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The main objectives of this study were to describe the epidemiology and microbiology of community-acquired bacteraemia (CAB) in patients with sepsis and to determine the associated crude mortality.
Coexistence of pulmonary embolism and systemic arterial embolism suggest the diagnosis of paradoxical embolism which suggests the presence of intracardiac defects such as patent foramen ovale (PFO).
Viral attachment to the host cell is critical for tissue and species specificity of virus infections. Recently, pattern of viral attachment (PVA) in human respiratory tract was determined for highly pathogenic avian influenza virus of subtype H5N1. However, PVA of human influenza viruses and other avian influenza viruses in either humans or experimental animals is unknown.
Rheumatology International, Volume 27, Number 10, August 2007 , pp. 919-925(7)
Pleural involvement is the most frequent manifestation of rheumatoid arthritis (RA) in the chest. We report here two patients who presented with large exudative pleural effusions and subsequently developed sero-positive RA. In both cases, the differential cell count of the pleural effusion suggested empyema.
Clinical and Experimental Pharmacology and Physiology, Volume 34, Number 10, October 2007 , pp. 1044-1050(7)
The general term `nanoparticle' (NP) is used to define any particle less than 100 nm in at least one dimension and NPs are generally classified as natural, anthropogenic or engineered in origin. Anthropogenic, also referred to as `ultrafine' particles (UFPs), are predominately combustion derived and are characterized by having an equivalent spherical diameter less than 100 nm.
Morbidity from asthma disproportionately affects black people. Whether this excess morbidity is fully explained by differences in asthma severity, access to care, or socioeconomic status (SES) is unknown.
The activities of the HS (sulfhydryl or thiolic) group in the cysteine of glutathione or various low-weight soluble molecules (thiolic drugs), such as N-acethylcysteine, mesna, thiopronine and dithiotreitol or stepronine and erdosteine (prodrugs), include its antioxidant activity in the airways during the release of reactive oxygen or nitrogen species (ROS, RNS) by polymorphonuclear neutrophils (PMNs) activated in response to exogenous or endogenous stimuli.
A T tube is an upper airway device well described in the literature which is used to maintain tracheal lumen patency. Although tube occlusion is a known complication, it can be minimized by certain precautions.
Acidic inhalers can be associated with increased adverse reactions. Objectives: This study aimed to determine the acute local tolerability of acidic aqueous placebo formulations delivered via Respimat® Soft Mist Inhaler
(SMI) and placebo chlorofluorocarbon metered dose inhaler (CFC-MDI).
Methods relying on nasal ciliary motility for the diagnosis of primary ciliary dyskinesia (PCD) are often hampered by secondary ciliary dyskinesia. A functional test for pulmonary mucociliary clearance, which is not influenced by secondary nasal ciliary defects, would be a valuable tool in a PCD workup.
Auto-adjustable continuous positive airway pressure devices are widely used in titration procedures to determine therapeutic pressure levels in obstructive sleep apnea patients. However, differences in operational characteristics may influence the effect on the apnea-hypopnea index (AHI).
Sleep and Breathing Volume 11, Number 3 / September, 2007 165-170
Termination of hypoxia results in a transient ventilatory decline referred to as post-hypoxic ventilatory decline (PHVD). We wished to determine whether PHVD is due to changes in ventilatory motor output or upper airway mechanics.
Respirology Volume 12 Issue 5 Page 683-691, September 2007
Most asthmatics with mucus hypersecretion have difficulty in clearing their secretions so that mucus plugs and airway obstruction are commonly present. Inhaled mannitol facilitates clearance of mucus. This study investigated the changes in the physical properties of sputum in response to mannitol in asthmatics with chronic cough and sputum production.
Respirology Volume 12 Issue 5 Page 719-723, September 2007
Previous studies have shown little or no improvement in pulmonary function and arterial blood oxygenation after therapeutic thoracocentesis. This study investigated changes in pulmonary function, arterial blood gases and dyspnoea after therapeutic thoracocentesis in patients with paradoxical movement (PM) of a hemidiaphragm due to pleural effusion.
Volume 12 Issue 5 Page 759-762, September 2007doi:10.1111/j.1440-1843.2007.01117.x
The ATS/ERS Task Force on Lung Function Testing recently proposed guidelines for the interpretation of pulmonary function tests and suggested that a reduction in FEV1 be used for categorizing both obstructive and restrictive abnormalities. This changes the severity stratification algorithm of restrictive patterns diagnosed by spirometry, that are currently categorized based on reduction in VC. This study examined the level of agreement between these two categorization schemes.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 706-712, (2007)
Obstructive sleep apnea (OSA) is associated with adverse cardiovascular outcomes, including myocardial infarction and stroke. Atherosclerosis is a key mechanism for these cardiovascular events. Recent cross-sectional studies showed the presence of early signs of atherosclerosis in patients with OSA who were free of comorbidities.
To differentiate among atypical adenomatous hyperplasia (AAH), bronchioloalveolar carcinoma (BAC), and adenocarcinoma showing ground-glass opacity (GGO) on CT scans, we conducted a study to determine the optimal parameter on CT number analysis using three-dimensional (3D) computerized quantification.
The Proceedings of the American Thoracic Society 4:507-511 (2007)
The change in FEV1 has been the traditional metric used to define the progression of chronic obstructive pulmonary disease in affected patients. Consequently, various treatments have "targeted" the accelerated decline in FEV1 in an attempt to modify or alter the disease process.
Airway hyper-responsiveness (AHR) is a key feature of asthma and a causal relationship between airway inflammation and AHR has been identified. The aim of the current study was to clarify the effect of proinflammatory cytokines and asthma medication on primary human airway smooth muscle (ASM) inositol phosphate (IPx) signalling and define the regulatory loci involved.
Respirology Volume 12 Issue 5 Page 749-753, September 2007
Current international consensus guidelines identify a number of indicators for the establishment of home mechanical ventilation (HMV) for patients with neuromuscular diseases but do not address the possible clinical differences between each of the underlying disorders. This study assessed the differences in the physiological parameters of patients with neuromuscular disease commenced on HMV for the treatment of symptomatic chronic hypercapnic respiratory failure.
