bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective population-based study on the survival of patients with lung cancer
Authors: Mäkitaro R. , Pääkko P. , Huhti E. , Bloigu R. , Kinnula V.L. 
Published: October 2002

The purpose of this study was to evaluate the change, over 20 yrs, in the survival of lung cancer patients in a population-based study.Information on all patients with lung cancer in a defined geographical area during 1990–1992 (n=602) was prospectively gathered. The survival of these patients was assessed and also compared with the results of a similar study in the same area during the years 1968–1971 (n=446).The 5-yr survival had improved during 20 yrs from 4% to 12%. The 5-yr survival of the patients with squamous cell carcinoma had increased from 6% to 16%, and adenocarcinoma from 4% to 19%, whereas the survival of small cell carcinoma had remained the same (2% and 3%, respectively). Even though the recent patients were older than those of the earlier series the proportion of surgically treated patients had remained the same (16% and 20%), but the 5-yr survival of patients who had been operated on had increased significantly from 23% to 48%. The differences in survival in the second cohort (1990–1992) between histological types (Chi-squared logrank=59.2), tumour, node, metastasis stages (Chi-squared logrank=199.6), symptomatic stages (Chi-squared logrank=120, p<0.001) and treatment (Chi-squared logrank=277) were significant.Based on this study the independent prognostic factors for better survival of lung cancer patients are tumour, node, metastasis stages I and II, surgical treatment and Feinstein's symptomatic stages I and II.
The effects of respiratory infections, atopy, and breastfeeding on childhood asthma
Authors: Oddy W.H. , de Klerk N.H. , Sly P.D. , Holt P.G. 
Published: October 2002

The objectives of the present study were to quantify the association of atopy and respiratory infections with asthma, and exclusive breastfeeding with respiratory illness, atopy and asthma in children.A cohort study of 2,602 children enrolled prior to birth and followed prospectively, provided data on respiratory illness, the method of feeding in the first year of life, as reported on a prospective diary card, and current asthma at the age of 6 yrs (defined as doctor-diagnosed asthma with wheeze in the last year or cough without a cold, and currently taking either preventer or reliever asthma medication), as reported by parental questionnaire. Atopy was defined by a positive skin-prick test assessed at the age of 6 yrs.Wheezing lower respiratory illness (LRI) in the first year of life, particularly multiple episodes of wheezing LRI, increased the risk for current asthma in both nonatopic (odds ratio (OR) 4.10, p⪕0.0005) and atopic children (OR 9.00, p⪕0.0005), but did not increase the risk for atopy. In contrast, up to three upper respiratory tract infections demonstrated a negative association and four or more a positive risk for current asthma in unadjusted (p=0.006) and adjusted (p=0.057) analysis. Following adjustment, exclusive breastfeeding for <4 months was associated with an increased risk for current asthma (OR 1.36, 95% confidence interval 1.00–1.85, p=0.047).Wheezing lower respiratory illness in the first year of life and atopy are independently associated with increased risk for current asthma at the age of 6 yrs, suggesting that their effects are mediatedviadifferent causal pathways and that these risk factors are multiplicative when they operate concomitantly within individual children. Exclusive breastfeeding protects against asthmaviaeffects on both these pathways, as well as through other as yet undefined mechanisms.
Lung function of school children with low levels of α1-antitrypsin and tobacco smoke exposure
Authors: von Ehrenstein O.S. , von Mutius E. , Maier E. , Hirsch T. , Carr D. , Schaal W. , Roscher A.A. , Olgemöller B. , Nicolai T. , Weiland S.K. 
Published: October 2002

