Acute exercise is associated with reduced exhaled nitric oxide in physically inactive adults with asthma.

Background: Although exercise has multiple health benefits, relatively little attention has been paid to its potential therapeutic effects in those with asthma.

Objective: To examine the effects of acute exercise on inflammation in physically inactive and active adults with asthma.

Methods: Fourteen adults with asthma (n = 6 physically inactive, n = 8 physically active) completed (1) 30 minutes of moderate-intensity exercise on a treadmill and (2) 30 minutes of rest in random order, with 4 weeks between sessions.

Induced sputum IL-8 gene expression, neutrophil influx and MMP-9 in allergic bronchopulmonary aspergillosis.

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to the fungus Aspergillus fumigatus, causing severe asthma that may progress to bronchiectasis. Sputum neutrophilia can occur in association with sputum eosinophilia and correlates with the degree of bronchiectasis. The mechanisms of sputum neutrophilia in ABPA are not known.

Anti-inflammatory effect of itraconazole in stable allergic bronchopulmonary aspergillosis: a randomized controlled trial.

Background: Allergic bronchopulmonary aspergillosis (ABPA) complicates chronic asthma and results from hypersensitivity to the fungus Aspergillus fumigatu s, causing an intense systemic immune response and progressive lung damage.

Objective: We sought to determine whether treatment with the antifungal agent itraconazole reduced eosinophilic airway inflammation in subjects with ABPA.

Methods: A randomized, double-blind, placebo-controlled trial was performed in stable subjects with ABPA (n = 29).

Heterogeneity of airway inflammation in persistent asthma : evidence of neutrophilic inflammation and increased sputum interleukin-8.

Study Objectives: To identify the characteristics of airway inflammation in persistent asthma and to examine the role of neutrophilic inflammation in noneosinophilic persistent asthma.

Methods: Nonsmoking adults (n = 56) with persistent asthma and healthy control subjects (n = 8) underwent hypertonic saline solution challenge and sputum induction. Selected sputum portions were dispersed with dithiothreitol and assayed for total cell count, cellular differential, supernatant eosinophil cationic protein (ECP), myeloperoxidase, and interleukin (IL)-8.

Induced sputum eosinophils and neutrophils and bronchiectasis severity in allergic bronchopulmonary aspergillosis.

Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to the fungus Aspergillus fumigatus that may progress to bronchiectasis. The aim of the present study was to characterize airway inflammation in patients with clinically stable ABPA and asthma, and to correlate this with bronchiectasis severity. Subjects with ABPA and central bronchiectasis (ABPA-CB; n=16) and ABPA with serological evidence alone (ABPA-S; n=10) were studied.

Acute anti-inflammatory effects of inhaled budesonide in asthma: a randomized controlled trial.

Corticosteroids can have acute effects on airway function and methacholine airway responsiveness in asthma as early as 6 h after dosing, suggesting there may be an acute anti-inflammatory effect of inhaled corticosteroid in asthma. This study aimed to determine the effects of a single dose of inhaled budesonide on sputum eosinophils and mast cells in adults with asthma, and to examine whether the mechanism of clearance of eosinophils was by apoptosis. A randomized, double-blind, placebo-controlled, crossover study was conducted.

Airway mast cells and eosinophils correlate with clinical severity and airway hyperresponsiveness in corticosteroid-treated asthma.

Background: The relationship between airway inflammation and asthma severity in corticosteroid-treated asthma is unclear.

Objectives: Our purpose was to characterize the inflammatory cell profile of the airway lumen and epithelium in corticosteroid-treated asthma and to relate these findings to clinical and physiologic markers of asthma severity.

Methods: Adults (n = 20) with asthma received standardized high-dose inhaled corticosteroid therapy with beclomethasone 2000 microgram per day for 8 weeks.

Induced sputum eosinophil cationic protein (ECP) measurement in asthma and chronic obstructive airway disease (COAD).

Background: Induced sputum is a useful way to monitor airway inflammation in asthma, but cell counts are time-consuming and labour intensive.

Objective: The aim of this study was to evaluate a novel processing method using eosinophil cationic protein (ECP) as a biochemical marker of sputum eosinophil number and activation in subjects with asthma and other airway diseases.

Methods: Sputum was dispersed with dithiothreitol and centrifuged to yield cell free supernatant and a cell pellet.

Chronic cough resembles asthma with IL-5 and granulocyte-macrophage colony-stimulating factor gene expression in bronchoalveolar cells.

Background: Chronic cough is a multifactorial condition, which, like asthma, can be associated with eosinophilic airway inflammation. In asthma, airway eosinophilia is believed to be mediated by cytokines such as interleukin-5 and granulocyte-macrophage colony stimulating factor (GM-CSF). The role of these cytokines in chronic cough is unclear.

A systematic evaluation of mechanisms in chronic cough.

We tested the hypothesis that hyperresponsiveness of the upper airway (UAHR) is present in patients with chronic cough of diverse etiology. We determined the frequency of bronchial hyperresponsiveness (BHR), hyperresponsiveness of the upper airway, sputum eosinophilia, pulmonary aspiration, and psychological symptoms in adults with chronic cough. Consecutive adults (n = 30) presenting to a tertiary referral clinic with chronic cough were compared with a group of 20 asymptomatic adults.

Using quality-control analysis of peak expiratory flow recordings to guide therapy for asthma.

Objective: To compare the action points in published asthma management plans with those derived from quality-control analysis of peak expiratory flow recordings.

Design: Longitudinal observational study.

Setting: An ambulatory asthma education and management program in a tertiary care hospital.

A case of Actinomyces meyeri pneumonia in a child.

Pulmonary actinomycosis is an uncommon infection whose diagnosis is often delayed as clinically the disease may mimic tuberculosis or cancer. It is rare in children. We present the first report from Australasia of a case of Actinomyces meyeri pneumonitis in a 13-year-old boy.

Occult ruptured spleen--two unusual clinical presentations.

Case reports of two patients with occult rupture of the spleen are presented. In one, blunt trauma appeared to involve only the neck and upper chest, resulting in two distinct tracheal injuries and no clinical indication of abdominal injury. On the 5th day after injury this patient strangulated an indirect inguinal hernia.

Hypersensitivity pneumonitis in a mouldy house.

Two cases of hypersensitivity pneumonitis, one confirmed by histopatholgy, are described. The patients were members of different families and developed the disease as occupants, at separate times, of the same inner-city dwelling. We believe the disorder resulted from exposure to thermophilic microorganisms prevalent in their domestic environment.

Fat embolism syndrome: incidence, significance and early features.

During the period 1968 to 1978 a total of 447 patients were treated in the Royal Newcastle Hospital for acute respiratory failure after injury. In 321 patients respiratory failure occurred after thoracic and/or long bone injury. In only 17 of these could a diagnosis of fat embolism syndrome (FES) as a sole cause of respiratory failure be substantiated when strict diagnostic criteria were applied.

Terminal exacerbation of chronic melioidosis in New South Wales.

A fatal case of melioidosis, thought to be the third recorded from New South Wales, is presented. Infection probably occurred in Queensland. The patients presented with a subcutaneous abscess complicated by pyaemia, extensive lung involvement and septicaemic shock.

Eosinophilic meningitis (angiostrongylosis): a probable case.

A probable case of eosinophilic meningitis is described. This report is thought to be the first of a case of this disorder diagnosed in New South Wales, although infection probably occurred in Queensland. The life cycle of the parasite Angiostrongylus cantonensis is outlined briefly and the clinical manifestations of this disease are discussed.