Recent studies have provided evidence that the human circadian timing system has an influence on respiration and respiratory control. Both sleep and circadian mechanisms combine to mediate the rise in lower airway resistance in nocturnal asthma. In rats, circadian rhythms in minute ventilation are present in both wakefulness and sleep, implying that circadian and sleep mechanisms also combine to influence the control of breathing.
Surgery Today Volume 37, Number 9 / September, 2007 740-744
Acute pulmonary embolism (APE) is a serious cardiovascular disease associated with high mortality rates. We analyzed the clinical characteristics, treatment, and outcome of patients with APE in a general hospital in Japan.
Sleep apnoea is common in patients with end-stage renal disease (ESRD) and is improved by nocturnal haemodialysis (NHD). Recent findings from our laboratory indicate the development of ESRD is associated with pharyngeal narrowing. We hypothesized that NHD increases pharyngeal cross-sectional area and that this is associated with an improvement in sleep apnoea.
Pediatric Radiology Volume 37, Number 9 / September, 2007 879-884
Spontaneous pneumothorax (SPTX) is a relatively common condition. In patients with SPTX, CT has been advocated to identify blebs and bullae (BB) to help in management planning.
Lung Volume 185, Number 5 / September, 2007 263-270
Particulate matter less than PM10 and aromatic chemicals formed during incomplete combustion of organic matter are major environmental pollutants because of their toxic potential.
The Annals of Pharmacotherapy: Vol. 41, No. 10, pp. 1625-1631
Asthma is a major health problem and the most frequent cause of chronic illness and emergency department (ED) visits in children. Limited data examining the ED management of pediatric asthma within university teaching hospitals across the US exist.
Chronic alveolar hypoxia induces pulmonary hypertension, evident from elevated pulmonary artery pressure (PAP), pulmonary vascular resistance, right ventricular hypertrophy (RVH), and increased muscularization of the pulmonary vasculature. Additionally, the vasoconstrictor response to acute hypoxia (HPV) may be reduced in the remodeled vasculature.
A 74-year-old man with idiopathic pulmonary fibrosis (IPF) developed severe dyspnea on exertion after the readministration of imatinib mesylate for chronic myeloid leukemia.
Pediatric Dermatology, Volume 24, Number 4, July/August 2007 , pp. E22-E25(1)
Pulmonary manifestations are well recognized during the acute phase of Stevens-Johnson syndrome but persistent pulmonary sequela is rarely reported. We report two boys with bronchiolitis obliterans following the acute phase of Stevens-Johnson syndrome and discuss the clinical picture and treatment of persistent pulmonary complications with reference to earlier reports.
inical and Experimental Pharmacology and Physiology, Volume 34, Number 10, October 2007 , pp. 1029-1036(8)
Asthma and chronic obstructive pulmonary disease (COPD) are chronic airway diseases characterized by airflow obstruction. The B2-adrenoceptor mediates bronchodilatation in response to exogenous and endogenous B-adrenoceptor agonists.
Superior vena cava obstruction (SVCO) is commonly caused by neoplastic venous compression and presents with typical symptoms and signs. Its clinical severity presumably depends on the degree of obstruction and the adequacy of venous collateral formation.
In patients who are weaned with a tracheostomy tube (TT), continuous positive airway pressure (CPAP) is frequently used. Dedicated CPAP systems or ventilators with bulky tubing are usually applied. However, CPAP can also be effective without a ventilator by the disposable Boussignac CPAP (BCPAP) system that is normally used with face masks.
Sleep and Breathing Volume 11, Number 3 / September, 2007 129-138
Impaired simulated driving performance has been demonstrated in obstructive sleep apnoea-hypopnoea syndrome (OSAHS) patients. Although continuous positive airway pressure (CPAP) generally improves simulated driving performance, the effects of oral-appliance (OA) therapy are unknown.
Sleep and Breathing Volume 11, Number 3 / September, 2007 159-164
Ramelteon is a selective MT1/MT2-receptor agonist indicated for insomnia treatment. Because it has no depressant effects on the nervous system, it is not expected to affect the control of breathing. The potential effects of ramelteon on apneic and hypopneic events and arterial oxygen saturation (SaO2) in individuals with obstructive sleep apnea were assessed.
We reviewed the literature concerning pathogenesis, clinical features, diagnosis and treatment of interstitial lung disease (ILD) in patients with systemic sclerosis (SSc). ILD is detectable in approximately 70% of patients at autopsy. Nonspecific interstitial pneumonia (NSIP) is the most common pathologic finding.
Combined pulmonary fibrosis and emphysema (CPFE) is a unique disorder described in several case series of upper lobe emphysema associated with lower lobe fibrosis. Patients with this entity have relatively preserved lung volumes and spirometry but marked reductions in diffusing capacity on pulmonary function testing.
The Proceedings of the American Thoracic Society 4:549-553 (2007)
The optimal care of patients with chronic obstructive pulmonary disease generally requires combining pharmacologic and nonpharmacologic therapies. The latter include smoking cessation, the encouragement of physical activity and exercise, influenza and pneumonia vaccinations, education on adherence to medical therapy, collaborative self-management strategies, such as a plan to manage exacerbations, and advance directives.
The Proceedings of the American Thoracic Society 4:522-525 (2007)
Chronic obstructive pulmonary disease (COPD) is associated with pulmonary and systemic inflammation. The latter is likely to contribute significantly to the pathobiology of numerous extrapulmonary effects of the disease-the so-called systemic effects of COPD.
Sleep apnoea frequently affects patients with end-stage renal disease. However, it is still unclear whether or to what extent sleep disorders may affect functional capacity and quality of life in haemodialysis patients. We tested the hypothesis that apneic dialysis patients due to the lack of restorative sleep will have a further reduced functional capacity and further compromised quality of life compared to their non-apneic counterparts.
Researchers have found that patients with obstructive sleep apnea have higher levels of apoptotic cells from the endothelium of their blood vessels circulating in their bloodstream than people who do not have obstructive sleep apnea, which may explain why those with apnea are at higher risk for cardiovascular disease. The findings appear in the June 1 issue of the American Journal of Respiratory and Critical Care Medicine.
The aim of this study was to estimate the rate and describe the characteristics of complementary and alternative medicine (CAM) use by children with asthma in a paediatric primary care clinic in southern Israel.