Exposure to environmental tobacco smoke (ETS) and other air pollutants has been associated with small decrements in lung function. The susceptibility to pollution exposure may, however, vary substantially between individuals. Children with an impaired protease-antiprotease balance may be particularly vulnerable. Therefore this study aimed to investigate the effects of ETS exposure on children with reduced levels of α1-antitrypsin (α1-AT).Random samples of school children (aged 9–11 yrs) (n=3,526) were studied according to the International Study of Asthma and Allergies in Childhood (ISAAC) phase II protocol, including parental questionnaires, pulmonary function and allergy testing. Blood samples were obtained to measure plasma levels of α1-AT and to genotype for pleomorphic protein inhibitor (Pi)Z and PiS alleles.Children with low levels of α1-AT (≤116 mg·dL−1) showed significant, albeit small decrements in baseline lung function. When exposed to ETS, pronounced decrements of pulmonary function, particularly in measures of mid- to end-expiratory flow rates, were seen in these children as compared to exposed children with normal levels of α1-AT. The mean levels of % predicted±se in both groups were: maximum expiratory flow at 50% of vital capacity 79.4±7.2versus99.0±1.5, maximum expiratory flow at 25% of vital capacity 67.4±10.0versus100.3±2.1, maximal midexpiratory flow 73.7±8.6versus99.9±1.7.These findings suggest that school children with low levels of α1-antitrypsin are at risk of developing pronounced decrements in pulmonary function, particularly if they are exposed to environmental tobacco smoke. Parents of children with heterozygous α1-antitrypsin deficiency resulting in significantly reduced blood concentrations should be advised to prevent their children from being exposed to environmental tobacco smoke and dissuade them from taking up smoking.
Intracellular glutathione and bronchoalveolar cells in fibrosing alveolitis: effects ofN-acetylcysteine
Authors: Behr J. , Degenkolb B. , Krombach F. , Vogelmeier C. 
Published: October 2002

Extracellular glutathione deficiency and exaggerated oxidative stress may contribute to the pathogenesis of fibrosing alveolitis (FA). High-doseN-acetylcysteine (NAC) supplementation partially reverses extracellular glutathione depletion and oxidative damage, but effects on intracellular glutathione are unknown.Intracellular total glutathione (GSHt) and activation of bronchoalveolar lavage cells (BAC) obtained from 18 FA patients (9 males, aged 52±2 yrs), before and after 12 weeks of oral NAC (600 mgt.i.d.), were assessed. Eight healthy nonsmokers (2 males, aged 36±6 yrs) served as a control group.Intracellular GSHtwas decreased in FA (1.57±0.20 nmol·1×106BAC−1versus2.78±0.43 nmol·106BAC−1). After NAC treatment, the intracellular GSHtcontent increased (1.57±0.20versus1.87±0.19 nmol·1×106BAC−1). The spontaneous oxidative activity of BAC decreased after NAC treatment (2.7±0.8versus1.0±0.2 nmol·1×106BAC−1·h−1). Interleukin-8 concentration (82.1±31.5versus80.0±22.6 pg·mL bronchoalveolar fluid (BALF), nonsignificant (ns)) and myeloperoxidase activity (1.93±0.64versus1.55±0.47 mU·mL−1BALF, ns) did not change significantly, but were found to be inversely correlated to intracellular GSHt.In conclusion, high-doseN-acetylcysteine supplementation increases intracellular glutathione levels slightly. This increase is associated with a mild reduction of oxidative activity but not with a reduction of bronchoalveolar cell activation in these patients.
Expiratory flow limitation during exercise in COPD: detection by manual compression of the abdominal wall
Authors: Abdel Kafi S. , Sersté T. , Leduc D. , Sergysels R. , Ninane V. 
Published: October 2002

Manual compression of the abdomen (MCA) during spontaneous expiration is a simple method for the detection of flow limitation in the chronic obstructive pulmonary disease (COPD) patients during resting breathing, based on comparison of flow/volume curves obtained during MCA with that of the preceding control breath. It was assessed whether this nonstandardized technique is also feasible during exercise.MCA was performed during resting breathing and constant-exercise work at one- and two-thirds maximal mechanical power output (W′max) in six normal subjects and 12 COPD patients. Changes in end-expiratory lung volume (EELV) were also studied.With the aid of inspection, abdominal palpation and lung auscultation, MCA could always be applied during expiration. Flow limitation was never detected in the six normal subjects, whereas four of the COPD patients were flow limited at rest, seven during exercise at one-thirdW′maxand nine during exercise at two-thirdsW′max. Expiratory flow limitation detected by MCA was always associated with an increase in EELV during exercise, indicating dynamic hyperinflation occurrence or increase.It is concluded that manual compression of the abdomen is a very simple and reliable method for the detection of flow limitation during exercise.
Acute protection against exercise-induced bronchoconstriction by formoterol, salmeterol and terbutaline
Authors: Richter K. , Janicki S. , Jörres R.A. , Magnussen H. 
Published: October 2002

