Pulmonary function testing in children's interstitial lung disease.
ald F Abstract The use of pulmonary function tests (PFTs) has been widely described in airway diseases like asthma and cystic fibrosis, but for children's interstitial lung disease (chILD), which encompasses a broad spectrum of pathologies, the usefulness of PFTs is still undetermined, despite widespread use in adult interstitial lung disease. A literature review was initiated by the COST/Enter chILD working group aiming to describe published studies, to identify gaps in knowledge and to propose future research goals in regard to spirometry, whole-body plethysmography, infant and pre-school PFTs, measurement of di...
Source: Respiratory Care - July 25, 2020 Category: Respiratory Medicine Authors: Ring AM, Carlens J, Bush A, Castillo-Corullón S, Fasola S, Gaboli MP, Griese M, Koucky V, La Grutta S, Lombardi E, Proesmans M, Schwerk N, Snijders D, Nielsen KG, Buchvald F Tags: Eur Respir Rev Source Type: research

Respiratory viral sepsis: epidemiology, pathophysiology, diagnosis and treatment.
Abstract According to the Third International Consensus Definition for Sepsis and Septic Shock, sepsis is a life-threatening organ dysfunction resulting from dysregulated host responses to infection. Epidemiological data about sepsis from the 2017 Global Burden of Diseases, Injuries and Risk Factor Study showed that the global burden of sepsis was greater than previously estimated. Bacteria have been shown to be the predominant pathogen of sepsis among patients with pathogens detected, while sepsis caused by viruses is underdiagnosed worldwide. The coronavirus disease that emerged in 2019 in China and now in many ...
Source: Respiratory Care - July 25, 2020 Category: Respiratory Medicine Authors: Gu X, Zhou F, Wang Y, Fan G, Cao B Tags: Eur Respir Rev Source Type: research

Community-Acquired Pneumonia: A Global Perspective.
PMID: 32629485 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - July 8, 2020 Category: Respiratory Medicine Authors: Wunderink RG, Feldman C Tags: Semin Respir Crit Care Med Source Type: research

The Role of Streptococcus pneumoniae in Community-Acquired Pneumonia.
Abstract With the notable exceptions of the United States and Canada in particular, the global burden of disease in adults due to invasive infection with the dangerous respiratory, bacterial pathogen, Streptococcus pneumoniae (pneumococcus) remains. This situation prevails despite the major successes of inclusion of polysaccharide conjugate vaccines (PCVs) in many national childhood immunization programs and associated herd protection in adults, as well as the availability of effective antimicrobial agents. Accurate assessment of the geographic variations in the prevalence of invasive pneumococcal disease (IPD) ha...
Source: Respiratory Care - July 8, 2020 Category: Respiratory Medicine Authors: Feldman C, Anderson R Tags: Semin Respir Crit Care Med Source Type: research

Emerging Resistance of Gram Negative Pathogens in Community-Acquired Pneumonia.
Abstract In recent decades, there has been a growing interest about the role of gram negative bacteria in community-acquired pneumonia (CAP), especially Pseudomonas aeruginosa, Enterobacteriaceae, and Acinetobacter baumannii. The prevalence of these pathogens differs largely according to the local ecology and the geographical location. Identifying gram negative bacteria, and in particular resistant gram negative bacteria, is of paramount importance in patients with CAP because these pathogens are associated with higher clinical severity and unfavorable outcomes. The use of individualized risk factors to predict ea...
Source: Respiratory Care - July 8, 2020 Category: Respiratory Medicine Authors: Amati F, Restrepo MI Tags: Semin Respir Crit Care Med Source Type: research

Melioidosis: A Neglected Cause of Community-Acquired Pneumonia.
Abstract Melioidosis, caused by the facultative intracellular gram-negative pathogen Burkholderia pseudomallei, is an emerging cause of community-acquired pneumonia across the tropics. The majority of patients present with pneumonia with or without sepsis, but localized and asymptomatic infection is also well recognized. Recent modeling and epidemiological studies have demonstrated the widespread presence of B. pseudomallei in otherwise unrecognized regions with a predicted mortality of 90,000 deaths worldwide. Innovative environmental studies are also uncovering how hydrodynamic, pedology, fauna, and weather even...
Source: Respiratory Care - July 8, 2020 Category: Respiratory Medicine Authors: Virk HS, Mukhopadhyay C, Wiersinga WJ Tags: Semin Respir Crit Care Med Source Type: research

