Corticosteroids for CAP, influenza and COVID-19: when, how and benefits or harm?
CONCLUSIONS: The use of corticosteroids has been considered as a potential alternative co-adjuvant treatment in patients with pneumonia. In patients with COVID-19, the evidence is quite strong and there is a clear benefit of the use of corticosteroids in those patients presenting severe forms of disease. PMID: 33568526 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - February 13, 2021 Category: Respiratory Medicine Authors: Martin-Loeches I, Torres A Tags: Eur Respir Rev Source Type: research

The role of mucin 1 in respiratory diseases.
Abstract Recent evidence has demonstrated that mucin 1 (MUC1) is involved in many pathological processes that occur in the lung. MUC1 is a transmembrane protein mainly expressed by epithelial and hematopoietic cells. It has a receptor-like structure, which can sense the external environment and activate intracellular signal transduction pathways through its cytoplasmic domain. The extracellular domain of MUC1 can be released to the external environment, thus acting as a decoy barrier to mucosal pathogens, as well as serving as a serum biomarker for the diagnosis and prognosis of several respiratory diseases such a...
Source: Respiratory Care - February 5, 2021 Category: Respiratory Medicine Authors: Ballester B, Milara J, Cortijo J Tags: Eur Respir Rev Source Type: research

Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research.
Abstract Acute respiratory distress syndrome (ARDS) is a devastating critical illness that can be triggered by a wide range of insults and remains associated with a high mortality of around 40%. The search for targeted treatment for ARDS has been disappointing, possibly due to the enormous heterogeneity within the syndrome. In this perspective from the European Respiratory Society research seminar on "Precision medicine in ARDS", we will summarise the current evidence for heterogeneity, explore the evidence in favour of precision medicine and provide a roadmap for further research in ARDS. There is evide...
Source: Respiratory Care - February 5, 2021 Category: Respiratory Medicine Authors: Bos LDJ, Artigas A, Constantin JM, Hagens LA, Heijnen N, Laffey JG, Meyer N, Papazian L, Pisani L, Schultz MJ, Shankar-Hari M, Smit MR, Summers C, Ware LB, Scala R, Calfee CS Tags: Eur Respir Rev Source Type: research

Update on biology and management of mesothelioma.
Abstract Malignant pleural mesothelioma is an aggressive, incurable cancer that is usually caused by asbestos exposure several decades before symptoms arise. Despite widespread prohibition of asbestos production and supply, its incidence continues to increase. It is heterogeneous in its presentation and behaviour, and diagnosis can be notoriously difficult. Identification of actionable gene mutations has proven challenging and current treatment options are largely ineffective, with a median survival of 10-12 months.However, the past few years have witnessed major advances in our understanding of the biology and ...
Source: Respiratory Care - January 22, 2021 Category: Respiratory Medicine Authors: Asciak R, George V, Rahman NM Tags: Eur Respir Rev Source Type: research

Bronchoscopic diagnosis and treatment of endobronchial carcinoid: case report and review of the literature.
Abstract Carcinoid tumours are rare neuroendocrine neoplasms that mostly occur in younger adults with low tendencies to metastasise. Based on their histological characteristics, they are divided into typical and atypical subtypes. The most common presenting symptoms are due to central airway obstruction. The first step in the diagnostic assessment should be a computed tomography (CT) scan, as it provides information both for local tumour extent and lymph node involvement. Bronchoscopy is the main tool for histological confirmation, evaluation of bronchial wall invasion and removal of endobronchial manifestation wi...
Source: Respiratory Care - January 9, 2021 Category: Respiratory Medicine Authors: Papaporfyriou A, Domayer J, Meilinger M, Firlinger I, Funk GC, Setinek U, Kostikas K, Valipour A Tags: Eur Respir Rev Source Type: research

Outcomes associated with comorbid diabetes among patients with COPD exacerbation: findings from the ACURE registry.
CONCLUSIONS: AECOPD patients with comorbid diabetes had a more severe profile and higher direct hospitalization cost. Diabetes screening and integrated care programs might help reduce the heavy comorbidity and economic burden. Moreover, corticosteroids and metformin could be considered in the treatment of these patients. Trial registration Clinicaltrials.gov with the identifier NCT0265752. PMID: 33407433 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - January 6, 2021 Category: Respiratory Medicine Authors: Mao X, Liang C, Niu H, Dong F, Huang K, Chen Y, Huang K, Zhan Q, Zhang Y, Huang Y, Yang T, Wang C Tags: Respir Res Source Type: research

