MedWorm: Respiratory Medicine Research

Development of new measurement system of thoracic excursion with biofeedback: reliability and validity

Journal of NeuroEngineering and Rehabilitation — Mon, 20 May 2013 04:00:00 +0100

Conclusion: The novel measurement system, BREATH, has high intra- and inter-evaluator reliabilities and validity; therefore it can lead us more effective respiratory exercise. Using its biofeedback data, this system may help patients with respiratory disease to do exercises more efficiently and clinicians to assess the respiratory exercise more accurately. (Source: Journal of NeuroEngineering and Rehabilitation)

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Chronic respiratory disease, comorbid cardiovascular disease, and mortality in a representative adult U.S. cohort

Respirology — Mon, 20 May 2013 04:00:00 +0100

ConclusionsIn this large US population‐based cohort, the presence of obstruction, restriction, or respiratory symptoms alone was associated with higher adjusted risk of overt CVD. (Source: Respirology)

Oxidative stress and antioxidant enzyme activity in South Indian male smokers with Chronic Obstructive Pulmonary Disease

Respirology — Mon, 20 May 2013 04:00:00 +0100

ConclusionOur study demonstrates that there is an oxidant antioxidant imbalance in COPD patients and suggests the importance of GPx in maintaining lung function. (Source: Respirology)

Capability of hypertonic saline cough provocation test to predict the response to inhaled corticosteroids in chronic cough: a prospective, open-label study

Cough — Mon, 20 May 2013 04:00:00 +0100

Conclusions: Saline test cannot predict the responsiveness to inhaled corticosteroids in chronic cough but it may be utilized to monitor the effect of this treatment.Trial registration: The study was registered in ClinicalTrials.gov database (KUH5801112). ClinicalTrials.gov Identifier: NCT00859274 (Source: Cough)

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Endostatin, an angiogenesis inhibitor, ameliorates bleomycin-induced pulmonary fibrosis in rats

Respiratory Research — Mon, 20 May 2013 04:00:00 +0100

Conclusions: Our findings suggest that endostatin treatment inhibits the increased MVD, inflammation and alveolar epithelial cell apoptosis, consequently ameliorating BLM-induced pulmonary fibrosis in rats. (Source: Respiratory Research)

Rate of progression of CT-quantified emphysema in male current and ex-smokers: a follow-up study

Respiratory Research — Mon, 20 May 2013 04:00:00 +0100

The objective of this study was to investigate the effect of length of smoking cessation and clinical / demographical factors on the rate of emphysema progression and FEV1-decline in male heavy smokers. Methods: 3,670 male smokers with mean (SD) 40.8 (17.9) packyears underwent chest CT scans and pulmonary function tests at baseline and after 1 and 3 years follow-up. Smoking status (quitted >=5, >=1- (Source: Respiratory Research)

Acute fibrinous and organizing pneumonia associated with influenza A/H1N1 pneumonia after lung transplantation

BMC Pulmonary Medicine - Latest articles — Sun, 19 May 2013 04:00:00 +0100

Conclusion: To our knowledge we present the first case of AFOP triggered by viral infection, here proven to be influenza virus A/H1N1. Thus, also in the setting of viral infection the highly deadly differential diagnosis of AFOP must be considered. (Source: BMC Pulmonary Medicine - Latest articles)

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An Impulse Radio Ultrawideband System for Contactless Noninvasive Respiratory Monitoring

IEEE Transactions on Biomedical Engineering — Sat, 18 May 2013 15:10:10 +0100

We design a impulse radio ultrawideband radar monitoring system to track the chest wall movement of a human subject during respiration. Multiple sensors are placed at different locations to ensure that the backscattered signal could be detected by at least one sensor no matter which direction the human subject faces. We design a hidden Markov model to infer the subject facing direction and his or her chest movement. We compare the performance of our proposed scheme on $hbox{15}$ human volunteers with the medical gold standard using respiratory inductive plethysmography (RIP) belts, and show that on average, our estimation is over $hbox{81}%$ correlated with the measurements of a RIP belt system. Furthermore, in order to automatically differentiate between periods of normal and abnormal bre...

Airway Morphology From High Resolution Computed Tomography in Healthy Subjects and Patients With Moderate Persistent Asthma

The Anatomical Record Part B: The New Anatomist — Fri, 17 May 2013 04:00:00 +0100

In this study, a commercial software package was used to segment the airway tree of seven healthy and six moderately persistent asthmatic patients from high resolution computed tomography images. The process was assessed with regards to the treatment of the images of the asthmatic group. The in vivo results for the bronchial length, diameter, WT, branching, and rotation angles are reported and compared per generation for different lobes. Furthermore, some popular mathematical relationships between these morphometric characteristics were examined in order to verify their validity for both groups. Our results suggest that, even though some relationships agree very well with previously published data, the compartmentalization of airways into lobes and the presence of disease may significantly...

Efficacy, safety and tolerability of GSK2190915, a 5-lipoxygenase activating protein inhibitor, in adults and adolescents with persistent asthma: a randomised dose-ranging study

Respiratory Research — Fri, 17 May 2013 04:00:00 +0100

The objective of this study was to evaluate GSK2190915 efficacy, dose--response and safety in subjects with persistent asthma treated with short-acting beta2-agonists (SABAs) only. Methods: Eight-week multicentre, randomised, double-blind, double-dummy, stratified (by age and smoking status), parallel-group, placebo-controlled study in subjects aged >=12 years with a forced expiratory volume in 1 second (FEV1) of 50--85% predicted. Subjects (n = 700) were randomised to receive once-daily (QD) oral GSK2190915 (10--300 mg), twice-daily inhaled fluticasone propionate 100 mug, oral montelukast 10 mg QD or placebo. The primary endpoint was mean change from baseline (randomisation) in trough (morning pre-dose and pre-rescue bronchodilator) FEV1 at the end of the 8-week treatment period. Secondar...

Prevalence of multidrug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa in an Italian hospital

Journal of Infection and Public Health — Thu, 16 May 2013 08:12:35 +0100

Summary: The severity and extent of disease caused by multidrug-resistant organisms (MDROs) varies by the population(s) affected and the institution(s) at which these organisms are found; therefore, preventing and controlling MDROs are extremely important.A retrospective study of patients who were infected with Acinetobacter baumannii or Pseudomonas aeruginosa was performed at the Spedali Civili Hospital in Brescia, Italy, from 2007 to 2010.A total of 167 (0.52%) A. baumannii isolates and 2797 P. aeruginosa (8.7%) isolates were identified among 31,850 isolates.Amikacin and colistin were the most active agents against A. baumannii strains. Multidrug resistance (MDR) was observed in 57 isolates (54%). Most MDR isolates (42 out of 57, 73%) were resistant to four classes of antibiotics.P. aeru...

Do socioeconomic inequalities in mortality vary between different Spanish cities? a pooled cross-sectional analysis

BMC Public Health - Latest articles — Thu, 16 May 2013 04:00:00 +0100

Conclusions: This study provides a general overview of the relationship between deprivation and mortality for a sample of large Spanish cities combined. This joint study allows the exploration of and, if appropriate, the quantification of the variability in that relationship for the set of cities considered. (Source: BMC Public Health - Latest articles)

Remediating buildings damaged by dampness and mould for preventing or reducing respiratory tract symptoms, infections and asthma (Review)

Evidence-Based Child Health: A Cochrane Review Journal — Thu, 16 May 2013 04:00:00 +0100

Abstract BackgroundDampness and mould in buildings have been associated with adverse respiratory symptoms, asthma and respiratory infections of inhabitants. Moisture damage is a very common problem in private houses, workplaces and public buildings such as schools. ObjectivesTo determine the effectiveness of remediating buildings damaged by dampness and mould in order to reduce or prevent respiratory tract symptoms, infections and symptoms of asthma. Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2), which contains the Cochrane Acute Respiratory Infections Group's Specialised Register, MEDLINE (1951 to June week 1, 2011), EMBASE (1974 to June 2011), CINAHL (1982 to June 2011), Science Citation Index (1973 to June 201...

Commentaries on ‘Remediating buildings damaged by dampness and mould for preventing or reducing respiratory tract symptoms, infections and asthma’

Evidence-Based Child Health: A Cochrane Review Journal — Thu, 16 May 2013 04:00:00 +0100

Abstract These are commentaries on a Cochrane review, published in the issue of EBCH, first published as: Sauni R, Uitti J, Jauhiainen M, Kreiss K, Sigsgaard T, Verbeek JH. Remediating buildings damaged by dampness and mould for preventing or reducing respiratory tract symptoms, infections and asthma. Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD007897. DOI: 10.1002/14651858.CD007897.pub2. (Source: Evidence-Based Child Health: A Cochrane Review Journal)

Taste perception: from the tongue to the testis

Molecular Human Reproduction — Thu, 16 May 2013 04:00:00 +0100

In mammals, the sense of taste helps in the evaluation and consumption of nutrients, and in avoiding toxic substances and indigestible materials. Distinct cell types expressing unique receptors detect each of the five basic tastes: salty, sour, bitter, sweet and umami. The latter three tastes are detected by two distinct families of G protein-coupled receptors: T2Rs and T1Rs. Interestingly, these taste receptors have been found in tissues other than the tongue, such as the digestive system, respiratory system, brain, testis and spermatozoa. The functional implications of taste receptors distributed throughout the body are unknown. We therefore reviewed the remarkable advances in our understanding of the molecular basis of taste perception in ‘taste’ and ‘non-taste’ ...

