Papers by Ephraim Bar-yishay
CHEST Journal, 2002
... Ephraim Bar-Yishay, PhD. Institute of Pulmonology, Hadassah University Hospital Jerusalem, Is... more ... Ephraim Bar-Yishay, PhD. Institute of Pulmonology, Hadassah University Hospital Jerusalem, Israel. Correspondence to: Ephraim Bar-Yishay, PhD, Institute of ... Thorax 38,760-765. Abstract/FREE Full Text. ↵ Sears, MR, Jones, DT, Holdaway, MD, et al Prevalence of bronchial ...
Bookmarks Related papers MentionsView impact
CHEST Journal, 2009
Bookmarks Related papers MentionsView impact
American Journal of Respiratory and Critical Care Medicine, 2003
Bookmarks Related papers MentionsView impact
Thorax, 1982
Bookmarks Related papers MentionsView impact
Thorax, 1995
BACKGROUND--Bronchial hyperreactivity to methacholine is present in children with asthma and othe... more BACKGROUND--Bronchial hyperreactivity to methacholine is present in children with asthma and other types of paediatric chronic obstructive pulmonary disease (COPD), while hyperreactivity to exercise is more specific for asthma. Adenosine 5'-monophosphate (AMP) is a potent bronchoconstrictor and, like exercise, may provoke asthma by activating mast cells. This study investigated the suitability of AMP as a specific challenge for asthma in
Bookmarks Related papers MentionsView impact
Annals of internal medicine
To assess the effect of lowering altitude to that of the lowest place on earth (Dead Sea) on arte... more To assess the effect of lowering altitude to that of the lowest place on earth (Dead Sea) on arterial oxygenation and exercise performance in patients with hypoxemia and end-stage lung disease. A cohort of 10 patients. Pulmonary function laboratories in Jerusalem, Israel, and at the Dead Sea. 10 patients with end-stage lung disease who were receiving long-term oxygen therapy. The 4 males and 6 females were 12 to 77 years old. Four patients had chronic obstructive pulmonary disease; 2 had cystic fibrosis; 3 had pulmonary fibrosis; and 1 had pulmonary hypertension (thromboembolic). Mean forced vital capacity was 1.54 L (54% of predicted value) and mean forced expiratory volume in 1 second was 0.85 L (35% of predicted value). Spirometry, blood gas analysis, progressive exercise testing, and sleep oximetry were done in Jerusalem (altitude, 800 m above sea level; barometric pressure, 696 mm Hg); the same measurements were done 6 days after arrival at the Dead Sea (altitude, 402 m below sea level; barometric pressure, 800 mm Hg) and then 7 to 14 days later in Jerusalem. Arterial oxygenation increased from a median partial pressure of arterial oxygen of 51.6 mm Hg in Jerusalem to 67.0 mm Hg at the Dead Sea, an increase of 15.2 mm Hg (95% CI of paired difference, 4.1 to 20.4 mm Hg; P = 0.001). Partial pressure of arterial carbon dioxide increased from a median of 43.2 to 45.9 mm Hg, an increase of 2.7 mm Hg (CI, 0.5 to 6.4 mm Hg; P = 0.004), with a borderline significant change in the alveolar-arterial gradient. Arterial oxygen saturation increased from a median of 87.7% to 92.8%, a change of 4.8% (CI, 1.9% to 9.8%; P = 0.003). Exercise performance also improved as maximum oxygen uptake increased from a median of 827 mL/min to 1056 mL/min, an increase of 203 mL/min (CI, 54 to 388 mL/min; P = 0.006). Sleep oximetry also improved as median arterial oxygen saturation measured during sleep increased from 85% to 90%, a change of 5% (CI, 2% to 7%; P = 0.005), and percentage of sleep time with an oxygen saturation rate of 90% or more increased from a median of 24% to 73%, a change of 49% (CI, 20% to 87%; P = 0.02). No change in spirometry was noted. All patients felt less dyspneic and reported improved functional capacity with reduced need for oxygen. Descent to low altitude can improve arterial oxygenation, exercise performance, and sleep oximetry and consequently the quality of life in patients with hypoxemia and advanced lung disease.