Q Fever (Coxiella Burnetii).
C, Torres A Abstract Q fever is a zoonotic infectious disease caused by the Coxiella burnetii bacterium. It is an obligate intracellular pathogen with a high infection capacity that proliferates exclusively in an acidified medium, forming a lysosome-like vacuole. It presents a peculiar phenomenon called "antigenic phase variation," produced by a modification in the complexity of the membrane lipopolysaccharides. Q fever can be found worldwide and presents variable clinical features and geographical distribution. It mostly affects people in rural areas who are in contact with animals. The most common type...
Source: Respiratory Care - July 8, 2020 Category: Respiratory Medicine Authors: España PP, Uranga A, Cillóniz C, Torres A Tags: Semin Respir Crit Care Med Source Type: research

Endemic Fungi Presenting as Community-Acquired Pneumonia: A Review.
Abstract In endemic areas, dimorphic fungal infections due to Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides posadasii/immitis account for up to 30% of cases of community-acquired pneumonia. Because respiratory manifestations are often indistinguishable from common bacterial causes of pneumonia, the diagnosis of pulmonary histoplasmosis, blastomycosis, and coccidioidomycosis is often delayed and associated with antibiotics overuse. In addition to being highly endemic to certain regions of North America, dimorphic fungi have global significance due to established areas of endemicity in all six i...
Source: Respiratory Care - July 8, 2020 Category: Respiratory Medicine Authors: Azar MM, Malo J, Hage CA Tags: Semin Respir Crit Care Med Source Type: research

Nocardia spp.: A Rare Cause of Pneumonia Globally.
Abstract Members of the Nocardia genus are ubiquitous in the environment. These aerobic, gram-positive organisms can lead to life-threatening infection, typically in immunocompromised hosts such as solid organ transplant recipients or those receiving immunosuppressive medications for other reasons. This current review discusses the microbiology of nocardiosis, risk factors for infection, clinical manifestations, methods for diagnosis, and treatment. Nocardiosis primarily affects the lung but may also cause skin and soft tissue infection, cerebral abscess, bloodstream infection, or infection involving other organs....
Source: Respiratory Care - July 8, 2020 Category: Respiratory Medicine Authors: Lynch JP, Reid G, Clark NM Tags: Semin Respir Crit Care Med Source Type: research

Other Respiratory Viruses as a Cause of Community-Acquired Pneumonia.
Abstract Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality worldwide. There is growing appreciation of the burden of noninfluenza viral pathogens in CAP. Due to multiple factors including pneumococcal vaccination programs, declining rates of cigarette smoking, an aging population, and increasingly sensitive diagnostic tests, respiratory viruses are now the most common pathogens detected in CAP, outpacing Streptococcus pneumoniae. Noninfluenza respiratory pathogens are widely accepted as causal pathogens in CAP including in immunocompetent patients. This review provides an overview of f...
Source: Respiratory Care - July 8, 2020 Category: Respiratory Medicine Authors: Walter JM Tags: Semin Respir Crit Care Med Source Type: research

A study on infectivity of asymptomatic SARS-CoV-2 carriers.
CONCLUSION: In summary, all the 455 contacts were excluded from SARS-CoV-2 infection and we conclude that the infectivity of some asymptomatic SARS-CoV-2 carriers might be weak. PMID: 32513410 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - June 11, 2020 Category: Respiratory Medicine Authors: Gao M, Yang L, Chen X, Deng Y, Yang S, Xu H, Chen Z, Gao X Tags: Respir Med Source Type: research

Never-smoker African-American women suffer more from COPD compared with never-smoker Caucasian women.
PMID: 32461210 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - May 30, 2020 Category: Respiratory Medicine Authors: Sumon M, Mehari A Tags: Eur Respir Rev Source Type: research