The onset of bronchoprotection as obtained by various β2-agonists has not been examined in a comparitive study. In this study, the onset of bronchodilation and protection against exercise-induced bronchoconstriction in asthmatics after inhalation of the long-acting β2-agonists formoterol and salmeterol and the short-acting β2-agonist terbutaline were measured.Twenty-five subjects with asthma and a history of exercise-induced bronchoconstriction (mean baseline forced expiratory volume in one second (FEV1): 90% predicted; mean fall in FEV1after exercise: 31% from baseline) were enrolled in this double-blind, double-dummy, placebo-controlled, randomized, four-period crossover study. Exercise challenges were performed on 12 days at either 5, 30, or 60 min after inhalation of a single dose of formoterol (12 µg Turbuhaler®), salmeterol (50 µg Diskus®), terbutaline (500 µg Turbuhaler®) or placebo.Exercise-induced bronchoconstriction (maximum fall in FEV1or area under the curve) did not differ significantly between terbutaline, formorerol and salmeterol either 5, 30, or 60 min after inhalation of the study medication. In contrast, the onset of bronchodilation was slower after salmeterol compared to terbutaline and formoterol (p<0.05, each), which both showed a similar time course. At all time points between 5 and 60 min, formoterol provided significantly greater bronchodilation than salmeterol (p<0.05).These data indicate that equipotent doses of the bronchodilators salmeterol, formoterol and terbutaline were similarly effective with respect to their short-term protective potency against exercise-induced bronchoconstriction, despite the fact that the time course of bronchodilation was significantly different between the three β2-agonists.
Colistin stimulates the activity of neutrophil elastase andPseudomonas aeruginosaelastase
Authors: Jones A. , Elphick H. , Pettitt E. , Everard M.L. , Evans G.S. 
Published: October 2002

Nonantimicrobial effects of antibiotics may contribute to their activity in the treatment of infective airway disease. The aim of this study was to identify antibiotics used for the treatment of infection in cystic fibrosis that may alter the activity of human neutrophil elastase (HNE) andPseudomonas aeruginosaelastase (PE).The effect of antibiotics on the activity of purified HNE and PE, and HNE in sputum was assessed using colourimetric and fluorescent substrate assays by kinetic measurements, and by examining the interaction of HNE with inhibitors.Ceftazidime, tobramycin, and gentamycin slightly inhibited purified HNE activity whereas erythromycin and colistin significantly stimulated purified HNE and PE (395 and 557%, respectively). However, only colistin increased HNE activity in sputum (+102%) and was therefore studied in more detail. This increase in activity was not due an interference with the specific inhibition of HNE by α1-antitrypsin but colistin was found to reverse the inhibitory effects of small molecular weight molecules like heparin.Colistin increases the activity of human neutrophil elastase andPseudomonas aeruginosaelastase, two proteases that contribute to the pathogenesis of cystic fibrosis airway disease.
Risk of chemotherapy-induced pulmonary fibrosis is associated with polymorphic tumour necrosis factor-a2 gene
Authors: Libura J. , Bettens F. , Radkowski A. , Tiercy J.M. , Piguet P.F. 
Published: October 2002