Gastroesophageal reflux disease is a risk factor for sputum production in the general population: the Nagahama study.
CONCLUSIONS: Cross-sectional and longitudinal analysis demonstrated an association in the general population between sputum production and GERD, as well as PND, independent of known risk factors. The presence of GERD should be assessed in patients complaining of sputum production. PMID: 33407482 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - January 6, 2021 Category: Respiratory Medicine Authors: Morimoto C, Matsumoto H, Nagasaki T, Kanemitsu Y, Ishiyama Y, Sunadome H, Oguma T, Ito I, Murase K, Kawaguchi T, Tabara Y, Niimi A, Muro S, Matsuda F, Chin K, Hirai T Tags: Respir Res Source Type: research

Developing a scoring tool to estimate the risk of deterioration for normotensive patients with acute pulmonary embolism on admission.
This study aimed to develop a tool for predicting deterioration among normotensive patients with acute PE on admission. METHODS: Clinical, laboratory, and computed tomography parameters were retrospectively collected for normotensive patients with acute PE who were treated at a Chinese center from January 2011 to May 2020 on admission into the hospital. The endpoint of the deterioration was any adverse outcome within 30 days. Eligible patients were randomized 2:1 to derivation and validation cohorts, and a nomogram was developed and validated by the aforementioned cohorts, respectively. The areas under the curves...
Source: Respiratory Care - January 6, 2021 Category: Respiratory Medicine Authors: Gao Y, Ji C, Zhao H, Han J, Shen H, Jia D Tags: Respir Res Source Type: research

Nicotine Dependence and Stress Susceptibility in E-cigarette smokers: The Korea National Health and Nutrition Examination Survey 2013-2017.
In this study, 28,059 participants from the Korea National Health and Nutrition Examination Survey (2013-2017) were classified into three groups: non-smokers, smokers (current- and ex-smokers of combustible cigarettes only), and e-smokers (current- and ex-smokers of e-cigarettes regardless of combustible cigarette use). Results: Among the participants, 16,980 (60.5%), 9,247 (33.0%), and 1,832 (6.4%) were non-smokers, smokers, and e-smokers, respectively. E-smokers were younger, more educated, and had a higher household income than non-smokers or smokers. The number of e-smokers smoking within 5 minutes of waking up (31.5% vs 19.8%, P
Source: Respiratory Care - January 6, 2021 Category: Respiratory Medicine Authors: Kim JY, Kang HS, Jung JW, Jung SY, Park HJ, Park JS, Park JH, Lee SH, Chun EM, Park DI, Park J, Choi HS, Korean Smoking Cessation Study Group Tags: Tuberc Respir Dis (Seoul) Source Type: research

Reminiscence therapy-based care program relieves anxiety, depression and improvs quality of life in post-operational non-small cell lung cancer patients.
CONCLUSION: RTCP effectively relieves anxiety and depression, improvs QoL, but did not prolong survival, suggesting its value as a non-pharmacological approach for post-operational NSCLC management. PMID: 33400384 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - January 5, 2021 Category: Respiratory Medicine Authors: Liu M, Li Y Tags: Clin Respir J Source Type: research

Persistence of both reversible airway obstruction and higher blood eosinophils may predict lung function decline in severe asthma.
CONCLUSION: Persistent SABA-induced FEV1>12%, especially when associated to BE>300 cells/mL, may be a marker of accelerated lung function decline in severe asthmatics despite maximal step-5 treatment. The highest bronchodilation associated to the lowest BE levels should be the main goal of asthma treatment to prevent such decline. PMID: 33400385 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - January 5, 2021 Category: Respiratory Medicine Authors: Sposato B, Scalese M, Ricci A, Rogliani P, Paggiaro P, Omalizumab Italian Study Group Tags: Clin Respir J Source Type: research

Mediastinal mass in an tuberculosis-exposed 2-year old child with neurofibromatosis type 1 - TB or not TB?
perling C Abstract A toddler with neurofibromatosis type 1 (NF1) was evaluated for tuberculosis (TB) after exposure. Chest X-ray (CXR) revealed a mediastinal mass indicating lymphadenopathy. However, magnetic resonance imaging showed a large plexiform thoracic neurofibroma. CXR performed for TB screening in NF1 patients cannot clearly differentiate lymphadenopathy from thoracic plexiform neurofibroma. Cross sectional imaging is therefore indicated for classification of mediastinal masses. PMID: 33364157 [PubMed] (Source: Respiratory Care)
Source: Respiratory Care - December 30, 2020 Category: Respiratory Medicine Authors: Krüger R, Potratz C, Hernáiz-Driever P, Lala B, Feiterna-Sperling C Tags: Respir Med Case Rep Source Type: research

