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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. The stent was placed in the airway with good coverage of the fistula, which was located 3 cm above the carina.
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):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. We recently encountered the case of a 24-year-old woman with EIP in the central airways that was successfully treated with nonsurgical multimodality approach using a combination of steroid therapy, radiotherapy, and repetitive bronchoscopic electrocauterizations.
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. Members of the World Bronchology Foundation (Philanthropic arm of the World Bronchology Foundation) went on-site to deliver a rigid bronchoscope and accessories (Bryan Corp, Woburn, MA). Hands-on training of 2 experienced flexible bronchoscopists occurred daily for 5 days, to achieve proficiency in rigid bronchoscopic resection, dilation, and electrocautery, as well as to recognize indications, contraindications, and patient safety measures pertaining to interventional procedures in patients with central airway obstruction.
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.
The laryngeal mask airway (LMA) has been advocated as an alternative technique to tracheal intubation for airway management of children with recent upper respiratory tract infections (URIs). The authors determined the occurrence of adverse respiratory events and identified the associated risk factors to assess the safety of LMA in children.
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.
rent Medical Research and Opinion, Volume 23, Number 11, November 2007 , pp. 2655-2665(11)
Chronic obstructive pulmonary disease (COPD) is a chronic condition and a major public health concern. Moreover, its prevalence is increasing. COPD commonly affects patient performance of daily activities that people perform in order to meet basic needs, fulfill usual roles, and maintain their health and well-being. What types of activities are affected and to what degree? How do these effects change over time? What impact, positive or negative, do various treatments have on the capacity of patients to perform activities? To address these questions, the concept of activity performance must be defined and appropriately measured.
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. We present 2 cases of massive hemoptysis secondary to malignancies. Both cases required an extralong endotracheal tube to accomplish selective lung isolation. We used a unique technique of constructing an extralong endotracheal tube from 2 regular endotracheal tubes at the bedside.
Annals of Allergy, Asthma and Immunology, Volume 99, Number 5, November 2007 , pp. 419-423(5)
Asthma is a significant public health problem that results in 1.8 million annual emergency department (ED) visits. Many ED visits may be prevented with specialized asthma care.
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.
Pediatric Infectious Disease Journal. 26(11):1019-1024, November 2007
Chronic respiratory morbidity has been reported in prematurely born infants after respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) lower respiratory tract infections (LRTIs). The aim of this study was to determine the impact of viral LRTI on lung function at follow-up of prematurely born infants.
Scandinavian Journal of Infectious Diseases 28 September 2007
Abstract
The aim of the current study was to investigate the contribution of various strategies to increase influenza vaccine uptake among health care workers (HCWs) working in hospitals in Greece during the 2005-2006 season. A total of 132 Greek public hospitals participated in the study. The mean HCWs vaccination rate against influenza during 2005-2006 was 16.36% compared with 1.72% during the previous season.
The aim of the study was to investigate the inflammatory reaction during the birch pollen season in birch-allergic patients with rhinitis or asthma as the predominant symptom.
Journal of Clinical Gastroenterology. 41(10):918-921, November/December 2007
Recent studies have shown an association between obstructive sleep apnea (OSA) and elevated liver enzymes in patients with nonalcoholic fatty liver disease (NAFLD). The aim of the current study was to compare biochemical and histologic findings in patients with NAFLD as a function of OSA status.
The mammalian heart synthesises and secretes B-type natriuretic peptide (BNP), which has potent diuretic, natriuretic and vascular smooth muscle-relaxing effects as well as complex interactions with the hormonal and nervous systems. Recent studies described that BNP was acute phase reactant. In this study, we aimed to evaluate BNP levels in patients with pneumonia.
Metered-dose inhalers and spacers (MDI+S) are at least as effective as nebulizers for treating children with mild to moderate asthma exacerbations. Despite advantages in terms of efficacy, side effects, and ease of use, MDI+S are not used in many North American pediatric emergency departments (PEDs).
Clinical & Experimental Allergy, Volume 37, Number 11, November 2007 , pp. 1602-1608(7)
Evidence exists that exposure to high levels of microbial agents such as endotoxin in the farm environment decreases the risk of atopic sensitization. Genetic variation in innate immunity genes may modulate the response to microbial agents and thus influence susceptibility to asthma and atopy.
Clinical & Experimental Allergy, Volume 37, Number 11, November 2007 , pp. 1609-1615(7)
Recent investigations suggest that prostaglandin E2 (PGE2) is important in the pathogenesis of not only aspirin-intolerant asthma but also asthma unrelated to aspirin intolerance.
Streptococcal toxic shock syndrome and associated myositis caused by group A beta-hemolytic streptococcus pyogenes generally have a poor outcome despite aggressive operative treatment. Frequently the diagnosis is missed initially as the clinical features are non-specific. The progression to a toxic state is rapid and unless definitive treatment measures are initiated early, the end result can be catastrophic.
Scandinavian Journal of Infectious Diseases 04 October 2007
Following influenza, the elderly and those with chronic heart/lung diseases are often affected by bacterial complications such as pneumonia. Whether neutrophil and monocyte functions are affected differently in patients with or without complications is less well known. Therefore, blood neutrophil and monocyte surface receptor expressions were measured in patients with influenza A, with or without complications, by means of flow cytometry.
Scandinavian Journal of Infectious Diseases 04 October 2007
Plasma levels of high mobility group box chromosomal protein-1 (HMGB-1), as well as of other inflammatory molecules such as interleukin-6 (IL-6), regulated on activation normal T-cell expressed and secreted (RANTES), and soluble intercellular adhesion molecule-1 (sICAM-1), were determined in patients with bacterial pneumonia coinfected with influenza virus. HMGB-1 levels were significantly elevated in these patients compared to patients undergoing mild bacterial pneumonia alone (p<0.01).
Scandinavian Journal of Infectious Diseases 04 October 2007
The aim of the present study was to examine the modification of initial empirical treatment based on the microbiological results of bronchoscopic techniques after comparing the diagnostic yield of protected specimen brush (PSB) and bronchoalveolar lavage (BAL) in the immunocompetent patient with community acquired pneumonia (CAP) with results obtained from conventional sputum cultures. 88 patients with presumptive diagnosis of CAP necessitating hospitalization were prospectively studied. Fibreoptic bronchoscopy with quantitative PSB and BAL cultures for common pathogens, mycobacteria and fungi was performed.
Australasian Radiology, Volume 51, Number 6, December 2007 , pp. 567-569(3)
A 30-year-old male fire eater presented following aspiration of hydrocarbon fuel during a performance. A plain chest radiograph carried out 2-h after aspiration showed left lower lobe consolidation. The patient subsequently developed worsening shortness of breath, haemoptysis, fever and myalgia and a repeat plain chest radiograph showed extensive bilateral pulmonary consolidation with mediastinal and bilateral hilar lymphadenopathy. Computed tomography showed features consistent with necrotizing pneumonia.
European Journal of Neurology, Volume 14, Number 11, November 2007 , pp. 1236-1243(8)
Catathrenia (nocturnal groaning) is a rare condition characterized by monotonous irregular groans occurring during sleep. Groaning was associated with disproportionate prolonged expiration causing reduced breathing rate without oxygen desaturation. The breathing pattern with prolonged expiration and sound production alternated with a normal respiratory pattern without groaning. Endoesophageal pressure during groaning showed mildly positive swings at the initial phase of expiration suggesting a partial mild expiratory upper airway obstruction. At the end of the follow-up period, all patients reported persistent nocturnal groaning but no other clinical manifestations.
Journal of the New Zealand Medical Association, 26-October-2007, Vol 120 No 1264
Penetrating thoracic trauma poses a management challenge to the on-call surgeon. A casual and unwary approach can lead to unforeseen complications in the initial height of management of such patients. We present a case of penetrating thoracic trauma where initial management with closed tube thoracostomy resulted in intubation of the stomach that had herniated into the chest through a diaphragmatic rent. Patients with penetrating injuries to the zone between the abdomen and chest should be managed with a high index of suspicion.
Western Journal of Nursing Research, Vol. 29, No. 7, 845-863 (2007)
The primary purpose of this secondary data analysis was to evaluate the efficacy and suitability of the Memorial Symptom Assessment Scale (MSAS) for use with patients with severe chronic obstructive pulmonary disease (COPD). Symptoms experienced by patients with severe COPD were assessed in the original investigation using the 32-item MSAS.
