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Acute pneumonitis consequent on pleurodesis with Viscum album extract: severe chest images but benign clinical course
Abstract Chemical pleurodesis is widely recommended in the treatment of pulmonary air leak of different etiologies as well as malignant pleural effusions and chylothorax. Conventional chemical pleurodesis using erythromycin, tetracycline, hydrophilic fumed silica, autologous blood and talc slurry has been standardized, and its complications, including high fever, intractable chest pain, and acute lung injury, seem to be frequent. Viscum album extract is a new chemical agent for pleurodesis, and only a few studies have reported outcomes of such chemical pleurodesis in the treatment of malignant pleural e...
Source: Multidisciplinary Respiratory Medicine - November 27, 2014 Category: Respiratory Medicine Source Type: research

Multiple logistic regression analysis of risk factors in elderly pneumonia patients: QTc interval prolongation as a prognostic factor
Conclusions These findings suggest potential prognostic factors for pneumonia in elderly patients, including a prolonged QTc interval (> 0.44 seconds). (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - November 22, 2014 Category: Respiratory Medicine Source Type: research

COPD: adherence to therapy
Abstract Adherence to medical therapies is a growing issue, so much so that the World Health Organization defined it as “a new pharmacological problem”. The main factors affecting compliance are: frequency of administration, rapid onset of action, role of device. The most severe consequence of non-adherence is the increased risk of poor clinical outcome, associated with worsening of the quality of life and increase in health-care expenditure. It appears crucial to identify those COPD patients who are “poorly or not at all compliant with their treatment”. In order to evaluate adherence to the med...
Source: Multidisciplinary Respiratory Medicine - November 22, 2014 Category: Respiratory Medicine Source Type: research

Clinical efficacy and tolerability of an immune-stimulant * constituted by inactivated bacterial bodies in the prophylaxis of infectious episodes of airways: a double blind, placebo-controlled, randomized, multicentre study
Conclusion The administration of bacterial lysate (Buccalin ®) in patients with RRTI had the capacity to significantly reduce the number of days with IE in a multicentre, randomized, placebo controlled, clinical study. The treatment was safe. Of note, all patients were free to be treated with the best concomitant therapies. In these conditions, the positive results observed demonstrated that this bacterial lysate has maintained its capacity of reducing the days with infections in patients with RRTI, also in association to the concomitant therapies available nowadays. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - November 19, 2014 Category: Respiratory Medicine Source Type: research

Carrageenan nasal spray in virus confirmed common cold: individual patient data analysis of two randomized controlled trials
Conclusions Administration of carrageenan nasal spray in children as well as in adults suffering from virus-confirmed common cold reduced duration of disease, increased viral clearance and reduced relapses of symptoms. Carrageenan nasal spray appeared as an effective treatment of common cold in children and adults. Trial registration Pooled data from ISRCTN52519535 and ISRCTN80148028 (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - November 12, 2014 Category: Respiratory Medicine Source Type: research

Sedation in non-invasive ventilation: do we know what to do (and why)?
Abstract This review examines some of the issues encountered in the use of sedation in patients receiving respiratory support from non-invasive ventilation (NIV). This is an area of critical and intensive care medicine where there are limited (if any) robust data to guide the development of best practice and where local custom appears to exert a strong influence on patterns of care. We examine aspects of sedation for NIV where the current lack of structure may be contributing to missed opportunities to improve standards of care and examine the existing sedative armamentarium. No sing...
Source: Multidisciplinary Respiratory Medicine - November 4, 2014 Category: Respiratory Medicine Source Type: research

Metabolomic profile of amniotic fluid to evaluate lung maturity: the diaphragmatic hernia lamb model
Conclusions Alveolar tissue and fetal global growth ameliorated after TO. Metabolomics provided useful information on biochemical details during lung maturation. Metabolomic profiling would help to identify the best time to perform TO, in order to increase survival of CDH affected patients. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - November 4, 2014 Category: Respiratory Medicine Source Type: research

