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Update in Pulmonary

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https://www.readbyqxmd.com/read/29327393/pulmonary-hypertension-in-interstitial-lung-disease-limitations-of-echocardiography-compared-to-cardiac-catheterization
#1
Gregory J Keir, S John Wort, Maria Kokosi, Peter M George, Simon L F Walsh, Joseph Jacob, Laura Price, Simon Bax, Elisabetta A Renzoni, Toby M Maher, Peter MacDonald, David M Hansell, Athol U Wells
BACKGROUND AND OBJECTIVE: In interstitial lung disease (ILD), pulmonary hypertension (PH) is a major adverse prognostic determinant. Transthoracic echocardiography (TTE) is the most widely used tool when screening for PH, although discordance between TTE and right heart catheter (RHC) measured pulmonary haemodynamics is increasingly recognized. We evaluated the predictive utility of the updated European Society of Cardiology/European Respiratory Society (ESC/ERS) TTE screening recommendations against RHC testing in a large, well-characterized ILD cohort...
January 12, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29326000/epidemiology-of-tuberculosis-in-spain-results-obtained-by-the-national-epidemiological-surveillance-network-in-2015
#2
Rosa Cano-Portero, Rocío Amillategui-Dos Santos, Raquel Boix-Martínez, Amparo Larrauri-Cámara
The epidemiological surveillance data for tuberculosis in Spain in 2015 is analysed in this report. This information was gathered through cases reported to the Red Nacional de Vigilancia Epidemiológica [National Epidemiological Surveillance Network]. In addition, the update of the treatment of the cases reported in 2014 is included. The incidence rate of tuberculosis in 2015 was 10.59 cases per 100,000 inhabitants, 10% less than in 2014. This decrease was mainly due to the sustained decreased trend of pulmonary tuberculosis rates, from other locations and in adults, while for cases of tuberculous meningitis and in children the decrease is less marked, with a tendency to stabilization...
January 8, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29318284/screening-for-adolescent-idiopathic-scoliosis-us-preventive-services-task-force-recommendation-statement
#3
David C Grossman, Susan J Curry, Douglas K Owens, Michael J Barry, Karina W Davidson, Chyke A Doubeni, John W Epling, Alex R Kemper, Alex H Krist, Ann E Kurth, C Seth Landefeld, Carol M Mangione, Maureen G Phipps, Michael Silverstein, Melissa A Simon, Chien-Wen Tseng
Importance: Adolescent idiopathic scoliosis, a lateral curvature of the spine of unknown cause with a Cobb angle of at least 10°, occurs in children and adolescents aged 10 to 18 years. Idiopathic scoliosis is the most common form and usually worsens during adolescence before skeletal maturity. Severe spinal curvature may be associated with adverse long-term health outcomes (eg, pulmonary disorders, disability, back pain, psychological effects, cosmetic issues, and reduced quality of life)...
January 9, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29316681/non-transfusion-dependent-thalassemia-an-update-on-complications-and-management
#4
REVIEW
Joseph Sleiman, Ali Tarhini, Rayan Bou-Fakhredin, Antoine N Saliba, Maria Domenica Cappellini, Ali T Taher
Patients with non-transfusion-dependent thalassemia (NTDT) experience many clinical complications despite their independence from frequent transfusions. Morbidities in NTDT stem from the interaction of multiple pathophysiological factors: ineffective erythropoiesis, iron overload (IOL), and hypercoagulability. Ineffective erythropoiesis and hemolysis are associated with chronic hypoxia and a hypercoagulable state. The latter are linked to a high prevalence of thromboembolic and cerebrovascular events, as well as leg ulcers and pulmonary hypertension...
January 8, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29315455/home-versus-in-patient-treatment-for-deep-vein-thrombosis
#5
REVIEW
Richard Othieno, Emmanuel Okpo, Rachel Forster
BACKGROUND: Deep vein thrombosis (DVT) occurs when a blood clot blocks blood flow through a vein, which can occur after surgery, after trauma, or when a person has been immobile for a long time. Clots can dislodge and block blood flow to the lungs (pulmonary embolism (PE)), causing death. DVT and PE are known by the term venous thromboembolism (VTE). Heparin (in the form of unfractionated heparin (UFH)) is a blood-thinning drug used during the first three to five days of DVT treatment...
