bluuebunny/crossref_metadata_2025_split huggingface dataset:
Air pollution and hospital admissions for respiratory conditions in Rome, Italy
Authors: Fusco D. , Forastiere F. , Michelozzi P. , Spadea T. , Ostro B. , Arcà M. , Perucci C.A. 
Published: October 2002

Most of the evidence regarding the association between particulate air pollution and emergency room visits or hospital admissions for respiratory conditions and asthma comes from the USA. European time-series analyses have suggested that gaseous air pollutants are important determinants of acute hospitalization for respiratory conditions, at least as important as particulate mass. The association between daily mean levels of suspended particles and gaseous pollutants (sulphur dioxide, nitrogen dioxide, carbon monoxide, ozone) was examined. The daily emergency hospital admissions for respiratory conditions in the metropolitan area of Rome during 1995–1997 were also recorded.Daily counts of hospital admissions for total respiratory conditions (43 admissions·day−1), acute respiratory infections including pneumonia (18·day−1), chronic obstructive pulmonary disease (COPD) (13·day−1), and asthma (4.5·day−1) among residents of all ages and among children (0–14 yrs) were analysed. The generalized additive models included spline smooth functions of the day of study, mean temperature, mean humidity, influenza epidemics, and indicator variables for day of the week and holidays.Total respiratory admissions were significantly associated with same-day level of NO2(2.5% increase per interquartile range (IQR) change, 22.3 µg·m−3) and CO (2.8% increase per IQR, 1.5 mg·m−3). No effect was found for particulate matter and SO2, whereas O3was associated with admissions only among children (lag 1, 5.5% increase per IQR, 23.9 µg·m3). The effect of NO2was stronger on acute respiratory infections (lag 0, 4.0% increase) and on asthma among children (lag 1, 10.7% increase). The admissions for all ages for asthma and COPD were associated only with same-day level of CO (5.5% and 4.3% increase, respectively). Multipollutant models confirmed the role of CO on all respiratory admissions, including asthma and COPD, and that of NO2on acute respiratory infections. Among children, O3remained a strong indicator of acute respiratory infections.Carbon monoxide and photochemical pollutants (nitrogen dioxide, ozone) appear to be determinants of acute respiratory conditions in Rome. Since carbon monoxide and nitrogen dioxide are good indicators of combustion products from traffic related sources, the detected effect may be due to unmeasured fine and ultrafine particles.
The sleep apnoea/hypopnoea syndrome depresses waking vagal tone independent of sympathetic activation
Authors: Hilton M.F. , Chappell M.J. , Bartlett W.A. , Malhotra A. , Beattie J.M. , Cayton R.M. 
Published: October 2002

The modest daytime hypertension and sympathetic upregulation associated with the sleep apnoea/hypopnoea syndrome (SAHS), does not explain the relatively large increased risk of cardiac morbidity and mortality in the SAHS patients population. Therefore, efferent vagal and sympathetic activity was evaluated during wakefulness in SAHS subjects and matched healthy controls, in order to determine if vagal downregulation may play a role in the aetiology of cardiac disease in the SAHS.The awake autonomic nervous system function of 15 male subjects, with mild-to-moderate SAHS was compared to that of 14 healthy controls matched for age, body mass index, gender and blood pressure. All subjects were free from comorbidity. Vagal activity was estimated from measurements of heart rate variability high frequency power (HF) and sympathetic activity was measured from urine catecholamine excretion.The %HF power was significantly (p<0.03) reduced in SAHS patients (10±1.6 (mean±sem)) as compared to controls (17±3). In addition, HF power correlated with the apnoea/hypopnoea index in the SAHS subjects (R=−0.592, p=0.02). There was no statistically significant difference in the daytime excretion of nonadrenaline between control (242±30 nmol·collection−1) and SAHS (316±46 nmol·collection−1) subjects (p=0.38).In these sleep apnoea/hypopnoea syndrome patients there was limited evidence of increased waking levels of urine catecholamines. The principal component altering waking autonomic nervous system function, in the sleep apnoea/hypopnoea syndrome subjects, was a reduced daytime efferent vagal tone.
Vitamin E attenuates the injurious effects of bioactive phospholipids on human ciliated epitheliumin vitro
Authors: Feldman C. , Anderson R. , Theron A.J. , Steel H.C. , van Rensburg C.E.J. , Cole P.J. , Wilson R. 
Published: October 2002

