bluuebunny/crossref_metadata_2025_split huggingface dataset:
Respiratory symptoms, bronchitis and asthma in children of Central and Eastern Europe
Authors: Leonardi G.S. , Houthuijs D. , Nikiforov B. , Volf J. , Rudnai P. , Zejda J. , Gurzau E. , Fabianova E. , Fletcher T. , Brunekreef B. 
Published: September 2002

The multicentre Central European Study of Air Pollution and Respiratory Health (CESAR) aimed to measure the respiratory health of schoolchildren using a standardised questionnaire in six countries of Central and Eastern Europe (CEE), allowing comparisons within this region and with other European countries.A cross-sectional study was conducted in 25 urban areas of Bulgaria, Czech Republic, Hungary, Poland, Romania, and Slovakia in 1996. Parents of 21,743 schoolchildren of age 7–11 yrs completed a questionnaire based on items from the World Health Organization and International Study of Asthma and Allergies in Childhood questions on cough and wheeze symptoms, as well as on diagnoses by doctors.Life-time prevalence of bronchitis was 55.9%, asthma 3.9%, and asthmatic, spastic or obstructive bronchitis 12.3%. In CEE countries the prevalence of bronchitis is higher and prevalence of asthma appears lower than in Western Europe. However, if asthma is defined as a diagnosis of either asthma or asthmatic, spastic or obstructive bronchitis, then its prevalence is comparable to Western Europe, or higher.In this region, within-country variation for most respiratory parameters is less than between-country variation. Between-country comparisons in doctors' diagnoses appear dependent on the choice of definition of asthma. Europe-wide comparisons in prevalence of respiratory symptoms and diagnosis are reported in this study. Some of the East-West difference in asthma prevalence may be attributable to differences in diagnostic practice.
Histopathological studies on the effects of peroxynitrite on the lungs and trachea of rabbits: Fig. 1.—
Authors: Farshid A.A. , Sadeghi-Hashjin G. , Ferdowsi H.R. 
Published: September 2002

Peroxynitrite (ONOO−) is the reaction product between nitric oxide and the superoxide anion. It is a biological oxidant and cytotoxic anion, producedin vivo, which might cause inflammation and damage to the lungs. This study was designed to investigate whether direct contact with peroxynitrite could cause pathological changes in the airways.Twenty New Zealand rabbits were divided into four experimental groups. They were anesthetised by intravascular injection of thiopental sodium, and peroxynitrite (0.5 mL of a 10 mM solution) was inoculated intratracheally. At 2 h, 24 h, 48 h, and 72 h postinoculation trachea and lungs were isolated for histopathology.The histopathological observations in the lungs were congestion, serous exudation, infiltration of leukocytes and degeneration, which were found to be time-dependent. Changes were similar at 48 and 72 h. Degenerative changes were not progressive. The changes in the trachea were congestion, oedema, leukocyte infiltration, and degeneration of tracheal epithelium.This study shows that peroxynitrite formation in the respiratory tract induces lung inflammation and degenerative changes.
Talcage by medical thoracoscopy for primary spontaneous pneumothorax is more cost-effective than drainage: a randomised study
Authors: Tschopp J-M. , Boutin C. , Astoul P. , Janssen J-P. , Grandin S. , Bolliger C-T. , Delaunois L. , Driesen P. , Tassi G. , Perruchoud A-P. ,   and the ESMEVAT team
Published: September 2002