Current developments and future directions in respiratory physiotherapy.
M, Burtin C Abstract Respiratory physiotherapists have a key role within the integrated care continuum of patients with respiratory diseases. The current narrative review highlights the profession's diversity, summarises the current evidence and practice, and addresses future research directions in respiratory physiotherapy. Herein, we describe an overview of the areas that respiratory physiotherapists can act in the integrated care of patients with respiratory diseases based on the Harmonised Education in Respiratory Medicine for European Specialists syllabus. In addition, we highlight areas in which further evid...
Source: Respiratory Care - December 19, 2020 Category: Respiratory Medicine Authors: Rodrigues A, Muñoz Castro G, Jácome C, Langer D, Parry SM, Burtin C Tags: Eur Respir Rev Source Type: research

Current developments and future directions in COPD.
Abstract The European Respiratory Society journals publish respiratory research and policy documents of the highest quality, offering a platform for the exchange and promotion of scientific knowledge. In this article, focusing on COPD, the third leading cause of death globally, we summarise novel research highlights focusing on the disease's underlying mechanisms, epidemiology and management, with the aim to inform and inspire respiratory clinicians and researchers. PMID: 33268439 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - December 5, 2020 Category: Respiratory Medicine Authors: Mathioudakis AG, Vanfleteren LEGW, Lahousse L, Higham A, Allinson JP, Gotera C, Visca D, Singh D, Spanevello A Tags: Eur Respir Rev Source Type: research

Pulmonary alveolar microlithiasis.
Abstract Pulmonary alveolar microlithiasis (PAM) is a fascinating rare lung disease that is associated with the accumulation of hydroxyapatite microliths within the lumen of the alveolar spaces. In most patients, PAM is discovered incidentally on radiographs performed for other purposes, and the typical disease course is characterised by slowly progressive respiratory insufficiency over decades. Recent genetic analyses that have revealed that the deficiency of the sodium-phosphate cotransporter NPT2B is the cause of PAM have enabled the development of powerful animal models that inform our approach to disease mana...
Source: Respiratory Care - November 29, 2020 Category: Respiratory Medicine Authors: Kosciuk P, Meyer C, Wikenheiser-Brokamp KA, McCormack FX Tags: Eur Respir Rev Source Type: research

Coinfection with Pseudomonas aeruginosa and Aspergillus fumigatus in cystic fibrosis.
CONCLUSION: A complex bi-directional relationship exists between P. aeruginosa and A. fumigatus, exhibiting both mutually antagonistic and cooperative facets. Cross-sectional data indicate a worsened disease state in coinfected patients; however, robust longitudinal studies are required to derive causality and to determine whether interspecies interaction contributes to disease progression. PMID: 33208485 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - November 20, 2020 Category: Respiratory Medicine Authors: Keown K, Reid A, Moore JE, Taggart CC, Downey DG Tags: Eur Respir Rev Source Type: research

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis.
Abstract This systematic review aimed to systematise the different designs used to deliver pulmonary rehabilitation during acute exacerbations of COPD (AECOPD) and explore which ones are the most effective. PubMed, Scopus, Web of Science, EBSCO and Cochrane were searched. Randomised controlled trials comparing pulmonary rehabilitation or at least one of its components with usual care or comparing different components of pulmonary rehabilitation were included. Network meta-analysis was conducted in MetaXL 5.3 using a generalised pairwise modelling framework. Pooled effects compared each treatment to usual care. 42 ...
Source: Respiratory Care - November 20, 2020 Category: Respiratory Medicine Authors: Machado A, Matos Silva P, Afreixo V, Caneiras C, Burtin C, Marques A Tags: Eur Respir Rev Source Type: research

Bronchoscopic treatment of inoperable nonsmall cell lung cancer.
Abstract Patients with unresectable lung cancer range from those with early-stage or pre-invasive disease with comorbidities that preclude surgery to those with advanced stage disease in whom surgery is contraindicated. In such cases, a multidisciplinary approach to treatment is warranted, and may involve medical specialties including medical oncology, radiation oncology and interventional pulmonology. In this article we review bronchoscopic approaches to surgically unresectable lung cancer, including photodynamic therapy, brachytherapy, endoscopic ablation techniques and airway stenting. Current and past literatu...
Source: Respiratory Care - November 10, 2020 Category: Respiratory Medicine Authors: Kniese CM, Musani AI Tags: Eur Respir Rev Source Type: research

