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Clinical Respiratory Journal

Beng Leong Lim, Si Oon Cheah, Hsin Kai Goh, Francis Chun Yue Lee, Yih Yng Ng, Wen Jia Guo, Marcus Eng Hock Ong
INTRODUCTION: Hyperoxemia in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) leads to adverse outcomes. It remains prevalent in the pre-hospital Emergency Medical Services (EMS) and Emergency Department (ED). OBJECTIVE: To determine key predictors for hyperoxemia in AECOPD in EMS and ED. METHODS: This was a prospective observational study of AECOPD patients in EMS and two EDs. Hyperoxemia was defined as PaO2 > 65 mmHg (corresponds to SpO2 > 92%)...
February 19, 2019: Clinical Respiratory Journal
Magno F Formiga, Isabel Vital, Gisel Urdaneta, Brett Masters, Julio Herrera, Michael A Campos, Lawrence P Cahalin
BACKGROUND: COPD is associated with an inflammatory response that becomes more pronounced in acute exacerbations. Considerable attention has recently focused on the value of several inflammatory mediators in predicting worsening of COPD-related symptoms. Whereas respiratory muscle dysfunction is also widely present in this population, little is known about how systemic inflammation relates to inspiratory muscle dysfunction in COPD. METHODS: 53 males with mild-to-very severe airflow obstruction underwent blood sampling for 23 inflammatory markers including acute-phase proteins, cytokines, and adipokines...
February 18, 2019: Clinical Respiratory Journal
Claire Tissot, Pierre Gay, Clement Brun, Marios E Froudarakis
Lung cancer is the most common fatal malignancy worldwide. Approximately 75% of NSCLC patients are diagnosed at an advanced or a metastatic stage. Since 2007, NSCLC patients with malignant pleural effusion are staged as M1 disease. During the last decades, chemotherapeutic agents failed to offer significant improvement of survival in patients with metastatic disease. The current review aims to summarize the actual situation of the recently developed therapies in patients with lung cancer and malignant pleural effusion...
February 8, 2019: Clinical Respiratory Journal
Barbara Vogt, Victoria Hennig, Kathinka Deuß, Lorenz Balke, Norbert Weiler, Inéz Frerichs
BACKGROUND: Pulmonary function is not routinely assessed in patients without respiratory disease and symptoms before surgery, even if they are smokers. We aimed to check whether the new spirometric reference values of the worldwide Global Lung Initiative (GLI) affected the preoperative assessment of lung function in allegedly lung-healthy patients compared with the still commonly used old predicted values. METHODS: 219 allegedly lung-healthy non-smokers, past and current smokers were examined by spirometry before elective surgery...
February 8, 2019: Clinical Respiratory Journal
Zafeiris Louvaris, Stavroula Spetsioti, Vasileios Andrianopoulos, Nikolaos Chynkiamis, Helmut Habazettl, Harrieth Wagner, Spyros Zakynthinos, Peter D Wagner, Ioannis Vogiatzis
INTRODUCTION: Impedance cardiography (IC) derived from morphological analysis of the thoracic impedance signal is now commonly used for non-invasive assessment of cardiac output (CO) at rest and during exercise. However, in COPD, conflicting findings put its accuracy into question. OBJECTIVES: We therefore compared concurrent CO measurements captured by IC (PhysioFlow™ : COIC ) and by the indocyanine green dye dilution method (CODD ) in patients with COPD. METHODS: Fifty paired CO measurements were concurrently obtained using the two methods from 10 patients (FEV1 :50...
February 5, 2019: Clinical Respiratory Journal
Yashaswini Yeragunta, Stefan W Leichtle, Renli Qiao
BACKGROUND: The shortage in intensivist workforce has been long recognized but no solution has been identified. Meanwhile, while fellowships in Pulmonary and Critical Care Medicine (PCCM) are expanding, other Critical Care Medicine (CCM) programs are contracting. No explanation exists for this contradictory trend, although understanding contributory factors may lead to a solution for the shortage. The fundamental difference between PCCM and other CCM programs lies in the residency training of trainees...
February 5, 2019: Clinical Respiratory Journal
Ahmet Öz, Tufan Çınar, Mert İlker Hayıroğlu, Şahin Avşar, Muhammed Keskin, Ahmet Lütfüllah Orhan
INTRODUCTION AND OBJECTIVES: Prior studies demonstrated that plasma osmolality may have a predictive value for in-hospital mortality in patients with heart failure and acute coronary syndrome. In addition, plasma glucose and blood urea nitrogen (BUN) levels, the components of plasma osmolality, have been shown to be an important contributor for in-hospital mortality in acute pulmonary embolism (APE) patients. Hence, the objective of the current study is to evaluate the effect of plasma osmolality upon admission with in-hospital mortality in patients with APE...
