Conclusions: Anaemia is frequent not only in COPD but also in other severe respiratory diseases combined with CRF. It was associated with advanced age, several comorbidities, impaired nutritional state and elevations of pH and PaO2, probably because of hyperventilation. Its prognostic impact has to be elucidated in future studies.
Daytime hypercapnia that develops in morbidly obese individuals in the absence of concurrent lung or neuromuscular disease is referred to as the obesity hypoventilation syndrome (OHS). The characteristic polysomnographic (PSG) abnormality is marked sleep hypoxemia. Although the likelihood of hypoventilation increases with increasing body mass index (BMI), it is too simplistic to think of this disorder arising merely from chest wall restriction due to excess weight.
Rather, this is a disorder which emerges when the compensatory mechanisms that normally operate to maintain ventilation appropriate for the level of obesity are impaired. OHS develops from a complex interaction between abnormal respiratory function, sleep disordered breathing and diminished respiratory drive. Irrespecti...
Use of the inhaled corticosteroid budesonide is not associated with an increased risk for pneumonia in asthma patients, results from a review of published studies indicate.
The ability to diagnose and monitor asthma on the basis of noninvasive measurements of airway cellular dysfunction is difficult in the typical clinical setting.
Objective: Metabolomics is the study of molecules created by cellular metabolic pathways. We hypothesized that the metabolic activity of children with asthma would differ from healthy children without asthma. Furthermore, children having an asthma exacerbation would be different compared with children with stable asthma in outpatient clinics. Finally, we hypothesized that 1H-nuclear magnetic resonance (NMR) would measure such differences using urine samples, one of the least invasive forms of biofluid sampling.
Methods: Children (135 total, ages 4-16 years) were enrolled, having met the criteria of healthy controls (C), stable asthma in the outpatient clinic (AO), or unstable asthma in the emergency department (AED). Partial least squares discriminant analysis was performed on the NMR data to create models of separation (70 metabolites were measured/urine sample). Some NMR data were withheld from modeling to be run blindly to determine possible diagnostic accuracy.
Results: On the basis of the model of AO versus C, 31 of 33 AO samples were correctly diagnosed with asthma (94% accuracy). Only 1 of 20 C samples was incorrectly labeled as asthma (5% misclassification). On the basis of the AO versus AED model, 31 of the 33 AO samples were correctly diagnosed as outpatient asthma (94% accurate).
Conclusion: This is the first report suggesting that 1H-NMR analysis of human urine samples has the potential to be a useful clinical tool for physicians treating asthma.
The unique World Allergy Organization (WAO) Guidelines for the Assessment and Management of Anaphylaxis were created in response to the absence of global guidelines for anaphylaxis.
They were developed after documenting that essential medications, supplies, and equipment for assessment and management of anaphylaxis are not universally available worldwide. Additionally, they were developed with the awareness that any health care professional might, at some time, have to assess and manage anaphylaxis in a low-resource environment, whether this be a country, a region, or a specific location, such as an aircraft cabin or a remote area. They incorporate contributions from more than 100 allergy/immunology specialists on 6 continents received through the WAO member societies and the WAO Board of Directors. I
n order to transcend language barriers, the principles of anaphylaxis assessment and management set forth in the guidelines are summarized in 5 comprehensive illustrations.