In some patients, chemotherapy (CHT) of cancer can result in pulmonary inflammation and fibrosis, eventually leading to respiratory insufficiency.As animal studies have underlined the importance of major histocompatibility complex (MHC) genes in the susceptibility to bleomycin (BLM)-induced pulmonary fibrosis, the authors typed human leukocyte antigen-DR (HLA-DR) and tumor necrosis factor (TNF) genes in patients treated for Hodgkin's disease by a therapy including bleomycin.Patients were divided into pulmonary responders (PR) (n=21) or nonresponders (PNR) (n=20) on the basis of pulmonary alterations detected on chest radiography and the cumulated amount of BLM injected. The incidence of TNFa2, a microsatellite allele in the promoter region of the TNFB gene reported to be associated with increased TNF-α production, was significantly higher in PR than PNR (65%versus19%). HLA-DRB1*15 showed a weak but nonsignificant association with the PR phenotype (50%versus14%), as well as HLA-DRB1*03 (30%versus19%) and TNFA-308*2 (30%versus14 %). TNFa2 and DR15 were independent risk factors and the occurrence of either genetic marker was 85%versus29% in the PR and PNR groups respectively.Thus, the polymorphic TNFa2 microsatellite is associated with a risk of chemotherapy-induced pulmonary fibrosis.
Socioeconomic deprivation and asthma prevalence and severity in young adolescents
Authors: Poyser M.A. , Nelson H. , Ehrlich R.I. , Bateman E.D. , Parnell S. , Puterman A. , Weinberg E. 
Published: October 2002

This study used the international study of asthma and allergies in childhood (ISAAC) to investigate the association between asthma and socioeconomic deprivation among young adolescents in Cape Town, South Africa.The completed ISAAC written and video questionnaires of 4,706 13–14-yr-old school pupils were used. The prevalence of asthma symptoms was analysed by a local index of socioeconomic deprivation, based on residential location and defined on a 10-category scale from least to most deprived. Linear trends were examined visually and the prevalence odds ratio was used to summarize overall trends.In general, the least socioeconomically deprived pupils reported higher prevalences of asthma symptoms “ever” and “in the last 12 months”. In contrast, the most socioeconomically deprived pupils reported higher asthma-symptom occurrence monthly or more frequently in the previous 12 months. A subgroup of pupils from low-income areas commuting to better-off schools showed the highest symptom prevalences.The findings are consistent with a model in which an increase in the incidence of asthma is driven by factors associated with improved social circumstances, whereas severity is determined by factors associated with poverty. The impact of social mobility on asthma, including reporting of symptoms, deserves closer study.
Effects of antibiotics on protected specimen brush sampling in ventilator-associated pneumonia
Authors: Prats E. , Dorca J. , Pujol M. , Garcia L. , Barreiro B. , Verdaguer R. , Gudiol F. , Manresa F. 
Published: October 2002

The effects of antibiotic treatment on the results of protected specimen brushing (PSB) in ventilator-associated pneumonia were prospectively assessed by performing this procedure before antibiotic treatment, and 12, 24, 48 and 72 h after initiation of antibiotic treatment, in 35 ventilated patients who developed pneumonia during mechanical ventilation.The number of micro-organisms isolated, their concentration (colony-forming units (cfu)·mL−1), and the number of cases with a positive PSB (≥103 cfu·mL−1) were evaluated.Within 12 h of the initiation of effective antibiotic treatment a rapid, significant decrease in the numbers of organisms isolated, their individual concentrations and the percentage of positive PSB results were observed. Certain bacterial species (Streptococcus pneumoniae,Haemophilus influenzee) appeared to be more vulnerable to antibiotics than others (Staphylococcus aureus,Pseudomonas aeruginosa,Acinetobacter baumanni).This data confirms that prior antibiotic treatment, even after only a few hours of activity, significantly decreases the sensitivity of protected brush specimen; this effect appears to be particularly marked among the species involved in early ventilator associated pneumonia.
Frequency and clinical characteristics of rapid-onset fatal and near-fatal asthma
Authors: Plaza V. , Serrano J. , Picado C. , Sanchis J. 
Published: October 2002

