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Therapeutic Advances in Respiratory Disease

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https://www.readbyqxmd.com/read/30014783/advances-in-proton-therapy-in-lung-cancer
#1
Melissa A L Vyfhuis, Nasarachi Onyeuku, Tejan Diwanji, Sina Mossahebi, Neha P Amin, Shahed N Badiyan, Pranshu Mohindra, Charles B Simone
Lung cancer remains the leading cause of cancer deaths in the United States (US) and worldwide. Radiation therapy is a mainstay in the treatment of locally advanced non-small cell lung cancer (NSCLC) and serves as an excellent alternative for early stage patients who are medically inoperable or who decline surgery. Proton therapy has been shown to offer a significant dosimetric advantage in NSCLC patients over photon therapy, with a decrease in dose to vital organs at risk (OARs) including the heart, lungs and esophagus...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/30014774/addition-of-hyaluronic-acid-improves-tolerance-to-7-hypertonic-saline-solution-in-bronchiectasis-patients
#2
Luis Máiz, Rosa M Girón, Eva Prats, Marta G Clemente, Eva Polverino, Silvia Caño, Rosa Cordovilla, Jordi Dorca, Carlos Peñalver, Félix Baranda, Miguel A Martínez-García
BACKGROUND: The excessive retention of sputum in the airways, leading to pulmonary infections, is a common consequence of bronchiectasis. Although inhalation of 7% hypertonic saline (HS) has proven an effective method to help remove the mucus, many patients are intolerant of this treatment. The addition of 0.1% hyaluronic acid to HS (HS+HA) could increase tolerance to HS in these patients. The main objective of this study was to evaluate the tolerability of HS+HA in bronchiectasis patients who are intolerant to HS...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29993339/using-step-counters-to-promote-physical-activity-and-exercise-capacity-in-patients-with-chronic-obstructive-pulmonary-disease-a-meta-analysis
#3
Shanhu Qiu, Xue Cai, Xuyi Wang, Can He, Martina Zügel, Jürgen Michael Steinacker, Uwe Schumann
BACKGROUND: Although step counters are popularly employed for physical rehabilitation in chronic obstructive pulmonary disease (COPD) patients, their effectiveness is inconsistent and even questioned. This meta-analysis aimed to investigate whether step counter use increases physical activity or improves exercise capacity in COPD patients. METHODS: Electronic databases were searched for randomized controlled trials that assessed the efficacy of step counter use in increasing physical activity or in improving exercise capacity...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29952251/contemporary-best-practice-in-the-management-of-malignant-pleural-effusion
#4
Coenraad F N Koegelenberg, Jane A Shaw, Elvis M Irusen, Y C Gary Lee
Malignant pleural effusion (MPE) affects more than 1 million people globally. There is a dearth of evidence on the therapeutic approach to MPE, and not surprisingly a high degree of variability in the management thereof. We aimed to provide practicing clinicians with an overview of the current evidence on the management of MPE, preferentially focusing on studies that report patient-related outcomes rather than pleurodesis alone, and to provide guidance on how to approach individual cases. A pleural intervention for MPE will perforce be palliative in nature...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29865929/noninvasive-ventilation-and-respiratory-physical-therapy-reduce-exercise-induced-bronchospasm-and-pulmonary-inflammation-in-children-with-asthma-randomized-clinical-trial
#5
Maisi Muniz Cabral David, Evelim Leal de Freitas Dantas Gomes, Maryjose Carvalho Mello, Dirceu Costa
BACKGROUND: Asthma is characterized by hyperresponsiveness of the airways, and exercise-induced bronchospasm (EIB) is a symptom that limits a large proportion of asthmatic patients, especially children. Continuous positive airway pressure (CPAP) leads to a reduction in the reactivity of the airways. The aim of this study was to evaluate the effect of outpatient treatment with CPAP and bilevel pressure combined with respiratory physical therapy for children and adolescents with asthma following bronchial hyperresponsiveness caused by an exercise bronchoprovocation test...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29857783/efficacy-and-safety-of-fluticasone-propionate-formoterol-fumarate-in-pediatric-asthma-patients-a-randomized-controlled-trial
