Focus on the cetirizine use in clinical practice: a reappraisal 30  years later
AbstractAntihistamines are currently one of the most commonly administered categories of drugs. They are used to treat symptoms that are secondary to histamine release, which is typical of certain allergic conditions, including rhinitis, conjunctivitis, asthma, urticaria, and anaphylaxis. Cetirizine belongs to the second-generation family, so, it is very selective for peripheral H1 receptors, is potent and quickly relieves symptoms, exerts additional anti-allergic/anti-inflammatory effects, and is usually well-tolerated. It has been marketed 30  years ago. In these years, a remarkable body of evidence has been built...
Source: Multidisciplinary Respiratory Medicine - December 6, 2019 Category: Respiratory Medicine Source Type: research

Image analysis in posttreatment non-small cell lung cancer surveillance: specialists ’ interpretations reviewed by the thoracic multidisciplinary tumor board
ConclusionsIn an experienced MTB, the agreement between imaging specialists and the rest of the MTB with regard to the interpretation of images is high in a setting of posttreatment lung cancer image surveillance. It seems that in cases of disagreements, the rates of more accurate interpretation are well balanced between imaging specialists and the MTB.Trial registrationISRCTN16281786, Date 23. February 2017. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - December 4, 2019 Category: Respiratory Medicine Source Type: research

Clinical course and management of idiopathic pulmonary fibrosis
AbstractIdiopathic pulmonary fibrosis (IPF) is a progressive, fatal interstitial lung disease (ILD) with an unpredictable clinical course. Although IPF is rare, healthcare professionals should consider IPF as a potential cause of unexplained chronic dyspnea and/or cough in middle-aged/elderly patients and refer patients to a pulmonologist for evaluation. Making a diagnosis of IPF requires specialist expertise. Multidisciplinary discussion, involving at minimum a pulmonologist and a radiologist with expertise in the differential diagnosis of ILDs, is required to ensure the most accurate diagnosis. Prompt diagnosis of IPF is...
Source: Multidisciplinary Respiratory Medicine - December 2, 2019 Category: Respiratory Medicine Source Type: research

Daytime noninvasive ventilatory support for patients with ventilatory pump failure: a narrative review
AbstractOver the past three decades, the use of noninvasive ventilation or “NIV” to assuage symptoms of hypoventilation for patients with early onset or mild ventilatory pump failure has been extended to up to the use of continuous noninvasive ventilatory support (CNVS) at full ventilatory support settings as a definitive alternative to tracheostomy mechanical ventilat ion. NVS, along with mechanical insufflation-exsufflation, now provides a noninvasive option for the management of both chronic and acute respiratory failure for these patients. The most common diagnoses for which these methods are useful include...
Source: Multidisciplinary Respiratory Medicine - November 30, 2019 Category: Respiratory Medicine Source Type: research

Correction to: Patients ’ usability of seven most used dry-powder inhalers in COPD
Discussion (pag 6 of 9, just below Fig. 4) must be corrected as follows: (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - November 26, 2019 Category: Respiratory Medicine Source Type: research

Sensitization to inhaled allergens in asthmatic children in southern Jordan: a cross-sectional study
ConclusionsSensitization to inhaled allergens is highly prevalent in children with asthma and wheezing episodes in southern Jordan and may be correlated with the severity of the disease. Therefore, appropriate measures to recognize and avoid these allergens are highly recommended. Most children in our study suffered from concomitant allergic rhinitis, indicating that an appropriate diagnosis and treatment of allergic rhinitis could significantly improve asthma control and thus the quality of life of these children.Trial registrationThis study is not a clinical trial. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - November 8, 2019 Category: Respiratory Medicine Source Type: research

Observational vignette study to examine patient and healthcare provider perceived impact of asthma-related exacerbations in the US
ConclusionsUnderstanding the distinctions between how patients and HCPs perceive the impact of exacerbations is important for optimizing patient care. HCPs may be less aware of patient ’s concerns about exacerbation-related pain/discomfort. Studies are needed to further understand patient-HCP interactions regarding asthma-related exacerbations. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - November 5, 2019 Category: Respiratory Medicine Source Type: research

