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Multidisciplinary Respiratory Medicine

María-José Giménez, Lorenzo Aguilar, Juan José Granizo
Fifteen years after its licensure, this revision assesses the role of cefditoren facing the current pharmacoepidemiology of resistances in respiratory human-adapted pathogens ( Streptococcus pneumoniae , Streptococcus pyogenes , Haemophilus influenzae and Moraxella catarrhalis ). In the era of post- pneumococcal conjugate vaccines and in an environment of increasing diffusion of the fts I gene among H. influenzae isolates, published studies on the cefditoren in vitro microbiological activity, pharmacokinetic/pharmcodynamic (PK/PD) activity and clinical efficacy are reviewed...
2018: Multidisciplinary Respiratory Medicine
Andrea Gramegna, Stefano Aliberti, Marco Confalonieri, Angelo Corsico, Luca Richeldi, Carlo Vancheri, Francesco Blasi
Background: The European Respiratory Society recently published an important statement reviewing available evidence on diagnosis and treatment of lung disease associated to alpha-1 antitrypsin deficiency (AATD). Several issues on this topic still remain unresolved and subject of interpretation according to different standard procedures and healthcare systems worldwide. The purpose of this commentary is to offer a critical contribution to most of these controversial issues in light of an Italian perspective for the management of this disease...
2018: Multidisciplinary Respiratory Medicine
Ami R Buikema, Lee Brekke, Amy Anderson, Eleena Koep, Damon Van Voorhis, Lucie Sharpsten, Beth Hahn, Riju Ray, Richard H Stanford
Background: Chronic obstructive pulmonary disease (COPD) is associated with high clinical and economic burden. Optimal pharmacological therapy for COPD aims to reduce symptoms and the frequency and severity of exacerbations. Umeclidinium/vilanterol (UMEC/VI) is an approved combination therapy for once-daily maintenance treatment of patients with COPD. This study evaluated the impact of delaying UMEC/VI initiation on medical costs and exacerbation risk. Methods: A retrospective analysis of patients with COPD who initiated UMEC/VI between 4/28/2014 and 7/31/2016 was conducted using the Optum Research Database...
2018: Multidisciplinary Respiratory Medicine
Sherif Mohamed, Hassan Bayoumi, Nashwa Abd El-Aziz, Ehab Mousa, Yasser Gamal
Background: No studies have addressed the impact of lung cancer (LC) on prognosis of patients with idiopathic pulmonary fibrosis (IPF) in Upper Egypt. We aimed to evaluate the prevalence and risk factors for LC among IPF patients and its impact on their outcomes and survival in Upper Egypt. Methods: A total of 246 patients with IPF who had complete clinical and follow up data were reviewed. They were categorized into 2 groups: 34 patients with biopsy-proven LC and IPF (LC-IPF) and 212 patients with IPF only (IPF)...
2018: Multidisciplinary Respiratory Medicine
Sara Roversi, Piera Boschetto, Bianca Beghe', Michela Schito, Martina Garofalo, Mariarita Stendardo, Valentina Ruggieri, Roberto Tonelli, Alessandro Fucili, Roberto D'Amico, Federico Banchelli, Leonardo M Fabbri, Enrico M Clini
Chronic obstructive pulmonary disease (COPD) is a common comorbidity of heart failure (HF), but remains often undiagnosed, and we aimed to identify symptoms predicting COPD in HF. As part of an observational, prospective study, we investigated stable smokers with a confirmed diagnosis of HF, using the 8-item COPD-Assessment-Test (CAT) questionnaire to assess symptoms. All the items were correlated with the presence of COPD, and logistic regression models were used to identify independent predictors. 96 HF patients were included, aged 74, 33% with COPD...
2018: Multidisciplinary Respiratory Medicine
Ernesto Crisafulli, Enric Barbeta, Antonella Ielpo, Antoni Torres
Background: Patients with chronic obstructive pulmonary disease (COPD) may experience an acute worsening of respiratory symptoms that results in additional therapy; this event is defined as a COPD exacerbation (AECOPD). Hospitalization for AECOPD is accompanied by a rapid decline in health status with a high risk of mortality or other negative outcomes such as need for endotracheal intubation or intensive care unit (ICU) admission. Treatments for AECOPD aim to minimize the negative impact of the current exacerbation and to prevent subsequent events, such as relapse or readmission to hospital...
2018: Multidisciplinary Respiratory Medicine
Alessandra Siciliani, Erino Angelo Rendina, Mohsen Ibrahim
Background: Tracheal surgery requires a highly specialized team of anesthesiologists, thoracic surgeons, and operative support staff. It remain a formidable challenge for surgeons due to the criticality connected to anatomical considerations, intraoperative airway management, technical complexity of reconstruction, and the potential postoperative morbidity and mortality. Main body: This article focuses on the main technical aspects and literature data regarding laryngotracheal and tracheal resection and reconstruction...