Bioactive phospholipids (PL), particularly lysophosphatidylcholine (LPC), are being increasingly implicated in the pathogenesis of various acute and chronic inflammatory disorders, particularly those of the airways, while there is emerging evidence that vitamin E may function as a natural antagonist of these lipid mediators of inflammation. The aims of this study were to document the effects of vitamin E on the inhibition of ciliary beating and damage to structural integrity of human ciliated epithelium induced by the PL, platelet-activating factor (PAF), lyso-PAF and LPCin vitroin relation to the anti-oxidative and membrane-stabilizing properties of the vitamin.Ciliary beat frequency was measured by a phototransistor technique, and damage to structural integrity assessed by a visual-scoring index, while superoxide production by polymorphonuclear leukocytes and membrane-stabilizing potential were measured using lucigenin-enhanced chemiluminescence and haemolytic procedures, respectively.All three PL caused inhibition of ciliary beating and structural damage to human ciliated epithelium by membrane-directed cytotoxic mechanisms, which were potentiated by human polymorphonuclear leukocytes due to induction of oxidant-mediated injury. Both direct and phagocyte-inflicted epithelial injury was attenuated by vitamin E. In haemolytic and chemiluminescence assays, vitamin E neutralized both the membrane-destabilizing and pro-oxidative actions of all three PL, while spectrophotometric analysis of mixtures of vitamin E with PAF, lyso-PAF and LPC revealed alterations in peak intensity, as well as peak shifts, indicative of physicochemical interactions between the vitamin and the PL.Vitamin E status may be a determinant of susceptibility to phospholipid-mediated airway inflammation and damage.
Effect of airway opening manoeuvres on thoraco-abdominal asynchrony in anaesthetized children
Authors: Reber A. , Bobbià S.A. , Hammer J. , Frei F.J. 
Published: October 2002

Thoraco-abdominal asynchrony is frequently encountered during inhalation anaesthesia in children with adenotonsillar hypertrophy causing an upper airway obstruction. The study goal was to evaluate the impact of different airway opening manoeuvres on thoraco-abdominal asynchrony as a measure of airway obstruction.Thirty anaesthetized children (aged 2–8 yrs; sevoflurane 3% in 50% oxygen/nitrous oxide) were studied prior to elective adenotonsillectomy using respiratory inductance plethysmography to record ribcage and abdominal wave forms as a basis for calculation of the phase angle. Five airway situations were compared: 1) baseline (unsupported mandible); 2) chin lift; 3) chin lift combined with continuous positive airway pressure of 10 cmH2O; 4) jaw thrust; and 5) jaw thrust combined with continuous positive airway pressure of 10 cmH2O.Three children had complete upper airway obstruction at baseline and were excluded from the study. With chin lift, thoraco-abdominal asynchrony improved in three patients, worsened in three patients and was unchanged in 21 patients. Additional continuous positive airway pressure during chin lift did not markedly reduce thoraco-abdominal asynchrony (phase angle 89±43°, p=0.33). Jaw thrust resulted in a significant decrease of the phase angle (from 106±53° at baseline to 65±49°, p<0.01); when combined with continuous positive airway pressure, no further effect on thoraco-abdominal asynchrony was found (72±44°).In anaesthetized children with adenotonsillar hypertrophy, airway opening manoeuvres have distinct effects on thoraco-abdominal asynchrony. Delivery of continuous positive airway pressure and jaw thrust can be the first airway opening manoeuvres to improve breathing patterns. Chin lift without additional continuous positive airway pressure should be used with caution in these patients because it may convert partial into almost complete airway obstruction.
Attenuation by oralN-acetylcysteine of bleomycin-induced lung injury in rats
Authors: Cortijo J. , Cerdá-Nicolás M. , Serrano A. , Bioque G. , Estrela J.M. , Santangelo F. , Esteras A. , Llombart-Bosch A. , Morcillo E.J. 
Published: October 2002