Bookmarks Related papers MentionsView impact
CHEST Journal, 2015
Palivizumab reduces the severity of respiratory syncytial virus (RSV) infection in premature infa... more Palivizumab reduces the severity of respiratory syncytial virus (RSV) infection in premature infants, but whether there is a protective effect beyond pre-school age is unknown. This study sought to assess the short- and long-term effects of palivizumab immunization on respiratory morbidity and pulmonary function at school age in children born extremely prematurely. Infants born before 29 weeks' gestation in 2000-2003 were assessed at school age by parental questionnaire, hospital chart review, and lung function tests. Children born immediately before the introduction of routine palivizumab prophylaxis were compared to age-matched children who received palivizumab prophylaxis during the first RSV season. Sixty-three children of mean age 8.9 years were included: 30 had received palivizumab and 33 had not (controls). The groups were similar for gestational age, birth weight, need for mechanical ventilation and oxygen supplementation. Fifty-three percent of the palivizumab compared to 39% of the control group had BPD (P=0.14). Wheezing occurred in the first 2 years of life in 27% of the palivizumab group and 70% of controls (P=0.008); respective hospitalization rates were 33% and 70% (P=0.001). At school age, rates of hyper-responsiveness (PC20 <1mg/ml) were 33% and 48%, respectively (P=0.38). Spirometry, lung volumes, diffusion, and exhaled nitric oxide were within normal limits, with no significant differences between groups. Palivizumab prophylaxis was associated with reduced wheezing episodes and hospitalizations during the first 2 years of life in children born extremely prematurely. However, it does not affect pulmonary outcome at school age.
Bookmarks Related papers MentionsView impact
The Israel Medical Association journal: IMAJ
The forced oscillation technique is a noninvasive and effort-independent technique that is well s... more The forced oscillation technique is a noninvasive and effort-independent technique that is well suited for lung function measurement in young children. FOT employs small-amplitude pressure oscillations superimposed on normal breathing. Therefore, it has the advantage over conventional lung function techniques in that it does not require patient cooperation for conducting respiratory maneuvers. To test the feasibility of the FOT test in preschool children and to compare the results to the commonly used spirometry before and after the administration of bronchodilator therapy. Forty-six children (median age 4.9 years, range 1.8-18.3) attending the pulmonary clinic at Schneider Children's Medical Center tried to perform FOT and routine spirometry. Results were retrospectively analyzed. Of the 46 children 40 succeeded in performing FOT and only 29 succeeded in performing simple spirometry. All but one of the 32 children aged 4 years and above (97%) could perform both tests. Nine of 1...
Bookmarks Related papers MentionsView impact
Pediatric Pulmonology
Exhaled nitric oxide (eNO) has been used to diagnose asthma in adults and children using either t... more Exhaled nitric oxide (eNO) has been used to diagnose asthma in adults and children using either the slow vital capacity method (SVCm) or, in younger children, the tidal breathing method (TBm). Adenosine 5'-monophosphate (AMP) challenge also has been found to be a sensitive and specific test for the diagnosis of asthma. In the present study, we used the AMP provocation concentration that caused wheezing (PCW) to confirm the diagnosis of asthma (PCW < or = 200 mg/mL). We studied 36 children (2-7 years) with mild intermittent asthma, 13 children (3-7 years) with moderate persistent asthma treated with inhaled steroids, 20 nonasthmatic children (2-7 years) with chronic cough and recurrent pneumonia, and 15 healthy children (4-6 years). Expired gas was collected in collection bags by the TBm, and eNO was measured. We evaluated the efficacy of eNO values in diagnosing asthma. The mean eNO level of the mild intermittent asthmatic children (5.6 +/- 0.4 ppb) not receiving inhaled cort...
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Thorax, 1983
To evaluate the effect of negative ionisation of inspired air on bronchial reactivity, 11 asthmat... more To evaluate the effect of negative ionisation of inspired air on bronchial reactivity, 11 asthmatic children were challenged twice by exercise and 10 were challenged twice by histamine inhalation. The children breathed negatively ionised air (4 X 10(5) - 10 X 10(5) ions/cm3) or control room air in random order in a double-blind fashion. All challenges were matched in terms
Bookmarks Related papers MentionsView impact
Pediatric pulmonology, 2011
Prone sleeping position, use of soft mattresses and head covering by bedclothes are known risk fa... more Prone sleeping position, use of soft mattresses and head covering by bedclothes are known risk factors for sudden infant death syndrome (SIDS). Rebreathing carbon dioxide (CO(2) ) may be a possible mechanism or a confounding factor of SIDS. To compare the aeration properties of a new concept of infant sleeping surface (Net) to three commercial mattresses advertised to improve aeration and to two standard infant mattresses. Two experiments were performed: (I) A container (head box), filled with 7% CO(2) mixture, was opened to the mattress to allow gas mixture to passively diffuse outside and equilibrate with the surrounding room air. (II) Simulation of normal breathing of an infant, using a unidirectional reciprocal syringe, to determine CO(2) accumulation within the head box. CO(2) concentrations in the head box were continuously measured until CO(2) levels fell below 1% or for 5 min (experiment I), or until CO(2) accumulation levels plateaued or for 6 min (experiment II). The Net h...
