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https://www.readbyqxmd.com/read/29138547/efficacy-of-tiotropium-and-indacaterol-monotherapy-and-their-combination-on-dynamic-lung-hyperinflation-in-copd-a-random-open-label-crossover-study
#1
Keisaku Fujimoto, Haruna Yamazaki, Midori Ura, Yoshiaki Kitaguchi
Background and objective: The difference in efficacy of long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs) for dynamic lung hyperinflation (DLH) in COPD is unclear. The purpose of this study was to elucidate the difference in efficacy of LAMA and LABA alone and the combination thereof for DLH. Subjects and methods: Thirty stable patients were enrolled and randomly divided into two groups following baseline measurements. One group was treated with 5 μg tiotropium (Respimat inhaler) for 4 weeks following a 4-week treatment with 150 μg indacaterol, while the other group was treated with indacaterol for 4 weeks following a 4-week treatment with tiotropium...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29123390/hyperinflated-lungs-compress-the-heart-during-expiration-in-copd-patients-a-new-finding-on-dynamic-ventilation-computed-tomography
#2
Yanyan Xu, Tsuneo Yamashiro, Hiroshi Moriya, Maho Tsubakimoto, Nanae Tsuchiya, Yukihiro Nagatani, Shin Matsuoka, Sadayuki Murayama
Purpose: The aims of this study were to evaluate dynamic changes in heart size during the respiratory cycle using four-dimensional computed tomography (CT) and to understand the relationship of these changes to airflow limitation in smokers. Materials and methods: A total of 31 smokers, including 13 with COPD, underwent four-dimensional dynamic-ventilation CT during regular breathing. CT data were continuously reconstructed every 0.5 s, including maximum cross-sectional area (CSA) of the heart and mean lung density (MLD)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29122915/elevated-lung-clearance-index-in-infants-with-cystic-fibrosis-shortly-after-birth
#3
Elisabeth Kieninger, Sophie Yammine, Insa Korten, Pinelopi Anagnostopoulou, Florian Singer, Urs Frey, Anne Mornand, Maura Zanolari, Isabelle Rochat, Daniel Trachsel, Dominik Mueller-Suter, Alexander Moeller, Carmen Casaulta, Philipp Latzin
It is not known at what age lung function impairment may arise in children with cystic fibrosis (CF). We assessed lung function shortly after birth in infants with CF diagnosed by newborn screening.We performed infant lung function measurements in a prospective cohort of infants with CF and healthy controls. We assessed lung clearance index (LCI), functional residual capacity (FRC) and tidal breathing parameters. The primary outcome was prevalence and severity of abnormal lung function (±1.64 z-scores) in CF...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29110280/body-weight-and-mortality-in-copd-focus-on-the-obesity-paradox
#4
REVIEW
Francesco Spelta, A M Fratta Pasini, L Cazzoletti, M Ferrari
The positive association between overweight, obesity, and cardiovascular and all-cause mortality is well established, even though this relation is typically U shaped with an increased risk also in low-weight subjects. However, being overweight or obese has been associated with a better prognosis in subjects suffering from chronic diseases, id est the "obesity paradox". In both community-dwelling and hospitalized patients with COPD, several studies have reported a significant protective effect of obesity on all-cause mortality, indicating that also in obstructive pulmonary diseases, an obesity paradox may be present...
November 6, 2017: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/29108896/brazilian-intragastric-balloon-consensus-statement-bibc-practical-guidelines-based-on-experience-of-over-40-000-cases
#5
Manoel Galvao Neto, Lyz Bezerra Silva, Eduardo Grecco, Luiz Gustavo de Quadros, André Teixeira, Thiago Souza, Jimi Scarparo, Artur A Parada, Ricardo Dib, Rena Moon, Josemberg Campos
BACKGROUND: Intragastric balloons (IGBs) are a minimally invasive option for obesity treatment, acting as a space-occupying device and leading to weight loss through increased satiety. This device has been growing in popularity owing to its safety profile and good weight loss results. However, there are no published guidelines that standardize the technical aspects of the procedure. OBJECTIVES: To create a practical guideline for intragastric balloon usage. SETTING: Private and Academic Settings, Brazil...
September 28, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29106562/incomplete-fissures-are-associated-with-increased-alveolar-ventilation-via-spiracles-in-severe-emphysema
#6
Samih Khauli, Eric Abston, Hassan Sajjad, Servet Bolukbas, Julio Mott Ancona Lopez, Roberto Saad, Surya P Bhatt, Michael Eberlein
OBJECTIVES: In emphysema, air can flow preferentially via collateral pathways, which can connect an entire lung when incomplete fissures are present. Spiracles are openings through the chest wall into the lung parenchyma. We previously observed increased alveolar ventilation (VA) in subjects with severe emphysema, when spiracles occurred during lung transplant operations. In this study, we set out to identify a computed tomography (CT) imaging phenotype associated with improved VA via spiracles in severe emphysema...
