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resistant copd

Sarah Jones, William D-C Man, Wei Gao, Irene J Higginson, Andrew Wilcock, Matthew Maddocks
BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews Issue 1, 2013 on Neuromuscular electrical stimulation for muscle weakness in adults with advanced disease.Patients with advanced progressive disease often experience muscle weakness, which can impact adversely on their ability to be independent and their quality of life. In those patients who are unable or unwilling to undertake whole-body exercise, neuromuscular electrical stimulation (NMES) may be an alternative treatment to enhance lower limb muscle strength...
October 17, 2016: Cochrane Database of Systematic Reviews
Hanna Knihtilä, Anne Kotaniemi-Syrjänen, Anna S Pelkonen, Satu Kalliola, Mika J Mäkelä, L Pekka Malmberg
INTRODUCTION: Early origins of chronic obstructive pulmonary disease have been recognized. Impulse oscillometry (IOS) is suitable for assessment of lung function also in preschool children, and some novel indices have been connected to assessment of small airway function. However, limited data exist on the sensitivity of these new indices to detect lung function deficits in young symptomatic children. METHODS: IOS measurements of 103 healthy preschool children were evaluated to establish reference equations for the difference between respiratory resistance at 5 and 20 Hz (R5-20), the relative difference of R5-20 (R5-20%), and area under the reactance curve (AX)...
October 13, 2016: Pediatric Pulmonology
J M Prins, T van der Poll
Better use of current antibiotics is warranted to curb increasing antimicrobial resistance rates. Procalcitonin guidance can safely reduce antibiotic usage when used to initiate or discontinue antibiotics in adult patients with a respiratory tract infection. However, the claimed reductions in antibiotic usage are mainly achieved in patients with acute bronchitis and exacerbations of COPD, conditions for which guidelines already discourage antibiotic treatment. Sequential procalcitonin measurements can also reduce the treatment duration of community-acquired pneumonia from 10-12 to 5-7 days, which is, however, already the recommended treatment duration for in- and outpatients under the current Dutch guidelines...
2016: Nederlands Tijdschrift Voor Geneeskunde
Eva Polverino, Graham H Bothamley, Delia Goletti, Jan Heyckendorf, Giovanni Sotgiu, Stefano Aliberti
The breadth and quality of scientific presentations on clinical and translational research into respiratory infections at the 2015 European Respiratory Society (ERS) International Congress in Amsterdam, the Netherlands, establishes this area as one of the leadings fields in pulmonology. The host-pathogen relationship in chronic obstructive pulmonary disease, and the impact of comorbidities and chronic treatment on clinical outcomes in patients with pneumonia were studied. Various communications were dedicated to bronchiectasis and, in particular, to different prognostic and clinical aspects of this disease, including chronic infection with Pseudomonas and inhaled antibiotic therapy...
July 2016: ERJ Open Research
Joanna C Watts, Claude S Farah, Leigh M Seccombe, Blake M Handley, Robin E Schoeffel, Amy Bertolin, Jessica Dame Carroll, Gregory G King, Cindy Thamrin
The forced oscillation technique (FOT) is gaining clinical acceptance, facilitated by more commercial devices and clinical data. However, the effects of variations in testing protocols used in FOT data acquisition are unknown. We describe the effect of duration of data acquisition on FOT results in subjects with asthma, chronic obstructive pulmonary disease (COPD) and healthy controls. FOT data were acquired from 20 healthy, 22 asthmatic and 18 COPD subjects for 60 s in triplicate. The first 16, 30 and 60 s of each measurement were analysed to obtain total, inspiratory and expiratory resistance of respiratory system (Rrs) and respiratory system reactance (Xrs) at 5 and 19 Hz...
April 2016: ERJ Open Research
Masahiro Kimura, Satoshi Wakita, Kotarou Ishikawa, Kazutaka Sekine, Satoshi Yoshikawa, Akira Sato, Kazuaki Okawa, Akinori Kashimura, Masayoshi Sakaguchi, Yasusato Sugahara, Daisuke Yamanaka, Naohito Ohno, Peter O Bauer, Fumitaka Oyama
Chitotriosidase (Chit1) is an enzyme associated with various diseases, including Gaucher disease, chronic obstructive pulmonary disease, Alzheimer disease and cystic fibrosis. In this study, we first expressed mouse mature Chit1 fused with V5 and (His)6 tags at the C-terminus (Chit1-V5-His) in the cytoplasm of Escherichia coli and found that most of the expressed protein was insoluble. In contrast, Chit1 tagged with Protein A at the N-terminus and V5-His at the C-terminus, was expressed in the periplasmic space of E...
2016: PloS One
Theodoros Vassilakopoulos, Dimitrios Toumpanakis
In obstructive lung diseases, airway inflammation leads to bronchospasm and thus resistive breathing, especially during exacerbations. This commentary discusses experimental evidence that resistive breathing per se (the mechanical stimulus) in the absence of underlying airway inflammation leads to lung injury and inflammation (mechanotransduction). The potential implications of resistive breathing-induced mechanotrasduction in COPD exacerbations are presented along with the available clinical evidence.
