bluuebunny/crossref_metadata_2025_split huggingface dataset:
Procalcitonin and C-reactive protein levels in HIV-positive subjects with tuberculosis and pneumonia
Authors: Schleicher G. K. , Herbert V. , Brink A. , Martin S. , Maraj R. , Galpin J. S. , Feldman C. 
Published: March 2005

Pulmonary tuberculosis (PTB) and pneumococcal community-acquired pneumonia (PCAP) are common causes of lower respiratory tract infections in HIV-seropositive patients and may have similar clinical and radiological features. This study aimed to assess the value of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in HIV-seropositive patients with pneumonia, and to investigate their potential role in differentiating pneumococcal from mycobacterial infections.HIV-seropositive patients admitted with pneumonia were evaluated prospectively, 34 with PTB and 33 with PCAP.All 33 patients in the PCAP group and 20 of 34 patients in the PTB group had elevated PCT levels (>0.1 ng·mL−1). All patients in both groups had elevated CRP levels (>10 mg·L−1). The PTB group had significantly lower CD4 T-lymphocyte counts, lower CRP levels, lower white cell counts, and lower PCT levels than the PCAP group. Receiver operating characteristic analysis showed that optimal discrimination between PTB and PCAP could be performed at a cut-off point of 3 ng·mL−1for PCT (sensitivity 81.8%; specificity 82.35%) and 246 mg·L−1for CRP (sensitivity 78.8%; specificity 82.3%).In conclusion, HIV-seropositive patients with pneumococcal community-acquired pneumonia had significantly higher procalcitonin and C-reactive protein levels than those with pulmonary tuberculosis. A procalcitonin level >3 ng·mL−1and a C-reactive protein level >246 mg·L−1were both highly predictive of pneumococcal infection.
The PREVASC study: the clinical effect of a multifaceted educational intervention to prevent childhood asthma
Authors: Schönberger H. J. A. M. , Dompeling E. , Knottnerus J. A. , Maas T. , Muris J. W. M. , van Weel C. , van Schayck C. P. 
Published: March 2005

As asthma is the most common chronic disease in childhood, much attention is directed towards primary prevention. Here, the clinical effectiveness of a multifaceted educational prevention was studied.A total of 476 high-risk children were recruited during the prenatal period by general practitioners and randomised to either: 1) a control group, receiving usual care; or 2) an intervention group in which families received instruction from nurses on how to reduce exposure of newborns to mite, pet and food allergens, and passive smoking.A total of 443 infants were followed-up for 2 yrs. At 2 yrs of age, the intervention group (n = 222) had less asthma-like symptoms, including wheezing, shortness of breath and night-time cough, than the control group (n = 221). No significant differences in total and specific immunoglobulin E were found between the groups. During the first 2 yrs of life, the incidence of asthma-like symptoms was similar in both groups; however, subanalysis revealed a significant reduction in the female, but not in the male, intervention group.In conclusion, the intervention used in this study was not effective in reducing asthma-like symptoms in high-risk children during the first 2 yrs of life, although it was modestly effective at 2 yrs. Follow-up is necessary to confirm whether the intervention can actually prevent the development of asthma.
New criteria for impaired fasting glucose and screening for diabetes in cystic fibrosis: Fig. 1—
Authors: Mueller-Brandes C. , Holl R. W. , Nastoll M. , Ballmann M. 
Published: March 2005

Cystic fibrosis-related diabetes mellitus (CFRD) is the most frequent comorbidity in cystic fibrosis. Its clinical relevance is stressed by the association with increased mortality, and decreased pulmonary and nutritional status. An annual oral glucose tolerance test (OGTT) is recommended as a screening test for CFRD, but this is often not realised because of its time- and resource-consuming nature. Therefore, alternative approaches are welcome.In 2003, the American Diabetes Association (ADA) lowered the cut-off point separating normal from elevated fasting plasma glucose from <6.1 mmol·L−1to <5.6 mmol·L−1, suggesting the performance of an OGTT only in those with impaired fasting glucose (IFG; range 5.6–6.0 mmol·L−1). The current authors tested whether this approach was reliable for the early identification of patients with CFRD.OGTTs from 1,128 patients (53% males; 47% females; median age 17.1 yrs) were available for analysis. A total of 101 (8.9%) OGTTs were classified as diabetic. The new ADA criteria for IFG increased the sensitivity to 82% (versus65%) and decreased the specificity to 70% (versus94%) compared with the old criteria used to identify patients with diabetic OGTTs.In conclusion, the American Diabetes Association approach of using impaired fasting glucose as an indication for performing selective oral glucose tolerance tests is definitely unsuitable when aiming at the early identification of patients with cystic fibrosis-related diabetes mellitus, and it cannot replace annual oral glucose tolerance tests.
Relationship between pulmonary function and lung cancer surgical outcome
Authors: Win T. , Jackson A. , Sharples L. , Groves A. M. , Wells F. C. , Ritchie A. J. , Laroche C. M. 
Published: March 2005

