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Expert Review of Respiratory Medicine

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https://www.readbyqxmd.com/read/28918658/the-role-of-upper-airway-pathology-as-a-co-morbidity-in-severe-asthma
#1
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/28891372/controversies-and-advances-in-the-management-of-ventilator-associated-pneumonia
#2
Katherine L Roberts, Marin H Kollef, Scott T Micek, Paul Juang
Although national surveillance data suggests that the incidence of ventilator associated pneumonia (VAP) is down-trending, it remains one of the most commonly encountered hospital acquired infections in the United States and worldwide. Its association with increased healthcare costs and worsened patient outcomes warrants continued effort to improve the care of patients with VAP. Areas covered: The increasing prevalence of multi-drug resistant bacteria further drives the need to explore advances in diagnostic and treatment options...
September 11, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28862062/methyl-cellulose-powder-for-prevention-and-management-of-nasal-symptoms
#3
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 1, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28826284/middle-east-respiratory-syndrome-coronavirus-five-years-later
#4
Ali A Rabaan
In the past five years, there have been 1,936 laboratory-confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in 27 countries, with a mortality rate of 35.6%. Most cases have arisen in the Middle East, particularly the Kingdom of Saudi Arabia, however there was a large hospital-associated outbreak in the Republic of Korea in 2015. Exposure to dromedary camels has been recognized by the World Health Organization (WHO) as a risk factor in primary cases, but the exact mechanisms of transmission are not clear...
August 21, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28826280/severe-therapy-resistant-asthma-in-children-translational-approaches-to-uncover-sub-phenotypes
#5
Aldara Martin Alonso, Valentina Fainardi, Sejal Saglani
Paediatric severe therapy resistant asthma (STRA) affects a very small proportion of all children with asthma, but results in significant morbidity, has a high risk of mortality and utilises approximately half of all healthcare resources for childhood asthma. children with STRA need add-on 'beyond guidelines' therapies because of poor control despite maximal conventional treatments and optimisation of basic asthma management. however, STRA is heterogeneous with marked phenotypic variation between patients and mechanisms from adult severe asthma cannot be extrapolated to children...
August 21, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28780895/the-use-of-pulmonary-clearance-medications-in-the-acutely-ill-patient
#6
Michael F Papacostas, Peter Luckett, Susan Hupp
Retention of airway secretions occurs in disease, leading to airway plugging, atelectasis, and worsened respiratory mechanics, making airway clearance an important therapeutic target. Areas covered: Many medications designed to enhance clearance of airway secretions are available. We will review the medications available to enhance airway clearance, their mechanisms of action, and the evidence available for their use in acutely ill patients. Expert commentary: In the cystic fibrosis (CF) population, beneficial effects have been shown in pulmonary function with the use of some of these agents...
August 18, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28756728/innovative-approaches-to-support-smoking-cessation-for-individuals-with-mental-illness-and-co-occurring-substance-use-disorders
#7
Smita Das, Judith J Prochaska
Tobacco remains the leading preventable cause of death in the US, accounting for over 520,000 deaths annually. While the smoking prevalence has declined over the past 50 years, those with mental illness and addictive disorders continue to smoke at high levels and with significant tobacco-related health problems. Areas covered: This review highlights the epidemiology, contributing factors, and evidence-base for intervening upon tobacco use in those with mental illness and addictive disorders. Historically underprioritized, a growing body of literature supports treating tobacco within mental health and addiction treatment settings...
August 9, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28786318/anti-pd-l1-combined-with-other-agents-in-non-small-cell-lung-cancer-combinations-with-non-immuno-oncology-agents
#8
Sonam Puri, Monica Chatwal, Jhanelle E Gray
Lung cancer is the most common cause of cancer-related deaths in the world. Despite recent advances, the estimated 5-year overall survival is only around 17%. There is an urgent need for development of new effective drug strategies for the treatment of advanced-stage lung cancer. Areas covered: This review focuses on ongoing research in immune and non-immune oncology combinations for the treatment of non-small cell lung cancer (NSCLC). Here, we will focus on the combination of PD-L1 inhibitors (immunotherapy) with chemotherapy, vascular endothelial growth factor inhibitors, targeted therapies, and radiation...
