bluuebunny/crossref_metadata_2025_split huggingface dataset:
IL‐4 fails to regulatein vitroberyllium-induced cytokines in berylliosis
Authors: Maier L.A. , Sawyer R.T. , Tinkle S.S. , Kittle L.A. , Barker E.A. , Balkissoon R. , Rose C. , Newman L.S. 
Published: July 2002

Bronchoalveolar lavage (BAL) cells from patients with chronic beryllium disease (CBD) have been used to evaluate the beryllium-specific immune response and potential immunotherapeutics. Beryllium induces interferon‐γ (IFN‐γ), interleukin‐2 (IL‐2), tumour necrosis factor‐α (TNF‐α), interleukin‐6 (IL‐6) and interleukin‐10 (IL‐10) from BAL cells. An antibody to IL‐2 and recombinant human (rHu) IL‐10 is able to partially suppress the beryllium-stimulated immune response. To obtain BAL cells, bronchoscopy is required, providing risk to the patient and a limited number of cells to study the immune response. As a result, the objectives of the study were to determine 1) whether CBD peripheral blood mononuclear cells (PBMNs) stimulated with beryllium would produce a similar cytokine pattern as BAL cells, and 2) whether this response could be modulated by interleukin‐4 (IL‐4), an immunomodulatory cytokine.CBD and normal individuals' PBMN and BAL cells were stimulated with and without beryllium sulfate. To modulate this antigen-stimulated response, we added rHu IL‐4 to the unstimulated and beryllium-stimulated cells. IFN‐γ, IL‐2, TNF‐α, IL‐6 and IL‐10 cytokine concentrations were determined from cell supernatants by enzyme-linked immunosorbent assays (ELISA), while IL‐4 messenger ribonucleic acid (mRNA) was assessed using polymerase chain reaction (PCR).Beryllium did not stimulate any of these cytokines from normal PBMNs. Increasing levels of IL‐6 and TNF‐α were produced constituitively by CBD PBMNs over time. Compared to the unstimulated CBD PBMNs, beryllium stimulated significant IFN‐γ, TNF‐α, IL‐2, IL‐6 and IL‐10 production. This response was similar to that stimulated from CBD BAL cells, although of a much lower magnitude. Low levels of IL‐4 mRNA were found in CBD and control PBMNs, which were not increased with beryllium stimulation. The beryllium-stimulated cytokine levels were not decreased by the addition of IL‐4. IL‐4 was unable to downregulate any of these beryllium-stimulated cytokines from CBD BAL cells or increase IL‐4 mRNA from either CBD PBMN or BAL cells, and thus is an unlikely immunomodulatory agent in CBD.From the data, it was concluded that chronic beryllium disease peripheral blood mononuclear cells provide a model to study the beryllium-stimulated immune response. Interleukin‐4's inability to downregulate any of the beryllium-stimulated cytokines makes it an unlikely therapeutic candidate in chronic beryllium disease.
Higher occurrence of asthma-related symptoms in an urban than a suburban area in adults, but not in children
Authors: Wieringa M.H. , Vermeire P.A. , Van Bever H.P. , Nelen V.J. , Weyler J.J. 
Published: July 2002

In young adults, a higher occurrence of asthma-related symptoms was found in an urban than an adjacent suburban area in a survey performed in 1991. The authors now wondered whether such differences could be established in other age groups.The present study (in 1996) included 14,299 subjects, aged 5–75 yrs, of a random sample of the general population in the same two adjacent areas: the centre of Antwerp (Belgium) and its south suburban border. The standardized European Community Respiratory Health Survey (ECRHS) and International Study of Asthma and Allergies in Childhood (ISAAC) questionnaires were used to assess the occurrence of asthma-related symptoms.Higher rates were confirmed in urban compared to suburban Antwerp in adults (20–75 yrs), but no such area differences were found in children (5–8 and 12–15 yrs). Adjustment for a number of recorded risk factors did not seem to affect the area differences in asthma-related symptoms. Comparing the survey results of 1991 and 1996 in 20–44 yr old adults, the findings suggest a slight increase in reported respiratory symptoms in both areas.A higher occurrence of asthma symptoms was observed in the urban than suburban area in adults, but not in children. This might be explained by a progressive effect of long-term exposure to the “urban environment”. However, longitudinal studies are necessary to further clarify the factors accounting for these age-related area differences.
Ultrafine particles in urban air and respiratory health among adult asthmatics
Authors: Penttinen P. , Timonen K.L. , Tiittanen P. , Mirme A. , Ruuskanen J. , Pekkanen J. 
Published: July 2002

