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Neumología

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29 papers 0 to 25 followers
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#1
REVIEW
Marc Miravitlles, Antonio Anzueto, José R Jardim
The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments...
June 20, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28694199/initiation-of-non-invasive-ventilation-for-sleep-related-hypoventilation-disorders-advanced-modes-and-devices
#2
REVIEW
Bernardo J Selim, Lisa Wolfe, John M Coleman, Naresh Dewan
Although non-invasive ventilation (NIV) has been used since the 1960's in the polio epidemic, the development of modern bilevel PAP devices did not become a reality until the 1990's. Over the last 25 years bilevel PAP technology options have exponentially increased. The number of patients receiving this treatment both in the acute setting as well as at home is steadily growing. However, a knowledge gap exists in the way these device settings are adjusted to achieve synchrony and match patient's unique respiratory failure physiology...
July 7, 2017: Chest
https://www.readbyqxmd.com/read/27825511/severe-respiratory-failure
#3
REVIEW
Rupert Williams, Gavin Salt, Tom Jackson, Leianora Mazur, Natalia Briceno, Brian Clapp, Simon Redwood, Nick Barrett, Ronak Rajani, Amedeo Chiribiri
No abstract text is available yet for this article.
November 5, 2016: Lancet
https://www.readbyqxmd.com/read/28528348/effect-of-home-noninvasive-ventilation-with-oxygen-therapy-vs-oxygen-therapy-alone-on-hospital-readmission-or-death-after-an-acute-copd-exacerbation-a-randomized-clinical-trial
#4
RANDOMIZED CONTROLLED TRIAL
Patrick B Murphy, Sunita Rehal, Gill Arbane, Stephen Bourke, Peter M A Calverley, Angela M Crook, Lee Dowson, Nicholas Duffy, G John Gibson, Philip D Hughes, John R Hurst, Keir E Lewis, Rahul Mukherjee, Annabel Nickol, Nicholas Oscroft, Maxime Patout, Justin Pepperell, Ian Smith, John R Stradling, Jadwiga A Wedzicha, Michael I Polkey, Mark W Elliott, Nicholas Hart
Importance: Outcomes after exacerbations of chronic obstructive pulmonary disease (COPD) requiring acute noninvasive ventilation (NIV) are poor and there are few treatments to prevent hospital readmission and death. Objective: To investigate the effect of home NIV plus oxygen on time to readmission or death in patients with persistent hypercapnia after an acute COPD exacerbation. Design, Setting, and Participants: A randomized clinical trial of patients with persistent hypercapnia (Paco2 >53 mm Hg) 2 weeks to 4 weeks after resolution of respiratory acidemia, who were recruited from 13 UK centers between 2010 and 2015...
June 6, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28629920/pulmonary-hypertension-in-parenchymal-lung-diseases-any-future-for-new-therapies
#5
REVIEW
Sergio Harari, Davide Elia, Marc Humbert
Pulmonary hypertension (PH) due to chronic lung diseases is associated with a poor prognosis, regardless of the underlying respiratory condition. Updated PH guidelines recommend optimal treatment of the underlying lung disease, including long-term oxygen therapy, in patients with chronic hypoxaemia despite the lack of randomized controlled clinical trials supporting this statement. So far, randomized controlled trials on drugs approved for pulmonary arterial hypertension (PAH) have yielded discouraging results in both interstitial lung diseases (ILD) and chronic obstructive pulmonary diseases (COPD) with PH...
June 16, 2017: Chest
https://www.readbyqxmd.com/read/28598197/hypersensitivity-pneumonitis-perspectives-in-diagnosis-and-management
#6
Martina Vasakova, Ferran Morell, Simon Walsh, Kevin Leslie, Ganesh Raghu
Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease caused by recurrent exposure to one or more offending inducers in genetically susceptible individuals. It mimics other acute and chronic pulmonary diseases and is often misdiagnosed as idiopathic pulmonary fibrosis (IPF) or another idiopathic interstitial pneumonia if the history of exposure to the inducer is not elicited. We propose a new classification of HP based not only on clinical data but also radiologic and histopathologic findings which might have potential to serve as predictors of disease behaviour and therefore guide management...
