January 2005

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

10885.   Bacharier LB, Strunk RC, Mauger D, White D, Lemanske RF Jr, Sorkness CA. Classifying asthma severity in children: mismatch between symptoms, medication use, and lung function. Am J Respir Crit Care Med. 2004 Aug 15;170(4):426-32.  

10886.   Beier J, Beeh KM, Kornmann O, Buhl R. Induced sputum methodology: Validity and reproducibility of total glutathione measurement in supernatant of healthy and asthmatic individuals. J Lab Clin Med. 2004 Jul;144(1):38-44.

10887.   Bhowmick B, Niven R. Unilateral vocal cord palsy: a non-psychogenic cause of vocal cord dysfunction. Respir Med. 2004 Jul;98(7):677-8.

10888.   Chae SC, Lee YC, Park YR, Shin JS, Song JH, Oh GJ, Hong ST, Pae HO, Choi BM, Chung HT. Analysis of the polymorphisms in eotaxin gene family and their association with asthma, IgE, and eosinophil. Biochem Biophys Res Commun. 2004 Jul 16;320(1):131-7.

10889.   Covar RA, Spahn JD, Murphy JR, Szefler SJ; Childhood Asthma Management Program Research Group. Progression of asthma measured by lung function in the childhood asthma  management program. Am J Respir Crit Care Med. 2004 Aug 1;170(3):234-41. 

10890.    Guerra S, Wright AL, Morgan WJ, Sherrill DL, Holberg CJ, Martinez FD. Persistence of asthma symptoms during adolescence: role of obesity and age at the onset of puberty. Am J Respir Crit Care Med. 2004 Jul 1;170(1):78-85. 

10891.    Jacobs JE, Maille AR, Akkermans RP, van Weel C, Grol RP. Assessing the quality of life of adults with chronic respiratory diseases in routine primary care: construction and first validation of the 10-Item Respiratory Illness Questionnaire-monitoring 10 (RIQ-MON10). Qual Life Res. 2004 Aug;13(6):1117-27.

10892.    Malmberg LP. Exhaled nitric oxide in childhood asthma--time to use inflammometry rather than spirometry? J Asthma. 2004 Aug;41(5):511-20. Review. 

10893.    Matsumoto K, Inoue H, Fukuyama S, Tsuda M, Ikegami T, Kibe A, Yoshiura Y, Komori M, Hamasaki N, Aizawa H, Nakanishi Y. Decrease of interleukin-10-producing T cells in the peripheral blood of severe  unstable atopic asthmatics. Int Arch Allergy Immunol. 2004 Aug;134(4):295-302. 

10894.    Monticelli S, Solymar DC, Rao A. Role of NFAT proteins in IL13 gene transcription in mast cells. J Biol Chem. 2004 Aug 27;279(35):36210-8. 

10895.    Phoa LL, Toelle BG, Ng K, Marks GB. Effects of gas and other fume emitting heaters on the development of asthma during childhood. Thorax. 2004 Sep;59(9):741-5.

10896.    Prieto L, Seijas T, Gutierrez V, Uixera S, Bruno L, Lopez R. Exhaled nitric oxide levels and airway responsiveness to adenosine 5'-monophosphate in subjects with nasal polyposis. Int Arch Allergy Immunol. 2004 Aug;134(4):303-9. 

10897.   Sharafkhaneh A, Officer TM, Goodnight-White S, Rodarte JR, Boriek AM. Novel method for measuring effects of gas compression on expiratory flow. Am J Physiol Regul Integr Comp Physiol. 2004 Aug;287(2):R479-84. 

10898.   van Strien RT, Gent JF, Belanger K, Triche E, Bracken MB, Leaderer BP. Exposure to NO2 and nitrous acid and respiratory symptoms in the first year of life. Epidemiology. 2004 Jul;15(4):471-8.


10899.   Asakura T, Ishii Y, Chibana K, Fukuda T. Leukotriene D4 stimulates collagen production from myofibroblasts transformed by TGF-beta. J Allergy Clin Immunol. 2004 Aug;114(2):310-5.

10900.   Cosio BG, Mann B, Ito K, Jazrawi E, Barnes PJ, Chung KF, Adcock IM. Histone acetylase and deacetylase activity in alveolar macrophages and blood mononocytes in asthma. Am J Respir Crit Care Med. 2004 Jul 15;170(2):141-7. 

10901.   Deshpande DA, Dogan S, Walseth TF, Miller SM, Amrani Y, Panettieri RA, Kannan MS. Modulation of calcium signaling by interleukin-13 in human airway smooth muscle: role of CD38/cyclic adenosine diphosphate ribose pathway. Am J Respir Cell Mol Biol. 2004 Jul;31(1):36-42. 

10902.   Gounni AS, Hamid Q, Rahman SM, Hoeck J, Yang J, Shan L. IL-9-mediated induction of eotaxin1/CCL11 in human airway smooth muscle cells. J Immunol. 2004 Aug 15;173(4):2771-9.

10903.   Kowal K, Osada J, Zukowski S, Dabrowska M, Dubuske L, Bodzenta-Lukaszyk A. Expression of interleukin 4 receptors in bronchial asthma patients who underwent specific immunotherapy. Ann Allergy Asthma Immunol. 2004 Jul;93(1):68-75.

10904.   Mak JC, Leung HC, Ho SP, Law BK, Lam WK, Tsang KW, Ip MS, Chan-Yeung M. Systemic oxidative and antioxidative status in Chinese patients with asthma. J Allergy Clin Immunol. 2004 Aug;114(2):260-4.

10905.   Matthay MA, Clements JA. Coagulation-dependent mechanisms and asthma. J Clin Invest. 2004 Jul;114(1):20-3. Review.

10906.   Mishra V. Effect of obesity on asthma among adult Indian women. Int J Obes Relat Metab Disord. 2004 Aug;28(8):1048-58.

10907.   Qian Z, Chapman RS, Hu W, Wei F, Korn LR, Zhang JJ. Using air pollution based community clusters to explore air pollution health effects in children. Environ Int. 2004 Jul;30(5):611-20.

10908.   Shi HZ. Eosinophils function as antigen-presenting cells. J Leukoc Biol. 2004 Sep;76(3):520-7.   

10909.   Wong TW, Yu TS, Liu HJ, Wong AH. Household gas cooking: a risk factor for respiratory illnesses in preschool children. Arch Dis Child. 2004 Jul;89(7):631-6.


10910.   Carter EP, Garat C, Imamura M. Continual emerging roles of HO-1: protection against airway inflammation. Am J Physiol Lung Cell Mol Physiol. 2004 Jul;287(1):L24-5. Review.

10911.   de Asis ML, Greene R. A cost-effectiveness analysis of a peak flow-based asthma education and self-management plan in a high-cost population. J Asthma. 2004 Aug;41(5):559-65. Review.

10912.   Karmaus W, Fussman C. Consumption of milk fat and reduced asthma risk in pre-school children. Thorax. 2004 Aug;59(8):725; author reply 725-6. 

10913.    Lin S, Gomez MI, Hwang SA, Franko EM, Bobier JK. An evaluation of the asthma intervention of the New York State Healthy  Neighborhoods Program. J Asthma. 2004 Aug;41(5):583-95.

10914.   Oddy WH, Sherriff JL, de Klerk NH, Kendall GE, Sly PD, Beilin LJ, Blake KB, Landau LI, Stanley FJ. The relation of breastfeeding and body mass index to asthma and atopy in  children: a prospective cohort study to age 6 years. Am J Public Health. 2004 Sep;94(9):1531-7.



April 2005

Some Selected Abstracts:

Dinakar C. Exhaled nitric oxide in the clinical management of asthma. Curr Allergy Asthma Rep. 2004 Nov; 4(6):454-9. Review.

Section of Allergy/Asthma/Immunology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA.

