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https://www.readbyqxmd.com/read/28508234/surgical-treatment-of-extraesophageal-manifestations-of-gastroesophageal-reflux-disease
#1
REVIEW
Feroze Sidwa, Alessandra L Moore, Elaine Alligood, P Marco Fisichella
OBJECTIVE: To review the current literature on the role of antireflux surgery (ARS) for the treatment of extraesophageal manifestations of GERD. The extraesophageal manifestations of gastroesophageal reflux disease (GERD) include chronic cough, laryngopharyngeal reflux, and asthma. They are responsible for significant morbidity in affected patients and a high economic burden on healthcare resources. We recently published a larger review on the symptoms, diagnosis, medical, and surgical treatment of the extraesophageal manifestations of GERD...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28434014/prospective-open-label-evaluation-of-long-term-low-dose-doxycycline-for-difficult-to-treat-chronic-rhinosinusitis-with-nasal-polyps
#2
A C Pinto Bezerra Soter, T F Bezerra, R Pezato, T R Teles Abdo, R M Pilan, F R Pinna, P Gevaert, T van Zele, C Bachert, R L Voegels
BACKGROUND: This study aimed to assess clinical outcomes of long-term low-dose oral doxycycline therapy in difficult-to-treat chronic rhinosinusitis with polyps (CRSwNP). METHODS: This was a prospective, open-label study of 60 patients with difficult-to-treat CRSwNP who had undergone endoscopic sinus surgery. Patients were divided into two groups: 28 received nasal steroids, saline irrigation, and doxycycline (200 mg on the first day, followed by 100 mg once daily) for 12 weeks, while 30 received only nasal steroids and saline irrigation...
June 1, 2017: Rhinology
https://www.readbyqxmd.com/read/28424691/increased-autophagy-related-5-gene-expression-is-associated-with-collagen-expression-in-the-airways-of-refractory-asthmatics
#3
Audrey H Poon, David F Choy, Fazila Chouiali, Rakhee K Ramakrishnan, Bassam Mahboub, Severine Audusseau, Andrea Mogas, Jeffrey M Harris, Joseph R Arron, Catherine Laprise, Qutayba Hamid
BACKGROUND: Fibrosis, particularly excessive collagen deposition, presents a challenge for treating asthmatic individuals. At present, no drugs can remove or reduce excessive collagen in asthmatic airways. Hence, the identification of pathways involved in collagen deposition would help to generate therapeutic targets to interfere with the airway remodeling process. Autophagy, a cellular degradation process, has been shown to be dysregulated in various fibrotic diseases, and genetic association studies in independent human populations have identified autophagy-related 5 (ATG5) to be associated with asthma pathogenesis...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28400693/ludwig-s-angina-a-nightmare-worsened-by-adverse-drug-reaction-to-antibiotics
#4
Mohamed Hisham, Mundilipalayam N Sivakumar, R S Senthil Kumar, P Nandakumar
A 52-year-old obese gentleman presented to the hospital with complaints of fever and shortness of breath for 10 days. He was admitted in the ward and treated for acute exacerbation of asthma. He was shifted to the Intensive Care Unit (ICU) for persistent fever, neck swelling, airway obstruction and desaturation. Ludwig's angina was suspected and computed tomography of neck confirmed it. A difficult airway was anticipated and preceded with surgical tracheostomy. The patient had hypersensitivity reactions to piperacillin/tazobactam; hence, he was treated with clindamycin and metronidazole...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28388228/clinical-management-of-severe-therapy-resistant-asthma
#5
Kian Fan Chung
Severe therapy-resistant asthma is an area where there has been recent advances in understanding that is percolating into improvements in management. Areas covered: This review covers the recent definition and approach to the diagnosis of severe asthma and its differentiation from difficult-to-treat asthma. The recent advances in phenotyping severe asthma and in ensuing changes in management approaches together with the introduction of new therapies are covered from a review of the recent literature. Expert commentary: After ascertaining the diagnosis of severe asthma, patients need to be treated adequately with existing therapies...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28370985/is-bronchial-thermoplasty-cost-effective-as-treatment-for-problematic-asthma-patients-singapore-s-perspective-on-a-global-model
#6
Hai V Nguyen, Saideep Bose, Shweta Mital, Anthony Chau Ang Yii, Shin Yuh Ang, Sean Shao Wei Lam, Devanand Anantham, Eric Finkelstein, Mariko Siyue Koh
BACKGROUND AND OBJECTIVE: Bronchial thermoplasty (BT) has been shown to be effective at reducing asthma exacerbations and improving asthma control for patients with severe persistent asthma but it is also expensive. Evidence on its cost-effectiveness is limited and inconclusive. In this study, we aim to evaluate the incremental cost-effectiveness of BT combined with optimized asthma therapy (BT-OAT) relative to OAT for difficult-to-treat and severe asthma patients in Singapore, and to provide a general framework for determining BT's cost-effectiveness in other healthcare settings...
