Clinical significance of the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in acute exacerbations of COPD: present and future
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a leading cause of hospitalisation and death in COPD patients. In addition to the identification of better strategies to prevent AECOPD, there is an intense focus on discovering novel markers of disease severity that enhance risk stratification on hospital admission for the targeted institution of aggressive versus supportive treatments. In the quest for such biomarkers, an increasing body of evidence suggests that specific indexes derived from routine complete blood counts, i.e. the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte...
Source: European Respiratory Review - November 2, 2022 Category: Respiratory Medicine Authors: Zinellu, A., Zinellu, E., Mangoni, A. A., Pau, M. C., Carru, C., Pirina, P., Fois, A. G. Tags: COPD and smoking Reviews Source Type: research
Nicotine or tobacco abstinence?
We read with interest the meta-analysis by Hanewinkel et al. [1] regarding e-cigarette use and nicotine abstinence. The summary graph from the manuscript (shown here as figure 1a) clearly illustrates the competing issues in comparing the harms or benefits of these two smoking cessation adjuncts. (Source: European Respiratory Review)
Source: European Respiratory Review - November 2, 2022 Category: Respiratory Medicine Authors: Murray, R. L., Evison, M., Callister, M. E. Tags: COPD and smoking Correspondence Source Type: research
Prevalence, risk factors and treatments for post-COVID-19 breathlessness: a systematic review and meta-analysis
Persistent breathlessness >28 days after acute COVID-19 infection has been identified as a highly debilitating post-COVID symptom. However, the prevalence, risk factors, mechanisms and treatments for post-COVID breathlessness remain poorly understood. We systematically searched PubMed and Embase for relevant studies published from 1 January 2020 to 1 November 2021 (PROSPERO registration number: CRD42021285733) and included 119 eligible papers. Random-effects meta-analysis of 42 872 patients with COVID-19 reported in 102 papers found an overall prevalence of post-COVID breathlessness of 26% (95% CI 23–29) when...
Source: European Respiratory Review - November 2, 2022 Category: Respiratory Medicine Authors: Zheng, B., Daines, L., Han, Q., Hurst, J. R., Pfeffer, P., Shankar-Hari, M., Elneima, O., Walker, S., Brown, J. S., Siddiqui, S., Quint, J. K., Brightling, C. E., Evans, R. A., Wain, L. V., Heaney, L. G., Sheikh, A. Tags: Respiratory clinical practice, Respiratory infections and tuberculosis Reviews Source Type: research
Risk of serious COVID-19 outcomes among adults and children with moderate-to-severe asthma: a systematic review and meta-analysis
Conclusions
Adults with severe asthma are at increased risk of COVID-19 hospitalisation compared to nonusers. Our analysis highlighted the dearth of studies in children with asthma investigating serious COVID-19 outcomes. (Source: European Respiratory Review)
Source: European Respiratory Review - November 2, 2022 Category: Respiratory Medicine Authors: Lee, B., Lewis, G., Agyei-Manu, E., Atkins, N., Bhattacharyya, U., Dozier, M., Rostron, J., Sheikh, A., McQuillan, R., Theodoratou, E., for the Usher Network for COVID-19 Evidence Reviews (UNCOVER) group Tags: Asthma and allergy Reviews Source Type: research
Respiratory infections
, whether acute or chronic, are extremely frequent in both adults and children, representing an increased economic burden on healthcare systems, morbidity and mortality. These infections can be either community- or hospital-acquired. Both non-immunosuppressed and immunosuppressed patients can develop such health issues, although prevalence is higher in the latter group. In terms of microbial aetiology, the causative pathogen can be viral, bacterial, fungal or parasitic. In this European Respiratory Review (ERR) series, the authors review some key issues relating to the aforementioned topics. (Source: European Respiratory Review)
Source: European Respiratory Review - October 19, 2022 Category: Respiratory Medicine Authors: Niederman, M. S., Torres, A. Tags: Respiratory infections and tuberculosis Editorials Source Type: research
Non-Aspergillus mould lung infections
Non-Aspergillus filamentous fungi causing invasive mould infections have increased over the last years due to the widespread use of anti-Aspergillus prophylaxis and increased complexity and survival of immunosuppressed patients. In the few studies that have reported on invasive mould infection epidemiology, Mucorales are the most frequently isolated group, followed by either Fusarium spp. or Scedosporium spp. The overall incidence is low, but related mortality is exceedingly high. Patients with haematological malignancies and haematopoietic stem cell transplant recipients comprise the classical groups at risk of infection ...
