bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angioedema from angiotensin‐converting enzyme (ACE) inhibitor treated with complement 1 (C1) inhibitor concentrate
Authors: Nielsen E. W. , Gramstad S. 
Published: August 2005

Background:  Up to seven in every 1000 patients experience angioedema from angiotensin‐converting enzyme (ACE) inhibitors, even after many years of use. In 2003, every 20th Norwegian used an ACE inhibitor.Case report:  A 61‐year‐old woman with chronic obstructive pulmonary disease and a past acute myocardial infarction had used 7.5 mg of ramipril daily for the past 7 years. She also used acetylsalicylic acid, simvastatin, theophylline and salmeterol. One night she woke up with edema of the tongue. On hospital arrival, 250 mg of hydrocortisone and 5 mg of dexchlorpheniramine were given intravenously (i.v.) and 0.3 mg of epinephrine was given subcutaneously (s.c.). The edema of the tongue progressed over the next 8 h and made the tongue protrude. Fiberscopy revealed glassy edema of the arytenoids. Inspiratory stridor was heard and the patient could not speak. She became increasingly uneasy and restless. Berinert® complement 1 (C1) inhibitor concentrate (1500 units) was administered i.v. Over the following 20 min, stridor gradually subsided, the patient calmed and she was able to talk.Discussion:  ACE inhibitor‐provoked angioedema shares many clinical features with hereditary angioedema (HAE), including a limited effect of steroids, antihistamines and epinephrine. HAE, caused by excess bradykinin formation as a result of C1 inhibitor deficiency, usually has its laryngeal edema effectively reversed by C1 inhibitor in less than 0.5 h. Although patients experiencing ACE inhibitor‐provoked angioedema have normal C1 inhibitor values, as in our patient, excess bradykinin is probably important as ACE breaks down bradykinin. It is unknown why ACE inhibitor‐provoked angioedema appears in some and sometimes after many years of use.Conclusion:  We believe that C1 inhibitor was effective in reversing the ACE inhibitor‐induced angioedema in our patient.
High success rate and low incidence of headache and neurological symptoms with two spinal needle designs in children*
Authors: Kokki H. , Turunen M. , Heikkinen M. , Reinikainen M. , Laisalmi M. 
Published: August 2005

Background:  In children, only a few trials have evaluated the use of spinal needles with special tip designs. In this study, we compared the success rate and incidence of post‐dural puncture complaints of two small‐gauge spinal needle designs used in children undergoing spinal anaesthesia (SA).Methods:  Three hundred and three children aged 9 months to 17 years presenting for subumbilical surgery were randomly assigned to have a 26G Atraucan (n = 156) or 27G Whitacre (n = 147) spinal needle for SA. The number of attempts to obtain successful cerebrospinal fluid (CSF) return and the success rate of SA were recorded. The first week of recovery was recorded by a diary.Results:  Both groups had a similar one‐attempt success rate: 80% in the Atraucan group and 81% in the Whitacre group. Failure to obtain CSF occurred in one patient in the Atraucan group and in two patients in the Whitacre group. Paraesthesia was observed more commonly in the Whitacre group (10%) than in the Atraucan group (2%) (P = 0.004). The success rate of SA was 96%, with no differences between the two needles; one child was given general anaesthesia and 11 children (3%) a single dose of supplemental analgesia for the skin incision. Forty‐one children (15%) developed a headache, 13 of which were classified as post‐dural puncture headache (PDPH), seven cases (5%) in the Atraucan group and six (4%) in the Whitacre group; none of the children required a blood patch. Fifteen children (10%) in the Atraucan group and nine (7%) in the Whitacre group developed low back pain. Two children (1%) in the Atraucan group and four (3%) in the Whitacre group developed transient neurological symptoms (TNSs).Conclusion:  Both needles were associated with a high success rate and a low incidence of complaints.
Factors explaining the intention to give blood among the general population
Authors: Godin G. , Sheeran P. , Conner M. , Germain M. , Blondeau D. , Gagné C. , Beaulieu D. , Naccache H. 
Published: August 2005

