Therapeutic advances in respiratory disease
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Ther Adv Respir Dis · Dec 2009
Historical ArticleThe traditional diagnosis and treatment of respiratory diseases: a description from Avicenna's Canon of Medicine.
This article presents selected text on respiratory medicine from the famous book of medicine, Al-Qanun fi al-Tibb (the Canon of Medicine) by Avicenna (981-1037 AD), which was taught for 600 years as a standard text of medicine across medieval Europe. The authentic manuscript of the Canon of Medicine is located in the Central Library of the Tehran University of Medical Sciences, and the section on respiratory diseases was studied for the most relevant information - information that would be informative and interesting for present day physicians and pulmonologists. The results of the analysis are presented in the article. ⋯ In the time of Avicenna, the presentation of respiratory diseases, their treatment and their prognosis was much different than in modern times. There was more reliance on history, physical examination (which was mostly based on visual observation), individual variation, environmental factors, diet, and so on, for diagnosis and treatment. Nevertheless, going through a popular historic text such as the Canon of Medicine adds to our knowledge of the developments in the area of respiratory medicine at the time of Avicenna.
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Ther Adv Respir Dis · Aug 2009
Randomized Controlled Trial Multicenter Study Comparative StudyEffect on lung function and morning activities of budesonide/formoterol versus salmeterol/fluticasone in patients with COPD.
Patients with chronic obstructive pulmonary disease (COPD) often experience symptoms and problems with activities early in the morning. This is the first study to compare the effect of budesonide/formoterol and salmeterol/fluticasone on lung function, symptoms and activities early in the morning. ⋯ Short-term treatment with budesonide/formoterol DPI or salmeterol/fluticasone DPI was effective in patients with COPD. Budesonide/formoterol had a more rapid onset of effect compared with salmeterol/fluticasone and resulted in greater improvements in ability to perform morning activities despite the lower inhaled corticosteroid dose.
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Ther Adv Respir Dis · Jun 2009
Case ReportsSarcoidosis-associated pulmonary hypertension: a role for endothelin receptor antagonists?
Data on the treatment of sarcoidosis-associated pulmonary hypertension are scarce, while the variety of underlying pathophysiologic mechanisms are a major limitation in the implementation of a universal therapy. We report a 47-year-old male patient who presented with stage II sarcoidosis and associated severe pulmonary hypertension. Corticosteroid treatment resolved parenchymal lesions of the lung while vascular involvement did not respond, with the patient remaining in poor functional status. Addition of bosentan, a dual endothelin receptor antagonist, resulted in marked improvement in functional class and exercise capacity of the patient, allowing gradual tapering of steroids.
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Ther Adv Respir Dis · Feb 2009
Randomized Controlled Trial Comparative StudyEffect of bosentan upon pulmonary hypertension in chronic obstructive pulmonary disease.
Pulmonary hypertension (PH) in chronic obstructive pulmonary disease [COPD] is mainly determined by hypoxemia under respiratory failure by means of the functional hypoxemic vasoconstrictor response. Organic changes of vessels, pulmonary vascular remodelling, is gaining increasing relevance. An imbalance of endothelial products takes place with overload of vasoconstrictors and thrombogenic autacoids over vasodilators and anticoagulant factors. Among vasoconstrictors, endothelin is claimed to be an important factor. Our aim is to assess the effect of the anti-endothelin drug Bosentan on pulmonary hemodynamics and lung function in patients affected by COPD and PH. ⋯ This preliminary report suggests that the use of Bosentan in the treatment of PH in COPD is beneficial.
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Ther Adv Respir Dis · Aug 2008
ReviewOxidant--antioxidant imbalance in asthma: scientific evidence, epidemiological data and possible therapeutic options.
Prevalence of asthma has increased considerably in recent decades throughout the world especially in developed countries. Airway inflammation is thought to be prime cause for repeated episodes of airway obstruction in asthmatics. Several studies have shown that reactive oxygen species (ROS) play a key role in initiation as well as amplification of inflammation in asthmatic airways. ⋯ Epidemiological data also support the scientific evidence of oxidant-antioxidant imbalance in asthmatics. Therefore, the supplementation of antioxidants to boost the endogenous antioxidants or scavenge excessive ROS production could be utilized to dampen/prevent the inflammatory response in asthma by restoring oxidant-antioxidant balance. This review summarizes the scientific and epidemiological evidence linking asthma with oxidant-antioxidant imbalance and possible antioxidant strategies that can be used therapeutically for better management of asthma.