Immunostimulants in respiratory diseases: focus on Pidotimod
AbstractUsefulness of Pidotimod and its role as immunostimulant, has been discussed, we know, for several decades. Nevertheless, there is still much to know. Understanding its mechanisms and its potential usefulness in airway infections and its prevention, asthma both Th2 and non Th2 type, bronchiectasis, as adjuvant in vaccination and in allergen immunotherapy still remains to clearly unveil. The aim of this paper was to provide a useful updated review of the role of the main available immunostimulants, giving particular focus on Pidotimod use and its potentials utility in respiratory diseases. Pidotimod showed its useful...
Source: Multidisciplinary Respiratory Medicine - November 4, 2019 Category: Respiratory Medicine Source Type: research

Observational study of the effects of upper respiratory tract infection on hydration status
ConclusionsIn this pilot observational study, we found no evidence that URTIs such as common cold are associated with dehydration, contrary to popular belief. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - October 31, 2019 Category: Respiratory Medicine Source Type: research

Indoor exposure to particulate matter and volatile organic compounds in dwellings and workplaces and respiratory health in French farmers
AbstractIntroductionFew investigations have related objective assessments of indoor air pollutants to respiratory health in farmers, in spite of the many rural environmental hazards to which they are exposed. Chemical air pollution has been particularly neglected.ObjectiveWe investigated the relationships of indoor exposure to particulate matter (PM) and volatile organic compounds (VOCs) to respiratory health in farmers.MethodsNineteen  VOCs (5 families) and PM (from ultrafine to total suspended particles (TSP)) were objectively assessed in dwellings and workplaces in 109 French farmers during a week. To take into a...
Source: Multidisciplinary Respiratory Medicine - October 2, 2019 Category: Respiratory Medicine Source Type: research

Approaching two decades of cystic fibrosis research in Qatar: a historical perspective and future directions
AbstractCystic fibrosis (CF) is a genetic disease caused by a  defect of CF transmembrane conductance regulator (CFTR) gene. CF affects multiple systems, predominantly with respiratory involvement. In Qatar, researchers have been exploring various aspects of the disease for almost 20 years. PubMed and Google Scholar were reviewed for articles related to CF in Qatar. The first publication appeared in the year 2000. Since then, several studies have been conducted on CF patients in Qatar considering a variety of topics. The presence of the CFTR I1234V mutation in a certain Arab tribe stands out as a distinguishing...
Source: Multidisciplinary Respiratory Medicine - October 1, 2019 Category: Respiratory Medicine Source Type: research

Patients ’ usability of seven most used dry-powder inhalers in COPD
ConclusionsUsability is a multifaceted indicator that contributes to assess the factual DPIs ’ convenience in real life. DPIs are characterized by different levels of real-life usability, which can be checked, compared and ranked by means of the GUS score. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - September 13, 2019 Category: Respiratory Medicine Source Type: research

Diagnosing COPD in primary care: what has real life practice got to do with guidelines?
ConclusionsCOPD care in primary practice remains suboptimal. Incorrect approach often leads to incorrect grading and mistreatment. Points for improvement should be identified in further studies. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - September 9, 2019 Category: Respiratory Medicine Source Type: research

Use of narrative medicine to identify key factors for effective doctor –patient relationships in severe asthma
ConclusionsThese approaches of NM are useful in daily clinical practice, with the goal of improving the quality of life (QOL) of patients with severe asthma, even in cases in which the doctor-patient relationship isn ’t initially good. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - September 2, 2019 Category: Respiratory Medicine Source Type: research

