bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maturation of the cholinergic response of tracheal smooth muscle in the piglet
Authors: Rodriguez Ricardo J. , Dreshaj Ismail A. , Kumar Ganesh , Miller Martha J. , Martin Richard J. 
Published: March 2007

AbstractMaturational changes of the contractile properties of airway smooth muscle have been suggested to occur during the late prenatal and early postnatal period in the piglet. However, the timing and mechanisms involved remain elusive. Therefore, we studied isometric contraction of tracheal smooth muscle (TSM) to evaluate the effects of maturation on (1) the response of TSM to the muscarinic agonist acetylcholine (Ach); and (2) the regulatory activity of acetylcholinesterase (AChE) during the early postnatal period in the piglet. Studies were per‐ formed in 1–5‐day‐old (n = 6) and 14–22‐day‐old (n = 8) anesthetized, mechanically ventilated piglets. Changes in tracheal tension were measured in vivo from an open tracheal segment and normalized for both longitudinal length of the tracheal segment and cross‐sectional area. Dose‐ response curves to locally applied Ach were obtained before and after the intravenous administration of the AChE inhibitor physostigmine (Phys). Ach‐induced changes in tracheal tension significantly increased with maturation during the first 3 weeks of life (P < 0.01), regardless of normalization method. The addition of Phys significantly increased the cholinergic responses of TSM in both age groups (P < 0.02). However, this increase was comparable between age groups. There was also no difference in AChE activity measured in tracheal smooth muscle homogenates between the 1–5 and 14–22‐day‐old animals. These data indicate that maturation significantly enhances the cholinergic responses of tracheal smooth muscle in the early postnatal period in the piglet. As the regulatory activity of AChE is equally developed in the first and third postnatal weeks, this does not account for the observed differences in force generation at these ages. Pediatr Pulmonol. 1994; 18: 28–33. © 1994 Wiley‐Liss. Inc.
Antioxidant status in asthma
Authors: Powell Colin V. E. , Nash Audrey A. , Powers Hilary J. , Primhak Robert A. 
Published: March 2007

AbstractReduced levels of glutathione peroxidase (GSH‐Px) have been observed in adults with asthma. This study examines the antioxidant status in children with asthma compared with a control group in a cross‐sectional analysis. Red blood cell GSH‐Px, superoxide dismutase (SOD), and plasma concentrations of retinol, vitamin C, alpha tocopherol, and cholesterol were measured in 37 subjects (26 males) with stable controlled asthma. Thirty‐five subjects (20 males) without eczema, hayfever, or recurrent respiratory symptoms were used as a control group. Children with asthma had significantly reduced red blood cell GSH‐Px activity compared with controls [median (inter‐quartile range) for asthma group, 10.25 (9.25–11.91)]; for control group, 11.75 (10.34–12.26) IU/g Hb; P = 0.0061. There were no significant differences in activity of SOD or vitamin C, retinol, or alpha tocopherol/cholesterol ratio. The reduction in GSH‐Px activity may have therapeutic and etiological implications for asthma. The effects of disease activity and treatment on antioxidant status needs for further study. Pediatr Pulmonol. 1994; 18:34–38. © 1994 Wiley‐Liss. Inc.
Improved outcome for young children with AIDS, Pneumocystis carinii pneumonia, and acute respiratory failure
Authors: Wong Hector R. , Chundu Koteswara R. 
Published: March 2007

AbstractObjective: To describe the clinical course of children with acquired immunodeficiency syndrome, requiring mechanical ventilation secondary to Pneumocystis carinii pneumonia, with respect to intensive care unit outcome, long‐term survival after intensive care unit discharge, and possible predictors of outcome.Design: Retrospective case series.Setting: Multidisciplinary, tertiary, pediatric intensive care unit.Patients: Thirteen consecutive patients accounting for 15 admissions to the intensive care unit, from September 1986 through December 1991, with the diagnoses of acquired immunodeficiency syndrome, P. carinii pneumonia, and acute respiratory failure requiring mechanical ventilation.Results: All patients were less than 2 years of age and acquired human immunodeficiency virus infection perinatally. Survival after 15 admissions to the intensive care unit was 60%. Mean (± SD) and median long‐term survival for the nine intensive care unit survivors was 30 ± 12.9 months and 27 months, respectively. Maximum oxygenation index and minimum partial pressure of arterial oxygen to fraction of inspired oxygen ratio were significantly different between survivors and nonsurvivors.Conclusions: Young children with acquired immunodeficiency syndrome who develop acute respiratory failure secondary to P. carinii pneumonia and who require mechanical ventilation may have a better acute outcome and long‐term survival than previously reported.Pediatr Pulmonol. 1994;18:114–118. © 1994 Wiley‐Liss, Inc.
Legionella and Pneumocystis pneumonias in asthmatic children on high doses of systemic steroids
Authors: Abernathy‐Carver K. J. , Fan L. L. , Boguniewicz M. , Larsen G. L. , Leung D. Y. M. 
Published: March 2007