Management of asthma has gradually evolved from the concept of controlling bronchial hyper responsiveness to focusing on control of inflammation. The awareness of airway remodeling, and the emergence of data suggesting irreversibility of some of these changes, despite standard-of-care pharmacotherapies such as inhaled steroids, has highlighted the need for early detection; effective diagnosis and treatment; monitoring responses and adhering to treatment; and predicting exacerbations. Pre-clinical intervention strategies targeted toward picking up early suggestions of asthma before irreversible airway changes occur may open the door to primary prevention approaches. Although invasive methods, such as bronchial biopsy, remain the gold standard to understanding and treating asthma, there is a preference for noninvasive techniques for reasons of convenience, ease of use, and patient comfort. In this article, recent data that support the use of exhaled nitric oxide as a noninvasive biomarker of inflammation in clinical practice are reviewed.


Lemanske RF. Viral infections and asthma inception. J Allergy Clin Immunol. 2004 Nov; 114(5):1023-6. Review.

Departments of Pediatrics and Medicine, Division of Pediatric Allergy, Immunology, and Rheumatology, University of Wisconsin Medical School, 600 Highland Avenue, Madison, WI 53792, USA.

Respiratory tract infections caused by viruses have been implicated in the pathogenesis of asthma. Of these respiratory pathogens, viruses have been demonstrated to be associated with asthma epidemiologically in at least 3 ways ( Fig 1 ). First, during infancy, certain viruses have been implicated in the inception of the asthmatic phenotype. Genetic susceptibility, particularly genes coding for a topic phenotypic characteristics, might differentiate, at least in part, those children who are destined to have persistent wheezing, asthma, or both later in childhood. Second, repeated exposure to infectious viruses in daycare centers or in households with multiple older siblings increases the number of respiratory infections, but in doing so, it might paradoxically reduce the long-term risk of allergies and asthma through either pre-existing or newly formed alterations in cytokine response profiles. Third, in patients with established asthma, particularly children, viral upper respiratory tract infections play a significant role in producing acute exacerbations of airway obstruction that might result in frequent outpatient visits or in hospitalizations. This review will highlight available data on respiratory syncytial virus infections and their relationship to asthma inception in childhood.


Mehta SV, Parkin PC, Stephens D, Keogh KA, Schuh S. Oxygen saturation as a predictor of prolonged, frequent bronchodilator therapy in children with acute asthma.

Division of Pediatric Emergency Medicine, The Hospital for Sick Children, University of Toronto, Canada.

OBJECTIVES: To examine if the initial oxygen saturation (SaO2) in the Emergency Department is a useful predictor of prolonged frequent bronchodilator therapy (FBT) in children with acute asthma. STUDY DESIGN: Prospective cohort study of 273 children, 1 to 17 years of age, requiring systemic corticosteroids. Patients were categorized as needing FBT for >4 hours (n=166) versus >4 hours (n=107) and >12 hours (n=79) versus >12 hours (n=194). Multiple logistic regression determined the association between SaO2 and these outcomes. RESULTS: Baseline SaO2 remains a significant independent predictor of FBT for >4 hours (OR=0.81) and >12 hours (OR=0.84); 91% of patients with SaO2 of 90% to 91% had FBT >4 hours and 80% of patients with SaO2 of < or =89% had FBT >12 hours. Children with SaO2 of < or =91% are 14.7 and 12.0 times more likely to require FBT for >4 hours and >12 hours, respectively, than those with SaO2 of 98% to 100%. The interval likelihood ratios for FBT >4 hours were 12.3 for SaO2 of < or =89%, 6.5 for 90% to 91%, but only 1.8 for 92% to 93%. The likelihood ratios for FBT >12 hours decreased from 9.8 for SaO2 of < or =89% to 3.5 for SaO2 of 90% to 91%. CONCLUSIONS: SaO2 is a useful predictor of FBT >4 hours if it is < or =91% and of FBT >12 hours if it is < or =89%. J Pediatr. 2004 Nov;145(5):641-5. Erratum in: J Pediatr. 2004 Dec; 145(6):864.


Barnes PJ.  New drugs for asthma. Nat Rev Drug Discov. 2004 Oct; 3(10):831-44. Review.

National Heart and Lung Institute, Imperial College Faculty of Medicine, Dovehouse Street, London SW3 6LY, UK.

Asthma is a major and increasing global health problem and, despite major advances in therapy, many patients' symptoms are not adequately controlled. Treatment with combination inhalers, which contain a corticosteroid and long-acting beta (2) adrenoceptor agonist, is the most effective current therapy. There is therefore a search for new therapies, particularly safe and effective oral treatments and those that are more efficacious in severe asthma. New therapies in development include mediator antagonists and inhibitors of cytokines, although these therapies might be too specific to be very effective. New anti-inflammatory therapies include corticosteroids and inhibitors of phosphodiesterase-4, p38 mitogen-activated protein kinase and nuclear factor-kappa B. The prospects for a curative treatment are on the horizon.      


Douwes J, Le Gros G, Gibson P, Pearce N. Can bacterial endotoxin exposure reverse atopy and atopic disease? J Allergy Clin Immunol. 2004 Nov; 114(5):1051-4.

Centre for Public Health Research, Massey University, Wellington Campus, Private Box 756, Wellington, New Zealand.

Studies have shown that endotoxin exposure in childhood is associated with a reduced risk of atopy and atopic asthma. It is commonly assumed that these effects only occur in early life. However, recent epidemiologic studies suggest that immune deviation might take place throughout life. Assuming that the immune system is not fixed after the first years of life, we hypothesize that endotoxin exposure might not only inhibit the development of atopic sensitization and disease at any time throughout life but might also reverse this process. This novel extension of the hygiene hypothesis is primarily based on the indirect evidence of several epidemiologic observations showing a reduction in atopy in adults highly exposed to endotoxin that is unlikely to be explained by protective effects alone. In addition, some animal studies demonstrated the potential of endotoxin to down regulate pre-existing airway eosinophilia and hyper reactivity. However, there is currently little direct evidence that endotoxin might reverse atopy and allergic diseases. Observational studies and randomized trials to test this hypothesis could ultimately lead to the development of novel treatments for atopic diseases, such as allergic asthma, hay fever, and eczema.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

11343.    Araujo MI, Hoppe B, Medeiros M Jr, Alcantara L, Almeida MC, Schriefer A, Oliveira RR, Kruschewsky R, Figueiredo JP, Cruz AA, Carvalho EM. Impaired T helper 2 response to aeroallergen in helminth-infected patients with asthma. J Infect Dis. 2004 Nov 15;190(10):1797-803. 

11344. Latha GS, Vijaya Lakshmi V, Surekha Rani H, Murthy KJR. Use of gynandropsis pollen fractions to assess the effect of hyposensitization in patients of bronchial asthma. Indian Journal of Allergy Asthma and Immunology. 2004 Jan-Jun; 18(1): 25-31

11345.     Aroni R, Goeman D, Stewart K, Thien F, Sawyer S, Abramson M, Douglass J. Enhancing validity: what counts as an asthma attack? J Asthma. 2004 Oct;41(7):729-37.

11346.     Campos FL, da Silva-Junior FP, de Bruin VM, de Bruin PF. Melatonin improves sleep in asthma: a randomized, double-blind, placebo-controlled study. Am J Respir Crit Care Med. 2004 Nov 1;170(9):947-51.

11347.     Chavannes N, Schermer T, Akkermans R, Jacobs JE, van de Graaf G, Bollen R, van Schayck O, Bottema B. Impact of spirometry on GPs' diagnostic differentiation and decision-making. Respir Med. 2004 Nov;98(11):1124-30.

11348.     Crabbe H, Barber A, Bayford R, Hamilton R, Jarrett D, Machin N. The use of a European telemedicine system to examine the effects of pollutants and allergens on asthmatic respiratory health. Sci Total Environ. 2004 Dec 1;334-335:417-26.

