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The purpose of this study was to compare the dosimetric accuracy of IMRT plans for targets in lung with the accuracy of standard uniform-intensity conformal radiotherapy for different dose calculation algorithms. Tests were performed utilizing a special phantom manufactured from cork and polystyrene in order to quantify the uncertainty of two commercial TPS for IMRT in the lung. Ionization and film measurements were performed at various measuring points/planes.
To investigate the effects of welding fumes on the glycoconjugates in nasal respiratory mucosa, male Sprague-Dawley rats were exposed to manual metal arc stainless steel (MMA-SS) welding fumes at a concentration of 56-76 mg/m3 total suspended particulate for 2 h/day in an inhalation chamber for 90 days.
Chronic inflammation in asthma and chronic obstructive pulmonary disease drives pathological structural remodelling of the airways. Using tiotropium bromide, acetylcholine was recently identified as playing a major regulatory role in airway smooth muscle remodelling in a guinea pig model of ongoing allergic asthma.
The incidence of asthma has increased the world over, and current therapies for the disease suffer from potential side-effects. This has created an opportunity to develop novel therapeutic approaches. Here, the anti-inflammatory activity of choline was investigated in a mouse model of allergic airway inflammation.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 805-813, (2007)
Our study has shown that plasma levels of ghrelin, a stomach-derived peptide, are significantly reduced in sepsis, and that ghrelin administration improves organ blood flow via a nuclear factor (NF)-kB-dependent pathway. However, it remains unknown whether ghrelin has any protective effects on severe sepsis-induced acute lung injury (ALI) and, if so, whether inhibition of NF-kB plays any role in it.
Advancing age is associated with a decline in the strength of the skeletal muscles, including those of respiration. Respiratory muscles can be strengthened with nonrespiratory activities.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0134-x
This paper reports on the case of an oral appliance used in the treatment of obstructive sleep apnea syndrome (OSAS) fitted to a superior total prosthesis.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0118-x
There is no universally accepted method to determine effective therapy for central sleep apnea (CSA). Continuous positive airway pressure (CPAP) applied acutely most often does not eliminate apneas and hypopneas.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0119-9
In the narrowed upper airway of patients with obstructive sleep apnea (OSA), a neuromuscular compensatory mechanism augments the activity of the upper airway dilator muscles in defense of upper airway patency, particularly during inspiration.
Psychiatry and Clinical Neurosciences, Volume 61, Number 5, October 2007 , pp. 558-563(6)
The aim of the present paper was to clarify the factors influencing subjective daytime sleepiness in patients with obstructive sleep apnea syndrome (OSAS). Subjects included 230 adult male OSAS patients aged 20-73-years.
Journal of the American Society of Echocardiography, Volume 20, Issue 10, Pages 1167-1171
Pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) are important hemodynamic parameters in patients with advanced cardiopulmonary disease. We undertook this study to determine whether Doppler tissue imaging of the tricuspid annulus could be used to assess PAP and PVR noninvasively.
Cochrane Database of Systematic Reviews 2007 Issue 3
Respiratory distress syndrome (RDS) is a significant cause of morbidity and mortality in preterm infants. RDS is caused by a deficiency, dysfunction, or inactivation of pulmonary surfactant. Numerous surfactants of either animal extract or synthetic design have been shown to improve outcomes. New surfactant preparations that include peptides or whole proteins that mimic endogenous surfactant protein have recently been developed and tested.
Annals of Allergy, Asthma and Immunology, Volume 99, Number 4, October 2007 , pp. 371-374(4)
Therapy-resistant asthma is an important clinical problem. However, before considering asthma truly therapy resistant, it is essential to exclude diagnoses that may masquerade as therapy-resistant asthma, such as vocal cord dysfunction and recurrent aspiration, as well as factors related to loss of asthma control, including poor compliance, exposure to allergens, and sinusitis. Corticosteroid-induced myopathy may be an unrecognized but potentially important consideration in both settings.
International Archives of Occupational and Environmental Health, Volume 80, Number 8, August 2007 , pp. 711-719(9)
There is growing concern about adverse respiratory health effects from exposure to indoor air pollution. The purpose of this study was to analyze association between exposure to volatile organic compounds (VOC) and asthma in adults.