Asthma is among the most common chronic diseases in childhood and steadily increasing in prevalence. Identification of risk predictors for a hospitalization for atopic asthma in childhood may help design prevention programmes and improve our understanding of disease pathobiology.
Acta Paediatrica Volume 96 Issue 10 Page 1470-1473, October 2007
The present study was performed to explore the validity of discharge diagnoses on asthma in the Danish National Patient Registry compared with medical records.
Acta Paediatrica Volume 96 Issue 10 Page 1542-1545, October 2007
Congenital anomalies causing airway obstruction in the newborn are potentially fatal. However if an effective airway can be maintained the long-term prognosis is often excellent. We present four cases of airway obstruction, three of which were diagnosed antenatally.
Cochrane Database of Systematic Reviews 2007 Issue 3
Bronchiectasis is a major cause of respiratory morbidity especially in developing countries. In affluent countries, bronchiectasis is increasingly recognised in certain subsections of communities (e.g. Aboriginal communities) as well as a coexistent disease/comorbidity and disease modifier in respiratory diseases such as COPD (reported rates of 29-50% in adults).
Pediatric Critical Care Medicine. 8(5):465-469, September 2007
To determine whether inhaled steroid administration after cardiopulmonary bypass will attenuate pulmonary inflammation and improve lung compliance and oxygenation.
The Proceedings of the American Thoracic Society 4:512-521 (2007)
Chronic obstructive pulmonary disease (COPD) progression is characterized by accumulation of inflammatory mucous exudates in the lumens of small airways, and thickening of their walls, which become infiltrated by innate and adaptive inflammatory immune cells.
Current immunosuppression protocols to prevent lung transplant rejection reduce pro-inflammatory and T-helper type 1 (Th1) cytokines. However, Th1 T-cell pro-inflammatory cytokine production is important in host defense against bacterial infection in the lungs.
Annals of the Rheumatic Diseases 2007;66:1369-1373
This study investigated the clinical impression that there was an increased prevalence of respiratory disorders in both the Hypermobility Syndrome (HMS)/Benign Joint Hypermobility Syndrome (BJHS) and Ehlers-Danlos Syndrome (EDS), compared with the normal population.
The American Journal of Emergency Medicine, Volume 25, Issue 7, Pages 770-773
Pulmonary embolism (PE) is a common condition, but the diagnostic strategy for the evaluation of suspected PE is somewhat controversial. Despite the use of various biochemical markers (such as D-dimer and C-reactive protein) and various probability calculation algorithms based on clinical findings for that purpose, there is still a need for more specific and practical markers in PE diagnosis. The aim of this study was to investigate the diagnostic value of ischemia-modified albumin (IMA) levels in the diagnosis of PE.
Respirology Volume 12 Issue 5 Page 754-758, September 2007
The Pneumonia Severity Index (PSI) was developed to predict mortality in community-acquired pneumonia (CAP). It has been prospectively validated to identify patients who are at low risk of death and thereby aid in the selection of patients for outpatient management. This study assessed the compliance of medical staff at a university teaching hospital with the use of the PSI and the PSI-based local antibiotic guidelines in admitted patients.
Archives of Orthopaedic and Trauma Surgery Volume 127, Number 7 / September, 2007 553-555
Diffuse idiopathic skeletal hyperostosis (DISH) is a common disorder among the elderly. The diagnosis is made on radiological findings and most of the cases are asymptomatic. In the cases with spinal involvement, bridging ossification of the anterior longitudinal ligament is a common finding.
Brief exposure to cigarette smoke is not generally associated with pulmonary injury and may adversely affect the lung only if underlying disease is present. To test this hypothesis, our laboratory performed a series of experiments involving exposure of hamsters to second-hand cigarette smoke (2 h/day for 5 days), either immediately before or after induction of acute pulmonary injury by intratracheal administration of amiodarone.
Doctors are exhorted to always place the stethoscope directly on the skin and never to auscultate through clothing. Nevertheless, casual observation reveals that doctors and even pulmonologists often violate this principle.
We determined the relative efficacy of subcutaneous (SC) treprostinil in stable World Health Organization class II and III patients transitioned from IV epoprostenol.
Mismatching of ventilation to perfusion is found in patients with COPD, left ventricular failure (LVF), and pulmonary vascular diseases. Such mismatching may be due to ventilation or perfusion defects or both.
Pulmonary hypertension is a severe pulmonary vascular disease leading to rapid deterioration and death. Histological and clinical evidence suggests that smooth muscle proliferation is part of the pathogenesis of the disease.
IV epoprostenol is a highly effective therapy for pulmonary arterial hypertension (PAH). However, monitoring the efficacy and adjusting the dose of epoprostenol often requires serial invasive hemodynamic measurements.
Clinical Pulmonary Medicine. 14(5):302-305, September 2007
Atelectasis occurs frequently in the medical and surgical patient. Complications of prolonged atelectasis include worsening hypoxemia, respiratory failure, and pneumonia. Flexible bronchoscopy along with chest physiotherapy has been advocated for the prompt resolution of atelectasis. However, it is unclear whether one treatment is superior. We reviewed the existing literature to determine whether flexible fiberoptic bronchoscopy is superior to chest physiotherapy for the initial treatment of atelectasis.
Better knowledge of the evolution of persistent pulmonary hypertension after acute pulmonary embolism (PE) is required to optimize the indication and timing of pulmonary endarterectomy (PEA).
Pulmonary Langerhans cell histiocytosis (PLCH) is an uncommon interstitial lung disease which can lead to serious respiratory failure. The correlation between high-resolution computed tomography (HRCT) findings and lung function have not been studied in depth.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 636-643, (2007)
The natural history of idiopathic pulmonary fibrosis (IPF) has been characterized as a steady, predictable decline in lung function over time. Recent evidence suggests that some patients may experience a more precipitous course, with periods of relative stability followed by acute deteriorations in respiratory status. Many of these acute deteriorations are of unknown etiology and have been termed acute exacerbations of IPF.
Although organizing pneumonia (OP) is a common pathological finding, studies including a substantial number of patients with idiopathic forms from a unique center and a long follow-up are rare.
The Proceedings of the American Thoracic Society 4:526-534 (2007)
Chronic obstructive pulmonary disease (COPD) is a treatable disease characterized by progressive airflow limitation. Prevention of disease progression, improvement of symptoms, exercise tolerance, health status, and decrease in exacerbations and in mortality are the main goals of the management of COPD. Bronchodilators play a pivotal role in the treatment of symptomatic patients with COPD.
