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By Tamer IbraHeem Pulmonologist searching for science
Yasunori Enomoto, Yutaro Nakamura, Thomas V Colby, Takeshi Johkoh, Hiromitsu Sumikawa, Koji Nishimoto, Katsuhiro Yoshimura, Sayomi Matsushima, Yoshiyuki Oyama, Hironao Hozumi, Masato Kono, Tomoyuki Fujisawa, Noriyuki Enomoto, Naoki Inui, Toshihide Iwashita, Takafumi Suda
BACKGROUND: Radiologic pleuroparenchymal fibroelastosis (PPFE)-like lesion including pulmonary apical cap can be occasionally observed in clinical settings. However, the significance of radiologic PPFE-like lesion is unclear in connective tissue disease (CTD)-related interstitial lung disease (ILD). MATERIALS AND METHODS: A total of 113 patients with CTD-related ILD were enrolled and assessed for radiologic PPFE-like lesion, which was defined as bilateral, upper lobe, and subpleural dense consolidations with or without pleural thickening on chest high-resolution computed tomography...
2017: PloS One
Fulsen Bozkus, Nursel Dikmen, Anil Samur
BACKGROUND: Microalbuminuria, used as a marker of endothelial dysfunction, is a predictor of mortality for any reason and of cardiovascular events. Recent research on the management of COPD has focused more on comorbidities, including cardiovascular events. The objective of this study was to investigate the incidence of microalbuminuria and whether it is associated with physiological and clinical features in a subject group that was classified in line with the new version of the Global Initiative for Chronic Obstructive Lung Disease stages...
March 2017: Respiratory Care
A Miskovic, A B Lumb
Postoperative pulmonary complications (PPCs) are common, costly, and increase patient mortality. Changes to the respiratory system occur immediately on induction of general anaesthesia: respiratory drive and muscle function are altered, lung volumes reduced, and atelectasis develops in > 75% of patients receiving a neuromuscular blocking drug. The respiratory system may take 6 weeks to return to its preoperative state after general anaesthesia for major surgery. Risk factors for PPC development are numerous, and clinicians should be aware of non-modifiable and modifiable factors in order to recognize those at risk and optimize their care...
March 1, 2017: British Journal of Anaesthesia
Khalil Ansarin, Davood Attaran, Hamidreza Jamaati, Mohammad Reza Masjedi, Hamidreza Abtahi, Ali Alavi, Masoud Aliyali, Amir Mohammad Hashem Asnaashari, Reza Farid-Hosseini, Seyyed Mohammad Ali Ghayumi, Hassan Ghobadi, Atabak Ghotb, Abolhassan Halvani, Abbas Nemati, Mohammad Hossein Rahimi Rad, Masoud Rahimian, Ramin Sami, Hamid Sohrabpour, Sasan Tavana, Mohammad Torabi-Nami, Parviz Vahedi
Challenges in the assessment, diagnosis and management of severe, difficult-to-control asthma are increasingly regarded as clinical needs yet unmet. The assessments required to determine asthma severity, comorbidities and confounding factors, disease phenotypes and optimal treatment are among the controversial issues in the field. The respiratory care experts' input forum (RC-EIF), comprised of an Iranian panel of experts, reviewed the definition, appraised the available guidelines and provided a consensus for evaluation and treatment of severe asthma in adults...
2015: Tanaffos
Maliheh Ghadiri, Paul M Young, Daniela Traini
INTRODUCTION: During the last few decades, cell-based therapies have shown great potential to treat patients with lung diseases. It has been proposed that the administration of cells into an injured lung could be considered as a therapeutic method to repair and replace lost lung tissue. Using this method, transplanted cells with the ability to proliferate and differentiate into alveolar cells, have been suggested as a therapeutic strategy for IPF treatment. AREAS COVERED: In this review, the latest investigations using various types of cells for IPF therapy have been presented...
2016: Expert Opinion on Biological Therapy
David Cluck, Paul Lewis, Brooke Stayer, Justin Spivey, Jonathan Moorman
PURPOSE: The chemistry, pharmacokinetic and pharmacodynamic properties, efficacy, and safety of the recently introduced combination antimicrobial agent ceftolozane-tazobactam are reviewed. SUMMARY: Ceftolozane-tazobactam (Zerbaxa, Cubist Pharmaceuticals) is a cephalosporin β-lactam and β-lactamase inhibitor marketed as a fixed-dose combination agent for the treatment of complicated urinary tract and intraabdominal infections. Its dosing and chemistry provide expansive antimicrobial coverage of gram-negative organisms, including Pseudomonas aeruginosa, and stable activity against many β-lactamases, as well as coverage of most extended-spectrum β-lactamase-producing organisms and some anaerobes...
