bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distribution of therapeutic response in asthma control between oral montelukast and inhaled beclomethasone
Authors: Baumgartner R.A. , Martinez G. , Edelman J.M. , Rodriguez Gomez G.G. , Bernstein M. , Bird S. , Angner R. , Polis A. , Dass S.B. , Lu S. , Reiss T.F. 
Published: January 2003

The distribution of responses in study populations provides a novel method of comparing the benefit of two treatments. This 6‐week, randomised, placebo-controlled, double-blind study compared the effectiveness of oral montelukast with inhaled beclomethasone in chronic asthma by assessing the distribution and overlap of patient responses to therapy, as measured by a clinical outcome (asthma control days).A total of 730 adult patients with asthma, age 15–65 yrs, with a forced expiratory volume in one second (FEV1) at baseline of 50–85% of predicted and ≥15% improvement in FEV1after inhaled β‐agonist were enrolled. After a 2–week placebo run-in period, patients were randomly allocated to receive montelukast (10 mg once daily), inhaled beclomethasone (200 µg twice daily) or placebo. The primary end-point (per cent of asthma control days) was compared between treatments as the overlap in the response distributions.The overlap of the distribution of responses between the montelukast and beclomethasone groups was 89% for per cent asthma control days and 96% for change from baseline in FEV1. The mean (±sd) per cent asthma control days in the montelukast and beclomethasone groups was significantly higher than that in the placebo group (placebo 40.0±35.8, montelukast 50.7±37.1, beclomethasone 57.9±36.1). The mean differences between montelukast and placebo, beclomethasone and placebo, and montelukast and beclomethasone were significant. The mean per cent change (±sd) from baseline in FEV1was 12.1±18.7 and 13.9±20.8 in the montelukast and beclomethasone groups, respectively, and significantly greater than that in the placebo group (6.4±20.1); there was no significant difference between the montelukast and beclomethasone groups in mean values or response distribution. There was also no difference among treatment groups in the frequency of adverse experiences.A comparison of the response distribution is an important approach to comparing therapies; montelukast and beclomethasone provided similar response distributions for the end-point of per cent asthma control days over a 6‐week treatment period.
Efficacy and safety of budesonide/formoterol in the management of chronic obstructive pulmonary disease
Authors: Szafranski W. , Cukier A. , Ramirez A. , Menga G. , Sansores R. , Nahabedian S. , Peterson S. , Olsson H. 
Published: January 2003

The efficacy and safety of budesonide/formoterol in a single inhaler compared with placebo, budesonide and formoterol were evaluated in patients with moderate-to-severe chronic obstructive pulmonary disease (COPD).In a 12-month, randomised, double-blind, placebo-controlled, parallel-group study in 812 adults (mean age 64 yrs, mean forced expiratory volume in one second (FEV1) 36% predicted normal), patients received two inhalations twice daily of either budesonide/formoterol (Symbicort®) 160/4.5 µg (delivered dose), budesonide 200 µg (metered dose), formoterol 4.5 µg or placebo. Severe exacerbations and FEV1(primary variables), peak expiratory flow (PEF), COPD symptoms, health-related quality of life (HRQL), mild exacerbations, use of reliever β2‐agonist and safety variables were recorded.Budesonide/formoterol reduced the mean number of severe exacerbations per patient per year by 24%versusplacebo and 23%versusformoterol. FEV1increased by 15%versusplacebo and 9%versusbudesonide. Morning PEF improved significantly on day 1versusplacebo and budesonide; after 1 week, morning PEF was improvedversusplacebo, budesonide and formoterol. Improvements in morning and evening PEFversuscomparators were maintained over 12 months. Budesonide/formoterol decreased all symptom scores and use of reliever β2‐agonists significantlyversusplacebo and budesonide, and improved HRQLversusplacebo. All treatments were well tolerated.These results suggest a role for budesonide/formoterol in the long-term management of moderate-to-severe chronic obstructive pulmonary disease.
Genetic polymorphisms associated with acute pulmonary embolism and deep venous thrombosis
Authors: Nizankowska-Mogilnicka E. , Adamek L. , Grzanka P. , Domagala T.B. , Sanak M. , Krzanowski M. , Szczeklik A. 
Published: January 2003