Sleep and Breathing Volume 11, Number 3 / September, 2007 171-176
Nasal continuous positive airway pressure (CPAP) is the treatment of choice in severe obstructive sleep-disordered breathing (SDB). Partial obstruction is usually considered as mild SDB with poor CPAP adherence. In a retrospective study, we investigated the occurrence of partial obstruction in 233 age and BMI-matched male-female pairs and its impact on CPAP adherence after one year using static-charge-sensitive bed.
Few studies have compared treatment strategies in patients with asthma poorly controlled on low dose inhaled corticosteroids, and little is known about the effects of different treatments on airway inflammation. In this double-blind, placebo-controlled, parallel group study, we compared the effects of salmeterol plus fluticasone propionate (FP) (SeretideTM; SFC) and FP plus montelukast (FP/M) on sputum inflammatory markers, airway responsiveness, lung function, and symptoms in adult asthmatics.
Necrotizing sarcoid granulomatosis (NSG) is a rare entity mainly characterized by a prominent granulomatous vasculitis affecting middle-aged or old individuals and with a favorable prognosis.
Sleep and Breathing Volume 11, Number 3 / September, 2007 149-157
This study was performed to determine whether there is a protective association between participation in vigorous or vigorous/moderately vigorous physical activity and the prevalence of sleep-disordered breathing (SDB). Polysomnographic and questionnaire data from the baseline examination of 4,275 participants in the Sleep Heart Health Study (SHHS) were analyzed in relation to information on amount of physical activity and other potentially relevant factors collected from five SHHS parent cohorts (Atherosclerosis Risk in Communities Study, Cardiovascular Health Study, Framingham Heart Study, Strong Heart Study, and Tucson Epidemiologic Study of Airways Obstructive Diseases).
Critical Care Medicine. 35(10):2243-2250, October 2007
Patients with trauma-associated acute lung injury have better outcomes than patients with other clinical risks for lung injury, but the mechanisms behind these improved outcomes are unclear. We sought to compare the clinical and biological features of patients with trauma-associated lung injury with those of patients with other risks for lung injury and to determine whether the improved outcomes of trauma patients reflect their baseline health status or less severe lung injury, or both.
An 11-year-old girl was referred to our institution with complete obstruction of the left main stem bronchus by an endoluminal mass and was successfully treated by a combination of laser and mechanical debulking.
This is the first report of the efficacy of anti-TNF treatment in a patient with lung fibrosis and pulmonary hypertension associated with advanced systemic sclerosis, refractory to conventional therapies.
Critical Care Medicine. 35(10):2402-2407, October 2007
Noninvasive ventilation has assumed an important role in the management of respiratory failure in critical care units, but it must be used selectively depending on the patient's diagnosis and clinical characteristics.
Respirology Volume 12 Issue 5 Page 670-674, September 2007
The functional properties of endothelial cells in pulmonary microvessels are affected by elevations in the level of vascular endothelial growth factor (VEGF) in inflamed airways. An increase in the level of circulating thrombomodulin (TM), a molecular marker of endothelial cells, with exercise is associated with the VEGF level in asthmatic airways. This study investigated whether the airway VEGF level reflects changes in circulating TM levels with exercise in patients with COPD.
Nonobese diabetics with diabetic autonomic neuropathy (DAN) show an elevated prevalence of obstructive sleep apnea-hypopnea (OSAH). Objective: It was the aim of this study to assess if the presence of DAN could further increase the risk of developing OSAH in obese diabetics.
Noninvasive ventilation (NIV) is being increasingly used in hypercapnic chronic obstructive pulmonary disease (COPD) patients but the most appropriate ventilation mode is still not known.
Weight loss has been shown effective in the treatment of the obstructive sleep apnea-hypopnea syndrome. Regrettably, many obese patients are unable to achieve sustained and useful weight loss by dietary means.
Noninvasive mechanical ventilation (NIV) is known to reduce hypoventilation and improves respiratory and peripheral muscle endurance in patients with chronic respiratory failure (CRF) due to thoracic restriction.
Obesity hypoventilation syndrome (OHS) can be treated with noninvasive positive pressure ventilation (NIPPV). Once clinical stability is achieved, continuous positive airway pressure (CPAP) can be recommended in many cases.
Lung Volume 185, Number 5 / September, 2007 295-301
The finding of trichomonads in bronchoalveolar lavage fluid (BALF) samples from an acute respiratory distress syndrome (ARDS) patient, never previously reported, incited us to search for these parasites retrospectively in the BALF of patients with ARDS or related pathologies.
The Proceedings of the American Thoracic Society 4:502-506 (2007)
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease responsible for a large human and economic burden around the world. Cigarette smoking is the main risk factor for COPD in the developed world, although other important risk factors include occupational exposures, air pollution, airway hyperresponsiveness, asthma, and genetic predisposition.
Appropriate emergency measures are essential in improving the outcome of patients with thoracic injuries. Pathophysiological background and basic principles of emergency treatment decisions should be already taught in undergraduate medical curricula. The effectiveness of a computer simulation model on thoracic trauma management was evaluated.
In recent years, influenza surveillance data has expanded to include alternative sources such as emergency department data, absenteeism reports, pharmaceutical sales, website access and health advice calls. This study presents a review of alternative data sources for influenza surveillance, summarizes the time advantage or timeliness of each source relative to traditional reporting and discusses the strengths and weaknesses of competing approaches.
The use of rituximab has been uncommonly associated with delayed pulmonary toxicity. We present a case of interstitial pneumonitis and diffuse alveolar hemorrhage, which represents the second such case reported in the literature
It is important that those taking part in research trials are as representative as possible of those with the disease being studied. In a study of those with chronic obstructive pulmonary disease involving pulmonary rehabilitation, 120 of 297 suitable patients responded that they did not wish to take part in the trial. We were keen to know why these patients declined to take part in the study.
Journal of Allergy and Clinical Immunology, Volume 120, Issue 2, Pages 329-333
We recruited 8 patients with mild-to-moderate asthma and 8 healthy volunteers as a control group. Fiberoptic bronchoscopy with endobronchial biopsy was successfully performed in all subjects.