Diagnoses and management of adult cough: An Indian Environmental Medical Association (EMA) position paper.
CONCLUSION: The analyses provides a real world approach to the management of acute or chronic cough in various clinical conditions with pro- or antitussive agents while avoiding their misuse in empirical settings. PMID: 32469706 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - May 30, 2020 Category: Respiratory Medicine Authors: Shankar PS, Korukonda K, Bendre S, Behera D, Mirchandani L, Awad NT, Prasad R, Bhargava S, Sharma OP, Jindal SK Tags: Respir Med Source Type: research

Easy measurement of health related quality of life in patients with cystic fibrosis by the COPD assessment test (CAT) - A pilot study.
Abstract BACKGROUND: Quality of life (QOL) is an important patient-related outcome (PRO) in patients with cystic fibrosis (CF). There are several QOL questionnaires like the "Cystic Fibrosis Questionnaire Revised" (CFQ-R) or the "St George's Respiratory Questionnaire" (SGRQ) that are well validated in CF. The aim of the study was to evaluate whether the easily applicable "COPD assessment test" (CAT) can be used in CF patients. METHODS: 42 CF patients were recruited within the PulmoHOM study, a prospective, observational cohort study. The CAT, the SGRQ and the CFQ-R were handed ou...
Source: Respiratory Care - May 30, 2020 Category: Respiratory Medicine Authors: Pott J, Krill A, Wilkens H, Bals R Tags: Respir Med Source Type: research

BNP/NT-proBNP in pulmonary arterial hypertension: time for point-of-care testing?
Abstract Despite the advent of new therapies and improved outcomes in patients with pulmonary arterial hypertension (PAH), it remains a life-shortening disease and the time to diagnosis remains unchanged. Strategies to improve outcomes are therefore currently focused on earlier diagnosis and a treatment approach aimed at moving patients with PAH into a category of low-risk of 1-year mortality. B-type natriuretic peptide (BNP; or brain natriuretic peptide) and N-terminal prohormone of BNP (NT-proBNP) are released from cardiac myocytes in response to mechanical load and wall stress. Elevated levels of BNP and NT-pro...
Source: Respiratory Care - May 19, 2020 Category: Respiratory Medicine Authors: Lewis RA, Durrington C, Condliffe R, Kiely DG Tags: Eur Respir Rev Source Type: research

The supportive care needs of people living with pulmonary fibrosis and their caregivers: a systematic review.
CONCLUSION: People with pulmonary fibrosis report many unmet needs for supportive care, particularly related to insufficient information and lack of psychosocial support. These data can inform the development of comprehensive care models for people with pulmonary fibrosis and their loved ones. PMID: 32350085 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - May 2, 2020 Category: Respiratory Medicine Authors: Lee JYT, Tikellis G, Corte TJ, Goh NS, Keir GJ, Spencer L, Sandford D, Khor YH, Glaspole I, Price J, Hey-Cunningham AJ, Maloney J, Teoh AKY, Watson AL, Holland AE Tags: Eur Respir Rev Source Type: research

Thoracic ultrasound in the modern management of pleural disease.
Abstract Physician-led thoracic ultrasound (TUS) has substantially changed how respiratory disorders, and in particular pleural diseases, are managed. The use of TUS as a point-of-care test enables the respiratory physician to quickly and accurately diagnose pleural pathology and ensure safe access to the pleural space during thoracentesis or chest drain insertion. Competence in performing TUS is now an obligatory part of respiratory speciality training programmes in different parts of the world. Pleural physicians with higher levels of competence routinely use TUS during the planning and execution of more sophist...
Source: Respiratory Care - May 2, 2020 Category: Respiratory Medicine Authors: Hassan M, Mercer RM, Rahman NM Tags: Eur Respir Rev Source Type: research

Chitotriosidase: a marker and modulator of lung disease.
Abstract Chitotriosidase (CHIT1) is a highly conserved and regulated chitinase secreted by activated macrophages; it is a member of the 18-glycosylase family (GH18). CHIT1 is the most prominent chitinase in humans, can cleave chitin and participates in the body's immune response and is associated with inflammation, infection, tissue damage and remodelling processes. Recently, CHIT1 has been reported to be involved in the molecular pathogenesis of pulmonary fibrosis, bronchial asthma, COPD and pulmonary infections, shedding new light on the role of these proteins in lung pathophysiology. The potential roles of CHIT...
Source: Respiratory Care - May 2, 2020 Category: Respiratory Medicine Authors: Chang, Sharma L, Dela Cruz CS Tags: Eur Respir Rev Source Type: research