Airborne particles are associated with adverse health effects and contribute to excess mortality in epidemiological studies. A recent hypothesis proposes that the high numbers of ultrafine (<0.1 μm diameter) particles in ambient air might provoke alveolar inflammation and subsequently cause exacerbations in pre-existing cardiopulmonary diseases.To test the hypothesis adult asthmatics were followed with daily peak expiratory flow (PEF) measurements and symptom and medication diaries for six months, while simultaneously monitoring particulate pollution in ambient air. The associations between daily health endpoints of 57 asthmatics and indicators of air pollution were examined by multivariate regression models.Daily mean number concentration of particles, but not particle mass (PM10(particle mass <10 μm), PM2.5–10, PM2.5, PM1), was negatively associated with daily PEF deviations. The strongest effects were seen for particles in the ultrafine range. However, the effect of ultrafine particles could not definitely be separated from other traffic generated pollutants, namely nitric oxide, nitrogen dioxide and carbon monoxide. No associations were observed with respiratory symptoms or medication use.Particle mass measurements can be strongly influenced by mechanically produced, soil-derived particles, which may not be associated with adverse health effects. Therefore, air quality monitoring should include particle number concentrations, which mainly reflect ultrafine particles.
Elevated nitrite in breath condensates of children with respiratory disease
Authors: Formanek W. , Inci D. , Lauener R.P. , Wildhaber J.H. , Frey U. , Hall G.L. 
Published: July 2002

The aim of the study was to determine the differences in nitrite, in the exhaled breath condensates of healthy children and those children with asthma, cystic fibrosis (CF) and nonasthmatic, episodic cough.Breath condensates were obtained from 66 children (43 males:23 females, 3.1–16 yrs) and included 29 asthmatics, 12 clinically stable CF patients, 12 children with cough but not asthma and 13 healthy volunteers. The collected condensate was assayed colourimetrically using the Griess reaction to determine nitrite concentrations.Patients with CF (median: 5–95% percentiles; 2.02: 0.43–6.37 µM) or asthma (2.10: 0.63–5.45 µM) had significantly higher levels of nitrite compared to healthy subjects (0.41: 0.13–1.83 µM; p<0.05) or subjects with cough (0.75: 0.03–1.75 µM; p<0.05).Airway inflammation, as assessed by the nitrite in breath condensates, is present in children with asthma and cystic fibrosis, but not those children with nonasthmatic, episodic cough. Nitrite can be conveniently, cheaply and rapidly measured in breath condensates of children as young as 3 yrs of age, and may prove useful for the assessment of airway inflammation in children with respiratory disease.
Effect of inhaled heparin on lung function and coagulation in healthy volunteers
Authors: Bendstrup K.E. , Gram J. , Jensen J.I. 
Published: July 2002

The aim of the present study was to investigate the safety of increasing doses of a well-defined lower respiratory tract (LRT) dose of inhaled heparin with regard to pulmonary function and coagulation.Ten volunteers inhaled heparin from Sidestream jet nebulizers loaded with 100,000, 200,000, 300,000 or 400,000 International Units (IU) of heparin. Lung function, antifactor (anti)-Xa, activated partial thromboplastin time (APTT), tissue factor pathway inhibitor (TFPI), whole blood clotting time, platelets, von Willebrand factor, and C‐reactive protein were determined before and 1, 3, 6, and 24 h after inhalation.The highest LRT dose was 32,000 IU heparin. Inhaled heparin did not affect pulmonary function. The area under the curve of the anti-Xa activity increased with increasing doses of heparin (p=0.005), but remained unchanged for all other variables. Peak anti-Xa activity was 0.113 IU·mL−16 h after inhalation of 400,000 IU heparin. When compared to baseline values: anti-Xa increased after 200,000 (p=0.03), 300,000 (p=0.004), and 400,000 IU (p=0.002) heparin; APTT increased to a maximum of 1.03 6 h after inhalation of 400,000 IU heparin (p=0.05); TFPI increased after 100,000 (p=0.01), 200,000 (p=0.01), 300,000 (p=0.006) and 400,000 IU (p<0.001).Inhaled heparin delivery of 32,000 International Units to the lower respiratory tract can safely be inhaled for clinical or research purposes.
Noninvasive ventilation in cystic fibrosis patients with acute or chronic respiratory failure
Authors: Madden B.P. , Kariyawasam H. , Siddiqi A.J. , Machin A. , Pryor J.A. , Hodson M.E. 
Published: July 2002