2018: Multidisciplinary Respiratory Medicine
Matteo Fontana, Roberto Tonelli, Filippo Gozzi, Ivana Castaniere, Alessandro Marchioni, Riccardo Fantini, Francesca Coppi, Filippo Natali, Elisabetta Rovatti, Enrico Clini
Background: Hemoptysis is a frequent sign of respiratory and non-respiratory diseases. While in most cases the underlying cause is rapidly identified, sometimes the real etiology might be misdiagnosed with dramatic delay in treatment. Case presentation: A 46-year-old man with hiatal hernia and a history of aortic surgery for aortic coarctation presented with dramatic episodes of hemoptysis and subsequent severe anemia (6,9 g/dl). Digestive and respiratory endoscopy resulted not exhaustive, thus he underwent a contrast-enhanced computed tomography (CT) scan of the chest that showed an aneurysmal dilatation of the descending thoracic aorta with suspected aortobronchial fistula...
2018: Multidisciplinary Respiratory Medicine
Francesco Menzella, Luca Codeluppi, Mirco Lusuardi, Carla Galeone, Franco Valzania, Nicola Facciolongo
Background: Acute respiratory failure can be triggered by several causes, either of pulmonary or extra-pulmonary origin. Pompe disease, or type II glycogen storage disease, is a serious and often fatal disorder, due to a pathological accumulation of glycogen caused by a defective activiy of acid α-glucosidase (acid maltase), a lysosomal enzyme involved in glycogen degradation. The prevalence of the disease is estimated between 1 in 40,000 to 1 in 300,000 subjects. Case presentation: This case report describes a difficult diagnosis of late-onset Pompe disease (LOPD) in a 52 year old Caucasian woman with acute respiratory failure requiring orotracheal intubation and subsequent tracheostomy for long-term mechanical ventilation 24 h/day...
2018: Multidisciplinary Respiratory Medicine
Stefano Aliberti, Luigi Ruffo Codecasa, Andrea Gori, Giovanni Sotgiu, Maura Spotti, Antonio Di Biagio, Andrea Calcagno, Stefano Nardini, Baroukh Maurice Assael, Enrico Tortoli, Giorgio Besozzi, Maurizio Ferrarese, Alberto Matteelli, Enrico Girardi, Saverio De Lorenzo, Manuela Seia, Andrea Gramegna, Bruno Del Prato, Leonardo Terranova, Martina Oriano, Nicola Sverzellati, Mehdi Mirsaeidi, James D Chalmers, Charles S Haworth, Michael R Loebinger, Timothy Aksamit, Kevin Winthrop, Felix C Ringshausen, Giuliana Previdi, Francesco Blasi
Background: A substantial increase in pulmonary and extra-pulmonary diseases due to non-tuberculous mycobacteria (NTM) has been documented worldwide, especially among subjects suffering from chronic respiratory diseases and immunocompromised patients. Many questions remain regarding the epidemiology of pulmonary disease due to NTM (NTM-PD) mainly because reporting of NTM-PD to health authorities is not mandated in several countries, including Italy. This manuscript describes the protocol of the first Italian registry of adult patients with respiratory infections caused by NTM (IRENE)...
2018: Multidisciplinary Respiratory Medicine
Steven L Taylor, Lex E X Leong, Fredrick M Mobegi, Jocelyn M Choo, Lucy D Burr, Steve Wesselingh, Geraint B Rogers
Determining the effects of antimicrobial therapies on airway microbiology at a population-level is essential. Such analysis allows, for example, surveillance of antibiotic-induced changes in pathogen prevalence, the emergence and spread of antibiotic resistance, and the transmission of multi-resistant organisms. However, current analytical strategies for understanding these processes are limited. Culture- and PCR-based assays for specific microbes require the a priori selection of targets, while antibiotic sensitivity testing typically provides no insight into either the molecular basis of resistance, or the carriage of resistance determinants by the wider commensal microbiota...
2018: Multidisciplinary Respiratory Medicine
Andrea Gramegna, Stefano Aliberti, Manuela Seia, Luigi Porcaro, Vera Bianchi, Carlo Castellani, Paola Melotti, Claudio Sorio, Enza Consalvo, Elisa Franceschi, Francesco Amati, Martina Contarini, Michele Gaffuri, Luca Roncoroni, Barbara Vigone, Angela Bellofiore, Cesare Del Monaco, Martina Oriano, Leonardo Terranova, Maria Francesca Patria, Paola Marchisio, Baroukh M Assael, Francesco Blasi
Background: Bronchiectasis is the final result of different processes and most of the guidelines advocate for a careful evaluation of those etiologies which might be treated or might change patients' management, including cystic fibrosis (CF). Main body: CFTR mutations have been reported with higher frequency in bronchiectasis population. Although ruling out CF is considered as a main step for etiological screening in bronchiectasis, CF testing lacks of a standardized approach both from a research and clinical point of view...
