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https://www.readbyqxmd.com/read/29145795/use-of-immunohistochemistry-to-demonstrate-in-vivo-expression-of-the-burkholderia-mallei-virulence-factor-bpab-during-experimental-glanders
#1
Shawn M Zimmerman, Mackenzie E Long, Jeremy S Dyke, Tomislav P Jelesijevic, Frank Michel, Eric R Lafontaine, Robert J Hogan
Burkholderia mallei causes the highly contagious and debilitating zoonosis glanders, which infects via inhalation or percutaneous inoculation and often culminates in life-threatening pneumonia and sepsis. In humans, glanders is difficult to diagnose and requires prolonged antibiotic therapy with low success rates. No vaccine exists to protect against B. mallei, and there is concern regarding its use as a bioweapon. The authors previously identified the protein BpaB as a potential target for devising therapies due to its role in adherence to host cells and the formation of biofilms in vitro and its contribution to pathogenicity in a mouse model of glanders...
January 1, 2017: Veterinary Pathology
https://www.readbyqxmd.com/read/29129177/copd-x-australian-and-new-zealand-guidelines-for-the-diagnosis-and-management-of-chronic-obstructive-pulmonary-disease-2017-update
#2
Ian A Yang, Juliet L Brown, Johnson George, Sue Jenkins, Christine F McDonald, Vanessa M McDonald, Kirsten Phillips, Brian J Smith, Nicholas A Zwar, Eli Dabscheck
Chronic obstructive pulmonary disease (COPD) is characterised by persistent respiratory symptoms and chronic airflow limitation, and is associated with exacerbations and comorbidities. Advances in the management of COPD are updated quarterly in the national COPD guidelines, the COPD-X plan, published by Lung Foundation Australia in conjunction with the Thoracic Society of Australia and New Zealand and available at http://copdx.org.au. Main recommendations: Spirometry detects persistent airflow limitation (post-bronchodilator FEV1/FVC < 0...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29110790/long-term-management-of-patients-with-end-stage-lung-diseases
#3
REVIEW
Domenica Federica Briganti, Frank D'Ovidio
Long-term management of end-stage lung disease differs from interstitial lung disease to chronic obstructive pulmonary disease to cystic fibrosis to pulmonary vascular disease. The management includes pharmacological therapy that is disease specific such as antibiotic therapy for cystic fibrosis, antifibrotic drugs in idiopathic pulmonary fibrosis; long-acting beta-agonists, long-acting muscarinic antagonist, and inhaled corticosteroids in chronic obstructive pulmonary disease; and vasodilators in pulmonary arterial hypertension...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29080051/reducing-unnecessary-chest-x-rays-antibiotics-and-bronchodilators-through-implementation-of-the-nice-bronchiolitis-guideline
#4
Richard Breakell, Benjamin Thorndyke, Julie Clennett, Christian Harkensee
Chest X-rays (CXR), antibiotics and inhaled/nebulized therapy are overused in bronchiolitis, despite evidence-based guidelines suggesting supportive management only. This study investigates the effect of the implementation of the NICE bronchiolitis guideline in a secondary paediatric unit in England. We present a quality improvement project with a completed audit cycle (winter 2014-2015 and 2015-2016) pre- and post-implementation of the NICE bronchiolitis guideline. The educational intervention included sessions for raising awareness of appropriate and inappropriate management of bronchiolitis for both clinicians and nursing staff...
October 28, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29077527/the-rationale-and-evidence-for-use-of-inhaled-antibiotics-to-control-pseudomonas-aeruginosa-infection-in-non-cystic-fibrosis-bronchiectasis
#5
Rajiv Dhand
Non-cystic fibrosis bronchiectasis (NCFBE) is a chronic inflammatory lung disease characterized by irreversible dilation of the bronchi, symptoms of persistent cough and expectoration, and recurrent infective exacerbations. The prevalence of NCFBE is on the increase in the United States and Europe, but no licensed therapies are currently available for its treatment. Although there are many similarities between NCFBE and cystic fibrosis (CF) in terms of respiratory symptoms, airway microbiology, and disease progression, there are key differences, for example, in response to treatment, suggesting differences in pathogenesis...