Scandinavian Journal of Infectious Diseases 11 October 2007
To determine the frequency of pertussis in children 16 y who had prolonged cough (14 d), a prospective study was conducted at an outpatient clinic of a paediatric hospital. Nasopharyngeal swabs were taken for culture and nucleic acid testing by polymerase chain reaction (PCR) for Bordetella pertussis. Immunoglobulin A and immunoglobulin G antibodies against pertussis toxin (PT) were tested by ELISA in paired serum samples. A total of 148 patients were recruited during 1 y. Pertussis was detected in 25 (16.9%) patients with at least 1 of the tests. PCR was positive in 12 patients, and 9 cases was diagnosed serologically.
International Journal of Clinical Practice doi:10.1111/j.1742-1241.2007.01272.x
In this study, we evaluated the effect of ageing on treatment response by comparing two groups of patients with asthma. All asthmatic patients in the study were assessed on repeated occasions once admitted to the hospital: soon after admission (0 h), and then at 5th, 10th, 24th, 48th, 72nd hour, 7th day and in stable period. We compared two groups of patients: younger asthmatics, which had 33 younger aged <60, and elderly asthmatics, comprised of 29 elderly aged -60 years.
In the present study, we used tumor necrosis factor-R1 knock out mice (TNF-alphaR1KO) to understand the roles of TNF-alpha on epithelial function in models of carrageenan-induced acute lung inflammation. In order to elucidate whether the observed anti-inflammatory status is related to the inhibition of TNF-alpha, we also investigated the effect of etanercept, a TNF-alpha soluble receptor construct, on lung TJ function.
Sepsis remains the leading cause of death in critically ill patients. One of the primary organs affected by sepsis is the lung, presenting as the Acute Respiratory Distress Syndrome (ARDS). Organ damage in sepsis involves an alteration in gene expression, making gene transfer a potential therapeutic modality. This work examines the feasibility of applying simian virus 40 (SV40) vectors for pulmonary gene therapy.
The effects of continuous positive airway pressure (CPAP) for obstructive sleep apnoea (OSA) on insulin resistance are not clear. Trials have found conflicting results and no appropriate control groups have been used.
Among the idiopathic interstitial pneumonias, the two entities-idiopathic pulmonary fibrosis (IPF) characterised by the presence of the usual interstitial pneumonia pattern of histopathology (IPF/UIP) and non-specific interstitial pneumonia (NSIP; same nomenclature for the histopathological pattern and idiopathic disease)-have provoked considerable debate.
Respiratory muscle weakness is an important clinical problem. Tests of varying complexity and invasiveness are available to assess respiratory muscle strength. The relative precision of different tests in the detection of weakness is less clear, as is the value of multiple tests.
We read with interest the article by Barlow et al. The CURB-65 criteria currently recommended by the British Thoracic Society (BTS) based on the study by Lim et al are useful and more pragmatic than other criteria, as shown in their study.
An exacerbation of chronic obstructive pulmonary disease (COPD) has a serious impact on disease progression and is associated with high medical costs, but the cause of about one-third of exacerbations cannot be identified. Adequate protective reflexes in the airways play an important role in the prevention of aspiration of bacteria-containing oropharyngeal or gastric secretions. Impairment of these reflexes, such as the swallowing reflex, therefore represents a potential risk factor for exacerbations of COPD. We have conducted a cross-sectional survey to evaluate the prevalence of impairment of the swallowing reflex in patients with COPD and to determine whether this is a risk factor for COPD exacerbations.
Exposure to metal working fluid (MWF) has been associated with outbreaks of extrinsic allergic alveolitis (EAA) in the USA, with bacterial contamination of MWF being a possible cause, but is uncommon in the UK. Twelve workers developed EAA in a car engine manufacturing plant in the UK, presenting clinically between December 2003 and May 2004. This paper reports the subsequent epidemiological investigation of the whole workforce.
It has been accepted for more than 20 years that asthma is an inflammatory disease of the airways, but it is more recent that airways inflammation has been accepted to be important in chronic obstructive pulmonary disease (COPD).
Skeletal muscle dysfunction is a common feature in chronic obstructive pulmonary disease (COPD) which is associated with intrinsic muscular abnormalities. One of the most consistently reported alterations is a shift from fibre type I to II in the vastus lateralis of these patients. Surprisingly, the relationship between this shift and the severity and phenotype of COPD remains unclear. A study was conducted to determine whether vastus lateralis muscle fibre type proportions are associated with COPD disease severity and to provide reference values for the proportions of fibre types in the vastus lateralis in COPD.
Skeletal muscle wasting commonly occurs in patients with chronic obstructive pulmonary disease (COPD) and has been associated with the presence of systemic inflammation. This study investigated whether rehabilitative exercise training decreases the levels of systemic or local muscle inflammation or reverses the abnormalities associated with muscle deconditioning.
Airway inflammation in chronic obstructive pulmonary disease (COPD) is characterised by infiltration of CD8+ T cells and CD68+ macrophages and an increased number of neutrophils, whereas few studies have described the presence of eosinophils. Although the anti-inflammatory effects of corticosteroids in stable COPD are unclear, recent studies suggest that combination therapy could be beneficial. A study was therefore undertaken to evaluate combined salmeterol/fluticasone propionate (SFC) and fluticasone propionate (FP) alone on inflammatory cells in the airways of patients with COPD.
Airflow limitation in chronic obstructive pulmonary disease (COPD) is caused by a mixture of small airway disease and emphysema, the relative contributions of which may vary among patients. Phenotypes of COPD classified purely based on severity of emphysema are not well defined and may be different from the classic phenotypes of "pink puffers" and "blue bloaters".
The interrelationships between air pollution, lung function and the incidence of childhood asthma have yet to be established. A study was undertaken to determine whether lung function is associated with new onset asthma and whether this relationship varies by exposure to ambient air pollutants.
Traumatic pulmonary pseudocyst (TPP) is a rare complication, sometimes encountered after blunt thoracic trauma and even more rarely following penetrating injuries. It is more common among pediatric and young adult patients. Although TPP is usually benign in nature, complications associated with hemoptysis and secondary infection may develop. The treatment is conservative. In this report, we present two rare cases of TPP occuring after a high-speed accident and a stab wound injury, where conservative treatment provided good outcomes.
The Internet Journal of Emergency and Intensive Care Medicine. 2007. Volume 10 Number 2
Pulmonary embolism is still a challenging diagnosis and a very high index of suspicion is required. Symptoms and signs of acute right heart failure are still non-specific and often vary according to the precipitating condition. In this particular case, evolving liver failure and severe coagulation disorder as the initial presentation made the management of this patient very challenging and several causes of sudden decompensated liver failure were ruled out. Acute reduction of splanchnic flow was considered but in the context of relative good oxygenation and no history or clinical signs of deep venous thrombosis, the diagnosis of pulmonary embolism was not considered as a primary cause of liver failure and evolving multiple organ failure.
Recent incidents where highly pathogenic influenza A H5N1 viruses have spread from avian species into humans have prompted the development of cell-based production of influenza vaccines as an alternative to or replacement of current egg-based production. Madin-Darby canine kidney (MDCK) cells are the primary cell-substrate candidate for influenza virus production but an efficient system for the direct rescue of influenza virus from cloned influenza cDNAs in MDCK cells did not exist.
Pediatric Emergency Care. 23(10):727-730, October 2007
Children frequently visit emergency departments with asthma exacerbations. Many of these asthmatic children may have fever and/or pneumonia, but when associated with eosinophilia or evidence of vasculitis, other diagnoses should be considered. Churg-Strauss syndrome is a rare form of systemic vasculitis, which usually occurs in patients with asthma in association with eosinophilia. The diagnosis of Churg-Strauss syndrome can be difficult because this syndrome may arise at first as a common association between asthma and allergic rhinitis. A delay in diagnosis and treatment may increase the morbidity from the complications of vasculitis. We report a young asthmatic adolescent who presented with vasculitis, eosinophilia, and peripheral neuropathy.
Acid-induced lung injury from aspiration is one of the most important causes of ARDS. Calcitonin gene-related peptide (CGRP) is a neuropeptide that has various biological actions. The current study investigated whether CGRP might have pathophysiological roles in acid-induced lung injury.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 849-857, (2007)
In studies of childhood asthma from two different ethnic groups, we attempted to replicate associations with five potential asthma susceptibility genes previously identified by positional cloning.
Dimensions of Critical Care Nursing. 26(5):182-186, September/October 2007
Unfortunately, acute pulmonary embolism is still a far too common occurrence. Fortunately, with prompt recognition, diagnosis, and treatment, mortality can be reduced. This article provides an overview of risk factors, diagnostic studies, and treatment of patients with acute pulmonary embolism in the critical care setting.
