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https://www.readbyqxmd.com/read/29440886/missed-diagnosis-and-overtreatment-of-copd-among-smoking-primary-care-population-in-central-greece-old-problems-persist
#1
Eirini Stafyla, Ourania S Kotsiou, Konstantina Deskata, Konstantinos I Gourgoulianis
Background: The diagnosis of COPD is not always consistent with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy in daily clinical practice, especially in primary care. This study aimed to estimate the overall COPD prevalence and severity, to identify differences between newly and previously diagnosed patients, and to evaluate the potential COPD overtreatment in a smoking population attending a primary care spirometry surveillance program. Methods: A study was conducted in 10 primary health care centers of Central Greece during a 7-month period...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29440883/do-not-do-in-copd-consensus-statement-on-overuse
#2
Felipe Villar-Álvarez, Raúl Moreno-Zabaleta, Jose Joaquin Mira-Solves, Eduardo Calvo-Corbella, Salvador Díaz-Lobato, Fernando González-Torralba, Ascensión Hernando-Sanz, Sara Núñez-Palomo, Sergio Salgado-Aranda, Beatriz Simón-Rodríguez, Paz Vaquero-Lozano, Isabel María Navarro-Soler
Background: To identify practices that do not add value, cause harm, or subject patients with chronic obstructive pulmonary disease (COPD) to a level of risk that outweighs possible benefits (overuse). Methods: A qualitative approach was applied. First, a multidisciplinary group of healthcare professionals used the Metaplan technique to draft and rank a list of overused procedures as well as self-care practices in patients with stable and exacerbated COPD. Second, in successive consensus-building rounds, description files were created for each "do not do" (DND) recommendation, consisting of a definition, description, quality of supporting evidence for the recommendation, and the indicator used to measure the degree of overuse...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29433725/palliative-care-and-interventional-pulmonology
#3
REVIEW
Muhammad Sajawal Ali, Lubna Sorathia
Since pulmonary pathologies, such as lung cancer and chronic obstructive pulmonary disease (COPD), are some of the leading causes of morbidity and mortality around the world, pulmonologists are likely to encounter patients with unmet palliative care needs. This article focuses on the symptoms and complications encountered by patients with terminal pulmonary conditions, briefly describes the non-interventional palliative strategies, and then discusses more advanced therapies available in the realm of interventional pulmonology...
March 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29433713/pulmonologist-s-road-map-to%C3%A2-mediastinal-lymph-node%C3%A2-imaging
#4
REVIEW
Hamza Jawad, Jonathan H Chung
Mediastinal lymph node station maps are intended to facilitate nodal staging in patients with non-small cell lung cancer. These maps have been revised over time and the International Association for Study of Lung Cancer (IASLC) map is the latest rendition. This article illustrates the imaging appearance of each of the IASLC map mediastinal lymph node stations, overviews some of the mediastinal lymph node sampling techniques, and discusses common pitfalls of the IASLC map. It also reviews mediastinal anatomic variants and pathologic features that may simulate lymphadenopathy...
March 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29420619/a-national-survey-of-lung-cancer-specialists-views-on-low-dose-ct-screening-for-lung-cancer-in-korea
#5
Dong Wook Shin, Sohyun Chun, Young Il Kim, Seung Joon Kim, Jung Soo Kim, SeMin Chong, Young Sik Park, Sang-Yun Song, Jin Han Lee, Hee Kyung Ahn, Eun Young Kim, Sei Hoon Yang, Myoung Kyu Lee, Deog Gon Cho, Tae Won Jang, Ji Woong Son, Jeong-Seon Ryu, Moon-June Cho
Lung cancer specialists play an important role in designing and implementing lung cancer screening. We aimed to describe their 1) attitudes toward low-dose lung computed tomography (LDCT) screening, 2) current practices and experiences of LDCT screening and 3) attitudes and opinions towards national lung cancer screening program (NLCSP). We conducted a national web-based survey of pulmonologists, thoracic surgeons, medical oncologists, and radiological oncologists who are members of Korean Association for Lung Cancer (N = 183)...
