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  1. Article ; Online: Asthma: Pathophysiology and Diagnosis

    Yeh, Susie Yim / Schwartzstein, Richard

    Asthma, Health and Society

    Abstract: Although asthma is a common disorder affecting approximately 7.8% of the United States population (Schiller et al. 2006) or 23 million Americans, the pathogenesis of this disease remains to be fully elucidated. Extensive research over the last few ... ...

    Abstract Although asthma is a common disorder affecting approximately 7.8% of the United States population (Schiller et al. 2006) or 23 million Americans, the pathogenesis of this disease remains to be fully elucidated. Extensive research over the last few decades has yielded a better understanding of asthma. We know that the basic features of asthma include episodic airways inflammation, airways hyperresponsiveness, and mucous hypersecretion. Although we understand the basic clinical features of asthma, the links between symptoms, physical signs, and underlying pathophysiological mechanisms are still being delineated. Asthma is a heterogeneous disease process with varying phenotypes and presentations. In this chapter, we will briefly explore some major theories of asthma pathogenesis, both new and old. We will also explore how understanding the pathophysiology of asthma can help us to understand the symptoms and presentation of asthma, as well as the best strategies for diagnosing this disease.
    Keywords covid19
    Publisher PMC
    Document type Article ; Online
    DOI 10.1007/978-0-387-78285-0_2
    Database COVID19

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  2. Article ; Online: Therapeutic interventions and oxidative stress in diabetes.

    Rahangdale, Shilpa / Yeh, Susie Yim / Malhotra, Atul / Veves, Aristidis

    Frontiers in bioscience (Landmark edition)

    2009  Volume 14, Issue 1, Page(s) 192–209

    Abstract: Many therapeutic agents that are used in patients with diabetes mitigate oxidative stress. These agents are of particular interest because oxidative stress is elevated in diabetes and is thought to contribute to vascular dysfunction. Agents that merely ... ...

    Abstract Many therapeutic agents that are used in patients with diabetes mitigate oxidative stress. These agents are of particular interest because oxidative stress is elevated in diabetes and is thought to contribute to vascular dysfunction. Agents that merely quench already formed reactive oxygen species have demonstrated limited success in improving cardiovascular outcomes. Thus, although vitamin E, C, and alpha lipoic acid appeared promising in animal models and initial human studies, subsequent larger trials have failed to demonstrate improvement in cardiovascular outcomes. Drugs that limit the production of oxidative stress are more successful in improving vascular outcomes in patients with diabetes. Thus, although statins, ACE inhibitors, ARBs and thiazolinediones are used for varied clinical purposes, their increased efficacy in improving cardiovascular outcomes is likely related to their success in reducing the production of reactive oxygen species at an earlier part of the cascade, thereby more effectively decreasing the oxidative stress burden. In particular, statins and ACE inhibitors/ ARBs appear the most successful at reducing oxidative stress and vascular disease and have potential for synergistic effects.
    MeSH term(s) Animals ; Diabetes Mellitus/drug therapy ; Diabetes Mellitus/metabolism ; Diabetic Angiopathies/drug therapy ; Diabetic Angiopathies/metabolism ; Endothelium, Vascular/drug effects ; Endothelium, Vascular/physiopathology ; Humans ; Nitrosation ; Oxidative Stress
    Language English
    Publishing date 2009-01-01
    Publishing country Singapore
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2704569-9
    ISSN 2768-6698 ; 1093-9946
    ISSN (online) 2768-6698
    ISSN 1093-9946
    DOI 10.2741/3240
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Upper airway function in the pathogenesis of obstructive sleep apnea: a review of the current literature.

    Owens, Robert L / Eckert, Danny J / Yeh, Susie Yim / Malhotra, Atul

    Current opinion in pulmonary medicine

    2008  Volume 14, Issue 6, Page(s) 519–524

    Abstract: Purpose of review: Obstructive sleep apnea is an increasingly prevalent disease, with a considerable societal burden. The disease is defined by recurrent intermittent collapse of the upper airway. Understanding of and treatment for the disease is ... ...

    Abstract Purpose of review: Obstructive sleep apnea is an increasingly prevalent disease, with a considerable societal burden. The disease is defined by recurrent intermittent collapse of the upper airway. Understanding of and treatment for the disease is largely confined to relief of the mechanical obstruction of the upper airway by application of continuous positive airway pressure, and less commonly weight loss or surgery. However, recent work has focused on the function, rather than structure alone, of the upper airway.
    Recent findings: The following contributors to upper airway structure and function have been studied: traditional fixed anatomical abnormalities, dynamic anatomical changes, upper airway dilator muscle dysfunction, lung volumes, and instability in control of breathing. In each patient with obstructive sleep apnea, the relative contribution of each of these components may be quite variable. The studies reviewed here describe methods to evaluate these factors, and some attempts at treatment.
    Summary: Ongoing studies are attempting to classify patients on the basis of the underlying pathophysiology. This work suggests that obstructive sleep apnea is a heterogeneous disease with multiple root causes. Ultimately, such a classification may allow more individualized treatment, not only relying on mechanical relief of the upper airway obstruction.
    MeSH term(s) Continuous Positive Airway Pressure ; Humans ; Pharynx/physiopathology ; Positive-Pressure Respiration ; Respiratory Muscles/physiopathology ; Respiratory System/physiopathology ; Sleep Apnea, Obstructive/etiology ; Sleep Apnea, Obstructive/physiopathology
    Language English
    Publishing date 2008-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1285505-4
    ISSN 1531-6971 ; 1070-5287 ; 1078-1641
    ISSN (online) 1531-6971
    ISSN 1070-5287 ; 1078-1641
    DOI 10.1097/MCP.0b013e3283130f66
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Endothelial function in obstructive sleep apnea.

