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https://www.readbyqxmd.com/read/29346118/mycobacterium-avium-complex-pulmonary-disease-new-epidemiology-and-management-concepts
#1
Leah Lande, Jason George, Theodore Plush
PURPOSE OF REVIEW: The prevalence of Mycobacterium avium complex (MAC)-related pulmonary disease has been increasing because of environmental factors, changes in organism virulence, and evolving host susceptibility. Treatment is often complicated by adverse effects, development of drug resistance, and refractory disease, with recurrence rates as high as 25-45%. RECENT FINDINGS: Aerosolization of water, soil, or dusts are the likely sources of MAC-related pulmonary disease in susceptible individuals...
January 15, 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29344434/rare-multidrug-resistant-pulmonary-nocardiosis-in-aids
#2
Cherry O Onaiwu, Manasa Velagapudi, Luay Sarsam, Lindsay Utley, Lauren Bricker, Venkata Sunil Bendi, Renuga Vivekanandan
Nocardiosis is an opportunistic infection in patients with depressed cell-mediated immunity. Inhalation is the primary route for exposure via dust particles. Patients with acquired immune deficiency syndrome (AIDS) are at increased risk of disseminated disease. A challenge in the diagnosis of pulmonary nocardiosis is that it can mimic other pulmonary diseases. Nocardia farcinica tends to be a more virulent, multidrug-resistant strain with an increased tendency to disseminate. This report describes a 64-year-old man with AIDS found to have pulmonary nocardiosis that did not respond to standard antibiotic therapy...
November 11, 2017: Curēus
https://www.readbyqxmd.com/read/29338445/investigational-inhaled-therapies-for-non-cf-bronchiectasis
#3
Sabina Antonela Antoniu
Bronchiectasis not related to cystic fibrosis (non-CF bronchiectasis) are associated with a high unmet therapeutic need due to the lack of specifically authorized medications, especially via the inhalation route. In non-CF bronchiectasis chronic infection with Pseudomonas aeruginosa is common and favored by the persistent local inflammation and viscid sputum production. Therefore inhaled antibiotics, mucolytics or anti-inflammatory agents could represent appropriate therapeutic interventions in this setting Areas covered: This review herein discusses the inhaled therapies currently under investigation for non-CF bronchiectasis and their potential therapeutic positioning in exacerbation versus stable state...
January 17, 2018: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/29310404/extracorporeal-membrane-oxygenation-combined-with-continuous-renal-replacement-therapy-in-cutaneous-burn-and-inhalation-injury-caused-by-hydrofluoric-acid-and-nitric-acid
#4
Qinhua Pu, Jinxian Qian, Weiyi Tao, Aixiang Yang, Jian Wu, Yaodong Wang
RATIONALE: Hydrofluoric acid (HF) is a highly corrosive agent and can cause corrosive burns. HF can penetrate deeply into tissues through intact skin and the lipid barrier, leading to painful liquefactive necrosis, and inducing hypocalcemia and hypomagnesemia. In this study, we hypothesize that continuous renal replacement therapy (CRRT) may be beneficial in addressing hemodynamic instability in cases of HF poisoning. PATIENT CONCERNS: A 25-year-old man fell into an electroplating pool containing 10% HF and 50% nitric acid...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29303286/-cystic-fibrosis-in-adults
#5
Libor Fila
Cystic fibrosis (CF) is an inherited disease caused by mutations in the transmembrane conductance regulator (CFTR) gene. The disease leads to dysfunction of the exocrine glands with high concentration of chloride in the sweat and formation of abnormally viscous mucus in the respiratory, digestive and reproductive tract. Chronic sinopulmonary disease, exocrine pancreatic insufficiency, liver disease, intestinal obstruction, impaired nutritional status, salt loss syndrome and male infertility dominates in the clinical presentation...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29260786/-the-use-of-fenspiride-for-the-combined-treatment-of-exacerbation-of-chronic-laryngitis
#6
M A Ryabova
The present study was carried out based at the Department of Otorhinolaryngology of I.P. Pavlov First State Medical University of Saint-Petersburg. The objective of this work was to elucidate the efficacy and safety of fenspiride therapy for the treatment of exacerbation of chronic laryngitis associated with an acute respiratory infection. The patients comprising the main group received fenspiride (Eurespal, 'Servier', France) at the standard dose in addition to the conventional therapy with the use of antibiotics, inhalation, and voice rest...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/29229103/effect-of-budesonide-formoterol-pressurized-metered-dose-inhaler-on-exacerbations-versus-formoterol-in-chronic-obstructive-pulmonary-disease-the-6-month-randomized-rise-revealing-the-impact-of-symbicort-in-reducing-exacerbations-in-copd-study
#7