2018: PloS One
https://www.readbyqxmd.com/read/29420114/role-of-ct-chest-and-cytology-in-differentiating-tuberculosis-from-presumed-sarcoidosis-in-uveitis
#6
Reema Bansal, Amod Gupta, Ritesh Agarwal, Mohit Dogra, Garvit Bhutani, Vishali Gupta, M R Dogra, Deeksha Katoch, Ashutosh Nath Aggarwal, Aman Sharma, Raje Nijhawan, Ritambara Nada, Uma Nahar Saikia, Pranab Dey, Digambar Behera
PURPOSE: To report the role of CT chest and cytology in suspected tubercular and sarcoid uveitis. METHODS: This is a retrospective, interventional case series of 376 uveitis patients with suspected ocular tuberculosis (TB)/sarcoidosis seen between January 2010 and April 2015 at the Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh. All underwent CT chest, and had following inclusion criteria: (1) Presence of active granulomatous anterior/intermediate/posterior uveitis or panuveitis; (2) a documented tuberculin skin test/QuantiFERON-TB Gold test; (3) all other causes of infectious/non-infectious uveitis ruled out...
February 8, 2018: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/29413501/integration-of-3d-printing-and-additive-manufacturing-in-the-interventional-pulmonologist-s-toolbox
#7
Nicolas Guibert, Laurent Mhanna, Alain Didier, Benjamin Moreno, Pierre Leyx, Gavin Plat, Julien Mazieres, Christophe Hermant
New 3D technologies are rapidly entering into the surgical landscape, including in interventional pulmonology. The transition of 2D restricted data into a physical model of pathological airways by three-dimensional printing (3DP) allows rapid prototyping and fabrication of complex and patient-specific shapes and can thus help the physician to plan and guide complex procedures. Furthermore, computer-assisted designed (CAD) patient-specific devices have already helped surgeons overcome several therapeutic impasses and are likely to rapidly cover a wider range of situations...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29397301/-vocal-cord-dyskinesia-and-or-asthma
#8
J J Braun, C Delmas, A Charloux, P Schultz, F de Blay
INTRODUCTION: Vocal cord dyskinesia or vocal cord dysfunction (VCD) is characterized by intermittent abnormal adduction of the vocal cords leading to airflow limitation at the level of the larynx, in the absence of local organic disease. It may occur in isolation or in association with asthma. The pathophysiology is complex and poorly understood. Wheeze, stridor or apparent upper airway obstruction are the most common symptoms. It occurs in a wide age range, more commonly in women, and diagnosis is often delayed and leads to unnecessary treatments (intubation, tracheostomy and high dose steroids)...
January 31, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29393584/complications-and-risk-factors-in-pediatric-bronchoscopy-in-a-tertiary-pediatric-respiratory-center
#9
Julia Carlens, Jan Fuge, Timothy Price, David S DeLuca, Mareike Price, Gesine Hansen, Nicolaus Schwerk
Bronchoscopy is an established procedure routinely used by pediatric pulmonologists. Despite its frequent application, data on complications and specific risk factors are scarce and sometimes conflicting. AIM: The aim of this study was to evaluate frequency and severity of clearly defined complications of bronchoscopy in children that occur both during and after the procedure, and to identify potential risk factors. METHOD: A retrospective single-center analysis of 670 elective bronchoscopies in 522 children aged 0-17 years during the time period of 2008-2012 was performed...
