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Therapeutic Advances in Respiratory Disease

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https://www.readbyqxmd.com/read/28425346/ambrisentan-a-review-of-its-use-in-pulmonary-arterial-hypertension
#1
Belinda N Rivera-Lebron, Michael G Risbano
Pulmonary arterial hypertension (PAH) is a progressive disease defined by an elevation in pulmonary arterial pressure that can lead to right heart failure and death. Ambrisentan is a selective endothelin receptor antagonist approved for the treatment of idiopathic, heritable PAH and connective tissue disease-associated PAH. Ambrisentan has been shown to improve exercise capacity and hemodynamics with an acceptable side-effect profile. It has also proven to be safely used in combination with other PAH-specific medications, especially with phosphodiesterase-5 inhibitors...
April 1, 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28391760/use-of-temperature-controlled-laminar-airflow-in-the-management-of-atopic-asthma-clinical-evidence-and-experience
#2
John O Warner
Avoidance of allergens in the treatment of asthma has hitherto not achieved significant benefit despite the strong evidence that allergy both increases severity and contributes to exacerbations of asthma. House dust mite, cat and dog allergens are the most common perennial allergic triggers and most avoidance strategies have focused on reducing exposures in bedrooms. Cochrane reviews have suggested that they neither significantly reduce allergen levels nor improve asthma. While the lack of efficacy may be assumed to be a consequence of exposures occurring outside the bedroom, prolonged sleep is associated with increased susceptibility to bronchospasm and airway inflammation...
April 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28391759/current-treatment-of-tracheoesophageal-fistula
#3
Changzhi Zhou, Yi Hu, Yang Xiao, Wen Yin
Tracheoesophageal fistulas (TEFs) often occur with esophageal or bronchial carcinoma. Currently, we rely on implantation of delicate devices, such as self-expanding and silicone stents, in the esophagus or trachea to cover the fistula and expand the stenosis in order to relieve patient pain. However, because each case is different, our approach may not be effective for every patient. Consequently, new devices and technology have emerged to address these situations, such as degradable stents, Amplatzer(®) devices, endobronchial one-way umbrella-shaped valves, and transplantation of mesenchymal stem cells...
April 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28134007/optimizing-quality-of-life-in-patients-with-idiopathic-pulmonary-fibrosis
#4
Mirjam J G van Manen, J J Miranda Geelhoed, Nelleke C Tak, Marlies S Wijsenbeek
Idiopathic pulmonary fibrosis (IPF) is a devastating, progressive and ultimately fatal lung disease. The combination of poor prognosis, uncertainty of disease course and severe symptom burden heavily impacts patients' and their families' quality of life. Though new antifibrotic drugs have been shown to decrease disease progression, the effect on health-related quality of life (HRQOL) has not been convincingly demonstrated. In a relentless disease such as IPF, striving to optimize HRQOL should complement the endeavour to prolong life...
March 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28150539/current-best-practice-in-rehabilitation-in-interstitial-lung-disease
#5
Atsuhito Nakazawa, Narelle S Cox, Anne E Holland
Interstitial lung disease (ILD) is a group of chronic respiratory diseases characterized by dyspnoea on exertion and decline in health-related quality of life (HRQL). People with ILD experience significant exercise limitation with contributors that include ventilatory limitation, impaired gas exchange, decreased cardiac function and skeletal muscle dysfunction. Pulmonary rehabilitation (PR) is well established in patients with chronic obstructive pulmonary disease (COPD) as a means to overcome exercise limitation and improve activity-related dyspnoea...
February 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27913761/best-practices-in-the-treatment-of-early-cystic-fibrosis-lung-disease
#6
Marijke Proesmans
For many years, management of cystic fibrosis (CF) lung disease was focused on symptomatic treatment of chronic lung infection, which is characterized by cough and sputum production, leading to progressive lung damage. With increasing survival and better knowledge of the pathogenesis of CF lung disease, it has become clear that treatment has to start very early because lung damage occurs in young patients, often before obvious symptoms appear. The arrival of new cystic fibrosis transmembrane conductance-regulator (CFTR)-correcting therapies will bring more opportunities to prevent the disease, apart from only treating chronic lung infection...
February 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27872176/the-evolving-landscape-of-combination-therapy-for-pulmonary-arterial-hypertension
#7
Matthew Griffin, Terence K Trow
Pulmonary arterial hypertension (PAH) is a progressively fatal disease, and the goal in treatment is to prevent disease progression. The standard of care often involves medications from multiple therapeutic classes, and there has been significant interest both in the choice of agent as well as the timing of initiation. There is a growing body of support for starting multiple medications at the time of diagnosis, or 'upfront ', rather than using sequential addition to prevent clinical deterioration.
