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https://www.readbyqxmd.com/read/29781138/comparison-of-the-progressive-resolution-optimizer-and-photon-optimizer-in-vmat-optimization-for-stereotactic-treatments
#1
Han Liu, Benjamin Sintay, Keith Pearman, Qingyang Shang, Lane Hayes, Jacqueline Maurer, Caroline Vanderstraeten, David Wiant
The photon optimization (PO) algorithm was recently released by Varian Medical Systems to improve volumetric modulated arc therapy (VMAT) optimization within Eclipse (Version 13.5). The purpose of this study is to compare the PO algorithm with its predecessor, progressive resolution optimizer (PRO) for lung SBRT and brain SRS treatments. A total of 30 patients were selected retrospectively. Previously, all the plans were generated with the PRO algorithm within Eclipse Version 13.6. In the new version of PO algorithm (Version 15), dynamic conformal arcs (DCA) were first conformed to the target, then VMAT inverse planning was performed to achieve the desired dose distributions...
May 20, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29779416/long-term-triple-therapy-de-escalation-to-indacaterol-glycopyrronium-in-copd-patients-sunset-a-randomized-double-blind-triple-dummy-clinical-trial
#2
Kenneth R Chapman, John R Hurst, Stefan-Marian Frent, Michael Larbig, Robert Fogel, Tadhg Guerin, Donald Banerji, Francesco Patalano, Pankaj Goyal, Pascal Pfister, Konstantinos Kostikas, Jadwiga A Wedzicha
RATIONALE: There are no studies on ICS withdrawal in patients on long-term triple therapy in the absence of frequent exacerbations. OBJECTIVE: To evaluate the efficacy and safety of the direct de-escalation from long-term triple therapy to indacaterol/glycopyrronium in non-frequently exacerbating COPD patients. METHODS: This 26-week, randomized, double-blind, triple-dummy study assessed the direct change from long-term triple therapy to indacaterol/glycopyrronium (110/50μg once daily) or continuation of triple therapy (tiotropium 18μg once daily plus combination of salmeterol/fluticasone propionate [50/500μg] twice daily) in non-frequently exacerbating patients with moderate-to-severe COPD...
May 20, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29778658/marijuana-and-lung-disease
#3
REVIEW
Donald P Tashkin
As marijuana smoking prevalence increases in the U.S. concern regarding its potential risks to lung health has also risen, given the general similarity in the smoke contents between marijuana and tobacco. Most studies have found a significant association between marijuana smoking and chronic bronchitis symptoms after adjustment for tobacco. While reports are mixed regarding associations between marijuana smoking and lung function, none has shown a relationship to decrements in forced expired volume in 1 sec (FEV1) and few have found a relationship to a decreased ratio of FEV1 to forced vital capacity (FVC), possibly related to an association between marijuana and an increased FVC...
May 17, 2018: Chest
https://www.readbyqxmd.com/read/29775687/effects-of-bronchodilation-on-biomarkers-of-peripheral-airway-inflammation-in-copd
#4
Pierachille Santus, Dejan Radovanovic, Susanna Mascetti, Alessia Pauletti, Vincenzo Valenti, Marco Mantero, Alberto Papi, Marco Contoli
Peripheral airway inflammation and dysfunction are key elements in the pathogenesis of COPD. The exhaled alveolar fraction of nitric oxide (CANO) is an indirect biomarker of lung peripheral inflammation. We tested whether inhaled long-acting bronchodilators (LABA) can affect CANO and we evaluated correlations with lung mechanics in patients with COPD. Two-centre, randomised, double blind, crossover study including COPD patients with moderate-to-severe airflow obstruction. Following a pharmacological washout, multi-flow exhaled fraction of NO (FENO), plethysmography, lung diffusion (DLCO), single breath nitrogen washout test and dyspnoea were measured in a crossover manner at baseline and 30, 60 and 180 minutes following administration of salmeterol (Sal) or formoterol fumarate (FF)...
