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https://www.readbyqxmd.com/read/29046036/-spontaneous-pneumomediastinum-and-subcutaneous-emphysema-associated-with-bronchospasm-in-a-woman-with-no-history-of-asthma
#1
Tonatiuh Ramses Bedolla-Pulido, Martín Bedolla-Barajas
BACKGROUND: Spontaneous pneumomediastinum most relevant triggering events are cough, vomiting, nutritional problems, physical activity and use of inhaled drugs. Association of spontaneous pneumomediastinum with non-asthma-related bronchospasm is an infrequent event. CLINICAL CASE: This is the case of a 21-year-old woman without personal or family history of asthma, allergic rhinitis or atopy who during late puerperium had 39 °C fever, paroxysmal cough and chest oppression of sudden onset, as well as wheezing and subcutaneous emphysema of the neck; she had no previous nasal symptoms...
July 2017: Revista Alergia Mexico: Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C
https://www.readbyqxmd.com/read/29044160/eosinophilia-and-clinical-outcome-of-chronic-obstructive-pulmonary-disease-a-meta-analysis
#2
Jeffery Ho, Wajia He, Matthew T V Chan, Gary Tse, Tong Liu, Sunny H Wong, Czarina C H Leung, Wai T Wong, Sharon Tsang, Lin Zhang, Rose Y P Chan, Tony Gin, Joseph Leung, Benson W M Lau, William K K Wu, Shirley P C Ngai
Numerous studies have investigated the association between eosinophilia and clinical outcome of patients with chronic obstructive pulmonary disease (COPD) but the evidence is conflicting. We conducted a pooled analysis of outcome measures comparing eosinophilic and non-eosinophilic COPD patients. We searched articles indexed in four databases using Medical Subject Heading or Title and Abstract words including COAD, COPD, eosinophil, eosinophilia, eosinopenia from inception to December 2016. Observational studies and randomized controlled trials with parallel groups comparing COPD patients with and without eosinophilia were included...
October 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29038166/why-and-how-to-step-down-chronic-asthma-drugs
#3
REVIEW
Michael R Gionfriddo, John B Hagan, Matthew A Rank
Asthma is a common chronic airways disease. The goal of asthma management is to control symptoms while minimizing the side effects of treatment. Following a period of stable asthma, clinicians should consider stepping down treatment. This approach is recommended by current guidelines. Step-down has been studied for several types of asthma drug regimens, and certain approaches may have lower risk than others. Systematic reviews of multiple trials support the following specific step-down approaches: optimizing inhaled corticosteroid dosing when stepping down oral corticosteroid, reducing inhaled corticosteroid from a higher dose, lowering inhaled corticosteroid-long acting bronchodilator (ICS-LABA) dose while adding ICS-LABA on-demand, adding leukotriene receptor antagonist (LTRA) while lowering inhaled corticosteroid dose, and using allergen immunotherapy when reducing inhaled corticosteroid from a higher dose...
October 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29036018/precision-medicine-in-asthma-linking-phenotypes-to-targeted-treatments
#4
Kian F Chung
PURPOSE OF REVIEW: Asthma is a heterogeneous disease consisting of different phenotypes that are driven by different mechanistic pathways. The purpose of this review is to emphasize the important role of precision medicine in asthma management. RECENT FINDINGS: Despite asthma heterogeneity, the approach to management has been on the basis of disease severity, with the most severe patients reserved for the maximum treatments with corticosteroids and bronchodilators...
October 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29034296/diagnosis-of-asthma-in-symptomatic-children-based-on-measures-of-lung-function-an-analysis-of-data-from-a-population-based-birth-cohort-study
#5
Clare Murray, Philip Foden, Lesley Lowe, Hannah Durrington, Adnan Custovic, Angela Simpson
BACKGROUND: Concerns have been expressed about asthma overdiagnosis. The UK National Institute of Health and Care Excellence (NICE) proposed a new diagnostic algorithm applying four lung function measures sequentially (ratio of forced expiratory volume in 1 s [FEV1] to forced vital capacity [FVC] <70%, bronchodilator reversibility ≥12%, fractional exhaled nitric oxide [FeNO] ≥35 parts per billion, and peak expiratory flow variability >20%). We aimed to assess the diagnostic value of three of the tests individually, and then test the proposed algorithm in symptomatic children...
