Nebulized Hypertonic Saline Without Adjunctive Bronchodilators for Children With Bronchiolitis
CONCLUSIONS:
The use of 3% saline solution without adjunctive bronchodilators for inpatients with bronchiolitis had a low rate of adverse events in our center. Additional clinical trials of 3% saline solution in bronchiolitis should evaluate its effectiveness in the absence of adjunctive bronchodilators. (Source: PEDIATRICS)...
POSTED 09/01/2010 at 10:03 AM --
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Preoperative introduction and maintenance immunosuppression therapy of oral-only tacrolimus, mycophenolate mofetil and steroids reduce acute rejection episodes after lung transplantation [Original articles]
Conclusions: Our results suggest that a standard immunosuppressive regimen of TAC and MMF orally administered and introduced prior to skin incision for LTX surgery and maintained long-term might reduce the incidence of acute and chronic rejection. Viral infections and not BOS seemed to be the limiting factor of long-term survival. (Source: European Journal of Cardio-Thoracic Surgery)...
POSTED 08/30/2010 at 01:58 PM --
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Long-term outcome of double-lung and heart-lung transplantation for pulmonary hypertension: a comparative retrospective study of 219 patients [Original articles]
Conclusions: In patients with end-stage PH, good long-term survival rates were obtained using either DLT or HLT. However, these results were achieved with preferential use of HLT in patients with right heart failure or CSPS. Obliterative bronchiolitis-related death was less common with HLT than with DLT. (Source: European Journal of Cardio-Thoracic Surgery)...
POSTED 08/30/2010 at 01:58 PM --
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Bronchiolitis obliterans and the risk of pneumothorax after transbronchial biopsy
Abstract: The safety of bronchoscopy and specifically transbronchial biopsy has not been studied in patients with bronchiolitis obliterans. We discuss two patients with bronchiolitis obliterans as a complication of graft versus host disease following allogeneic stem cell transplant. Both underwent bronchoscopy and transbronchial biopsy, which was complicated by pneumothoraces. Patients with bronchiolitis obliterans have an increased risk of spontaneous air leak syndromes. Although no data exists regarding the safety of transbronchial biopsies in patients with airflow obstruction in general, they appear to have increased rates of pneumothoraces following transthoracic biopsies. It is important to consider the potentially increased risk of pneumothoraces when deciding to pursue bronchoscopy ......
POSTED 08/28/2010 at 02:52 AM --
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RSV bronchiolitis âmay not increase asthma riskâ
Results from a Danish study of twins indicate that respiratory syncytial virus bronchiolitis may not be directly associated with an increased risk for asthma in children. (Source: MedWire News - Pediatrics)...
POSTED 08/23/2010 at 07:00 PM --
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Acute bronchodilator responsiveness in bronchiolitis obliterans syndrome following hematopoietic stem cell transplantation.
CONCLUSIONS: This study suggests that (a) airway smooth muscle tone plays a significant role in BOS following HSCT, and (b) the common knowledge of BOS as an irreversible obstructive disease may stem from the limitation of simple spirometry to detect changes in small airways.
PMID: 20724742 [PubMed - as supplied by publisher] (Source: Chest)...
POSTED 08/18/2010 at 06:00 PM --
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Towards evidence based medicine for paediatricians
(Source: Archives of Disease in Childhood)...
POSTED 08/17/2010 at 11:34 AM --
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Nebulized 3% Saline Without Adjunctive Bronchodilators May Be Safe for Bronchiolitis
In a retrospective cohort, nebulized 3% saline solution without adjunctive bronchodilators for inpatients with bronchiolitis had a low rate of adverse events. Medscape Medical News (Source: Medscape Today Headlines)...
POSTED 08/15/2010 at 11:31 PM --
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Chest physiotherapy was of no benefit to children hospitalised with acute pneumonia
(Source: Archives of Disease in Childhood - Education and Practice)...