May 15, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29763568/near-infrared-activatable-phthalocyanine-poly-l-glutamic-acid-conjugate-enhanced-in-vivo-safety-and-antitumor-efficacy-towards-an-effective-photodynamic-cancer-therapy
#5
Hoay Yan Cheah, Elena Gallon, Fabienne Dumoulin, See Ziau Hoe, Nina Japundžić-Žigon, Sofija Glumac, Hong Boon Lee, Prem Anand, Lip Yong Chung, Maria Jesus Vicent, Lik Voon Kiew
We previously developed a new zinc (II) phthalocyanine (ZnPc) derivative (Pc 1) conjugated to poly-L-glutamic acid (PGA) (1-PG) to address the limitations of ZnPc as part of an antitumor photodynamic therapy approach, which include hydrophobicity, phototoxicity and non-selectivity in biodistribution and tumor targeting. During this study, we discovered that 1-PG possessed high near infrared (NIR) light absorptivity (λmax = 675 nm), good singlet oxygen generation efficiency in an aqueous environment, and enhanced photocytotoxic efficacy and cancer cell uptake in vitro...
May 15, 2018: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#6
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29743094/feasibility-and-safety-of-low-flow-extracorporeal-co-2-removal-managed-with-a-renal-replacement-platform-to-enhance-lung-protective-ventilation-of-patients-with-mild-to-moderate-ards
#7
Matthieu Schmidt, Samir Jaber, Elie Zogheib, Thomas Godet, Gilles Capellier, Alain Combes
BACKGROUND: Extracorporeal carbon-dioxide removal (ECCO2 R) might allow ultraprotective mechanical ventilation with lower tidal volume (VT) (< 6 ml/kg predicted body weight), plateau pressure (Pplat ) (< 30 cmH2 O), and driving pressure to limit ventilator-induced lung injury. This study was undertaken to assess the feasibility and safety of ECCO2 R managed with a renal replacement therapy (RRT) platform to enable very low tidal volume ventilation of patients with mild-to-moderate acute respiratory distress syndrome (ARDS)...
May 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29743071/cost-effectiveness-of-lung-volume-reduction-coil-treatment-in-patients-with-severe-emphysema-results-from-the-2-year-follow-up-crossover-revolens-study-revolens-2-study
#8
Julie Bulsei, Sylvie Leroy, Jeanne-Marie Perotin, Hervé Mal, Charles-Hugo Marquette, Hervé Dutau, Arnaud Bourdin, Jean-Michel Vergnon, Christophe Pison, Romain Kessler, Vincent Jounieaux, Mathieu Salaün, Armelle Marceau, Sylvain Dukic, Coralie Barbe, Margaux Bonnaire, Gaëtan Deslee, Isabelle Durand-Zaleski
BACKGROUND: The REVOLENS study compared lung volume reduction coil treatment to usual care in patients with severe emphysema at 1 year, resulting in improved quality-adjusted life-year (QALY) and higher costs. Durability of the coil treatment benefit and its cost-effectiveness at 2 years are now assessed. METHODS: After one year, the REVOLENS trial's usual care group patients received coil treatment (second-line coil treatment group). Costs and QALYs were assessed in both arms at 2 years and an incremental cost-effectiveness ratio in cost per QALY gained was calculated...
May 9, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29735190/potential-morbidity-reduction-with-proton-radiation-therapy-for-breast-cancer
#9
REVIEW
Lior Z Braunstein, Oren Cahlon
Proton radiotherapy confers significant dosimetric advantages in the treatment of malignancies that arise adjacent to critical radiosensitive structures. To date, these advantages have been most prominent in the treatment of pediatric and central nervous system malignancies, although emerging data support the use of protons among other anatomical sites in which radiotherapy plays an important role. With advances in the overall treatment paradigm for breast cancer, most patients with localized disease now exhibit long-term disease control and, consequently, may manifest the late toxicities of aggressive treatment...
April 2018: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/29727214/hemodynamic-effects-of-incremental-lung-hyperinflation
#10
William Spencer Cheyne, Jinelle C M Gelinas, Neil Derek Eves
Dynamic hyperinflation (DH) is common in COPD and is associated with dyspnea and exercise intolerance. DH also has adverse cardiac effects, though the magnitude of DH and the mechanisms responsible for the hemodynamic impairment remain unclear. We hypothesized that incrementally increasing DH would systematically reduce left-ventricular (LV) end diastolic volume (LVEDV) and stroke volume (LVSV) due to direct ventricular interaction (DVI). Twenty-three healthy subjects (22{plus minus}2yrs) were exposed to varying degrees of expiratory loading to induce DH such that inspiratory capacity (IC) was decreased by 25, 50, 75 and 100%, (100% DH = IC of resting tidal volume plus inspiratory reserve volume ≈0...
