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Increased H1N1 Infection Rate in Children with Asthma.

CONCLUSION: During peak 2009 H1N1 Flu season, asthmatic children were infected almost twice as often with H1N1 compared to other respiratory viruses. H1N1 infection also caused increased severity of cold symptoms compared to other viral infections. Given the increased susceptibility for infection in asthmatics, these findings reinforce the need for yearly influenza vaccination to prevent infection, and raise new questions about the mechanism for enhanced susceptibility to influenza infection in asthma.

Subclinical Interstitial Lung Disease: Why you Should Care.

The widespread use of high-resolution computed tomography in clinical and research settings has increased the detection of interstitial lung abnormalities (ILA) in asymptomatic and undiagnosed individuals.

We recently reported that in smokers, ILA were present in about 1 of every 12 high-resolution computed tomography (HRCT) scans, however the long-term significance of these subclinical changes remains unclear. Studies in families affected with pulmonary fibrosis, smokers with COPD, and patients with inflammatory lung disease, have shown that asymptomatic and undiagnosed individuals with ILA have reductions in lung volumes, functional limitations, increased pulmonary symptoms, histo-pathologic changes, and molecular profiles simi...

Air pollution and chronic obstructive pulmonary disease

Limited data suggest that outdoor air pollution (such as ambient air pollution or traffic‐related air pollution) and indoor air pollution (such as second‐hand smoking and biomass fuel combustion exposure) are associated with the development of chronic obstructive pulmonary disease (COPD), but there is insufficient evidence to prove a causal relationship at this stage. It also appears that outdoor air pollution is a significant environmental trigger for acute exacerbation of COPD, leading to increasing symptoms, emergency department visits, hospital admissions and even mortality.

Improving ambient air pollution and decreasing indoor biomass combustion exposure by improving home ventilation are effective measures that may substantially improve the health of the general public. (S...

Asthma and obesity: A known association but unknown mechanism

The obese asthma phenotype is an increasingly common encounter in our clinical practice. Epidemiological data indicate that obesity increases the prevalence and incidence of asthma, and evidence that obesity precedes the development of asthma raises the possibility of a causal association. Obese patients with asthma experience more symptoms and increased morbidity compared with non‐obese asthma patients. Despite more than a decade of research into this association, the exact mechanisms that underlie the interaction of obesity with asthma remain unclear.

It is unlikely that the asthma–obesity association is simply due to comorbidities such as obstructive sleep apnoea or gastroesophageal reflux disease. Although inflammatory pathways are purported to play a role, there is scant d...

Link between chronic obstructive pulmonary disease and coronary artery disease: Implication for clinical practice

Chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD) are global epidemics that incur significant morbidity and mortality. These diseases are frequently found in combination, and they can also be found independent of the common causal factors, primarily smoking. Both conditions are systemic disorders with overlapping mechanisms and pathophysiologic processes.

CAD has a strong effect on the severity and prognosis of COPD and vice versa, including acute exacerbations. Even the most recent practical clinical recommendations driven by Clinical Practice Guidelines still focus on one disease at a time, and do not provide advice for the management of patients with associated chronic conditions. COPD should be approached in a more comprehensive manner, including th...

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