Erythromycin and Reflux Events in Premature Neonates: A Randomized Clinical Trial
Conclusions: Enteral EES did not decrease reflux events on 24-hour pH-MII at the dose studied. Therefore, it may be ineffective in the treatment of GERD in premature neonates. (Source: Journal of Pediatric Gastroenterology and Nutrition)
Source: Journal of Pediatric Gastroenterology and Nutrition - November 26, 2018 Category: Gastroenterology Tags: Clinical Trials: Gastroenterology Source Type: research

Two placebo-controlled crossover studies in healthy subjects to evaluate gastric acid neutralization by an alginate-antacid formulation (Gaviscon Double Action).
CONCLUSIONS: These studies demonstrate the effective acid neutralizing capacity of Gaviscon DA versus placebo in healthy, fasted subjects. This adds to the evidence base for the combination of alginates and antacids. [Eudra CT 2014-003158-15; 2016-000539-42]. PMID: 30470147 [PubMed - as supplied by publisher] (Source: Drug Development and Industrial Pharmacy)
Source: Drug Development and Industrial Pharmacy - November 26, 2018 Category: Drugs & Pharmacology Tags: Drug Dev Ind Pharm Source Type: research

The dysphagia stress test for rapid assessment of swallowing difficulties in esophageal conditions
Conclusions& InferencesThe DST is the first rapid assessment tool designed for gastroenterology clinics with direct observation of swallowing ability across several conditions to mitigate issues related to patient self ‐report of esophageal symptoms. (Source: Neurogastroenterology and Motility)
Source: Neurogastroenterology and Motility - November 25, 2018 Category: Gastroenterology Authors: Tiffany H. Taft, Emily Kern, Kristen Starkey, Jenna Craft, Meredith Craven, Bethany Doerfler, Laurie Keefer, Peter Kahrilas, John Pandolfino Tags: ORIGINAL ARTICLE Source Type: research

Weight Management as a Treatment Option for Gastroesophageal Reflux Disease: A Mechanical or Metabolic Rescuer?
Authors: Lee H PMID: 30466199 [PubMed - in process] (Source: Gut and Liver)
Source: Gut and Liver - November 24, 2018 Category: Gastroenterology Tags: Gut Liver Source Type: research

An integrated serum and urinary metabonomic research of Rhizoma Curcumae-Rhizoma Sparganii drug pair in hysteromyoma rats based on UPLC-Q-TOF-MS analysis
ConclusionsThis study provides a useful method to get insight into the integrated metabonomic mechanism of RCRS drug pair on HY rats.Graphical abstract (Source: Journal of Ethnopharmacology)
Source: Journal of Ethnopharmacology - November 24, 2018 Category: Drugs & Pharmacology Source Type: research

Impact of abdominal visceral adiposity on adult asthma symptoms
ConclusionRegardless of sex, abdominal visceral fat was associated with reduced asthma quality of life independent of other obesity indices, and this may be explained by the impact of abdominal visceral fat on reduced FEV1 % predicted and higher risk for GERD and depression. Therefore, visceral adiposity may have more clinical influence on asthma symptoms than any other obesity indices. (Source: The Journal of Allergy and Clinical Immunology: In Practice)
Source: The Journal of Allergy and Clinical Immunology: In Practice - November 24, 2018 Category: Allergy & Immunology Source Type: research

Risk factors for oesophageal cancer
Publication date: Available online 22 November 2018Source: Best Practice & Research Clinical GastroenterologyAuthor(s): Shao-Hua Xie, Jesper LagergrenAbstractThe two main histological subtypes of oesophageal cancer, squamous cell carcinoma and adenocarcinoma, have distinct risk factor profiles. For oesophageal squamous cell carcinoma, tobacco smoking and excess alcohol use are the main risk factors. For adenocarcinoma, gastro-oesophageal reflux disease and obesity are main risk factors, whereas tobacco smoking is a moderately strong risk factor and infection with Helicobacter pylori decreases the risk. Dietary factors ...
Source: Best Practice and Research Clinical Gastroenterology - November 23, 2018 Category: Gastroenterology Source Type: research

Managing comorbid conditions in severe asthma.
Authors: Bardin PG, Rangaswamy J, Yo SW Abstract Asthma care has increasingly focused on personalised management for severe asthma, and recognition of the role and importance of comorbid conditions has increased. Severe asthma can be crippling; associated comorbid conditions often play a key role in the significant disease morbidity and frequently contribute to a severe and difficult-to-treat asthma phenotype. Comorbid conditions can be broadly grouped as being either airway-related or airway-unrelated. Airway-related comorbid conditions with the greatest impact are allergic rhinitis, chronic rhinosinusitis, vocal ...
Source: Medical Journal of Australia - November 22, 2018 Category: General Medicine Tags: Med J Aust Source Type: research