2018: Multidisciplinary Respiratory Medicine
Stefano Aliberti, James D Chalmers
No abstract text is available yet for this article.
2018: Multidisciplinary Respiratory Medicine
Martina Contarini, Amelia Shoemark, Jessica Rademacher, Simon Finch, Andrea Gramegna, Michele Gaffuri, Luca Roncoroni, Manuela Seia, Felix C Ringshausen, Tobias Welte, Francesco Blasi, Stefano Aliberti, James D Chalmers
Bronchiectasis represents the final pathway of several infectious, genetic, immunologic or allergic disorders. Accurate and prompt identification of the underlying cause is a key recommendation of several international guidelines, in order to tailor treatment appropriately. Primary ciliary dyskinesia (PCD) is a genetic cause of bronchiectasis in which failure of motile cilia leads to poor mucociliary clearance. Due to poor ciliary function in other organs, individuals can suffer from chronic rhinosinusitis, otitis media and infertility...
2018: Multidisciplinary Respiratory Medicine
Philip Robinson, Lucy Morgan
The contemporary diagnosis of bronchiectasis requires CT scanning to describe specific structural lung changes. Scoring systems have been designed and validated in some specific causes of bronchiectasis to allow investigators to correlate CT changes with other indices of disease severity, to describe changes over time, with exacerbation and in response to treatment. Several scoring systems have been developed for CF including the Bhalla Score, Brody score, and the Helbich score. These scoring systems have also been applied to other causes of bronchiectasis including Primary Ciliary Dyskinesia (PCD)...
2018: Multidisciplinary Respiratory Medicine
Matteo Bosio, Elena Salvaterra, Francesca Datturi, Patrizia Morbini, Michele Zorzetto, Simona Inghilleri, Stefano Tomaselli, Patrizia Mangiarotti, Federica Meloni, Isa Cerveri, Giulia Maria Stella
Background: Malignant pleural mesothelioma (MPM) is an aggressive tumor with poor prognosis, mainly associated with work or environmental exposure to asbestos. MPM's molecular profile is largerly unexplored and effective therapies are still lacking. MPM rarely harbours those somatic genetic lesions that usually characterize solid epithelial-derived tumors. On this basis, our study aims at investigating MPM epigenetic profile. Methods: We here assessed through immunohistochemistry, FISH and methylation specific PCR, the expression of 5-hydroxymethylcytosine (5- hmC) - an epigenetic marker and an important regulator of embryonic development and carcinogenesis - and the methylation status of the promoter of the MTAP gene - encoding for an enzyme involved in the rescue process of methionine and adenine - in two relevant series of FF-PE MPM samples derived from MPM thoracoscopic biopsies...
2018: Multidisciplinary Respiratory Medicine
Davide Piloni, Claudio Tirelli, Rita Di Domenica, Valentina Conio, Amelia Grosso, Vanessa Ronzoni, Filippo Antonacci, Pasquale Totaro, Angelo G Corsico
Background: Double aortic arch is a rare congenital and complete vascular ring around trachea and esophagus. It is usually diagnosed during infancy. The symptoms are generally related to respiratory and gastroesophageal tracts. Case presentation: A 20-year-old female patient was referred to our outpatient clinic for persistent dry cough. She had a history of an episode of inhalation of food bolus as an infant and recurrent bronchitis, anorexia and allergic bronchial asthma since the childhood...
2018: Multidisciplinary Respiratory Medicine
Stephanie Attard Camilleri, Juanita Camilleri Casingena, Kentaro Yamagata, Martin Balzan
Background: Understanding positive and negative influences on adult immunization status can help healthcare providers to better identify and target patients who are likely to need immunization. Our aim was to assess and compare influenza and pneumococcal (IV/PV) immunisation rates to identify vaccination predictors in Malta. Method: One group consisted of all medical patients discharged from Mater Dei Hospital (MDH) over a one week period in February 2013. Patients were administered a phone questionnaire...
2018: Multidisciplinary Respiratory Medicine
Roberto W Dal Negro, Luca Bonadiman, Paola Turco
[This corrects the article DOI: 10.1186/s40248-018-0131-x.].
2018: Multidisciplinary Respiratory Medicine
Masoud Fallahi, Somaye Mahdavikian, Alireza Abdi, Fariba Borhani, Parvin Taghizadeh, Behzad Hematpoor
Background: Despite advances with regard to "do not attempt resuscitation order", physicians are still reluctant to implement it. In fact, while the nurses could be of great help in making decision about "do not attempt resuscitation order," they are mostly neglected in this process. The current study was conducted to determine the nurses and physicians' viewpoints about decision making process of "do not attempt resuscitation order". Methods: A descriptive analytical study was carried out with participation of 152 physicians and 152 nurses...
2018: Multidisciplinary Respiratory Medicine
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