The British Thoracic Society and American College of Chest Physician guidelines outline criteria for investigating patients for lung cancer surgery. However, the guidelines are based on relatively old studies. Therefore, the relationship between pulmonary function test results and surgical outcome were studied prospectively in a large cohort of lung cancer patients.From January 2001 to December 2003, 110 patients underwent surgery for lung cancer. All underwent full lung function testing in order to predict post-operative lung function.The hospital mortality rate was 3% and major complication rate 22%. There was poor overall outcome in 13%. Mean pre-operative lung function values were: forced expiratory volume in one second (FEV1) 2.0 L (79.4% of the predicted value), and carbon monoxide diffusing capacity of the lung (DL,CO) 73.6% pred. The mean post-operative lung function values were: FEV11.4 L (55.6% pred), andDL,CO51.3% pred. All lung function values were better predictors of poor surgical outcome when expressed as a percentage of the predicted value. Using a threshold of pre-operative FEV1of 47% pred resulted in the most useful positive and negative predictive probabilities, 0.90 and 0.67, respectively.Lung function values expressed as a percentage of the predicted value are more useful predictors of post-operative outcome than absolute values. The threshold of predicted forced expiratory volume in one second for surgical intervention could be lower (45–50% pred) than is currently accepted without increased mortality.
Low-dose inhaled corticosteroids and the risk of acute myocardial infarction in COPD
Authors: Huiart L. , Ernst P. , Ranouil X. , Suissa S. 
Published: March 2005

Inflammation plays a major role in the development and complications of atherosclerosis. Here, the dose-related impact of inhaled corticosteroids (ICS), used for their anti-inflammatory properties, on the risk of acute myocardial infarction (AMI) is studied in a cohort of chronic obstructive pulmonary disease (COPD) patients.Saskatchewan (Canada) health services databases were used to form a population-based cohort of 5,648 patients, ≥55 yrs, who received a first treatment for COPD between 1990 and 1997. A nested case-control analysis was conducted, where 371 cases presenting with a first AMI were matched with 1,864 controls, based on the date of cohort entry and age. A conditional logistic regression was used to estimate the effect of ICS, after adjusting for use of oral corticosteroids, severity of COPD, sex, systemic hypertension, diabetes and cardiovascular disease.ICS were used in the prior year by 42.2% of cases and 46.4% of controls. Overall, current use of ICS was not associated with a significant decrease in the risk of AMI. However, a 32% reduction in the risk of AMI was observed for doses ranging 50–200 µg·day−1.In conclusion, very low doses of inhaled corticosteroids may be associated with a reduction in the risk of acute myocardial infarction.
Analysis of the cues used by patients when making assessments of their asthma severity
Authors: Barley E. A. , Jones P. W. 
Published: March 2005

This study measured the relative contribution of four cues: symptoms, effect on activities, emotions and social life, to patients' judgments of overall asthma severity.Judgement analysis techniques were applied to patients' assessments of overall asthma severity using asthma states described in scenarios based on these cues.Altogether, 40 patients, mean age 52 yrs, mean forced expiratory volume in one second 67% predicted, were studied. The relative importance of the cues varied widely between patients; symptoms contributed to 47% of the judgment of asthma severity (range 15–86%), activities 19% (1–73%), emotions 14% (0–43%), and social life 19% (2–57%). Some patients had difficulty with the judgment task, they tended to be older or have worse health. A total of 21 patients had consistent judgment policies. Cluster analysis identified two policy types. In one, symptoms were weighted heavily, in the other all cues were weighted similarly. Policies were not related to disease or demographic factors.Symptoms are important cues for patients when assessing asthma severity, but other cues may be more important in some patients. Patients fall into two groups: those who rely on symptoms and those who use several cues.
CCR5 expression and CC chemokine levels in idiopathic pulmonary fibrosis
Authors: Capelli A. , Di Stefano A. , Gnemmi I. , Donner C. F. 
Published: March 2005

