Metabolic and cardiorespiratory effects of decreasing lung hyperinflation with budesonide/formoterol in COPD: a randomized, double-crossover, placebo-controlled, multicenter trial

Studies suggest that acute decreases in lung hyperinflation at rest improves cardiac function and increases lung vascular perfusion from decompression of a compromised heart. In those studies, changes in resti...
Source: Respiratory Research - Category: Respiratory Medicine Authors: Tags: Research Source Type: research

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Publication date: Available online 2 February 2020Source: Journal of Photochemistry and Photobiology C: Photochemistry ReviewsAuthor(s): Miguel N. Pinto, Pradip K. MascharakAbstractThe recent discovery of the salutary effects of carbon monoxide (CO) in chronic obstructive pulmonary disease (COPD), ischemic perfusion damage, graft implantation, as well as its pro-apoptotic effects on hyper-proliferating cells has raised interest in delivering small doses of CO to biological targets under controlled conditions. In such attempts, photoactive metal carbonyl complexes (photoCORMs) have shown promise and several accounts of canc...
Source: Journal of Photochemistry and Photobiology C: Photochemistry Reviews - Category: Chemistry Source Type: research
CONCLUSION: The extracorporeal carbon dioxide removal device used in the study provides efficient clearance of CO2 at low sweep flow rates which then plateaus. This has implications for how the device may be used in clinical practice, particularly during the weaning phase where the final discontinuation of the device may take longer than anticipated. (ClinicalTrials.gov: NCT02086084, registered 13 March 2014, https://clinicaltrials.gov/ct2/show/NCT02086084 ). PMID: 31928313 [PubMed - as supplied by publisher]
Source: Perfusion - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Perfusion Source Type: research
Exertional dyspnea disproportional to the effort is the most common (cardinal)symptom of heart disease. Whenever we discuss the mechanism of cardiac dyspnea , we primarily attribute it to left heart disease, elevated LVEDP and the resultant pulmonary congestion.Conventional teaching in the past (may be in the present too !) doesn’t implicate raised RVEDP in the genesis of dyspnea. It’s good to recall , the sensation of dyspnea is felt at the peri -Amygdala nuclear zone after complex processing with various cortical and sub-cortical level .It is subjected to as many afferent triggers other than J receptors in pu...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Cardiology - Clinical Clinical cardiology Uncategorized does raised rvedp cause dyspnea dyspnea in pulmonary hypertension mechanism of dyspnea Source Type: blogs
The objective of this analysis was to analyze treatment effects of indacaterol/glycopyrronium (IND/GLY) on pulmonary ventilation/perfusion match (VQM) and regional ventilation dynamics.Methods: CLAIM was a randomized, double-blind, single-center, placebo-controlled, 2 period cross-over trial. 62 hyperinflated COPD patients were enrolled to receive IND/GLY (110/50 μg q.d.) for 14 days followed by placebo or vice versa. Regional lung ventilation dynamics and perfusion was measured in three coronal slices using phase-resolved functional lung (PREFUL)-MRI. The regional MRI flow-volume curves during continuous tidal volume b...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
PAH is characterized by impaired pulmonary gas exchange, with worsening of ventilation/perfusion ratio and increase in physiological dead space. In our Institute, we developed a rehabilitation program for PAH patients with aerobic, resistive and breathing exercises, including CB sessions. CB resulted useful in conditions characterized by a gas exchange impairment as chronic obstructive pulmonary disease, heart failure and high altitude hypoxia, improving oxygenation and vagal activity and concomitantly reducing sympathoexcitation, with a favorable effect on symptoms and prognostic variables.Our purpose is to evaluate the p...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and chronic care Source Type: research
Background: It remains a challenge to identify best target lobe with the highest outcomes in severe COPD following endoscopic lung volume reduction (ELVR).Aim and Objectives: We analyzed the outcomes after ELVR though using lobar ventilation (V) and perfusion (Q) quantitation combing with HRCT to identify the targeted lobe.Methods: Patients with severe COPD were prospectively recruited and underwent unilateral ELVR between Feb 2013 and Oct 2018 at Macquarie University Hospital. 19 patients in the study group were used the lower lobar VQ combing with HRCT and 44 patients in the control group performed planar VQ scan only re...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Interventional pulmonology Source Type: research
In this study, it was aimed to select the best incision management system to keep the incision edges together and prevent wound opening, and infection by protecting the incision. In this study, 60 patients who underwent abdominal surgery were evaluated regarding their risk of wound dehiscence. In our clinic, high-risk cases of abdominal surgery are performed, the risk factors being ischemia along the incision line, dirty and contaminated wound, obesity, tension on the suture line, traumatization of the wound site, age at onset (> 65), body mass index (BMI)> 30, diabetes mellitus, chronic obstructive pulmonary disease...
Source: Journal of Medicine and Life - Category: General Medicine Tags: J Med Life Source Type: research
A 40-something male presents to the stabilization room for evaluation following head on motor vehicle collision (MVC).  Pt was reported restrained driver, hit at city speeds,  with + airbag deployment.The MVC was unquestionably caused by the other car, not by this driver.The patient complained to EMS of chest pain and a prehospital EKG en route was concerning for STEMI.The patient was at all times hemodynamically stable, without evidence of any profuse bleeding.He had an ECG recorded on arrival to the ED:Anterior and Inferior STEMI with diffuse hyperacute T-waves. This ECG really can't be anything else. ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
CONCLUSIONS AND IMPLICATIONS: To our knowledge, this is the first pre-clinical study to show that Tiotropium bromide induces Ca2+ signalling via CaMKII and L-type Ca2+ channels to result in cell damage. This has significant clinical impact due to long term use of TB in COPD patients, and warrants assessment of cardiac drug safety. PMID: 31618660 [PubMed - as supplied by publisher]
Source: Toxicology and Applied Pharmacology - Category: Toxicology Authors: Tags: Toxicol Appl Pharmacol Source Type: research
CONCLUSION: In this pilot study in patients with COPD who referred for myocardial perfusion scintigraphy, the feasibility and safety of adenosine in a graded protocol along with a good pre-stress assessment and a short acting bronchodilator treatment was documented. PMID: 31273356 [PubMed - as supplied by publisher]
Source: Hellenic Journal of Nuclear Medicine - Category: Nuclear Medicine Tags: Hell J Nucl Med Source Type: research
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