Simple thoracoscopic talcage (TT) is a safe and effective treatment of primary spontaneous pneumothorax (PSP). However, its efficacy has not previously been estimated in comparison with standard conservative therapy (pleural drainage (PD)).In this prospective randomised comparison of two well-established procedures of treating PSP requiring at least a chest tube, cost-effectiveness, safety and pain control was evaluated in 108 patients with PSP (61 TT and 47 PD).Patients in both groups had comparable clinical characteristics. Drainage and hospitalisation duration were similar in TT and PD patients. There were no complications in either group. The immediate success rate was different: after prolonged drainage (>7 days), 10 out of 47 PD patients, but only 1 out of 61 TT patients required a TT as a second procedure. Total costs of hospitalisation including any treatment procedure were not significantly different between TT and PD patients. Pain, measured daily by visual analogue scales, was statistically higher during the first 3 days in TT patients but not in those patients receiving opiates. One month after leaving hospital, there was no significant difference in residual pain or full working ability: 20 out of 58 (34%)versus10 out of 47 (21%) and 36 out of 61 (59%)versus26 out of 39 (67%) in TTversusPD groups, respectively. After 5 yrs of follow-up, there had been only three out of 59 (5%) recurrences of pneumothorax after TT, but 16 out of 47 (34%) after conservative treatment by PD. Cost calculation favoured TT pleurodesis especially with regard to recurrences.In conclusion, thoracoscopic talc pleurodesis under local anaesthesia is superior to conservative treatment by chest tube drainage in cases of primary spontaneous pneumothorax that fail simple aspiration, provided there is efficient control of pain by opioids.
Safety of formoterol by Turbuhaler® as reliever medication compared with terbutaline in moderate asthma
Authors: Ind P.W. , Villasante C. , Shiner R.J. , Pietinalho A. , Böszörményi N.G. , Soliman S. , Selroos O. 
Published: September 2002

The present study compared the safety of 4.5 µg formoterol with 0.5 mg terbutaline, both by Turbuhaler® and used as needed, in addition to regular formoterol in moderate asthma.In this double-blind parallel-group study, 357 patients taking a moderate-to-high dose of inhaled corticosteroids and additional terbutaline (2–5 inhalations·day−1during run-in) were randomised to either formoterol or terbutaline as needed in addition to formoterol 9 µgb.i.d.over 12 weeks. Adverse events, serum potassium levels, electrocardiogram, vital signs and lung function were assessed monthly; peak expiratory flow and severe asthma exacerbations were recorded daily.Patients used 2.16 (range 0.0–6.3) formoterol and 2.34 (range 0.1–7.5) terbutaline relief inhalations·day−1. No clinically significant differences in safety variables were found between treatments. Statistically greater increases in cardiac frequency (2.6 beats·min−1, p=0.03) were found on terbutaline. There were 44 and 52 severe asthma exacerbations with formoterol and terbutaline, respectively, with no significant difference in time to first exacerbation. There was also no difference between treatments for other efficacy measures (peak expiratory flow, forced expiratory volume in one second and morning/evening symptom scores).Formoterol 4.5 µg as needed was at least as safe, well tolerated and effective as terbutaline 0.5 mg in stable patients (requiring up to 6 relief inhalations·day−1) taking formoterol plus inhaled corticosteroids regularly over 12 weeks.
Vaccination of COPD patients with a pneumococcus type 6B tetanus toxoid conjugate vaccine
Authors: Jonsson S. , Vidarsson G. , Valdimarsson H. , Schiffman G. , Schneerson R. , Jonsdottir I. 
Published: September 2002

This paper examines how pneumococcal type 6B polysaccharide conjugated to tetanus toxoid (Pn6B-TT) compares to a 23 valent pneumococcal vaccine (pneumococcal polysaccharide (PPS)-23) with respect to immunogenicity and serum opsonic activity in patients with chronic obstructive pulmonary disease (COPD).Patients with COPD aged 55–75 yrs were vaccinated with Pn6B-TT (n=10) or with PPS-23 (n=9). Healthy young adults (HA) were vaccinated with Pn6B-TT as controls. Total antibodies to serotype 6B polysaccharide were measured by radioimmunoassay and immunoglobulin (Ig)G antibodies by enzyme-linked immunosorbent assay. Opsonic activity was measured by a phagocytosis assay using human neutrophils as effector cells.The patient groups were comparable by age, smoking history, lung function and use of steroids. COPD patients vaccinated with Pn6B-TT or PPS-23 showed an increase in IgG antibodies and a nonsignificant increase in opsonic activity. This was similar to the increase in IgG and opsonic activity seen in HA. There was a significant correlation between antibody levels and opsonic activity in COPD patients vaccinated both with Pn6B-TT and PPS-23.Pneumococcal antibodies have been shown to confer protection from infection. The results of the present study indicate that protective immunity can be expected in elderly chronic obstructive pulmonary disease patients vaccinated with conjugate vaccines.
Systemic cytokine levels in community-acquired pneumonia and their association with disease severity
Authors: Antunes G. , Evans S.A. , Lordan J.L. , Frew A.J. 
Published: September 2002