Management of tracheo-oesophageal fistula in adults.
Abstract Tracheo-oesophageal fistula (TOF) is a pathological connection between the trachea and the oesophagus that is associated with various underlying conditions including malignancies, infections, inhalation injuries and traumatic damage. As the condition spans multiple organ systems with varying aetiologies and acuities, TOF poses unique diagnostic and management challenges to pulmonologists, gastroenterologists and thoracic surgeons alike. Although stents have been a cornerstone in the management of TOF, there exists a large gap in our understanding of their efficacy and precise methodology, making stenting ...
Source: Respiratory Care - November 10, 2020 Category: Respiratory Medicine Authors: Kim HS, Khemasuwan D, Diaz-Mendoza J, Mehta AC Tags: Eur Respir Rev Source Type: research

The effects of lung volume reduction treatment on diffusing capacity and gas exchange.
Abstract Lung volume reduction (LVR) treatment in patients with severe emphysema has been shown to have a positive effect on hyperinflation, expiratory flow, exercise capacity and quality of life. However, the effects on diffusing capacity of the lungs and gas exchange are less clear. In this review, the possible mechanisms by which LVR treatment can affect diffusing capacity of the lung for carbon monoxide (D LCO) and arterial gas parameters are discussed, the use of D LCO in LVR treatment is evaluated and other diagnostic techniques reflecting diffusing capacity and regional ventilation (V')/perfusion (Q') misma...
Source: Respiratory Care - October 30, 2020 Category: Respiratory Medicine Authors: van Dijk M, Klooster K, Ten Hacken NHT, Sciurba F, Kerstjens HAM, Slebos DJ Tags: Eur Respir Rev Source Type: research

Unsolved Mysteries: High-Frequency Jet Ventilation in the Neonatal ICU.
PMID: 33099485 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2020 Category: Respiratory Medicine Authors: Miller AG, Bartle RM Tags: Respir Care Source Type: research

Administering Inhaled Nitric Oxide: Still More to Understand.
PMID: 33099486 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2020 Category: Respiratory Medicine Authors: Betit P, Wheeler CR, Liu J Tags: Respir Care Source Type: research

Decreasing Unplanned Extubations in the Neonatal ICU.
PMID: 33099487 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2020 Category: Respiratory Medicine Authors: Lauderbaugh DL, Sutherland KM Tags: Respir Care Source Type: research

Editor's Commentary.
Authors: PMID: 33099488 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - October 27, 2020 Category: Respiratory Medicine Tags: Respir Care Source Type: research

The Use of a Novel Quantitative Marker of Echogenicity of Pleural Fluid in Parapneumonic Pleural Effusions.
Abstract Background: Thoracic ultrasound is an essential tool in the daily clinical care of pleural effusions and especially parapneumonic pleural effusions (PPEs), in terms of diagnosis, management, and follow-up. Hypoechogenicity index (HI) is a quantitative marker of pleural fluid echogenicity. We aimed to examine associations of HI with pleural inflammation in patients with PPE. Methods: All patients included underwent a thoracic ultrasound with HI determination at the first day of their admission for a PPE. Thoracentesis was performed in all patients. Demographics, laboratory measurements, and clinical d...
Source: Respiratory Care - October 23, 2020 Category: Respiratory Medicine Authors: Varsamas C, Kalkanis A, Gourgoulianis KI, Malli F Tags: Can Respir J Source Type: research

The Outcome of Hydroxychloroquine in Patients Treated for COVID-19: Systematic Review and Meta-Analysis.
Conclusion: This meta-analysis and systematic review, which included a limited number of poorly designed studies of patients with COVID-19, revealed HCQ is intolerable, unsafe, and not efficacious. Similarly, HCQ + AZ combination was not different from HCQ alone in curbing mortality and ICU admission. PMID: 33082891 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - October 23, 2020 Category: Respiratory Medicine Authors: Ayele Mega T, Feyissa TM, Dessalegn Bosho D, Kumela Goro K, Zeleke Negera G Tags: Can Respir J Source Type: research

A case of post adenoviral bronchiectasis being managed at home with humidified high flow nasal cannula (HHFNC).
Abstract Human adenovirus is an important cause of febrile illness affecting mainly respiratory system ranging from pharyngitis, coryza to fatal pneumonia. Though most of the infections are trivial and results in complete recovery but it may result in considerable morbidities and mortalities in selected patients who developed severe adenoviral infections especially Pneumonia(ADVP)/Lower respiratory tract infection(LRTI). Severe adenoviral pneumonia is notorious to produce long term sequelae in the form of post infectious bronchiolitis obliterans (PIBO) or even bronchiectasis. Here we present a case of a ten months...
Source: Respiratory Care - October 23, 2020 Category: Respiratory Medicine Authors: Singh D, Rajbanshi A, Giri PP Tags: Respir Med Case Rep Source Type: research