Source: European Respiratory Review - October 19, 2022 Category: Respiratory Medicine Authors: Puerta-Alcalde, P., Garcia-Vidal, C. Tags: Respiratory infections and tuberculosis Series Source Type: research
How and when to manage respiratory infections out of hospital
Lower respiratory infections include acute bronchitis, influenza, community-acquired pneumonia, acute exacerbation of COPD and acute exacerbation of bronchiectasis. They are a major cause of death worldwide and often affect the most vulnerable: children, elderly and the impoverished. In this paper, we review the clinical presentation, diagnosis, severity assessment and treatment of adult outpatients with lower respiratory infections. The paper is divided into sections on specific lower respiratory infections, but we also dedicate a section to COVID-19 given the importance of the ongoing pandemic. Lower respiratory infectio...
Source: European Respiratory Review - October 19, 2022 Category: Respiratory Medicine Authors: Cavallazzi, R., Ramirez, J. A. Tags: Respiratory infections and tuberculosis Series Source Type: research
The threat of multidrug-resistant/extensively drug-resistant Gram-negative respiratory infections: another pandemic
Antibiotic resistance is recognised as a global threat to human health by national healthcare agencies, governments and medical societies, as well as the World Health Organization. Increasing resistance to available antimicrobial agents is of concern for bacterial, fungal, viral and parasitic pathogens. One of the greatest concerns is the continuing escalation of antimicrobial resistance among Gram-negative bacteria resulting in the endemic presence of multidrug-resistant (MDR) and extremely drug-resistant (XDR) pathogens. This concern is heightened by the identification of such MDR/XDR Gram-negative bacteria in water and ...
Source: European Respiratory Review - October 19, 2022 Category: Respiratory Medicine Authors: Reynolds, D., Burnham, J. P., Vazquez Guillamet, C., McCabe, M., Yuenger, V., Betthauser, K., Micek, S. T., Kollef, M. H. Tags: Respiratory infections and tuberculosis Series Source Type: research
Respiratory viruses: their importance and lessons learned from COVID-19
Respiratory virus infection can cause severe illnesses capable of inducing acute respiratory failure that can progress rapidly to acute respiratory distress syndrome (ARDS). ARDS is related to poor outcomes, especially in individuals with a higher risk of infection, such as the elderly and those with comorbidities, i.e. obesity, asthma, diabetes mellitus and chronic respiratory or cardiovascular disease. Despite this, effective antiviral treatments available for severe viral lung infections are scarce. The coronavirus disease 2019 (COVID-19) pandemic demonstrated that there is also a need to understand the role of airborne...
Source: European Respiratory Review - October 19, 2022 Category: Respiratory Medicine Authors: Cilloniz, C., Luna, C. M., Hurtado, J. C., Marcos, M. A., Torres, A. Tags: Respiratory infections and tuberculosis Series Source Type: research
Phage therapy for pulmonary infections: lessons from clinical experiences and key considerations
Lower respiratory tract infections lead to significant morbidity and mortality. They are increasingly caused by multidrug-resistant pathogens, notably in individuals with cystic fibrosis, hospital-acquired pneumonia and lung transplantation. The use of bacteriophages (phages) to treat bacterial infections is gaining growing attention, with numerous published cases of compassionate treatment over the last few years. Although the use of phages appears safe, the lack of standardisation, the significant heterogeneity of published studies and the paucity of robust efficacy data, alongside regulatory hurdles arising from the exi...
