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Pulse Oximetry in Pediatric Practice

The introduction of pulse oximetry in clinical practice has allowed for simple, noninvasive, and reasonably accurate estimation of arterial oxygen saturation. Pulse oximetry is routinely used in the emergency department, the pediatric ward, and in pediatric intensive and perioperative care. However, clinically relevant principles and inherent limitations of the method are not always well understood by health care professionals caring for children. The calculation of the percentage of arterial oxyhemoglobin is based on the distinct characteristics of light absorption in the red and infrared spectra by oxygenated versus deoxygenated hemoglobin and takes advantage of the variation in light absorption caused by the pulsatility of arterial blood. Computation of oxygen saturation is achieved wit...

Flutiform® Offers Safe And Efficient Treatment For Asthma Patients, Phase III Study Data

At the European Respiratory Society (ERS) congress data from three phase III studies presented by Napp Pharmaceuticals Ltd. showed that using a single aerosol inhaler flutiform, a combination of fluticasone propionate (fluticasone) an inhaled corticosteroid (ICS) and formoterol fumarate (formoterol), a long-acting β2-agonist (LABA), can offer a safe and efficient treatment for patients with asthma. The data presented supports previous studies that have demonstrated the efficacy and safety of the fluticasone/formoterol combination in adults and adolescents (aged 12 years and above)... (Source: Health News from Medical News Today)

Real‐time Four‐dimensional Radiotherapy for Lung Cancer

Respiratory motion considerably influences dose distribution and thus clinical outcomes in radiotherapy for lung cancer. Breath‐holding, breath‐coaching, respiratory gating with external surrogates, and mathematical predicting models all have inevitable uncertainty due to the unpredictable variations of internal tumor motion. The amplitude of the same tumor can vary with standard deviations > 5mm occurring in 23% of T1‐2N0M0 non‐small cell lung cancers. Residual motion varied 1 to 6 mm (95th percentile) for the 40% duty cycle of respiratory gating with external surrogates. The four‐dimensional computed tomography are all vulnerable to problems relating to the external surrogates. Real‐time four‐dimensional radiotherapy (4DRT), where the temporal changes in anatomy during t...

Regulation of neutrophils by interferon-{gamma} limits lung inflammation during tuberculosis infection.

Resistance to Mycobacterium tuberculosis requires the host to restrict bacterial replication while preventing an over-exuberant inflammatory response. Interferon (IFN) γ is crucial for activating macrophages and also regulates tissue inflammation.

We dissociate these two functions and show that IFN-γ(-/-) memory CD4(+) T cells retain their antimicrobial activity but are unable to suppress inflammation. IFN-γ inhibits CD4(+) T cell production of IL-17, which regulates neutrophil recruitment. In addition, IFN-γ directly inhibits pathogenic neutrophil accumulation in the infected lung and impairs neutrophil survival. Regulation of neutrophils is important because their accumulation is detrimental to the host.

We suggest that neutrophilia during tuberculosis indicates failed Th1 immunity or loss of IFN-γ responsiveness. These results establish an important antiinflammatory role for IFN-γ in host protection against tuberculosis.

Triggers of asthma and COPD: Are they different?

Asthma symptoms can be triggered by a variety of factors commonly referred to as "triggers". Some of these factors can also induce severe asthma exacerbations. Thus, it can be assumed that actions taken against such triggers may prevent the progression of the disease. However, limited data exist on the clinical importance of these triggers in patients with chronic obstructive pulmonary disease (COPD).

OBJECTIVE: To compare the effect of triggers on symptoms and actions taken against certain modifiable triggers in patients with asthma and COPD.

METHODS: The study was conducted in a university hospital between June 2009 and June 2010. Patients with asthma and COPD were asked to complete a questionnaire in which both the factors triggering symptoms and the actions taken against several triggers were assessed.

RESULTS: Three hundred consecutive adult patients (150 asthma, 150 COPD) were enrolled to the study. The frequency of triggering factors was similar in both groups. Vaccination rates for influenza and pneumococcus were significantly higher in patients with COPD. However, such anti-allergic approaches as the use of strategies to decrease dust exposure, the use of anti-mite bed sheets, and the removal of pets from the home were more commonly employed by asthmatic patients.

CONCLUSION: This study revealed that certain triggers affected COPD and asthma patients to the same degree. Therefore, triggers and strategies for controlling modifiable triggers should be more concentrated on during education in both groups. However, the preventive effect of these strategies on disease progression, particularly in patients with COPD, needs clarification.

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