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https://www.readbyqxmd.com/read/28442313/the-role-of-neutrophil-elastase-inhibitors-in-lung-diseases
#1
Eva Polverino, Edmundo Rosales-Mayor, Glenn E Dale, Klaus Dembowsky, Antoni Torres
In many respiratory diseases characterised by an intense inflammatory response, the balance between proteolytic enzymes (proteases, including elastases) and their inhibitors (proteinases inhibitors) is not neutral. In fact, an excess activity of neutrophil elastase (NE) and similar proteases has been reported to cause tissue damage and to alter the remodelling process in many clinical conditions such as pneumonia, respiratory distress and acute lung injury [ALI]. In recent years, several experimental NE inhibitors have been tested in preclinical and clinical studies of different conditions of inflammatory lung injury such as ALI and pneumonia, with contrasting results...
April 22, 2017: Chest
https://www.readbyqxmd.com/read/28442312/expert-statements-on-the-standard-of-care-in-critically-ill-adult-patients-with-atypical-haemolytic-uraemic-syndrome
#2
REVIEW
Elie Azoulay, Paul Knoebl, José Garnacho-Montero, Katerina Rusinova, Gennadii Galstian, Philippe Eggimann, Fekri Abroug, Dominique Benoit, Michael von Bergwelt-Baildon, Julia Wendon, Marie Scully
BACKGROUND: Atypical haemolytic uraemic syndrome (aHUS) presents similarly to thrombotic thrombocytopenic purpura (TTP), and other causes or conditions with thrombotic microangiopathy (TMA) such as DIC or sepsis. Similarity in clinical presentation may hinder diagnosis and optimal treatment selection in the urgent setting in the ICU. However, there is currently no consensus on the diagnosis or treatment of aHUS for ICU specialists. This review aims to summarise available data on the diagnosis and treatment strategies of aHUS in the ICU in order to enhance the understanding of aHUS diagnosis and outcomes in patients managed in the ICU...
April 22, 2017: Chest
https://www.readbyqxmd.com/read/28442311/sleep-phase-delay-in-cystic-fibrosis-a-potential-new-manifestation-of-cystic-fibrosis-transmembrane-regulator-dysfunction
#3
Judy L Jensen, Christopher R Jones, Christiana Kartsonaki, Kristyn A Packer, Frederick R Adler, Theodore G Liou
BACKGROUND: Cystic fibrosis (CF) transmembrane regulator (CFTR) protein dysfunction causes CF. Improving survival allows detection of increasingly subtle disease manifestations. CFTR dysfunction in the central nervous system (CNS) may disturb circadian rhythm and thus sleep phase. We studied sleep in adults to better understand potential CNS CFTR dysfunction. METHODS: We recruited participants from April 2012 through April 2015 and administered the Munich Chronotype Questionnaire (MCTQ)...
April 22, 2017: Chest
https://www.readbyqxmd.com/read/28442310/copd-osa-overlap-syndrome-evolving-evidence-regarding-epidemiology-clinical-consequences-and-management
#4
REVIEW
Walter T McNicholas
Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome (OSA) are both highly prevalent, which implies that both disorders occurring together (overlap syndrome) is likely to be common based on chance association alone. However, different clinical COPD phenotypes influence the likelihood of co-existing OSA in that the increased lung volumes and low body mass index (BMI) associated with the predominant emphysema phenotype protects against OSA, whereas the higher likelihood of peripheral edema and increased BMI associated with the predominant chronic bronchitis phenotype promotes OSA...
April 22, 2017: Chest
https://www.readbyqxmd.com/read/28438605/identifying-barriers-to-delivering-the-abcde-bundle-to-minimize-adverse-outcomes-for-mechanically-ventilated-patients-a-systematic-review
#5
Deena Kelly Costa, Matthew White, Emily Ginier, Milisa Manojlovich, Sushant Govindan, Theodore J Iwashyna, Anne E Sales
BACKGROUND: Improved outcomes are associated with the Awakening, Breathing Coordination, Delirium and Early mobility/exercise (ABCDE) bundle; however, implementation issues are common. As yet, no study has integrated the barriers to ABCDE to provide an overview of reasons for less successful efforts. The purpose of this review was to identify and catalog the barriers to ABCDE delivery based on a widely used implementation framework, and provide a resource to guide clinicians in overcoming barriers to implementation...
April 21, 2017: Chest
https://www.readbyqxmd.com/read/28434937/defining-a-research-agenda-to-address-the-converging-epidemics-of-tuberculosis-and-diabetes-part-2-underlying-biological-mechanisms
#6
REVIEW
Katharina Ronacher, Reinout van Crevel, Julia Critchley, Andrew A Bremer, Larry S Schlesinger, Anil Kapur, Randall Basaraba, Hardy Kornfeld, Blanca I Restrepo
There is growing interest in the re-emerging interaction between type 2 diabetes (DM) and tuberculosis (TB), but the underlying biological mechanisms are poorly understood despite their possible implications in clinical management. Experts in epidemiological, public health, basic science and clinical studies recently convened and identified research priorities for elucidating the underlying mechanisms for the co-ocurrence of TB and DM. We identified gaps in current knowlege of altered immunity in DM patients during TB, where most studies suggest an under-performing innate immunity, but exaggerated adaptive immunity to Mycobacterium tuberculosis...