2016: International Journal of Chronic Obstructive Pulmonary Disease
Carla S Andrews, Shingo Matsuyama, Byung-Cheol Lee, Jian-Dong Li
Upper respiratory tract inflammatory diseases such as asthma and chronic obstructive pulmonary diseases (COPD) affect more than one-half billion people globally and are characterized by chronic inflammation that is often exacerbated by respiratory pathogens such as nontypeable Haemophilus influenzae (NTHi). The increasing numbers of antibiotic-resistant bacterial strains and the limited success of currently available pharmaceuticals used to manage the symptoms of these diseases present an urgent need for the development of novel anti-inflammatory therapeutic agents...
September 28, 2016: Scientific Reports
Sibei Chen, Ying Li, Zeguang Zheng, Qun Luo, Rongchang Chen
BACKGROUND: This study is to explore the components and related mechanism responsible for the increase of work of breathing (WB) in chronic obstructive pulmonary disease (COPD) patients. METHODS: Eight COPD patients and eight healthy volunteers were recruited in the study. The rebreathing method was used to increase end-tidal CO2 partial pressure (PetCO2) and stimulate the increase in ventilation (VE). The increase in VE, WB, and changes in the compositions of WB were observed and analyzed...
August 2016: Journal of Thoracic Disease
Iulia Popescu, M Bradley Drummond, Lucio Gama, Allison Lambert, Aki Hoji, Tiffany Coon, Christian A Merlo, Robert A Wise, Jeanne Keruly, Janice E Clements, Gregory D Kirk, John F McDyer
BACKGROUND:  Lung CD4(+) depletion/dysfunction, CD8(+) alveolitis, smoking, and poor HIV control are features of HIV-associated COPD, but these changes have not been evaluated in smokers at-risk for COPD. We evaluated the impact of viral suppression following initiation of antiretroviral therapy (ART) on HIV-specific immunity and lung CD4:CD8 balance. METHODS:  Using flow cytometry, we assessed lung/blood T-cell immunity in 12 actively- smoking HIV+ patients pre- and post-ART following viral suppression...
September 9, 2016: Journal of Infectious Diseases
Shehab M Abd El-Kader, Osama H Al-Jiffri, Fadwa M Al-Shreef
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a main risk for morbidity, associated with alterations in systemic inflammation. Recent studies proved that morbidity and mortality of COPD is related to systemic inflammation as it contributes to the pathogenesis of atherosclerosis and cardiovascular disease. However, increase of inflammatory cytokines adversely affects quality of life, alteration in ventilatory and skeletal muscles functions. Moreover, exercise training has many beneficial effects in correction of the adverse effects of COPD...
June 2016: African Health Sciences
Koundinya Desiraju, Anurag Agrawal
Impulse oscillometry (IOS) is a variant of forced oscillation technique, described by Dubois over 50 years ago, which permits passive measurement of lung mechanics. In this method, sound waves are superimposed on normal tidal breathing, and the disturbances in flow and pressure caused by the external waves are used to calculate parameters describing the resistance to airflow and reactive parameters that mostly relate to efficient storage and return of energy by the lung. It requires minimal patient cooperation and can be done easily in subjects who are unable to perform spirometry...
July 2016: Lung India: Official Organ of Indian Chest Society
Idris Samad, Lee Akst, Selmin Karatayli-Özgürsoy, Kristine Teets, Marissa Simpson, Ashwyn Sharma, Simon R A Best, Alexander T Hillel
Importance: Endoscopic airway surgery is a frequently used procedure in the management of laryngotracheal stenosis (LTS); however, no established outcome measures are available to assess treatment response. Objective: To assess acoustics and aerodynamic measures and voice- and dyspnea-related quality of life (QOL) in adult patients with LTS who undergo endoscopic airway surgery. Design, Setting, and Participants: This case series compared preoperative measures and postoperative outcomes among adult patients who underwent endoscopic airway surgery for LTS from September 1, 2013, to September 30, 2015, at the tertiary care Johns Hopkins Voice Center...
August 11, 2016: JAMA Otolaryngology—Head & Neck Surgery
Elodie Ehrmann, Anne Jolivet-Gougeon, Martine Bonnaure-Mallet, Thierry Fosse
INTRODUCTION: Capnocytophaga genus was recently known to highly contribute to the beta-lactam (BL) and macrolide-lincosamide-streptogramin (MLS) resistance gene reservoir in the oral microbiota (BL: blaCSP-1 and blaCfxA; MLS: erm(F) and erm(C)). But fluoroquinolone (FQ) resistance remains uncommon in literature, without available data on resistance mechanisms. CASE REPORT: For the first time, a case of acute exacerbation of chronic obstructive pulmonary disease (COPD) was described in a 78-year-old immunocompetent patient due to a multidrug-resistant Capnocytophaga gingivalis isolate with significant microbiological finding...
