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The widespread use of genetically altered mouse models of experimental asthma has stimulated the development of lung function techniques in vivo to characterize the functional results of genetic manipulations. Here, we describe various classical and recent methods of measuring airway responsiveness in vivo including both invasive methodologies in anesthetized, intubated mice (repetitive / non-repetitive assessment of pulmonary resistance (RL) and dynamic compliance (Cdyn); measurement of low-frequency forced oscillations (LFOT)) and noninvasive technologies in conscious animals (head-out body plethysmography; barometric whole-body plethysmography).
International Archives of Allergy and Immunology 2008;145:111-121
The allergen-induced release of CCL17/thymus and activation-regulated chemokine (TARC) may be crucial in asthmatic airway inflammation by recruitment of Th2 cells.
Critical Care Medicine. 35(9):2031-2036, September 2007
To determine whether the use of a nurse-implemented sedation protocol could reduce the incidence of ventilator-associated pneumonia in critically ill patients.
Critical Care Medicine. 35(9):2064-2070, September 2007
To assess whether bacteremic ventilator-associated pneumonia (B-VAP) differs in terms of risk factors, organisms, and outcomes from nonbacteremic VAP (NB-VAP).
Clinical & Experimental Immunology, Volume 149, Number 3, September 2007 , pp. 463-469(7)
Chronic obstructive pulmonary disease (COPD) is an inflammatory disorder characterized by the presence of non-fully reversible airflow limitation. The study was undertaken to investigate the involvement of alpha-1-antitrypsin (a1AT) and T lymphocyte subsets in the pathogenesis of COPD. Blood samples of 50 subjects, including 25 healthy volunteers and 25 patients with COPD, were analysed.
To compare changes in behavior after adenotonsillectomy in children with either mild sleep-disordered breathing (SDB) or obstructive sleep apnea (OSA).
There has been growing awareness that alleviation of wound pain and associated symptoms after obstructive sleep apnea (OSA) surgeries may improve the quality of care. We performed a hospital-based study to compare the effectiveness and safety of two different regimens in the treatment of postoperative pain.
The Proceedings of the American Thoracic Society 4:316-320 (2007)
Effective doses, and the corresponding risks of radiation-induced cancers, are presented for patients undergoing chest computed tomography (CT) examinations. Patient dose calculations were based on the characteristics of 16-slice CT scanner from 4 imaging equipment vendors.
Critical Care Medicine. 35(9):2007-2015, September 2007
Although critical illness neuromyopathy might interfere with weaning from mechanical ventilation, its respiratory component has not been investigated. We designed a study to assess the level of respiratory muscle weakness emerging during the intensive care unit stay in mechanically ventilated patients and to examine the correlation between respiratory and limb muscle strength and the specific contribution of respiratory weakness to delayed weaning.
Critical Care Medicine. 35(9):2037-2050, September 2007
Pulmonary hypertension may be encountered in the intensive care unit in patients with critical illnesses such as acute respiratory distress syndrome, left ventricular dysfunction, and pulmonary embolism, as well as after cardiothoracic surgery. Pulmonary hypertension also may be encountered in patients with preexisting pulmonary vascular, lung, liver, or cardiac diseases. The intensive care unit management of patients can prove extremely challenging, particularly when they become hemodynamically unstable. The objective of this review is to discuss the pathogenesis and physiology of pulmonary hypertension and the utility of various diagnostic tools, and to provide recommendations regarding the use of vasopressors and pulmonary vasodilators in intensive care.
European Journal of Neurology, Volume 14, Number 9, September 2007 , pp. 989-992(4)
Chronic obstructive pulmonary disease (COPD) is a risk factor for cardiovascular disorders and different types of stroke. The present retrospective study investigates whether COPD is also a risk factor for the development of seizures in stroke patients.
Pediatric Allergy and Immunology, Volume 18, Supplement 18, November 2007 , pp. 22-24(3)
Respiratory infections are the main causes of chronic or recurrent cough in children. Children present 3.8-8 infective episodes per year with cough lasting, on average, 1-3 wk and 10% will still have cough after 4 wk. There is evidence of over-treatment of cough with antibiotics, anti-asthmatic drugs (in Italy) and symptomatic treatments, all with insufficient evidence of efficacy.
We investigated changes in the geography of Chronic Obstructuve Pulmonary Disease (COPD) hospitalization charges in California over the period of 1993 and 1999. There is little information available at less than the county level for this increasingly costly disease in California. We found, using a uniform grid unit method, (4X4 and 16X16 mile urban and rural grids respectively, using zip codes as the base source for information) positive relationships between COPD charges and age, percentage Hispanics, and number of tobacco outlets.
A 36-year-old man with adult-onset nonallergic triad asthma developed acute bronchospasm and copious sputum production during an offshore sailing excursion on the Gulf Coast of Florida. Symptoms were linked to proximity to blooms of the marine dinoflagel-late Karenia brevis ("red tide") and heavy aerosolized brevetoxin exposure, and symptoms recurred during rechallenge.
Pulmonary function testing remains part of the routine preoperative investigations in patients with pectus excavatum, although there is evidence that reduced exercise capacity is predominantly due to impaired cardiovascular performance rather than ventilatory limitation.
The aim of this study was to compare the central inspiratory drive (P0.1) response to hypoxia and hypercapnia between different age groups of elderly, nonsmoker, healthy subjects and young healthy controls
External agents, especially metal and wood dust, are believed to be risk factors for development of idiopathic pulmonary fibrosis (IPF). The aim of this case-control study was to investigate which occupational exposure types are associated with development of severe pulmonary fibrosis (PF), and especially IPF.
It is unclear why the neutrophil differential count in induced sputum (IS) from normal children is highly variable. Since levels of neutrophil chemoattractant cytokines and oxidative stress are determinants of airway neutrophilia in animal models, we sought to determine the association between IS neutrophils from healthy children and (i) interleukin-8 (IL-8) and (ii) the oxidative stress marker 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG).
In pregnant women, the reported cases of hemoptysis were most often mild and had an identified cause. Between November 2003 and January 2006, three pregnant women at 16-20 weeks gestation were admitted to our respiratory intensive care unit for massive hemoptysis.
Journal of Digital Imaging 14 August 2007 0897-1889
We have created a content-based image retrieval framework for computed tomography images of pulmonary nodules. When presented with a nodule image, the system retrieves images of similar nodules from a collection prepared by the Lung Image Database Consortium (LIDC).
The characteristics, incidence and risk factors for acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) may depend on definitions and geography.
Continuous positive airway pressure (CPAP) is frequently used in patients attending emergency units. Its combination with nebulization is sometimes necessary in those patients presenting with a CPAP dependency.
A few population-based studies assessing the etiology of community-acquired pneumonia in both hospitalized and ambulatory patients, with special emphasis on the etiologic role of viral infections, have been reported. The purpose of this study was to assess microbiological differences according to initial site of care in patients with community-acquired pneumonia.
