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Open Journal of respiratory Diseases 2018年第2期8卷 21-32页

作者： Soichiro Hozawa Michikazu Terada Maki Hozawa hiroshima allergy and respiratory clinic Hiroshima Japan

Background: Primary care physicians in Japan see many patients in a given day;consequently, they find it challenging to devote sufficient time for detailed clinical consultation and evaluation of asthma control status. The aim of this study was to investigate asthma symptoms that reveal the presence of inadequately controlled asthma. Methods: A pooled analysis of baseline data from 100 patients with asthma treated with inhaled corticosteroid(s) (ICS) alone or ICS/long-acting beta-agonist who participated in three previous clinical trials was performed. Asthma control status and asthmatic symptoms were determined using a five-item Asthma Control Questionnaire, and whether asthmatic symptoms reflect clinical markers was investigated. Results: Nocturnal awakening owing to asthmatic symptoms was observed only in the uncontrolled asthma group. Patient-reported wheezing was not observed in the group with well-controlled asthma, but was observed in all patients in the uncontrolled asthma group. Virtually all patients, irrespective of asthma control status, reported symptoms in the morning, limitation of normal daily activities, and shortness of breath. Conclusions: The presence of nocturnal awakening due to asthma and wheezing likely reflected uncontrolled asthma. These results will lead to re-recognition that clinical interview, querying nocturnal awakening from asthma and wheezing is a simple and useful approach to assess asthma control status in a primary care setting.

关键词： Asthma Control Status Asthma Control Questionnaire Nocturnal Awakening Wheezing Primary Care

Metabolomics studies identify novel diagnostic and prognostic indicators in patients with alcoholic hepatitis

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World Journal of Hepatology 2016年第10期8卷 499-508页

作者： Mona Ascha Zeneng Wang Mustafa S Ascha Raed Dweik Nizar N Zein David Grove J Mark Brown Stephanie Marshall Rocio Lopez Ibrahim A Hanouneh Department of Gastroenterology and Hepatology Cleveland Clinic Department of Cellular and Molecular Medicine Cleveland Clinic Department of Pulmonary Allergy and Critical Care Medicine/Respiratory Institute Cleveland Clinic Department of Quantitative Health Science Cleveland Clinic Minnesota Gastroenterology Min- neapolis

AIM: To identify plasma analytes using metabolomics that correlate with the diagnosis and severity of liver disease in patients with alcoholic hepatitis(AH).METHODS: We prospectively recruited patients with cirrhosis from AH(n = 23) and those with cirrhosis with acute decompensation(AD) from etiologies other than alcohol(n = 25). We used mass spectrometry to identify 29 metabolic compounds in plasma samples from fasted subjects. A receiver operating characteristics analysis was performed to assess the utility of biomarkers in distinguishing acute AH from alcoholic cirrhosis. Logistic regression analysis was performed to build a predictive model for AH based on clinical characteristics. A survival analysis was used to construct Kaplan Meier curves evaluating transplant-free ***: A comparison of model for end-stage liver disease(MELD)-adjusted metabolomics levels between cirrhosis patients who had AD or AH showed that patients with AH had significantly higher levels of betaine, and lower creatinine, phenylalanine, homocitrulline, citrulline, tyrosine, octenoyl-carnitine, and symmetric dimethylarginine. When considering combined levels, betaine and citrulline were highly accurate predictors for differentiation between AH and AD(area under receiver operating characteristics curve = 0.84). The plasma levels of carnitine [0.54(0.18, 0.91); P = 0.005], homocitrulline [0.66(0.34, 0.99); P < 0.001] and pentanoyl-carnitine [0.53(0.16, 0.90); P = 0.007] correlated with MELD scores in patients diagnosed with AH. Increased levels of many biomarkers(carnitine P = 0.005, butyrobetaine P = 0.32, homocitrulline P = 0.002, leucine P = 0.027, valine P = 0.024, phenylalanine P = 0.037, tyrosine P = 0.012, acetyl-carnitine P = 0.006, propionyl-carnitine P = 0.03, butyryl-carnitine P = 0.03, trimethyl-lisine P = 0.034, pentanoyl-carnitine P = 0.03, hexanoyl-carnitine P = 0.026) were associated with increased mortality in patients with AH. CONCLUSION: Metabolomics plasma anal

关键词： Metabolomics Biomarkers Liver disease Model for end-stage liver disease Cirrhosis Alcoholic hepatiti