Occupational risk factors associated with respiratory symptoms among tannery workers in Mojo town, Southeast Ethiopia, 2018: a comparative cross-sectional study
This study aimed to investigate the magnitude and risk factors associated with work-related respiratory symptoms among tannery industry workers in Mojo town, Ethiopia.MethodsA comparative cross-sectional study was conducted from March to May 2018. A total of 602 (299 exposed to tannery factories) and 303 unexposed (civil servants) were included using the stratified sampling method. The British Medical Research Council (BMRC) questionnaire was pretested and interviewer-administered for data collection. A binary logistic regression analysis was performed to identify the factors associated with respiratory symptoms. The signi...
Source: Multidisciplinary Respiratory Medicine - August 5, 2019 Category: Respiratory Medicine Source Type: research

Efficacy and safety profile of doxofylline compared to theophylline in asthma: a meta-analysis
ConclusionsDoxofylline is an effective and safe methylxanthine for the treatment of asthma, with an efficacy/safety profile greater than that of theophylline.Trial registrationMeta-analysis registration:CRD42019119849. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - August 3, 2019 Category: Respiratory Medicine Source Type: research

Prevalence, risk factors and outcomes of patients coming from the community with sepsis due to multidrug resistant bacteria
AbstractBackgroundAlthough previous studies showed an increasing prevalence of infections due to multi-drug resistant (MDR) bacteria in the community, specific data on sepsis are lacking. We aimed to assess prevalence, risk factors and outcomes of patients with sepsis due to MDR bacteria.MethodsAn observational, retrospective study was conducted on consecutive adult patients coming from the community and admitted to the Policlinico Hospital, Milan, Italy, with a diagnosis of sepsis between January 2011 and December 2015. Primary study outcome was in-hospital mortality.ResultsAmong 518 patients, at least one MDR bacteria wa...
Source: Multidisciplinary Respiratory Medicine - July 5, 2019 Category: Respiratory Medicine Source Type: research

Long term management of obstructive sleep apnea and its comorbidities
AbstractObstructive sleep apnea (OSA) is a worldwide highly prevalent disease associated with systemic consequences, including excessive sleepiness, impairment of neurocognitive function and daytime performance, including driving ability. The long-term sequelae of OSA include and increase risk for cardiovascular, cerebrovascular and metabolic syndrome disorders that ultimately lead to premature death if untreated. To ensure optimal long-term outcomes, the assessment and management of OSA should be personalized with the involvement of the appropriate specialist. Most studies have demonstrated inmediate improvement in daytim...
Source: Multidisciplinary Respiratory Medicine - July 4, 2019 Category: Respiratory Medicine Source Type: research

Role of blood glucose and fat profile in lung function pattern of Indian type 2 diabetic subjects
ConclusionsIt is difficult to draw a clear conclusion about the cause-effect relationship or clinical impact based on this study alone. However, identification of clinically meaningful elements for developing a screening program is critical. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - July 1, 2019 Category: Respiratory Medicine Source Type: research

Interobserver variability of ventilatory anaerobic threshold in asymptomatic volunteers
ConclusionsExperienced physicians show high agreement when determining AT in asymptomatic volunteers. However, agreement between physicians and qualified medical assistants is lower, and there is substantial deviation in AT determination between physicians or medical assistants and software-based algorithms. This must be considered when using AT as a decision tool. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - June 10, 2019 Category: Respiratory Medicine Source Type: research

Endotracheal metastasis of hepatocellular carcinoma: a case report
We describe the case of a 75  years old patient with a history of hepatocellular carcinoma, with acute respiratory failure due to tracheal obstruction by metastasis, successfully treated with airway disobstruction with rigid bronchoscope. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - June 6, 2019 Category: Respiratory Medicine Source Type: research

Treatment of COPD: the simplicity is a resolved complexity
(Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - June 3, 2019 Category: Respiratory Medicine Source Type: research

