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Respiratory Medicine

This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 6.

Exacerbations in non-COPD patients: truth or myth--authors' response
Dear Sir, We are grateful to Dr Khurana and Dr Aggarwal for their interest1 in our paper.2 On their first point, we agree that we should be careful about terminology. We evaluated a random sample of individuals representative of the general population rather than patients, so the findings that episodes of respiratory events occurred in these subjects would likely reflect real events in the general population. Furthermore, our study definition for exacerbations was the same standard questionnaire criteria for exacerbations used in clinical trials of selected patients with COPD.3 On the second point on aetiologies for non-CO...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Tan, W. C., Bourbeau, J., Aaron, S., FitzGerald, J. M., Hernandez, P., Cowie, R., Chapman, K. R., Marciniuk, D., Maltais, F., Buist, S., O'Donnell, D., Sin, D. D., for the CanCOLD Collaborative Research Group Tags: PostScript Source Type: research

Pulmonary vascular volumes and airways obstruction in SCD patients
Dear Editor We read with interest the recent paper by Chaudry et al1 in which the authors describe an obstructive ventilatory defect in children with sickle cell disease (SCD) which was not linked to bronchial hyper-responsiveness, as assessed by methacholine challenge testing, or to eosinophillic inflammation. Their results further demonstrate that the airflow obstruction seen in children with SCD may not solely be due to asthma. Indeed, in children with SCD, we have shown that pulmonary capillary blood volume is increased compared to matched controls, and is correlated with airflow obstruction as assessed by impulse osci...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Greenough, A., Lunt, A. Tags: PostScript Source Type: research

Letter to the Editor in reply to 'Pulmonary vascular volumes and airways obstruction in SCD patients'
Dear Editor, We thank Professor Greenough and Dr Lunt for their interest1 in our manuscript,2 and for the suggestion that changes in pulmonary vascular volumes may lead to airflow obstruction. In this group of sickle cell diseased (SCD) children and controls, we used carbon monoxide transfer (DLCO) related to pulmonary blood flow (Qpeff) at rest and on exercise as a surrogate for pulmonary capillary blood volume.3 DLCO corrected for haemoglobin and surface area was significantly higher in SCD at rest, but only by about 10%, while Qpeff was 15–20% higher. DLCO:Qpeff, therefore, was significantly lower in SCD at rest a...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Crowley, S., Chaudry, R. A., Rosenthal, M., Bush, A. Tags: PostScript Source Type: research

Cochrane corner: is integrated disease management for patients with COPD effective?
Patients with COPD experience respiratory symptoms, impairments of daily living and recurrent exacerbations. The aim of integrated disease management (IDM) is to establish a programme of different components of care (ie, self-management, exercise, nutrition) in which several healthcare providers (ie, nurses, general practitioners, physiotherapists, pulmonologists) collaborate to provide efficient and good quality of care. The aim of this Cochrane systematic review was to evaluate the effectiveness of IDM on quality of life, exercise tolerance and exacerbation related outcomes. Searches for all available evidence were carri...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Kruis, A. L., Smidt, N., Assendelft, W. J. J., Gussekloo, J., Boland, M. R. S., Rutten-van Molken, M., Chavannes, N. H. Tags: Clinical trials (epidemiology), Open access, General practice / family medicine, Quality improvement Chest clinic Source Type: research

Changes to inhaled corticosteroid dose when initiating combination inhaler therapy in long-acting {beta} agonist-naive patients with asthma: a retrospective database analysis
Retrospective prescribing data were obtained from 46 general practice surgeries in NHS Scotland. Patients with asthma who were naïve to previous long-acting β agonist therapy and initiated combination inhaler therapy in 2008–2009 were classified according to the inhaled corticosteroid (ICS) dose in their combination inhaler compared with the highest dose of ICS they received before initiation. Among the 685 patients (541 (79.0%) who had been prescribed an ICS previously), those originally on low-, medium- or high-dose ICS were changed to high-dose combination therapy in 122/250 (48.8%), 94/151 (62.3%) or 85...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Covvey, J. R., Johnston, B. F., Wood, F., Boyter, A. C. Tags: Asthma, Drugs: respiratory system Chest clinic Source Type: research

