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Pulmonary medicine

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https://www.readbyqxmd.com/read/28731387/a-comparative-analysis-of-pulmonary-and-critical-care-medicine-guideline-development-methodologies
#1
Noah C Schoenberg, Alan F Barker, John Bernardo, Robin R Deterding, Jerrold J Ellner, Dean R Hess, Neil R MacIntyre, Fernando J Martinez, Kevin C Wilson
BACKGROUND: The Institute of Medicine (IOM) standards for guideline development have had unintended negative consequences. A more efficient approach is desirable. OBJECTIVE: To determine whether a modified Delphi process early during guideline development discriminates recommendations that should be informed by a systematic review from those that can be based upon expert consensus. METHODS: The same questions addressed by IOM-compliant pulmonary or critical care guidelines were addressed by expert panels using a modified Delphi process, the Convergence of Opinion on Recommendations and Evidence (CORE) process...
July 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28722289/concise-review-a-safety-assessment-of-adipose-derived-cell-therapy-in-clinical-trials-a-systematic-review-of-reported-adverse-events
#2
REVIEW
Navid Mohamadpour Toyserkani, Mads Gustaf Jørgensen, Siavosh Tabatabaeifar, Charlotte Harken Jensen, Søren Paludan Sheikh, Jens Ahm Sørensen
The popularity of adipose-derived cell therapy has increased over the last decade, and the number of studies published annually is growing. However, concerns regarding safety in the setting of previous malignancy or the use of allogeneic cells have been raised. We therefore aimed to systematically review all clinical studies using adipose-derived cell therapy to identify reported adverse events with a special focus on risk of thromboembolic, immunological and oncological safety concerns. Our systematic search resulted in 70 included studies involving more than 1,400 patients that were treated with adipose-derived cell therapy...
July 19, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28722078/true-prevalence-of-copd-and-its-association-with-peripheral-arterial-disease-in-the-internal-medicine-ward-of-a-tertiary-care-hospital
#3
Jonathan Tschopp, Philippe Dumont, Daniel Hayoz
OBJECTIVES: The primary objective was to determine the prevalence of confirmed chronic obstructive pulmonary disease (COPD) in patients aged 45 years or more who were admitted to the internal medicine ward of our tertiary care hospital (HFR Fribourg, Switzerland), and were either "tagged" as having COPD or at risk for COPD. The secondary objective was to determine the prevalence of the association of COPD with peripheral artery disease (PAD) in this population. METHODOLOGY: We evaluated all consecutive patients aged 45 years, admitted to our internal medicine ward between November 2013 and March 2014...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28702957/non-invasive-ventilation-for-the-management-of-acute-hypercapnic-respiratory-failure-due-to-exacerbation-of-chronic-obstructive-pulmonary-disease
#4
REVIEW
Christian R Osadnik, Vanessa S Tee, Kristin V Carson-Chahhoud, Joanna Picot, Jadwiga A Wedzicha, Brian J Smith
BACKGROUND: Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: To compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28702316/sporotrichosis-in-a-liver-transplant-patient-a-case-report-and-literature-review
#5
Renato Ferreira da Silva, Miguel Bonfitto, Francisco Inaldo Mendes da Silva Junior, Margarete Teresa Gottardo de Ameida, Rita de Cma da Silva
The liver transplant patient was admitted to the hospital with hyperemic, granulomatous, ulcerated lesion in the anterior compartment of the right lower limb with report of local trauma. The agent Sporothrix schenckii was isolated from biopsy of the lesion and lymph nodes of the right lower limb. In this case, the treatment was difficult because the patient has severe pulmonary hypertension and took the following drugs: warfarin, sildenafil, and tacrolimus. These medicines interact with the antifungal, which made it difficult...
September 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28700167/-relevance-of-contrast-ultrasound-with-microbubbles-in-vascular-medecine
#6
Andreas Erdmann, Barbara Ney, Adriano Alatri, Luca Calanca, Lucia Mazzolai
Application of ultrasound contrast media has become a standard in diagnostic imaging in cardiology and in the characterization of focal lesions in multiple organs, especially of the liver. In the past years there was a growing body of evidence for their usefulness in vascular medicine. The development of contrast media, microbubbles with a stabilizing envelope and filled with gaz, small enough to pass through pulmonary capillaries made real-time imaging of organ perfusion possible. Ultrasound contrast media are rapidly eliminated by exhalation and can safely be administered to patients with renal failure...
