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Current Concepts: The Prevention of Ventilator-Associated Pneumonia
Ventilator-associated pneumonia represents a significant cause of morbidity and mortality and is associated with longer hospitalizations and increased costs. What strategies can the clinician caring for the mechanically-ventilated patient employ to prevent this common nosocomial infection?
Journal Article, March 1999
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The Interplay Between Otitis Media and Rhinitis in Children
Prevention of otitis media (OM) would decrease the incidence of its most serious complication, hearing loss. Because rhinitis is the most significant factor predisposing to OM, the most effective strategy to prevent hearing loss due to OM may be to improve clinical interventions for rhinitis
Journal Article, March 1999
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Alpha1-Antitrypsin Deficiency in COPD: Clinical Implications
In the setting of asthma, early emphysema due to alpha1-antitrypsin deficiency (alpha1-ATD) is an unusual and frequently missed diagnosis. Early identification and preventive measures including counseling to not smoke or smoking cessation, and adequate immunization against influenza, as well as alpha1-AT replacement therapy, may improve outcomes.
Journal Article, March 1999
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Genetic Variability of Surfactant Protein-B and Respiratory Distress Syndrome: Clinical Implications
The link between respiratory distress syndrome (RDS) and surfactant deficiency, especially in preterm infants, has been known since the late 1950s. But how do specific alterations in genes encoding surfactant proteins influence the clinical course of RDS and how effective is surfactant replacement therapy for neonatal respiratory failure?
Journal Article, February 1999
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Preventing the Emergence of the $100,000 Asthmatic
A small subset of frequently-hospitalized patients -- the $100,000 asthmatics -- claim a large portion of asthma healthcare expenditures. Management by specialists might keep these patients out of the hospital, reducing costs and improving outcomes.
Journal Article, February 1999
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Infection by Asthma-Associated Viruses: Clinical Implications
What role do viral respiratory tract infections play in asthma pathogenesis? What effect does acute infection have on asthma exacerbation? These are just some of the issues addressed by this expert in pulmonary pathology.
Journal Article, February 1999
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Mechanisms of Asthma: The Role of Neurokinins, Nitric Oxide, and Genetics
Neuropeptides (such as NKA and SP) and the reactive gas NO may be more important in airway mechanics and respiration than previously thought. And, evidence for genetic susceptibility to asthma continues to grow as linkage analyses and genome screens identify candidate genes. But just how significant a role do neural mechanisms and genetic factors play in asthma pathogenesis?
Journal Article, February 1999
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Nasal Polyposis: Rationale for Treatment with Topical Intranasal Corticosteroids
Nasal polyposis, a common manifestation of chronic sinusitis, occurred in 31 million Americans in the 1-year period from 1988 to 1989. Over the past three decades, medical management with corticosteroids has supplanted surgery as the primary approach to treatment because of high recurrence rates after surgery alone.
Journal Article, January 1999
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Aspiration Pneumonia: Current Concepts and Approach to Management
Aspiration pneumonia usually presents in patients with underlying disease that predisposes to host defense impairment. Identification of causative pathogens and targeting high-risk patients are critical to effective management.
Journal Article, January 1999
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Optimizing Deposition of Aerosolized Drug in the Lung: A Review
Metered-dose inhalers, DPIs, and nebulizers are the devices available for administering pharmacologically active aerosol to the lower airway. But how effective are they and what factors influence the deposition of aerosol particles?
Journal Article, January 1999
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Environmental Control of Asthma
Dust mites, cockroaches, cats, dogs and other animals, mold, and cigarette smoke all contribute to the etiology of atopic asthma. Vinyl zippered covers on bedsheets, HEPA filters on air vents, and removal of carpets from floors or pets from the home, can be effective strategies for reducing the number of asthmatic episodes and the overall incidence of asthma.
Journal Article, January 1999
