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A case of pulmonary veno-occlusive disease: diagnostic dilemmas and therapeutic challenges
Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary hypertension (PH). Misdiagnosis of the disease is common since PVOD presents with clinical and radiographic features mimicking idiopathic pulmonary arterial hypertension or even PH due to interstitial lung disease. Vasodilators may not be efficacious in PVOD and may in fact worsen hemodynamic status with the development of pulmonary edema. Lung transplantation represents the best treatment option. In the present report we describe the challenging diagnosis of PVOD in a patient with PH referred to our department. Final diagnosis was established by surgical...
Source: Therapeutic Advances in Respiratory Disease - March 27, 2013 Category: Respiratory Medicine Authors: Sourla, E., Paspala, A., Boutou, A., Kontou, P., Stanopoulos, I., Pitsiou, G. Tags: Reviews Source Type: research

Bronchoscopic staging of lung cancer
Advances in bronchoscopy have contributed valuable tools to the diagnosis and staging of lung cancer. Detection of lesions at the premalignant microscopic stage has become possible with autofluorescence bronchoscopy and narrow band imaging. Bronchoscopy also allows for sampling of visible intra-bronchial lesions and for transbronchial needle aspiration of lesions in pulmonary parenchyma. With endobronchial ultrasound guidance, real-time evaluation and biopsy of mediastinal and pulmonary lesions can be achieved, enabling accurate clinical and pathological T-staging and N-staging without the need for surgery. In combination ...
Source: Therapeutic Advances in Respiratory Disease - March 27, 2013 Category: Respiratory Medicine Authors: Hanna, W. C., Yasufuku, K. Tags: Reviews Source Type: research

Transplanting the adolescent cystic fibrosis patient: can we do it?
Bilateral lung transplantation remains a treatment for end-stage cystic fibrosis (CF) lung disease when there is no further medical or surgical treatment available. The aim of lung transplantation is to improve patient life expectancy. The consensus view that lung transplantation extends life in children has been challenged. However, challengers have faced alternative explanations of their finding and it is largely accepted that lung transplantation in the adolescent patient population is an important treatment modality. The goal of this article is to address these concerns and assist with developing creative approaches to...
Source: Therapeutic Advances in Respiratory Disease - March 27, 2013 Category: Respiratory Medicine Authors: Oshrine, K., McGrath, D., Goldfarb, S. Tags: Reviews Source Type: research

Management of asthma during pregnancy
Asthma is an inflammatory lung condition that is the most common chronic disease affecting pregnancy. The changes in pulmonary physiology during pregnancy include increased minute ventilation, decreased functional residual capacity, increased mucus production, and airway mucosa hyperemia and edema. Pregnancy is also associated with a physiological suppression of the immune system. Many studies have described the heterogeneous immune system response in women with asthma during pregnancy, which partly explains why asthma has been shown to worsen, improve, or remain stable in equal proportions of women during pregnancy. Asthm...
Source: Therapeutic Advances in Respiratory Disease - March 27, 2013 Category: Respiratory Medicine Authors: Maselli, D. J., Adams, S. G., Peters, J. I., Levine, S. M. Tags: Reviews Source Type: research

Nebulized arformoterol: what is its place in the management of COPD?
Chronic obstructive pulmonary disease (COPD) is a serious global health burden. Comprehensive management of COPD includes both pharmacologic and non-pharmacologic interventions aimed at improving disease-related functional capacity, health-related quality of life, and survival. The primary medications used for treatment of COPD are inhaled bronchodilator drugs which are delivered directly to the patient’s airways through a number of different mechanisms. Arformoterol, the (R,R) enantiomer of racemic formoterol, was the first long-acting beta agonist approved by the U.S. Food and Drug Administration (FDA) for nebulize...
Source: Therapeutic Advances in Respiratory Disease - March 27, 2013 Category: Respiratory Medicine Authors: Miles, M. C., Donohue, J. F., Ohar, J. A. Tags: Reviews Source Type: research