December 7, 2016: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28688027/pharmacokinetics-of-fentanyl-and-its-derivatives-in-children-a-comprehensive-review
#7
REVIEW
Victoria C Ziesenitz, Janelle D Vaughns, Gilbert Koch, Gerd Mikus, Johannes N van den Anker
Fentanyl and its derivatives sufentanil, alfentanil, and remifentanil are potent opioids. A comprehensive review of the use of fentanyl and its derivatives in the pediatric population was performed using the National Library of Medicine PubMed. Studies were included if they contained original pharmacokinetic parameters or models using established routes of administration in patients younger than 18 years of age. Of 372 retrieved articles, 44 eligible pharmacokinetic studies contained data of 821 patients younger than 18 years of age, including more than 46 preterm infants, 64 full-term neonates, 115 infants/toddlers, 188 children, and 28 adolescents...
July 7, 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/28686445/discovery-and-optimization-of-chromeno-2-3-c-pyrrol-9-2h-ones-as-novel-selective-and-orally-bioavailable-phosphodiesterase-5-inhibitors-for-the-treatment-of-pulmonary-arterial-hypertension
#8
Deyan Wu, Tianhua Zhang, Yiping Chen, Yadan Huang, Haiju Geng, Yanfa Yu, Chen Zhang, Zengwei Lai, Yinuo Wu, Xiaolei Guo, Jianwen Chen, Hai-Bin Luo
Phosphodiesterase 5 (PDE5) inhibitors have been used as clinical agents to treat erectile dysfunction and pulmonary arterial hypertension (PAH). Herein, we detail the discovery of a novel series of chromeno[2,3-c]pyrrol-9(2H)-one derivatives as selective and orally bioavailable inhibitors against phosphodiesterase 5. Medicinal chemistry optimization resulted in 2, which exhibits a desirable inhibitory potency of 5.6 nM with remarkable selectivity as well as excellent pharmacokinetic properties and an oral bioavailability of 63...
July 7, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28685643/clinical-effect-of-cyp2c9-5-6-genotype-on-a-patient-s-warfarin-dose-requirement
#9
Alison L H Quinn, Ina Liko, James C Lee
We describe a 38-year-old African-American female treated with warfarin for acute bilateral pulmonary emboli who is a carrier of two rare CYP2C9 variant alleles, *5 and *6, along with VKORC1 -1639GG and CYP4F2 433Val/Val genotypes. Warfarin was dosed according to the hospital's Personalized Medicine Program recommendations of 5-6 mg/day for the first 6 days, and reduced to 2.5 mg/day starting on day 8 and continued for the following 3 weeks. This case sheds further light on the cumulative clinical impact of the CYP2C9 variant alleles, *5 and *6, on warfarin dose requirements and practical considerations for warfarin genotyping in a racially and ethnically diverse population...
July 7, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28682308/survival-trends-from-the-prader-willi-syndrome-association-usa-40-year-mortality-survey
#10
Ann M Manzardo, James Loker, Janalee Heinemann, Carolyn Loker, Merlin G Butler
PurposePrader-Willi syndrome (PWS) is a complex genetic disorder characterized by hyperphagia and morbid obesity with increased cardiopulmonary and hyperphagia-related mortality. Survival trends in PWS were evaluated to assess the impact of modern interventions on mortality risk.MethodsThe Prader-Willi Syndrome Association (USA) 40-year mortality syndrome-specific database of 486 death reports was utilized to examine survival trends in PWS and cohort effects for recent deaths (years 2000-2015, N=331) relative to deaths prior to 2000 (N=94)...