Annals of Allergy, Asthma and Immunology, Volume 99, Number 4, October 2007 , pp. 334-339(6)
Asthma is an inflammatory condition of the airways, and there is some evidence to suggest that it is associated with a systemic inflammatory response, as measured by C-reactive protein (CRP) and fibrinogen. Exhaled nitric oxide is a noninvasive measure of asthmatic airway inflammation.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0120-3
Women with polycystic ovarian syndrome (PCOS) have been shown to have a very high prevalence of obstructive sleep apnea (OSA). Screening for OSA is recommended for PCOS patients. How far this is carried out in actual practice is unknown. To study practice patterns with regard to screening for OSA in physicians-both obstetrician/gynecologists (ObGyn) and endocrinologist-who manage PCOS.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0112-3
Patients with obstructive sleep apnea (OSA), in comparison to controls, have increased levels of circulating epinephrine and norepinephrine, both of which are risk factors for the development of central serous chorioretinopathy (CSCR). The aim of this pilot study was to investigate the frequency of symptoms that suggest OSA in CSCR patients and normal controls.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0132-z
Correlation between obesity and obstructive sleep apnea has been documented in both adults and children. This investigation evaluated importance of body mass index (BMI) in relation to age as predictor of severity of obstructive sleep-disordered breathing (SDB).
Cough is an airway defensive reflex consisting of an inspiratory phase followed by a forced expiratory effort initially against a closed glottis, followed by active glottal opening and rapid expiratory flow. The expiration reflex (ER) differentiates from cough for the lack of a preparatory inspiration.
Primary Care Respiratory Journal Volume 16 Issue 5 October 2007 Pages 291-298
In 1993, the British Thoracic Society (BTS) issued guidelines for the management of spontaneous pneumothorax (SP). These were refined in 2003. AIM: To determine adherence to the 2003 BTS SP guidelines in a district general hospital.
Primary Care Respiratory Journal Volume 16 Issue 5 October 2007 Pages 319-320
A pilot study was undertaken to assess the respiratory component of primary care nurses’ working time. 13 nurses were interviewed and 10 completed a diary during one working week. The nurses spent a mean 6.6% of their time caring for those with respiratory disease and were of the opinion that during this time they undertook 68% of the management of long term respiratory illness in the practices. More time was spent with those with asthma than with other respiratory conditions and the nurses felt that they were appropriately trained for the tasks undertaken. However, with more training they felt that they could undertake more basic care of those patients with
COPD, and more advanced care of those patients with asthma.
Primary Care Respiratory Journal Volume 16 Issue 5 October 2007 Pages 299-303
The major reason for treating chronic rhinitis is to improve quality of life. Although primary symptoms cause morbidity in their own right, these symptoms are significantly aggravated by the impact of cognitive dysfunction and quality of life.
Primary Care Respiratory Journal Volume 16 Issue 5 October 2007 Pages 304-310
To assess the route to secondary care for patients with possible occupational asthma, and to document the duration of workrelated symptoms and referral times.
Primary Care Respiratory Journal Volume 16 Issue 5 October 2007
To investigate the feasibility of improving asthma management - in particular, the implementation of individualised asthma action plans (AAPs) for poorly-controlled adult asthma patients - by providing training in asthma-focused clinical and communication skills for practice nurses who deliver asthma clinics.
Hemodialysis International, Volume 11, Number 4, October 2007 , pp. 435-441(7)
Sleep disorders are common in patients with end-stage renal disease (ESRD). Using a simple questionnaire, we estimate the probability of sleep apnea in ESRD patients, determine the factors associated with a higher probability of sleep apnea, and determine the association between the probability of sleep apnea and cardiovascular and all-cause mortality.
International Archives of Occupational and Environmental Health, Volume 80, Number 8, August 2007 , pp. 701-710(10)
Some epidemiological literature has observed that air pollution effects on health differed across regional or individual socioeconomic position. This study evaluated whether regional and individual socioeconomic position, as indicated by health insurance premiums, modified the effect of air pollution on hospital visits for asthma.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0117-y
Hypoxia promotes adherence of leukocytes to endothelial cells by inducing expression of adhesion molecules like intercellular adhesion molecule 1 (ICAM-1). Increased serum levels of circulating ICAM-1 (cICAM-1) have been reported in adults with sleep apnea and associated hypoxemia.
An 11-month-old boy with congenital pulmonary vein stenosis, partial anomalous pulmonary venous connection, and ventricular septal defect is described. Angiocardiography demonstrated stenosis between the right upper pulmonary vein and high superior vena cava and obstruction of the right lower pulmonary vein. For pulmonary vein stenosis, we performed transverse sutured plasty for the right upper pulmonary vein, followed by right lower lobectomy. In some patients, combined management for pulmonary vein stenosis is effective.
A 43-year-old man was referred to our institution with severe extrinsic compression of the trachea at the level of the main carina secondary to an aortic aneurysm, causing respiratory distress and requiring mechanical ventilation. The patient had a past history of Marfan's syndrome and tracheomegaly (the estimated tracheal diameter bronchoscopically was 28 mm).