October 2017: Lancet Child Adolesc Health
https://www.readbyqxmd.com/read/29017524/chronic-obstructive-pulmonary-disease-bronchial-asthma-and-allergic-rhinitis-in-the-adult-population-within-the-commonwealth-of-independent-states-rationale-and-design-of-the-core-study
#6
Yuriy Feshchenko, Liudmila Iashyna, Damilya Nugmanova, Olga Gyrina, Marina Polyanskaya, Alexander Markov, Maryna Moibenko, Janina Makarova, Luqman Tariq, Marcelo Horacio S Pereira, Elcan Mammadbayov, Irada Akhundova, Averyan Vasylyev
BACKGROUND: Main treatable Chronic Respiratory Diseases (CRDs) like Chronic Obstructive Pulmonary Disease (COPD), Bronchial Asthma (BA) and Allergic Rhinitis (AR) are underdiagnosed and undertreated worldwide. CORE study was aimed to assess the point prevalence of COPD, BA and AR in the adult population of major cities of Commonwealth of Independent States (CIS) countries - Azerbaijan, Kazakhstan, and Ukraine based on study questionnaires and/or spirometry, and to document risk factors, characterize the COPD, BA and AR population to provide a clearer "epidemiological data"...
October 10, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28993871/dual-bronchodilation-with-indacaterol-maleate-glycopyrronium-bromide-compared-with-umeclidinium-bromide-vilanterol-in-patients-with-moderate-to-severe-copd-results-from-two-randomized-controlled-cross-over-studies
#7
Edward Kerwin, Gary T Ferguson, Shahin Sanjar, Thomas Goodin, Anthony Yadao, Robert Fogel, Samopriyo Maitra, Biswajit Sen, Tim Ayers, Donald Banerji
PURPOSE: To compare the efficacy and safety of two long-acting dual bronchodilator combinations: indacaterol/glycopyrrolate (IND/GLY) versus umeclidinium/vilanterol (UMEC/VI). METHODS: Studies A2349 and A2350 were replicate, randomized, double-blind, double-dummy, active-controlled, cross-over studies in patients with moderate-to-severe COPD. Patients were randomized to sequential 12-week treatments of twice-daily IND/GLY 27.5/15.6 μg and once-daily UMEC/VI 62...
October 9, 2017: Lung
https://www.readbyqxmd.com/read/28993264/sensory-mechanical-effects-of-a-dual-bronchodilator-and-its-anticholinergic-component-in-copd
#8
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/28987804/pharmacodynamics-pharmacokinetics-and-safety-of-revefenacin-td-4208-a-long-acting-muscarinic-antagonist-in-patients-with-chronic-obstructive-pulmonary-disease-copd-results-of-two-randomized-double-blind-phase-2-studies
#9
Dean Quinn, Christopher N Barnes, Wayne Yates, David L Bourdet, Edmund J Moran, Peter Potgieter, Andrew Nicholls, Brett Haumann, Dave Singh
BACKGROUND: Revefenacin (TD-4208) is a potent, lung-selective, long-acting muscarinic antagonist currently in development for once-daily treatment of chronic obstructive pulmonary disease (COPD). We evaluated the pharmacodynamics (bronchodilator activity), pharmacokinetics (PK) and safety of single- and multiple-dose administrations of nebulized revefenacin in two clinical trials (Study 0059 and Study 0091) in patients with moderate to severe COPD. METHODS: In Study 0059, 32 patients were randomized to receive a single dose of revefenacin (350 or 700 μg), active control ipratropium (500 μg) or placebo inhalation solution administered via standard jet nebulizer in a double-blind, crossover fashion...
October 4, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28982946/role-of-bronchodilation-and-pattern-of-breathing-in-increasing-expiratory-flow-during-progressive-hypercapnia-in-chronic-obstructive-pulmonary-disease
#10
Kevin E Finucane, Bhajan Singh
Hypercapnia (HC) in-vitro relaxes airway smooth muscle; in-vivo it increases respiratory effort, tidal expiratory flows (V'exp), and, by decreasing inspiratory duration (Ti), increases elastic recoil pressure (Pel) via lung visco-elasticity; however, its effect on airway resistance is uncertain. We examined the contributions of bronchodilation, Ti and expiratory effort to increasing V'exp ̇with progressive HC in 10 COPD subjects, mean FEV1 53% predicted. Lung volumes (Vl), V'exp, esophageal pressure (Pes), Ti and end tidal PCO2 (PetCO2) were measured during 6 tidal breaths followed by an inspiratory capacity (IC), breathing air and at 3 levels of HC...