Pro-inflammatory and anti-inflammatory cytokines are important mediators in the host response to infection. In contrast to the pro-inflammatory cytokines little is known about anti-inflammatory cytokines in community-acquired pneumonia (CAP) and their relation to disease severity.Circulating levels of three pro-inflammatory cytokines (interleukin (IL)-1β, IL-6 and tumour necrosis factor (TNF)-α) and two anti-inflammatory cytokines (IL-10, IL-1 receptor antagonist (IL-1ra)) were measured using an enzyme immunoassay on admission, day 3 and day 5 in 24 patients with CAP. The modified British Thoracic Society (BTS) prognostic rule and Acute Physiology and Chronic Health Evaluation (APACHE) II score were used to assess disease severity.IL-6, TNF-α, IL-10 and IL-1ra concentrations were detected in most patients on admission and decreased significantly on day 3 and day 5 in all survivors. A significant difference between the BTS high-risk and low-risk groups was only found for IL-6 (median (range) 477 pg·mL−1(7.6–1402 pg·mL−1)versus81.6 pg·mL−1(0–943 pg·mL−1); p<0.05). IL-6 also correlated with the APACHE II scores on admission.Concentrations of anti-inflammatory cytokines were elevated on admission in community-acquired pneumonia but they did not correlate with disease severity scores.
The role of EGF-R expression on patient survival in lung cancer: a systematic review with meta-analysis
Authors: Meert A-P. , Martin B. , Delmotte P. , Berghmans T. , Lafitte J-J. , Mascaux C. , Paesmans M. , Steels E. , Verdebout J-M. , Sculier J-P. 
Published: September 2002

The prognostic value of epidermal growth factor receptor (EGF-R) for survival of patients with lung cancer remains controversial. The authors performed a systematic review of the literature in order to clarify its impact.Published studies were identified using an electronic search in order to aggregate the available survival results, after a methodological assessment using a scale specifically designed by the European Lung Cancer Working Party (ELCWP). To be eligible, a study had to have dealt with EGF-R assessment in lung cancer patients on the primary site and to have analysed survival according to EGF-R expression.Among the 16 eligible studies, 14 assessed any nonsmall-cell lung cancer (NSCLC) subtype, one adenocarcinoma only and one squamous-cell carcinoma only. The overall median quality score was 56.3%, with no significant difference either between studies assessable or not assessable for meta-analysis or between studies with significant and nonsignificant results. One individual trial reported a survival benefit for patients with EGF-R expression, three a survival disadvantage and 12 no statistically significant difference. Eleven studies (2,185 patients) provided sufficient data to allow a meta-analysis of the survival results. EGF-R expression positivity was determined according to the cut-off as determined by the authors. The meta-analysis showed that EGF-R expression was not a statistically significant prognostic factor for survival in NSCLC. In the subgroup of studies using immunohistochemistry, statistical tests reached a significant level against EGF-R.Epidermal growth factor receptor might be a poor prognostic factor for survival in nonsmall-cell lung cancer. The amplitude of the impact is small, however, and may be subject to publication bias.
An overnight comparison of two ventilators used in the treatment of chronic respiratory failure
Authors: Highcock M.P. , Morrish E. , Jamieson S. , Shneerson J.M. , Smith I.E. 
Published: September 2002

Differences between bilevel ventilators used for noninvasive intermittent positive pressure ventilation (NIPPV) have been demonstrated during bench testing. However, there are no clinical studies comparing these machines. The authors have previously shown that the Quantum pressure support ventilator and Sullivan variable positive airway pressure II ST differ in performance during bench testing. To examine the clinical significance of this, these two machines were compared in the overnight treatment of subjects with chronic respiratory failure.Ten clinically-stable subjects with thoracic scoliosis were recruited. The subjects were already established on NIPPV, but none were using either of the ventilators to be tested. After familiarisation, the patients used the two ventilators in random order on consecutive nights. Peripheral oxygen saturation and transcutaneous carbon dioxide tension (Pt,CO2) were measured continuously, and sleep was recorded using polysomnography.There were no significant differences in arterial oxygen saturation,Pt,CO2or sleep duration and quality between the two nights.Despite previously illustrated variation in laboratory performance, no differences were seen between the two ventilators when comparing overnight gas exchange and sleepin vivo. Further study is required to evaluate the significance of the differences found during bench testing in the clinical setting.
Survival in COPD patients after regular use of fluticasone propionate and salmeterol in general practice
Authors: Soriano J.B. , Vestbo J. , Pride N.B. , Kiri V. , Maden C. , Maier W.C. 
Published: September 2002