A 62-year-old female sausage packer reported progressive work-related asthma, rhinitis and contact urticaria after contact to dry sausages refined by moulds. Whereas skin prick tests with commercial mould extracts were negative, the patient showed weak skin sensitization to a cultivated mould sample from a dry sausage.
Journal of Vascular Surgery, Volume 46, Issue 3, Pages 526-532
This study investigated the prevalence and distribution of deep vein thrombosis (DVT) in patients with symptomatic pulmonary embolism (PE) to establish a screening protocol to reduce unnecessary venous duplex scanning using different D-dimer level rather than single cutoff point of 0.5 ug/mL in patients with low and moderate pretest clinical probability (PTP).
Medical Hypotheses, Volume 69, Issue 4, Pages 858-859
Bronchial asthma is an inflammatory disease, and neurogenic inflammation may play important role in asthma mechanisms. But asthma also is an inflammatory disease with paroxysmal clinical picture. It is known that migraine and trigeminal neuralgia also are inflammatory diseases with paroxysmal clinical picture, and neurogenic inflammation plays important role in their mechanisms.
The characteristics, risk factors, and outcome of patients with nosocomial pneumococcal bacteremia (NPB) have not been described in large, population-based studies.
The presence of somatic mutations in epidermal growth factor receptor (EGFR) predicts the effectiveness of EGFR tyrosine kinase inhibitors (TKIs). It would be ideal if an EGFR mutation could be detected in biopsy samples, since the majority of non-small cell lung cancer patients are inoperable at the time of presentation.
This clinical report describes a 3.5-year-old boy suffering from chronic daytime fatigue, accumulated snoring and dramatically appearing apnea during sleep.
Sleep-related breathing disorders (SRBD) are frequently encountered health problems in the general population. Habitual snoring and obstructive sleep apnea/hypopnea syndrome (OSAHS) constitute most SRBD diagnoses.
Sleep and Breathing Volume 11, Number 3 / September, 2007 139-147
There is increasing evidence that mandibular advancement devices (MADs) can be an effective treatment for some patients with obstructive sleep apnea, a highly prevalent chronic disease. In this study, the objectives were to objectively assess the effectiveness of MAD therapy using a limited channel recorder, and to develop a model for identifying patients who may be appropriate for MAD therapy as the initial treatment option.
Journal of Allergy and Clinical Immunology, Volume 120, Issue 2, Pages 359-365
Allergic Rhinitis and its Impact on Asthma (ARIA) differentiates mild from moderate/severe patients on the basis of 4 severity items. The high prevalence of moderate/severe patients suggests the need to differentiate between them.
Otolaryngology - Head and Neck Surgery, Volume 137, Issue 3, Pages 394-399
To identify risk factors predisposing to postextubation complications and the incidence of subglottic stenosis following endotracheal intubation for bronchiolitis.
To evaluate factors predicting the diagnostic yield of transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS) in small peripheral pulmonary lesions (PPLs) 30 mm in mean diameter.
Sleep and Breathing Volume 11, Number 3 / September, 2007 177-185
Excessive daytime sleepiness (EDS) is one of the most frequent symptoms in patients with obstructive sleep apnea syndrome (OSAS). However, not all patients with OSAS manifest EDS. The aim of this study was to assess whether differential circulatory levels of inflammatory mediators would account for differences in somnolence among patients with OSAS.
Noninvasive positive pressure ventilation (NPPV) delivered via a mouthpiece (mNPPV) has been successfully used in stable chronic restrictive respiratory insufficiency, but not in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure (ARF).
The Proceedings of the American Thoracic Society 4:543-548 (2007)
Chronic obstructive pulmonary disease (COPD) is increasing in the United States and throughout the world. There have been a number of advances in the treatment of this disease within the last several decades, and these improved therapies continue to become available, making the prospects for the future encouraging. Bronchodilation is the treatment of choice, and we point out in this article the potential availability of many new bronchodilators.
Asthma is a waxing and waning disease that leads to structural changes in the airways, such as subepithelial fibrosis, increased mass of airway smooth muscle and epithelial metaplasia.
The aim of this work was to study whether social factors are risk factors for obstructive sleep apnea (OSA). A second objective was to investigate gender differences in relation to referral to a sleep laboratory for sleep-related breathing symptoms.
Guidelines on acute lower respiratory tract infections recommend restrictive use of antibiotics, however, in patients with relevant co-morbid conditions treatment with antibiotics should be considered. Presently, it is unknown whether GPs adhere to these guidelines and target antibiotic treatment more often at patients with risk-elevating conditions.
Interstitial lung disease (ILD) related to therapy with the drug gefitinib has been well reported. The adverse pulmonary effects of erlotinib are less well known. We report a case of fatal pulmonary toxicity in a patient with advanced non-small cell lung cancer who received erlotinib.
This study aimed to define the prevalence, severity, and progression of nonpulmonary organ dysfunction, and its impact on outcome in patients with acute respiratory failure (ARF) at a respiratory ICU of a tertiary referral hospital in northern India.
The diagnostic criteria for acute lung injury (ALI) and ARDS utilize the PaO2/fraction of inspired oxygen (FIO2) [P/F] ratio measured by arterial blood gas analysis to assess the degree of hypoxemia. We hypothesized that the pulse oximetric saturation (SpO2)/FIO2 (S/F) ratio can be substituted for the P/F ratio in assessing the oxygenation criterion of ALI.
The ventilator discontinuation process is a critical component of ICU care. Ongoing ventilator dependency is caused by both disease factors (eg, respiratory, cardiac, metabolic, and neuromuscular) and clinician management factors (eg, failing to recognize discontinuation potential and inappropriate ventilator settings/management).
Recent studies have implicated the 5-lipoxygenase/leukotriene (LT) pathway in cardiovascular disease (CVD), which may have important implications for asthmatics because several drugs that target this pathway are currently used to treat asthma. We sought to determine whether montelukast, a cysteinyl LT antagonist, and low-dose theophylline affected serum inflammatory and lipid CVD risk factors in a recently completed clinical trial in asthmatic patients.
Allergy and Asthma Proceedings, Volume 28, Number 4, July/August 2007 , pp. 454-461(8)
Early sensitization to inhaled allergens predicts later asthma and allergy until school age, but studies on early exposure have given conflicting results. The purpose of this study was to evaluate the association between early wheezing, early exposure, or sensitization to pets and pollens and later asthma or allergy until adulthood.