Antioxidant therapy may be useful in diseases with impaired oxidant-antioxidant balance such as pulmonary fibrosis. This study examines the effect ofN-acetylcysteine (NAC) on bleomycin-induced lung fibrosis in rats.NAC (3 mmol·kg−1; oral) was given daily from 1 week prior to a single intratracheal instillation of bleomycin (2.5 U·kg−1) or saline, until 14 days postinstillation.NAC partially decreased the augmented collagen deposition in bleomycin-exposed rats (hydroxyproline content was 4,354±386 and 3,416±326 µg·lung−1in vehicle-treated and NAC-treated rats, respectively; p<0.05). The histological assessment using a semiquantitative score showed less collagen deposition and inflammatory cells in NAC-treated rats compared to those receiving bleomycin alone. NAC failed to inhibit the bleomycin-induced increases in lung wet weight and in cell counts and protein levels of bronchoalveolar lavage fluid, but significantly increased total glutathione and taurine levels in bronchoalveolar lavage fluid.These results indicate that oralN-acetylcysteine improves the pulmonary antioxidant protection and may be useful in reducing lung damage produced by bleomycin.
The German cystic fibrosis quality assurance project: clinical features in children and adults
Authors: Wiedemann B. , Steinkamp G. , Sens B. , Stern M. 
Published: October 2002

Cystic fibrosis (CF) is a complex disease which requires interdisciplinary care in specialized CF centres. In Germany, 97 paediatric and adult outpatient clinics agreed to report clinical data of their patients to a newly established registry, the Cystic Fibrosis Quality Assurance (CFQA) project. This article characterizes the design of the CFQA and the health status of the patients enrolled by the end of 1997.Data from 4,306 patients reported to the CFQA project were analysed. Nutritional status and lung function of the patients were examined as well as the use of specific therapeutic interventions.Mean age of all 4,182 patients alive by the end of 1997 was 15.7 yrs (maximum, 58 yrs), and 35.8% of patients were >18.0 yrs of age. One-third of the CF population were treated in the nine largest centres (each caring for >100 patients). Abnormal nutritional status (weight-for-height >90% of predicted or body mass index <19.0 kg·m2, respectively) was observed in 26.8% of children and adolescents and in 38.3% of adults. Lung function was abnormal (forced expiratory volume in one second <80% predicted) in the majority of adults (83.9%) and in 42.5% of the younger patients. The mortality rate was 1.4 of 100 patients in 1997. No clear association of clinical status with centre size was observed.The clinical features of patients treated in German cystic fibrosis centres were generally comparable to those reported from other countries, although improvements are certainly warranted. The Cystic Fibrosis Quality Assurance project represents an important tool for future progress in the quality of cystic fibrosis care.
The effects of an anti-CD4 monoclonal antibody, keliximab, on peripheral blood CD4+ T-cells in asthma
Authors: Kon O.M. , Sihra B.S. , Loh L.C. , Barkans J. , Compton C.H. , Barnes N.C. , Larché M. , Kay A.B. 
Published: October 2002