#6
Anna Płoszczuk, Miroslava Bosheva, Kay Spooner, Tammy McIver, Sanjeeva Dissanayake
BACKGROUND: The efficacy and safety of fluticasone propionate/formoterol fumarate pressurized metered-dose inhaler (pMDI) (fluticasone/formoterol; Flutiform® ; 100/10 µg b.i.d.) was compared with fluticasone propionate (Flixotide® Evohaler® pMDI; 100 µg b.i.d.) and fluticasone/salmeterol (Seretide® Evohaler® pMDI; 100/50 µg b.i.d.) in a pediatric asthma population (EudraCT number: 2010-024635-16). METHODS: A double-blind, double-dummy, parallel group, multicenter study...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29857780/tolerability-of-inhaled-n-chlorotaurine-in-humans-a-double-blind-randomized-phase-i-clinical-study
#7
Roland Arnitz, Markus Stein, Petra Bauer, Barbara Lanthaler, Herbert Jamnig, Sabine Scholl-Bürgi, Katharina Stempfl-Al-Jazrawi, Hanno Ulmer, Bernhard Baumgartner, Sabine Embacher, Simon Geisler, Johanna M Gostner, Bernhard Müllinger, Beate Kälz, Markus Nagl
BACKGROUND: N-chlorotaurine (NCT), a long-lived oxidant produced by human leukocytes, can be synthesized chemically and used topically as a well-tolerated antiseptic to different body regions including sensitive ones. The aim of this study was to test the tolerability of inhaled 1% NCT in aqueous solution upon repeated application. METHODS: The study was performed double-blind and randomized with a parallel test group (1% NCT) and control group (0.9% NaCl as placebo)...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29781361/erythromycin-combined-with-corticosteroid-reduced-inflammation-and-modified-trauma-induced-tracheal-stenosis-in-a-rabbit-model
#8
Qin Enyuan, Xu Mingpeng, Gan Luoman, Gan Jinghua, Li Yu, Li Wentao, Hou Changchun, Li Lihua, Meng Xiaoyan, Zhou Lei, Liu Guangnan
BACKGROUND: Patients with endotracheal intubation or tracheostomy are subject to benign tracheal stenosis (TS), for which current therapies are unsatisfactory. We conducted a preliminary investigation of drugs and drug combinations for the prevention and treatment of TS in a rabbit model. METHODS: Fifty-four rabbits were apportioned into nine groups according to treatment: sham-operated control; untreated TS model; amikacin; budesonide; erythromycin; penicillin; amikacin + budesonide; erythromycin + budesonide; and penicillin + budesonide...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29737943/real-world-outcomes-in-patients-with-chronic-obstructive-pulmonary-disease-initiating-long-acting-mono-bronchodilator-therapy
#9
Lindsay G S Bengtson, Michael DePietro, Jeffrey McPheeters, Kathleen M Fox
BACKGROUND: Randomized clinical trials have shown long-acting mono bronchodilator therapy to be efficacious in improving lung function and dyspnea, while reducing exacerbations; however, less is known regarding the effectiveness in routine clinical practice. This study examined treatment patterns, rescue medication use, healthcare resource utilization and costs, and exacerbations in patients with chronic obstructive pulmonary disease (COPD) who initiated long-acting mono bronchodilator therapy in real-world settings...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29697011/influence-of-the-vibralung-acoustical-percussor-on-pulmonary-function-and-sputum-expectoration-in-individuals-with-cystic-fibrosis
#10
Courtney M Wheatley, Sarah E Baker, Cori M Daines, Hanna Phan, Marina G Martinez, Wayne J Morgan, Eric M Snyder
BACKGROUND: The Vibralung Acoustical Percussor is a new airway clearance therapy (ACT) utilizing intrapulmonary sound waves in addition to positive expiratory pressure (PEP). We evaluated the safety of the Vibralung and collected preliminary data on its ability to mediate sputum expectoration in individuals with cystic fibrosis (CF). METHODS: Over two separate studies, 10 and 11 mild to moderate CF patients were recruited for study I and II, respectively. Study I: Vibralung was used for 20 min with either no sound (NS: PEP only) or sound (S: PEP and sound) on randomized visits...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29692212/use-of-glucocorticoids-in-patients-with-copd-exacerbations-in-china-a-retrospective-observational-study
#11
Jing Zhang, Jinping Zheng, Kewu Huang, Yahong Chen, Jingping Yang, Wanzhen Yao
BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common in patients with underlying moderate to severe COPD and are associated with increased health and economic burden. International and Chinese guidelines recommend using glucocorticoids for the management of AECOPD because glucocorticoid therapy has been shown to benefit clinical outcomes. However, only scant data are available for current status of glucocorticoid therapy in hospitalized AECOPD patients in China...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29609511/extended-release-oral-treprostinil-in-the-management-of-pulmonary-arterial-hypertension-clinical-evidence-and-experience
#12
James C Coons, Taylor Miller
Treprostinil diolamine is the first oral prostacyclin approved for the treatment of pulmonary arterial hypertension (PAH) to improve exercise capacity. Clinical studies have demonstrated modest benefit as monotherapy, whereas no difference in exercise capacity was observed with combination therapy. However, these trials were limited by subtherapeutic dosing owing to intolerable adverse effects. Prostacyclin-related adverse effects, such as nausea, diarrhea, headache, flushing, and jaw pain, are prevalent. More recent pharmacokinetic and clinical studies illustrate the dose-response relationship and the importance of achieving clinically effective doses...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29595366/dabrafenib-in-combination-with-trametinib-in-the-treatment-of-patients-with-braf-v600-positive-advanced-or-metastatic-non-small-cell-lung-cancer-clinical-evidence-and-experience
#13
Arjun Khunger, Monica Khunger, Vamsidhar Velcheti
Mutations in the BRAF oncogene are found in 2-4% of all non-small cell lung cancer (NSCLC) patients. The most common activating mutation present within the BRAF oncogene is associated with valine substitution for glutamate at position 600 (V600E) within the BRAF kinase. BRAF-targeted therapies are effective in patients with melanoma and NSCLC harboring BRAF V600E mutation. In both melanoma and NSCLC, dual inhibition of both BRAF and the downstream mitogen-activated protein kinase (MEK) improves response rates compared with BRAF inhibition alone...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29537340/single-inhaler-triple-therapy-utilizing-the-once-daily-combination-of-fluticasone-furoate-umeclidinium-and-vilanterol-in-the-management-of-copd-the-current-evidence-base-and-future-prospects
#14
Mario Malerba, Matteo Nardin, Giuseppe Santini, Nadia Mores, Alessandro Radaeli, Paolo Montuschi
Maintenance pharmacological treatment for stable chronic obstructive pulmonary disease (COPD) is based on inhaled drugs, including long-acting muscarinic receptor antagonists (LAMA), long-acting β2 -adrenoceptor agonists (LABA) and inhaled corticosteroids (ICS). Inhaled pharmacological treatment can improve patients' daily symptoms and reduce decline of pulmonary function and acute exacerbation rate. Treatment with all three inhaled drug classes is reserved for selected, more severe, patients with COPD when symptoms are not sufficiently controlled by dual LABA/LAMA therapy and exacerbations are frequent...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29506460/clinical-pulmonary-infection-score-and-a-spot-serum-procalcitonin-level-to-guide-discontinuation-of-antibiotics-in-ventilator-associated-pneumonia-a-study-in-a-single-institution-with-high-prevalence-of-nonfermentative-gram-negative-bacilli-infection
#15
Phunsup Wongsurakiat, Sirapat Tulatamakit
Background We wanted to determine the impact of combined Clinical Pulmonary Infection Score (CPIS) and a spot serum procalcitonin (PCT)-guided protocol to shorten the duration of antibiotic treatment in patients with ventilator-associated pneumonia (VAP), mainly caused by nonfermentative gram-negative bacilli (NF-GNB). Methods Patients with VAP who received appropriate antibiotics for 7 days, temperature ⩽ 37.8°C, without shock, and CPIS ⩽ 6 were allocated to the PCT group or conventional group according to the treating physicians' decisions...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29499614/use-of-functional-respiratory-imaging-to-characterize-the-effect-of-inhalation-profile-and-particle-size-on-lung-deposition-of-inhaled-corticosteroid-long-acting-%C3%AE-2-agonists-delivered-via-a-pressurized-metered-dose-inhaler
#16
Cedric Van Holsbeke, Jan De Backer, Wim Vos, Jonathan Marshall
