bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational and environmental risk factors for respiratory symptoms in rural Beijing, China
Authors: Zhang L-X. , Enarson D.A. , He G-X. , Li B. , Chan-Yeung M. 
Published: January 2003

The aim of the present study was to determine the effects of occupational and environmental exposure on respiratory symptoms in adults in rural Beijing, China.Thirty randomly selected villages in the counties of Shunyi and Tongxian, 50 km north and east, respectively, of the city of Beijing, China, participated in this study. Village doctors interviewed all residents aged ≥15 yrs and completed the International Union Against Tuberculosis and Lung Disease Questionnaire on Bronchial Symptoms translated into Chinese with added questions on smoking and occupational and environmental exposure.Of the eligible population, 22,528 adults (98%) took part. The prevalence of all respiratory symptoms,i.e.asthma-like symptoms, asthma attacks in the last 12 months, chronic cough and chronic phlegm, was low. Significant determinants for respiratory symptoms were age, sex, smoking and county of residence. A dose-dependent relationship was found between cumulative cigarette consumption and prevalence of respiratory symptoms. After adjusting for these variables, exposure to insecticides and fertilisers significantly increased the risk of most of the respiratory symptoms, whereas exposure to indoor air pollution from domestic fuels did not.Exposure to chemicals such as insecticides and fertilisers contributed independently to the risk of respiratory symptoms in rural Beijing, China.
Applicability of laser scanning cytometry to study paediatric alveolar macrophages
Authors: Bunn H.J. , Woltmann G. , Grigg J. 
Published: January 2003

Laser scanning cytometry (LSC) generates quantitative information on immune receptor expression from cells cytocentrifuged onto a microscope slide. In children, the description of developmental changes in immune receptor expression on alveolar macrophages (AM) has been limited by the small number of cells recovered by bronchoalveolar lavage (BAL). The applicability of LSC to the study of AM from normal children was therefore assessed.AM were obtained by BAL of normal children following intubation prior to elective surgery. The ability of LSC to identify the cytoplasm of AM was assessed using either: 1) autofluorescence; 2) forward scatter; 3) nuclear staining with propidium iodide; or 4) a fluorescent-labelled monoclonal antibody to CD68, a pan-macrophage antigen.LSC could only reliably identify individual AM when stained with CD68. The sensitivity for detecting single whole AM using CD68 was 0.97 and the positive predictive value was 0.88, respectively, with excellent repeatability. In addition, a range of immunofluorescence parameters were generated for CD68.It is concluded that laser scanning cytometry is suited to the study of immune receptor expression from small numbers of paediatric alveolar macrophages, when CD68 is used for cell identification.
Effects of noninvasive ventilation on lung hyperinflation in stable hypercapnic COPD
Authors: Díaz O. , Bégin P. , Torrealba B. , Jover E. , Lisboa C. 
Published: January 2003

Two previous uncontrolled studies have suggested that noninvasive mechanical ventilation (NIMV) in patients with hypercapnic chronic obstructive pulmonary disease (COPD) improves arterial blood gas tensions by decreasing lung hyperinflation with the consequent reduction in inspiratory loads and changes in ventilatory pattern. The aim of this randomised placebo-controlled study was to determine whether these mechanisms play a pivotal role in the effects of NIMV on arterial blood gases.Thirty-six stable hypercapnic COPD patients were randomly allocated to NIMV or sham NIMV. A 2-week run-in period was followed by a 3-week study period, during which ventilation was applied 3 h·day−1, 5 days a week. Arterial blood gases, spirometry, lung volumes, and respiratory mechanics were measured before and after application of NIMV.Patients submitted to NIMV showed changes (mean (95% confidence interval)) in daytime arterial carbon dioxide tension (Pa,CO2) and arterial oxygen tension of −1.12 (−1.52–−0.73) kPa (−8.4 (−11.4–−5.5) mmHg) and 1.14 (0.70–1.50) kPa (8.6 (5.3–11.9) mmHg), respectively. Total lung capacity, functional residual capacity (FRC) and residual volume were found to be reduced by 10 (7–13), 25 (18–31), and 36 (27–45)% of their predicted value, respectively, whereas forced expiratory volume in one second and forced vital capacity increased by 4 (1.5–6.9) and 9 (5–13)% pred, respectively. Tidal volume (VT) increased by 181 (110–252) mL. All of the above changes were significant compared with sham NIMV. Changes inPa,CO2were significantly related to changes in dynamic intrinsic positive end-expiratory pressure, inspiratory lung impedance,VTand FRC.It was concluded that the beneficial effects of noninvasive mechanical ventilation could be explained by a reduction in lung hyperinflation and inspiratory loads.
Exhaled nitric oxide in specific challenge tests to assess occupational asthma
Authors: Piipari R. , Piirilä P. , Keskinen H. , Tuppurainen M. , Sovijärvi A. , Nordman H. 
Published: January 2003