Background and Objectives  The aim of this study was to identify factors explaining the intention to donate blood.Materials and Methods  A random sample of 4000 respondents drawn from the general population received a questionnaire by mail. This questionnaire assessed variables as defined by the most prominent social cognitive theories.Results  Overall, the respondents expressed a neutral mean level of intention to give blood in the next 6 months (2·84 on a five‐point scale); 56·2% had never given blood in the past. The variables explaining 74% of the variance of intention were: perceived behavioural control (β = 0·39; P < 0·001); factors facilitating taking action (β = 0·25; P < 0·001); anticipated regret (β = 0·16; P < 0·001); moral norm (β = 0·11; P < 0·001); attitude (β = 0·08; P < 0·01); level of education (β = −0·03; P < 0·05); and past experience in giving blood (β = 0·09; P < 0·001). Nonetheless, the predictive power of perceived behavioural control and moral norm was higher among the ever donors (both at P < 0·01) compared to the never donors, whereas the reverse was observed for attitude (P < 0·05).Conclusions  People's intentions are mainly determined by perceived barriers and obstacles regarding blood donations. This suggests that promotional strategies should focus on the elimination of barriers to action as well as the development of a higher perception of control. Also, messages should be adapted to the targeted population, based on their previous blood donation behaviour (i.e. never donors vs. ever donors).
Dissociation in the effect of nedocromil on mannitol‐induced cough or bronchoconstriction in asthmatic subjects*
Authors: KOSKELA Heikki O. , MARTENS Ruth , BRANNAN John D. , ANDERSON Sandra D. , LEUPPI Joerg , CHAN Hak‐Kim 
Published: August 2005

Objective:  Inhaled mannitol induces both bronchoconstriction and cough. Nedocromil sodium greatly attenuates mannitol‐induced bronchoconstriction. Knowledge about the effect of nedocromil on mannitol‐provoked cough might, therefore, clarify the mechanisms of this response.Methodology:  Inhalation challenges with mannitol powder were performed after inhalation of 8 mg of nedocromil or its placebo in 24 subjects with asthma. The study was double‐blind, randomised, and placebo‐controlled. The mannitol‐provoked coughs were manually recorded and the mannitol‐induced bronchoconstriction was measured with a spirometer.Results:  The cumulative dose of mannitol that provoked at least two coughs tended to be higher on the nedocromil day than on the placebo day (34 (22–53) mg vs 26 (18–37) mg, P = 0.051). The cumulative number of coughs per dose of mannitol was slightly, but significantly, lower on the nedocromil than on the placebo day (4.2 (2.8–6.3) coughs/100 mg vs 6.1 (4.0–9.4) coughs/100 mg, P = 0.037). However, when analysed on a constant‐dose basis, nedocromil provided no protection for coughing (−1% protection), whereas the protection for bronchoconstriction was clear (55% protection).Conclusions:  Nedocromil strongly attenuates mannitol‐induced bronchoconstriction but has a negligible effect on mannitol‐provoked cough. Therefore, these responses seem to have different pathways in asthma. Recording of both provoked coughs and induced bronchoconstriction during mannitol challenge may provide supplementary information about a patient's disease.
A pilot study of aerosolized N‐acetylcysteine for idiopathic pulmonary fibrosis
Authors: TOMIOKA Hiromi , KUWATA Youichirou , IMANAKA Kazufumi , HASHIMOTO Kimio , OHNISHI Hisashi , TADA Kimihide , SAKAMOTO Hiroko , IWASAKI Hironobu 
Published: August 2005