April 19, 2017: Chest
https://www.readbyqxmd.com/read/28434936/defining-a-research-agenda-to-address-the-converging-epidemics-of-tuberculosis-and-diabetes-part-1-epidemiology-and-clinical-management
#7
REVIEW
Julia A Critchley, Blanca I Restrepo, Katharina Ronacher, Anil Kapur, Andrew A Bremer, Larry S Schlesinger, Randall Basaraba, Hardy Kornfeld, Reinout van Crevel
There is growing interest in the interaction between type 2 diabetes (DM) and tuberculosis (TB), but many research questions remain unanswered. Epidemiologists, basic scientists and clinical experts recently convened and identified priorities. This is the first of two reviews on this topic, summarising priority areas of research with regard to epidemiology, clinical management and public health. First, from an epidemiological point of view, more study is needed to determine the importance of transient hyperglycemia in TB patients, and on the importance of DM for the global epidemic of multi-drug resistant (MDR)-TB...
April 19, 2017: Chest
https://www.readbyqxmd.com/read/28427969/hyperbaric-oxygen-therapy-is-associated-with-lower-short-and-long-term-mortality-in-patients-with-carbon-monoxide-poisoning
#8
Chien-Cheng Huang, Chung-Han Ho, Yi-Chen Chen, Hung-Jung Lin, Chien-Chin Hsu, Jhi-Joung Wang, Shih-Bin Su, How-Ran Guo
BACKGROUND: To date, there has been no consensus about the effect of hyperbaric oxygen therapy (HBOT) on the mortality of patients with carbon monoxide poisoning (COP). This retrospective nationwide population-based cohort study from Taiwan was conducted to clarify this issue. METHODS: Using the Nationwide Poisoning Database, we identified 25,737 COP patients diagnosed between 1999 and 2012, including 7,278 patients who received HBOT and 18,459 patients who did not...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28427968/the-global-burden-of-atrial-fibrillation-and-stroke-a-systematic-review-of-the-clinical-epidemiology-of-atrial-fibrillation-in-asia
#9
Ying Bai, Yan-Liang Wang, Alena Shantsila, Gregory Y H Lip
BACKGROUND: Our previous review showed great variability on the incidence and prevalence of atrial fibrillation (AF) in non-Western cohorts, especially from Asian countries; in recent years, epidemiology studies on AF have been increasingly reported. METHODS: We therefore conducted an updated systematic review, to present the current knowledge base of AF epidemiology in Asian countries since our prior review. We also explored AF incidence and the risk of stroke in AF using meta-analysis, with I(2) testing the heterogeneity...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28427967/mechanisms-underlying-hiv-associated-non-infectious-lung-disease
#10
REVIEW
Rachel M Presti, Sonia C Flores, Brent E Palmer, Jeffrey J Atkinson, Catherine R Lesko, Bryan Lau, Andrew P Fontenot, Jesse Roman, John F McDyer, Homer L Twigg
Pulmonary disease remains a primary source of morbidity and mortality in persons living with HIV (PLWH), although the advent of potent combination antiretroviral therapy (cART) has resulted in a shift from predominantly infectious to noninfectious pulmonary complications. PLWH are at high risk for chronic obstructive pulmonary disease, pulmonary hypertension, and lung cancer even in the era of cART. The underlying mechanisms of this are incompletely understood, but recent research in both human and animal models suggest that oxidative stress, expression of matrix metalloproteinases, and genetic instability may result in lung damage which predisposes PLWH to these conditions...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28427966/intravenous-immunoglobulin-for-treatment-of-severe-refractory-heparin-induced-thrombocytopenia
#11
Anand Padmanabhan, Curtis G Jones, Shannon M Pechauer, Brian R Curtis, Daniel W Bougie, Mehraboon S Irani, Barbara J Bryant, Jack B Alperin, Thomas G Deloughery, Kevin P Mulvey, Binod Dhakal, Renren Wen, Demin Wang, Richard H Aster
BACKGROUND: HIT complicated by severe thrombocytopenia and thrombosis can pose significant treatment challenges. Use of alternative anticoagulants in this setting may increase bleeding risks, especially in patients who have a protracted disease course. Additional therapies are lacking in this severely affected patient population. METHODS: We describe three HIT patients who had severe thromboembolism and prolonged thrombocytopenia refractory to standard treatment but achieved an immediate and sustained response to intravenous immunoglobulin G (IVIg) therapy...
