BMC pulmonary medicine
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BMC pulmonary medicine · Mar 2016
ReviewThe use of inhaled antibiotic therapy in the treatment of ventilator-associated pneumonia and tracheobronchitis: a systematic review.
Ventilator-associated respiratory infections (tracheobronchitis, pneumonia) contribute significant morbidity and mortality to adults receiving care in intensive care units (ICU). Administration of broad-spectrum intravenous antibiotics, the current standard of care, may have systemic adverse effects. The efficacy of aerosolized antibiotics for treatment of ventilator-associated respiratory infections remains unclear. Our objective was to conduct a systematic review of the efficacy of aerosolized antibiotics in the treatment of ventilator-associated pneumonia (VAP) and tracheobronchitis (VAT), using the Cochrane Collaboration guidelines. ⋯ There is insufficient evidence for the use of inhaled antibiotic therapy as primary or adjuvant treatment of VAP or VAT. Additional, better-powered randomized-controlled trials are needed to assess the efficacy of inhaled antibiotic therapy for VAP and VAT.
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BMC pulmonary medicine · Mar 2016
A mortality prediction rule for non-elderly patients with community-acquired pneumonia.
No mortality prediction rule is suited for non-elderly patients with community-acquired pneumonia. Therefore, we tried to create a mortality prediction rule that is simple and suitable for non-elderly patients with community-acquired pneumonia. ⋯ Our newly proposed mortality risk scoring system may be appropriate for predicting mortality in non-elderly patients with community-acquired pneumonia. It showed a possibility of a better prediction value than the A-DROP and is easy to use in various clinical settings.
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BMC pulmonary medicine · Mar 2016
Case ReportsAdministration of nintedanib after discontinuation for acute exacerbation of idiopathic pulmonary fibrosis: a case report.
Nintedanib is a multi-target receptor tyrosine kinase inhibitor. In two recent randomized phase 3 trials (INPULSIS™-1 and -2), it has been shown to slow the disease progression of idiopathic pulmonary fibrosis (IPF) by reducing the decline in the forced vital capacity (FVC). Although the INPULSIS™ trials indicate that nintedanib may serve to prevent acute exacerbations or delay the time to the first acute exacerbation, a certain number of IPF patients develop acute exacerbations while receiving nintedanib. However, there has been no report on the readministration of nintedanib in IPF patients who develop acute exacerbations during initial treatment with nintedanib. ⋯ To the best of our our knowledge, this is the first reported case of an acute exacerbation of IPF during nintedanib treatment, wherein nintedanib was safely and successfully restarted after treatment of the acute exacerbation. Our case indicates that nintedanib can be safely resumed and a desired effect on FVC can be obtained, even in IPF patients who develop acute exacerbations. However, we recommend close monitoring and appropriate measures until the long-term safety profile is clarified.
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BMC pulmonary medicine · Mar 2016
Applicability of visceral adiposity index in predicting metabolic syndrome in adults with obstructive sleep apnea: a cross-sectional study.
Obstructive sleep apnea (OSA) is severely affected by visceral adiposity (VA) that correlates to another disorder-metabolic syndrome (MetS). However, little is known concerning the relation of visceral adiposity index (VAI)-a novel and simple indicator of VA, with OSA and MetS. The objective of the study was to analyze the association of VAI with both disorders and applicability to identify OSA patients at risk of MetS. ⋯ The present study suggested that VAI was significantly associated with MetS and OSA. As a simple and alternative approach obtained in everyday practice, it may offer a powerful tool to identify patients with OSA at risk of MetS.