Sarcoidosis (SA) is a multisystem granulomatous disorder of unknown etiology. It seems likely that in genetically different predisposed hosts, the same antigen(s) may cause the development of sarcoid Th1 response. The interaction of the T-cell receptor with the human leukocyte antigen-DQA1*03011 peptide-complex can affect T lymphocytes activation in a dose-response manner.
Community-acquired pneumonia is a frequent event in the course of chronic obstructive pulmonary disease (COPD). The aim of the present study was to provide information on clinical and microbiological characteristics and outcome of community-acquired pneumonia in these patients, in a comparative study with the non-COPD population.
Exacerbations of airway disease are eosinophilic, neutrophilic, both or neither, and this determines the treatment needed. We examined changes in the cellular nature of airway inflammation between consecutive exacerbations and their predictors in individual patients.
Systemic sclerosis (SSc) is frequently associated with interstitial lung disease (ILD) often leading to lung fibrosis. In this study we investigated whether matrix metalloproteinase 9 (MMP-9) and its natural inhibitor; the tissue inhibitor of matrix metalloproteinase 1 (TIMP-1), would be associated with remodelling in ILD in SSc.
Low-grade bronchus-associated lymphoid tissue (BALT) lymphoma is a rare tumour originating from the marginal zone of lymphoid tissue. It is a subgroup of B-cell extranodal non-Hodgkin's lymphoma with an indolent course. We report a case of this tumour with characteristic histologic feature. The patient had non-specific respiratory complaints. The tumour occluded the right bronchus intermedius. He received radiation therapy alone, resulting in complete remission of the tumour and disappearance of symptoms.
Journal of the Medical Association of Thailand Vol90 No.8 1530-3823
To evaluate the effect of long-term treatment with continuous positive airway pressure (CPAP) on the heart rate variability (HRV) of obstructive sleep apnea (OSA) patients.
NEJM Volume 357:1094-1104 September 13, 2007 Number 11
Venous thromboembolism is treated with unfractionated heparin or low-molecular-weight heparin, followed by a vitamin K antagonist. We investigated the potential use of idraparinux, a long-acting inhibitor of activated factor X, as a substitute for standard therapy.
NEJM Volume 357:1105-1112 September 13, 2007 Number 11
The extended use of vitamin K antagonists for prophylaxis against venous thromboembolism is often constrained by risk–benefit limitations and inconvenience. We evaluated the efficacy and safety of a 6-month extension of prophylaxis against recurrent venous thromboembolism with idraparinux in patients who had initially received 6 months of prophylaxis with an anticoagulant.
European Journal of Pediatrics, Volume 166, Number 9, September 2007 , pp. 889-899(11)
Surfactant therapy has significantly changed clinical practice in neonatology over the last 25 years. Recent trials in infants with respiratory distress syndrome (RDS) have not shown superiority of any natural surfactant over another.
American Journal of Surgical Pathology. 31(8):1292-1296, August 2007
von Hippel-Lindau disease is an autosomal dominant inherited disorder characterized by a predisposition to multiple neoplasms. Renal cell carcinoma and hemangioblastomas of the retina and cerebellum are the most common of these, but other neoplasms and cysts also occur throughout the body.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 457-466, 2007
Fetal distal lung epithelium (FDLE) must increase amiloride-sensitive epithelial Na+ channel (ENaC) activity during the perinatal period to increase Na+ transport and fluid clearance.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 494-500, 2007
Disintegrin and metalloprotease proteins (ADAMs) are membrane-anchored glycoproteins involved in cell adhesion, cell fusion, protein ecto-domain shedding, and intracellular signaling. We examined whether the disintegrin domain of ADAM-15 (named ddADAM-15) containing an Asp-Gly-Asp (RGD) integrin-binding motif could interfere with airway smooth muscle cell (ASMC) adhesion and migration.
Current Opinion in Pulmonary Medicine. 13(5):368-371, September 2007
Although usually developing in advanced stages of the disease, venous thromboembolism may also appear before the cancer has become symptomatic and may lead to an earlier diagnosis of cancer. One clinical implication of a high risk of occult cancer in patients with acute venous thromboembolism could be an extensive diagnostic workup at the time of presentation.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 467-476, 2007
Lung surfactant is secreted through the fusion of lamellar bodies with the plasma membrane of alveolar epithelial type II cells. Annexin A2, a Ca2+- and phospholipid-binding protein, promotes the fusion of lamellar bodies with the plasma membrane. Soluble N-ethylmaleimide-sensitive factor attachment protein receptors (SNAREs) are known to have an essential role in surfactant secretion.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 447-456, 2007
The earliest structural change in hypoxia-induced pulmonary hypertension is increased proliferation of adventitial fibroblasts. This fibroproliferative response occurs in acute and chronic hypoxic models, is dependent on p38 mitogen-activated protein (MAP) kinase activation, is selective for the pulmonary circulation, and would seem an important therapeutic target.
The ongoing outbreak of highly pathogenic avian influenza virus (HPAIV) in birds, the incidence of transmission to humans with a resulting high mortality rate, and the possibility of a human pandemic warrant the development of effective human vaccines against HPAIV.
Journal of Virology, October 2007, p. 10389-10401, Vol. 81, No. 19
H9N2 influenza viruses have become established in terrestrial poultry in different Asian countries over the last 2 decades. Our previous study demonstrated that quail harbor increasingly diverse novel H9N2 reassortants, including both Chicken/Beijing/1/94 (Ck/Bei-like) and Quail/Hong Kong/G1/97 (G1-like) viruses. However, since 1999, the genesis and evolution of H9N2 viruses in different types of poultry have not been investigated systematically.
Journal of Virology, October 2007, p. 10402-10412, Vol. 81, No. 19
An H6N1 virus, A/teal/Hong Kong/W312/97 (W312), was isolated during the "bird flu" incident in Hong Kong in 1997. Genetic analysis suggested that this virus might be the progenitor of the A/Hong Kong/156/97 (HK/97) H5N1 virus, as seven of eight gene segments of those viruses had a common source.
Journal of Virology, September 2007, p. 9950-9955, Vol. 81, No. 18
Avian influenza H5N1 virus is a major threat for the emergence of a pandemic virus. As of 12 June 2007, the virus has been reported in 45 countries, and 312 human cases with 190 deaths have been confirmed.
The unparallelled spread of highly pathogenic avian influenza A (HPAI) H5N1 viruses has resulted in devastating outbreaks in domestic poultry and sporadic human infections with a high fatality rate. To better understand the mechanism(s) of H5N1 virus pathogenesis and host responses in humans, we utlized a polarized human bronchial epithelial cell model that expresses both avian alpha-2,3 and human alpha-2,6 linked sialic acid receptors on the apical surface and supports productive replication of both H5N1 and H3N2 viruses.
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 414-423, 2007
Development of gene transfer vectors with regulated, lung-specific expression will be a useful tool for studying lung biology and developing gene therapies. In this study we constructed a series of lentiviral vectors with regulatory elements predicted to produce lung-specific transgene expression: the surfactant protein C promoter (SPC) for alveolar epithelial type II cell (AECII) expression, the Clara cell 10-kD protein (CC10) for Clara cell expression in the airway, and the Jaagskiete sheep retrovirus (JSRV) promoter for expression in both cell types.
