Respiratory medicine
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Respiratory medicine · Apr 2016
Meta AnalysisNintedanib in patients with idiopathic pulmonary fibrosis: Combined evidence from the TOMORROW and INPULSIS(®) trials.
The Phase II TOMORROW trial and two Phase III INPULSIS(®) trials investigated the efficacy and safety of nintedanib versus placebo in patients with idiopathic pulmonary fibrosis (IPF). To obtain an overall estimate of the treatment effect of nintedanib 150 mg twice daily (bid), pooled and meta-analyses of data from these three trials were conducted. ⋯ Nintedanib has a beneficial effect on slowing disease progression in patients with IPF.
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Respiratory medicine · Apr 2016
Whistle and cough pressures in children with neuromuscular disorders.
Expiratory muscle strength is a determinant of cough function. Maximal static expiratory pressure (PEmax) manoeuvres are widely used but are limited by patient motivation and technique. The study hypothesized that whistle mouth (PmW) and cough gastric (PgasCough) pressures might provide additional tests of expiratory muscle strength in children and young adults with neuromuscular disease (NMD). ⋯ PmW and PgasCough are simple and valuable tests to assess expiratory muscle strength in children and young adults with NMD. These tests are particularly useful in children having difficulties to perform PEmax manoeuvre. They have the great advantage of their simplicity, but PgasCough is limited by its invasiveness.
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Respiratory medicine · Apr 2016
ReviewThe three tiers of screening for sarcoidosis organ involvement.
Sarcoidosis may involve any organ in the body. Organ involvement with sarcoidosis may go undetected. This manuscript addresses a suggested approach to screening for sarcoidosis organ involvement. ⋯ The third tier of screening is complex and involves the performance of multiple tests/algorithms or examinations by subspecialists to search for specific organ involvement. The third tier of screening is used to evaluate eye sarcoidosis, vitamin D dysregulation associated with sarcoidosis, and cardiac sarcoidosis. It is hoped that this approach to screening for sarcoidosis organ involvement will be a springboard for rigorous examination of this process that is likely to benefit sarcoidosis patients.
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Acute bronchiolitis is the most frequent lower respiratory tract infection in infants. Only small subsets of patients develop severe disease resulting in hospitalization despite having no identifiable risk factors. There is still a debate as to the role of capnometry in assessing ventilation in children with acute respiratory distress, and bronchiolitis in particular. ⋯ Capnometry readings upon arrival to the ED did not predict hospital admission or hospital discharge eligibility. Among hospitalized patients, EtCO2 did not correlate with the evaluated disease severity measures. Wang score was found to be the most consistent predictor of significant outcomes.