bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and rate of diagnosis of allergic rhinitis in Europe
Authors: Bauchau V. , Durham S.R. 
Published: October 2004

To measure the prevalence of allergic rhinitis among European adults and the proportion of undiagnosed subjects, a two-step, cross-sectional, population-based survey in Belgium, France, Germany, Italy, Spain, and the UK was undertaken.Step one of the study involved screening for allergic rhinitis by telephone interview, based on history of symptoms and/or self-awareness of the condition. Step two undertook confirmation of allergic rhinitis in a subset of the subjects screened positive; this was performed by a clinical diagnosis conducted in three to five clinical centres per country, including specific immunoglobulin E tests and a disease-specific questionnaire.A total of 9,646 telephone interviews were conducted between February and April 2001. Self-awareness of allergic rhinitis was reported by 19% of the subjects. Physician-based diagnosis of allergic rhinitis was reported by 13% of the subjects. In step two, 725 clinical assessments were conducted between May and August 2001. A total of 411 of patients, who underwent step two, had investigator-confirmed allergic rhinitis. Among patients with investigator-confirmed allergic rhinitis, 45% had not reported a previous diagnosis by a physician. Prevalence of subjects with clinically confirmable allergic rhinitis estimated by combining step one and step two data ranged from 17% in Italy to 29% in Belgium with an overall value of 23%.This large-scale study confirms that allergic rhinitis has a high prevalence in western Europe and is frequently undiagnosed.
No serological evidence ofRickettsia helveticainfection in Scandinavian sarcoidosis patients: Table 1—
Authors: Planck A. , Eklund A. , Grunewald J. , Vene S. 
Published: October 2004

Many agents have been suggested to elicit sarcoidosis, and, recently, an association was presented between this disease and the bacteriumRickettsia helvetica.The aim of this study was to investigate if serological support for such an association could be detected.Sera from 20 well-characterised sarcoidosis patients were investigated for anti-rickettsial immunoglobulin G antibodies with a micro-immunofluorescence technique.R. helvetica,R. conoriiandR. typhiserved as antigens.In conclusion, none of the investigated sera displayed detectable titres of anti-rickettsial immunoglobulin G antibodies. Thus, the current study does not support an association between rickettsia and sarcoidosis.
Asthma and cigarette smoking
Authors: Thomson N.C. , Chaudhuri R. , Livingston E. 
Published: October 2004

In most developed countries ∼25% of adults with asthma are current cigarette smokers. Asthma and active cigarette smoking interact to cause more severe symptoms, accelerated decline in lung function, and impaired short-term therapeutic response to corticosteroids.Cigarette smoking may modify inflammation that is associated with asthma, although there is limited published data on airway pathology in smokers with asthma. To date, the evidence points towards a combination of both heightened and suppressed inflammatory responses in smokers compared with nonsmokers with asthma.The mechanisms of corticosteroid resistance in asthmatic smokers are unexplained, but could be as a result of alterations in airway inflammatory cell phenotypes (e.g.increased neutrophils or reduced eosinophils), changes in the glucocorticoid receptor-α to -β ratio (e.g.overexpression of glucocorticoid receptor β), and increased activation of pro-inflammatory transcription factors (e.g.nuclear factor-κB) or reduced histone deacetylase activity.In conclusion, every effort should be made to encourage asthmatics who smoke to stop, although the effects of smoking cessation upon reversing the adverse effects of tobacco smoke on asthma control, therapeutic response to corticosteroids and airway pathology have yet to be fully elucidated. Alternative or additional therapies to inhaled corticosteroids are needed for asthmatic patients who are unable to quit smoking.
Impaired pulmonary status in cystic fibrosis adults with two mutatedMBL-2alleles
Authors: Davies J.C. , Turner M.W. , Klein N. ,   and the London MBL CF Study Group The London MBL CF Study Group: C. Booth, M. Johnson, N. Shen, K. Fidler, S. Sharma, J. Burgess, A. Bush, D.M. Geddes, E.W.F.W. Alton.
Published: October 2004