Measuring airway clearance outcomes in bronchiectasis: a review.
Abstract While airway clearance techniques (ACTs) are recommended for individuals with bronchiectasis, many trials have demonstrated inconsistent benefits or failed to reach their primary outcome. This review determined the most common clinical and patient-reported outcome measures used to evaluate the efficacy of ACTs in bronchiectasis. A literature search of five databases using relevant keywords and filtering for studies published in English, up until the end of August 2019, was completed. Studies included randomised controlled trials, using crossover or any other trial design, and abstracts. Studies were inclu...
Source: Respiratory Care - May 2, 2020 Category: Respiratory Medicine Authors: Franks LJ, Walsh JR, Hall K, Morris NR Tags: Eur Respir Rev Source Type: research

Esophageal Pressure Versus Gas Exchange to Set PEEP During Intraoperative Ventilation.
CONCLUSIONS: Oxygenation and respiratory system mechanics were improved when applying a ventilatory strategy tailoring PEEP to equalize expiratory transpulmonary pressure in subjects undergoing pelvic robotic surgery compared to a VGas-guided approach. (ClinicalTrials.gov registration NCT03153592). PMID: 32345760 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - April 30, 2020 Category: Respiratory Medicine Authors: Cammarota G, Lauro G, Sguazzotti I, Mariano I, Perucca R, Messina A, Zanoni M, Garofalo E, Bruni A, Della Corte F, Navalesi P, Bignami E, Vaschetto R, Mojoli F Tags: Respir Care Source Type: research

2019 Year in Review: Aerosol Therapy.
Abstract Relevant publications related to medicinal and toxic aerosols are discussed in this review. Treatment of COPD includes a combination of long-acting bronchodilators and long-acting muscarinic antagonists. A combination of aclidinium bromide and formoterol fumarate was approved in the United States. The combination was superior to its components alone, as well as tiotropium and a salmeterol-fluticasone combination. Increased risk of an asthma exacerbation was reported in children exposed to electronic nicotine delivery systems. A smart inhaler capable of recording inspiratory flow was approved in the United...
Source: Respiratory Care - April 30, 2020 Category: Respiratory Medicine Authors: Berlinski A Tags: Respir Care Source Type: research

E-Cigarettes, Vaping Devices, and Acute Lung Injury.
Abstract "E-cigarettes" are a class of consumer devices designed to deliver drugs, primarily nicotine or marijuana oils, to the lung by vaporization. Regulation of the devices in the United States is relatively minimal, and research on both epidemiology and potential toxicity has focused on nicotine devices. In 2019, an outbreak of an acute respiratory illness in the United States was traced back to the contamination of e-cigarette fluids with vitamin E acetate, which had been used to disguise the dilution of marijuana oils. The outbreak, termed "e-cigarette or vaping associated lung injury" by...
Source: Respiratory Care - April 30, 2020 Category: Respiratory Medicine Authors: Cobb NK, Solanki JN Tags: Respir Care Source Type: research

The Role of Noninvasive Ventilation in Cystic Fibrosis: A Cochrane Review Summary With Commentary.
PMID: 32345763 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - April 30, 2020 Category: Respiratory Medicine Authors: Willis LD Tags: Respir Care Source Type: research

Finding Best PEEP: A Little at a Time.
PMID: 32345764 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - April 30, 2020 Category: Respiratory Medicine Authors: Dries DJ, Marini JJ Tags: Respir Care Source Type: research

Will the Addition of Oscillations in Mechanical Insufflation-Exsufflation Ever Be Beneficial?
PMID: 32345765 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - April 30, 2020 Category: Respiratory Medicine Authors: Chatwin M, Toussaint M Tags: Respir Care Source Type: research

Editor's Commentary.
Authors: PMID: 32345766 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - April 30, 2020 Category: Respiratory Medicine Tags: Respir Care Source Type: research