Prevalence of sensitization to weed pollens of Humulus scandens,Artemisia vulgaris,and Ambrosia artemisiifolia in northern China

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2013年第3期14卷 240-246页

作者： Guo-dong HAO Yi-wu ZHENG Birgitte GJESING Xing-ai KONG Jing-yuan WANG Zhi-jing SONG Xu-xin LAI Nan-shan ZHONG Michael D.SPANGFORT Department of allergy Tangshan Gongren Hospital Research Asia Pacific ALK-Abelló A/S State Key Laboratory of respiratory Diseases Guangzhou Medical University

Objective:Weed pollens are common sources of allergens *** prevalence of weed pollen sensitization is not yet fully known in *** purpose of this study was to investigate the prevalence of sensitization to weed allergens from Artemisia,Ambrosia,and Humulus in northern ***:A total of 1144 subjects(aged from 5 to 68 years) visiting our clinic from June to October 2011 underwent intradermal testing using a panel of 25 allergen *** with positive skin responses to any pollen were further tested for their serum concentrations of IgE antibodies against Artemisia vulgaris,Ambrosia artemisiifolia,and Humulus scandens,and against the purified allergens,Art v 1 and Amb a ***:Of 1144 subjects,170 had positive intradermal reactions to pollen and 144 donated serum for IgE *** prevalence of positive intradermal responses to pollens of Artemisia sieversiana,Artemisia annua,***,and *** was 11.0%,10.2%,3.7%,and 6.6%,*** the intradermal positive subjects,the prevalence of specific IgE antigens to *** was 58.3%,to *** 14.7%,and to *** 41.0%.The prevalence of specific IgE antigens to the allergen Art v 1 was 46.9%,and to Amb a 1 was 11.2%.The correlation between the presence of IgE antibodies specific to *** and to the Art v 1 antigen was very *** with *** specific IgE also had *** specific IgE,but with relatively high levels of *** IgE *** were no correlations between the presence of IgE antibodies to *** and *** or to *** and ***:The intradermal prevalence of weed pollen sensitization among allergic subjects in northern China is about 13.5%.Correlations of specific IgE antibodies suggest that pollen allergens from Artemisia and Humulus are independent sources for primary sensitization.

关键词：临床医学诊断学实验室生物化学

Effects and Mechanisms of Actions of Chinese Herbal Medicines for Asthma

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Chinese Journal of Integrative Medicine 2011年第7期17卷 483-491页

作者：洪敏俐宋英李秀敏 Center for Chinese Medicine for allergy and Asthma Jaffe Food Allergy InstitutePediatric DepartmentDivision of Allergy and ImmunologyThe Mount Sinai School of Medicine respiratory Department Zhangzhou Traditional Chinese Medicine HospitalAffiliated Hospital of Fujian University of Traditional Chinese Medicine

Asthma is a chronic inflammatory disorder of airways that affects approximately 300 million adults and children *** therapy currently uses bronchodilators and *** side effects from chronic use of these drugs are *** medicine（CM）has a long history of human use in China and other Asian countries and well received by the *** as one component of Western integrative medicine（WIM）,it is required that CM use is supported by scientific *** the other hand,there are also suggestions that Western standardized medicine should consider personalized *** recent years there have been an increasing studies to narrow the gap between CM,the personalized medicine and Western medicine,evidence based *** communication reviews several CM studies published in the English language in details by reviewing the effects and mechanisms of actions on asthma from clinic and experimental studies. Chinese herbal medicines exhibit broad actions on multiple asthma pathologic *** mechanisms may involve antiinflammatory and immunomodulatory effects,inhibiting airway remodeling and normalization of hypothalamus,pituitary and adrenal（HPA）-axis ***,the mechanisms of actions of Chinese herbal medicines for asthma are not fully *** controlled clinical studies are warranted and some anti-asthma CM may be proved to be effective when used as monotherapy or complementary asthma therapies.

关键词： asthma complementary and alternative medicine Chinese medicine Chinese herbal medicine mechanism of action

Aspirin-exacerbated respiratory disease:Update on medical management

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第4期6卷 241-247页

作者： Andrew A.White Katharine Woessner Ronald Simon Scripps clinic Division of AllergyAsthm a and ImmunologyScripps Green HospitalSon DiegoCAUSA

Aspirin-exacerbated respiratory disease(AERD)is frequently diagnosed in patients with severe type 2 airway inflammation presenting with nasal polyps and severe *** has been associated with a recalcitrant course with high medical and surgical *** advent of recent biological and other targeted treatments show promise in the medical management of patient with *** goal of complete disease control where patients no longer require recurrent surgical procedures,systemic corticosteroid exposure and may live with a stable and relatively normal quality of life is now within *** work is necessary to identify biomarkers predictive of treatment response.