February 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27777372/current-best-practice-in-the-evaluation-and-management-of-malignant-pleural-effusions
#8
Steven Walker, Anna C Bibby, Nick A Maskell
Malignant pleural effusions (MPEs) are an important cause of cancer-related mortality and morbidity. It is a heterogeneous group of conditions, which leads to debilitating symptoms and confers a poor prognosis. Recent well-designed randomized trials have provided a broader evidence base for an expanding range of treatment options. Together, with new prognostic scoring systems and a greater understanding of how different patient phenotypes respond to treatment, this allows greater personalization of management...
February 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28043213/clinical-relevance-of-ige-mediated-sensitization-against-the-mould-alternaria-alternata-in-children-with-asthma
#9
Sylvia Lehmann, Anja Sprünken, Norbert Wagner, Klaus Tenbrock, Hagen Ott
BACKGROUND: Asthma in childhood has a prevalence of 5-10% in Germany and severe asthma accounts for about 5% in this patient group. Positive predictive values for severe asthma are atopy, a positive family history and sensitizations against inhalative allergens. Alternaria is an important inhalative allergen and sensitization is suspected to correlate with severe and lethal asthma. We investigated the prevalence and impact of Alternaria sensitization in paediatric asthma. METHODS: We reviewed paediatric patients with a diagnosis of low-grade, moderate and severe asthma...
January 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28043212/the-effect-of-acetazolamide-on-sleep-apnea-at-high-altitude-a-systematic-review-and-meta-analysis
#10
Hsin-Ming Liu, I-Jen Chiang, Ken N Kuo, Cher-Ming Liou, Chiehfeng Chen
BACKGROUND: Acetazolamide has been investigated for treating sleep apnea in newcomers ascending to high altitude. This study aimed to assess the effect of acetazolamide on sleep apnea at high altitude, determine the optimal therapeutic dose, and compare its effectiveness in healthy trekkers and obstructive sleep apnea (OSA) patients. METHODS: PubMed, Embase, Scopus, Cochrane Library, and Airiti Library databases were searched up to July 2015 for randomized controlled trials (RCTs) performed above 2500 m in lowlanders and that used acetazolamide as intervention in sleep studies...
January 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28043202/sex-specific-cardiopulmonary-exercise-testing-indices-related-to-hemodynamics-in-idiopathic-pulmonary-arterial-hypertension
#11
Ping Yuan, Tian-Xiang Chen, Bigyan Pudasaini, Jie Zhang, Jian Guo, Si-Jin Zhang, Lan Wang, Qin-Hua Zhao, Su-Gang Gong, Rong Jiang, Wen-Hui Wu, Jing He, Jin-Ming Liu, Qing-Hua Hu
BACKGROUND: Many studies have highlighted sex preponderance in idiopathic pulmonary arterial hypertension (IPAH). It is well established that there are differences in exercise capacities in the two sexes but how much of that difference reflects on disease severity or correlates to markers of severity in the two sexes is still not clear. Right heart catheterization (RHC) and cardiopulmonary exercise testing (CPET) have been widely used for assessing functional capacity, prognosis and treatment response in IPAH...
January 1, 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27856823/mepolizumab-in-the-management-of-severe-eosinophilic-asthma-in-adults-current-evidence-and-practical-experience
#12
Gilda Varricchi, Diego Bagnasco, Matteo Ferrando, Francesca Puggioni, Giovanni Passalacqua, Giorgio W Canonica
Eosinophils represent approximately 1% of peripheral blood leukocytes in normal donors and their maturation and differentiation in the bone marrow are mainly regulated by interleukin (IL)-5 [Broughton et al. 2015]. IL-5, a cytokine that belongs to the β common-chain family, together with IL-3 and granulocyte-macrophage colony-stimulating factor (GM-CSF), stimulates also the activation and survival of eosinophils and, to some extent, of basophils. IL-5 binds to a heterodimer receptor composed of the specific subunit IL-5Rα and a common subunit βc shared with IL-3 and GM-CSF...
January 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27784816/endoscopic-lung-volume-reduction-coil-treatment-in-patients-with-chronic-hypercapnic-respiratory-failure-an-observational-study
#13
Marcel Simon, Lars Harbaum, Tim Oqueka, Stefan Kluge, Hans Klose
BACKGROUND: Endoscopic lung volume reduction coil (LVRC) treatment is an option for selected patients with severe emphysema. In the advanced stages, emphysema leads to respiratory failure: hypoxemia and eventually chronic hypercapnic respiratory failure. It can be hypothesized that LVRC treatment, a procedure targeting hyperinflation and thereby reducing ventilatory workload, may be especially beneficial in patients with chronic hypercapnic respiratory failure. This study was conducted to gain first insights into the effects and the safety of LVRC treatment in patients with emphysema and chronic hypercapnic respiratory failure...
January 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27742781/endobronchial-valves-for-bronchopleural-fistula-pitfalls-and-principles
#14
Dany Gaspard, Thaddeus Bartter, Ziad Boujaoude, Haroon Raja, Rohan Arya, Nikhil Meena, Wissam Abouzgheib
BACKGROUND: Placement of endobronchial valves for bronchopleural fistula (BPF) is not always straightforward. A simple guide to the steps for an uncomplicated procedure does not encompass pitfalls that need to be understood and overcome to maximize the efficacy of this modality. OBJECTIVES: The objective of this study was to discuss examples of difficult cases for which the placement of endobronchial valves was not straightforward and required alterations in the usual basic steps...