October 5, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28981234/-treatment-of-stable-copd-gold-2017-and-the-associations%C3%A2
#11
A Legrand
GOLD 2017 Report highlights the importance of patient symptoms and exacerbation risks in influencing some therapeutic decisions for individualized patient care. Assessment of the severity of airway obstruction is now separated from the " ABCD " groups but remains a key step for the diagnosis, prognostication and nonpharmacological therapies of COPD patients. Inhaled long-acting bronchodilators, alone or in combination, have a central role in the treatment of COPD patients. Their prolonged action allows a significant improvement not only of FEV1, but also of dyspnoea and health status...
2017: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/28979112/sputum-cell-count-biomarkers-in-the-differentiation-of-asthma-copd-and-asthma-copd-overlap
#12
Jie Gao, Wutie Zhou, Bida Chen, Weiming Lin, Sifang Wu, Feng Wu
INTRODUCTION: Cell count in induced sputum is a noninvasive biomarker to assess airway inflammation phenotypes. Accordingly, sputum cell counts are extensively used in the treatment of asthma and COPD. Nevertheless, the clinical application of sputum cell counts in patients with asthma-COPD overlap (ACO) remains elusive. The aim of this study was to investigate sputum cell counts in patients with ACO which are different from those in patients with asthma and COPD and also to examine the relationship between sputum cell counts in bronchial reversibility and bronchial hyperresponsiveness (BHR)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28974677/longitudinal-outcomes-of-different-asthma-phenotypes-in-primary-care-an-observational-study
#13
Rishi J Khusial, Jacob K Sont, Rik J B Loijmans, Jiska B Snoeck-Stroband, Pim J J Assendelft, Tjard R J Schermer, Persijn J Honkoop
While asthma presentation is heterogeneous, current asthma management guidelines in primary care are quite homogeneous. In this study we aim to cluster patients together into different phenotypes, that may aid the general practitioner in individualised asthma management. We analysed data from the ACCURATE trial, containing 611 adult asthmatics, 18-50 year-old, treated in primary care, with one year follow-up. Variables obtained at baseline (n = 14), were assessed by cluster analysis. Subsequently, established phenotypes were assessed separately on important asthma outcomes after one year follow-up: asthma control (Asthma Control Questionnaire (ACQ)), quality of life (Asthma Quality of Life Questionnaire (AQLQ)), exacerbation-rate and medication-usage...
October 3, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28972658/atopy-in-people-aged-40-and-over-relation-to-airflow-limitation
#14
Elyse Marie Guevara-Rattray, Frances L Garden, Alan L James, Richard Wood-Baker, Michael J Abramson, David P Johns, A Sonia Buist, Peter G J Burney, E Haydn Walters, Brett G Toelle, Guy B Marks
BACKGROUND: Previous studies have reached conflicting conclusions about the role of atopy as a risk factor for COPD. In part, this is attributable to variation in the definitions of airflow limitation and the treatment of people with asthma. OBJECTIVE: To establish whether there is any independent association between atopy and post-bronchodilator airflow limitation in the general population aged 40 years and over. METHODS: A cross-sectional survey was conducted in a general population sample of 2415 people aged 40 years and over in Australia...
October 3, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28972600/spirometric-and-hygienic-criteria-in-recognition-of-occupational-copd-in-poland-a-retrospective-analysis-of-medical-records
#15
Aneta Kleniewska, Jolanta Walusiak-Skorupa, Agnieszka Lipińska-Ojrzanowska, Kamila Szcześniak, Marta Wiszniewska
OBJECTIVES: Chronic obstructive pulmonary disease (COPD) may be work-related. It has been estimated that 15% of the population burden of COPD is attributable to occupational exposure. However, in Poland COPD is rarely recognized as an occupational disease. The aim of the study has been to analyze the causes of the low prevalence of work-related COPD in the context of the existing criteria as well as to analyze which part of the assessment - clinical or hygienic one - is responsible for such a low rate of occupational COPD recognitions...