February 2, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29393015/-weak-respiratory-muscles-as-a-first-sign-of-als-symptoms-may-put-the-physician-on-the-wrong-track
#10
D Kiers, M Meermans, E Verstraete, H J van Leeuwen
BACKGROUND: Patients with decreased exercise tolerance and orthopnoea are often referred to an internist, a cardiologist or a pulmonologist. These symptoms can also be caused by weakness of the respiratory muscles, as an indication of a neuromuscular disease. If these symptoms are not recognized as such, this may result in a delay in timely diagnosis. CASE DESCRIPTION: An 82-year-old man had suffered from decreased exercise tolerance for 18 months. For the last months he had been sleeping upright and had lost 20 kg in weight...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29391786/narrative-medicine-to-improve-the-management-and-quality-of-life-of-patients-with-copd-the-first-experience-applying-parallel-chart-in-italy
#11
Paolo Banfi, Antonietta Cappuccio, Maura E Latella, Luigi Reale, Elisa Muscianisi, Maria Giulia Marini
Purpose: Poor adherence to therapy and the failure of current smoking cessation programs demonstrate that the current management of COPD can be improved, and it is necessary to educate physicians about new approaches for taking care of patients. Parallel chart is a narrative medicine tool that improves the doctor-patient relationship by asking physicians to write about their patients' lives, thereby encouraging reflective thoughts on care. Patients and methods: Between October 2015 and March 2016, 50 Italian pulmonologists were involved in the collection of parallel charts of anonymous patients with COPD...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29389468/prevalence-and-pattern-of-usage-of-complementary-and-alternative-medicine-among-south-indian-asthma-patients-in-a-tertiary-care-hospital
#12
Sabarathinam Sarvesh, Mathivanan Koushik Muthu Raja, Muhasaparur Ganesan Rajanandh, Palanichamy Seenivasan
OBJECTIVES: The study aimed to investigate the prevalence of CAM users among asthmatic patients in a tertiary care South Indian hospital. METHODS: Prospective, cross sectional study was conducted in 394 asthmatic patients. RESULTS: 30.4% of the patients used CAM therapies. The most commonly used CAM treatment was herbal medicine followed by pranayama (controlled breathing exercises). Most of the CAM users were found to be in lower middle class...
February 2018: Complementary Therapies in Clinical Practice
https://www.readbyqxmd.com/read/29388084/unexplained-cough-it-is-time-to-rule-out-sjogren-s-syndrome
#13
Matthew Koslow, Shaye Kivity, Vicktoria Vishnevskia-Dai, Issahar Ben-Dov
Sjogren's syndrome is associated with chronic cough, but sicca symptoms are missing from cough evaluation guidelines. We evaluated patients with unexplained cough for undiagnosed Sjogren's syndrome. Patients referred to our pulmonary clinic (Sheba Medical Center, 2009 to 2012) with unexplained cough and concomitant dry eyes were selected for evaluation. Unexplained cough was defined as chronic cough of unknown etiology despite algorithm-based evaluation and treatment. Patients were evaluated in a dedicated clinic by a pulmonologist, rheumatologist, and ophthalmologist specializing in autoimmune disease...
January 31, 2018: Clinical Rheumatology
https://www.readbyqxmd.com/read/29372629/chest-tube-drainage-of-the-pleural-space-a-concise-review-for-pulmonologists
#14
REVIEW
José M Porcel
Chest tube insertion is a common procedure usually done for the purpose of draining accumulated air or fluid in the pleural cavity. Small-bore chest tubes (≤14F) are generally recommended as the first-line therapy for spontaneous pneumothorax in non-ventilated patients and pleural effusions in general, with the possible exception of hemothoraces and malignant effusions (for which an immediate pleurodesis is planned). Large-bore chest drains may be useful for very large air leaks, as well as post-ineffective trial with small-bore drains...
January 24, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29372069/diagnosis-and-treatment-of-latent-tuberculosis-in-patients-with-multiple-sclerosis-expert-consensus-on-behalf-of-the-colombian-association-of-neurology-committee-of-multiple-sclerosis
#15
Carlos Navas, Carlos A Torres-Duque, Joe Munoz-Ceron, Carlos Álvarez, Juan R García, Luis Zarco, Lázaro A Vélez, Carlos Awad, Carlos Alberto Castro
Background: Multiple sclerosis is an inflammatory and neurodegenerative demyelinating disease. Current treatment of multiple sclerosis focuses on the use of immunomodulatory, immunosuppressant, and selective immunosuppressant agents. Some of these medications may result in high risk of opportunistic infections including tuberculosis. Objective: The purpose of this study was to obtain consensus from a panel of neurologists, pulmonologists, infectious disease specialists, and epidemiology experts regarding the diagnosis, treatment, and monitoring of latent tuberculosis in patients with multiple sclerosis...
