PubMed Journal Database | American journal of respiratory and critical care medicine - Page: 4 
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Showing PubMed Articles 76–100 of 125 from American journal of respiratory and critical care medicine
Airway Endothelial Dysfunction in Asthma and COPD: A Challenge for Future Research.
Endothelial dysfunction in the extrapulmonary circulation has been linked to cardiovascular disease. Recent investigations have revealed that in the airway circulation, cigarette smoking, COPD and asthma are also accompanied by endothelial dysfunction. Inhaled glucocorticosteroids can partially or fully restore normal endothelium-dependent vasodilation in these conditions thereby identifying the airway endothelium as a novel therapeutic target in the treatment of airway disease. The role of the defective en...
RATIONALE: There is epidemiological evidence that the use of acetaminophen may increase the risk of developing asthma. OBJECTIVE: To investigate the risk of asthma and other allergic disorders associated with the current use of acetaminophen in 13 to 14 year old children in different populations worldwide. METHODS: As part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, 13 to 14 year old children completed written and video questionnaires, obtaining data on current sympt...
BACKGROUND: Psychosocial stress is known to influence the pathophysiology of asthma. Although stress has been linked to serum markers of inflammatory activity and exaggerated responding to allergen challenge in asthma, few studies have examined inflammatory activity in the airways linked to psychosocial stress alone. Furthermore, although studies have demonstrated lower levels or reactivity of endogenous cortisol in asthma, the association with airway inflammatory activity in stress remains unexplored. OBJE...
RATIONALE: Systolic deceleration or ânotchingâ of the right ventricular outflow tract Doppler flow velocity envelope (FVERVOT), relates to pathologic wave reflection in the setting of elevated pulmonary artery impedance. OBJECTIVES: We investigated whether simple visual assessment of FVERVOT morphology aids in hemodynamic differentiation and detection of pulmonary vascular disease among a referral PH cohort. METHODS: We reviewed hemodynamics, echocardiography, and clinical data for 88 patients referred fo...
Genome-wide Association Study Identifies BICD1 as a Susceptibility Gene for Emphysema.
RATIONALE: COPD, characterized by airflow limitation, is a disorder with high phenotypic and genetic heterogeneity. Pulmonary emphysema is a major but variable component of COPD; familial data suggest that different components of COPD, such as emphysema, may be influenced by specific genetic factors. OBJECTIVE: To identify genetic determinants of emphysema assessed through high-resolution chest computed tomography in individuals with COPD. Methods and Measurement: We performed a genome-wide association stud...
BACKGROUND: The potential role of statins in treating COPD is controversial and it is unclear what anatomic COPD lesions statins affect. METHODS: We exposed guinea pigs to cigarette smoke for 6 months. In half of the animals, simvastatin therapy was initiated after 3 months of smoke exposure. Pulmonary arterial systolic pressures were monitored weekly using a radiotelemetric catheter; additional physiologic and morphologic measurements were made at sacrifice after 6 months. Precision cut lung explants were...
Rationale Fibrotic response to lung injury depends upon development of a fibrogenic population of myofibroblasts. The importance of resident interstitial fibroblasts and role of TGFbeta in this process is unclear. Objectives To define the importance of TGFbeta signalling in resident lung fibroblasts in the development of experimental pulmonary fibrosis. Methods A compound genetic strategy in which mice homozygous for a floxed TbetaRII allele were crossed with a transgenic strain harbouring a fibroblast-spec...
Mucoid and Nonmucoid Burkholderia cepacia Complex Bacteria in Cystic Fibrosis Infections.
RATIONALE: Infection with Burkholderia cepacia complex (BCC) bacteria in cystic fibrosis (CF) is associated with an unpredictable rate of pulmonary decline. Some BCC, but not others, elaborate copious mucoid exopolysaccharide endowing them with a gross mucoid phenotype, the clinical significance of which has not been described. OBJECTIVES: To determine if there was a correlation between bacterial mucoid phenotype, as assessed in a semi-quantitative manner from plate culture, and severity of disease as asses...
The T-Helper Cell Type 1-Immune Response to Gram-Negative Bacterial Infections is Impaired in COPD.
RATIONALE: The increased susceptibility to bacterial infections in chronic obstructive pulmonary disease (COPD) is critical for exacerbations. Toll-like receptor-4 (TLR4) detects bacteria via lipopolysaccharide (LPS) and induces interferon gamma- (IFNgamma-) based immune responses. The direct responsiveness of TH1-lymphocytes to LPS is disputed as they lack surface expression of the TLR4 co-receptor CD14. OBJECTIVE: We hypothesized that the TH1-mediated adaptive immune response to bacterial infections is im...
Inhibition of Allergic Bronchial Asthma by Thrombomodulin is Mediated by Dendritic Cells.
RATIONALE: Bronchial asthma is caused by inappropriate acquired immune responses to environmental allergens. It is a major health problem, with a prevalence that is rapidly increasing. Curative therapy is not currently available. OBJECTIVES: To test that hypothesis that thrombomodulin inhibits allergic bronchial asthma by inducing tolerogenic dendritic cells. METHODS: The protective effect of thrombomodulin was evaluated using a murine asthma model. Asthma was induced in mice by exposure to chicken egg oval...
