Six patients with asthma were enrolled (three men and three women; mean age, 28 years). Asthma was diagnosed according to the criteria of the American Thoracic society. All asthmatic patients were nonsmokers, and two of the asthmatic patients had atopy. None of the patients with asthma had complications from other lung disease, and they did not have a history suggesting systemic viral infections, tumors, or autoimmune diseases. Systemic steroid was not used in asthmatic patients during the previous 3 months.
Six healthy volunteers (two men and four women; mean age, 26 years) were enrolled from graduate students at the College of Medicine, Korea University, and served as control subjects. All control subjects were nonsmokers and had normal findings on chest radiography, normal airway reactivity, and normal pulmonary function test results; and they had no current respiratory symptoms, were nonatopic, and had no respiratory infections within the previous month. None were receiving any medications. Informed consents were obtained from each subject for their participation in the study, and the approval of the protocol was obtained by the Clinical Research Ethics Committee of Korea University Medical Center.
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In patients with PAH, increasing PAP eventually leads to right-sided heart failure and often to sudden cardiac death. Available treatments consist of anticoagulation and pulmonary vasodilators such as phosphodiesterase-5 inhibitors, endothelin-receptor antagonists, calcium-channel blockers, or prostanoids, but patients with severe right-heart failure and low cardiac output are often refractory to these agents.
In recent years, atrial septostomy has emerged as palliative therapy or bridge to transplantation. In severe PAH, this procedure creates a right-to-left shunt reducing right ventricle preload. It has been shown to result in an increased cardiac output and an augmentation of systemic oxygen transport despite the fall in systemic arterial oxygen satura-tion. A major drawback of the procedure is the high incidence of spontaneous closure or decrease in orifice size, with repeat septostomy being required in 3 to 17% depending on the performed technique. Oversizing of the orifice represents another hazard, leading to severe hypoxia or left ventricular failure due to an excessive shunt volume.
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Pulmonary arterial hypertension (PAH) is characterized by a progressive increase of pulmonary vascular resistance eventually leading to right-heart failure. PAH includes idiopathic PAH and pulmonary hypertension associated with various conditions such as congenital systemic-to-pulmonary shunts. Prognosis to a large extent depends on the underlying etiology. Before the availability of targeted medical therapies, the median survival for patients with idiopathic PAH was 2.8 years. Patients with Eisenmenger syndrome have a more favorable prognosis (3-year survival rates > 75%). Treatment consists of pulmonary vasodilator therapy, long-term oxygen therapy, anticoagulation, and lung transplantation or, at times, heart-lung transplantation.- In recent years, percutaneous atrial septostomy has been established as palliative treatment or bridge to transplantation in patients with severe right-heart failure refractory to conventional therapy.
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High-altitude pulmonary edema (HAPE) is a form of noncardiogenic pulmonary edema, which affects between 0.2% and 15% of people who ascend to altitudes between 2,500 and 5,000 m, and which may be fatal if not recognized and treated promptly. Given the increasing number of people traveling to alpine regions for work or pleasure, improving our ability to prevent, diagnose, and manage HAPE would be of great benefit, as would an increased understanding of its pathophysiology. With regard to new prophylactic drugs, Maggiorini et al recently demonstrated a benefit for the phosphodiesterase inhibitor tadalafil and the corticosteroid dexamethasone in preventing HAPE in known susceptible individuals. On the diagnostic front, Fagen-holz and colleagues in this issue of CHEST describe a relatively simple diagnostic technique that has the potential to enhance our understanding of the time course of the disease and to facilitate research on other important questions related to its development.
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People 50 and older who have had recent asthma activity appear to be at an increased risk of abdominal aortic aneurysm, a new study suggests.
An abdominal aortic aneurysm is a weak spot in the body’s main artery, the aorta, where it passes through the abdomen. That weak spot can rupture, causing massive bleeding. The researchers also found that people with recent asthma activity were more likely to have an aneurysm rupture compared to those without recent asthma activity.
“People with abdominal aortic aneurysm who were diagnosed with asthma within the past year had more than a 50 percent greater risk of ruptured aneurysms than those without asthma,” said lead researcher Guo-Ping Shi, from Brigham and Women’s Hospital in Boston.
Men diagnosed with asthma within the preceding six months were twice as likely to have an aortic aneurysm rupture, Shi said, adding that the risk was much lower among women.
Read on http://www.medicinenet.com/script/main/art.asp?articlekey=193646.
An analysis of respiratory symptoms is shown in Tables 2 and 3. The results confirm the findings in the previous report of 298 women. Daily chronic cough was unusual in nonsmokers and ex-smokers, but the prevalence became progressively greater with increase in the number of cigarettes smoked (Table 2(a)). The prevalence of cough was significantly greater in all smoking groups compared with nonsmokers and ex-smokers (P<0.001). Sputum production followed the same pattern as cough and the prevalence of sputum production was greater in all smoking groups than among nonsmokers and exsmokers (P<0.001) (Table 2(b)). Sputum volume was usually small but there were 17 women who produced more than a tablespoonful in 24 hours and, of these, 16 were moderate or heavy smokers and one was a nonsmoker (Table 2(c)). The sputum was usually clear, white or gray but there was an increased prevalence of yellow or green sputum (at least in part or with colds) in moderate and heavy smokers. Seven women had usually yellow or green sputum (one moderate and six heavy smokers). There was a progressive increase in the prevalence of chronic bronchitis (chronic cough and sputum present on most days during at least three months in each of two successive years),2 with increase in cigarette smoking, and the differences between smoking groups and nonsmoking groups were highly significant (P<0.001) (Table 2(d)). Almost half of the heavy smokers might be considered to have chronic bronchitis. Many of the smokers had had an increase in sputum in the previous five years and even during the previous year, and there were significant differences between nonsmokers and smokers in this respect (P<0.05), (Table 2(e)).
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A comparison of smoking habits in the United States in 1955 and in 1966 showed a drop in cigarette consumption in men under 55 years of age, but among women, there was an increase in cigarette consumption for every age group. Another survey in the spring of 1970 showed a much larger drop in cigarette consumption in the four years from 1966 to 1970 compared with the 11 years from 1955 to 1966. This drop was particularly noted in men under 64 years of age and, for the first time, the increase in cigarette consumption among women under 55 years of age leveled off. The increase among women over 55 years was of a lesser magnitude than previously. Similar results have been found in surveys by the Department of National Health and Welfare in Canada but of particular concern is the increase of regular smokers reported among girls 15 to 19 years of age, from 19 percent in 1965 to 25 percent in 1970. Recently, there has been increasing attention paid to women smokers because of the relationship between maternal smoking during pregnancy and harm to the unborn child. Protect yoursef in case of erectile dysfunction together with My Canadian Pharmacy – https://mycanadian-pharmacy.net/secure-the-unborn-child-during-the-treatment-of-erectile-dysfunction-my-canadian-pharmacy-has-got-some-suggestions.html.
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