To study the mechanisms by which hepatocyte growth factor (HGF) down-regulates collagen and connective tissue growth factor (CTGF) in scleroderma (systemic sclerosis [SSc]) lung fibroblasts.
Primary pulmonary lymphoepithelioma-like carcinoma is a very rare subtype of lung cancer. This report documents the CT features of 16 Chinese patients diagnosed with primary pulmonary lymphoepithelioma-like carcinoma from January 1999 to December 2005. A pre-treatment CT was used to assess the tumour site, size, borders, pleural and vascular involvement, and the presence of lymph node involvement. The majority of the patients were female non-smokers with centrally located tumours. Lymph node involvement and bronchial and vascular encasement were frequent. In an Epstein-Barr virus endemic area, primary pulmonary lymphoepithelioma-like carcinoma is an important differential diagnosis to consider.
The duration of automatic computer-controlled continuous positive airway pressure device (autoCPAP) initiation at home varies largely between sleep centers. Our objectives were to evaluate the cost-effectiveness and to find the optimal trial duration.
Pulmonary hypertension (PH) is a well-known complication of chronic obstructive pulmonary disease (COPD). It remains unclear whether exercise parameters can be used to discriminate between COPD patients with associated PH (COPD-PH) and COPD patients without associated PH (COPD-nonPH).
International Journal of Clinical Practice doi:10.1111/j.1742-1241.2007.01380.x
B-type natriuretic peptide (BNP) is a neurohormone secreted from cardiac ventricles in response to ventricular strain. The aim of present study was to evaluate the role of BNP in the diagnosis of the right ventricular (RV) dysfunction in acute pulmonary embolism (PE).
International Journal of Clinical Practice doi:10.1111/j.1742-1241.2007.01373.x
A proportion of asthmatic patients can achieve total control according to the Global Initiative for Asthma/National Institute of Health guidelines. The aim of this study was to investigate whether total control of asthma is accompanied by the remission of airway inflammation and bronchial hyperresponsiveness.
Several studies of real-time endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) have reported a sensitivity of approximately 90% in the diagnosis of mediastinal and hilar malignancies. However, few studies have addressed its role in the diagnosis of sarcoidosis. The aim of the present study was to assess the utility of EBUS-TBNA in confirming a pathological diagnosis of sarcoidosis.
Malignant pleural effusions (MPEs) complicate the clinical course of patients with a broad array of malignancies, which are most often due to lymphomas or carcinomas of the breast, lung, gastrointestinal tract or ovaries. Patients may present with a MPE as the initial manifestation of a cancer or develop an effusion during the advanced phases of a known malignancy.
American Family Physician October 15, 2007 Vol. 76 No. 8
There are 600,000 cases of venous thromboembolism (VTE) in the United States every year. Of all persons with undetected or untreated pulmonary embolism, 26 percent will have a fatal embolic event, and another 26 percent will have a recurrent embolic event that could become fatal. Therefore, an early diagnosis of VTE is important to prevent mortality and morbidity in this population.
To compare the efficacy of auto-CPAP (AutoSet Spirit, ResMed) versus fixed-CPAP (S6 Elite, ResMed) in improving daytime sleepiness, health status, objective compliance and the ultimate treatment preference in patients with severe OSA.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 902-912, (2007)
The incidence of bronchopulmonary dysplasia (BPD), a chronic lung disease of newborns, is paradoxically rising despite medical advances. We demonstrated elevated bombesin-like peptide levels in infants that later developed BPD. In the 140-day hyperoxic baboon model of BPD, anti-bombesin antibody 2A11 abrogated lung injury.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 878-885, (2007)
Severe sepsis is associated with an exacerbated procoagulant state with protein C (PC) system impairment. In contrast, the inflammatory and coagulation status of nonseptic patients with organ failure (OF) is less documented.
Effective and timely management of COPD should reduce the risk of hospitalization. The purpose of this study was to describe variations in COPD hospital admission rates as an indicator of the adequacy of primary care services.
Antimicrobial Agents and Chemotherapy, November 2007, p. 3969-3976, Vol. 51, No. 11
We evaluated the recent prevalence of antimicrobial-resistant Haemophilus influenzae isolated from the upper respiratory tracts (URT) of patients in Japan. Mutations in the ftsI gene, which encodes penicillin binding protein 3 (PBP3), and the clonal dissemination of the resistant strains were also investigated. A total of 264 H. influenzae isolates were collected from patients with URT infections.
Clinical & Experimental Immunology, Volume 150, Number 2, November 2007 , pp. 263-273(11)
In vitro studies have contributed substantially to the understanding of immunopathology of respiratory syncytial virus (RSV)-mediated disease. In the present study we compared the effect of RSV-infected dendritic cells on the time-course of the primary and memory/effector T cell response in vitro.
The purpose of this study was to evaluate the performance of a computer-aided program that allows automated matching of metastatic pulmonary nodules imaged with two serial clinical chest CT studies.
Traffic exposure is a major contributor to ambient air pollution for people living close to busy roads. The relationship between traffic exposure and lung function remains inconclusive in adults.
Clinical Microbiology and Infection doi:10.1111/j.1469-0691.2007.01837.x
Serotype 19F pneumococci were a leading cause of infections among children in Athens, Greece during 2001–2006. In total, 143 19F isolates were typed by pulsed-field gel electrophoresis
(PFGE), and 38 isolates representing the main PFGE types were also characterised by multilocus sequence typing. A diversity of distinct strains belonging to sequence types 236, 1035, 274, 172 and 319 were identified, but
multidrug-resistant isolates related to the Taiwan19F-14 clone (ST236) constituted 76.9% of the isolates. Spread of the Taiwan19F-14 clone explains, in part, the high incidence of antibiotic resistance observed among pneumococci reported recently from Athens.
Clinical Microbiology and Infection doi:10.1111/j.1469-0691.2007.01834.x
Mycoplasma is a well-recognised pathogen that colonises mucosal surfaces of humans and animals. Mycoplasma pneumoniae infects the upper and lower respiratory tracts of children and adults, leading to a wide range of respiratory and non-respiratory clinical conditions.
Pediatric Transplantation, Volume 11, Number 7, November 2007 , pp. 736-742(7)
To evaluate the role of BAL, CTB, and OLB in the management of pulmonary infiltrates in pediatric HSCT recipients, we conducted a retrospective review of clinical records of pediatric HSCT recipients. Data were analyzed using Chi-square for dichotomous andanovafor continuous variables.
International Journal of Oral and Maxillofacial Surgery, Volume 36, Issue 9, Pages 845-848
Temporomandibular joint (TMJ) ankylosis affects the growth of the mandible and results in gross facial deformities. A critical clinical feature of long-standing TMJ ankylosis is retrogenia, which when combined with an inability to open the mouth leads to severe compromise of the airway. A case is presented of obstructive sleep apnoea syndrome secondary to TMJ ankylosis that was corrected by a new technique employing simultaneous genial distraction along with interposition arthroplasty.
Cochrane Database of Systematic Reviews 2007 Issue 4
Viral epidemics or pandemics such as of influenza or severe acute respiratory syndrome (SARS) pose a significant threat. Antiviral drugs and vaccination may not be adequate to prevent catastrophe in such an event.
Overdistention of the lung tissue during mechanical ventilation may initiate ventilator-induced lung injury (VILI). Release of cytokines, including IL-8, may be responsible for VILI, although the mechanisms remain unclear. This study aimed to determine whether stretch-induced IL-8 production is dependent on degradation of IkappaB (IkappaB) and the resulting Rel A translocation into the nucleus.
A 53-year-old lady with blood-stained sputum and pleuritic pain had a lingular opacity on CXR which failed to resolve. A bronchial aspirate and transbronchial biopsy revealed features of bronchocentric granulomatosis with dichotomous branching hyphae suggestive of Aspergillus infection. However, subsequent fungal culture grew Pseudallescheria boydii. This case demonstrates the similarity of clinical and histological features caused by these two fungi. This appears to be the first reported case of pulmonary pseudallescheria with a bronchocentric granulomatous response.
Asthma and allergic rhinitis are significant, increasing causes of morbidity worldwide. Pollen, a major cause of seasonal rhinitis/conjunctivitis, carries proteolytic enzymes on its surface. We showed previously that peptidase allergens from house dust mites compromise epithelial barrier function by degrading the extracellular domains of the tight junction proteins, occludin and claudin, thus facilitating allergen delivery across epithelial layers. In this study, we aimed to determine whether peptidases from allergenic pollens should similarly be considered to have a role in disrupting tight junctions.
