatment of cardiac arrhythmias. The typical presentation is a subacute infiltrative lung illness with bilateral infiltrates that develops within several years of treatment onset. We describe a previously unrecognized complication of long-term amiodarone use, characterized by cough and black airway pigmentation that resolved with discontinuation of amiodarone.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 954-956, (2007)
Sleep apnea causes impairment in performance and is associated with an increased risk of motor vehicle crashes compared with the general population of drivers. Despite this increased risk, the actual number of accidents is still quite low, although the implications are significant in commercial vehicle drivers.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 1048-1053, (2007)
Catamenial and endometriosis-related pneumothorax are considered relatively rare entities. Their clinical characteristics and outcome are incompletely known.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 1026-1034, (2007)
The Scleroderma Lung Study enrolled 158 patients with scleroderma-related interstitial lung disease in a placebo-controlled trial of oral cyclophosphamide (CYC). Although treatment-related benefits in pulmonary function, skin scores, and patient-centered outcomes were demonstrated after 1 year of therapy, the duration of benefit beyond 1 year was unclear.
Journal of Bronchology. 14(4):242-245, October 2007
Bronchoscopic palliative treatment is a modality that could reduce the symptoms in patients with inoperable lung cancer. Our interest is to study the palliative effect of intrabronchial chemotherapy using cisplatin, in patients with inoperable lung cancers.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 957-969, (2007)
Cystic fibrosis is a recessive genetic disease characterized by dehydration of the airway surface liquid and impaired mucociliary clearance. As a result, individuals with the disease have difficulty clearing pathogens from the lung and experience chronic pulmonary infections and inflammation. Death is usually a result of respiratory failure. Newly introduced therapies and aggressive management of the lung disease have resulted in great improvements in length and quality of life, with the result that the median expected survival age has reached 36 years.
PEDIATRICS Vol. 120 No. 5 November 2007, pp. e1203-e1211
Although many children with obstructive sleep apnea syndrome have complete resolution of obstructive sleep apnea syndrome after adenotonsillectomy, some patients have persistent obstructive sleep apnea syndrome requiring positive airway pressure treatment. Little is known about positive airway pressure adherence among school-aged children and adolescents.
Journal of Nuclear Medicine Vol. 48 No. 11 1889-1896
Pulmonary uptake of 18F-FDG assessed with PET has been used to quantify the metabolic activity of inflammatory cells in the lung. This assessment involves modeling of tracer kinetics and knowledge of a time-activity curve in pulmonary artery plasma as an input function, usually acquired by manual blood sampling.
Sarcoidosis is an inflammatory disease of unknown etiology, most commonly affecting the lungs. Activated CD4+ T cells accumulate in the lungs of individuals with sarcoidosis and are considered to be of central importance for inflammation.
Squamous metaplasia (SM) is common in smokers and is associated with airway obstruction in chronic obstructive pulmonary disease (COPD). A major mechanism of airway obstruction in COPD is thickening of the small airway walls.
Airway dendritic cells (DCs) are key regulators of pulmonary immune responses. However, information is limited regarding the characteristics of airway DCs in human lung diseases.
Pleural effusion is a common complication of various diseases. Conventional methods are not always capable of establishing the cause of pleural effusion, so alternative tests are needed. The aim of this study was to explore means of discriminating between different pleural effusion groups, malignant, parapneumonic and tuberculous, based on the combined function of seven biological markers.
In patients with asthma and chronic obstructive pulmonary disease, the addition of long-acting
Beta2-agonists (LABA) to glucocorticosteroids (GCS) results in better control than increasing the dose of GCS alone. In smooth muscle cells and fibroblasts, one apparent underlying mechanism involves the ability of LABAs to activate the glucocorticoid receptor
(GR).
Bronchiolitis obliterans syndrome (BOS), a process of fibro-obliterative occlusion of the small airways in the transplanted lung, is the most common cause of lung transplant failure. We tested the role of cell-mediated immunity to collagen type V [col(V)] in this process. PBMC responses to col(II) and col(V) were monitored prospectively over a 7-year period.
The lungs are the most frequent sites of these infections, and in different geographic regions, tuberculosis, bacterial pneumonia and Pneumocystis jiroveci are the dominant pathogens.
Acute exacerbations are important in the clinical course of COPD, yet the underlying mechanisms are poorly understood. Systemic inflammation is now considered as an important component in the disease process. In this study we evaluated longitudinally the systemic inflammation during hospital treatment for acute exacerbation and after clinical recovery.
