Abstract:
:The term "steroid-resistant (SR) asthma" has been used to describe a group of asthmatics who demonstrate persistent airway obstruction and inflammation despite treatment with high doses of systemic glucocorticoids. There are at least two forms of SR asthma, that is, primary and acquired types. Type I SR asthma is acquired and is associated with abnormally reduced glucocorticoid receptor (GR) ligand and DNA binding affinity. Type II SR asthma is due to a primary GR binding abnormality. An important distinction between these two types of SR asthma is that the GR defect in Type I, but not Type II, SR asthma is reversible in culture and is sustained by incubation with combination IL-2 and IL-4. The treatment of these patients requires a systematic approach to rule out confounding factors, including triggers of immune activation, optimizing steroid therapy, and use of alternative strategies to inhibit airway inflammation.
journal_name
Clin Chest Medjournal_title
Clinics in chest medicineauthors
Leung DY,Szefler SJdoi
10.1016/s0272-5231(05)70405-6subject
Has Abstractpub_date
1997-09-01 00:00:00pages
611-25issue
3eissn
0272-5231issn
1557-8216pii
S0272-5231(05)70405-6journal_volume
18pub_type
杂志文章,评审abstract::In the past it was believed that respiratory disability could be objectively assessed by comparing the measured O2 consumption requirement of the job with the subjects' measured or estimated maximal oxygen consumption. More recently, it has become clear that this "classic" paradigm does not completely apply to all sit...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1992-06-01 00:00:00
abstract::Lung function testing has undisputed value in the comprehensive assessment and individualized management of chronic obstructive pulmonary disease, a pathologic condition in which a functional abnormality, poorly reversible expiratory airway obstruction, is at the core of its definition. After an overview of the physio...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2020.06.004
更新日期:2020-09-01 00:00:00
abstract::Our understanding of chronic bronchitis has been hampered by the fact that the diagnosis is based upon historical evidence of recurrent cough and sputum without any requirement that certain physiologic or microscopic criteria be met. Despite the fact that epidemiological studies have implicated viruses, bacteria, and ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1981-01-01 00:00:00
abstract::The features of cardiovascular and pulmonary disease in exercise testing are described. In general, ventilatory limitation is the most common factor in lung disease. An early anaerobic threshold and a decreased VO2 mix in the absence of ventilatory limitation is the usual feature of severe heart disease. ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::Although Burkholderia cepacia colonizes a relatively small proportion of individuals with cystic fibrosis (CF), it is associated with significant morbidity and mortality, and has had a profound impact on infection control practices. This article reviews the current understanding of the epidemiology of B. cepacia infec...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70094-0
更新日期:1998-09-01 00:00:00
abstract::This article focuses primarily on the recent literature on abdominal compartment syndrome (ACS) and the definitions and recommendations published by the World Society for the Abdominal Compartment Syndrome. The definitions regarding increased intra-abdominal pressure (IAP) are listed and are followed by an overview of...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2008.09.003
更新日期:2009-03-01 00:00:00
abstract::The features characterizing pneumonia due to Mycoplasma pneumoniae are described. Typical cases, along with chest radiographs of laboratory-documented cases, are presented. ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::This article review available strategies for mechanically ventilating patients with the adult respiratory distress syndrome. The authors first present the conventional strategies of mechanical ventilation: volume-limited mechanical ventilation with positive end-expiratory pressure (PEEP) at normal inspiratory-expirato...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::Cellular dysfunction is a commonplace sequelum of sepsis and other systemic inflammatory conditions. Impaired energy production (related to mitochondrial inhibition, damage, and reduced protein turnover) appears to be a core mechanism underlying the development of organ dysfunction. The reduction in energy availabilit...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2008.06.003
更新日期:2008-12-01 00:00:00
abstract::With the increasing threat of pandemic influenza and catastrophic bioterrorism, it is important for intensive care providers to be prepared to meet the challenge of large-scale airborne epidemics causing mass casualty respiratory failure. The severe acute respiratory syndrome outbreak exposed the vulnerability of heal...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2008.01.001
更新日期:2008-06-01 00:00:00
abstract::For clinicians involved in airway management, a plan of action for dealing with the difficult airway or a failed intubation should be developed well in advance of encountering a patient in whom intubation is not routine. When difficulty is anticipated, the equipment necessary for performing a difficult intubation shou...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::The pharmacologic treatment of the reversible elements of chronic obstructive pulmonary disease is discussed in this article. Discussion focuses on three classes of bronchodilator drugs--the sympathomimetic agents, the methylxanthines, and the anticholinergic agents. A section on corticosteroid use in patients with ch...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1986-12-01 00:00:00
abstract::The Hispanic population in the United States is diverse in many respects. Although there is marked variation in the prevalence, morbidity, and mortality of asthma among Hispanic subgroups in the United States, these differences are poorly understood. Future stu-dies of asthma should include large samples of Hispanic s...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2006.04.004
更新日期:2006-09-01 00:00:00
abstract::Illicit drug users comprise a substantial and growing proportion of the HIV-infected population. Although they develop pulmonary complications common to all HIV transmission groups, they also have unique respiratory illnesses due to the direct effect of the illicit drugs on the lung. Bacterial infections, tuberculosis...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70348-8
