Publications
1241 results found
Webb AK, Dodd ME, Bush A, 2004, Nebulized antibiotics in cystic fibrosis and non-CF bronchiectasis in children and adults, Practical Handbook of Nebulizer Theory, Editors: Boe, O'Driscoll, Dennis, London, Publisher: Martin Dunitz, Pages: 115-136
Bush A, 2004, Small is beautiful: but may be breathless., Chron Respir Dis, Vol: 1, Pages: 181-182, ISSN: 1479-9723
Bush A, 2004, Treatment options of asthma in infancy, PEDIATRIC PULMONOLOGY, Pages: 20-22, ISSN: 8755-6863
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- Citations: 1
Bush A, Suri R, Webb AK, 2004, Nebulizers in cystic fibrosis and non-CF bronchiectasis in children and adults, Practical Handbook of Nebulizer Theory, Editors: Boe, O'Driscoll, Dennis, London, Publisher: Martin Dunitz, Pages: 137-162
Levy ML, Godfrey S, Irving CS, et al., 2004, Wheeze detection: Recordings vs. assessment of physician and parent, JOURNAL OF ASTHMA, Vol: 41, Pages: 845-853, ISSN: 0277-0903
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- Citations: 43
Bush A, 2004, What is new in cystic fibrosis, Vaiku Pulmonologija ir alergologija, Pages: 2419-2430
Karatza AA, Narang I, Rosenthal M, et al., 2004, Treatment of primary pulmonary hypertension with oral sildenafil, RESPIRATION, Vol: 71, Pages: 192-194, ISSN: 0025-7931
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- Citations: 20
Bush A, 2004, Classification of phenotypes, PEDIATRIC PULMONOLOGY, Pages: 30-33, ISSN: 8755-6863
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- Citations: 5
Bush A, 2004, Viruses and Asthma, Vaiku Pulmonologija ir alergologija, Pages: 2379-2388
Bush A, 2004, Primary ciliary dyskinesia: diagnosis, management and organization of clinics, Vaiku Pulmonologija ir alergologija, Pages: 2397-2410
Bush A, 2004, Phenotype specific treatment of asthma in childhood., Paediatr Respir Rev, Vol: 5 Suppl A, Pages: S93-101, ISSN: 1526-0542
The term "asthma syndrome" encompasses a range of disorders, all characterised clinically by combinations of cough, wheeze and breathlessness. In older children, evidence of variable airway obstruction is manifest by change in peak flow over time or with treatment, reduction in peak flow on exercise, and a positive methacholine challenge. The underlying pathology includes combinations of bronchial hyperreactivity (BHR), airway inflammation and alterations in underlying baseline airway calibre or compliance. This is not merely of academic importance, but is fundamental to organizing appropriate treatment. In children with symptoms with viral colds and also between colds, and in particular if they are atopic, the underlying abnormality is likely to be T-cell driven, eosinophil-mediated airway inflammation. There is compelling evidence that early treatment with inhaled corticosteroids is essential if airway remodelling is to be avoided and optimum long-term lung function is to be achieved. The pathophysiology of wheezing with viral colds in the non-atopic infant is completely different; such infants have evidence of abnormal lung function soon after birth and before their first episode of viral wheeze, and no evidence of either bronchial hyperreactivity or airflow inflammation. Response to inhaled steroids is very poor. For most infants with wheeze, it is currently not possible to predict whether they will go on to the picture of established asthma. Post-bronchiolitic asthma syndrome also does not respond to inhaled steroids, because prolonged symptoms are likely due to abnormal pre-morbid airway function, albeit worsened by atopy. Phenotype-specific treatment is also important in older children who have severer asthma and do not respond to high dose inhaled steroids. We have delineated a group with marked BHR but no evidence of inflammation who respond to subcutaneous terbutaline, and a second group with steroid resistant inflammation who may do better with
Saglani S, Payne DNR, Nicholson AG, et al., 2003, The safety and quality of endobronchial biopsy in children under five years old, THORAX, Vol: 58, Pages: 1053-1057, ISSN: 0040-6376
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- Citations: 32
Ferreira FA, Lex C, Bush A, et al., 2003, Gastroesophageal reflux and inflammation in bronchoalveolar lavage in children, Winter Meeting of the British Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: 66-67, ISSN: 0040-6376
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- Citations: 1
Lex C, Ferreira F, Payne DNR, et al., 2003, Comparison of noninvasive and invasive methods for assessment of airway inflammation in children with asthma, Winter Meeting of the British Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: 61-61, ISSN: 0040-6376
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- Citations: 2
Bush A, Rubin BK, 2003, Macrolides as biological response modifiers in cystic fibrosis and bronchiectasis., Semin Respir Crit Care Med, Vol: 24, Pages: 737-748, ISSN: 1069-3424
For 50 years, macrolide antibiotics have been used to treat community acquired pneumonia and atypical infections such as Chlamydia pneumonia and Mycoplasma. In the late 1960s it was noted that when the 14-member ring macrolide antibiotic troleandomycin was given to asthma patients who required large doses of systemic corticosteroids, they could often reduce their steroid dose or even stop steroids completely without exacerbation of their asthma. Because of this experience, Prof. S. Kodoh and colleagues first used erythromycin as an immunomodulatory agent to treat diffuse panbronchiolitis (DPB). DPB is a cystic fibrosis (CF)-like condition seen predominantly in young, nonsmoking adults in Japan and Korea. The introduction of erythromycin profoundly improved survival, and in many of these very ill patients the illness disappeared. Since then, research has focused attention on many non-antibacterial, disease modifying effects of this class of compounds. These include downregulation of proinflammatory cytokines via an effect on nuclear transcription factors, reduction in adhesion molecule expression, suppression of inducible nitric oxide synthase (iNOS), reduced neutrophil chemotaxis and degranulation, inhibition of neutrophil elastase, cytoprotection against bioactive phospholipids, improvement in the rheological properties of mucus, reduction in bronchial hyperreactivity, and, perhaps, modulation of neutrophil death by apoptosis pathways, and in the end, airway remodeling. Additionally, they have unconventional effects on microorganisms, including inhibiting Pseudomonas aeruginosa twitching motility and thus biofilm formation. There are small case series and three large randomized controlled trials that have established unequivocal evidence of benefit in CF. There is less evidence for an immunomodulatory effect in bronchiectasis. Future work is likely to focus on the development of macrolides with disease-specific modes of action.