The experience of using noninvasive ventilation (NIV) in 113 adult cystic fibrosis (CF) patients with chronic respiratory failure, during episodes of acute deterioration in respiratory function is reported.The patients aged 15–44 yrs were divided into three groups. Group A consisted of 65 patients (median forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) 0.7/1.4 L) who were on a lung transplant waiting list. Group B consisted of 25 patients (median FEV1/FVC 0.7/1.4 L) who were being evaluated for lung transplantation. Group C consisted of 23 patients (median FEV1/FVC 0.6/1.2 L) who were not being considered for lung transplantation.The mean duration of NIV support for groups A, B and C was 61 (range: 1–600) days, 53 (1–279) days and 45 (0.5–379) days respectively. Twenty-three patients in group A subsequently received lung transplantation and 12 of these patients had a median survival of 39 months postsurgery. Thirty-nine patients died and three awaited transplantation. Five patients in group B received a transplant four of whom survived; thirteen patients died and seven awaited transplantation. Twenty patients in group C died.Noninvasive ventilation improved hypoxia but failed to correct hypercapnia in these cystic fibrosis patients. Noninvasive ventilation is useful in the treatment of acute episodes of respiratory failure in cystic fibrosis patients with end-stage lung disease who have been accepted, or are being evaluated, for lung transplantation. For these patients, there is a possibility of prolonging life if they are successfully treated for their acute episode of respiratory failure until transplantation. In this group, treatment is not merely prolonging the process of dying.
Incidence of asthma and respiratory symptoms by sex, age and smoking in a community study
Authors: Eagan T.M.L. , Bakke P.S. , Eide G.E. , Gulsvik A. 
Published: July 2002

The purpose of this study was to establish incidence rates for a wide range of respiratory symptoms and asthma, and relate them to sex, age, and smoking habits.A cohort established in 1985 as a random sample from the population of Western Norway, aged 15–70 yrs, was followed-up in 1996–1997. Of the initial cohort of 3,786 subjects, a total of 2,819 replied to mailed questionnaires at both baseline and follow-up.The 11‐yrs cumulative incidence of asthma was 4.0% in males and 3.5% in females. For respiratory symptoms, the cumulative incidences for both sexes varied between 2.0% (dyspnoea grade 4) and 25.8% (wheezing), being higher in females than males for most symptoms. For calculation of odds ratios (ORs) multivariate logistic regression analyses were used. The sex and smoking-adjusted incidences increased by age for all symptoms except wheezing and attacks of dyspnoea. Those starting to smoke within the follow-up had ORs of 1.9–2.2 for the cough symotoms compared to never-smokers, after adjusting for sex, age, and pack-yrs.To conclude, the 11‐yrs incidence of dyspnoea increased with increasing pack-yrs, after adjusting for sex, age, and changes in smoking habits. This indicated that when analysing other risk factors, adjustment has to be made for the risks posed by smoking, sex and age.
Diagnosis and treatment of invasive pulmonary aspergillosis in neutropenic patients
Authors: Reichenberger F. , Habicht J.M. , Gratwohl A. , Tamm M. 
Published: July 2002