October 27, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/29064184/cystic-fibrosis-clinical-characteristics-associated-with-dornase-alfa-treatment-regimen-change
#6
Donald R VanDevanter, Marcia L Craib, David J Pasta, Stefanie J Millar, Wayne J Morgan, Michael W Konstan
BACKGROUND: When the chronic respiratory therapy dornase alfa was made commercially available for cystic fibrosis (CF) more than 20 years ago, two regimens were approved: 2.5 mg inhaled once daily (QD) or twice daily (BID). In the intervening years, there has been little guidance as to when to use each regimen. We have studied clinical practice patterns captured in the Epidemiologic Study of CF (ESCF) during the decade following dornase alfa approval (1994-2005) to better understand clinical characteristics associated with QD versus BID dornase alfa use...
October 24, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28983645/-pseudomonas-aeruginosa-infections-in-chronic-obstructive-pulmonary-disease-role-of-long-term-antibiotic-treatment
#7
REVIEW
G G U Rohde, T Welte
Chronic Pseudomonas aeruginosa colonization in the airways of patients with chronic obstructive pulmonary disease (COPD) is probably associated with increased mortality and morbidity and a faster progress of COPD, although this has not been conclusively proven by studies. Studies demonstrating an improvement in prognosis in COPD patients by early eradication of Pseudomonas or at least a reduction of the bacterial burden by either inhaled or oral antibiotic maintenance therapy, are missing. An impact on the exacerbation rate has only been shown for macrolide maintenance treatment; however, this effect could be explained by the inclusion of patients with bronchiectasis in the studies...
November 2017: Der Internist
https://www.readbyqxmd.com/read/28980592/-the-prevalence-of-the-fungal-flora-in-association-with-chronic-inflammatory-pathology-of-the-larynx
#8
V Ya Kunel'skaya, S G Romanenko, G B Shadrin, D I Krasnikova
The present article was designed to analyze the prevalence and clinical features of laryngomycosis associated with chronic inflammatory diseases of the larynx. We examined 430 patients suffering from chronic pharyngitis and found the fungal flora in 100 (23.2%) of them. Diagnostics of the fungal infection was performed by the microscopic study of the stained preparations (including the Gram method, Romanovskiy-Giemsa and fluorescent microscopy). The sowing on elective nutrient media was used. The study revealed the presence of yeast fungi (Candida) in 98 patients (98%) and mold fungi (Aspergillus) in the remaining two (2%)...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28965921/therapeutic-approaches-of-asthma-and-copd-overlap
#9
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/28904326/intravenous-polymyxins-revival-with-puzzle
#10
Yun Yu, Aihua Fei, Zengbin Wu, Chengjin Gao, Shuming Pan
With the increasing incidence of multi-drug resistant strains, especially carbapenem resistant strains, polymyxsins (mainly colistin and polymyxin B) based regimens seem to be a revival as an effective treatment of last resort in these infections. Evidence from 47 clinical trials or case series we reviewed showed that polymyxins based regimens are effective and have less toxicity compared with previous trials. When used alone, the mortality of intravenous polymyxsins ranged from 0% to 74.3%, clinical response (cure and improvement) rate was 7-82...
2017: Bioscience Trends
https://www.readbyqxmd.com/read/28885458/compassionate-nitric-oxide-adjuvant-treatment-of-persistent-mycobacterium-infection-in-cystic-fibrosis-patients
#11
Karin Yaacoby-Bianu, Michal Gur, Yazeed Toukan, Vered Nir, Fahed Hakim, Yuval Geffen, Lea Bentur
BACKGROUND: Mycobacterium abscessus is one of the most antibiotic-resistant pathogens in Cystic Fibrosis (CF) patients. Nitric Oxide (NO) has broad-spectrum antimicrobial activity. Clinical studies indicated that it is safe and tolerable when given as 160 ppm intermittent inhalations. METHODS: A prospective compassionate adjunctive inhaled NO therapy in two CF patients with persistent Mycobacterium abscessus infection. RESULTS: No adverse events were reported...
