Relationships between emphysema and airways metrics at high-resolution computed tomography (HRCT) and ventilatory response to exercise in mild to moderate COPD patients
In Chronic Obstructive Pulmonary Disease (COPD) patients, the opportunity to carry out a thoracic high-resolution CT (HRCT) scan and to perform an incremental cardiopulmonary exercise test (CPET) increases the possibility to identify the different clinical features of disease. The aim of our study was to evaluate the relationships between HRCT metrics (on emphysema by low attenuation areas-LAA% and airways by wall area-WA%) and CPET variables related to the dynamic response to exercise in terms of elastic balance (Δ rest-to-peak IC/TLC) and ventilation capacity for carbon dioxide output (VE/VCO2 slope and VE/VCO2 intercep...
Source: Respiratory Medicine CME - June 20, 2016 Category: Respiratory Medicine Authors: Ernesto Crisafulli, Veronica Alfieri, Mario Silva, Marina Aiello, Panagiota Tzani, Gianluca Milanese, Giuseppina Bertorelli, Nicola Sverzellati, Alfredo Chetta Source Type: research
The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections
In airway infections, biofilm formation has been demonstrated to be responsible for both acute and chronic events, and constitutes a genuine challenge in clinical practice. Difficulty in eradicating biofilms with systemic antibiotics has led clinicians to consider the possible role of non-antibiotic therapy. The aim of this review is to examine current evidence for the use of N-acetylcysteine (NAC) in the treatment of biofilm-related respiratory infections. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 15, 2016 Category: Respiratory Medicine Authors: Francesco Blasi, Clive Page, Gian Maria Rossolini, Lucia Pallecchi, Maria Gabriella Matera, Paola Rogliani, Mario Cazzola Tags: Review article Source Type: research
Pulmonary vein stenosis complicating radiofrequency catheter ablation for atrial fibrillation: A literature review
Radiofrequency catheter ablation has become a widely used intervention in the treatment of atrial fibrillation. Pulmonary vein stenosis (PVS) is one of the most serious complications associated with this procedure; the degree of stenosis ranges from mild ( (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 13, 2016 Category: Respiratory Medicine Authors: Hawa Edriss, Tatiana Denega, Victor Test, Kenneth Nugent Tags: Review article Source Type: research
Profile of difficult to treat asthma patients referred for systematic assessment
We determined the proportion of asthma patients under specialist care who remain difficult-to-treat and might benefit from systematic assessment. We additionally report the characteristics and indications for referral in 90 patients who received systematic assessment for difficult asthma. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 12, 2016 Category: Respiratory Medicine Authors: N. Radhakrishna, T.R. Tay, F. Hore-Lacy, R. Hoy, E. Dabscheck, M. Hew Source Type: research
Tiotropium improves lung function, exacerbation rate, and asthma control, independent of baseline characteristics including age, degree of airway obstruction, and allergic status
Many patients with asthma remain symptomatic despite treatment with inhaled corticosteroids (ICS) with or without long-acting β2-agonists (LABAs). Tiotropium add-on to ICS plus a LABA has been shown to improve lung function and reduce exacerbation risk in patients with symptomatic asthma. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 12, 2016 Category: Respiratory Medicine Authors: Huib A.M. Kerstjens, Petra Moroni-Zentgraf, Donald P. Tashkin, Ronald Dahl, Pierluigi Paggiaro, Mark Vandewalker, Hendrik Schmidt, Michael Engel, Eric D. Bateman Source Type: research
Activity limitation and exertional dyspnea in adult asthmatic patients: What do we know?
