Chlamydial pneumonia and asthma: a potentially important relationship

Article Abstract:

During the past decade, mortality from asthma has increased in most industrialized nations, including the United States. Hospitalization patterns for children with asthma have also changed during this period. These fluctuations could have been caused by a true increase in cases of asthma, an increase in the number of genetically susceptible individuals, increased survival of infants and children with respiratory disorders, better documentation of cases, better access to medical care, or more accurate diagnosis. Several recent studies have explored specific causative agents in an effort to explain why more patients are being diagnosed with asthma. In the July 10, 1991 issue of The Journal of the American Medical Association, David Hahn and his colleagues suggest that the relation between Chlamydia pneumoniae infection and subsequent asthmatic bronchitis could account for the increase in asthma among adults. The fact that about half the adults worldwide have been exposed to C. pneumoniae may also help to explain the rising incidence (number of cases) of asthma. Other research has shown that while both the incidence and mortality of asthma have risen, rate of increase in deaths has been slower than the increase in new cases. Efforts to reduce the incidence of asthma by decreasing environmental exposure, such as control of dust mites in the home and allergens in the workplace, take several weeks or longer to produce improvement. Even greater difficulty is encountered when mold spores common in the environment are the cause of asthma attacks. A recent study of respiratory arrest in asthmatics revealed that among children and adults exposed to the spores of one particular mold, the risk of arrest was significantly greater. These studies may help to identify preventable causes of asthma attacks, and explain the fluctuations in asthma-related illness and death. (Consumer Summary produced by Reliance Medical Information, Inc.)

Cases, Complications and side effects, Asthma, Chlamydia infections, editorial

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The ARDS lung: new insights from computed tomography

Article Abstract:

CT scanning has improved the understanding of lung function in patients with adult respiratory distress syndrome (ARDS). It was previously thought that ARDS caused progressive, diffuse stiffness in the lungs that lowered lung volume. However CT scanning has revealed that the effects of ARDS are not homogeneous and that lungs in patients with ARDS are functionally small, not stiff. There are areas of lungs that are irreversibly damaged, areas with basically normal ventilation and areas with poor ventilation. The weight of the accumulated fluid in the affected lungs can cause areas to compress and collapse. Use of positive end-expiratory pressure (PEEP) that is equal to or greater than the superimposed hydrostatic pressure can re-inflate collapsed lung tissue. However, PEEP that is sufficient to reopen collapsed areas may over-inflate and damage normal areas. Further studies are needed to determine levels of PEEP that prevent collapse while minimizing damage to healthy lung tissue.

Editorial, Usage, Physiological aspects, CT imaging, CAT scans, Acute respiratory distress syndrome, Adult respiratory distress syndrome, Positive pressure respiration

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