Cystic fibrosis is associated with an increased risk of Barrett's esophagus
Cystic fibrosis (CF) patients have increased risks of gastrointestinal cancers, including esophageal adenocarcinoma. Gastroesophageal reflux disease (GERD) is highly prevalent in CF and manifests at early ages. CF patients may be at increased risk for long-term sequelae of chronic GERD, including Barrett's esophagus (BE). We aimed to assess whether patients with CF have an increased risk of BE or related neoplasia. (Source: Journal of Cystic Fibrosis)
Source: Journal of Cystic Fibrosis - November 22, 2018 Category: Respiratory Medicine Authors: Rita M. Knotts, Quinn S. Solfisburg, Claire Keating, Emily DiMango, Charles J. Lightdale, Julian A. Abrams Tags: Original Article Source Type: research

Differentiation of esophageal pH-impedance characteristics classified by the mucosal integrity marker in human neonates.
Abstract BACKGROUND: In adults, distal baseline impedance (BI) is a determinant of esophageal mucosal integrity with values
Source: Pediatric Research - November 22, 2018 Category: Pediatrics Authors: Jadcherla SR, Hanandeh N, Hasenstab KA, Nawaz S Tags: Pediatr Res Source Type: research

Impairment of rat esophageal muscle contractility associated with experimental non ‐erosive esophageal mucosal damage
This article is protected by copyright. All rights reserved (Source: Experimental Physiology)
Source: Experimental Physiology - November 22, 2018 Category: Physiology Authors: Kalinne Kelly Lima Gadelha, Francisco Jos é Batista‐Lima, Daniel Maia Nogueira Oliveira, Emanuella Feitosa de Carvalho, Daniel Sifrim, Armênio Aguiar dos Santos, Pedro Jorge Caldas Magalhães Tags: RESEARCH PAPER Source Type: research

The Long-Term Adverse Event Profile of Oral Eliglustat for the Treatment of Gaucher Disease Type 1: Pooled Analysis of Data from 393 Patients in 4 Completed Trials
Conclusions:This pooled analysis of AE data from one Phase 2 and three Phase 3 completed eliglustat trials demonstrates long-term safety and tolerability of eliglustat in the treatment of adults with GD1.DisclosuresPeterschmitt: Sanofi Genzyme: Employment. Freisens: Sanofi Genzyme: Employment. Hou: Sanofi Genzyme: Employment. Underhill: Sanofi Genzyme: Employment. Foster: Sanofi Genzyme: Employment. Gaemers: Sanofi Genzyme: Employment. (Source: Blood)
Source: Blood - November 21, 2018 Category: Hematology Authors: Peterschmitt, M. J., Freisens, S., Hou, A. W., Underhill, L., Foster, M. C., Gaemers, S. J. M. Tags: 201. Granulocytes, Monocytes, and Macrophages: Poster III Source Type: research

Survivorship in AML - Outcomes of Acute Myelogenous Leukemia (AML) Patients (pts) after Maintaining Complete Remission (CR) for at Least 3 Years (yrs)
Introduction: Approximately 77% of younger pts and 49% of older pts with newly diagnosed AML achieve CR after induction chemotherapy (chemo). The majority of pts who achieve CR eventually relapse, with only approximately 30% of pts maintaining CR for 3 yrs or longer. Long-term outcomes in pts maintaining 1st CR for at least 3 yrs (AML survivors) remain largely unknown. The purpose of this study was to investigate long-term outcomes in this subset of pts.Methods: We performed a chart review of pts with AML treated at our institution from 2000-2015 who achieved CR for at least 3 yrs after their initial chemo ± allogen...
Source: Blood - November 21, 2018 Category: Hematology Authors: Major, C. K., Kantarjian, H. M., Borthakur, G., Kadia, T. M., Pemmaraju, N., Short, N. J., Daver, N. G., Jabbour, E. J., Champlin, R. E., Garcia-Manero, G., Konopleva, M. Y., Andreeff, M., Kornblau, S. M., Wierda, W. G., Pierce, S. A., Ravandi, F., Cortes Tags: 613. Acute Myeloid Leukemia: Clinical Studies: Poster III Source Type: research