The onset of fatal and near-fatal asthma attacks can be rapid. The objective of this study was to determine the frequency and clinical characteristics of rapid-onset asthma (ROA) in patients suffering fatal and near-fatal crises.Two-hundred and twenty patients with fatal or near-fatal attacks were enrolled in a multicentre, prospective study. ROA was defined as a crisis developing in ≤2 h. Data on patient and clinical characteristics were collected, and spirometric and allergy studies were performed when the patients were in a stable condition.Forty-five attacks (20%) were ROA and 175 (80%) were slow-onset asthma (SOA). The triggers for SOA and ROA attacks were different, with the ROA group having a significantly lower rate of suspected respiratory infection (7%versus38%), higher rates of fume/irritant inhalation (9%versus1%) and a higher intake of nonsteroidal anti-inflammatory drugs (14%versus3%). The ROA group exhibited significantly higher rates of impaired consciousness (63%versus44%), absence of lung sounds upon admission (68%versus42%), fewer hours of mechanical ventilation (13 hversus28 h) and fewer days of hospitalization (8 daysversus9.5 days) than the SOA group.The 20% frequency of rapid-onset fatal and near-fatal attacks in this study suggests that rapidly developing attacks may not be rare. These findings also support a distinct clinical profile for rapid-onset asthma marked by differences in triggers, severity of exacerbation and clinical course.
Bronchoscopic administration of bovine natural surfactant in ARDS and septic shock: impact on biophysical and biochemical surfactant properties
Authors: Günther A. , Schmidt R. , Harodt J. , Schmehl T. , Walmrath D. , Ruppert C. , Grimminger F. , Seeger W. 
Published: October 2002

The purpose of the present study was to investigate the impact of bronchoscopic surfactant administration, on the biochemical and biophysical surfactant properties, in patients with severe and early acute respiratory distress syndrome (ARDS) and septic shock.A total number of 27 ARDS patients received 300–500 mg·kg·body·weight−1of a natural bovine surfactant extract (Alveofact®)viaa flexible bronchoscope. Bronchoalveolar lavages were performed 3 h prior to, and 15–18 h and 72 h after surfactant administration. A comparison to healthy volunteers, undergoing an identical lavage procedure, was made (control, n=12).Severe biophysical and biochemical surfactant abnormalities were encountered throughout in the ARDS patients. These included a massive alveolar protein load, a reduced percentage of large surfactant aggregates (LA), a loss of palmitoylated phosphatidylcholine species and a significant reduction of surfactant apoprotein (SP)-A, SP-B and SP-C in the LA fraction. Both minimum (γmin) and adsorption (γads) surface tension values (pulsating bubble surfactometer) were dramatically increased. Surfactant treatment resulted in a marked increase in the lavagable phospholipid (PL) pool, but predominance of the alveolar surfactant-inhibitory protein load was still encountered. Far-reaching or even complete normalization of the PL profile, the LA fraction and its SP-B and SP-C (but not SP-A) content as well as the fatty acid composition of the phosphatidylcholine class was noted. Surface tension lowering properties (γmin and γads) significantly improved, but were still not fully normalized.Bronchoscopic administration of large quantities of natural bovine surfactant in severe acute respiratory distress syndrome causes far-reaching restoration of biochemical surfactant properties and significant improvement, however not full normalization, of biophysical surfactant function.
Survival of patients with biopsy-proven usual interstitial pneumonia and nonspecific interstitial pneumonia
Authors: Riha R.L. , Duhig E.E. , Clarke B.E. , Steele R.H. , Slaughter R.E. , Zimmerman P.V. 
Published: October 2002

This is the first Australian study to examine survival and clinical characteristics in biopsy-proven idiopathic interstitial pneumonia.A cohort of 70 patients from a single institution between January 1990 and December 1999 was reviewed.All patients were Caucasian, 23 (33%) female. Mean age±sd at diagnosis was 60±12 yrs for males and 54±14 yrs for females. A total 24% of patients had never smoked. The histopathological diagnoses were usual interstitial pneumonia (UIP) (n=59), nonspecific interstitial pneumonia (NSIP) (n=7), desquamative interstitial pneumonia (n=3) and acute interstitial pneumonia (n=11). Clinical and functional characteristics of the two main histological subgroups of UIP and NSIP showed significantly older patients in the UIP group and a significantly lower mean forced expiratory volume in one second (FEV1) in the NSIP group. Median survival for UIP was 78 months compared with 178 months for NSIP. No survival difference between treated and untreated patients with UIP was found. Multivariate analysis revealed smoking alone to be predictive of poorer survival.This study demonstrates the best median survival for usual interstitial pneumonia of available series and confirms a survival difference between usual interstitial pneumonia and nonspecific interstitial pneumonia. Furthermore, the reported results may have implications for treatment timing using conventional protocols currently recommended.