December 15, 2015: American Journal of Health-system Pharmacy: AJHP
Divya Reddy, Frederic F Little
INTRODUCTION: For decades glucocorticoids have been considered as the gold standard for the treatment of asthma. We present a case report of typical glucocorticoid-resistant asthma and current consensus in definitions of "severe refractory", "difficult" and "glucocorticoid-resistant" asthma. METHODS: Full-text papers and abstracts were identified on the basis of a comprehensive literature search primarily in MEDLINE (1966 to June 2012) but also in the Cochrane Central Register of Controlled Trials database...
December 2013: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Hamid Husain, Fahed Al-Fadhli, Fatima Al-Olaimi, Alshouq Al-Duraie, Ammar Qureshi, Waleed Al-Kandari, Amal K Mitra
OBJECTIVE: The aim of this study was to compare the health effects of shisha smoking with cigarette smoking among male college students in Kuwait. SUBJECTS AND METHODS: This cross-sectional study was conducted on 525 male students in Kuwait from September to October 2013. A pretested questionnaire was used for information on demographics and health complaints. Peak expiratory flow rate (PEFR) was measured using a portable peak flow meter. The outcome variables of health status were compared between smoking shisha, cigarettes, or both, and nonsmoking...
2016: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
José Manuel Porcel, Manuel Vives, Aureli Esquerda, Agustín Ruiz
AIM: To assess the value of the British Thoracic Society (BTS) and the American College of Chest Physicians (ACCP) guidelines to predict which patients with non-purulent parapneumonic effusions (PPE) warrant chest tube drainage. METHODS: A retrospective chart review was performed on all patients who underwent thoracentesis because of a PPE over a 10-year period at a Spanish medical center. Classification of PPE as complicated (CPPE) or uncomplicated (UPPE) was based on the clinician's decision to insert a chest tube to resolve the effusion...
May 2006: Respiratory Medicine
Umesh Goneppanavar, Rahul Magazine, Bhavya Periyadka Janardhana, Shreepathi Krishna Achar
Dexmedetomidine, an α2 agonist, has demonstrated its effectiveness as a sedative during awake intubation, but its utility in fiberoptic bronchoscopy (FOB) is not clear. We evaluated the effects of midazolam and dexmedetomidine on patient's response to FOB. The patients received either midazolam, 0.02 mg/kg (group M, n=27), or dexmedetomidine, 1 µg/kg (group D, n=27). A composite score of five different parameters and a numerical rating scale (NRS) for pain intensity and distress were used to assess patient response during FOB...
2015: Pulmonary Medicine
D Dunbar Ivy, Steven H Abman, Robyn J Barst, Rolf M F Berger, Damien Bonnet, Thomas R Fleming, Sheila G Haworth, J Usha Raj, Erika B Rosenzweig, Ingram Schulze Neick, Robin H Steinhorn, Maurice Beghetti
Pulmonary hypertension (PH) is a rare disease in newborns, infants, and children that is associated with significant morbidity and mortality. In the majority of pediatric patients, PH is idiopathic or associated with congenital heart disease and rarely is associated with other conditions such as connective tissue or thromboembolic disease. Incidence data from the Netherlands has revealed an annual incidence and point prevalence of 0.7 and 4.4 for idiopathic pulmonary arterial hypertension and 2.2 and 15.6 for pulmonary arterial hypertension, respectively, associated with congenital heart disease (CHD) cases per million children...
December 24, 2013: Journal of the American College of Cardiology
Raed A Dweik, Sharon Rounds, Serpil C Erzurum, Stephen Archer, Karen Fagan, Paul M Hassoun, Nicholas S Hill, Marc Humbert, Steven M Kawut, Michael Krowka, Evangelos Michelakis, Nicholas W Morrell, Kurt Stenmark, Rubin M Tuder, John Newman
BACKGROUND: Current classification of pulmonary hypertension (PH) is based on a relatively simple combination of patient characteristics and hemodynamics. This limits customization of treatment, and lacks the clarity of a more granular identification based on individual patient phenotypes. Rapid advances in mechanistic understanding of the disease, improved imaging methods, and innovative biomarkers now provide an opportunity to define PH phenotypes on the basis of biomarkers, advanced imaging, and pathobiology...
February 1, 2014: American Journal of Respiratory and Critical Care Medicine
Steven H Abman, John P Kinsella, Erika B Rosenzweig, Usha Krishnan, Thomas Kulik, Mary Mullen, David L Wessel, Robin Steinhorn, Ian Adatia, Brian Hanna, Jeffrey Feinstein, Jeffrey Fineman, Usha Raj, Tilman Humpl
Pulmonary arterial hypertension (PAH) contributes to disability and death in children with diverse cardiac, pulmonary, or systemic diseases, and therapeutic options are currently limited. Data from adult studies provide the basis for most PAH-specific therapies; however, many of these medications are commonly used in children on an off-label basis due to the life-threatening nature of PAH. Although currently approved for use in adult PAH, sildenafil is used extensively off-label for the treatment of neonates, infants, and children with PAH...
