bluuebunny/crossref_metadata_2025_split huggingface dataset:
Omalizumab inhibits allergen challenge-induced nasal response
Authors: Hanf G. , Noga O. , O'Connor A. , Kunkel G. 
Published: February 2004

Elevated serum levels of antigen-specific immunoglobulin (Ig)E are often associated with allergic respiratory diseases. This parallel-group, randomised, double-blind, placebo-controlled trial was designed to study the influence of omalizumab on the early nasal response to allergen challenge reflected by symptom score and inflammatory marker levels in nasal lavage fluid (NAL).A total of 23 patients with allergic rhinitis took part in the study, 11 were given placebo and omalizumab was administered subcutaneously in 12. Omalizumab or placebo were given at 2‐ or 4‐week intervals based on a patient's body weight and IgE levels to a total dose of 0.016 mg·kg−1·IgE−1(IU·mL−1) every 4 weeks.Compared to placebo, 16 weeks of treatment with omalizumab significantly inhibited allergen challenge-induced nasal symptoms (median symptom score 7.0–0.5versus7.0–7.0) and inhibited the increase of human serum albumin (median 15.3–0.12 mg·mL−1versus8.2–19.7 mg·mL−1) in the NAL after allergen challenge. Treatment with omalizumab induced a significant decrease in tumour necrosis factor‐α levels in basal NAL, but no change was seen for histamine.These results indicate that subcutaneously administered monoclonal anti-immunoglobulin‐E antibody, omalizumab, inhibits the nasal responses to allergen challenge of patients with allergic rhinitis. Omalizumab may provide a new strategy for the treatment of allergic rhinitis.
Iron lungversusconventional mechanical ventilation in acute exacerbation of COPD
Authors: Corrado A. , Ginanni R. , Villella G. , Gorini M. , Augustynen A. , Tozzi D. , Peris A. , Grifoni S. , Messori A. , Nozzoli C. , Berni G. 
Published: February 2004

The aim of this randomised study was to compare the effects of iron lung ventilation (ILV) with invasive mechanical ventilation (IMV) in patients with acute respiratory failure (ARF) due to exacerbation of chronic obstructive pulmonary disease.Forty-four patients with ARF were assigned either to ILV (22 patients) or IMV (22 patients). Primary end-points were the improvement in gas exchange and complications related to mechanical ventilation.On admission ILV and IMV groups did not differ in age, simplified acute physiology score II, arterial oxygen tension (Pa,O2)/inspiratory oxygen fraction (FI,O2), arterial carbon dioxide tension (Pa,CO2) and pH. Compared with baseline, ILV and IMV induced a similar and significant improvement inPa,O2/FI,O2,Pa,CO2and pH after 1 h of treatment and at discontinuation of mechanical ventilation. Major complications tended to be more frequent in patients treated with IMV than in those treated with ILV (27.3%versus4.5%), whereas mortality rate was similar (27.3%versus18.2%). The ventilator-free days and the length of hospital stay were significantly lower in the ILV than in the IMV group.This study suggests that iron lung ventilation is as effective as invasive mechanical ventilation in improving gas exchange in chronic obstructive pulmonary disease patients with acute respiratory failure, and is associated with a tendency towards a lower rate of major complications.
Increased mortality in COPD among construction workers exposed to inorganic dust
Authors: Bergdahl I.A. , Torén K. , Eriksson K. , Hedlund U. , Nilsson T. , Flodin R. , Järvholm B. 
Published: February 2004

The aim of this study was to find out if occupational exposure to dust, fumes or gases, especially among never-smokers, increased the mortality from chronic obstructive pulmonary disease (COPD).A cohort of 317,629 Swedish male construction workers was followed from 1971 to 1999. Exposure to inorganic dust (asbestos, man-made mineral fibres, dust from cement, concrete and quartz), gases and irritants (epoxy resins, isocyanates and organic solvents), fumes (asphalt fumes, diesel exhaust and metal fumes), and wood dust was based on a job-exposure matrix. An internal control group with “unexposed” construction workers was used, and the analyses were adjusted for age and smoking.When all subjects were analysed, there was an increased mortality from COPD among those with any airborne exposure (relative risk 1.12 (95% confidence interval (CI) 1.03–1.22)). In a Poisson regression model, including smoking, age and the major exposure groups, exposure to inorganic dust was associated with an increased risk (hazard ratio (HR) 1.10 (95% CI 1.06–1.14)), especially among never-smokers (HR 2.30 (95% CI 1.07–4.96)). The fraction of COPD among the exposed attributable to any airborne exposure was estimated as 10.7% overall and 52.6% among never-smokers.In conclusion, occupational exposure among construction workers increases mortality due to chronic obstructive pulmonary disease, even among never-smokers.
Influence of exercise training on cardiac baroreflex sensitivity in patients with COPD
Authors: Costes F. , Roche F. , Pichot V. , Vergnon J.M. , Garet M. , Barthelemy J-C. 
Published: February 2004