Idiopathic pulmonary fibrosis (IPF) is an untreatable diffuse parenchymal lung disease with a median survival of < 3 years. Pulmonary hypertension (PH) is frequently seen in patients with IPF and is commonly attributed to hypoxic vasoconstriction and capillary destruction.
Stomatococcus mucilaginosus was isolated from 8 patients suffering from lower respiratory tract infections over a 4-y period (1999-2003). The infections ranged from mild cases of pneumonia to a life-threatening case of recurrent lung abscesses in a neutropenic patient. The various strains were cultured from specimens obtained by bronchoscopy, blood, and sputum specimens.
A systematic review was conducted to determine the benefits of disease-specific health education for people with chronic obstructive pulmonary disease (COPD). A search was conducted through Medline, CINAHL, PsycINFO, Embase, Cochrane Library, Physiotherapy Evidence Database and reference lists to obtain publications reporting on educational interventions compared with usual medical care.
It has been previously established that montelukast provides protection against exercise-induced bronchoconstriction (EIB) after a single dose. The present objective was to assess the onset and duration of this protective action in a trial that included both positive and negative controls.
Serum levels of circulating markers associated with cardiovascular morbidity are elevated in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). These factors are studied in patients mainly before the application of therapy with continuous positive airway pressure (CPAP), and the effects of CPAP treatment on them have not been thoroughly studied. Therefore, the aim of the study was to examine the effect of compliance to CPAP therapy on these factors.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 644-649, (2007)
Biopsychosocial models of asthma have been proposed in the literature, but few empirical tests of social factors at various levels of influence have been conducted.
American Journal of Respiratory and Critical Care Medicine Vol 176. pp. 691-697, (2007)
We hypothesized that idiopathic NSIP is an autoimmune disease and the lung manifestation of undifferentiated connective tissue disease (UCTD), a recently described, distinct entity.
Malignant pleural effusions (MPEs) are a troublesome and debilitating complication of advanced malignancies, with > 150,000 cases in the United States each year. The standard management approach begins with a diagnostic and/or therapeutic thoracentesis. Should the MPE recur, a more definitive management strategy is often undertaken with several approaches available to the chest physician or surgeon.
Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity in the UK and is increasingly seen in elderly patients, often requiring multiple courses of steroids. We present a case of a 72 year old lady with repeated exacerbations of COPD which did not respond to conventional treatment. Herpes simplex virus (HSV1) tracheobronchitis was diagnosed following a rigid bronchoscopy and her symptoms improved with intravenous acyclovir. This is the first published case of HSV tracheitis in a non immunosuppressed individual with chronic lung disease.
Inhaled nitric oxide (INO) can improve hypoxemia and reduce pulmonary hypertension, but there is a wide range of response to INO. Objectives: The aim of this study was to evaluate the effect of different INO concentrations in acute respiratory distress syndrome (ARDS) patients.
Measurement of nitric oxide (NO) and nitrite/nitrates (NOx) levels in exhaled breath condensate (EBC) are non-invasive techniques, which can be used to monitor airway inflammatory diseases. Production of NO is often increased in inflammatory diseases of the airways, including exacerbations of chronic obstructive pulmonary disease (COPD).
Sarcoidosis is a systemic granulomatous disease of unknown etiology, in which the lungs and intrathoracic lymph nodes are predominant sites of involvement. Pulmonary hypertension is a known complication of sarcoidosis. Treatment of sarcoidosis-associated pulmonary hypertension has traditionally focused on the initiation of systemic corticosteroids, but has had inconsistent results.
The Annals of Pharmacotherapy: Vol. 41, No. 10, pp. 1728-1733
To determine whether nebulized budesonide inhalation suspension (BIS) is effective in treating adults with asthma that has been uncontrolled by inhaled therapies.
Persistent lobar atelectasis in pediatric patients on mechanical ventilation results in impaired gas exchange and lung mechanics and contributes to a further need for mechanical ventilation.
Diabetic Medicine, Volume 24, Number 10, October 2007 , pp. 1168-1171(4)
Patients with diabetes mellitus (DM) are considered to be more susceptible to several types of infections, including community-acquired pneumonia. However, it is not clear whether DM is a risk factor for development of hospital-acquired pneumonia (HAP), an infection with considerable morbidity and mortality worldwide.
Pediatrics International, Volume 49, Number 5, October 2007 , pp. 631-636(6)
Varying effects of pancuronium on neonatal pulmonary mechanics have been documented, including a decrease in pulmonary compliance or no significant change in compliance; but measurements of respiratory mechanics or quantification of episodes of hypoxemia in preterm newborns receiving vecuronium (Norcuron, Bedford Labs, Bedford, OH, USA) have not been reported. The objective of the present study was to quantify the short-term effects of vecuronium on pulmonary mechanics and episodes of hypoxemia in preterm infants receiving mechanical ventilation.
The Proceedings of the American Thoracic Society 4:535-542 (2007)
The effectiveness of inhaled corticosteroids (ICS) in patients with chronic obstructive pulmonary disease (COPD) remains controversial. Randomized controlled trials, meta-analyses, medication withdrawal studies, and observational reports have examined this question, with mixed results.
