Leigh Meyers <[EMAIL PROTECTED]>
"Isn't Nitric Oxide =3D NOX, the bad-bad emmision from cars, one of the=20 
first things to be smog-controlled after the 'draft tube' went and pcv=20 
valves sprouted on engines like little silver mushrooms?
If so, is it ok to drive my Lincoln Navigator down to... Children's=20 Hospital 
of Philadelphia... and idle it outside the preemie ward for a bit?

Inhaled Nitric Oxide Reduces Lung Disease in Premature Babies
http://www.newswise.com/articles/view/522202/?sc=3Ddwhn

Hello:
Definitely not a chemist - but an RCT-ologist.
i) NO + O2 -> peroxynitrites = heavily toxic to lungs by creation of oxygen 
free radicals.
ii) Concentration of inhaled NO (iNO) is low - and does not create high local 
peroxynitrites.
iii) Local effects in lungs does vasodilate lung blood vessels. Different from 
an effect of inhaling the gas in large atmosphere with o2.
iv) NO & preterms likely a subgroup analysis - as one RCT-ologist says, beware 
the sirens of subgroup analysis.
Likely NO helps only helps one smaller area of infant disease - where the BP in 
the lungs extremely high (left-over from being an in-utero advantage = 
'Persistent Pulmonary Hypertension Newborn'). Usually problem in term - not 
preerm - babies.
v) Do not idle your car if you feel any smidgen of Green-ness -or preventive 
health care advocacy. Do ont now enough about it, but I think emissions contain 
other nasty stuff.

AS another economic aspect of this:
-No as a health agent discovered in Boston;
- The gas was 'patented'
- The RCT's were funded by public purse (CIHR; NIH)
- Upon demonstration of efficacy & low risk in a particular patient population 
(to wit: high BP = 'PPHN') -> the patent exercised
- Overnight the cost rocketed up.
- In EEC - court challenge effective.
- In USA & Canada -> legal & patent challenges ineffective.
Almost singled-handedly, this agent will introduce a huge cost escalation into 
hospital budgets by virtue of this agent.
- Hence lot of (on present data at least) hyped claimes for NO.

H

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