Exhaled nitric oxide (NO) is a marker of eosinophilic inflammation of the airway mucosa accompanying changes in the clinical condition of asthma. Allergen exposure has been associated with delayed elevation of exhaled NO. The aim of this study was to assess the asthmatic airway inflammation with exhaled NO measurements during specific bronchial challenge tests with occupational agents.Forty patients with suspected occupational asthma were investigated. Specific bronchial challenge tests were performed with forced expiratory volume in one second or peak expiratory flow follow-up, supplemented by exhaled NO measurements before and 24 h after challenge tests.In active challenges, which induced bronchoconstriction, a significant mean increase of exhaled NO concentration was noted. In patients with a normal or slightly increased (<14.5 parts per billion (ppb)) basal NO level and a late bronchoconstriction, a significant increase in exhaled NO was seen. Patients with a high basal NO level (>14.5 ppb) and a significant bronchoconstriction did not show a significant NO elevation. Challenge tests without bronchoconstriction were not associated with a significant elevation of exhaled NO.Exhaled nitric oxide measurements can be used to indicate the development of airway inflammation accompanying late asthmatic reaction after bronchial challenge tests in patients with a normal or slightly increased basal nitric oxide concentration.
Copenhagen City Heart Study: longitudinal analysis of ventilatory capacity in diabetic and nondiabetic adults
Authors: Lange P. , Parner J. , Schnohr P. , Jensen G. 
Published: January 2003

The natural history of lung function in diabetes is unknown due to the lack of longitudinal observations.The decline of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) was studied over 15 yrs in the 17,506 adult participants of The Copenhagen City Heart Study, which included 266 individuals with diabetes.Multiple linear regression and a mixed-effects model were used, taking into account correlation between repeated measurements and adjusting for relevant confounders. In both sexes, FEV1and FVC were consistently lower in diabetic individuals, compared with healthy individuals, with an average reduction of ∼8% of the predicted value. Longitudinal analyses showed that the decline of FEV1and FVC in diabetic individuals was similar to that observed in nondiabetic subjects.It was concluded that although diabetic subjects have, on average, a lower forced expiratory volume in one second and forced vital capacity than individuals without diabetes, this deficit seems not to be progressive in the long term. These observations may be of importance with regard to diabetes treatment with inhaled pulmonary insulin, which is likely to become available within a few years.
Vascular endothelial growth factor mRNA and protein expression in airway epithelial cell linesin vitro
Authors: Koyama S. , Sato E. , Tsukadaira A. , Haniuda M. , Numanami H. , Kurai M. , Nagai S. , Izumi T. 
Published: January 2003

Vascular endothelial growth factor (VEGF) plays multifunctional roles in vascular permeability, repair and remodelling processes, in addition to the maintenance of vascular structure and function. In the present study, the potential of airway epithelial cell lines, BEAS-2B cells and A549 cells, to release and express VEGF in unstimulated and stimulated conditions was evaluated.The secretion and expression of VEGF were evaluated by enzyme-linked immunosorbant assay and by reverse transcriptase-polymerase chain reaction. The isoforms of released VEGF were determined by high-performance liquid chromatography.BEAS-2B cells and A549 cells released VEGF constitutively. Interleukin (IL)-1β and tumour necrosis factor (TNF)-α augmented the release of VEGF in a time- and dose-dependent manner. The released VEGF was 165 amino acid residues in either condition.Pseudomonas aeruginosalipopolysaccharide (LPS), interferon (IFN)-γ, smoke extract (SE), neutrophil elastase (NE), and bradykinin stimulated the release of VEGF. Keracinocyte growth factor (KGF), which reduces vascular permeability, also stimulated both cells to release VEGF. VEGF messenger ribonucleic acid (mRNA) was expressed both time- and dose-dependently at 2 h, and declined after 2 h in response to IL-1β and TNF-α. The expression of VEGF mRNA in airway epithelial cells was also augmented by LPS, IFN-γ, SE, NE, and KGF stimulation.These data suggest that airway epithelial cells may regulate the maintenance of vascular structure and function, as well as vascular permeability, repair and remodelling processes, in a variety of lung conditions by expressing vascular endothelial growth factor.
The management of childhood asthma in the community
Authors: Maziak W. , von Mutius E. , Beimfohr C. , Hirsch T. , Leupold W. , Keil U. , Weiland S.K. 
Published: January 2003

