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Expert Review of Respiratory Medicine

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https://www.readbyqxmd.com/read/29130355/adherence-and-outcomes-a-systematic-review-of-palivizumab-utilization
#1
Sophie K Wong, Abby Li, Krista L Lanctôt, Bosco Paes
Palivizumab is a humanized monoclonal antibody used for respiratory syncytial virus (RSV) prophylaxis. RSV is the primary cause of lower respiratory tract infection in children aged <2 years, and can give rise to high-burden hospitalization and respiratory complications in later life. Adherence to a monthly dosing regimen, both in timing and injection number, is essential to sustain therapeutic levels of palivizumab and maintain protective status. Deviation from the approved dosing schedule may reduce the efficacy of palivizumab and increase the risk of breakthrough RSV infection and hospitalization...
November 13, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29111830/surgical-and-non-surgical-management-of-malignant-pleural-effusions
#2
Deirdre B Fitzgerald, Coenraad F N Koegelenberg, Kazuhiro Yasufuku, Y C Gary Lee
Optimal management of malignant pleural effusion (MPE) is important in the care of patients with advanced cancer. Surgical (especially video-assisted thoracoscopic surgery (VATS)) and non-surgical strategies are available. Clinicians should be aware of the evidence supporting the use of different modalities to guide treatment choice. Areas covered: This review covers published evidence of the advantages and disadvantages of VATS and non-surgical alternatives for MPE management. Expert commentary: Randomized clinical trials (RCTs) are needed to define the roles and benefits of VATS as existing literature is often flawed by selection bias...
November 9, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29115880/treatment-response-heterogeneity-in-asthma-the-role-of-genetic-variation
#3
Susanne J H Vijverberg, Niloufar Farzan, Elise M A Slob, Anne H Neerincx, Anke H Maitland-van der Zee
Asthmatic patients show a large heterogeneity in response to asthma medication. Rapidly evolving genotyping technologies have led to the identification of various genetic variants associated with treatment outcomes. Areas covered: This review focuses on the current knowledge of genetic variants influencing treatment response to the most commonly used asthma medicines: short- and long-acting beta-2 agonists (SABA/LABA), inhaled corticosteroids (ICS) and leukotriene modifiers. This review shows that various genetic variants have been identified, but none are currently used to guide asthma treatment...
November 8, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29082808/an-overview-of-the-current-management-of-chronic-obstructive-pulmonary-disease-can-we-go-beyond-the-gold-recommendations
#4
Mario Cazzola, Paola Rogliani, Ermanno Puxeddu, Josuel Ora, Maria Gabriella Matera
Treatment recommendations are based on randomized controlled trials (RCTs). However, only about 1 in 20 people meet the inclusion criteria for RCTs forming consensus guidelines in chronic obstructive pulmonary disease (COPD). Consequently, the one-size-fits-all approach focused merely on traditional symptoms and risk of exacerbations is inadequate to treat COPD. COPD needs a personalized medicine strategy because of the relevance of COPD heterogeneity for subject-based health risk assessment and stratification in the clinical arena...
November 3, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29082801/management-of-baseline-and-new-sub-solid-nodules-in-ct-lung-cancer-screening
#5
Marjolein A Heuvelmans, Joan E Walter, Matthijs Oudkerk
No abstract text is available yet for this article.
October 30, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29072087/respiratory-muscle-function-and-exercise-limitation-in-patients-with-chronic-obstructive-pulmonary-disease-a-review
#6
Noppawan Charususin, Sauwaluk Dacha, Rik Gosselink, Marc Decramer, Andreas von Leupoldt, Thomas Reijnders, Zafeiris Louvaris, Daniel Langer
Respiratory muscle dysfunction is common and contributes to dyspnea and exercise limitation in patients with chronic obstructive pulmonary disease (COPD). Improving dynamic function of respiratory muscles during exercise might help to reduce symptoms and improve exercise capacity. Areas covered: The aims of this review are to 1) summarize physiological mechanisms linking respiratory muscle dysfunction to dyspnea and exercise limitation; 2) provide an overview of available therapeutic approaches to better maintain load-capacity balance of respiratory muscles during exercise; and 3) to summarize current knowledge on potential mechanisms explaining effects of interventions aimed at optimizing dynamic respiratory muscle function with a special focus on inspiratory muscle training...
October 26, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29050527/how-might-transbronchial-cryobiopsy-improve-diagnosis-and-treatment-of-diffuse-parenchymal-lung-disease-patients
#7
Venerino Poletti, Claudia Ravaglia, Alessandra Dubini, Sara Piciucchi, Giulio Rossi, Sissel Kronborg-White, Sara Tomassetti
No abstract text is available yet for this article.
