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Multidisciplinary Respiratory Medicine

Pascal Urwyler, Nebal Abu Hussein, Pierre O Bridevaux, Prashant N Chhajed, Thomas Geiser, Peter Grendelmeier, Ladina Joos Zellweger, Malcolm Kohler, Sabrina Maier, David Miedinger, Michael Tamm, Robert Thurnheer, Thomas Dieterle, Joerg D Leuppi
Background: The Swiss COPD cohort was established in 2006 to collect data in a primary care setting. The objective of this study was to evaluate possible predictive factors for exacerbation and re-exacerbation. Methods: In order to predict exacerbation until the next visit based on the knowledge of exacerbation since the last visit, a multistate model described by Therneau and Grambsch was performed. Results: Data of 1,247 patients (60.4% males, 46...
2019: Multidisciplinary Respiratory Medicine
Claudia Ravaglia, Marcello Bosi, Athol U Wells, Carlo Gurioli, Christian Gurioli, Alessandra Dubini, Sara Piciucchi, Silvia Puglisi, Susanna Mascetti, Antonella Arcadu, Sara Tomassetti, Venerino Poletti
Background: Prognostic evaluation in idiopathic pulmonary fibrosis (IPF) may be important as it can guide management decisions, but the potential role of honeycomb changes in providing information about outcome and survival of patients with IPF, particularly if diagnosed using cryobiopsy, has not been evaluated. Aim of this study was to determinate whether a relationship exists between honeycombing on cryobiopsy and clinical/radiological picture and outcome in patients with IPF and to assess whether the same pathologic criteria that have been used to define the UIP pattern (usual interstitial pneumonia) for surgical biopsy can also be applied to cryobiopsy...
2019: Multidisciplinary Respiratory Medicine
Martina Oriano, Leonardo Terranova, Antonio Teri, Samantha Sottotetti, Luca Ruggiero, Camilla Tafuro, Paola Marchisio, Andrea Gramegna, Francesco Amati, Fabrizio Nava, Elisa Franceschi, Lisa Cariani, Francesco Blasi, Stefano Aliberti
Background: The analysis of microbiome in respiratory samples is a topic of great interest in chronic respiratory diseases. The method used to prepare sputum samples for microbiome analysis is very heterogeneous. The selection of the most suitable methodology for DNA extraction is fundamental to have the most representative data. The objective of this study was to compare different conditions for DNA extraction from sputum in adult patients with bronchiectasis. Methods: Five sputum samples from bronchiectasis patients were collected at the Policlinico Hospital in Milan, Italy...
2019: Multidisciplinary Respiratory Medicine
Paolo I Banfi, Eleonora Volpato, John R Bach
Non-invasive ventilation (NIV) is the treatment of choice for patients symptomatic for respiratory muscle dysfunction. It can normalize gas exchange and provide up to continuous non-invasive ventilator support (CNVS) as an alternative to intubation and tracheotomy. It is usually provided via non-invasive facial interfaces or mouthpieces, but these can be uncomfortable and uncosmetic. The intermittent abdominal pressure ventilator (IAPV) has been used for diurnal ventilatory support since 1938 but has been off the market since about 1990...
2019: Multidisciplinary Respiratory Medicine
Zewudu Andualem, Zemichael Gizaw, Laekemariam Bogale, Henok Dagne
Background: Poor indoor air quality is a great problem in schools due to a high number of students per classroom, insufficient outside air supply, poor construction and maintenance of school buildings. Bacteria in the indoor air environment pose a serious health problem. Determination of bacterial load in the indoor environment is necessary to estimate the health hazard and to create standards for indoor air quality control. This is especially important in such densely populated facilities like schools...
2019: Multidisciplinary Respiratory Medicine
Andrea Boccatonda, Valentina Decorato, Giulio Cocco, Stefano Marinari, Cosima Schiavone
Background: Some previous works have tested LUS use in diagnosing and monitoring interstitial lung diseases. B-lines are main sonographic signs for interstitial diseases. Increasing evidences suggest that dyspnea and impaired exercise capacity in IPF patients can be related, at least in part, to respiratory muscle dysfunction, in particular to diaphragm functionality. Both B-mode and M-mode ultrasound techniques have been employed to assess diaphragm excursion (DE), which measures the distance that the diaphragm is able to move during the respiratory cycle...
2019: Multidisciplinary Respiratory Medicine
Lisa H Lancaster
The six-minute walk test (6MWT) is a simple test that is widely used to assess functional exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). Patients with IPF have reduced exercise capacity due to a number of factors, such as impaired respiratory mechanics and circulatory problems. As a self-paced and usually submaximal exercise test, the 6MWT reflects the exercise level of everyday activities. Variables measured during the 6MWT, such as six-minute walk distance (6MWD) and desaturation, are strong predictors of mortality in patients with IPF...
