bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful treatment of severe respiratory papillomatosis with intravenous cidofovir and interferon α-2b
Authors: Armbruster C. , Kreuzer A. , Vorbach H. , Huber M. , Armbruster C. 
Published: October 2002

In contrast to uncomplicated juvenile laryngeal papillomas which may regress spontaneously, papillomatosis involving pulmonary parenchyma is associated with a poor outcome.This report represents the case of a 34 yr-old female in whom respiratory papillomatosis resulted in voice problems and recurrent pneumonias due to bronchial obstruction. A computed tomographic scan of the chest showed worsening bilateral round cavitating consolidations. Bronchoscopy revealed polypoid lesions of the right vocal cord and the midtrachea which were confirmed as squamous papillomatosis by histology.Interferon (IFN)α-2b treatment was inefficient as was cidofovir monotherapy on a maintenance basis. Six months of IFN-α-2b and cidofovir in combination led to a complete macroscopic disappearance of the laryngeal lesions and to an impressive regression of the tracheal papillomas and of the intrapulmonary consolidations.These data provide support that severe respiratory papillomatosis can be safely treated by interferon α-2b and cidofovir in combination. Probably the same mechanisms as in ribavirin plus interferon α-2b, in the treatment of patients with chronic hepatitis C, are responsible for the therapeutic success in this case.
Reduced late asthmatic response by repeated low-dose allergen exposure
Authors: Palmqvist M. , Cui Z-H. , Sjöstrand M. , Lindén A. , Lötvall J. 
Published: October 2002

Allergic asthmatic individuals are often exposed to low-doses of allergen in their everyday life. Extended exposure to allergen has lead to down-regulation of the allergic process in cell systems and in animal models. The aim of this study was to evaluate whether any such inhibitory mechanism of allergic responses can be seen in manin vivo.Patients with mild asthma were repeatedly and double-blindly exposed to 25% of the individual dose of allergen that caused an early (EAR) and late asthmatic reaction (LAR). One day after the low-dose allergen or placebo exposure periods, the same individual was given a high-dose allergen challenge. Sputum and blood were collected for the evaluation of eosinophils.Exposure to repeated low doses of allergen induced increased bronchial methacholine responsiveness 6 h after the final allergen exposure (p=0.018), and an increase in the number of eosinophils in sputum. By contrast, the late asthmatic response after challenge with a high dose of allergen was significantly attenuated by ∼30% at 24 h after the final low-dose allergen exposure (p=0.03).In summary, repeated low doses of allergen given directly to the airways, attenuate the high-dose allergen-induced late response, despite enhanced bronchial hyperresponsiveness to methacholine and elevated sputum eosinophils prior to allergen challenge.
The feasibility of airways hyperresponsiveness as an inclusion criterion for studies on childhood asthma
Authors: Kamps A.W.A. , Visser M.J. , de Vries T.W. , van Aalderen W.M.C. , Postma D.S. , Brand P.L.P. 
Published: October 2002

The feasibility of moderately severe airway hyperresponsiveness (AH) was examined as an inclusion criterion for clinical trials in asthmatic children.During the baseline period of a long-term clinical trial in asthmatic children, maintenance therapy with fluticasone (200 µg·day−1) was stopped for a maximum of 8 weeks and methacholine challenges were performed at 2-week intervals or earlier if the patients' condition deteriorated. Patients were eligible to continue the study if the provocative dose of methacholine causing a 20% fall in forced expired volume in one second (FEV1) (PD20) was <80 µg.Fifty-one per cent of the children did not develop a PD20<80 µg after withdrawal of fluticasone. Patients with or without a PD20<80 µg did not differ in duration of asthma, duration of treatment, or peak flow variation. Patients with a PD20<80 µg had higher levels of total and specific immunoglobulin-E, and lower levels of FEV1and mean maximal expiratory flow than patients with a PD20≥80 µg. Forty-four per cent of the patients with a PD20≥80 µg did not have any symptoms during the wash-out period and 39% of these patients remained free from symptoms during one year follow-up.The results of this study suggest that recruiting asthmatic children for clinical trials may be difficult if airways hyperresponsiveness is used as the sole inclusion criterion.
Respiratory illness and healthcare utilization in children: the primary and secondary care interface
Authors: Cropper J.A. , Frank T.L. , Frank P.I. , Laybourn M.L. , Hannaford P.C. 
Published: October 2002

