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Steffen T Simon, Irene J Higginson, Sara Booth, Richard Harding, Vera Weingärtner, Claudia Bausewein
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD)...
October 20, 2016: Cochrane Database of Systematic Reviews
Josefin Sundh, Scott Montgomery, Mikael Hasselgren, Mary Kämpe, Christer Janson, Björn Ställberg, Karin Lisspers
Health status is a prognostic factor included in the assessment of chronic obstructive pulmonary disease (COPD). The aim of our study was to examine the associations of clinical factors with change in health status over a 7-year follow-up period. In 2005, 970 randomly selected primary and secondary care patients with a COPD diagnosis completed questionnaires including the Clinical COPD Questionnaire (CCQ); and in 2012, 413 completed the CCQ questionnaire again. Linear regression used difference in mean total CCQ score between 2005 and 2012 as the dependent variable...
October 20, 2016: NPJ Primary Care Respiratory Medicine
Savino Spadaro, Maurizia Capuzzo, Giorgia Valpiani, Sara Bertacchini, Riccardo Ragazzi, Francesca Dalla Corte, Simona Terranova, Elisabetta Marangoni, Carlo Alberto Volta
BACKGROUND: Fatigue has not been investigated in long-term Intensive Care Unit (ICU) survivors. This study aimed to assess fatigue through a specific instrument, namely the Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scale, in ICU survivors one year after hospital discharge. A secondary aim was to compare the findings of FACIT-F with those of the Vitality domain (VT) of the 36-item Short-Form Health Survey (SF-36). METHODS: This prospective cohort study was performed on 56 adult patients with a Length Of Stay (LOS) in ICU longer than 72 h...
October 18, 2016: Health and Quality of Life Outcomes
Glenwood Goss, Chun-Ming Tsai, Frances A Shepherd, Lyudmila Bazhenova, Jong Seok Lee, Gee-Chen Chang, Lucio Crino, Miyako Satouchi, Quincy Chu, Toyoaki Hida, Ji-Youn Han, Oscar Juan, Frank Dunphy, Makoto Nishio, Jin-Hyoung Kang, Margarita Majem, Helen Mann, Mireille Cantarini, Serban Ghiorghiu, Tetsuya Mitsudomi
BACKGROUND: Osimertinib (AZD9291) is an oral, potent, irreversible EGFR tyrosine-kinase inhibitor selective for EGFR tyrosine-kinase inhibitor sensitising mutations, and the EGFR Thr790Met resistance mutation. We assessed the efficacy and safety of osimertinib in patients with EGFR Thr790Met-positive non-small-cell lung cancer (NSCLC), who had progressed after previous therapy with an approved EGFR tyrosine-kinase inhibitor. METHODS: In this phase 2, open-label, single-arm study (AURA2), patients aged at least 18 years with centrally confirmed EGFR Thr790Met-positive mutations, locally advanced or metastatic (stage IIIB/IV) NSCLC who progressed on previous EGFR tyrosine-kinase inhibitor therapy received osimertinib 80 mg orally once daily; treatment could continue beyond progression if the investigator observed a clinical benefit...
October 14, 2016: Lancet Oncology
Anne Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
OBJECTIVES: To describe the epidemiology of dyspnoea presenting to emergency departments (EDs) in the Asia-Pacific region, to understand how it is investigated and treated and its outcome. METHODS: Prospectiveinterrupted time series cohort study conducted at three time points in EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia of adult patients presenting to the ED with dyspnoea as a main symptom. Data were collected over three 72-hour periods and included demographics, co-morbidities, mode of arrival, usual medications, pre-hospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome and final hospital diagnosis...
October 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Deepak Kumar Mishra, Shalima Gautam, B K Goyal, Ramesh Kawar
Coronary cameral fistulae are rare and bicoronary pulmonary artery fistulae is even rarer. This is a case of a 70 year old male who presented to us with complaints of chest pain and dyspnoea. His ECG showed ST-T changes in inferior and anterior precordial leads suggestive of ischaemia in those territories. His coronary angiogram revealed bilateral coronary pulmonary arterial fistulae arising from left circumflex and right coronary artery and draining into pulmonary artery without any atherosclerotic narrowing of coronaries...
May 2016: Journal of the Association of Physicians of India
K P Suraj, Neethu K Kumar, E Jyothi, Kiran Vishnu Narayan, G Biju
BACKGROUND: But so far there is no proven pharmacological treatment for Idiopathic pulmonary fibrosis (IPF). As trials investigating different agents with different mechanisms of actions are going on, encouraging results have led to the licensing of the first IPF-specific drug, Pirfenidone. OBJECTIVE: To assess the proportion of IPF among interstitial lung disease patients and to assess their treatment response to Pirfenidone. MATERIAL AND METHODS: All consecutive patients attending the outpatient department from 1st January 2012 to 30th June 2012 with a proven diagnosis of Interstitial lung Disease (ILD) were included in this longitudinal cohort study...