July 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29105540/mechanically-ventilating-the-severe-asthmatic
#7
Abdullah E Laher, Sean K Buchanan
The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to various other pathologies requiring mechanical ventilation, acute asthma is generally associated with better outcomes. This review serves as a practical guide to the physician managing patients with severe acute asthma requiring mechanical ventilation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29100513/ghrelin-therapy-improves-lung-and-cardiovascular-function-in-experimental-emphysema
#8
Nazareth de Novaes Rocha, Milena Vasconcellos de Oliveira, Cássia Lisboa Braga, Gabriela Guimarães, Lígia de Albuquerque Maia, Gisele de Araújo Padilha, Johnatas Dutra Silva, Christina Maeda Takiya, Vera Luiza Capelozzi, Pedro Leme Silva, Patricia Rieken Macedo Rocco
BACKGROUND: Emphysema is a progressive disease characterized by irreversible airspace enlargement followed by a decline in lung function. It also causes extrapulmonary effects, such as loss of body mass and cor pulmonale, which are associated with shorter survival and worse clinical outcomes. Ghrelin, a growth-hormone secretagogue, stimulates muscle anabolism, has anti-inflammatory effects, promotes vasodilation, and improves cardiac performance. Therefore, we hypothesized that ghrelin might reduce lung inflammation and remodelling as well as improve lung mechanics and cardiac function in experimental emphysema...
November 3, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29090035/congenital-lobar-emphysema-in-infants
#9
Ioana Badiu, Anca Hiriscau, Iulia Lupan, Gabriel Samasca
Congenital lobar emphysema in infants is a disorder that is detected most often in newborns or young infants. We report here the case of a 4-month-old infant who at two months suddenly presented upper respiratory infections, treated symptomatically, but evolution showed shortness of breath, wheezing, weight deficit. Thoracic ultrasound revealed left upper lobe hyperinflation causing mediastinal displacement to the right, a slightly reduced blood supply at this level, and a lobar emphysema appearance. Bronchoscopy evidenced a thickening in the left bronchial tree, due to left upper lobe emphysema...
June 2017: Mædica
https://www.readbyqxmd.com/read/29084022/glittre-adl-multiple-tasks-induce-similar-dynamic-hyperinflation-with-different-metabolic-and-ventilatory-demands-in-patients-with-copd
#10
Aline Almeida Gulart, Anelise Bauer Munari, Caroline Tressoldi, Karoliny Dos Santos, Manuela Karloh, Anamaria Fleig Mayer
PURPOSE: This cross-sectional study compared the physiological responses and dynamic hyperinflation (DH) of the Glittre-ADL test (TGlittre) and its specific tasks in patients with chronic obstructive pulmonary disease (COPD). METHODS: Thirty patients with COPD performed the TGlittre. The individual tasks included stand up and sit down (TSS); climb up and down stairs (TSTAIRS); walk on a flat surface (TWALK); and move objects onto and off a shelf (TSHELF). While performing these tasks, the physiological responses were evaluated and inspiratory capacity measured before and immediately after the tests...
November 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29063595/pulmonary-anatomy-and-a-case-of-unilateral-aplasia-in-a-common-snapping-turtle-chelydra-serpentina-developmental-perspectives-on-cryptodiran-lungs
#11
E R Schachner, J C Sedlmayr, R Schott, T R Lyson, R K Sanders, M Lambertz
The common snapping turtle (Chelydra serpentina) is a well studied and broadly distributed member of Testudines; however, very little is known concerning developmental anomalies and soft tissue pathologies of turtles and other reptiles. Here, we present an unusual case of unilateral pulmonary aplasia, asymmetrical carapacial kyphosis, and mild scoliosis in a live adult C. serpentina. The detailed three-dimensional (3D) anatomy of the respiratory system in both the pathological and normal adult C. serpentina, and a hatchling are visualized using computed tomography (CT), microCT, and 3D digital anatomical models...
October 24, 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/29054230/near-complete-obliteration-of-the-left-hemithorax-by-congenital-lobar-emphysema-in-an-adult
#12
Nakesha King, Shilpa S Ramesh, Michael Essandoh, Robert E Merritt
Congenital lobar emphysema is a rare pulmonary malformation typically diagnosed during infancy and is characterized by bullous disease. A 28-year-old woman, who presented with 1 week of progressive dyspnea and chest pain, was found to have left hemithoracic lung hyperinflation with perfusion deficit upon radiographic evaluation. Bullous disease was found intraoperatively to originate from 1 lower lobe segment. Normal parenchymal lung expansion occurred following resection of the affected segment. Therefore, we present a rare case of congenital lobar emphysema resulting in near-complete occupancy of the left hemithorax and diagnosed in a previously asymptomatic adult without history of predisposing factors...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29042764/the-association-between-objectively-measured-physical-activity-and-morning-symptoms-in-copd
#13
Amanda R van Buul, Marise J Kasteleyn, Niels H Chavannes, Christian Taube
PURPOSE: The morning is the most bothersome period for COPD patients. Morning symptom severities in different Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages are not well studied. Furthermore, factors that are associated with morning symptoms, especially the associations with objectively measured physical activity, are also not well described. MATERIALS AND METHODS: The aim of this cross-sectional observational study was to assess morning symptom severity in GOLD A, B, C and D patients, according to the definitions of the GOLD 2015 statement...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29033350/phenotypical-characterization-of-human-rhinovirus-infections-in-severely-premature-children
#14
Geovanny F Perez, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos E Rodriguez-Martinez, Dinesh Pillai, Gustavo Nino
BACKGROUND: Human Rhinovirus (HRV) has been identified as the most common cause of acute respiratory infections and hospitalizations in premature children. It is unclear if premature children are more susceptible to HRV due to their decreased pulmonary reserve or because they have enhanced lower airway reactivity to HRV. METHODS: We conducted a retrospective analysis of the clinical respiratory presentation of all PCR-confirmed HRV infections in full-term and premature children aged ≤3 years in our institution...
