49 research outputs found
Clinical applications of infant lung function testing
The studies in this thesis show that research in the field of lung function
testing in infants has moved from methodological issues towards clinical applications.
This development is mainly the result of publications of guidelines for
infant lung function testing and standardization of the equipment used, by the
European Respiratory Society en de American Thoracic Society (ERS/ATS)
(7-10). As a result, normative data have become available for different lung
function methods, allowing comparison of data from different centers. In
addition, several biomedical engineering companies have marketed equipment
with specifications according to the guidelines given by the ERS/ATS. These
developments are a necessity for wide applications of infant lung function
testing in a clinical setting, such as collaborative studies and multicenter drug
trials in infants with airway disease (II). On the other hand, there are high costs
for buying complete recording systems and training the staff. In addition, most
methods require sedation of the infant. Therefore, infant lung function
measurements will probably be established primarily in larger, mostly academic,
centers. The forthcoming challenges for those involved in this field will
be to develop methods that are cheap to buy and simple to use, still providing
essential information. These methods should be applicable in infants without
sedation. When this has been achieved, infant lung function testing may even move out of the clinic (II)
Blue rubber-bleb naevus syndrome: report of a case with consumption coagulopathy complicated by manifest thrombosis
Abstract
Blue rubber-bleb naevus (BRBN) syndrome is a rare disorder characterized by subcutaneous and gastrointestinal haemangiomas. The latter may lead to bleeding complications. A case is reported in which a process of chronic intravascular coagulation resulted in serious thrombotic complications. In the presence of a chronic consumption coagulopathy, it remains uncertain whether antiplatelet drugs are of prophylactic antithrombotic value
Exhaled nitric oxide predicts asthma relapse in children with clinical asthma remission
BACKGROUND: Nitric oxide in exhaled air (FE(NO)) is a marker of
eosinophilic airway inflammation. A study was undertaken to determine
whether FE(NO) predicts asthma relapse in asymptomatic asthmatic children
in whom inhaled corticosteroids are discontinued. METHODS: Forty children
(21 boys) of mean age 12.2 years on a median dose of 400 mug budesonide or
equivalent (range 100-400) were included. FE(NO) was measured before and
2, 4, 12, and 24 weeks after withdrawal of steroids. A relapse was defined
as more than one exacerbation per month, or need for beta agonist
treatment on 4 days per week for at least 2 weeks, or diurnal peak flow
variability of >20%. FE(NO) measurements were performed online with an
expiratory flow of 50 ml/s. RESULTS: Nine patients relapsed. Two and 4
weeks after withdrawal of steroids geometric mean FE(NO) in children who
were about to relapse was higher than in those who did not relapse: 35.3
ppb v 15.7 ppb at 2 weeks (ratio 2.3; 95% CI 1.2 to 4.1; p = 0.01) and
40.8 ppb v 15.9 ppb at 4 weeks (ratio 2.6; 95% CI 1.3 to 5.1). An FE(NO)
value of 49 ppb at 4 weeks after discontinuation of steroids had the best
combination of sensitivity (71%) and specificity (93%) for asthma relapse.
CONCLUSION: FE(NO) 2 and 4 weeks after discontinuation of steroids in
asymptomatic asthmatic children may be an objective predictor of asthma
relapse
Exhaled nitric oxide measurements with dynamic flow restriction in children aged 4-8 yrs
Fractional exhaled nitric oxide concentration (FENO) depends on exhalation
flow; however, children often are unable to perform controlled flow
procedures. Therefore, a device was developed for off-line FENO sampling,
with dynamic flow restriction (DFR). The authors compared off-line w
Compliance, hysteresis, and collapsibility of human small airways
We tested the hypothesis that airway wall dimensions are important
determinants for the mechanical properties of airways. Lung tissue was
obtained from 31 smokers with different degrees of chronic obstructive
pulmonary disease (COPD) who were operated on for a solitary lung lesion.
Segments of small airways (n = 35) were mounted on cannulas in an organ
bath and inflated and deflated cyclically between +15 and -15 cm H(2)O.
For each airway this was done at baseline, after methacholine, and after
isoprenaline. Specific compliance (sCdyn), specific hysteresis (seta), and
pressure at which the airways collapsed (Pcol) were calculated from each
recording. Airway wall dimensions were measured morphometrically. Lung
function parameters of airflow obstruction were correlated to sCdyn, seta,
and Pcol. At baseline, after methacholine, and after isoprenaline sCdyn
was 0.059, 0.052, and 0. 085 cm H(2)O(-)(1), seta was 13.5, 12.9, and
7.1%, and Pcol was -3.4, -3.5, and -1.9 cm H(2)O, respectively.
Differences between sCdyn, seta, and Pcol after methacholine and after
isoprenaline were highly significant (p < 0.001). Of all dimensions
studied, smooth muscle area, but not total wall ar
Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine
[This corrects the article DOI: 10.1186/s13054-016-1208-6.]