AbstractAsthma is increasingly treated as an inflammatory disease with inhaled and/or systemic corticosteroids. We report 3 cases of unusual pneumonias associated with high doses of oral steroids. Two patients contracted Legionella pneumonia and one patient contracted Pneumocystis carinii pneumonia. With increasing usage, it is important for physicians to be aware of the possible infectious complications of high dose steroids. This report highlights the risk of corticosteroid treatment in asthma in predisposing to opportunistic infections that have not heretofore been readily associated with asthma.Pediatr Pulmonol. 1994;18:135–138. © 1994 Wiley‐Liss, Inc.
The effect of transfusion on pulmonary function in patients with thalassemia major
Authors: Santamaria F. , Villa M. P. , Werner B. , Cutrera R. , Barreto M. , Ronchetti R. 
Published: March 2007

AbstractPulmonary involvement has been documented in thalassemia major (TM). We studied 12 patients with TM before and 24 hr after transfusion to evaluate the effect of transfusion on baseline lung function. Personal and family histories of respiratory illnesses were obtained by a questionnaire. Spirometry and carbon monoxide diffusion capacity (KCO) measurements were made. Blood gases (P, and S,) were determined on arterialized samples. Baseline expiratory volumes and flows were within normal range in all patients. Transfusion resulted in a significant reduction of forced expiratory volume in 1 sec (FEV1) and forced expiratory flow between 25 and 75% vital capacity (FEF25–75%). In two subgroups of patients identified by the questionnaire, those with no history of airway disease had normal baseline flows and no posttransfusion changes; those with history of airway obstruction had lower pretransfusion flows and significantly decreased posttransfusion FEV1 and FEF25–75%. The mean pretransfusion KCO value of 80% predicted for the whole group, significantly increased after transfusion (P < 0.05). Blood gases also significantly increased after transfusion (P < 0.05). When tested for the spirometric response to albuterol, patients with a history of asthma had a slightly greater increase in FEV1 and FEF25–75% than those who had never had asthma. We conclude that in our small study group, transfusion resulted in improved gas exchange and lung perfusion. The effect on flow limitation evident in some patients could, in part, be related to a preexisting bronchial hyperreactivity. Accurate evaluation of pulmonary function and of bronchial reactivity is advisable for patients with TM. Pediatr Pulmonol. 1994;18:139–143. © 1994 Wiley‐Liss, Inc.
Forced expiratory maneuvers in children aged 3 to 5 years
Authors: Kanengiser Steven , Dozor Allen J. 
Published: March 2007

AbstractThere is no consensus about reproducibility and reliability of spirometry in young children. We evaluated forced expiratory maneuvers from 98 children aged 3 to 5 years with a variety of respiratory disorders before and after bronchodilator treatment. Forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV,) were analyzed for reproducibility by the American Thoracic Society criteria and for reliability based on the coefficient of variation (CVYo). Over 90% of the patients cooperated, however, while 95% could exhale for at least 1 second, very few generated an FEV, on all 6 “best” efforts. This clearly improved with age. Of all patients nearly 60% performed reproducible pre‐and postbronchodilator sets of FVC but only 32% performed reproducible sets of FEV1. Based on the CV%, those patients who could reproducibly perform an FVC and FEV, did it quite reliably (mean CV%, 9.38 and 7.01 for FVC and FEV1, respectively). We conclude that while some very young children can perform spirometry, reliability of performance cannot be assumed in this age group. Pediatr Pulmonol. 1994;18:144–149. © 1994 Wiley‐Liss, Inc.
Ventilation–perfusion relationships in preterm infants after surfactant treatment
Authors: Bowen Winslade , Martin Camilia R. , Krauss Alfred N. , Auld Peter A. M. 
Published: March 2007