Group B streptococcus (GBS) is a major cause of neonatal pneumonia. The early interactions between innate airway defenses and this pathogen are likely to be a critical factor in determining the outcome for the host.
Allergy and Asthma Proceedings, Volume 28, Number 4, July/August 2007 , pp. 462-467(6)
Chronic cough can be a complicated and frustrating diagnostic dilemma. The aim of this study was to identify the possible causes of chronic nonspecific cough in seemingly healthy children using fiberoptic bronchoscopy (FOB) and bronchoalveolar lavage (BAL).
American Journal of Respiratory Cell and Molecular Biology. Vol. 37, pp. 485-493, 2007
Transforming growth factor (TGF)-B1 activity has been shown to increase vascular endothelial barrier permeability, which is believed to precede several pathologic conditions, including pulmonary edema and vessel inflammation.
Current Medical Research and Opinion, Volume 23, Number 8, August 2007 , pp. 1841-1847(7)
Concentrations of garenoxacin in plasma and samples of lung parenchyma, bronchial mucosa, and bone were determined following single-dose administration.
European Journal of Pediatrics, Volume 166, Number 9, September 2007 , pp. 957-966(10)
Surveillance systems for acute respiratory infections (ARI) in children currently are often limited in terms of the panel of pathogens and the age range investigated or are only syndromic and at times only active in the winter season.
Medicine & Science in Sports & Exercise. 39(9):1481-1486, September 2007
Aerobic training has been shown to be effective in improving cardiopulmonary fitness in asthmatic children. However, the actual impact of physical training on clinical indicators of disease control remains controversial.
The safety and tolerability of indacaterol, a novel once-daily β2-agonist bronchodilator with a fast onset of action, were assessed in 156 asthma patients in a
multicentre, randomized, double-blind, placebo-controlled study. Patients received indacaterol 200, 400 or 600μg or placebo once daily for 28 days. Adverse events
(AEs), laboratory assessments, vital signs, electrocardiograms, spirometry and physical examinations were monitored. Indacaterol pharmacokinetics were assessed.
The COPD airway is infiltrated with CD8+ T cells, which has led to a virus being implicated in its pathogenesis. Some investigators have suggested a role for the persistence of the adenovirus E1A in bronchial epithelial cells. We examined respiratory tract specimens from COPD patients for the presence of E1A DNA and mRNA using real-time PCR.
Bordetella pertussis causes whooping cough, an endemic respiratory disease that is increasing in prevalence despite vaccination efforts. Although host immunity is modulated by virulence factors of this pathogen, it is unclear what host factors are required to overcome their effects.
To identify variables patients use to determine the severity of their asthma, the perceived severity (PS), using a fuzzy decision-making analysis (FDMA). To compare these variables with those involved in the assessment of asthma severity according to the global initiative for asthma (GINA) guidelines, the objective severity (OS).
Inflammation is a universal pathological reaction and is characterized among other things by increased heat production. The question stays whether the contribution of the inflamed lung tissues to the overall exhaled breath temperature (EBT) can be reliably detected and used in everyday clinical practice.
Reliable, noninvasive approaches to the diagnosis of pulmonary hypertension in idiopathic pulmonary fibrosis are needed. We tested the hypothesis that the forced vital capacity to diffusing capacity ratio and room air resting pulse oximetry may be combined to predict mean pulmonary artery pressure (MPAP) in idiopathic pulmonary fibrosis.
Patients with chronic obstructive pulmonary disease (COPD) present increased airway resistance, air trapping, pulmonary hyperinflation, and diaphragm muscle alterations, all of which affect pulmonary mechanics.
The severity of asthma varies in patients in primary care. The aim of this study was to identify factors related to asthma severity in a primary care setting.
We wished to evaluate the effects of inhaled formoterol, a long-acting B2-adrenergic agonist, on exercise tolerance and dynamic hyperinflation (DH) in severely disabled chronic obstructive pulmonary disease (COPD) patients.
Fast and accurate etiologic diagnosis of pneumonia in immunocompromised patients is essential for a good outcome. Utility of bronchoalveolar lavage (BAL) samples has already been established, but studies about them are scarce and limited to few countries. We aimed to evaluate the accuracy of a diagnostic protocol, emphasizing on local epidemiology, rapidity, and yield of different techniques.
Clinical & Experimental Allergy, Volume 37, Number 7, July 2007 , pp. 1049-1054(6)
Several observational studies have demonstrated an association between obesity and asthma. Studies evaluating exhaled nitric oxide levels and obesity have revealed that a higher body mass index (BMI) is associated with elevated exhaled nitric oxide levels. Airway inflammation using sputum cell counts has not been assessed in obese patients with airway diseases.
PEDIATRICS Vol. 120 No. 3 September 2007, pp. e521-e526
The objectives of this study were to describe parents' perceived need for and concerns about their child's asthma medications and to assess the weighted impact of these positive and negative beliefs on parent-reported adherence.
The Journal of Obstetrics and Gynaecology Research, Volume 33, Number 5, October 2007 , pp. 734-738(5)
Herein is reported a case of late-onset pulmonary embolism following pelvic surgery, despite prophylactic measures in the perioperative period. Twenty-six days after hysterectomy and pelvic lymphadenectomy for endometrial carcinoma, an 83-year-old woman developed a pulmonary embolism.
Oseltamivir is a neuraminidase inhibitor effective in the treatment of influenza. In this Japanese study, the sensitivity of influenza B virus to neuraminidase inhibitors was assessed in 74 children before and after treatment with oseltamivir, and in a further 348 untreated patients, 66 of whom were adults.
Obliterative bronchiolitis (OB), the main cause of lung allograft failure, is characterised by airway inflammation, neutrophilia, remodelling and fibrosis. Recent studies of the macrolide antibiotic azithromycin in OB, including one from our centre, have reported improved lung function with rescue therapy.
European Radiology, Volume 17, Number 8, August 2007 , pp. 1943-1953(11)
The purpose of this study was to determine non-invasively the frequency of ectopic bronchial arteries (BA) (i.e., bronchial arteries originating at a level of the descending aorta other than T5-T6 or from any aortic collateral vessel) on multidetector-row CT angiograms (CTA) obtained in patients with hemoptysis.
European Radiology, Volume 17, Number 8, August 2007 , pp. 1954-1959(6)
This study was an analysis of the correlation between pulmonary embolism (PE) and patient survival. Among 694 consecutive patients referred to our institution with clinical suspicion of acute PE who underwent CT pulmonary angiography, 188 patients comprised the study group: 87 women (46.3%, median age: 60.7; age range: 19-88 years) and 101 men (53.7%, median age: 66.9; age range: 21-97 years). PE was assessed by two radiologist who were blinded to the results from the follow-up.
The first study compares the effect of three modes of ventilation on cardiovascular and respiratory physiologic variables in 14 patients with acute respiratory distress syndrome (ARDS).