Noninvasive Ventilation as a Weaning Strategy in Subjects with Acute Hypoxemic Respiratory Failure.
CONCLUSIONS: The strategy of NIV weaning did not decrease hospital mortality in subjects with hypoxemic AHRF, but it did shorten the ICU lengths of stay and reduce adverse events. PMID: 32345740 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 28, 2020 Category: Respiratory Medicine Authors: Shan M, Pang X, Wang W, Lan C, Chen R, Zhu C, Liu Q Tags: Respir Care Source Type: research

Multiplex Ventilation: A Simulation-based Study of Ventilating Two Patients with One Ventilator.
CONCLUSIONS: These experiments confirmed the potential for markedly different ventilation and oxygenation for patients with uneven respiratory system impedances during multiplex ventilation. Three critical problems must be solved to minimize risk: (1) partitioning of inspiratory flow from the ventilator individually between the two patients, (2) measurement of VT delivered to each patient, and (3) provision for individual PEEP. We provide suggestions for solving these problems. PMID: 32345741 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 28, 2020 Category: Respiratory Medicine Authors: Chatburn RL, Branson RD, Hatipoğlu U Tags: Respir Care Source Type: research

Environmental fungal sensitisation associates with poorer clinical outcomes in COPD.
CONCLUSION: Fungal sensitisation is prevalent in COPD and associates with frequent exacerbations representing a potential treatable trait. Outdoor and indoor (home) environments represent a key source of fungal allergen exposure, amenable to intervention, in "sensitised" COPD. PMID: 32341102 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 27, 2020 Category: Respiratory Medicine Authors: Tiew PY, Ko FWS, Pang SL, Matta SA, Sio YY, Poh ME, Lau KJX, Mac Aogáin M, Jaggi TK, Ivan FX, Gaultier NE, Uchida A, Drautz-Moses DI, Xu H, Koh MS, Hui DSC, Tee A, Abisheganaden JA, Schuster SC, Chew FT, Chotirmall SH Tags: Eur Respir J Source Type: research

Understanding the Renin-Angiotensin-Aldosterone-SARS-CoV-Axis: A Comprehensive Review.
CONCLUSION: Proposed interventions for SARS-CoV-2 predominantly focus on viral microbiology and aim to inhibit viral cellular injury. While these therapies are promising, immediate use may not be feasible, and the time window of their efficacy remains a major unanswered question. An alternative approach is the modulation of the specific downstream pathophysiologic effects caused by virus that lead to morbidity and mortality. We propose a preponderance of evidence that supports clinical equipoise regarding the efficacy of RAAS-based interventions, and the imminent need for a multisite randomised controlled clinical trial to...
Source: Respiratory Care - April 27, 2020 Category: Respiratory Medicine Authors: Ingraham NE, Barakat AG, Reilkoff R, Bezdicek T, Schacker T, Chipman JG, Tignanelli CJ, Puskarich MA Tags: Eur Respir J Source Type: research

Telomere length in patients with unclassifiable interstitial lung disease: a cohort study.
PMID: 32341108 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 27, 2020 Category: Respiratory Medicine Authors: Ley B, Liu S, Elicker BM, Henry TS, Vittinghoff E, Golden JA, Jones KD, Wolters PJ Tags: Eur Respir J Source Type: research

Implementing lung health interventions in low- and middle-income countries - a FRESH AIR systemaktic review and meta-synthesis.
Abstract The vast majority of patients with chronic respiratory disease live in low- and middle-income countries (LMICs). Paradoxically, relevant interventions often fail to be effective particularly in these settings, as LMICs lack solid evidence on how to implement interventions successfully. Therefore, we aimed to identify factors critical to the implementation of lung health interventions in LMICs, and weight their level of evidence.This systematic review followed Cochrane methodology and PRISMA reporting standards. We searched eight databases without date- or language restrictions in July 2019, and included a...
Source: Respiratory Care - April 27, 2020 Category: Respiratory Medicine Authors: Brakema EA, Vermond D, Pinnock H, Lionis C, Kirenga B, Pham Le A, Sooronbaev T, Chavannes NH, van der Kleij RMJJ, FRESH AIR collaborators Tags: Eur Respir J Source Type: research