The aim of the present study was to assess the management of children with asthma in the community.Community-based random samples of children aged 5–7 and 9–11 yrs in Dresden and Munich, Germany, were studied in 1995–1996 using the phase II protocol of the International Study of Asthma and Allergies in Childhood. Detailed information on the use of antiasthma drugs and accessory treatment in the past year was collected by parental questionnaire. A total of 11,094 (response rate 83%) children participated.Among children with wheeze in the last year, 36% had used bronchodilators and 19% were on regular anti-inflammatory treatment. The strongest determinant of treatment was a physician's diagnosis of asthma. Forty-seven per cent of the children with current wheeze had not been diagnosed as asthmatics and received hardly any treatment (9% bronchodilators and 2% anti-inflammatory drugs), despite an increased prevalence of severe asthma symptoms, bronchial hyperresponsiveness and atopic sensitisation compared with children without asthma symptoms. The proportion of children regularly using inhaled steroids was small (6%) among current wheezers and reached only 21% among children with diagnosed asthma and >12 wheezing attacks in the last year. Inhaled steroid use was lower in Munich than in Dresden and inversely related to the use of alternative remedies.Further efforts to improve the diagnosis and treatment of childhood asthma are needed. These should aim to increase awareness of the chronic nature of asthma and the need for treatment according to current guidelines.
Effect of medroxyprogesterone on arterial blood gases, leptin and neuropeptide Y in postmenopausal females
Authors: Saaresranta T. , Irjala K. , Polo O. 
Published: January 2003

Natural progesterone, a potent respiratory stimulant, stimulates leptin production in premenopausal females. Leptin and its counterpart neuropeptide Y (NPY) have recently been linked with respiration. The effect of medroxyprogesterone acetate (MPA) on arterial blood gases, serum leptin and NPY was evaluated in this study.Fourteen postmenopausal females with respiratory impairment, due mostly to chronic obstructive pulmonary disease, were recruited for a randomised, double-blind, placebo-controlled crossover trial. Arterial blood gases, serum leptin and NPY concentrations were measured at baseline and after 14 days of treatment with placebo and MPA, separated by a 6-week washout period.Thirteen patients completed the trial. The mean±sd carbon dioxide tension in arterial blood (Pa,CO2) was 5.4±0.6 kPa at baseline, and decreased by 0.8±0.3 kPa during treatment with MPA. The oxygen tension in arterial blood (Pa,O2) and pH did not change. At baseline, the mean base excess was 0.6±1.9 mmol·L−1and the mean bicarbonate (HCO3−) concentration was 25.1±1.6 mmol·L−1. With MPA, base excess decreased by 2.2±1.2 mmol·L−1and HCO3−by 1.9±1.0 mmol·L−1from baseline. The mean concentrations of serum leptin (19.8±9.9 µg·L−1at baseline, 19.7±9.8 µg·L−1with MPA) or NPY (94.0±18.3 pmol·L−1at baseline, 85.1±41.2 pmol·L−1with MPA) did not change. However, the reduction inPa,CO2correlated with the reduction of serum leptin concentration.Medroxyprogesterone acetate effectively decreased the carbon dioxide tension in postmenopausal females with chronic respiratory impairment. The results suggest that a decrease in the carbon dioxide tension of ≥0.9 kPa is necessary for a reduction in serum leptin concentration.
What predicts poor collection of medication among children with asthma? A case-control study
Authors: Irvine L. , Crombie I.K. , Alder E.M. , Neville R.G. , Clark R.A. 
Published: January 2003