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Inactivity-induced phrenic and hypoglossal motor facilitation are differentially expressed following intermittent vs. sustained neural apnea

Journal of Applied Physiology — Thu, 16 May 2013 04:00:00 +0100

Reduced respiratory neural activity elicits a rebound increase in phrenic and hypoglossal motor output known as inactivity-induced phrenic and hypoglossal motor facilitation (iPMF and iHMF, respectively). We hypothesized that, similar to other forms of respiratory plasticity, iPMF and iHMF are pattern sensitive. Central respiratory neural activity was reversibly reduced in ventilated rats by hyperventilating below the CO2 apneic threshold to create brief intermittent neural apneas (5, ~1.5 min each, separated by 5 min), a single brief massed neural apnea (7.5 min), or a single prolonged neural apnea (30 min). Upon restoration of respiratory neural activity, long-lasting (>60 min) iPMF was apparent following brief intermittent and prolonged, but not brief massed, neural apnea. Further, b...

Antibody and CD8+ T cell memory response to influenza A/PR/8/34 infection is reduced in treadmill-exercised mice, yet still protective

Journal of Applied Physiology — Thu, 16 May 2013 04:00:00 +0100

Moderate exercise may decrease the severity of influenza infection and reduce lung viral load. The possibility that an exercise-associated reduction in lung viral load early in infection could contribute to decreased serum antibody and reduced memory response were investigated. BALB/c mice exercised for 8 wk and were then infected with influenza A/PR/8/34 (intranasal route). Influenza-specific serum antibody was assessed for 6 mo post primary infection, at which time mice were infected again with influenza A/PR/8/34. After primary infection, exercise reduced morbidity/mortality, attenuated lung cytokines, and decreased serum anti-influenza IgG and IgG2a from day 14 to day 180 post primary infection. After secondary infectious challenge, exercised mice did not show any signs of illness, but...

Calpain and caspase-3 play required roles in immobilization-induced limb muscle atrophy

Journal of Applied Physiology — Thu, 16 May 2013 04:00:00 +0100

Prolonged skeletal muscle inactivity results in a rapid decrease in fiber size, primarily due to accelerated proteolysis. Although several proteases are known to contribute to disuse muscle atrophy, the ubiquitin proteasome system is often considered the most important proteolytic system during many conditions that promote muscle wasting. Emerging evidence suggests that calpain and caspase-3 may also play key roles in inactivity-induced atrophy of respiratory muscles, but it remains unknown if these proteases are essential for disuse atrophy in limb skeletal muscles. Therefore, we tested the hypothesis that activation of both calpain and caspase-3 is required for locomotor muscle atrophy induced by hindlimb immobilization. Seven days of immobilization (i.e., limb casting) promoted signific...

Early and long-term results of pectoralis muscle flap reconstruction versus sternal rewiring following failed sternal closure [THORACIC]

European Journal of Cardio-Thoracic Surgery — Thu, 16 May 2013 04:00:00 +0100

CONCLUSIONS In our study, muscle flap reconstruction guaranteed better early and late-term results as shown by lower rates of mortality, procedure failure and hemisternum stability. Moreover, Group 1 patients had greater postoperative VC, lower NYHA class and better quality of life. These results suggest that, in patients with multiple bone fracture, the rewiring approach does not promote physiological bone consolidation, whereas the muscle flap reconstruction can assure more physiological ventilatory dynamics. (Source: European Journal of Cardio-Thoracic Surgery)

Early and late outcome after surgical treatment of acquired non-malignant tracheo-oesophageal fistulae [THORACIC]

European Journal of Cardio-Thoracic Surgery — Thu, 16 May 2013 04:00:00 +0100

CONCLUSIONS Surgical treatment of TOF is associated with good results in terms of control of acute symptoms and long-term outcome, particularly concerning oral intake and spontaneous breathing. (Source: European Journal of Cardio-Thoracic Surgery)

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The utility of surgical lung biopsy in cancer patients with acute respiratory distress syndrome

Journal of Cardiothoracic Surgery — Thu, 16 May 2013 04:00:00 +0100

Conclusions: In selected critically ill cancer patients with ARDS, SLB had a high diagnostic yield rate and an acceptable surgical complication rate. (Source: Journal of Cardiothoracic Surgery)

The development of Pediatric Critical Care Medicine at The Children's Hospital of Philadelphia: an interview with Dr. John J. ‘Jack’ Downes

Pediatric Anesthesia — Thu, 16 May 2013 04:00:00 +0100

Summary Dr. John J. ‘Jack’ Downes (1930–), the anesthesiologist‐in‐chief at The Children's Hospital of Philadelphia (1972–1996), has made numerous contributions to pediatric anesthesia and critical care medicine through a broad spectrum of research on chronic respiratory failure, status asthmaticus, postoperative risks of apnea in premature infants, and home‐assisted mechanical ventilation. However, his defining moment was in January 1967, when The Children's Hospital of Philadelphia inaugurated its pediatric intensive care unit—the first of its kind in North America. During his tenure, he and his colleagues trained an entire generation of pediatric anesthesiologists and intensivists and set a standard of care and professionalism that continues to the present day. Based on ...

Prevalences of asthma and rhinitis among adolescents in the city of Fortaleza, Brazil: temporal changes

Jornal Brasileiro de Pneumologia — Thu, 16 May 2013 02:11:14 +0100

CONCLUSIONS: Our data show that the prevalences of asthma and rhinitis symptoms remain high among females and private school students. (Source: Jornal Brasileiro de Pneumologia)

Tomographic and functional findings in severe COPD: comparison between the wood smoke-related and smoking-related disease

Jornal Brasileiro de Pneumologia — Thu, 16 May 2013 02:11:14 +0100

CONCLUSIONES: En pacientes con EPOC-L severa no hay enfisema en la TCAR. El hallazgo más importante es el compromiso severo de la vía aérea. La disminución de la DLCO y del VA con DLCO/VA normal es probablemente determinada por la obstrucción bronquial severa y la mezcla incompleta del gas inspirado en la maniobra de la respiración única de la prueba de difusión.OBJECTIVE: Wood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD. METHODS: Twenty-t...

CT Findings of Sinonasal Respiratory Epithelial Adenomatoid Hamartoma: A Closer Look at the Olfactory Clefts [HEAD & NECK]

American Journal of Neuroradiology — Wed, 15 May 2013 04:00:00 +0100

CONCLUSIONS: Both clinical presentations of REAH are associated with OC widening on CT scan. In the setting of polypoid disease, an OC width of > 10 mm should increase suspicion for the presence of REAH. (Source: American Journal of Neuroradiology)

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Airway exposure to staphylococcal enterotoxin A potentiates allergen-induced bone marrow eosinophilia and trafficking to peripheral blood and airways

AJP: Lung Cellular and Molecular Physiology — Wed, 15 May 2013 04:00:00 +0100

Bone marrow (BM) eosinopoiesis is a common feature during allergen exposure in atopic individuals. Airway exposure to staphylococcal superantigens aggravates allergic airway disease and increases the output of BM eosinophils. However, the exact mechanisms regulating eosinophil mobilization and trafficking to the peripheral circulation and airways remain to be elucidated. Therefore, this study aimed to investigate the mechanisms determining the BM eosinopoiesis in allergic mice under exposure to staphylococcal enterotoxin A (SEA). Ovalbumin (OVA)-sensitized male BALB/C mice were intranasally exposed to SEA (1 μg), and at 4, 12, 24, and 48 h later animals were challenged with OVA (10 μg, twice a day). Measurement of IL-5, eotaxin, and granulocyte-macrophage colony-stimulating factor (G...

Hydrogen gas reduces hyperoxic lung injury via the Nrf2 pathway in vivo

AJP: Lung Cellular and Molecular Physiology — Wed, 15 May 2013 04:00:00 +0100

We examined lung function by blood gas analysis, extent of lung injury, and expression of HO-1. We also investigated the role of NF-E2-related factor (Nrf) 2, which regulates HO-1 expression, by examining the expression of Nrf2-dependent genes and the ability of hydrogen to reduce hyperoxic lung injury in Nrf2-deficient mice. Hydrogen treatment during exposure to hyperoxia significantly improved blood oxygenation, reduced inflammatory events, and induced HO-1 expression. Hydrogen did not mitigate hyperoxic lung injury or induce HO-1 in Nrf2-deficient mice. These findings indicate that hydrogen gas can ameliorate hyperoxic lung injury through induction of Nrf2-dependent genes, such as HO-1. The findings suggest a potentially novel and applicable solution to hyperoxic lung injury and provide...

Nociceptin/orphanin FQ receptor activation decreases the airway hyperresponsiveness induced by allergen in sensitized mice

AJP: Lung Cellular and Molecular Physiology — Wed, 15 May 2013 04:00:00 +0100

In conclusion, we demonstrated a role for the NOP receptor and N/OFQ pathway in the AHR induced by allergen, probably through a modulation of the immune response that triggers the development of AHR that involves pro- and anti-inflammatory cytokines. (Source: AJP: Lung Cellular and Molecular Physiology)

Combustion derived ultrafine particles induce cytochrome P-450 expression in specific lung compartments in the developing neonatal and adult rat

AJP: Lung Cellular and Molecular Physiology — Wed, 15 May 2013 04:00:00 +0100

Vehicle exhaust is rich in polycyclic aromatic hydrocarbons (PAH) and can be a dominant contributor to ultrafine urban particulate matter (PM). Exposure to ultrafine PM is correlated with respiratory infections and asthmatic symptoms in young children. The lung undergoes substantial growth, alveolarization, and cellular maturation within the first years of life, which may be impacted by environmental pollutants such as PM. PAHs in PM can serve as ligands for the aryl hydrocarbon receptor (AhR) that induces expression of certain isozymes in the cytochrome P-450 superfamily, such as CYP1A1 and CYP1B1, localized in specific lung cell types. Although AhR activation and induction has been widely studied, its context within PM exposure and impact on the developing lung is poorly understood. In r...