January 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27733490/therapeutic-management-of-patients-with-rheumatoid-arthritis-and-associated-interstitial-lung-disease-case-report-and-literature-review
#15
Andrea Picchianti Diamanti, Milica Markovic, Giuseppe Argento, Simonetta Giovagnoli, Alberto Ricci, Bruno Laganà, Raffaele D'Amelio
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that can present different extrarticular manifestations involving heart, lungs and kidneys. In recent years there has been a growing awareness of the central role played by the lungs in the onset and progression of RA. In particular interstitial lung disease (ILD) is a common pulmonary manifestation that may be related to the inflammatory process itself, infectious complications and to the treatments used. Management of patients with ILD/RA is still a challenge for clinicians, both synthetic [mainly methotrexate (MTX), leflunomide] and biologic immunosuppressors [mainly anti-tumor necrosis factor (TNF)α] have in fact been related to the onset or worsening of lung diseases with conflicting data...
January 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27678500/applications-and-mechanisms-of-immunotherapy-in-allergic-rhinitis-and-asthma
#16
Jasper H Kappen, Stephen R Durham, Hans In 't Veen, Mohamed H Shamji
Clinical and immunologic tolerance are hallmarks of successful allergen immunotherapy (AIT). Clinical benefits such as reduced symptoms, pharmacotherapy intake and improvement of quality of life persist following cessation of treatment. Successful AIT is associated with suppression of allergic inflammatory cells such as mast cells, eosinophils and basophils in target organs. Furthermore, AIT down-regulates type 2 innate lymphoid cells and allergen-specific type 2 T-helper (Th2) cells. The immunologic tolerant state following AIT is associated with the induction of distinct phenotypes of regulatory T-cells (T-regs) including interleukin (IL)-10-, IL-35- and transforming growth factor (TGF)-β- producing T-regs and FoxP3(+) T-regs...
January 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27595643/a-review-of-therapeutic-agents-for-the-management-of-pulmonary-arterial-hypertension
#17
Stella S Hahn, Mina Makaryus, Arunabh Talwar, Mangala Narasimhan, Gulrukh Zaidi
Pulmonary arterial hypertension (PAH) is an uncommon, progressive and life threatening disease characterized by a proliferative vasculopathy of the small muscular pulmonary arterioles resulting in elevated pulmonary vascular resistance and eventually right ventricular failure. An increasing understanding of the pathobiology of PAH and its natural history has led to the development of numerous targeted therapies. Despite these advances there is significant progression of disease and the survival rate remains low...
January 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28030992/macrolides-a-promising-pharmacologic-therapy-for-chronic-obstructive-pulmonary-disease
#18
Shilin Qiu, Xiaoning Zhong
Chronic inflammation plays a central role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, there are no effective anti-inflammatory pharmacologic therapies available for COPD so far. Recent evidence suggests that an immunologic mechanism has a role in the pathogenesis of COPD. Macrolides possess anti-inflammatory and immune-modulating effects may be helpful in the treatment of COPD. Several clinical studies have shown that long-term use of macrolides reduces the frequency of COPD exacerbations...
December 1, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27784815/osimertinib-in-the-treatment-of-patients-with-epidermal-growth-factor-receptor-t790m-mutation-positive-metastatic-non-small-cell-lung-cancer-clinical-trial-evidence-and-experience
#19
REVIEW
Ivana Sullivan, David Planchard
Patients with advanced epidermal growth factor receptor (EGFR) mutant non-small cell lung cancer (NSCLC) are particularly sensitive to treatment with first- or second-generation EGFR tyrosine kinase inhibitors such as gefitinib, erlotinib and afatinib, which block the cell-signaling pathways that drive the growth of tumor cells. Unfortunately, the majority of patients develop resistance to them after a median duration of response of around 10 months, and in over half of these patients the emergence of the EGFR T790M resistance mutation is detected...
December 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27655919/experience-with-indwelling-pleural-catheters-in-the-treatment-of-recurrent-pleural-effusions
#20
REVIEW
Michel Chalhoub, Zulfiqar Ali, Louis Sasso, Michael Castellano
Recurrent pleural effusions are frequently encountered in clinical practice. Whether malignant or nonmalignant, they often pose a challenge to the practicing clinician. When they recur, despite optimum medical therapy of the underlying condition and repeated thoracenteses, more invasive definitive approaches are usually required. Since its introduction in 1997, the PleurX catheter became the preferred method to treat recurrent malignant pleural effusions. Since then, a number of publications have documented its utility in managing recurrent nonmalignant pleural effusions...
December 2016: Therapeutic Advances in Respiratory Disease
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