July 6, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28677827/the-overlaps-of-asthma-or-copd-with-osa-a-focused-review
#11
REVIEW
Robert L Owens, Madalina M Macrea, Mihaela Teodorescu
Asthma, chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea (OSA) are the most common respiratory disorders worldwide. Given demographic and environmental changes, prevalence for each is likely to increase. Although exact numbers are not known, based on chance alone, many people will be affected by both lower airways obstruction and concomitant upper airway obstruction during sleep. Some recent studies suggest that there is a reciprocal interaction, with chronic lung disease predisposing to OSA, and OSA worsening control and outcomes from chronic lung disease...
July 5, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28676861/natural-scaffolds-for-regenerative-medicine-direct-determination-of-detergents-entrapped-in-decellularized-heart-valves
#12
Monica Dettin, Annj Zamuner, Filippo Naso, Antonella Monteleone, Michele Spina, Gino Gerosa
The increasing urgency for replacement of pathological heart valves is a major stimulus for research on alternatives to glutaraldehyde-treated grafts. New xenogeneic acellular heart valve substitutes that can be repopulated by host cells are currently under investigation. Anionic surfactants, including bile acids, have been widely used to eliminate the resident cell components chiefly responsible for the immunogenicity of the tissue, even if detergent toxicity might present limitations to the survival and/or functional expression of the repopulating cells...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28675413/nano-p%C3%A3-gott-och-ont-m%C3%A3-jligheter-och-risker-med-nanoteknologi
#13
Bengt Fadeel
Engineered nanomaterials are produced for a wide range of applications, not least in medicine. Indeed, the field of nanomedicine is rapidly attaining maturity, with novel nanoscale constructs for diagnosis or therapy, or both (so-called theranostics). However, close attention should be paid to the potential environmental and human health impact of the emerging nanotechnologies. More information on human and environmental exposure is needed, along with a more detailed understanding of the hazard potential of different classes of nanomaterials...
July 4, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28675062/lung-regeneration-using-amniotic-fluid-mesenchymal-stem-cells
#14
Alireza Azargoon, Babak Negahdari
Respiratory diseases, such as chronic obstructive pulmonary disease (COPD), pulmonary hypertension and lung fibrosis, are yet a major challenge in the world and they result in irreversible structural lung damage. Lung transplantation as the only therapeutic option face some major challenges like graft rejection and cancer, arising as a result of immunosuppression. A low survival rate faced by lung transplantation patients is presently limited to approximately 5 years. Lungs shortage therefore calls for a mechanism that would increase the availability of suitable organs for transplantation...
July 4, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28674777/osa-and-prolonged-oxygen-desaturation-during-sleep-are-strong-predictors-of-poor-outcome-in-ipf
#15
Marcello Bosi, Giulia Milioli, Francesco Fanfulla, Sara Tomassetti, Jay H Ryu, Liborio Parrino, Silvia Riccardi, Andrea Melpignano, Anna Elisabetta Vaudano, Claudia Ravaglia, Paola Tantalocco, Andrea Rossi, Venerino Poletti
PURPOSE: Sleep Breathing Disorders (SBD) are frequently found in idiopathic pulmonary fibrosis (IPF) and they are associated with worse quality of sleep and life and with higher mortality. The study aimed at evaluating the impact of SBD on prognosis (mortality or disease progression) in 35 patients with mild to moderate IPF. METHODS AND RESULTS: Obstructive sleep apnea (OSA) was diagnosed in 25/35 patients with IPF: 14/35 mild, 7/35 moderate, and 4/35 severe. According to the American Academy of Sleep Medicine (AASM) definition, sleep-related hypoxemia was found in 9/35 patients with IPF...
July 3, 2017: Lung
https://www.readbyqxmd.com/read/28673474/new-developments-and-future-challenges-of-nuclear-medicine-and-molecular-imaging-for-pulmonary-embolism
#16
Pierre-Yves Le Roux, Philippe Robin, Pierre-Yves Salaun
Although widely validated, current tests for pulmonary embolism (PE) diagnosis, i.e. computed tomography pulmonary angiography (CTPA) and V/Q planar scintigraphy, have some limitations. Drawbacks of CTPA include the radiation dose, some contra indications and a rising concern about a possible overdiagnosis/overtreatment of PE. On the other hand, V/Q planar scintigraphy has a high rate of non-diagnostic tests responsible for complex diagnostic algorithms. Since the PIOPED study, imaging equipment and radiopharmaceuticals have greatly evolved allowing the introduction of techniques that improve imaging of lung ventilation and perfusion...
