The Regulation of Fatty Acid Synthase by Exosomal miR-143-5p and miR-342-5p in Idiopathic Pulmonary Fibrosis.

Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive disease caused by an aberrant repair of injured alveolar epithelial cells. The maintenance of the alveolar epithelium and its regeneration after the damage is fueled by alveolar type II (ATII) cells. Injured cells release exosomes containing microRNAs (miRNAs), which can alter the recipient cells' function.

Effect of Triple Therapy with Budesonide-Formoterol-Tiotropium Versus Placebo-Tiotropium on Sleep Quality in Patients with Chronic Obstructive Pulmonary Disease.

Background: Factors responsible for poor sleep quality in patients with chronic obstructive pulmonary disease (COPD) includes the effects of medications. This study evaluates the effect of the inhaled triple therapy of budesonide-formoterol-tiotropium versus placebo-tiotropium on sleep quality in COPD patients.

Methods: Twenty-three patients (11 [48%] males; age 55 [51-60, 48--5] years; body mass index [BMI] 25 [22-30, 18-40] kg/m; forced expiratory volume in 1 second [FEV]1.

Use of positional therapy when incorporated into a diagnosis-treatment algorithm for obstructive sleep apnea.

Purpose: Positional obstructive sleep apnea (OSA) is prevalent. We hypothesized that by incorporating positional therapy into a diagnosis-treatment algorithm for OSA it would frequently be prescribed as an appropriate first-line therapy.

Methods: Fifty-nine members (45 males, 49±9 yrs, BMI 35.

HIV-1 Nef promotes cell proliferation and microRNA dysregulation in lung cells.

Non-small cell lung cancer (NSCLC) represents about 85% of all lung cancer cases. Lung cancer is the most frequent non-AIDS-defining malignancies in HIV-infected patients. The mechanism of the increased risk for lung cancer in HIV-1 patients is poorly understood.

Determinants of CPAP Adherence in Hispanics with Obstructive Sleep Apnea.

Purpose. We hypothesized that socioeconomic factors and a language barrier would impact adherence with continuous positive airway pressure (CPAP) among Hispanics with obstructive sleep apnea (OSA). Methods.

Physiologic correlates of sleep quality in severe emphysema.

Background: Sleep quality is poor in severe emphysema. We hypothesized that in addition to nocturnal oxygen desaturation, the severity of airflow obstruction and degree of thoracic hyperinflation are responsible.

Methods: Twenty-five patients (14 males, 64 ± 6 [ ± SD] yrs, BMI 24.

Comparison of positional therapy to CPAP in patients with positional obstructive sleep apnea.

Study Objectives: We hypothesized that positional therapy would be equivalent to continuous positive airway pressure (CPAP) at normalizing the apnea-hypopnea index (AHI) in patients with positional obstructive sleep apnea (OSA).

Methods: Thirty-eight patients (25 men, 49 +/- 12 years of age, body mass index 31 +/- 5 kg/m2) with positional OSA (nonsupine AHI <5 events/h) identified on a baseline polysomnogram were studied. Patients were randomly assigned to a night with a positional device (PD) and a night on CPAP (10 +/- 3 cm H2O).

Lymphoid follicle cells in chronic obstructive pulmonary disease overexpress the chemokine receptor CXCR3.

Rationale: The mechanisms underlying formation of lung lymphoid follicles (LF) in chronic obstructive pulmonary disease (COPD) are unknown. The chemokine receptor CXCR3 regulates immune responses in secondary lymphoid structures elsewhere in the body and is highly expressed by Th1 lymphocytes in the airway in COPD. Because chemokine receptors control inflammatory cell homing to inflamed tissue, we reasoned that CXCR3 may contribute to LF formation in COPD.

Treatment of sleep disordered breathing in congestive heart failure.

In patients with congestive heart failure, sleep disordered breathing occurs commonly and is associated with an increased mortality. In addition to central sleep apnea (Cheyne-Stokes respiration), obstructive sleep apnea is more prevalent in patients with congestive heart failure than in the general population. As a result, a number of treatments have been investigated, with varying results.

Comorbidities in chronic obstructive pulmonary disease.

Comorbidities such as cardiac disease, diabetes mellitus, hypertension, osteoporosis, and psychological disorders are commonly reported in patients with chronic obstructive pulmonary disease (COPD) but with great variability in reported prevalence. Tobacco smoking is a risk factor for many of these comorbidities as well as for COPD, making it difficult to draw conclusions about the relationship between COPD and these comorbidities. However, recent large epidemiologic studies have confirmed the independent detrimental effects of these comorbidities on patients with COPD.