Right ventricular function is frequently abnormal in patients with systemic sclerosis, but whether this is related to pulmonary vascular complications of the disease is unclear.
Annuals of Internal medicine 6 November 2007 Volume 147 Issue 9 Pages 639-653
Chronic obstructive pulmonary disease (COPD) is a common and disabling condition in adults. Information about therapeutic effectiveness and adverse effects of common treatment options and how clinical and spirometric characteristics affect outcomes is not well known but is important for clinicians caring for patients with stable COPD.
In patients with emphysema being evaluated for lung volume reduction surgery, Doppler echocardiography has been used to screen for pulmonary hypertension as an indicator of increased peri-operative risk.
To evaluate our experience with patients who presented with chronic cough and how exhaled nitric oxide predicted response to inhaled corticosteroid (ICS) therapy.
Despite the introduction of new drugs that have changed the course of pulmonary arterial hypertension (PAH), some patients are still refractory to treatment and deteriorate rapidly. Long-acting phosphodiesterase-5 inhibitors are a new class of drugs that are effective in PAH.
Obesity may contribute to the development and clinical expression of asthma. However, how obesity can influence response to asthma medications is still uncertain.
Dyspnea and exercise limitation are common in patients with idiopathic pulmonary arterial hypertension (IPAH). Recently, a reduction in inspiratory and expiratory muscle strength has been observed in IPAH.
Bronchiectasis is a heterogeneous disease in terms of its clinical and functional presentation. Some isolated parameters have been used to assess the severity of bronchiectasis or its response to treatment.
Sjogren's syndrome can cause many organic changes, but is rarely accompanied by pleuritis. We report a 65-year-old patient with primary Sjogren's syndrome who developed bilateral pleuritis with moderately large effusions.
Journal of Dermatology, Volume 34, Number 11, November 2007 , pp. 769-772(4)
We report an autopsy case of a 60-year-old Japanese woman who died 27 years after the onset of systemic sclerosis and 4 years after the diagnosis of pulmonary arterial hypertension. Oral administration of bosentan was effective in improving her dyspnea but had to be stopped because of drug eruption along with fever and eosinophilia.
European Journal of Emergency Medicine. 14(6):360-362, December 2007
We report a 68-year-old man with chronic voice hoarseness, who presented to the emergency room with left-sided chest and hypochondrial pain. Chest radiograph showed a large mediastinal mass confirmed to be a thoracic aortic aneurysm by an emergent computed tomography scan.
European Journal of Internal Medicine, Volume 18, Issue 7, Pages 524-530
Current guidelines suggest the use of non-invasive ventilation (NIV) in hypercapnic chronic obstructive pulmonary disease (COPD) exacerbations in patients presenting with a pH of 7.25-7.35. The aim of this study was to investigate the role of NIV in COPD patients with chronic hypercapnic respiratory failure admitted to the hospital with acute exacerbations and an arterial pH of 7.35 or higher.
European Journal of Internal Medicine, Volume 18, Issue 7, Pages 542-547
The aim of the present study was to identify early risk factors for prolonged mechanical ventilation (PMV) in chronic obstructive pulmonary disease (COPD) patients admitted to respiratory intensive care units (RICU) for acute hypercapnic respiratory failure.
Our aim was to investigate the association between respiratory symptoms and mortality from ischaemic heart disease (IHD) and stroke in a population during 30 years follow-up.
This study estimated the healthcare resource utilisation and costs of chronic obstructive pulmonary disease (COPD) patients, staged by severity, in the Italian pneumology departments (PDs).
Sarcoidosis is a global disorder whose breadth of organ involvement can often be underappreciated. Head and neck manifestations include involvement of the skin, salivary glands, sinonasal cavity, and larynx. Of cases of upper airway sarcoidosis, laryngeal sarcoidosis and airway compromise portend a greater risk of fatal outcomes.
To determine whether clinicians' prognoses in patients with severe acute exacerbations of obstructive lung disease admitted to intensive care match observed outcomes in terms of survival.
A 53-year-old woman reported having a persistent cough and bloody sputum. She did not smoke but had received a diagnosis of Sjogren's syndrome. Chest CT revealed middle lobe syndrome, bronchiectasis and diffuse centrilobular nodular lesions.
Journal of Bronchology. 14(4):227-232, October 2007
Several techniques are currently available to improve the diagnostic yield of routine flexible bronchoscopy. In the present study, we have evaluated the contribution of 2 methods used in our community practice: electromagnetic navigation (EMN, superDimension Ltd, Herzliya, Israel) and rapid on-site cytologic evaluation of obtained tissue samples.