The aim of the present study was to quantify the healthcare utilization of a child population according to level of respiratory illness.A stratified random sample of 713 children was selected from respondents to a postal respiratory questionnaire, carried out in two general practice populations in 1993. Children were stratified into four groups according to the number of positive responses to five key questions. These groups were used as indicators of likelihood of asthma diagnosis. A search was made of these childrens' practice records covering a 2-yr period, to include both primary and secondary healthcare.There was a significant increase across positive response groups in the proportion of children having primary and secondary care based consultations, particularly for respiratory conditions (p=0.001). There was also a significant increase in prescribing. Of those children considered to be “likely asthmatics” from their questionnaire responses, 8.1% (n=31) did not receive any primary or secondary care for a respiratory problem over the 2-yr period.As the likelihood of respiratory illness increased in this population, more demand was made upon resources for the treatment of respiratory illness. Quantification of this demand enables evidence based resource allocation decisions to be made. This method of quantification could be applied in other populations.
Exhaled nitric oxide in chronic obstructive pulmonary disease: relationship to pulmonary function
Authors: Ansarin K. , Chatkin J.M. , Ferreira I.M. , Gutierrez C.A. , Zamel N. , Chapman K.R. 
Published: October 2002

The following study was undertaken in order to determine how exhaled nitric oxide (eNO) levels in former smokers with chronic obstructive pulmonary disease (COPD) compared to eNO levels in patients with asthma and in healthy nonsmoking volunteers. The study also aimed to determine any relationship between eNO levels in COPD and: 1) conventional measures of lung function; and 2) inhaled corticosteroid (ICS) use.In former smokers with COPD, nonsmokers with asthma and volunteers, eNO levels, spirometry, lung volumes, carbon monoxide diffusion capacity of the lung (DL,CO) and resting oxygen saturation (Sa,O2) were measured.Median eNO was significantly higher among patients with COPD than among healthy volunteers (p=0.003) but lower than among patients with asthma (p<0.01). There was no significant difference in eNO levels between COPD patients using ICS and those not using ICS. By contrast, eNO was lower among asthma patients who used ICS (median 32 parts per billion (ppb); 25–75% range 16–54) than among asthma patients who did not (51 ppb; 32–87) (p=0.034). Among patients with COPD, eNO was inversely correlated with forced expiratory volume in one second,DL,COandSa,O2, and was positively correlated with the residual lung volume/total lung capacity ratio. Among patients with asthma, no significant correlations were found.Exhaled nitric oxide is increased in patients with chronic obstructive pulmonary disease, an increase that is influenced by structural abnormalities of tobacco-induced lung damage.
Metabolic characteristics of the deltoid muscle in patients with chronic obstructive pulmonary disease
Authors: Gea J.G. , Pasto M. , Carmona M.A. , Orozco-Levi M. , Palomeque J. , Broquetas J. 
Published: October 2002

The purpose of this study was to analyse key enzyme activities of the deltoid muscle (DM) in chronic obstructive pulmonary disease (COPD) patients.The activities of one oxidative enzyme (citrate synthase (CS)), two glycolytic enzymes (lacatate dehydrogenase (LD); and phosphofructokinase (PFK)) and one enzyme related to the use of energy stores (creatine kinase (CK)) were determined in the DM of 10 patients with COPD and nine controls. Exercise capacity (cycloergometry) and the handgrip strength were also evaluated.Although exercise capacity was markedly reduced in COPD (57±20% predicted), their handgrip strength was relatively preserved (77±19% pred). The activity of LD was higher in the COPD patients (263.9±68.2versus184.4±46.5 mmol·min−1·g−1, p<0.01), with a similar trend for CS (67.3±33.3versus46.0±17.4 mmol·min−1·g−1, p=0.07). Interestingly, the activity of the latter enzyme was significantly higher than controls if only severe COPD patients were considered (81.8±31.2 mmol·min−1·g−1, p<0.01). PFK and CK activities were similar for controls and COPD.Chronic obstructive patients show a preserved or even increased (severe disease) oxidative capacity in their deltoid muscle. This coexists with a greater capacity in the anaerobic part of the glycolysis. These findings are different to those previously observed in muscles of the lower limbs.
Quality of life of idiopathic pulmonary fibrosis patients
Authors: Vries J. De , Kessels B.L.J. , Drent M. 
Published: October 2002