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 617-623, (2007)
The mechanical dysfunction accompanying parenchymal diseases such as pulmonary fibrosis and emphysema may follow a different course from the progression of the underlying microscopic pathophysiology itself, particularly in the early stages. It is tempting to speculate that this may reflect the geographical nature of lung pathology. However, merely ascribing mechanical dysfunction of the parenchyma to the vagaries of lesional organization is unhelpful without some understanding of how the two are linked.
Spontaneous pneumothorax is a common problem and in patients at risk of recurrence, excision of the source of the air leak and pleurodesis is very effective in reducing further episodes. In the 15 years since the introduction of video assisted thoracic surgery (VATS), practice has changed towards this much less invasive procedure and away from thoracotomy.
The pathogenesis of severe infantile respiratory illness due to respiratory syncytial virus (RSV) and influenza virus is not fully understood. Some evidence suggests there is an increased T lymphocyte and cytokine response to infection. However, this cross-sectional study found otherwise.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 532-555, (2007)
Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization.
nals of Allergy, Asthma and Immunology, Volume 99, Number 3, September 2007 , pp. 244-253(10)
Identifying baseline inflammatory biomarkers that predict susceptibility to size-specific particulate matter (PM) independent of gaseous pollutants could help us better identify asthmatic subpopulations at increased risk for the adverse health effects of PM.
A dynamic single-path mathematical model was developed that is capable of analyzing detailed deposition patterns of inhaled particles in human lungs. Weibel's symmetric lung morphology was adopted as the basic lung structure, and detailed transport processes were evaluated numerically using the fully implicit procedure. Deposition efficiencies by specific mechanisms were individually examined for accuracy and new empirical formulas were incorporated whenever appropriate.
Recent studies have suggested the possibility of invariant natural killer T cells (iNKT) playing an important role in the pathogenesis of asthma. To explore this hypothesis, the authors measured the numbers of iNKT in the airways of patients with stable mild/moderate asthma, patients with stable or exacerbated chronic obstructive pulmonary disease (COPD) and controls.
European Journal of Echocardiography, Volume 8, Issue 5, Pages 403-405
We present a case of acquired pulmonary artery branch stenosis caused by pulmonary thromboembolism. The patient presented with symptoms mimicking aortic dissection. An emergent transesophageal echocardiogram showed a high gradient across the right pulmonary artery along with mobile thrombi. The vital importance making an accurate diagnosis and ruling out aortic dissection is emphasized in view of the need for urgent heparinization or thrombolysis for pulmonary thromboembolism as this is contraindicated in aortic dissection.
The Journal of Heart and Lung Transplantation, Volume 26, Issue 8, Pages 862-864
Human metapneumovirus (hMPV) has recently been shown to be a prominent cause of respiratory infections in immunocompromised hosts, and is associated with high morbidity and mortality. We report a case of hMPV pneumonia in a lung transplant recipient presenting with respiratory failure and sepsis syndrome. hMPV was diagnosed by polymerase chain reaction, and treated with intravenous ribavirin with a successful outcome.
We report the successful use of vasopressin in the management of hypotension in association with severe right ventricular (RV) failure in two patients with advanced idiopathic pulmonary arterial hypertension.
The aim of this study was to determine the benefit of lower extremity CT venography (CTV) with pulmonary CT angiography (CTA) for diagnosing thromboembolic (TE) disease.
The Journal of Infectious Diseases 2007;196:928-935
Antibodies to pneumococcus are thought to represent the primary mechanism of naturally acquired resistance to colonization. Here, however, we show that, in patients with chronic obstructive pulmonary disease (COPD), resistance to pneumococcal colonization is not associated with higher concentrations of serum anti-capsular or -noncapsular antibodies.
To define the contribution of polymorphisms in genes encoding tumor necrosis factor (TNF), mannose-binding lectin (MBL), and Fc receptor IIa (FCGR2A) as well as clinical factors, to the development of pneumonia in patients with systemic lupus erythematosus (SLE).
Allergy and Asthma Proceedings, Volume 28, Number 4, July/August 2007 , pp. 449-453(5)
Previously, evidence has been provided that sensitization is frequent in asthmatic children and polysensitization represents the natural history of allergy. The aim of this study was to investigate whether polysensitization may occur primarily in infants with wheezing.
The American Journal of Medicine, Volume 120, Issue 8, Pages S14-S22
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable systemic disease with symptoms that overlap other respiratory illnesses. An estimated 24 million adults in the United States have COPD, but >50% of them are misdiagnosed or undiagnosed. Spirometry remains the "gold standard" for diagnosing COPD and for monitoring the progression of the disease. Cigarette smoking is the main cause of COPD; therefore, smoking cessation is an integral component of any program to reduce COPD risk and delay or limit the progression of airflow obstruction.
Inhaled corticosteroids (ICS) are standard treatment for persistent asthma but it is important to "step down" treatment when possible to minimise adverse effects. The optimal strategy for reducing treatment in mild asthma has not yet been determined.
Inspiratory occlusion evoked cortical potentials (the respiratory related-evoked potentials, RREPs) bear witness of the processing of changes in respiratory mechanics by the brain. Their impairment in children having suffered near-fatal asthma supports the hypothesis that relates asthma severity with the ability of the patients to perceive respiratory changes. It is not known whether or not chronic respiratory defects are associated with an alteration in brain processing of inspiratory loads. The aim of the present study was to compare the presence, the latencies and the amplitudes of the P1, N1, P2, and N2 components of the RREPs in children with chronic lung or neuromuscular disease.
It is generally accepted that emphysematous lungs are characterized by an increase in the numbers of neutrophils, macrophages, and CD8+ T lymphocytes, the lasts having increased cytotoxic activity. Because systemic inflammation is also a component of emphysema, we hypothesize that peripheral CD8+ T lymphocytes of emphysematous smokers who show evidence of systemic inflammation will have higher expression of cytotoxic molecules.
Journal of Sleep Research, Volume 16, Number 3, September 2007 , pp. 319-326(8)
The aim of the study was to identify craniofacial and pharyngeal anatomical factors directly related to obstructive sleep apnoea (OSA). The design and setting was a hospital-based, case-controlled study.
Clinical & Experimental Allergy, Volume 37, Number 9, September 2007 , pp. 1334-1339(6)
Bronchial asthma is a chronic inflammatory disorder of the airways. Recently, it has been suggested that complement plays significant roles in asthma. Mannose-binding lectin (MBL) is one of the key molecules in complement activation pathways that are associated with several infectious and immune disorders.
PEDIATRICS Vol. 120 No. 3 September 2007, pp. e471-e477
Parents and children often overreport adherence to treatment regimens, which in turn complicates interpretation and application of clinical trial findings. The objective of this investigation was to test the effect of reporting mode on accuracy of inhaled corticosteroid-adherence reporting in children with asthma and their parents under conditions similar to those of an asthma clinical trial.