Mannose-binding lectin has recently been identified as a modifier of severity in cystic fibrosis, although studies have produced differing results and the mechanism of action remains unclear.The current authors have studied large cohorts of adults (n=298) and children (n=260) to explore this apparent relationship further.Adults with two structural mutations, but not heterozygotes, had significantly reduced lung function and oxygen saturations, more frequent hospital admissions and raised systemic inflammatory markers. This was not related to increased rates of infection withPseudomonas aeruginosa, and there was no increased susceptibility toBurkholderia cepacia. None of these findings was mirrored in the paediatric cohort.In conclusion, severe mannose-binding lectin deficiency appears to be detrimental to cystic fibrosis adults, although heterozygotes are not affected. It is suggested that this is not related to impaired complement-mediated bacterial killing, and a link with the host inflammatory response is hypothesised. If mannose-binding lectin replacement is developed as a new approach to treatment for this disease, the present study would suggest that the small group of severely deficient patients with two structural mutations may be the group to benefit.
Effect ofin uterogrowth retardation on lung function at follow-up of prematurely born infants: Table 1—
Authors: Greenough A. , Yuksel B. , Cheeseman P. 
Published: October 2004

The aim of the study was to determine if prematurely born children who had suffered intra-uterine growth retardation (IUGR) had more severe lung function abnormalities than those born an appropriate weight for gestational age (AGA).Analysis of the lung function results of 119 infants (median (range) gestational age of 30 (23–35) weeks) was undertaken. In total, 31 of the infants had suffered IUGR and were born small for gestational age (SGA). Functional residual capacity and airways resistance (Raw) were measured at a median post-natal age of 10 (6–24) months. Specific airway conductance (sGaw) was calculated from thoracic gas volume andRaw.The SGA children were born at a greater gestational age and had a lower body weight at testing than the AGA children.Rawand sGawdiffered between the SGA and AGA children. Regression analysis demonstrated that lung volumes were significantly related to body weight at testing,Rawwas related to IUGR, maternal smoking and bronchopulmonary dysplasia, and sGawto maternal smoking.In conclusion, these results suggest that prematurely born infants who have suffered intra-uterine growth retardation may be at increased risk of impaired lung function at follow-up.
Paediatric lung transplantation
Authors: Mallory G.B. , Spray T.L. 
Published: October 2004

Since 1990, lung transplantation has been performed in infants, children and adolescents in small numbers, and the numbers, in comparison with adult transplants, remain small today. The indications for lung transplantation are similar in childhood when compared with adults, but the disease entities are distinct.In children, severe pulmonary vascular disease is most commonly associated with developmental abnormalities or congenital heart disease, as opposed to idiopathic pulmonary hypertension. Cystic fibrosis is the dominant indication for lung transplantation in older childhood and adolescence.The operative approach to lung transplantation in early life differs from that in adults, in that cardiopulmonary bypass is more likely to be utilised and bilateral lung transplantation is strongly preferred to single lung transplantation. Living donor lung transplantation is proportionately more common in children and adolescents than in adults. Post-transplant complications related to viral infection and post-transplant lymphoproliferative disease are more common and more likely to be severe and life-threatening. Bronchiolitis obliterans is the most important complication after paediatric lung transplantation and limits both the quality of life and duration of survival, as in adults.
Medical thoracoscopy: hormone receptor content in pleural metastases due to breast cancer
Authors: Schwarz C. , Lübbert H. , Rahn W. , Schönfeld N. , Serke M. , Loddenkemper R. 
Published: October 2004