AbstractArterial‐alveolar partial pressure differences for oxygen, carbon dioxide, and nitrogen were measured before and after surfactant replacement therapy on 15 occasions in 14 ventilator‐dependent preterm infants with hyaline membrane disease (HMD). Eight treatments resulted in a significant improvement in arterial partial pressure of oxygen (PaO2) 2 hr after treatment; 7 did not. Neither group showed any significant change in arterial‐alveolar partial pressure differences for oxygen, nitrogen, and carbon dioxide. This observation suggests that if surfactant replacement therapy produces an improvement in PaO2 it does so by recruitment of atelectatic alveoli with a balanced ventilation perfusion ratio rather than by redistribution of ventilation within already ventilated alveoli.Pediatr Pulmonol. 1994;18:155–162. © 1994 Wiley‐Liss, Inc.
The Hering–Breuer deflationary reflex in the newborn infant
Authors: Marsh Michael J. , Fox Grenville F. , Hoskyns E. Wren , Milner Anthony D. 
Published: March 2007

AbstractInitial observations on healthy term infants using the forced partial expiratory flow‐volume technique with an inflatable jacket suggested that this technique was stimulating the Hering‐Breuer deflationary reflex,1 a reflex which has not been systematically studied in man. To investigate this fully, esophageal pressure, jacket pressure, flow and volume at the mouth were recorded during the forced partial expiratory flow‐volume maneuver on 10 infants (mean age, 3.1 days; birth weight, 3533 g; gestation, 39.8 weeks). A total of 186 measurements were performed at different points in the respiratory cycle. In 159 (85%) recordings inspiratory effort was evident with a fall in esophageal pressure within 166 msec; in some cases this occurred before the jacket was fully inflated. This was associated with a reduction of 23.4 cm H2O in mean intrathoracic pressure, which was 2.5 times that occurring during normal tidal breathing. In the remaining 27 measurements a plateau pressure was associated with closure of the upper airway. When the squeeze was applied at low lung volumes (end‐expiration) the inspiratory effort occurred significantly earlier (133 msec) and stronger (reducing peak intrathoracic pressure to 15.8 cm H2O) than when applied at end‐inspiration (181 msec with a reduction in intrathoracic pressure to 25.2 cm H2O). The observed inspiratory response was highly consistent, representing the deflationary reflex as described by Hering and Breuer in 1868.2,3 The stronger and more rapid onset of inspiration at low lung volume supports the claim made by Breuer that it has a protective role on functional residual capacity (FRC) in young infants.Pediatr Pulmonol. 1994;18:163–169. © 1994 Wiley‐Liss, Inc.
Diaphragmatic paralysis in children: A review of 11 cases
Authors: Commare M. C. , Kurstjens S. P. , Barois A. 
Published: March 2007

AbstractWe reviewed 11 pediatric cases of diaphragmatic paralysis related to nonspinal‐cord injury which were managed in our Intensive Care Unit over the past 10 years. Three cases were secondary to birth trauma, 7 followed surgical procedures for congenital heart disease, and 1 occurred in association with injuries sustained in a motor vehicle accident. The paralysis was bilateral in 8 children. The diagnosis was initially suspected on clinical grounds because of respiratory distress, impossibility of weaning from the ventilator, and paradoxical abdominal respiratory movements. Confirmatory investigations included chest radiography, which revealed elevation of the affected hemidiaphragm, fluoroscopy and ultrasound, both of which demonstrated diminished diaphragmatic movement. Electromyography exhibited a failure of diaphragmatic response to phrenic nerve stimulation in 8 patients. All patients were mechanically ventilated: tracheostomy was required in 5 patients. Physiotherapy was considered a beneficial adjuvant measure. Diaphragmatic plication was attempted without success in 3 children. Seven children recovered without sequelae: Partial respiratory autonomy was achieved after an average of 2.6 months, complete autonomy after an average of 5.4 months. Two patients developed chronic lung disease; one of them remains unresponsive, and one child died following accidental extubation. We conclude that the diagnosis of diaphragmatic paralysis is predominantly clinical, and that the outcome of patients treated by adequate endotracheal mechanical ventilation is usually favorable.Pediatr Pulmonol. 1994;18:187–193. © 1994 Wiley‐Liss, Inc.
The use of aerosolized pentamidine for prophylaxis of Pneumocystis carinii pneumonia in children with leukemia
Authors: O'Sullivan Brian P. , Spaulding Rhoda 
Published: March 2007

