Chest
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COPD QVA149 PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Patients with severe-to-very severe COPD require intensified therapy to reduce risk of exacerbations. Such patients may benefit from additional bronchodilation. Once-daily QVA149 is a dual bronchodilator consisting of a fixed-dose combination of two long-acting bronchodilators, indacaterol and glycopyrronium. ⋯ Jadwiga Wedzicha: Consultant fee, speaker bureau, advisory committee, etc.: JW has received speaking fee and/or for advisory boards from GlaxoSmithKline, AstraZeneca, Novartis, Bayer, Boehringer Ingelheim, Nycomed. Chiesi and Respifor as well as travel reimbursements from Boehringer Ingelheim. JW has received research grants from GlaxoSmithKline, AstraZeneca, Chiesi and Novartis. Joachim Ficker: Consultant fee, speaker bureau, advisory committee, etc.: Dr. Ficker has received speaker fees from AstraZeneca, GlaxoSmithKline, Boehringer Ingelheim, Pfizer, Nycomed, Almirall, Berlin-C hemie, Takeda and Novartis, consulting fees from AstraZeneca, Boehringer Ingelheim, and Novartis. Angel FowlerTaylor: Employee: The author is an employee of Novartis Pharmaceuticals Corporation Donald Banerji: Employee: The author is an employee of Novartis Pharmaceuticals Corporation The following authors have nothing to disclose: Dennis Niewohner, Thomas SandströmClinical trial results of QVA149, combination of two approved products indacaterol and glycopyrronium, will be presented, QVA149 is in the late stage phase 3 trials prior to approval.
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Comorbidities of OSA PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: To investigate the prevalence and impact of undiagnosed obstructive sleep apnea (OSA) in patients undergoing coronary artery bypass grafting (CABG) and to compare 3 different clinical survey methods: Epworth, Berlin, and Sleep Apnea Clinical Score. Secondary objectives were to study post-operative clinical outcomes. ⋯ The following authors have nothing to disclose: Mark Fenton, Samuel Stewart, Robert Skomro, John Reid, John Gjevre, David Cotton, Ankona Banarjee, Taras Mycyk, Dorothy Thomson, Greg DalshaugNo Product/Research Disclosure Information.
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Pleural CasesSESSION TYPE: Case ReportsPRESENTED ON: Sunday, March 23, 2014 at 09:00 AM - 10:00 AMINTRODUCTION: Patients with large pleural effusions often experience dramatic relief from dyspnea after thoracentesis. While this is well-recognized, the physiological basis for such relief remains poorly understood. One commonly held belief is that thoracentesis allows for lung reexpansion, ventilation of previously atelectatic lung, and improved ventilation-perfusion matching, subsequently leading to dyspnea relief. This contrasts with the concept of "length-tension inappropriateness," which posits chest wall mechanics best explain dyspnea relief. ⋯ Our case established that dyspnea relief after thoracentesis likely results from changes in chest wall mechanics and/or work of breathing. This observation has direct clinical implications and could inform therapeutic decisions.Reference #1: Brown NE et al. Changes in pulmonary mechanics and gas exchange following thoracentesis. Chest. 1978; 74: 540-42Reference #2: Estenne M et al. Mechanism of relief of dyspnea after thoracentesis in patients with large pleural effusions. Am J Med. 1983; 74(5):813-9Reference #3: Wang LM et al. Improved lung function after thoracentesis in patients with paradoxical movement of a hemidiaphragm secondary to a large pleural effusion. Respirology. 2007; 12(5):719-23DISCLOSURE: The following authors have nothing to disclose: Mary Klecka, Fabien MaldonadoNo Product/Research Disclosure Information.
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Telemedicine PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: To determine if an early assisted discharge program for chronic obstructive pulmonary disease (COPD) exacerbations, with telemonitoring and telephone control, is equally effective and more efficient in terms of use of health care resources, that a home care provided by hospital department respiratory ⋯ The following authors have nothing to disclose: Patricia Mínguez, Beatriz Cadavid, Carmen Mata, Rosa Malo, Miriam Aguilar, Manuel Valle, Andrea Trisan, Antolín Lopez, Mario Pascual, Juan Fragua, Piedad UssettiNo Product/Research Disclosure Information.
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Patients with refractory asthma frequently have elements of laryngopharyngeal reflux (LPR) with potential aspiration contributing to their poor control. We previously reported on a supraglottic index (SGI) scoring system that helps in the evaluation of LPR with potential aspiration. However, to further the usefulness of this SGI scoring system for bronchoscopists, a teaching system was developed that included both interobserver and intraobserver reproducibility. ⋯ In this study, we demonstrate that with an organized educational approach, bronchoscopists can develop skills to have highly reproducible assessment and scoring of supraglottic abnormalities. The SGI can be used to determine which patients need additional intervention to determine causes of LPR and gastroesophageal reflux. Identification of this problem in patients with refractory asthma allows for personal, individual directed therapy to improve asthma control.