Despite substantial evidence regarding the benefits of combined use of inhaled corticosteroids and long-acting β2-agonists in asthma, such evidence remains limited for chronic obstructive pulmonary disease (COPD). Observational data may provide an insight into the expected survival in clinical trials of fluticasone propionate (FP) and salmeterol in COPD.Newly physician-diagnosed COPD patients identified in primary care during 1990–1999 aged ≥50 yrs, of both sexes and with regular prescriptions of respiratory drugs were identified in the UK General Practice Research Database. Three-year survival in 1,045 COPD patients treated with FP and salmeterol was compared with that in 3,620 COPD patients who regularly used other bronchodilators but not inhaled corticosteroids or long-acting β2-agonists. Standard methods of survival analysis were used, including adjustment for possible confounders.Survival at year 3 was significantly greater in FP and/or salmeterol users (78.6%) than in the reference group (63.6%). After adjusting for confounders, the survival advantage observed was highest in combined users of FP and salmeterol (hazard ratio (HR) 0.48 (95% confidence interval 0.31–0.73)), followed by users of FP alone (HR 0.62 (0.45–0.85)) and regular users of salmeterol alone (HR 0.79 (0.58–1.07))versusthe reference group. Mortality decreased with increasing number of prescriptions of FP and/or salmeterol.In conclusion, regular use of fluticasone propionate alone or in combination with salmeterol is associated with increased survival of chronic obstructive pulmonary disease patients managed in primary care.
α1-antitrypsin deficiency: a report from the 2nd meeting of the Alpha One International Registry, Rapallo (Genoa, Italy), 2001
Authors: Luisetti M. , Miravitlles M. , Stockley R.A. 
Published: September 2002

The Alpha One International Registry is a scientific foundation established to comply with a World Health Organization recommendation to develop a multinational registry of α1-antitrypsin deficiency, with the aim of creating a common database of subjects recognised in a standardised way.A commitment of the Alpha One International Registry members, belonging to 15 national registries, is to meet every 2 yrs in an open scientific conference to provide a scientific and clinical update on the deficiency. The second Alpha One International Registry meeting was held in Rapallo (Genoa, Italy) on September 27th–28th, 2001, and 26 speakers provided an exhaustive overview of all aspects of α1-antitrypsin deficiency, including epidemiology, genetics, biochemistry, associated conditions, established and novel therapeutic options, and markers of efficacy. In the framework of a rare and often under-recognised condition, this meeting is likely to be central to improving understanding and increasing awareness of α1-antitrypsin deficiency.
Sodium cromoglycate and doxantrazole are oxygen radical scavengers
Authors: Sadeghi-Hashjin G. , Nijkamp F.P. , Henricks P.A.J. , Folkerts G. 
Published: September 2002

The effects of two mast cell stabilisers, sodium cromoglycate (SCG) and doxantrazole, on the formation of reactive oxygen species (ROS) were studied. Guinea-pig alveolar macrophages (AMs) generated lucigenin-dependent chemiluminescence (LDCL). This was increased when the cells were stimulated by phorbol myristate acetate (PMA) or zymosan (by 133% and 464%, respectively, in total LDCL over 60 min). SCG decreased PMA-induced LDCL at higher concentrations (10 mM, by 55%) than doxantrazole (1 mM, by 75%). SCG decreased radical production by AMs in response to zymosan in a concentration-dependent manner by ≤72%. Doxantrazole (0.1–1 mM) diminished total LDCL by 30–80%. In addition, glucose oxidase led to LDCL generation when incubated with glucose in a cell-free medium. This was inhibited by 47–83% in the presence of SCG or doxantrazole. SCG and doxantrazole inhibited the hydrogen peroxide- and peroxynitrite-induced LDCL by ≤92%. Moreover, these drugs slightly increased the survival rate of the AMs.It is concluded that doxantrazole- and sodium cromoglycate-inhibited lucigenin-dependent chemiluminescence production by guinea-pig alveolar macrophages is due to a direct scavenging effect on reactive oxygen species. Doxantrazole is ∼10-times more potent. Mast cell stabilisers may be effective in allergic asthma not only by preventing the allergen-induced mediator release, but also by preventing radical-induced lung damage.
Prone position in acute respiratory distress syndrome
Authors: Pelosi P. , Brazzi L. , Gattinoni L. 
Published: September 2002