Pleural metastases are common in the course of breast cancer, but, to date, the role of oestrogen receptor (OR) and progesterone receptor (PgR) content in metastatic tissue has been poorly evaluated.A series of 50 consecutive patients with a history of breast cancer (median age 64 yrs, range 40–86 yrs), which presented with pleural effusion and therefore underwent medical thoracoscopy, was analysed. Metastatic pleural involvement was histologically confirmed in all patients. The hormone receptor status of the pleural metastases was investigated using the immunohistochemical method in 49 and the biochemical method in 31 cases. The immunohistochemical test was performed using monoclonal antibodies. Biochemical analysis was performed on specimens quick-frozen in liquid nitrogen. OR and PgR were measured with the dextran-coated charcoal assay and Scatchard analysis.Immunohistochemical analysis yielded 29 OR-positive and 25 PgR-positive cases and biochemical analysis yielded 16 OR-positive and four PgR-positive cases, sometimes discrepant to hormone status of the primary breast cancer. Using a semiquantitative immunoreactive score, there was a significant association between receptor positivity and survival, but only for PgR positivity.Immunohistochemical and biochemical detection of hormone receptors (oestrogen and progesterone) in pleural metastases of breast cancer is feasible based on medical thoracoscopy as the method of choice, by which sufficient specimens may be obtained. The receptor status may enable a decision on antihormonal treatment. Whether a positive receptor status in pleural metastatic tissue is associated with a better prognosis remains to be confirmed.
Azithromycin for cystic fibrosis
Authors: Southern K.W. , Barker P.M. 
Published: October 2004

During what is a relatively barren time for new therapies for cystic fibrosis (CF), azithromycin has received a lot of attention as a potential treatment for CF lung disease. Laboratory studies suggest that azithromycin may have indirect actions, including anti-inflammatory, in addition to the standard antibacterial properties. The unique pharmacokinetics of azithromycin sets it aside from other macrolide antibiotics, but may result in increased resistance patterns.Three well-designed randomised controlled trials have demonstrated a small but significant improvement in respiratory function (forced expiratory volume in one second) with azithromycin compared with placebo. These trial results are confirmed by a recent meta-analysis. Mild adverse events (wheeze, diarrhoea and nausea) were significantly increased in one trial. There is no clear consensus regarding the correct dose and length of treatment with azithromycin.The present review discusses the role of azithromycin in the management of cystic fibrosis and the need for close monitoring of patients started on this drug. In addition, clinics should liaise closely with their microbiology departments and monitor resistance patterns.
Body mass index and asthma incidence among USA adults
Authors: Ford E.S. , Mannino D.M. , Redd S.C. , Mokdad A.H. , Mott J.A. 
Published: October 2004

The aim of this study was to examine the association between body mass index (BMI) and asthma incidence.Data from the baseline examination conducted during 1971–1975, and the first follow-up conducted during 1982–1984, of the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study (a cohort study) was used. Asthma was self-reported or reported by proxies. BMI was calculated from measured height and weight obtained during the baseline examination.Among 9,456 participants aged 25–74 yrs who were free of asthma at baseline, 317 participants reported a diagnosis of asthma during the follow-up interview. Compared with participants with a BMI of 18.5–<25.0 kg·m−2, the odds ratio (OR) for those with a BMI of ≥35 kg·m−2was 1.87 (95% confidence interval (CI) 1.12–3.13). ORs were similar for males and females. However, only 125 of the 298 participants who recalled a date of onset reported a diagnosis that occurred after their baseline examination. Among this group of participants, BMI was not significantly associated with asthma incidence (OR 1.52, 95% CI 0.62–3.77).In conclusion, although obese people reported more “incident” asthma during follow-up, it remains unclear whether this represents reactivation of previously diagnosed asthma or the onset of new cases, and whether these new cases actually represent true asthma or respiratory symptoms misdiagnosed as asthma.
Smoking and asthma in adults
Authors: Piipari R. , Jaakkola J.J.K. , Jaakkola N. , Jaakkola M.S. 
Published: October 2004

Studies on the effect of smoking on adulthood asthma have provided contradictory results. The current authors conducted a population-based incident case-control study to assess the effects of current and past smoking on the development of asthma in adults.During a 2.5 yr study period, all new asthma cases clinically diagnosed (n=521) and randomly selected controls (n=932) from a geographically defined district in southern Finland were recruited.The risk of developing asthma was significantly higher among current smokers with an adjusted odds ratio (OR) of 1.33 (95% confidence interval 1.00–1.77) and among ex-smokers with an adjusted OR 1.49 (1.12–1.97) compared with never-smokers. Among current smokers, the risk increased up to 14 cigarettes·day−1, and a similar trend was observed in relation to cumulative smoking.In conclusion, the current results support the hypothesis that smoking causes asthma in adulthood.
Severe community-acquired pneumonia: assessment of microbial aetiology as mortality factor
Authors: Paganin F. , Lilienthal F. , Bourdin A. , Lugagne N. , Tixier F. , Génin R. , Yvin J-L. 
Published: October 2004