Clinical phenotypes of SARS-CoV-2: Implications for clinicians and researchers.
Abstract Patients with COVID19 present a broad spectrum of clinical presentation. Whereas hypoxemia is the marker of severity, different strategies of management should be customised to five specific individual phenotypes. Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic vasoconstriction, being associated with severe hypoxemia with "normal" (>40 mL·cm-1 H20) lung compliance and likely represents pulmonary microvascular thrombosis. Phenotype 5 is often associated with high plasma procalcitonin, and has low pulmonary compliance, being a result of co-infection...
Source: Respiratory Care - April 27, 2020 Category: Respiratory Medicine Authors: Rello J, Storti E, Belliato M, Serrano R Tags: Eur Respir J Source Type: research

Minimal clinically important differences in average, best, worst and current intensity and unpleasantness of chronic breathlessness.
CONCLUSION: An improvement of about 10 mm on a 100 mm VAS is likely to be clinically meaningful across commonly used measures of chronic breathlessness (current intensity, unpleasantness, and average, best and worst intensity over the last 24 h) - to evaluate clinical benefit and effects in therapeutic trials. PMID: 32341113 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 27, 2020 Category: Respiratory Medicine Authors: Ekström M, Johnson MJ, Huang C, Currow DC Tags: Eur Respir J Source Type: research

Targeting BMPR2 Trafficking with Chaperones - An Important Step Towards Precision Medicine in Pulmonary Arterial Hypertension.
PMID: 32339467 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 27, 2020 Category: Respiratory Medicine Authors: Andruska A, Ali K, Spiekerkoetter E Tags: Am J Respir Cell Mol Biol Source Type: research

The Value of Combined Radial Endobronchial Ultrasound-Guided Transbronchial Lung Biopsy and Metagenomic Next-Generation Sequencing for Peripheral Pulmonary Infectious Lesions.
Conclusions: R-EBUS-guided TBLB is a safe and effective technique in the diagnosis of peripheral lung infectious lesions. R-EBUS significantly facilitates the accurate insertion of bronchoscope into the lesions, which improves positivity rate of mNGS analysis in pathogen detection. The R-EBUS probe position within lesion produced a higher positivity rate of mNGS analysis. Nevertheless, the presence of anechoic and luminant areas on ultrasonic image was correlated with poor mNGS positivity rate. PMID: 32322324 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - April 24, 2020 Category: Respiratory Medicine Authors: Li G, Huang J, Li Y, Feng J Tags: Can Respir J Source Type: research

H1N1 with fatal viral septicemia in a normal child: A case report.
Abstract Regardless of the agent, the inflammatory response is interconnected with infection. Mostly the initial response to infection is severe sepsis and characterized by a pro-inflammatory state, which then progresses to an anti-inflammatory state that develops and favors secondary infections (Florescu and Kalil, 2011) [1]. T-helper 1 (Th1) cells activated by microorganisms increase transcription of pro-inflammatory cytokines such as tumor necrosis factor (TNF-α), interferon-γ (INF-γ), and interleukin-2 (IL-2) (Hotchkiss and Karl, 2003; Brown and Jones, 2004; Russell, 2006) [[2], [3], [4]]. Di...
Source: Respiratory Care - April 24, 2020 Category: Respiratory Medicine Authors: Ahmed AR Tags: Respir Med Case Rep Source Type: research

Use of esophageal balloon manometry in the management of pediatric acute respiratory distress syndrome.
We describe our first ever experience of successful usage of esophageal balloon pressure manometry in a child with acute respiratory distress syndrome. This is a six-year-old girl who presented with shortness of breath and fever and was found to be in severe acute respiratory distress syndrome due to septic shock secondary to group A streptococcus. The patient was managed using an esophageal balloon manometry for positive end-expiratory pressure titration. She was liberated from invasive mechanical ventilation on day 7 of hospital course. Esophageal balloon manometry guided positive end-expiratory pressure for 103 out of 1...
Source: Respiratory Care - April 24, 2020 Category: Respiratory Medicine Authors: Insley E, Pezzano C, Ambati S, Lydon D, Walker D, Barry S Tags: Respir Med Case Rep Source Type: research