A Novel Phycobiliprotein Alleviates Allergic Airway Inflammation by Modulating Immune Responses.
RATIONALE: It has been claimed that phycocyanin exhibits pharmaceutical functions in inhibiting histamine release and leukotriene biosynthesis. In allergic asthma, these inflammatory mediators are crucial for disease progression. OBJECTIVES: The aim of this study was to evaluate the therapeutic potential of R-phycocyanin against allergic airway inflammation. METHODS: Mouse bone marrow-derived dendritic cells (BMDCs) were used to evaluate the immunomodulatory functions of R-phycocyanin. In addition, an airwa...
RATIONALE: Flow volume loops (FVL) in some bilateral lung (BLT) and heart lung transplant (HLT) patients suggest variable extrathoracic obstruction in the absence of identifiable causes. These FVLs have supranormal expiratory and normal inspiratory flows (SUPRA pattern). OBJECTIVES: Characterize the relationship of the SUPRA pattern to predicted donor and recipient lung volumes, airway size, and survival. METHODS: We performed a retrospective review of adult BLT/HLT patients. We defined the SUPRA FVL patter...
RATIONALE: Significant progress has been made in understanding the pathogenesis of acute respiratory distress syndrome (ARDS). Recent advances in hospital practice may reduce the incidence of this lethal syndrome. OBJECTIVE: To observe incidence trends and associated outcomes of ARDS METHODS: This population-based cohort study was conducted in Olmsted County, Minnesota. Using a validated electronic screening protocol, investigators identified critically ill patients with acute hypoxemia and bilateral pulmon...
Threshold of Biologic Responses of the Small Airway Epithelium to Low Levels of Tobacco Smoke.
RATIONALE: Epidemiologic data demonstrate that individuals exposed to low levels of tobacco smoke have decrements in lung function and higher risk for lung disease compared to unexposed individuals. Although this risk is small, low level tobacco smoke exposure is so widespread, it is a significant public health concern. OBJECTIVES: To identify biologic correlates of this risk, we hypothesized that, compared to un-exposed individuals, individuals exposed to low levels of tobacco smoke have biologic changes i...
Management of Community-acquired Pneumonia in Adults.
Despite many advances in medical science, the mortality rate from CAP has changed very little in the past four decades. Death and adverse outcomes from CAP result from a complex interplay between the pathogen and the host. Newer information on the effect of pneumonia on comorbidity and underlying diseases, especially long term, suggests this is an important additional axis differs from the traditional triangular concept of pathogen, host defense, and antibiotic treatment. A number of clinical scoring system...
Protective Role of Peroxisome Proliferator-Activated Receptor-{beta}/{delta} in Septic Shock.
RATIONALE: PPAR-beta/delta is a transcription factor that belongs to the PPAR nuclear hormone receptor family, but the role of PPAR-beta/delta in sepsis is unknown. OBJECTIVE: We investigated the role of PPAR-beta/delta in murine models of lipopolysaccharide (LPS)-induced organ injury/dysfunction and cecal ligation and puncture (CLP)-induced polymicrobial sepsis. METHODS: Wild-type (WT) and PPAR-beta/delta knockout (KO) mice, and C57BL/6 mice were subjected to LPS for 16 h. C57BL/6 mice received the PPAR-be...
Nosocomial Pneumonia in the Intensive Care Unit Acquired during Mechanical Ventilation or Not.
RATIONALE: Most current information on hospital-acquired pneumonia (HAP) is extrapolated from patients with ventilator-associated pneumonia (VAP). No studies evaluated HAP in the intensive care unit (ICU) in non-ventilated patients. OBJECTIVES: To compare pneumonia in the ICU acquired or not during ventilation. METHODS: We prospectively collected 315 episodes of ICU-acquired pneumonia. We compared clinical and microbiological characteristics of patients with VAP (n=164, 52%) and non-ventilator ICU-acquired...
Targeted Delivering of Amikacin into Granuloma.
RATIONALE: Non tuberculous mycobacterial (NTM) infection is a growing problem in the United States and remains under-recognized in the developing world. The management of NTM infections is further complicated by several factors including the need to use high systemic doses of toxic agents, the length of therapy and the development of drug resistance. OBJECTIVES: We have evaluated the use of monocyte derived dendritic cells as a delivery vehicle for a luminescent derivative of amikacin prepared by conjugatio...
Surviving the Night in the ICU: Who Needs Senior Intensivists?
24-hour staffing of intensive care units by trained specialists: one leap at a time.
Air pollution, population vulnerability, and standards for ambient air quality.
Cystic Fibrosis Pulmonary Guidelines: Pulmonary Complications: Hemoptysis and Pneumothorax.
Rationale: Cystic fibrosis (CF) is a recessive genetic disease characterized by dehydration of the airway surface liquid and impaired mucociliary clearance. As a result, individuals with the disease have difficulty clearing pathogens from the lung and experience chronic pulmonary infections and inflammation. There may be intermittent pulmonary exacerbations or acute worsening of infection and obstruction, which require more intensive therapies. Hemoptysis and pneumothorax are complications commonly reported...
Compromised T-Cell Immunity and Virus-like Structure in a Patient with Pulmonary Hypertension.
Prediction of arterial oxygen tension: validation of a novel formula.