Community-acquired pneumonia (CAP) remains a major cause of mortality. The aetiology of CAP has rarely been identified as a mortality risk factor. A prospective study was conducted to assess the prognostic factors of CAP patients admitted to the intensive care unit (Centre Hospitalier Departmental Félix Guyon, St Denis de la Réunion, France), with a special emphasis on microbial aetiology.All variables assessing severity were collected, with a special emphasis on microbial investigations. Among 112 immunocompetent patients (mean±sdage 54.7±15.1 yrs), 84% were male. Severity of CAP was demonstrated by mortality rate (43%), shock (48%), simplified acute physiology score (SAPS; 46.4±21.6) and mechanical ventilation support (82%). Mean risk factor score was 2.2±1.2. Microbiological identification was obtained in 78.6% of cases, with positive blood culture in 33%. Most frequently, microbial agents wereStreptococcus pneumoniaeandKlebsiella pneumoniae(42% and 22%, respectively).The univariate analysis recorded the usual mortality variables: age, alcohol consumption, SAPS, shock, mechanical ventilation, positive end expiratory pressure level, positive blood culture, multilobar infiltrates on chest radiograph, neutropenia, and acidosis, and foundK. pneumoniae(versusS. pneumoniae, and all CAP) as a mortality factor. The multivariate analysis demonstrated that septic shock (relative risk (RR) 141),K. pneumoniaeCAP (RR 27), SAPS (RR 10.7) and positive blood culture (RR 2.7) were independent factors related to death.In conclusion, the present study found that the microbial aetiology,Klebsiella pneumoniae, was an independent risk factor for mortality in severe community-acquired pneumonia.
Manganese superoxide dismutase is increased in the airways of smokers' lungs
Authors: Harju T. , Kaarteenaho-Wiik R. , Sirviö R. , Pääkkö P. , Crapo J.D. , Oury T.D. , Soini Y. , Kinnula V.L. 
Published: October 2004

Oxidant stress is a key mechanism for smoking-induced chronic obstructive pulmonary disease (COPD). Smoking has been shown to upregulate several antioxidant enzymes, with potential effects on the prevention of the disease and/or its progression. Superoxide dismutases (SOD)s are the only enzymes capable of consuming superoxide radicals. The purpose of the present study was to investigate SODs in the lungs of nonsmokers, smokers and COPD patients.Manganese superoxide dismutase (MnSOD), copper zinc SOD (CuZnSOD), and extracellular SOD (ECSOD), were investigated by immunohistochemistry in the airways of 13 nonsmokers, 20 smokers and 22 COPD patients with mild-to-moderate disease. Lung tissue homogenates of three nonsmokers and four smokers were used for Western blot and enzyme activity analysis.The expression of MnSOD was higher in the central bronchial epithelium of smokers with COPD and in the alveolar epithelium of smokers without or with COPD than innonsmokers. Lung MnSOD immunoreactivity, evaluated by Western blotting and specific activity, were 33% and 51% higher, respectively, in smokers than in nonsmokers. No major changes could be observed in lung CuZnSOD or ECSOD immunoreactivities.Manganese superoxide dismutase is elevated in the alveolar epithelium of cigarette smokers, probably due to the increased oxidant burden in smokers' lungs.
Eosinophil degranulation status in allergic rhinitis: observations before and during seasonal allergen exposure
Authors: Ahlstrom-Emanuelsson C.A. , Greiff L. , Andersson M. , Persson C.G.A. , Erjefält J.S. 
Published: October 2004