June 27, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28672914/the-levels-of-serum-pro-calcitonin-and-high-sensitivity-c-reactive-protein-in-the-early-diagnosis-of-chronic-obstructive-pulmonary-disease-during-acute-exacerbation
#17
Dejie Gao, Xincan Chen, He Wu, Haidong Wei, Jinling Wu
The level of of procalcitonin (PCT) and high-sensitivity C-reactive protein (hs-CRP) in the acute exacerbation of COPD (AECOPD) was investigated. Total of 20 patients with acute exacerbation of COPD who were admitted to the Department of Respiratory Medicine, Binzhou Center Hospital in the period of October 2012 to April 2015 were enrolled in the AECOPD group. According to the color of the sputum, the patients with AECOPD were divided into purulent sputum group (n=8) and non-purulent sputum group (n=12). In addition, 15 healthy people from the outpatient medical center were also selected as healthy control group...
July 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28669771/antidiabetic-antioxidant-and-anti-inflammatory-properties-of-water-and-n-butanol-soluble-extracts-from-saharian-anvillea-radiata-in-high-fat-diet-fed-mice
#18
Chouaib Kandouli, Mathieu Cassien, Anne Mercier, Caroline Delehedde, Emilie Ricquebourg, Pierre Stocker, Mourad Mekaouche, Zineb Leulmi, Aicha Mechakra, Sophie Thétiot-Laurent, Marcel Culcasi, Sylvia Pietri
ETHNOPHARMACOLOGICAL RELEVANCE: According to Saharian traditional medicine, Anvillea radiata Coss. & Dur. (Asteraceae) has been valued for treating a variety of ailments such as gastro-intestinal, liver and pulmonary diseases, and has gained awareness for its beneficial effect on postprandial hyperglycemia. However, to best of our knowledge, no detailed study of the antidiabetic curative effects of this plant has been conducted yet. AIM OF THE STUDY: To determine the hypoglycemic and antidiabetic effect of dietary supplementation with Anvillea radiata extracts on high-fat-diet (HFD)-induced obesity and insulin resistance in C57BL/6J mice in relation with antioxidant, anti-inflammatory, pancreatic beta-cells and skeletal muscle protection, and digestive enzyme inhibiting properties...
July 31, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28664473/comparison-of-the-ameliorative-effects-of-qingfei-tongluo-formula-and-azithromycin-on-mycoplasma-pneumoniae-pneumonia
#19
Zhen Xiao, Yonghong Jiang, Xuan Gao, Shuzhu Lin, Yan Lin, Xiuxiu Liu, Dan Tan, Zhiyan Jiang
Mycoplasma pneumoniae pneumonia (MPP) is a common disease in children. Qingfei Tongluo formula (QTF) has been used for the treatment of MPP clinically, but the therapeutic effect remains unclear compared to conventional treatments with Western medicines. Therefore, the aim of this study was to assess changes in the expression levels of relevant factors associated with microcirculation after MPP and to compare the therapeutic effect of QTF with that of azithromycin (AZM) on experimental mice with MPP. A total of 174 children admitted with clinical diagnoses of pneumonia (80 MPP and 94 non-MPP) were used to identify differences in the expression patterns of factors in the microcirculation using an enzyme-linked immunosorbent assay...
June 29, 2017: Journal of Natural Medicines
https://www.readbyqxmd.com/read/28662832/vascular-causes-of-syncope-an-emergency-medicine-review
#20
Brit Long, Alex Koyfman
BACKGROUND: Syncope is a common emergency department (ED) complaint, accounting for 2% of visits annually. A wide variety of etiologies can result in syncope, and vascular causes may be deadly. OBJECTIVE: This review evaluates vascular causes of syncope and their evaluation and management in the ED. DISCUSSION: Syncope is defined by a brief loss of consciousness with loss of postural tone and complete, spontaneous recovery without medical intervention...
June 26, 2017: Journal of Emergency Medicine
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