11349.     Dik N, Tate RB, Manfreda J, Anthonisen NR. Risk of physician-diagnosed asthma in the first 6 years of life. Chest. 2004 Oct;126(4):1147-53.

11350.     Dinakar C. Exhaled nitric oxide in the clinical management of asthma. Curr Allergy Asthma Rep. 2004 Nov;4(6):454-9. Review.

11351.     Guy ES, Kirumaki A, Hanania NA. Acute asthma in pregnancy. Crit Care Clin. 2004 Oct;20(4):731-45, x. Review.

11352.     Lemanske RF. Viral infections and asthma inception. J Allergy Clin Immunol. 2004 Nov;114(5):1023-6. Review.

11353.     Magnan A. Tools to assess (and achieve?) long-term asthma control. Respir Med. 2004 Oct;98 Suppl B:S16-21. Review.

11354.     Majima Y. Clinical implications of the immunomodulatory effects of macrolides on sinusitis. Am J Med. 2004 Nov 8;117 Suppl 9A:20S-25S. Review.

11355.     Mehta SV, Parkin PC, Stephens D, Keogh KA, Schuh S. Oxygen saturation as a predictor of prolonged, frequent bronchodilator therapy in children with acute asthma. J Pediatr. 2004 Nov;145(5):641-5. Erratum in: J Pediatr. 2004 Dec;145(6):864.

11356.     Peat JK, Mihrshahi S, Kemp AS, Marks GB, Tovey ER, Webb K, Mellis CM, Leeder SR. Three-year outcomes of dietary fatty acid modification and house dust mite reduction in the Childhood Asthma Prevention Study. J Allergy Clin Immunol. 2004 Oct;114(4):807-13.

11357.     Ruffin R. Peak expiratory flow (PEF) monitoring. Thorax. 2004 Nov;59(11):913-4.

11358.     Schaub B, von Mutius E. The marketing of asthma and allergies. Lancet. 2004 Oct 16;364(9443):1389-90.

11359.     Steinshamn S, Sandsund M, Sue-Chu M, Bjermer L. Effects of montelukast and salmeterol on physical performance and exercise economy in adult asthmatics with exercise-induced bronchoconstriction. Chest. 2004 Oct;126(4):1154-60.

11360.     Virchow JC. Guidelines versus clinical practice--which therapy and which device? Respir Med. 2004 Oct;98 Suppl B:S28-34. Review.


11361.     Babu KS, Davies DE, Holgate ST. Role of tumor necrosis factor alpha in asthma. Immunol    Allergy Clin North Am. 2004 Nov;24(4):583-97, v-vi. Review.

11362.     Barnes PJ. New drugs for asthma. Nat Rev Drug Discov. 2004 Oct;3(10):831-44. Review.

11363.     Kay AB, Klion AD. Anti-interleukin-5 therapy for asthma and hypereosinophilic syndrome. Immunol Allergy Clin North Am. 2004 Nov;24(4):645-66, vii. Review.

11364.     London SJ, Promislow JH. Breastfeeding and asthma in adolescents.Am J Public Health. 2004 Nov;94(11):1843;.

11365.   Sandberg S, Jarvenpaa S, Penttinen A, Paton JY, McCann DC. Asthma exacerbations in children immediately following stressful life events: a Cox's hierarchical regression.Thorax. 2004 Dec;59(12):1046-51.

11366.  Sun YC, Chu HW. Do neutrophils actively participate in airway inflammation and remodeling in asthma? Chin Med J (Engl). 2004 Nov;117(11):1739-42.


11367.     Douwes J, Le Gros G, Gibson P, Pearce N. Can bacterial endotoxin exposure reverse atopy and atopic disease? J Allergy Clin Immunol. 2004 Nov;114(5):1051-4.



 July 2005

Some Selected Abstracts:


 Amsden GW.Anti-inflammatory effects of macrolides--an underappreciated benefit in the treatment of community-acquired respiratory tract infections and chronic inflammatory pulmonary conditions? J Antimicrob Chemother. 2005 Jan;55(1):10-21.

The Clinical Pharmacology Research Center and Department of Adult and Pediatric Medicine, Bassett Healthcare, Cooperstown, NY, USA.

BACKGROUND: It has been recognized for more than 20 years that the macrolides have immunomodulatory effects that are beneficial for those suffering from chronic pulmonary inflammatory syndromes, such as diffuse panbronchiolitis, cystic fibrosis, asthma and bronchiectasis. The macrolides have consistently been associated with decreased length of stay and mortality when used alone or in combination with beta-lactam antibiotics. This effect can be demonstrated against combinations consisting of beta-lactams and other antibiotics active against 'atypical chest pathogens' when treating community-acquired pneumonia (CAP) in hospitalized patients. As such, it appears that the macrolides' effects in CAP patients are more than just antibacterial in nature. AIMS OF THIS REVIEW: This review aims: to give the reader information on the background areas described, as well as related areas; to review the CAP benefits with macrolides and how they may be related to the immunomodulatory properties they demonstrate, albeit in a shorter period of time than previously demonstrated with chronic pulmonary disorders; to use ex vivo data to support these extrapolations. LITERATURE SEARCH: A literature search using Medline was conducted from 1966 onwards, searching for articles with relevant key words such as macrolide, diffuse panbronchiolitis, community-acquired pneumonia, biofilm, immunomodulation, cystic fibrosis, erythromycin, clarithromycin, roxithromycin and azithromycin, bronchiectasis and asthma. When appropriate, additional references were found from the bibliographies of identified papers of interest. Any relevant scientific conference proceedings or medical texts were checked when necessary. CONCLUSIONS: (1) Research into macrolide immunomodulation for chronic pulmonary disorders demonstrates consistent positive effects, although of types other than seen with diffuse panbronchiolitis. These effects, together with their inhibitory activity on biofilms, have the potential to make them a useful option. (2) The benefits for CAP are consistent, and higher when a macrolide is given with another atypical agent than if the other atypical agent is given alone, suggesting a non-antibacterial benefit. (3) Recent research of the immunomodulatory properties of azithromycin imply that azithromycin may have a previously unknown short-term biphasic effect on inflammation modulation: enhancement of host defence mechanisms shortly after initial administration followed by curtailment of local infection/inflammation in the following period. (4) Additional in vivo research is needed prior to developing any firm conclusions.


1.                      Buhl R. Anti-IgE antibodies for the treatment of asthma. Curr Opin Pulm Med. 2005 Jan;11(1):27-34. Review. 

Pulmonary Department, Mainz University Hospital, Germany.

PURPOSE OF REVIEW: Allergic asthma is a hypersensitivity reaction initiated by immunologic mechanisms mediated by IgE antibodies. IgE plays a central role in the initiation and propagation of the inflammatory cascade and thus the allergic response. Targeting factors involved in the allergic response, such as IgE, is a novel strategy for new therapies. Attenuating allergic disease by specifically inhibiting IgE and the development of the monoclonal anti-IgE antibody, omalizumab, were major breakthroughs in asthma management. RECENT FINDINGS: Several studies have shown that omalizumab has significant anti-inflammatory effects and that it may act on multiple components of the inflammatory cascade. Specific binding of IgE by omalizumab reduces both the early allergic response and the late allergic response and symptoms of IgE-mediated allergy. The long-term clinical efficacy of omalizumab has been demonstrated along with improvements in quality of life. As add-on therapy in severe asthma, omalizumab reduces the requirement for inhaled corticosteroids and improves disease control. Clinical studies have shown that the patients who benefit most from omalizumab therapy are those at high risk of exacerbations, those with poorly controlled and/or severe asthma, and those with IgE-mediated comorbidities. SUMMARY: Omalizumab is a significant addition to current asthma treatments and shows great promise as a therapy for allergic asthma and for patients with concomitant allergic rhinitis. This is particularly true for difficult-to-treat patients with moderate to severe allergic asthma who have poorly controlled disease on conventional therapies, experience severe adverse effects secondary to high-dose or prolonged corticosteroid treatment, have frequent exacerbations, and/or are at high risk of hospitalization. Future studies will continue to investigate the anti-inflammatory mechanisms of anti-IgE therapy. Because many of these mechanisms are common to all IgE-mediated allergic diseases, the efficacy of omalizumab in other allergic diseases should be further explored.