January 2018: Multiple Sclerosis Journal—Experimental, Translational and Clinical
https://www.readbyqxmd.com/read/29370438/impact-of-diffuse-large-b-cell-lymphoma-on-visits-to-different-provider-specialties-among-elderly-medicare-beneficiaries-challenges-for-care-coordination
#16
Rahul Garg, Usha Sambamoorthi, Xi Tan, Soumit K Basu, Treah Haggerty, Kimberly M Kelly
Newly diagnosed diffuse large B-cell lymphoma (DLBCL) can pose significant challenges to care coordination. We utilized a social-ecological model to understand the impact of DLBCL diagnosis on visits to primary care providers (PCPs) and specialists, a key component of care coordination, over a 3-year period of cancer diagnosis and treatment. We used hurdle models and multivariable logistic regression with the Surveillance Epidemiology and End Result-Medicare linked dataset to analyze visits to PCPs and specialists by DLBCL patients (n = 5,455) compared with noncancer patients (n = 14,770)...
January 23, 2018: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/29369769/who-pays-to-care-for-the-seriously-ill-maybe-it-s-insurance-companies
#17
Jan Greene
The newish specialty of palliative care struggles to win over the specialists and hospitalists who might refer patients. Some want to protect their turf. And too often, palliative care is lumped in with hospice and viewed as "giving up" on patients that oncologists, pulmonologists, and cardiologists are working so hard to save.
January 2018: Managed Care
https://www.readbyqxmd.com/read/29361243/emphysematous-and-nonemphysematous-gas-trapping-in-chronic-obstructive-pulmonary-disease-quantitative-ct-findings-and-pulmonary-function
#18
Mariaelena Occhipinti, Matteo Paoletti, Francesca Bigazzi, Gianna Camiciottoli, Riccardo Inchingolo, Anna Rita Larici, Massimo Pistolesi
Purpose To identify a prevalent computed tomography (CT) subtype in patients with chronic obstructive pulmonary disease (COPD) by separating emphysematous from nonemphysematous contributions to total gas trapping and to attempt to predict and grade the emphysematous gas trapping by using clinical and functional data. Materials and Methods Two-hundred and two consecutive eligible patients (159 men and 43 women; mean age, 70 years [age range, 41-85 years]) were prospectively studied. Pulmonary function and CT data were acquired by pulmonologists and radiologists...
January 23, 2018: Radiology
https://www.readbyqxmd.com/read/29355547/%C3%AE-blockers-in-chronic-obstructive-pulmonary-disease-a-cohort-study-from-the-tonado%C3%A2-research-programme
#19
François Maltais, Roland Buhl, Andrea Koch, Valeria C Amatto, Jim Reid, Lars Grönke, Ulrich Bothner, Florian Voß, Lorcan McGarvey, Gary T Ferguson
BACKGROUND: Cardiovascular disease is a frequent co-morbidity in patients with chronic obstructive pulmonary disease (COPD). Many clinicians, particularly pulmonologists, are reluctant to use β-adrenoceptor blocking agents (β-blockers) in patients with COPD, despite their proven effectiveness in preventing cardiovascular events. METHODS: The large (5,162 patients) phase III TONADO® 1 and 2 studies assessed lung function and patient-reported outcomes (PROs) in patients with moderate to very severe COPD receiving long-acting bronchodilator treatment over 1 year...
January 16, 2018: Chest
https://www.readbyqxmd.com/read/29346248/the-utility-of-ultrasound-to-diagnose-tunnel-tract-infection-related-to-indwelling-pleural-catheters
#20
Jose Cardenas-Garcia, Neal Fitzpatrick, George Z Cheng
Indwelling pleural catheter (IPC) infections lead to increased morbidity and treatment failure in patients with chronic recurrent pleural effusions. Ultrasonography is a readily available diagnostic tool used by pulmonologists on a daily basis. Ultrasonography has been used to identify the etiology of indwelling peritoneal catheter obstruction, including infection of the exit site and tunnel tract. The use of ultrasonography to identify tunnel-tract infection involving IPC has not been reported. We describe the ultrasonographic characteristics of 3 cases of confirmed tunnel-tract infection and compared them with noninfected chronic IPCs...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
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