Increased production of industrial devices constructed with nanostructured materials raises the possibility of environmental and occupational human exposure with consequent adverse health effects. Ultrafine (nano) particles are suspected of having increased toxicity due to their size characteristics that serve as carrier transports. For this reason, it is critical to refine and improve existing deposition models in the nano-size range.
Residence in urban areas with much traffic has been associated with various negative health effects. However, the contribution of traffic emissions to these adverse health effects has not been fully determined. Therefore, the objective of this in vivo study is to compare the pulmonary and systemic responses of rats exposed to particulate matter (PM) obtained from various locations with contrasting traffic profiles.
Fiber deposition efficiency in the tracheobronchial region was studied by using two human airway replicas. Carbon fibers with a monodisperse diameter of 3.66 were delivered into lung casts at the flow rates of 15, 45, and 60 L/min. Deposition efficiencies in each airway bifurcation were obtained individually. Even though the data shows large variability among the bifurcations within the same generation, there is a general trend for the data obtained in these two replicas. Our results show that fiber deposition for carbon fibers increases with the Stokes number, indicating that inertial impaction is the dominant mechanism.
International Journal of Clinical Practice doi:10.1111/j.1742-1241.2007.01414.x
Although there is a general agreement for the recommendation of the influenza vaccine to persons with chronic obstructive pulmonary disease (COPD), the magnitude of clinical effectiveness and benefit from the annual vaccination is controversial. We assessed the effects of annual influenza vaccination on winter mortality in older adults with COPD.
This study aimed to assess prospectively the accuracy, safety and outcome of flex-rigid pleuroscopy in the diagnosis of patients with indeterminate pleural effusions.
While recent studies have shown that patients with COPD and patients with asthma exhibit evidence of airway and systemic inflammation, markers of systemic inflammation have not been compared between the two diseases.
The aim of this study was to develop a simple prediction model for the underlying diagnosis of solitary pulmonary nodules (SPN) based on clinical characteristics and thin-section CT findings.
While primary spontaneous pneumothorax (PSP) is common in adolescents and young adults, simultaneous bilateral PSP (SBPSP) is rare and can be life-threatening if it progresses to tension pneumothorax. This study reviewed cases of PSP to identify the clinical features of SBPSP.
Thymoma is a common primary neoplasm of the anterior mediastinum. However, it can also arise in other locations, including the neck, the posterior mediastinum, the lung, base of the skull and the pleural cavity. There are only three previous case reports of thymoma located in the middle mediastinum. This report describes a patient together with a review of the literature on middle mediastinal thymoma.
International Journal of Clinical Practice doi:10.1111/j.1742-1241.2006.00773.x
Sarcoidosis is a chronic disease with an unknown aetiology. Our aim was to evaluate the pattern of seasonality of stage 1 sarcoidosis subjects who had symptoms by all cases, by age and by both genders. In this study, we used Roger's test for cyclic variation to prove that this seasonal variation was more than chance.
Influenza virus binds to cell receptors via sialic acid (SA) linked glycoproteins. They recognize SA on host cells through their haemagglutinins (H). The distribution of SA on cell surfaces is one determinant of host tropism and understanding its expression on human cells and tissues is important for understanding influenza pathogenesis. The objective of this study therefore was to optimize the detection of alpha2,3 -linked and alpha2,6-linked SA by lectin histochemistry by investigating the binding of Sambucus nigra agglutinin (SNA) for SAalpha2,6Gal and Maackia amurensis agglutinin (MAA) for SAalpha2,3Gal in the respiratory tract of normal adults and children.
Allergy, Volume 62, Number 10, October 2007 , pp. 1119-1124(6)
Bronchial hyperresponsiveness is a characteristic feature of asthma, and is usually measured by bronchial challenges using direct or indirect stimuli...Conclusions: Our results suggest that bronchial responsiveness to AMP is more closely related to airway inflammation, compared with that to methacholine, and support the potential usefulness of AMP challenges in detecting inflammatory changes in young children with asthma.
Allergy, Volume 62, Number 10, October 2007 , pp. 1146-1151(6)
An asthma score was proposed in the European Community Respiratory Health Survey (ECRHS) framework, as dichotomous definitions could be less appropriate in the study of chronic diseases.
One in five intensive care unit (ITU) admissions is due to severe sepsis and according to several studies the incidence of sepsis in the general population is increasing. However, the limitations of these studies include variations in the definition of sepsis and the possible inaccuracy of discharge diagnosis codes.
Sleep affects the control of circulation and respiratory function. Gender and age are also known to have a profound impact on the neural control of circulation. We investigated whether gender affects sleep-related cardiovascular and respiratory responses and whether these vary according to healthy subjects being young or middle-aged.
Cochrane Database of Systematic Reviews 2007 Issue 4
Bronchiectasis is increasing recognised as a co-morbidity in many respiratory illness. Anti inflammatory drugs may reduce the inflammatory cascade and thus reduce symptoms and slow long term pulmonary decline.
The optimal role of vasopressor therapy in septic shock is not known. We hypothesized that the variability in the use of vasopressors to treat hypotension is associated with subsequent organ failures.
Intensive Care Medicine 0342-4642 10.1007/s00134-007-0879-5
During pressure support ventilation (PS), an abrupt increase in ventilator pressure above the pre-set level is considered to signify expiratory muscle activity. However, relaxation of inspiratory muscles may also cause the same phenomenon, and this hypothesis has not been explored. The aim of this study is to examine the cause of this increase in ventilator pressure, during PS, in critically ill patients.
Pediatric Infectious Disease Journal. 26(10):961-963, October 2007
Recurrences of Legionnaires' disease have been reported uncommonly and rarely in immunocompromised children. We describe a 9-year-old girl with 2 episodes of culture proven infection with Legionella pneumophila. First episode occurred during induction chemotherapy for acute lymphoblastic leukemia and the second shortly after the bone marrow transplant.
To determine changes in behavior and sleep in children before and after adenotonsillectomy for sleep-disordered breathing (SDB) using the validated Pediatric Sleep Questionnaire (PSQ) and Conners' Parent Rating Scale-Revised Short Form (CPRS-RS).
Antimicrobial Agents and Chemotherapy, November 2007, p. 3977-3982, Vol. 51, No. 11
Data comparing the treatment outcomes of the two most frequently recommended empirical antibiotic regimens for community-acquired pneumonia (CAP)-combination therapy with an extended-spectrum Beta-lactam and a macrolide (BL+M) or fluoroquinolone (F) monotherapy-for patients with severe CAP are sparse.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 886-891, (2007)
Acute lung injury (ALI) that develops 6 hours after transfusion (TRALI) is the leading cause of transfusion-related mortality. Several transfusion characteristics have been postulated as risk factors for TRALI, but the evidence is limited to retrospective studies.
The waterpipe, also known as shisha, hookah, narghile, goza, and hubble bubble, has long been used for tobacco consumption in the Middle East, India, and parts of Asia, and more recently has been introduced into the smokeless tobacco market in western nations. We reviewed the published literature on waterpipe use to estimate daily nicotine exposure among adult waterpipe smokers.
The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 11, November 2007 , pp. 1237-1245(9)
Respiratory tract infections represent a common problem in everyday practice. The development of the World Wide Web can assist clinicians and other medical care professionals in finding useful information on various clinical conditions, including upper and lower respiratory tract infections.
To investigate the longitudinal impact of smoking cessation and relapse on the exercise habits of apparently healthy Japanese men, 750 subjects presenting for a checkup at a metropolitan health center were surveyed annually for 7 years. Exercise was dichotomously classified as none or any. Subjects were grouped in two categories: 98 smokers who ceased smoking during the second year of the study, matched with 196 continuing smokers and 196 men who had never smoked; and 52 relapsed smokers (including 2 new smokers) who did not smoke at baseline or at Year 1 but smoked from Year 2 to final follow-up, matched with 104 continuing smokers and 104 never-smokers
We hypothesized that first-time submassive pulmonary embolism (PE) can cause persistent, significant cardiopulmonary problems, including right ventricular damage and worsened quality of life in patients with no prior cardiopulmonary disease.
Clinical & Experimental Allergy, Volume 37, Number 11, November 2007 , pp. 1594-1601(8)
Eosinophilic airway inflammation is a key pathophysiological feature of asthma that can predict treatment response. However, the prognostic value of sputum eosinophilia is not established.