Compliance with asthma medication is recognised to be a problem. Acquisition of medication is the first step towards compliance. Factors predicting poor collection of prophylactic medication were investigated.A case/control study was conducted. Cases were children who had had at least two consultations for poorly controlled asthma in 1 yr and collected prescriptions of prophylactic medication irregularly. Controls were children whose prescriptions were collected as instructed.Levels of knowledge about asthma and asthma medication were high in both groups. Parents of cases were more likely to perceive their child's asthma to be moderate or severe and more likely to report that their child's asthma was not well controlled. They reported more night-time symptoms, exercise symptoms and school absence. Parents of cases were less likely to report that administering inhalers was part of the evening routine. They were less likely to perceive their child's prophylactic medication to be very effective and more reluctant to administer prophylactic medication.Some parents may decide to undertreat their children, although lack of organised routine may contribute to poor compliance. Parents need guidance on interpreting symptoms and support in establishing routines for the administration of medication.
The carbon intensity of electricity: how many kgC per kWhe?
Authors: Hitchin E R , Pout C H 
Published: January 2003

While it is relatively easy to describe how a change in electricity demand causes a change in carbon emissions from a system of grid-supplied power, it is by no means easy to quantify this. The following have all been used to determine the carbon emissions from changes in electricity demand: • the system-average carbon intensity (that is, the ratio between all carbon emitted to all power distributed); • the carbon intensity of the typical marginal plant; and • the carbon intensity of new plant built or avoided. All of these are valid in certain circumstances, but in others can give misleading results. This paper brings together existing information and new results of modeling a limited number of situations to propose, pro tem, a working set of figures for England and Wales, together with recommendation for their application. Further modelling and analysis is proposed to refine thesefigures.
A combined approach for improving cardiopulmonary bypass in coronary artery surgery: a pilot study
Authors: Baufreton Christophe , de Brux Jean Louis , Binuani Patrice , Corbeau Jean-Jacques , Subayi Jean Baptiste , Daniel Jean Claude , Treanor Patrick 
Published: January 2003

Background: This is a pilot study carried out to assess the feasibility and the clinical impact of a combined approach of cardiopulmonary bypass (CPB) with reduced anti-coagulation. Methods: We used a retrospective, non-randomized analysis of 45 consecutive patients undergoing coronary artery bypass using standard CPB with full anticoagulation (activated clotting time, ACT, > 450 s) (Group 1; n= 23) or closed, heparin-coated CPB with low anticoagulation (ACT> 250 s), precise heparin and protamine titration, controlled suction, and retrograde autologous prime (Group 2; n= 22). Results: Patients were similar except for a higher incidence of three-vessel disease in Group 2 (77.3% versus 47.8%; p < 0.03). Heparin was reduced by 41% in Group 2 and protamine by 56% ( p < 0.0001). Total postoperative blood loss was similar between Groups 1 and 2 (429 ± 149 versus 435 ± 168 ml, respectively). However, the operative hematocrit decrease was lower in Group 2 (-1.6± 7.5% versus -6.9± 4.8%; p= 0.007), although hemodilution was similar, as reflected by the blood protein level. The need for postoperative inotropic support was less frequent in Group 2 (36.4% versus 65.2%; p= 0.05). Within the subgroup of patients weaned from CPB without requiring inotropic support ( n= 35), the cardiac index dropped significantly in Group 1 ( p= 0.003) 6 h after the start of CPB, whereas it remained stable in Group 2 ( p= 0.92). Using multivariate analyses, Group 2 was found to be more protected than Group 1 against myocardial cellular injury ( p= 0.046) and need for postoperative inotropic support ( p= 0.014). Conclusion: The pejorative postoperative outcome in coronary artery surgery was attenuated through a combined approach aimed at improving CPB.
Functional recovery after cardiac rehabilitation
Authors: van Houten C D , Angenot E LD , Lankhorst G J , Devillé W , Beckerman H 
Published: January 2003