Atypical Chronic Myeloid Leukemia
We present one of the rare presentations of aCML in an elderly patient.Case: A 76 year old male presented to the Hematology clinic for consultation after discharge from local hospital for elevated WBC count. Past medical history was significant for COPD, acid reflux, peripheral arterial disease and hypertension. Physical exam was unremarkable. Initial labs were significant for leukocytosis of 30 k/cu mm, anemia with Hb 10 gm/dl, thrombocytosis 695,000 with neutrophilia of ANC 25,200. Peripheral blood was negative for JAK2 V617F and BCR-ABL. Peripheral blood flow cytometry showed granulocytic left shift with 1.5% myeloblast...
Source: Blood - November 21, 2018 Category: Hematology Authors: Ashangari, C., Tumula, P. K. Tags: 632. Chronic Myeloid Leukemia: Therapy Source Type: research

Gastroenterology for the Internist
Gastroenterology disorders such as gastroesophageal reflux disease (GERD) and irritable bowel syndrome are a common indication for primary care office visits. Patients with chronic gastroenterology and hepatology disorders are often followed closely by both internists and gastroenterologists. This issue of Medical Clinics of North America is dedicated to advances in the management of common gastroenterology and hepatology disorders managed by both internists and gastroenterologists and the new developments and challenges related to these disorders. (Source: Medical Clinics of North America)
Source: Medical Clinics of North America - November 20, 2018 Category: Primary Care Authors: Kerry B. Dunbar Tags: Preface Source Type: research

Gastroesophageal Reflux in Asymptomatic Patients with Diabetes: An Impedance Study Diabetes, Obesity and Gastroesophageal Reflux
Exp Clin Endocrinol Diabetes DOI: 10.1055/a-0783-2327 Introduction Gastroesophageal reflux disease (GERD) is more frequent in patients with diabetes mellitus (DM).The aim of the present study was to evaluate GER in asymptomatic patients with DM using 24-h pH impedance. Materials and Methods 19 healthy controls and 35 patients with DM without typical GERD symptoms were enrolled in the study. A 24-h pH-impedance study, esophageal manometry and gastroscopy were performed on all patients with DM. In the control group, an impedance study was performed on all subjects, and gastroscopy and esophageal manometry were performed on t...
Source: Experimental and Clinical Endocrinology and Diabetes - November 20, 2018 Category: Endocrinology Authors: Gokturk, Suut Akyuz, Filiz Arici, Serpil Alpaslan, Busra Ormeci, Asli Soyer, Ozlem Mutluay Evirgen, Sami Cavus, Bilger Uzum, Ayse Kubat Gul, Nurdan Akyuz, Umit Karaca, Cetin Demir, Kadir Kaymakoglu, Sabahattin Satman, Ilhan Besisik, Fatih Tags: Article Source Type: research

Mechanisms of Aerodigestive Symptoms in Infants with Varying Acid Reflux Index Determined by Esophageal Manometry
To test whether symptom generation in infants is related to the severity of gastroesophageal reflux disease (GERD) symptoms as determined by the Acid Reflux Index (ARI), stimulus media, and stimulus volume during provocative esophageal manometry. (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - November 19, 2018 Category: Pediatrics Authors: Carissa R. Collins, Kathryn A. Hasenstab, Saira Nawaz, Sudarshan R. Jadcherla Tags: Original Articles Source Type: research

Correlation between high salivary pepsin concentration and chronic pharyngitis.
Conclusion: PEPTESTTM allowed for a non-invasive, reliable method for the diagnosis of GERD and measurement of salivary pepsin concentrations. The medium to high concentrations of pepsin found in patients could be a contributing factor to the cause of chronic pharyngitis. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hodgson, R., Wang, Q., Wang, X., Dettmar, P. Tags: Clinical Problems Source Type: research

Gastroesophageal reflux (GER)-associated cough: Effect of treatment on cellular and neurogenic inflammation
Background: GER-associated cough may involve neutrophilic (Jatakanon Thorax 1999), and neurogenic inflammation, the latter being indicated by elevated sputum levels of substance P (SP; Patterson Thorax 2007). Whether they are interrelated, and are affected by treatment, are unknown.Methods: We prospectively recruited 37 patients with GER-associated chronic cough (20 females, aged 53.6 yrs) according to the Japanese Cough Guideline. A PPI rabeprazole 20 mg qd and a prokinetic itopride 50 mg tid were given for 4 wks. Before and after this, we examined cough and reflux symptoms by scores of cough VAS, Japanese version of Leic...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Takeda, N., Takemura, M., Fukumitsu, K., Asano, T., Kanemitsu, Y., Kubota, E., Niimi, A. Tags: Clinical Problems Source Type: research