    Atkeson, Amy / Yeh, Susie Yim / Malhotra, Atul / Jelic, Sanja

    Progress in cardiovascular diseases

    2008  Volume 51, Issue 5, Page(s) 351–362

    Abstract: Untreated obstructive sleep apnea (OSA) is an independent risk factor for hypertension, myocardial infarction, and stroke. The repetitive hypoxia/reoxygenation and sleep fragmentation associated with OSA impair endothelial function. Endothelial ... ...

    Abstract Untreated obstructive sleep apnea (OSA) is an independent risk factor for hypertension, myocardial infarction, and stroke. The repetitive hypoxia/reoxygenation and sleep fragmentation associated with OSA impair endothelial function. Endothelial dysfunction, in turn, may mediate increased risk for cardiovascular diseases. Specifically, in OSA, endothelial nitric oxide availability and repair capacity are reduced, whereas oxidative stress and inflammation are enhanced. Treatment of OSA improves endothelial vasomotor tone and reduces inflammation. We review the evidence and possible mechanisms of endothelial dysfunction as well as the effect of treatment on endothelial function in OSA.
    MeSH term(s) Animals ; Antioxidants/therapeutic use ; Blood Coagulation ; Cardiovascular Diseases/etiology ; Cardiovascular Diseases/physiopathology ; Cardiovascular Diseases/prevention & control ; Continuous Positive Airway Pressure ; Endothelium, Vascular/metabolism ; Endothelium, Vascular/physiopathology ; Hemodynamics ; Humans ; Hypoxia/physiopathology ; Inflammation/physiopathology ; Inflammation Mediators/metabolism ; Mandibular Advancement/instrumentation ; Nitric Oxide/metabolism ; Oxidative Stress ; Regeneration ; Sleep Apnea, Obstructive/complications ; Sleep Apnea, Obstructive/physiopathology ; Sleep Apnea, Obstructive/therapy ; Sleep Deprivation/physiopathology
    Chemical Substances Antioxidants ; Inflammation Mediators ; Nitric Oxide (31C4KY9ESH)
    Language English
    Publishing date 2008-12-20
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 209312-1
    ISSN 1873-1740 ; 1532-8643 ; 0033-0620
    ISSN (online) 1873-1740 ; 1532-8643
    ISSN 0033-0620
    DOI 10.1016/j.pcad.2008.08.002
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Total serum bilirubin does not affect vascular reactivity in patients with diabetes.

    Yeh, Susie Yim / Doupis, John / Rahangdale, Shilpa / Horr, Samuel / Malhotra, Atul / Veves, Aristidis

    Vascular medicine (London, England)

    2009  Volume 14, Issue 2, Page(s) 129–136

    Abstract: Bilirubin may have a major role in the prevention of cardiovascular disease based on recent data regarding its anti-oxidant properties. We determined the relationship between total serum bilirubin and vascular reactivity in a large cohort of individuals ... ...