March 31, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28347832/the-genus-achyranthes-a-review-on-traditional-uses-phytochemistry-and-pharmacological-activities
#7
REVIEW
Xirui He, Xiaoxiao Wang, Jiacheng Fang, Yu Chang, Ning Ning, Hao Guo, Linhong Huang, Xiaoqiang Huang
ETHNOPHARMACOLOGICAL RELEVANCE: Achyranthes L. (Amaranthaceae), also known as Chaff Flower and Niuxi/, mainly includes two famous medicinal species namely A. bidentata and A. aspera. A. bidentata has been widely used as blood-activating and stasis-resolving medicine for the treatment of various diseases including amenorrhea, dysmenorrhea, lumbago, gonalgia, paraplegia, edema, stranguria, headache, dizziness, odontalgia, oral ulcer, hematemesis, and epistaxis. A. aspera has been widely used to treat various diseases, including gynecological disorder, asthma, ophthalmia, odontalgia, haemorrhoids, and abdominal tumor, and has been applied to difficult labour, wound healing, insect and snake bites...
May 5, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#8
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
June 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28325523/total-management-of-chronic-obstructive-pulmonary-disease-copd-as-an-independent-risk-factor-for-cardiovascular-disease
#9
REVIEW
Katsuya Onishi
Patients with cardiovascular disease (CVD) often have multiple comorbid conditions that may interact with each other, confound the choice of treatments, and reduce mortality. Chronic obstructive pulmonary disease (COPD) is one of the most important comorbidities of CVD, which causes serious consequences in patients with ischemic heart disease, stroke, arrhythmia, and heart failure. COPD shares common risk factors such as tobacco smoking and aging with CVD, is associated with less physical activity, and produces systemic inflammation and oxidative stress...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28284783/the-allergist-s-role-in-detection-of-severe-alpha-1-antitrypsin-deficiency
#10
Theodore Kelbel, Darren Morris, Deirdre Walker, Maria Paula Henao, Timothy Craig
BACKGROUND: Alpha-1 antitrypsin deficiency (AATD) frequently presents as difficult to manage asthma or asthma with fixed obstruction and is well documented as being underdiagnosed in the population. OBJECTIVE: This study aimed to better describe allergists'/immunologists' involvement in the care of patients with AATD and whether they currently contribute to the underdiagnosis by lack of screening for the condition. METHODS: Using the Research Electronic Data Capture tool, we submitted a questionnaire to 500 patients with severe AATD (ZZ, SZ, ZNull, and FZ) through the Alpha-1 Foundation Research Registry to collect information about patient diagnosis and treatment patterns...
March 8, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28283854/management-of-the-asthma-copd-overlap-syndrome-acos-a-review-of-the-evidence
#11
REVIEW
Kristin L Hines, R Stokes Peebles
PURPOSE OF REVIEW: Examine the definition of the asthma-COPD overlap syndrome (ACOS) and current treatment strategies. RECENT FINDINGS: Patients with the ACOS have a lower quality of life and suffer from more complications than those affected by either disease alone. Diagnosis of ACOS is difficult because of the clinical similarities between the two diseases and the various phenotypes that comprise the syndrome. Defining treatment strategies for ACOS has been challenging because many clinical trials for asthma therapy have purposefully excluded patients with features of COPD, and COPD clinical trials have not included patients who might have an asthmatic component to their disease...
March 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28248008/can-biomarkers-help-us-hit-targets-in-difficult-to-treat-asthma
#12
REVIEW
Michael Fricker, Liam G Heaney, John W Upham
Biomarkers may be a key foundation for the precision medicine of the future. In this article, we review current knowledge regarding biomarkers in difficult-to-treat asthma and their ability to guide the use of both conventional asthma therapies and novel (targeted) therapies. Biomarkers (as measured by tests including prednisolone and cortisol assays and the fractional exhaled nitric oxide (NO) suppression test) show promise in the assessment and management of non-adherence to inhaled and oral corticosteroids...
April 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28159511/reslizumab-in-patients-with-inadequately-controlled-late-onset-asthma-and-elevated-blood-eosinophils
#13
Guy Brusselle, Matthew Germinaro, Sivan Weiss, James Zangrilli
INTRODUCTION: Asthma with adult onset and elevated blood eosinophils is a difficult-to-treat subgroup. This post hoc analysis evaluated reslizumab, an anti-interleukin-5 monoclonal antibody, in patients with late-onset eosinophilic asthma. METHODS: Data from two 52-week placebo-controlled trials of reslizumab IV 3 mg/kg every 4 weeks in patients aged 12-75 years with inadequately controlled asthma, ≥1 asthma exacerbation within 12 months, and screening blood eosinophils ≥400/μL (NCT01287039/NCT01285323) were stratified by age of asthma onset (<40 or ≥40 years)...