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Mineralocorticoid receptor antagonism attenuates experimental pulmonary hypertension

AJP: Lung Cellular and Molecular Physiology — Wed, 15 May 2013 04:00:00 +0100

Mineralocorticoid receptor (MR) activation stimulates systemic vascular and left ventricular remodeling. We hypothesized that MR contributes to pulmonary vascular and right ventricular (RV) remodeling of pulmonary hypertension (PH). We evaluated the efficacy of MR antagonism by spironolactone in two experimental PH models; mouse chronic hypoxia-induced PH (prevention model) and rat monocrotaline-induced PH (prevention and treatment models). Last, the biological function of the MR was analyzed in cultured distal pulmonary artery smooth muscle cells (PASMCs). In hypoxic PH mice, spironolactone attenuated the increase in RV systolic pressure, pulmonary arterial muscularization, and RV fibrosis. In rat monocrotaline-induced PH (prevention arm), spironolactone attenuated pulmonary vascular resi...

Mechanical induction of group V phospholipase A2 causes lung inflammation and acute lung injury

AJP: Lung Cellular and Molecular Physiology — Wed, 15 May 2013 04:00:00 +0100

This study tested the hypothesis that onset of VILI is triggered by activation of secretory group V phospholipase A2 (gVPLA2) in pulmonary vascular endothelium exposed to excessive mechanical stretch. High-magnitude cyclic stretch (18% CS) increased expression and surface exposure of gVPLA2 in human pulmonary endothelial cells (EC). CS-induced gVPLA2 activation was required for activation of ICAM-1 expression and polymorphonuclear neutrophil (PMN) adhesion to CS-preconditioned EC. By contrast, physiological CS (5% CS) had no effect on gVPLA2 activation or EC-PMN adhesion. CS-induced ICAM-1 expression and EC-PMN adhesion were attenuated by the gVPLA2-blocking antibody (MCL-3G1), general inhibitor of soluble PLA2, LY311727, or siRNA-induced EC gVPLA2 knockdown. In vivo, ventilator-induced lu...

Human neutrophil elastase-mediated goblet cell metaplasia is attenuated in TACE-deficient mice

AJP: Lung Cellular and Molecular Physiology — Wed, 15 May 2013 04:00:00 +0100

Neutrophilic inflammation is associated with chronic airway diseases. It has been observed that human neutrophil elastase (HNE), which is secreted by active neutrophils during inflammation, induces both mucin overproduction and goblet cell metaplasia. Several in vitro studies suggest that tumor necrosis factor-α converting enzyme (TACE) regulates the signaling axis that mediates HNE-induced mucin overproduction; however, it is unknown whether TACE performs a similar function in HNE-induced goblet cell metaplasia in vivo. We conducted this study to determine whether the inactivation of Tace gene expression attenuates HNE-induced goblet cell metaplasia in mice. Deletion of Tace is lethal shortly after birth in mice; therefore, we utilized Taceflox/floxR26CreER+/– mice and induced...

Systemic inflammation, depression and obstructive pulmonary function: a population-based study

Respiratory Research — Wed, 15 May 2013 04:00:00 +0100

Conclusions: This study found for the first time an association of depressive symptoms and pulmonary function in older adults which appeared to be partly mediated by proinflammatory cytokines. Further studies should be conducted to investigate proinflammatory immune markers and depressive symptoms as potential phenotypic indicators for chronic obstructive airway disorders in older adults. (Source: Respiratory Research)

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Zinc supplementation for probable serious bacterial infection in early infancy may reduce the need for antibiotic change

Evidence-Based Medicine — Wed, 15 May 2013 04:00:00 +0100

Commentary on: Bhatnagar S, Wadhwa N, Aneja S, et al.. Zinc as adjunct treatment in infants aged between 7 and 120 days with probable serious bacterial infection: a randomised, double-blind, placebo-controlled trial. Lancet 2012;379:2072–8. Context It has now been over 15 years since the publication of the landmark study by Sazawal et al1 demonstrating the efficacy of zinc supplementation during an acute diarrheal episode in children under 5. Since then, dozens of clinical trials have been undertaken to further unravel the role of zinc supplementation to reduce under-5 morbidity and mortality. It is widely accepted that in zinc-deficient populations, zinc supplementation has both curative and preventive effects in the management of acute or chronic childhood diarrhoea with ...

Long-term coffee consumption associated with reduced risk of total and cause-specific mortality

Evidence-Based Medicine — Wed, 15 May 2013 04:00:00 +0100

Commentary on: Freedman ND, Park Y, Abnet CC, Hollenbeck AR, Sinha R, et al.. Association of coffee drinking with total and cause-specific mortality. N Engl J Med 2012;366:1891–904. Context The effect of coffee consumption on health is being re-examined based on new evidence suggesting a beneficial effect of components in coffee other than caffeine,1–3 an effect that may be seen in the long term after the acute harmful effects of caffeine have disappeared. Supporting this idea, several recent well-designed cohort studies have found an inverse association between long-term coffee consumption and the risk of all-cause mortality in different populations.4–6 On the contrary, because coffee consumption can acutely increase the risk of several health problems (insomnia, anxiety...

Neonatal stress augments the hypoxic chemoreflex of adult male rats by increasing AMPA receptor‐mediated modulation

Experimental Physiology — Wed, 15 May 2013 04:00:00 +0100

New Findings •What is the central question of this study?Early life exposure to stress augments the hypoxic chemoreflex of adult male rats. This effect predisposes to respiratory instability during sleep. We used pharmacological and neuroanatomical approaches to determine whether a change in glutamatergic neurotransmission contributes to this abnormal respiratory phenotype. •What is the main finding and its importance?We initially showed that neonatal stress augments sensitivity to an AMPA/kainate receptor antagonist. Results from autoradiography experiments support this observation because they demonstrate that neonatal stress increases expression of AMPA receptors in key regions that regulate breathing. Region‐specific changes in brain‐derived neurotrophic factor expression m...

Chondrosarcoma Presenting as a Saddle Tumor Pulmonary Embolism

Journal of Cardiac Surgery — Wed, 15 May 2013 04:00:00 +0100

Abstract This is a case of an 18‐year‐old male who presented with hip pain, shortness of breath, and respiratory failure and was found to have a large saddle pulmonary embolus involving the pulmonary artery bifurcation, which extended into the main right and left pulmonary arteries, as well as the lobar branches bilaterally. The patient was taken to the operating room for an emergent pulmonary embolectomy where a significant amount of tumor was removed through an incision in the main pulmonary artery with pathology consistent with metastatic chondrosarcoma. (Source: Journal of Cardiac Surgery)

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Non-respiratory functions of the lung

Continuing Education in Anaesthesia, Critical Care — Wed, 15 May 2013 04:00:00 +0100

(Source: Continuing Education in Anaesthesia, Critical Care)

Major Pulmonary Embolism and Patent Foramen Ovale

Journal of Cardiothoracic and Vascular Anesthesia — Tue, 14 May 2013 15:11:35 +0100

The thrombus is localized in the pulmonary artery and its branches in most cases of major pulmonary embolism (MPE). Rare are the cases of biatrial thrombus entrapped in a patent foramen ovale (PFO). In such circumstances, MPE may be associated with cardiogenic shock, with a high risk of mortality. Fibrinolytic agents are the main treatment of MPE, but when they are contraindicated or failed to treat MPE, or in a patient with a risk of cardiac arrest by occlusion of cardiac blood flow, a surgical pulmonary embolectomy under cardiopulmonary bypass (CPB) remains the referred treatment. The authors report the case of a 59-year-old woman suffering from biatrial thrombus entrapped in a PFO with cardiogenic shock; she rapidly improved her respiratory and cardiac functions after an emergency surgi...

Intrathecal Morphine: The Forgotten Child

Journal of Cardiothoracic and Vascular Anesthesia — Tue, 14 May 2013 15:11:22 +0100

MOST PATIENTS EXPERIENCE considerable postoperative pain after thoracotomy. The pain originates from multiple sites and has somatic, visceral, and neurogenic components. The intensity of post-thoracotomy pain is related to the type and the extent of the surgical incision and is exacerbated during coughing. Pain after video-assisted thoracic surgery (VATS) is caused by damage to intercostal nerves that may have been crushed or severed during insertion of trocars. Respiratory function is impaired because patients tend to refrain from taking deep breaths that cause pain. Effective analgesia and inhibition of the perioperative stress response enable earlier patient mobilization, improve pulmonary gas exchange, and facilitate earlier discharge from the hospital. A reduction in length of stay de...