Bush A, Rubin BK, 2003, Macrolides as biological response modifiers in cystic fibrosis and bronchiectasis, SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 24, Pages: 737-747, ISSN: 1069-3424
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- Citations: 25
Saglani S, Payne DNR, McKenzie SA, et al., 2003, Relationship between parental reported wheeze, video questionnaire and bronchoscopy findings in pre-school children with troublesome respiratory symptoms, Winter Meeting of the British Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: 12-12, ISSN: 0040-6376
Hilliard TN, Madden N, Nicholson AG, et al., 2003, Airway inflammation and remodelling in children with cystic fibrosis, Winter Meeting of the British Thoracic-Society, Publisher: B M J PUBLISHING GROUP, Pages: 64-64, ISSN: 0040-6376
Li AM, Lex C, Zacharasiewicz A, et al., 2003, Cough frequency in children with stable asthma: correlation with lung function, exhaled nitric oxide, and sputum eosinophil count, THORAX, Vol: 58, Pages: 974-978, ISSN: 0040-6376
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- Citations: 25
Ranganathan SC, Goetz I, Hoo AF, et al., 2003, Assessment of tidal breathing parameters in infants with cystic fibrosis, EUROPEAN RESPIRATORY JOURNAL, Vol: 22, Pages: 761-766, ISSN: 0903-1936
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- Citations: 28
Midulla F, de Blic J, Barbato A, et al., 2003, Flexible endoscopy of paediatric airways, EUROPEAN RESPIRATORY JOURNAL, Vol: 22, Pages: 698-708, ISSN: 0903-1936
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- Citations: 158
Jeffery P, Holgate S, Wenzel S, et al., 2003, Methods for the assessment of endobronchial biopsies in clinical research: application to studies of pathogenesis and the effects of treatment., Am J Respir Crit Care Med, Vol: 168, Pages: S1-17, ISSN: 1073-449X
Li AM, Li AM, Bush A, et al., 2003, Homeopathy in childhood asthma, THORAX, Vol: 58, Pages: 826-826, ISSN: 0040-6376
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- Citations: 4
Li AM, Bush A, Wilson NM, 2003, Homeopathy in childhood asthma., Thorax, Vol: 58, ISSN: 0040-6376
Narang A, Maguire A, Nunn JH, et al., 2003, Oral health and related factors in cystic fibrosis and other chronic respiratory disorders, ARCHIVES OF DISEASE IN CHILDHOOD, Vol: 88, Pages: 702-707, ISSN: 0003-9888
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- Citations: 45
Csoma Z, Bush A, Wilson NM, et al., 2003, Nitric oxide metabolites are not reduced in exhaled breath condensate of patients with primary ciliary dyskinesia, CHEST, Vol: 124, Pages: 633-638, ISSN: 0012-3692
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- Citations: 39
Davies G, McShane D, Davies J, et al., 2003, Segregation and use of nonshared care settings reduce the risk of multiresistant <i>P-aeruginosa</i> infection -: Re:: Davies et al., "Multiresistant <i>Pseudomonas aeruginosa</i> in a pediatric cystic fibrosis center:: natural history and implications for segregation," Pediatr Pulmonol 2003;35:253-256 -: Reply, PEDIATRIC PULMONOLOGY, Vol: 36, Pages: 172-172, ISSN: 8755-6863
Bush A, Wallis C, 2003, Mutations of CFTR gene and intermediate sweat chloride levels, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 167, Pages: 1577-1577, ISSN: 1073-449X
Bush A, Wallis C, 2003, Mutations of CFTR gene and intermediate sweat chloride levels., Am J Respir Crit Care Med, Vol: 167, ISSN: 1073-449X
Shute J, Marshall L, Bodey K, et al., 2003, Growth factors in cystic fibrosis - when more is not enough., Paediatr Respir Rev, Vol: 4, Pages: 120-127, ISSN: 1526-0542
In the airways of patients with cystic fibrosis, repeated cycles of infection and inflammation are responsible for bronchial wall thickening, a major determinant of loss of FEV(1) and progressive damage to the small and large airways. Proteolytic degradation of elastin, collagen and fibronectin fibrils in the tissue matrix leads to the loss of normal tissue architecture and the development of bronchiectasis, the most commonly observed morphological change on high-resolution computed tomography examination. We have reviewed the evidence for increased expression of growth factors (TGF, HGF, FGF, EGF, VEGF) and activation of tissue repair processes in cystic fibrosis. Significantly higher concentrations of the growth factors compared with normal do not appear to prevent or reverse structural remodelling in the airways. The reasons why this process appears to be ineffective are discussed and we speculate on alternative strategies that might have a significant impact on the observed structural changes.
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