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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
Alison Pieterse, Susan D Hanekom
Background: Uncertainty exists regarding the physiological basis of physiotherapy strategies to facilitate mucus clearance. The aim of this review was to describe the physiological factors and intrinsic conditions that facilitate airway mucus transport. Method: A scoping review was performed. A systematic literature search of six databases was executed. Eligibility criteria were applied by two researchers to reach the aim of the review. Papers were identified independently by two reviewers on title, abstract and full-text level...
2018: Multidisciplinary Respiratory Medicine
Saori Nishizawa, Keisuke Anan, Kazunori Tobino, Masanobu Okahisa, Yuki Goto, Kojin Murakami, Takuto Sueyasu, Miyuki Munechika, Kohei Yoshimine, Mai Yoshino
Background: Recently, it is reported that Actinomyces meyeri is the most common species causing actinomycosis. However, to our knowledge, there was no report about pulmonary actinomycosis attributable to A. meyeri presenting as cardiac tamponade. Case presentation: Hereby we describe a case of pulmonary actinomycosis attributable to A. meyeri presenting as cardiac tamponade. At first, the patient was diagnosed with bacterial pericarditis with lung abscess in the left lower lung lobe and underwent pericardial drainage...
2018: Multidisciplinary Respiratory Medicine
Roberto W Dal Negro, Luca Bonadiman, Paola Turco
Background: Bronchial asthma is an inflammatory disease of the airways. Beclomethasone dipropionate/Formoterol (BDP/F) and Fluticasone furoate/Vilanterol (FF/V) are two of the most effective LABA/ICS combinations for managing persistent bronchial asthma. Aim of the study was to compare the outcomes achieved in mild-to-moderate asthma patients assuming BDP/F 100/6 μg b.i.d. (Group A) or FF/V 92/22 μg once-daily (Group B) for 12-months. No head-to-head long-term comparison is available at present...
2018: Multidisciplinary Respiratory Medicine
Amber Mortensen, Lauren Cherrier, Rajat Walia
Background: The drug pirfenidone has been shown to slow the progression and decrease mortality of idiopathic pulmonary fibrosis (IPF). Its exact mechanism is unknown, but it likely inhibits pro-fibrotic cytokine transforming growth factor beta, a known contributor to wound healing. We evaluated whether patients taking pirfenidone until lung transplantation had increased risk of impaired wound healing post-transplant. This information could determine whether pirfenidone should be discontinued prior to listing to allow for a wash-out period...
2018: Multidisciplinary Respiratory Medicine
Waleed M Sweileh, Samah W Al-Jabi, Sa'ed H Zyoud, Ansam F Sawalha
Background: Outdoor air pollution is a major threat to global public health that needs responsible participation of researchers at all levels. Assessing research output is an important step in highlighting national and international contribution and collaboration in a certain field. Therefore, the aim of this study was to analyze globally-published literature in outdoor air pollution - related respiratory health. Method: Outdoor air pollution documents related to respiratory health were retrieved from Scopus database...
2018: Multidisciplinary Respiratory Medicine
Ida Pesonen, Lisa Carlson, Nicola Murgia, Riitta Kaarteenaho, Carl Magnus Sköld, Marjukka Myllärniemi, Giovanni Ferrara
Background: Idiopathic pulmonary fibrosis (IPF) is characterized by progressive loss of lung function with high mortality within the first 5 years from diagnosis. In 2011-2014, two drugs, pirfenidone and nintedanib, have been approved worldwide for prevention of IPF progression. National IPF-registries have been established in both Finland and Sweden. Our study explored potential differences in the care of IPF in these two countries. Methods: Patients included consecutively in the Finnish and Swedish IPF-registries from January 1, 2014 through December 31, 2016 were included in the study...
2018: Multidisciplinary Respiratory Medicine
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