Sensitisation of the cough reflex in childbearing women to mechanical stimuli: a cross-sectional study
Background: The cough reflex in childbearing women has been found to be more sensitive to chemical stimuli than that in other populations. However, the effect of age and sex on the cough reflex threshold (CRT) triggered by mechanical stimuli has not been studied.Aim: Our objective was to explore the association between age and sex, and CRT triggered by mechanical stimuli (air pulses) in childbearing women using a previously validated laryngopharyngeal endoscopic esthesiometer and laser rangefinder (LPEER).Methods: A cohort of 118 subjects, half of whom were female (49%), aged 19-95 years (a mean of 55.7 years), were prospe...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Giraldo-Cadavid, L. F., Fernandez, S., Burguete, J., Paez, N., Agudelo-Otalora, L. M., Arbulu, M., Galvis, A. M. Tags: Clinical Problems Source Type: research

Blood eosinophils fluctuation in asthmatics on Omalizumab-a mirror of disease outcomes improvement?
Conclusions: In the studied population, a reduction in BE was evident, as well as a significant reduction in exacerbations, improvement in asthma control, quality of life and lung function.BE has been related with some treatable traits such as exacerbations and lung function, and the cutoff value of ≥400/μL related with greater risk. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Maia Santos, L. V., Ramos, B., Chaves Loureiro, C. Tags: Monitoring Airway Disease Source Type: research

Does the nature of adult difficult asthma differ by age of onset? Findings from WATCH.
Background: Phenotypic differences between early-onset (EODA) and adult-onset (AODA) difficult asthma in adulthood are not well described.Aim: To characterise EODA and AODA in difficult asthma.Methods: The Wessex AsThma CoHort of difficult asthma (WATCH) is a longitudinal study at University Hospital Southampton (UHS) UK set up in 2015. To date, 380 patients are enrolled from the UHS tertiary difficult asthma clinic. Clinical features of EODA (age ≤18 yrs) and AODA (age>18 yrs) are presented here.Results: Of 368 patients with available data, 51.6% had EODA and 48.4% AODA (median age of onset 4.0 yrs v 40.5 yrs respectively (p
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Mistry, H., Freeman, A., Thirlwall, Y., Harvey, M. A. E., Barber, C., Haitchi, H. M., Newell, C., Cheng, Y., Varkonyi-Sepp, J., Kurukulaaratchy, R. J. Tags: Monitoring Airway Disease Source Type: research

Comorbidities in the difficult asthma clinic: results from WATCH
Background: Multiple co-morbidities are associated with disease control, healthcare utilization and quality of life in difficult asthma.Aim: To evaluate the prevalence of comorbidities in patients with difficult asthma in the Wessex AsThma CoHort of difficult asthma (WATCH).Methods: Our prospective observation cohort study has enrolled 380 patients with severe asthma. History of co-morbidities is collected at enrolment. Data is presented as percentages and chi squared tests were used to calculate differences between groups.Results: Comorbidity(n)Prevalence (%)Gender Difference(male % vs female %)Age of Onset Difference (ea...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Azim, A., Mistry, H., Harvey, M. A., Thirlwall, Y., Dennison, P., Freeman, A., Newell, C., Haitchi, H. M., Howarth, P. H., Kurukulaaratchy, R. Tags: Monitoring Airway Disease Source Type: research

Does early-onset difficult asthma in adulthood differ by sex? Findings from WATCH.
Background: Whether the nature of early-onset difficult adult asthma differs by sex remains unclear.Aim: To assess clinical characteristics of early-onset difficult asthma in adulthood stratified by sex.Method: The Wessex AsThma CoHort of difficult asthma (WATCH) at University Hospital Southampton (UHS) UK has enrolled 380 patients from the UHS tertiary difficult asthma clinics. We compared clinical characteristics between sexes in patients with early-onset difficult asthma (age of diagnosis ≤18 years).Results: 190 patients had early-onset difficult asthma; 72.1% female (F) and 27.9% male (M). Median age of diagnosis (F...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Mistry, H., Azim, A., Thirlwall, Y., Mitchell, F., Barber, C., Haitchi, H. M., Newell, C., Dennison, P., Cheng, Y., Kurukulaaratchy, R. J. Tags: Monitoring Airway Disease Source Type: research