April 17, 2017: Chest
https://www.readbyqxmd.com/read/28414029/how-well-does-capture%C3%A2-translate-an-exploratory-analysis-of-a-copd-case-finding-method-for-spanish-speaking-patients
#12
Wilson A Quezada, Beth A Whippo, Patricia A Jellen, Nancy K Leidy, David Mannino, Katherine J Kim, MeiLan K Han, Julia F Houfek, Barry Make, Karen G Malley, Catherine A Meldrum, Stephen Rennard, Barbara P Yawn, Fernando Martinez, Byron M Thomashow
BACKGROUND: This study tested the properties of a Spanish translation of CAPTURE™ (COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk) with selective use of peak expiratory flow (PEF). METHODS: Analyses of data from the Spanish-speaking cohort of the cross-sectional, case-control study used to develop CAPTURE. Translation procedures included forward and backward translation, reconciliation, and cognitive interviewing to assure linguistic and cultural equivalence...
April 13, 2017: Chest
https://www.readbyqxmd.com/read/28414033/counterpoint-are-advanced-practice-professionals-more-likely-to-achieve-better-tobacco-cessation-results-than-physicians-no
#13
EDITORIAL
Mario F Perez, Lori A Bastian, Cheryl Oncken
No abstract text is available yet for this article.
April 12, 2017: Chest
https://www.readbyqxmd.com/read/28414032/rebuttal-from-drs-perez-bastian-and-oncken
#14
EDITORIAL
Mario F Perez, Lori A Bastian, Cheryl Oncken
No abstract text is available yet for this article.
April 12, 2017: Chest
https://www.readbyqxmd.com/read/28414031/rebuttal-from-drs-hitsman-baker-and-king
#15
EDITORIAL
Brian Hitsman, Amanda L Baker, Andrea King
No abstract text is available yet for this article.
April 12, 2017: Chest
https://www.readbyqxmd.com/read/28414030/point-are-advanced-practice-professionals-more-likely-to-achieve-better-tobacco-cessation-results-than-physicians-yes
#16
EDITORIAL
Brian Hitsman, Amanda L Baker, Andrea King
No abstract text is available yet for this article.
April 12, 2017: Chest
https://www.readbyqxmd.com/read/28411114/circulating-biologically-active-adrenomedullin-bio-adm-predicts-hemodynamic-support-requirement-and-mortality-during-sepsis
#17
Pietro Caironi, Roberto Latini, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Giuseppe Maggio, Marco Cavana, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Serge Masson
BACKGROUND: The biological role of adrenomedullin, a hormone involved in hemodynamic homeostasis, is controversial in sepsis, since administration of either the peptide or an antibody against it may be beneficial. METHODS: Plasma bio-ADM was assessed on days 1, 2 and 7 after randomization of 956 patients with sepsis or septic shock to albumin or crystalloids for fluid resuscitation in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of bio-ADM and its time-dependent variation with fluid therapy, vasopressor administration, organ failures and mortality...
April 11, 2017: Chest
https://www.readbyqxmd.com/read/28411113/restrictive-spirometry-pattern-is-associated-with-increased-arterial-stiffness-in-men-and-women
#18
I-Hsuan Wu, Zih-Jie Sun, Feng-Hwa Lu, Yi-Ching Yang, Chieh-Ying Chou, Chih-Jen Chang, Jin-Shang Wu
BACKGROUND: There is growing evidence that pulmonary function impairment has been found to be related to cardiovascular events and death. Some studies showed that the level of forced vital capacity (FVC) was negatively related to arterial stiffness, but most studies were confined to males and none of them examined the association of the presence of restrictive spirometry pattern with arterial stiffness. Therefore, this study aimed to investigate the association of restrictive spirometry pattern with arterial stiffness by gender...
April 11, 2017: Chest
https://www.readbyqxmd.com/read/28411112/morphine-use-in-the-emergency-department-and-outcomes-of-patients-with-acute-heart-failure-a-propensity-score-matching-analysis-based-on-the-eahfe-registry
#19
Òscar Miró, Víctor Gil, Francisco J Martín-Sánchez, Pablo Herrero, Javier Jacob, Alexandre Mebazaa, Veli-Pekka Harjola, José Ríos, Judd E Hollander, W Frank Peacock, Pere Llorens
OBJECTIVE: To determine the relationship between short-term mortality and intravenous morphine use in emergency department (ED) patients diagnosed with acute heart failure (AHF). METHODS: Consecutive AHF patients presenting to 34 Spanish EDs from 2011 to 2014 were eligible for inclusion. The subjects were divided into those with or without intravenous morphine treatment (M and WOM groups, respectively) during ED stay. The primary outcome was 30-day all-cause mortality, and secondary outcomes were mortality at different intermediate time points, in-hospital mortality, and length of hospital stay (LOS)...
April 11, 2017: Chest
https://www.readbyqxmd.com/read/28400116/the-role-of-infection-in-interstitial-lung-diseases-a-review
#20
REVIEW
Natalya Azadeh, Andrew H Limper, Eva M Carmona, Jay H Ryu
Interstitial lung diseases (ILD) comprise an array of heterogeneous parenchymal lung diseases that are associated with a spectrum of pathologic, radiologic and clinical manifestations. There are ILDs with known etiologies and those that are idiopathic, making treatment strategies challenging. Prognosis can vary according to the type of ILD but many exhibit gradual progression with an unpredictable clinical course in individual patients as seen in idiopathic pulmonary fibrosis and the phenomenon of "acute exacerbation"(AE)...
April 8, 2017: Chest
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