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Respiratory Medicine

Oliver Distler, Janet Pope, Chris Denton, Yannick Allanore, Marco Matucci-Cerinic, Janethe de Oliveira Pena, Dinesh Khanna
: RISE-SSc is a randomized, double-blind, placebo-controlled phase 2 study investigating the efficacy and safety of riociguat in patients with diffuse cutaneous systemic sclerosis (dcSSc). Based on positive results from riociguat trials in patients with pulmonary hypertension and chronic thromboembolic pulmonary hypertension in combination with the known antiproliferative and antifibrotic effects seen in animal models, patients with SSc may benefit from treatment with riociguat. Patients with SSc meeting the ACR/EULAR systemic sclerosis classification criteria with diffuse cutaneous SSc (dcSSc) subset per LeRoy criteria, and a disease duration of less than or equal to 18 months will be randomized to placebo or riociguat 0...
September 28, 2016: Respiratory Medicine
Joao Cravo, Antonio M Esquinas
No abstract text is available yet for this article.
August 4, 2016: Respiratory Medicine
Sean J Callahan, Meng Xia, Susan Murray, Kevin R Flaherty
BACKGROUND: A group of patients with idiopathic pulmonary fibrosis (IPF) presents with disease affecting one lung markedly more than the other. At this time, it is unclear how this population differs from those who present with more symmetric disease. We sought to explain the characteristics of the asymmetric group and how their disease progresses. METHODS: In this retrospective case-control study we accessed an interstitial lung disease (ILD) database and identified 14 asymmetric IPF cases via high-resolution computed tomography (HRCT) scoring of each lung lobe's disease severity...
October 2016: Respiratory Medicine
Vasileios Andrianopoulos, Bartolome R Celli, Frits M E Franssen, Victor M Pinto-Plata, Peter M A Calverley, Lowie E G W Vanfleteren, Ioannis Vogiatzis, Jørgen Vestbo, Alvar Agusti, Per S Bakke, Stephen I Rennard, William MacNee, Ruth Tal-Singer, Julie C Yates, Emiel F M Wouters, Martijn A Spruit
Exercise-induced oxygen desaturation (EID) is related to mortality in patients with chronic obstructive pulmonary disease (COPD). We investigated: (1) the prevalence of EID; (2) the relative-weight of several physiological determinants of EID including pulmonary emphysema, and (3) the relationship of EID with certain patients' clinical characteristics. Data from 2050 COPD patients (age: 63.3 ± 7.1years; FEV1: 48.7 ± 15.7%pred.) were analyzed. The occurrence of EID (SpO2post ≤88%) at the six-minute walking test (6MWT) was investigated in association with emphysema quantified by computed-tomography (QCT), and several clinical characteristics...
October 2016: Respiratory Medicine
Sula Mazimba, Eliany Mejia-Lopez, George Black, Jamie L W Kennedy, James Bergin, Jose A Tallaj, Mohammad Abuannadi, Andrew D Mihalek, Kenneth C Bilchick
BACKGROUND: Diastolic pulmonary gradient (DPG), calculated as the difference between pulmonary artery diastolic pressure and mean pulmonary capillary wedge pressure ≥ 7 mmHg is associated with pulmonary vascular disease and portends poor prognosis in heart failure (HF). The prognostic relevance of DPG in group 1 pulmonary hypertension (PH) is uncertain. METHODS: Using the Pulmonary Hypertension Connection (PHC) risk equation for 225 patients in the NIH-PPH, the 5-year probability of death was calculated, which was then compared with DPG using a Cox proportional hazards model...
October 2016: Respiratory Medicine
Federica Trucco, Marina Pedemonte, Chiara Fiorillo, Paola Tacchetti, Giacomo Brisca, Claudio Bruno, Carlo Minetti
Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant inherited disorder characterized by selective weakness of face and upper arms and girdle. Respiratory involvement in FSHD has been described mainly in the most severely affected patients. In this work we tested the respiratory function by spirometry in 12 patients affected by FSHD with onset before 18 years. Spirometry results were correlated with motor involvement and compared to aged matched group of Becker patients. Of note FSHD patients present a peculiar pattern characterized by a flat shape in flow-volume loop...
October 2016: Respiratory Medicine
Kaoruko Shimizu, Ruriko Seto, Hironi Makita, Masaru Suzuki, Satoshi Konno, Yoichi M Ito, Rie Kanda, Emiko Ogawa, Yasutaka Nakano, Masaharu Nishimura
BACKGROUND: Our previous studies suggested that the site of bronchodilation on CT might differ between inhaled β2 agonists and inhaled anticholinergics in COPD. AIM: To assess and compare the bronchodilation effects of inhaled indacaterol and glycopyrronium/indacaterol by airway generation in large airways using CT. METHODS: CT scans at full inspiration and pulmonary function tests were done in 25 patients with moderate-severe COPD before and 4-5 weeks after daily inhalation of indacaterol and again another 4-5 weeks after inhalation of glycopyrronium/indacaterol...