Late Breaking Abstract - Inhaled corticosteroids (ICS), blood eosinophils (EOS), and FEV1 decline in patients with Chronic Obstructive Pulmonary Disease in a large UK primary healthcare setting
Background: Personalised therapy for COPD patients is debated. We investigated whether the rate of FEV1 decline differs between patients with and without ICS-containing medications, stratified by blood EOS level.Methods: The UK Clinical Practice Research Datalink (primary care records) and Hospital Episode Statistics (hospital records) were used to identify COPD patients with ≥2 FEV1 measurements ≥6 months apart. Follow-up started from first FEV1 until censoring at death, leaving database or first ICS-containing prescription (if not baseline ICS-containing user). The nearest blood EOS 2 years prior to the start of fo...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Whittaker, H., Mullerova, H., Jarvis, D., Barnes, N., Jones, P., Compton, C., Kiddle, S., Quint, J. Tags: Epidemiology Source Type: research

Aspiration Syndrome in Children Under One Year of Age
Intranatal aspiration syndrome (AS) in newborns remains a relevant topic in neonatology. Less attention was paid to postnatal aspiration in neonates and infants, despite its clinical significance. Objective of the research - to study AS frequency and structure in children under one year of age, improvement of diagnostic and therapeutic tactics for this pathology. Authors analyzed history of 1052 children (624 neonates and 428 infants), hospitalized in the Department of breast somatic of St. Vladimir's Children's Clinical Hospital in 2014. Aspiration was suspected in 115 children (10,9% of all admissions to the department),...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Zaitseva, N., Borisova, T., Besedina, M., Tolstova, E., Tilikina, L., Efimova, E., Radimova, E., Ionova, E., Zaytseva, O. Tags: Paediatric respiratory epidemiology Source Type: research

Does cobblestone appearance on bronchoscopy suggest gastro-oesophageal reflux disease?
Conclusions: Tracheal cobblestone appearance has a poor sensitivity but good specificity for gastro-oesophageal reflux as defined by a De Meester score>14.72. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Duru, C., Walker, L., Scott, A. Tags: Paediatric bronchology Source Type: research

The etiological specificity of bronchiectasis in Tunisian children
Conclusion: Primary ciliary dyskinisea is the main etiology of BR in Tunisian children. A diagnostic procedure based on thorough history, physical exam, and focused laboratory evaluation is recommended for children with BR. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hamdi, B., Bdira, B., Ben Jemai, E., Ammari, S., Ammar, J., Berraies, A., Hamzaoui, A. Tags: Paediatric bronchology Source Type: research

Fiberoptic endoscopic evaluation of swallowing as a diagnostic tool in infant silent aspiration
Conclusion: Silent aspiration is a quite common contributing factor in infants with chronic/recurrent wet cough and/or noisy breathing and can be easily detected with FEES. This may help to avoid more complex and unnecessary or expensive examinations.cv (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Grammeniatis, V., Delides, A., Nikolopoulos, T., Galani, A., Priftis, K., Douros, K. Tags: Paediatric bronchology Source Type: research

Changes in forced oscillatory parameters in reversibility testing as predictors for cough variant asthma
Conclusion: The FOT is superior to spirometry or FeNO measurements in predicting CVA. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Shirai, T., Watanabe, H., Akamatsu, T., Tamura, K., Masuda, T., Takahashi, S., Tanaka, Y., Endo, Y., Suzuki, T., Noguchi, R., Saigusa, M., Yamamoto, A., Shishido, Y., Akita, T., Morita, S., Asada, K. Tags: Clinical Problems Source Type: research

Symptomatic GORD in difficult asthma is associated with worse asthma control and related comorbidities: Findings from WATCH
Background: Difficult asthma is associated with increased prevalence of gastro-oesophageal reflux disease (GORD). However, it is unclear how controlling comorbid GORD impacts difficult asthma.Aim: To evaluate the impact of effectively controlling GORD symptoms in difficult asthmatics in the Wessex AsThma Cohort of difficult asthma (WATCH) Southampton UK.Methods: A retrospective analysis was undertaken to compare the reported symptoms of GORD in 311 adult asthmatics on treatment for GORD. We compared patients with ongoing GORD symptoms against those with no symptoms using Chi square (categorical data) and Mann-Whitney U tes...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Thirlwall, Y., Tariq, K., Mistry, H., Azim, A., Barber, C., Bentley, K., Newell, C., Haitchi, H. M., Djukanovic, R., Kurukulaaratchy, R. Tags: Nurses Source Type: research