Despite the fact that extensive degranulation is a likely prerequisite for a pathogenic role of eosinophils, little is known about the degranulation status of these cells in eosinophilic conditions. The present study of the ultrastructure of tissue eosinophils explores eosinophil degranulation in allergic rhinitis before and during seasonal allergen exposure.A total of 23 patients scored symptomsq.d., prior to and during the pollen season. The numbers of mucosal eosinophils and their degranulation status were determined in nasal biopsies. Furthermore, nasal lavage fluid levels of eosinophil cationic protein (ECP) and α2-macroglobulin were assessed as indices of eosinophil activity and plasma exudation, respectively.Seasonal allergen exposure was associated with increased nasal symptoms, increased lavage fluid levels of ECP and α2-macroglobulin, and increased numbers of tissue eosinophils. In the tissue, transmission electron microscopy revealed a moderate piecemeal degranulation already prior to the season (mean±sd37±2.7% altered granules). Seasonal allergen exposure increased this degranulation (87±1.8%), and produced local areas with extensive deposition of granule proteins. The degree of eosinophil degranulation correlated with levels of ECP in lavage fluids obtained at histamine challenge.In conclusion, this study demonstrated that the nasal mucosa in allergic rhinitis features moderately degranulated eosinophils already at nonsymptomatic baseline conditions. In association with the development of symptomatic seasonal allergic rhinitis, the tissue deposition of eosinophil granule proteins is dramatically elevated through increased eosinophil numbers, together with markedly augmented degranulation of individual cells.
Enhanced PMN response in chronic bronchitis and community-acquired pneumonia
Authors: Strassburg A. , Droemann D. , van Zandbergen G. , Kothe H. , Dalhoff K. 
Published: October 2004

Chronic bronchitis is a frequent underlying disease in community-acquired pneumonia (CAP). It is unclear to what extent an impaired or exaggerated innate immune response contributes to disease manifestations and severity.To assess the role of neutrophil activation and recruitment during acute pneumonic episodes, peripheral polymorphonulcear neutrophil (PMN) activation, chemotactic activity, interleukin-8 (CXCL-8) and CXCL-8 receptor (CXCR) expression and apoptosis rate were evaluated in CAP patients with and without chronic bronchitis. In addition, the expression of CXCRs and CXCL-8 was assessed on pulmonary neutrophils in chronic bronchitis patients to compare the activation of the chemokine system in different compartments. CAP severity was assessed by the simplified acute physiology score II and the prognosis of disease was assessed by the pneumonia severity index (PSI).An increased chemotactic activity of PMN from chronic bronchitis patients with CAP was found, which was not related to the expression of CXCRs. In addition, a decreased apoptosis rate of PMN was observed. Chemotactic activity was related to the PSI. Comparison of peripheral and pulmonary PMN revealed enhanced CXCL-8 levels and a decreased CXCR expression in the lung.In conclusion, neutrophil function in patients with chronic bronchitis and community-acquired pneumonia is characterised by an increased chemotactic activity combined with a decreased apoptosis rate. The downregulation of interleukin-8 receptors in the pulmonary compartment deserves further investigation.
Disturbed alveolar fibrin turnover during pneumonia is restricted to the site of infection
Authors: Choi G. , Schultz M.J. , van Till J.W.O. , Bresser P. , van der Zee J.S. , Boermeester M.A. , Levi M. , van der Poll T. 
Published: October 2004

Severe infection is associated with profound alterations in the systemic haemostatic balance, with activation of coagulation and suppressed fibrinolysis. Within the alveolar compartment, similar disturbances have been described during pulmonary inflammation. The current authors investigated whether local haemostasis was influenced during ventilator-associated pneumonia (VAP).In five patients with unilateral VAP, bronchoalveolar lavage fluid (BALF) was obtained from both the infected site (as identified on chest radiograph) and the contralateral noninfected lung (with no clinical or radiographic abnormalities). Markers for coagulation and fibrinolysis were compared between infected and noninfected lungs. A total of 10 healthy volunteers and 10 mechanically ventilated patients without pneumonia served as controls.Strong activation of coagulation (high levels of thrombin-antithrombin complexes, soluble tissue factor and factor VIIa) was detected in BALF from infected lungs, compared with that from noninfected lungs and controls. Furthermore, in infected lungs, fibrinolysis was depressed, with high levels of plasminogen activator inhibitor type 1.In conclusion, ventilator-associated pneumonia is characterised by a hypercoagulant state at the site of infection.