Frequently an inherited predisposition to thrombosis remains clinically silent until an additional environmental factor intervenes. The present study aimed to assess distribution of inherited risk factors of venous thrombosis in patients with venous thromboembolism (VTE).The prevalences of factor V Leiden (FV Leiden), prothrombin factor II G20210A (FII G20210A), C677T and A1298C of methylenetetrahydrofolate reductase (MTHFR) mutations were studied in 149 VTE patients and 100 controls.The following key risks were established: previous deep venous thrombosis or pulmonary embolism (23.5%), bed rest (34.2%), immobilisation of lower limb (10.1%), hospitalisation (30.9%) and obesity (28.9%). In 29 (19%) patients and in three (3%) controls FV Leiden was found. A significant association between VTE and FV Leiden was established. There were six (4%) carriers of the FII G20210A among VTE patients and one in the controls. No associations between VTE and MTHFR polymorphisms (C677T, A1298C) were found. In three of 149 patients both FV Leiden and FII G20210A polymorphisms were observed. The mean protein C activity was slightly, though nonsignificantly, smaller in VTE patients.In conclusion, there was a positive association between venous thromboembolism and factor V Leiden. Only a weak trend favouring a relationship between prothrombin factor II G20210A and venous thrombolism was present. No associations between common polymorphisms of methylenetetrahydrofolate reductase and venous thromboembolism were found.
Effectiveness of oral moxifloxacin in standard first-line therapy in community-acquired pneumonia
Authors: Torres A. , Muir J-F. , Corris P. , Kubin R. , Duprat-Lomon I. , Sagnier P-P. , Höffken G. 
Published: January 2003

Based on recent guidelines for the management of community-acquired pneumonia, this study was designed to evaluate the effectiveness of a new fluoroquinolone compared with standard antimicrobial regimens, in conditions relating as closely as possible to the real world setting.In this study, 564 patients were randomised to either oral moxifloxacin (400 mgo.d.) or to standard oral therapy (amoxicillin 1 gt.i.d.or clarithromycin 500 mgb.i.d.alone or in combination) for up to 14 days using a double-blind procedure. The choice between the three standard regimens was made by the clinician prior to randomisation. Clinical response, quality of life, symptoms, healthcare resources and safety were assessed.In the per-protocol population, clinical success was reported for 201 of 215 (93.5%) and 217 of 231 (93.9%) in the moxifloxacin and standard groups, respectively, at 7–10 days post-therapy. At 28–35 days follow-up, continued clinical cure was observed in 183 of 192 (95.3%) moxifloxacin and 207 of 221 (93.7%) standard groups. Drug-related adverse events were reported in 55 of 274 (20%) moxifloxacin and 86 of 279 (31%) standard patients with diarrhoea >5%.Oral moxifloxacin monotherapy was as effective as, and better tolerated than, optimal antibiotic strategy represented either by mono- or combination therapy (amoxicillin and/or clarithromycin) in community-acquired pneumonia management.
Monitoring the quality of laboratories and the prevalence of resistance to antituberculosis drugs: Italy, 1998–2000
Authors: Migliori G.B. , Centis R. , Fattorini L. , Besozzi G. , Saltini C. , Orefici G. , Piersimoni C. , Gori A. , Cassone A. ,   the Italian Multicentre Study on Resistance to Antituberculosis drugs (SMIRA) Study Group
Published: January 2003

In 1998 a network of 20 regional tuberculosis (TB) laboratories (the Italian Multicentre Study on Resistance to Antituberculosis drugs (SMIRA) network) was established in Italy to implement proficiency testing and to monitor the prevalence of drug resistance nationwide. The network managed 30% of all TB cases reported in Italy each year.The aim of the present report is to describe: 1) the accuracy of drug-susceptibility testing in the network; 2) the prevalence of drug resistance for the period 1998–2000.Data were collected from the network laboratories. Sensitivity to streptomycin and ethambutol increased from the first survey (1998–1999) to the second survey (2000) from 87.7 to 91.9%. Specificity, predictive values for resistance and susceptibility, efficiency and reproducibility were consistent in both surveys. In previously untreated cases, the prevalence of multidrug-resistance was the same in both surveys (1.2%), while a slight decrease from the first to the second survey was observed for monoresistance to rifampicin (from 0.8 to 0.4%) and isoniazid (from 2.9 to 2%).The significant association found between isoniazid resistance and immigration is a useful indicator for both clinicians managing individual tuberculosis cases and public health services planning control strategies.
Impact of nurse-led outpatient management of children with asthma on healthcare resource utilisation and costs
Authors: Kamps A.W.A. , Roorda R.J. , Kimpen J.L.L. , Overgoor-van de Groes A.W. , van Helsdingen-Peek L.C.J.A.M. , Brand P.L.P. 
Published: January 2003