What can we learn from Idiopathic Pulmonary Fibrosis Registries?
Conclusion: Our patients present years after becoming symptomatic, with significant lung function impairment and co-morbidities. 69% of our patients are prescribed antifibrotics which is higher than published uptake in Europe and the US. Our registry provides insights into the diagnosis and management of IPF patients in the real-world setting. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Lodhi, T., Leonard, C., Rivera Ortega, P., Morris, H., Marshall, T., Zakis, K., Garfoot, T., Hayton, C., Greaves, M., Blaikley, J., Chaudhuri, N. Tags: Idiopathic interstitial pneumonias Source Type: research

Diaphragm in the role of esophageal sphincter and possibilities of treatment of esophageal reflux disease using physiotherapeutic procedures
Background: Diaphragm (crural part), is considered to be a part of the antireflux barrier. This work is dedicated to the diaphragm in the role of the lower esophageal sphincter (LES). We want to point out the potential impact of the diaphragm on the competence of this LES by patients with esophageal reflux disease and to reveal the possibilities how physiotherapy can help in the training of this part of the skeletal muscle.Method: The group: 60 patients. average 46,5 (20 - 77) years, 29 women and 31 men. BMI 26.2. Examination using MMS's High Resolution Esophageal Manometry using a 36-channel and a special spirometry focus...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Bitnar, P., Hlava, S., Stovicek, J., Kobesova, A. Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research

Prevalence of co-morbidities and clinical features in patients with obstructive sleep apnea and chronic obstructive pulmonary disease.
This study aimed to compare the prevalence of co-morbidities and the clinical features in patients with OSA and OS. We analyzed demographic, polygraphic data and co-morbidities from two cohorts of patients, 69 (45 males) with OSA (FVC 94% FEV1 93%) and 79 (65 males) with OS (FVC 82% FEV1 65 %). There were no significant differences between the two groups in demographics (age 67±12 vs 69 ±8, BMI 33.6±6 vs 32±6, OSA vs OS), epworth sleepiness scale (7.7±6 vs 9±4, OSA vs OS) and Mallampati score (3.2±0.1 vs 3.0±01, OSA vs OS.) The two groups had comparable apnea/hypopnea...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Spicuzza, L., Frasca, E., Doria, G., Cacopardo, G., Crimi, C., Campisi, R., Crimi, N., Di Maria, G. Tags: Sleep and control of breathing Source Type: research

Association Between Swallow-Associated Respiratory Arousal and Nocturnal Gastroesophageal Reflux Occurrence in Patients with Coexisting Obstructive Sleep Apnea and Gastroesophageal Reflux Disease
Background: Respiratory arousal leads to gastroesophageal reflux (GER) in patients with coexisting obstructive sleep apnea (OSA) and gastroesophageal reflux disease (GERD). However, the precise mechanism remains unclear. Literatures have addressed swallow related lower esophageal sphincter relaxation as an important mechanism of GERD.Aims and objectives: To determine the association between swallow-associated respiratory arousal and GER in patients with coexisting OSA and GERD.Methods: A Case–crossover study among 10 patients with known moderate-severe OSA and GERD was conducted. Participants underwent simultaneous p...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Jantarangsi, N., Jaimchariyatam, N., Gonlachanvit, S., Desudchit, T. Tags: Sleep and control of breathing Source Type: research

Snoring and nocturnal gastroesophageal reflux in the ECRHS III: Association to lung function and respiratory symptoms
Introduction: Snoring and nocturnal gastroesophageal reflux (nGER) are each associated with respiratory symptoms, but their effect combined is not known. We aimed to study the association of lung function and respiratory symptoms with snoring and nGER.Methods: We used data from the European Community Respiratory Health Survey (ECRHS) III, a cross-sectional multi-centre general population study comprising 5715 participants. Post-bronchodilator spirometry was performed, and information on respiratory, sleep and nGER symptoms was collected. Habitual snoring was defined as reporting of snoring 'loudly or disturbingly, frequent...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Emilsson, O. I., Amid Hägg, S., Jarvis, D., Garcia-Aymerich, J., Gislason, T., Janson, C., On Behalf Of The Ecrhs Sleep Working Group. Tags: Sleep and control of breathing Source Type: research

Pepsin as a biomarker of reflux in NAR patients
Rationale: The backflow of gastric contents into the esophagus can cause Gastroesophageal reflux disease (GERD). When reflux surpasses the esophagus, respiratory-like symptoms are experienced, often leading to misdiagnosis. Non-allergic rhinitis (NAR) has symptoms similar to respiratory diseases and GERD. Using Peptest (RD Biomed Limited, UK) the aim was to determine pepsin concentration in NAR patients, certify links between NAR and GERD and prevent further misdiagnosis.Methods: 31 patients with negative CT sinus scans and allergen skin prick tests were recruited from ENT outpatient visits. Patients completed a Reflux Dis...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Lenham, R., Wang, Q., Wang, X., Dettmar, P. Tags: Respiratory infections Source Type: research