Martindale S, McNeill G, Devereux G, Campbell D, Russell G, Seaton A. Antioxidant intake in pregnancy in relation to wheeze and eczema in the first two years of life. Am J Respir Crit Care Med. 2005 Jan 15;171(2):121-8. 

Department of Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, Scotland, United Kingdom.

Two thousand women were recruited for a prospective investigation of the influence of maternal antioxidant intake in pregnancy on the development of asthma and eczema in children. A food frequency questionnaire was used to characterize diet during pregnancy and blood antioxidant levels were measured. Postal questionnaires were used to follow up the 1,924 singleton children born to the cohort at 6, 12, and 24 months of age. There were no associations between maternal antioxidant intake and wheezing symptoms and eczema in the children's first year. In the children's second year, maternal vitamin E intake during pregnancy was negatively associated with wheeze in the absence of a "cold" (p for trend 0.010) and, in children whose mothers were atopic, there was a negative association between maternal vitamin E intake and childhood eczema (p for trend 0.024). Maternal vitamin C intake during pregnancy was positively associated with "ever wheeze" and eczema during the children's second year. This study suggests that maternal dietary antioxidant intakes during pregnancy may modify the risks of developing wheeze and eczema during early childhood. Further follow up of the cohort will determine whether maternal diet during pregnancy is associated with asthma and atopic disease in later childhood.


Schultz TE.Sevoflurane administration in status asthmaticus: a case report. AANA J. 2005 Feb;73(1):35-6. 

              Frances Mahon Deaconess Hospital, Glasgow, Montana, USA.

              This case report describes the use of sevoflurane in a 26-year-old woman who presented to a rural critical access hospital emergency department in status asthmaticus and subsequently failed conventional therapy. Although the use of potent inhalation agents in the treatment of refractory status asthmaticus has been documented, there is little written about the use of sevoflurane in this situation. Sevoflurane was administered for approximately 2(1/2) hours, stabilizing the patient's condition enough to allow fixed-wing air transport to a tertiary facility.


Secnik K, Swensen A, Lage MJ. Comorbidities and costs of adult patients diagnosed with attention-deficit hyperactivity disorder. Pharmacoeconomics. 2005;23(1):93-102.

Lilly Research Laboratories, Indianapolis, Indiana, USA.

INTRODUCTION: The purpose of this retrospective study was to examine the prevalence of comorbidities, resource use, direct medical costs, and the costs associated with missed work for adults diagnosed with attention-deficit hyperactivity disorder (ADHD). STUDY DESIGN: From a large claims database that captures inpatient, outpatient and prescription drug services, individuals diagnosed with ADHD between the years 1999 and 2001 were retrospectively identified. The ADHD cohort (n = 2252) were matched with a non-ADHD cohort (n = 2252) on a 1 : 1 ratio, based upon age, gender, metropolitan statistical area and type of insurance coverage. The ADHD cohort was compared with the non-ADHD cohort for differences in comorbidities and direct medical costs (inpatient, outpatient and prescription drug costs) using year 2001 prices. Using data from six Fortune 200 employers, time missed from work and costs associated with absenteeism, short-term disability and worker's compensation was examined for a subsample (n = 354) of the employees diagnosed with ADHD. Chi-square and t-statistics were used to compare the ADHD population with the control group with regards to comorbidites and service use. Analysis of covariance and multivariate regressions were used to examine differences in days missed from work, direct medical costs and costs associated with missed work. RESULTS: Adults diagnosed with ADHD were significantly more likely to have a comorbid diagnosis of asthma (p = 0.0014), anxiety (p < 0.0001), bipolar disorder (p < 0.0001), depression (p < 0.0001), drug or alcohol abuse (p < 0.0001), antisocial disorder (p = 0.0081) or oppositional disorder (p = 0.0022) compared with the control group. Controlling for the impact of comorbidities, adults diagnosed with ADHD had significantly higher outpatient costs (USD 3009 vs USD 1492; p < 0.0001), inpatient costs (USD 1259 vs USD 514; p < 0.0001), prescription drug costs (USD 1673 vs USD 1008; p < 0.0001), and total medical costs (USD 5651 vs USD 2771; p < 0.0001) compared with the non-ADHD cohort. Employees diagnosed with ADHD missed significantly more days due to 'unofficial' absences (4.33 days vs 1.13 days; p < 0.0001). CONCLUSIONS: The results demonstrate that adults diagnosed with ADHD have a higher prevalence of comorbidities, higher medical costs and more absences than matched individuals without ADHD. These findings suggest that there may be an opportunity for the effective treatment of ADHD to lead to cost-offsets.


Spaggiari E, Zompatori M, Verduri A, Chetta A, Bna C, Ormitti F, Sverzellati N, Rabaiotti E.Early smoking-induced lung lesions in asymptomatic subjects. Correlations between high resolution dynamic CT and pulmonary function testing. Radiol Med (Torino). 2005 Jan-Feb;109(1-2):27-39.

Sezione di Diagnostica per Immagini e UO di Scienze Radiologiche, Dipartimento di Scienze Cliniche,Universita degli Studi, Parma, Italy.

PURPOSE: To evaluate the prevalence and significance of the pathological effects of cigarette smoking on the lung and the sensitivity of high-resolution CT (HRCT) in the recognition of early smoking-induced lesions in asymptomatic former or current smokers. MATERIALS AND METHODS: We performed a prospective and consecutive analysis of 36 volunteers (16 males, 20 females), 10 non-smokers (3 males; 7 females) and 26 smokers (13 males; 13 females / 17 current smokers; 9 former smokers), all asymptomatic and with normal respiratory flows. These subjects underwent lung function testing and HRCT, after providing written informed consent for the study. The HRCT scans were obtained at three pre-selected levels (aortic arch, tracheal carina and venous hilum). The same scans were obtained in post-expiration phase. At the level of the apical segmental bronchus of the right upper lobe, we measured on the monitor wall thickening, and the total and internal diameters using the techniques reported in literature. Each study was independently evaluated by two radiologists that were blinded to all clinical and functional data; they also evaluated the presence, prevalence and type of emphysema, areas of patchy hyperlucency and oligoemia in the inspiration phase and areas of expiratory air trapping. The extension was evaluated with the visual score method. The data obtained were analysed with the Windows SPSS package for statistical analysis. RESULTS: The two groups (non smokers and smokers) showed significant differences in some functional tests such as FEV1 (p<0.005) and Tiffeneau index (p<0.005), which were lower in current-smokers or former-smokers, although still within the normal range. The HRCT study did not show areas of emphysema or air trapping in non smokers. In the smokers' group, air trapping was observed in 30.7% of cases: 33.3% former-smokers and 29.4% current smokers (mean extension was 21.36% in former smokers and 9.48% in current smokers). Mean extension in the smokers' group was 13.94%. Pulmonary emphysema was found in 34.6% of cases in the smokers' group: 33.3% former-smokers and 35.2% current-smokers. Emphysema was prevalent in the upper lobes (88.8%). Mean extension was 8.76% in the former smokers group and 18.81% in current-smokers, with a total mean extension of 15.47% in the smokers' group. Statistically, there was a significant difference between non-smokers and smokers as regards emphysema extension and expiratory air trapping (p=0.034 and p=0.050, respectively). The smokers' group had a significantly wider diameter of the apical segmental bronchus of the right upper lobe than the controls. There was no significant statistical correlation between this dilatation and the emphysema score (r=0.051; p=0.81). The entity of smoking history did not correlate with emphysema extension or air trapping or with the size of the apical segmental bronchus of the right upper lobe. CONCLUSIONS: Our study demonstrates that HRCT is more sensitive and specific than commonly-used functional tests for the evaluation of initial emphysema in asymptomatic smokers. We observed expiratory air trapping only in the smokers' group, and only of the lobular type, without evidence of disease in inspiratory scans. Among the smokers and former-smokers, air trapping was found in 30.7% of subjects, with a mean extension lower than 10%. Our results therefore suggest that, even in asymptomatic subjects, expiratory air trapping is probably pathological and, once bronchial asthma has been excluded, it may be related to cigarette smoking and indicate early inflammatory bronchiolar damage. HRCT may therefore be regarded as a useful tool in the early diagnosis of smoking-related lung disease.


