Reduction Of Lipid-laden Macrophage Index After Laparoscopic Nissen Fundoplication In Cystic Fibrosis Patients After Lung Transplantation
alveolar; aspiration; association; bronchoalveolar lavage fluid; children; chronic rejection; cystic fibrosis; fat-embolism; gastroesophageal reflux; gastroesophageal-reflux disease; laparoscopic; lipid-laden macrophage index; lung; macrophages; marker; Nissen fundoplication; Oil Red O stain; pepsin; pulmonary aspiration; Surgery; transplantation; transplantation
Background Lipid-laden macrophage (LLM) index could be potentially useful in assessing gastroesophageal (GE) reflux and aspiration after lung transplantation (LT) in patients with cystic fibrosis (CF). Methods A retrospective review of CF patients undergoing LT and/or laparoscopic Nissen fundoplication (LNF) from January 1, 2009, to December 31, 2011, was performed. Results Seventeen CF patients (nine women), mean (+/- SD) age 27.9 +/- 7.5 yr, underwent LT with mean (+/- SD) pre-transplant FEV1 of 20.9 +/- 5.0% predicted. Seventy percentage (12/17) of patients underwent LNF without complications within 12 wk of LT. After LT, but prior to antireflux surgery, there was no significant difference in the mean (+/- SD) baseline LLM index (154 +/- 41 vs. 146 +/- 51, p = NS) between patients who were to undergo LNF and patients who did not. After LNF, a significant reduction in the mean (+/- SD) LLM index occurred following the procedure (154 +/- 4174 +/- 54, p < 0.0001) while each patient reported resolution of symptoms of GE reflux, whereas 40% (2/5) undergoing only medical treatment reported resolution of symptoms. Conclusions Significant reduction in the LLM index occurred after LNF in CF patients after LT that correlated with resolution of clinical symptoms of GE reflux.
Hayes D; Kirkby S; McCoy K S; Mansour H M; Khosravi M; Strawbridge H; Tobias J D
Clinical Transplantation
2013
2013-01
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/ctr.12020" target="_blank" rel="noreferrer noopener">10.1111/ctr.12020</a>
The Effect Of Mold Sensitization And Humidity Upon Allergic Asthma
allergic rhinitis; allergy; asthma; bronchial responsiveness; childhood asthma; children; dampness; dry cold-air; exercise-induced asthma; home; humidity; induced bronchoconstriction; mold; pulmonary-function; respiratory health survey; Respiratory System; severity
Introduction: Humidity is commonly associated with increased airway hyperresponsiveness in asthma. Objective: To examine mold sensitization in patients with allergic asthma or allergic rhinitis and self-reports of humidity as exacerbating factors of clinical symptoms. Methods: A retrospective, cross-sectional study at a University hospital outpatient allergy and asthma clinic was performed. A total of 106 patients with either allergic asthma or allergic rhinitis completed standard prick-puncture skin testing with 17 allergens and controls and completed standardized forms addressing trigger factors for clinical symptoms. Results: Allergic asthmatics sensitized to Cladosporium were more likely to have a more severe asthma severity class (odds ratio=4.26, confidence interval=1.3016.93). Sensitization to Alternaria, Cladosporium, Helminthosporium, Aspergillus and Dermatophagoides pteronyssinus in asthma was associated with higher likelihood for previous hospitalization, while sensitization to Cladosporium, Helminthosporium, Aspergillus, Dermatophagoides pteronyssinus and cockroach in asthma was associated with higher likelihood of having reduced pulmonary function based on forced expiratory volume in 1s. Furthermore, allergic asthmatics more commonly reported humidity as an exacerbating factor of symptoms than did patients only with allergic rhinitis (68.42% vs 42.86%, respectively; P<0.05). Conclusion: Mold sensitization is highly associated with more severe asthma, while humidity is more of an exacerbating factor in patients with allergic asthma as compared with allergic rhinitis alone. Further delineation between mold sensitization and humidity is needed to determine whether these are independent factors in asthma. Please cite this paper as: Hayes D Jr, Jhaveri MA, Mannino DM, Strawbridge H and Temprano J. The effect of mold sensitization and humidity upon allergic asthma. Clin Respir J 2013; 7: 135144.
Hayes D; Jhaveri M A; Mannino D M; Strawbridge H; Temprano J
Clinical Respiratory Journal
2013
2013-04
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1111/j.1752-699X.2012.00294.x" target="_blank" rel="noreferrer noopener">10.1111/j.1752-699X.2012.00294.x</a>