Correlation of symptoms with total IgE and specific IgE levels in patients presenting with allergic rhinitis
Conclusions: The determination of IgE in allergic rhinitis is a supportive method. However, it cannot be recommended for routine use because of the time loss and high cost. (Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - March 27, 2013 Category: Respiratory Medicine Authors: Karli, R., Balbaloglu, E., Uzun, L., Cinar, F., Ugur, M. B. Tags: Original Research Source Type: research

Acknowledgements
(Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - February 4, 2013 Category: Respiratory Medicine Tags: Acknowledgements Source Type: research

Pulmonary arterial hypertension in pregnant women
Pulmonary arterial hypertension (PAH) is characterized by pulmonary vascular remodeling that limits the ability of the pulmonary vascular bed to withstand the physiological changes of pregnancy. Historically, pregnancy in PAH carries a high risk to the parturient. Normal pulmonary vasculature can withstand the hemodynamic and physiological changes associated with pregnancy without the development of respiratory symptomatology. However, in the presence of pulmonary vascular remodeling the capacity to handle these changes is compromised. During pregnancy, increase in cardiac output from the increased intravascular volume can...
Source: Therapeutic Advances in Respiratory Disease - February 4, 2013 Category: Respiratory Medicine Authors: Safdar, Z. Tags: Reviews Source Type: research

Tadalafil as monotherapy and in combination regimens for the treatment of pulmonary arterial hypertension
The purpose of this review is to evaluate the use of tadalafil as monotherapy and in combination regimens for the treatment of pulmonary arterial hypertension (PAH). A systematic English language search of the medical literature using PubMed was conducted between January 1960 and May 2012 using the search terms ‘tadalafil’, ‘therapy’, ‘pulmonary (arterial) hypertension’ and ‘combination therapy’. Special emphasis was given to controlled clinical trials and case studies relevant for the use of tadalafil in PAH. The search revealed 113 relevant publications, 31 of which were cl...
Source: Therapeutic Advances in Respiratory Disease - February 4, 2013 Category: Respiratory Medicine Authors: Udeoji, D. U., Schwarz, E. R. Tags: Reviews Source Type: research

Indacaterol 75 {micro}g once daily for the treatment of patients with chronic obstructive pulmonary disease: a North American perspective
Chronic obstructive pulmonary disease (COPD) is a progressive disease in which patients become increasingly disabled by their symptoms and limited in their activities. Health-related quality of life may be profoundly impaired even in the early stages of the disease. Treatment with long-acting inhaled bronchodilators can improve lung function, symptoms and health status and reduce exacerbations of COPD. This review profiles the efficacy, safety and tolerability of indacaterol, an inhaled β2-agonist bronchodilator for once-daily maintenance treatment of patients with COPD. After 12 weeks of treatment with a once-daily d...
Source: Therapeutic Advances in Respiratory Disease - February 4, 2013 Category: Respiratory Medicine Authors: Kerwin, E. M., Williams, J. Tags: Reviews Source Type: research

Efficacy and safety of roflumilast in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis
Conclusions: The efficacy of roflumilast appears modest compared with other available therapies for COPD. Further studies are needed to investigate the risk–benefit ratio and long-term safety of roflumilast before its wider use. (Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - February 4, 2013 Category: Respiratory Medicine Authors: Oba, Y., Lone, N. A. Tags: Original Research Source Type: research

A feasibility evaluation of oral pressure therapy for the treatment of obstructive sleep apnea
Conclusion: This proof-of-concept study suggests that OPT can produce clinically relevant relief of OSA in certain subjects who are readily identified by PSG during trial use of the noninvasive system. OPT shows promise as a new treatment option for OSA in appropriate patients. (Source: Therapeutic Advances in Respiratory Disease)
Source: Therapeutic Advances in Respiratory Disease - February 4, 2013 Category: Respiratory Medicine Authors: Farid-Moayer, M., Siegel, L. C., Black, J. Tags: Original Research Source Type: research