October 2016: Respiratory Medicine
Andrea Arfè, Francesco Blasi, Luca Merlino, Giovanni Corrao
OBJECTIVE: We investigated the real-world effectiveness of several drugs (including short- and long-acting beta-agonists [SABAs and LABAs], inhaled corticosteroids [ICS], and antibiotics) in preventing severe asthma exacerbations by carrying-out a large observational study based on the healthcare utilization databases of the Italian Lombardy Region. METHODS: We identified all patients aged 6-40 years who performed an Emergency Department visit for asthma during 2010-2012 as cases...
October 2016: Respiratory Medicine
Raquel Pinto Carbonera, Fernanda Maria Vendrusculo, Márcio Vinícius Fagundes Donadio
BACKGROUND: Interactive video games are recently being used as an exercise tool in cystic fibrosis (CF). This study aimed to assess the literature describing whether video games generate a physiological response similar to the exercise intensity needed for training in CF. METHODS: An online search in PubMed, Embase, Cochrane, SciELO, LILACS and PEDro databases was conducted and original studies describing physiological responses of the use of video games as exercise in CF were included...
October 2016: Respiratory Medicine
Breda Cushen, Niamh McCormack, Kerrie Hennigan, Imran Sulaiman, Richard W Costello, Brenda Deering
BACKGROUND: One-third of patients with an exacerbation of Chronic Obstructive Pulmonary Disease(COPD) are re-hospitalised at 90 days. Exacerbation recovery is associated with reductions in lung hyperinflation and improvements in symptoms and physical activity. We assessed the feasibility of monitoring these clinical parameters in the home. We hypothesised that the degree of change in spirometry and lung volumes differs between those who had an uneventful recovery and those who experienced a further exacerbation...
October 2016: Respiratory Medicine
M Engelkes, H M Janssens, M A J de Ridder, M C J M Sturkenboom, J C de Jongste, K M C Verhamme
Real-life data on the incidence rates (IR) and risk factors of severe asthma exacerbations in children are sparse. We aimed to assess IR and risk factors of severe asthma exacerbations in children in real life. We conducted a population-based cohort study using a Dutch GP database containing complete medical records of >1 million patients. All records of children with physician-diagnosed asthma aged 5-18 years between 2000 and 2012 were examined for exacerbations, defined as either hospitalization, emergency department visit or need of systemic steroids for asthma...
October 2016: Respiratory Medicine
Revital Abitbul, Israel Amirav, Hannah Blau, Soliman Alkrinawi, Micha Aviram, David Shoseyov, Lea Bentur, Avraham Avital, Chaim Springer, Moran Lavie, Dario Prais, Husein Dabbah, Nael Elias, Arnon Elizur, Shmuel Goldberg, Avigdor Hevroni, Eitan Kerem, Anthony Luder, Yehudah Roth, Malena Cohen-Cymberknoh, Marta Ben Ami, Avigdor Mandelberg, Galit Livnat, Elie Picard, Joseph Rivlin, Moshe Rotschild, Ruth Soferman, Niki T Loges, Heike Olbrich, Claudius Werner, Alexander Wolter, Martina Herting, Julia Wallmeier, Johanna Raidt, Heymut Omran, Huda Mussaffi
BACKGROUND: Primary Ciliary Dyskinesia (PCD) is rare and its features in Israel have not been described. AIMS: to assess prevalence utilizing state-of-the-art diagnostic techniques, and describe clinical features, diagnostic and management practices in Israel. METHODS: A national multicenter study from 2012 to 2013 recruited patients diagnosed or suspected of having PCD. Diagnosis was verified using: nasal Nitric Oxide (nNO); High-speed Video Microscope Analysis (HVMA); Transmission Electron Microscopy (TEM) of cilia; Immuno-fluorescence staining (IF) for ciliary proteins, and genetic analysis...
October 2016: Respiratory Medicine
Kenneth Chew, Kate Carey, Genevieve Ho, Kylie-Ann Mallitt, John Widger, Michelle Farrar
BACKGROUND: The multidisciplinary care of Duchenne muscular dystrophy (DMD) incorporates management of nutrition and the respiratory system, however the effect of body habitus on respiratory function in DMD is poorly understood. The present study examined the impact of nutritional status on respiratory function in DMD to guide further treatment strategies. METHODS: Anthropometric and respiratory parameters, such as body mass index (BMI) z-scores, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were retrospectively analysed with a mixed linear model in 34 DMD patients...