September 6, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28874611/how-should-aerosols-be-delivered-during-invasive-mechanical-ventilation
#12
Rajiv Dhand
The delivery of aerosols to mechanically ventilated patients presents unique challenges and differs from inhaled drug delivery in spontaneously breathing patients in several respects. Successful aerosol delivery during invasive mechanical ventilation requires careful consideration of a host of factors that influence the amount of drug inhaled by the patient. Pressurized metered-dose inhalers and nebulizers (jet, ultrasonic, and vibrating mesh) are the most commonly used aerosol delivery devices in these patients, although other delivery devices, such as dry powder inhalers, soft mist inhalers, and intratracheal nebulizing catheters, could also be adapted for in-line use...
October 2017: Respiratory Care
https://www.readbyqxmd.com/read/28872662/current-options-in-aerosolised-drug-therapy-for-children-receiving-respiratory-support
#13
REVIEW
S Trend, B S von Ungern-Sternberg, S G Devadason, A Schultz, M L Everard
Inhalation of aerosolised medications are the mainstay of treatment for a number of chronic lung diseases and have several advantages over systemically-administered medications. These include more rapid onset of action for drugs such as β-adrenergic agonists when compared with oral medication, high luminal doses for inhaled antibiotics when used to treat endobronchial infection, and an improved therapeutic index compared with systemic delivery for these and other classes of drugs such as corticosteroids. The use of aerosolised drugs to treat patients whose tracheas are intubated is less well established, in part because systemic delivery via the intravenous route can be a simpler alternative for many drugs...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/28856066/estimation-of-time-period-for-effective-human-inhalational-anthrax-treatment-including-antitoxin-therapy
#14
Lewis Rubinson, Alfred Corey, Dan Hanfling
INTRODUCTION: Infrequent natural human inhalational anthrax cases coupled with high bioterrorism risk have brought about use of animal models to serve as the basis for approval of novel treatments. For inhalational anthrax, protective antigen (PA) drives much of the mortality, and raxibacumab, an anti-PA monoclonal antibody, has been approved for therapeutic use using the Animal Rule. Given the paucity of human inhalational anthrax clinical data including PA kinetics, the post-exposure period for effective treatment of human disease remains unknown...
July 28, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28854668/current-and-future-therapies-for-pseudomonas-aeruginosa-infection-in-patients-with-cystic-fibrosis
#15
Wynne D Smith, Emmanuelle Bardin, Loren Cameron, Claire L Edmondson, Katie V Farrant, Isaac Martin, Ronan A Murphy, Odel Soren, Andrew R Turnbull, Natasha Wierre-Gore, Eric W Alton, Jacob G Bundy, Andrew Bush, Gary J Connett, Saul N Faust, Alain Filloux, Paul S Freemont, Andrew L Jones, Zoltan Takats, Jeremy S Webb, Huw D Williams, Jane C Davies
Pseudomonas aeruginosa opportunistically infects the airways of patients with cystic fibrosis and causes significant morbidity and mortality. Initial infection can often be eradicated though requires prompt detection and adequate treatment. Intermittent and then chronic infection occurs in the majority of patients. Better detection of P. aeruginosa infection using biomarkers may enable more successful eradication before chronic infection is established. In chronic infection P. aeruginosa adapts to avoid immune clearance and resist antibiotics via efflux pumps, β-lactamase expression, reduced porins and switching to a biofilm lifestyle...