February 3, 2019: Clinical Respiratory Journal
Jolanta Nowak, Bartosz Hudzik, Jacek T Niedziela, Piotr Rozentryt, Marek Ochman, Piotr Przybyłowski, Marian Zembala, Mariusz Gąsior
INTRODUCTION: Idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) show poor prognosis. The importance of left (LV) and right (RV) ventricular morphology and function in patients with end-stage lung diseases referred for lung transplantation (LT) is not well established. OBJECTIVES: To assess whether LV and RV echocardiographic parameters influence survival of patients with IPF, COPD and other interstitial lung diseases (ILD) awaiting LT...
January 31, 2019: Clinical Respiratory Journal
Sergio Harari, Antonella Caminati, Marco Confalonieri, Venerino Poletti, Carlo Vancheri, Alberto Pesci, Rogliani Paola, Fabrizio Luppi, Carlo Agostini, Paola Rottoli, Alessandro Sanduzzi Zamparelli, Alfredo Sebastiani, Rossana Della Porta, Francesco Salton, Barbara Messore, Sara Tomassetti, Roberta Rosso, Alice Biffi, Ermanno Puxeddu, Stefania Cerri, Francesco Cinetto, Rosa Metella Refini, Marialuisa Bocchino, Loreta Di Michele, Claudia Specchia, Carlo Albera
INTRODUCTION: GAP system have proven to be an easy tool for predicting disease stages and survival in IPF patients. OBJECTIVE: To validate mortality risk as determined by the GAP system in a real-life multicenter IPF population treated with pirfenidone. METHODS: The study included patients who received pirfenidone for at least 6 months. The GAP calculator and the GAP index were determined. The primary outcome was all-cause mortality. The prognostic accuracy of the GAP system was evaluated with respect to calibration and discrimination...
January 23, 2019: Clinical Respiratory Journal
Rong Jiang, Hui Liu, Bigyan Pudasaini, Rui Zhang, Jian-Lin Xu, Lan Wang, Qin-Hua Zhao, Ping Yuan, Jian Guo, Jing He, Su-Gang Gong, Cheng Wu, Wen-Hui Wu, Ci-Jun Luo, Hong-Ling Qiu, Zhi-Cheng Jing, Jin-Ming Liu
BACKGROUND: Pulmonary hypertension patients with mean pulmonary artery pressure (mPAP) ≥ 25 mmHg had impaired cardiopulmonary exercise testing (CPET). Borderline mean pulmonary pressures (boPAP; 21-24 mmHg) represents early pulmonary vasculopathy. The CPET characteristics of boPAP is a matter of discussion. We aimed to determine the CPET profile of such borderline hemodynamics. METHODS: A matched case-control study was conducted on consecutive boPAP patients at the Shanghai Pulmonary Hospital between Jan 2012 and Jan 2017...
January 22, 2019: Clinical Respiratory Journal
Ajay Kumar Mishra, Kamal Kant Sahu, James Atem
BACKGROUND: Disseminated herpes zoster infection occurs mostly in immunocompromised hosts. There have been recent reports of disseminated zoster with chemotherapeutic regimens and newer monoclonal antibodies. CASE REPORT: The present case describes a 61-year-old patient presenting with disseminated herpes zoster after initiation of benralizumab, an anti-IL-5 monoclonal antibody for severe persistent asthma. His initial vesicular lesions limited to left lumbar dermatomes progressed extensively resulting in dissemination on his body...
January 21, 2019: Clinical Respiratory Journal
Mevlüt Karataş, Meşide Gündüzöz, Türkan Nadir Öziş, Osman Gökhan Özakıncı, Dilek Ergun
INTRODUCTION: Occupational exposure to crystalline silica over time may result with silicosis: a fatal, irreversible occupational disease leading to lung function impairment. A complex inflammatory process, excessive accumulation of mesenchymal cells collagen production are the primary mechanisms underlying silicosis. Neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) have emerged as representative indices of systemic inflammation. OBJECTIVES: The purpose of the present study was to investigate the relationship between NLR, PLR and silicosis...
January 21, 2019: Clinical Respiratory Journal
Linna Huang, Nannan Zhang, Xu Huang, Shuyu Xiong, Yingying Feng, Yi Zhang, Min Li, Qingyuan Zhan
INTRODUCTION: There has been a rapid increase in the number of influenza and invasive pulmonary aspergillosis (IPA) co-infection. OBJECTIVES: To explore the risk factors and predictors of a poor prognosis in influenza and IPA co-infection. METHODS: We included patients with confirmed influenza during the 2017 to 2018 influenza season and cases of influenza and IPA co-infection in the literature. RESULTS: A total of 64 patients with influenza infection were admitted to ICU...