Antimicrobial Agents and Chemotherapy, November 2007, p. 3810-3815, Vol. 51, No. 11
The objective of this study was to investigate the relationship between pharmacokinetic and pharmacodynamic parameters, on the basis of the mutant prevention concentration (MPC) concept, and the emergence of resistant mutants of Streptococcus pneumoniae to fluoroquinolone antibacterials.
American family Physician October 15, 2007 Vol. 76 No. 8
Chronic obstructive pulmonary disease (COPD) is a common problem among patients presenting to primary care. This condition has multiple individual and combined treatment regimens.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 913-920, (2007)
High cortisol levels are of prognostic value in sepsis. The predictive value of cortisol in pneumonia is unknown. Routinely available assays measure serum total cortisol (TC) and not free cortisol (FC). Whether FC concentrations better reflect outcome is uncertain.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 843-848, (2007)
The protective effect of breastfeeding on early respiratory infections is well established, but its relationship to the development of subsequent asthma remains controversial.
Smoking-induced diffuse interstitial lung processes include respiratory
bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease
(RBILD), desquamative interstitial pneumonia (DIP) and Langerhans' cell
histiocytosis. The histological, radiological and clinical features of respiratory
bronchiolitis, RBILD and DIP are reviewed, with particular reference to management issues; Langerhans' cell histiocytosis is covered elsewhere in this series of articles. Possible relationships between smoking and other diffuse lung diseases are explored briefly.
Disease Management & Health Outcomes, Volume 15, Number 5, 2007 , pp. 279-287(9)
The Health Plan Employer Data and Information Set (HEDIS) of the National Committee for Quality Assurance is a set of standardized performance measures, the goal of which is to enable purchasers and consumers to evaluate the quality of different health plans.
International Journal of Clinical Practice, Volume 61, Number 11, November 2007 , pp. 1884-1888(5)
This study was designed to report factors associated with asthma hospital admission, such as patient characteristics, type of admission and subsequent outcome i.e. discharge or death, for the years 2000-2005. These data are used for health economic models regarding asthma burden in the hospital setting in Australia.
Cochrane Database of Systematic Reviews 2007 Issue 4
Cough is often distressing for patients with pneumonia. Accordingly they often use over-the-counter (OTC) cough medications (mucolytics or cough suppressants). These might provide relief in reducing the severity of cough, but conversely, suppression of the cough mechanism might impede airway clearance and cause harm.
Clinical & Experimental Allergy, Volume 37, Number 11, November 2007 , pp. 1676-1680(5)
Environmental perfume exposure may cause respiratory symptoms. Individuals with asthma and perfume contact allergy report such symptoms more frequently than others. However, immunologic mechanisms have not been demonstrated and the symptoms are not associated with IgE-mediated allergy. The study aimed to investigate whether basophils from patients with respiratory symptoms related to perfume released more histamine in the presence of perfume as compared with healthy volunteers.
To assess whether exclusive and prolonged breast feeding reduces the risk of childhood asthma and allergy by age 6.5 years.
Design Cluster randomised trial.
Rapid eye movement (REM) sleep behavior disorder (RBD) is frequently found in Parkinson’s disease (PD). PD has been classified in different subtypes and it is unknown if RBD occurs more often in one particular subtype.
The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 11, November 2007 , pp. 1253-1259(7)
Although several clinical prediction rules exist for lower respiratory tract infection (LRTI), few are for acute bronchitis (acute bronchitis) and most have not been validated in high human immunodeficiency virus (HIV) prevalence settings.
Sleep Medicine Volume 8, Issue 7, Pages 773-778 (November 2007)
Obstructive sleep apnea-hypopnea syndrome (OSAHS) patients undergo continuous positive airway pressure (CPAP) treatment for the first time on titration night, and then the effect of overnight CPAP treatment is estimated immediately. The purpose of this study is to compare the effects of CPAP-pretreated and non-pretreated on patients with OSAHS.
Sleep Medicine Volume 8, Issue 7, Pages 760-767 (November 2007)
Sleep affects the control of circulation and respiratory function. Gender and age are also known to have a profound impact on the neural control of circulation. We investigated whether gender affects sleep-related cardiovascular and respiratory responses and whether these vary according to healthy subjects being young or middle-aged.
Sleep Medicine Volume 8, Issue 7, Pages 704-710 (November 2007)
The duration of automatic computer-controlled continuous positive airway pressure device (autoCPAP) initiation at home varies largely between sleep centers. Our objectives were to evaluate the cost-effectiveness and to find the optimal trial duration.
Sleep Medicine Volume 8, Issue 7, Pages 695-703 (November 2007)
Quality of life (QOL) and sleepiness for patients with sleep apnea/hypopnea syndrome (SAHS) might improve with continuous positive airway pressure devices working in auto-adjust mode (autoCPAP) by allowing pressure modulations following patient needs. Clinical comparisons between devices driven by different algorithms are needed.
Pediatric Infectious Disease Journal. 26(10):897-903, October 2007
Diagnosis of Mycoplasma pneumoniae pneumonia is challenging because of the lack of standardized rapid tests. Many serologic tests and polymerase chain reaction (PCR) based methods are used with different diagnostic criteria.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 589-597, 2007
We previously showed that the MUC5B gene expression was elevated by phorbol 12-myristate 13-acetate (PMA) through an epidermal growth factor receptor-independent Ras/MEKK1/JNK and P38 signaling-based transcriptional mechanism.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 578-588, 2007
Cyclooxygenase-2 (COX-2) is a key enzyme in the production of prostaglandins and thromboxanes from free arachidonic acid. Increasing evidence suggests that COX-2 plays a role in tumorigenesis. A variety of stimuli induce COX-2 and it is overexpressed in many tumors, including non-small cell lung cancer (NSCLC).
Sleep and Breathing 1520-9512 10.1007/s11325-007-0115-0
Obstructive sleep apnea (OSA) is a common disease with significant medical and psychiatric comorbidities. The literature documenting the effects of continuous positive airway pressure (CPAP) treatment on mood in OSA patients is mixed.
Emergency Medicine News:Volume 29(8)August 2007p 33-34
Community-acquired pneumonia is a common and potentially serious infection in children. For the purposes of this review, pneumonia is defined as the presence of fever, acute respiratory symptoms, or both, plus evidence of parenchymal infiltrates on chest x-ray. This definition differs from that of the World Health Organization which defines it solely on the basis of clinical findings.
Allergy, Volume 62, Number 10, October 2007 , pp. 1189-1198(10)
Budesonide/formoterol (Symbicort) Maintenance and Reliever Therapy (SMART) is an effective asthma-management approach that treats symptoms with rapid increases in budesonide/formoterol. The cost-effectiveness of SMART vs higher fixed-dose budesonide/formoterol or salmeterol/fluticasone is unknown.
Primary Care Respiratory Journal Volume 16 Issue 5 October 2007
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.
Cystic fibrosis is a multisystem disease characterized primarily by chronic pulmonary infection and bronchiectasis, pancreatic exocrine impairment, and elevated sweat chloride. In the last 4 decades, new treatment strategies and aggressive nutritional management have resulted in a significant increase in expected survival, with median predicted survival in cystic fibrosis now to older than 35 years. This increase in predicted survival has also been aided by a greater appreciation of the potential variability in the presentation and severity of cystic fibrosis, resulting in identification of a growing number of mild cases. As it is estimated that within the next decade more than half of all individuals with cystic fibrosis will be aged 18 years or older, adult medicine caregivers are increasingly likely to encounter patients with cystic fibrosis and be exposed to their unique medical management.
The American Thoracic Society (ATS)/European Respiratory Society (ERS)-Global Initiative for Chronic Obstructive Lung Disease (GOLD) has developed a new staging system based on the degree of airflow obstruction. Its validity to predict exercise capacity as an outcome has not been extensively studied. We hypothesized that exercise performance measured by cardiopulmonary exercise test (CPET) results should decline significantly with each disease stage, independent of gender.
Primary Care Respiratory Journal Volume 16 Issue 5 October 2007
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.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 553-561, 2007
Neuroimmune interactions play a critical role in the pathogenesis of asthma. Symptoms like wheezing and cough have been attributed to neural dysregulation, whereas sensitization and the induction of allergic inflammation have been linked with the activity of dendritic cells. Neuropeptides were previously shown to control dendritic cell function in vitro, suggesting interactions between dendritic cells and sensory nerves.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0109-y
Mandibular repositioning appliances (tMRAs) designed with a titratable mechanism are effective to treat obstructive sleep apnea syndrome (OSAS) but are not widely used, although many studies have proven their value.