    Abstract Bilirubin may have a major role in the prevention of cardiovascular disease based on recent data regarding its anti-oxidant properties. We determined the relationship between total serum bilirubin and vascular reactivity in a large cohort of individuals with diabetes, a disease associated with known oxidant stress. We studied 302 individuals: 52 controls, 37 with type 1 diabetes, 213 with type 2 diabetes. High-resolution ultrasound was used to measure flow-mediated dilation (FMD; endothelium-dependent) and nitroglycerin-induced dilation (NID, endothelium-independent) of the brachial artery. Laser Doppler perfusion imaging was used to measure microvascular reactivity in the forearm skin before and after iontophoresis of acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent). Bilirubin levels were higher in the type 2 diabetes group (0.71 +/- 0.34 mg/dl) compared to controls (0.56 +/- 0.26 mg/dl, p < 0.0001). A weak inverse correlation was observed between bilirubin and FMD (r = -0.125, p = 0.032) and skin endothelium-dependent vasodilation (r = -0.157, p = 0.019). In multivariate analyses, however, these correlations were not statistically significant. There is no association between bilirubin levels and vascular reactivity in the macro- and microcirculation of individuals with diabetes. Bilirubin, therefore, does not correlate with predictors of cardiovascular risk in the diabetic population.
    MeSH term(s) Acetylcholine/administration & dosage ; Administration, Cutaneous ; Adult ; Aged ; Bilirubin/blood ; Brachial Artery/diagnostic imaging ; Brachial Artery/drug effects ; Brachial Artery/physiopathology ; Cross-Sectional Studies ; Diabetes Mellitus, Type 1/blood ; Diabetes Mellitus, Type 1/physiopathology ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/physiopathology ; Female ; Forearm ; Humans ; Iontophoresis ; Laser-Doppler Flowmetry ; Male ; Microcirculation/drug effects ; Middle Aged ; Nitroglycerin/administration & dosage ; Nitroprusside/administration & dosage ; Regional Blood Flow ; Skin/blood supply ; Ultrasonography ; Vasodilation/drug effects ; Vasodilator Agents/administration & dosage
    Chemical Substances Vasodilator Agents ; Nitroprusside (169D1260KM) ; Nitroglycerin (G59M7S0WS3) ; Acetylcholine (N9YNS0M02X) ; Bilirubin (RFM9X3LJ49)
    Language English
    Publishing date 2009-04-14
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1311628-9
    ISSN 1477-0377 ; 1358-863X
    ISSN (online) 1477-0377
    ISSN 1358-863X
    DOI 10.1177/1358863X08098273
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: The influence of intermittent hypoxemia on platelet activation in obese patients with obstructive sleep apnea.

    Rahangdale, Shilpa / Yeh, Susie Yim / Novack, Victor / Stevenson, Karen / Barnard, Marc R / Furman, Mark I / Frelinger, Andrew L / Michelson, Alan D / Malhotra, Atul

    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine

    2011  Volume 7, Issue 2, Page(s) 172–178

    Abstract: Objectives: Literature regarding platelet function in obstructive sleep apnea (OSA) has considerable limitations. Given the central role of platelets in atherothrombosis and the known cardiovascular risk of OSA, we hypothesized that OSA severity is ... ...

    Abstract Objectives: Literature regarding platelet function in obstructive sleep apnea (OSA) has considerable limitations. Given the central role of platelets in atherothrombosis and the known cardiovascular risk of OSA, we hypothesized that OSA severity is predictive of platelet function, independent of known comorbidities.
    Design: Obese subjects, without comorbidities, underwent overnight, in-lab polysomnography. The following morning, 5 biomarkers of platelet activation were measured by whole-blood flow cytometry at baseline and in response to agonists (no stimulation, stimulation with 5 μM ADP agonist, and stimulation with 20 μM ADP agonist): platelet surface P-selectin, activated glycoprotein (GP) IIb/IIIa, and GPIb receptor expression, platelet-monocyte aggregation (PMA) and platelet-neutrophil aggregation (PNA).
    Results: Of the 77 subjects, 47 were diagnosed with OSA (median apnea-hypopnea index [AHI] of 24.7 ± 28.1/h in subjects with OSA and 3.0 ± 3.9/h in subjects without OSA, p < 0.001). The groups were matched for body mass index, with a mean body mass index of 40.3 ± 9.6 kg/m(2) in subjects with OSA and 38.9 ± 6.0 kg/m(2) in subjects without OSA (p = 0.48). A comparison of time spent with an oxygen saturation of less than 90% showed that subjects who had 1 minute or more of desaturation time per hour of sleep had lower GPIb fluorescence in circulating platelets, as compared with those subjects who had less than 1 minute of desaturation time per hour of sleep; similar findings were observed following 5 μM and 20 μM of ADP stimulation, as compared with control vehicle, suggesting higher levels of circulating platelet activity. In multivariate analyses, only nocturnal hypoxemia and female sex predicted agonist response. Platelet surface P-selectin, platelet surface-activated GPIIb/IIIa, PMA, and PNA were not significantly correlated with markers of OSA.
    Conclusions: In obese patients with OSA, platelet activation is associated with greater levels of oxygen desaturation, compared with matched control subjects. Metrics other than AHI (e.g., hypoxemia) may determine OSA-related thrombotic risk.
    MeSH term(s) Adolescent ; Adult ; Aged ; Biomarkers/blood ; Body Mass Index ; Chi-Square Distribution ; Female ; Flow Cytometry ; Humans ; Hypoxia/blood ; Hypoxia/etiology ; Male ; Obesity/blood ; Obesity/complications ; Platelet Activation/physiology ; Polysomnography ; Sleep Apnea, Obstructive/blood ; Sleep Apnea, Obstructive/complications ; Statistics, Nonparametric ; Young Adult
    Chemical Substances Biomarkers
    Language English
    Publishing date 2011-04-16
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2397213-0
    ISSN 1550-9397 ; 1550-9389
    ISSN (online) 1550-9397
    ISSN 1550-9389
    Database MEDical Literature Analysis and Retrieval System OnLINE

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