Abdominal MR Imaging in Children: Motion Compensation, Sequence Optimization, and Protocol Organization [Pediatric Imaging]

Radiographics recent issues — Tue, 14 May 2013 04:00:00 +0100

Familiarity with basic sequence properties and their trade-offs is necessary for radiologists performing abdominal magnetic resonance (MR) imaging. Acquiring diagnostic-quality MR images in the pediatric abdomen is challenging due to motion, inability to breath hold, varying patient size, and artifacts. Motion-compensation techniques (eg, respiratory gating, signal averaging, suppression of signal from moving tissue, swapping phase- and frequency-encoding directions, use of faster sequences with breath holding, parallel imaging, and radial k-space filling) can improve image quality. Each of these techniques is more suitable for use with certain sequences and acquisition planes and in specific situations and age groups. Different T1- and T2-weighted sequences work better in different age gr...

Respirology Case Reports ‐ Birth of a new online journal

Respirology — Tue, 14 May 2013 04:00:00 +0100

(Source: Respirology)

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Respirology Case Reports – New and filling a gap

Respirology — Tue, 14 May 2013 04:00:00 +0100

(Source: Respirology)

Clinical usefulness of a guideline‐based screening tool for the diagnosis of allergic rhinitis in asthmatics: the SACRA (Self Assessment of Allergic Rhinitis and Asthma) Questionnaire.

Respirology — Tue, 14 May 2013 04:00:00 +0100

ConclusionsSACRA may be a clinically useful tool for identifying bronchial asthma patients with AR. (Source: Respirology)

Carriage of Mycoplasma pneumoniae in the Upper Respiratory Tract of Symptomatic and Asymptomatic Children: An Observational Study

PLoS Medicine — Tue, 14 May 2013 04:00:00 +0100

Conclusions Although our study has limitations, such as a single study site and limited sample size, our data indicate that the presence of M. pneumoniae in the URT is common in asymptomatic children. The current diagnostic tests for M. pneumoniae are unable to differentiate between asymptomatic carriage and symptomatic infection.Please see later in the article for the Editors' Summary (Source: PLoS Medicine)

Cardiologists are more willing to prescribe β‐blockers than respiratory physicians: an Australasian clinical scenario survey

Internal Medicine Journal — Tue, 14 May 2013 04:00:00 +0100

ConclusionsOur perception that cardiologists were more willing to prescribe β‐blockers than respiratory physicians was confirmed. This probably results from a difference in focus (namely focus on benefit by cardiologists vs focus on risk by respiratory physicians), although other factors including awareness of limitations of pulmonary function testing by respiratory physicians may have been involved. Until better tests are available (that discriminate between patients who are likely to suffer bronchoconstriction from those who are not), it is likely that this difference between the specialties will remain. (Source: Internal Medicine Journal)

Lower respiratory tract viral infections in pediatric abdominal organ transplant recipients: A single hospital inpatient cohort study

Pediatric Transplantation — Tue, 14 May 2013 04:00:00 +0100

This study indicates that rhinovirus is a significant cause of morbidity in this single center cohort of pediatric abdominal organ transplant recipients. (Source: Pediatric Transplantation)

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Predictive factors for early mortality among patients with methicillin-resistant Staphylococcus aureus bacteraemia

Journal of Antimicrobial Chemotherapy — Tue, 14 May 2013 04:00:00 +0100

Conclusions In our large cohort of patients several factors were related to EM, but the only distinctive predictor of EM was inappropriate initial antibiotic therapy. (Source: Journal of Antimicrobial Chemotherapy)

Chest X-ray and electrocardiogram in post-cardiac surgery follow-up clinics: should this be offered routinely or when clinically indicated?

Interactive CardioVascular and Thoracic Surgery — Tue, 14 May 2013 04:00:00 +0100

CONCLUSIONS There is a strong correlation between clinical indication for CXR and/or ECG and management alterations. These investigations should be performed during the routine follow-up of adult cardiac surgical patients using a patient-centred approach based on signs and symptoms. (Source: Interactive CardioVascular and Thoracic Surgery)

Late outcomes for the surgical management of absent pulmonary valve syndrome in infants

Interactive CardioVascular and Thoracic Surgery — Tue, 14 May 2013 04:00:00 +0100

CONCLUSIONS Surgical treatment of APVS has got favourable outcomes in terms of mortality and reoperation rate. Different methods of RVOT reconstruction do not affect the surgical outcome. Patients required long-term follow-up for postoperative respiratory complications secondary to persistent bronchomalacia. (Source: Interactive CardioVascular and Thoracic Surgery)

The role of intercostal cryoanalgesia in post-thoracotomy analgesia

Interactive CardioVascular and Thoracic Surgery — Tue, 14 May 2013 04:00:00 +0100

CONCLUSIONS We suggest that cryoanalgesia be considered as a simple, safe, inexpensive, long-term form of post-thoracotomy pain relief. Cryoanalgesia effectively restores FEV1 values at the second postop month. (Source: Interactive CardioVascular and Thoracic Surgery)

Routine postoperative chest X-ray is unnecessary following the Nuss procedure for pectus excavatum

Interactive CardioVascular and Thoracic Surgery — Tue, 14 May 2013 04:00:00 +0100

CONCLUSIONS Only patients with respiratory symptoms after the Nuss procedure need a chest X-ray. A routine chest X-ray can be limited to the time of discharge where the position of the bar(s) is also checked. (Source: Interactive CardioVascular and Thoracic Surgery)

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Does a minimally invasive approach result in better pulmonary function postoperatively when compared with median sternotomy for coronary artery bypass graft?

Interactive CardioVascular and Thoracic Surgery — Tue, 14 May 2013 04:00:00 +0100

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was ‘Does a minimally invasive approach result in better pulmonary function postoperatively when compared with median sternotomy for coronary artery bypass graft?’. Procedures such as limited sternotomy and minimally invasive direct coronary artery bypass (MIDCAB) though a minithoracotomy were regarded as minimally invasive. Overall, 681 papers were found, of which eight represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, evidence level, relevant outcomes and results of these papers were tabulated. Three randomized, controlled trials (RCT) were included: One study sugg...

The association between obesity and outpatient visits for acute respiratory infections in Ontario, Canada

International Journal of Obesity — Tue, 14 May 2013 04:00:00 +0100

Authors: M A Campitelli, L C Rosella & J C Kwong (Source: International Journal of Obesity)

In Vitro Delivery of Aerosolized Treprostinil via Modern Mechanical Ventilation

Journal of Aerosol Medicine and Pulmonary Drug Delivery — Tue, 14 May 2013 03:03:29 +0100

Journal of Aerosol Medicine and Pulmonary Drug Delivery , Vol. 0, No. 0. (Source: Journal of Aerosol Medicine and Pulmonary Drug Delivery)

Influence of Exhalation Valve and Nebulizer Position on Albuterol Delivery During Noninvasive Positive Pressure Ventilation

Journal of Aerosol Medicine and Pulmonary Drug Delivery — Mon, 13 May 2013 15:51:13 +0100

Journal of Aerosol Medicine and Pulmonary Drug Delivery , Vol. 0, No. 0. (Source: Journal of Aerosol Medicine and Pulmonary Drug Delivery)

Lung Deposition and Pharmacokinetics of Nebulized Cyclosporine in Lung Transplant Patients

Journal of Aerosol Medicine and Pulmonary Drug Delivery — Mon, 13 May 2013 15:51:02 +0100

Journal of Aerosol Medicine and Pulmonary Drug Delivery , Vol. 0, No. 0. (Source: Journal of Aerosol Medicine and Pulmonary Drug Delivery)

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Comparison of Laser Diffraction Measurements by Mastersizer X and Spraytec to Characterize Droplet Size Distribution of Medical Liquid Aerosols

Journal of Aerosol Medicine and Pulmonary Drug Delivery — Mon, 13 May 2013 15:50:56 +0100

Journal of Aerosol Medicine and Pulmonary Drug Delivery , Vol. 0, No. 0. (Source: Journal of Aerosol Medicine and Pulmonary Drug Delivery)

Elan buys stake in Theravance royalties for $1 billion

bizjournals.com Health Care:Hospitals headlines — Mon, 13 May 2013 14:26:30 +0100

Elan Corp. has made a $1 billion deal to buy a share of royalties from new drugs made by Theravance Inc., as it works to spurn a takeover offer by Royalty Pharma, Bloomberg reports. The deal will give Elan 21 percent of royalties earned by Theravance from GlaxoSmithKline Plc on four respiratory medicines. Elan's board last month rejected a $5.7 billion takeover bid from Royalty Pharma. Elan said it is planning to announce several more deals this year. Read more at Bloomberg. (Source: bizjournals.com Health Care:Hospitals headlines)

Growth characteristics of human parechovirus 1 to 6 on different cell lines and cross- neutralization of human parechovirus antibodies: a comparison of the cytopathic effect and real time PCR

Virology Journal — Mon, 13 May 2013 04:00:00 +0100

Conclusion: When replication is monitored by PCR, growth of HPeV genotypes 1 to 6 is supported by most of the cell lines tested, where viral replication is measured before appearance of CPE. A combination of HT29 and Vero cells would therefore support replication of all culturable HPeV types, so viral replication could be detected by PCR within 3 days for all genotypes.In addition, we showed efficient neutralization for HPeV1, 2, 4, 5, while cross- neutralization was shown between these types, indicating possible common neutralizing epitopes. For HPeV3 no efficient (cross-) neutralization was shown, indicating different neutralizing epitopes for HPeV3 compared to the other HPeV genotypes. (Source: Virology Journal)

Outpatient respiratory management of the child with severe neurological impairment

Archives of Disease in Childhood - Education and Practice — Mon, 13 May 2013 04:00:00 +0100

Most paediatricians will have faced the challenge of managing respiratory problems in the child with severe neurological impairment. These children are under-represented in clinical trials, and data is therefore often extrapolated from other groups, for example children with cystic fibrosis. This means that robust evidence for respiratory management in children with severe neurological impairment is often lacking. Here we have attempted to piece together the existing evidence to provide a rational approach to the management of respiratory problems in children with severe neurological impairment. We also hope to highlight areas of uncertainty, in order to aid honest discussions with families. The respiratory management of the child with neuromuscular disease is beyond the scope of this arti...