Acute high-risk pulmonary embolism requiring thrombolytic therapy in a COVID-19 pneumonia patient despite intermediate dosing deep vein thromboprophylaxis.
Abstract Cytokine storm induced by the coronavirus 19 (COVID-19) profoundly activates the coagulation cascade causing venous thromboembolism (VTE). Initial studies from Wuhan, China showed increased incidence of VTE in patients with no standard deep vein thrombosis (DVT) prophylaxis in COVID-19 pneumonia patients. Few have argued for high intensity or intermediate DVT prophylaxis in COVID-19 patients with the incidence of VTE ranging from 16 to 27% despite standard DVT prophylaxis. However, no guideline recommendations presently exist to prescribe augmented DVT prophylaxis in these patients due to lack of evidence...
Source: Respiratory Care - October 23, 2020 Category: Respiratory Medicine Authors: Salam S, Mallat J, Elkambergy H Tags: Respir Med Case Rep Source Type: research

Converging pathways in pulmonary fibrosis and Covid-19 - The fibrotic link to disease severity.
horsson G Abstract As Covid-19 affects millions of people worldwide, the global health care will encounter an increasing burden of the aftermaths of the disease. Evidence shows that up to a fifth of the patients develop fibrotic tissue in the lung. The SARS outbreak in the early 2000 resulted in chronic pulmonary fibrosis in a subset (around 4%) of the patients, and correlated to reduced lung function and forced expiratory volume (FEV). The similarities between corona virus infections causing SARS and Covid-19 are striking, except that the novel coronavirus, SARS-CoV-2, has proven to have an even higher communicab...
Source: Respiratory Care - October 23, 2020 Category: Respiratory Medicine Authors: Wigén J, Löfdahl A, Bjermer L, Elowsson-Rendin L, Westergren-Thorsson G Tags: Respir Med X Source Type: research

The Role of Granzyme B Containing Cells in the Progression of Chronic Obstructive Pulmonary Disease.
Abstract Background: Lung inflammation plays a vital role in the pathogenesis of chronic obstructive pulmonary disease (COPD), but the characteristics of the inflammatory process remains unclear. There is growing interest in the role of granzyme B (GzmB) because CD8+ T cells can induce apoptosis of target cells by releasing GzmB, which in turn may cause tissue injury and remodeling. However, GzmB is also expressed by regulatory cells, which are able to suppress CD8+ T cell. The role of GzmB+ cells needs to be defined in COPD. Methods: GzmB+ and CD8+ cells on alveolar wall of surgically resected lungs of micro...
Source: Respiratory Care - October 20, 2020 Category: Respiratory Medicine Authors: Kim WD, Chi HS, Choe KH, Kim WS, Hogg JC, Sin DD Tags: Tuberc Respir Dis (Seoul) Source Type: research

Lung Myofibroblast Promote Macrophage Pro-fibrotic Activity Through Lactate-induced Histone Lactylation.
Abstract Augmented glycolysis due to metabolic reprogramming in lung myofibroblasts is critical to their pro-fibrotic phenotype. The primary glycolysis byproduct, lactate, is also secreted into the extracellular milieu, together with which, myofibroblasts and macrophages form a spatially restricted site usually described as fibrotic niche. Therefore, we hypothesized that myofibroblast glycolysis might have a non-cell autonomous effect through lactate regulating the pathogenic phenotype of alveolar macrophages. Here, we demonstrated that there was a markedly increased lactate in the conditioned media of TGF-β1...
Source: Respiratory Care - October 19, 2020 Category: Respiratory Medicine Authors: Cui H, Xie N, Banerjee S, Ge J, Jiang D, Dey T, Matthews QL, Liu RM, Liu G Tags: Am J Respir Cell Mol Biol Source Type: research

Variability of forced vital capacity in progressive interstitial lung disease: a prospective observational study.
CONCLUSIONS: Daily home spirometry is feasible in IPF and non-IPF ILD and facilitates the identification of FVC variability, which was associated with disease progression. PMID: 33076914 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - October 19, 2020 Category: Respiratory Medicine Authors: Veit T, Barnikel M, Crispin A, Kneidinger N, Ceelen F, Arnold P, Munker D, Schmitzer M, Barton J, Schiopu S, Schiller HB, Frankenberger M, Milger K, Behr J, Neurohr C, Leuschner G Tags: Respir Res Source Type: research

Long-term clinical course and outcomes of immunoglobulin G4-related lung disease.
CONCLUSIONS: Most patients showed a favorable outcome with regards to radiologic improvement and maintenance of pulmonary function; however, the response differed according to the radiologic subtype. PMID: 33076916 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - October 19, 2020 Category: Respiratory Medicine Authors: Kang J, Park S, Chae EJ, Song JS, Hwang HS, Kim SJ, Song TJ, Kim MW, Song JW Tags: Respir Res Source Type: research