May 4, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29724400/functional-associations-of-pleuroparenchymal-fibroelastosis-and-emphysema-with-hypersensitivity-pneumonitis
#11
Joseph Jacob, Arlette Odink, Anne Laure Brun, Claudio Macaluso, Angelo de Lauretis, Maria Kokosi, Anand Devaraj, Sujal Desai, Elisabetta Renzoni, Athol U Wells
BACKGROUND: Pleuroparenchymal fibroelastosis (PPFE) has been described in hypersensitivity pneumonitis (HP) yet its functional implications are unclear. Combined pulmonary fibrosis and emphysema (CPFE) has occasionally been described in never-smokers with HP, but epidemiological data regarding its prevalence is sparse. CTs in a large HP cohort were therefore examined to identify the prevalence and effects of PPFE and emphysema. METHODS: 233 HP patients had CT extents of interstitial lung disease (ILD) and emphysema quantified to the nearest 5%...
May 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29717473/comparison-of-quick-recovery-outcome-of-inhalable-doxorubicin-and-cisplatin-in-lung-cancer-patients-a-randomized-double-blind-single-center-trial
#12
Zhen Li, Min Song, Zhun He, Ling Zong, Bo Jiang, Tao Zhang, Zhiliang Hu
Systematic chemotherapy has required high time span for recovery in cancer patients, serious toxic effects, and increased the time of cancer-free survival of patient but decreased the overall survival time of patients irrespective of diseased condition(s). To compare the quick recovery of inhalable doxorubicin and cisplatin in the lung cancer patients. A total of 240 patients with non-small cell lung cancer (NSCLC) patients were randomly divided into two groups of 120 each. Patients had inhaled 25 mg/m2 doxorubicin (DON group) or 10 mg/m2 cisplatin (CPN group) once in a day for 21 days...
May 1, 2018: Drug Delivery and Translational Research
https://www.readbyqxmd.com/read/29716434/effect-of-sildenafil-on-pulmonary-circulation-and-cardiovascular-function-in-near-term-fetal-sheep-during-hypoxemia
#13
Amarnath Bhide, Leena Alanne, Juha Rasanen, Heikki Huhta, Juulia Junno, Merja Kokki, Tiina Erkinaro, Pasi Ohtonen, Mervi Haapsamo, Ganesh Acharya
Sildenafil is a potential new treatment for placental insufficiency in human pregnancies as it reduces the breakdown of vasodilator nitric oxide. Pulmonary vasodilatation is observed in normoxemic fetuses following sildenafil administration. Placental insufficiency often leads to fetal hypoxemia that can cause pulmonary vasoconstriction and fetal cardiac dysfunction as evidenced by reduced isovolumic myocardial velocities. We tested the hypotheses that sildenafil, when given directly to the hypoxemic fetus, reverses reactive pulmonary vasoconstriction, increases left ventricular cardiac output by increasing pulmonary venous return, and ameliorates hypoxemic myocardial dysfunction...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29707561/integrated-respiratory-and-palliative-care-may-improve-outcomes-in-advanced-lung-disease
#14
Natasha Smallwood, Michelle Thompson, Matthew Warrender-Sparkes, Peter Eastman, Brian Le, Louis Irving, Jennifer Philip
The unaddressed palliative care needs of patients with advanced, nonmalignant, lung disease highlight the urgent requirement for new models of care. This study describes a new integrated respiratory and palliative care service and examines outcomes from this service. The Advanced Lung Disease Service (ALDS) is a long-term, multidisciplinary, integrated service. In this single-group cohort study, demographic and prospective outcome data were collected over 4 years, with retrospective evaluation of unscheduled healthcare usage...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29700954/influence-of-respiratory-motion-management-technique-on-radiation-pneumonitis-risk-with-robotic-stereotactic-body-radiation-therapy
#15
Christopher H Chapman, Christopher McGuinness, Alexander R Gottschalk, Sue S Yom, Adam A Garsa, Mekhail Anwar, Steve E Braunstein, Atchar Sudhyadhom, Paul Keall, Martina Descovich
PURPOSE/OBJECTIVES: For lung stereotactic body radiation therapy (SBRT), real-time tumor tracking (RTT) allows for less radiation to normal lung compared to the internal target volume (ITV) method of respiratory motion management. To quantify the advantage of RTT, we examined the difference in radiation pneumonitis risk between these two techniques using a normal tissue complication probability (NTCP) model. MATERIALS/METHOD: 20 lung SBRT treatment plans using RTT were replanned with the ITV method using respiratory motion information from a 4D-CT image acquired at the original simulation...