Pulmonary lipomas are rare benign tumors that are usually found endobronchially. Undiagnosed, they can lead to the serious late sequelae associated with endobronchial obstruction. In the majority of cases, they are located in the first three subdivisions of the tracheobronchial tree, and therefore, they are amenable to endoscopic techniques for diagnostic and therapeutic purposes.
This paper discusses emerging information on exposure to air pollution from traffic and health and raises two key questions with regard to the impact of traffic on public health: 1) is there sufficient evidence to infer that traffic is causing adverse health effects, and; 2) what is the magnitude of the adverse impact of traffic on health? Topics addressed include characterization of exposure to traffic-related pollutants; the findings of epidemiological studies to date; and investigative approaches and the related challenges - including bias, model-based conclusions, and sample size issues - in characterizing the health effects of air pollution from traffic.
The 6-min walk distance (6-MWD) is a global marker of functional capacity and prognosis in chronic obstructive pulmonary disease (COPD), but less explored in other chronic respiratory diseases.
Chronic cough is a common symptom but only a fraction of patients seek medical attention. Addressing the causes of chronic cough may lead to control of cough; however, this approach is not always successful since there is a certain degree of failure even when the cause(s) of cough are adequately treated; in idiopathic cough, there is no cause to treat. Persistent cough may be associated with deterioration of quality of life, and treatment with cough suppressants is indicated.
Inflammation & Allergy - Drug Targets (Formerly ‘Current Drug Targets, Volume 6, Number 3, September 2007 , pp. 150-159(10)
Asthma is a chronic inflammatory disease of the airways which affects about 10-25% of children in Western countries. Monitoring of inflammation is considered an important tool in the diagnosis and follow-up of asthma, including assessment of severity and response to treatment.
Percutaneous vertebroplasty (PV) has recently become a very common procedure for vertebral compression fractures. Extravasation of cement, a common event associated with vertebroplasty, may lead to cement emboli in the lungs.
Although 23-valent polysaccharide pneumococcal vaccine (PPV) does not prevent community-acquired pneumonia (CAP), it might still improve outcomes in those who develop pneumonia. We tested this hypothesis using a population-based cohort of hospitalized patients with CAP.
Southern Medical Journal. 100(10):1015-1021, October 2007
Deep venous thrombosis and pulmonary embolism are potentially life-threatening problems that present diagnostic challenges. To employ objective diagnostic tests in an efficient, safe, and cost-effective manner, the clinical probability of these disorders should be estimated before testing. A number of clinical prediction rules are available for suspected deep venous thrombosis, while there are three major prediction rules available for estimating the probability of pulmonary embolism. Recent modifications of the Wells score for deep venous thrombosis simplify its use. Although the Wells score for pulmonary embolism is commonly used, two other rules are useful for this disorder as well. This review summarizes the clinical prediction rules and gives recommendations about their application.
New England Journal of Medicine Volume 357:1487-1495 October 11, 2007 Number 15
Pathological features of the airway in young children with severe recurrent wheeze suggest an association between bacterial colonization and the initiating events of early asthma. We conducted a study to investigate a possible association between bacterial colonization of the hypopharynx in asymptomatic neonates and later development of recurrent wheeze, asthma, and allergy during the first 5 years of life.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0137-7
Residual excessive sleepiness (ES) and impaired cognition can occur despite effective and regular nasal continuous positive airway pressure (nCPAP) therapy in some patients with obstructive sleep apnea (OSA). A pooled analysis of two 12-week, randomized, double-blind studies in nCPAP-adherent patients with ES associated with OSA evaluated the effect of armodafinil on wakefulness and cognition.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0125-y
The Berlin questionnaire (BQ) has been used to help identify patients at high risk of having sleep apnea in primary care and atrial fibrillation patients. The BQ may be a useful adjunct in sleep medicine and research, but it has never been validated in a sleep clinic population.
Cough is one of the most common reasons for medical consultation and it is responsible for a large human and socioeconomic burden. Current guidelines provide a useful framework for cough management and summarize current knowledge of causes and optimal testing sequences and treatments of cough.
Endothelial dysfunction and cardiovascular diseases are frequent in patients with obstructive sleep apnea (OSA). Circulating endothelial progenitor cells (EPCs) contribute to repair dysfunctional endothelium and have been related to increased cardiovascular risk.
International Journal of Dermatology, Volume 46, Number 10, October 2007 , pp. 1078-1080(3)
A 60-year-old man presented to the Emergency Department (ED) with large, painful, indurated plaques on the right thigh, left abdomen, left chest, and right chest, which began without any preceding trauma on the right thigh 3 weeks prior to presentation in the ED. He was initially treated with cefazolin 1 g three times daily as home infusions.