Fluid Balance Predicts Need for Intubation in Patients with Respiratory Failure Initiated on High Flow Nasal Cannula.
Abstract BACKGROUND: High Flow Nasal Cannula (HFNC) has gained widespread use for acute hypoxemic respiratory failure on the basis of recent publications demonstrating fewer intubations and perhaps lower mortality in certain situations. However, a subset of patients initiated on HFNC for respiratory failure ultimately do require intubation. Our goal is to identify patient level features predictive of this outcome. MATERIALS AND METHODS: This is a retrospective cohort study of patients with hypoxemic respiratory failure treated with HFNC. Individuals were described as having "succeeded" (if weaned fr...
Source: Respiratory Care - October 19, 2020 Category: Respiratory Medicine Authors: Varipapa RJ, DiGiacomo E, Jamieson DB, Desale S, Sonti R Tags: Respir Care Source Type: research

Design and performance testing of a novel emergency ventilator for in-hospital use.
Abstract Background: The rapidly evolving COVID-19 pandemic has led to increased use of critical care resources, particularly mechanical ventilators. Amidst growing concerns that the health care system could face a shortage of ventilators in the future, there is a need for an affordable, simple, easy to use, emergency stockpile ventilator. Methods: Our team of engineers and clinicians designed and tested an emergency ventilator that uses a single limb portable ventilator circuit. The circuit is controlled by a pneumatic signal with electronic microcontroller input, using air and oxygen sources found in standa...
Source: Respiratory Care - October 16, 2020 Category: Respiratory Medicine Authors: Knorr JM, Sheehan MM, Santana DC, Samorezov S, Sammour I, Deblock M, Kuban B, Chaisson N, Chatburn RL Tags: Can J Respir Ther Source Type: research

Clinical characteristics and changes of clinical features in patients with asthma-COPD overlap in Korea according to different diagnostic criteria.
Conclusion: In the present study, prevalence and clinical characteristics of ACO varied depending on the diagnostic criteria applied. PMID: 33045813 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - October 13, 2020 Category: Respiratory Medicine Authors: Lim JU, Kim DK, Lee MG, Hwang YI, Shin KC, In KH, Lee SY, Rhee CK, Yoo KH, Yoon HK Tags: Tuberc Respir Dis (Seoul) Source Type: research

Implications of managing Chronic Obstructive Pulmonary Disease (COPD) in Cardiovascular Diseases.
This study aimed at summarizing the current knowledge regarding the prevalence of COPD in heart failure, ischemic heart disease, and atrial fibrillation. We have also discussed the real-life clinical presentation and practical implications of managing COPD in cardiac diseases. We searched Pubmed, Scopus, EMBASE, and Google Scholar for studies published between 1981 to May 2020 reporting the prevalence of COPD in the three specified cardiac diseases. COPD has a high prevalence in heart failure, atrial fibrillation, and ischemic heart disease. Despite this, COPD remains under-diagnosed and under-managed in the majority of pa...
Source: Respiratory Care - October 13, 2020 Category: Respiratory Medicine Authors: Deshmukh K, Khanna A Tags: Tuberc Respir Dis (Seoul) Source Type: research

Costs of a clinical pathway with point-of-care testing during influenza epidemic in a Dutch hospital.
Abstract Our study aim was to determine how a new clinical pathway, including PCR-based influenza point-of-care test (POCT), influences the hospitalisation costs of patients suspected of influenza presenting at the emergency department of a Dutch hospital during two consecutive influenza epidemics (2016-2017 and 2017-2018). Compared to mean costs per patient of €3661 in 2016-2017, the implementation of this new clinical pathway with influenza POCT in 2017 was associated with mean costs per influenza-positive patient of €2495 in 2017-2018 (P = .3). Our study suggests favourable economic results ...
Source: Respiratory Care - October 12, 2020 Category: Respiratory Medicine Authors: Marbus SD, Lutgens SPM, van Gageldonk-Lafeber AB, Hazenberg EHLCM, Hermans MHA, Suijkerbuijk AWM Tags: Influenza Other Respir Viruses Source Type: research

COVID-19 multidisciplinary high dependency unit: the Milan model.
Abstract COVID-19 is a complex and heterogeneous disease. The pathogenesis and the complications of the disease are not fully elucidated, and increasing evidence shows that SARS-CoV-2 causes a systemic inflammatory disease rather than a pulmonary disease. The management of hospitalized patients in COVID-19 dedicated units is advisable for segregation purpose as well as for infection control. In this article we present the standard operating procedures of our COVID-19 high dependency unit of the Policlinico Hospital, in Milan. Our high dependency unit is based on a multidisciplinary approach. We think that the mult...
Source: Respiratory Care - October 9, 2020 Category: Respiratory Medicine Authors: Aliberti S, Amati F, Pappalettera M, Di Pasquale M, D'Adda A, Mantero M, Gramegna A, Simonetta E, Oneta AM, Privitera E, Gori A, Bozzi G, Peyvandi F, Minoia F, Filocamo G, Abbruzzese C, Vicenzi M, Tagliabue P, Alongi S, Blasi F Tags: Respir Res Source Type: research