Prevalence and clinical relevance of comorbidities in IPF
Background: Comorbidities such as heart disease, pulmonary hypertension, gastroesophageal reflux disease (GERD) are frequently reported in patients with idiopathic pulmonary fibrosis (IPF), but with great variability in prevalence.Aim: We investigated the prevalence of comorbidities at diagnosis in IPF and evaluated their impact on disease course, particularly in the light of the recent introduction of the new anti-fibrotic therapies.Methods: We retrospectively retrieved information from records of patients with diagnosis of IPF from two different "IPF Clinics" in Rome. 425 records were analyzed for comorbidity p...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Puxeddu, E., Calzetta, L., Barrile, A., Cavalli, F., Sebastiani, A., Cazzola, M., Rogliani, P. Tags: Idiopathic interstitial pneumonias Source Type: research

Role of gastroesophageal reflux in interstitial lung disease associated to connective tissue disease.
Introduction: it is controversial if gastroesophageal reflux (GER) is involved in etiology and severity of interstitial lung disease (ILD) associated to connective tissue disease (CTD).Objectives: evaluate the frequency of GER in ILD associated to CTD and correlate GER to CTD type, ILD severity and imaging pattern.Methods: multicenter historical cohort study. Patients with ILD associated to CTD attended in 4 hospitals, were evaluated. Variables: age, gender, type of CTD, GER symptoms (pyrosis, regurgitation), high resolution scan (HRCT) ILD pattern and esophagus dilatation, forced vital capacity (FVC), DLCO.Results: n=70, ...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Diaz Cuna, C., Consani, S., Torres, V., Alonso, F., Berez, A. Tags: ILD/DPLD of known origin Source Type: research

Safety of riociguat for chronic thromboembolic pulmonary hypertension (CTEPH): Interim data from a prospective non-interventional study in Japan
Conclusions: The AE profile of riociguat in clinical practice in Japan appears consistent with clinical trials globally and in Japan. The most common AEs are consistent with the vasodilating action of riociguat. Most common drug-related AEs, No. of patients (%)Hypotension40 (5.8)Headache19 (2.8)Gastroesophageal reflux disease8 (1.2)Dizziness8 (1.2)Diarrhoea6 (0.9)Abdominal discomfort6 (0.9)Peripheral oedema5 (0.7)Dyspepsia5 (0.7)Nausea5 (0.7) (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Tanabe, N., Ogo, T., Hatano, M., Tazaki, Y., Sunaya, T., Saikawa, A., Sakaguchi, T. Tags: Pulmonary hypertension Source Type: research

Characterising the Adult Obese-Difficult Asthma Phenotype within the WATCH cohort
Conclusion: Obese asthmatics appear to perceive their symptoms as more severe, have a greater prevalence of functional co-morbidities and lose a greater number of days to illness, but have lower airway inflammation as assessed by FeNO. Different mechanisms may be driving symptoms in Obese-Difficult Asthma, requiring specific assessment and management strategies. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Freeman, A., Azim, A., Harvey, M. A. E., Mistry, H. M., Haitchi, H. M., Newell, C., Wilkinson, T. M., Varkonyi-Sepp, J., Mitchell, F., Kurukulaaratchy, R. J. Tags: Clinical Problems Source Type: research

Chronic pain in patients with chronic obstructive pulmonary disease
Introduction: Many individuals with chronic obstructive pulmonary disease (COPD) report suffering from chronic pain, which is often underestimated by physicians. It could affect the patient’s quality of life.Aims and objectives: To determine common origins of chronic pain in individuals with COPD, its impact on their quality of life and its contribution to the emergence of anxiety and depression symptoms.Methods: A cross-sectional study of male individuals with COPD was conducted at the Pneumology Department of Hedi Chaker Hospital in Sfax (Tunisia) between January 10 and February 10 2018. Dyspnea severity was strati...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Walid, F., Malek, C., Wajdi, K., Nadia, M., Najla, B., Sameh, M., Amina, K., Hajer, A., Karim, R., Ilhem, Y., Samy, K. Tags: Clinical Problems Source Type: research

