American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2013
ReviewExercise-induced pulmonary hypertension: physiological basis and methodological concerns.
Exercise stresses the pulmonary circulation through increases in cardiac output (. Q) and left atrial pressure. Invasive as well as noninvasive studies in healthy volunteers show that the slope of mean pulmonary artery pressure (mPAP)-flow relationships ranges from 0.5 to 3 mm Hg.min. ⋯ Exercise has to be dynamic to avoid the increase in systemic vascular resistance and abrupt changes in intrathoracic pressure that occur with resistive exercise and can lead to unpredictable effects on the pulmonary circulation. Postexercise measurements are unreliable because of the rapid return of pulmonary vascular pressures and flows to the baseline resting state. Recent studies suggest that exercise-induced increase in PAP to a mean higher than 30 mm Hg may be associated with dyspnea-fatigue symptomatology.
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Am. J. Respir. Crit. Care Med. · Mar 2013
Quantifying health services use for chronic obstructive pulmonary disease.
Chronic obstructive pulmonary disease (COPD), a common manageable condition, is a leading cause of death. A better understanding of its impact on health-care systems would inform strategies to reduce its burden. ⋯ Individuals with COPD use large and disproportionate amounts of health services. Strategies that target this group are needed to improve their health and minimize their need for health services.
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Epigenetic and/or genetic variation in the gene encoding the receptor for adenylate-cyclase activating polypeptide 1 (ADCYAP1R1) has been linked to post-traumatic stress disorder in adults and anxiety in children. Psychosocial stress has been linked to asthma morbidity in Puerto Rican children. ⋯ Epigenetic and genetic variants in ADCYAP1R1 are associated with asthma in Puerto Rican children.
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Am. J. Respir. Crit. Care Med. · Mar 2013
Pathogenic bacteria colonizing the airways in asymptomatic neonates stimulates topical inflammatory mediator release.
Bacterial colonization of neonatal airways with the pathogenic bacterial species, Moraxella catarrhalis, Streptococcus pneumoniae, and Haemophilus influenzae, is associated with later development of childhood asthma. ⋯ M. catarrhalis and H. influenzae colonization of the airways of asymptomatic neonates is associated with an inflammatory immune response of the airway mucosa, which may result in chronic inflammation.