Mouth occlusion pressure measurement is widely used for assessment of respiratory muscle function, particularly in patients with respiratory failure. However, its predictive value for long-term survival remains largely unexplored.
Allergic rhinitis is a predisposing factor for developing clinical asthma. Moreover, allergic rhinitis is often associated with bronchial hyperresponsiveness (BHR). We hypothesise that patients with asthma have more small airway involvement than those with allergic rhinitis and BHR alone.
Journal of Bronchology. 14(4):233-236, October 2007
Dexmedetomidine (Precedex) is a sedative with a profile which is very appealing for short procedures, but its use in bronchoscopy has not yet been studied. This pilot study examines the efficacy and safety of dexmedetomidine during bronchoscopy in patients with pulmonary compromise. Patients were prospectively enrolled. Dexmedetomidine was administered before and during the procedure.
Increased airway responsiveness to Beta-agonists is noted in asthmatics and smokers. The lung may be exposed to chemical warfare agents such as mustard gas and pulmonary complications of exposure range from no effect to severe bronchial stenosis.
Estimating the degree of pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) is not always straight forward. Standard pulmonary function tests provide only a crude estimate of this important aspect of COPD. In addition, good patient cooperation cannot always be achieved and therefore adds to the uncertainties with regard to the extent of hyperinflation of the lung.
In November 2005, the American Thoracic and European Respiratory Societies jointly published a statement proposing a new interpretation scheme for pulmonary function tests. The practical effect of adoption of these new guidelines has not yet been studied. The purpose of the current study was to address the effects of the new interpretation strategy on the relative distribution of obstructive and restrictive diagnoses in patients evaluated at a single academic medical center laboratory.
Allergic bronchopulmonary aspergillosis (ABPA) is a complex disease, triggered by a hypersensitivity reaction to the allergens of Aspergillus fumigatus, a fungus that opportunistically colonizes the lungs of patients with asthma. The diagnosis of ABPA is difficult. A major problem is the lack of standardized allergens used in the determination of specific IgE, but the use of recombinant allergens has been proposed to overcome this.
Exercise-induced bronchoconstriction (EIB) is a highly prevalent condition, whose pathophysiology is not well understood. Endothelins are proinflammatory, profibrotic, broncho- and vasoconstrictive peptides which play an important role in the development of airway inflammation and remodeling in asthma. The aim of the study was to evaluate the changes in endothelin-1 levels in exhaled breath condensate following intensive exercise in asthmatic patients.
Hypoxia induces the proliferation of pulmonary arterial smooth muscle cell (PASMC) in vivo and in vitro, and prostacyclin analogues are thought to inhibit the growth of PASMC. Previous studies suggest that p27kip1, a kind of cyclin-dependent kinase inhibitor, play an important role in the smooth muscle cell proliferation. However, the mechanism of hypoxia and the subcellular interactions between p27kip1 and prostacyclin analogues in human pulmonary arterial smooth muscle cell (HPASMC) are not fully understood.
Contents of the epithelial lining fluid (ELF) of the bronchi are of central interest in lung diseases, acute lung injury and pharmacology. The most commonly used technique broncheoalveolar lavage is invasive and may cause lung injury.
Archives of Gerontology and Geriatrics, Volume 45, Issue 3, Pages 273-280
The objective of the present study was to determine the relationships between the cognitive function and quality of life in the patients with chronic obstructive pulmonary disease (COPD).
Nontuberculous mycobacteria (NTM) are intracellular pathogens that elicit a specific T-cell response characterized by the production of proinflammatory cytokines, including interferon (IFN)-alpha, tumor necrosis factor (TNF)-alpha, and interleukin (IL)-12.
In bacterial empyema the pleural mesothelium is constantly exposed to microorganisms. Staphylococcus aureus (S. aureus) is one of the most frequent pathogens associated with empyema. In an earlier study we demonstrated that S. aureus induced barrier dysfunction in pleural mesothelial cell monolayers.
Canadian Respiratory Journal October 2007, Volume 14 Issue 7: 423-425
The invitation to contribute to the present issue of the Journal, celebrating the 50th anniversary of the Canadian Thoracic Society (CTS), provides me with an opportunity to document what, in my view, is one of the most effective collective interventions in the field of epidemiology and occupational health.