Source: European Respiratory Review - October 5, 2022 Category: Respiratory Medicine Authors: Mitropoulou, G., Koutsokera, A., Csajka, C., Blanchon, S., Sauty, A., Brunet, J.-F., von Garnier, C., Resch, G., Guery, B. Tags: Pulmonary pharmacology and therapeutics, Respiratory infections and tuberculosis Reviews Source Type: research
Prognostic value of echocardiography-derived right ventricular dysfunction in haemodynamically stable pulmonary embolism: a systematic review and meta-analysis
Conclusions
RVD is frequent in PE and associated with adverse outcomes. However, data quality and publication bias are limitations of existing evidence. (Source: European Respiratory Review)
Source: European Respiratory Review - October 5, 2022 Category: Respiratory Medicine Authors: Prosperi-Porta, G., Ronksley, P., Kiamanesh, O., Solverson, K., Motazedian, P., Weatherald, J. Tags: Pulmonary vascular disease Reviews Source Type: research
Riociguat and the right ventricle in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension
Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are progressive diseases that can lead to right heart failure and death. Right ventricular dysfunction, hypertrophy and maladaptive remodelling are consequences of increased right ventricular (RV) afterload in PAH and CTEPH and are indicative of long-term outcomes. Because RV failure is the main cause of morbidity and mortality in PAH and CTEPH, successful treatments should lead to improvements in RV parameters. Riociguat is a soluble guanylate cyclase stimulator approved for the treatment of PAH and inoperable or persistent/rec...
Source: European Respiratory Review - October 5, 2022 Category: Respiratory Medicine Authors: Benza, R. L., Langleben, D., Hemnes, A. R., Vonk Noordegraaf, A., Rosenkranz, S., Thenappan, T., Hassoun, P. M., Preston, I. R., Ghio, S., Badagliacca, R., Vizza, C. D., Lang, I. M., Meier, C., Grünig, E. Tags: Pulmonary vascular disease Reviews Source Type: research
The effects of COVID-19 on respiratory muscle performance: making the case for respiratory muscle testing and training
This article will review the impact of SARS-CoV-2 infection on RM performance and provide clinical recommendations for screening RM performance and treatment interventions. (Source: European Respiratory Review)
Source: European Respiratory Review - October 5, 2022 Category: Respiratory Medicine Authors: Severin, R., Franz, C. K., Farr, E., Meirelles, C., Arena, R., Phillips, S. A., Bond, S., Ferraro, F., Faghy, M., on behalf of the HL-PIVOT Network Tags: Respiratory infections and tuberculosis Reviews Source Type: research
Diagnostic yield and safety of transbronchial lung cryobiopsy and surgical lung biopsy in interstitial lung diseases: a systematic review and meta-analysis
Conclusions:
TBLC has a fairly good diagnostic yield, an acceptable safety profile and a lower mortality rate than VATS. The best results are obtained from more experienced centres. (Source: European Respiratory Review)
Source: European Respiratory Review - October 5, 2022 Category: Respiratory Medicine Authors: Rodrigues, I., Estevao Gomes, R., Coutinho, L. M., Rego, M. T., Machado, F., Morais, A., Novais Bastos, H. Tags: Interstitial and orphan lung disease, Respiratory clinical practice Reviews Source Type: research
Biochemical shunt: where and how?
G. Harutyunyan and co-workers, in their reply to our correspondence, introduce the fascinating concept of "biochemical shunt" to help explain some of the gas exchange abnormalities reported in patients with early coronavirus disease 2019 (COVID-19). In brief, they assert the plausibility that the oxyhaemoglobin dissociation curve (ODC), which may be normal in the arterial and venous blood, could be altered (i.e. reduced oxygen affinity) in the pulmonary blood flowing through diseased alveolar capillaries. It is not easy for us to understand which COVID-19-related factors, or metabolites, might alter the ODC specifically in...
Source: European Respiratory Review - September 20, 2022 Category: Respiratory Medicine Authors: Busana, M., Camporota, L., Gattinoni, L. Tags: Respiratory infections and tuberculosis Correspondence Source Type: research
