bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral airway involvement in asthma assessed by single-breath SF6and He washout
Authors: Gustafsson P.M. , Ljungberg H.K. , Kjellman B. 
Published: September 2008

The aim of the study was to assess how deep into the acinar region the airway response to cold dry-air hyperventilation challenge (CACh) reaches in subjects with asthma of different severity.Peripheral airway function was measured using a single-breath sulphur hexafluoride (SF6) and helium (He) washout test and overall airway function by forced expiratory volume in one second (FEV1) at rest, after CACh and β2-therapy in 55 adults with a history of asthma. The normalised phase-III slopes (SnIII) for SF6and He were used to assess peripheral airway obstruction and the (SF6-He) SnIIIdifference to indicate where obstruction occurred. While a greater HeversusSF6slope increase indicates a response close to the acinar entrance, the reverse indicates a response deeper into the acinar airspaces.Twelve subjects had a major fall in FEV1(≥20%) after CACh, 16 a minor fall (10–19%), and 27 did not react. Resting He and SF6SnIIIwere significantly greater in major responders with respect to minor and nonresponders, while resting FEV1did not differ between the three groups. The major responders showed marked increases of He and SF6SnIIIafter CACh, with greater increase for He resulting in a negative (SF6-He) SnIIIdifference.To conclude, airways close to the acinar entrance participate in the overall airway response to cold-air challenge in asthmatic adults with marked airway hyperresponsiveness to cold, dry air.
Prevalence and risk factors of asthma and wheezing among US adults: an analysis of the NHANES III data
Authors: Arif A.A. , Delclos G.L. , Lee E.S. , Tortolero S.R. , Whitehead L.W. 
Published: September 2008

The prevalence of asthma has been on the increase in the USA and worldwide. To understand the worsening epidemiological trends of asthma, this study analysed the data from the third National Health and Nutrition Examination Survey (NHANES III) to determine the prevalence and risk factors for asthma and wheezing among US adults.This analysis used data from 18,825 US adults aged ≥20 yrs who had participated in the NHANES III project. After excluding subjects with physician­diagnosed emphysema, a total of 18,393 subjects were included in the final analysis.The prevalence of current asthma (asthma) was 4.5% and the prevalence of wheezing in the previous 12 months (wheezing) was 16.4%. Mexican­Americans exhibited the lowest prevalence of asthma when compared with other race/ethnic groups. Multiple logistic regression analysis showed that Mexican­Americans were less likely to report asthma when compared to non­Hispanic whites. Low education level, female sex, current and past smoking status, pet ownership, lifetime diagnosis of physician­diagnosed hay fever and obesity were all significantly associated with asthma and/or wheezing. No significant effect of indoor air pollutants, as derived from the use of household heating/cooking appliances, on asthma and wheezing was observed in this study.In conclusion, this study observed racial/ethnic differences in the prevalence of asthma and wheezing and identified several important risk factors that may contribute to development and/or exacerbation of asthma and wheezing. Contrary to earlier reports, the proxy measures of indoor air pollution used in this study were not found to be associated with increased risk of asthma and wheezing.
Long-term changes in adult asthma prevalence
Authors: Brogger J. , Bakke P. , Eide G.E. , Johansen B. , Andersen A. , Gulsvik A. 
Published: September 2008

There has been an increase in asthma prevalence among children. Little evidence is available regarding long-term changes in asthma prevalence in adults.Two cross-sectional studies were performed among adults aged 15–70 yrs in Oslo, Norway, in 1972 and again in 1998–1999 (n=39,998). A postal self-completed questionnaire was used. Exactly the same questions and survey methods were used in both studies. In 1998–1999, additional telephone follow-up was included for postal nonresponders.The crude prevalence of ever having had a doctor's diagnosis of asthma increased from 3.4 to 9.3%. The prevalence of wheezing increased from 17.8 to 25.8% and attacks of breathlessness from 12.6 to 16.7%. After controlling for smoking, the risk of asthma among those aged <40 yrs had tripled. The increase in asthma was 50% greater in females than males. The prevalence of symptoms increased less than asthma diagnosis. Wheezing increased by 50% in those aged <40 yrs, with smaller increases at greater ages. The increase in symptoms was seen among both asthmatics and nonasthmatics.There has been a large increase in the prevalence of asthma diagnosis and asthma-like symptoms in adults. The increase is less pronounced among those aged >40 yrs.
C-reactive protein levels in community-acquired pneumonia
Authors: García Vázquez E. , Martínez J.A. , Mensa J. , Sánchez F. , Marcos M.A. , de Roux A. , Torres A. 
Published: September 2008