October 25, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29025350/the-patient-with-a-complex-chronic-respiratory-disease-a-specialist-of-his-own-life
#8
Sarah Houben-Wilke, Ingrid Ml Augustin, Birgit Bref Wouters, Rosita Ah Stevens, Daisy Ja Janssen, Martijn A Spruit, Lowie Egw Vanfleteren, Frits Me Franssen, Emiel Fm Wouters
The independent and central role of the patient with a complex chronic respiratory disease in targeted, personalized disease management strategies is becoming increasingly important. Patients are the ones living with the disease and are finally responsible for their lives underlining their role as essential members of the interdisciplinary treatment team. Areas covered: The present paper narratively reviews existing research and discusses the special, as well as specialized, role of the patient with a complex chronic respiratory disease in the healthcare system and highlights fundamental elements of the (future) relationship between patient and healthcare professionals...
October 25, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29016232/algorithm-for-the-management-of-asthma-in-pregnant-women-a-protocol-to-optimize-processes-in-healthcare
#9
Eva Martinez-Moragón, Auxiliadora Romero-Falcón, Juan Luis García-Rivero
Asthma is the most common chronic disease in pregnant women. Its evolution during pregnancy could improve, stay the same or worsen, especially in cases where there is a loss of clinical control. This can lead to maternal and fetal hypoxia with serious adverse perinatal outcomes. Areas covered: This article reviews physiological modifications in pregnancy, effects of pregnancy on asthma, and possible consequences on fetus development. Furthermore, it reviews evidence on assessment and both pharmacological and non-pharmacological management of asthma in pregnant and breastfeeding women as well as in acute exacerbations...
October 23, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29048936/computed-tomography-in-hypersensitivity-pneumonitis-main-findings-differential-diagnosis-and-pitfalls
#10
Olívia Meira Dias, Bruno Guedes Baldi, Francesca Pennati, Andrea Aliverti, Rodrigo Caruso Chate, Márcio Valente Yamada Sawamura, Carlos Roberto Ribeiro de Carvalho, André Luis Pereira de Albuquerque
Hypersensitivity pneumonitis (HP) is a disease with variable clinical presentation in which inflammation in the lung parenchyma is caused by the inhalation of specific organic antigens or low molecular weight substances in genetically susceptible individuals. Alterations of the acute, subacute and chronic forms may eventually overlap, and the diagnosis based on temporality and presence of fibrosis (acute/inflammatory HP vs. chronic HP) seems to be more feasible and useful in clinical practice. Differential diagnosis of chronic HP with other interstitial fibrotic diseases is challenging due to the overlap of the clinical history, and the functional and imaging findings of these pathologies in the terminal stages...
October 19, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28974118/clinical-respiratory-scales-which-one-should-we-use
#11
Antonio José Justicia-Grande, Jacobo Pardo Seco, Irene Rivero Calle, Federico Martinón-Torres
There are countless clinical respiratory scales for acute dyspnoea. Most healthcare professionals choose one based on previous personal experience or following local practice, unaware of the implications of their choice. The lack of critical comparisons between those different tools has been a widespread problem that only recently has begun to be addressed via score validation studies. Here we try to assess and compare the quality criteria of measurement properties of acute dyspnoea scores. Areas covered: A literature review was conducted by searching the PubMed database...
October 17, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28976216/how-should-treatment-approaches-differ-depending-on-the-severity-of-asthma
#12
Maciej Kupczyk, Piotr Kuna
Asthma is nowadays regarded as a syndrome of various overlapping phenotypes with defined clinical characteristics, different underlying inflammatory mechanisms, identifiable genetic background, environmental risk factors and possible biomarkers. There are no doubts that due to the diversity of asthma, a 'one size fits all' management of the disease is no longer valid. Areas covered: Nowadays asthma management is based on the control of the disease, and the goals of asthma treatment are defined as good symptom control, decreased future risk of exacerbations, fixed airflow limitation, and side-effects of treatment...
October 16, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28978239/endothelial-function-in-patients-with-chronic-obstructive-pulmonary-disease-a-systematic-review-of-studies-using-flow-mediated-dilatation
#13
Anouk W Vaes, Martijn A Spruit, Jan Theunis, Nandu Goswami, Lowie E Vanfleteren, Frits M E Franssen, Emiel F M Wouters, Patrick De Boever
BACKGROUND: Cardiovascular disease is an important cause of morbidity and mortality in chronic obstructive pulmonary disease (COPD). Endothelial function may be involved in the pathogenesis of cardiovascular disease. In contrast to the attention given to pulmonary endothelial dysfunction, little is known about peripheral vascular changes in COPD. Therefore, we reviewed the literature on peripheral endothelial function in COPD. METHODS: Databases were screened for studies using ultrasound-based flow-mediated dilation (FMD), the reference method for assessing peripheral endothelial function, in stable COPD patients...
October 12, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28984485/exercise-induced-bronchospasm-in-a-hot-and-dry-region-study-of-asthmatic-rhinitistic-and-asymptomatic-adolescents
#14
Marco Aurélio de Valois Correia Junior, Emília Chagas Costa, Silvia Wanick Sarinho, José Ângelo Rizzo, Emanuel Sávio Cavalcanti Sarinho
BACKGROUND: Exercise-induced bronchospasm (EIB) is the bronchial narrowing that occurs after intense exercise in a significant number of asthmatics and in some non-asthmatics. This study aims to evaluate the occurrence of EIB in adolescents with asthma, rhinitis and respiratory asymptomatics in a hot and dry climate. RESEARCH DESIGN AND METHODS: This is a cross-sectional study based on an epidemiological study that evaluated the prevalence of asthma in schoolchildren in a semi-arid zone of Brazil...