Application of veno-arterial-venous extracorporeal membrane oxygenation in differential hypoxia
Abstract Veno-arterial extracorporeal membrane oxygenation (ECMO) through the femoral vein and artery may cause differential hypoxia, i.e., lower PaO2 in the upper body than in the lower body, because of normal cardiac output with severe impairment of pulmonary function. Hereby, we report the diagnosis and the treatment of differential hypoxia caused by veno-arterial ECMO. A 39-year-old man received cardiopulmonary resuscitation from a cardiac arrest due to acute myocardial infarction. Even after more than 30 min of resuscitation, spontaneous circulation had not resumed. Next, we performed veno-arterial...
Source: Multidisciplinary Respiratory Medicine - November 4, 2014 Category: Respiratory Medicine Source Type: research

Patient reported experiences of CT guided lung biopsy: a prospective cohort study
Conclusions Our study demonstrates CT guided lung biopsy is a safe procedure and is generally well tolerated. Some patients may experience significant and lasting pain and therefore should be counselled about this pre-procedure. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - October 31, 2014 Category: Respiratory Medicine Source Type: research

AIMAR survey on complex forms of bronchial asthma and COPD, their management and perception of critical issues
Conclusions Complex forms of bronchial asthma and COPD are frequently observed and considered present in variable percentages ranging from about 10% to about 50% of patients visited and considered typical of patients with a previous history of asthma. Risk factors such as smoking, obesity, bronchial hyperreactivity and genetic predisposition are considered important. Diagnosis is difficult solely on the basis of symptoms in approximately 50% of cases, and a previous history of asthma, history of spirometry and presence of allergy are of help. Treating inflammation and reducing exacerbations are consid...
Source: Multidisciplinary Respiratory Medicine - October 28, 2014 Category: Respiratory Medicine Source Type: research

COPD: maximization of bronchodilation
Abstract The most recent guidelines define COPD in a multidimensional way, nevertheless the diagnosis is still linked to the limitation of airflow, usually measured by the reduction in the FEV1/FVC ratio below 70%. However, the severity of obstruction is not directly correlated to symptoms or to invalidity determined by COPD. Thus, besides respiratory function, COPD should be evaluated based on symptoms, frequency and severity of exacerbations, patient’s functional status and health related quality of life (HRQoL). Therapy is mainly aimed at increasing exercise tolerance and reducing dyspnea, with imp...
Source: Multidisciplinary Respiratory Medicine - October 15, 2014 Category: Respiratory Medicine Source Type: research

Experience with exercise right heart catheterization in the diagnosis of pulmonary hypertension: a retrospective study
Conclusion In this real-life experience in symptomatic patients undergoing exercise RHC for suspected PH, we found that exercise RHC is safe. The facts that the vast majority of patients with mPAP-values between 20 and 24.9 mmHg at rest had exercise PH and the older age of patients with resting PH may indicate that exercise PH is a precursor of resting PH. Whether earlier treatment start in patients with exercise PH would stabilize the disease should be addressed in future studies. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - October 15, 2014 Category: Respiratory Medicine Source Type: research

A novel biomarker in the diagnosis of parapneumonic effusion: neutrophil gelatinase-associated lipocalin
Conclusions NGAL can be used in the diagnosis of diseases with an acute inflammatory course. Serum and pleural NGAL levels can differentiate PPE from other diseases causing pleural fluid with high sensitivity and specificity. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - September 15, 2014 Category: Respiratory Medicine Source Type: research

Diagnostic delay of pulmonary nontuberculous mycobacterial infection in China
Conclusions Our results indicate a significant diagnostic delay of NTM diseases in China, especially for rural patients with limited access to higher-level healthcare services. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - September 11, 2014 Category: Respiratory Medicine Source Type: research

CAT correlates positively with respiratory rate and is a significant predictor of the impact of COPD on daily life of patients: a cross sectional study
Conclusion The CAT is a sensitive tool to assess the current health status of COPD patients, and in Southern Brazil it is positively correlated with respiratory rate. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - September 9, 2014 Category: Respiratory Medicine Source Type: research