January 9, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29312742/clinical-characteristics-and-outcomes-of-lung-cancer-patients-with-combined-pulmonary-fibrosis-and-emphysema-a-systematic-review-and-meta-analysis-of-13-studies
#6
Chuan Li, Wenwen Wu, Nan Chen, Huizi Song, Tianjian Lu, Zhenyu Yang, Zihuai Wang, Jian Zhou, Lunxu Liu
Background: The characteristic and outcomes of lung cancer patients with combined pulmonary fibrosis and emphysema (CPFE) have long been assessed, but results were controversial. Therefore, we performed a meta-analysis to assess the clinical features and prognosis of lung cancer patients with CPFE. Methods: The databases PubMed, Embase, and Web of Science (updated to October 1, 2017) were searched for eligible studies. Pooled odds ratios (ORs), weighted mean differences (WMD) or hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used to evaluate the clinicopathological characteristics, the short-term outcome after operation and long-term survival of lung cancer patients with CPFE compared with lung cancer patients without CPFE (fibrosis, emphysema, and normal)...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29305137/diagnosis-and-management-of-spinal-muscular-atrophy-part-2-pulmonary-and-acute-care-medications-supplements-and-immunizations-other-organ-systems-and-ethics
#7
Richard S Finkel, Eugenio Mercuri, Oscar H Meyer, Anita K Simonds, Mary K Schroth, Robert J Graham, Janbernd Kirschner, Susan T Iannaccone, Thomas O Crawford, Simon Woods, Francesco Muntoni, Brunhilde Wirth, Jacqueline Montes, Marion Main, Elena S Mazzone, Michael Vitale, Brian Snyder, Susana Quijano-Roy, Enrico Bertini, Rebecca Hurst Davis, Ying Qian, Thomas Sejersen
This is the second half of a two-part document updating the standard of care recommendations for spinal muscular atrophy published in 2007. This part includes updated recommendations on pulmonary management and acute care issues, and topics that have emerged in the last few years such as other organ involvement in the severe forms of spinal muscular atrophy and the role of medications. Ethical issues and the choice of palliative versus supportive care are also addressed. These recommendations are becoming increasingly relevant given recent clinical trials and the prospect that commercially available therapies will likely change the survival and natural history of this disease...
November 23, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/29298459/embolisation-for-pulmonary-arteriovenous-malformation
#8
REVIEW
Charlie C-T Hsu, Gigi Nc Kwan, Hannah Evans-Barns, Mieke L van Driel
BACKGROUND: Pulmonary arteriovenous malformations are abnormal direct connections between the pulmonary artery and pulmonary vein which result in a right-to-left shunt. They are associated with substantial morbidity and mortality mainly from the effects of paradoxical emboli. Potential complications include stroke, cerebral abscess, pulmonary haemorrhage and hypoxaemia. Embolisation is an endovascular intervention based on the occlusion of the feeding arteries the pulmonary arteriovenous malformations thus eliminating the abnormal right-to-left-shunting...
January 4, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29290580/diagnosis-and-management-of-spinal-muscular-atrophy-part-1-recommendations-for-diagnosis-rehabilitation-orthopedic-and-nutritional-care
#9
Eugenio Mercuri, Richard S Finkel, Francesco Muntoni, Brunhilde Wirth, Jacqueline Montes, Marion Main, Elena S Mazzone, Michael Vitale, Brian Snyder, Susana Quijano-Roy, Enrico Bertini, Rebecca Hurst Davis, Oscar H Meyer, Anita K Simonds, Mary K Schroth, Robert J Graham, Janbernd Kirschner, Susan T Iannaccone, Thomas O Crawford, Simon Woods, Ying Qian, Thomas Sejersen
Spinal muscular atrophy (SMA) is a severe neuromuscular disorder due to a defect in the survival motor neuron 1 (SMN1) gene. Its incidence is approximately 1 in 11,000 live births. In 2007, an International Conference on the Standard of Care for SMA published a consensus statement on SMA standard of care that has been widely used throughout the world. Here we report a two-part update of the topics covered in the previous recommendations. In part 1 we present the methods used to achieve these recommendations, and an update on diagnosis, rehabilitation, orthopedic and spinal management; and nutritional, swallowing and gastrointestinal management...
