Respiratory medicine
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Respiratory medicine · Nov 2015
Electronic nose analysis of exhaled breath to diagnose ventilator-associated pneumonia.
Exhaled breath analysis is an emerging technology in respiratory disease and infection. Electronic nose devices (e-nose) are small and portable with a potential for point of care application. Ventilator-associated pneumonia (VAP) is a common nosocomial infection occurring in the intensive care unit (ICU). The current best diagnostic approach is based on clinical criteria combined with bronchoalveolar lavage (BAL) and subsequent bacterial culture analysis. BAL is invasive, laborious and time consuming. Exhaled breath analysis by e-nose is non-invasive, easy to perform and could reduce diagnostic time. Aim of this study was to explore whether an e-nose can be used as a non-invasive in vivo diagnostic tool for VAP. ⋯ E-nose lacked sensitivity and specificity in the diagnosis of VAP in the present study for current clinical application. Further investigation into this field is warranted to explore the diagnostic possibilities of this promising new technique.
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Respiratory medicine · Oct 2015
Randomized Controlled TrialTiotropium + olodaterol shows clinically meaningful improvements in quality of life.
Tiotropium + olodaterol improves lung function and symptoms compared to monotherapies in chronic obstructive pulmonary disease (COPD). The OTEMTO 1 and 2 studies investigated the effects of tiotropium + olodaterol on lung function and health-related quality of life compared to placebo in patients with moderate to severe COPD. ⋯ Tiotropium + olodaterol improved lung function and quality of life compared to placebo and tiotropium 5 μg.
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Respiratory medicine · Oct 2015
Mayo clinic experience of lung transplantation in pulmonary lymphangioleiomyomatosis.
Lymphangioleiomyomatosis (LAM) is a rare, cystic lung disease that generally results in progressive decline in lung function. Despite advancement of pharmacological therapy for LAM, lung transplantation remains an important option for women with end-stage LAM. ⋯ Lung transplant remains a viable treatment for patients with end-stage LAM. The role of sirolimus peri-transplantation remains ill-defined.
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Respiratory medicine · Sep 2015
Comparative StudyRed blood cell distribution width [RDW] and long-term mortality after community-acquired pneumonia. A comparison with proadrenomedullin.
Proadrenomedullin (proADM), a cardiovascular biomarker, has shown high prognostic power for community-acquired pneumonia (CAP) outcomes. Red-blood-cell distribution width (RDW), linked to cardiovascular disorders, has been associated with short-term and medium-term mortality after CAP. Our objective was to assess the accuracy of both biomarkers for CAP long-term mortality (>90 days). ⋯ Both proADM and RDW > 14 (HR, 4.116) were independent risk factors for long-term mortality and were associated with poorer survival. Our findings agree with the suggested association between cardiovascular disease and long-term CAP mortality. RDW, routinely provided as part of the whole blood count, and especially associated with clinical scores, can provide useful information about long-term CAP outcomes.
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Respiratory medicine · Sep 2015
Randomized Controlled Trial Multicenter StudyEfficacy and safety of umeclidinium added to fluticasone furoate/vilanterol in chronic obstructive pulmonary disease: Results of two randomized studies.
The aim of these studies (NCT01957163; NCT02119286) was to evaluate the efficacy and safety of umeclidinium (UMEC 62.5 μg and 125 μg) added to fluticasone furoate/vilanterol (FF/VI, 100/25 μg) in chronic obstructive pulmonary disease (COPD). ⋯ The results from these two studies demonstrate that the addition of umeclidinium (62.5 μg and 125 μg) to FF/VI (100/25 μg) provides statistically significant and clinically meaningful improvements in lung function compared with placebo + FF/VI in patients with COPD. Statistically significant improvements in quality of life with UMEC + FF/VI versus placebo + FF/VI were reported in one study only. Safety profiles were consistent across all treatment groups in both studies. These studies support the use of triple therapy in COPD, providing physicians with an alternative treatment option.