Respiratory medicine
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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.
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Respiratory medicine · Mar 2016
Validity of transcutaneous PCO2 in monitoring chronic hypoventilation treated with non-invasive ventilation.
Non-invasive ventilation (NIV) is an efficient treatment for patients with chronic hypercapnic respiratory failure (CRF), but requires regular monitoring to detect both diurnal and nocturnal residual hypercapnia. The present study was designed to determine 1) whether transcutaneous PCO2 (PtcCO2) is a valid tool for monitoring PaCO2 in this group of patients, and 2) if overnight instrumental drift of the PtcCO2 sensor is clinically significant. ⋯ With the device tested, in stable patients under NIV-treatment for CRF, PtcCO2 accurately reflects PaCO2. PtcCO2 can be used to monitor CO2 overnight during NIV without any clinically significant drift. TRIAL REGISTRATION N°: NCT01845233.
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Respiratory medicine · Mar 2016
Glucose tolerance and cardiovascular risk biomarkers in non-diabetic non-obese obstructive sleep apnea patients: Effects of long-term continuous positive airway pressure.
Insulin resistance, glucose dyshomeostasis and oxidative stress are associated to the cardiovascular consequences of obstructive sleep apnea (OSA). The effects of a long-term continuous positive airway pressure (LT-CPAP) treatment on such mechanisms still remain conflicting. ⋯ In non-obese non-diabetic OSA patients, nocturnal oxygen desaturation is strongly associated to insulin resistance. LT-CPAP does not improve glucose homeostasis nor insulin sensitivity but has a favorable effect on antioxidant capacity and cardiovascular risk biomarkers.
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Respiratory medicine · Feb 2016
Randomized Controlled Trial Multicenter StudyReductions in eosinophil biomarkers by benralizumab in patients with asthma.
Eosinophilic inflammation is frequently associated with increased asthma severity. Benralizumab is a humanized, afucosylated, anti-interleukin-5Rα monoclonal antibody that selectively depletes eosinophils and basophils through enhanced antibody-dependent cell-mediated cytotoxicity. ⋯ In two independent studies, serum IL-5, EDN, and ECP were modulated following benralizumab. Eosinophil depletion after benralizumab also resulted in significant reductions in EDN and ECP concentrations, suggesting that cytotoxic granule proteins were not released after eosinophil reduction.