The effect of total particulate matter (TPM) from cigarette smoke on the expression and binding properties of nicotinic acetylcholine receptors (nAChRs) was investigated using a human neuroblastoma cell line (SH-SY5Y).
Little is known of the current smoking cessation activities of practice nurses and their attitudes toward giving smoking cessation advice. This study aimed to (a) compare practice nurses' reports of giving smoking cessation advice as part of cervical screening with their reports of giving such advice in cardiovascular disease screening and diabetes care, (b) compare their beliefs about providing such advice in these three contexts, and (c) determine the strongest predictors of their reports of giving smoking cessation advice. A survey was completed by 152 practice nurses in the United Kingdom.
A smoker's risk of disease and death from cigarettes is related directly to the duration of smoking. The present study compared duration of smoking between a state-level population of Anglo versus highly acculturated Latino ever-smokers (N = 6,100). Kapla-Meier analysis was used to obtain weighted median smoking duration.
Journal of Thoracic Imaging. 22(3):271-273, August 2007
Babesiosis is a tick-borne illness caused by the protozoan Babesia microti. Most patients are asymptomatic but the infection may produce a spectrum of symptoms in immunocomprimised patients, especially asplenic patients. These range from mild fever, sweats, fatigue, and myalgias to severe multiorgan failure, including acute respiratory distress syndrome and death. Radiographic appearances include bilateral patchy air space and interstitial opacities.
Eosinophils are oxidant-sensitive cells considered relevant in allergic inflammation. The present study aimed to examine the effects of the antioxidant N-acetyl-L-cysteine (NAC) on constitutive and cytokine-delayed apoptosis in human isolated eosinophils.
Journal of Thoracic Imaging. 22(3):259-262, August 2007
Broncholithiasis is the presence of intrabronchial calcification or ossification. We report a case of broncholiths resulting from extrusion of calcified mediastinal lymph node into a bronchus associated with esophagobronchial fistula that became more symptomatic after bronchoscopic removal of the broncholiths.
Journal of Telemedicine and Telecare, Volume 13, Number 6, September 2007 , pp. 310-317(8)
We performed a process evaluation of a nurse-led telemonitoring programme for patients with asthma. The indicators used to evaluate the programme were feasibility, consistency of peak expiratory flow (PEF) tests, compliance and patient satisfaction. Patients in the intervention group received a home monitor in which spirometry results and symptoms could be recorded.
Antimicrobial Agents and Chemotherapy, September 2007, p. 3346-3353, Vol. 51, No. 9
Respiratory syncytial virus (RSV) is the most common cause of lower respiratory tract infections worldwide, yet no effective vaccine or antiviral treatment is available. Here we report the discovery and initial development of RSV604, a novel benzodiazepine with submicromolar anti-RSV activity.
A 'Positioner' preventing sleeping on the back can effectively reduce obstructive sleep apnea (OSA), but not always snoring for patients with long-term OSA. By preference, the device should be used for younger snorers without OSA as a training tool to avoid sleeping on the back. Instructions and support by a nurse are necessary for compliance.
The aim of the study was to define the details of the history and clarify the cause for respiratory distress, justify the need for surgical correction and suggest a rational operative technique for patients with lung aplasia.
nical & Experimental Allergy, Volume 37, Number 9, September 2007 , pp. 1320-1325(6)
Asthma is a common disabling condition, with known environmental and familial risk factors and with their assumed interactions. We wanted to carry out a family study on asthma to address gene-environment interactions at a population level.
Clinical & Experimental Allergy, Volume 37, Number 9, September 2007 , pp. 1303-1311(9)
Exhaled nitric oxide and inflammatory biomarkers in exhaled breath condensate may be useful to diagnose and monitor childhood asthma. Their ability to indicate an asthma diagnosis, and to assess asthma severity and control, is largely unknown.
We previously proposed that novel expression and/or conformation of autoantigens in the target tissue may play a role in generating phenotype-specific immune responses. The strong association of autoantibodies to histidyl-transfer RNA synthetase (HisRS, Jo-1) with interstitial lung disease in patients with myositis led us to study HisRS expression and conformation in the lung.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 2 April 2007 , pages 91 - 105
Small airway obstruction and emphysematous destruction account for the airflow limitation that defines chronic obstructive pulmonary disease (COPD). While laser capture microdissection (LCM) allows gene expression studies in small airways separately from the surrounding parenchyma, tissue size limits the number of genes examined.
Clinical & Experimental Allergy, Volume 37, Number 7, July 2007 , pp. 1033-1039(7)
Cockroach allergy is an important cause of inner city asthma. To perform valid studies on the diagnosis and treatment of cockroach allergy, biological potencies of test extracts need to be established, and a surrogate in vitro test for biological potency should be chosen.
Chronic obstructive pulmonary disease (COPD) poses a high risk for postoperative pulmonary complications after lung cancer surgery. We sought to determine the impact of this disease on long-term survival after surgical resection and to identify prognostic factors in pathological stage IA lung cancer.
Journal of Nuclear Medicine Vol. 48 No. 9 1411-1415
Use of a very low probability interpretation of ventilation/perfusion (V/Q) lung scans, if verified by prospective evaluation to have a low positive predictive value (PPV), will reduce the number of nondiagnostic interpretations of V/Q scans and may be particularly useful in patients with a relative contraindication to CT.
The Proceedings of the American Thoracic Society 4:449-452 (2007)
The cause of idiopathic pulmonary fibrosis (IPF) remains unknown. Although the observed biologic and biochemical processes associated with the disease are consistent with a fibrotic process, they are not necessarily unique to IPF. Furthermore, the importance of these observations will not be apparent until a directed therapy alters the natural history of the disease. There are essentially no studies that explain the unique histologic features of this disease. As mechanistic data accumulates, it is our opinion that these data should pass the test of explaining the clinical histologic features of the disease before it can be assumed that these features are unique for IPF.
American Journal of Medicine Volume 120, Issue 8, Pages S4-S13 (August 2007)
Bronchodilators are the mainstay of chronic obstructive pulmonary disease (COPD) therapy. Inhaled short-acting B2-agonists generally have a more rapid onset of effect and shorter duration of action than short-acting anticholinergic agents, and are usually prescribed as "rescue" medication to relieve acute bronchospasm. For patients with persistent symptoms, maintenance therapy with inhaled long-acting B2-agonists is preferable to short-acting B2-agonists because long-acting B2-agonists provide more predictable, longer-lasting improvements in lung function.
Health care utilization for respiratory symptoms is very common in infancy. Little is known about the determinants of visiting a physician for such complaints in infants. We investigated which factors determine the likelihood of visiting a physician for respiratory symptoms in the first year of life of their offspring.
Clinical & Experimental Allergy, Volume 37, Number 7, July 2007 , pp. 1049-1054(6)
Several observational studies have demonstrated an association between obesity and asthma. Studies evaluating exhaled nitric oxide levels and obesity have revealed that a higher body mass index (BMI) is associated with elevated exhaled nitric oxide levels. Airway inflammation using sputum cell counts has not been assessed in obese patients with airway diseases.