Contribution of pulmonary function tests (PFTs) to the diagnosis and follow up of connective tissue diseases
ConclusionsThe lung should be carefully studied during CTDs. PFTs can represent an important prognostic tool for diagnosis and follow up of RA-ILD, but, on their own, lack sufficient specificity or sensitivity to describe lung involvement in SSDs and IIMs. Several composite indexes potentially able to describe the evolution of lung damage and response to treatment in SSDs are under investigation. Considering the potential severity of these conditions, an HRCT jointly with PFTs should be performed in all new diagnoses of SSDs and IIMs. Moreover, follow up PFTs should be interpreted in the light of the risk factor for respir...
Source: Multidisciplinary Respiratory Medicine - May 15, 2019 Category: Respiratory Medicine Source Type: research

Motivation and response rates in bronchoscopy studies
ConclusionResponse rates of about 50% in bronchoscopy studies make large bronchoscopy studies feasible, but the fact that participants are motivated by their own health status places a large responsibility on the investigators regarding the accuracy of the provided study information. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - May 2, 2019 Category: Respiratory Medicine Source Type: research

A case of airway aluminosis with likely secondary pleuroparenchymal fibroelastosis
ConclusionsTBLB with elemental analysis might be useful in differentiating idiopathic PPFE from secondary causes in dust inhalation related disease, such as aluminosis. This case indicated that inhalation of aluminium might cause secondary PPFE, with attention needing to be paid to avoid further exposure. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - April 15, 2019 Category: Respiratory Medicine Source Type: research

Does transbronchial lung cryobiopsy give useful information in asthmatic patients?
ConclusionWe suggest the potential role of TBLC in asthmatic patients: its safety and its acceptable diagnostic accuracy lead to consider this procedure instead of SLB when histological changes in lung parenchyma are needed for the differential diagnosis. Furthermore, TLBC could be useful for research in the pathobiology of asthma and severe asthma. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - April 8, 2019 Category: Respiratory Medicine Source Type: research

Acute cough in Italian children: parents ’ beliefs, approach to treatment, and the family impact
AbstractBackgroundAcute cough is the most common symptom among children in primary care, but the impact of cough episodes was never investigated in Italian families.MethodsA cross-sectional telephone survey was conducted on a representative sample of Italian families, randomly selected from general population; a specific and validated questionnaire was used.ResultsThe sample (604 calls) was uniform by geographical distribution, and by children age and gender. Mean cough episode was 3.1/year, they were short lasting (only 4.7%>  2 weeks). Independent predictors of children cough episodes were parents’...
Source: Multidisciplinary Respiratory Medicine - April 4, 2019 Category: Respiratory Medicine Source Type: research

Clinical characteristics and outcomes of patients with severe acute respiratory infections (SARI): results from the Egyptian surveillance study 2010 –2014
ConclusionsViral pathogens were encountered in one-third of hospitalized adult and pediatric Egyptian patients with SARI, while atypical bacteria had a minor role. Highest rates of viral infections were reported for RSV, PIV, and adenovirus. Viral infections had neither negative impacts on clinical features nor outcomes of patients with SARI in our locality. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - April 1, 2019 Category: Respiratory Medicine Source Type: research

Bronchoalveolar lavage cell profiles and proteins concentrations can be used to phenotype extrinsic allergic alveolitis patients
ConclusionsSpecific subgroup of EAA patients with more severe functional impact, distinct BALF cell profile and higher IL-4R α BALF concentration can be differentiated. Correlations between the BALF concentrations of PAR-2, MMP-7 and TNF-α with clinical parameters may reflect the role of inflammation in the pathogenesis of EAA. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - March 12, 2019 Category: Respiratory Medicine Source Type: research

The upward shift of hilar structures and tracheal deviation in pleuroparenchymal fibroelastosis
In this study, the ratio of the length of the lung apex to the hilum and the length of the apex to the base of the right lung was measured using chest computed tomography (CT) at the time of the diagnosis, and the relationship with clinical parameters was investigated. We also examined the deviations of the trachea on chest radiographs and compared them with those in idiopathic pulmonary fibrosis (IPF) and early-stage lung cancer. Thirty-eight PPFE patients in a previous study included 20 patients who simultaneously showed the lower lobe lesions. The median ratio of the length of the apex to the hilum/apex to the base was ...
Source: Multidisciplinary Respiratory Medicine - March 7, 2019 Category: Respiratory Medicine Source Type: research