Objective:  Idiopathic pulmonary fibrosis poses a significant therapeutic challenge because of its progressive course. Since oxidative stress plays an important role in the pathogenesis of idiopathic pulmonary fibrosis, an open, randomized trial of long‐term inhalation therapy with the antioxidant, N‐acetylcysteine was conducted.Methodology:  A total of 30 patients with idiopathic pulmonary fibrosis were randomly assigned to one of the following inhalation therapies: N‐acetylcysteine (352 mg per day) or bromhexine hydrochloride (4 mg per day) as the control. Efficacy was assessed by analysing changes occurring from baseline to 12 months in pulmonary function, the 6‐min walking test, high‐resolution CT, health‐related quality of life, and serum KL‐6‐values.Results:  Four patients (n = 2 in each group) died within 12 months due to progression of idiopathic pulmonary fibrosis. A total of 22 patients (control, n = 12; N‐acetylcysteine, n = 10) completed the study. At 12 months there were significant differences between the N‐acetylcysteine and control groups in terms of mean changes in lowest SaO2 during the 6‐min walking test (−0.3 ± 2.1% vs −6.8 ± 1.8%, P < 0.05), serum KL‐6 (−482 ± 220 U/mL vs 176 ± 204 U/mL, P < 0.05), and the ground‐glass score on high‐resolution CT (−1.3 ± 1.6 vs 6.7 ± 1.5, P < 0.01). No significant differences were observed in pulmonary function, 6‐min walking distance or quality of life.Conclusions:  These data suggest that although long‐term aerosolized N‐acetylcysteine administration did not influence pulmonary function or quality of life, it may delay disease progression as evidenced by exercise desaturation, high‐resolution CT, and serum KL‐6.
Effects of ambient particulate matter on peak expiratory flow rates and respiratory symptoms of asthmatics during Asian dust periods in Korea
Authors: PARK Jeong Woong , LIM Young Hee , KYUNG Sun Young , AN Chang Hyeok , LEE Sang Pyo , JEONG Seong Hwan , JU Young‐Su 
Published: August 2005

Objective:  Dust generating events frequently produce ambient dust particles that are less than 10 µm in diameter, and these have been linked to adverse effects in the general population. However, the evidence linking these particles to adverse effects on the airways of asthmatic individuals is limited. The objective of this study was to investigate the possible adverse effects of Asian dust events on the respiratory functions and symptoms of subjects with bronchial asthma.Methodology:  From March to June 2002, individuals were enrolled who had been diagnosed as having asthma by bronchial challenge or by their bronchodilator response. The patients were divided into three groups according to asthma severity: mild, moderate and severe. Patients with other major disease states were excluded. Patients completed twice‐daily diaries monitoring PEF, respiratory symptoms, and daily activities. The daily and hourly mean levels of particulate matter <10 µm in diameter (PM10), as well as nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3) and carbon monoxide (CO) were measured at 10 monitoring sites in Incheon, Korea.Results:  Dust events occurred 14 times during the study period. On dusty days there were increased levels of PM10, decreased levels of NO2 and SO2, and no change in the CO levels, compared to the levels on control days. An increase in PM10 concentration was associated with increases in PEF variability of >20% (P < 0.05), more night‐time symptoms (P < 0.05), and a decrease in the mean PEF (P < 0.05), calculated by longitudinal data analysis. In contrast, there was no association between the PM10 levels and bronchodilator inhaler use or daytime respiratory symptoms. Using a general additive Poisson regression model, a borderline association was noted between PM10 and respiratory symptoms, with a relative risk of 1.05 (95% confidence interval (CI), 0.99–1.17). There was no association between the PM10 concentrations and PEF measurements, with PEF variability of >20% between the morning and evening values and a relative risk of 1.05 (95% CI, 0.89–1.24) in all subjects.Conclusions:  This study provides evidence that Asian dust events are impacting on the respiratory symptoms of subjects with bronchial asthma, and ambient air pollution, particularly elevated PM10, might be one of the aggravating factors.
Endobronchial metastases: a clinicopathological analysis
Authors: DURSUN Adile Berna , DEMIRAG Funda , BAYIZ Hulya , SERTKAYA Durdu 
Published: August 2005