June 9, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28549662/simplified-diagnostic-management-of-suspected-pulmonary-embolism-the-years-study-a-prospective-multicentre-cohort-study
#7
Tom van der Hulle, Whitney Y Cheung, Stephanie Kooij, Ludo F M Beenen, Thomas van Bemmel, Josien van Es, Laura M Faber, Germa M Hazelaar, Christian Heringhaus, Herman Hofstee, Marcel M C Hovens, Karin A H Kaasjager, Rick C J van Klink, Marieke J H A Kruip, Rinske F Loeffen, Albert T A Mairuhu, Saskia Middeldorp, Mathilde Nijkeuter, Liselotte M van der Pol, Suzanne Schol-Gelok, Marije Ten Wolde, Frederikus A Klok, Menno V Huisman
BACKGROUND: Validated diagnostic algorithms in patients with suspected pulmonary embolism are often not used correctly or only benefit subgroups of patients, leading to overuse of computed tomography pulmonary angiography (CTPA). The YEARS clinical decision rule that incorporates differential D-dimer cutoff values at presentation, has been developed to be fast, to be compatible with clinical practice, and to reduce the number of CTPA investigations in all age groups. We aimed to prospectively evaluate this novel and simplified diagnostic algorithm for suspected acute pulmonary embolism...
May 23, 2017: Lancet
https://www.readbyqxmd.com/read/28610911/airway-glucose-homeostasis-a-new-target-in-the-prevention-and-treatment-of-pulmonary-infection
#8
REVIEW
Emma H Baker, Deborah L Baines
In health, the glucose concentration of airway surface liquid (ASL) is 0.4mM, around 12 times lower than blood glucose concentration. Airway glucose homeostasis is a set of processes that actively maintain low ASL glucose concentration against the transepithelial gradient. Tight junctions between airway epithelial cells restrict paracellular glucose movement. Epithelial cellular glucose transport and metabolism removes glucose from ASL. Low ASL glucose concentrations make an important contribution to airways defence against infection, limiting bacterial growth by restricting nutrient availability...
June 10, 2017: Chest
https://www.readbyqxmd.com/read/28461307/diagnosis-of-asthma-copd-overlap-the-five-commandments
#9
EDITORIAL
Marc Miravitlles
No abstract text is available yet for this article.
May 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/26628461/using-venous-blood-gas-analysis-in-the-assessment-of-copd-exacerbations-a-prospective-cohort-study
#10
Tricia M McKeever, Glenn Hearson, Gemma Housley, Catherine Reynolds, William Kinnear, Tim W Harrison, Anne-Maree Kelly, Dominick E Shaw
INTRODUCTION: Identifying acute hypercapnic respiratory failure is crucial in the initial management of acute exacerbations of COPD. Guidelines recommend obtaining arterial blood samples but these are more difficult to obtain than venous. We assessed whether blood gas values derived from venous blood could replace arterial at initial assessment. METHODS: Patients requiring hospital treatment for an exacerbation of COPD had paired arterial and venous samples taken...
March 2016: Thorax
https://www.readbyqxmd.com/read/28574275/a-novel-drug-eluting-indwelling-pleural-catheter-for-the-management-of-malignant-effusions
#11
Rahul Bhatnagar, Natalie Zahan-Evans, Christine Kearney, Anthony J Edey, Louise J Stadon, Alain Tremblay, Nick A Maskell
No abstract text is available yet for this article.
June 2, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/21157355/bronchoaspiration-incidence-consequences-and-management
#12
REVIEW
Beatrice Beck-Schimmer, John M Bonvini
Aspiration is defined as the inhalation of oropharyngeal or gastric contents into the lower respiratory tract. Upon injury, epithelial cells and alveolar macrophages secrete chemical mediators, attracting and activating neutrophils, which in turn release proteases and reactive oxygen species, degrading the alveolocapillary unit. Aspiration can lead to a range of diseases such as infectious pneumonia, chemical pneumonitis or respiratory distress syndrome with significant morbidity and mortality. It occurs in approximately 3-10 per 10 000 operations with an increased incidence in obstetric and paediatric anaesthesia...