Agreement between chest ultrasonography and chest X-ray in patients who have undergone thoracic surgery: preliminary results
ConclusionAnalysis of agreement between chest X-ray and chest US showed that ultrasonography is able to detect important findings for surgeons. Limitations and advantages have been found for both chest X-ray and chest US. Knowing the limits of each one is important to really justify and optimize the use of ionizing radiations. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - March 4, 2019 Category: Respiratory Medicine Source Type: research

Obstructive sleep apnea and comorbidities: a dangerous liaison
AbstractObstructive sleep apnea (OSA) is a highly prevalent disease, and is traditionally associated with increased cardiovascular risk. The role of comorbidities in OSA patients has emerged recently, and new conditions significantly associated with OSA are increasingly reported. A high comorbidity burden worsens prognosis, but some data suggest that CPAP might be protective especially in patients with comorbidities. Aim of this narrative review is to provide an update on recent studies, with special attention to cardiovascular and cerebrovascular comorbidities, the metabolic syndrome and type 2 diabetes, asthma, COPD and ...
Source: Multidisciplinary Respiratory Medicine - February 14, 2019 Category: Respiratory Medicine Source Type: research

Idiopathic pulmonary fibrosis: prognostic impact of histologic honeycombing in transbronchial lung cryobiopsy
ConclusionsThe same pathologic criteria that have been used to define the UIP pattern in surgical biopsies (with honeycombing changes considered as non-mandatory for the definition of the pattern itself) can be applied to cryobiopsy samples, as the presence of these changes do not define different clinical or radiological phenotypes of patients with IPF. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - February 8, 2019 Category: Respiratory Medicine Source Type: research

The Proceedings of the 16th Italian Convention of Investigators in Cystic Fibrosis
(Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - February 6, 2019 Category: Respiratory Medicine Source Type: research

Predictive factors for exacerbation and re-exacerbation in chronic obstructive pulmonary disease: an extension of the Cox model to analyze data from the Swiss COPD cohort
The objective of this study was to evaluate possible predictive factors for exacerbation and re-exacerbation.MethodsIn order to predict exacerbation until the next visit based on the knowledge of exacerbation since the last visit, a multistate model described by Therneau and Grambsch was performed.ResultsData of 1,247 patients (60.4% males, 46.6% current smokers) were analyzed, 268 (21.5%) did not fulfill spirometric diagnostic criteria for COPD. Data of 748 patients (63% males, 44.1% current smokers) were available for model analysis. In order to predict exacerbation an extended Cox Model was performed. Mean FEV1/FVC-rati...
Source: Multidisciplinary Respiratory Medicine - February 5, 2019 Category: Respiratory Medicine Source Type: research

Comparison of different conditions for DNA extraction in sputum - a pilot study
ConclusionsNone of the conditions emerged to be superior to the others even if enzyme-based kits seem to be needed in order to have a higher extraction yield. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - January 31, 2019 Category: Respiratory Medicine Source Type: research

Efficacy of new intermittent abdominal pressure ventilator for post-ischemic cervical myelopathy ventilatory insufficiency
AbstractNon-invasive ventilation (NIV) is the treatment of choice for patients symptomatic for respiratory muscle dysfunction. It can normalize gas exchange and provide up to continuous non-invasive ventilator support (CNVS) as an alternative to intubation and tracheotomy. It is usually provided via non-invasive facial interfaces or mouthpieces, but these can be uncomfortable and uncosmetic. The intermittent abdominal pressure ventilator (IAPV) has been used for diurnal ventilatory support since 1938 but has been off the market since about 1990. Now, however, with greater emphasis on non-invasive management, a new IAPV is ...
Source: Multidisciplinary Respiratory Medicine - January 28, 2019 Category: Respiratory Medicine Source Type: research