关键词： Aspirin-exacerbated respiratory disease Samter syndrome Aspirin intolerant asthma Nasal polyposis Severe asthma

Predictors of mortality after transjugular portosystemic shunt

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World Journal of Hepatology 2016年第11期8卷 520-529页

作者： Mona Ascha Sami Abuqayyas Ibrahim Hanouneh Laith Alkukhun Mark Sands Raed A Dweik Adriano R Tonelli Department of Gastroenterology and Hepatology Cleveland Clinic Department of Internal Medicine Cleveland Clinic Minnesota Gastroenterology Department of Diagnostic Radiology Cleveland Clinic Department of Pulmonary Allergy and Critical Care MedicineRespiratory InstituteCleve- land Clinic

AIM:To investigate if echocardiographic and hemodynamic determinations obtained at the time of transjugular intrahepatic portosystemic shunt(TIPS)can provide prognostic information that will enhance risk stratification of ***:We reviewed medical records of 467 patients who underwent TIPS between July 2003 and December 2011 at our *** recorded information regarding patient demographics,underlying liver disease,indication for TIPS,baseline laboratory values,hemodynamic determinations at the time of TIPS,and echocardiographic measurements both before and after *** recorded patient comorbidities that may affect hemodynamic and echocardiographic *** also calculated Model for Endstage Liver Disease(MELD)score and Child Turcotte Pugh(CTP)*** following pre-and post-TIPS echocardiographic determinations were recorded:Left ventricular ejection fraction,right ventricular(RV)systolic pressure,subjective RV dilation,and subjective RV *** recorded the following hemodynamic measurements:Right atrial(RA)pressure before and after TIPS,inferior vena cava pressure before and after TIPS,free hepatic vein pressure,portal vein pressure before and after TIPS,and hepatic venous pressure gradient(HVPG).RESULTS:We reviewed 418 patients with portal hypertension undergoing *** pressure increased by a mean ± SD of 4.8 ± 3.9 mmH g(P < 0.001),HVPG decreased by 6.8 ± 3.5 mmH g(P < 0.001).In multivariate linear regression analysis,a higher MELD score,lower platelet count,splenectomy and a higher portal vein pressure were independent predictors of higher RA pressure(R = 0.55).Three variables predicted 3-mo mortality after TIPS in a multivariate analysis:Age,MELD score,and CTP grade *** in the RA pressure after TIPS predicted long-term mortality(per 1 mm Hg change,HR = 1.03,95%CI:1.01-1.06,P < 0.012).CONCLUSION:RA pressure increased immediately after TIPS particularly in patients with worse liver function,portal hypertension,emergent TI

关键词： Transjugular intrahepatic portosystemic shunt Transjugular portosystemic shunts Right atrial pressur

COVID-19 frequency and clinical course in children with asthma

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World Journal of Virology 2023年第5期12卷 272-285页

作者： Muhammet Cihat Ozata Ummugulsum Dikici Oner Ozdemir Medical Faculty Sakarya UniversityAdapazari 54100SakaryaTurkiye Department of Pediatric allergy and Immunology Sakarya UniversityAdapazarı54100SakaryaTürkiye

BACKGROUND The epidemic of severe acute respiratory syndrome coronavirus 2 infection,known as the coronavirus disease 2019(COVID-19),has caused a global health *** its emergence,numerous studies have focused on various clinical manifestations and outcomes in different ***,studies are ongoing as the consequences and impact of COVID-19 in children with chronic diseases such as asthma are *** To fill this research gap by retrospectively evaluating the course,laboratory,and clinical findings of COVID-19 among 414 asthmatic children followed up from the pediatric allergy outpatient clinic and known to have had *** The data of 5510 patients over the age of 5 diagnosed with asthma in our hospital's data were retrospectively scanned with specific parameters using protocol numbers from the hospital filing *** data included retrospective evaluation of pulmonary function test results before and after COVID-19,routine hematological and biochemical parameters,sensitization states(total IgE,specific IgE,and skin prick test results),and radiological(computed tomography)*** inquire about the course and symptoms of COVID-19,asthma patients or their parents were then called and evaluated with a *** As a result of retrospectively scanning the data of 5510 asthma patients over the age of 5,it was determined that 414(7.5%)patients had *** mean age of 414 patients was 17.18±4.08(min:6;max:28)*** hundred and three of our 414 patients are male,and 211 are *** their vaccination status was questioned,21.5% were *** the symptoms of our 290 patients were questioned,it was stated that 59.0% had fever *** rate of using regular prophylactic asthma medications was 19%.The rate of using salbutamol in asthma was found to be 22%.The rate of patients using methylprednisolone was 1%.Emergency service admission was 17.2%,and hospitalization was found to be 4.8%.Leukopenia(<40