Bronchodilators in wheezy under 2-year-olds: when and which (if any)?

Archives of Disease in Childhood - Education and Practice — Mon, 13 May 2013 04:00:00 +0100

Clinical case Amy is 13 months old and presented to the children's emergency department with a 5-week history of wheezing. Her parents explain that they have seen her general practitioner twice and attended the local walk-in centre three times over the last month. She has been prescribed antibiotics and salbutamol both of which Amy ‘hates’. On examination, she had a dry cough with mild respiratory distress. She has occasional crepitations and widespread wheeze. Parents smoke ‘outside the house’ but neither has asthma. She is their first child. Clinically, she is well but parents would like to know whether inhalers will help. Introduction Birth cohort studies have demonstrated that approximately one-third of the children aged between 1 and 5 years suffer re...

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Autonomic cardio‐respiratory reflex reactions and superselective ophthalmic arterial chemotherapy for retinoblastoma

Pediatric Anesthesia — Mon, 13 May 2013 04:00:00 +0100

ConclusionAdverse cardio‐respiratory reactions are commonly observed in SOAC for retinoblastoma. We believe that the adverse clinical signs represent an autonomic reflex response, akin to the trigemino‐cardiac or oculo‐respiratory reflexes, and all patients should be considered at‐risk. Reactions occur only during second or subsequent procedures and can be life‐threatening. The routine use of intravenous atropine does not seem to have altered the incidence or severity of these reactions. Anesthetists and interventional neuroradiologists involved in SOAC must be vigilant to ensure adverse reactions, when they develop, are treated quickly and effectively. (Source: Pediatric Anesthesia)

Tension gastrothorax: a rare cause of breathlessness

Emergency Medicine Journal — Mon, 13 May 2013 04:00:00 +0100

A 67-year-old lady presented to the emergency department with a 4 day history of breathlessness for which she had started clarithromycin. She had a history of a hiatal hernia repair in 1996 and had recently started inhalers for presumed chronic obstructive pulmonary disease (COPD). Her pulse was 101 bpm, blood pressure 174/120 mm Hg, respiratory rate 36 and O2 saturations 88% on air. She was clammy, dyspnoeic and auscultation of her chest revealed global wheeze. She was treated for an exacerbation of COPD. A chest radiograph showed a massive gastrothorax with mediastinal shift (figure 1). Attempts to pass a nasogastric tube were unsuccessful and she rapidly deteriorated, becoming drowsy, dropping her blood pressure to 108/60 mm Hg and O2 saturations to 86% on ...

Validation of SAPS3 Admission Score and Its Customization for Use in Korean ICU Patients: A Prospective Multicenter Study

Respirology — Mon, 13 May 2013 04:00:00 +0100

ConclusionsGeneral and regional Australasia SAPS3 admission scores showed poor calibration for use in Korean ICU patients, but the prognostic power of the SAPS3 was significantly improved by customization. Prediction models should be customized before being used to predict mortality in different regions of the world. (Source: Respirology)

Chronic cough hypersensitivity syndrome

Cough — Mon, 13 May 2013 04:00:00 +0100

Chronic cough has been suggested to be due to three conditions, asthma, post nasal drip, and reflux disease. A different paradigm has evolved in which cough is viewed as the primary condition characterised by afferent neuronal hypersensitivity and different aspects of this syndrome are manifest in the different phenotypes of cough. There are several advantages to viewing cough hypersensitivity as the unifying diagnosis; Communication with patients is aided, aetiology is not restricted and therapeutic avenues opened. Cough Hypersensitivity Syndrome is a more applicable label to embrace the clinical manifestations of this disabling disease. (Source: Cough)

Asbestosis: Past voices from the Mumbai factory floor

Indian Journal of Occupational and Environmental Medicine — Mon, 13 May 2013 04:00:00 +0100

Conclusion: Apart from the radical step of ban on asbestos, there is a need of community-based sustainable, affordable, and accessible rehabilitation program with a component of palliative care which will consider the different needs of this marginalized group. The need for such a program is intense as the number of asbestisis patients will keep on increasing till 30 to 40 years of asbestos ban. (Source: Indian Journal of Occupational and Environmental Medicine)

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Respiratory morbidity due to ammonia exposure among the employees of a urea manufacturing industry located in western part of India

Indian Journal of Occupational and Environmental Medicine — Mon, 13 May 2013 04:00:00 +0100

This study explores the magnitude of respiratory morbidity among employees of a urea manufacturing industry and to establish its association with exposure to ammonia. Data was collected related to significant respiratory illnesses of all the employees over a period of 10 years using computer-based medical record system of the industry's hospital. The results obtained from the data analysis showed that there is no cause and effect relationship between exposure to ammonia and respiratory morbidity. Thus it was advised to the medical authority at industry to go for mass treatment with anthelmintics and that all the employees should be screened for specific allergens and this information should be used while managing respiratory morbidity. (Source: Indian Journal of Occupational and Env...

A Novel Case of Transient Right Ventricular Failure in a Patient With Respiratory Distress

Journal of Intensive Care Medicine — Mon, 13 May 2013 04:00:00 +0100

We report the case of a 61-year-old woman with no significant pulmonary or cardiac disease who presented with hypoxic respiratory failure in the setting of opioid overdose. She remained obtunded despite naloxone treatment and required endotracheal intubation as well as norepinephrine therapy for persistent hypotension. A transthoracic echocardiogram demonstrated isolated severe RV dysfunction without any LV abnormalities. Cardiac catheterization showed no obstructive coronary artery disease, pulmonary hypertension, or elevated left atrial pressures, and chest imaging only revealed signs of aspiration. Over the next 6 days, the patient’s cardiac and respiratory function improved, and a repeat echocardiogram demonstrated complete normalization of RV function. This case demonstrates a n...

Heat stress does not augment ventilatory responses to presyncopal limited lower body negative pressure

Experimental Physiology — Mon, 13 May 2013 04:00:00 +0100

The objective of this project was to test the hypothesis that ventilatory responses to reductions in central blood volume and arterial pressure during simulated haemorrhage are enhanced when individuals are heat stressed rather than normothermic. Eight healthy men (34 ± 9 years old, 176 ± 6 cm tall and 80.2 ± 4.2 kg body weight) underwent a simulated haemorrhagic challenge via LBNP until presyncope on two separate occasions, namely normothermic control and whole‐body heat‐stress trials. Baseline ventilation and core and mean skin temperatures were not different between trials (all P > 0.05). Prior to LBNP, heat stress increased core (from 36.8 ± 0.2 to 38.2 ± 0.2°C, P < 0.05) and mean skin temperatures (from 33.9 ± 0.5 to 38.1 ± 0.6°C, P < 0.05), as well as minute ven...

Synthesis of Acylguanidine Zanamivir Derivatives as Neuraminidase Inhibitors and the Evaluation of Their Bio-activities

RSC - Organic Biomolecular Chemistry — Sun, 12 May 2013 16:11:23 +0100

Org. Biomol. Chem., 2013, Accepted ManuscriptDOI: 10.1039/C3OB40624E, CommunicationChun-Cheng Lin, JTA Hsu, Jinn-Moon Yang, Mark von Itzstein, Kai-Cheng Hsu, Hui-Chen Hung, Ming-Yu Fang, Anindya Das, Tsung-Che Chang, Chien-Hung Lin, Kwok Kong T. MongInfluenza virus is the cause of major respiratory illness in human populations, and the trimeric viral hemagglutinin (HA) and neuraminidase (NA) proteins are the two most prominent antigens targeted by...The content of this RSS Feed (c) The Royal Society of Chemistry (Source: RSC - Organic Biomolecular Chemistry)

Lung Assist Device: Development of Microfluidic Oxygenators for Preterm Infants with Respiratory Failure

RSC - Lab Chip latest articles — Sun, 12 May 2013 08:10:39 +0100

Lab Chip, 2013, Accepted ManuscriptDOI: 10.1039/C3LC41417E, PaperWen Wu, Niels Rochow, Emily Chan, Asmaa Manan, Christoph Fusch, Dipen Nagpal, Ponnambalam Ravi Selvaganapathy, Gerhard FuschThis paper reports the development of microfluidic oxygenator (MFO) units designed of a lung assist device (LAD) for newborn infants. This device will be connected to the umbilical vessels like...The content of this RSS Feed (c) The Royal Society of Chemistry (Source: RSC - Lab Chip latest articles)

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[News & Analysis] Infectious Diseases: Amid Heightened Concerns, New Name for Novel Coronavirus Emerges

Science: Current Issue — Sun, 12 May 2013 07:11:07 +0100

Pathogen to be christened Middle East respiratory syndrome coronavirus, or MERS-CoV.Author: Martin Enserink (Source: Science: Current Issue)

Characterization of the use of a cycle ergometer to assist in the physical therapy treatment of critically ill patients