Numerous instruments have been developed to examine the impact of activities on breathlessness. The primary purpose of this study was to examine the validity and responsiveness of the self-administered computerized (SAC) versions of the multidimensional baseline dyspnea index (BDI) and the transition dyspnea index (TDI).
Sleep and Breathing 1520-9512 10.1007/s11325-007-0103-4
Although the psychomotor vigilance task (PVT) is commonly used in sleep and other research settings, normative data for PVT performance in children have not been published. This report presents normal PVT performance measures among children without a sleep disorder participating in the Tucson Children’s Assessment of Sleep Apnea
(TuCASA) study.
Idiopathic pulmonary fibrosis (IPF) is one of a group of interstitial lung diseases that are characterized by excessive matrix deposition and destruction of the normal lung architecture. Long-term survival of IPF patients is poor, with a 5-year survival rate of only 20%. Despite a lack of evidence-based benefit, IPF has historically been treated with corticosteroids and/or cytotoxic agents such as prednisone.
We hypothesized that adding 5 days of prednisone to standard therapy for acute pulmonary exacerbations in patients with cystic fibrosis (CF) would result in a more rapid and greater increase in lung function.
There is a distinct lack of information on the prognosis of asthma in the elderly. In order to compare mortality rates of elderly people with and without asthma and to identify mortality risk factors in those with asthma, 1,233 ambulatory patients aged 65 years with a diagnosis of asthma (n = 210) or chronic nonrespiratory conditions (n = 1,023) were enrolled in a multicentric study. Patients underwent baseline spirometry and multidimensional assessment and were then followed up for a mean of 57.9 months (SD 16.9). We compared mortality rates in the two groups and identified predictors of death using multivariable survival analysis.
Treatment failure (TF) is defined as a clinical condition with inadequate response to antimicrobial therapy. Clinical response should be evaluated within the first 72 h of treatment, whereas infiltrate images may take up to 6 weeks to resolve. Early failure is considered when ventilatory support and/or septic shock appear within the first 72 h. The incidence of treatment failure in community-acquired pneumonia is 10 to 15%, and the mortality is increased nearly fivefold.
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.
Allergy, Volume 62, Number 10, October 2007 , pp. 1158-1165(8)
Farm exposures may protect against childhood asthma, hay fever and eczema. Whether farm exposures also confer protection in adult farmers remains unclear. Moreover, little is known about the role of timing of exposure. We assessed the effects of current and childhood farm exposures on asthma, hay fever and eczema in farmers and a rural nonfarming control population.
Allergy, Volume 62, Number 10, October 2007 , pp. 1139-1145(7)
Dendritic cells are key contributors to initiation and maintenance of T-cell immunity to inhaled allergen. The purpose of this study was to enumerate the changes in peripheral blood myeloid (mDCs) and plasmacytoid dendritic cells (pDCs), the DCs expressing chemokine receptor 6 (CCR6) and chemokine receptor 7 (CCR7), following diluent and allergen inhalation in asthmatic subjects.
Am J Physiol Lung Cell Mol Physiol 293: L952-L959, 2007. First published August 10, 2007
Acute hypoxia causes pulmonary vasoconstriction and coronary vasodilation. The divergent effects of hypoxia on pulmonary and coronary vascular smooth muscle cells suggest that the mechanisms involved in oxygen sensing and downstream effectors are different in these two types of cells. Since production of reactive oxygen species (ROS) is regulated by oxygen tension, ROS have been hypothesized to be a signaling mechanism in hypoxia-induced pulmonary vasoconstriction and vascular remodeling. Furthermore, an increased ROS production is also implicated in arteriosclerosis.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 606-616, 2007
Gram-negative bacteria can stimulate mucin production, but excessive mucus supports bacterial infection and consequently leads to airway obstruction. Therefore, the effect of dexamethasone (DEX) and the antioxidant acetyl-cysteine (ACC) on bacteria-induced mucus expression was investigated.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 598-605, 2007
Bone morphogenetic proteins (BMPs) are multifunctional cytokines, which play a key role in vascular development and remodeling. Heme oxygenase-1 (HO-1), the rate-limiting enzyme in heme catabolism, has been shown to be protective against vascular and lung injury. In a microarray study, we identified HO-1 as a major target of BMP4 signaling in human pulmonary artery smooth muscle cells (PASMCs), and confirmed the induction of HO-1 mRNA and protein by RT-PCR and Western blotting, respectively.
Atrial fibrillation (AF) is associated with a prothrombotic state, which is related to endothelial damage/dysfunction. Plasma levels of soluble E-selectin (sE-sel), von Willebrand factor (vWf), and soluble thrombomodulin (sTM) have been used as indexes of endothelial activation, damage/dysfunction, and endothelial damage, respectively. Nitric oxide is also made by a healthy endothelium, and a total body nitrate/nitrite product (NOx) is used as a measure of endothelial nitric oxide production. We hypothesized that the levels of these markers of endothelial function would be abnormal in patients with paroxysmal, persistent, and permanent AF.
Annals of the Rheumatic Diseases 2007;66:1467-1472
Endothelin receptor antagonism has become an important component in the treatment of pulmonary arterial hypertension (PAH) associated with connective tissue disease (CTD). The purpose of this study was to analyse the safety and effectiveness of sitaxsentan, a selective antagonist of the ETA receptor, in a cohort of patients with PAH and CTD. Short-term clinical and haemodynamic effects and longer-term follow-up data are presented.
Intensivmedizin und Notfallmedizin 0175-3851 Volume 44, Number 7 / October, 2007
The respiratory distress syndrome (RDS) is a life threatening complication of preterm birth. RDS is mainly caused by the immaturity of the preterm lung with respect to surfactant. The surfactant deficiency induces a cascade that results in lung failure and further surfactant inactivation by proteinaceous exsudates from the injured lung.
American Journal of Infection Control, Volume 35, Issue 7, Pages 467-469
H5N1 avian influenza has been widely spreading in fowl in the Eastern Hemisphere and has caused hundreds of severe human cases. Here, information regarding the 224 human cases of H5N1 avian influenza reported by the World Health Organization (WHO) before June 2006 were surveyed and analyzed.
Intensive Care Medicine 0342-4642 10.1007/s00134-007-0850-5
To compare in intubated patients manually ventilated in order to mirror the ventilator, the respiratory and hemodynamic effects induced by a bag device equipped with an inspiratory gas flow-limiting valve (Smart Bag, 0-Two Medical Technologies Inc., Mississauga, ON, Canada) and a Standard bag.
Intensive Care Medicine 0342-4642 10.1007/s00134-007-0895-5
Community acquired pneumonia (CAP) is the most important clinical infection. Therefore, the CAP competence network CAPNETZ was instituted in Germany. The aim of this substudy was to evaluate the value of pro-atrial natriuretic peptide (MR-proANP) and pro-vasopressin (CT-proAVP) for severity assessment and outcome prediction in CAP.
Journal of Allergy and Clinical Immunology, Volume 120, Issue 4, Pages 813-819
Increased vascularity and expression of vascular endothelial growth factor (VEGF) are recognized features of the asthmatic airway. The association of vascular remodeling with airway hyperresponsiveness (AHR) is unclear.
Cochrane Database of Systematic Reviews 2007 Issue 4
The co-administration of inhaled corticosteroids and long-acting beta-agonists in a combined inhaler is intended to facilitate adherence to medication regimens, and to improve efficacy in COPD. In this review they are compared with mono component long-acting beta-agonists.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 617-623, 2007
Smoking cigarettes is the major risk factor for chronic obstructive pulmonary disease (COPD). COPD is a condition associated with chronic pulmonary inflammation, characterized by macrophage activation, neutrophil recruitment, and cell injury. Many substances contained in cigarette smoke, including reactive oxygen species (ROS), have been proposed to be responsible for the inflammatory process of COPD.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0129-7
Cervico facial lipomas are relatively rare and only a few of them affect retropharyngeal space. Because of their slow growth rate, they can reach large size before causing respiratory disturbances and surgery is the treatment of choice.