Effect of comorbidities on severity and clinical parameters of COPD
Conclusion: These results suggest that most comorbid diseases do not affect severity, respiratory symptoms, exercise capacity, or quality of life, but osteoporosis is associated with more symptoms, worse exercise capacity, and poor respiratory-specific quality of life. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Park, S. J., Park, S. Y., Rhee, C. K., Yoo, K. H. Tags: Clinical Problems Source Type: research

COPD: CT Thorax - friend or foe: Clinical utility of CT in diagnosing co-morbidities.
Conclusion: Study reveals a high prevalance of potentially treatable extra pulmonary and pulmonary comorbidities. We recommend a list of these treatable comorbidities be included as part of the standard work up of COPD patients undergoing CT as it would enable better patient outcomes. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Vohra, A., Raza, S., Dalal, P., Kaul, S. Tags: Clinical Problems Source Type: research

Gastro-oesophageal reflux, reflux-associated respiratory symptoms and severity of Chronic Obstructive Pulmonary Disease in Sri Lankan patients.
This study evaluated this relationship in a cohort of Sri Lankan COPD patients.Methods: A validated GORD screening questionnaire assessed frequency and severity of 7 GORD and 5 RAR symptoms, in 67 COPD patients (83.6% male, mean age (SD) 66.8 (10.2) years) and 69 comparable controls (71% male, mean age (SD) 66.2 (8.1) years). The subjects were GORD symptom positive if the composite GORD score was ≥ 12.5. Medication use, smoking history and spirometry were also recorded.Results: The mean (SD) GORD symptom score of COPD patients; 29.9 (20.6) was higher than controls; 10.6 (5.2);P
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Amarasiri, D. L., Chaturanta, S., Hettige, H. N., Hitige, D. G., Gunasekera, N. U., Wickramaratna, K. M., Nizamdeen, M. G., Gunasekera, K. D., Ranasinha, C. D. Tags: Clinical Problems Source Type: research

Medication Effect on Acute Exacerbation and Mortality in Patients with Coexistent COPD and GERD
Objective: The effect of antacid therapy for patients with chronic obstructive pulmonary disease (COPD) and gastroesophageal reflux disease (GERD) remains unclear.Methods: Using Taiwan’s National Health Insurance Research Database, we conducted a nationwide population-based study. COPD patients with or without GERD were enrolled. Patients with COPD who were not prescribed COPD medication and patients with GERD who did not undergo upper gastrointestinal endoscopy or 24-hour pH monitoring were excluded. The primary endpoint was acute exacerbation and mortality.Results: The study included 3,485 COPD with GERD patients a...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Su, V. Y.-F. Tags: Clinical Problems Source Type: research

Sex differences in COPD comorbidities
Conclusions: COPD women, as compared with men, had similar distribution of disease severity and more exacerbations, despite milder smoking history. Women had higher prevalence of anxiety, valvular disease, thyroid disease, but lower prevalence of ischemic heart and cerebral disease and neoplastic disease. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: de Blasio, F., Dassetto, D., Aredano, I., Coni, F., Ambrosanio, R., Rella, A. M., Di Tria, R., Bucca, C. Tags: Clinical Problems Source Type: research

Asthma treatment in real life
Introduction: The controller to total asthma medication ratio (CTR) is a good measure of controller adherence and has been related to asthma outcomes. Better knowledge on drug use of asthmatics in the general population might provide directions to improve asthma control in real life.Aim: To describe the use of respiratory drugs in asthmatics and investigate factors associated with a high CTR.Methods: A retrospective cohort study (2007-2016) in patients with asthma, 5 years or older from 2 primary care databases namely IPCI (NL) and THIN (UK). Asthma was defined as at least 1 asthma disease code in combination with ≥2 pr...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Baan, E. J., Karimi, L., Heeremans, A., Brusselle, G. G., Sturkenboom, M., Janssens, H. M., Lahousse, L., Verhamme, K. M. Tags: General Practice and Primary Care Source Type: research

Etiology of bronchiectasis in Finland
Conclusions: Asthma was associated to bronchiectasis in 76% of the patients but it was estimated as etiology in only every fifth patient. However, retrospectively it is difficult to exclude asthma as a background cause in many cases with recurrent asthma like symptoms and respiratory infections. Nevertheless, in one fifth of the patients no identifiable cause was found. None of the patients had had tuberculosis. Lung function test results were well preserved and in 66% bronchiectasis was restricted to one-three lobes. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Mäntylä, J., Mazur, W., Viinanen, A., Purokivi, M., Kauppi, P. Tags: Epidemiology Source Type: research