Revista Brasileira de Terapia Intensiva — Sun, 12 May 2013 02:11:03 +0100

Endobronchial ultrasound: from lung cancer diagnosis and staging to translational research

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

(Source: Jornal Brasileiro de Pneumologia)

Relationship between exercise capacity and quality of life in adolescents with asthma

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: Higher levels of physical activity indicate better quality of life, as do lower perception of dyspnea and less leg fatigue. The 6MST proved to be a viable option for evaluating exercise capacity in adolescents with asthma, because it reflects the discomfort that asthma causes during activities of daily living. (Source: Jornal Brasileiro de Pneumologia)

Prevalences of asthma and rhinitis among adolescents in the city of Fortaleza, Brazil

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: Our data show that the prevalences of asthma and rhinitis symptoms remain high among females and private school students. (Source: Jornal Brasileiro de Pneumologia)

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A clinical decision support system for venous thromboembolism prophylaxis at a general hospital in a middle-income country

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: It is possible to increase the use of appropriate VTE prophylaxis in economically constrained settings through the use of a computerized protocol adhered to by trained professionals. The underutilization of prophylaxis continues to be a major problem, indicative of the need for ongoing improvement in the quality of inpatient care. (Source: Jornal Brasileiro de Pneumologia)

Tomographic and functional findings in severe COPD

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONES: En pacientes con EPOC-L severa no hay enfisema en la TCAR. El hallazgo más importante es el compromiso severo de la vía aérea. La disminución de la DLCO y del VA con DLCO/VA normal es probablemente determinada por la obstrucción bronquial severa y la mezcla incompleta del gas inspirado en la maniobra de la respiración única de la prueba de difusiónOBJECTIVE: Wood smoke exposure is a risk factor for COPD. For a given degree of airway obstruction, the reduction in DLCO is smaller in individuals with wood smoke-related COPD than in those with smoking-related COPD, suggesting that there is less emphysema in the former. The objective of this study was to compare HRCT findings between women with wood smoke-related COPD and women with smoking-related COPD. METHODS: Twenty-tw...

Pulmonary changes on HRCT scans in nonsmoking females with COPD due to wood smoke exposure

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: Wood smoke exposure causes predominantly bronchial changes, which can be detected by HRCT, even in patients with mild COPD. (Source: Jornal Brasileiro de Pneumologia)

Epidemiological aspects of respiratory symptoms treated in the emergency room of a tertiary care hospital

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSION: We found a high prevalence of respiratory symptoms as the motive for emergency room visits by adult and pediatric patients. Our results could inform decisions regarding the planning of prevention measures. Further epidemiological studies are needed in order to clarify the risk factors for severe respiratory symptoms. (Source: Jornal Brasileiro de Pneumologia)

Effects of methylprednisolone on inflammatory activity and oxidative stress in the lungs of brain-dead rats

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: In this model of brain death, the early and late administration of methylprednisolone had similar effects on inflammatory activity and lipid peroxidation in lung tissue. (Source: Jornal Brasileiro de Pneumologia)

Diagnostic contribution of molecular analysis of the cystic fibrosis transmembrane conductance regulator gene in patients suspected of having mild or atypical cystic fibrosis

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: The molecular analysis of the CFTR gene coding region showed a limited contribution to the diagnostic investigation of patients suspected of having mild or atypical CF. In addition, there were no associations between the clinical characteristics and the genetic diagnosis. (Source: Jornal Brasileiro de Pneumologia)

Reference values for the incremental shuttle walk test in healthy subjects: from the walk distance to physiological responses

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: Our results provide reference values for ISWD and physiological responses to the ISWT, which can be properly estimated by determining simple demographic and anthropometric characteristics in healthy adults > 40 years of age. The ISWT could be used in assessing physical fitness in the general adult population and in designing individualized walking programs. (Source: Jornal Brasileiro de Pneumologia)

Mortality due to respiratory diseases in the elderly after influenza vaccination campaigns in the Federal District, Brazil, 1996-2009

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: Influenza vaccination appears to have a positive impact on the prevention of mortality due to respiratory diseases, particularly in the population aged 70 or over. (Source: Jornal Brasileiro de Pneumologia)

Experimental study on the efficiency and safety of the manual hyperinflation maneuver as a secretion clearance technique

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: Under the conditions tested, MH produced safe Palv levels despite high Pprox. However, the MH maneuver was often performed in a way that did not favor secretion removal (PIF exceeding PEF), even after instruction. The unfavorable PIF/ PEF ratio was attributable to overly rapid inflations and low V T. (Source: Jornal Brasileiro de Pneumologia)

Prevalence of latent tuberculosis infection and risk of infection in patients with chronic kidney disease undergoing hemodialysis in a referral center in Brazil

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

CONCLUSIONS: In the population studied, the prevalence of LTBI was high, and the mean annual risk of infection was similar to that reported for the general population of Brazil, which suggests recent infection. (Source: Jornal Brasileiro de Pneumologia)

Completeness of tuberculosis reporting forms in five Brazilian capitals with a high incidence of the disease

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

O objetivo deste estudo foi avaliar a completude das fichas de notificações de tuberculose de cinco capitais brasileiras com alta incidência regional de tuberculose em 2010 - Salvador, Rio de Janeiro, Cuiabá, Porto Alegre e Belém - através dos relatórios de tabulação do Sistema Nacional de Informação de Agravos e Notificações. Porto Alegre e Cuiabá apresentaram os melhores resultados, enquanto o Rio de Janeiro, capital com o maior número de notificações de tuberculose no país, apresentou o pior. A baixa completude desses formulários pode comprometer a qualidade do Programa Nacional de Controle da Tuberculose e repercutir na assistência e nos processos decisórios.The aim of this study was to evaluate the completeness of tuberculosis reporting forms in the greater metrop...

Current status and clinical applicability of endobronchial ultrasound-guided transbronchial needle aspiration

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA, punção aspirativa por agulha guiada por ultrassom endobrônquico) tem desempenhado um papel fundamental no diagnóstico de lesões mediastinais, paratraqueais e peribrônquicas, assim como no estadiamento linfonodal da neoplasia pulmonar. Por se tratar de exame endoscópico minimamente invasivo cujo rendimento diagnóstico tem se mostrado comparável aos métodos cirúrgicos estabelecidos, o procedimento de EBUS-TBNA ganhou espaço rapidamente e já se encontra integrado à rotina de investigação em serviços de referência. Para a realização de EBUSTBNA, é importante o planejamento prévio ao procedimento, que deve incluir uma análise minuciosa dos exames radiológicos e cuidado especial com a coleta e pr...

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Pulmonary hypertension and pulmonary artery dissection

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

A dissecção da artéria pulmonar é uma complicação fatal da hipertensão pulmonar de longa duração que se manifesta como dor torácica aguda e lancinante, dispneia progressiva, choque cardiogênico ou morte súbita. Sua incidência é subestimada, e as opções terapêuticas são ainda limitadas. O aparecimento de uma dor torácica aguda ou nova, choque cardiogênico ou morte súbita em pacientes portadores de hipertensão pulmonar deve alertar para o diagnóstico de dissecção da artéria pulmonar.Pulmonary artery dissection is a fatal complication of long-standing pulmonary hypertension, manifesting as acute, stabbing chest pain, progressive dyspnea, cardiogenic shock, or sudden death. Its incidence has been underestimated, and therapeutic options are still scarce. In patients wi...

Efficacy of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in evaluating lung cancer recurrence

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

Impending paradoxical embolism across the interatrial septum

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

Whole-body magnetic resonance imaging for the evaluation of thoracic involvement in disseminated paracoccidioidomycosis

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

Successful thoracoscopic thymectomy in an infant

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

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Underdiagnosis of respiratory diseases during an economic downturn and the need for spirometry as a screening test

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

Authors' reply

Jornal Brasileiro de Pneumologia — Sat, 11 May 2013 13:11:31 +0100

Discontinuous gas exchange exhibition is a heritable trait in speckled cockroaches Nauphoeta cinerea

Journal of Evolutionary Biology — Sat, 11 May 2013 04:00:00 +0100

Abstract The regulation of insect respiratory gas exchange has long been an area of interest. In particular, the reason why insects from at least five orders exhibit patterns of gas exchange that include regular periods of spiracular closure has been the source of much controversy. Three adaptive hypotheses propose that these discontinuous gas‐exchange cycles (DGCs) evolved to either limit water loss across respiratory surfaces, facilitate gas exchange in underground environments or to limit oxidative damage. It is possible that DGCs evolved independently multiple times and for different reasons, but for DGCs to be a plausible target for natural selection, they must be heritable and confer a fitness benefit. In a previous study of cockroaches Nauphoeta cinerea, we demonstrated that DGCs ...