Tong GM, Rude RK.Magnesium deficiency in critical illness. J Intensive Care Med. 2005 Jan-Feb;20(1):3-17.Review. 

              University of Southern California, School of Medicine, Los Angeles, CA 90089-9317, USA.

Magnesium (Mg) deficiency commonly occurs in critical illness and correlates with a higher mortality and worse clinical outcome in the intensive care unit (ICU). Magnesium has been directly implicated in hypokalemia, hypocalcemia, tetany, and dysrhythmia. Moreover, Mg may play a role in acute coronary syndromes, acute cerebral ischemia, and asthma. Magnesium regulates hundreds of enzyme systems. By regulating enzymes controlling intracellular calcium, Mg affects smooth muscle vasoconstriction, important to the underlying pathophysiology of several critical illnesses. The principle causes of Mg deficiency are gastrointestinal and renal losses; however, the diagnosis is difficult to make because of the limitations of serum Mg levels, the most common assessment of Mg status. Magnesium tolerance testing and ionized Mg2+ are alternative laboratory assessments; however, each has its own difficulties in the ICU setting. The use of Mg therapy is supported by clinical trials in the treatment of symptomatic hypomagnesemia and preeclampsia and is recommended for torsade de pointes. Magnesium therapy is not supported in the treatment of acute myocardial infarction and is presently undergoing evaluation for the treatment of severe asthma exacerbation, for the prevention of post-coronary bypass grafting dysrhythmias, and as a neuroprotective agent in acute cerebral ischemia.


Wong KW. Clinical efficacy of n-3 fatty acid supplementation in patients with asthma. . J Am Diet Assoc. 2005 Jan;105(1):98-105. Review. 

Department of Agriculture and Human Ecology, Virginia State University, PO Box 9211, Petersburg, VA 23806, USA.

The rising prevalence of asthma is an alarming health concern. The morbidity and mortality associated with asthma not only disrupts the quality of life, but it also escalates health care costs. Asthma is a chronic inflammatory disease of the respiratory tract. An exaggerated production of the arachidonic acid-derived eicosanoids, leukotrienes, has been implicated as the chemical trigger for inflammation. n-3 fatty acid supplementation has been shown to suppress the synthesis of the n-6 series of leukotrienes by competing and inhibiting the metabolism of arachidonic acid. The results from epidemiological studies suggested that fish consumption was beneficially associated with lung function and prevalence of asthma. The data generated from clinical trials, however, indicated that n-3 fatty acid supplementation did not consistently improve severity of symptoms, lung functions, airway responsiveness, and medication use in asthmatic patients. Future research should focus on the effects of long-term supplementation using weight-based dosages on specific biochemical markers and clinical outcomes. Leading organizations have not included nutrition as part of the management guidelines for asthma. Meanwhile, regular fish consumption at least three times per week should be highly encouraged as part of a well-balanced diet and to meet the adequate intake levels established for n-3 fatty acids.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

  1. Ball SD, Kertesz D, Moyer-Mileur LJ. Dietary supplement use is prevalent among children with a chronic illness. J Am Diet Assoc. 2005 Jan;105(1):78-84.

  2. Beyer J, Kuchibhatla M, Gersing K, Krishnan KR. Medical comorbidity in a bipolar outpatient clinical population. Neur opsychopharmacology. 2005 Feb;30(2):401-4.

  3. Heaney LG, Robinson DS. Severe asthma treatment: need for characterising patients. Lancet. 2005 Mar 12;365(9463):974-6. Review. 

  4. Kabra S K, Lodha R. Management of unresponsive asthma. Indian J Pediat 2004, 71(8), 729-32.

  5. Lipworth BJ. Phosphodiesterase-4 inhibitors for asthma and chronic obstructive pulmonary disease. Lancet. 2005 Jan 8;365(9454):167-75. Review. 

  6. Martindale S, McNeill G, Devereux G, Campbell D, Russell G, Seaton A.   Antioxidant intake in pregnancy in relation to wheeze and eczema in the first two years of life. Am J Respir Crit Care Med. 2005 Jan 15;171(2):121-8. 

  7. Namazy JA, Schatz M.  Pregnancy and asthma: recent developments. Curr Opin Pulm Med. 2005 Jan;11(1):56-60. Review. 

  8. Pruitt B, Jacobs M.  Caring for a patient with asthma. Nursing. 2005 Feb;35(2):48-51. Review.  

  9. Queiroz R D M, Sarinho S W, Sarihno E S C, Ximenes R A A. Relationship between BCG scar size and asthma in children. Indian Pediat 2004, 41(9), 916-21.

  10. Secnik K, Swensen A, Lage MJ. Comorbidities and costs of adult patients diagnosed with attention-deficit hyperactivity disorder. Pharmacoeconomics. 2005;23(1):93-102. 

  11. Sherriff A, Farrow A, Golding J, Henderson J. Frequent use of chemical household products is associated with persistent wheezing in pre-school age children. Thorax. 2005 Jan;60(1):45-9. 

  12. Singh M, Mathew J L, Malhi P, Srinivas B R, Kumar L. Comparison of improvement in quality of life score with objective parameters of pulmonary function in Indian asthmatic children receiving inhaled corticosteroid therapy . Indian Pediat 2004, 41(11), 1143-7.

  13. Singh M. Newer drugs for asthma. Indian J Pediat 2004, 71(8), 721-7.

  14. Spaggiari E, Zompatori M, Verduri A, Chetta A, Bna C, Ormitti F, Sverzellati N, Rabaiotti E. Early smoking-induced lung lesions in asymptomatic subjects. Correlations between high resolution dynamic CT and pulmonary function testing. Radiol Med (Torino). 2005 Jan-Feb;109(1-2):27-39. 

  15. Stock S, Redaelli M, Luengen M, Wendland G, Civello D, Lauterbach KW.  Asthma: prevalence and cost of illness. Eur Respir J. 2005 Jan;25(1):47-53. 

  16. Taylor DR, Cowan JO, Greene JM, Willan AR, Sears MR.  Asthma in remission: can relapse in early adulthood be predicted at 18 years of age? Chest. 2005 Mar;127(3):845-50.

  17. Tong GM, Rude RK. Magnesium deficiency in critical illness. J Intensive Care Med. 2005 Jan-Feb;20(1):3-17. Review. 

  18. Wong KW. Clinical efficacy of n-3 fatty acid supplementation in patients with asthma. J Am Diet Assoc. 2005 Jan;105(1):98-105. Review. 

  1. Buhl R. Anti-IgE antibodies for the treatment of asthma. Curr Opin Pulm Med. 2005 Jan;11(1):27-34. Review.

  2. Buysse CM, de Jongste JC, de Hoog M. Life-threatening asthma in children:  treatment with sodium bicarbonate reduces PCO2. Chest. 2005 Mar;127(3):866-70.

  3. Covar RA, Macomber BA, Szefler SJ.  Medications as asthma triggers. Immunol Allergy Clin North Am. 2005 Feb;25(1):169-90. Review.  