Invasive pulmonary aspergillosis is a major cause of morbidity and mortality in neutropenic patients.Microbiological and serological tests are of limited value. The diagnosis should be considered in neutropenic patients with fever not responding to antibiotics, and typical findings on thoracic computed tomography scan. Whenever possible, diagnosis should be confirmed by tissue examination. Newer techniques, such as polymerase chain reaction may change the current diagnostic approach.Therapeutic strategies consist of prophylaxis in risk groups and the early application of antifungal agents in suspected or probable disease. Amphotericin B as desoxycholate or lipid formulation is the current standard medication in invasive infection, although it has major side effects. Its role is challenged by the new azole derivates, such as itraconazole and voriconazole, and the new echinocandins. Additional therapies with cytokines, such as granulocyte macrophage colony stimulating factor and interferon‐γ, and with granulocyte transfusions are under evaluation. In selected cases lung resection is of proven diagnostic and therapeutic value.This paper analyses the current understanding of the pathogenesis and epidemiology of invasive aspergillosis and reviews the actual diagnostic and therapeutic strategies for invasive pulmonary aspergillosis in neutropenic patients.
Statin-induced fibrotic nonspecific interstitial pneumonia
Authors: Lantuejoul S. , Brambilla E. , Brambilla C. , Devouassoux G. 
Published: July 2002

Statins inhibit the 3‐hydroxy‐3‐methylglutaryl coenzyme A reductase, reduce the serum level of low-density lipoprotein cholesterol, and are extensively prescribed to prevent cardiovascular mortality and morbidity. Few systemic adverse effects, such as pseudopolymyositis, lupus-like syndromes, and anecdotal hypersensitivity pneumonitis, have been reported.A simvastatin-induced diffuse interstitial pneumonia associated with a nonspecific interstitial pneumonia pattern at histological analysis is repoted here. Ultrastructural analysis showed a diffuse cytoplasmic accumulation of intralysosomial lamellar inclusions in type II pneumonocytes, histiocytes and endothelial cells, suggesting a shared pathogenesis with amphiphilic drug-induced toxic lung injury. Because statins are increasingly prescribed, statin-induced interstitial lung disorders may be more frequently observed and early recognition will be required.
European framework for tuberculosis control and elimination in countries with a low incidence
Authors: Broekmans J.F. , Migliori G.B. , Rieder H.L. , Lees J. , Ruutu P. , Loddenkemper R. , Raviglione M.C. 
Published: July 2002

As countries approach the elimination phase of tuberculosis, specific problems and challenges emerge, due to the steadily declining incidence in the native population, the gradually increasing importance of the importation of latent tuberculosis infection and tuberculosis from other countries and the emergence of groups at particularly high risk of tuberculosis.Therefore, a Working Group of the World Health Organization (WHO), the International Union Against Tuberculosis and Lung Disease (IUATLD) and the Royal Netherlands Tuberculosis Association (KNCV) have developed a new framework for low incidence countries based on concepts and definitions consistent with those of previous recommendations from WHO/IUATLD Working Groups.In low-incidence countries, a broader spectrum of interventions is available and feasible, including: 1) a general approach to tuberculosis which ensures rapid detection and treatment of all the cases and prevention of unnecessary deaths; 2) an overall control strategy aimed at reducing the incidence of tuberculosis infection (risk-group management and prevention of transmission of infection in institutional settings) and 3) a tuberculosis elimination strategy aimed at reducing the prevalence of tuberculosis infection (outbreak management and provision of preventive therapy for specified groups and individuals).Government and private sector commitment towards elimination, effective case detection among symptomatic individuals together with active case finding in special groups, standard treatment of disease and infection, access to tuberculosis diagnostic and treatment services, prevention (e.g.through screening and bacille Calmette-Guéria immunization in specified groups), surveillance and treatment outcome monitoring are prerequisites to implementing the policy package recommended in this new framework document.
Assessment of activities of daily living with an ambulatory monitoring system: a comparative study in patients with chronic low back pain and nonsymptomatic controls
Authors: Spenkelink C D , Hutten M MR , Hermens H J , Greitemann B OL 
Published: July 2002