Little attention has been paid to quality of life (QOL) in idiopathic pulmonary fibrosis (IPF). Therefore, the aim of this study was to address this issue and study the relationship between QOL, depressive symptoms, and breathlessness in these patients.Forty-one IPF patients and 41 healthy persons matched for age and sex completed the World Health Organization Quality of Life assessment instrument-100. The IPF patients also completed the Beck Depression Inventory, the Bath Breathlessness Scale, a social support questionnaire and a question concerning perceived seriousness of illness.Compared to the control group, QOL in IPF patients was mainly impaired in the domains “physical health” and “level of independence”. A number of relationships were found between pulmonary function tests and QOL. The QOL facet “negative feelings” was highly associated with scores on depression. Subjective breathlessness was related to depressive symptoms and QOL. Moreover, sex and effective/emotional breathlessness predicted overall QOL.In conclusion, the impairment of the quality of life areas “physical health” and “level of independence” are important issues in idiopathic pulmonary fibrosis. Subjective breathlessness, especially the effective/emotional scale, seems related to quality of life and depressive symptoms. Rehabilitation programmes are needed that are aimed at physiological aspects and psychosocial aspects of idiopathic pulmonary fibrosis in order to enhance the quality of life of these patients.
Eotaxin and monocyte chemoattractant protein-1 in chronic eosinophilic pneumonia
Authors: Tateno H. , Nakamura H. , Minematsu N. , Amakawa K. , Terashima T. , Fujishima S. , Luster A.D. , Lilly C.M. , Yamaguchi K. 
Published: October 2002

Chronic eosinophilic pneumonia (CEP) is characterized by chronic or recurrent pulmonary infiltrates with eosinophils, but the precise mechanism of eosinophil accumulation has not been fully elucidated. Eotaxin is one of the CC chemokines that selectively recruits eosinophils and contributes to the pathogenesis of allergic airway diseases including asthma, but its roles in pathogenesis of CEP have not been fully elucidated.The authors measured concentrations of eotaxin and other CC chemokines, monocyte chemoattractant protein-1 (MCP-1), regulated on activation, normal T-cell expressed and secreted, macrophage inflammatory protein-1α, and the eosinophil activating Th2 cytokine interleukin (IL)-5 in bronchoalveolar lavage (BAL) fluid from CEP patients (n=11), and compared these concentrations with those from control subjects (n=6).The eotaxin (904±203versus29±7 pg·mL−1, p=0.0001), MCP-1 (194±57versus15±2 pg·mL−1, p<0.05), and IL-5 (7.8±2.0versus2.7±0.6 pg·mL−1, p<0.05) levels were significantly higher for cases with CEP in comparison to those serving as controls. Proportions of eosinophil and lymphocyte counts were greater in BAL fluid from CEP patients. Eotaxin and IL-5 levels correlated with the proportion of eosinophils in BAL fluid from CEP patients. MCP-1 correlated with the relative lymphocyte numbers.In short, eotaxin, interleukin-5, and monocyte chemoattractant protein-1 levels were higher in the BAL fluid of CEP patients and these levels may contribute to eosinophil and lymphocyte recruitment and activation in the airways as found with this disorder.
Epidemiology of chronic obstructive pulmonary disease
Authors: Antó J.M. , Vermeire P. , Vestbo J. , Sunyer J. 
Published: October 2002