更新日期:1996-12-01 00:00:00
abstract::Hemodynamic monitoring is a diagnostic tool. Because hemodynamic monitoring often requires invasive procedures, it can be associated with an increased incidence of untoward events. Like any diagnostic tool, its ability to improve outcome will be primarily related to the survival benefit enjoyed by specific therapies t...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(03)00095-9
更新日期:2003-12-01 00:00:00
abstract::Nonresolving pneumonia is a common and frequently misunderstood problem faced by the practicing pulmonologist. While radiographic resolution of most infections is relatively long and lags behind clinical signs of recovery, data suggest that a variety of host defense problems are a consequence of systemic illness and a...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1987-09-01 00:00:00
abstract::Traditional tuberculosis (TB) infection control focuses on the known patient with TB, usually on appropriate treatment. A refocused, intensified TB infection control approach is presented. Combined with active case finding and rapid molecular diagnostics, an approach called FAST is described as a convenient way to cal...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2019.07.010
更新日期:2019-12-01 00:00:00
abstract::Leptospirosis is a worldwide disease. In this time of globalization knowledge about leptospirosis is important. Although pulmonary involvement has an incidence varying from 20% to 70% and its exteriorization may vary from mild to severe, The severe form appears to be becoming more prevalent (at least in Brazil) and ma...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(01)00010-7
更新日期:2002-06-01 00:00:00
abstract::The process of smoking cessation involves progression through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Most patients are not prepared to take action on their smoking, yet most smoking cessation programs are designed for smokers who are so prepared. Small percentages...
journal_title:Clinics in chest medicine
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::Obstructive sleep-disordered breathing consists of a spectrum ranging from the upper airway resistance syndrome to complete apnea. Although this disorder is relatively common, it is still under-recognized, resulting in a significant increase in morbidity and mortality. In this article, we describe the rationale for tr...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70434-2
更新日期:1998-03-01 00:00:00
abstract::Elevated serum IgE has many etiologies including parasitic infection, allergy and asthma, malignancy, and immune dysregulation. The hyper-IgE syndromes caused by mutations in STAT3, DOCK8, and PGM3 are monogenic primary immunodeficiencies associated with high IgE, eczema, and recurrent infections. These primary immuno...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2016.04.016
更新日期:2016-09-01 00:00:00
abstract::Although they are complex, the pulmonary-renal syndromes can be readily understood and managed using a clinical approach firmly grounded in the fundamental pathophysiology of these disorders. Several important principles must be borne in mind. First, therapeutic intervention must be preceded by making as firm a diagno...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-12-01 00:00:00
abstract::The psychosocial assessment of applicants to the Toronto Lung Transplant Program provides the team with a variety of information including coping style; adjustment to illness; presence and management of psychiatric disorders; ability to adhere to medical recommendations; and available social support. This information ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-06-01 00:00:00
abstract::Thoracic imaging is widely used to detect lower respiratory tract infections, identify their complications, and aid in differentiating infectious from noninfectious thoracic disease. Less commonly, the combination of imaging findings and a clinical setting can favor infection with a specific organism. This confluence ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2015.02.005
更新日期:2015-06-01 00:00:00
abstract::Given that poor asthma management leads to such devastating rates of morbidity and mortality in this country, efforts must be made to increase the knowledge, skills, and behaviors of persons with asthma. The suggestions and recommendations provided here represent a blend of academic opinion and practical advice on met...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-12-01 00:00:00
abstract::This article reviews several important noninfectious pulmonary complications that threaten survival, pulmonary function, and quality of life after lung transplantation. Topics reviewed include primary graft dysfunction (PGD), native lung hyperinflation, anastomotic complications, phrenic nerve injury, pleural complica...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2005.06.006
更新日期:2005-12-01 00:00:00
abstract::The older adult demonstrates several alterations in the ventilatory response to exercise relative to the young adult. These differences are primarily caused by the aging-induced loss of elastic recoil of the lung, which reduces expiratory airflow rates along the effort-independent portion of the maximal volitional flo...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-06-01 00:00:00
abstract::Viral pneumonia is a common complication for patients with hematologic malignancies and after hematopoietic cell transplantation causing significant morbidity, and often mortality. Infections are predominantly caused by herpes viruses, either by reactivation of latent infection, or less commonly primary infection, or ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2016.12.009
更新日期:2017-06-01 00:00:00
abstract::Endobronchial ablative therapies, such as mechanical debulking, laser therapy, electrocautery, argon plasma coagulation, cryotherapy, brachytherapy, photodynamic therapy, microdebrider bronchoscopy, resector balloon deobstruction, and intratumoral chemotherapy, are performed through a rigid or flexible bronchoscope in...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2017.11.008
更新日期:2018-03-01 00:00:00
abstract::Biologic drugs have revolutionized the treatment of certain hematologic, autoimmune, and malignant diseases, but they may place patients at risk for reactivation or acquisition of tuberculosis. This risk is highest with the tumor necrosis factor-alpha (TNF-α) inhibitors. Amongst this class of drugs, the monoclonal ant...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2019.07.003
更新日期:2019-12-01 00:00:00