A Retrospective Study of Acute Postoperative Pain After Cesarean Delivery in Patients With Opioid Use Disorder Treated With Opioid Agonist Pharmacotherapy.

Objective: We aimed to quantify the effect of opioid agonist pharmacotherapy on pain management after cesarean delivery, compared with patients not on these medications.

Methods: Patients undergoing cesarean delivery at our institution between January 2016 and December 2018 were stratified by peripartum use of opioid agonist pharmacotherapy versus no agonist therapy. We compared 24-hour postoperative opioid consumption not including buprenorphine and methadone, in milligram morphine equivalents (MME) (primary outcome), highest pain score on a 0 to 10 numerical rating scale in the first 24 postoperative hours, and postoperative length of stay in hours (secondary outcomes) between groups.

Influence of cardiac dysfunction and systemic inflammation on pulmonary function and airway responsiveness in obese subjects.

Purpose: Obesity is associated with left ventricular diastolic dysfunction and altered heart rate variability, as well as pulmonary dysfunction. The relationship between asthma and cardiac dysfunction in severely obese subjects is unknown, although it has been hypothesized that cardiac dysfunction may contribute to increase airway hyper-responsiveness (AHR). This study aimed to determine if AHR is associated with left ventricular diastolic dysfunction and heart rate variability in severely obese subjects.

Effect of bariatric surgery on airway response and lung function in obese subjects with asthma.

Background: Obesity is a risk factor for self-reported asthma and makes asthma management more difficult. The effects of bariatric surgery on asthma in severely obese subjects remain to be documented.

Methods: In this prospective study, 12 asthmatic patients with severe obesity were evaluated before, 6 and 12 months after bariatric surgery.

Adiposity and pulmonary function: relationship with body fat distribution and systemic inflammation.

Purpose: Obesity is associated with changes in pulmonary function and increased systemic inflammation. We explored the relationships among adiposity, body fat distribution indices, serum inflammatory markers and pulmonary function.

Methods: This was a post-hoc cross-sectional analysis that included subjects who had previously participated in randomized studies on obesity at our centre.

Leptin and adiponectin in obese and non-obese subjects with asthma.

Objective: To understand the role of leptin and adiponectin in obese asthmatics.

Methods: We compared serum leptin, adiponectin and sputum leptin levels in 44 non-obese and 44 obese subjects.

Results: We found higher serum leptin (P < 0.

Benefits of low-dose inhaled fluticasone on airway response and inflammation in mild asthma.

Rationale: Current guidelines suggest that asthma should be controlled with the lowest dose of maintenance medication required.

Objectives: To evaluate the effects of a low dose of inhaled corticosteroid compared to a placebo, on airway inflammation and responsiveness in patients with mild symptomatic asthma.

Methods: In this randomized double-blind, placebo-controlled, parallel group study, we looked at the influence of inhaled fluticasone propionate 250 microg/day for 3 months followed by 100 microg/day for 9 months on airway inflammation and methacholine responsiveness in non-smoking subjects with mild allergic asthma.

Gender differences in the prevalence of airway hyperresponsiveness and asthma in athletes.

Background: Although athletes have a high prevalence of airway hyperresponsiveness (AHR) and asthma, little is known about possible gender differences in regard to these features. We looked at the comparative prevalence of AHR, physician-diagnosed asthma and respiratory symptoms during exercise in female (F) and male (M) athletes.

Method: A retrospective analysis was done on 2 groups of athletes: Group 1 (n=100) taking part in a study on the prevalence of AHR to methacholine (PC(20)<16mg/ml) and Group 2 (n=698), taking part in a provincial survey on the prevalence of physician-diagnosed asthma.

Obesity and asthma: a specific phenotype?

Background: Obesity is associated with an increased prevalence of asthma, especially in women, and appears to be more severe in the obese. This study aimed to determine if obese subjects have a specific asthma phenotype.

Methods: Forty-four consecutive obese subjects (body mass index [BMI] > or = 30 kg/m(2)) and 44 consecutive nonobese subjects (BMI < 25 kg/m(2)), all with asthma, completed an asthma control questionnaire, and underwent methacholine challenge with symptom perception scores, and sputum induction for differential cell count.

Lung hyperinflation, perception of bronchoconstriction and airway hyperresponsiveness.