Special Staining of the Liquid-Based Cytopathology Test in Bronchoalveolar Lavage Fluid for Diagnosis of Invasive Pulmonary Aspergillosis with Nonneutropenic Patients.
This study showed that special staining of LCT in BAL fluid may be a novel method for the diagnosis of IPA, and the GMS of LCT had higher sensitivity and specificity, which was superior to PAS. PMID: 32318126 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - April 23, 2020 Category: Respiratory Medicine Authors: Hu Y, Zheng L, Pan D, Shao L, Xu X, Yu Y, Zhuang Q, Deng Z, Chen Z Tags: Can Respir J Source Type: research

Bronchial HPV; the good the bad and the unknown.
Discussion: Tissue sample is the best sample in order to determine and distinguish the two entities, local treatment should be considered as first option when possible. PMID: 32309132 [PubMed] (Source: Respiratory Care)
Source: Respiratory Care - April 22, 2020 Category: Respiratory Medicine Authors: Zarogoulidis P, Tryfon S, Sapalidis K, Tsakiridis K, Baka S, Huang H, Bai C, Hohenforst-Schmidt W, Hatzibougias D, Athanasiou E, Vagionas A, Saroglou M, Kosmidis C Tags: Respir Med Case Rep Source Type: research

Coronavirus - preventing an occupational hazard among doctors.
PMID: 32307691 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 20, 2020 Category: Respiratory Medicine Authors: Malhotra N, Gupta N, Ish P Tags: Adv Respir Med Source Type: research

Middle East Respiratory Syndrome Coronavirus and Severe Acute Respiratory Syndrome Coronavirus.
Abstract Emerging infectious diseases continue to be of a significant importance worldwide with the potential to cause major outbreaks and global pandemics. In 2002, the world had witnessed the appearance of the severe acute respiratory syndrome coronavirus in China which disappeared abruptly within 6 months. About a decade later, a new and emerging novel coronavirus named the Middle East respiratory syndrome coronavirus (MERS-CoV) was described in a patient from Saudi Arabia. These two coronaviruses shared multiple similarities in the epidemiology, clinical presentations, and posed challenges in its prevention an...
Source: Respiratory Care - April 18, 2020 Category: Respiratory Medicine Authors: Al-Tawfiq JA, Memish ZA Tags: Semin Respir Crit Care Med Source Type: research

Clinical characteristics of the BREATHE cohort - a real-life study on patients with asthma and COPD.
tegaard T, Bjermer L Abstract Background: The BREATHE study is a cross-sectional study of real-life patients with asthma and/or COPD in Denmark and Sweden aiming to increase the knowledge across severities and combinations of obstructive airway disease. Design: Patients with suspicion of asthma and/or COPD and healthy controls were invited to participate in the study and had a standard evaluation performed consisting of questionnaires, physical examination, FeNO and lung function, mannitol provocation test, allergy test, and collection of sputum and blood samples. A subgroup of patients and healthy controls had a ...
Source: Respiratory Care - April 16, 2020 Category: Respiratory Medicine Authors: Backer V, Klein DK, Bodtger U, Romberg K, Porsbjerg C, Erjefält JS, Kristiansen K, Xu R, Silberbrandt A, Frøssing L, Hvidtfeldt M, Obling N, Jarenbäck L, Nasr A, Tufvesson E, Mori M, Winther-Jensen M, Karlsson L, Nihlén U, Veje Flintegaard T, Bjermer Tags: Eur Clin Respir J Source Type: research

"Elasto-Lung Point": a new tool for the sonographic confirmation of pneumothorax.
CONCLUSION: The "elasto-lung point" was able to confirm the diagnosis of pneumothorax in every investigated patient. USE is a simple, reproducible and inexpensive technique that can contribute to the diagnosis of pneumothorax, such as the classic "stratosphere" or "Bar Code" sign in M-mode. No false negative cases were observed. PMID: 32289200 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 14, 2020 Category: Respiratory Medicine Authors: Bandelli GP, Levi G, Quadri F, Marchetti GP Tags: Clin Respir J Source Type: research