Bookmarks Related papers MentionsView impact
The Israel Medical Association journal : IMAJ, 2011
In infants, small volume nebulizers with a face mask are commonly used to facilitate aerosol ther... more In infants, small volume nebulizers with a face mask are commonly used to facilitate aerosol therapy. However, infants may be disturbed by mask application, causing poor mask-to-face seal and thus reducing the dose delivered. To compare lung function response to bronchodilator nebulization via two delivery devices: hood versus mask. We studied 26 recurrently wheezy infants aged 45.8 weeks (95% confidence interval 39.6-52.0). Inhalations of 0.30 mg/kg salbutamol were administered in two alliqots 30 minutes apart using mask and hood in alternating order (M+H or H+M). Response to inhalations was measured by maximal expiratory flows at functional residual capacity (V'maxFRC) at 5 minute intervals after each dose, and area under the V'maxFRC curve (AUC) was documented. A small but significant response to salbutamol was observed following the second inhalation with V'maxFRC, improving by 31.7% (7.2-56.2, P (0.02) and AUC by 425% x min (-154, 1004; P < 0.02). The improvement...
Bookmarks Related papers MentionsView impact
The Israel Medical Association journal : IMAJ, 2009
Bookmarks Related papers MentionsView impact
Israel journal of medical sciences, 1982
Lung function tests were performed on 14 infants 22 to 67 wk following mechanical ventilation of ... more Lung function tests were performed on 14 infants 22 to 67 wk following mechanical ventilation of 6 h to 51 days and on 5 infants of comparable age who had been treated with continuous positive airway pressure (CPAP). Airway resistance increased (P less than 0.01) and specific airway conductance decreased (P less than 0.001) in the ventilated infants compared with the CPAP-treated group who were normal. The airway resistance and specific airway conductance were normal in two ventilated infants and in one CPAP-treated infant who were studied earlier in the neonatal period. There were no significant differences in thoracic gas volume between groups of ventilated and nonventilated babies studied initially or at follow-up. There was no relationship between lung damage and the following: peak inspiratory pressure, the duration of high pressure ventilation, the level of CPAP or its duration, or the duration of greater than 60% oxygen administration. The degree of lung damage was not relate...
Bookmarks Related papers MentionsView impact
Pediatrics, 1986
Two siblings, a 14.5-year-old boy and his 11.5-year-old sister, with congenital nemaline myopathy... more Two siblings, a 14.5-year-old boy and his 11.5-year-old sister, with congenital nemaline myopathy presented with severe respiratory failure and, in the case of the older patient, with cor pulmonale and systemic hypertension. The children were treated initially by continuous mechanical ventilation, but after a few weeks they only required ventilation at night. At the start of treatment, both were found to have a decreased ventilatory response to CO2 which apparently improved during 4 to 5 years of follow-up treatment. It has not been possible to wean them from nocturnal mechanical ventilation, but during the daytime they attend school and function almost normally. It is postulated that respiratory failure in nemaline myopathy may not be related to the severity of the muscle weakness but may result from a disturbance of the feedback required for normal control of breathing.
Bookmarks Related papers MentionsView impact
Neuromuscular Disorders, 1994
The present study describes the use of simple video games for a 5-week regimen of respiratory mus... more The present study describes the use of simple video games for a 5-week regimen of respiratory muscle training in 15 patients with Duchenne muscular dystrophy (DMD) at various stages of the disease. The games were re-arranged to be operated and driven by the respiratory efforts of the patient and to incorporate accurate ventilation and time measurements. Improvement in respiratory performance was determined by maximum voluntary ventilation (MVV), maximal achieved ventilation (VEmax) during a progressive isocapnic hyperventilation manoeuvre (PIHV) and the PIHV duration. The actual training period was 23 +/- 4 days (mean +/- S.D.) at ventilatory effort of 46 +/- 6% MVV, for 10 +/- 3 min day-1. Patients with moderate impairment of lung function tests (LFT) showed an improvement in MVV, VEmax, and duration of PIHV of 12 +/- 7% (p &lt; 0.02), 53 +/- 25% (p &lt; 0.001) 57 +/- 21% (p &lt; 0.01), respectively. Improvements correlated with actual training time and ventilation level, %MVV, but negatively correlated with years of immobilization and with the initial MVV. We conclude that computerized respiratory games may be applied for breathing exercises and may improve respiratory performance in recently immobilized children with DMD who have moderate impairment of LFT.
Bookmarks Related papers MentionsView impact
Respiratory Medicine, 2009
Bookmarks Related papers MentionsView impact
Uploads
Papers by Ephraim Bar-yishay