In 2006, Critical Care provided important and clinically relevant research data in the field of multiple organ failure, sepsis, and shock. This review summarizes the results of the experimental studies and clinical trials and discusses them in the context of the relevant scientific and clinical background.
The aim of the present study was to evaluate the association between smoking, chronic conditions, and short-term disability in a representative community sample. The analysis was based on data from 115,548 respondents from the Canadian Community and Health Survey (CCHS-2.1), a nationally representative survey. Smoking status, chronic conditions, and short-term disability were assessed by self-report.
Scandinavian Journal of Infectious Diseases 30 July 2007
Simkania negevensis, a recently found Chlamydia-like organism, has been associated with bronchiolitis and pneumonia in children. S. negevensis findings have been common also in healthy, non-symptomatic subjects.
We describe the use of noninvasive bilevel positive airway pressure (BiPAP) in a critically ill, hypoxemic and morbidly obese patient for preoxygenation prior to rapid sequence induction of anesthesia.
Allergic occupational asthma is frequent in farming populations. As educational interventions can improve disease management, the short-term effect of an educational intervention in asthmatic farmers was evaluated on the basis of spirometric indices and exhaled nitric oxide fraction (FeNO).
Current Opinion in Critical Care. 13(5):586-591, October 2007
Treatment protocols targeting the rapid administration of appropriate antibiotics and hemodynamic support are now recognized as a key measure in the initial care of patients presenting with severe sepsis and septic shock. Strong evidence exists showing that time parameters, particularly in the emergency department, are as important as the nature of the treatment administered.
Am J Physiol Lung Cell Mol Physiol 293: L686-L692, 2007
MUC1 is a membrane-tethered mucin-like glycoprotein expressed on the surface of various mucosal epithelial cells as well as hematopoietic cells. Recently, we showed that MUC1 suppresses flagellin-induced Toll-like receptor (TLR) 5 signaling both in vivo and in vitro through cross talk with TLR5.
Am J Physiol Lung Cell Mol Physiol 293: L660-L667, 2007
Fluticasone furoate (FF) is a novel enhanced-affinity glucocorticoid that has been developed as topical therapy for allergic rhinitis. The pharmacological properties of FF have been investigated using a number of in vitro experimental systems.
Am J Physiol Lung Cell Mol Physiol 293: L762-L768, 2007. First published June 22, 2007
Neutrophil elastase (NE), a serine protease present in high concentrations in the airways of cystic fibrosis patients, injures the airway epithelium. We examined the epithelial response to NE-mediated proteolytic injury. We have previously reported that NE treatment of airway epithelial cells causes a marked decrease in epithelial DNA synthesis and proliferation.
Am J Physiol Lung Cell Mol Physiol 293: L720-L729, 2007
Several mutations within the BRICHOS domain of surfactant protein C (SP-C) have been linked to interstitial lung disease. Recent studies have suggested that these mutations cause misfolding of the proprotein (proSP-C), which initiates the unfolded protein response to resolve improper folding or promote protein degradation.
Am J Physiol Lung Cell Mol Physiol 293: L520-L524, 2007
In this synopsis of a symposium at EB2007, we start with an overview of noise and impedance analyses that have been applied to various epithelial barriers. Noise analysis yields specific information about ion channels and their regulation in epithelial and endothelial barriers. Impedance analysis can yield information about apical and basolateral membrane conductances and paracellular conductance of both epithelial and endothelial barriers.
Am J Physiol Lung Cell Mol Physiol 293: L517-L519, 2007
In recent years, pulmonary research has focused increasingly on the understanding of proinflammatory endothelial and epithelial signaling pathways underlying lung injury that is well known to be associated with high morbidity and mortality. Although traditionally considered separately, current research shows considerable convergence in epithelial and endothelial signaling mechanisms.
We sought to examine whether type 2 diabetes increases risk of death and complications following pneumonia and to assess the prognostic value of admission hyperglycemia.
Am J Physiol Lung Cell Mol Physiol 293: L651-L659, 2007
We have previously shown that cardiogenic pulmonary edema fluid (EF) increases Na+ and fluid transport by fetal distal lung epithelia (FDLE). We now report the effect of EF on Na+ and fluid transport by the adult lung.br />
The aetiology of sarcoidosis is currently unknown. Due to the clinical and histological similarities between sarcoidosis and tuberculosis, the role of mycobacteria has been repeatedly investigated as an aetiological agent for sarcoidosis. The current meta-analysis aimed to evaluate the available molecular evidence on the possible role of mycobacteria in the development of sarcoidosis.
Management plans for childhood asthma show limited success in optimising asthma control. The aim of the present study was to assess whether a treatment strategy guided by airway hyperresponsiveness (AHR) increased the number of symptom-free days and improved lung function in asthmatic children, compared with a symptom-driven reference strategy.
The present study compared ß-lactam macrolide ("combination") therapy versus ß-lactam alone
("monotherapy") for hospitalised community-acquired pneumonia, using propensity scores to adjust for the differences between patients.
Severe asthma exacerbations are periods of intense airway inflammation that have been hypothesised to contribute to structural changes in the airways. If so, accelerated lung function decline over time should be more prevalent in adult patients with asthma who have frequent exacerbations than those without, but to date this has not been demonstrated.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 3 September 2007 , pages 289 - 291
Evaluation of the environment of patients is an important function of the primary care physician and assists the caregiver in providing an improved quality of life for one's patients. In addition to data collection and therapy, assessment of both the basic and instrumental activities of daily living is a primary concern, especially in patients with chronic diseases such as chronic obstructive pulmonary disease.
In the present review of airway remodelling and its response to therapies, clinical observations about airway physiological abnormalities, assumed to be caused by remodelling processes, are related to what is known about the components of structural changes from airway sampling and histopathological analysis.
Used appropriately, biomarkers improve the assessment of respiratory tract infections and sepsis. Most prominently, circulating procalcitonin levels increase by a factor of several tens of thousands during sepsis. Using a sensitive assay, procalcitonin safely and markedly reduces antibiotic usage in respiratory tract infections and nonbacterial meningitis.
Chronic obstructive pulmonary disease (COPD) patients experiencing frequent exacerbations demonstrate increased stable-state airway inflammation. Tiotropium has been shown to reduce exacerbation frequency, but its effect on airway inflammation is unknown. The aim of the present study was to investigate the effect of tiotropium on sputum inflammatory markers and exacerbation frequency.
The Journal of Sexual Medicine, Volume 4, Number 5, September 2007 , pp. 1241-1246(6)
With the recent increased recognition and treatment of hypogonadism in men, a caution has been given that testosterone replacement therapy (TRT) may cause or aggravate obstructive sleep apnea syndrome (OSA).
Journal of Thoracic Oncology. 2(8):773-776, August 2007
In esophageal cancer, the liver, lung, and bones are the most common sites of visceral metastases. Isolated chest wall metastases are quite extraordinary and occur very rarely.
