The American review of respiratory disease
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Am. Rev. Respir. Dis. · Oct 1990
ReviewDifferential roles of opioid receptors in respiration, respiratory disease, and opiate-induced respiratory depression.
In summary, these findings indicate the importance of designing future experiments that delineate between opioid and nonopioid forms of respiratory disease and dysfunction, and the need to identify means of diagnosing them in order to achieve successful recovery. Apparently there is great diversity between animal species in terms of contributions of endogenous opioids to tonic control of ventilation, and future work should strive to identify which species is most appropriate as a model of human ventilatory control and disease. Certain opioid receptor types appear to be linked to independent respiratory functions. ⋯ This may be achieved by creating drugs selective for single receptors or by creating drugs with desirable combinations of receptor selectivities. The combinations of mixed agonists/antagonists with pure mu agonists currently in use today are promising, as they provide analgesia with reduced respiratory depression. In the early days of opiate research and development, combination drug regimens were thoroughly tested to determine the "ideal ratios" that would retain analgesic properties but not the other undesirable effects such as respiratory depression (196).(ABSTRACT TRUNCATED AT 400 WORDS)
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Am. Rev. Respir. Dis. · Sep 1989
ReviewChronic obstructive pulmonary disease: a definition and implications of structural determinants of airflow obstruction for epidemiology.
Chronic obstructive pulmonary disease (COPD) may be defined as a process characterized by the presence of chronic bronchitis or emphysema that may lead to the development of airways obstruction; airways obstruction need not be present at all stage of the process and may be partially reversible. The pathologic changes in the lungs due to smoking affect three regions: the bronchi, bronchioles, and parenchyma. The bronchi show enlargement of the submucosal glands with dilation of their ducts; infiltration with neutrophils and lymphocytes is present but not prominent. ⋯ The compliance of the lungs of smokers is decreased even when a emphysema and airflow limitation are mild. Standard epidemiologic tools do not differentiate emphysema from other causes of airflow obstruction. Most persons dying of COPD will have severe emphysema.
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Am. Rev. Respir. Dis. · Aug 1989
ReviewIntensive care unit survival of patients with systemic illness.
Many patients with systemic illness are admitted to intensive care units (ICUs) and placed on life support. This occurs in patient populations even when the projected mortality rate might be as high as 80 to 90%. Patients with systemic illness often are life-support-dependent in ICUs as chronically critically ill patients for many weeks. ⋯ Numerous studies have identified that chronologic age is associated with increased mortality rates. However, a better assessment would be biologic age, which would take into account both chronologic age and health status. ICU survival of patients with cancer, hematologic neoplasms, renal failure, liver failure, AIDS, and burns is reviewed.(ABSTRACT TRUNCATED AT 250 WORDS)