Objective: To study the effect of a cardiac rehabilitation programme based on the guidelines of the Dutch Heart Association (DHA). Design: Randomized controlled trial with a waiting list control group. Setting: Outpatient clinic of Rehabilitation Centre Amsterdam. Subjects: Forty patients with a first myocardial infarction. Interventions: Immediately after randomization the experimental group started the rehabilitation programme; the waiting list control group started after six weeks. No other type of treatment was given during the waiting period. Main outcome measures: Physical recovery, tested by means of an exercise test on a bicycle ergometer, and feelings of well-being (MPVH-W), handicap (MPVH-H) and distress (MPVH-D), tested using a Dutch questionnaire: the Medische Psychologische Vragenlijst voor Hartpatiënten, MPVH (medical psychological questionnaire for cardiac patients). Results: The adjusted treatment effects of the cardiac rehabilitation programme were 4.72% on the exercise test, 3.43 points on MPVH-W, –1.93 points on MPVH-H, and 0.12 points on MPVH-D. These effects were not statistically significant. Conclusion: Changes after a cardiac rehabilitation programme are relatively small, but are found in both the physical and the psychosocial domain.
Training symmetry of weight distribution after stroke: a randomized controlled pilot study comparing task-related reach, Bo bath and feedback training approaches
Authors: Mudie M H , Winzeler-Mercay U , Radwan S , Lee L 
Published: January 2003

Objective: To determine (1) the most effective of three treatment approaches to retrain seated weight distribution long-term after stroke and (2) whether improvements could be generalized to weight distribution in standing. Setting: Inpatient rehabilitation unit. Design: Forty asymmetrical acute stroke subjects were randomly allocated to one of four groups in this pilot study. Changes in weight distribution were compared between the 10 subjects of each of three treatment groups (task-specific reach, Bobath, or Balance Performance Monitor [BPM] feedback training) and a no specific treatment control group. One week of measurement only was followed by two weeks of daily training sessions with the treatment to which the subject was randomly allocated. Measurements were performed using the BPM daily before treatment sessions, two weeks after cessation of treatment and 12 weeks post study. Weight distribution was calculated in terms of mean balance (percentage of total body weight) or the mean of 300 balance points over a 30-s data run. Results: In the short term, the Bobath approach was the most effective treatment for retraining sitting symmetry after stroke ( p = 0.004). Training with the BPM and no training were also significant ( p = 0.038 and p = 0.035 respectively) and task-specific reach training failed to reach significance ( p = 0.26). At 12 weeks post study 83% of the BPM training group, 38% of the task-specific reach group, 29% of the Bobath group and 0% of the untrained group were found to be distributing their weight to both sides. Some generalization of symmetry training in sitting to standing was noted in the BPM training group which appeared to persist long term. Conclusions: Results should be treated with caution due to the small group sizes. However, these preliminary endings suggest that it might be possible to restore postural symmetry in sitting in the early stages of rehabilitation with therapy that focuses on creating an awareness of body position.
Follow-up services for stroke survivors after hospital discharge-a randomized control study
Authors: Andersen Hanne Elkjaer , Eriksen Karen , Brown Anne , Schultz-Larsen Kirsten , Forchhammer Birgitte Hysse 
Published: January 2003

Objective: To evaluate whether follow-up services for stroke survivors could improve functional outcome and reduce readmission rate. In this paper results of functional outcome are reported. Design: Randomized controlled trial allocating patients to one of three different types of aftercare: (1) follow-up home visits by a physician, (2) physiotherapist instruction in the patient's home, or (3) standard aftercare. Subjects: Stroke patients with persisting impairment and disability who, after completing inpatient rehabilitation, were discharged to their homes. Outcome measures: Six months after discharge, functional outcome was assessed with Functional Quality of Movement, Barthel Index, Frenchay Activity Index and Index of Extended Activites of Daily Living. Results: One-hundred and fifty-five stroke patients were included in the study. Fifty-four received follow-up home visits by a physician, 53 were given instructions by a physiotherapist in their home and 48 received standard aftercare only. No statistically signi cant differences in functional outcome six months after discharge were demonstrated between the three groups. However, all measurements showed a tendency towards higher scores indicating better function in both interventions groups compared with the control group. Conclusion: Follow-up services after stroke may be a way of improving functional outcome. The results of the present study should be evaluated in future trials. More research in this eld is needed, especially studies of how to support stroke survivors to resume social and leisure activities.