The high burden of asthma on healthcare utilisation and costs warrants economic appraisal of management approaches. The authors previously demonstrated that the efficacy of nurse-led outpatient management of childhood asthma was comparable to management by a paediatrician and now report on the healthcare utilisation and costs of both management approaches.A total of 74 newly referred children with asthma were randomly assigned to a 1‐yr follow-up by paediatricians or asthma nurse. Healthcare utilisation was recorded and associated costs calculated for both management approaches.There were no significant differences in healthcare utilisation except for the total time spent on patient contact (136(n=14)versus187(n=41) min, for patients followed-up by paediatrician and an asthma nurse repectively). Costs within the healthcare sector were reduced by 7.2% in favour of nurse-led care. The reduction in costs was solely attributable to a 17.5% reduction in the costs of outpatient visits. Nurse-led care appeared to be cost-saving even if the duration of follow-up visits would be twice that of doctor's visits. Overall healthcare costs (within and outside the healthcare sector) were 4.1% lower for nurse-led outpatient management compared to traditional medical care.Nurse-led outpatient management of childhood asthma can be provided at a lower cost than medical care by paediatricians.
Single arterial occlusion to locate resistance in patients with pulmonary hypertension
Authors: Fesler P. , Pagnamenta A. , Vachiéry J‐L. , Brimioulle S. , Abdel Kafi S. , Boonstra A. , Delcroix M. , Channick R.N. , Rubin L.J. , Naeije R. 
Published: January 2003

The purpose of this study was to determine the site of increased resistance using the arterial occlusion technique in patients with severe pulmonary hypertension.Pulmonary vascular resistance was partitioned in arterial and venous components based on double exponential fitting analysis of the pulmonary artery pressure decay curve: after balloon occlusion in 36 patients with pulmonary arterial hypertension (PAH); at baseline and during the inhalation of 20 parts per million of nitric oxide (NO); in four patients with chronic thromboembolic pulmonary hypertension; and in two patients with pulmonary veno-occlusive disease.In the patients with PAH, at baseline, mean pulmonary artery pressure was 56±2 mmHg (mean±se), with an arterial component of resistance of 63±1%. Inhaled NO did not change the partition of resistance. The arterial component of resistance amounted on average to 42% and 77% in the patients with veno‐occlusive disease and the patients with thromboembolic pulmonary hypertension, respectively. However, the partitioning of resistance did not discriminate between these three diagnostic categories.The occlusion technique may help to locate the predominant site of increased resistance in patients with severe pulmonary hypertension, but does not allow for a satisfactory differential diagnosis on an individual basis.
Use of anti-inflammatory therapy and asthma mortality in Japan
Authors: Suissa S. , Ernst P. 
Published: January 2003

Asthma treatment guidelines were introduced in Japan in the 1990s, insisting as elsewhere, on the importance of anti-inflammatory therapy. The present study assessed whether use of anti-inflammatory medications was associated with a decrease in asthma mortality in Japan, the first country to use leukotriene receptor antagonists.A population-based ecological study was conducted, spanning the period 1987–1999, among people aged 5–34 yrs in Japan. The association between the yearly rate of asthma death and sales of inhaled corticosteroids and leukotriene receptor antagonists was estimated using Poisson regression.The yearly asthma death rate was stable at 6–7 deaths per million before the introduction of leukotriene receptor antagonists in 1995 and decreased by 23% thereafter, reaching 3.5 per million in 1999. The rate of asthma death was found to decrease with increasing use of both leukotriene receptor antagonists and inhaled corticosteroids. The rate ratio of asthma death was 0.96 per 1 million 25-day treatment courses of inhaled corticosteroids and 0.80 for every 1 million 25-day treatment courses of leukotriene receptor antagonists, consumed per year in Japan.The increasing use of inhaled corticosteroids and leukotriene receptor antagonists may have contributed to the significant reduction in asthma mortality among young asthmatics in Japan.
Markers of activity in clinically recovered human leukocyte antigen-DR17-positive sarcoidosis patients
Authors: Planck A. , Eklund A. , Grunewald J. 
Published: January 2003

