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The effect of delaying initiation with umeclidinium/vilanterol in patients with COPD: an observational administrative claims database analysis using marginal structural models
ConclusionsPrompt use of UMEC/VI following a physician visit for COPD appears to result in economic and clinical benefits, with reductions in medical costs and exacerbation risk. Additional research is warranted to assess the benefits of initiating UMEC/VI as a first-line therapy compared with escalation to UMEC/VI from monotherapies. (Source: Multidisciplinary Respiratory Medicine)
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

Breathlessness, but not cough, suggests chronic obstructive pulmonary disease in elderly smokers with stable heart failure
AbstractChronic obstructive pulmonary disease (COPD) is a common comorbidity of heart failure (HF), but remains often undiagnosed, and we aimed to identify symptoms predicting COPD in HF. As part of an observational, prospective study, we investigated stable smokers with a confirmed diagnosis of HF, using the 8-item COPD-Assessment-Test (CAT) questionnaire to assess symptoms. All the items were correlated with the presence of COPD, and logistic regression models were used to identify independent predictors. 96 HF patients were included, aged 74, 33% with COPD. Patients with HF and COPD were more symptomatic, but only breat...
Source: Multidisciplinary Respiratory Medicine - October 1, 2018 Category: Respiratory Medicine Source Type: research

State of the art in tracheal surgery: a brief literature review
This article focuses on the main technical aspects and literature data regarding laryngotracheal and tracheal resection and reconstruction. Particular attention will be paied to anastomotic and non-anastomotic complications.Short conclusionResults from literature confirm that, when feasible, laryngotracheal and tracheal resection and reconstruction is the treatment of choice in cases of benign stricture and malign neoplasm. Careful patient selection, operative planning, and execution are required for optimal results. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - September 12, 2018 Category: Respiratory Medicine Source Type: research

An uncommon cause of hemoptysis: aortobronchial fistula
ConclusionWe briefly review the literature to raise clinical awareness on this uncommon cause of hemoptysis. (Source: Multidisciplinary Respiratory Medicine)
Source: Multidisciplinary Respiratory Medicine - September 10, 2018 Category: Respiratory Medicine Source Type: research

Acute respiratory failure as presentation of late-onset Pompe disease complicating the diagnostic process as a labyrinth: a case report
DiscussionThe most frequent presentation of myopathies, including LOPD, is proximal limb muscle weakness. Respiratory related symptoms (dyspnea on effort, reduced physical capacity, recurrent infections, etc.) and respiratory failure are often evident in the later stages of the diseases, but they have been rarely described as the onset symptoms in LOPD. In our case, a third stage LOPD, the cooperation between pulmonologists and neurologists was crucial in reaching a correct diagnosis despite a very complex clinical scenario due to different confounding co-morbidities as potential causes of respiratory failure and an atypic...
Source: Multidisciplinary Respiratory Medicine - September 1, 2018 Category: Respiratory Medicine Source Type: research

Why, when and how to investigate primary ciliary dyskinesia in adult patients with bronchiectasis
We describe the main PCD diagnostic tests and compare the two international PCD diagnostic guidelines. The expensive multi-test diagnostic approach requiring a high level of expertise and specialist equipment, make the multifaceted PCD diagnostic pathway complex. Therefore, the risk of late or missed diagnosis is high and has clinical and research implications.Defining the number of patients with bronchiectasis due to PCD is complex. To date, few studies outlining the aetiology of adult patients with bronchiectasis conduct screening tests for PCD, but they do differ in their diagnostic approach. Comparison of these studies...
Source: Multidisciplinary Respiratory Medicine - August 9, 2018 Category: Respiratory Medicine Source Type: research