January 20, 2019: Clinical Respiratory Journal
Samuel P Trethewey, Ross G Edgar, Julien Morlet, Rahul Mukherjee, Alice M Turner
INTRODUCTION: Non-invasive ventilation (NIV) is recommended for treatment of acute hypercapnic respiratory failure (AHRF) in acute exacerbations of COPD. National UK audit data suggests that mortality rates are rising in COPD patients treated with NIV. OBJECTIVE: To investigate temporal trends in in-hospital mortality in COPD patients undergoing a first episode of ward-based NIV for AHRF. METHODS: Retrospective study of hospitalised COPD patients treated with a first episode of ward-based NIV at a large UK teaching hospital between 2004 to 2017...
January 19, 2019: Clinical Respiratory Journal
Zhu Zhang, Jieping Lei, Zhenguo Zhai, Yuanhua Yang, Jun Wan, Wanmu Xie, Chen Wang
BACKGROUND: Major bleeding (MB) and clinically relevant bleeding (CRB) are the most common seen complications associated with anticoagulation treatment for pulmonary embolism (PE) patients. A bleeding risk score (BRS) may help to accurately determine the risk of bleeding and make better decisions for patients in clinical practice. METHODS: Patients diagnosed as acute PE and met the inclusion criteria in Beijing Chao-Yang Hospital from January 2009 to September 2013 were consecutively enrolled...
January 19, 2019: Clinical Respiratory Journal
Madalina M Macrea, Robert L Owens, Thomas Martin, Dan Smith, Kris Ann Oursler, Atul Malhotra
INTRODUCTION: A majority of patients with chronic obstructive pulmonary disease (COPD) die of cardiovascular disease (CVD), yet the mechanisms responsible for this association are not fully understood. It remains unknown if isolated nocturnal oxygen desaturation (iNOD) could be one of the potential pathways by which the "inflammatory COPD" phenotype leads to CVD. OBJECTIVES: We aimed to evaluate if COPD patients who meet the Medicare guidelines for nocturnal oxygen therapy (iNOT+) had higher serum hs-CRP and IL-6 than those who did not meet guidelines for iNOT (iNOT-)...
January 14, 2019: Clinical Respiratory Journal
Shuang-Lan Xu, Jiao Yang, Chun-Fang Zhang, Shuang-Yan Xu, Fang-Yun Zhao, Li-Qiong Liu, Chun-Lin Xie, Xi-Qian Xing, Yun Zhu
OBJECTIVE: To determine the association of serum cardiac troponin (cTn) with the mortality of pulmonary hypertension (PH) patients via a meta-analysis. DATE SOURCE: We searched PubMed and EMBASE from inception to October 25, 2017. STUDY SELECTION: The reference lists of the retrieved articles were also consulted. The Q test and I2 test were used for to assess heterogeneity. The relationship between cTn elevation and mortality was analyzed...
January 13, 2019: Clinical Respiratory Journal
Jérôme Plojoux, Marios Froudarakis, Jean-Paul Janssens, Paola M Soccal, Jean-Marie Tschopp
The pathophysiology and management of primary spontaneous pneumothorax (PSP) are subject of debate. Despite advances in the understanding of its etiopathogenesis and improvements in its management, implementation in clinical practice is suboptimal. In this manuscript, we review the recent literature with a focus on PSP pathophysiology and management. Blebs and emphysema-like changes (ELC) are thought to contribute to the pathophysiology of PSP but cannot explain all cases. Recent studies emphasize the role of a diffuse porosity of the visceral pleura...
January 7, 2019: Clinical Respiratory Journal
Luis Moral, Ismael Martín, Ana Fernández, Paola Cárdenas, Teresa Toral
Patients with complicated pneumonia usually require invasive procedures and have a protracted course of the disease, although most children have a complete recovery with no evident long-term sequelae. Recovery is monitored by clinical findings, biochemical measurements in blood and imaging studies of the chest (x-ray and ultrasound). Lung ultrasound has been widely used in the study of pneumonia and its complications, but Doppler ultrasound, and echocardiography have been less often. This article is protected by copyright...
January 4, 2019: Clinical Respiratory Journal
Everardo Hernández-Plata, Ana Claudia Velázquez-Wong, Carmina Jiménez-Ramírez, Fernando Fernández-Ramírez, Luz María Galicia-Sánchez, César Antonio Flores-García, José Manuel Hernández-Hernández, Haydeé Rosas-Vargas, Juan Carlos Huicochea-Montiel, Eliseo Espinosa-Poblano
OBJECTIVES: Lung Metastasizing Leiomyomatosis (LML) is an infrequently diagnosed pathology developed after sexual maturation, commonly preceded by uterine myomas. Symptoms can include difficulties to breathe, cough, dyspnea and pain, due to mechanical obstruction exerted by expanding local growing leiomyomas. Lung leiomyomas are normally detected by imaging studies, but nowadays the precise diagnosis demands histological characterization of biopsies obtained from the affected tissues...
December 29, 2018: Clinical Respiratory Journal
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