April 26, 2018: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/29696728/predictive-value-of-eosinophils-and-neutrophils-on-clinical-effects-of-ics-in-copd
#16
Floor J Hartjes, Judith M Vonk, Alen Faiz, Pieter S Hiemstra, Thérèse S Lapperre, Huib A M Kerstjens, Dirkje S Postma, Maarten van den Berge
BACKGROUND AND OBJECTIVE: Inflammation is present to a variable degree and composition in patients with COPD. This study investigates associations between both eosinophils and neutrophils in blood, sputum, airway wall biopsies and bronchoalveolar lavage (BAL) and their potential use as biomarkers for clinical response to inhaled corticosteroids (ICS). METHODS: In total, 114 steroid-naïve COPD patients of the Groningen Leiden Universities Corticosteroids in Obstructive Lung Disease (GLUCOLD) study using ICS or placebo during 30-month follow-up were included...
April 26, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29692995/living-with-copd-the-struggle-for-breath-and-for-lung-volume-reduction-therapies
#17
EDITORIAL
Ravi Mahadeva, Zaid Zoumot
Access to lung volume reduction for advanced emphysema http://ow.ly/Iqru30jbvbE.
April 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29692608/increased-matrix-metalloproteinase-9-to-tissue-inhibitor-of-metalloproteinase-1-ratio-in-smokers-with-airway-hyperresponsiveness-and-accelerated-lung-function-decline
#18
Chun-Yu Lo, Hung-Yu Huang, Jung-Ru He, Tzu-Ting Huang, Chih-Chen Heh, Te-Fang Sheng, Kian Fan Chung, Han-Pin Kuo, Chun-Hua Wang
Background: Airway hyperresponsiveness (AHR) is associated with airway inflammation and a rapid decline in lung function and is a predictor of future risk of COPD among smokers. Alveolar macrophages (AMs) from patients with COPD release a greater amount of matrix metalloproteinase (MMP)-9. We hypothesized that the imbalance between MMP-9 and tissue inhibitor of metalloproteinase-1 (TIMP-1) is related to AHR in smokers. Patients and methods: Healthy smokers with AHR (AHR + S) or smokers without AHR (AHR - S; divided according to a methacholine challenge test) and nonsmokers without AHR (AHR - NS) were enrolled...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29679678/characterisation-of-40-mg-ml-and-100-mg-ml-tobramycin-formulations-for-aerosol-therapy-with-adult-mechanical-ventilation
#19
Jayesh A Dhanani, Patrician Tang, Steven C Wallis, Suzanne L Parker, Preeti Pandey, John F Fraser, Jeremy Cohen, Adrian Barnett, Jason R Roberts, Hak-Kim Chan
BACKGROUND: Preservative-free tobramycin is commonly used as aerosolized therapy for ventilator associated pneumonia. The comparative delivery profile of the formulations of two different concentrations (100 mg/ml and 40 mg/ml) is unknown. This study aims to evaluate the aerosol characteristics of these tobramycin formulations in a simulated adult mechanical ventilation model. METHODS: Simulated adult mechanical ventilation set up and optimal settings were used in the study...
April 18, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29676590/emphysema-management-from-investigational-endobronchial-coils-to-lung-transplantation
#20
Harpreet Singh Grewal, Atul C Mehta
This brief imaging case report highlights a successful bridge to lung transplantation after endobronchial coil assisted lung volume reduction procedure. Our patient was a 64-year-old male with severe emphysema (FEV1:19%, RV: 289%, TLC: 143%), on maximum medical regimen who was enrolled into the Lung Volume Reduction Coil Treatment (RENEW) Study. He underwent bilateral endobronchial coil placement in a two-step procedure, with an immediate improvement in symptoms and pulmonary function testing (FEV1:21%, RV: 254%, TLC: 138%)...
April 20, 2018: American Journal of Respiratory and Critical Care Medicine
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