CC chemokines play an important role in the pathogenetic mechanisms of interstitial lung disease, while a downregulation of CC chemokine receptor (CCR)5 in the fibrotic stages of sarcoidosis has been observed.To evaluate the involvement of CC chemokines and the expression of CCR5 in idiopathic pulmonary fibrosis (IPF) and, more specifically, in usual interstitial pneumonia, 35 subjects were studied. CC chemokine ligand (CCL)2, CCL3 and CCL4 levels were measured in the bronchoalveolar lavage fluid (BALF) of 18 nonsmoker control subjects and 17 patients affected by IPF. CCR5 expression was evaluated in alveolar macrophages and lymphocytes.The BALF levels of all chemokines were significantly increased in IPF: median (range) CCL3 1.6 (1.0–11.1)versus1.2 (0.0–3.8) pg·mL−1; CCL4 6.2 (1.3–96.0)versus3.4 (0.3–6.8) pg·mL−1; and CCL2 60.1 (16.7–251.3)versus4.6 (0.5–119.4) pg·mL−1. CCL2 levels correlated negatively with the carbon monoxide diffusing capacity of the lung (DL,CO) and arterial oxygen tension. CCR5 expression was significantly reduced in lymphocytes from IPF compared with controls.The CC chemokines investigated are involved in the inflammatory mechanisms of idiopathic pulmonary fibrosis, and the results are in agreement with the hypothesis of a downregulation of the T-helper 1 immunological response in this disease.
Asthma during pregnancy: mechanisms and treatment implications
Authors: Murphy V. E. , Gibson P. G. , Smith R. , Clifton V. L. 
Published: March 2005

Asthma is becoming increasingly prevalent worldwide. Numerous historical and prospective cohort studies have investigated the effects of maternal asthma on pregnancy outcome; however, the data has been conflicting and many studies have not used standard classifications for asthma severity. Overall, the literature suggests that asthmatic females are more at risk of low birth weight neonates, pre-term delivery and complications such as pre-eclampsia, especially in the absence of actively managed asthma treated with inhaled corticosteroids. Pregnancy with a female foetus may particularly increase the risk of these outcomes.In addition, pregnancy has an effect on the course of asthma. The risk of an exacerbation requiring medical intervention may be as high as 50% in females with severe asthma and this may further increase the risk of poor outcomes, particularly low birth weight and pre-term delivery.The mechanisms responsible for changes in asthma with pregnancy, or alterations in pregnancy outcomes due to asthma have not been thoroughly explored. Maternal inflammatory pathways may contribute to reduced foetal growth through alterations in placental function.Asthma treatment, by reducing maternal inflammation and preventing exacerbations, is safe for use in pregnant females and contributes to improved outcomes for both mother and foetus.
Endothelial interactions of neutrophils under flow in chronic obstructive pulmonary disease
Authors: Woolhouse I. S. , Bayley D. L. , Lalor P. , Adams D. H. , Stockley R. A. 
Published: March 2005

It is generally accepted that the neutrophil is central to the pathogenesis of chronic obstructive pulmonary disease (COPD). Enhanced endothelial interactions of this cell may contribute to the susceptibility of smokers who develop the disease; however, these interactions have not previously been studied in COPD. The aim of the current study was to determine whether enhanced endothelial interactions of neutrophils from smokers are a predisposing factor for the development of COPD.Endothelial interactions under flow and adhesion molecule expression of peripheral blood neutrophils were compared between seven never-smokers (NS), seven healthy smokers (HS), 11 COPD patients with severe α1-antitrypsin deficiency (PiZ) and neutrophils from 11 COPD patients without the deficiency (PiM).Total adhesive and migratory responses (per mm2endothelium per 106neutrophils) were significantly greater in the PiM group (mean±se704.2±57.9versus509.3±48.8 in the PiZ group, 499.3±40.1 in the HS and 491.2±33.7 in the NS). This corresponded with increased macrophage antigen-1 (CD11b) expression on stimulated neutrophils in the PiM group compared with the PiZ group (mean±serelative fluorescence intensity 1.4±0.1versus1.1±0.1).In conclusion, the enhanced endothelial interaction of neutrophils from smokers who have developed chronic obstructive pulmonary disease in the presence of normal levels of α1-antitrypsin deficiency, but not in those with severe α1-antitrypsin deficiency, suggests that this is a predisposing factor for the development of the disease, and upregulation of macrophage antigen-1 may be responsible.
Angiotensin II antagonism fails to ameliorate bleomycin-induced pulmonary fibrosis in mice
Authors: Keogh K. A. , Standing J. , Kane G. C. , Terzic A. , Limper A. H. 
Published: March 2005

