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Sedation and weaning from mechanical ventilation: time for ‘best practice’ to catch up with new realities?
Abstract Delivery of sedation in anticipation of weaning of adult patients from prolonged mechanical ventilation is an arena of critical care medicine where opinion-based practice is currently hard to avoid because robust evidence is lacking. We offer some views on this subject, hoping to stimulate debate among colleagues. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - August 29, 2014 Category: Respiratory Medicine Source Type: research

Evaluation of reactive oxygen metabolites in patients with non-small cell lung cancer after chemotherapy
Conclusions NSCLC patients had significantly elevated ROMs levels before chemotherapy compared with normal healthy subjects. Chemotherapy may suppress ROMs production in responders but not in non-responders. ROMs level may be a predictor of clinical outcome in patients receiving chemotherapy for NSCLC. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - August 29, 2014 Category: Respiratory Medicine Source Type: research

Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial
Conclusions Bariatric surgery effectively reduces neck and waist circumference, increases maximum ventilatory pressures, enhances sleep architecture and reduces respiratory sleep disorders, specifically obstructive sleep apnea, in patients with severe obesity. Trial registration The protocol for this study was registered with the World Health Organization (Universal Trial Number: U1111-1121-8873) and Brazilian Registry of Clinical Trials – ReBEC (RBR-9k9hhv). (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - August 9, 2014 Category: Respiratory Medicine Source Type: research

Audit on the appropriateness of integrated COPD management: the “ALT-BPCO” project
Conclusions It is easier to resolve the gaps in specialist clinical practice than the organizational gaps, changing which is the politicians’ task. Correcting specialists’ inappropriateness may be worthless if this is not accompanied by improvement of the organizational obstacles. The search for appropriateness should not be limited only to specialists or to a strict control of drug prescription but should include all the organizational aspects. Implementation of COPD-GL calls for actions on the part of both specialists and the health system. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - July 18, 2014 Category: Respiratory Medicine Source Type: research

On the ethics of withholding and withdrawing medical treatment
Abstract A general rationale is presented for withholding and withdrawing medical treatment in end-of-life situations, and an argument is offered for the moral irrelevance of the distinction, both in the context of pharmaceutical treatments, such as chemotherapy in cancer, and in the context of life-sustaining treatments, such as the artificial ventilator in lateral amyotrophic sclerosis. It is argued that this practice is not equivalent to sanctioning voluntary active euthanasia and that it is not likely to favour it. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - July 16, 2014 Category: Respiratory Medicine Source Type: research

Bronchial asthma and chronic obstructive pulmonary disease: research activity in Arab countries
Conclusions The present data showed relatively low research productivity about bronchial asthma and COPD in Arab countries. Research output can be improved by investing more in international and national collaborative research projects in the field of asthma and COPD. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - July 8, 2014 Category: Respiratory Medicine Source Type: research

Association between peripheral muscle strength, exercise performance, and physical activity in daily life in patients with Chronic Obstructive Pulmonary Disease
Conclusions Peripheral muscle strength may be associated with exercise performance but not with physical activity in daily life. This may be due to the fact that EP tests evaluate patients’ true abilities while PADL accelerometers may not. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - July 3, 2014 Category: Respiratory Medicine Source Type: research

Swallowing disorders in tracheostomised patients: a multidisciplinary/multiprofessional approach in decannulation protocols
Abstract Safe removal of tracheal cannula is a major goal in the rehabilitation of tracheostomised patients to achieve progressive independence from mechanical support and reduce the risk of respiratory complications. A tracheal cannula may also cause significant discomfort to the patient, making verbal communication difficult. Particularly when cuffed, tracheal cannula reduces the normal movement of the larynx which can further compromise the basic swallowing defect. A close connection between respiratory, phonating, swallowing and feeding abilities to be recovered, implies a strict integration among d...
Source: Multidisciplinary Respiratory Medicine - June 20, 2014 Category: Respiratory Medicine Source Type: research

Pneumocafé project: an inquiry on current COPD diagnosis and management among General Practitioners in Italy through a novel tool for professional education
Conclusions The results obtained with this project confirm the validity of this informal approach to professional education. Furthermore, this inquiry provided important insights about the general management of COPD and the process of integration between RS and GPs activities on this disease condition in the long run. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - June 12, 2014 Category: Respiratory Medicine Source Type: research

The influence of active and passive smoking on the cardiorespiratory fitness of adults
Conclusion VO2max was significantly higher in non-smokers compared to active smokers and passive smokers. However, the VO2max of passive smokers did not differ from active smokers. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - June 9, 2014 Category: Respiratory Medicine Source Type: research

A novel diagnostic algorithm for chronic and subacute cough
Conclusions The proposed algorithm is a promising and practical approach to diagnose chronic and subacute cough. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - June 7, 2014 Category: Respiratory Medicine Source Type: research

Look at the lung: can chest ultrasonography be useful in pregnancy?
Conclusions Chest US evaluation during pregnancy is a useful diagnostic tool to detect and monitor respiratory diseases, avoiding excessive X-rays exposure. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - June 6, 2014 Category: Respiratory Medicine Source Type: research

Idiopathic pulmonary fibrosis and coronary artery disease
Abstract Idiopathic pulmonary fibrosis (IPF) is defined as a chronic fibrosing interstitial disease of unknown cause, limited to the lungs, and associated with the histopathologic and/or radiologic pattern of usual interstitial pneumonia (UIP); it generally progresses into respiratory failure and death. Although progression of the disease is the most common cause of death, there are increasing reports of its association with other pathologies has been reported: e.g., IPF patients seem more susceptible to cardiovascular diseases. Therefore, other pathologies might also influence the natural course. ...
Source: Multidisciplinary Respiratory Medicine - May 30, 2014 Category: Respiratory Medicine Source Type: research

Does zafirlukast reduce future risk of asthma exacerbations in adults? Systematic review and meta-analysis
Conclusions Our study suggests that zafirlukast, as the first-line therapy, significantly reduces mild to moderate but not severe asthma exacerbations. In the add-on regimen, zafirlukast could not reduce asthma exacerbations, which would perhaps result from small sample size and needs to be further studied. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - May 28, 2014 Category: Respiratory Medicine Source Type: research

Expression of aquaporins in bronchial tissue and lung parenchyma of patients with chronic obstructive pulmonary disease
Conclusions This study provides pilot observations on the differences in AQP1 and AQP5 expression between COPD patients and COPD-resistant smokers. Our findings suggest a potential role for AQP1 in the pathogenesis of COPD. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - May 26, 2014 Category: Respiratory Medicine Source Type: research