CD4+ T-cells are likely to be involved as a source of pro-inflammatory cytokines in asthma. This study assessed the effects of an infusion of keliximab (IDEC CE9.1), an anti-CD4+ monoclonal antibody, on peripheral blood CD4+ T-cells in corticosteroid-dependent asthmatics.Three cohorts of patients (termed C0.5: n=6, C1.5: n=5, and C3.0: n=5) received a single infusion of 0.5, 1.5 or 3.0 mg·kg−1, respectively, with a fourth receiving placebo (Cpl: n=6), and were followed-up for 4 weeks. By flow cytometry in peripheral blood, pre- and postinfusion assessment was made of: a) CD4 and CD8 counts and mean fluorescence; b) CD25, human leukocyte antigen-DR (HLA-DR), CD45RO and CD45RA expression on CD4+ T-cells; and c) interferon (IFN)-γ, interleukin (IL)-4 and IL-5 expression in CD4+ T-cells. Keliximab'sin vitroeffects on allergen-specific peripheral blood mononuclear cells (PBMC) proliferation in atopic asthmatics were also evaluated.There was a significant increase in lung function (peak expiratory flow rate) in the C3.0group. Following infusion in C0.5, C1.5and C3.0but not Cpl: 1) the CD4, but not CD8 count was significantly decreased; 2) there was total loss of Leu3a staining; 3) there were significant reductions in the mean fluorescence of OKT4 binding; and 4) there were significant reductions in the numbers of CD25, HLA-DR, CD45RO and CD45RA/CD4+ cells. There were no changes in CD4+ cell expression of IFN-γ, IL-4 or IL-5. Keliximab caused a significant reduction in T-cell proliferation as compared to a control monoclonal antibody.Keliximab, as an anti-CD4 monoclonal antibody, leads to a transient reduction in the number of CD4+ T-cells and modulation of CD4+ receptor expression in severe asthmatics. The effects of keliximab may be mediated through a decrease in CD4+ surface expression and T-lymphocyte numbers, in addition to a reduction in allergen-induced proliferation.
Fluticasone and salmeterol downregulatein vitro, fibroblast proliferation and ICAM-1 or H-CAM expression
Authors: Silvestri M. , Fregonese L. , Sabatini F. , Dasic G. , Rossi G.A. 
Published: October 2002

β2-adrenoreceptor agonists have pharmacological properties that may suggest an inhibitory effect on various aspects of the inflammatory and repair processes that characterize asthma.Since fibroblasts express β2-adrenoreceptors, the effects of different concentrations (0.1–100 nM) of fluticasone propionate (FP), salmeterol (S) and their combination (FP+S) on lung fibroblast proliferation and adhesion molecule expression were evaluated.Stimulation of human foetal lung fibroblasts with a fibrogenic cytokine, basic fibroblast growth factor (bFGF), resulted in a [methyl-3H] thymidine ([3H]TdR) uptake, four-fold higher than that of control cultures (p=0.0001) and was significantly inhibited by S, at all the concentrations tested (0.1–100 nM; p<0.05). No changes in bFGF-induced cell proliferation were observed in the presence of FP (0.1–100 nM; p>0.05, all comparisons). In addition, the association FP+S did not improve the inhibitory activity of S alone (p>0.05, each comparison). An upregulation of intercellular adhesion molecule-1 (ICAM-1) expression was induced by tumour necrosis factor-α (TNF-α) (p=0.0004), but not by interleukin-4 (IL-4) (p>0.05), while none of the two cytokines were able to increase hyaluronic-cellular adhesion molecule (H-CAM) expression by lung fibroblasts (p>0.05). A significant downregulation of ICAM-1 or H-CAM expression was demonstrated in the presence of FP or S, at all concentrations tested (0.1–100 nM; p<0.01, each comparison). Interestingly, S (10 nM and 100 nM) was able to enhance the inhibitory activity of FP on ICAM-1 expression (p<0.01), but not on H-CAM expression (p>0.1).These results show that in human foetal lung fibroblasts, fluticasone propionate and salmeterol are effective in modulatingin vitro, different lung fibroblast biological functions that are likely to be involved in airway remodelling.
Host immune response toChlamydia pneumoniaeheat shock protein 60 is associated with asthma
Authors: Huittinen T. , Hahn D. , Anttila T. , Wahlström E. , Saikku P. , Leinonen M. 
Published: October 2002

