Management of nontuberculous mycobacterial pulmonary disease

Purpose of review To highlight recent original research and specialty society guidelines regarding the diagnosis and treatment of nontuberculous mycobacterial (NTM) pulmonary disease. Recent findings The prevalence of NTM pulmonary disease has risen in recent years. The prevalence of individual NTM species varies geographically, although Mycobacterium avium complex (MAC) and Mycobacterium abscessus complex (MABC) remain among the most commonly encountered in many regions. Diagnosis and treatment of NTM pulmonary disease can be complex but guideline-based recommendations have been published. However, adherence to guideline recommendations is poor. Drug susceptibility testing plays a role with important caveats for treatment. Alternative therapies are being explored with older antimycobacterial drugs like clofazimine, which has demonstrated efficacy and tolerability for treatment-refractory NTM infections, and a novel formulation of amikacin for inhalation which may be better tolerated than parenteral administration. Several studies have shown that patients will have recurrences as high as 48%, and that these are not solely relapses but many cases are reinfections with a new organism. United States and European research registries of patients with non-cystic fibrosis bronchiectasis are expected to provide needed data on clinical characteristics of patients at risk for NTM pulmonary disease. Summary The evidence base for optimal management of NTM pulmonary disease is exp...
Source: Current Opinion in Pulmonary Medicine - Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and Michael S. Niederman Source Type: research

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CONCLUSIONS: Pilates should be considered for patients with NCDs, as it improves exercise tolerance. Future studies with robust methodologies are still needed to clarify its effectiveness on outcomes with moderate, limited or conflicting evidence and to establish the most suitable intervention protocol. PMID: 30012382 [PubMed - in process]
Source: Complementary Therapies in Medicine - Category: Complementary Medicine Authors: Tags: Complement Ther Med Source Type: research
My love affair with spicy food came to a sad end a few years ago. Age — and I’m guessing too many jalapenos — have left me prone to heartburn if I eat meals with a fiery flare. My doctor says there’s no underlying condition causing the problem, and advises me to avoid the foods that seem to trigger symptoms. But that’s tricky sometimes. So I was particularly interested when a friend suggested that an over-the-counter (OTC) digestive enzyme supplement might help. I learned pretty quickly that there are lots of ads for the pills and powders. It’s a booming business, with sales for OTC dige...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Complementary and alternative medicine Digestive Disorders Health Source Type: blogs
Vancomycin remains the gold standard of treatment for methicillin-resistant Staphylococcus aureus (MRSA) serious infections; however, the emergence of strains with reduced vancomycin susceptibility warrants the need for alternative therapies. Tigecycline (TGC) is a broad-spectrum protein synthesis inhibiting antibiotic that is active against Gram-positive and Gram-negative organisms, including multidrug-resistant (MDR) bacteria. The FDA approved its use for the treatment of complicated skin and skin structure infections, complicated intra-abdominal infections, and community-acquired bacterial pneumonia.
Source: International Journal of Antimicrobial Agents - Category: Drugs & Pharmacology Authors: Tags: Letter to the Editor Source Type: research
CONCLUSIONS: Autogenic drainage is a challenging technique that requires commitment from the individual. As such, this intervention merits systematic review to ensure its effectiveness for people with cystic fibrosis. From the studies assessed, autogenic drainage was not found to be superior to any other form of airway clearance technique. Larger studies are required to better evaluate autogenic drainage in comparison to other airway clearance techniques in view of the relatively small number of participants in this review and the complex study designs. The studies recruited a range of participants and were not powered to ...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
CONCLUSIONS: The evidence suggests that prophylaxis with bypassing agents may be effective in reducing bleeding in males with hemophilia with inhibitors. However, there is a lack of evidence for the superiority of one agent over the other or for the optimum dosage regimen. Further studies are needed to evaluate the benefits and harms of prophylaxis treatment on health-related quality of life, as well as the effects of dose of bypassing agents on the outcomes. PMID: 28944952 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Authors: De Marco S, Piccioni M, Pagiotti R, Pietrella D Abstract Pseudomonas aeruginosa is a common biofilm-forming bacterial pathogen implicated in lung, skin, and systemic infections. Biofilms are majorly associated with chronic lung infection, which is the most severe complication in cystic fibrosis patients characterized by drug-resistant biofilms in the bronchial mucus with zones, where reactive oxygen species concentration is increased mainly due to neutrophil activity. Aim of this work is to verify the anti-Pseudomonas property of propolis or bud poplar resins extracts. The antimicrobial activity of propoli...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
This study was designed to determine whether yoga might alleviate symptoms of pain, sleep disturbance, anxiety, and depression in children with cystic fibrosis (CF). CF is the most common genetic, life-limiting chronic disease among Caucasian populations. It primarily affects the lungs but also many other secretory organs and consequently leads to significant morbidities. Research has shown that children with CF have significantly increased depression, anxiety, and pain compared to their healthy counterparts. Subjects participated in six one-on-one sessions over a 10-week period with a certified instructor who designed eac...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
CONCLUSIONS: Given the high frequency and number of modalities used and lack of patient and disease characteristics predicting use, we recommend that health care providers should routinely ask about complementary and alternative medicine among all pediatric cystic fibrosis patients and assist patients in understanding the potential benefits and risks to make informed decisions about its use. PMID: 27863612 [PubMed - in process]
Source: Complementary Therapies in Clinical Practice - Category: Complementary Medicine Authors: Tags: Complement Ther Clin Pract Source Type: research
Authors: Lu X, Zhang S, Yang C, Wang Z, Zhao L, Wu Z, Xie J Abstract TongXie-YaoFang (TXYF) can effectively alleviate the symptoms of diarrhea-predominant irritable bowel syndrome (D-IBS) patients. However, the curative mechanism has not been fully clarified. The study was designed to investigate the effect of TXYF on the colonic ion transport induced by serotonin (5-HT) in D-IBS rats. A method of multiple stress (neonatal maternal separation (NMS) combined with restraint stress (RS)) was used to induce the D-IBS model. The model rats were randomly divided into two groups: NMS + RS group and TXYF-formula group, and...
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Abstract OBJECTIVE: The purpose of this study was to investigate the effects of motivational and relaxation music on affective responses during exercise in patients with cystic fibrosis (CF). METHODS: Thirty-seven patients with CF performed the 6-min walk test (6MWT) under three experimental conditions: listening to no music, relaxation music, and motivational music. 6-min distance × body weight product (6MWORK) was calculated for each trial. Patients' affective responses during exercise was evaluated with Feeling Scale (FS). The motivational qualities of music were evaluated with th...
Source: Complementary Therapies in Clinical Practice - Category: Complementary Medicine Authors: Tags: Complement Ther Clin Pract Source Type: research
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