A group of 23 Australian infants who demonstrated flow limitation in expiratory breathing at 4 weeks of age continued to have reduced lung function ability and increased airway resistance through age 11. The researchers found that the association between airway resistance and reduced lung function, present in infancy and persisting into childhood, strongly suggested that it is due to an underlying factor present in very early life that may include in utero tobacco exposure or genetic factors. When the children reached 2 years of age, the researchers found that the flow-limited youngsters had a seven-fold higher incidence of physician-diagnosed asthma. They believe the children in the flow-limited group may be expected to retain their increased airway resistance and the trend toward reduced pulmonary function into adult life. The research appears in the first issue for May of the American Thoracic Society’s peer- reviewed American Journal of Respiratory and Critical Care Medicine.
INCREASED DISEASE SEVERITY FROM RHINOVIRUS IN INFANTS WITH ACUTE BRONCHIOLITIS
Researchers published the first study to observe a significant correlation between rhinovirus infection and increased disease severity in infants with acute bronchiolitis. Bronchiolitis is a viral infection of the lower respiratory tract, occurring mostly in children under age 2. It is characterized by respiratory distress, wheezing on expiration, low grade fever, cough, and nasal discharge. The acute form of the disease is a major cause of hospitalization in that age group. After controlling for a number of variables among the study group, the Greek investigators found that the presence of rhinovirus increased the risk of severe disease by approximately five-fold. Overall, sensitive polymerase chain reaction testing revealed the presence of a virus in 87 of 118 total infants (73.7 percent). Respiratory syncytial virus was found in 63 of the 87 cases, and rhinovirus in 25 (29 percent). Multiple viruses represented almost 20 percent of the cases. They discovered that rhinovirus infection led patients to the hospital quicker than did respiratory syncytial virus. The study appears in the first issue for May of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.
EXERCISE RESPONSE IN WOMEN WITH SICKLE CELL DISEASE
A study was published that showed women with sickle cell anemia can safely perform maximal cardiopulmonary exercise if they are allowed to stop when the need arises. The researchers tested 17 women, ages 20 to 45, with sickle cell anemia to evaluate the safety and effectiveness of physical training for patients with this disease. Sickle cell disease is an inherited condition that affects black persons almost exclusively. It is characterized by sickle-cell shaped red blood cells and chronic hemolytic anemia. According to the authors, many adults with the problem complain of significant exercise intolerance. The 17 women underwent symptom-limited exercise testing, and all completed it without serious complications. Fifteen of the 17 stopped exercise due to leg discomfort; 6 of the 17 patients complained of mild shortness of breath. The researchers said that the pathophysiologic pattern of the women suggests all of the patients were exercise-limited by their “cardiovascular system.” Yet none of the women had electrocardiogram changes or characteristic patterns suggestive of myocardial ischemia (decreased blood supply to the heart). The research appears in the first issue of May of the American Thoracic Society’s peer-reviewed American Journal of Respiratory and Critical Care Medicine.
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Journal
American Journal of Respiratory and Critical Care Medicine