Based on current evidence, transforming growth factor (TGF)-β plays a central pathogenic role in the development of pulmonary fibrosis. There is growing evidence that angiotensin II can serve as a stimulus for TGF-β-mediated lung fibrosis. However, the role of angiotensin II in the pathobiology of pulmonary fibrosisin vivoremains unclear and the therapeutic potential for targeting angiotensin II in a bleomycin-induced pulmonary fibrosis model is not well known.Therefore, the aim of this study was to test whether the angiotensin II antagonist, losartan, attenuated the development of bleomycin-induced pulmonary fibrosis in two distinct murine strains, C57/BL6 and Sv129. This was determined by histopathology and quantification of collagen content by hydroxyproline assay.Despite demonstrable angiotensin II antagonismin vivoand a reduction in measures of acute lung injury, losartan therapy, at a dose shown to reduce renal and cardiac fibrosis in mice, failed to significantly ameliorate bleomycin-induced pulmonary fibrosis.In conclusion, these data suggest that the pulmonary fibrotic disease processin vivois not solely dependent on angiotensin II activity and the potential for angiotensin II receptor blockers as a therapeutic strategy in patients with pulmonary fibrosis may be limited.
Interleukin-16 in tuberculous and malignant pleural effusions
Authors: Qin X-J. , Shi H-Z. , Huang Z-X. , Kang L-F. , Mo W-N. , Wu C. 
Published: March 2005

The aim of this study was to explore the presence of interleukin (IL)-16 in pleural effusions, the correlation between IL-16 levels and cytological parameters, as well as the chemoattractant activity of IL-16 on CD4+ T-lymphocytes.Total nucleated cell and differential counts, and IL-16 concentrations in the pleural effusion from 32 patients with tuberculous pleurisy and 30 patients with lung cancer were determined. Three-colour flow cytometry was performed to determine T-lymphocyte subsets in cell pellets of pleural effusion. The chemoattractant activity of IL-16 for CD4+ T-lymphocytes was also analysed.The levels of IL-16 were significantly higher in tuberculous than in malignant effusions. However, IL-16 levels could not be used for diagnostic purposes due to significant overlap between the two groups. Positive correlations were found between the IL-16 levels and CD4+ T-cells, and pleural fluid was chemotactic for CD4+ T-cellsin vitro. Intrapleural administration of IL-16 to patients produced a marked progressive influx of CD4+ T-cells into the pleural space.Compared with malignant pleural effusion, interleukin-16 appeared to be increased in tuberculous pleural effusion. Interleukin-16 levels were positively related to the numbers of CD4+ T-cells, and interleukin-16 could directly induce CD4+ T-cell infiltration into the pleural space.
Relationship between the inoculum dose ofStreptococcus pneumoniaeand pneumonia onset in a rabbit model
Authors: Yershov A. L. , Jordan B. S. , Guymon C. H. , Dubick M. A. 
Published: March 2005

It is generally assumed that the development of bacterial pneumonia becomes possible when the dose of inhaled or aspirated pathogens overwhelms the respiratory tract host defence system, but this hypothesis has not yet been tested either clinically or experimentally.This study evaluated inoculum dose in relation to onset of experimental pneumococcal pneumonia, and estimated the median effective dose resulting in pneumonia in healthy New Zealand White rabbits (mean±sd4.75±0.25 kg (n = 27)). Rabbits were endobronchially inoculated with increasing doses ofStreptococcus pneumoniaeand pneumonia onset was observed over the following 96 h. The diagnostic approach was based on the Clinical Pulmonary Infection Score, modified for use in rabbits.Inoculation ofS. pneumoniaeat doses of >4.60 log10cfu made the development of pneumonia in rabbits more predictable (up to 90%). Lower doses of bacteria failed to cause pneumonia in 80% of inoculated animals. The median effective dose was estimated by means of logistical regression, probit analyses and the Reed–Muench method, and corresponded to 4.32, 4.38 and 4.67 log10cfu, respectively.It is speculated that development of pneumococcal pneumonia becomes more likely when the inoculum dose exceeds a threshold of antibacterial protection, making inoculum dose a risk factor for disease onset.
Hypoxaemia in chronic obstructive pulmonary disease patients during a commercial flight
Authors: Akerø A. , Christensen C. C. , Edvardsen A. , Skjønsberg O. H. 
Published: March 2005

