Lung
-
Chronic cough is a common condition that causes considerable physical and psychological morbidity. The physical symptoms of cough are readily apparent; however, the psychosocial symptoms are often overlooked. ⋯ They should be used in conjunction with other cough severity measures such as cough frequency monitors to obtain a more complete assessment of cough severity. Recent cough guidelines endorse the measurement of cough-specific quality of life and these questionnaires are ideal tools to facilitate this.
-
The aim of this retrospective study was to determine the utility of the spirometric measurements FVC, FEV1, and FEV1/FVC in diagnosing pulmonary restriction. Spirometry and lung volume measurements performed on the same patient visit were analyzed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of (1) FVC
or=LLN were compared to diagnose restriction based on lung volume measurements. ⋯ Consistent with earlier findings, the negative predictive value for a normal FVC (>or=LLN) to exclude pulmonary restriction was high in this series (up to 95.7%). Also, a spirometric diagnosis of "restriction" (FVC or=LLN) had a positive predictive value of 26.3-73.9%. On this basis, normal FVC can be regarded as excluding restriction with high reliability. -
Comparative Study Clinical Trial
Increased pleural fluid adenosine deaminase levels in patients with malignant pleural effusions: a potential predictor of talc pleurodesis outcome.
Chemical pleurodesis using various sclerosing agents is accepted palliative therapy for patients with recurrent, symptomatic, malignant pleural effusions (MPE). However, the utility of various clinical and biochemical parameters in predicting pleurodesis outcome is still controversial. The objective of this study was to investigate the relationship between pleural fluid adenosine deaminase (Pf-ADA) levels and talc pleurodesis outcomes, and to compare Pf-ADA levels to various other biochemical variables with respect to predicting talc pleurodesis outcome in patients with MPE. ⋯ In analysis of the subgroup, Pf-ADA were found to be a good marker for discrimination between successful and unsuccessful pleurodesis in patients with MM (p < 0.001) but not in the MPC group (p = 0.068). These results indicate that Pf-ADA levels could be considered predictors of the outcome of pleurodesis, especially in patient with MM. Furthermore, the present study also demonstrated that Pf-ADA level is a superior test to predict the outcome of pleurodesis compared to pleural fluid pH and albumin level.
-
Comparative Study
Pleural mesothelial cells mediate inflammatory and profibrotic responses in talc-induced pleurodesis.
Intrapleural talc is used to produce pleurodesis in malignant pleural effusions. Prior in vivo studies have documented an acute inflammatory response to talc in the pleural space but the cellular source of cytokines has not been identified. The aim of this study was to investigate the acute response of rabbit pleural mesothelial cells challenged with talc used for pleurodesis and compare it to prior studies of the response to talc in the rabbit pleural space. ⋯ At 6 h, the IL-8, VEGF, and TGF-beta(1) levels produced by talc-exposed PMC increased significantly and remained elevated for up to 48 h. These cytokine levels rose at similar times and at the same or higher levels than have been measured in the rabbit pleural space in prior studies. We report that viable, talc-exposed, pleural mesothelial cells may actively mediate the primary inflammatory pleural response in talc-induced pleurodesis.
-
A recent study showed that long-term administration of the inducible nitric oxide synthase (iNOS) inhibitor L-NIL reduced the development of pulmonary hypertension. The purpose of the present study was to identify the effect of an another iNOS inhibitor, ONO-1714, on the development of pulmonary hypertensive vascular changes in chronic hypoxic pulmonary hypertension in rats. ONO-1714 was administered to rats exposed to hypobaric hypoxia (air at 380 mmHg) for 10 days. ⋯ There were no significant differences among rats with and without long-term administration of ONO-1714 in pulmonary artery pressure, right ventricular hypertrophy, medial wall thickness of muscular arteries, and the percentage of muscularized arteries at the alveolar wall and duct levels. Although there was a significantly increased expression of iNOS as assessed with the reverse-transcription polymerase chain reaction in rats that were exposed to 10 days of hypobaric hypoxia, we could not detect a significant level of iNOS protein by Western blotting. ONO-1714 does not have a therapeutic role in preventing the development of chronic hypoxic pulmonary hypertension.