Indoor bacterial load and its correlation to physical indoor air quality parameters in public primary schools
ConclusionsHigh bacterial load was found in public primary schools in the Gondar city as compared to different indoor air biological standards. Temperature, relative humidity and particulate matter concentration (PM2.5 and PM10) were associated with the indoor bacterial load.Staphylococcus aureus, Coagulase-negative Staphylococcus species andBacillus species were among isolated bacterial species. Attention should be given to control those physical factors which favour the growth and multiplication of bacteria in the indoor environment of classrooms to safeguard the health of students and teachers in school. (Source: Multid...
Source: Multidisciplinary Respiratory Medicine - January 22, 2019 Category: Respiratory Medicine Source Type: research

Ultrasound evaluation of diaphragmatic mobility in patients with idiopathic lung fibrosis: a pilot study
AbstractBackgroundSome previous works have tested LUS use in diagnosing and monitoring interstitial lung diseases. B-lines are main sonographic signs for interstitial diseases. Increasing evidences suggest that dyspnea and impaired exercise capacity in IPF patients can be related, at least in part, to respiratory muscle dysfunction, in particular to diaphragm functionality. Both B-mode and M-mode ultrasound techniques have been employed to assess diaphragm excursion (DE), which measures the distance that the diaphragm is able to move during the respiratory cycle.MethodsThe main objective of this case-control study was to e...
Source: Multidisciplinary Respiratory Medicine - December 14, 2018 Category: Respiratory Medicine Source Type: research

Utility of the six-minute walk test in patients with idiopathic pulmonary fibrosis
AbstractThe six-minute walk test (6MWT) is a simple test that is widely used to assess functional exercise capacity in patients with idiopathic pulmonary fibrosis (IPF). Patients with IPF have reduced exercise capacity due to a number of factors, such as impaired respiratory mechanics and circulatory problems. As a self-paced and usually submaximal exercise test, the 6MWT reflects the exercise level of everyday activities. Variables measured during the 6MWT, such as six-minute walk distance (6MWD) and desaturation, are strong predictors of mortality in patients with IPF. However, the results of a 6MWT are affected by numer...
Source: Multidisciplinary Respiratory Medicine - December 13, 2018 Category: Respiratory Medicine Source Type: research

From CPAP to tailored therapy for obstructive sleep Apnoea
AbstractObstructive Sleep Apnoea (OSA) is a common sleep disorder that is associated with daytime symptoms and a range of comorbidity and mortality. Continuous Positive Airway Pressure (CPAP) therapy is highly efficacious at preventing OSA when in use and has long been the standard treatment for newly diagnosed patients. However, CPAP therapy has well recognised limitations in real world effectiveness due to issues with patient acceptance and suboptimal usage. There is a clear need to enhance OSA treatment strategies and options. Although there are a range of alternative treatments (e.g. weight loss, oral appliances, posit...
Source: Multidisciplinary Respiratory Medicine - December 3, 2018 Category: Respiratory Medicine Source Type: research

OSAS: its burden increases, not enough the awareness
(Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - December 3, 2018 Category: Respiratory Medicine Source Type: research

Assessment of survival in patients with idiopathic pulmonary fibrosis using quantitative HRCT indexes
ConclusionsCT-histogram derived indexes may provide an accurate estimation of survival in IPF patients. They demonstrate a correlation with PFTs, highlighting their possible use in clinical practice. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - December 1, 2018 Category: Respiratory Medicine Source Type: research