Effects of oxygen therapy on left ventricular function in patients with Cheyne-Stokes respiration and congestive heart failure.

Study Objectives: Whereas both oxygen therapy and nasal continuous positive airway pressure (CPAP) decrease the apnea-hypopnea index (AHI) in patients with Cheyne-Stokes respiration (CSR) and congestive heart failure (CHF), only nasal CPAP is known to affect the left ventricular ejection fraction (LVEF). We therefore evaluated the effects of 1 month of nocturnal oxygen therapy on LVEF.

Methods: Ten patients (52 +/- 12 years) with CHF (LVEF of 12% +/- 5%) and CSR (AHI 57 +/- 61 events/hour) were studied.

Mortality and functional performance in severe emphysema after lung volume reduction or transplant.

The purpose of this endeavor is to compare the morbidity, mortality and costs of LVRS versus transplantation in severe emphysema. This was a retrospective review of severe emphysema patients who received LVRS (n = 70) from 1994-1999, or transplant (n = 87) from 1994-2004. Change in functional status was calculated by the change in modified BODE (mBODE) score.

Advanced emphysema in African-American and white patients: do differences exist?

Background: Emphysema is the only smoking-related disease in which white patients have higher prevalence and higher attributable mortality rates than African-American patients. Epidemiologic studies have not addressed, nor explained, the observed racial differences in emphysema.

Study Objectives: To determine whether white and African-American patients differ with respect to the magnitude, anatomic distribution, and physiologic impairments of emphysema.

Effects of lung volume reduction surgery on sleep quality and nocturnal gas exchange in patients with severe emphysema.

Study Objectives: We hypothesized that associated with improvements in respiratory mechanics, lung volume reduction surgery (LVRS) would result in an improvement in both sleep quality and nocturnal oxygenation in patients with severe emphysema.

Design: Prospective randomized controlled trial.

Setting: University hospital.

Cor pulmonale and sleep-disordered breathing in patients with restrictive lung disease and neuromuscular disorders.

Cor pulmonale frequently develops in patients with restrictive lung disease and neuromuscular disorders. Sleep disordered breathing, including nocturnal hypoventilation and obstructive apnea, has been associated with the development of cor pulmonale and may affect morbidity. The mechanisms responsible for sleep disordered breathing include defects in the control of breathing, respiratory muscle dysfunction, and abnormalities in chest wall and lung compliance.

The effects of high-flow vs low-flow oxygen on exercise in advanced obstructive airways disease.

Study Objectives: Current options to enhance exercise performance in patients with COPD are limited. This study compared the effects of high flows of humidified oxygen to conventional low-flow oxygen (LFO) delivery at rest and during exercise in patients with COPD.

Design: Prospective, nonrandomized, nonblinded study.

Smoking patterns in African Americans and whites with advanced COPD.

Background: The prevalence and mortality associated with COPD increases with age, with higher rates observed in whites than African Americans. Causes and explanations for smoking-related racial differences on the respiratory system have not been determined.

Objective: To investigate racial differences in smoking patterns and lung function in patients with advanced COPD.

Complications of long-term mechanical ventilation.

Complications of LTMV should be considered in the context of underlying diseases and comorbidities, the trigger for ventilator dependency, and site of care. These factors have an impact on outcome and on the type and severity of complications. In view of the complexity of chronically ill VAIs, complications of mechanical ventilation become the major impediment in achieving the ultimate goal of LTMV, extending life, and improving psychophysiologic function and quality of life.

Respiratory failure after lung transplantation.

Study Objectives: To characterize patients who acquired postoperative respiratory failure after lung transplantation (LT), and to identify risks associated with postoperative respiratory failure and poor surgical outcome.

Study Design: Retrospective clinical analysis in a tertiary care transplantation center.

Methods: We reviewed the records of 80 consecutive patients who underwent LT from April 1994 to May 1999, analyzing their records for a number of preoperative and perioperative variables and complications.

Effects of nasal continuous positive airway pressure on oxygen body stores in patients with Cheyne-Stokes respiration and congestive heart failure.

Study Objectives: The mechanism(s) by which nasal continuous positive airway pressure (CPAP) is effective in the treatment of Cheyne-Stokes respiration (CSR) in patients with congestive heart failure (CHF) remains uncertain, and may involve an increase in total oxygen body stores (dampening), changes in central and peripheral controller gain, and/or improvement in cardiac function. The purpose of this study was to evaluate the effects of nasal CPAP on total oxygen stores, as measured by the rate of fall of arterial oxyhemoglobin saturation (dSaO(2)/dt), to determine if dampening may play a role in the attenuation of CSR in patients with CHF.

Design: Prospective controlled trial.