Limitation of activity is the most cited symptom described by uncontrolled asthma patients. Assessment of activity limitation can be undertaken through several ways, more or less complex, subjective or objective. Yet little is known about the link between patients sensations and objective measurements.The present review reports the current knowledge regarding activity limitation and symptom perception (i.e., exertional dyspnea) in adult patients with asthma. This work is based on references indexed by PubMed, irrespective of the year of publication. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 8, 2016 Category: Respiratory Medicine Authors: François Vermeulen, Gilles Garcia, Vincent Ninane, Pierantonio Laveneziana Tags: Review article Source Type: research
Novel variants of SERPIN1A gene: Interplay between alpha1-antitrypsin deficiency and chronic obstructive pulmonary disease
Alpha1-antitrypsin (AAT) is one of the major circulating anti-protease whose levels in circulation are raised during excessive amount of proteases, especially neutrophil elastase (NE) released during the course of inflammation. Proteolytic attack of NE on peripheral organs, more exclusively on lung parenchyma has severe consequence that may precipitate pulmonary emphysema. Normally, human body has its own molecular and physiological mechanisms to synthesize and regulate the production of anti-protease like AAT to mitigate the extent of inflammatory damage. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 8, 2016 Category: Respiratory Medicine Authors: Arif Bashir, Naveed Nazir Shah, Younis Mohammad Hazari, Mudasir Habib, Samirul Bashir, Nazia Hilal, Mariam Banday, Syed Asrafuzzaman, Khalid Majid Fazili Tags: Review article Source Type: research
Improvement of physical activity after endobronchial valve treatment in emphysema patients
Bronchoscopic lung volume reduction using endobronchial valves is a promising treatment for severe emphysema patients without collateral ventilation. Physical activity is an important contributing factor for the autonomy, morbidity and mortality of these patients. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 8, 2016 Category: Respiratory Medicine Authors: Jorine E. Hartman, Karin Klooster, Dirk-Jan Slebos, Nick H.T. ten Hacken Source Type: research
Stepping down from combination asthma therapy: The predictors of outcome
Stepping down from combination asthma therapy (inhaled corticosteroids (ICS) + long-acting β2 agonists (LABA)) is often avoided due to fear of exacerbations, which may lead to overmedication in well-controlled asthma. A better knowledge about the predictors of outcome might encourage clinicians to start stepping down more often than previously. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 8, 2016 Category: Respiratory Medicine Authors: Heikki O. Koskela, Minna K. Purokivi, Jouko Kokkarinen Source Type: research
Comparison of endobronchial ultrasound and high resolution computed tomography as tools for airway wall imaging in asthma and chronic obstructive pulmonary disease
Airway remodeling in asthma and chronic obstructive pulmonary disease (COPD) results in bronchial wall thickening. Bronchial wall thickness (BWT) can be assessed in high-resolution computed tomography (HRCT) and endobronchial ultrasound (EBUS). (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 8, 2016 Category: Respiratory Medicine Authors: Katarzyna Gorska, Piotr Korczynski, Michal Mierzejewski, Justyna Kosciuch, Malgorzata Zukowska, Marta Maskey-Warzechowska, Rafał Krenke Source Type: research
Perioperative respiratory care in obese patients undergoing bariatric surgery: Implications for clinical practice
Obesity is an increasing problem worldwide. The number of people with obesity doubled since the 1980's to affect an estimated 671 million people worldwide. Obese patients in general have an altered respiratory physiology and can have an impaired lung function, which leads to an increased risk of developing pulmonary complications during anaesthesia and after bariatric surgery (approximately 8%). Therefore the respiratory management of the bariatric surgical patient provides a number of challenges. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 6, 2016 Category: Respiratory Medicine Authors: Sjaak Pouwels, Frank W.J.M. Smeenk, Loes Manschot, Bianca Lascaris, Simon Nienhuijs, R. Arthur Bouwman, Marc P. Buise Tags: Review article Source Type: research
Prevalence of depression in COPD: A systematic review and meta-analysis of controlled studies
This study aimed to systematically review the prevalence of depression in COPD and controls and to explore remaining causes of inter-study variability in the reported prevalence. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 6, 2016 Category: Respiratory Medicine Authors: Darlan L. Matte, Marcia M.M. Pizzichini, Andrea T.C. Hoepers, Alexandre P. Diaz, Manuela Karloh, Mirella Dias, Emilio Pizzichini Tags: Review article Source Type: research
Challenges in managing Pseudomonas aeruginosa in non-cystic fibrosis bronchiectasis
An Expert Forum was held at the 2014 European Respiratory Society International Congress to address issues involved in the management of Pseudomonas aeruginosa infection in patients with non-cystic fibrosis bronchiectasis (NCFB). Multiple studies have found that chronic P. aeruginosa infection is associated with more severe disease and higher morbidity and mortality. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 6, 2016 Category: Respiratory Medicine Authors: Robert Wilson, Timothy Aksamit, Stefano Aliberti, Anthony De Soyza, J. Stuart Elborn, Pieter Goeminne, Adam T. Hill, Rosario Menendez, Eva Polverino Tags: Review article Source Type: research
Observational study of lung transplant recipients surviving 20 years
Lung transplant recipients have reduced long-term survival compared with other solid organ recipients. There is a lack of published data on the characteristics of very long term survivors. (Source: Respiratory Medicine CME)
Source: Respiratory Medicine CME - June 6, 2016 Category: Respiratory Medicine Authors: Sasiharan Sithamparanathan, Logan Thirugnanasothy, Stephen Clark, John H. Dark, Andrew J. Fisher, Kate F. Gould, Asif Hasan, James L. Lordan, Gerard Meachery, Gareth Parry, Paul A. Corris Tags: Clinical trial paper Source Type: research
Management of obese patients with respiratory failure – A practical approach to a health care issue of increasing significance
In the general population, prevalence of obesity is increasing continuously. Concomitantly, a growing number of obese patients with severe illnesses presents at intensive care units (ICU). Particularly respiratory management of this patient group poses a challenge to intensive care physicians because of differences in respiratory anatomy and physiology in obese compared to non-obese individuals.Aim of this review is to present treatment options for critically ill obese patients requiring mechanical ventilation based on current studies concerning patient positioning, ventilatory regimen as well as extended therapy with veno...
Source: Respiratory Medicine CME - June 5, 2016 Category: Respiratory Medicine Authors: Alicia Jeanette Fischer, Sven Kaese, Pia Lebiedz Tags: Review article Source Type: research