Purpose: To compare the influence of underlying airway inflammation and lung hyperinflation on dyspnea during induced bronchoconstriction in subjects with mild asthma (or asymptomatic airway hyperresponsiveness (AAHR).

Methods: Fourteen mild asthmatic and 14 AAHR subjects had methacholine and 5'-adenosine monophosphate (AMP) challenges, and induced sputum analysis. Changes in inspiratory capacity (IC) and respiratory symptom scores were measured after challenges.

Deep inspiration avoidance and airway response to methacholine: Influence of body mass index.

Objective: To evaluate the effects of deep inspiration avoidance response to methacholine inhalation in 23 nonobese (body mass index between 18 kg/m2 and 30 kg/m2) and 27 obese (body mass index 30 kg/m2 or greater), nonatopic, nonasthmatic normal subjects.

Methods: Each subject had four methacholine challenges. In tests A and B, the first postmethacholine forced expiratory volume in 1 s (FEV1) was measured at 30 s and 3 min postinhalation, respectively; tests C and D were single-dose tests (using the final dose of test B), with the first postmethacholine FEV1 being obtained at 3 min, without (test C) or with (test D) 20 min of deep inspiration avoidance before inhalation.

Clinical features and airway inflammation in mild asthma versus asymptomatic airway hyperresponsiveness.

Rationale: We still do not know why some subjects with airway hyperresponsiveness (AHR) experience no respiratory symptoms.

Objectives: Our aim was to compare pulmonary function, perception of bronchoconstriction, and airway inflammation in atopic subjects with mild recently diagnosed (<5 years, n=30) or longer-standing (5 years or more, n=30) symptomatic asthma in comparison with atopic subjects with asymptomatic AHR (n=27).

Methods: All subjects had measurements of expiratory flows, PC(20) methacholine, perception of breathlessness and induced sputum cell differential, eosinophil cationic protein and alpha(2)-macroglobulin levels.

Lower airway inflammatory responses to high-intensity training in athletes.

Purpose: There is an increased prevalence of asthma and airway hyperresponsiveness in elite athletes, particularly in swimmers. High intensity exercise may induce airway inflammation and subsequent remodelling in these subjects. Our aim was to evaluate the effects of high-intensity training on induced-sputum cell populations in elite athletes.

Deep inspiration avoidance and methacholine response in normal subjects and patients with asthma.

Background: Deep inspiration (DI) avoidance and time intervals between inhalation and measurement of FEV1 may influence methacholine challenges.

Objectives: (1) To compare the degree of airway response to methacholine when the initial FEV1 measurements are obtained either 30 s or 3 min after inhalation, (2) to evaluate a simplified method to study the influence of DI avoidance before inhalation on the fall in FEV1, and (3) to determine if methacholine has a cumulative effect.

Participants/methods: Twenty-five patients with asthma and 21 normal subjects without asthma.

Asthma and sleep apnea in patients with morbid obesity: outcome after bariatric surgery.

Background: Asthma and sleep apnea syndrome (SAS) are frequently reported in obese patients. The authors determined the prevalence of asthma and SAS in morbidly obese patients and the effect of biliopancreatic diversion with duodenal switch (BPD-DS) on these conditions.

Methods: 398 patients were evaluated for bariatric surgery in a university-affiliated tertiary care center.

Comparative prevalence of asthma in different groups of athletes: a survey.

Background: The type of air predominantly inhaled during training seems to play an important role in the development of airway hyperresponsiveness in athletes; however, this factor has not been evaluated for asthma.

Objective And Patients: To compare the prevalence of self-reported and/or physician-diagnosed asthma among four groups of athletes categorized according to the type of air predominantly inhaled during training: cold air (n=176), dry air (n=384), humid air (n=95), and mixed dry and humid air (n=43).

Method: Self-administrated questionnaires were used.

Prevalence of respiratory symptoms in an athlete population.

This study aimed to look at the prevalence and type of respiratory symptoms experienced by athletes and to assess the possible influence on the perception of symptoms of training duration and environment. A group of 698 athletes (107 with diagnosed or self-reported asthma) filled out a questionnaire on their respiratory condition. They exercised either in cold air (n = 176), dry air (n = 384), humid air (n = 95) or mixed dry and humid air (n = 43).