  4. Saxon A, Diaz-Sanchez D.  Air pollution and allergy: you are what you breathe. Nat Immunol. 2005 Mar;6(3):223-6.

  5. Spahr JE, Krawiec ME.   The early origins of asthma: nature, nurture, or parturition? Ann Allergy Asthma Immunol. 2005 Feb;94(2):211-2.

  1. Amsden GW.  Anti-inflammatory effects of macrolides--an underappreciated benefit in the treatment of community-acquired respiratory tract infections and chronic inflammatory pulmonary conditions? J Antimicrob Chemother. 2005 Jan;55(1):10-21.

  2. Anderson J. Not enough spores? J Allergy Clin Immunol. 2005 Feb;115(2):426-7; author reply 427.

  3. Barnes PJ. A single inhaler for asthma? Am J Respir Crit Care Med. 2005 Jan 15;171(2):95-6.

  4. Currie GP, Devereux GS, Lee DK, Ayres JG. Recent developments in asthma management. BMJ. 2005 Mar 12;330(7491):585-9. Review.

  5. Currie GP, Lee DK, Anderson WJ. Vitamin E supplements in asthma. Thorax. 2005 Feb;60(2):171-2; author reply 172. 

  6. Flores G. Preventing hospitalisations for children. Lancet. 2005 Jan 15;365(9455):201-2.

  7. Korst LM, Gornbein JA, Gregory KD. Rethinking the cesarean rate: how pregnancy complications may affect interhospital comparisons. Med Care. 2005 Mar;43(3):237-45.

  8. O'Driscoll H. Keeping employer and employee happy. Prof Nurse. 2005 Feb;20(6):24-5.

  9. Ramsey CD, Celedon JC. The hygiene hypothesis and asthma. Curr Opin Pulm Med. 2005 Jan;11(1):14-20. Review.

  10. Rosted P, Warnakulasuriya S. A survey on the uses of acupuncture by a group of  K dentists.Br Dent J. 2005 Feb 12;198(3):139-43.

  11. Schultz TE. Sevoflurane administration in status asthmaticus: a case report. AANA J. 2005 Feb;73(1):35-6.

  12. Shee C. Corticosteroids and acute asthma. Lancet. 2005 Jan 22;365(9456):294.

  13. Toelle BG, Marks GB. The ebb and flow of asthma. Thorax. 2005 Feb;60(2):87-8.



October 2005

Some Selected Abstracts:


Argalious M, Motta P, Khandwala F, Samuel S, Koch CG, Gillinov AM, Yared JP, Starr NJ, Bashour CA. "Renal dose" dopamine is associated with the risk of new-onset atrial fibrillation after cardiac surgery. Crit Care Med. 2005 Jun;33(6):1327-32.

Department of General Anesthesiology, The Cleveland Clinic Foundation, Cleveland OH 44195, USA.

OBJECTIVE: "Renal dose" dopamine (rDA; 1-3 microg/kg per min) is administered to patients after cardiac surgery to preserve or improve renal function. Many of these patients develop new-onset postoperative atrial fibrillation or atrial flutter (pAF) that could be related to rDA administration. The objective of this investigation was to determine whether there was an association between rDA and new-onset pAF in patients undergoing coronary artery bypass grafting with cardiopulmonary bypass (CABG). SETTING: Research hospital. SUBJECTS: The study population consisted of 1,731 patients undergoing CABG. INTERVENTIONS: CABG with and without rDA. DESIGN: After approval by the institutional review board, a retrospective study using the Cardiothoracic Anesthesia Patient Registry was undertaken to determine the association between rDA and pAF in patients undergoing CABG. Patients with a documented history of atrial fibrillation, those who required inotrope use during or after surgery, and those having valve surgery were excluded. MEASUREMENTS AND MAIN RESULTS: One-thousand seven-hundred thirty-one patients undergoing CABG during the period of January 1, 2000, through June 30, 2002, were the study population; of these, 15.0% (260/1,731) developed pAF. The incidence of pAF was 23.3 % (41/176) among patients who received rDA and 14.1% (219/1,555) among those who did not receive rDA. In the multivariable logistic regression model, patient age, gender, chronic obstructive pulmonary disease or asthma, and rDA were associated with pAF (p < .01). Receipt of rDA increased the odds of developing pAF by 74%, independent of the effect of other variables. CONCLUSIONS: Renal-dose dopamine is associated with a 1.74 odds ratio of pAF developing after CABG.


Bruton A, Holgate ST. Hypocapnia and asthma: a mechanism for breathing retraining? Chest. 2005 May;127(5):1808-11.

University of Southampton, Highfield, Southampton, SO17 1BJ, UK.

There is some evidence that breathing retraining may be beneficial for patients with asthma, but the mechanism behind this benefit is still unknown. One hypothesis is that individuals can be trained to raise carbon dioxide levels and thereby reverse the bronchoconstrictive effects of hypocapnia and utilize the bronchodilatory effects of hypercapnia. This theory presupposes that individuals with asthma have lower carbon dioxide levels than the healthy population. This article reviews the available evidence supporting the hypothesis and concludes that although attractive, there is currently insufficient evidence to attribute the benefits of breathing retraining to this mechanism.


Haque RA, Usmani OS, Barnes PJ. Chronic idiopathic cough: a discrete clinical entity? Chest. 2005 May;127(5):1710-3.

Airways Disease Section, National Heart & Lung Institute, Imperial College, Dovehouse St, London, SW3 6LY, UK.

STUDY OBJECTIVES: Despite the success of specialist cough clinics, there is increasing recognition of a subgroup of chronic coughers in whom a diagnosis cannot be made even after thorough, systematic investigation. We call this condition chronic idiopathic cough (CIC). The aim of this study is to compare the clinical characteristics of CIC patients with those of coughers in whom a diagnosis has been established (non-CIC) to see if there is a recognizable clinical pattern that distinguishes CIC from non-CIC. DESIGN: Retrospective analysis of the medical records of chronic cough patients. SETTING: The Royal Brompton Hospital Chronic Cough Clinic, London. PATIENTS: One hundred patients with chronic cough referred to the Royal Brompton Hospital Cough Clinic between October 2000 and February 2004. RESULTS: Seventy-one percent of all patients were female. Median age was 57 years (range, 19 to 81 years), with a median duration of symptoms of 48 months (range, 2 to 384 months). The primary diagnoses were CIC (42%), postnasal drip syndromes (22%), gastroesophageal reflux disease (16%), asthma (7%), and others (13%). In CIC patients, the median age at referral, age at onset of cough, and proportion of females did not differ significantly from non-CIC patients. CIC patients had a longer median duration of cough (72 months vs 24 months, p = 0.002), were more likely to report an upper respiratory tract infection (URTI) as the initial trigger of their cough (48% vs 24%, p = 0.0014), and had a significantly lower cough threshold in response to capsaicin (log concentration of capsaicin required to induce five or more coughs, - 0.009 vs 0.592, p = 0.032) than non-CIC patients. CONCLUSIONS: Patients with CIC commonly describe a URTI that initiates their cough, which then lasts for many years, and they demonstrate an exquisitely sensitive cough reflex. We believe that CIC may be a distinct clinical entity with an as-yet unidentified underlying pathology.


Janse AJ, Uiterwaal CS, Gemke RJ, Kimpen JL, Sinnema G. A difference in perception of quality of life in chronically ill children was found between parents and pediatricians. J Clin Epidemiol. 2005 May;58(5):495-502.

Department of Pediatrics, Wilhelmina Children's Hospital, University Medical Center Utrecht, The Netherlands.

