Medicine and Health Sciences Commons^™

Obstructive Lung Disease Models: What Is Valid, Jill M. Ferdinands, David M. Mannino

David M. Mannino

Use of disease simulation models has led to scrutiny of model methods and demand for evidence that models credibly simulate health outcomes. We sought to describe recent obstructive lung disease simulation models and their validation. Medline and EMBASE were used to identify obstructive lung disease simulation models published from January 2000 to June 2006. Publications were reviewed to assess model attributes and four types of validation: first-order (verification/debugging), second-order (comparison with studies used in model development), third-order (comparison with studies not used in model development), and predictive validity. Six asthma and seven chronic obstructive pulmonary disease models were identified. Seven …

Perinatal Outcomes In Pregnancy With Asthma, Rashid Zaheer Syed, Ali Bin Sarwar Zubairi, Muhammad Ahsan Zafar, Rahat Qureshi

Department of Obstetrics & Gynaecology

Objective: To examine the relationship between asthmatic pregnancies and selected maternal and neonatal outcomes in a representative cohort.

Methods: A retrospective cohort study was conducted at the Aga Khan University Hospital during the year 2004. A random selection was made of 65 asthmatic and 63 non-asthmatic singleton births. The neonatal outcomes studied were birth weight, premature birth and Apgar scores at 1 and 5 minutes. The maternal outcomes studied were number of hospital admissions, and number of documented UTI during the studied pregnancy and past history of abortions and stillbirths.

Resluts: The mean age of asthmatics and nonasthmatics were 28.0 …

Subcutaneous Late Phase Responses Are Augmented During Local Inhalational Tolerance In A Murine Asthma Model, Anurag Singh, Roger S. Thrall, Linda A. Guernsey, William F. Carson Iv, Eric R. Secor Jr, Robert E. Cone, Thiruchandurai V. Rajan, Craig M. Schramm

UCHC Articles - Research

Acute exposure of sensitized mice to antigen elicits allergic airway disease (AAD) characterized by Th2 cytokine-dependent pulmonary eosinophilia, methacholine hyperresponsiveness and antigen-specific IgE elevation. However, chronic exposure induces a local inhalational tolerance (LIT), with resolution of the airway responses but persistent systemic IgE production. To further determine if systemic immunologic responses were maintained during LIT, we assessed subcutaneous late phase responses to ovalbumin in this model. Sensitized and AAD mice developed small subcutaneous responses to ovalbumin, with footpad thickness increasing to 113.7 and 113.6% of baseline, respectively. In comparison, LIT mice developed marked foot swelling (141.6%). Histologic examination confirmed increased …

A Program To Change The Approach To Care Of Children With Asthma In The Primary Care Setting Did Not Reduce Rates Of Hospital Admissions: Lessons Learned From A Descriptive Study, Sheniz Moonie, Robert C. Strunk, Mario Castro

Environmental & Occupational Health Faculty Publications

Asthma is a critical global health issue. It affects people of all ages in countries throughout the world. The prevalence of asthma is increasing in most countries among young children who also represent the greatest proportion of health care utilization. Outpatient asthma-treatment programs managed by chest physicians or allergists have reduced hospitalizations, yet programs in pediatric offices have not successfully impacted hospitalizations. The Community Asthma Program (CAP) was designed to support pediatrician use of clinical guidelines in their everyday office practice. The goal was to reduce asthma hospitalizations by 15 percent from selected pediatric practices. A study was done in …

Chronic Disease Medication Use In Managed Care And Indemnity Insurance Plans, Randall S. Stafford, Stephen M. Davidson, Harriet Davidson, Heidi Miracle-Mcmahill, Sybil L. Crawford, David Blumenthal

Sybil L. Crawford

OBJECTIVE: To evaluate the impact of managed care on the use of chronic disease medications. DATA SOURCE: Claims data from 1997 from two indemnity and three independent practice association (IPA) model managed care insurance plans. RESEARCH DESIGN: Cross-sectional analysis of claims data. DATA COLLECTION: Adult patients with diabetes mellitus (DM, n = 26,444), congestive heart failure (CHF, n = 7,978), and asthma (n = 9,850) were identified by ICD-9 codes. Chronic disease medication use was defined through pharmacy claims for patients receiving one or more prescriptions for drugs used in treating these conditions. Using multiple logistic regression we adjusted for …

Effect Of Chronic Airway Inflammation Induced By Allergen Sensitization On Vagal Bronchopulmonary Sensory Nerves In Rats, Guangfan Zhang

University of Kentucky Doctoral Dissertations

Airway hyperresponsivness (AHR) is one of most prominent pathophysiological features of asthma. Increasing evidence suggests that vagal bronchopulmonary afferents may be involved in the development of AHR. However, the underlying mechanisms are not clear. Therefore, the purpose of this dissertation was to investigate the effect of chronic airway inflammation induced by allergen sensitization on vagal bronchopulmonary afferents. The study was carried out in an animal model of allergic asthma. Brown-Norway rats were sensitized by intraperitoneal Ovalbumin (Ova) and exposed to aerosolized Ova 3 times/week for three weeks. Control rats received the vehicle. In vivo single-fiber recording technique was applied in …

Serum Transforming Growth Factor-Β (Tgf-Β), Matrix Metalloproteinase-2 (Mmp-2), Matrix Metalloproteinase-9 (Mmp-9) And Tissue Inhibitors Of Metalloproteinase (Timp-1) Levels In Childhood Asthma, Fi̇gen Doğu, Ali̇şan Yildiran, Deni̇z Güloğlu, Funda Erol Çi̇pe, Mutlu Yüksek, Emel Babacan, Aydan İki̇nci̇oğullari

Turkish Journal of Medical Sciences

Aims: Airway remodelling is a characteristic feature of asthma and is a dynamic process involving extracellular matrix (ECM) production and its degradation. In this regard, the matrix metalloproteinases (MMPs) and their specific inhibitors known as tissue inhibitors of metalloproteinases (TIMPs) have been shown to be important in this process. In the present study, transforming growth factor (TGF)-\beta, MMP-2, MMP-9 and TIMP-1 levels in serum samples of children with stable asthma and healthy controls were evaluated to determine whether these levels show any difference between asthmatic and healthy children and whether or not these levels change with atopic status. Materials and …

Peripheral Blood Lymphocyte Activation And Rantes Levels In Asthma, Gaye Erten, Benan Müselli̇m, Bülent Tutluoğlu, Bi̇lun Gemi̇ci̇oğlu, Günnur Deni̇z

Turkish Journal of Medical Sciences

Aim: Bronchial mucosal inflammation is one of the major characteristics of atopic asthma. Th2 activation and the related cytokine profile, eosinophil activation and infiltration play the main role in the pathogenesis of atopic asthma. The aim of this study was to demonstrate the activation and RANTES (regulated on activation, normal T-cell expressed and presumably secreted) expression of peripheral blood lymphocytes of non-atopic and atopic asthmatic patients. Materials and Methods: CD3, CD4, CD8, CD16, CD23, CD25, CD45RA and CD45RO expressions were determined in 22 asthma patients and 20 healthy control subjects by flow cytometry, and RANTES levels were measured by ELISA. …