Functional analysis and evaluation of respiratory cilia in healthy Chinese children.
CONCLUSIONS: We established the reference range for CBF, beat pattern and ultrastructure in healthy Chinese children. Using similar methodology, we found a lower overall mean CBF than previously obtained European values. This study highlights the need to establish normative data for ciliary function in different populations. PMID: 33036612 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - October 9, 2020 Category: Respiratory Medicine Authors: Lee SL, O'Callaghan C, Lau YL, Lee CD Tags: Respir Res Source Type: research

Procalcitonin and lung ultrasound algorithm to diagnose severe pneumonia in critical paediatric patients (PROLUSP study). A randomised clinical trial.
CONCLUSION: This algorithm will help us to diagnose bacterial pneumonia and to prescribe the correct antibiotic treatment. A reduction of antibiotics per patient, of the treatment length, and of the exposure to ionizing radiation and in costs is expected. TRIAL REGISTRATION: NCT04217980 . PMID: 33032612 [PubMed - in process] (Source: Respiratory Care)
Source: Respiratory Care - October 8, 2020 Category: Respiratory Medicine Authors: Rodríguez-Fanjul J, Guitart C, Bobillo-Perez S, Balaguer M, Jordan I Tags: Respir Res Source Type: research

European Respiratory Society Statement on Thoracic Ultrasound.
Abstract Thoracic ultrasound is increasingly considered to be an essential tool for the pulmonologist. It is used in diverse clinical scenarios, including as an adjunct to clinical decision making for diagnosis, a real-time guide to procedures, and a predictor or measurement of treatment response. The aim of this European Respiratory Society task force was to produce a statement on thoracic ultrasound for pulmonologists using thoracic ultrasound within the field of respiratory medicine. The multidisciplinary panel performed a review of the literature, addressing major areas of thoracic ultrasound practice and appl...
Source: Respiratory Care - October 8, 2020 Category: Respiratory Medicine Authors: Laursen CB, Clive A, Hallifax R, Pietersen PI, Asciak R, Davidsen JR, Bhatnagar R, Bedawi EO, Jacobsen N, Coleman C, Edey A, Via G, Volpicelli G, Massard G, Raimondi F, Evison M, Konge L, Annema J, Rahman NM, Maskell N Tags: Eur Respir J Source Type: research

Continuous positive airway pressure in Covid-19 patients with moderate-to-severe respiratory failure.
PMID: 33033151 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - October 8, 2020 Category: Respiratory Medicine Authors: Brusasco C, Corradi F, Di Domenico A, Raggi F, Timossi G, Santori G, Brusasco V, Galliera CPAP-Covid-19 study group Tags: Eur Respir J Source Type: research

The Effects of Chronic Intermittent Hypoxia in Bleomycin-induced lung injury on Pulmonary Fibrosis via Regulating the NF- κB/Nrf2 Signaling Pathway.
Conclusion: CIH accelerated lung fibrosis in BLE-induced lung injury in mice, potentially by regulating the NF-κB/Nrf2 signaling pathway. Our results implicate PF as a potential therapeutic agent for treating pulmonary fibrosis in individuals with OSA and idiopathic pulmonary fibrosis. PMID: 33027868 [PubMed - as supplied by publisher] (Source: Respiratory Care)
Source: Respiratory Care - October 8, 2020 Category: Respiratory Medicine Authors: Kang HH, Kim IK, Yeo CD, Kim SW, Lee HY, Im JH, Kwon HY, Lee SH Tags: Tuberc Respir Dis (Seoul) Source Type: research

Percutaneous tracheostomy in COVID-19 patients: The Miami model.
Abstract The surge in critically ill patients requiring mechanical ventilation fueled by the COVID-19 pandemic has strained healthcare systems globally. With the increasing need for critical care resources, tracheostomy can facilitate weaning from mechanical ventilation and potentially increase availability of critical care resources. In this case series of three patients, we describe our technique for performing bedside percutaneous tracheostomy on patients with persistently positive SARS-CoV-2 real time polymerase chain reaction (RT-PCR). We hope to provide proceduralists with a specific method for percutaneous ...
Source: Respiratory Care - October 7, 2020 Category: Respiratory Medicine Authors: Akkineni S, Adkinson BC, Arias S Tags: Respir Med Case Rep Source Type: research