BACKGROUND AND OBJECTIVES: Quality of life measurements can help to estimate the well-being of chronically ill patients, and disclose discrepancies in perception between physicians and patients that might otherwise interfere with the effectiveness of treatment. The objective was to investigate the differences in perception of quality of life between parents of chronically ill children and pediatricians. METHODS: A cross-sectional study was conducted in four tertiary pediatric care centers in The Netherlands. The Health Utilities Index mark 3 (HUI3) was used by 37 pediatricians and 279 parents of patients (children aged 1 to 17 years) with cystic fibrosis admitted either in daycare or for a pneumonia, or patients with newly diagnosed acute lymphoblastic leukemia, juvenile idiopathic arthritis, or asthma. RESULTS: Differences in perception of quality of life between parents and pediatricians appeared to be dependent of the disease. In patients with acute lymphoblastic leukemia (OR 7.4; [95% CI 2.88-18.97], juvenile idiopathic arthritis (4.7; [95% CI 2.00-11.22]), and asthma (2.3; [95% CI 1.13-4.69]) a difference in perception was more likely to occur than in patients with cystic fibrosis admitted in daycare. CONCLUSION: At the onset of a chronic disease, the parents of pediatric patients may be misunderstood by health care professionals, especially in subjective attributes. Assessment of quality of life may contribute to better understanding between pediatricians and parents, and thus may even enhance compliance and treatment effects.


Larsen GL, Kang JK, Guilbert T, Morgan W. Assessing respiratory function in young children: Developmental considerations. J Allergy Clin Immunol. 2005 Apr;115(4):657-66; quiz 667.

National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206, USA.

The purpose of this review is to provide practitioners and clinical investigators with an update on methods of assessing respiratory function in young children. The importance of this topic is presented in light of the natural history of asthma, as well as maturational changes that occur early in life in terms of airway development. Models of disease are cited to support the concept that injury of the mammalian airway early in postnatal life might have far-reaching consequences in terms of control of airway caliber and responsiveness. The methods currently available to measure respiratory function in our younger patients are outlined. The ability of children to perform the maneuvers necessary for this testing is considered as a function of age. Areas in which research and development are needed are highlighted.


Lee B, Woo P. Chronic cough as a sign of laryngeal sensory neuropathy: diagnosis and treatment. Ann Otol Rhinol Laryngol. 2005 Apr;114(4):253-7.

Department of Otolaryngology-Head and Neck Surgery, The Grabscheid Voice Center, Mount Sinai Medical Center, One Gustave L. Levy Place, New York, NY 10029, USA.

Chronic cough is often attributed to reflux, postnasal drip, or asthma. We present 28 patients who had chronic cough or throat-clearing as a manifestation of sensory neuropathy involving the superior or recurrent laryngeal nerve. They had been identified as having sudden-onset cough, laryngospasm, or throat-clearing after viral illness, surgery, or an unknown trigger. Cough and laryngospasm were the most common complaints. Seventy-one percent of the patients had concomitant superior laryngeal nerve or recurrent laryngeal nerve motor neuropathy documented by laryngeal electromyography or videostroboscopy. After a negative workup for reflux, asthma, or postnasal drip, these patients were treated with gabapentin at 100 to 900 mg/d. Symptomatic relief was achieved in 68% of the patients. Sensory neuropathy of the recurrent laryngeal nerve or superior laryngeal nerve should be considered in the workup for chronic cough or larynx irritability. Symptomatic management of patients with cough and laryngospasm due to a suspected sensory neuropathy may include the use of antiseizure medications such as gabapentin.


Leggett JJ, Johnston BT, Mills M, Gamble J, Heaney LG. Prevalence of gastroesophageal reflux in difficult asthma: relationship to asthma outcome. Chest. 2005 Apr;127(4):1227-31.

Regional Respiratory Centre, Level 8, Belfast City Hospital, Lisburn Rd, Belfast, BT97AB, UK.

STUDY OBJECTIVES: To determine the prevalence of gastroesophageal reflux disease (GERD)-both symptoms and objective evidence-using 24-h dual-probe pH monitoring in difficult asthma, and the relationship between the presence and treatment of GERD to clinical outcome. DESIGN AND SETTING: As part of a systematic evaluation protocol, 68 subjects with difficult-to-control asthma attending a difficult asthma clinic were referred for dual-probe ambulatory pH esophageal monitoring. RESULTS: Esophageal probe data were available in 52 patients (76%) with difficult asthma. The prevalence of GERD/GERD-associated asthma symptoms was 75% (39 of 52 patients; 95% confidence interval [CI], 63 to 84.7%). The prevalence of GERD as evidenced by an abnormal pH profile at the distal esophageal probe was 55% (29 of 52 patients; 95% CI, 40 to 69%). The prevalence of GERD at the proximal probe was 34.6% (18 of 52 patients; 95% CI, 23.6 to 51%). The prevalence of GERD was similar in asthmatic subjects who responded to intervention and those who remained difficult to control (therapy resistant). Asymptomatic GERD was present in 9.6% (5 of 52 patients); 16% of cough episodes correlated with acid reflux. CONCLUSIONS: In difficult-to-control asthma, GERD is common, but identification and treatment of GERD do not appear to relate to improvement in asthma control in this population.


Linehan MF, Hazell ML, Frank TL, Frank PI. Prevalence of respiratory symptoms in under 5s: 1993 to 2001. Arch Dis Child. 2005 May;90(5):516-9.

General Practice Research Unit, North West Lung Research Centre, Wythenshawe Hospital, Manchester M23 9LT, UK.

AIM: To describe changes in the prevalence of respiratory symptoms in 1-4 year olds in two general practice populations observed on four occasions over an eight year period. METHODS: In 1993, 1995, 1999, and 2001, questionnaires were posted to the parents of patients aged 15 years or younger and registered with either of two general practices. Only children aged 1-4 years at time of questionnaire completion were included in this study. For each survey, the prevalence of five key variables was determined. RESULTS: The response rates for all children in the four surveys were 72.8%, 70.6%, 65.0%, and 60.7% respectively. When respondents aged 1-4 years old were stratified into one-year age bands, there was a decrease in the prevalence of symptoms over the study period. This was statistically significant for wheeze and night cough in 2 year olds and for night cough in 4 year olds. Repeated antibiotic prescriptions decreased significantly for 2 and 3 year olds. There were no changes in the prevalence of hay fever or eczema and family history of asthma. CONCLUSIONS: The downward trend in symptom prevalence might represent a real decrease in symptoms or improvements in treatment. In the absence of changes in the prevalence of hay fever and family history of asthma, the downward trend in symptom prevalence may suggest changes in the prevalence of conditions other than asthma.


Stewart JH. Hypnosis in contemporary medicine. Mayo Clin Proc. 2005 Apr;80(4):511-24.

Department of Internal Medicine and Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Jacksonville, Fla 32224, USA.

Hypnosis became popular as a treatment for medical conditions in the late 1700s when effective pharmaceutical and surgical treatment options were limited. To determine whether hypnosis has a role in contemporary medicine, relevant trials and a few case reports are reviewed. Despite substantial variation in techniques among the numerous reports, patients treated with hypnosis experienced substantial benefits for many different medical conditions. An expanded role for hypnosis and a larger study of techniques appear to be indicated.

Diagnosis, Diagnostics, Immunodiagnosis & Immunodiagnostics:

12525.   Acharya V, Sahoo R, Shenoy SM, Antony S, Anand R. Study of isolation of Mycoplasma pneumoniae in asthmatics by sputum culture. Lung India. 2005 Apr; 22(2): 50-53.

12526.  Albsoul-younes AM, Al-Doghim IA, Al-Safi SA, Najada AS. Improving quality of life in asthmatic children. Indian J Pediat 2004;71(120):1075-8.

12527.  Douwes J. (1-->3)-Beta-D-glucans and respiratory health: a review of the scientific evidence. Indoor Air. 2005 Jun;15(3):160-9. Review.

12528.   Fardon TC, Lipworth BJ. An own GOAL or a real breakthrough? Am J Respir Crit Care Med. 2005 May 1;171(9):1060

12529.  Fass R, Quan SF, O'Connor GT, Ervin A, Iber C. Predictors of heartburn during sleep in a large prospective cohort study. Chest. 2005 May;127(5):1658-66. 