Lesson of the month: extrinsic allergic (bronchiolo)alveolitis and metal working fluids
Introduction One of us was asked to consider a diagnosis of occupational asthma for a man who had worked for 20 years as a metal turner in a large, modern factory producing specialised machine parts. He described a 2 year history of severe breathlessness that improved when he was not at work. His spirometry was restrictive with a FEV1 of 1.35 L (40% predicted) and FVC of 1.8 L (45% predicted), a ratio of 75%. Other lung function measurements indicated gas trapping; his TLC was 5.01 L (79% predicted) and RV/TLC 170% predicted. A high resolution CT scan of his lungs revealed a widespread ‘mosai...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Cullinan, P., D'Souza, E., Tennant, R., Barber, C. Tags: Open access, Pneumonia (infectious disease), TB and other respiratory infections, Chemotherapy, Asthma, Interstitial lung disease, Pneumonia (respiratory medicine), Radiology (diagnostics), Occupational and environmental medicine Chest clinic Source Type: research

Intrapulmonary lipomatosis
A 70-year-old woman with a history of bronchiectasis diagnosed with bilateral pulmonary nodules was examined. She was a non-obese (body mass index: 18.3 kg/m2), non-diabetic never-smoker. The pulmonary nodules had been present for 4 years. Chest CT revealed multiple, well-defined and homogenous subcentimetre nodules of variable sizes scattered in the left and right lungs. The average nodule was –150 Hounsfield units (HU) with a density slightly less than muscle and similar to fat (HU: –50 to –200). The follow-up chest CTs with an interval of 4 years demonstrated slight growth of those pulmo...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Liu, C.-Y., Yu, Y.-C., Hsieh, C.-C., Wang, Y.-H., Chou, T.-Y. Tags: Images in Thorax, Drugs: infectious diseases, Screening (oncology), Radiology (diagnostics) Chest clinic Source Type: research

What's hot that the other lot got
CPAP for the over 65s with obstructive sleep apnoea syndrome Continuous positive airway pressure (CPAP) use for middle-aged patients with symptomatic moderate-severe obstructive sleep apnoea (OSA) has a clear evidence base showing patient benefit and cost effectiveness. Despite many clinicians using CPAP in older patients, specific evidence for this practice is limited. McMillan et al (Lancet Respir Med 2014. pii: S2213-2600(14)70172-9) have reported the results of the PREDICT trial (CPAP in older people with OSA syndrome). This UK trial involved 14 recruiting sites, where consecutive patients aged 65 years or above with a...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Prudon, B. Tags: Health policy, Bronchiolitis, Drugs: infectious diseases, HIV/AIDS, TB and other respiratory infections, Sleep disorders (neurology), Child health, Infant health, Bronchitis, Sleep disorders (respiratory medicine), Health service research Chest clinic Source Type: research

The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial
Babies born to mothers given antenatal diet and lifestyle advice are less likely to have high birth weight or respiratory distress than those born to women on standard care, indicating that healthy diet in pregnancy is linked to improved infant outcomes. (Source: BMC Medicine)
Source: BMC Medicine - October 13, 2014 Category: Internal Medicine Authors: Jodie DoddAndrew McPheeDeborah TurnbullLisa YellandAndrea DeussenRosalie GrivellCaroline CrowtherGary WittertJulie OwensJeffrey RobinsonTrial Group For the LIMIT Randomised Source Type: research

Technosphere Insulin (Afrezza): A New, Inhaled Prandial Insulin.
CONCLUSION: TI is a novel inhaled insulin that provides prandial coverage to patients with diabetes, representing an alternative to bolus insulin injections. PMID: 25313261 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)
Source: The Annals of Pharmacotherapy - October 13, 2014 Category: Drugs & Pharmacology Authors: Nuffer W, Trujillo JM, Ellis SL Tags: Ann Pharmacother Source Type: research

Measurement of eNO with portable analyzer might improve the management of persistent cough at primary care practice in Japan.
CONCLUSIONS: Measurement of eNO could be one of the management tools for persistent cough at primary care practice. PMID: 25307553 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - October 13, 2014 Category: Respiratory Medicine Authors: Watanabe K, Shinkai M, Shinoda M, Hara Y, Yamaguchi N, Rubin BK, Ishigatsubo Y, Kaneko T Tags: Clin Respir J Source Type: research

Safety of interventional bronchoscopy through complication review at a cancer center.
CONCLUSION: The complication rate with regards to bronchoscopy is comparable to historical controls according to the related literature, and their occurrence appears to be sporadic, not relevant to patient characteristics and mostly related to the bronchoscopy itself rather than the introduction of new techniques. Bronchoscopy remains safe along with technical innovations. However, risk recognition and effective prevention is essential. PMID: 25307369 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - October 13, 2014 Category: Respiratory Medicine Authors: Hsu LH, Liu CC, Ko JS, Chen CC, Feng AC Tags: Clin Respir J Source Type: research