A detergent-free strategy for the reconstitution of active enzyme complexes from native biological membranes into nanoscale discs

BMC Biotechnology - Latest articles — Sat, 11 May 2013 04:00:00 +0100

Conclusions: We report a novel process for reconstituting fully operational protein complexes directly from cellular membranes into nanoscale lipid bilayers using the SMA copolymer. This facile, single-step strategy obviates the requirement for detergents and yields membrane complexes suitable for structural and functional studies. (Source: BMC Biotechnology - Latest articles)

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An examination of factors influencing delayed discharge of older people from hospital

International Journal of Geriatric Psychiatry — Fri, 10 May 2013 15:11:13 +0100

ConclusionPatient characteristics and especially the organisation of care in hospital and the provision of services on discharge are related to the likelihood of delayed discharge and LOS. Improved services and structures to systematically assess and treat patient needs in hospital, together with the timely provision of services providing post‐discharge services tailored to individual circumstances, are required. Copyright © 2013 John Wiley & Sons, Ltd. (Source: International Journal of Geriatric Psychiatry)

Lung Lavage in Meconium Aspiration Syndrome

Acta Paediatrica — Fri, 10 May 2013 04:00:00 +0100

Modulation of airway epithelial cell functions by Pidotimod: NF-kB cytoplasmatic expression and its nuclear translocation are associated with an increased TLR-2 expression

Italian Journal of Pediatrics — Fri, 10 May 2013 04:00:00 +0100

Conclusion: Through different effects on ERK1/2 and NF-kB, pidotimod was able to increase the expression of TLR-2 proteins, surface molecules involved in the initiation of the innate response to infectious stimuli. The lack of effect on ICAM-1 expression, the receptor for rhinovirus, and on IL-8 release, the potent chemotactic factor for neutrophils (that are already present in sites of infection), may represent protective functions. If confirmed in vivo, these activities may, at least in part, clarify the mechanism of action of this molecule at airway level. (Source: Italian Journal of Pediatrics)

Elevated circulating CTLA‐4 levels are related to lung function and inflammation in COPD

Respirology — Fri, 10 May 2013 04:00:00 +0100

(Source: Respirology)

Anti-inflammatory effects of clarithromycin in ventilator-induced lung injury

Respiratory Research — Fri, 10 May 2013 04:00:00 +0100

Conclusions: Clarithromycin ameliorates ventilator-induced lung injury and decreases neutrophil recruitment into the alveolar spaces. This could explain the advantages of macrolides in patients with acute lung injury and mechanical ventilation. (Source: Respiratory Research)

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Complications associated with endobronchial ultrasound-guided transbronchial needle aspiration: a nationwide survey by the Japan Society for Respiratory Endoscopy

Respiratory Research — Fri, 10 May 2013 04:00:00 +0100

Conclusions: Although the complication rate associated with EBUS-TBNA was found to be low, severe complications, including infectious complications, were observed, and the incidence of device breakage was high. Since the use of EBUS-TBNA is rapidly expanding in Japan, an educational program for its safe performance should be immediately established. (Source: Respiratory Research)

Granulocyte colony stimulating factor exacerbates antineutrophil cytoplasmic antibody vasculitis

Annals of the Rheumatic Diseases — Fri, 10 May 2013 04:00:00 +0100

Conclusions These data suggest that GCSF, which is raised in patient serum, may play an important role in exacerbating disease in ANCA vasculitis. In addition, GCSF therapy for neutropenia should be used with caution in these patients. (Source: Annals of the Rheumatic Diseases)

Suppression of elevations in serum C reactive protein levels by anti-IL-6 autoantibodies in two patients with severe bacterial infections

Annals of the Rheumatic Diseases — Fri, 10 May 2013 04:00:00 +0100

Serum C reactive protein (CRP) is generally elevated by infection. We encountered two patients with severe bacterial infections without increases in CRP. Patient 1: A 67-year-old man developed thoracic empyema by Escherichia coli and Streptococcus intermedius. His body temperature was 36.6°C, his leukocyte count was elevated (9960/μl) and he was negative for CRP (0.01 mg/dl). Despite antibiotic treatment, he died of respiratory failure. Patient 2: A 56-year-old woman developed multiple subcutaneous abscesses by Staphylococcus aureus. She had rheumatoid arthritis (RA) for 30 years and was treated with sodium aurothiomalate. Her body temperature was 37.4°C, and leukocyte count (5600/μl) and CRP (0.05 mg/dl) were not elevated. She recovered with antibiotics. Neith...

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Impact of clinical and health services research projects on decision-making: a qualitative study

Health Research Policy and Systems — Fri, 10 May 2013 04:00:00 +0100

Conclusions: In this study and according to key informants, the impact of these research projects on decision-making can be direct (the application of a finding or innovation) or indirect, contributing to a more complex change in clinical practice and healthcare organization, both having other contextual factors. The channels used to transfer this new knowledge to clinical practice are complex. Local scientific societies and the relationships between researchers and decision-makers can play a very important role. Specifically, the relationships between managers and research teams and the mutual knowledge of their activity have shown to be effective in applying research funding to practice and decision-making. Finally the facilitating factors and barriers identified by the respondents are c...

MINIREVIEW: Heme Sensor Proteins [Protein Structure and Folding]

Journal of Biological Chemistry — Fri, 10 May 2013 04:00:00 +0100

Heme is a prosthetic group best known for roles in oxygen transport, oxidative catalysis, and respiratory electron transport. Recent years have seen the roles of heme extended to sensors of gases such as O2 and NO and cell redox state, and as mediators of cellular responses to changes in intracellular levels of these gases. The importance of heme is further evident from identification of proteins that bind heme reversibly, using it as a signal, e.g. to regulate gene expression in circadian rhythm pathways and control heme synthesis itself. In this minireview, we explore the current knowledge of the diverse roles of heme sensor proteins. (Source: Journal of Biological Chemistry)

Effect of avian influenza A H5N1 infection on the expression of microRNA-141 in human respiratory epithelial cells

BMC Microbiology - Latest articles — Fri, 10 May 2013 04:00:00 +0100

Conclusions: Since TGF-beta2 is an important cytokine that can act as both an immunosuppressive agent and a potent proinflammatory molecule through its ability to attract and regulate inflammatory molecules, and previous report showed that only seasonal influenza H1N1 (but not the other avian influenza subtypes) could induce a persistent expression of TGF-beta2, we speculate that the modulation of TGF-beta2 expression by different influenza subtypes via miR-141 might be a critical step for determining the outcome of either normal or excessive inflammation progression. (Source: BMC Microbiology - Latest articles)

Arterial blood gas parameters in pet rabbits anaesthetized using a combination of fentanyl‐fluanisone‐midazolam‐isoflurane

The Journal of Small Animal Practice — Fri, 10 May 2013 04:00:00 +0100

ObjectivesBlood gas analysis is a well‐recognized method to monitor pulmonary function, blood oxygenation, ventilation and acid–base status during general anaesthesia. The aim of this study was to report blood gas analysis results in pet rabbits (Oryctolagus cuniculus) obtained during general anaesthesia using a portable clinical analyser. MethodsThirty‐two rabbits were premedicated with 0·2 mL/kg fentanyl and fluanisone. Anaesthesia was induced with 0·2 mg/kg midazolam and maintained with 2% isoflurane in oxygen via endotracheal tube. Arterial blood samples were taken from the central ear artery 10 minutes after induction of anaesthesia. ResultsRespiratory acidaemia was observed during anaesthesia. Mean ±sd (range) arterial blood pH was 7·33 ±0·08 (7·15 to 7·48). PaCO2 and P...

The otolaryngology hospitalist

The Laryngoscope — Fri, 10 May 2013 04:00:00 +0100

ConclusionsTo our knowledge, ours is the first full‐time otolaryngology hospitalist model in the United States. The hospitalist practice is a conceptually viable and clinically beneficial paradigm that should be considered at other similar institutions. Level of EvidenceN/A. (Source: The Laryngoscope)

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The impact of an antibiotic specific prescription form in the accident and emergency department

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions The recently introduced antibiotic specific prescription proforma helped prescribers in AED achieve 90% compliance with the Trust antimicrobial guidelines. The majority of prescriptions that were not compliant with guidelines had been prescribed out-of-hours, when the prescription was not in use. Nine prescriptions were for upper respiratory tract infections which are usually viral and antibiotics have not been shown to improve outcomes.1 This suggests that antibiotics are possibly being overused for this indication. In conclusion, AED prescribers should be made aware of the Trust prescribing guidance for antimicrobials and use of the pre-printed AED prescription should be encouraged out-of-hours as a prescribing tool to encourage the prudent prescribing of antibiotics. (Source...

Epidemiology and potential associated risk factors of drug-related problems in hospitalised children in UK

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions DRPs were common in the hospitalised children in this study; the most frequent were dosing problems; the majority of them were preventable. Polypharmacy and presence of respiratory system diseases were strong predictors of DRPs. The high percentage of preventable DRPs emphasises the importance of providing more training to healthcare professionals in the prescribing and use of medicines in children to minimise the risk of DRPs. (Source: Archives of Disease in Childhood)

Supernumerary intrathoracic rib

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

An 8-year-old afebrile boy presented with a 10-day history of runny nose and coughing, with no history of lung or other systemic disease and no sign of respiratory distress, tachypnoea or tachycardia. Chest radiography revealed that anterior portion of the right third rib was oriented caudally and ended mid-thorax (figure 1). A thick band extended from the anterior edge of the third rib to the anterior portion of the sixth rib, causing retraction of the attached pleura. Unenhanced helical thorax CT demonstrated inward and downward sloping of the distal end of the right third rib (figures 2 and 3). A thick band extended from the medial end of the third rib and attached to the diaphragm, which was pulled superiorly. These findings were consistent with a supernumerary intrathoracic rib, a rar...