February 2011: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28530497/acute-eosinophilic-pneumonia-and-tracheitis-associated-with-smoking
#13
Seung Yong Park, Jee Hyuk Kim, Myoung Ja Chung, Chin Ho Rhee, Seoung Ju Park
No abstract text is available yet for this article.
June 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28513453/chronic-obstructive-pulmonary-disease
#14
REVIEW
Klaus F Rabe, Henrik Watz
Chronic obstructive pulmonary disease (COPD) kills more than 3 million people worldwide every year. Despite progress in the treatment of symptoms and prevention of acute exacerbations, few advances have been made to ameliorate disease progression or affect mortality. A better understanding of the complex disease mechanisms resulting in COPD is needed. Smoking cessation programmes, increasing physical activity, and early detection and treatment of comorbidities are further key components to reduce the burden of the disease...
May 13, 2017: Lancet
https://www.readbyqxmd.com/read/28446601/diffuse-parenchymal-lung-disease
#15
REVIEW
Sara Tomassetti, Claudia Ravaglia, Venerino Poletti
Between September 2015 and August 2016 there were >1500 publications in the field of diffuse parenchymal lung diseases (DPLDs). For the Clinical Year in Review session at the European Respiratory Society Congress that was held in London, UK, in September 2016, we selected only five articles. This selection, made from the enormous number of published papers, does not include all the relevant studies that will significantly impact our knowledge in the field of DPLDs in the near future. This review article provides our personal view on the following topics: early diagnosis of idiopathic pulmonary fibrosis, current knowledge on the multidisciplinary team diagnosis of DPLDs and the diagnostic role of transbronchial cryobiopsy in this diagnostic setting, insights on the new entity of interstitial pneumonia with autoimmune features, and new therapeutic approaches for scleroderma-related interstitial lung disease...
June 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/25546531/hypercapnia-clinical-relevance-and-mechanisms-of-action
#16
REVIEW
Claire Masterson, Gail Otulakowski, Brian P Kavanagh
PURPOSE OF REVIEW: Multiple clinical and laboratory studies have been conducted to illustrate the effects of hypercapnia in a range of injuries, and to understand the mechanisms underlying these effects. The aim of this review is to highlight and interpret information obtained from these recent reports and discuss how they may inform the clinical context. RECENT FINDINGS: In the last decade, several important articles have addressed key elements of how carbon dioxide interacts in critical illness states...
February 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28404656/the-art-of-breathing-oxygen
#17
Gary P Anderson, Tom Kotsimbos
No abstract text is available yet for this article.
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28385354/triple-therapy-for-symptomatic-patients-with-copd
#18
Leonardo M Fabbri, Sara Roversi, Bianca Beghé
No abstract text is available yet for this article.
May 13, 2017: Lancet
https://www.readbyqxmd.com/read/26937187/exacerbations-of-copd
#19
REVIEW
Ian D Pavord, Paul W Jones, Pierre-Régis Burgel, Klaus F Rabe
Exacerbations of chronic obstructive pulmonary disease (COPD) are defined as sustained worsening of a patient's condition beyond normal day-to-day variations that is acute in onset, and that may also require a change in medication and/or hospitalization. Exacerbations have a significant and prolonged impact on health status and outcomes, and negative effects on pulmonary function. A significant proportion of exacerbations are unreported and therefore left untreated, leading to a poorer prognosis than those treated...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/26316767/pulmonary-hypertension-diagnostic-and-therapeutic-challenges
#20
REVIEW
Isabel S Bazan, Wassim H Fares
Pulmonary hypertension (PH) is a hemodynamic and pathophysiologic state that can be found in multiple conditions with associated symptoms of dyspnea, decreased exercise tolerance, and progression to right heart failure. The World Health Organization has classified PH into five groups. The first group is pulmonary arterial hypertension (PAH), which can be idiopathic, heritable, due to drugs and toxins, or associated with conditions such as connective tissue diseases, congenital heart disease, portal hypertension, and others...
2015: Therapeutics and Clinical Risk Management
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