Flavobacterium maotaiense sp. nov., isolated from the fresh water.
Abstract Two novel strains, T9T and T10, were isolated from water samples collected from Chishui River flowing through Maotai town, Guizhou, southwest of China. The isolates were yellow-pigmented, Gram-reaction-negative, rod-shaped, non-motile, and aerobic. Phylogenetic analysis based on 16S rRNA gene sequences showed that the isolates belonged to the genus Flavobacterium, and showed highest similarities to that of Flavobacterium hibernum ACAM 376 T (97.0 %), followed by Flavobacterium granuli Kw05T (96.7 %) and Flavobacterium pectinovorum DSM 6368T (96.7 %). The novel species were able to grow at 20-37°C (optimum...
Source: International Journal of Systematic and Evolutionary Microbiology - October 13, 2014 Category: Microbiology Authors: Feng Q, Gao Y, Nogi Y, Tan X, Han L, Zhang Y, Lv J Tags: Int J Syst Evol Microbiol Source Type: research

Extracorporeal membrane oxygenation use in patients with traumatic brain injury.
We report two cases of TBI patients treated with ECMO. PMID: 25313096 [PubMed - as supplied by publisher] (Source: Perfusion)
Source: Perfusion - October 13, 2014 Category: Cardiovascular & Thoracic Surgery Authors: Biscotti M, Gannon W, Abrams D, Agerstrand C, Claassen J, Brodie D, Bacchetta M Tags: Perfusion Source Type: research

Effect of ezogabine retigabine on the PK of digoxin
Tompson DJ, Crean CS, Buraglio M, Arumugham T (Source: International Journal of COPD)
Source: International Journal of COPD - October 12, 2014 Category: Respiratory Medicine Source Type: research

Improving inhaler adherence in patients with chronic obstructive pulmonary disease: a cost-effectiveness analysis.
CONCLUSIONS: Optimization of current pharmacotherapy (e.g. close monitoring of inhalation technique and medication adherence) has been shown to be cost-saving and should be considered before adding new therapies. PMID: 24929799 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: van Boven JF, Tommelein E, Boussery K, Mehuys E, Vegter S, Brusselle GG, Rutten-van Mölken MP, Postma MJ Tags: Respir Res Source Type: research

Impact of self-reported gastroesophageal reflux disease in subjects from COPDGene cohort.
CONCLUSIONS: In COPD the presence of physician-diagnosed GERD is associated with increased symptoms, poorer QOL and increased frequency of exacerbations at baseline and during follow-up. These associations are maintained after controlling for PPI use. The PPI-exacerbations association could result from confounding-by-indication. PMID: 24894541 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: Martinez CH, Okajima Y, Murray S, Washko GR, Martinez FJ, Silverman EK, Lee JH, Regan EA, Crapo JD, Curtis JL, Hatabu H, Han MK, COPDGene Investigators Tags: Respir Res Source Type: research

Arsenic trioxide inhibits transforming growth factor-β1-induced fibroblast to myofibroblast differentiation in vitro and bleomycin induced lung fibrosis in vivo.
CONCLUSIONS: In summary, these data indicate that low concentrations of ATO inhibit TGF-β1-induced fibroblast to myofibroblast differentiation and decreases bleomycin induced pulmonary fibrosis. PMID: 24762191 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: Luo F, Zhuang Y, Sides MD, Sanchez CG, Shan B, White ES, Lasky JA Tags: Respir Res Source Type: research

Lung ultrasound for the diagnosis of pneumonia in adults: a systematic review and meta-analysis.
CONCLUSIONS: Our meta-analysis supports that LUS, when conducted by highly-skilled sonographers, performs well for the diagnosis of pneumonia. General practitioners and Emergency Medicine physicians should be encouraged to learn LUS since it appears to be an established diagnostic tool in the hands of experienced physicians. PMID: 24758612 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: Chavez MA, Shams N, Ellington LE, Naithani N, Gilman RH, Steinhoff MC, Santosham M, Black RE, Price C, Gross M, Checkley W Tags: Respir Res Source Type: research

