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Diet and asthma: nutrition implications from prevention to treatment.

Asthma is characterized by lung airway inflammation initiated and perpetuated by an inappropriate immune response, increased airway responsiveness, and variable airflow obstruction. In Western countries there has been a marked increase in asthma prevalence such that it has become a public health concern. It has been hypothesized that the increase may be due to changing antioxidant intake, increasing dietary ratio of n-6:n-3 polyunsaturated fatty acids (PUFA), and vitamin D deficiency (and supplementation).

Observational studies have reported associations between asthma and dietary antioxidants (vitamin E, vitamin C, carotenoids, selenium, polyphenols, and fruit), PUFA, and vitamin D. However, supplementing the diets of adults with asthma with antioxidants and n-3 PUFA has minimal, if any, clinical benefit. Currently there is insufficient evidence to support the use of nutrient supplements to complement conventional treatment; however, results of ongoing studies are awaited, and additional research is required, particularly in children.

Interest in the potential of dietary intervention during pregnancy to reduce the likelihood of childhood asthma has increased. A small number of cohort studies have highlighted associations between childhood asthma and reduced maternal intake of some nutrients (vitamin E, vitamin D, selenium, zinc, and PUFA) during pregnancy. Although vitamin D intervention studies during pregnancy are ongoing and two intervention studies suggest that dietary PUFA manipulation during pregnancy may be advantageous, further trials are needed to establish if modification of maternal nutrient intake during pregnancy can be used as a healthy, low cost, public health measure to reduce the prevalence of childhood asthma.

Wheezing in the pediatric patient. A review of prehospital management of two childhood diseases--bronchiolitis and asthma.

A wheeze is a high-pitched, musical, continuous sound that originates from oscillations in narrowed airways. Wheezing is most often the result of bronchiolitis in infants and asthma in older children.

This article will discuss the similarities and differences between these two childhood diseases, along with management of the infant or child with wheezing.

Serum bilirubin and risk of respiratory disease and death.

Serum total bilirubin levels in healthy patients reflect genetic and environmental factors that could influence the risk of developing respiratory disease.

Use of specific airway resistance to assess bronchodilator response in children

A 42% decrease in sRaw predicted FEV1 reversibility reasonably well, whereas a smaller decrease in sRaw failed to detect approximately one out of two positive responses detected by FEV1, with no influence of height or age.

Pathology of the Pleura: What the Pulmonologists Need to Know

Primary and metastatic pleural neoplasms, and non‐neoplastic pleural diseases, can have similar clinical, radiographic, and gross features. However, treatments and prognoses of these diverse pleural conditions vary greatly. Accurate diagnosis of pleural disease is therefore extremely important; and histologic interpretation of pleural biopsies is vital to rendering an accurate diagnosis. Smaller biopsies contribute to the difficulties in accurately characterizing pleural lesions; and immunostains are frequently employed in their assessment.

Diffuse malignant mesothelioma, the most common primary pulmonary neoplasm, is rare; however, other less common primary pleural neoplasms, including solitary fibrous tumor, the most common benign primary pleural neoplasm, occur. These neoplasm...

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