The Proceedings of the American Thoracic Society 4:554-564 (2007)
The diagnosis and treatment of acute exacerbations (AEs) of chronic obstructive pulmonary disease (COPD) is controversial. In this section, we review (1) the epidemiology of this condition; (2) the etiology-many patients with AECOPD are thought to have a combination of viral and bacterial infections, which contribute to their exacerbation. Bacterial organisms are isolated more commonly after viral infections in patients with COPD.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 565 - 568
Chlamydia pneumoniae infection might play a role in the pathology of asthma, but its role in infantile asthma remains obscure. The presence of Chlamydia pneumoniae was serologically determined in wheezing infants who were then re-examined 1-year later to determine whether or not asthma is associated with this type of infection. Wheezing infants progressed to asthma more frequently after infection with Chlamydia pneumoniae than those who were not infected. These findings suggested that Chlamydia pneumoniae infection triggers asthma in wheezy infants.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 497 - 500
This article presents the design and evaluation of the Teacher Asthma Management and Information Seeking Scale. Based on a sample of 593 kindergarten to eighth grade teachers, the scale yielded two factors: the Asthma Management (= 0.90) and the Information Seeking Factor (= 0.71). This scale fills a needed gap in the literature regarding assessment tools for school-based asthma management that focus on teacher behavior.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 555 - 563
This 12-week, double-blind, parallel-group study compared the efficacy and safety of once daily ciclesonide and twice daily fluticasone propionate in patients aged 12-75 years with persistent asthma.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 583 - 587
Florida red tides are naturally occurring blooms of the marine dinoflagellate, Karenia brevis. K. brevis produces natural toxins called brevetoxins. Brevetoxins become part of the marine aerosol as the fragile, unarmored cells are broken up by wave action. Inhalation of the aerosolized toxin results in upper and lower airway irritation.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 515 - 520
Intranasal and inhaled corticosteroid administration concurrently in comorbid allergic rhinitis (AR) and asthma may potentially enhance cortisol suppression.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 575 - 581
This study aimed at identifying cognitive and emotional representations relevant for improving health care communication and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD).
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 521 - 527
To evaluate whether dietary habits and anthropometric and lifestyle characteristics are associated with the prevalence of asthma symptoms, a sample of 700 Greek schoolchildren were evaluated through a standardized questionnaire.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 547 - 554
Self-reported symptoms, FEV1, and clinician judgment are all used to evaluate asthma control. The relative utility of each measure of control cannot be easily assessed. Item response theory (IRT) approaches allow for the direct comparison of the utility of different types of measures used to assess control. The objective of this study was to evaluate the validity and reliability of evaluating asthma control using symptom, clinical, and physiologic measures by applying an IRT approach.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 489 - 496
This article reviews the empirical literature related to knowledge, competence, volition, and financial compensation in the biomedical research decision-making of children, adolescents, and parents.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 529 - 534
Tobacco smoke (TS) exposure can induce airway hyperresponsiveness, especially in asthma. A feature of asthma is eosinophilia. We hypothesized that tobacco smoke exposure enhances eosinophil responsiveness in sensitized guinea pigs.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 543 - 546
Little is known about the contribution of indoor molds to the symptoms of asthma and/or rhinitis in children monosensitized to molds. We aimed to investigate the effect of indoor mold spore concentrations on daily symptoms of asthma and/or rhinitis in children monosensitized to molds.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 535 - 541
A cumulative risk framework was used to examine the impact of the presence of multiple risk factors on key asthma outcomes (i.e., health-related quality of life [HRQoL], severity) for a sample of 149 inner-city African-American youth with asthma. The presence of a greater number of risk factors was associated with lower HRQoL and greater severity, regardless of age or gender.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 569 - 573
The aim of the present study was to assess the relationship between serum eosinophil cationic protein levels and the severity of exercise-induced bronchoconstriction in asthmatic children.
Journal of Asthma, Volume 44, Issue 7 September 2007 , pages 501 - 508
Abstract
The costs and effectiveness of asthma action plans for children were evaluated in a cross-sectional economic analysis. Direct health care and indirect costs, nights with symptoms, and asthma attacks were measured in 879 Ontario children with asthma.
The therapeutic effect of inhaled corticosteroids (ICS) may be affected by the metabolism of the drug in the target organ. We investigated the in vitro metabolism of beclomethasone dipropionate (BDP), budesonide (BUD), ciclesonide (CIC), and fluticasone propionate (FP) in human lung precision-cut tissue slices. CIC, a new generation ICS, is hydrolyzed by esterases in the upper and lower airways to its pharmacologically active metabolite desisobutyryl-ciclesonide (des-CIC).
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.
Journal of Occupational Medicine and Toxicology 2007, 2:8
The occurrence of occupational lung diseases is decreasing due to improvements in occupational health in recent years; however, silicosis and its complications remain important occupational health problems. We have studied the role of emphysema and bullae as predictive factors of secondary spontaneous pneumothorax in acute and accelerated silicosis.
Clinical Pulmonary Medicine. 14(5):249-257, September 2007
Researchers in the field of asthma genetics employ a broad variety of approaches to identify genes involved in asthma and its related phenotypes. Genome-wide screens identify chromosomal regions linked with disease in families from which candidate genes or positionally cloned genes are identified.
Clinical Pulmonary Medicine. 14(5):308-309, September 2007
A shift to administering antibiotic therapy for community-acquired pneumonia within 4 hours in the emergency department leads to more inappropriate treatment without improving outcomes.
Clinical Pulmonary Medicine. 14(5):306-307, September 2007
Autoadjusting continuous positive airway pressure (APAP) does not have the same beneficial effect on cardiovascular and metabolic measures as fixed continuous positive airway pressure (CPAP).
Clinical Pulmonary Medicine. 14(5):307-308, September 2007
The use of systemic corticosteroids in early acute respiratory distress syndrome (ARDS) improves measures of lung injury and as well as outcomes in ARDS.
The American Journal of Emergency Medicine, Volume 25, Issue 7, Pages 862.e5-862.e6
Hypersensitivity reactions after sea urchin (echinoderm) "spine injuries" have been described. Most often these reactions are local granulomatous nodules or rashes. We describe a case of eosinophilic pneumonitis without any clear cause in a patient who stepped on a black sea urchin a day before the onset of symptoms.
To compare changes in behavior after adenotonsillectomy in children with either mild sleep-disordered breathing (SDB) or obstructive sleep apnea (OSA).
Clinical Pulmonary Medicine. 14(5):286-295, September 2007
Cor pulmonale is a condition characterized by right ventricular hypertrophy, dilation, or both, occurring as a result of parenchymal lung disease, impaired respiratory neuromuscular mechanics, or altered ventilatory drive. Changes in right ventricular structure and function are a consequence of elevations in pulmonary arterial pressure and pulmonary vascular resistance, ie, pulmonary hypertension.
Clinical Pulmonary Medicine. 14(5):278-280, September 2007
Sarcoidosis is a systemic disease of unknown cause that can rarely involve upper respirator tract. Manifestations of sarcoidosis in the upper respiratory tract range form asymptomatic disease to upper airway obstruction and respiratory failure.