May 2016: Journal of the Association of Physicians of India
Hanneke Ac van Helvoort, Laura M Willems, Pn Richard Dekhuijzen, Hieronymus Wh van Hees, Yvonne F Heijdra
In patients with chronic obstructive pulmonary disease (COPD), exercise capacity is reduced, resulting over time in physical inactivity and worsened health status. It is unknown whether ventilatory constraints occur during activities of daily life (ADL) in early stages of COPD. The aim of this study was to assess respiratory mechanics during ADL and to study its consequences on dyspnoea, physical activity and health status in early-stage COPD compared with healthy controls. In this cross-sectional study, 39 early-stage COPD patients (mean FEV1 88±s...
October 13, 2016: NPJ Primary Care Respiratory Medicine
Padmanee Sharma, Margaret K Callahan, Petri Bono, Joseph Kim, Pavlina Spiliopoulou, Emiliano Calvo, Rathi N Pillai, Patrick A Ott, Filippo de Braud, Michael Morse, Dung T Le, Dirk Jaeger, Emily Chan, Chris Harbison, Chen-Sheng Lin, Marina Tschaika, Alex Azrilevich, Jonathan E Rosenberg
BACKGROUND: Few effective treatments exist for patients with advanced urothelial carcinoma that has progressed after platinum-based chemotherapy. We assessed the activity and safety of nivolumab in patients with locally advanced or metastatic urothelial carcinoma whose disease progressed after previous platinum-based chemotherapy. METHODS: In this phase 1/2, multicentre, open-label study, we enrolled patients (age ≥18 years) with urothelial carcinoma of the renal pelvis, ureter, bladder, or urethra at 16 sites in Finland, Germany, Spain, the UK, and the USA...
October 7, 2016: Lancet Oncology
Sushil Kumar Mishra, Pawan Kumar Jain, Sukhdev Gupta
Pseudocyst is a common complication of Acute and chronic pancreatitis. However, its extension into the mediastinum is a rare entity. We present a case of 52 years male with acute on chronic pancreatitis (alcohol related) who presented with dysphagia and dyspnoea and was found to have a pancreatic pseudocyst extending upto the neck. Ultrasound fails to pick up mediastinal pseudocysts and requires additional imaging modalities - CT and MRI. Management of Mediastinal pseudocyst depends upon underlying etiology, ductal anatomy, size of the pseudocyst, and availability of expertise...
March 2016: Journal of the Association of Physicians of India
Savinda Liyanagedara, Robert McLeod, Hassan A Elhassan
Exercise induced laryngeal obstruction (EILO) is a condition where inappropriate vocal cord or glottic closure occurs during exercise. This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines the Cochrane, Embase, Ovid MEDLINE and PubMed databases were searched. Four search domains "exercise", "induced", "laryngeal" and "obstruction" were used...
October 11, 2016: European Archives of Oto-rhino-laryngology
Tara Rheault, Sanjeev Khindri, Mitra Vahdati-Bolouri, Alison Church, William A Fahy
This study compared the efficacy and safety of once-daily umeclidinium 62.5 µg with once-daily glycopyrronium 50 µg in patients with moderate-to-severe chronic obstructive pulmonary disease. This was a 12-week, multicentre, randomised, open-label, parallel-group study ( NCT02236611). Patients were randomised 1:1 to umeclidinium 62.5 µg or glycopyrronium 50 µg administered via Ellipta or Breezhaler dry powder inhaler, respectively. The primary endpoint was trough forced expiratory volume in 1 s (FEV1) at day 85 in the per-protocol population...
April 2016: ERJ Open Research
Andrew Martin, Graeme van der Meer, Dora Blair, Murali Mahadevan, Michel Neeff, Colin Barber, Nicola Mills, Lesley Salkeld, Maayan Gruber
OBJECTIVE: Aspirated foreign bodies in children present a potentially life-threatening condition and can be challenging to diagnose. This study aims to elucidate the characteristics and outcome of children with long-standing aspirated foreign bodies. METHODS: Retrospective case series of all cases of confirmed long-standing aspirated foreign bodies (LSAFB) between January 2003 to December 2015 in a single paediatric tertiary-level institution, defined as more than two weeks from choking episode or beginning of symptoms...