October 10, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28967797/pulmonary-disease-by-non-tuberculous-mycobacteria-clinical-management-unmet-needs-and-future-perspectives
#15
Lars-Olof Larsson, Eva Polverino, Wouter Hoefsloot, Luigi R Codecasa, Roland Diel, Stephen G Jenkins, Michael R Loebinger
The number of patients with pulmonary disease caused by non-tuberculous mycobacteria (NTM) is increasing globally. Poor resistance against infections, for example, due to pre-existing lung diseases, immune deficiency and immune-modulating treatment, predisposes the population to developing pulmonary NTM disease. The incidence of pre-existing lung diseases such as chronic obstructive pulmonary disease and bronchiectasis has also increased. NTM disease diagnosis is often delayed due to non-specific symptoms. The therapeutic arsenal is limited and adherence to treatment guidelines is often low since the treatment regimens are complex, lengthy and side effects are common...
October 10, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28933228/is-there-sufficient-evidence-to-support-the-use-of-vitamin-supplements-in-the-asthmatic-patient
#16
Shahabeddin Rezaei, Nima Rezaei, Maryam Mahmoudi, Zahra Aryan
No abstract text is available yet for this article.
September 26, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28918658/the-role-of-upper-airway-pathology-as-a-co-morbidity-in-severe-asthma
#17
Amelia Licari, Ilaria Brambilla, Maria De Filippo, Dimitri Poddighe, Riccardo Castagnoli, Gian Luigi Marseglia
Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple co-morbidities and risk factors. Several co-morbidities may contribute to worsen asthma control and complicate diagnostic and therapeutic management of severe asthmatic patients. Areas covered: A prevalent cluster of chronic upper airway co-morbid diseases is recognized in severe asthma. Evaluation for these disorders should always be considered in clinical practice. The aim of this review is to provide an updated overview of the prevalence, the pathogenetic mechanisms, the clinical impact and the therapeutic options for upper airway pathology in severe asthma, focusing on chronic rhinosinusitis and allergic rhinitis...
September 16, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28862062/methyl-cellulose-powder-for-prevention-and-management-of-nasal-symptoms
#18
Todor A Popov, Nils Åberg, Jean Emberlin, Peter Josling, Natalia I Ilyina, Nikolai P Nikitin, Martin Church
HPMC-p, an inert micronized powder form of hydroxy-propyl-methyl-cellulose, when insufflated nasally, provides a natural barrier against pollen allergens and noxious agents. This overview assesses the efficacy and safety of this patented powder product and delivery system without an analogue among the cellulose derivatives. Areas covered: Twenty-six studies with HPMC-p were critically appraised to obtain an updated characteristic of the product. Most studies assessed the efficacy of HPMC-p as a nasal barrier enforcing measure: one experimental setup evaluated its ability to prevent or delay the diffusion of allergen through it, two clinical studies used allergen provocation tests, and the remaining relied on clinical criteria in open real world or placebo controlled designs...
September 6, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28994337/aerosol-therapy-through-high-flow-nasal-cannula-in-pediatric-patients
#19
Awni M Al-Subu, Scott Hagen, Marlowe Eldridge, Juan Boriosi
High flow nasal cannula (HFNC) is increasingly used in pediatric patients suffering from respiratory failure. In some disease processes, patients may also benefit from aerosol therapy. Therefore, the use of HFNC to deliver aerosolized medications is a convenient and attractive option. Areas covered: This review aims to appraise available evidence concerning the efficiency of aerosol nebulized therapy delivery using HFNC in pediatric patients. Expert commentary: Delivery of aerosol particles is a very complex process and depends on the use of oxygen vs...
December 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28956954/hiv-related-chronic-lung-disease-in-adolescents-are-we-prepared-for-the-future
#20
Pierre Goussard, Robert P Gie
Chronic lung diseases (CLD) are the most chronic disease occurring in adolescents living with human immunodeficiency virus (ALHIV). In ALHIV who received antiretroviral therapy (ART) late in childhood, bronchiectasis, bronchiolitis obliterans and interstitial pneumonitis are common. In adolescents who received ART early in life the spectrum of CLD has changed with asthma and chronic obstructive pulmonary disease being common. Areas covered: The aim of this paper was to review CLD in ALHIV. We conducted a literature review of electronic databases focusing on CLD that were common prior to the introduction of ART (1996-2004), the present situation where ART is widely available (2005 to 2016), and articles which aided us speculating on the impact of HIV-related CLD in adolescents transitioning to adult HIV-clinics...
December 2017: Expert Review of Respiratory Medicine
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