In the last few years prone positioning has been used increasingly in the treatment of patients with acute respiratory distress syndrome (ARDS) and this manoeuvre is now considered a simple and safe method to improve oxygenation. However, the physiological mechanisms causing respiratory function improvement as well as the real clinical benefit are not yet fully understood. The aim of this review is to discuss the physiological and clinical effects of prone positioning in patients with ARDS.The main physiological aims of prone positioning are: 1) to improve oxygenation; 2) to improve respiratory mechanics; 3) to homogenise the pleural pressure gradient, the alveolar inflation and the ventilation distribution; 4) to increase lung volume and reduce the amount of atelectatic regions; 5) to facilitate the drainage of secretions; and 6) to reduce ventilator-associated lung injury.According to the available data, the authors conclude that: 1) oxygenation improves in ∼70–80% of patients with early acute respiratory distress syndrome; 2) the beneficial effects of oxygenation reduce after 1 week of mechanical ventilation; 3) the aetiology of acute respiratory distress syndrome may markedly affect the response to prone positioning; 4) extreme care is necessary when the manoeuvre is performed; 5) pressure sores are frequent and related to the number of pronations; 6) the supports used to prone and during positioning are different and nonstandardised among centres; and 7) intensive care unit and hospital stay and mortality still remain high despite prone positioning.
Equipment needs for noninvasive mechanical ventilation
Authors: Schönhofer B. , Sortor-Leger S. 
Published: September 2002

Noninvasive mechanical ventilation (NIV) has a long tradition for the treatment of chronic respiratory failure and more recently has also been applied in acute respiratory failure. Based on this experience both critical care ventilators and portable ventilators are used to perform NIV. The individual choice of ventilator type should depend on the patient's condition and also on the expertise of attending staff, therapeutic requirements and the location of care.The majority of studies have used pressure-targeted ventilation in the assist mode. Positive qualities of pressure support ventilation (PSV) are leak compensation, good patient/ventilator synchrony and the option of integrated positive end-expiratory pressure to counteract the effect of dynamic hyperinflation. In this article, some crucial issues concerning PSV (i.e.triggering into inspiration, pressurisation, cycling into expiration and carbon dioxide rebreathing) and some corrective measures are discussed.The parameters which should be monitored during noninvasive ventilation are presented. The interface between patient and ventilator is a crucial issue of noninvasive ventilation. Advantages and disadvantages of face and nasal masks are discussed. Finally, causes and possible remedies of significant air leaks and some technical accessories for noninvasive ventilation are dealt with.
Apparent but not real increase in asthma prevalence during the 1990s
Authors: Barraclough R. , Devereux G. , Hendrick D.J. , Stenton S.C. 
Published: September 2002

The authors investigated changes in asthma prevalence and perception of bronchoconstriction over 6 yrs in adults of Newcastle-upon-Tyne.Postal questionnaires were sent to 6,000 subjects aged 20–44 yrs in 1992–1993 and 1998–1999. Random samples of 600 responders had assessments of atopy, airway responsiveness, and their ability to perceive methacholine-induced bronchoconstriction. The prevalences of asthmatic symptoms, physician-diagnosis, and medication use increased by an average of 4.4%, particularly in subjects aged <30 yrs (8.7versus2.7). Atopy prevalence increased from 25% to 31% but atopics and nonatopics had similar mean changes in questionnaire data (5.2versus3.4). The probability of a positive methacholine test decreased as did the mean methacholine dose/response slope (0.00527 to 0.00379), indicating lower levels of airway responsiveness. This can be largely explained by an increase in use of inhaled corticosteroids (5.0–9.3%). The proportion of subjects perceiving bronchoconstriction during methacholine tests increased from 63 to 77%.The authors conclude that current changes in asthma epidemiology in adults may result from increased awareness of symptoms (and/or an increased willingness to report them), and from an increased willingness of physicians to make the diagnosis and prescribe treatment, not from increased disease prevalence.