Objective: The aim of this study was twofold: (1) to investigate whether differences in activities of daily living exist between patients with chronic low back pain (CLBP) and nonsymptomatic controls; (2) to investigate the day-today variability in daily activities. Design: Physical activities were measured over a 24-hour period with an ambulant monitoring system. Setting: Measurements were carried out in the subject's own environment. Subjects: Forty-seven CLBP patients and 10 nonsymptomatic controls participated in this study. Results: On group level, CLBP patients show a lower activity pattern compared with controls, especially during the evening. This is re‘ected in a lower walking step frequency during the day and evening, more lying time during the day and a lower physical activity level, less standing time and more lying time during the evening. The day-to-day variability in activity pattern is high and similar for both the patient and control group. Conclusion: The lower activity level especially found during the evening might indicate that patients need all their capacity to perform the tasks imposed during the day and as a consequence have less capacity left for their leisure time, in general the evening. This suggests the existence of an imbalance between the patient's physical capacity and the imposed environmental load. The large but similar day-to-day variability in activity pattern, which does not support the clinical findings of ‘bad days’ in CLBP patients, suggests the need for repeated measures.
Speech and language therapy for dysarthria due to nonprogressive brain damage: a systematic Cochrane review
Authors: Sellars Cameron , Hughes Thomas , Langhorne Peter 
Published: July 2002

Background: Dysarthria is a common sequel of nonprogressive brain damage (typically stroke and traumatic brain damage). Impairment-based therapy and a wide variety of compensatory management strategies are undertaken by speech and language therapists with this patient population. Objective: To determine the efficacy of speech and language therapy interventions for adults with dysarthria following nonprogressive brain damage. Design: Systematic review. Search strategy: This review has drawn on the search strategies developed for the following Cochrane Groups as a whole: Stroke, Injuries, and Infectious Diseases. Relevant trials were identified in the Specialised Registers of Controlled Trials. We also searched the trials register of the Cochrane Rehabilitation and Related Therapies Field. The Cochrane Controlled Trials Register, MEDLINE, EMBASE, CINAHL, PsycLIT, and Linguistics and Language Behavior Abstracts were electronically searched. Hand-searching of the International Journal of Language and Communication Disorders and of reference lists from relevant articles and conference proceedings was also undertaken. Colleagues were approached to identify other possible published and unpublished studies. Selection criteria: Unconfounded randomized controlled trials. Data collection and analysis: One reviewer assessed trial quality. Two co-reviewers were available to examine any potential trials for possible inclusion in the review. Main results: No trials of the required standard were identified. Reviewers' conclusions: There is no evidence of the quality required by this review to support or refute the effectiveness of speech and language therapy interventions for dysarthria following nonprogressive brain damage. There is an urgent need for good quality research in this area.
Systematic reviews in rehabilitation for stroke: issues and approaches to addressing them
Authors: Greener J , Langhorne P 
Published: July 2002

Objectives: To describe the problems encountered when undertaking systematic reviews of rehabilitation and to give advice to reviewers about ways of addressing these issues. Background: Evidence-based practice has become established as a way of linking clinical practice with research evidence. The most robust evidence is usually considered to be that from randomized controlled trials, and from systematic reviews of these trials. However, most reviews have focused on drug and surgical interventions, and few reviews have been produced in the field of rehabilitation. This may be due to the unique difficulties that are posed by reviews in this area. Experience of systematic reviews in aphasia: We describe the challenges that occurred when carrying out systematic reviews of speech and language therapy for aphasia following stroke, and of ways to deliver rehabilitation services to people who have suffered a stroke. Issues arose at all stages of the reviews and included: using expertise; planning the review; defining the health care problem, patients, outcomes and interventions of interest; searching for, interpreting and synthesizing the results of the studies identified; and deriving implications from the review. Suggestions made to address these challenges include: developing a suitable team of reviewers; using inclusive and broad criteria for inclusion of trials to a review; developing appropriate search strategies; and using caution in arriving at conclusions. It is important to be explicit about decisions made during the review process concerning how to handle the challenges. Practical advice about carrying out reviews in the field of stroke rehabilitation is likely to be helpful to reviewers of other rehabilitative interventions. There are likely to be relatively few studies available for such reviews, and limitations in drawing specific practical conclusions. Such undertakings are, however, useful in setting the agenda for further research.