Fatal refractory cardiac arrest as presentation of systemic amyloidosis.
Abstract Amyloidosis is a challenging diagnosis in the absence of clinical suspicion. The two patients reported here lacked any symptoms suggestive of amyloidosis. Instead, they presented with sudden, unexplained cardiac arrests that were persistent, treatment refractory, and ultimately fatal. Post-mortem examination unexpectedly revealed evidence of diffuse, systemic amyloidosis throughout multiple organ systems. We bring awareness to this unusual presentation of systemic amyloidosis that portends to poor outcome. PMID: 32274327 [PubMed] (Source: Respiratory Care)
Source: Respiratory Care - April 12, 2020 Category: Respiratory Medicine Authors: Chung P, Wheeler S, Fong A, Hurth K, Yaghmour B Tags: Respir Med Case Rep Source Type: research

High CO2 Levels Impair Lung Wound Healing.
Abstract Delayed lung repair leads to alveolo-pleural fistulae which are a major cause of morbidity following lung resections. We have reported that intrapleural hypercapnia is associated with delayed lung repair after lung resection. Here, we provide new evidence that hypercapnia delays wound closure of both large airway and alveolar epithelial cell monolayers due to inhibition of epithelial cell migration. Cell migration and airway epithelial wound closure was dependent on Rac1-GTPase activation which was suppressed by hypercapnia directly, through the upregulation of AMP-kinase, and indirectly, through inhibiti...
Source: Respiratory Care - April 10, 2020 Category: Respiratory Medicine Authors: Bharat A, Angulo M, Sun H, Akbarpour M, Alberro A, Cheng Y, Shigemura M, Berdnikov S, Welch LC, Kanter JA, Budinger GRS, Lecuona E, Sznajder JI Tags: Am J Respir Cell Mol Biol Source Type: research

Hiding in Plain Sight: The Basement Membrane in Pulmonary Vascular Remodeling.
PMID: 32275838 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - April 10, 2020 Category: Respiratory Medicine Authors: Chakraborty A, de Jesus Perez VA Tags: Am J Respir Cell Mol Biol Source Type: research

Genome-wide Analysis Reveals Mucociliary Remodeling of the Nasal Airway Epithelium Induced by Urban PM2.5.
Abstract Air pollution particulate matter 100 genes), which included transcriptional drivers of mucus metaplasia (SPDEF, FOXA3). Exposure to a higher OE dose modified the expression of 1,240 genes and further exacerbated expression responses observed at the moderate dose, including the mucus secretory program. Moreover, the higher OE dose significantly increased the MUC5AC/MUC5B gel-forming mucin expression ratio and strongly downregulated ciliated cell expression programs, including key ciliating cell transcription factors (FOXJ1, MCIDAS). Chronic OE stimulation induced mucus metaplasia-like remodeling characteri...
Source: Respiratory Care - April 10, 2020 Category: Respiratory Medicine Authors: Montgomery MT, Sajuthi SP, Cho SH, Everman JL, Rios CL, Goldfarbmuren KC, Jackson ND, Saef B, Cromie M, Eng C, Medina V, Elhawary JR, Oh SS, Rodriguez-Santana J, Vladar EK, Burchard EG, Seibold MA Tags: Am J Respir Cell Mol Biol Source Type: research

Relationship between Particulate Matter (PM10) and Airway Inflammation Measured with Exhaled Nitric Oxide Test in Seoul, Korea.
Conclusion: The positive correlation was found in both healthy people and asthmatic patients. Therefore, PM10 can increase airway inflammation. PMID: 32256904 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - April 9, 2020 Category: Respiratory Medicine Authors: Choi J, Sim JK, Oh JY, Lee YS, Hur GY, Lee SY, Shim JJ, Moon JY, Min KH Tags: Can Respir J Source Type: research

Pressure Regulated Volume Control (PRVC): Set it and forget it?
We describe two cases where this adaptive mode of ventilation became maladaptive leading to patient-ventilator dyssynchrony. PMID: 32257782 [PubMed] (Source: Respiratory Care)
Source: Respiratory Care - April 9, 2020 Category: Respiratory Medicine Authors: Singh G, Chien C, Patel S Tags: Respir Med Case Rep Source Type: research