This case documents the occurrence of hemoptysis secondary to pulmonary artery pseudoaneurysm in a 19-year-old man who was admitted for hypertriglyceridemic pancreatitis. The pseudoaneurysm derived from a necrotizing pneumonia within the same pulmonary segment. After an extensive workup, the pseudoaneurysm was diagnosed by pulmonary angiography and treated with coil embolization.
Clinical Pulmonary Medicine. 14(5):296-301, September 2007
This report describes a 23-year-old man with exposure to fiberglass who presented with dry cough of 4 months duration. Computed tomography of the chest showed mediastinal lymph node enlargement and pulmonary infiltrates.
Evidence-Based Dentistry (2007) 8, 5-Study selection Studies chosen were randomised controlled trials (RCT) or quasi-RCT comparing all types of oral and functional orthopaedic appliances with placebo or no treatment, in children of 15 years old or younger.
Intensive Care Medicine 0342-4642 10.1007/s00134-007-0829-2
To determine the relationship between measures of critical illness (sedative/analgesic administration, wakefulness and organ dysfunction), intensive care unit (ICU) recall and symptoms of posttraumatic stress disorder.
In obesity, the addition of mass loading of the chest wall by adipose tissue decreases compliance, but its ventilation does not seem to be a limiting factor to physical performance.
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e1035-e1042
Preterm infants with bronchopulmonary dysplasia often demonstrate sucking difficulties. The aim of this study was to determine whether the severity of bronchopulmonary dysplasia affects not only coordination among suck-swallow-respiration but also sucking endurance and performance itself.
While the early diagnosis of cancer has been fully respected, it is still however often difficult for clinicians to confirm malignant pleural effusions (PE), which essentially indicate the end-stage cancer. It has now been demonstrated that vascular endothelial growth factor (VEGF) is a pivotal angiogenesis factor and associated with tumor growth and metastasis. The aim of this study was then to assess the diagnostic performance of VEGF in malignant PE.
Am J Physiol Lung Cell Mol Physiol 293: L903-L912, 2007
Nitric oxide modulates vascular smooth muscle cell (SMC) cytoskeletal kinetics and phenotype, in part, by stimulating cGMP-dependent protein kinase I (PKGI). To identify molecular targets of PKGI, an interaction trap screen in yeast was performed using a cDNA encoding the catalytic region of PKGI and a human lung cDNA library.
Am J Physiol Lung Cell Mol Physiol 293: L843-L854, 2007
Reversible phosphorylation of cytoskeletal and cytoskeleton-associated proteins is a significant element of endothelial barrier function regulation. Therefore, understanding the mechanisms of phosphorylation/dephosphorylation of endothelial cell cytoskeletal proteins is vital to the treatment of severe lung disorders such as high permeability pulmonary edema.
Am J Physiol Lung Cell Mol Physiol 293: L1037-L1044, 2007
Airway smooth muscle (ASM) metabolizes arachidonic acid (AA) through various enzymatic pathways, including cytochrome P-450 (CYP-450) -hydroxylase, which leads to the production of 20-hydroxyeicosatetraenoic acid (20-HETE).
Am J Physiol Lung Cell Mol Physiol 293: L1053-L1058, 2007
Components of surfactant act as opsonins and enhance phagocytosis of bacteria; whether this process occurs with atmospheric fine particles has not been shown. We have studied the interactions of fine particles (urban PM2.5) and surfactant removed from normal human lungs by lavage, using a surface analysis technique. The aim was to identify which of the chemical components of brochoalveolar lavage (BAL) deposit on the surfaces of urban PM2.5. Deposition of surfactant components on urban PM2.5 surfaces was reported in previous studies, but molecular identification and relative quantification was not possible using simple data analysis.
Am J Physiol Lung Cell Mol Physiol 293: L972-L981, 2007
Oxidant stress has been implicated in the pathogenesis of chronic lung disorders like idiopathic pulmonary fibrosis. However, mechanisms that link oxidant stress to fibrogenesis remain partially elucidated. Emerging data suggest an important role for the extracellular thiol/disulfide redox environment.
Am J Physiol Lung Cell Mol Physiol 293: L991-L999, 2007
Electrolyte transport by airway epithelia regulates the quantity and composition of liquid covering the airways. Previous data indicate that airway epithelia can absorb NaCl. At the apical membrane, cystic fibrosis transmembrane conductance regulator (CFTR) provides a pathway for Cl- absorption. However, the pathways for basolateral Cl- exit are not well understood.
The latest links to journal article abstracts on Respiratory, Pulmonary, COPD, Mechanical Ventilation, Ventilator Weaning, Respiratory Therapy, Asthma, Cardio-Vascular, Sleep Apnea, CPAP, BiPAP, and other related clinical topics.