Chronic obstructive pulmonary disease (COPD) is a leading cause of world-wide mortality and disability. On average ∼5–15% of adults in industrialized countries have COPD defined by spirometry. In 1990, COPD was considered to be at the twelfth position world-wide as a cause of combined mortality and disability but is expected to become the fifth cause by the year 2020.COPD has a chronic long-lasting course characterized by irreversible decline of forced expiratory volume in one second (FEV1), increasing presence of dyspnoea and other respiratory symptoms, and progressive deterioration of health status. After diagnosis the 10-yr survival rate is ∼50% with more than one-third of patients dying due to respiratory insufficiency.Several environmental exposures such as air pollution increase the risk of death in COPD patients. The aetiology of COPD is overwhelmingly dominated by smoking although many other factors could play a role. Particular genetic variants are likely to increase the susceptibility to environmental factors although little is known about which are the relevant genes. There is clear evidence about the role of the α-1-antitrypsin but the fraction of COPD attributable to the relevant variants is only 1%. Phenotypic traits that are considered to play a role in the development of COPD include sex, with females being at a higher risk, bronchial responsiveness and atopy. There is strong causal evidence regarding the relationship between smoking and COPD with decline in FEV1levelling off after smoking cessation. Passive smoking has been found to be associated with a small though statistically significant decline in FEV1. Other risk factors that are likely to be relevant in the development of COPD are occupation, low socioeconomic status, diet and possibly some environmental exposures in early life.Although there is accumulating evidence that oxygen therapy, pharmacological treatment and rehabilitation may improve the course of chronic obstructive pulmonary disease, preventing smoking continues to be the most relevant measure, not only to prevent chronic obstructive pulmonary disease, but also to arrest its development.
Bacteria, antibiotics and COPD
Authors: Wilson R. 
Published: October 2002

Bacterial infection is one of several important causes of exacerbations of chronic obstructive pulmonary disease (COPD) that may coexist. COPD is a heterogeneous condition and the incidence of bacterial infection is not uniform; mucus hypersecretion may be an important risk factor.The bacteriology of infections varies depending on the severity of the underlying airway disease. There is now a much better understanding of the pathogenesis of bacterial infections of the respiratory mucosa. Lower airway bacterial colonization may be a stimulus for chronic inflammation and may influence the interval between exacerbations.Antibiotic resistance has increased in all the major pathogens. Antibiotics are an important part of the treatment of acute exacerbations of COPD and the decision about whether to give an antibiotic can be made on clinical grounds. It is more difficult to decide, on the available evidence, whether patient characteristics and the risk of antibiotic resistance should influence choice of empiric antibiotic treatment.Most new antibiotics are modifications of existing structures, suggesting that every effort should be made to conserve the sensitivity of current antibiotics by using them appropriately.
Urban air pollution and chronic obstructive pulmonary disease: a review
Authors: Sunyer J. 
Published: October 2002

There is consistency in the findings that relate the acute increases in urban air pollution (mainly the particulate matter) and the short-term health effects (i.e.mortality and hospital admissions) on patients suffering from chronic obstructive pulmonary disease (COPD). Beyond the acute effects, a relevant public health and scientific question is to what extent chronic exposure to air pollution is related with lung function impairment and development of COPD.The few cross-sectional studies showed an increase of self-reported diagnosis of chronic bronchitis and emphysema, breathlessness and mucus hypersecretion and lower levels of lung function in the more polluted areas. The two cohort studies in children have found a retardation of pulmonary function growth, and the only cohort in adults a faster decline of lung function.Given the intrinsic limitations of cross-sectional studies to separate the timing between exposure and effects, and the weaknesses of the cohorts (i.e.few areas, short follow-up, only one retest, lack of individual weighting of air pollution measure) there is a need for new prospective studies. These should be performed in a large number of geographical areas and with a long follow-up to asses the impact of long-term air pollution on lung function growth and decline, and on incidence, duration, severity and survival of chronic obstructive pulmonary disease.
Human leukocyte antigen genes may outweigh racial background when generating a specific immune response in sarcoidosis
Authors: Grunewald J. , Eklund A. 
Published: October 2002

Presented is a sarcoidosis patient of African origin, who was adopted at an early age and grew up in Sweden.This patient displayed an immune response identical to that previously reported in human leukocyte antigen (HLA)-DR17 positive Caucasian sarcoidosis patients in Scandinavia, with T-cell receptor AV2S3+ T-cells accumulating in the lungs. HLA typing also established that she was DR17 positive, which is a rare HLA type for individuals of African origin.To the authors' knowledge, this specific immune response has not previously been reported in patients of African origin. Moreover, the clinical manifestations of sarcoidosis were similar to those known to be strongly linked to HLA-DR17 in Scandinavians,i.e.with Löfgren's syndrome.The case presented here suggests certain human leukocyte antigen genes to be strongly linked to specific immune responses that are identical irrespective of the racial background. If such an immune response were important for the subsequent clinical manifestations, this case would argue for the importance of human leukocyte antigen genes in the genetic predisposition to sarcoidosis.
Interleukin-12 as successful adjuvant in tuberculosis treatment
Authors: Greinert U. , Ernst M. , Schlaak M. , Entzian P. 
Published: October 2002