November 23, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/29288933/targeting-the-renin-angiotensin-system-as-novel-therapeutic-strategy-for-pulmonary-diseases
#10
REVIEW
Wan Shun Daniel Tan, Wupeng Liao, Shuo Zhou, Dan Mei, Wai-Shiu Fred Wong
The renin-angiotensin system (RAS) plays a major role in regulating electrolyte balance and blood pressure. RAS has also been implicated in the regulation of inflammation, proliferation and fibrosis in pulmonary diseases such as asthma, acute lung injury (ALI), chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF) and pulmonary arterial hypertension (PAH). Current therapeutics suffer from some drawbacks like steroid resistance, limited efficacies and side effects. Novel intervention is definitely needed to offer optimal therapeutic strategy and clinical outcome...
December 27, 2017: Current Opinion in Pharmacology
https://www.readbyqxmd.com/read/29285754/oral-anticoagulation-in-people-with-cancer-who-have-no-therapeutic-or-prophylactic-indication-for-anticoagulation
#11
REVIEW
Lara A Kahale, Maram B Hakoum, Ibrahim G Tsolakian, Charbel F Matar, Maddalena Barba, Victor E D Yosuico, Irene Terrenato, Francesca Sperati, Holger Schünemann, Elie A Akl
BACKGROUND: Oral anticoagulants may improve the survival of people with cancer through both an antitumor effect and antithrombotic effect, yet increase the risk of bleeding. OBJECTIVES: To evaluate the efficacy and safety of oral anticoagulants in ambulatory people with cancer undergoing chemotherapy, hormonal therapy, immunotherapy or radiotherapy, but otherwise have no standard therapeutic or prophylactic indication for anticoagulation. SEARCH METHODS: We conducted a comprehensive literature search in February 2016 that included a major electronic search of Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 1), MEDLINE (Ovid) and Embase (Ovid); handsearching of conference proceedings; checking of references of included studies; a search for ongoing studies; and using the 'related citation' feature in PubMed...
December 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29282699/dizziness-in-the-emergency-department-an-update-on-diagnosis
#12
Rainer Spiegel, Mark Kirsch, Christiane Rosin, Heiko Rust, Thomas Baumann, Raoul Sutter, Hergen Friedrich, Martina Göldlin, René Müri, Roger Kalla, Roland Bingisser, Georgios Mantokoudis
This review aims to assist emergency physicians in finding the underlying aetiology when a patient presents with dizziness to the emergency department. After reading this review, the emergency physician will be able to consider the most relevant differential diagnoses and have an idea about dangerous aetiologies that require immediate action. The emergency physician will also know what diagnostic steps need to be taken at what time, such as the three-component HINTS Test (Head Impulse, Nystagmus, and Test-of-Skew), which helps with distinguishing central from peripheral causes of the acute vestibular syndrome...
December 28, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29279020/short-term-outcomes-comparison-between-preterm-infants-with-and-without-acute-hypoxic-respiratory-failure-attributable-to-presumed-pulmonary-hypoplasia-after-prolonged-preterm-premature-rupture-of-membranes-before-25-gestational-weeks
#13
Ga Young Park, Won Soon Park, Hye Soo Yoo, So Yoon Ahn, Se In Sung, Sung Shin Kim, Yun Sil Chang
OBJECTIVE: To determine the updated outcomes of preterm infants with acute hypoxic respiratory failure attributable to presumed pulmonary hypoplasia (PH) following maternal midtrimester prolonged preterm premature rupture of membranes (PPROM). STUDY DESIGN: Among preterm infants with birthweight < 1500 g and 23-34 weeks gestational age in a single center, infants exposed to maternal prolonged (≥ 7 days) PPROM before 25 gestational weeks (PPPROM25, n = 76) were retrospectively reviewed...
December 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29258327/long-acting-bronchodilator-use-in-the-management-of-stable-copd-a-review
#14
Aya Wail Abukwaik, Rupal Mansukhani, Mary Barna Bridgeman
OBJECTIVE: To review the management of chronic obstructive pulmonary disease (COPD), with a focus on updated information regarding the use of long-acting bronchodilators in the prevention of exacerbations and outcomes associated with this disease. DATA SOURCES: A literature search of the MEDLINE databases through November 2017 was conducted. All published articles regarding use of bronchodilator therapy in the management of COPD were evaluated. References of selected articles, data from poster presentations, and abstract publications were additionally reviewed...