Decreased spontaneous cardiac baroreflex sensitivity (BRS), which could lead to the onset of cardiovascular events, has been demonstrated in chronic obstructive pulmonary disease patients. This study evaluates the effects of an exercise training programme on BRS.Twenty-one chronic obstructive pulmonary disease patients (mean±sd age 62±9 yrs; forced expiratory volume in one second 43.6±18.1% of the predicted value) with mild hypoxaemia (arterial oxygen tension 8.96±1.18 kPa) were compared to 18 healthy age-matched subjects. BRS was calculated as the slope of the baroreflex sequences between spontaneous changes in systolic blood pressure and subsequent consecutive relative risk deviation length, and was measured in the supine position and following head-up tilt for sympathetic stimulation.Pulmonary function test results and blood gas levels, measured only in patients, did not change after the training programme. Exercise training increased the maximal sustained workload (16.5%) and peak oxygen consumption (20.5%). Before training, BRS was lower in patients than in controls (2.7±1.5versus7.8±4.9 ms·mmHg−1) and tilting induced a smaller reduction in BRS (13versus34%). After training, BRS increased to 3.4±2.6 ms·mmHg−1in patients but remained lower than in controls. The response to the tilt test remained unchanged after training.It is concluded that, in chronic obstructive pulmonary disease patients, exercise training is associated with a gain in spontaneous baroreflex sensitivity, reflecting cardiovascular benefits.
Follow-up of 452 totally implantable vascular devices in cystic fibrosis patients
Authors: Munck A. , Malbezin S. , Bloch J. , Gerardin M. , Lebourgeois M. , Derelle J. , Bremont F. , Sermet I. , Munck M-R. , Navarro J. 
Published: February 2004

The use and complications of totally implantable vascular access devices (TIVADs) were examined during multiple courses of antibiotics in cystic fibrosis (CF) patients.This retrospective study involved 36 CF centres. Risk factors for removal and septicaemia were sought by survival analysis of censored data. Multivariate Cox models were constructed with removal or septicaemia as the event and the characteristics of TIVADs as explanatory variables.TIVADs (n=452) were implanted in 315 patients. The mean functional time per device was 32±25 months. Long-term complications occurred with 188 devices (42%); they consisted mainly of occlusion (21%, requiring removal in 77%), infection (9.3%, requiring removal in 85%; septicaemia in 7.3%; rate 0.3 per 1,000 days, Candida in 66%), and vascular thrombosis (4.7%, removal in 58%). Multivariate survival analysis showed that removal, whatever the reason, was associated with polyurethane (versussilicone) and routine use of the device for blood sampling (versusnever). No risk factors, including heparin lock, were identified for septicaemia or for removal for obstruction.Totally implantable venous access devices appear to be safe and reliable for long-term intermittent venous access. Although retrospective, this study suggests that the characteristics of the material and blood sampling are risk factors for removal.
Low incidence of pulmonary complications following nonmyeloablative stem cell transplantation
Authors: Nusair S. , Breuer R. , Shapira M.Y. , Berkman N. , Or R. 
Published: February 2004