Clinical Characteristics of Asymptomatic Patients with SARS-CoV-2 in Zhejiang: An Imperceptible Source of Infection.
In this study, epidemiological investigations were conducted in the Zhejiang province to understand the epidemiology and clinical characteristics of asymptomatic patients with COVID-19. Methods: This retrospective study was carried out on 22 asymptomatic patients and 234 symptomatic patients with COVID-19 who were hospitalized in Zhejiang Duodi Hospital from January 21 to March 16, 2020. The characteristics of epidemiology, demography, clinical manifestations, and laboratory data of mild patients were compared and analyzed. Results: The median age was 28 years in asymptomatic patients and 48 years in symptomatic ...
Source: Respiratory Care - October 4, 2020 Category: Respiratory Medicine Authors: Dai W, Chen X, Xu X, Leng Z, Yu W, Lin H, Li H, Lin J, Qiu Z, Dai Y Tags: Can Respir J Source Type: research

The Association Between Chronic Kidney Disease and New Onset Renal Replacement Therapy on the Outcome of COVID-19 Patients: A Meta-analysis.
Abstract Objective: The aim of the study was to evaluate the association between chronic kidney disease (CKD) and new onset renal replacement therapy (RRT) with the outcome of Coronavirus Disease 2019 (COVID-19) in patients. Methodology: A systematic literature search from several databases was performed on studies that assessed CKD, use of RRT, and the outcome of COVID-19. The composite of poor outcome consisted of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care, and use of mechanical ventilator. Results: Nineteen studies with a total of 7216 patients were...
Source: Respiratory Care - October 3, 2020 Category: Respiratory Medicine Authors: Pranata R, Supriyadi R, Huang I, Permana H, Lim MA, Yonas E, Soetedjo NNM, Lukito AA Tags: Clin Med Insights Circ Respir Pulm Med Source Type: research

Urine in the lung: An uncommon cause of transudative pleural effusion.
Abstract Urinothorax [UT], the accumulation of urine in the pleural space, is an uncommon cause of pleural effusions resulting from trauma, obstruction, or iatrogenic causes. Thoracentesis with pleural fluid analysis and evaluation of biochemical characteristics, such as pleural fluid creatinine (PCr) to serum creatinine ratio (Scr), is necessary to establish this diagnosis. This case illustrates a 93 year old man with a complicated past medical history including chronic kidney disease stage 4, adenocarcinoma of the prostate status post brachytherapy complicated by proctitis, high grade transitional cell carcinoma...
Source: Respiratory Care - October 3, 2020 Category: Respiratory Medicine Authors: Sullivan A, Lanham T, Bohra N, Ellis B, Kahn D Tags: Respir Med Case Rep Source Type: research

Tracheobronchopathia osteochondroplastica (TPO) associated with tracheobronchial amyloidosis (TBA).
Abstract Tracheobronchopathia osteochondroplastica (TPO) is an idiopathic disease involving the cartilage rings of the large airway, characterized by submucosal calcified nodules. Localized tracheobronchial amyloidosis (TBA) is another rare disease with localized amyloid deposits in the tracheobronchial tree. The two diseases rarely coincide, and only a few case reports and series have been reported. A patient with dyspnea was referred to our clinic for suspicion of TBA. Chest computed tomography (CT) scan showed marked thickening of the tracheobronchial wall with calcified endobronchial submucosal nodules. The no...
Source: Respiratory Care - October 3, 2020 Category: Respiratory Medicine Authors: Song JY, Kim BG, Zo S, Park S, Han JH, Kim H Tags: Respir Med Case Rep Source Type: research

Extracorporeal membrane oxygenation in Stenotrophomonas maltophilia pneumonia during acute myeloid leukemia: A case report.
We report a case of a 46-year-old man with Stenotrophomonas maltophilia hemorrhagic pneumonia acquired during consolidation chemotherapy for acute myeloid leukemia in whom VV ECMO lead to a good clinical outcome. The stabilization of his respiratory status achieved with VV ECMO allowed time for trimethoprim-sulfamethoxazole antibiotic therapy to improve the pneumonia. We suggest the background of patients, including comorbidities and general conditions, should be taken into account when considering the clinical indications of ECMO. PMID: 32995263 [PubMed] (Source: Respiratory Care)
Source: Respiratory Care - October 3, 2020 Category: Respiratory Medicine Authors: Saito K, Aokage T, Sato T, Tsukahara K, Tokioka F, Otake T, Irie H, Ueda Y Tags: Respir Med Case Rep Source Type: research