Airway obstruction can be better predicted using Global Lung Function Initiative spirometry reference equations in Marfan syndrome.

Marfan syndrome is a genetic disorder of the connective tissue, including involvement of the lungs.Pulmonary function test was performed in 32 asymptomatic adult Marfan patients using European Community for Coal and Steel (ECCS) and Global Lung Function Initiative (GLI) reference values.Using GLI equations for reference, significantly lower lung function values were noted for forced vital capacity (FVC) (87.0 ± 16.6% vs. 97.1 ± 16.9%; P < 0.01) and forced expiratory volume in the first second (FEV1) (79.6 ± 18.9% vs. 88.0 ± 19.1%; P < 0.01) predicted compared to ECCS. Obstructive ventilatory pattern was present in 25% of the cases when calculating with GLI lower limit of normal (LLN), and it was significantly more common in men as compared to women (n = 6, 50% vs. n = 2, 10%; P = 0.03).GLI is more suitable to detect early ventilatory changes including airway obstruction in young patients with special anatomic features, and should be used as a standard way of evaluation in asymptomatic Marfan population.

Airway pathogens during the first year after lung transplantation: a single-center experience.

After lung transplantation, a high level of immunosuppression is needed to prevent rejection. This demand renders recipients more sensitive to infections. As pulmonary infections are a major clinical problem during the first postoperative year after lung transplantation, preventive treatment and regular surveillance examinations are needed for immediate, adequate therapy. We describe the airway pathogens registered during the first posttransplantation year among our 12 lung transplant recipients since December 2008. Samples were obtained for microbiologic analysis from the upper and lower respiratory tracts and from serum as part of routine care. During the first year after transplantation the most frequent pathogens were fungi (Candida albicans 82%; Aspergillus 50%), Pneumocystis (8%), gram-negative bacteria (Pseudomonas spp 60%; Klebsiella 25%, Acinetobacter 17%; Escherichia Coli 17%; and Enterococcus faecalis 25%), and Staphylococcus aureus (50%, including methicillin-resistant strains 25%). This pathogen spectrum in the first postoperative year after lung transplantation was similar to other centers. Colonization with Pseudomonas or fungi presented early and was prevalent among our patients.

Severe mixed sleep apnea after bilateral lung transplantation in a cystic fibrosis patient: a case report.

BACKGROUND: Lung transplantation is the only treatment for end-stage lung disease in selected patients. After lung transplantation, patient recovery is often slow owing to severe underlying diseases in the patient producing hypoxemia before, during, and after surgery, as well as infections and rejection episodes. Postoperative breathing and ventillatory disorders are also associated with diaphragmatic dysfunction and/or phrenic nerve damage. METHODS: Herein we have reported a case of a 35-year-old man undergoing bilateral lung transplantation owing to worsening of chronic respiratory failure from cystic fibrosis. After uncomplicated surgery, weaning was delayed due to nighttime dyspnea and hypoxemia attributed to diaphragm dysfunction. After improvement of diaphragm function, the symptoms persisted, requiring noninvasive nocturnal ventilatory support. Polysomnography confirmed severe mixed sleep apnea. RESULTS: Effective treatment with noninvasive bi-level positive airway pressure spontaneous/timed mode (BiPAP S/T) ventilation during the nights rendered the patient symptom free. Polysomnography confirmed successful treatment. CONCLUSION: Disordered breathing while sleeping is common after solid organ transplantation. BiPAP S/T ventilator therapy was effective to the treat dominantly central sleep apnea in our patient.

Comparison of aortic arch and carotid sinus distensibility in humans--relation to baroreflex sensitivity.

