Background: Smoking may cause inflammation of the airways and impairment of lung function. To determine the relationship between the type and degree of airways inflammation and the decline in lung function, leucocytes in the sputum of smokers and ex-smokers were examined.
Methods: Forty six smokers and ex-smokers of median age 64 years (25%; 75% percentiles 62;66) with a smoking history of 40.1 (31.7;53) pack years were studied with lung function tests and a questionnaire at the end of a 15 year follow up period. Sputum was induced by inhalation of hypertonic saline and differential leucocyte counts were performed on cytospin preparations.
Results: Adequate sputum samples were obtained in 38 subjects (78%). The ratio of forced expiratory volume in one second (FEV1) to vital capacity (VC) was 67.1 (60; 72)% and the annual decline in FEV1 was 19.4 (12;30) ml/year. Subjects with airways obstruction (FEV1/VC < 63%) had more neutrophils (77 (50;86)%) than those without airways obstruction (60 (43;73)%). The percentage of neutrophils was also significantly greater (77 (62;85)%) in those with chronic expectoration than in those without expectoration (57 (45;75)%. Increased levels of neutrophils in the sputum were correlated with a rapid decline in FEV1 over the 15 year follow up period.
Conclusions: Airways obstruction and chronic expectoration, as well as accelerated decline in lung function, are associated with increased numbers of neutrophils in the sputum of smokers and ex-smokers which suggests that neutrophilic inflammation of the airways may be involved in the pathogenesis of chronic obstructive pulmonary disease.
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http://dx.doi.org/10.1136/thx.51.3.267 | DOI Listing |
Turk J Emerg Med
January 2025
Department of Emergency and Trauma, Hospital Sultan Haji Ahmad Shah, Pahang, Malaysia.
Snake-related injury (SRI) is one of the most common medical emergencies encountered in tropical countries such as Malaysia. The majority of snake bites are nonvenomous, while the less common venomous snakebite can cause major disability or even death. There are 16 pit viper species documented in Malaysia which can be categorized based on their habitat.
View Article and Find Full Text PDFIndian J Crit Care Med
November 2024
Department of Pediatrics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.
Objective: To study the efficacy of intravenous dexamethasone in preventing postextubation airway obstruction (PEAO).
Design: A double-blinded randomized controlled trial.
Study Setting: The study was conducted in level 3 PICU at AIIMS, Raipur, India, from December 2019 to September 2022.
BMC Pulm Med
January 2025
Department of Respiratory Medicine, The Second Hospital of Jilin University, No. 4026 Yatai street, Changchun, 130041, Jilin, China.
Background: Ectopic thyroid tissue (ETT) is a rare congenital anomaly caused by the abnormal embryonic migration of thyroid tissue, leading to its presence outside its usual pretracheal location. This condition can lead to diagnostic challenges, especially when located within the airway, as it mimics other respiratory disorders such as asthma.
Case Presentation: We report the case of a 69-year-old man with endotracheal ETT presenting with severe dyspnea, and the lesion was initially suspected to be malignant.
Chest
January 2025
Division of Respirology, Critical Care and Sleep Medicine, Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Alpha-1-Antitrypsin (A1AT) deficiency is a common hereditary disorder associated with increased risk of developing chronic obstructive pulmonary disease (COPD). Many individuals with severe A1AT deficiency go undiagnosed, or are diagnosed late, and fail to benefit from disease-specific counseling and modifying care. Since the 2012 Canadian Thoracic Society (CTS) A1AT deficiency clinical practice guideline, new approaches to optimal diagnosis using modern genetic testing and studies of A1AT augmentation therapy have been published.
View Article and Find Full Text PDFLaeknabladid
February 2025
Emergency Department, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
A case is reported of a man in his 70s that presented to the emergency department due to difficulty swallowing after a fall. He was found to have a large retropharyngeal hematoma, which led to complete airway obstruction about an hour after the injury. As oral endotracheal intubation was impossible due to the bleeding, an emergency cricothyrotomy was performed in an ambulance by an emergency medicine trainee.
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