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Simultaneous bilateral spontaneous pneumothorax is an uncommon and serious medical problem frequently related to an underlying lung disease such as parenchymal lung disease, inflammatory events or neoplasms.
Intensive Care Medicine 0342-4642 10.1007/s00134-007-0833-6
Measurement of functional residual capacity (FRC) during controlled and especially during assisted ventilation remains a challenge in the physiological evaluation of ventilated patients. To validate a bag-in-box closed helium dilution technique allowing measurements both during pressure-controlled (PCV) and pressure-support ventilation (PSV).
Western Journal of Emergency Medicine Volume 8 Issue 3 2007
We examined the effect of two B2-adrenoreceptor (B2AR) polymorphisms (A46G and C79G) in asthmatics presenting to the Emergency Department (ED) in relation to their response to standard therapy measured by change in Forced Expiratory Volume at one second (FEV1).
The Internet Journal of Thoracic and Cardiovascular Surgery ISSN: 1524-0274
Saddle emboli are one of the most severe forms of Pulmonary Embolism and are associated with high mortality rates. Patient salvage depends upon making an early diagnosis, although there is still much controversy regarding the ideal therapeutic strategy for confirmed cases. We present a case where embolectomy was performed to extract a saddle embolus and explore the available management options.
Intensive Care Medicine 0342-4642 10.1007/s00134-007-0847-0
In a cohort of mechanically ventilated patients to compare the automatic tidal volume (V T)-respiratory rate (RR) combination generated by adaptive support ventilation (ASV) for various lung conditions.
Cochrane Database of Systematic Reviews 2007 Issue 3
Pulmonary emboli can have potentially fatal consequences. Inferior vena caval filters are metal alloy devices that mechanically trap fragmented thromboemboli from the deep leg veins en route to the pulmonary circulation. Filters in current clinical use are designed to be introduced (and in the case of retrievable filters, removed) percutaneously. Although their deployment seems of theoretical benefit, their clinical efficacy and adverse event profile is unclear.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0140-z
Patients with complex sleep apnea syndrome (CompSAS) have obstructive sleep apnea but develop troublesome central sleep apnea activity or Cheyne-Stokes breathing when provided continuous positive airway pressure (CPAP) therapy.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0108-z
Insufficient sleep may lead to adverse health effects, influencing body weight. This study quantified the prevalence of short sleep and the association between sleep duration and overweight in a sample of suburban students. Cross-sectional study was conducted in 2004, involving 529 students from Bay High School, Bay Village, OH, USA, using self-administered questionnaires assessing lifestyle and sleep behaviors.
Bacterial DNA containing motifs of unmethylated CpG dinucleotides (CpG-ODN) initiate an innate immune response mediated by the pattern recognition receptor Toll-like receptor 9 (TLR9). This leads in particular to the expression of proinflammatory mediators such as tumor necrosis factor (TNF-alpha) and interleukin-1beta (IL-1beta). TLR9 is expressed in human and murine pulmonary tissue and induction of proinflammatory mediators has been linked to the development of acute lung injury. Therefore, the hypothesis was tested whether CpG-ODN administration induces an inflammatory response in the lung via TLR9 in vivo.
Inpatient rehabilitation improves dyspnea and increases self-esteem between admission and discharge in patients with moderate chronic obstructive pulmonary disease (COPD). Some researchers nevertheless argue that the changes may be due to nursing effects and thus that scores will decrease quickly at home after discharge. This study assessed the change in dyspnea, self-esteem and physical self mean scores and stability in patients with moderate COPD during three consecutive four-week periods: at home, during an inpatient rehabilitation program, and again at home post-discharge.
Respirology Volume 12 Issue 5 Page 763-768, September 2007
It would be desirable in a large country such as India that a single set of reference equations be used to interpret lung function tests performed across the entire country. This study compared north, west and south reference equations in interpreting spirometry results in north Indian patients.
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e1028-e1034
Obstructive sleep apnea has a strong male predominance in adults but not in children. The collapsible portion of the upper airway is longer in adult men than in women (a property that may increase vulnerability to collapse during sleep). We sought to test the hypothesis that in prepubertal children, pharyngeal airway length is equal between genders, but after puberty boys have a longer upper airway than girls, thus potentially contributing to this change in apnea propensity.
We describe an unusual case of a patient with eosinophilic pleural effusion (EPE) associated with long-term propylthiouracil (PTU) administration. A 43-year-old woman was admitted to our hospital after complaining of chest pain.
Cochrane Database of Systematic Reviews 2007 Issue 3
The primary objective is to determine the effects of recruitment manoeuvre for adults with acute lung injury receiving mechanical ventilation on mortality, duration of mechanical ventilation and duration of hospitalization.