Bone marrow transplantation is associated with pulmonary opportunistic infections and immune-mediated pulmonary processes such as idiopathic pneumonia syndrome and bronchiolitis obliterans. The aim of the present study was to test the hypothesis that nonmyeloablative stem cell transplantation (NST) has less adverse effects on the lungs.A review was undertaken of the pulmonary complications occurring in 53 patients with various haematological malignancies, some of whom were considered high-risk patients with chemoresistant disease, who underwent fludarabine-based irradiation-free conditioning for NST performed between March 1996 and October 1998. All data related to transplant procedure, disease outcome, graft-versus-host disease (GVHD), chest imaging, microbial cultures and lung biopsies, were retrieved from information collected prospectively at the time of transplantation.The median follow-up period after transplantation was 45 months, with 35 patients surviving >100 days. Approximately half of the patients displayed some form of GVHD, with 11% developing severe chronic GVHD. In 17 (32%) patients, the lungs were somehow adversely affected. Only two (3.8%) patients developed a clinical picture consistent with idiopathic pneumonia syndrome and none developed diffuse alveolar haemorrhage or bronchiolitis obliterans.Dose-reduced conditioning is associated with a low rate of pulmonary toxicity and side-effects. These findings may extend understanding of significant immune-mediated complications occurring after bone marrow transplantation.
Prediction equations for normal and low lung function from the Health Survey for England
Authors: Falaschetti E. , Laiho J. , Primatesta P. , Purdon S. 
Published: February 2004

The aim of this study was to derive new spirometric reference equations for the English population, using the 1995/1996 Health Survey for England, a large nationally representative cross-sectional study.The measurements used were the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) of a sample of 6,053 “healthy” (nonsmokers with no reported diagnosis of asthma or respiratory symptoms) White people aged ≥16 yrs. Multiple regression analysis, with age and height as predictors, was carried out to estimate prediction equations for mean FEV1, FVC and FEV1/FVC, separately for males and females. A method based on smoothing multiple estimates of the fifth percentiles of residuals was used to derive prediction equations for the lower limit of normal lung function.The new equations fit the current English adult population considerably better than the European Coal and Steel Community equations, and the proportions of people with “low” (below the fifth percentile) lung function are closer to those expected throughout the whole adult age range (16 to >75 yrs). For the age ranges the studies share in common, the new equations give estimates close to those derived from other nonlinear equations in recent studies.It is, therefore, suggested that these newly developed prediction equations be used for the White English population in both epidemiological studies and clinical practice.
Aerosol cyclosporin therapy in lung transplant recipients with bronchiolitis obliterans
Authors: Iacono A.T. , Corcoran T.E. , Griffith B.P. , Grgurich W.F. , Smith D.A. , Zeevi A. , Smaldone G.C. , McCurry K.R. , Johnson B.A. , Dauber J.H. 
Published: February 2004

The majority of patients who develop bronchiolitis obliterans, after lung transplantation, die within 2–3 yrs after onset since treatment with conventional immunosuppression is typically ineffective. A case/control study was conducted in lung transplant recipients with biopsy-documented bronchiolitis obliterans to determine whether aerosol cyclosporin use contributed to increased survival.The cases comprised 39 transplant recipients who received open-label aerosol cyclosporin treatment in addition to conventional immunosuppression. The controls were transplant recipients treated with conventional immunosuppression alone. There were 51 controls from the University of Pittsburgh Medical Center and 100 from a large multicentric database (Novartis Lung Transplant Database).Forced expiratory volume in one second expressed as a percentage of the predicted value was an independent predictor of survival in all patients with bronchiolitis obliterans. Cox proportional-hazards analysis revealed a survival advantage for aerosol cyclosporin cases compared to the Pittsburgh control group. A survival advantage was also seen when comparing study cases to multicentric controls.Aerosol cyclosporin, given with conventional immunosuppression to lung transplant recipients with bronchiolitis obliterans, provides a survival advantage over conventional therapy alone.
Preservation of post-transplant lung function with aerosol cyclosporin
Authors: Corcoran T.E. , Smaldone G.C. , Dauber J.H. , Smith D.A. , McCurry K.R. , Burckart G.J. , Zeevi A. , Griffith B.P. , Iacono A.T. 
Published: February 2004

Post-lung transplant use of aerosol cyclosporin (ACsA) is considered by examining the relationship between deposited aerosol dose and effect.In a sub-study of placebo controlled trials of ACsA as a rejection prophylaxis, 15 drug subjects received aerosol dose quantification tests to gage their ability to effectively deposit the nebulised drug in their transplanted lung(s). A total of seven placebo subjects received mock deposition tests. The deposited doses and mock doses were compared to changes in the forced expiratory volume in one second, at six time points during the 2‐yr trial period (ACsA was started within 6 weeks post-transplant).Linear relationships were demonstrated between deposited dose and improvement in lung function in the drug subjects at all intervals. Mock dose data from placebo subjects did not demonstrate similar correlation. Based on these results, subjects were grouped by dose and compared. Subjects depositing ≥5 mg of the drug in the periphery of their transplant(s) had improving pulmonary function on average. Low-dose and placebo subjects demonstrated declines, more A2–A4 rejection events in the latter portion of the trial, and more chronic rejection beyond the end of the trial.A dose-to-effect relationship is demonstrated for aerosol cyclosporin in terms of pulmonary function and biopsy proven rejection.
Central nervous system metastases of a pulmonary epitheloid haemangioendothelioma
Authors: Díaz R. , Segura Á. , Calderero V. , Cervera I. , Aparicio J. , Jordá M.V. , Pellín L. 
Published: February 2004