January 31, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28143691/changing-paradigms-in-the-treatment-of-severe-asthma-the-role-of-biologic-therapies
#14
Rohit K Katial, Greg W Bensch, William W Busse, Bradley E Chipps, Joshua L Denson, Anthony N Gerber, Joshua S Jacobs, Monica Kraft, Richard J Martin, Parameswaran Nair, Michael E Wechsler
Cytokine antagonists are monoclonal antibodies that offer new treatment options for refractory asthma but will also increase complexity because they are effective only for patients with certain asthma subtypes that remain to be more clearly defined. The clinical and inflammatory heterogeneity within refractory asthma makes it difficult to manage the disease and to determine which, if any, biologic therapy is suitable for a specific patient. The purpose of this article is to provide a data-driven discussion to clarify the use of biologic therapies in patients with refractory asthma...
March 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28115224/the-burden-of-obesity-in-asthma-and-copd-role-of-adiponectin
#15
REVIEW
Andrea Bianco, Ersilia Nigro, Maria Ludovica Monaco, Maria Gabriella Matera, Olga Scudiero, Gennaro Mazzarella, Aurora Daniele
The influence of obesity on development, severity and prognosis of both asthma and COPD is attracting growing interest. The impact of obesity on the respiratory system ranges from structural modifications (decline of total lung capacity) to humoral alterations. Adipose tissue strongly contributes to the establishment of an inflammatory state being an important source of adipokines. Amongst adipokines, adiponectin is an important component of organ cross talk with adipose tissue exerting protective effects on a variety of pathophysiological processes...
January 20, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28027938/superimposed-pressure-oscillations-an-alternative-to-treat-airway-hyperresponsiveness-in-an-acute-sensitized-airways-mouse-model
#16
M J Jo-Avila, A M Al-Jumaily
The main driving mechanism during an asthma attack is the hyper-constrictions of airway smooth muscle (ASM), which reduces the airway lumen and makes normal breathing difficult. In spite of some noticeable side effects, bronchodilator drugs such as salbutamol are used to alleviate these symptoms by inducing temporary relaxation of the contracted ASM. In vitro studies have shown that mechanical oscillation can induce relaxation in isolated contracted ASM obtained from healthy subjects but not from asthmatics...
December 24, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27942210/airflow-obstruction-is-it-asthma-or-is-it-copd
#17
REVIEW
Paola Rogliani, Josuel Ora, Ermanno Puxeddu, Mario Cazzola
Despite the availability of guideline recommendations, diagnostic confusion between COPD and asthma appears common, and often it is very difficult to decide whether the obstruction is caused by asthma or COPD in a patient with airway obstruction. However, there are well-defined features that help in differentiating asthma from COPD in the presence of fixed airflow obstruction. Nonetheless, the presentations of asthma and COPD can converge and mimic each other, making it difficult to give these patients a diagnosis of either condition...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#18
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27905828/procedural-and-short-term-safety-of-bronchial-thermoplasty-in-clinical-practice-evidence-from-a-national-registry-and-hospital-episode-statistics
#19
Julie Burn, Andrew J Sims, Kim Keltie, Hannah Patrick, Sally A Welham, Liam G Heaney, Robert Niven
OBJECTIVE: Bronchial thermoplasty (BT) is a novel treatment for severe asthma. Its mode of action and ideal target patient group remain poorly defined, though clinical trials provided some evidence on efficacy and safety. This study presents procedural and short-term safety evidence from routine UK clinical practice. METHODS: Patient characteristics and safety outcomes (procedural complications, 30-day readmission and A&E attendance, length of stay) were assessed using two independent data sources, the British Thoracic Society UK Difficult Asthma Registry (DAR) and Hospital Episodes Statistics (HES) database...
December 1, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27865877/cough-in-the-athlete-chest-guideline-and-expert-panel-report
#20
REVIEW
Louis-Philippe Boulet, Julie Turmel, Richard S Irwin
BACKGROUND: Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess the following in this population: (1) the main causes of acute and recurrent cough, either exercise-induced or not, (2) how cough is assessed, and (3) how cough is treated in this population. From the systematic review, suggestions for management were developed. METHODS: This review was performed according to the CHEST methodological guidelines and Grading of Recommendations Assessment, Development and Evaluation framework until April 2015...
February 2017: Chest
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