Interleukin-12 (IL-12) proved to be an effective and successful adjuvant to a standard antituberculotic medication in a patient suffering from progressive clinical tuberculosis (TB).IL-12 is a potent enhancer of interferon-γ production which is necessary for killing intracellular bacteria like mycobacteria. This patient's TB was progressive, although sensitivity to first-line antituberculotics was proven and medication was given as directly observed therapy over more than 8 months. The 3-month adjuvant therapy with IL-12 significantly and convincingly improved results.It is believed that this case, the first in the literature to describe adjuvant interleukin-12 therapy in tuberculosis, strongly encourages the study of adjuvant interleukin-12 therapy on a more systematic basis.
Diagnosis of nosocomial pneumonia in medical ward: repeatability of the protected specimen brush
Authors: Herer B. , Fuhrman C. , Demontrond D. , Gazevic Z. , Housset B. , Chouaïd C. 
Published: October 2002

The aims of this study were to assess the repeatability of two pairs of protected specimen brushes (PSB) done successively in the same lung area and either processed at the bedside or in the laboratory, and to provide a description of the bacteriological findings in 39 cases of suspected nosocomial pneumonia occurring in nonventilated patients.Four PSB were divided into two pairs. One pair of brushes (Pb) was prepared at bedside and then sent to the laboratory; the other pair (Pl) was immediately sent to the laboratory for complete processing.According to a 103 colony forming units (cfu)·mL−1threshold, 49% out of 156 PSB were positive. Using the 103 cfu·mL threshold, the Pl brushes were 89.7% concordant while the Pb brushes were 76.9% concordant. The repeatability as expressed by Κ-value of the cultures of PSB was higher for Pl brushes than for Pb brushes (Κ-values of 0.795 and 0.537 respectively, p=0.12). Bacterial species were isolated in 58.3% of 156 PSB (176 isolates). In 14 cases, cultures of PSB disclosed more than one micro-organism in a concentration >103 cfu·mL−1. The most frequently isolated organisms werePseudomonasspp. (23.9%), Enterobacteriaceae (23.3%),Streptococcusspp. (21.6%) andStaphylococcusspp. (13.1%). Polymicrobial cultures were more frequent if the patient had a tracheostomy (seven out of the nine patients with a tracheostomyversusseven out of the 30 patients without a tracheostomy, p<0.01). Bacteriological discrepancies leading to a potential troublesome choice in antibiotherapy were observed in 31.8% of the patients for Pl brushes and 56.5% of the patients for Pb brushes.There is a low degree of repeatability of protected specimen brushes outside intensive care units which seem dependent on sampling processing. The distribution of pathogens found in case of suspicion of nosocomial pneumonia in nonventilated patients appears to be similar to that obtained in ventilator-associated pneumonia.
Total energy expenditure in children with obstructive sleep apnoea syndrome
Authors: Bland R.M. , Bulgarelli S. , Ventham J.C. , Jackson D. , Reilly J.J. , Paton J.Y. 
Published: October 2002

Childhood obstructive sleep apnoea syndrome (OSAS) acts as a check on growth and nutritional status. An increase in sleeping energy expenditure has been proposed as a possible mechanism, but to date, no studies have determined whether energy requirements (total energy expenditure; TEE) are raised in OSAS. The aim of this study was to test the hypothesis that OSAS is associated with increased TEE.Eleven children (mean±sd 5.8±2.2 yrs of age) with OSAS confirmed by nocturnal polysomnography were each matched with a pair of healthy controls (n=22) of the same age and sex. TEE was measured using the doubly-labelled water method in all subjects. In 10/11 patients TEE was also measured after adenotonsillectomy and changes in TEE assessed.There was no significant difference in TEE between patients (mean±sd 325±44 kJ·kg−1·day−1) and controls (339±48 kJ·kg−1·day−1), nor between patients and age- and sex-specific literature data on TEE, using the doubly-labelled water method. Differences in TEE within patients, beforeversusafter surgery, were minor and not statistically significant.This study does not support the hypothesis that obstructive sleep apnoea syndrome in childhood is associated with increased energy requirements, and suggests that alternative explanations for the effect of this syndrome on growth and energy balance should be sought.