The pathogenesis of acute lung injury includes transendothelial diapedesis of leukocytes into lung tissues and disruption of endothelial/epithelial barriers leading to protein-rich oedema. In vitro studies show that the microtubule network plays a role in the regulation of endothelial permeability as well as in neutrophil locomotion. It was hypothesised that the microtubule-stabilising agent, taxol, might attenuate inflammation and vascular leak associated with acute lung injury in vivo.
Moraxella catarrhalis is a major cause of infectious exacerbations of chronic obstructive lung disease. Cyclooxygenase (COX)-derived prostaglandins, such as prostaglandin E2 (PGE2), are considered to be important regulators of lung function. The present authors tested the hypothesis that M. catarrhalis induces COX-2-dependent PGE2 production in pulmonary epithelial cells.
Clinical Nuclear Medicine. 32(9):707-710, September 2007
A 59-year-old woman with a history of fibrosing mediastinitis secondary to histoplasmosis diagnosed on mediastinoscopy presented with dyspnea. A ventilation-perfusion scan demonstrated decreased perfusion to the entire right lung. In addition, the perfusion images demonstrated focal abnormal activity in part of the liver. On computed tomography of the chest, there was significant soft tissue opacification in the mediastinum occluding the right pulmonary artery, with passage of the injected contrast via collateral vessels to the liver. The main collateral pathway was via the right internal thoracic vein and the umbilical vein. Pulmonary angiography confirmed complete occlusion of the right pulmonary artery.
Clinical Nuclear Medicine. 32(9):703-706, September 2007
Fibrosing mediastinitis is an uncommon benign disorder, and its pathogenesis and management remain unclear. Conventional imaging techniques (chest radiographs, CT, MRI) may suggest its diagnosis but are frequently nonspecific, and it frequently mimics a malignant process by presenting as a mediastinal mass without calcifications, encasing, and infiltrating adjacent mediastinal structures, and showing an overall aggressive behavior.
We report the case of a 55-year-old male patient who presented with non-specific pulmonary symptoms (cough,
haemoptysis, fever up to 39°C, night sweats and weight loss). After empirical antibiotic therapy prescribed by his primary care physician, the patient showed no improvement in symptoms. Laboratory findings were: elevated C-reactive protein and
C-ANCA, leukocytosis and thrombocytosis, and anaemia.
Journal of Pediatric Orthopaedics. 27(6):677-681, September 2007
Scoliosis has been associated with reduced pulmonary capacity; however, the source of the reduction in capacity (left, right, or both lungs) is not clear. The objective of this study was to investigate trends in left, right, and total lung volume and left/right lung volume asymmetry with spinal curve severity in scoliosis.
Am J Physiol Lung Cell Mol Physiol 293: L611-L618, 2007
There is abundant epidemiological data linking prenatal environmental tobacco smoke with childhood asthma and wheezing, but the underlying molecular and physiological mechanisms that occur in utero to explain this link remain unelucidated. Several studies suggest that nicotine, which traverses the placenta, is a causative agent. Therefore, we studied the effects of nicotine on lung branching morphogenesis using embryonic murine lung explants.
Annals of Emergency Medicine, Volume 50, Issue 3, Pages 221-230
We evaluate the effectiveness of an educational program in hospital emergency departments (EDs) targeting reduction in antibiotic overuse for acute respiratory tract infections.
Current Anaesthesia & Critical Care, Volume 18, Issue 2, Pages 61-68
Despite an increased understanding of the aetiology and pathogenesis of bronchial asthma, attempts to classify its severity have proved difficult. Objective changes in cardiopulmonary function do not consistently correlate with symptomatic decline during an acute exacerbation of asthma. Whilst the majority of such episodes are treatment-responsive, a number of asthmatics still succumb to the severest form of the disease every year, often despite aggressive medical therapy.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 3 September 2007 , pages 191 - 194
Interpreting changes in outcomes of clinical trials in chronic obstructive pulmonary disease should be viewed from a broader perspective than only the statistical significance of the findings. The minimal clinical difference in outcome measures provides a conceptual framework to assist in clinical trial interpretation and a methodology to assess the clinical relevance of study results.
Bronchial biopsy specimens from chronic obstructive pulmonary disease (COPD) patients demonstrate increased numbers of CD8+ T-lymphocytes, macrophages and, in some studies, neutrophils and eosinophils. Smoking cessation affects the rate of forced expiratory volume in one second (FEV1) decline in COPD, but the effect on inflammation is uncertain. Bronchial biopsy inflammatory cell counts were compared in current and ex-smokers with COPD.
The present investigation examined the relationships between anxiety sensitivity and motivation to quit smoking, barriers to smoking cessation, and reasons for quitting smoking among 329 adult daily smokers.
This study assessed the cost-effectiveness of two low-intensity programs for quitting smokeless tobacco, based on results of a randomized trial with 1,069 volunteer participants. Cost data were collected for two levels of intervention: manual only (a self-help manual) and assisted self-help (the manual plus a videotape and two supportive phone calls from tobacco cessation counselors).
The National Asthma Education and Prevention Program Expert Panel guidelines for the management of asthma recommend that patients who require daily asthma medications have allergy testing for perennial indoor allergens and that, when triggers are found, exposure to allergens and pollutants be controlled through avoidance and abatement.
The aim of the present study was to determine the relative value of incremental and constant load tests in detecting changes in inspiratory muscle endurance following high-intensity inspiratory muscle training (H-IMT) in chronic obstructive pulmonary disease.
Melatonin is a pineal hormone that regulates the human cycle of sleep and wakefulness. Plasma melatonin levels were investigated in patients with obstructive sleep apnoea syndrome (OSAS).
Annals of Emergency Medicine, Volume 50, Issue 3, Pages 236-245
Direct laryngoscopy with manual in-line stabilization is standard of care for acute trauma patients with suspected cervical spine injury. Ethical and methodologic constraints preclude controlled trials of manual in-line stabilization, and recent work questions its effectiveness.
Scandinavian Journal of Infectious Diseases 21 June 2007
Pneumonia caused by Streptococcus pneumoniae is a significant cause of morbidity and mortality during influenza virus epidemics. We had previously advanced the hypothesis that interactions of pneumococcus with the receptor for platelet activating factor (PAFR) in the lung were facilitated by antecedent influenza virus infection and play a major role in the pathogenesis of bacterial superinfections. Although influenza enhanced the adherence of pneumococci to respiratory epithelial cells in vitro, chemical or antibody-mediated blockade of the PAFR did not affect adherence.
Different particle types cause excessive lung inflammation that is thought to play a role in the various types of pathology they produce. Recently attention has been focused on nanoparticles due to their presence in environmental particulate air pollution, their use and exposure in occupational settings, and their potential use in nanotechnology and novel therapeutics. We have shown previously that the surface area metric drives the overload response. We have instilled a number of low-toxicity dusts of various particle sizes and assessed neutrophil influx into the lung at 18-24 h postinstillation.