Objective:  It is important to distinguish endobronchial metastases (EBM) from both primary lung cancers and benign lesions, as treatment will differ. The clinicopathological characteristics of EBM cases were documented to see whether any distinguishing features exist.Methodology:  Histological cases diagnosed as EBM in the pathology laboratory of a tertiary hospital were re‐evaluated. Symptoms, primary tumour sites, recurrence interval, radiological and bronchoscopic features, and histopathological properties were assessed.Results:  There were 18 cases (eight female, 10 male) with EBM. All were diagnosed by bronchoscopic bronchial biopsy. The primary tumour sites were: colorectal (4), breast (3), renal (3), lymphoma (3), rhabdomyosarcoma (2), bladder (1), thyroid (1) and malignant melanoma (1). The mean time from the diagnosis of the primary tumour to their presentation was 3.89 ± 1.09 (range, 0–19) years. In five patients, EBM was diagnosed synchronously with their extra pulmonary primary tumour. Two had other metastatic sites. Haemoptysis and cough were the more common symptoms. Interestingly, three patients were asymptomatic. There was no predilection for a particular airway segment to be involved but a predilection for the upper lobe existed. Endoscopic appearance was polypoid in 10 cases and mucosal infiltration in the remainder. Histopathological examination revealed epithelial tissue at the surface of the tumour in nine cases and four of these were metaplastic. In all but one there was inflammation, mainly lymphocytic. Necrosis was present in 10 cases and bleeding was seen in four. There were no statistically significant differences between the level of lymphocytic inflammation and other clinicopathological parameters.Conclusion:  EBM is a rare condition that can be synchronous or occur late. Surprisingly, it can be asymptomatic. It is usually found in the upper lobes. Lymphocytic inflammation is a common histopathological finding. There is need for further studies to clarify the clinical importance of EBM.
Inhaled corticosteroid for persistent cough following upper respiratory tract infection
Authors: PORNSURIYASAK Prapaporn , CHAROENPAN Poonkasem , VONGVIVAT Kulanee , THAKKINSTIAN Ammarin 
Published: August 2005

Objective:  The aim of this study was to determine the clinical effect of inhaled corticosteroid treatment for persistent cough, post upper respiratory tract infection (URTI) in previously healthy individuals, and on bronchial hyperresponsiveness (BHR).Methodology:  This was a prospective, randomized, double‐blinded, placebo‐controlled study conducted at a university hospital. A total of 30 non‐asthmatic, non‐smoking patients who were >15 years old and who had persistent post‐URTI cough for >3 weeks were assessed by a physical examination, CXR and spirometry, and were allocated to receive inhaled budesonide (400 µg/puff, twice daily) or placebo for 4 weeks. If a patient suffered from sinusitis, it was a requirement that it had been well treated. A symptom score (frequency of cough, frequency of coughing bouts, symptoms associated with cough, night‐time cough, frequency of taking medications to relieve cough, and number of medications) was recorded at entry, and after 2 and 4 weeks of treatment. A methacholine challenge test was performed at entry and after 4 weeks of treatment.Results:  The mean symptom scores for the treatment group (9.4) and the placebo group (9.8) at baseline were not significantly different (P = 0.79), and no differences were found between the groups after week 2 and week 4 of treatment (3.93 and 4.27 vs 2.26 and 2.66, P = 0.29). The mean change in symptom scores from baseline to week 2 and to week 4 of treatment were also not different between groups (5.93 and 5.6 vs 7.00 and 7.58, P = 0.23). No difference between groups was found in the mean changes in FEV1, FVC, and FEF25–75% after 4 weeks of treatment. A positive bronchial provocation test occurred in three patients (10%) but these were borderline.Conclusion:  Inhaled corticosteroid is ineffective in treating persistent post‐URTI cough in previously healthy individuals.
Mucociliary clearance in patients with chronic asthma: Effects of β2 agonists
Authors: DAVISKAS Evangelia , ANDERSON Sandra D. , SHAW Janet , EBERL Stefan , SEALE J. Paul , YANG Ian A. , YOUNG Iven H. 
Published: August 2005