The diagnostic value of C-reactive protein (CRP) admission serum levels as an indicator of the aetiology of community-acquired pneumonia (CAP) was evaluated.A cohort of 1,222 patients with CAP was assessed. CRP levels were analysed in 258 patients with a single aetiological diagnosis.The mean CRP values in patients with pyogenic, atypical, viral andLegionella pneumophilapneumonia were: 16 mg·dL−1, 13 mg·dL−1, 14 mg·dL−1and 25 mg·dL−1, respectively. CRP levels were not significantly different among patients outcome research team (PORT) groups (19 mg·dL−1in groups I–II, 16 mg·dL−1in group III and 16 mg·dL−1in groups IV–V. A cut-off point of 25 mg·dL−1had a sensibility, specificity, positive predictive value and negative predictive value of 0.6, 0.83, 0.3, and 0.94, respectively. After controlling for age and PORT score, the odds of having a CRP level >25 mg·dL−1was 6.9 times higher in patients withL. pneumophilapneumonia than in those with non-L. pneumophilapneumonia.Patients withLegionella pneumophilapneumonia had higher C-reactive protein levels than those with pneumonia of any other aetiology, independently of severity of infection. Being a cheap and readily available test, C-reactive protein may be a useful adjunctive procedure in the diagnosis of community-acquired pneumonia.
Effect of intravenous hydrocortisone on nocturnal airflow limitation in childhood asthma
Authors: Landstra A.M. , Boezen H.M. , Postma D.S. , van Aalderen W.M.C. 
Published: September 2008

Low endogenous cortisol levels appear to contribute to the pathophysiology of nocturnal asthma. Lower cortisol levels are associated with lower forced expiratory volume in one second (FEV1) levels in children with asthma. The aim of the present study was to identify whether substitution of low serum cortisol with intravenous hydrocortisone decreases 24-h FEV1variation and/or indirect measures of airway inflammation.Hydrocortisone was given over 24 h in a double-blind randomised crossover design to 26 subjects. FEV1was measured every 4 h during 24 h; blood eosinophils and airway responsiveness to methacholine and adenosine 5′-monophosphate (AMP) were measured at 04:00 h and 16:00 h.Cortisol levels increased during the night and morning hours. FEV1values were higher at all time points in children with nocturnal asthma (n=10; 24-h FEV1variation ≥15%) which was significant at 08:00 h, unlike in the non-nocturnal asthma (NA−) group (n=16). Numbers of eosinophils (109·L−1) at 04:00 h decreased in the asthma group (median 0.61 (range 0.05–1.42)versus0.52 (0.05–1.79)). Provocative dose causing a 20% fall in FEV1(PD20) methacholine did not change, whereas PD20AMP improved only at 16:00 h in the NA− group (72.0 (0.13–144.0)versus144.0 (2.25–144.0) mg·mL−1).These results show that substitution of lower endogenous 24-h values of cortisol contribute to higher forced expiratory volume in one second values and a decrease of blood eosinophils as an inflammatory marker in more severe airway obstruction.
Determinants of altered quality of life in patients with sleep-related breathing disorders
Authors: Sforza E. , Janssens J.P. , Rochat T. , Ibanez V. 
Published: September 2008

Recent reports have suggested that altered quality of life and well-being are reported by patients with sleep-related breathing disorders (SRBD). There seems to be no data available in the literature on factors underlying these behavioural consequences. In this study, health-related quality of life (HRQL) scores were examined in SRBD patients in order to establish which factors are implicated in these disturbances.The study group consisted of 130 patients: 49 snorers and 81 patients with obstructive sleep apnoea. The Medical Outcome Survey Short Form-36 questionnaire was administered the morning after the sleep study and scores for the eight dimension scores were obtained. Patient's data were compared to normative sex- and age-matched data.In comparison with normal values, scores for all HRQL dimensions were decreased in SRBD patients, with a greater impact on subscores for “vitality”, “physical role”, “social functioning”, “mental health” and “role emotional” dimensions. While impairment in physical function was mostly influenced by sleep stage and obesity, subjective daytime sleepiness mainly affected the other dimensions.The authors conclude that the altered health-related quality of life of sleep-related breathing disorder patients is a multifactorial phenomenon depending on the interaction of sleep stages, daytime sleepiness and obesity, with no significant contribution of sleep fragmentation, hypoxaemia and apnoea recurrence.
Evaluation of a quantitative real-time PCR for the detection of respiratory syncytial virus in pulmonary diseases
Authors: Borg I. , Rohde G. , Löseke S. , Bittscheidt J. , Schultze-Werninghaus G. , Stephan V. , Bufe A. 
Published: September 2008

