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Allen J Dozor

Publications and source records attributed to Allen J Dozor.

6 recordsLinked to original sources

Lung lesions in children with Crohn's disease presenting as nonresolving pneumonias and response to infliximab therapy.

Lung lesions in children with Crohn's disease are often difficult to diagnose and treat. We report here 3 children (aged 13, 14, and 17 years) on immunosuppressive therapy for previously diagnosed Crohn's disease who presented with nonresolving pneumonias. All 3 had unfavorable response to empiric antibiotics and had progression of lesions. Cultures of sputum and blood did not yield any organisms. Subsequent lung biopsies revealed noncaseating granulomas with giant cells in 2 subjects and bronchiolitis obliterans with organizing pneumonia in the third. All patients were treated with infliximab, a novel anti-tumor necrosis factor monoclonal antibody, and showed rapid clinical and radiologic response. We emphasize that a high index of suspicion for noninfectious etiologies needs to be maintained in patients with Crohn's disease who present with lung lesions to ensure timely intervention. Infliximab therapy seems to be effective and well tolerated in such patients.

Adolescent↗

Effect of deep inspiration on airway caliber in children with asthma.

The objective of this study was to assess the effect of deep inspiration (DI) on airway caliber in school-age children with asthma. Thirty children with asthma (10 from each group of mild, moderate, and severe persistent asthma as defined by the National Asthma Education and Prevention Program guidelines of the National Heart, Lung, and Blood Institute) were enrolled, and their results were compared to those obtained in 7 healthy children. Subjects performed a partial expiratory flow volume curve (P) initiated from approximately 70% of vital capacity (VC) followed by a maximal expiratory flow volume (M) maneuver begun from total lung capacity (TLC). The M/P ratio at 30% of the VC (M/P30) was calculated. Specific airway conductance (sGaw) was measured before and immediately after DI, using standard techniques. Differences in M/P30 and sGaw ratios between asthma and control groups were compared with Student's unpaired t-tests. One-way ANOVA was used to compare the effect of DI on M/P30 and sGaw ratios among the various asthma severity groups. The M/P30 ratio (mean +/- 1 SD) was significantly lower in children with moderate and severe persistent asthma (0.73 +/- 0.21 and 0.72 +/- 0.1, respectively) than in healthy controls (1.69 +/- 0.62) (P < 0.05). In mild persistent asthmatics, there was limited bronchodilation (M/P30 = 1.1 +/- 0.35, P = 0.052). There was a significant inverse correlation between M/P30 ratio and severity of asthma (r = -0.684, P < 0.01). The mean sGaw ratio was decreased in asthmatic subjects compared to healthy controls (0.98 +/- 0.17 vs. 1.13 +/- 0.16, P = 0.062). In conclusion, in school-age children, the effects of DI on airway caliber are similar in direction to those observed in adults, i.e., bronchodilation in healthy and mild asthmatics, and bronchoconstriction (BC) in moderate to severe asthmatics. This finding suggests that forces that determine airway caliber in school-age children are similar to those forces in adults.

Anthropometry↗

Dietary intake of soy genistein is associated with lung function in patients with asthma.

To determine if micronutrient intake is associated with asthma severity, we administered the Block food frequency questionnaire to participants in a randomized clinical trial of the safety of influenza vaccine for asthmatics. The nutrition substudy included 1033 participants, aged 12-75. Intake of antioxidant vitamins, soy isoflavones, total fruits and vegetables, fats, and fiber was compared with asthma severity at baseline [forced expiratory volume in 1 second (FEV1), peak expiratory flow rate (PEF), asthma symptoms] and the rate of asthma exacerbations during the 2 weeks following influenza vaccination. The only nutrient that had a consistent association with asthma severity was genistein, a soy isoflavone. None of the nutrients evaluated were related to asthma exacerbation rate when adjusted for known confounders. The FEV1 in genistein consumers of at least 250 microg/1000 Kcal/day was 82.1% predicted, 79.9% predicted for those who consumed between 1 and 249 microg/1000 kcal, and 76.2% predicted in genistein nonconsumers (p=0.006); the PEF was 82.7% predicted, 80.8% predicted, and 78.3% predicted, respectively (p=0.009). There were no differences in the Asthma Symptom Utility Index (ASUI). We could not account for these results based on differences in demographics, body mass index, or consumption of other nutrients. Thus, increasing consumption of genistein is associated with better lung function in patients with asthma. Further studies are needed to determine whether dietary supplementation with genistein can reduce asthma severity.

Adolescent↗

Plasma and red blood cell zinc in cystic fibrosis.

The objectives of this study were to measure plasma and red blood cell (RBC) zinc concentrations in patients with cystic fibrosis (CF), and examine their relationship to nutritional status and pulmonary function. Plasma and RBC zinc levels were compared in 53 CF patients ranging in age from 0.5-46 years. Their relationships to weight (% ideal weight) and forced expired volume in 1 sec (FEV(1)) (% predicted value) were examined. After excluding improperly handled specimens, RBC zinc levels in 51 patients and plasma zinc concentrations in 40 patients were included for analysis. Sixteen of 51 (31%) patients had low RBC zinc levels compared to 4 of 40 (10%) with low plasma zinc concentrations (P < 0.01). Thirteen of 38 patients (34%) in whom both values were obtained had low RBC zinc concentrations compared to 4 of 38 (11%) with low plasma zinc levels (P < 0.022). Neither low RBC nor plasma zinc levels correlated with nutritional status or lung function. In conclusion, about one third of patients with CF had low RBC zinc levels. Plasma zinc concentrations may not adequately reflect overall zinc status. This deficiency did not appear to be related to either nutritional status or lung function. The significance of low RBC zinc in CF is unknown.

Adolescent↗

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Asthma↗