December 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29250755/extracorporeal-lung-support-for-advanced-lung-failure-a-new-era-in-thoracic-surgery-and-translational-science
#15
REVIEW
Norihisa Shigemura
For the patients with progressively decompensating acute or acute-on-chronic respiratory failure, the first-choice treatment remains as mechanical ventilation. Despite the consistent value of mechanical ventilation, the majority of lung specialists are aware of its limitations, in particular for the patients with advanced lung failure, and inherent drawbacks that augment disease progression. More recently, the concept of allowing the lungs to 'rest and recover' has been supported by quite a few clinical studies...
December 18, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29225809/venous-air-embolism-related-to-the-use-of-central-catheters-revisited-with-emphasis-on-dialysis-catheters
#16
REVIEW
Steve Siu-Man Wong, Hau C Kwaan, Todd S Ing
Venous air embolism is a dreaded condition particularly relevant to the field of nephrology. In the face of a favourable, air-to-blood pressure gradient and an abnormal communication between the atmosphere and the veins, air entrance into the circulation is common and can bring about venous air embolism. These air emboli can migrate to different areas through three major routes: pulmonary circulation, paradoxical embolism and retrograde ascension to the cerebral venous system. The frequent undesirable outcome of this disease entity, despite timely and aggressive treatment, signifies the importance of understanding the underlying pathophysiological mechanism and of the implementation of various preventive measures...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29216806/an-industry-update-the-latest-developments-in-therapeutic-delivery
#17
Iain Simpson
This industry update covers the period from 1 September through 30 September 2017, and is based on information sourced from company press releases, scientific literature, patents and various news websites. The month saw the US FDA approve three new molecular entities, Aliqopa (copanlisib dihydrochloride) (Bayer Healthcare); Solosec (secnidazole) (Symbiomix Therapeutics) and Verzenio (abemaciclib) (Eli Lilly and Co). Intarcia Therapeutics Inc. has its application for approval of a novel drug device combination of exenatide for the treatment of diabetes rejected by FDA but said that it will work to address the concerns and refile the application...
January 2018: Therapeutic Delivery
https://www.readbyqxmd.com/read/29215803/reference-values-for-spirometry-derived-using-lambda-mu-sigma-lms-method-in-korean-adults-in-comparison-with-previous-references
#18
Bum Seak Jo, Jun Pyo Myong, Chin Kook Rhee, Hyoung Kyu Yoon, Jung Wan Koo, Hyoung Ryoul Kim
BACKGROUND: The present study aimed to update the prediction equations for spirometry and their lower limits of normal (LLN) by using the lambda, mu, sigma (LMS) method and to compare the outcomes with the values of previous spirometric reference equations. METHODS: Spirometric data of 10,249 healthy non-smokers (8,776 females) were extracted from the fourth and fifth versions of the Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2009; V, 2010-2012)...
January 15, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29209910/efficacy-and-safety-of-nintedanib-for-the-treatment-of-idiopathic-pulmonary-fibrosis-an-update
#19
José Antonio Rodríguez-Portal
Idiopathic pulmonary fibrosis is a fatal form of progressive fibrosing interstitial pneumonia with limited treatment options. In recent years, its management has been transformed with the approval of two new antifibrotic drugs: nintedanib and pirfenidone. Nintedanib is a tyrosine kinase inhibitor that efficiently slows idiopathic pulmonary fibrosis progression and has an acceptable tolerability profile. This article reviews new available evidence on the long-term efficacy and safety of nintedanib in patients with idiopathic pulmonary fibrosis...
December 5, 2017: Drugs in R&D
https://www.readbyqxmd.com/read/29206657/dual-bronchodilator-therapy-for-chronic-obstructive-pulmonary-disease-evidence-for-the-efficacy-and-safety-of-fixed-dose-combination-treatments-in-the-setting-of-recent-guideline-updates
#20
Steven D Deas, Nikhil Huprikar
PURPOSE OF REVIEW: Recent updates to the GOLD guidelines emphasize the use of combination LABA and LAMA bronchodilators for patients with chronic obstructive pulmonary disease with persistent dyspnea despite monotherapy or frequent exacerbations despite LAMA monotherapy. There are several commercially available LABA/LAMA fixed dose combination inhalers, which are likely to become the principle therapy for many patients with COPD. RECENT FINDINGS: In the last 4 years, there have been a number of large clinical trials evaluating the efficacy and safety of combined LAMA and LABA bronchodilators...
December 4, 2017: Current Opinion in Pulmonary Medicine
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