August 8, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28752776/efficacy-and-safety-of-inhaled-corticosteroids-relative-to-fluticasone-propionate-a-systematic-review-of-randomized-controlled-trials-in-asthma
#9
See-Hwee Yeo, Bhumika Aggarwal, Sumitra Shantakumar, Aruni Mulgirigama, Peter Daley-Yates
Many trials have been published comparing inhaled corticosteroid (ICS) treatments in asthma. However, mixed results necessitate the summarization of available evidence to aid in decision-making. Areas covered: This systematic review evaluated randomized controlled trials (RCTs) that compared the efficacy and safety of inhaled fluticasone propionate (FP) with other ICS including beclomethasone dipropionate (BDP), budesonide (BUD) and ciclesonide (CIC). PubMed was searched and 54 RCTs that fit pre-determined criteria were included...
August 4, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28745925/clinical-care-of-children-with-primary-ciliary-dyskinesia
#10
Jane S Lucas, Mikkel Christian Alanin, Samuel Collins, Amanda Harris, Helle Krogh Johansen, Kim G Nielsen, Jean Francois Papon, Phil Robinson, Woolf T Walker
Primary ciliary dyskinesia (PCD) is a rare heterogeneous disorder, usually inherited as an autosomal recessive condition but X-linked inheritance is also described. Abnormal ciliary function in childhood leads to neonatal respiratory distress in term infants, persistent wet cough, bronchiectasis, chronic rhinosinusitis, and hearing impairment; approximately 50% of patients have situs inversus. There is a paucity of evidence for treating PCD, hence consensus guidelines are predominantly influenced by knowledge from cystic fibrosis (CF)...
August 2, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28743228/airway-inflammation-in-chronic-obstructive-pulmonary-disease-copd-a-true-paradox
#11
Mathew Suji Eapen, Stephen Myers, Eugene Haydn Walters, Sukhwinder Singh Sohal
Chronic obstructive pulmonary disease (COPD) is primarily an airway condition, which mainly affects cigarette smokers and presents with shortness of breath that is progressive and poorly reversible. In COPD research, there has been a long held belief that airway disease progression is due to inflammation. Although this may be true in the airway lumen with innate immunity activated by the effect of smoke or secondary to infection, the accurate picture of inflammatory cells in the airway wall, where the pathophysiological COPD remodeling occurs, is uncertain and debatable...
August 2, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28737047/the-role-of-mucoactive-agents-in-the-mechanically-ventilated-patient-a-review-of-the-literature
#12
Bradley L Icard, Edmundo Rubio
The management of airway secretions in the mechanically ventilated patient is a routine task throughout all intensive care units. The current treatment strategies are primarily based on anecdotal experiences rather than statistical evidence. Areas covered: This review article evaluates the data from published trials surrounding mucoactive agents and their use in the critically ill patient population. We completed an extensive search through PUBMED and CINAHL via EBSCO, along with the Cochran library to find all trials using mucoactive agents in the critically ill patient population...
July 26, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28715922/dlk1-dio3-imprinted-locus-deregulation-in-development-respiratory-disease-and-cancer
#13
Jhon R Enterina, Katey S S Enfield, Christine Anderson, Erin A Marshall, Kevin W Ng, Wan L Lam
The imprinted DLK1-DIO3 locus at 14q32.1-32.31 holds biological significance in fetal development, whereby imprinting errors are causal to developmental disorders. Emerging evidence has implicated this locus in other diseases including cancer, highlighting the biological parallels between fetal organ and tumour development. Areas covered: Controlled regulation of gene expression from the imprinted DLK1-DIO3 locus at 14q32.1-32.31 is crucial for proper fetal development. Deregulation of locus gene expression due to imprinting errors has been mechanistically linked to the developmental disorders Kagami-Ogata Syndrome and Temple Syndrome...
