sodium-ethylxanthate and Pneumonia

Allergic asthma is a chronic Th2 inflammation in the lungs that constricts the airways and presents as coughing and wheezing. Asthma mostly affects boys in childhood and women in adulthood, suggesting that shifts in sex hormones alter the course of the disease. Alveolar macrophages have emerged as major mediators of allergic lung inflammation in animal models as well as humans. Whether sex differences exist in macrophage polarization and the molecular mechanism(s) that drive differential responses are not well understood. We found that IL-4-stimulated bone marrow-derived and alveolar macrophages from female mice exhibited greater expression of M2 genes in vitro and after allergen challenge in vivo. Alveolar macrophages from female mice exhibited greater expression of the IL-4Rα and estrogen receptor (ER) α compared with macrophages from male mice following allergen challenge. An ERα-specific agonist enhanced IL-4-induced M2 gene expression in macrophages from both sexes, but more so in macrophages from female mice. Furthermore, IL-4-stimulated macrophages from female mice exhibited more transcriptionally active histone modifications at M2 gene promoters than did macrophages from male mice. We found that supplementation of estrogen into ovariectomized female mice enhanced M2 polarization in vivo upon challenge with allergen and that macrophage-specific deletion of ERα impaired this M2 polarization. The effects of estrogen are long-lasting; bone marrow-derived macrophages from ovariectomized mice implanted with estrogen exhibited enhanced IL-4-induced M2 gene expression compared with macrophages from placebo-implanted littermates. Taken together, our findings suggest that estrogen enhances IL-4-induced M2 gene expression and thereby contributes to sex differences observed in asthma.

Topics: Adult; Animals; Asthma; Cell Differentiation; Cells, Cultured; Child; Estrogens; Female; Humans; Interleukin-4; Macrophages, Alveolar; Male; Mice; Mice, Inbred C57BL; Pneumonia; Sex; Signal Transduction; Th2 Cells

To observe the trends in vital capacity (VC) over time in tetraplegics 20 years and more after injury, the effects of age at injury, severity of injury and gender on this trend.. The medical records of all spinal cord injured persons admitted to a regional spinal injury center from January 1960 to December 1996 were reviewed. Fifty-seven patients had documented post-rehabilitation VC (mean 1.3+/-1.1 years) and VC at 10 (mean 11.8+/-2.69) and 20 (20.60+/-2.67) years post injury and beyond.. The mean age at injury was 23.2+/-9.1 years. Severity of injury when classified according the system proposed by Coll et al were: Group 1: C1-4 Frankel A injury: 11.6%, Group 2: C5-8 Frankel A injury: 55.6%, Group 3: C2-8 Frankel B and C: 29.8% and Group 4: C2-8 Frankel D: 3.5% respectively. The mean VC at initial, 10 and 20 years post injury was 2586+/-948, 2803+/-940 and 2525+/-818 cc respectively. Multivariate analysis of variance revealed that there was significant difference in VC over a 20 year period, (F(2,54)=8.43, P<0.05). The difference between VC at 10 years and VC at 20 years accounted for the 19.8% of the variance in VC over time (F(1,55)=12.35, P<0.05). Age at injury, gender and severity of injury did not have a significant influence on the rate of decline in VC. Analysis of a subset of 26 patients who were followed up more than 20 years post injury (range 22 to 34.5 years) revealed similar, with a greater drop in the VC from 10 years post injury (F(1,23)=6.52, P<0.05). In this subset of patients, the mean VC at initial injury was 2840.9+/-847.3 cc, at 10 years was 2549.6+/-750.3 cc, at 20 years was 2400.9+/-724.1 cc and beyond 20 years was 2194.2+/-738.7 cc. There was no significant difference in mean VC between non smokers and ex/current smokers at initial, 10 and 20 years post injury, using the independent t-test (P>0.05).. Vital capacity in tetraplegics declines significantly over the years, with a greater decline occurring at more than 20 years post injury.

Topics: Adolescent; Adult; Age of Onset; Bronchitis; Chronic Disease; Female; Follow-Up Studies; Humans; Male; Middle Aged; Multivariate Analysis; Pneumonia; Pulmonary Ventilation; Quadriplegia; Respiration; Sex; Sleep Apnea Syndromes; Smoking; Spinal Cord Injuries; Tracheal Stenosis; Tracheotomy; Vital Capacity

Variations in the rates of major procedures by race and gender are well described, but few studies have assessed the quality of care by race and gender for basic hospital services.. To assess quality of care by race and gender.. Retrospective review of medical records.. Stratified random sample of 2,175 Medicare beneficiaries hospitalized for congestive heart failure or pneumonia in Illinois, New York, and Pennsylvania during 1991 and 1992.. Explicit process criteria and implicit review by physicians.. In adjusted analyses, black patients with congestive heart failure or pneumonia received lower quality of care overall than other patients with these conditions by both explicit process criteria and implicit review (P < 0.05). On explicit measures, overall quality of care did not differ by gender for either condition, but significant differences were noted on explicit subscales. Women received worse cognitive care than men from physicians for both conditions, better cognitive care from nurses for pneumonia, and better therapeutic care for congestive heart failure (P < 0.05). Women received worse quality of care than men by implicit review (P = 0.03) for congestive heart failure but not pneumonia.. Consistent racial differences in quality of care persist in basic hospital services for two common medical conditions. Physicians, nurses, and policy makers should strive to eliminate these differences. Gender differences in quality of care are less pronounced and may vary by condition and type of provider or service.

