Current Respiratory Medicine Reviews - Volume 2, Issue 3, 2006

Bronchopulmonary Dysplasia (BPD) continues to be a major problem despite advances in the management of the sick preterm. Current evidence supports a multifactorial etiology to this disease. Prematurity is the cardinal factor; others include pulmonary baro/volu trauma, hyperoxia, and inflammation. A clearer understanding of genetic susceptibility for BPD has recently emerged. Twin studies have shown that 53% of the Read More

Airways are protected from pathogens by forces allied with innate and adaptive immunity. Recent investigations establish critical defensive roles for leukocyte and mast cell serine-class peptidases garrisoned in membrane-bound organelles-here termed Granule-Associated Serine Peptidases of Immune Defense, or GASPIDs. Some better characterized GASPIDs include neutrophil elastase and cathepsin G (which defend against b Read More

Small airway plays a major role in viral infection of the respiratory tract in infants and young children. Indeed these early viral infections have been shown to lead to airway remodeling and early development of non allergic asthma by affecting the expression of critical growth factors. In the old child and adult however, and until very recently, asthma has been considered largely a disease of the large airways. But as our understa Read More

Ventilator associated pneumonia remains a cause of significant morbidity and mortality in Intensive Care patients despite advances in knowledge and technology. The presence of an endotracheal tube bypassing the normal airway barriers, oropharyngeal bacterial colonisation, patient position and repetitive micro-aspiration tip the host-pathogen relationship in favour of the pathogen and promote lung infection in a time-depen Read More

Chronic obstructive pulmonary disease (COPD) is a common, complex disorder, and dissection of its individual components is considered one of the research priorities for this disease. Several lines of evidence suggest that, in spite of the massive role of cigarette smoking, common COPD is not just an environmental phenocopy of COPD associated with alpha1-antitrypsin deficiency: from the racial/ethnic variability in COPD preval Read More

Pleural diseases are a commonly encountered problem by general physicians and chest specialists alike. Despite this, there has been a lack of research over the last few decades in this important field. This review focuses on new developments in the management of pleural effusions. We have restricted our attention, in the main, to randomised controlled trials. The review is evidence-based with practical suggestions from Read More

Exposure to hyperoxia (> 95% O2) is a necessary therapeutic treatment used to maintain tissue oxygenation in patients with compromised lung function and decreased pulmonary gas exchange. Hyperoxia causes increased formation of reactive oxygen species (ROS), which accumulate in the cells of the lung resulting in cell death and compromised tissue function. Recent observations have demonstrated that different lung Read More

Pulse oximetry is commonly used in clinical practice as an indirect monitor of blood oxygen saturation. There are many factors, however, that can interfere with accurate readings. We present a case of a woman with metastatic thyroid cancer that had a sudden drop in her pulse oximetry during bronchoscopy and that eventually was found to have an uncommon cause for a misleading persistently low oxygen saturation.

For decades, neurologic and pulmonary disorders have been associated to diabetes mellitus (DM) and more recently to obesity. Many studies have attempted to establish the association between sleep apnea and adult-onset DM. Growing evidence exists demonstrating the association between insulin-resistance and obstructive sleep apnea (OSA), as well as sleep-disordered breathing (SDB) in non-obese diabetic patients with aut Read More

Thickening of the basement membrane zone (BMZ) is a characteristic feature of airway remodeling. The BMZ appears as three component layers: the laminas lucida, densa, and reticularis. The lamina reticularis of the BMZ is thickened in asthma, allergic rhinitis, eosinophil bronchitis and lung transplants. Collagen types I, III and V form heterogeneous fibers that account for the thickness of the BMZ. Proteoglycans are structura Read More

The selectin family of cell adhesion molecules (selectins) is comprised of three structurally related calciumdependent carbohydrate binding proteins, E-, P-, and L-selectin. Located on the surface of endothelial cells (E- and Pselectin), platelets (P-selectin) and of leucocytes (L-selectin), selectins are of vital importance for leukocyte recruitment and accumulation in the vasculature. Based on the unique architecture of the Read More