Gary T Ferguson, Donald P Tashkin, Tor Skärby, Carin Jorup, Kristina Sandin, Michael Greenwood, Kristine Pemberton, Frank Trudo
BACKGROUND: Prevention of exacerbations is a primary goal for chronic obstructive pulmonary disease (COPD) therapy. This randomized, double-blind, double-dummy, parallel-group, multicenter study evaluated the effect of budesonide/formoterol pressurized metered-dose inhaler (pMDI) versus formoterol dry powder inhaler (DPI) on reducing COPD exacerbations. METHODS: 1219 patients aged ≥40 years with moderate-to-very-severe COPD (per lung function) and a history of ≥1 COPD exacerbation received budesonide/formoterol pMDI 320/9 μg twice daily (BID) during a 4-week run-in...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29210888/pneumonia-in-a-teenager-hiding-a-fire-eating-stunt
#8
Michele Ghezzi, Marta Odoni, Oriana Testagrossa, Daniela Messina, Jorge Daniel Ruocco, Camillo Lovati, Ahmad Kantar
Pneumonia in children due to hydrocarbon aspiration is usually the result of an uncommon accidental event. However, an acute and severe type of pneumonia induced by hydrocarbon aspiration is occasionally experienced by entertainers known as fire-eaters. Different approaches to treat fire-eater's pneumonia appear in the literature. Although there is no consensus regarding the management of this condition, the use of antibiotic therapy is well recognized and recommended by some, whereas others recommend only supportive treatment...
November 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29180254/reclaiming-hijacked-phagosomes-hybrid-nano-in-micro-encapsulated-miap-peptide-ensures-host-directed-therapy-by-specifically-augmenting-phagosome-maturation-and-apoptosis-in-tb-infected-macrophage-cells
#9
Ankur Sharma, Kalpesh Vaghasiya, Pushpa Gupta, Umesh Datta Gupta, Rahul Kumar Verma
TB-Superbugs have emerged as one of the most challenging global health threat due to the decrease in effectiveness of conventional antibiotics. Meanwhile, Host defense peptides (HDP) have evolved as an alternative to classical therapeutics with lesser susceptibility of resistance. We describe the potential of nano-encapsulated synthetic Magainin-I analog peptide (MIAP) as Host Directed Therapy against TB. Micron-sized inhalable platform "Porous Nanoparticle Aggregates Particles (PNAP)" with nano-scale physiognomies were developed to improve the delivery of MIAP-peptide to the lungs and enhance its stability...
November 24, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/29161086/potential-role-of-the-lung-microbiome-in-shaping-asthma-phenotypes
#10
Kian Fan Chung
The introduction of 16s ribosomal RNA sequencing as a nonculture technique has led to the discovery of the presence of microbiota in the lower airways of healthy individuals. These bacterial communities may originate from the mouth and nasopharynx or from the environment by inhalation. The microbial composition of the lower airways may be modulated by dietary factors, antibiotic therapy, and microbial infections, particularly in early life. In addition, circulatory products from gut microbiota may influence the lung microbiota to maintain mucosal immunity...
November 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29158280/anti-pseudomonal-activity-of-phage-pev20-in-a-dry-powder-formulation-a-proof-of-principle-study-in-a-murine-lung-infection-model
#11
Rachel Yoon Kyung Chang, Ke Chen, Jiping Wang, Martin Wallin, Warwick Britton, Sandra Morales, Elizabeth Kutter, Jian Li, Hak-Kim Chan
Bacteriophage therapy is a promising alternative treatment to antibiotics as it has been documented to be efficacious against multi-drug resistant bacteria with minimal side effects. Several groups have demonstrated the efficacy of phage suspension in vivo to treat lung infections using intranasal delivery; however, phage dry powder administration to the lungs has not yet been explored. Powder formulations provide potential advantages over liquid formulation, including easy storage, transport and administration...
November 20, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29145795/use-of-immunohistochemistry-to-demonstrate-in-vivo-expression-of-the-burkholderia-mallei-virulence-factor-bpab-during-experimental-glanders
#12
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
#13
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
#14
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
#15
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...
January 2018: 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
#16
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
#17
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...
January 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28983645/-pseudomonas-aeruginosa-infections-in-chronic-obstructive-pulmonary-disease-role-of-long-term-antibiotic-treatment
#18
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
#19
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
#20
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
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