We compared aortic arch (AA) and carotid sinus (CS) distensibility, and determined the relationship between baroreflex sensitivity (BRS) and distensibility coefficients of AA and CS (DCAA and DCCS, respectively). In 47 healthy 19-71-year-old subjects, AA and CS end-diastolic diameter (D) and pulsatile distension (delta D) was measured with ultrasound and arterial pressure by sphygmomanometer and Finapres. DC was calculated as 2delta D/(D x delta P), where delta P is the pulse pressure. BRS was determined by the sequence method. Data are given as mean +/- S.D.; significance was set at p < 0.05. DCAA and DCCS were linearly related across subjects (r = 0.80, p < 0.001). No difference between DCAA and DCCS (3.8 +/- 1.4 x 10(-3) and 4.2 + 2.2 x 10(-3) mm Hg(-1), respectively) was found for all subjects (paired t-test). However, at ages < 35 years, DCCS exceeded DCAA, whereas this relation was reversed at ages > 35 years. Age accounted for 53% of variability in DCAA and 73% of variability in DCCS. BRS was related to DC (linear regression), with the BRS-DCAA relation being steeper and closer (r = 0.73, p < 0.001) than the BRS-DCCS relation (r = 0.54, p < 0.05). It is suggested that aortic baroreceptors may have a dominant role in heart rate control.

Organochlorine contaminant concentrations in caddisfly adults (Trichoptera) collected from great lakes connecting channels.

Pennsylvania-style light traps were used to capture adult Trichoptera from the St. Marys, St. Clair, Detroit and Niagara rivers, Canada. Adequate biomass was acquired in single, 2-h collections to permit triplicate gas chromatographic analyses of 1-4 g samples for 36 organochlorine contaminants. Contaminant levels varied unpredictably but relatively little among samples taken at monthly intervals over the summer. Samples collected simultaneously from the two sides of the Detroit R. reflected local sediment contaminant patterns, suggesting limited dispersal by adults. Genus-specific differences in contaminant concentrations within the Hydropsychidae and Leptoceridae probably reflect differences in larval habitats and manner of feeding. Contaminant concentrations and relative composition paralleled published reports of contaminants in sediments from collection locations. St. Marys R. caddisflies contained contaminant levels indistinguishable from samples collected at reference sites. St. Clair R. samples contained high levels of compounds associated with petrochemical industries located in the river's upstream reaches. High levels of polychlorinated biphenyls (PCBs) and most other contaminants in Detroit R. samples reflected industrial loadings near Detroit, Michigan. Niagara R. samples contained elevated concentrations of PCBs and pesticides. Cluster analysis grouped samples into five clusters each with unique contaminant composition. These also corresponded to geographic origin: St. Marys, St. Clair, Detroit and upper and lower Niagara rivers. The relative ease of collection and consistent results obtained render adult Trichoptera potentially valuable candidates for surveys of aquatic contamination over a broad range of geographical and ecological conditions.

Campylobacter strains isolated from slaughtered chickens: their sensitivity to antibiotics and resistance to erythromycin.

Antibiograms for 304 Campylobacter strains isolated in Csongrád county from slaughtered chickens in the years 1981 to 1983 were determined with the disk-agar diffusion method. The isolates, originating from two poultry-processing plants and two canteen kitchens proved to be sensitive to nalidixic acid, chloramphenicol, gentamicin and nitrofurantoin and resistant to penicillin. The antibiogram depended on the source of samples and, to a higher degree, on the year of sampling. The frequency of strains resistant to erythromycin was 5.7% in 1981 and 39.8% in 1983; for the resistant strains the minimum inhibiting concentration was greater than 250 micrograms erythromycin per ml. In the same periods 25.0% and 32.8% of the isolates were resistant to tetracycline and 23.3% and 49.2% to lincomycin, respectively. Simultaneous resistance to tetracycline, lincomycin and erythromycin occurred in 16.4% of the isolates.

Campylobacter jejuni contamination of slaughtered chickens.

Gut samples from 50 nonselected slaughtered chickens were obtained in two poultry processing plants and cultured for Campylobacter jejuni and Salmonella. Positive results were obtained in 84% and 4%, respectively. Viable C. jejuni and Salmonella were detected in every phase of processing, even during packaging for commercial purposes. Of surface samples taken from 118 slaughtered chickens prepared for delivery to consumers, 88 were contaminated by C. jejuni and 17 by Salmonella.