Respiratory syncytial virus (RSV) is known to cause acute lower respiratory tract infections (ARI) in young children and is involved in exacerbation of chronic obstructive pulmonary disease (COPD) in adults. The role of RSV in stable COPD and the viral load in different respiratory diseases has not been investigated to date.The present authors established and evaluated a quantitative TaqMan® real-time polymerase chain reaction assay specific for RSV subgroup A. Absolute quantification for the determination of viral load input was achieved using a control plasmid. The assay allowed for a quantification over a >6-log range and a detection limit of <10 RSV copies per reaction mixture.The assay was 30 times more sensitive than conventional nested polymerase chain reaction assays. Interassay sd was 1.3 and coefficient of variation 4.7% on average. Clinical specimens from infants with ARI (n=62) and elderly adults with COPD (n=125) were compared for viral loads. A total of 47% RSV-positive samples were found in the ARI study group and 28% in the COPD study group. The viral load of both study groups was found to differ significantly. In the ARI study group the viral load was increased almost 2000-fold, suggesting acute infection in this group and former or latent infection in the COPD group.Respiratory syncytial virus-A specific TaqMan® real-time polymerase chain reaction assay is a sensitive and rapid method for the determination of viral load in clinical samples. It enables differential statements concerning the involvement of respiratory syncytial virus in acute lower respiratory tract infections and chronic obstructive pulmonary disease to be achieved.
Possible anti-inflammatory effect of salmeterol against interleukin-8 and neutrophil activation in asthmain vivo
Authors: Reid D.W. , Ward C. , Wang N. , Zheng L. , Bish R. , Orsida B. , Walters E.H. 
Published: September 2008

In-vitrodata suggest that long-acting β2-agonists may have a neutrophil-stabilising effect. A reduction in airway wall eosinophil number following introduction of salmeterol in persistent asthma has previously been described. There is currently interest in the “neutrophil system” in asthma, and thus the aim of the present study was to investigate the effect of salmeterol on interleukin (IL)-8, neutrophils and myeloperoxidase (MPO) in persistent asthma.In the same 12-week double-blind parallel-group placebo-controlled study as described previously, the effects on bronchoalveolar lavage fluid (BALF) IL-8, neutrophils and MPO of introducing salmeterol (50 µgb.i.d.) or giving additional inhaled corticosteroid (fluticasone 100 µgb.i.d.) in 45 subjects with persistent asthma already on low/moderate doses of inhaled corticosteroids were further investigated.At baseline, BALF IL-8 but not neutrophil or MPO levels were significantly raised in the asthmatic subjects compared to normal controls. MPO levels correlated strongly with IL-8 levels, and weakly with BALF neutrophil numbers in the asthmatics. Fluticasone treatment resulted in significantly elevated neutrophil numbers, but not MPO or IL-8 levels. In contrast, introducing salmeterol significantly reduced IL-8 and MPO levels, but did not affect BALF neutrophil numbers. Interestingly, salmeterol and fluticasone showed significantly contrasting effects on MPO and neutrophils, and there was a divergent effect on IL-8 levels that almost reached significance.Excessive interleukin-8 levels may be relevant to asthma pathogenesis, even in the setting of moderate-dose inhaled corticosteroid therapy. Reduction in interleukin-8 production and possibly stabilisation of airway neutrophil numbers may explain the greater clinical benefit of adding a long-acting β2-agonist rather than merely increasing inhaled corticosteroid doses. Indeed, high-dose inhaled corticosteroid therapy alone may promote airway neutrophilia.
Definitions and types of work-related asthma: a nosological approach
Authors: Vandenplas O. , Malo J-L. 
Published: September 2008