The case of a 55‐yr-old male with a right pleural effusion and multiple bilateral nodules is reported. A diagnostic thoracothomy was necessary to obtain a definitive histological diagnosis.During the postoperative course, the subject's neurological condition deteriorated and multiple cerebral mass lesions were discovered. The pathological analysis of both lung and cerebral tumours revealed an atypical endothelial cell proliferation; vascular immunohistochemical markers, such as factor VIII and CD34, were strongly positive. His general condition remained poor and the patient died 18 months after the initial diagnosis.The final diagnosis was pulmonary epitheloid haemangioendothelioma with synchronous central nervous system dissemination, the first time the authors believe that association has been reported. Little is known of the prognosis and treatment of these tumours, due to their rarity. Negative prognostic factors appear to be the presence of symptoms, pleural effusion or multifocal presentations. Treatment should include surgical resection if possible; chemotherapy appears to have little effect. Watchful waiting is an acceptable option, especially in asymptomatic patients.
Inhaled steroids and mortality in COPD: bias from unaccounted immortal time
Authors: Suissa S. 
Published: February 2004

A recent observational study, which suggested that inhaled corticosteroids (ICS) with or without long-acting bronchodilators are effective at reducing all-cause mortality in chronic obstructive pulmonary disease (COPD) patients, may be subject to immortal time bias.This bias was assessed using a population-based cohort of 3,524 newly treated COPD patients from Saskatchewan, Canada, observed from 1990–1999. Regular users of bronchodilators or ICS were followed for 3 yrs, during which time 860 deaths occurred. Cox's proportional hazards model was used to compare the hierarchical intention-to-treat approach employed in the recent study, a technique subject to bias from two sources of immortal time, with the conventional intention-to-treat approach and the according-to-treatment approach.The adjusted rate ratio of death using the hierarchical intention-to-treat approach was 0.66 (95% confidence interval (CI) 0.57–0.76) for ICS use relative to bronchodilator use, compared with 0.75 (95% CI 0.62–0.90) with the conventional intention-to-treat approach. Conversely, the rate ratio was 0.94 (95% CI 0.81–1.09) with the according-to-treatment approach, which accounts for both sources of immortal time.In this study, regular inhaled corticosteroid use in chronic obstructive pulmonary disease was not found to reduce all-cause mortality. Suggestion of this benefit from a previous observational study is the result of bias from unaccounted immortal time in its cohort design and analysis.
Additive preventive effect of influenza and pneumococcal vaccines in elderly persons
Authors: Christenson B. , Hedlund J. , Lundbergh P. , Örtqvist Å. 
Published: February 2004

In 1999, all individuals ≥65 yrs of age (n=258,754) in Stockholm County, Sweden, were offered influenza and pneumococcal vaccination in a prospective study on the effectiveness of these vaccines in reducing the need for hospital treatment and death due to influenza, pneumonia and invasive pneumococcal disease (IPD). Data on hospitalisation and mortality during 1 yr were obtained from the administrative database in Stockholm County Council.Vaccination was performed in 124,702 (48%) subjects; 72,107 had both vaccines, 29,346 only had the influenza vaccine and 23,249 only had the pneumococcal vaccine. Compared with the unvaccinated cohort, a lower incidence of hospitalisation for all end-point diagnoses was seen in vaccinated persons.An additive effectiveness of vaccination was seen when both vaccines were given, with a reduction of hospital admissions for influenza (37%), pneumonia (29%) and IPD (44%). In-hospital mortality for pneumonia was significantly lower in those who received both vaccines, than in unvaccinated persons.To conclude, vaccination with influenza and pneumococcal vaccines together was effective in reducing the need for hospital admission for influenza and pneumonia. There was a strong indication that pneumococcal vaccination alone, was effective not only in the prevention of invasive pneumococcal disease, but also of pneumonia overall, although to a low degree.
No further increase in asthma, hay fever and atopic sensitisation in adolescents living in Switzerland
Authors: Braun-Fahrländer C. , Gassner M. , Grize L. , Takken-Sahli K. , Neu U. , Stricker T. , Varonier H.S. , Wüthrich B. , Sennhauser F.H. ,   the Swiss Study on Childhood Allergy and Respiratory symptoms with respect to Air Pollution (SCARPOL) team
Published: February 2004