American Journal of Rhinology, Volume 21, Number 5, 9/10 2007 , pp. 542-547(6)
Interleukin (IL)-4 and IL-6, respectively, markers of neutrophilic and eosinophilic inflammation, were analyzed in nasal and oral exhaled breath condensate to understand the inflammation of upper and lower airways in subjects with aspirin-induced asthma (AIA) syndrome, evaluating possible differences between AIA and the single pathological conditions included in AIA syndrome.
Chemical pleurodesis using various sclerosing agents is accepted palliative therapy for patients with recurrent, symptomatic, malignant pleural effusions (MPE). However, the utility of various clinical and biochemical parameters in predicting pleurodesis outcome is still controversial.
The aim of this study was to evaluate the value of pulmonary function tests performed before an autologous peripheral stem cell transplant (APSCT) in identifying patients who are at risk for developing post-transplant pulmonary complications.
Even though an inflammatory process is known to be the underlying cause of asthma, diagnosis is based on clinical history, reversible airway obstruction and bronchial hyperresponsiveness according to international guidelines. The fraction of exhaled nitric oxide (FENO) and induced sputum eosinophil count (Eos%) have been used as non-invasive inflammatory biomarkers.
European Journal of Clinical Investigation, Volume 37, Number 11, November 2007 , pp. 897-904(8)
Disuse and/or local inflammation in the muscle cannot be excluded as potential influences for the decreased muscle force in patients hospitalised due to an acute chronic obstructive pulmonary disease (COPD) exacerbation.
Critical Care Medicine. 35(11):2484-2490, November 2007
Although a number of studies have reported elevated levels of markers of myocardial necrosis among critically ill patients, the association between these markers and outcome remains poorly studied in patients with lung injury. We investigated the association of elevated troponin and creatine phosphokinase isoenzyme levels with mortality and organ failure in subjects with acute respiratory distress syndrome.
Allergy & Clinical Immunology International - Journal of the World Allergy Organization July 2007 , Vol 19 , No. 4
Nasal congestion is a common problem in patients being treated with nasal positive airway pressure therapy. Although the problem is common, its treatment is challenging. We sought to evaluate the use of Breathe Right Strips(®)(BRS)for improving nasal air flow in patients with obstructive sleep apnea
(OSA) and rhinitis on positive pressure therapy.
Canadian respiratory Journal October 2007, Volume 14 Issue 7: 432-434
Fifty years ago, chronic obstructive pulmonary disease (COPD) was the ideal disease for physiologically oriented clinicians to study, for a number of reasons. First, it was becoming recognized as a major health problem. Second, it could only be diagnosed reliably by physiological testing; x-rays did not work. Third, it was associated with a lot of interesting pathophysiology, including cor pulmonale, alterations in the control of ventilation, and perhaps most interesting of all, abnormalities that were primarily related to the distributions of ventilation and/or perfusion as opposed to global inadequacy of either of them.
Some studies have suggested that asthma may be a risk factor for coronary heart disease and stroke, particularly in women. Child and adult-onset asthma differ according to inflammatory characteristics and gender distribution. We examined whether childhood-onset and adult-onset asthma were associated with carotid artery intima-media thickness (IMT) in men and women in the Atherosclerosis Risk in Communities (ARIC) study.
British Journal of Infection Control, Vol. 8, No. 5, 8-12 (2007)
Influenza is a major cause of morbidity and mortality (DH, 2006; Watson et al 2001). In the United Kingdom (UK), the policy of encouraging influenza vaccine uptake in elderly people is a central tenet of managing winter pressures in the National Health Service (NHS) and preventing ill health among older people in the community.
The present study was designed to investigate an association of common -588C/T and -23G/T polymorphisms within glutamate cysteine ligase modifier subunit gene with susceptibility to bronchial asthma. A total of 435 ethnically Russian subjects were recruited in this study, including 221 patients with asthma and 214 sex and age matched healthy subjects.
Canadian Respiratory Journal October 2007, Volume 14 Issue 7: 393-397
The contributions of Canadians to pulmonary anatomy and pathology have been recognized internationally for almost a century, and the published abstracts of the 2007 meetings of the American Thoracic Society indicate that Canada has a bright future in this field. The introduction of computed tomography (CT) has had the greatest impact on the practice of chest medicine within living memory, because it allows the gross anatomy of the lung to be visualized noninvasively.
Canadian Respiratory Journal October 2007, Volume 14 Issue 7: 407-413
Although there were previous relevant contributions to the field of asthma in the workplace (AWP), Professor Jack Pepys is rightly considered to be the father of the discipline (1). In the 1970s, he popularized the use of simulated exposure testing to confirm the diagnosis of occupational asthma (OA) and reported many different causes as well as agents responsible for OA. He trained many students from different parts of the world; some of whom migrated to Canada.