Outcomes of lung transplantation for idiopathic pulmonary fibrosis (IPF) are thought to be worse than those for other indications, although the reasons are unknown. In addition, the choice of single versus double lung transplantation is unclear. To guide decision-making, we (1) compared survival of patients receiving transplantation for IPF with survival of patients receiving transplantation for non-IPF diagnoses, (2) identified risk factors for mortality after transplantation for IPF, and (3) ascertained whether double lung transplantation for IPF confers a survival advantage.
Cochrane Database of Systematic Reviews 2007 Issue 3
Persistent pulmonary hypertension in neonates (PPHN) is associated with high mortality. Currently, the therapeutic mainstay for PPHN is assisted ventilation and administration of inhaled nitric oxide (iNO). However, nitric oxide is costly and may not be appropriate in resource-poor settings. Approximately 30% of patients fail to respond to iNO. High concentrations of phosphodiesterases in the pulmonary vasculature has led to the use of phosphodiesterase inhibitors such as sildenafil or milrinone.
Journal of Medical Case Reports 2007, 1:107 1752-1947
We report a case of ipsilateral reexpansion pulmonary edema occurring after the insertion of a chest tube in a patient with spontaneous pneumothorax. The patient received supplemental oxygen via a non-rebreather face mask to compensate for hypoxemia. 24 hours after the acute event, the patient recovered completely without residual hypoxemia. Reexpansion pulmonary edema after the insertion of a thoracic drainage for pneumothorax or pleural effusion is a rare complication with a high mortality rate up to 20%. It should be considered in case of hypoxemia following the insertion of a chest tube. The exact pathophysiology leading to this complication is not known. Risk factors for reexpansion pulmonary edema should be evaluated and considered prior to the insertion of chest tubes. Treatment is supportive.
The Internet Journal of Anesthesiology. 2007. Volume 14 Number 1
Aspiration is defined as entry of a foreign substance, solid or liquid, into the respiratory tract or inhalation of fumes and vapors. Aspiration pneumonia is caused by a direct chemical insult due to the aspirated material or by a primary or secondary bacterial infection. A three-year-old, 15 kg male patient fell into sewage accidentally and was brought to our hospital. His body was all covered with sewage. Sewage was aspirated and tracheal intubation was performed. 250 ml of fluid was aspirated at nasogastric and intubation tube. Respiratory and cardiopulmonary support and antibiotics were immediately started. After 15 days, he was sent to service with stable vital signs. This is a report on a pediatric patient ICU therapy for aspiration pneumonia.
Acta Paediatrica Volume 96 Issue 10 Page 1464-1469, October 2007
Atopic infants hospitalized for wheezing not caused by respiratory syncytial virus (RSV) carry the highest risk for later asthma. In the present paper, early risk factors for later lung function abnormalities and for bronchial hyper-responsiveness (BHR) were evaluated in 81 children, hospitalized for bronchiolitis in infancy, at the median age of 12.3 years.
Pleural fluid (PF) pH measurement is important for establishing a diagnosis and for guiding clinical management. The current standard practice is to collect PF samples for pH measurement in heparinized syringes at room temperature and to instantaneously process these samples.
Current Opinion in Pulmonary Medicine. 13(6):479-483, November 2007
This review summarizes recent neuroimaging research into cerebral alterations observed in obstructive sleep apnea. Studies applying neuroimaging techniques over the past 10 years have made important contributions to our understanding of the neurocognitive changes associated with this disorder.
Bronchoalveolar lavage (BAL), induced sputum and exhaled breath markers (exhaled nitric oxide and exhaled breath condensate) can each provide biological insights into the pathogenesis of respiratory disorders. Some of their biomarkers are also employed in the clinical management of patients with various respiratory diseases. In the clinical context, however, defining normal values and cut-off points is crucial. The aim of the present review is to investigate to what extent the issue of defining normal values in healthy adults has been pursued for the biomarkers with clinical value.
Aspergillus spp. cultured in specimens from the airways of chronic obstructive pulmonary disease (COPD) patients are frequently considered as a contaminant. However, growing evidence suggests that severe COPD patients are at higher risk of developing invasive pulmonary aspergillosis (IPA), although IPA incidence in this population is poorly documented. Some data report that COPD is the underlying disease in 1% of patients with IPA.
Pulmonary hypertension (PH) may complicate idiopathic pulmonary fibrosis (IPF) but the prevalence of PH in IPF remains undefined. The present authors sought to describe the prevalence of PH in IPF.
Current Opinion in Pulmonary Medicine. 13(6):497-504, November 2007
Sudden infant death syndrome has inspired increasingly sophisticated studies at a time when rates are declining because of the Back-to-Sleep campaign, but ethnic disparities are widening. This review evaluates and discusses original, recent research in this area.