Impact of smoking on dendritic cell phenotypes in the airway lumen of patients with COPD.
CONCLUSION: COPD is characterized by a strongly reduced CCR5 expression on myeloid DCs in the airway lumen, which might hamper DC interactions with microbial antigens. Further studies are needed to better understand the role of CCR5 in the pathophysiology and microbiology of COPD. PMID: 24742278 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: Stoll P, Heinz AS, Bratke K, Bier A, Garbe K, Kuepper M, Virchow JC, Lommatzsch M Tags: Respir Res Source Type: research

Systemic steroids in COPD-the beauty and the beast.
PMID: 24708470 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: Vogelmeier CF Tags: Respir Res Source Type: research

A randomized clinical trial to assess the influence of a three months training program (gym-based individualized vs. calisthenics-based non-invidualized) in COPD-patients.
CONCLUSION: A low frequency outpatient training program may induce modest improvements in exercise capacity and muscle mass only if it is performed on an individualized basis. PMID: 24666558 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: Greulich T, Kehr K, Nell C, Koepke J, Haid D, Koehler U, Koehler K, Filipovic S, Kenn K, Vogelmeier C, Koczulla AR Tags: Respir Res Source Type: research

MMP-2 and TIMP-1 predict healing of WTC-lung injury in New York City firefighters.
CONCLUSIONS: Resistant cases displayed healing, returning to 99% of pre-exposure values. High TIMP-1 and MMP-2 predict healing. MMP/TIMP balance reflects independent pathways to airway injury and repair after WTC exposure. PMID: 24447332 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: Nolan A, Kwon S, Cho SJ, Naveed B, Comfort AL, Prezant DJ, Rom WN, Weiden MD Tags: Respir Res Source Type: research

Exhaled breath condensate in intubated neonates--a window into the lung's glutathione status.
CONCLUSIONS: GSH status in EBC samples of intubated newborns significantly correlated with the GSH status of the TA sample and was reflective of cellular GSH status in this cohort of neonatal patients. Non-invasive EBC sampling of intubated newborns holds promise for monitoring antioxidant status such as GSH in the premature lung. Further studies are necessary to evaluate the potential relationships between EBC biomarkers in the intubated premature newborn and respiratory morbidities. PMID: 24397246 [PubMed - indexed for MEDLINE] (Source: Respiratory Care)
Source: Respiratory Care - October 12, 2014 Category: Respiratory Medicine Authors: Rosso MI, Roark S, Taylor E, Ping X, Ward JM, Roche K, McCracken C, Brown LA, Gauthier TW Tags: Respir Res Source Type: research

Intercostal and forearm muscle deoxygenation during respiratory fatigue in patients with heart failure: potential role of a respiratory muscle metaboreflex.
Abstract The purpose of this study was to determine the effect of respiratory muscle fatigue on intercostal and forearm muscle perfusion and oxygenation in patients with heart failure. Five clinically stable heart failure patients with respiratory muscle weakness (age, 66±12 years; left ventricle ejection fraction, 34±3%) and nine matched healthy controls underwent a respiratory muscle fatigue protocol, breathing against a fixed resistance at 60% of their maximal inspiratory pressure for as long as they could sustain the predetermined inspiratory pressure. Intercostal and forearm muscle blood volume and oxygenati...
Source: Braz J Med Biol Res - October 12, 2014 Category: Research Authors: Moreno AM, Castro RR, Silva BM, Villacorta H, Junior MS, Nóbrega AC Tags: Braz J Med Biol Res Source Type: research

Cigarette Smoke-Exposed Candida albicans Increased Chitin Production and Modulated Human Fibroblast Cell Responses.
Abstract The predisposition of cigarette smokers for development of respiratory and oral bacterial infections is well documented. Cigarette smoke can also contribute to yeast infection. The aim of this study was to investigate the effect of cigarette smoke condensate (CSC) on C. albicans transition, chitin content, and response to environmental stress and to examine the interaction between CSC-pretreated C. albicans and normal human gingival fibroblasts. Following exposure to CSC, C. albicans transition from blastospore to hyphal form increased. CSC-pretreated yeast cells became significantly (P < 0.01) sensitiv...
Source: Biomed Res - October 12, 2014 Category: Research Authors: Alanazi H, Semlali A, Perraud L, Chmielewski W, Zakrzewski A, Rouabhia M Tags: Biomed Res Int Source Type: research