The Urge-to-Cough is a component of the brain motivation system that mediates cognitive responses to cough stimuli. There are six stages to the cough motivation-to-action system: (1) stimulus, the trigger for the neural event; (2) urge, the physical need to respond to the stimulus; (3) desire, translation of urge into a central neural targeted goal; (4) action, physical response that satisfies the urge-desire; (5) evidence, feedback to the neural system on the action; (6) reward, sensory system that determines if the urge was satisfied. Urge-to-Cough is related to three fundamental types of cough: (1) reflex cough, (2) voluntary cough, and (3) behavioral cough. Urge-to-Cough with reflex cough can be studied by measuring the sensations elicited by a cough stimulus.
The increase in adiposity associated with aging is a concern in older adults, especially as it relates to the risk for ventilatory complications. Therefore, the specific aim of this study was to determine the association of various measures of abdominal adiposity with lung function in a sample of older healthy Black women.
Cough is an important defensive pulmonary reflex that removes irritants, fluids, or foreign materials from the airways. However, when cough is exceptionally intense or when it is chronic and/or nonproductive it may require pharmacologic suppression. For many patients, antitussive therapies consist of OTC products with inconsequential efficacies.
The pH of sputum and exhaled breath condensate is abnormal in several pulmonary disorders. Though airway pH regulatory proteins may be abnormally expressed in human development, the tracheal aspirate pH of infants born prematurely has not been studied.
Canadian Respiratory Journal October 2007, Volume 14 Issue 7: 419-422
Farming, one of the oldest professions of mankind, is by far the one that employs the largest number of individuals worldwide. Although outdoor country work is supposedly healthy, farmers are at risk of respiratory diseases because of their work environment. This essay summarizes the major respiratory health risks to farmers in Canada.
Chronic cough is a common condition that causes considerable physical and psychological morbidity. The physical symptoms of cough are readily apparent; however, the psychosocial symptoms are often overlooked.
The recommended treatment of suspected tension pneumothorax is immediate needle decompression. Recommended sites and needle sizes for this procedure vary, and there are published reports of failed decompression as well as iatrogenic hemothorax. We investigated the optimal needle length and relative safety of three potential needle decompression sites
Acute inflammation in the lung is fundamentally important to host defence, but chronic or excessive inflammation leads to several common respiratory diseases, including asthma and acute respiratory distress syndrome.
Chronic obstructive pulmonary disease (COPD) is the fifth cause of morbidity and mortality in the developed world and represents a substantial economic and social burden. Patients experience a progressive deterioration up to end-stage COPD, characterised by very severe airflow limitation, severely limited and declining performance status with chronic respiratory failure, advanced age, multiple comorbidities and severe systemic manifestations/complications.
The aim of this study was to assess the feasibility and accuracy of a novel magnetic resonance-compatible (MRc)-spirometer. The influence of body posture, magnetic resonance (MR)-setting and image acquisition on lung function was evaluated. Dynamic MR imaging (dMRI) was compared with simultaneously measured lung function.
Canadian Respiratory Journal October 2007, Volume 14 Issue 7: 414-418
The allergen challenge has evolved, in less than 150 years, from a crude tool used to document the etiology of allergen-induced disease to a well-controlled tool used today to investigate the pathophysiology and pharmacotherapy of asthma.
Sleep apnoea is common in patients with end-stage renal disease (ESRD). It was hypothesised that this is related to a narrower upper airway. Upper airway dimensions in patients with and without ESRD and sleep apnoea were compared, in order to determine whether upper airway changes associated with ESRD could contribute to the development of sleep apnoea.
The benefit of systemic steroids as adjunctive treatment in patients with severe community-acquired pneumonia (CAP) remains unclear. The present study aimed to evaluate the impact of corticosteroid treatment on mortality in patients with severe CAP.
Cough is a common presenting symptom of many patients managed by allergists. For patients with chronic cough who are nonsmokers, have normal spirometry, and are not being treated with an ACE inhibitor, diagnosis usually focuses on differentiation between postnasal drip syndrome, asthma, gastroesophageal reflux disease, and nonasthmatic eosinophilic bronchitis, alone or in combination. Patients with severe COPD or GERD should be referred to appropriate specialists for those conditions. The management of conditions commonly treated by allergists (e.g., allergic rhinitis, asthma, sinusitis) follows the recommendations of current guidelines and/or practice parameters.
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