Association of Lower Airway Inflammation With Physiologic Findings in Young Children With Cystic Fibrosis

Pediatric Pulmonology — Thu, 09 May 2013 04:00:00 +0100

(Source: Pediatric Pulmonology)

Comparison of Lung Clearance Index Measured During Helium Washin and Washout in Children With Cystic Fibrosis

Pediatric Pulmonology — Thu, 09 May 2013 04:00:00 +0100

ConclusionIn CF patients, discordances between abnormal LCIWI and LCIWO were observed. LCIWI and LCIWO were only weakly correlated. This likely resulted from technical factors as the use of mainstream molar mass signal, a temperature model validated for infants only and absence of CO2 correction. Pediatr Pulmonol. 2013 9999:XX–XX. © 2013 Wiley Periodicals, Inc. (Source: Pediatric Pulmonology)

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The Use of Doripenem in Pediatric Cystic Fibrosis Patients in Case of Meropenem Shortages

Pediatric Pulmonology — Thu, 09 May 2013 04:00:00 +0100

We present three cases administering intermittent extended infusion doripenem in pediatric CF patients for the treatment of an APE in the case of replacing meropenem due to shortage. The delivery of beta‐lactam antibiotics via intermittent extended infusion should be considered in order to optimize the pharmacodynamics of beta‐lactams in the treatment of an APE. Pediatr Pulmonol. © 2013 Wiley Periodicals, Inc. (Source: Pediatric Pulmonology)

Early-Life Wheezing and Respiratory Syncytial Virus Prevention

New England Journal of Medicine — Wed, 08 May 2013 21:00:38 +0100

New England Journal of Medicine, Volume 368, Issue 19, Page 1839-1841, May 2013. (Source: New England Journal of Medicine)

Respiratory Syncytial Virus and Recurrent Wheeze in Healthy Preterm Infants

New England Journal of Medicine — Wed, 08 May 2013 21:00:30 +0100

New England Journal of Medicine, Volume 368, Issue 19, Page 1791-1799, May 2013. (Source: New England Journal of Medicine)

Progress in Pediatrics in 2012: choices in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses

Italian Journal of Pediatrics — Wed, 08 May 2013 04:00:00 +0100

In this review, we summarize the progresses in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses that have been published in The Italian Journal of Pediatrics in 2012. The induction of Treg activity by probiotics might be effective for promoting tolerance towards food allergens. Nasal cytology is useful in patients with rhinitis for diagnosing chronic non-allergic non-infectious diseases. Atopic eczema is associated both with an aberrant skin matrix and impaired systemic immune response. Therefore, isolated topical treatment may have suboptimal effect. Diagnostic work-up of exercise-induced anaphylaxis, including exercise challenge test, is necessary to reach a diagnosis. Studies may support a role for nutrition ...

Expression of phospho‐Ca2+/calmodulin‐dependent protein kinase II in the pre‐Bötzinger complex of rats

Journal of Neurochemistry — Wed, 08 May 2013 04:00:00 +0100

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Respiratory rate records: the repeated rate?

Journal of Clinical Nursing — Wed, 08 May 2013 04:00:00 +0100

(Source: Journal of Clinical Nursing)

Highlights from this issue

Thorax — Wed, 08 May 2013 04:00:00 +0100

Spit it out? What can we expect novel therapies to do for patients with cystic fibrosis (CF)? Everyone wants a cure, but how will we know if we have achieved it? Mortality is only applicable if Methuselah was the principle investigator, because survival curves are so flat. Horsley et al (see page 532) have studied the response of 46 biomarkers to intravenous antibiotic treatment of CF pulmonary exacerbations (also known as CF lung attack, see Thorax passim) and ingeniously used the results to suggest which of these biomarkers might be useful for following the response to novel therapies, in their case the gene therapy trial. They studied five domains (symptoms, physiology, CT, and pulmonary and systemic inflammatory markers), and the winners were physiological (spirometry, lung clearance i...

Inhaled corticosteroids in COPD: quantifying risks and benefits

Thorax — Wed, 08 May 2013 04:00:00 +0100

It is by no means straightforward to analyse the change in the rate of chronic obstructive pulmonary disease (COPD) exacerbations in clinical trials. Exacerbation rates do not follow a normal distribution, nor do they occur at random. High exacerbation rates in a few patients can make average rates difficult to calculate and interpret. So, surely, transforming exacerbation rates into numbers needed to treat (NNT) should help. Not necessarily so—this is the message from Professor Suissa's paper.1 He points out that the simplistic transformation from annual exacerbation rates to NNT in some published papers is misleading. He then goes on to present an alternative way of calculating NNT from survival curves showing time to first exacerbation, and a model to estimate such curves even if ...

Another chemokine target bites the dust?

Thorax — Wed, 08 May 2013 04:00:00 +0100

Scanning through the table of contents in Thorax, you might be forgiven for skipping over the paper by Wang et al.1 Redundancy in the chemokine field may not feel like news; however, I would suggest you pause and take time to read the article and perhaps reflect on a number of important issues that this study highlights. My reflections are about publishing negative data, the role of CCR8 in asthma and some general principles about drug discovery. The importance of negative studies The paper by Wang is somewhat unusual because it essentially reports a negative conclusion. Judging by the number of internet blogs on the topic, it seems there is genuine concern about the inability to publish negative results, and there is now quantitative evidence to suggest that there is a growing trend for j...

Alternatives to warfarin for the treatment of pulmonary emboli: the EINSTEIN-PE Study

Thorax — Wed, 08 May 2013 04:00:00 +0100

The last few years have seen new oral anticoagulant treatments emerge with a major advantage over conventional vitamin K antagonism with warfarin: they have a predictable dose response that negates the need for laboratory monitoring. Dabigatran (Pradaxa), a direct thrombin inhibitor, and rivaroxaban are two such medications licenced for the prevention of stroke in atrial fibrillation. Rivaroxaban (Xiralto) is a direct inhibitor of Factor Xa. The 2011 ROCKET-AF study showed its efficacy in stroke prevention.1 The EINSTEIN-PE study was designed to compare efficacy and safety of fixed-dose oral rivaroxaban therapy against standard heparin plus warfarin in the treatment of symptomatic pulmonary emboli.2 This Bayer-sponsored study was randomised, open-label and included 4833 patients, half of w...

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What exactly are we doing to improve low lung cancer survival in the United Kingdom?

Thorax — Wed, 08 May 2013 04:00:00 +0100

Low lung cancer survival When one is presented with a blinded report of survival rates for lung cancer across developed countries, how can one identify the result for the UK? Exactly, choose the one with the poorest outcome. You would be correct more often than not (unless Denmark was included). In 2007 and 2009, the EUROCARE Group published results of cancer survival identifying the UK among the countries with the lowest survival rates for lung cancer in Europe.1 2 As expected, this was met with a degree of outrage and attribution of poor UK results to differences in population characteristics and quality of reporting. An articulate defence launched by Moller et al hypothesised ‘less favourable stage distribution in the United Kingdom’ as the likely explanation for poor UK out...

Antagonism of chemokine receptor CCR8 is ineffective in a primate model of asthma

Thorax — Wed, 08 May 2013 04:00:00 +0100

Conclusions These results clearly demonstrate a dispensable role for CCR8 in ameliorating allergic airway disease in atopic primates, and suggest that strategies other than CCR8 antagonism should be considered for the treatment of asthma. (Source: Thorax)

Safety and tolerability of the novel inhaled corticosteroid fluticasone furoate in combination with the {beta}2 agonist vilanterol administered once daily for 52 weeks in patients >=12 years old with asthma: a randomised trial

Thorax — Wed, 08 May 2013 04:00:00 +0100

Conclusions FF/VI (100/25 µg or 200/25 µg) administered once daily over 52 weeks was well tolerated by patients aged ≥12 years with asthma. The overall safety profile of FF/VI did not reveal any findings of significant clinical concern. ClinicalTrials.gov NCT01018186 (Source: Thorax)

Appearance of remodelled and dendritic cell-rich alveolar-lymphoid interfaces provides a structural basis for increased alveolar antigen uptake in chronic obstructive pulmonary disease

Thorax — Wed, 08 May 2013 04:00:00 +0100

Conclusions Severe stages of COPD are associated with an emergence of remodelled and dendritic cell-rich alveolar–lymphoid interfaces. This novel type of immune remodelling, which predicts an increased capacity to respond to alveolar antigens, is suggested to contribute to aggravated inflammation in COPD. (Source: Thorax)

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Changes in physiological, functional and structural markers of cystic fibrosis lung disease with treatment of a pulmonary exacerbation

Thorax — Wed, 08 May 2013 04:00:00 +0100

Discussion We identify the key biomarkers of inflammation, imaging and physiology that alter alongside symptomatic improvement following treatment of an acute CF exacerbation. These data, in parallel with our study of biomarkers in patients with stable CF, provide important guidance in choosing optimal biomarkers for novel therapies. Further, they highlight that such acute therapy predominantly improves large airway parameters and systemic inflammation, but has less effect on airway inflammation. (Source: Thorax)

Number needed to treat in COPD: exacerbations versus pneumonias

Thorax — Wed, 08 May 2013 04:00:00 +0100

Conclusions The NNT is a useful measure of the effect of drugs, but its proper calculation is essential to prevent misleading clinical practice guidelines. (Source: Thorax)

Impact of the Tohoku earthquake and tsunami on pneumonia hospitalisations and mortality among adults in northern Miyagi, Japan: a multicentre observational study

Thorax — Wed, 08 May 2013 04:00:00 +0100

Conclusions A substantial increase in the pneumonia burden was observed among adults after the Tohoku earthquake and tsunami. Although the exact cause remains unresolved, multiple factors including population aging and stressful living conditions likely contributed to this pneumonia outbreak. (Source: Thorax)