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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.
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