Respirology Volume 12 Issue 5 Page 744-748, September 2007
A variety of markers, such as serum angiotensin-converting enzyme (sACE) and CXR have been used to evaluate the disease activity and progression of sarcoidosis. There are patients who have developed cardiac involvement several years after the initial diagnosis despite stable or decreased disease activity. This study clarified the clinical characteristics of those patients.
Obesity is an important risk factor for obstructive sleep apnoea syndrome (OSAS), insulin resistance and cardiovascular disease. The substitution of tryptophan 64 with arginine (Trp64Arg) polymorphism
(Arg variant) of the ß3-adrenergic receptor (ADRB3) has been associated with obesity. In this study, the prevalence of the Trp64Arg ADRB3 polymorphism in a large group of patients with OSAS and its association with body mass index (BMI), insulin resistance and hypertension were evaluated.
To assess subjective and objective improvement after single-stage multilevel minimally invasive treatment for obstructive sleep apnea/hypopnea syndrome (OSAHS).
Increased oxidative stress has been implicated in the pathogenesis of chronic obstructive pulmonary disease (COPD). This study investigated the risk of COPD and the substitution of alanine 16 with valine (Ala16Val) polymorphism of manganese-superoxide dismutase (Mn-SOD) and the cytosine to thymidine transition of nucleotide -262 (-262C>T) polymorphism of the catalase gene, and the activity of erythrocyte SOD and catalase.
Antimicrobial Agents and Chemotherapy, October 2007, p. 3568-3573, Vol. 51, No. 10
Pneumonia occurring outside of the hospital setting has traditionally been categorized as community-acquired pneumonia (CAP). However, when pneumonia is associated with health care risk factors (prior hospitalization, dialysis, residing in a nursing home, immunocompromised state), it is now more appropriately classified as a health care-associated pneumonia (HCAP).
PEDIATRICS Vol. 120 No. 4 October 2007, pp. e929-e937
The purpose of this work was to assess the impact of recently described human metapneumovirus and human coronavirus NL63 compared with other respiratory viruses by using sensitive molecular techniques in a cohort of healthy preschool-aged children. We also aimed to assess the use of parent collection to obtain an adequate respiratory specimen from acutely unwell children in the community.
The aim of the present study was to assess whether patients with pulmonary embolism (PE) could be managed as outpatients after early discharge from hospital using low molecular weight heparin instead of remaining as in-patients until effective oral anticoagulation was achieved.
Cochrane Database of Systematic Reviews 2007 Issue 3
To assess in children with croup evaluated in an emergency department or hospital setting, the effectiveness (measured by croup scores, rate of intubation, and health care utilization such as rate of hospitalizations) and safety (frequency and severity of side effects) of nebulized epinephrine versus placebo.
Cochrane Database of Systematic Reviews 2007 Issue 3
Persistent pulmonary hypertension of the newborn (PPHN) occurs in approximately 1.9 per 1000 newborns and may be more frequent in developing countries. There is strong evidence for the use of inhaled nitric oxide (iNO) and extra corporeal membrane oxygenation (ECMO) in the treatment of PPHN. However, many developing countries do not have access or the technical expertise required for these expensive therapies. Magnesium sulfate is a potent vasodilator and hence has the potential to reduce the high pulmonary arterial pressures associated with PPHN. If magnesium sulfate were found to be effective in the treatment of PPHN, this could be a cost effective and potentially life-saving therapy.
PEDIATRICS Vol. 120 No. 4 October 2007, pp. 805-813
The purpose of this work was to determine whether overweight in youth with mild-to-moderate asthma occurs with increased frequency and is accompanied by impaired psychological functioning.
PEDIATRICS Vol. 120 No. 4 October 2007, pp. 855-864
Although asthma is the most common cause of cough, wheeze, and dyspnea in children and adults, asthma is often attributed inappropriately to symptoms from other causes. Cough that is misdiagnosed as asthma can occur with pertussis, cystic fibrosis, primary ciliary dyskinesia, airway abnormalities such as tracheomalacia and bronchomalacia, chronic purulent or suppurative bronchitis in young children, and habit-cough syndrome.
Cochrane Database of Systematic Reviews 2007 Issue 3
To assess the effectiveness and safety of RSV monoclonal antibodies prophylaxis, compared with placebo or no prophylaxis, in reducing the risk of hospital admission, need for intensive care or mechanical ventilation, and mortality in high-risk infants and young children.
The clinical utility of spirometric screening of asymptomatic smokers for early signs of air flow limitation has recently come under review. The current authors propose that reduced forced expiratory volume in one second (FEV1) is more than a measure of airflow limitation, but a marker of premature death with broad utility in assessing baseline risk of chronic obstructive pulmonary disease (COPD), lung cancer, coronary artery disease and stroke, collectively accounting for 70-80% of premature death in smokers.