AbstractWe report our experience giving aerosolized pentamidine as prophylaxis for Pneumocystis carinii pneumonia (PCP) to 9 children (mean age, 7.33 years; range 3–17 years) with leukemia who were unable to tolerate trimethoprim‐sulfamethoxazole (TMP‐SMX) due to allergy or myelosuppression. The dose of pentamidine was modified for each child to correct for weight and approximate alveolar ventilation. We were able to administer the drug to younger children by using a cushioned face mask in place of the standard mouthpiece. One child experienced moderate coughing with administration of pentamidine. He and four others with a past medical history suggestive of reactive airways disease were pretreated with inhaled albuterol. No other adverse effects were noted. Treatment lasted an average of 8.11 ± 4.1 months per child; no case of PCP occurred. We conclude that aerosolized pentamidine can be administered to even very young children and may be of benefit to all immunosuppressed children unable to use TMP‐SMX prophylaxis. The adjusted dose used here appears to be safe, but further studies regarding drug delivery and efficacy are needed.Pediatr Pulmonol. 1994;18:226–231. ©1994 Wiley‐Liss, Inc.
The effects of Bone Marrow transplantation on pulmonary function in children
Authors: Quigley Patricia M. , Yeager Andrew M. , Loughlin Gerald M. 
Published: March 2007

AbstractThe effects of current methods of bone marrow transplantation (BMT) on pulmonary function in children have not been extensively studied. We reviewed serial pulmonary function tests (PFTs) in 25 children (median age, 9 yr; range, 4—15) who received allogeneic (n = 14) or autologous (n = 11) BMT for neoplastic diseases at The Johns Hopkins Hospital. The PFTs were obtained before BMT and at 6 months (early) and 15 months (late) after transplant. In all but 6 patients, PFTs were normal before BMT. A mild transient decline in carbon monoxide diffusing capacity (DLcO) was observed early after BMT but returned to baseline levels in the late post‐BMT period. A trend towards worsening of PFTs with increasing age of patients was observed. The presence of graft‐versus‐host disease (GVHD) and pretransplant seropositivity for cytomegalovirus (CMV) were associated with significant decrements in several measurements of pulmonary function in the early post‐BMT period. Patients given bulsulfan‐containing preparative regimens tended to have less impairment of PFTs than those given other regimens using other combination high‐dose chemotherapeutic agents or total body irradiation. These findings suggest that abnormalities in PFTs are common in the first months after BMT in pediatric patients but are not consistently associated with impairment of lung function when studied 15 months post‐transplant.Pediatr Pulmonol. 1994;18:361–367. ©1994 Wiley‐Liss, Inc.
Irreversibility of birth‐related changes in the pulmonary circulation
Authors: Levine Gail L. , Goetzman Boyd W. , Milstein Jay M. , Bennett Stephen H. 
Published: March 2007

AbstractWe hypothesized that establishing conditions of hypoxia and fluid filling of the airways in lungs of newborns would reproduce the high levels of pulmonary vascular resistance (PVR) observed in the fetal state. We assessed the hemodynamics of the left pulmonary circulation of 1‐to 3‐day‐old lambs during a variety of airway states while attempting to reestablish fetal conditions. Eleven animals were studied during both normoxemia and hypoxemia in a baseline airway state with a positive end‐expiratory pressure (PEEP) of 4 cm H2O, and in experimental airway states, of atelectasis, and fluid filling to 15 and 30 mL/kg and with PEEP of 12 cm HO. PVR increased while pulmonary blood flow decreased with all airway state changes as compared to baseline, suggesting a passive mechanism for these changes. With the addition of hypoxemia there was a further increase in PVR in all states accompanied by an increase in pulmonary blood flow, indicating that active vasoconstriction was responsible for the increase in PVR. The combined effects of hypoxemia and fluid filling, designed to approximate the fetal state, increased PVR to only 20–30% of fetal values. Thus, additional factors appear to be important in maintaining the high PVR of the fetal state. We speculate that ventilation of the lungs at birth irreversibly alters these factors.Pediatr Pulmonol. 1994;18:368–373.©1994 Wiley‐Liss, Inc.
Short‐term effects of three chest physiotherapy regimens in patients hospitalized for pulmonary exacerbations of cystic fibrosis: A cross‐over randomized study
Authors: Braggion C. , Cappelletti L. M. , Cornacchia M. , Zanolla L. , Mastella G. 
Published: March 2007