2018: Multidisciplinary Respiratory Medicine
Kate Sutherland, Kristina Kairaitis, Brendon J Yee, Peter A Cistulli
Obstructive Sleep Apnoea (OSA) is a common sleep disorder that is associated with daytime symptoms and a range of comorbidity and mortality. Continuous Positive Airway Pressure (CPAP) therapy is highly efficacious at preventing OSA when in use and has long been the standard treatment for newly diagnosed patients. However, CPAP therapy has well recognised limitations in real world effectiveness due to issues with patient acceptance and suboptimal usage. There is a clear need to enhance OSA treatment strategies and options...
2018: Multidisciplinary Respiratory Medicine
Antonio Sanna, Donato Lacedonia
No abstract text is available yet for this article.
2018: Multidisciplinary Respiratory Medicine
Sebastiano Emanuele Torrisi, Stefano Palmucci, Alessandro Stefano, Giorgio Russo, Alfredo Gaetano Torcitto, Daniele Falsaperla, Mauro Gioè, Mauro Pavone, Ada Vancheri, Gianluca Sambataro, Domenico Sambataro, Letizia Antonella Mauro, Emanuele Grassedonio, Antonio Basile, Carlo Vancheri
Background: The assessment of Idiopathic Pulmonary Fibrosis (IPF) using HRCT requires great experience and is limited by a significant inter-observer variability, even between trained radiologists. The evaluation of HRCT through automated quantitative analysis may hopefully solve this problem. The accuracy of CT-histogram derived indexes in the assessment of survival in IPF patients has been poorly studied. Methods: Forty-two patients with a diagnosis of IPF and a follow up time of 3 years were retrospectively collected; HRCT and Pulmonary Function Tests (PFTs) performed at diagnosis time were analysed; the extent of fibrotic disease was quantified on HRCT using kurtosis, skewness, Mean Lung Density (MLD), High attenuation areas (HAA%) and Fibrotic Areas (FA%)...
2018: Multidisciplinary Respiratory Medicine
Mama Moussa Diaw, Mamoudou Ndiaye, Niccolò Riccardi, Riccardo Ungaro, Riccardo Alagna, Daniela Maria Cirillo, Luigi Codecasa, Claudio Viscoli, Laura Ambra Nicolini, Giorgio Besozzi
Background: Since 2013 StopTB Italia Onlus supports the Senegalese National Tuberculosis Programme by improving diagnostic capability with technological interventions, ameliorating educational programs for health care personnel, rising awareness among civil society and providing economical support for patients during treatment. The purpose of our study was to assess the preliminary results of an interventional cooperation project in a peripheral health care facility in Senegal. Methods: An observational, retrospective, pre-post study was conducted to compare Tuberculosis (TB) retention in care and outcome between a one-year period before and a four-year period after...
2018: Multidisciplinary Respiratory Medicine
María-José Giménez, Lorenzo Aguilar, Juan José Granizo
Fifteen years after its licensure, this revision assesses the role of cefditoren facing the current pharmacoepidemiology of resistances in respiratory human-adapted pathogens ( Streptococcus pneumoniae , Streptococcus pyogenes , Haemophilus influenzae and Moraxella catarrhalis ). In the era of post- pneumococcal conjugate vaccines and in an environment of increasing diffusion of the fts I gene among H. influenzae isolates, published studies on the cefditoren in vitro microbiological activity, pharmacokinetic/pharmcodynamic (PK/PD) activity and clinical efficacy are reviewed...
2018: Multidisciplinary Respiratory Medicine
Andrea Gramegna, Stefano Aliberti, Marco Confalonieri, Angelo Corsico, Luca Richeldi, Carlo Vancheri, Francesco Blasi
Background: The European Respiratory Society recently published an important statement reviewing available evidence on diagnosis and treatment of lung disease associated to alpha-1 antitrypsin deficiency (AATD). Several issues on this topic still remain unresolved and subject of interpretation according to different standard procedures and healthcare systems worldwide. The purpose of this commentary is to offer a critical contribution to most of these controversial issues in light of an Italian perspective for the management of this disease...
2018: Multidisciplinary Respiratory Medicine
Ami R Buikema, Lee Brekke, Amy Anderson, Eleena Koep, Damon Van Voorhis, Lucie Sharpsten, Beth Hahn, Riju Ray, Richard H Stanford
Background: Chronic obstructive pulmonary disease (COPD) is associated with high clinical and economic burden. Optimal pharmacological therapy for COPD aims to reduce symptoms and the frequency and severity of exacerbations. Umeclidinium/vilanterol (UMEC/VI) is an approved combination therapy for once-daily maintenance treatment of patients with COPD. This study evaluated the impact of delaying UMEC/VI initiation on medical costs and exacerbation risk. Methods: A retrospective analysis of patients with COPD who initiated UMEC/VI between 4/28/2014 and 7/31/2016 was conducted using the Optum Research Database...