August 1, 2017: FEMS Microbiology Letters
https://www.readbyqxmd.com/read/28811074/management-of-multidrug-resistant-gram-negative-bacilli-infections-in-solid-organ-transplant-recipients-set-gesitra-seimc-reipi-recommendations
#16
REVIEW
J M Aguado, J T Silva, M Fernández-Ruiz, E Cordero, J Fortún, C Gudiol, L Martínez-Martínez, E Vidal, L Almenar, B Almirante, R Cantón, J Carratalá, J J Caston, E Cercenado, C Cervera, J M Cisneros, M G Crespo-Leiro, V Cuervas-Mons, J Elizalde-Fernández, M C Fariñas, J Gavaldà, M J Goyanes, B Gutiérrez-Gutiérrez, D Hernández, O Len, R López-Andujar, F López-Medrano, P Martín-Dávila, M Montejo, A Moreno, A Oliver, A Pascual, E Pérez-Nadales, A Román-Broto, R San-Juan, D Serón, A Solé-Jover, M Valerio, P Muñoz, J Torre-Cisneros
Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant (MDR) Gram-negative bacilli (GNB), as they are frequently exposed to antibiotics and the healthcare setting, and are regulary subject to invasive procedures. Nevertheless, no recommendations concerning prevention and treatment are available. A panel of experts revised the available evidence; this document summarizes their recommendations: (1) it is important to characterize the isolate's phenotypic and genotypic resistance profile; (2) overall, donor colonization should not constitute a contraindication to transplantation, although active infected kidney and lung grafts should be avoided; (3) recipient colonization is associated with an increased risk of infection, but is not a contraindication to transplantation; (4) different surgical prophylaxis regimens are not recommended for patients colonized with carbapenem-resistant GNB; (5) timely detection of carriers, contact isolation precautions, hand hygiene compliance and antibiotic control policies are important preventive measures; (6) there is not sufficient data to recommend intestinal decolonization; (7) colonized lung transplant recipients could benefit from prophylactic inhaled antibiotics, specially for Pseudomonas aeruginosa; (8) colonized SOT recipients should receive an empirical treatment which includes active antibiotics, and directed therapy should be adjusted according to susceptibility study results and the severity of the infection...
July 26, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/28810628/use-of-aerosol-inhalation-treatment-with-budesonide-and-terbutaline-sulfate-on-acute-pediatric-asthmatic-bronchitis
#17
Fangfang Bian, Yue-E Wu, Chong-Lin Zhang
The use of oxygen-driven aerosol inhalation therapy with budesonide (suspension) and terbutaline sulfate for the treatment of pediatric asthmatic bronchitis was studied. Sixty pediatric patients diagnosed with asthmatic bronchitis in Xuzhou Children's Hospital during the period comprising April 2013 to December 2015 were enrolled in the study. After randomly dividing the patients into a control (conventional dexamethasone drip) and a treatment group (inhalation of budesonide with terbutaline sulfate) of 30 patients each, the symptoms were treated using antibiotics when necessary...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28779834/inhaled-antibiotics-for-ventilator-associated-infections
#18
REVIEW
Lucy B Palmer
Multidrug-resistant organisms are creating a challenge for physicians treating the critically ill. As new antibiotics lag behind the emergence of worsening resistance, intensivists in countries with high rates of extensively drug-resistant bacteria are turning to inhaled antibiotics as adjunctive therapy. These drugs can provide high concentrations of drug in the lung that could not be achieved with intravenous antibiotics without significant systemic toxicity. This article summarizes current evidence describing the use of inhaled antibiotics for the treatment of bacterial ventilator-associated pneumonia and ventilator-associated tracheobronchitis...
September 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28778139/inhaled-or-nebulised-ciprofloxacin-for-the-maintenance-treatment-of-bronchiectasis
#19
REVIEW
Manjit K Cartlidge, Adam T Hill
Inhaled or nebulised antibiotics are a major topic of ongoing research interest in reducing exacerbations in bronchiectasis. There are no licenced inhaled or nebulised antibiotics currently in bronchiectasis. Areas covered: Inhaled or nebulised ciprofloxacin as a long-term treatment in bronchiectasis. Expert opinion: Results from the Phase III ongoing trials on inhaled or nebulised ciprofloxacin will be key for the outcome of the drugs but additionally, cost-effectiveness and longer-term studies will be necessary to determine the viability of the drug...
September 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28777122/improving-compliance-with-a-chronic-obstructive-pulmonary-disease-bundle-of-care-in-australian-emergency-departments-a-clinical-network-quality-improvement-project
#20
Anne-Maree Kelly, Jan Pannifex
OBJECTIVE: The aim of this study was to describe the impact of a clinical network-led quality improvement project on compliance with bundle of care elements (individually and as a 'bundle') for patients treated for chronic obstructive pulmonary disease exacerbations in the emergency department. PARTICIPANTS AND METHODS: A 9-month quality improvement project was performed by a modified knowledge transfer methodology with analysis before and after data collection...
August 2, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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