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Instant velocity and consistency of emitted cloud change by the different levels of canister filling with Metered Dose Inhalers (MDIs), but not with Soft Mist Inhalers (SMIs): a  bench study
ConclusionsMDIs are characterized by a substantial variability in both their instant velocity and consistency of the emitted cloud at different levels of canister filling. SMI generates a much slower soft mist cloud which is constantly homogeneous and independent of canister emptying. These peculiarities assessed at bench are suggesting a higher dose consistency and a much more effective therapeutic performance also in real life. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - May 29, 2017 Category: Respiratory Medicine Source Type: research

Mutational status predicts the risk of thromboembolic events in lung adenocarcinoma
ConclusionsOur study suggests that patients with lung adenocarcinoma bearing a EGFR-mutation have a decreased risk of VTE compared with patients with other forms of lung adenocarcinoma. Targeted therapy with TKI alone or in combination with other treatments seems to reduce the risk of VTE compared to other treatments not including TKI. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - May 29, 2017 Category: Respiratory Medicine Source Type: research

Recent advances in capsule-based dry powder inhaler technology
This article reviews recent advances in capsule-based DPI technology and the introduction of the ‘disposable’ DPI device. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - May 22, 2017 Category: Respiratory Medicine Source Type: research

Using PaCO2 values to grade obesity-hypoventilation syndrome severity: a retrospective study
ConclusionsClassification of OHS severity according to PaCO2 levels may be useful to provide a more defined characterization and, consequently, a more targeted management of OHS patients. Further studies are needed to confirm our findings. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - May 18, 2017 Category: Respiratory Medicine Source Type: research

Clinico- pathologic presentation of hypersensitivity pneumonitis in Egyptian patients: a multidisciplinary study
ConclusionThe diagnosis of HP presenting with predominant GGO pattern in HRCT requires a close interaction among clinicians, radiologists, and pathologists. Some environmental and household factors may be underestimated as etiologic factors. Further environmental and genetic studies are needed especially in patients with negative exposure history. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - May 8, 2017 Category: Respiratory Medicine Source Type: research

The evidence on tiotropium bromide in asthma: from the rationale to the bedside
AbstractSevere and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new treatment approaches has led to reconsider anticholinergic drugs as an option for asthma treatment. Tiotropium is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently considered as an option for steps 4 and 5 of the Global Initiative for Asthma. In large randomized clinical trials enrolling patients ...
Source: Multidisciplinary Respiratory Medicine - May 4, 2017 Category: Respiratory Medicine Source Type: research

Tele-medicine in respiratory diseases
AbstractInformation and Communication Technologies applied to health care and advances in sensor and data transmission technology allowed tele-medicine based programs of care also for patients with respiratory diseases.Different sensors, transmission devices and interventions are used in tele-medicine for some indications. Patients suffering from Chronic Obstructive Pulmonary Disease, asthma, neuromuscular diseases, ventilator assisted individuals and those undergoing pulmonary rehabilitation programs may benefit from this approach.The legal problems are still unsolved. Economic advantages for health care systems, though p...
Source: Multidisciplinary Respiratory Medicine - April 20, 2017 Category: Respiratory Medicine Source Type: research

Longitudinal assessment of bleomycin-induced lung fibrosis by Micro-CT correlates with histological evaluation in mice
ConclusionsMicro-CT data were in good agreement with histological read-outs as micro-CT was able to quantify effectively and non-invasively disease progression longitudinally and to reduce the variability and number of animals used to assess the damage. This suggests that this technique is a powerful tool for understanding experimental pulmonary fibrosis and that its use could translate into a more efficient drug discovery process, also helping to fill the gap between preclinical setting and clinical practice. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - April 10, 2017 Category: Respiratory Medicine Source Type: research

A reappraisal of the mucoactive activity and clinical efficacy of bromhexine
AbstractSince its introduction to the market in 1963, bromhexine, an over-the-counter drug, has been investigated for its activity in animal models and in humans with diverse respiratory conditions. Bromhexine is a derivate of theAdhatoda vasica plant used in some countries for the treatment of various respiratory diseases. Bromhexine has been found to enhance the secretion of various mucus components by modifying the physicochemical characteristics of mucus. These changes, in turn, increase mucociliary clearance and reduce cough. Principal clinical research studies were primarily developed in an era when stringent methodo...
Source: Multidisciplinary Respiratory Medicine - March 19, 2017 Category: Respiratory Medicine Source Type: research

Characteristics of an optimized patient information material for elderly patients with obstructive pulmonary diseases based on patients ’ and experts’ assessment
ConclusionsFor more effective information and improvement of adherence we recommend newly structured patient information sheets and information cards with content discussed with the targeted patients and their healthcare professionals.Customized, patient-centered information materials could improve the efficiency of patient education and make the follow-up of the various therapeutic plans easier for patients. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - March 13, 2017 Category: Respiratory Medicine Source Type: research

Ventilator associated pneumonia or ventilator induced pneumonia
AbstractVentilator associated pneumonia currently in vogue seems to have some pitfalls as far as the nomenclature is concerned and thus it imparts an erroneous impression to the reader. As the driving force is in fact the ventilator, the phraseology should preferably be changed to ventilator induced pneumonia to convey the in depth meaning of the term thus evading the terminology currently in practice. A new and emerging paradigm dealing with all side effects of mechanical ventilation can be helpful to solve this etymological conflict. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - February 27, 2017 Category: Respiratory Medicine Source Type: research

Each day is a new beginning
(Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - February 14, 2017 Category: Respiratory Medicine Source Type: research

The physiological basis and clinical significance of lung volume measurements
AbstractFrom a physiological standpoint, the lung volumes are either dynamic or static. Both subclasses are measured at different degrees of inspiration or expiration; however, dynamic lung volumes are characteristically dependent on the rate of air flow. The static lung volumes/capacities are further subdivided into four standard volumes (tidal, inspiratory reserve, expiratory reserve, and residual volumes) and four standard capacities (inspiratory, functional residual, vital and total lung capacities). The dynamic lung volumes are mostly derived from vital capacity. While dynamic lung volumes are essential for diagnosis ...
Source: Multidisciplinary Respiratory Medicine - February 8, 2017 Category: Respiratory Medicine Source Type: research

Once daily aerosolised tobramycin in adult patients with cystic fibrosis in the management of Pseudomonas aeruginosa chronic infection
AbstractIt is estimated that about 60 –70% of Cystic Fibrosis patients developPseudomonas aeruginosa chronic infection, with progressive loss of lung function, as well as increased antibiotic resistance and mortality.The current strategy is to maintain lung function by chronic suppressive antipseudomonas antibiotic therapy. Tobramycin inhalation solution was the first approved aerosolised antibiotic to be used againstP. aeruginosa; inhalatory tobramycin frequency of administration is twice daily and inhalation time is estimated to be 15 to 20  min.From the pharmacokinetic point of view, aminoglycosides are dose-dependen...
Source: Multidisciplinary Respiratory Medicine - February 6, 2017 Category: Respiratory Medicine Source Type: research

Pulmonary arterial hypertension associated with interferon therapy: a population-based study
ConclusionAlthough our analysis showed that the development of PAH is a rare event with interferon therapy, the risk of developing the disease is several fold higher than that for the general population. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - January 16, 2017 Category: Respiratory Medicine Source Type: research