September 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28993264/sensory-mechanical-effects-of-a-dual-bronchodilator-and-its-anticholinergic-component-in-copd
#15
Denis E O'Donnell, Amany F Elbehairy, Azmy Faisal, J Alberto Neder, Katherine A Webb
This randomized, double-blind, crossover study examined the physiological rationale for using a dual long-acting bronchodilator (umeclidinium/vilanterol (UME/VIL)) versus its muscarinic-antagonist component (UME) as treatment for dyspnea and exercise intolerance in moderate COPD. After each 4-week treatment period, subjects performed pulmonary function and symptom-limited constant-work rate cycling tests with diaphragm electromyogram (EMGdi), esophageal (Pes), gastric (Pga) and transdiaphragmatic (Pdi) pressure measurements...
October 7, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28986203/inhaled-nebulised-unfractionated-heparin-improves-lung-function-in-moderate-to-very-severe-copd-a-pilot-study
#16
Janis K Shute, Luigino Calzetta, Vittorio Cardaci, Stefania di Toro, Clive P Page, Mario Cazzola
BACKGROUND: COPD is an inflammatory airway disease characterised by progressive airflow limitation and air trapping, leading to lung hyperinflation and exercise limitation. Acute worsening of symptoms, including dyspnea, cough and sputum production, occurs during exacerbations which are associated with significantly reduced health related quality of life, and increased morbidity and mortality. Chronic bronchial mucus production and productive cough are risk factors for exacerbations. Medicines targeting bronchoconstriction and airway inflammation are the current mainstays of COPD therapy...
October 3, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28960914/cpap-and-epap-elicit-similar-lung-deflation-in-a-non-equivalent-mode-in-gold-3-4-copd-patients
#17
Paulo de Tarso Müller, Gustavo Christofoletti, Rodrigo Koch, João Henrique Zardetti Nogueira, Luiz Armando Pereira Patusco, Gaspar Rogério Chiappa
INTRODUCTION: Lung hyperinflation is associated with inspiratory muscle strength reduction, nocturnal desaturation, dyspnea, altered cardiac function and poor exercise capacity in advanced COPD. OBJECTIVES: We investigated the responses of inspiratory capacity (IC) and inspiratory muscle strength (PImax), comparing continuous positive airway pressure (CPAP) and expiratory positive airway pressure (EPAP) with the main hypothesis that there would be similar effects on lung deflation...
September 28, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28947021/medical-lung-volume-reduction-for-severe-emphysema-a-review
#18
REVIEW
Kalliopi Aggelou, Nikolaos Siafakas
Lung hyperinflation is the main pathophysiological mechanism significantly reducing the Quality of Life (QoL)and contributing to increased morbidity and mortality of the emphysematous patients. Therefore, the prime aim of the management of those patients is the deflation of their lungs. There are a number of treatments proven effective to reduce hyperinflation, such as,pharmacotherapy (bronchodilators/deflators), rehabilitation and surgical volume reduction. Recently, methods to reduce lung volume by a bronchoscopic approach had been developed...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28926283/more-options-for-treating-severe-hyperinflation-in-advanced-emphysema
#19
Gerard Criner
No abstract text is available yet for this article.
September 19, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28919730/a-new-functional-method-to-choose-the-target-lobe-for-lung-volume-reduction-in-emphysema-comparison-with-the-conventional-densitometric-method
#20
Juergen Hetzel, Michael Boeckeler, Marius Horger, Ahmed Ehab, Christopher Kloth, Robert Wagner, Lutz Freitag, Dirk-Jan Slebos, Richard Alexander Lewis, Maik Haentschel
BACKGROUND: Lung volume reduction (LVR) improves breathing mechanics by reducing hyperinflation. Lobar selection usually focuses on choosing the most destroyed emphysematous lobes as seen on an inspiratory CT scan. However, it has never been shown to what extent these densitometric CT parameters predict the least deflation of an individual lobe during expiration. The addition of expiratory CT analysis allows measurement of the extent of lobar air trapping and could therefore provide additional functional information for choice of potential treatment targets...
2017: International Journal of Chronic Obstructive Pulmonary Disease
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