BACKGROUND: Functional respiratory imaging (FRI) uses three-dimensional models of human lungs and computational fluid dynamics to simulate functional changes within airways and predict the deposition of inhaled drugs. This study used FRI to model the effects of different patient inhalation and drug formulation factors on lung deposition of an inhaled corticosteroid/long-acting β2 -agonist (ICS/LABA) combination, administered by a pressurized metered-dose inhaler. METHODS: Three-dimensional models of the lungs of six patients with asthma (mean forced expiratory volume in 1 s, 83%), treated with an ICS/LABA, were included...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29480071/use-of-endo-bronchial-end-tidal-co-2-test-for-location-of-the-pleural-air-leakage-in-patients-with-intractable-pneumothorax
#17
Yi-Ming Zeng, Yun-Feng Chen, Hui-Huang Lin, Xiao-Bin Zhang
BACKGROUND: Location of the affected bronchus of pleural air leaks is the most important step of trans-bronchoscopic bronchial occlusion for the treatment of intractable pneumothorax. The balloon occlusion test is the most commonly used technique, but has failed in some cases. The aim of the present study was: (1) to determine if endo-bronchial end-tidal CO2 (EtCO2 ) measurement can identify the affected bronchus that is the source of a persistent pleural air leak; and (2) to establish a methodology for endo-bronchial EtCO2 testing in locating affected bronchus in intractable pneumothorax...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29480070/endoscopic-lung-volume-reduction-coil-treatment-in-patients-with-very-low-fev-1-an-observational-study
#18
Marcel Simon, Lars Harbaum, Tim Oqueka, Stefan Kluge, Hans Klose
BACKGROUND: Endoscopic lung volume reduction coil (LVRC) treatment is a therapeutic option for selected patients with advanced emphysema. The effects and the safety of endoscopic lung volume reduction in patients with very low forced expired volume in one second (FEV1 ) remain to be determined. This study was conducted to assess the effects and the safety of LVRC treatment in patients with very low FEV1 . METHODS: The study was performed as a retrospective observational study in the Department of Respiratory Medicine at the University Medical Center Hamburg-Eppendorf on patients with very low FEV1 , defined as an FEV1 ⩽ 20% of predicted at baseline in whom LVRC treatment was performed between 1 April 2012 and 28 February 2017...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29439648/effect-of-12-weeks-of-once-daily-tiotropium-olodaterol-on-exercise-endurance-during-constant-work-rate-cycling-and-endurance-shuttle-walking-in-chronic-obstructive-pulmonary-disease
#19
François Maltais, Denis O'Donnell, Juan Bautista Gáldiz Iturri, Anne-Marie Kirsten, Dave Singh, Alan Hamilton, Kay Tetzlaff, Yihua Zhao, Richard Casaburi
BACKGROUND: The TORRACTO® study evaluated the effects of tiotropium/olodaterol versus placebo on endurance time during constant work-rate cycling and constant speed shuttle walking in patients with chronic obstructive pulmonary disease (COPD) after 12 weeks of treatment. METHODS: The effects of once-daily tiotropium/olodaterol (2.5/5 and 5/5 μg) on endurance time during constant work-rate cycle ergometry (CWRCE) after 6 and 12 weeks of treatment were compared with placebo in patients with COPD in a randomized, double-blind, placebo-controlled, parallel-group clinical trial...
January 2018: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/29411700/how-will-telemedicine-change-clinical-practice-in-chronic-obstructive-pulmonary-disease
#20
Michele Vitacca, Alessandra Montini, Laura Comini
Within telehealth there are a number of domains relevant to pulmonary care: telemonitoring, teleassistance, telerehabilitation, teleconsultation and second opinion calls. In the last decade, several studies focusing on the effects of various telemanagement programs for patients with chronic obstructive pulmonary disease (COPD) have been published but with contradictory findings. From the literature, the best telemonitoring outcomes come from programs dedicated to aged and very sick patients, frequent exacerbators with multimorbidity and limited community support; programs using third-generation telemonitoring systems providing constant analytical and decisionmaking support (24 h/day, 7 days/week); countries where strong community links are not available; and zones where telemonitoring and rehabilitation can be delivered directly to the patient's location...
January 2018: Therapeutic Advances in Respiratory Disease
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