关键词： COVID-19 SARS-CoV-2,Children Asthma Exacerbation allergy

Association of latitude and altitude with adverse outcomes in patients with COVID-19: The VIRUS registry

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World Journal of Critical Care Medicine 2022年第2期11卷 102-111页

作者： Aysun Tekin Shahraz Qamar Romil Singh Vikas Bansal Mayank Sharma Allison M LeMahieu Andrew C Hanson Phillip J Schulte Marija Bogojevic Neha Deo Simon Zec Diana J Valencia Morales Katherine A Belden Smith F Heavner Margit Kaufman Sreekanth Cheruku Valerie C Danesh Valerie M Banner-Goodspeed Catherine A St Hill Amy B Christie Syed A Khan Lynn Retford Karen Boman Vishakha KKumar John C O'Horo Juan Pablo Domecq Allan J Walkey Ognjen Gajic Rahul Kashyap Salim Surani TheSociety of Critical Care Medicine(SCCM)Discovery Viral Infection and respiratory Illness Universal Study(VIRUS):COVID-Registry Investigator Group Department of Anesthesiology Mayo ClinicRochesterMN 55905United States Post-baccalaureate Research Education Program Mayo Clinic College of Medicine and ScienceRochesterMN 55905United States Division of Pulmonary and Critical Care Medicine Department of Internal MedicineMayo ClinicRochesterMN 55905United States Division of clinical Trials and Biostatistics Department of Quantitative Health SciencesMayo ClinicRochesterMN 55905United States Alix School of Medicine Mayo ClinicRochesterMN 55905United States Division of Infectious Diseases Thomas Jefferson University HospitalPhiladelphiaPA 19107United States Prisma Health GreenvilleSC 29605United States Englewood Health EnglewoodNJ 07631United States Divisions of Cardiothoracic Anesthesiology and Critical Care Medicine Department of Anesthesiology and Pain ManagementUT Southwestern Medical CenterDallasTX 75390United States Center for Applied Health Research Baylor Scott and White HealthDallasTX 75246United States Department of Anesthesiology Critical Care and Pain MedicineBeth Israel Deaconess Medical CenterBostonMA 02215United States Allina Health MinneapolisMN 55407United States Department of Critical Care Atrium Health NavicentMaconGA 31201United States Division of Critical Care Medicine Mayo Clinic Health SystemMankatoMN 56001United States Society of Critical Care Medicine Mount ProspectIL 60056United States Division of Infectious Diseases Mayo ClinicRochesterMN 55905United States Division of Nephrology and Hypertension Department of Internal MedicineMayo ClinicRochesterMN 55905United States Pulmonary Center Division of PulmonaryAllergyCritical Care and Sleep MedicineDepartment of MedicineEvans Center of Implementation and Improvement SciencesBoston University School of MedicineBostonMA 02118United States Department of Pulmonary and Critical Care Medicine Texas A&M UniversityBryanTX 77807United States 不详

BACKGROUND The coronavirus disease 2019(COVID-19)course may be affected by environmental *** studies previously suggested a link between climatological factors and COVID-19 fatality ***,individual-level impact of these factors has not been thoroughly evaluated *** To study the association of climatological factors related to patient location with unfavorable outcomes in *** In this observational analysis of the Society of Critical Care Medicine Discovery Viral Infection and respiratory Illness Universal Study:COVID-19 Registry cohort,the latitudes and altitudes of hospitals were examined as a covariate for mortality within 28 d of admission and the length of hospital *** for baseline parameters and admission date,multivariable regression modeling was *** estimating equations were used to fit the *** Twenty-two thousand one hundred eight patients from over 20 countries were *** median age was 62(interquartile range:49-74)years,and 54%of the included patients were *** median age increased with increasing latitude as well as the frequency of ***,the percentage of comorbidities was lower in elevated *** within 28 d of hospital admission was found to be 25%.The median hospital-free days among all included patients was 20 *** the significant linear relationship between mortality and hospital-free days(adjusted odds ratio(aOR)=1.39(1.04,1.86),P=0.025 for mortality within 28 d of admission;aOR=-1.47(-2.60,-0.33),P=0.011 for hospital-free days),suggesting that adverse patient outcomes were more common in locations further away from the Equator;the results were no longer significant when adjusted for baseline differences(aOR=1.32(1.00,1.74),P=0.051 for 28-day mortality;aOR=-1.07(-2.13,-0.01),P=0.050 for hospital-free days).When we looked at the altitude’s effect,we discovered that it demonstrated a non-linear association with mortality wi