Prevalence rates of childhood asthma and allergy have been on the increase for several decades. The present study investigated whether this trend continued during the 1990s in adolescents living in Switzerland.Between 1992 and 2000, the change in prevalence of specific immunoglobulin E to aeroallergens, asthma symptoms and hay fever symptoms assessed by parents' and students' answers to the International Study of Asthma and Allergies in Childhood questions was investigated using three cross-sectional surveys. In total 1,324 (74.9%), 1,668 (80.6%) and 1,250 (73.9%) adolescents participated.Prevalence rates of asthma and current asthmatic symptoms remained constant, irrespective of whether the assessment was based on parental questionnaires or the student's self-completed written or video questionnaires (students' report of current wheeze 8.8, 7.3, and 8.3%). Similarly, no further increase was observed for reported hay fever rates and allergic sensitisation rates (positive multiscreen allergy test, SX1-test: 34.6, 38.9, and 35.6%, respectively). Although time trends in the occurrence of a series of known risk factors were recorded, none of these factors had a significant impact on asthma and allergy prevalence over time.No further increase in asthma and allergy rates occurred during the 1990s in adolescents living in Switzerland. However, to adequately assess the trend a longer period of observation is needed.
Comparison of single-breath and tidal breathing exhaled nitric oxide levels in infants
Authors: Franklin P.J. , Turner S.W. , Mutch R.C. , Stick S.M. 
Published: February 2004

The aim of this study was to compare two different methods, tidal breathing (TB) and single-breath (SB), for measuring fractional exhaled nitric oxide (FENO) in infants.FENOwas measured in 71 infants with either recurrent wheeze (n=32), recurrent cough (n=16) or no symptoms (healthy, n=23) using both methods. For TB measurements five breaths were collected into a gas sampling bag (off-line reservoir sampling). The SB method was modified from the raised volume rapid thoraco-abdominal technique. Agreement between the two methods was investigated and both methods were used to compare FENOin infants with and without symptoms.Flow dependence of SB FENOwas demonstrated using two expiratory flows (11 and 40 mL·s−1). There was a moderate correlation (r=0.60) but poor agreement between levels using the TB and SB methods. A significant difference in FENObetween healthy children and children with wheeze was found using the SB but not the TB method.Due to lower expiratory flow and reduced nasal nitric oxide contamination the single-breath technique may be more sensitive than the tidal breathing method for detecting differences in exhaled nitric oxide between infants with and without respiratory symptoms.
A short-term comparison of two methods of sputum expectoration in cystic fibrosis
Authors: Chatham K. , Ionescu A.A. , Nixon L.S. , Shale D.J. 
Published: February 2004

The aim of this study was to determine whether repeated maximum inspiratory vital capacity manoeuvres against a fixed resistance increased effective short-term sputum clearance in adults with cystic fibrosis (CF).Twenty adults with CF were randomised to receive, on alternate days, either standardised physiotherapy (SP) for 30 min, comprising postural drainage and the active cycle of breathing technique, or a series of resistive inspiratory manoeuvres (RIM) at 80% of their maximum sustained inspiratory pressure developed between residual volume and total lung capacity during the first 4 days of the treatment of an exacerbation of respiratory symptoms. Expectorated sputum was collected during and for 30 min after each treatment and weighed. Total protein, immunoreactive interleukin (IL)‐8 and human neutrophil elastase (HNE) concentrations, and the amount of each component expectorated, were determined.Compared with SP, RIM increased sputum weight two-fold, independent of treatment order or day. The concentrations of protein, IL-8 and HNE in sputum were similar for both treatments, while the quantity expectorated was greater with RIM treatment.In conclusion, short-term resistive inspiratory manoeuvres treatment was more effective at clearing sputum and inflammatory mediators than standardised physiotherapy.