October 2016: Respiratory Medicine
Fernanda Cordoba Lanza, Gustavo Falbo Wandalsen, Amelia Miyashiro Dos Santos, Dirceu Solé
BACKGROUND: Bronchodilator response (BDR) analyzed by the raised volume rapid thoracic compression (RVRTC) in wheezing infants is not yet well described, although bronchodilators (BD) are routine in the treatment of this population. OBJECTIVE: To evaluate BDR by RVRTC technique in infants with recurrent wheezing and compare to control group. METHOD: Cross sectional study, 45 infants, age 56 weeks (38-67 weeks). Two groups: wheezing group (WG: history of recurrent wheezing) and control group (CG)...
October 2016: Respiratory Medicine
Francisca Dias-Freitas, Catarina Metelo-Coimbra, Roberto Roncon-Albuquerque
The management of acute hypoxemic respiratory failure frequently includes the use of supraphysiological fractions of inspired oxygen (FiO2), which can be beneficial in the short-term but not without risks in the long-term, causing acute lung injury (ALI). Over the last few years, much attention has been devoted to the intracellular signaling transduction pathways that lead to hyperoxia-induced cell damage, particularly MAP kinase cascades. Identification of involved signaling molecules and understanding of the regulation of the main signal transduction pathways might provide the basis for improving the outcome of patients under high FiO2 exposure through more effective therapeutic interventions...
October 2016: Respiratory Medicine
Jorge Cervantes
Tuberculosis (TB) is one of the oldest infectious diseases that affected humankind. A quintessential social disease, TB remains one of the world's deadliest communicable diseases, with still a high mortality and burden of disease. Social representations of TB focus on aspects associated to feelings and manifestations awakened by the disease, sometimes reinforcing stigmas and prejudices about the way of perceiving TB. TB is a historic disease now reborn with a deeper social stigma. Despite the modest reduction in TB incidence worldwide, its incidence is still rising in certain crisis-affected populations like refugees, and in those bearing high prevalence of HIV, persisting poverty, especially in the developing world...
October 2016: Respiratory Medicine
Kate Grossman, Mary Beth Beasley, Sidney S Braman
RATIONALE: Hepatoid adenocarcinoma (HAC) is a rare malignant lung tumor that histologically resembles typical hepatocellular carcinoma (HCC) when it is metastatic to the lung. To date, this clinical entity has not been highlighted in the pulmonary literature. OBJECTIVE: We present a review of all known cases of HAC, including the relevant clinical and histopathological features important for pulmonologists. MEASUREMENTS AND MAIN RESULTS: The purpose of this report is to present a new case of HAC, with typical clinical and histologic features of this malignancy, and to summarize findings of previously reported cases...
October 2016: Respiratory Medicine
Marek Lommatzsch, Kai Bratke, Paul Stoll, Norbert Mülleneisen, Friedrich Prall, Andrea Bier, J Christian Virchow
BACKGROUND: The histologic diagnosis of Pulmonary Langerhans cell histiocytosis (PLCH) is invasive and can cause complications. To confirm the diagnosis of PLCH, guidelines therefore recommend measuring CD1a-positive bronchoalveolar lavage fluid (BALF) cells despite its poor sensitivity and specificity. Thus, an improved diagnostic accuracy of BALF cell analysis would be desirable. METHODS: Using four-colour flow cytometry, plasmacytoid and myeloid dendritic cells (DCs) were analysed in BALF of 10 newly diagnosed, untreated, smoking patients with PLCH, and compared with BALF DCs from 40 asymptomatic smokers and 21 never-smokers...
October 2016: Respiratory Medicine
Sandra Søgaard Tøttenborg, Peter Lange, Søren Paaske Johnsen, Henrik Nielsen, Truls Sylvan Ingebrigtsen, Reimar Wernich Thomsen
BACKGROUND: Low socioeconomic status has been associated with adverse outcomes in chronic obstructive pulmonary disease (COPD), but population-based data are sparse. We examined the impact of education, employment, income, ethnicity, and cohabitation on the risk of suboptimal adherence to inhaled medication, exacerbations, acute admissions, and mortality among COPD patients. METHODS: Using nationwide healthcare registry data we identified 13,369 incident hospital clinic outpatients with COPD during 2008-2012...
October 2016: Respiratory Medicine
Louise Zierau, Elisabeth Juul Gade, Svend Lindenberg, Vibeke Backer, Simon Francis Thomsen
Asthma may be associated with polycystic ovary syndrome (PCOS), and possibly patients with PCOS have a more severe type of asthma. The purpose of this systematic literature review is to summarize evidence of a coexistense of PCOS and asthma using the available literature. The search was completed on 01.01.2016. English language articles were retrieved using the search terms 'Asthma' AND 'PCOS', 'Asthma' AND 'systemic inflammation', 'Asthma' AND 'metabolic syndrome', 'asthma' AND 'gynaecology', 'PCOS' AND 'systemic inflammation', 'PCOS' AND 'metabolic syndrome', 'PCOS' AND 'allergy'...
October 2016: Respiratory Medicine
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