August 13, 2016: Anaerobe
Richard Y Kim, Brittany Rae, Rachel Neal, Chantal Donovan, James Pinkerton, Lohis Balachandran, Malcolm R Starkey, Darryl A Knight, Jay C Horvat, Philip M Hansbro
Corticosteroids are broadly active and potent anti-inflammatory agents that, despite the introduction of biologics, remain as the mainstay therapy for many chronic inflammatory diseases, including inflammatory bowel diseases, nephrotic syndrome, rheumatoid arthritis, chronic obstructive pulmonary disease and asthma. Significantly, there are cohorts of these patients with poor sensitivity to steroid treatment even with high doses, which can lead to many iatrogenic side effects. The dose-limiting toxicity of corticosteroids, and the lack of effective therapeutic alternatives, leads to substantial excess morbidity and healthcare expenditure...
July 2016: Clinical & Translational Immunology
Benjamin Luke Duell, Yu-Ching Su, Kristian Riesbeck
Nontypeable Haemophilus influenzae (NTHi) is a commensal microbe often isolated from the upper and lower respiratory tract. This bacterial species can cause sinusitis, acute otitis media in preschool children, exacerbations in patients suffering from chronic obstructive pulmonary disease, as well as conjunctivitis and bacteremia. Since the introduction of a vaccine against H. influenzae serotype b in the 1990s, the burden of H. influenzae-related infections has been increasingly dominated by NTHi. Understanding the ability of NTHi to cause infection is currently an expanding area of study...
August 10, 2016: FEBS Letters
Rosario Menéndez, Beatriz Montull, Soledad Reyes, Isabel Amara-Elori, Rafael Zalacain, Alberto Capelastegui, Javier Aspa, Luis Borderías, Juan J Martín-Villasclaras, Salvador Bello, Inmaculada Alfageme, Felipe Rodríguez de Castro, Jordi Rello, Luis Molinos, Juan Ruiz-Manzano, Antoni Torres
Community-acquired pneumonia (CAP) is a serious infection that may occasionally rapidly evolve provoking organ dysfunctions. We aimed to characterize CAP presenting with organ dysfunctions at the emergency room, with regard to host factors and causative microorganisms, and its impact on 30-day mortality. 460 of 4070 (11.3%) CAP patients had ≥2 dysfunctions at diagnosis, with a 30-day mortality of 12.4% vs. 3.4% in those with one or no dysfunctions. Among them, the most frequent causative microorganisms were Streptococcus pneumoniae, gram-negatives and polymicrobial etiology...
August 6, 2016: Journal of Infection
Amany F Elbehairy, Jordan A Guenette, Azmy Faisal, Casey E Ciavaglia, Katherine A Webb, Dennis Jensen, Andrew H Ramsook, J Alberto Neder, Denis E O'Donnell
Dyspnoea and activity limitation can occur in smokers who do not meet spirometric criteria for chronic obstructive pulmonary disease (COPD) but the underlying mechanisms are unknown.Detailed pulmonary function tests and sensory-mechanical relationships during incremental exercise with respiratory pressure measurements and diaphragmatic electromyography (EMGdi) were compared in 20 smokers without spirometric COPD and 20 age-matched healthy controls.Smokers (mean±sd post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity 75±4%, mean±sd FEV1 104±14% predicted) had greater activity-related dyspnoea, poorer health status and lower physical activity than controls...
September 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Tatsuhiko Harada, Yuji Ishimatsu, Atsuko Hara, Towako Morita, Shota Nakashima, Tomoyuki Kakugawa, Noriho Sakamoto, Kosuke Kosai, Koichi Izumikawa, Katsunori Yanagihara, Hiroshi Mukae, Shigeru Kohno
Secondary bacterial pneumonia (SBP) during influenza increases the severity of chronic obstructive pulmonary disease (COPD) and its associated mortality. Macrolide antibiotics, including clarithromycin (CAM), are potential treatments for a variety of chronic respiratory diseases owing to their pharmacological activities, in addition to antimicrobial action. We examined the efficacy of CAM for the treatment of SBP after influenza infection in COPD. Specifically, we evaluated the effect of CAM in elastase-induced emphysema mice that were inoculated with influenza virus (strain A/PR8/34) and subsequently infected with macrolide-resistant Streptococcus pneumoniae CAM was administered to the emphysema mice 4 days prior to influenza virus inoculation...
September 2016: Journal of Pharmacology and Experimental Therapeutics
Rohit Bavi, Raj Kumar, Shailima Rampogu, Yongseong Kim, Yong Jung Kwon, Seok Ju Park, Keun Woo Lee
High level of hematopoietic cell kinase (Hck) is associated with drug resistance in chronic myeloid leukemia. Additionally, Hck activity has also been connected with the pathogenesis of HIV-1 and chronic obstructive pulmonary disease. In this study, three-dimensional (3D) QSAR pharmacophore models were generated for Hck based on experimentally known inhibitors. A best pharmacophore model, Hypo1, was developed with high correlation coefficient (0.975), Low RMS deviation (0.60) and large cost difference (49.31), containing three ring aromatic and one hydrophobic aliphatic feature...
August 2, 2016: Journal of Receptor and Signal Transduction Research
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