Chlamydia pneumoniaeinfection has been associated with asthma. It has also been suggested that heat shock protein 60 (Hsp60) belonging to a class of highly conserved proteins may play a role in the pathogenesis of chlamydial infections. The purpose was to study whether the host immune response toC. pneumoniaeHsp60 is associated with asthma and decreased pulmonary function.An enzyme immunoassay was used to measure immunoglobulin-(Ig)A and IgG antibodies against recombinantC. pneumoniaeHsp60 and human Hsp60 in a study group consisting of 24 cases of recently symptomatic asthma and 62 nonasthmatic controls.A strong (r=0.50) and significant (p<0.001) correlation was observed betweenC. pneumoniaeand human Hsp60 IgA antibodies, but onlyC. pneumoniaeHsp60 IgA antibodies were significantly associated with asthma (p=0.02). Pulmonary function, as measured by forced expiratory volume in one second, also inversely correlated (r=−0.23, p=0.04) with the quantity ofC. pneumoniaeHsp60 IgA antibodies, suggesting an association with the severity of pulmonary obstruction.By showing an association ofChlamydia pneumoniaeheat shock protein 60 immunoglobulin A antibodies with asthma, the results support the hypothesis of an association betweenChlamydia pneumoniaeinfection and asthma and support the need for further investigations on the role of heat shock protein 60 in the pathogenesis of asthma.
Nasal potential difference measurements in patients with atypical cystic fibrosis
Authors: Wilschanski M. , Famini H. , Strauss-Liviatan N. , Rivlin J. , Blau H. , Bibi H. , Bentur L. , Yahav Y. , Springer H. , Kramer M.R. , Klar A. , Ilani A. , Kerem B. , Kerem E. 
Published: October 2002

The diagnosis of cystic fibrosis (CF) is based on characteristic clinical and laboratory findings. However, a subgroup of patients present with an atypical phenotype that comprises partial CF phenotype, borderline sweat tests and one or even no common cystic fibrosis transmembrane conductance regulator (CFTR) mutations. The aim of this study was to evaluate the role of nasal potential difference (PD) measurements in the diagnosis of CF patients with an atypical presentation and in a population of patients suspected to have CF.Nasal PD was measured in 162 patients from four different groups: patients with classical CF (n=31), atypical phenotype (n=11), controls (n=50), and patients with questionable CF (n=70). The parameter, or combination of nasal PD parameters was calculated in order to best discriminate all CF patients (including atypical CF) from the non-CF group.The patients with atypical CF disease had intermediate values of PD measurements between the CF and non-CF groups. The best discriminate model that assigned all atypical CF patients as CF used: e(response to chloride-free and isoproterenol/response to amiloride)with a cut-off >0.70 to predict a CF diagnosis. When this model was applied to the group of 70 patients with questionable CF, 24 patients had abnormal PD similar to the atypical CF group. These patients had higher levels of sweat chloride concentration and increased rate of CFTR mutations.Nasal potential difference is useful in diagnosis of patients with atypical cystic fibrosis. Taking into account both the sodium and chloride transport elements of the potential difference allows for better differentiation between atypical cystic fibrosis and noncystic fibrosis patients. This calculation may assist in the diagnostic work-up of patients whose diagnosis is questionable.
Molecular physiology of oxygen-sensitive potassium channels
Authors: Patel A.J. , Honoré E. 
Published: October 2002