Topics: Aged; Black or African American; Female; Heart Failure; Humans; Illinois; Linear Models; Male; Medicare; New York; Outcome and Process Assessment, Health Care; Pennsylvania; Pneumonia; Quality of Health Care; Racial Groups; Retrospective Studies; Severity of Illness Index; Sex; United States

Fifty mothers of children attending a hospital outpatient clinic with non-severe pneumonia (fast breathing but no chest indrawing) were interviewed in depth. Maternal perceptions and practices with clinical significance were documented. Results showed that most mothers initially tried "heat-producing" home remedies designed to counter the "coldness" of the disease, allowed only 2 days for any particular allopathic medicine to work, and did not go to the same practitioner twice. When mothers were asked what had alarmed them enough to come to the hospital, the symptoms named most frequently were persistent severe cough and high fever, inability to sleep and excessive crying. Fast breathing was spontaneously mentioned by only a few, although when questioned, 32/50 said that they had noticed it. The mothers who had prior experience with child pneumonia were more likely to notice fast breathing and also came to the hospital earlier than those who were inexperienced. Relatively higher levels of maternal education and income were suggestively associated with bringing a female child rather than a male child for pneumonia treatment. Fewer than half of the mothers knew where air goes when a person breathes in and where the lungs are located. Most held treatment preferences at odds with the protocols proposed for the national ARI program currently being initiated in Pakistan, e.g. they said that a doctor should use a stethoscope, should prescribe suspensions rather than tablets and should give injections. This study provides baseline data on attitudes and behaviors that can either be built on in that program or addressed through public education campaigns.

Topics: Attitude to Health; Child, Preschool; Developing Countries; Female; Health Education; Humans; Infant; Male; Medicine, Traditional; Mothers; Pakistan; Pneumonia; Sex

Topics: Adult; Aerosols; Aged; Asthma; Chlorpromazine; Female; Heart Diseases; Humans; Isoproterenol; Male; Middle Aged; Pneumonia; Postoperative Complications; Pulmonary Emphysema; Retrospective Studies; Sex

Topics: Adult; Aged; Aging; Arthritis, Rheumatoid; Bronchiectasis; Bronchitis; Chronic Disease; Female; Humans; Male; Middle Aged; Pneumonia; Retrospective Studies; Sex; Smoking

Topics: Adolescent; Air Pollution; Asthma; Bronchiectasis; Bronchitis; Bronchitis, Chronic; Child; Death Certificates; Emphysema; Epidemiology; Geriatrics; Humans; Infant; Lung Diseases; Mortality; Occupations; Pneumonia; Pneumonia, Viral; Pulmonary Emphysema; Respiratory Tract Neoplasms; Sex; Social Conditions; Tuberculosis; Tuberculosis, Pulmonary; United States

Topics: Aging; Asthma; Bronchiolitis; Bronchiolitis, Viral; Bronchitis; Child; Child, Hospitalized; Gastroenteritis; Humans; Illinois; Infant; Laryngitis; Meningitis; Mortality; Pneumonia; Respiratory Tract Infections; Sex; Sex Distribution; Statistics as Topic; Tonsillitis

Topics: Air Pollution; Asphyxia; Bronchitis; Cerebrovascular Disorders; Cough; Craniocerebral Trauma; Electrocardiography; Heart Failure; Humans; Myocardial Infarction; Neoplasm Metastasis; Neoplasms; Occupations; Peptic Ulcer; Pneumonia; Pneumothorax; Polycythemia; Pulmonary Emphysema; Pulmonary Heart Disease; Radiography, Thoracic; Respiratory Function Tests; Sex; Smoking; Suicide

Topics: Aging; Bacteria; Bronchial Neoplasms; Bronchiectasis; Bronchitis; Bronchography; Bronchoscopy; Humans; Lung Neoplasms; Pneumonia; Sex; Tuberculosis; Tuberculosis, Pulmonary

Topics: Asphyxia Neonatorum; Blood Group Antigens; Congenital Abnormalities; Diseases in Twins; Erythroblastosis, Fetal; Extraembryonic Membranes; Female; Fetal Death; Humans; Hyaline Membrane Disease; Infant; Infant Mortality; Infant, Newborn; Infant, Premature; Placenta; Pneumonia; Pregnancy; Sex; Statistics as Topic; Twins