October 2, 2017: International Journal of Occupational Medicine and Environmental Health
https://www.readbyqxmd.com/read/28966879/association-of-serum-lipids-and-obstructive-lung-disease-in-hispanic-latino-adults-of-diverse-backgrounds
#16
Majid Afshar, Donghong Wu, Ramon Durazo-Arvizu, Frank G Aguilar, Ravi Kalhan, Sonia M Davis, Robert Kaplan, Oana L Klein, Eliana P Mende, Maria S Pattany, Martha L Daviglus
RATIONALE: Substantial variation in the prevalences of obstructive lung disease exist between Hispanic/Latino heritage groups. Experimental studies have posited biological mechanisms linking serum lipids and lipid-lowering medications with obstructive lung disease. The aim of this study is to examine the associations of serum lipid levels with the prevalences of asthma and chronic obstructive pulmonary disease in the Hispanic Community Health Study/Study of Latinos and how these associations vary by Hispanic/Latino heritage group...
August 2017: Journal of Pulmonary & Respiratory Medicine
https://www.readbyqxmd.com/read/28965921/therapeutic-approaches-of-asthma-and-copd-overlap
#17
REVIEW
Mitsuko Kondo, Jun Tamaoki
Asthma and COPD overlap (ACO) is an important clinical phenotype, due to the low-health-related quality of life (QOL), rapid decline in lung function, frequent exacerbation, and high economic burden. However, no large-scaled therapeutic trials of ACO have been conducted. At present, ACO is treated according to asthma/COPD guidelines. The goals of ACO treatment are to relieve symptoms and improve QOL and lung functions. Treatment must also prevent disease progression, airway remodeling, exacerbation, complications, and comorbidities...
September 28, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28964817/adrb2-gene-polymorphism-and-emphysema-heterogeneity-can-modulate-bronchodilator-response-in-patients-with-emphysema
#18
Masafumi Nojiri, Shiro Mizuno, Kazuaki Nishiki, Ryo Kato, Ken Nakagawa, Taku Oikawa, Masaharu Iguchi, Kazuhiro Osanai, Takeshi Ishizaki, Hirohisa Toga
BACKGROUND: Genetic variation in the β2-adrenergic receptor (ADRB2) gene has been thought to have an important role in the differential response to β2-agonist therapy for asthma. However, previous studies have shown little evidence for an association between these ADRB2 variants and the bronchial dilator response (BDR) in chronic obstructive pulmonary disease (COPD) patients. This discrepancy could be explained by differences in the distribution and heterogeneity of pulmonary emphysema in COPD patients, since emphysema distribution and heterogeneity are thought to have a role in pulmonary function in COPD patients...
September 27, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28962794/corrigendum-to-inhaled-hyaluronic-acid-microparticles-extended-pulmonary-retention-and-suppressed-systemic-exposure-of-a-short-acting-bronchodilator-carbohydr-polym-172-2017-197-204
#19
Ying Li, Meihua Han, Tingting Liu, Dongmei Cun, Liang Fang, Mingshi Yang
No abstract text is available yet for this article.
December 1, 2017: Carbohydrate Polymers
https://www.readbyqxmd.com/read/28962200/3-dimensional-computed-tomography-imaging-of-the-ring-sling-complex-with-non-operative-survival-case-in-a-10-year-old-female
#20
Hironobu Fukuda, George Imataka, Fabrizio Drago, Kosaku Maeda, Shigemi Yoshihara
We report a case of a 10-year-old female patient who survived ring-sling complex without surgery. The patient had congenital wheezing from the neonatal period and was treated after a tentative diagnosis of infantile asthma. The patient suffered from allergy and was hospitalized several times due to severe wheezing, and when she was 22 months old, she was diagnosed with ring-sling complex. We used a segmental 4 mm internal diameter of the trachea for 3-dimensional computed tomography (3D-CT). Bronchial asthma is considered an exacerbating factor in infantile period and frequently required treatment with bronchodilator...
September 2017: Experimental and Therapeutic Medicine
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