March 15, 2013: American Journal of Respiratory and Critical Care Medicine
R Alvisi, C A Volta, E R Righini, M Capuzzo, R Ragazzi, M Verri, G Candini, G Gritti, J Milic-Emili
Several threshold values for predicting weaning outcome from mechanical ventilation have been proposed. These values, however, have been obtained in nonhomogeneous patient populations. The aim of the present study was to determine the threshold values in chronic obstructive pulmonary disease (COPD) patients and compare them to those reported for nonhomogeneous patient populations. The initial weaning trial included 81 COPD patients. Fifty-three of them underwent a successful weaning trial, whereas 28 failed it...
April 2000: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Armando J Huaringa, Allan Wang, Manuel H Haro, Francisco J Leyva
BACKGROUND: The quest to obtain an accurate way to predict success when weaning a patient from mechanical ventilation continues. The established parameters such as tidal volume (Vt), respiratory rate (f), negative inspiratory force (NIF), vital capacity (VC), and minute ventilation (V) have not predicted weaning accurately. The frequency-to-tidal volume ratio (f/Vt), or rapid shallow breathing index (RSBI) is a good predictor of weaning success if the value is low, but not when the value approximates 105...
November 2013: Journal of Intensive Care Medicine
Hermann Heinze, Beate Sedemund-Adib, Matthias Heringlake, Torsten Meier, Wolfgang Eichler
BACKGROUND: Measurement of functional residual capacity (FRC) is now possible at bedside, during mechanical ventilation. OBJECTIVES: To determine the relationship of measured absolute and relative predicted FRC values to oxygenation and respiratory-system compliance, and to identify variables that influence FRC in ventilated patients after cardiac surgery. METHODS: We retrospectively analyzed data from 99 patients ventilated after cardiac surgery...
May 2010: Respiratory Care
Ilaria Valentini, Eva Tonveronachi, Cesare Gregoretti, Chiara Mega, Luca Fasano, Lara Pisani, Stefano Nava
OBJECTIVE: To determine the effects of different tracheotomy tube sizes on diaphragm effort and weanability indices. METHODS: Ten tracheotomized and difficult to wean subjects were randomized to 2 T-piece trials, with different tracheotomy tube diameters: inner diameters 8 mm and 6.5 mm. Diaphragm pressure-time product per min. (PTP(di/min)), lung compliance and resistance (C(L) and R(L)), breathing pattern, tension-time index of the diaphragm (TT(di)), and the ratio of breathing frequency to tidal volume (f/V(T)) were recorded...
December 2012: Respiratory Care
Yves Lacasse, Martin Légaré, François Maltais
Current smokers who are prescribed home oxygen may not benefit from the therapy. In addition to being an obvious fire hazard, there is some evidence that the physiological mechanisms by which home oxygen is believed to operate are inhibited by smoking. Although their effectiveness is yet to be demonstrated, electronic cigarettes (e-cigarettes) are often regarded as an aid to smoking cessation. However, several burn accidents in e-cigarette smokers receiving home oxygen therapy have also been reported, leading Health Canada to release a warning of fire risk to oxygen therapy patients from e-cigarettes...
March 2015: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Junhong Jiang, Robert Browning, Noah Lechtzin, Jianan Huang, Peter Terry, Ko Pen Wang
INTRODUCTION: Conventional transbronchial needle aspiration (TBNA) has been around for over 30 years with sensitivities approaching 70-90%. Recent development of endobronchial ultrasound (EBUS) TBNA demonstrated even higher sensitivities among experts. However EBUS-TBNA is more costly and less available worldwide than conventional TBNA. A comparison study to determine the efficacy of TBNA with and without EBUS in the diagnosis and staging of lung cancer is described. METHODS: A total of 287 patients with mediastinal and hilar lymphadenopathy presenting for diagnosis and/or staging of lung cancer at enrolling institutions were included...
May 2014: Journal of Thoracic Disease
Hammad A Bhatti, Abubakar Bajwa, Junaid A Bhatti, James Cury, Adil Shujaat, Lisa Jones, Faisal Usman
BACKGROUND: The purpose of this study was to evaluate the diagnostic yield of endobronchial ultrasound with real-time-guided transbronchial needle aspiration (EBUS-TBNA), endobronchial forceps biopsy (EBBx), and 2D fluoroscopic-guided transbronchial forceps biopsy (TBLBx) for centrally located peribronchial lung lesions. METHODS: A retrospective chart review of consecutive patients who underwent EBUS-TBNA of centrally located peribronchial lesions, that is, medial margin of the mass within inner third of hemithorax by computerized tomography scan...
April 2013: Journal of Bronchology & Interventional Pulmonology
2015-04-28 11:12:51
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