Scandinavian human leukocyte antigen-DR17-positive (DR17+) sarcoidosis patients are characterised by a good prognosis. They also reveal an accumulation in bronchoalveolar lavage fluid of T‐lymphocytes expressing the T‐cell receptor V gene segment AV2S3 at disease onset. The authors of this study wished to establish whether AV2S3 T‐lymphocyte accumulation changes from disease onset to clinically resolved disease and how this relates to other activity parameters.Bronchoalveolar lavage fluid and serum from nine DR17+ sarcoidosis patients were examined at disease onset and after spontaneous resolution of clinical and radiographical signs of disease.Nine DR17+ patients with lung accumulated CD4+ AV2S3+ T‐cells were investigated after clinically recovery. At re-examination the percentage of CD4+ AV2S3+ lymphocytes in bronchoalveolar lavage fluid was normalised (29versus5.4%). A significant reduction in lymphocyte percentage (14versus4.4%) and a decrease in cellular concentration (179×106·L−1versus111×106·L−1) and CD4/CD8 ratio (5.2versus2.4) were also seen. In serum, the activity of angiotensin-converting enzyme (24.9versus14.0 U·mL−1) as well as the levels of neopterin (7.8versus5.3 nmol·L−1) decreased significantly after recovery.These results indicate that the locally accumulated AV2S3 positive T‐lymphocytes in bronchoalveolar lavage are involved in the pathogenic process of sarcoidosis in this patient group.
Pulmonary arterial hypertension in children
Authors: Widlitz A. , Barst R.J. 
Published: January 2003

For physicians to admit that a group of patients remains for whom no cure is available in modern medicine is intellectually unsatisfying. Pulmonary arterial hypertension is a rare condition. Because the symptoms are nonspecific and the physical finding can be subtle, the disease is often diagnosed in its later stages. The natural history of pulmonary arterial hypertension is usually progressive and fatal.At the 1998 Primary Pulmonary Hypertension World Symposium, clinical scientists from around the world gathered to review and discuss the future of pulmonary arterial hypertension. Bringing together experts from a variety of disciplines provided the opportunity for a better understanding of the pathology, pathobiology, risk factors, genetics, diagnosis and treatment for pulmonary arterial hypertension.Remarkable progress has been made in the field of pulmonary arterial hypertension over the past several decades. The pathology is now better defined and significant advances have occurred in understanding the pathobiological mechanisms. Risk factors have been identified and the genetics have been characterised. Advances in technology allow earlier diagnosis as well as better assessment of disease severity. Therapeutic modalities such as new drugs,e.g.epoprostenol, treprostinil and bosentan, and surgical interventions,e.g.transplantation and blade septostomy, which were unavailable several decades ago, have had a significant impact on prognosis and outcome. Thus, despite the inability to really cure pulmonary arterial hypertension, therapeutic advances over the past two decades have resulted in significant improvements in the outcome for children with various forms of pulmonary arterial hypertension.This review of pulmonary arterial hypertension will highlight the key features of pulmonary hypertension in infants and children and the current understanding of pulmonary arterial hypertension with specific recommendations for current practice and future directions.
Evaluation of an individualised asthma programme directed at behavioural change
Authors: Put C. , van den Bergh O. , Lemaigre V. , Demedts M. , Verleden G. 
Published: January 2003

An individualised asthma programme directed at behavioural change was evaluated in asthmatic subjects who reported complaints and impairment, despite adequate medical treatment.Mild-to-moderate asthma patients (n=23) were randomly assigned to a programme or waiting list condition. Outcome measures were: McMaster Asthma Quality of Life Questionnaire, Asthma Symptom Checklist, Negative Emotionality Scale, Knowledge, Attitude and Self-Efficacy Asthma Questionnaire, Adherence Scale, and peak flow measurements. Both groups were evaluated at three consecutive moments, each separated by 3 months; the programme was delivered between the first two evaluations. At onset the patient received a workbook containing information, exercises and homework assignments. Psycho-education, behavioural and cognitive techniques were introduced during six 1‐h individual sessions.Compared with controls the programme group reported less symptoms (obstruction, fatigue), better quality of life (activity, symptoms, emotions), decreased negative affectivity, and increased adherence, immediately after finishing the programme and at 3 months follow-up. All three cognitive variables (knowledge, attitude towards asthma, self-efficacy) and day and night peak flow ratings improved in the programme group but not in the waiting list group.Participation in an individualised programme resulted in improvement of asthma morbidity, and asthma-related behaviour and cognitions, in subjects reporting symptoms and impairment despite adequate medical therapy.
T‐helper 1 cells induce alveolitis but do not lead to pulmonary fibrosis in mice
Authors: Irifune K. , Yokoyama A. , Kohno N. , Sakai K. , Hiwada K. 
Published: January 2003