Ricin is a toxin and seed protein produced by the castor oil plant, Ricinus communis. The toxin is a dimeric protein consisting of an enzymic A chain and a B chain with lectin properties aiding the uptake of the whole molecule into cells. Ricin has been considered a possible military threat for several decades and is now also of some concern as a terrorist agent. The inhalation route is of primary concern in these situations, although previous attacks with ricin have used other approaches. Medical countermeasures against ricin are urgently required and the strategy adopted has been first to understand the nature of the problem, in this case the inhalation toxicology of ricin, followed by the preparation of vaccine antigens.
Large population-based studies of alternative tobacco use in the lesbian, gay, and bisexual (LGB) population are needed to more fully measure tobacco use outcomes. This descriptive study used standard measures of alternative tobacco use from two separate, statewide household-based studies to compare basic prevalence rates in the LGB population and the general population in California.
Scandinavian Journal of Infectious Diseases 27 July 2007
The present study investigated the utility of rapid microbiological methods in the aetiological diagnosis of community acquired pneumonia (CAP) according to the severity of CAP. Between 1999 and 2004, 384 adult patients with CAP were studied prospectively. In addition to standard microbiological methods, PCR and antigen detection techniques were used to identify pathogens. A total of 230 microbial agents in 209 patients were identified, with 134 (58.2%) identified by antigen detection or PCR tests. Of these 134 microbial agents, 95 (70.9%) were identified only by these rapid methods.
Pathology International, Volume 57, Number 10, October 2007 , pp. 698-702(5)
An 80-year-old woman with a pleomorphic carcinoma (PC) producing hCG was admitted to Nippon Steel Hirohata Hospital because of an abnormal shadow on CT seen during a follow-up examination after surgery for breast cancer. A right upper lobectomy was performed due to rapid growth of the shadow 3-months later. Macroscopically the tumor was a 4.8 × 4.0-cm well-circumscribed grayish-white mass.
Clinical Nuclear Medicine. 32(9):753-754, September 2007
We present the case of a 63-year-old woman chronic smoker with a history of severe rheumatoid arthritis, who presented with dyspnea and cough. Her chest x-ray film and CT scan (as part of a PET/CT scan) showed multiple lung nodules and a left pleural effusion. A PET scan (as part of a PET/CT scan) revealed no uptake in the larger lung nodules and intense left pleural uptake. The findings favored rheumatoid lung disease with rheumatoid pleural involvement, but malignant involvement was not excluded. A CT-guided lung and pleural biopsy confirmed the diagnosis of rheumatoid lung disease. On the basis of these findings, the patient was put on immunomodulators and responded to treatment.
Am J Physiol Lung Cell Mol Physiol 293: L790-L799, 2007
Both angiotensin II (ANG II) and transforming growth factor-1 (TGF-B1) are thought to be involved in mediating pulmonary fibrosis. Interactions between the renin-angiotensin system (RAS) and TGF-B1 have been well documented, with most studies describing the effect of ANG II on TGF-B1 expression. However, recent gene expression profiling experiments demonstrated that the angiotensin II type 1 receptor (AT1R) gene was a novel TGF-B1 target in human adult lung fibroblasts.
Am J Physiol Lung Cell Mol Physiol 293: L800-L808, 2007
Lymphangioleiomyomatosis, a multisystem disease affecting women, is characterized by proliferation of abnormal smooth muscle-like cells in the lungs, leading to cystic destruction of the parenchyma and recurrent pneumothoraces. Clinical characteristics of lymphangioleiomyomatosis patients were analyzed to determine the relationship of pneumothoraces to disease progression.
Journal of Cardiovascular Electrophysiology, Volume 18, Number 9, September 2007 , pp. 1006-1014(9)
Obstructive sleep apnea (OSA) affects approximately 4% of middle-aged men and 2% of middle-aged women. Cardiac arrhythmias are common problems in patients with OSA, even though the true prevalence and clinical relevance of cardiac arrhythmias remains to be determined. The presence and complexity of both tachyarrhythmias and bradyarrhythmias may influence morbidity, mortality, and the quality of life for OSA patients.
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Pediatric Allergy and Immunology, Volume 18, Supplement 18, November 2007 , pp. 28-30(3)
Exhaled nitric oxide (FENO) is a surrogate marker of eosinophilic airway inflammation. The measurement of this gas can be easily performed in children and the result is immediately available. Because of these characteristics, measurement of FENO is slowly becoming part of the routine clinical evaluation of an asthmatic patient. FENO measurement may have a role both in the diagnosis of asthma and as a guide in therapy algorithms.
This study examined the association of sociodemographic characteristics and smoking behaviors (i.e., cigarette, cigar, and waterpipe) with nicotine product harm perception in college freshmen. Students were asked to compare the perceived harmfulness of 11 nicotine-delivering products with that of a regular cigarette. Data were from a cross-sectional Internet survey conducted during the spring 2004 semester at a private university (N = 411). Binomial logistic regression was used to determine the association between sociodemographic and behavioral factors with nicotine product harm perception.
Pediatric Allergy and Immunology, Volume 18, Supplement 18, November 2007 , pp. 25-27(3)
Difficult asthma is rare in childhood; when child's asthma is difficult to control, review of the diagnosis and evaluation of the different risk factors for exacerbations are recommended. The relationship between rhinosinusitis and bronchial asthma is provided by epidemiologic data. Doubts persist as to whether rhinosinusitis worsens asthma, or whether these are manifestations in different parts of the respiratory tract of the same underlying disease process.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 3 September 2007 , pages 251 - 255
Individuals who have active lifestyles appear to reap substantial benefits. It is therefore of interest to assess level of activity and to determine whether interventions are capable of altering activities of daily life. Questionnaires are often employed because of their simplicity, but objective measures are sought. Long-term assessment of energy expenditure, either through doubly labeled water analysis or through measurements of expired gases are expensive and often impractical. Activity monitors include pedometers, heart rate monitors, accelerometers and integrated multisensor systems.
This study investigated prospectively the change in the influence of parents' and older siblings' smoking at the start of the childhood and adolescent smoking acquisition period (i.e., 3rd grade, or age 8) on the initiation and escalation of smoking over the course of adolescence. In a sample of 5,520 individuals in 3rd grade, we measured parents' and older siblings' smoking. Individuals' smoking data were provided at four grade intervals over the course of adolescence.
COPD: Journal of Chronic Obstructive Pulmonary Disease, Volume 4, Issue 3 September 2007 , pages 217 - 223
Exercise testing is useful to assess the degree of disability, prognosis for survival, presence of exercise-induced hypoxemia, and response to treatment in individuals with chronic obstructive pulmonary disease. Simple walking tests have been developed and are increasingly used in assessment of chronic obstructive pulmonary disease patients for clinical and research purposes. This article reviews how these tests are performed and to what degree they are reliable, and how these tests are used in assessment of individuals with chronic obstructive pulmonary disease.
A 45-year-old woman with previous repair of coarctation of aorta, ventricular septal defect closure, and progressive decline in her exercise capacity was admitted for the treatment of left leg deep venous thrombosis (DVT). She had a history of complete heart block and insertion of a pectoral pacemaker.