July 20, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28703045/the-role-of-human-host-genetics-in-tuberculosis-resistance
#14
Craig Kinnear, Eileen G Hoal, Haiko Schurz, Paul D van Helden, Marlo Möller
Tuberculosis (TB) remains a public health problem: the latest estimate of new incident cases per year is a staggering 10.4 million. Despite this overwhelming number, the majority of the immunocompetent population can control infection with Mycobacterium tuberculosis. The human genome underlies the immune response and contributes to the outcome of TB infection. Areas covered: Investigations of TB resistance in the general population have closely mirrored those of other infectious diseases and initially involved epidemiological observations...
July 20, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28699821/physical-activity-in-patients-with-copd-the-impact-of-comorbidities
#15
Leandro Cruz Mantoani, Silvina Dell'era, William MacNee, Roberto A Rabinovich
Comorbidities are common in patients with chronic obstructive pulmonary disease (COPD) and it plays an important role on physical activity (PA) in this population. Since low PA levels have been described as a key factor to predict morbi-mortality in COPD, it seems crucial to review the current literature available on this topic. Areas covered: This review covers the most common comorbidities found in COPD, their prevalence and prognostic implications. We explore the differences in PA between COPD patients with and without comorbidities, as well as the impact of the number or type of comorbidities on activity levels of this population...
July 20, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28699819/targeting-cytokines-in-asthma-therapy-could-il-37-be-a-solution
#16
Michael Wegmann
No abstract text is available yet for this article.
July 17, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28673104/biopsy-in-idiopathic-pulmonary-fibrosis-back-to-the-future
#17
Giulio Rossi, Paolo Spagnolo
Idiopathic Pulmonary Fibrosis (IPF) is a relentlessly progressive, fibrosing interstitial pneumonia characterized by a radiologic and/or histologic pattern of usual interstitial pneumonia (UIP). The availability of two effective anti-fibrotic drugs in IPF has encouraged the identification and treatment of patients in early stages in order to maximize clinical benefit. The ability of high-resolution computed tomography (HRCT) to identify a 'definite' UIP pattern is suboptimal, particularly in the absence of honeycombing...
July 10, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28621155/the-role-of-telemedicine-in-obstructive-sleep-apnea-management
#18
Vera Lugo, Jair Asir Villanueva, Onintza Garmendia, Josep M Montserrat
Obstructive sleep apnea (OSA) is a common disease that leads in notorious symptoms and comorbidities. Although general measures are important, continuous positive airway pressure (CPAP) is the best treatment option. However, compliance can be suboptimal and telemedicine may play a role to improve it. Areas covered: Review authors searched EMBASE, PubMed and Cochrane data bases using the following keywords: continuous positive airway pressure, Obstructive sleep apnea, telemedicine, respiratory telemedicine, information and communication technology...
June 29, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28730908/electrical-stimulation-for-the-treatment-of-obstructive-sleep-apnoea-a-review-of-the-evidence
#19
Valeria Bisogni, Martino F Pengo, Andrea De Vito, Giuseppe Maiolino, Gian Paolo Rossi, John Moxham, Joerg Steier
Obstructive sleep apnoea is an increasingly prevalent clinical condition with significant impact on individuals and public health. Continuous positive airway pressure therapy is the standard treatment, but adherence is limited and alternative treatments are needed. In this context, non-invasive and invasive methods for the electrical stimulation of upper airway dilator muscles have been demonstrated to be effective in selected patients. Areas covered: This review will cover investigations on the clinical effects, safety, and tolerability of non-invasive and invasive electrical stimulation of the upper airway for the management of obstructive sleep apnoea...
September 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28595486/special-considerations-for-the-diagnosis-and-treatment-of-invasive-pulmonary-aspergillosis
#20
Matthew William McCarthy, Thomas J Walsh
The diagnosis and treatment of invasive pulmonary aspergillosis (IPA) are ongoing challenges in clinical practice. While important advances have recently been made, including enhanced diagnostic modalities as well as novel therapeutic and prophylactic options, more effective options are urgently needed as the population of immunocompromised patients continues to expand. Areas covered: In this paper, we review novel approaches to diagnosis of IPA, including multiplex PCR, Matrix Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry and provide a detailed review of the extended-spectrum triazole isavuconazole, which was approved in 2015 to treat IPA...
September 2017: Expert Review of Respiratory Medicine
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