Implementing TB control in a rural, resource-limited setting: the stop-TB Italia project in Senegal
AbstractBackgroundSince 2013 StopTB Italia Onlus supports the Senegalese National Tuberculosis Programme by improving diagnostic capability with technological interventions, ameliorating educational programs for health care personnel, rising awareness among civil society and providing economical support for patients during treatment. The purpose of our study was to assess the preliminary results of an interventional cooperation project in a peripheral health care facility in Senegal.MethodsAn observational, retrospective, pre-post study was conducted to compare Tuberculosis (TB) retention in care and outcome between a one-...
Source: Multidisciplinary Respiratory Medicine - November 9, 2018 Category: Respiratory Medicine Source Type: research

Revisiting cefditoren for the treatment of community-acquired infections caused by human-adapted respiratory pathogens in adults
AbstractFifteen years after its licensure, this revision assesses the role of cefditoren facing the current pharmacoepidemiology of resistances in respiratory human-adapted pathogens (Streptococcus pneumoniae,Streptococcus pyogenes,Haemophilus influenzae andMoraxella catarrhalis). In the era of post- pneumococcal conjugate vaccines and in an environment of increasing diffusion of theftsI gene amongH. influenzae isolates, published studies on the cefditoren in vitro microbiological activity, pharmacokinetic/pharmcodynamic (PK/PD) activity and clinical efficacy are reviewed. Based on published data, an overall analysis is pe...
Source: Multidisciplinary Respiratory Medicine - November 2, 2018 Category: Respiratory Medicine Source Type: research

The effect of delaying initiation with umeclidinium/vilanterol in patients with COPD: an observational administrative claims database analysis using marginal structural models
This study evaluated the impact of delaying UMEC/VI initiation on medical costs and exacerbation risk.MethodsA retrospective analysis of patients with COPD who initiated UMEC/VI between 4/28/2014 and 7/31/2016 was conducted using the Optum Research Database. The index date was the first COPD visit after UMEC/VI available on US formulary (Commercial 4/28/2014; Medicare Advantage 1/1/2015). Patients were followed for 12  months post-index, and categorized into 12 cohorts corresponding to month (30-day period) of UMEC/VI initiation (i.e. Months 1–12) post-index. The outcomes studied during the follow up period incl...
Source: Multidisciplinary Respiratory Medicine - October 11, 2018 Category: Respiratory Medicine Source Type: research

Alpha-1 antitrypsin deficiency as a common treatable mechanism in chronic respiratory disorders and for conditions different from pulmonary emphysema? A commentary on the new European Respiratory Society statement
ConclusionsOver the past years, AATD has been interpreted as a common mechanism of inflammatory disequilibrium and tissue damage across different conditions. Future research is gradually pointing toward this new paradigm by expanding the evidence of the role of AAT as a potent immunomodulatory and anti-inflammatory drug in conditions different from pulmonary emphysema. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - October 8, 2018 Category: Respiratory Medicine Source Type: research

Prevalence, risk factors, and impact of lung Cancer on outcomes of idiopathic pulmonary fibrosis: a study from the Middle East
ConclusionsPrevalence of LC in IPF patients was 13.8%. Lung cancer has significant impacts on patients with IPF in Upper Egypt, in terms of clinical outcomes and survival. Smoking is the most significant independent predictor of LC development in IPF patients. A poorer survival was observed for patients with IPF developing LC, mainly due to LC progression, and to complications of its therapies. Further prospective, multicenter and larger studies are warranted. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - October 3, 2018 Category: Respiratory Medicine Source Type: research

Management of severe acute exacerbations of COPD: an updated narrative review
ConclusionSeveral treatments exist for severe AECOPD patients requiring hospitalization. Some treatments such as steroids and NIMV (in patients admitted with a hypercapnic acute respiratory failure and respiratory acidosis) are supported by strong evidence of their efficacy. HFNC oxygen therapy needs further prospective studies. Although antibiotics are preferred in ICU patients, there is a lack of evidence regarding the preferred drugs and optimal duration of treatment for non-ICU patients. Early rehabilitation, if associated with standard treatment of patients, is recommended due to its feasibility and safety. There are ...
Source: Multidisciplinary Respiratory Medicine - October 2, 2018 Category: Respiratory Medicine Source Type: research