AbstractThe aim of our study was to compare the short‐term efficacy of three different chest physiotherapy (CPT) regimens (PD, postural drainage; PEP, positive expiratory pressure physiotherapy; HFCC, high‐frequency chest compression physiotherapy) on patients with cystic fibrosis (CF) hospitalized for an acute pulmonary exacerbation. Sixteen patients with CF, 8 males, 8 females, aged 15‐27 years (mean, 20.3±4), met the inclusion criteria: 1) age over 14 years; 2) mild or moderate airway obstruction; 3) sputum volume > 30 mliday; 4) being proficient in PD and PEP CPT. Patients at admission had (mean±SD) forced volume in 1 second (FEV,), 52.2±21.9 percent predicted; Shwachman‐Kulczycki clinical score 65.1±11 points; Chrispin‐Norman chest radiography score 18.6±4.3 points. The three CPT regimens and a control‐treatment (CONT) were administered in a random sequence, each patient receiving each treatment twice a day (in 50 minute sessions) for 2 consecutive days. During CONT and for 30 minutes after each session only spontaneous coughing was allowed. Wet and dry weight of sputum were recorded during the 50‐minute sessions and 30 minutes afterward. Lung function was measured before and 30 minutes after each session. For each treatment a score was given by the patient for efficacy, and by both the patient and the physiotherapist for tolerance.Wet and dry weights of sputum collected during the sessions were greater for all CPT regimens than for CONT (P < 0.001, P < 0. 0001). No significant differences between the three CPT regimens for both wet and dry weights were found when the number of coughs was taken into account. No significant changes in lung function occurred. Tolerance and efficacy scores were similar for all regimens. We concluded that there were no differences in the short‐term efficacy between the three CPT regimens on hospitalized patients with CF. © 1995 Wiley‐Liss, Inc.
Diaphragmatic flutter in three babies with bronchopulmonary dysplasia and respiratory syncytial virus bronchiolitis
Authors: Adams J. A. , Zabaleta I. A. , Sackner M. A. 
Published: March 2007

AbstractAbnormalities of respiratory control, especially apnea, have been reported previously in infants with respiratory syncytial virus (RSV) infections. This is the first report of yet another abnormality of respiratory control, diaphragmatic flutter (DF), in infants with RSV infection. The presentation of these infants did not differ from the usual clinical presentation of RSV infection. While being monitored with respiratory inductive plethysmography for occurrences of apnea known to be common in RSV infection, DF was detected. This abnormality consisted of high frequency, diaphragmatic contractions which were intermittent in nature. They lasted no more than 4 days and were not associated with change in arterial oxygen saturation or heart rate. These infants were discharged free of DF and no further episodes have been observed over a 12‐month period. © 1995 Wiley‐Liss, Inc.
Late pulmonary function following repair of tracheoesophageal fistula or esophageal atresia
Authors: Robertson Dale F. , Mobaireek Khalid , Davis G. Michael , Coates Allan L. 
Published: March 2007

AbstractAlthough tracheoesophageal fistula and esophageal atresia (TEF‐EA) are surgically correctable, late respiratory complications have been reported. We administered a respiratory and gastrointestinal symptom questionnaire and performed standard pulmonary function tests (PFT's) and methacholine challenge testing on an unselected group of 25 subjects with TEF‐EA who underwent surgery at our institution between 1963 and 1985. Results were compared to predicted normals, as well as 10 sibling controls. While the mean values of lung function test results for the TEF‐EA group were within the normal range, they were significantly different from their siblings. Thirteen of the 25 TEF‐EA group (52%), but none (0%) of the controls, had abnormal pulmonary function. This was classified as restrictive in 9 (36%). obstructive in 3 (12%), and mixed in 1. In addition, airway hyperreactivity [defined as a positive methacholine challenge (PC20 ⩽ 8 mg/mL)], was found in 6 of 18 TEF‐EA subjects and 4 of the 9 controls who were evaluated. Comparison of TEF‐EA subjects with normal and abnormal PFTs showed no difference in the incidence of tracheomalacia, esophageal strictures or dilatation, recurrent pneumonias, or gastroesophageal reflux. The respiratory symptom score in the subjects and controls was similar, and did not correlate with abnormal pulmonary function. The cause of the pulmonary function abnormalities remains unexplained. Pediatr Pulmonol. 1995; 20:21–26. © 1995 Wiley‐Liss, Inc.