T‐helper (Th)1 cells have a pivotal role in the pathogenesis of hypersensitivity pneumonitis. Continued low-level exposure to the antigens may induce chronic hypersensitivity pneumonitis with lung fibrosis. Although such exposure may activate Th1 cells in the lung, it is not known whether activation of Th1 cellsper secan lead to pulmonary fibrosis. To determine this, the lung pathology induced by Th1 clones was investigated.Mice (BALB/c) were injected intraperitoneally with Th1 clones 1–4 times. Each injection was performed 4 days apart and was followed by repeated exposure to aerosolised ovalbumin (OVA) once a day for 5 days.The number of macrophages and lymphocytes in bronchoalveolar lavage fluids (BALF) increased as the number of Th1 transfers increased. The number of neutrophils also increased but peaked in the second transfer and then decreased following further transfers. Increased cell infiltration, thickness of alveolar walls and number of type II cells in the lung occurred. However, histological findings showed no evidence of fibrosis and hydroxyproline levels did not increase. Findings of histology and BALF were ameliorated 2 weeks after the discontinuation of OVA exposure, indicating the reversibility of the Th1-induced pathology.In conclusion, adoptive transfer of T‐helper 1 cells results in reversible alveolitis but does not lead to pulmonary fibrosis.
Acute interstitial pneumonia: report of a series
Authors: Bonaccorsi A. , Cancellieri A. , Chilosi M. , Trisolini R. , Boaron M. , Crimi N. , Poletti V. 
Published: January 2003

Four cases of acute interstitial pneumonia (AIP) are described with special emphasis on clinical background, lung imaging and bronchoalveolar lavage findings.A retrospective chart review of four patients with histologically-proven AIP, diagnosed between 1998 and 2000, was carried out. Clinical data, bronchoalveolar lavage (BAL) findings, high-resolution computed tomography (HRCT) and histological features were analysed.Three patients died and only one is in follow-up. HRCT showed areas of ground glass attenuation and alveolar consolidation in all patients. Histology, documented by open lung biopsy or autopsy specimens, was consistent with the organising form of diffuse alveolar damage pattern.BAL findings were characteristic, with a huge neutrophilia associated with scattered atypical type II pneumocytes collected in clusters with extracellular amorphous material (fragments of hyaline membranes) observed in two out of three cases.In this paper, four cases of acute interstitial pneumonia are reported in detail. The poor prognosis associated with this entity has been confirmed and the possible diagnostic role of the bronchoalveolar lavage is emphasised.
Nasal nitric oxide measurements for the screening of primary ciliary dyskinesia
Authors: Wodehouse T. , Kharitonov S.A. , Mackay I.S. , Barnes P.J. , Wilson R. , Cole P.J. 
Published: January 2003

Primary ciliary dyskinesia (PCD) presents to general practitioners with symptoms pertinent to a variety of specialists because of the involvement of ciliated epithelium in the upper/lower respiratory tract, ears, eyes and genital tract. There is no easy, reliable screening test for PCD, and thus, the majority of patients remain undiagnosed. Nitric oxide (NO) is measurable in nasal air of normal subjects and found to be low in cystic fibrosis (CF) and very low in PCD. Recently, it was suggested to play an important role in regulating ciliary motility. The aim of this study was to evaluate whether measurements of nasal NO could be used to screen for PCD.Nasal NO was measured from the nasal cavity by a chemiluminescence analyser in subjects with PCD, healthy controls, CF, idiopathic bronchiectasis, Young's syndrome and lone sinusitis.Nasal NO was significantly lower in PCD (64.0±36.6) compared with normal controls (759±145.8), idiopathic bronchiectasis (734±163.7), CF (447.5±162.6), lone sinusitis (1487±734) and Young's syndrome (644±129.9). Nasal NO was also significantly lower in PCD than CF patients.Measurement of nasal nitric oxide may therefore be used clinically in various specialities to screen suspected patients for primary ciliary dyskinesia.