Objective:  Chronic asthma is characterized by airway inflammation, mucus hypersecretion and impaired mucociliary clearance (MCC). We investigated baseline MCC and the acute effect of terbutaline in chronic asthmatics with sputum production while on long‐term treatment with salmeterol in combination with inhaled corticosteroids (ICS).Methodology:  MCC was measured at baseline and in response to 1 mg terbutaline (or placebo) on three visits over 80 min in 16 asthmatics (52 ± 13 years of age). Subjects who had greater than 10% absolute increase in MCC above baseline and placebo, after terbutaline, were categorized in group A and subjects who had less than 10% in group B.Results:  In group A subjects (n = 6), MCC increased from 23.7 ± 4.0% at baseline to 43.7 ± 4.9% with terbutaline (P < 0.0001) and to 34.4 ± 5.7% with placebo (P < 0.01). In group B subjects (n = 10), MCC remained similar: 11.3 ± 3.2% at initial baseline, 12.0 ± 3.2% with terbutaline and 7.3 ± 3.0% with placebo (P > 0.05). Group B subjects withdrew from all β2 agonists for a week and MCC was remeasured. After withdrawal, baseline MCC (7.0 ± 1.8%) was similar to the initial baseline value (P > 0.1) and MCC with terbutaline (15.8 ± 4.9%) was greater than baseline (P < 0.005) but remained abnormal in most subjects. Baseline percentage predicted FEV1 and FEF25−75% were 77.3 ± 7.2 and 41.7 ± 5.6 in group A and 59.9 ± 8.1 and 29.5 ± 8.4 in group B subjects, respectively.Conclusion:  MCC was impaired in most of these asthmatics with persistent airway obstruction and sputum production, despite regular treatment with ICS and salmeterol. In addition, there was little or no stimulation of MCC acutely after terbutaline in most of these asthmatics.
A prospective, multicentre clinical trial comparing cisplatin plus gemcitabine with cisplatin plus etoposide in patients with locally advanced and metastatic non‐small cell lung cancer
Authors: GOKSEL Tuncay , HATIPOGLU Osman Nuri , OZTURK Can , GORGUNER Metin , KIYIK Murat , YILMAZ Ugur , GUZELANT Asuman , TASBAKAN Sezai , TABAKOGLU Erhan , FIRAT Hikmet , TUTAR Umit , CIKRIKICIOGLU Sadettin , AKKOCLU Atila , SOYER Serdar , CAKIR Ebru , ITIL Oya , SANAL Salahattin 
Published: August 2005

Objective:  Cisplatin‐gemcitabine (PG) and cisplatin‐etoposide (PE) combinations are active regimens for non‐small cell lung cancer (NSCLC). The present study aimed to compare PG with PE in the treatment of patients with stage IIIB and IV NSCLC.Methodology:  We conducted a prospective, multicentre trial. A total of 166 patients were enrolled into the study and received either gemcitabine (1000 mg/m2) on days 1, 8 and 15 plus cisplatin (80 mg/m2) on day 2 every 4 weeks, or etoposide (100 mg/m2) on days 1, 2 and 3 plus cisplatin (80 mg/m2) on day 1 every 3 weeks.Results:  The overall response rate was superior in the PG group (54.8%vs 39.0%, P = 0.045). There was no significant difference in survival between the two groups, with respective median and 1‐year survival of 38 weeks and 33.3% for the PG group, and 34 weeks and 23.2% for the PE group. There was also no statistical difference for time to progression between the two groups. Neutropenia and thrombocytopenia were seen more frequently in the PG group (grade 3 neutropenia, 33.3%vs 15.9%, P = 0.012; grade 3 thrombocytopenia, 27.4%vs 3.7%, P < 0.001 and grade 4 thrombocytopenia, 10.7%vs 1.2%, P = 0.018).Conclusion:  PG is an active chemotherapy regimen and has a better response rate than PE in advanced NSCLC, although there was no difference in time to progression and overall survival. A higher incidence of haematological toxicity was seen with PG than with PE.
Contribution of aspirin‐intolerant asthma to near fatal asthma based on a questionnaire survey in Niigata Prefecture, Japan
Authors: YOSHIMINE Fumitoshi , HASEGAWA Takashi , SUZUKI Eiichi , TERADA Masaki , KOYA Toshiyuki , KONDOH Ariyoshi , ARAKAWA Masaaki , YOSHIZAWA Hirohisa , GEJYO Fumitake 
Published: August 2005