Pediatric Surgery International 0179-0358 10.1007/s00383-007-1956-0
Impaired lung development afflicts a range of newborns cared for by paediatric surgeons. As a result the speciality has led in the development of surgical models that illustrate the biomechanical regulation of lung growth. Using transgenic mutants, biologists have similarly discovered much about the biochemical regulation of prenatal lung growth. Airway smooth muscle (ASM) and its prenatal contractility airway peristalsis (AP) represent a novel link between these areas: ASM progenitors produce an essential biochemical factor for lung morphogenesis, whilst calcium-driven biomechanical ASM activity appears to regulate the same.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 544-552, 2007
Particulate hexavalent chromium (Cr(VI)) is a well-established human lung carcinogen with widespread exposure among people in occupational settings and the general public. However, no studies have examined the chromate-induced malignant transformation of human lung epithelial cells, its predominant target.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0104-3
Patients with temporomandibular dysfunction (TMD) require antero-posterior (AP) correction of mandibular position inter alia. Determination of the limit of the AP correction using a sibilant phoneme registration (SPR) protocol is essential in not increasing muscular tonus.
Acta Paediatrica Volume 96 Issue 10 Page 1426-1429, October 2007
The aetiological role of gastroesophageal reflux in apnea of prematurity is controversial. We hypothesized that transpyloric feeds, which decreases reflux and aspiration, will not be associated with decrease in reflux-related apnea.
Acta Paediatrica Volume 96 Issue 11 Page 1600-1605, November 2007
To study the relationship between serum cortisol and dehydroepiandrosterone sulphate (DHEAS) concentrations and death or bronchopulmonary dysplasia at 36 weeks of postmenstrual age in preterm infants.
Allergy, Volume 62, Number 10, October 2007 , pp. 1199-1204(6)
Obesity is linked to asthma in a yet poorly understood manner. We examined the relationship between obesity and asthma in a population-based sample of twins.
Journal of Dermatology, Volume 34, Number 10, October 2007 , pp. 705-708(4)
We report a case of a 69-year-old man with Sch0nlein-Henoch purpura who developed diffuse pulmonary hemorrhage. He complained of dyspnea and hemoptysis while he was treated with steroids for gastroenteropathy associated with Schonlein-Henoch
purpura.
The American Journal of Medicine, Volume 120, Issue 10, Pages 871-879
BackgroundSelection of patients for diagnostic tests for acute pulmonary embolism requires recognition of the possibility of pulmonary embolism on the basis of the clinical characteristics.
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.
Current Medical Research and Opinion, Volume 23, Number 10, October 2007 , pp. 2477-2483(7)
Arformoterol tartrate inhalation solution (15 ug/2 mL) is approved for the twice-daily, long-term maintenance treatment of bronchoconstriction in patients with chronic obstructive pulmonary diseases (COPD).
Cochrane Database of Systematic Reviews 2007 Issue 3
The pathogenesis of exercise induced bronchoconstriction is likely multifactorial and is not completely understood. Inflammation plays an important role in the pathogenesis of exercise induced bronchoconstriction in asthmatic subjects but the evidence seems less strong in non-asthmatic subjects. The management of exercise induced bronchoconstriction focuses on prevention, through both pharmacologic and non-pharmacologic interventions.
American Journal of Infection Control, Volume 35, Issue 7, Pages 448-454
While many health care workers (HCWs) who have respiratory infections take sick leave, others work following illness onset. Little is known about attendance practices of HCWs caring for persons with spinal cord injuries (SCI), a group at high risk for respiratory complications.
Journal of Internal Medicine, Volume 262, Number 4, October 2007 , pp. 449-457(9)
The association between HLA class II alleles and susceptibility to sarcoidosis is well documented. Further, the HLA-DRB1*15 and DQB1*0602 haplotype has been considered as a marker for both chronic and severe disease.
Am J Physiol Lung Cell Mol Physiol 293: L1059-L1068, 2007
Angiogenesis is an important feature of airway remodeling in both chronic asthma and chronic obstructive pulmonary disease (COPD). Airways in those conditions are exposed to excessive mechanical strain during periods of acute exacerbations. We recently reported that mechanical strain of human airway smooth muscle (HASM) led to an increase in their proliferation and migration.
Pediatric Infectious Disease Journal. 26(10):868-878, October 2007
Levofloxacin has established efficacy and safety in the treatment of community-acquired pneumonia (CAP) in adults, and its use as an alternative therapy for children with CAP has been proposed.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0143-9
The obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular abnormalities including left ventricular hypertrophy, left ventricular diastolic dysfunction, and endothelial dysfunction. The present study evaluated whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) and peak oxygen consumption (peak VO2), both integral markers of cardiovascular function, are related to OSAS severity.
A 25-year-old man presented with complaints of nonpleuritic, substernal chest pain, dyspnea, and decreasing exercise tolerance. His vital signs were normal, with the exception of an oxygen saturation level of 93% while breathing room air. During his assessment, he developed transient left facial droop, left arm and leg weakness, and an ataxic gait, which lasted 15 min then resolved spontaneously.
Primary spontaneous pneumothorax (PSP) is a common disease in young adults. With advances in its surgical treatment, ipsilateral recurrence is < 5%. However, contralateral recurrence remains a significant problem. The purpose of this retrospective study was to identify the factors associated with contralateral recurrence of PSP.
RBC transfusion has been associated with increased morbidity and mortality in a variety of clinical settings. We assessed the effect of RBC transfusion on in-hospital mortality in patients with acute lung injury (ALI).
Sleep and Breathing 1520-9512 10.1007/s11325-007-0130-1
To determine the effects of a nasal dilation appliance on 3-D nasopharyngeal airway patency. The sample comprised 187 adults (98 males, 89 females) with a history of sleep-disordered breathing.
A 66-year-old man with mitral stenosis on coumadin presents with hemoptysis caused by a capillary hemangioma of the proximal airways. Argon plasma coagulation was utilized to treat the lesions resulting in resolution of hemoptysis. Tracheobronchial capillary hemangiomas are rare in adults, but are easily discovered and treated with bronchoscopic intervention.
Primary Care Respiratory Journal Volume 16 Issue 5 October 2007
To investigate how best to encourage health professionals to promote, and for people with asthma to use, asthma action plans. METHODS: Systematic review. Randomised controlled trials published between 1960 and 2006 were searched using multiple electronic databases. Unpublished and ongoing studies were identified by contacting asthma experts internationally.
Allergic bronchopulmonary aspergillosis (ABPA) is a disease that presents with diverse clinicoradiologic manifestations. High-attenuation mucus (HAM) is a characteristic radiologic finding seen in patients with ABPA; however, the clinical significance of the entity remains unknown.
Obesity hypoventilation syndrome (OHS) consists of a combination of obesity and chronic hypercapnia accompanied by sleep-disordered breathing. During the last 3 decades, the prevalence of extreme obesity has markedly increased in the United States and other countries. With a global epidemic of obesity, the prevalence of OHS is bound to increase. Patients with OHS have a lower quality of life with increased health-care expenses and are at a higher risk for the development of pulmonary hypertension and early mortality compared to eucapnic patients with sleep-disordered breathing.
The diagnosis of pulmonary sarcoidosis can be established by a variety of techniques. Transbronchial lung biopsy is often the preferred approach, but it is frequently nondiagnostic and carries a risk of pneumothorax and bleeding. Mediastinoscopy is often suggested as the next diagnostic step but entails significant cost and associated morbidity. Endobronchial ultrasound (EBUS) with transbronchial needle aspiration (TBNA) is emerging as a safe, minimally invasive tool for the primary diagnosis of mediastinal and hilar lymphadenopathy. The purpose of this study was to assess the utility of EBUS-TBNA for pulmonary sarcoidosis.
Sleep and Breathing 1520-9512 10.1007/s11325-007-0111-4
We utilized well-established and validated quality of life (QoL) measures to test the validity of the Health Utilities Index (HUI) in patients with untreated sleep disorders in a cross-sectional study.
Allergy, Volume 62, Number 10, October 2007 , pp. 1101-1110(10)
Allergen bronchoprovocation tests have been used for more than two decades in the investigation of respiratory allergic diseases such as asthma and rhinitis. These bronchial challenges are now well standardized and can offer key information on the therapeutic potential of new agents and on their anti-inflammatory effects on the airways.
Allergy, Volume 62, Number 10, October 2007 , pp. 1171-1174(4)
Given the importance of airway inflammation in asthma, there has been an effort to incorporate inflammatory markers into its management. Measurement of fractional exhaled nitric oxide (FeNO) is a noninvasive marker of airway inflammation; however, the use of the available FeNO analyzer is limited by several factors including its cost and lack of transportability.
Allergy, Volume 62, Number 10, October 2007 , pp. 1166-1170(5)
Ninety-eight national preOlympic athletes underwent an accurate medical examination including a validated questionnaire for asthma and rhinitis, spirometric recordings and skin prick testing with a panel of the most frequent inhalant allergens. Bronchodilator and/or exercise challenge were also performed in asthmatic subjects.
Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms.
International Archives of Occupational and Environmental Health, Volume 80, Number 8, August 2007 , pp. 721-731(11)
Assessment of olfactory and chemesthetic sensitivity (feel, sensory irritation) to vapor of glutaraldehyde in young adult females. For chemesthetic sensitivity, assessment included the variable of duration, with focus on whether concentrations initially too low to evoke feel in the eye or upper airway might do so in exposures up to 15 min.
Lymphomatoid granulomatosis (LYG) is a rare multisystemic angiocentric lymphoproliferative disease, which can masquerade as necrotic tissue. There is a paucity of reports of LYG in renal transplant recipients.
Medicine & Science in Sports & Exercise. 39(10):1681-1686, October 2007
Asthma is frequently reported in endurance athletes, particularly in cross-country skiers. It has been reported that an exercise field test performed with the competitive type of exercise is the better for diagnosing asthma and bronchial hyperresponsiveness in athletes than bronchial provocation with methacholine.
American Journal of Clinical Nutrition, Vol. 86, No. 4, 1167-1173, October 2007
The objective was to determine whether serum zinc concentrations in nursing home elderly are associated with the incidence and duration of pneumonia, total and duration of antibiotic use, and pneumonia-associated and all-cause mortality.
Pediatric Infectious Disease Journal. The Global Burden of Acute Otitis Media in Children: Outcomes, Management, and Prospects for Prevention. 26(10) Supplement:S4-S7, October 2007
The burden of otitis media in developing and disadvantaged populations is substantial. This article looks at that burden in developed affluent and indigenous populations (in Australia). A model is presented to explain the high prevalence of chronic suppurative otitis media in indigenous populations, and an assessment of efforts to improve these outcomes if not prevent these infections is provided. Lastly, various international guidelines for managing acute otitis media are compared.
Pediatric Infectious Disease Journal. 26(10):904-908, October 2007
Rhinovirus is a recognized cause of common cold, proven to cause asthma exacerbations in children. In Spain, no description exists, as yet, as to the degree of burden rhinovirus infections represent among hospitalized infants. Our aim was to describe rhinovirus infections in hospitalized children, under 2 years of age, and to compare these with patients infected with respiratory syncytial virus (RSV).
Journal of Allergy and Clinical Immunology, Volume 120, Issue 4, Pages 856-862
Exhaled breath contains thousands of volatile organic compounds (VOCs) that could serve as biomarkers of lung disease. Electronic noses can distinguish VOC mixtures by pattern recognition.
Low-molecular-weight heparin (LMWH) is a popular alternative to unfractionated heparin (UH) for the treatment of pulmonary embolism (PE) and deep vein thrombosis (DVT), in part based on the perception of a lower risk for heparin-induced thrombocytopenia (HIT). To investigate the evidence supporting this perception, we performed a metaanalysis to compare the incidence of thrombocytopenia between LMWH and UH during PE and/or DVT treatment.
High expression of vascular endothelial growth factor (VEGF) induces subepithelial fibrosis associated with angiogenesis in patients with asthma. Thrombin is recognized as a new candidate mediating airway remodeling. Therefore, this study was designed to determine the role of up-regulated thrombin activity induced by VEGF on airway remodeling in patients with asthma.
High-frequency chest wall oscillation (HFCWO) is commonly used by cystic fibrosis (CF) patients for airway clearance. The primary objective of this study was to determine whether the use of a newer HFCWO device that generates oscillations with a triangular waveform results in greater sputum production than a commonly used device that generates oscillations with a sine waveform.
Clinical Orthopaedics & Related Research. 463:107-113, October 2007
In recent years, there has been an apparent increase in the incidence of pulmonary embolus after joint arthroplasty at our institution. We hypothesized the use of sophisticated imaging modalities such as the multidetector computed tomography scan, with better sensitivity, resulted in an apparent increase in the incidence of pulmonary embolus.
Journal of Allergy and Clinical Immunology, Volume 120, Issue 4, Pages 798-802
Maintenance treatment with inhaled corticosteroids is often required for asthmatic nursing women. Data on the transfer of inhaled corticosteroids from plasma to breast milk and the subsequent exposure of the breast-feeding infant has been unavailable.
Hydatid disease (human echinococcosis) is a zoonotic infection caused by larval forms (metacestodes) of the genus Echinococcus. Although pulmonary hypertension (PH) due to hydatid disease has been described, it is quite rare. We report a patient with chronic echinococcal embolic PH in whom treatment with novel PH therapies permitted successful resection of the hepatic cyst with a good outcome.
Following collapse of the World Trade Center (WTC), individuals reported new-onset respiratory symptoms. Despite symptoms, spirometry often revealed normal airway function. However, bronchial wall thickening and air trapping were seen radiographically in some subjects. We hypothesized that symptomatic individuals following exposure to WTC dust may have functional abnormalities in distal airways not detectable with routine spirometry.
Sleep-disordered breathing (SDB) is increasingly being recognized as an independent risk factor for hypertension and cardiovascular disease. Recent evidence suggests that the maladaptive physiologic response to SDB, particularly cardiovascular effects, may result in part from systemic inflammation. Although abnormal cytokine levels have been documented in SDB, data on whether SDB is associated with cellular activation are limited. Thus, this investigation sought to determine whether neopterin, a marker released by activated macrophages, is increased in SDB.
To determine the prevalence of blebs or bullae using thoracoscopy in young healthy adults, and to compare patient characteristics among those with and without blebs.
The ratio of FVC to slow inspiratory vital capacity (SVC) has been reported to reflect small airways obstruction, but its validity as such is still unclear. The aim of this study was to assess the applicability of the FVC/SVC ratio as a marker of small airways function in patients with bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTX), which is a disorder in which predominantly small airways obstruction causes progressive airflow limitation.
nal of Asthma, Volume 44, Issue 8 October 2007 , pages 609 - 611
Using the same questionnaire as in ISAAC Phase One study conducted in 1995, the ISAAC Phase Three was carried out in Bangkok and Chiang Mai, Thailand, in 2001, among children aged 6-7 and 13-14 years.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 651 - 658
The purpose of this study was to examine the associations between smoking, physical inactivity, obesity, and asthma severity among US adults. The magnitude of these associations was very strong.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 599 - 603
This study aimed to evaluate the association of diet with respiratory symptoms and asthma in schoolchildren in Taipei, Taiwan. An in-class interview survey elicited experiences of asthma and respiratory symptoms and consumption frequencies of the major food categories in 2290 fifth graders.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 613 - 619
The purpose of this study was to identify factors potentially associated with asthma self-care behavior among adult asthma patients. A correlational descriptive study was conducted with a convenience sample of 220 adults identified as having moderate-to-severe asthma and receiving outpatient care at a medical center in northern Taiwan.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 667 - 673
Using a composite measure based on clinical outcomes, the GOAL study showed that achievement of Total Control of asthma was time dependent with the proportion of controlled patients continuing to rise through the year-long study. Taking data from this study, we compared time taken to achieve Total Control with time taken to achieve total control of each individual clinical criterion on treatment with salmeterol/fluticasone propionate (SFC) or fluticasone propionate (FP) alone.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 605 - 608
In a study comparing low-dose theophylline to montelukast in poorly controlled asthmatics, 285 subjects consented to be screened for alpha-1 antitrypsin deficiency.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 593 - 598
Inadequate skill in the use of asthma inhalation devices by healthcare professionals has been well documented over the past 25 years. We performed a PubMed search of the English literature for studies regarding skill by physicians, medical students, pharmacists, nurses, and respiratory therapists in using asthma inhalation devices.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 659 - 666
Determine the prevalence and risk factors of wheeze and severe wheeze in 13-to 14-year-old children. Methods. The study was conducted August 2004 to February 2005 in the Polokwane area, South Africa.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 639 - 648
Socioeconomic and environmental differences do not fully explain differences in asthma prevalence, morbidity, and mortality among Puerto Ricans, African Americans, and Mexican Americans. Differences in response to albuterol may be a factor. We compared bronchodilator responsiveness between these three populations.
Journal of Asthma, Volume 44, Issue 8 October 2007 , pages 621 - 628
Decision-making about inhaler use is, in part, determined by the ability of asthmatic patients to compare their symptoms over time and to recall the previous response to the bronchodilator during an episode of asthma. The perception of airway symptoms across varied ethnic and cultural groups are poorly understood.
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