The aim of the study was to investigate hypoxaemia in chronic obstructive pulmonary disease patients during a commercial flight.The effect of a commercial flight, lasting 5 h 40 min, on arterial blood gas levels and symptoms in 18 chronic obstructive pulmonary disease patients with a pre-flight percutaneous oxygen saturation of ≥94% and self-reported ability to walk 50 m without severe dyspnoea was studied.The arterial oxygen tension (Pa,O2) decreased from sea level to cruising altitude (10.3±1.2versus8.6±0.8 kPa), but, thereafter, except for one patient, remained stable throughout the flight. During light exercise, however, there was further desaturation (percutaneous oxygen saturation 90±4versus87±4%). After 4 h, a decrease in arterial carbon dioxide tension (5.0±0.4versus4.8±0.4 kPa) and an increase in cardiac frequency (87±13versus95±13 beats·min-1) were observed. A pre-flightPa,O2of >9.3 kPa did not secure an acceptable in-flightPa,O2. Aerobic capacity showed the strongest correlation with in-flightPa,O2.In conclusion, following an initial decrease in arterial oxygen tension, chronic obstructive pulmonary disease patients in a stable state of their disease seem to maintain a stable arterial oxygen tension throughout a flight of intermediate duration, except when walking along the aisle. However, a decrease in arterial carbon dioxide tension, indicating compensatory hyperventilation, could imply a risk of respiratory fatigue during longer flights.
Decrease of vascular endothelial growth factor in macrophages from long-term smokers
Authors: Nagai K. , Betsuyaku T. , Ito Y. , Nasuhara Y. , Nishimura M. 
Published: March 2005

Vascular endothelial growth factor (VEGF), a survival factor for endothelial cells and a promoter of angiogenesis, is reportedly expressed in alveolar macrophages (AMs).To investigate whether long-term smoking with age affects VEGF expression in AMs, bronchoalveolar lavage (BAL) was performed on 18 young and 23 older volunteers with various smoking histories. The expressions of VEGF and its functional receptor, fms-like tyrosine kinase (Flt)-1, were quantified in AMs by real-time RT-PCR and, further, the level of VEGF in BAL fluid was determined by ELISA.VEGF mRNA in AMs demonstrated a 1.8-fold reduction in current smokers compared with nonsmokers in older subjects and, furthermore, a 1.5-fold downregulation in those with emphysema, although there was no difference between current smokers and nonsmokers among the young subjects. The downregulation in total VEGF mRNA was supported by the substantial reduction of VEGF121 and VEGF165 isoforms. However, in contrast, Flt-1 mRNA did not differ within the older groups, whereas it was upregulated in young current smokers compared with age-matched nonsmokers. VEGF in BAL fluid is significantly decreased in current smokers compared with nonsmokers, regardless of their age.In conclusion, these data imply that the biological availability of vascular endothelial growth factor in alveolar macrophages is impaired in older current smokers with long-term smoking histories.
Noninvasive assessment and monitoring of the pulmonary circulation
Authors: Vonk-Noordegraaf A. , van Wolferen S. A. , Marcus J. T. , Boonstra A. , Postmus P. E. , Peeters J. W. L. , Peacock A. J. 
Published: March 2005

In pulmonary vascular disease, changes in the pulmonary vascular bed will lead to altered pulmonary haemodynamics. This review describes the application of several physiological principles to measure these changes noninvasively by means of novel techniques.Flow characteristics of blood through the pulmonary vascular bed alter in pulmonary vascular disease. Recent developments in magnetic resonance imaging and computed tomography make it possible to visualise and quantify these abnormal flow patterns. Information regarding pulmonary perfusion can also be obtained by measuring the electrical impedance changes in the lung by electrical impedance tomography. A more indirect approach to measure the pulmonary blood flow is the measurement of the absorption of acetylene, a perfusion limited gas. Information on the pulmonary vascular bed can also be obtained by the measurement of exhaled products of the pulmonary vascular endothelium, such as nitric oxide.Although all the techniques described offer new ways to diagnose or monitor pulmonary vascular disease, clinical data on these techniques are limited. Further improvement and evaluation of the clinical value of these techniques are therefore obligatory before they can be used in clinical practice.