Objective:  Prevention of deaths due to asthma is one of the most important issues in asthma management. However, there are few epidemiological studies of asthma deaths in Japan.Methodology:  Over an 8‐week period in Niigata Prefecture, Japan, a questionnaire on asthma control and emergency episodes was administered to adult asthmatic patients. A questionnaire was also given to the patients’ physicians to obtain further clinical information. Patients who became unconscious during episodes of asthma, or who required intubation and ventilation, were allocated to a near‐fatal asthma group (NFA). Patients who did not fulfill these criteria were allocated to the non‐NFA group. The NFA group was divided into two subgroups, based on the date of their last NFA episode (old NFA ≥ 5 years and recent NFA < 4 years).Results:  Characteristic features of the NFA group included severe disease (23.1%vs 7.6%) with more aggressive patient management, including inhaled corticosteroid use (84.3%vs 72.0%). Multiple regression analysis confirmed that aspirin‐intolerant asthma (AIA) was strongly associated with NFA. There was no difference in the incidence of AIA between the recent and old NFA patients. This suggests the incidence of AIA in NFA did not improve over time.Conclusions:  A history of AIA may be a useful indicator of potential NFA and allow preventative methods to be introduced. It is therefore important to obtain a history of AIA and to be aware of the risk of NSAID administration to these patients.
Case‐control study of medical history and idiopathic pulmonary fibrosis in Japan
Authors: MIYAKE Yoshihiro , SASAKI Satoshi , YOKOYAMA Tetsuji , CHIDA Kingo , AZUMA Arata , SUDA Takafumi , KUDOH Shoji , SAKAMOTO Naomasa , OKAMOTO Kazushi , KOBASHI Gen , WASHIO Masakazu , INABA Yutaka , TANAKA Heizo ,   THE JAPAN IDIOPATHIC PULMONARY FIBROSIS STUDY GROUP
Published: August 2005

Objectives:  A few epidemiological studies have indicated that a patient's past medical history may contribute to the risk of developing idiopathic pulmonary fibrosis (IPF). A relationship between a history of selected disorders and the risk of IPF was assessed in a multicentre hospital‐based case‐control study in Japan.Methodology:  Included in the study were 104 patients of IPF, aged 40 years or over, who had been diagnosed within the previous 2 years, in accordance with the most recent criteria. Control subjects, aged 40 years or over, consisted of 56 hospitalized patients diagnosed as having acute bacterial pneumonia and four outpatients with the common cold. Adjustment was made for age, gender, region, pack‐years of smoking, employment status, occupational exposure and BMI.Results:  Medical histories of hypertension, hyperlipidaemia, coronary heart disease, diabetes mellitus, hepatitis C virus infection, tuberculosis, asthma, atopic dermatitis and allergic rhinitis were not statistically significantly associated with the risk of IPF, although cases were more likely to have suffered from allergic rhinitis and less likely to have been asthmatics than control subjects. Having a child with a history of allergic rhinitis, but not of asthma or atopic dermatitis, was significantly related to an increased risk of IPF.Conclusions:  These findings suggest that a genetic predisposition to allergic rhinitis may be associated with an increased risk of IPF.