12530.  Haque RA, Usmani OS, Barnes PJ. Chronic idiopathic cough: a discrete clinical entity? Chest. 2005 May;127(5):1710-3.

12531.  Larsen GL, Kang JK, Guilbert T, Morgan W. Assessing respiratory function in young children: Developmental considerations. J Allergy Clin Immunol. 2005 Apr;115(4):657-66; quiz 667. Review. 

12532.  Lee B, Woo P. Chronic cough as a sign of laryngeal sensory neuropathy: diagnosis and treatment. Ann Otol Rhinol Laryngol. 2005 Apr;114(4):253-7. 

12533.  Leggett JJ, Johnston BT, Mills M, Gamble J, Heaney LG. Prevalence of gastroesophageal reflux in difficult asthma: relationship to asthma outcome. Chest. 2005 Apr;127(4):1227-31.

12534.  Linehan MF, Hazell ML, Frank TL, Frank PI. Prevalence of respiratory symptoms in under 5s: 1993 to 2001. Arch Dis Child. 2005 May;90(5):516-9.

12535.  Poulose V. CO2 retention in acute severe asthma. Chest. 2005 May;127(5):1867.


12536.    Argalious M, Motta P, Khandwala F, Samuel S, Koch CG, Gillinov AM, Yared JP, Starr NJ, Bashour CA. "Renal dose" dopamine is associated with the risk of new-onset atrial fibrillation after cardiac surgery. Crit Care Med. 2005 Jun;33(6):1327-32.

12537.  Gerard C. Biomedicine. Asthmatics breathe easier when it's SNO-ing. Science. 2005 Jun 10;308(5728):1560-1.

12538.  Holgate ST, Holloway JW. Is big beautiful? The continuing story of ADAM33 and asthma. Thorax. 2005 Apr;60(4):263-4.

12539.  Holloway JW, Yang IA. Beta2-Adrenergic receptor polymorphism and asthma: true or false? J Allergy Clin Immunol. 2005 May;115(5):960-2. Review.

12540.  Huerta C, Lanes SF, Garcia Rodriguez LA. Respiratory medications and the risk of cardiac arrhythmias. Epidemiology. 2005 May;16(3):360-6. 

12541.  Joffe A, Radius S. Symptom-free day--$68; 2 weeks of childhood--priceless. Arch Pediatr Adolesc Med. 2005 May;159(5):498-9.

12542.  Lilly CM. Diversity of asthma: evolving concepts of pathophysiology and lessons from genetics. J Allergy Clin Immunol. 2005 Apr;115(4 Suppl):S526-31. Review.

12543.  Moffatt M, Hysi P, Cookson W. Haplotypes and asthma. Am J Respir Crit Care Med. 2005 May 15;171(10):1066-7.

12544.  Parnham MJ. Immunomodulatory effects of antimicrobials in the therapy of respiratory tract infections. Curr Opin Infect Dis. 2005 Apr;18(2):125-31. Review.

12545.  Schatz M, Chen PT, Macy E, Zeiger RS. Dispensing of proton pump inhibitor medication is independently associated with subsequent asthma emergency hospital utilization. Am J Med. 2005 Apr;118(4):431-4.

12546.  Schenker MB. Farming and asthma. Occup Environ Med. 2005 Apr;62(4):211-2.

12547.  Schmidt LM, Gotzsche PC. Of mites and men: reference bias in narrative review articles: a systematic review. J Fam Pract. 2005 Apr;54(4):334-8. Review.

12548.  Shapiro SD. COPD unwound. N Engl J Med. 2005 May 12;352(19):2016-9.

12549.  Suzuki K, Ohshima Y, Hata I, Tsukahara H, Omata N, Yasutomi M, Yamada A, Mayumi M. Salivary-type hyperamylasemia in theophylline poisoning. Pediatr Int. 2005 Apr;47(2):209-10.

12550.  Tang RB. Risk factors associated with the development of asthma. J Chin Med Assoc. 2005 May;68(5):199-201.

12551.  Trasande L, Thurston GD. The role of air pollution in asthma and other pediatric morbidities. J Allergy Clin Immunol. 2005 Apr;115(4):689-99. Review.


12552.   Broeders ME, Molema J, Burnell PK, Folgering HT. Ventolin Diskus and Inspyril Turbuhaler: an in vitro comparison. J Aerosol Med. 2005 Spring;18(1):74-82.

12553.   Bruton A, Holgate ST. Hypocapnia and asthma: a mechanism for breathing retraining? Chest. 2005 May;127(5):1808-11. 

12554.   Bruton A, Lewith GT. The Buteyko breathing technique for asthma: a review. Complement Ther Med. 2005 Mar;13(1):41-6.

12555.  Chu EK, Drazen JM.   Asthma: one hundred years of treatment and onward. Am J Respir Crit Care Med. 2005 Jun 1;171(11):1202-8.

12556.  Fabbri LM.  Does mild persistent asthma require regular treatment? N Engl J Med. 2005 Apr 14;352(15):1589-91.

12557.  Food and Drug Administration, HHS. Use of ozone-depleting substances; removal of essential-use designations. Final rule. Fed Regist. 2005 Apr 4;70(63):17167-92.

12558.  French B. Evaluating research for use in practice: what criteria do specialist nurses use? J Adv Nurs. 2005 May;50(3):235-43. 

12559.  Gijsbers B, Mesters I, Andre Knottnerus J, Legtenberg AH, van Schayck CP. Factors influencing breastfeeding practices and postponement of solid food to prevent allergic disease in high-risk children: results from an explorative study. Patient Educ Couns. 2005 Apr;57(1):15-21. 

12560.  Janse AJ, Uiterwaal CS, Gemke RJ, Kimpen JL, Sinnema G. A difference in perception of quality of life in chronically ill children was found between parents and pediatricians. J Clin Epidemiol. 2005 May;58(5):495-502.

12561.  Kalra M, Buncher R, Amin RS. Asthma as a risk factor for respiratory complications after adenotonsillectomy in children with obstructive breathing during sleep. Ann Allergy Asthma Immunol. 2005 May;94(5):549-52.

12562.  Laforest L, Pacheco Y, Bartsch P, Vincken W, Pietri G, Ernst P, Berard A, Van Ganse E.  Correlates of quality of life in patients with asthma. Ann Allergy Asthma Immunol. 2005 Apr;94(4):473-9.

12563.  Lata Kumar, Rajpur N, Majumdar S. Nitric oxide metabolites in induced sputum: a noninvasive marker of airway inflammation in asthma. Indian Pediatrics. 2005 Apr; 42(4): 329-337.

12564.  Lucas SR, Platts-Mills TA. Physical activity and exercise in asthma: relevance to etiology and treatment. J Allergy Clin Immunol. 2005 May;115(5):928-34. Review.

12565.  Senthilselvan A, Lawson JA, Rennie DC, Dosman JA. Regular use of corticosteroids and low use of short-acting beta2-agonists can reduce asthma hospitalization. Chest. 2005 Apr;127(4):1242-51.

12566.  Shirai T, Matsui T, Suzuki K, Chida K. Effect of pet removal on pet allergic asthma. Chest. 2005 May;127(5):1565-71.

12567.  Stewart JH. Hypnosis in contemporary medicine. Mayo Clin Proc. 2005 Apr;80(4):511-24. Review.

12568.  Suissa S, Ernst P. Bias in observational study of the effectiveness of nasal corticosteroids in asthma. J Allergy Clin Immunol. 2005 Apr;115(4):714-9.

12569. Suresh S, Pathak S. Chronotherapeutics: emerging role of biorhythms in optimizing drug therapy. Indian Journal of Pharmaceutical Sciences. 2005 Mar-Apr; 67(2): 135-140.