The workplace can trigger or induce asthma and cause the onset of different types of work-related asthma. Analysis of previous definitions of occupational asthma (OA) led to the conclusion that evidence of a direct causal relationship between workplace exposure and the development of asthma remains the key element for defining OA.Based on clinical features and pathophysiological mechanisms, the following conditions should be distinguished in the spectrum of work-related asthma: 1) immunological OA characterised by a latency period necessary to acquire immunologically induced sensitisation; 2) nonimmunological OA characterised by the rapid onset of asthma following single or multiple exposures to high concentrations of irritant compounds; 3) work-related asthma defined by exacerbation of symptoms in workers with pre-existing or coincident asthma; and 4) variant syndromes including eosinophilic bronchitis, potroom asthma, and asthma-like disorders caused by organic dusts.The issues and controversies relating to this approach are critically reviewed in order to stimulate the consensus development of operational definitions of work-related asthma.
Pathophysiology and pharmacological treatment of pulmonary hypertension in acute respiratory distress syndrome
Authors: Moloney E.D. , Evans T.W. 
Published: September 2008

Pulmonary hypertension (PH) is a characteristic feature of the acute respiratory distress syndrome (ARDS). The magnitude of PH has been shown to correlate with the severity of lung injury in patients with ARDS independently of the severity of associated hypoxaemia and has an adverse prognostic significance.Early in the histopathological evolution of ARDS, pulmonary vasoconstriction, thromboembolism and interstitial oedema contribute to the development of PH, although pulmonary vascular remodelling probably occurs eventually. Intravenous vasodilator agents lead to an increase in intrapulmonary shunting and systemic hypotension, which can limit their therapeutic use, and have not been shown to improve survival. By contrast, rapidly metabolised vasodilators administered by inhalation induce selective pulmonary vasodilatation and decrease shunting, but again do not appear to confer a survival benefit.Research aimed at further understanding the mechanisms that underlie pulmonary hypertension, a characteristic feature of the acute respiratory distress syndrome, are expected to provide improvements in pharmacological interventions for the treatment of pulmonary hypertension in the acute respiratory distress syndrome.
Immunological mechanisms in pleural disease
Authors: Antony V.B. 
Published: September 2008

The pleural membrane consisting of pleural mesothelial cells and its underlying connective tissue layers play a critical role in immunological responses in both local and systemic diseases. The pleura, because of its intimate proximity to the lung, is positioned to respond to inflammatory changes in the lung parenchyma. Importantly, several systemic diseases have a predilection for expression on the pleural surface.Immunological responses in the pleura include the development of pleural permeability and pleural effusion formation as well as the development of pleural fibrosis and scarring. Under either circumstance, the normal functioning of the pleura is impaired and has multiple consequences leading to increased morbidity and even mortality for the patient.During infections in the pleural space, the pleural mesothelium responds by actively recruiting inflammatory phagocytic cells and allowing the movement of proteins from the vascular compartment into the pleural space. The release of chemokines by the pleural mesothelium allows for directed migration of phagocytic cells from the basilar surface of the pleura towards the apical surface.In malignant disease, the pleura may be the site of primary tumours such as mesothelioma and also the site for malignant metastatic deposits. Certain cancers such as cancers of the breast, ovary, lung, and stomach have a predilection for the pleural mesothelium. The process whereby malignant cells attach to the pleural mesothelium and develop autocrine mechanisms for survival in the pleural space are elucidated in this review. The pleura functions not only as a mechanical barrier, but also as an immunologically and metabolically responsive membrane that is involved in maintaining a dynamic homeostasis in the pleural space.
Single-breath transfer factor in young healthy adults: 21% or 17.5% inspired oxygen?
Authors: Normand H. , Marie C. , Mouadil A. 
Published: September 2008