POSTED 08/05/2010 at 08:48 AM --
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The contribution of airway ischemia and vascular remodelling to the pathophysiology of bronchiolitis obliterans syndrome and chronic lung allograft dysfunction.
We describe how allograft ischemia may result in a hypoxic inflammatory milieu within the lung allograft that is conducive to vascular remodelling and angioneogenesis. SUMMARY: Whilst the published literature for vascular remodelling in post-transplant obliterative bronchiolitis is not as extensive as that for asthma, a disease also characterized by airway pathology, there are clear parallels and shared pathophysiological pathways between the two diseases. An understanding of the complex interaction between ischemia, vascular remodelling and chronic lung allograft dysfunction may lead to the future development of therapeutic strategies that can unravel this association.
PMID: 20693899 [PubMed - as supplied by publisher] (Source: Current Opinion in Organ Transplantation)...
POSTED 08/04/2010 at 06:00 PM --
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Bronchial blood supply after lung transplantation without bronchial artery revascularization.
Authors: Nicolls M, Zamora MR
PURPOSE OF REVIEW: This review discusses how the bronchial artery circulation is interrupted following lung transplantation and what may be the long-term complications of compromising systemic blood flow to allograft airways. RECENT FINDINGS: Preclinical and clinical studies have shown that the loss of airway microcirculations is highly associated with the development of airway hypoxia and an increased susceptibility to chronic rejection. SUMMARY: The bronchial artery circulation has been highly conserved through evolution. Current evidence suggests that the failure to routinely perform bronchial artery revascularization at the time of lung transplantation may predispose patients to develop the bronchiolitis obliterans syndrome.
PMID: 20689435 [PubMed ......
POSTED 08/03/2010 at 06:00 PM --
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Autonomic dysfunction with early respiratory syncytial virus-related infection
Abstract: Background: Apparent life-threatening events (ALTE) and/or prolonged apnoea have been well-documented during respiratory syncytial virus (RSV) infection in infants less than 2months of age but fundamental mechanisms remain unclear. The possibility of a central origin for the development of severe cardiac and respiratory events encouraged us, to explore the autonomic nervous system (ANS) profile of infected infants, since ANS activity may contribute to the constellation of symptoms observed during severe forms of RSV bronchiolitis.Methods: Eight infants (2 preterm and 6 full-term) less than 2months of age and presenting with severe and apnoeic forms of RSV infection were evaluated using non-invasive electrophysiological monitoring obtained simultaneously for approximately 2 consec......
POSTED 08/03/2010 at 04:11 AM --
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Duration of Illness in Infants With Bronchiolitis Evaluated in the Emergency Department
CONCLUSIONS:
Infants seen in the ED for bronchiolitis have a prolonged disease course, with substantial burden to the family. Symptom duration may be influenced by a propensity toward atopy. Clinicians may use this information for counseling families. (Source: PEDIATRICS)...
POSTED 08/02/2010 at 10:02 AM --
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Cryptogenic organizing pneumonia due to amiodarone: long-term follow-up after corticosteroid treatment.
We report a case of cryptogenic organizing pneumonia secondary to amiodarone treatment, its clinical course with significant improvement of clinical symptoms within a few days after discontinuation of amiodarone treatment and administration of corticosteroids. Also the infiltrations found in chest X-ray and computed tomography responded well and showed remarkable resolution tendency quickly. During 5 months of corticoid therapy pulmonary abnormalities gradually resolved almost completely and remained equal during the 8 months follow-up after corticoid termination.
PMID: 20668958 [PubMed - as supplied by publisher] (Source: Wiener Klinische Wochenschrift)...
POSTED 08/01/2010 at 06:00 PM --
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Th1 and th2 cytokine expression in nasopharyngeal secretions during acute bronchiolitis in children younger than two years old.
CONCLUSIONS: These findings show that Respiratory Syncytial Virus infection contributes to Th1 polarisation in immune response of respiratory mucosa, an effect that is similar to other environmental factors. Further studies are needed to assess immune response to other infectious causes of acute bronchiolitis.