Cost-effectiveness of initiating extrafine- or standard size-particle inhaled corticosteroid for asthma in two health-care systems: a retrospective matched cohort study.
CONCLUSIONS: Initiating ICS therapy for asthma as extrafine-particle ICS seems the dominant treatment option (less costly and more effective) compared with standard size-particle ICS in both the UK and the US. PMID: 25297072 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - October 12, 2014 Category: Primary Care Authors: Martin RJ, Price D, Roche N, Israel E, van Aalderen WM, Grigg J, Postma DS, Guilbert TW, Hillyer EV, Burden A, von Ziegenweidt J, Colice G Tags: NPJ Prim Care Respir Med Source Type: research

Respiratory medication use in an Australian developmental disability clinic population: messages for health care professionals.
This study describes respiratory medication use, reported prevalence of asthma, and asthma management practices undertaken in a clinic sample of Australian adults with ID. Results showed a prevalence of retrospectively reported asthma of 6%, with 86% of asthma patients prescribed inhaled medication. A review of patient records also indicated omission of some recommended asthma management strategies. PMID: 23693140 [PubMed - indexed for MEDLINE] (Source: Primary Care)
Source: Primary Care - October 12, 2014 Category: Primary Care Authors: Davis SR, Durvasula S, Merhi D, Young PM, Traini D, Bosnic-Anticevich SZ Tags: Aust J Prim Health Source Type: research

Comparison of innate immune agonists for induction of tracheal antimicrobial peptide gene expression in tracheal epithelial cells of cattle
Bovine respiratory disease is a complex of bacterial and viral infections of economic and welfare importance to the beef industry. Although tracheal antimicrobial peptide (TAP) has microbicidal activity against bacterial pathogens causing bovine respiratory disease, risk factors for bovine respiratory disease including BVDV and stress (glucocorticoids) have been shown to inhibit the induced expression of this gene. Lipopolysaccharide is known to stimulate TAP gene expression, but the maximum effect is only observed after 16?h of stimulation. The present study investigated other agonists of TAP gene expression in primary cu...
Source: BioMed Central - October 12, 2014 Category: Journals (General) Authors: Lesley BerghuisKhaled T AbdelazizJodi BierworthLeanna WyerGabriella JacobNiel A KarrowShayan SharifMary E ClarkJeff L Caswell Source Type: research

The association of plasma biomarkers with computed tomography-assessed emphysema phenotypes
RationaleChronic obstructive pulmonary disease (COPD) is a phenotypically heterogeneous disease. In COPD, the presence of emphysema is associated with increased mortality and risk of lung cancer. High resolution computed tomography (HRCT) scans are useful in quantifying emphysema but are associated with radiation exposure and high incidence of false positive findings (i.e., nodules). Using a comprehensive biomarker panel, we sought to determine if there was a peripheral blood biomarker signature of emphysema. Methods: 114 plasma biomarkers were measured using a custom assay in 588 individuals enrolled in the COPDGene study...
Source: Respiratory Research - October 12, 2014 Category: Respiratory Medicine Authors: Brendan CarolanGrant HughesJarrett MorrowCraig HershWanda O¿NealStephen RennardSreekumar PillaiPaula BelloniDebra CockayneAlejandro ComellasMeilan HanRachel ZemansKaterina KechrisRussell Bowler Source Type: research

The value of non-invasive ventilation
Non-invasive ventilation (NIV) use has increased markedly over the last 10 years. Children being treated with NIV are now a common sight in most paediatric intensive care units and high dependency units and nearly all tertiary respiratory units will look after a cohort of children who use NIV at home. Although the published evidence base for use of NIV in acute and chronic respiratory failure is relatively weak, it is now very unlikely that there will be any more randomised controlled trials of this intervention. Effectiveness of NIV will need to be evaluated on each child as it used. It is important to define the purpose ...
Source: Archives of Disease in Childhood - October 12, 2014 Category: Pediatrics Authors: Hull, J. Tags: Clinical trials (epidemiology) Review Source Type: research

When two trials conflict: bronchiolitis and hypertonic saline
The editors of JAMA Pediatrics must have been flummoxed when they received two papers at the same time describing the same interventional trial, with completely different results. Both were trials comparing 3% with 0.9% nebulised saline in bronchiolitis, and both were conducted in the emergency departments (EDs) of US children's hospitals. The editors took the brave decision to publish them simultaneously with an accompanying editorial. Both trials recruited infants under two years presenting to ED with a first episode of clinically diagnosed bronchiolitis, and both excluded those with pre-existing cardio-respiratory condi...
Source: Archives of Disease in Childhood - October 12, 2014 Category: Pediatrics Tags: Miscellanea Source Type: research