关键词： 28 d mortality Altitude COVID-19 Hospital-free days Latitude Outcomes

Exercise-Induced Bronchoconstriction Diagnostics:Impact of a Repeated Exercise Challenge Test

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Open Journal of respiratory Diseases 2014年第2期4卷 55-63页

作者： Maj R.Angell Liv Berit Augestad Thorbjorn S.Haugen Anne Frostad Thor Arne Gronnerod Trine Stensrud Department of Human Movement Science Faculty of Social Sciences and Technology ManagementNorwegian University of Science and Technology(NTNU)TrondheimNorway clinic for allergy and Airway Diseases OsloNorway Department of Sports Medicine Norwegian School of Sport SciencesOsloNorway

Exercise-Induced bronchoconstriction (EIB) is related to increased ventilation (VE) during exercise and describes the transient airway narrowing following exercise. A reliable diagnosis is essential for optimal treatment. The impact of a repeated exercise challenge test (ECT) in a clinical setting is not well established and conducting a repeated ECT with the possibility to adjust the exercise intensity on an individual basis may give more information. The aim of the study was to evaluate the test-retest reliability of an ECT for EIB and its association with exercise intensity. Methods: After examination by a pulmonologist, 20 referred subjects with symptoms strong indications of Exercise-Induced bronchoconstriction performed two consecutive exercise challenge tests on a treadmill. The exercise intensity of the repeated test was adjusted. Forced expiratory volume in 1 second (FEV1) was measured before and 1, 3, 6, 10, and 15 minutes after exercise. EIB was defined as a reduction of ≥ 10% in FEV1. Ventilation and heart rate were measured during exercise. Results: Five subjects tested positive in both tests, and ten subjects tested negative in both tests. Three subjects tested positive in the first test only, while two subjects tested positive in the second test only. The exercise intensity was not significantly different between the two tests for any of the subjects. Conclusion: There were 25% divergences in the diagnostic results of two consecutive exercise challenge tests. The difference in the test results was not explained by a difference in the exercise intensity.

关键词： Exercise-Induced Bronchoconstriction Exercise Challenge Test Forced Expiratory Volume in 1 Second Exercise Intensity

青少年哮喘漏诊危险因素的群体研究:欧登塞市学龄儿童调查

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英国医学杂志中文版 1998年第2期1卷 66-70页

作者： Hans C Siersted Jesper Boldsen Gert Mostgaard Niels Hyldebrandt Section of respiratory Diseases Department of Medicine C Odense University Hospital DK-5000 Odense CDenmark Departmnt of Cardiology Odense University Hospital henrik S Hansensenior registrar Centre for Health and Social Policy Odense UniversityDK-5230 Odense M Private Specialist clinic NΦrregade 16 DK-5000 Odense C specialist in allergy and internal medicine

目的:描述青少年哮喘漏诊的相关因素。设计:在人群队列研究中分析亚群。地点:丹麦欧登塞市。对象:为495名12～15岁学龄儿童,这些儿童是从3年前行队列研究的1 369名儿童中筛选出来,筛选是根据随机选择(n=292)和选择本人或家族成员中有过... 详细信息

目的:描述青少年哮喘漏诊的相关因素。设计:在人群队列研究中分析亚群。地点:丹麦欧登塞市。对象:为495名12～15岁学龄儿童,这些儿童是从3年前行队列研究的1 369名儿童中筛选出来,筛选是根据随机选择(n=292)和选择本人或家族成员中有过敏史或有哮喘样症状者(n=203)。

关键词：哮喘儿童乙酞甲胆碱欧登塞哮喘症状队列研究群体研究气道反应性激发试验体力活动呼气峰流速