For the measurement of the single-breath transfer factor of the lung for carbon monoxide (TL,CO,sb), the American Thoracic Society (ATS) recommends using a test gas with a 21% inspired fraction of oxygen (FI,O2) whereas the European Respiratory Society (ERS) expressly recommends 17–18%FI,O2. The ERS committee argues that with a higher concentration (e.g.21%) the alveolar fraction of oxygen (and accordinglyTL,CO,sb) “varies with the volume of the test gas which is inspired”, that is, presumably, in proportion to the volume of the test gas that is diluted in the alveolar volume.The current study measuredTL,CO,sband the transfer coefficient (KCO,sb) in duplicate in 67 healthy adults (age 17–23 yrs) using, in random order, an inspired gas containing either 17.5% or 21% oxygen. A correction was applied for carboxyhaemoglobin, in line with ATS recommendations.As expected,TL,CO,sbwas higher with 17.5%FI,O2test gas compared with 21%FI,O2test gas (11.98±2.68versus11.38±2.56 mmol·min−1·kPa−1, respectively) as well asKCO,sb(1.98±0.24versus1.90±0.23 mmol·min−1·kPa−1, respectively). The ratio ofTL,CO,sbmeasurements was strictly independent of the residual volume/total lung capacity ratio measured with plethysmography.Hence, the rationale used by the European Respiratory Society, which utilises a 17–18% inspired fraction of oxygen test gas for single-breath transfer of the lung for carbon monoxide measurements, would appear to be unwarranted in young healthy adults.
“Cyst-like” structures within the ciliary shafts in children with bronchiectasis
Authors: Pifferi M. , Cangiotti A.M. , Caramella D. , Pietrobelli A. , Ragazzo V. , De Marco E. , Macchia P. , Cinti S. , Boner A.L. 
Published: September 2008

“Cyst-like” structures within the ciliary shafts were considered in four adults as a primary defect involved in the development of bronchiectasis. In this study, the presence and the primary or secondary nature of this abnormality were assessed in children with bronchiectasis.High resolution computed tomography (HRCT) and nasal biopsies for motion analysis and transmission electron microscopy (TEM) evaluation of cilia were obtained in 45 children with recurrent lower airway infections and abnormal chest radiography.HRCT disclosed bronchiectasis in 35 out of 45 (77.8%) children and cyst-like structures were demonstrated with TEM in 29 out of 45 (64.4%) patients. Cyst-like structures were constantly associated with other ultrastructural abnormalities commonly observed in chronic inflammation, and were found both in subjects with primary and with secondary ciliary dyskinesia. When considering only patients with bronchiectasis, a significant correlation between prevalence of cyst-like structures and the severity of bronchiectasis was demonstrated. Follow-up (2–22 months) of seven patients demonstrated that in the five children with secondary dyskinesia, the ultrastructural defect completely disappeared and there was a small reduction in the abnormality in the two patients with primary dyskinesia.In contrast to one previous report, the reversibility of the defect suggests its secondary origin, which is most likely related to chronic airway inflammation.
Long-acting inhaled anticholinergic therapy improves sleeping oxygen saturation in COPD
Authors: McNicholas W.T. , Calverley P.M.A. , Lee A. , Edwards J.C. 
Published: September 2008

Oxygen desaturation occurs during sleep in severe chronic obstructive pulmonary disease (COPD), especially during rapid eye movement (REM) sleep, due to hypoventilation and ventilation-perfusion mismatching, but the possible contribution of airflow limitation is unclear.In a randomised, placebo-controlled, double-blind study of severe, stable COPD patients, the authors compared 4 weeks treatment with a long-acting inhaled anticholinergic agent (tiotropium), taken in the morning (tiotropium-AM), or in the evening (tiotropium-PM), on sleeping arterial oxygen saturation (Sa,O2) and sleep quality. Overnight polysomnography was performed at baseline and after 4 weeks treatment. A total of 95 patients with awake resting arterial oxygen tension ≤9.98 kPa (75 mmHg) were randomised, with a mean age of 66.4 yrs and mean forced expiratory volume in one second (FEV1) of 32% predicted.A total of 80 patients completed the study, of which 56 fulfilled the polysomnographic criterion of at least 2 h sleep in both sleep study nights and represent the group analysed. Tiotropium significantly improved spirometry compared with placebo. Both tiotropium-AM and tiotropium-PM groups had higherSa,O2during REM than placebo (+2.41% and +2.42%, respectively, and both pooled and tiotropium-PM groups had higherSa,O2during total sleep time (+2.49% and +3.06%, respectively). End-of-treatment FEV1correlated withSa,O2during REM sleep, however, tiotropium did not change sleep quality.Sustained anticholinergic blockade improves sleeping arterial oxygen saturation without affecting sleep quality.