Current Opinion in Pulmonary Medicine. 13(6):505-509, November 2007
This review examines in detail progress made regarding our understanding of the presence and pathophysiology of cognitive and behavioral morbidities among children with sleep disorders in general. Particular focus is given to pediatric obstructive sleep apnea.
Journal of Thoracic Oncology. 2(10):970-979, October 2007
Endobronchial ultrasonography (EBUS) has emerged as a new diagnostic tool that allows the bronchoscopist to see beyond the airway. The radial probe EBUS was first introduced to evaluate the airway structure, which has been shown to be useful for identifying the extent of tumor invasion in the central airway.
Journal of Intensive Care Medicine, Vol. 22, No. 5, 300-309 (2007)
It has been recognized that features of chronic obstructive pulmonary disease (COPD) and asthma overlap, often rendering a firm diagnosis difficult to achieve for the clinical practitioner. There are hypotheses suggesting that both asthma and COPD may indeed share common origins with differences in phenotypic presentation being related to disease evolution or interaction between endogenous and exogenous factors.
Journal of Intensive Care Medicine, Vol. 22, No. 5, 283-293 (2007)
Understanding pharmacoeconomic evaluation can empower clinicians to be stronger decision makers. However, cost-effectiveness analyses (CEAs) in critical care are sometimes not easy to understand and often not placed in context with other interventions. The purpose of this article is to clarify and simplify the CEA process using examples from critical care and severe sepsis.
World Journal of Surgery Volume 31, Number 10 / October, 2007 1996-2001
The purpose of this study was to evaluate the effect of sivelestat sodium hydrate, a selective inhibitor of neutrophil elastase in the systemic inflammatory response, pulmonary function, and the postoperative clinical course following esophagectomy. Patients with hypoxia associated with surgical stress in the intensive care unit (ICU) immediately after an esophagectomy were eligible for this study.
Muscle dysfunction is a characteristic feature of chronic obstructive pulmonary disease (COPD). Recent studies suggest that cytokines may operate as local regulators of both muscle function and regeneration. The aim of the present study was to characterise the expression of different cytokines in the external intercostal muscle of COPD.
Asthma prevalence is increasing in adult and paediatric patients. In the present study, the association between different leisure time activities and new onset of wheezing was analysed in adolescents aged 16-18 yrs taking part in a questionnaire-based follow-up of the International Study on Asthma and Allergies in Childhood in Munich and Dresden, Germany.
Clinical & Experimental Allergy, Volume 37, Number 10, October 2007 , pp. 1480-1486(7)
Asthma is caused by a complex interaction between multiple candidate genes and environmental factors. The Childhood Asthma Management Program reported lung function decline in a significant proportion of Caucasian asthmatic children, but such a relation has not been studied in other populations. Our group recently reported that interleukin-13 (IL13), interleukin-4 receptor-α and thymus and the activation-regulated chemokine interacted to influence asthma and raised plasma total
IgE. However, there has not been any study that has addressed the genetic influences for longitudinal lung function growth.
Congenital cystic adenomatoid malformations (CCAMs) are rarely diagnosed in adulthood. The present case study reports a case of a CCAM presenting as a cerebral air embolus during an international flight.
Respirology Volume 12 Issue 5 Page 740-743, September 2007
Endothelin-1 (ET-1), a potent vasoconstrictor peptide produced by endothelial cells, has been implicated in the dysfunction of various organs. To determine the role of ET-1 in acute lung injury (ALI) and ARDS, ET-1 levels were measured in epithelial lining fluid (ELF) and plasma obtained from patients with ALI/ARDS.
There are few longitudinal studies that investigated the radiological progression of silicosis among different occupational groups. Inhalation exposure to very high levels of crystalline silica can lead to acute silicosis. This longitudinal study was designed to determine association between mortality and radiological progression among individuals with rapidly progressive silicosis. Twenty-three subjects with silicosis had previously worked in the same stone-grinding factories, where they had been exposed to high airborne concentrations of silica powder dust. The diagnosis of rapidly progressive form of silicosis was made according to the National Institute for Occupational Safety and Health definition.
To evaluate the outcome of adenotonsillectomy for obstructive sleep apnea (OSA) in children using objective data from polysomnography supplemented by subjective proxy reports from the OSA-18 quality of life instrument.
The most frequently used parameters for assessing bronchoconstriction and bronchodilation are forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF).
The aim of the present study was to examine the effectiveness of tunnelled pleural catheters (TPC) in patients with malignant pleural effusions who would otherwise be candidates for pleurodesis.
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