2018: Multidisciplinary Respiratory Medicine
Sherif Mohamed, Hassan Bayoumi, Nashwa Abd El-Aziz, Ehab Mousa, Yasser Gamal
Background: No studies have addressed the impact of lung cancer (LC) on prognosis of patients with idiopathic pulmonary fibrosis (IPF) in Upper Egypt. We aimed to evaluate the prevalence and risk factors for LC among IPF patients and its impact on their outcomes and survival in Upper Egypt. Methods: A total of 246 patients with IPF who had complete clinical and follow up data were reviewed. They were categorized into 2 groups: 34 patients with biopsy-proven LC and IPF (LC-IPF) and 212 patients with IPF only (IPF)...
2018: Multidisciplinary Respiratory Medicine
Sara Roversi, Piera Boschetto, Bianca Beghe', Michela Schito, Martina Garofalo, Mariarita Stendardo, Valentina Ruggieri, Roberto Tonelli, Alessandro Fucili, Roberto D'Amico, Federico Banchelli, Leonardo M Fabbri, Enrico M Clini
Chronic obstructive pulmonary disease (COPD) is a common comorbidity of heart failure (HF), but remains often undiagnosed, and we aimed to identify symptoms predicting COPD in HF. As part of an observational, prospective study, we investigated stable smokers with a confirmed diagnosis of HF, using the 8-item COPD-Assessment-Test (CAT) questionnaire to assess symptoms. All the items were correlated with the presence of COPD, and logistic regression models were used to identify independent predictors. 96 HF patients were included, aged 74, 33% with COPD...
2018: Multidisciplinary Respiratory Medicine
Ernesto Crisafulli, Enric Barbeta, Antonella Ielpo, Antoni Torres
Background: Patients with chronic obstructive pulmonary disease (COPD) may experience an acute worsening of respiratory symptoms that results in additional therapy; this event is defined as a COPD exacerbation (AECOPD). Hospitalization for AECOPD is accompanied by a rapid decline in health status with a high risk of mortality or other negative outcomes such as need for endotracheal intubation or intensive care unit (ICU) admission. Treatments for AECOPD aim to minimize the negative impact of the current exacerbation and to prevent subsequent events, such as relapse or readmission to hospital...
2018: Multidisciplinary Respiratory Medicine
Alessandra Siciliani, Erino Angelo Rendina, Mohsen Ibrahim
Background: Tracheal surgery requires a highly specialized team of anesthesiologists, thoracic surgeons, and operative support staff. It remain a formidable challenge for surgeons due to the criticality connected to anatomical considerations, intraoperative airway management, technical complexity of reconstruction, and the potential postoperative morbidity and mortality. Main body: This article focuses on the main technical aspects and literature data regarding laryngotracheal and tracheal resection and reconstruction...
2018: Multidisciplinary Respiratory Medicine
Matteo Fontana, Roberto Tonelli, Filippo Gozzi, Ivana Castaniere, Alessandro Marchioni, Riccardo Fantini, Francesca Coppi, Filippo Natali, Elisabetta Rovatti, Enrico Clini
Background: Hemoptysis is a frequent sign of respiratory and non-respiratory diseases. While in most cases the underlying cause is rapidly identified, sometimes the real etiology might be misdiagnosed with dramatic delay in treatment. Case presentation: A 46-year-old man with hiatal hernia and a history of aortic surgery for aortic coarctation presented with dramatic episodes of hemoptysis and subsequent severe anemia (6,9 g/dl). Digestive and respiratory endoscopy resulted not exhaustive, thus he underwent a contrast-enhanced computed tomography (CT) scan of the chest that showed an aneurysmal dilatation of the descending thoracic aorta with suspected aortobronchial fistula...
2018: Multidisciplinary Respiratory Medicine
Francesco Menzella, Luca Codeluppi, Mirco Lusuardi, Carla Galeone, Franco Valzania, Nicola Facciolongo
Background: Acute respiratory failure can be triggered by several causes, either of pulmonary or extra-pulmonary origin. Pompe disease, or type II glycogen storage disease, is a serious and often fatal disorder, due to a pathological accumulation of glycogen caused by a defective activiy of acid α-glucosidase (acid maltase), a lysosomal enzyme involved in glycogen degradation. The prevalence of the disease is estimated between 1 in 40,000 to 1 in 300,000 subjects. Case presentation: This case report describes a difficult diagnosis of late-onset Pompe disease (LOPD) in a 52 year old Caucasian woman with acute respiratory failure requiring orotracheal intubation and subsequent tracheostomy for long-term mechanical ventilation 24 h/day...
2018: Multidisciplinary Respiratory Medicine
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