November 2016: International Journal of Pediatric Otorhinolaryngology
Vibe Maria Laden Nielsen, Jacob Madsen, Anette Aasen, Anne Pernille Toft-Petersen, Kenneth Lübcke, Bodil Steen Rasmussen, Erika Frischknecht Christensen
BACKGROUND: Patients with acute respiratory failure are at risk of deterioration during prehospital transport. Ventilatory support with continuous positive airway pressure (CPAP) can be initiated in the prehospital setting. The objective of the study is to evaluate adherence to treatment and effectiveness of CPAP as an addition to standard care. METHODS: In North Denmark Region, patients with acute respiratory failure, whom paramedics assessed as suffering from acute cardiopulmonary oedema, acute exacerbation of chronic obstructive pulmonary disease or asthma were treated with CPAP using 100 % O2 from 1 March 2014 to 3 May 2015...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Richa Mittal, Sunil K Chhabra
The new A-B-C-D Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification of severity of chronic obstructive pulmonary disease (COPD) is based on combined symptoms and exacerbation risk assessment. The assumed equivalence between dyspnoea modified Medical Research Council (mMRC) grade ≥2 and COPD Assessment Test (CAT) score ≥ 10 to identify more symptoms has been questioned. Whether the exacerbation risk assessment criteria, old GOLD spirometry staging and frequency of exacerbations, are equivalent has not been examined...
October 10, 2016: COPD
Sophette Gers, Christiaan Potgieter, Isabella Wright, Belinda Peyrot
Bluetongue virus (BTV) was sporadically isolated over a four year period (2010-2014) from several alpaca carcasses that were presented for necropsy at the Western Cape Provincial Veterinary Laboratory, South Africa. Typically, the a ected animals had a history of acute dyspnoea and progressive weakness before death. Consistent hydrothorax and severe lung oedema in all lead to a preliminary diagnosis of Bluetongue, despite the absence of ulceration and hyperaemia of the oral mucosa which is characteristic of this viral infection in sheep...
September 30, 2016: Veterinaria Italiana
Christian Michael Horvath, Martin Horvath Brutsche, Otto Dagobert Schoch, Bernarde Schillig, Florent Baty, Dieter vonOw, Jochen Julius Rüdiger
Non-invasive ventilatory support is frequently used in patients with severe respiratory failure (SRF), but is often limited to intensive care units (ICU). We hypothesized that an instantaneous short course of NIV (up to 2 h), limited to regular working hours as an additional therapy on the emergency department (ED) would be feasible and could improve patient´s dyspnoea measured by respiratory rate and Borg visual dyspnea scale. NIV was set up by an interdisciplinary respiratory care team. Outside these predefined hours NIV was performed in the ICU...
October 8, 2016: Internal and Emergency Medicine
Jing-Yu Tan, Janelle Yorke, Amelie Harle, Jacky Smith, Fiona Blackhall, Mark Pilling, Alex Molassiotis
CONTENT: The Dyspnoea-12 (D-12) is a well validated instrument in respiratory illnesses for breathlessness assessment, but its psychometric properties have not been tested in lung cancer. OBJECTIVES: To demonstrate the psychometric properties of the D-12 in lung cancer patients. METHODS: Baseline data from a lung cancer feasibility trial were adopted for this analysis. D-12 and a series of patient-reported tools including five Numeric Rating Scales (NRS), the Hospital Anxiety and Depression Scale (HADS) and the Lung Cancer Symptom Scale (LCSS) were employed for the psychometric assessment...
October 5, 2016: Journal of Pain and Symptom Management
Moisés A Calderón, Carmen Vidal, Pablo Rodríguez Del Río, Jocelyne Just, Oliver Pfaar, Ana I Tabar, Inmaculada Sánchez-Machín, Petra Bubel, Jesus Borja, Peter Eberle, Rainer Reiber, Michel Bouvier, Alain Lepelliez, Ludger Klimek, Pascal Demoly
BACKGROUND: Outside clinical trials, data on systemic reactions (SRs) due to allergen immunotherapy (AIT) are scarce. METHODS: A prospective, longitudinal, web-based survey of "real-life" respiratory allergen immunotherapy (AIT) clinical practice was conducted in France, Germany and Spain. SRs were recorded and coded according to the Medical Dictionary for Regulatory Activities (MedDRA) and risk factors associated with SRs were identified. RESULTS: A total of 4,316 patients (corresponding to 4,363 ongoing courses of AIT) were included...
October 8, 2016: Allergy
Laetitia Lempereur, Ludovic Martinelle, Françoise Marechal, Calixte Bayrou, Anne Catherine Dalemans, Manuela Schnyder, Bertrand Losson
BACKGROUND: Canine angiostrongylosis, a gastropod-borne helminthic infection, is increasingly being described in North America and is now reported in many European countries. In dogs, Angiostrongylus vasorum may cause a wide spectrum of clinical signs. Respiratory distress such as coughing and dyspnoea are the most frequently described manifestations. The aim of the present study was to gain additional information on the distribution, prevalence and risk factors associated with A. vasorum infection in dog from southern Belgium through the combined used of a commercially available in-clinic assay for detection of circulating antigen (Angio Detect™, IDEXX, Westbrook, USA) and coprology in two different canine populations: dogs with clinical signs compatible with angiostrongylosis and asymptomatic dogs or dogs presented for unrelated conditions (control)...
October 6, 2016: Parasites & Vectors
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