Physiological adaptation to acute hypoxia involves oxygen-sensing by a variety of specialized cells including carotid body type I cells, pulmonary neuroepithelial body cells, pulmonary artery myocytes and foetal adrenomedullary chromaffin cells.Hypoxia induces depolarization by closing a specific set of potassium channels and triggers cellular responses. Molecular biology strategies have recently allowed the identification of the K+channel subunits expressed in these specialized cells.Several voltage-gated K+channel subunits comprising six transmembrane segments and a single pore domain (Kv1.2, Kv1.5, Kv2.1, Kv3.1, Kv3.3, Kv4.2 and Kv9.3) are reversibly blocked by hypoxia when expressed in heterologous expression systems. Additionally, the background K+channel subunit TASK-1, which comprises four transmembrane segments and two pore domains, is also involved in both oxygen- and acid-sensing in peripheral chemoreceptors.Progress is currently being made to identify the oxygen sensors. Regulatory β subunits may play an important role in the modulation of Kv channel subunits by oxygen.
Sparfloxacin in the treatment of drug resistant tuberculosis or intolerance of first line therapy
Authors: Lubasch A. , Erbes R. , Mauch H. , Lode H. 
Published: October 2002

Patients with multiresistant tuberculosis (TB) and patients with intolerance of first line antituberculosis drugs present a major treatment problem. Sparfloxacin is highly active against mycobacteria, but the use is restricted by side effects and the contribution to antituberculosis therapy is unclear. A prospective study has therefore been performed to analyse the efficacy and tolerability of sparfloxacin in cases of resistant TB or intolerance of first line therapy.Between April 1993 and April 1999, 30 TB patients (28 with pulmonary TB and two with lymph node TB) were treated with combinations of sparfloxacin and at least two other drugs at the Chest Hospital Heckeshorn, Berlin. Sixteen patients were infected by resistant mycobacteria (one single drug resistance (SDR), one polyresistance, and 14 multidrug resistances (MDR); 14 males (age range 23–53 yrs), 2 females (68–74 yrs)). Twelve patients (11 males, one female, 27–80 yrs) had not tolerated first line antituberculosis drugs. Two additional male patients had continuous proof ofMycobacterium tuberculosisin sputum without resistance during therapyThe duration of sparfloxacin therapy during hospitalization ranged 2.5–4 months. Twenty-five patients completed therapy and were cured according to this study's definition. Although sparfloxacin was generally well tolerated, five mild phototoxic reactions and six moderate prolongations of the electrocardiographic QT-interval (30–40 ms compared to baseline ≤450 ms) were registered without clinical symptoms in the patient group.In summary, sparfloxacin proved an effective and safe alternative antituberculosis drug for complicated tuberculosis.
Oxygen desaturation on the six-minute walk test and mortality in untreated primary pulmonary hypertension
Authors: Paciocco G. , Martinez F.J. , Bossone E. , Pielsticker E. , Gillespie B. , Rubenfire M. 
Published: October 2002

There are no reliable predictors of mortality in primary pulmonary hypertension (PPH). This study assessed whether exercise oxygen desaturation and distance achieved during a six-minute walk are associated with mortality in moderately symptomatic patients with PPH.Thirty-four patients with PPH underwent a pretreatment six-minute walk test, and an invasive haemodynamic assessment of pulmonary vasodilator reserve, to select the best treatment option (epoprostenol in 27 and nifedipine in 7). Median follow-up was 26 months (12 months for the nonsurvivors was 26%), and median survival, >46 months by Kaplan-Maier estimate.The mean±sd distance walked was 275±155 m and reduction in arterial oxygen saturation (Sa,O2) at maximal distance (ΔSa,O2) was 8.4±4.5%. A distance ≤300 m increased mortality risk by 2.4, and a ΔSa,O2of ≥10 % increased mortality risk by 2.9. OnlySa,O2at peak distance, ΔSa,O2and pulmonary vascular resistance (PVR) were related to mortality. After adjusting for PVR, there remained a 27% increase in risk of death for each per cent decrease inSa,O2.The six-minute walk distance and exercise oxygen saturation may be helpful in selecting patients with primary pulmonary hypertension for whom transplant listing is appropriate.