Variability of inflammatory cell counts on bronchial biopsies of normal subjects.

Bronchial biopsies are currently used to study the pathophysiology of airway diseases, and comparisons are often made with biopsies from healthy volunteers. It is therefore important to evaluate the variability in each parameter analyzed in bronchial biopsies of healthy volunteers in order to be able to discriminate significant changes. We analyzed bronchial biopsies of 31 nonsmoking, nonatopic healthy subjects who volunteered as normal controls for studies on pathophysiology of asthma.

Airway inflammation in asthma with incomplete reversibility of airflow obstruction.

This study aimed to determine whether there is a persistent or different type of airway inflammation in patients with an incomplete reversibility of airflow obstruction (IRAO) despite optimal treatment and if so, whether it is associated with an accelerated decline of pulmonary function. Fifteen asthmatic patients with IRAO, and 23 with complete reversibility of airflow obstruction (CRAO) had a spirometry and an induced-sputum (IS) analysis. Past FEV1 values were recorded over 2-12 years during periods of stable asthma.

Are questionnaires on respiratory symptoms reliable predictors of airway hyperresponsiveness in athletes and sedentary subjects?

This study aimed at determining the frequency of respiratory symptoms in high-level athletes and whether respiratory questionnaires are reliable predictors of airway hyperresponsiveness (AHR) in this population compared with control subjects. One hundred high-level athletes exercising in different conditions of ambient air (dry, humid, cold or mixed dry and humid) and 50 sedentary control subjects answered four question sets on exercise-induced symptoms of postnasal drip (Q1), breathlessness, chest tightness and wheezing (Q2), and cough (Q3). Another question set (Q4) evaluated the self-description of nociceptive sensations associated with respiratory symptoms.

Influence of sympatho-vagal balance on airway responsiveness in athletes.

The increased prevalence of airway hyperresponsiveness (AHR) observed among athletes suggests that high-level training may contribute to the development of AHR. We investigated the possible influence of the sympatho-vagal balance on this phenomenon in 40 athletes and 10 sedentary controls. Each subject filled out a respiratory questionnaire, had a methacholine challenge, and measurements were made of their baseline plasma catecholamines [epinephrine (E), norepinephrine (NE) and dopamine (DA)] as a reflection of sympathetic tone, and their heart rate variability (SDNN: standard deviation of all normal-to-normal intervals) as an indicator of parasympathetic tone.

Cytokine expression in the lower airways of nonasthmatic subjects with allergic rhinitis: influence of natural allergen exposure.

Background: Natural exposure to pollen provokes an increase in airway responsiveness in nonasthmatic subjects with seasonal allergic rhinitis. This natural exposure may induce inflammatory cell recruitment and cytokine release, leading to lower airway inflammation.

Objective: The aim of this study was to characterize lower airway inflammation in nonasthmatic pollen-sensitive subjects.

Airway hyperresponsiveness, inflammation, and subepithelial collagen deposition in recently diagnosed versus long-standing mild asthma. Influence of inhaled corticosteroids.

This study aimed at documenting airway inflammation and subepithelial collagen deposition in patients using only inhaled beta(2)-agonists with either recently diagnosed asthma (RDA: /= 13 yr, n = 16) and at the influence of an intense inhaled corticosteroid (ICS) treatment on these parameters, in relation to changes in airway responsiveness. Patients had a methacholine inhalation test and a bronchoscopy with bronchial biopsies before and after an 8-wk treatment with inhaled fluticasone propionate (FP), 1,000 microgram/day. Baseline FEV(1) (mean +/- SEM) was normal and similar in both groups (RDA: 98.

Airway hyperresponsiveness in elite athletes.

It has been suggested that high-level training could contribute to the development of airway hyperresponsiveness (AHR), but the comparative effects of different sports on airway function remains to be determined. We evaluated 150 nonsmoking volunteers 18 to 55 yr of age; 100 athletes divided into four subgroups of 25 subjects each according to the predominant estimated hydrocaloric characteristic of ambient air inhaled during training: dry air (DA), cold air (CA), humid air (HA) and a mixture of dry and humid air (MA), and 50 sedentary subjects. Each subject had a respiratory questionnaire, a methacholine challenge, allergy skin-prick tests, and heart rate variability recording for evaluation of parasympathetic tone.