PMID: 20685025 [PubMed - as supplied by publisher] (Source: Allergologia et Immunopathologia)...
POSTED 08/01/2010 at 06:00 PM --
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Patient Report: Airâleak and transient coronary artery dilation in postâinfectious bronchiolitis obliterans
(Source: Pediatrics International)...
POSTED 07/31/2010 at 06:00 PM --
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Serum KL-6 level and the development of bronchiolitis obliterans syndrome in lung transplant recipients
In this study, we followed serum KL-6 levels and lung functions prospectively in lung transplant recipients who were within the first five-yr post-transplant and had no evidence of BOS at the time of study entry. Mean peak KL-6 levels were 596.16 ± 309.32 U/mL in the nine recipients who developed BOS compared to 352.41 ± 140.68 in 36 recipients who did not (p = 0.05). Six of the nine patients with BOS had an absolute rise in KL-6 above baseline level >200 U/mL compared to two of the 37 who had the same increase in KL-6 but did not develop BOS. Using the 200 U/mL elevation of KL-6 from baseline as a threshold for a positive test would produce a sensitivity of 67%, specificity of 95%, PPV of 75%, and a NPV of 92%. In addition, mean KL-6 levels of patients during acute rejection were not si......
POSTED 07/26/2010 at 06:00 PM --
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Immunomodulation by IFN-γ in patients with resistant infections and accompanying bronchiolitis obliterans following allo-SCT
Immunomodulation by IFN-γ in patients with resistant infections and accompanying bronchiolitis obliterans following allo-SCT
Bone Marrow Transplantation advance online publication, July 26, 2010. doi:10.1038/bmt.2010.172
Authors: J Ammer, J Hahn, D Wolff, B Holler, K Landfried, A Hautmann, O I Hamer, Ch Schulz, G Hildebrandt, M Grube, R Andreesen
& E Holler (Source: Bone Marrow Transplantation)...
POSTED 07/25/2010 at 06:00 PM --
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Respiratory Syncytial Virus Limits {alpha} Subunit of Eukaryotic Translation Initiation Factor 2 (eIF2{alpha}) Phosphorylation to Maintain Translation and Viral Replication [Microbiology]
The impact of respiratory syncytial virus (RSV) on morbidity and mortality is significant in that it causes bronchiolitis in infants, exacerbations in patients with obstructive lung disease, and pneumonia in immunocompromised hosts. RSV activates protein kinase R (PKR), a cellular kinase relevant to limiting viral replication (Groskreutz, D. J., Monick, M. M., Powers, L. S., Yarovinsky, T. O., Look, D. C., and Hunninghake, G. W. (2006) J. Immunol. 176, 1733–1740). It is activated by autophosphorylation, likely triggered by a double-stranded RNA intermediate during replication of the virus. In most instances, ph-PKR targets the subunit of eukaryotic translation initiation factor 2 (eIF2) protein via phosphorylation, leading to an inhibition of translation of cellular and viral protein......
POSTED 07/23/2010 at 08:37 AM --
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Epidemiological Trends in Pediatric Urolithiasis at United States Freestanding Pediatric Hospitals
The objective of this study was to examine trends in the epidemiology of urolithiasis at pediatric hospitals nationwide.Materials and Methods: The Pediatric Health Information System database is a national database covering 42 freestanding United States pediatric hospitals that captures inpatient admissions, and emergency department and outpatient surgery visits. We searched the Pediatric Health Information System database to identify children (18 years old or younger) treated for urolithiasis between 1999 and 2008. Patients with urolithiasis were measured as a proportion of the total number of patients seen per hospital annually. Trends were verified by comparing results to 2 other common pediatric diagnosesâappendicitis and viral bronchiolitis.Results: We identified 7,921 children diag......
POSTED 07/20/2010 at 06:00 PM --
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