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Invasive candidiasis presenting multiple pulmonary cavitary lesions on chest computed tomography
Abstract We herein report a case of invasive candidiasis presenting rare findings on chest computed tomography (CT). The chest CT scan showed multiple small cavitary lesions and nodules with surrounding ground-glass opacity, and also bilateral pleural effusion. Although this CT finding is thought as specific for pulmonary aspergillosis, two sets of blood culture specimens were drawn which yielded Candida albicans in our case. Antifungal therapy was started and the chest CT findings showed a remarkable improvement. To our knowledge, this is the first case report describing multiple pulmonary cavitary les...
Source: Multidisciplinary Respiratory Medicine - March 20, 2015 Category: Respiratory Medicine Source Type: research

Rethinking the withholding/withdrawing distinction: the cultural construction of “life-support” and the framing of end-of-life decisions
Abstract This paper is a theoretical and empirically informed examination of the naturalist distinction between withholding and withdrawing life-support. Drawing on the history of mechanical ventilation and on a recent Israeli law containing a novel approach to disconnecting life-support at the end of life, it is argued that the design of machines predicates the division line between “active” and “passive” interventions, and that the distinction itself might be morally self-defeating. Informed by insights from moral psychology, behavioral economics and phi...
Source: Multidisciplinary Respiratory Medicine - March 17, 2015 Category: Respiratory Medicine Source Type: research

Recurrent lung atelectasis from fibrin plugs as a very early complication of bronchial thermoplasty: a case report
Conclusion The originality of our case report is related to the recurrence of bronchial plugging with lobar atelectasis within one and five hours respectively, after two sequential BT procedures. At the histological evaluation the bronchial plugs appeared very different from the typical mucoid asthma plugs, being composed prevalently by fibrin. It can be hypothesized that intense thermal stimulation of the bronchial mucosa may represent a strong boost for inflammation in susceptible patients, with microvascular alteration induced directly by heat or through the release of mediators. ...
Source: Multidisciplinary Respiratory Medicine - March 8, 2015 Category: Respiratory Medicine Source Type: research

Sedation options for the morbidly obese intensive care unit patient: a concise survey and an agenda for development
Conclusion None of the agents currently available is ideal for every situation encountered in the management of morbidly obese patients. This article identifies additional research needed to place sedation practice of obese patients on a more systematic footing. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - March 7, 2015 Category: Respiratory Medicine Source Type: research

Change in prevalence of restrictive lung impairment in the U.S. population and associated risk factors: the National Health and Nutrition Examination Survey (NHANES) 1988–1994 and 2007–2010
Conclusions The overall prevalence of restrictive pattern and moderate to more severe restrictive pattern decreased between the 1988–1994 and 2007–2010 survey periods despite a population increase in the proportion of comorbidities associated with restrictive pattern (i.e. diabetes and abdominal obesity). This suggests a decline in individual risk factors for restrictive pattern and a need for future research. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - February 28, 2015 Category: Respiratory Medicine Source Type: research

Recommendations for the early diagnosis of COPD: the AIMAR view
(Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - February 22, 2015 Category: Respiratory Medicine Source Type: research

Limitation of the therapeutic effort: ethical and legal justification for withholding and/or withdrawing life sustaining treatments
Abstract Withholding and withdrawing a treatment already established are two forms of limitation of the therapeutic effort (LTE). The question of undergoing or not undergoing lifesaving medical treatments is not restricted to a specific health care context, as it refers to a variety of treatments, and it does not concern a restricted group of diseases. LTE has become part of the options compatible with the good clinical practice, in accordance with a deep change in modern medicine’s ‘mission’ along with the increased importance attributed to the patient’s general, personal condition, and to the ...
Source: Multidisciplinary Respiratory Medicine - February 17, 2015 Category: Respiratory Medicine Source Type: research

Reviewer acknowledgement 2014
Contributing reviewers The editors of Multidisciplinary Respiratory Medicine would like to thank all of our reviewers who have contributed to the journal in Volume 9 (2014). (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - February 2, 2015 Category: Respiratory Medicine Source Type: research

INDACO project: COPD and link between comorbidities, lung function and inhalation therapy
Conclusions Our study showed a high prevalence of comorbidities in COPD, with some differences related to gender. Number of comorbidities and airflow obstruction represent the determinant of inhalation therapy prescription. Dyspnoea and acute exacerbation of COPD, unlikely suggested by guidelines, are not significant drivers of therapy in the real life setting of our study. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - January 27, 2015 Category: Respiratory Medicine Source Type: research

Peripheral muscle strength and functional capacity in patients with moderate to severe asthma
Conclusions The individuals with asthma had lower functional capacity and levels of physical activity as well as a higher percentage of body fat compared to healthy individuals. This suggests that such patients have a reduced physical performance stemming from a sedentary lifestyle. Despite the existence of few studies reporting moderate to severe asthmatic patients and functional capacity assessment, it is clear that the assessment presented in the current study is a valid and accessible tool in clinical practice. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - January 21, 2015 Category: Respiratory Medicine Source Type: research

Tailored therapy for severe asthma
Abstract Patients with severe asthma or COPD have often a suboptimal symptom control due to inadequate treatment. A better understanding of pathogenetic mechanisms, phenotypes, endotypes and the new technologies available in the fields of molecular biology and immunogenetics have made it possible to synthesize specific monoclonal antibodies virtually able to interact with any target antigen, or to open a way for new therapeutic target options. At the moment, the only biologic drug available in clinical practice is omalizumab. To overcome the limits of omalizumab, the research has focused on new monoclon...
Source: Multidisciplinary Respiratory Medicine - January 16, 2015 Category: Respiratory Medicine Source Type: research

Standards of suitability for the management of chronic obstructive respiratory diseases
Conclusions The results of this Third Consensus Conference revealed some certainties and many doubts and diversities of view also on topics whose importance is well demonstrated in scientific literature. Thus, there is still a long distance to cover before reaching a suitable standardization of COPD management and such situation urges the need for improving not only the health professional’s operativeness but also the organizational support by competent institutions. In this context some initiatives organized by AIMAR in cooperation with other respiratory scientific societies and patients’ associa...
Source: Multidisciplinary Respiratory Medicine - December 18, 2014 Category: Respiratory Medicine Source Type: research

Pharmacologic rationale, efficacy and safety of the fixed-dose co-formulation of indacaterol and glycopyrronium
Abstract Chronic obstructive pulmonary disease (COPD) is a widespread respiratory disorder, usually characterized by progressive and poorly reversible airflow limitation. Inhaled long-acting bronchodilators, namely LABA (long-acting β2-adrenergic agonists) and LAMA (long-acting muscarinic receptor antagonists) are the mainstay of COPD treatment. Because the symptoms of many patients with COPD do not satisfactorily improve by using a single, either LABA or LAMA bronchodilator, the synergism of action resulting from the combination of the different bronchodilating mechanisms activated by LABA and LAMA, r...
Source: Multidisciplinary Respiratory Medicine - December 8, 2014 Category: Respiratory Medicine Source Type: research

Health and social impacts of COPD and the problem of under-diagnosis
In conclusion, we firmly believe that an early and correct diagnosis can influence positively the progress of the disease (lowering the lung function impairment), decrease the risk of exacerbations, relieve symptoms and increase the patients’ quality of life leading also to a decrease in costs associated to the exacerbations and hospitalization of the patient. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - December 6, 2014 Category: Respiratory Medicine Source Type: research

Enhancing the diagnosis and management of COPD in Primary care
(Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - November 28, 2014 Category: Respiratory Medicine Source Type: research