Clinical Pulmonary Medicine. 14(5):265-277, September 2007
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial lung disease seen as part of multisystem Langerhans cell histiocytosis, or as an isolated form of the disease. The majority of cases of the latter are seen in adults and associated with cigarette smoking, which probably plays a central etiologic role.
Subjects with COPD display heterogeneity in clinical, physiologic, and radiologic characteristics, which are thought to result from different pathophysiologic mechanisms. It is important to identify and understand specific phenotypes for patient management. We investigated differences in emphysema distribution and health status in 1-antitrypsin deficient subjects (PiZ) with discordant lung function.
Clinical Pulmonary Medicine. 14(5):258-264, September 2007
Recent reports have identified alcoholism to have an important public health impact and cause a substantial loss of lives worldwide. For a long time alcoholism has been identified to favor pulmonary infections. But only in the last 2 decades the alterations induced by ethanol to the complex mechanisms of lung defense have been recognized.
Pleuropulmonary blastomas are rare malignant intrathoracic tumors of early childhood. They appear as a pulmonary- and/or pleural-based mass and their pathogenesis and relationship to other pediatric solid tumors is not well understood.
We have shown previously that the chemokine receptors CXCR3 and CXCR6 are coexpressed by Th1 cells infiltrating the lung and the granuloma of patients with sarcoidosis. In this study, we evaluated the role of CCL20/CCR6 interaction in the pathogenesis of acute and chronic pulmonary sarcoidosis.
Obstructive sleep apnea syndrome (OSAS) is associated with cardiovascular diseases, in particular systemic arterial hypertension. We postulated that intermittent nocturnal hypoxia in OSAS may be associated to decreased fractional exhaled nitric oxide (FENO) levels from distal airspaces.
Travel Medicine and Infectious Disease, Volume 5, Issue 5, Pages 301-305
A 21-year-old soldier developed anorexia, vomiting, diarrhea and fever 10 days after returning to the United States from an 8-month deployment in Afghanistan. His symptoms persisted over the next 5 days until he presented in respiratory failure with a partial pressure oxygen: concentration of inspired oxygen (PaO2:FiO2) ratio of 63, requiring urgent intubation and ventilator support.
It has been shown that the ß2-integrin molecule is up-regulated in circulating neutrophils in COPD subjects. However, little has been reported about the expression of the cell surface molecules in such patients and their relationship with pulmonary function. The aim of the present study was to investigate the surface expression of molecules in circulating neutrophils and to clarify their possible role in the airflow limitation of
COPD.
The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 10, October 2007 , pp. 1062-1065(4)
The Community-Acquired Pneumonia Organization (CAPO) was created in 1999, with the goal to facilitate international research in the field of pneumonia. This manuscript reviews the development of CAPO, summarises the core clinical study and functions of the project's statistical and data coordinating center and describes current research opportunities.
Allergic diseases including asthma have risen considerably in prevalence in the last 50 years. A concomitant rise in autoimmune disease suggests a defect in immunoregulation, rather than a reduction in T-helper type 1 immunity.
Since the condition was first described four decades ago, alpha-1-antitrypsin (A1AT) deficiency has served as a model for other disease processes. A1AT is the archetypal serpin designed to ensnare proteases, a process that involves significant conformational change within the molecule.
To detect any change in exposure to secondhand smoke among primary schoolchildren after implementation of smoke-free legislation in Scotland in March 2006.
Viral respiratory infections may precipitate acute exacerbations of COPD (AECOPD). However, little is known about viral etiology related to AECOPD in Asia. We aimed to study the viral etiology of AECOPD in Hong Kong.
Placebo is commonly used in short-term randomized trials for pulmonary arterial hypertension (PAH). Currently, outcome data regarding placebo are lacking. We conducted a systematic review and performed a metaanalysis to assess its effect.
The aim of this study was to evaluate the short-term benefits of a pulmonary rehabilitation program in chronic obstructive pulmonary disease (COPD) patients.
Endobronchial ultrasonography (EBUS) is useful in localizing peripheral lung lesions. Previous reports have revealed that several characteristic echoic patterns correlate well with the histopathologic findings of benign and malignant lesions. Therefore, EBUS may be also useful in the differential diagnosis of malignant lesions of the lung.
Reliable, noninvasive approaches to the diagnosis of pulmonary hypertension (PH) in patients with idiopathic pulmonary fibrosis (IPF) are needed. We tested the hypothesis that chest CT-determined extent of pulmonary fibrosis and/or main pulmonary artery diameter (MPAD) can be used to identify the presence of PH in patients with advanced IPF.
Evidence-based guidelines recommend that acutely ill hospitalized medical patients who are at risk of venous thromboembolism (VTE) should receive prophylaxis. Our aim was to characterize the clinical practices for VTE prophylaxis in acutely ill hospitalized medical patients enrolled in the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE).
Journal of Internal Medicine, Volume 262, Number 3, September 2007 , pp. 311-340(30)
Chronic obstructive pulmonary disease (COPD) is a condition which is characterized by irreversible airway obstruction due to narrowing of small airways, bronchiolitis, and destruction of the lung parenchyma, emphysema. It is the fourth most common cause of mortality in the world and is expected to be the third most common cause of death by 2020.
Positive airway pressure (PAP) is the treatment of choice for patients with moderate-to-severe obstructive sleep apnea (OSA). Randomized controlled trials have demonstrated that PAP can effectively reduce the apnea-hypopnea index and improve subjective and objective sleepiness.
Though more common in male patients, primary spontaneous pneumothorax might be expected to occur reasonably often in female patients of child-bearing age. However, < 50 cases of pneumothorax in pregnancy have been previously reported. Special risks are posed for both the mother and the fetus in this situation. Previous management strategies have varied widely, without describing the more modern and less invasive techniques, and existing pneumothorax guidelines do not incorporate this difficult scenario.
Chronic obstructive pulmonary disease (COPD) is a heterogeneous syndrome characterized by varying degrees of airflow limitation and diffusion impairment. There is increasing evidence to suggest that COPD is also characterized by systemic inflammation. The primary goal of this study was to identify soluble proteins in plasma that associate with the severity of airflow limitation in a COPD cohort with stable disease. A secondary goal was to assess whether unique markers associate with diffusion impairment, based on diffusion capacity of carbon monoxide (DLCO), independent of the forced expiratory volume in 1 second (FEV1).
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