BMC pulmonary medicine
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BMC pulmonary medicine · Dec 2019
Meta AnalysisEfficacy of glucocorticoids for the treatment of macrolide refractory mycoplasma pneumonia in children: meta-analysis of randomized controlled trials.
Mycoplasma pneumoniae is one of the most common pathogens causing community acquired pneumonia in children. Although the rate of macrolide-refractory Mycoplasma pneumoniae (MRMP) has increased, systemic glucocorticoids as a treatment option has not been validated yet. The purpose of this study was to assess the efficacy of glucocorticoids add-on in the treatment of MRMP in children through systematic review and meta-analysis. ⋯ Glucocorticoid add-on treatment for MRMP can significantly shorten the duration of fever and hospital stay and decrease the level of CRP. These results should be confirmed by adequately powered studies in the future.
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BMC pulmonary medicine · Nov 2019
Multicenter StudyBaseline characteristics and comorbidities in the CAnadian REgistry for Pulmonary Fibrosis.
The CAnadian REgistry for Pulmonary Fibrosis (CARE-PF) is a multi-center, prospective registry designed to study the natural history of fibrotic interstitial lung disease (ILD) in adults. The aim of this cross-sectional sub-study was to describe the baseline characteristics, risk factors, and comorbidities of patients enrolled in CARE-PF to date. ⋯ CTD-ILD, IPF, and unclassifiable ILD made up 80% of ILD diagnoses at ILD referral centers in Canada, while idiopathic NSIP was rare when adhering to recommended diagnostic criteria. CCI had a very narrow distribution across our cohort suggesting it may be a poor discriminator in assessing the impact of comorbidities on patients with ILD.
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BMC pulmonary medicine · Nov 2019
Comparative StudyContemporary portable oxygen concentrators and diverse breathing behaviours -- a bench comparison.
Decades of clinical research into pulsed oxygen delivery has shown variable efficacy between users, and across a user's behaviours (sleep, rest, activity). Modern portable oxygen concentrators (POCs) have been shown as effective as other oxygen delivery devices in many circumstances. However, there are concerns that they are not effective during sleep when the breathing is shallow, and at very high respiratory rates as during physical exertion. It can be challenging to examine the determinants of POC efficacy clinically due to the heterogeneity of lung function within oxygen users, the diversity of user behaviour, and measurement issues. Representative bench testing may help identify key determinants of pulsed-oxygen device efficacy. ⋯ The results are supportive of contemporary POC triggering abilities. The differences shown in ultimate trigger sensitivity may have relevance to oronasal breathing during sleep or other challenging scenarios for pulsed oxygen delivery, such as dominant mouth breathing during exertion or unfavourable nasal geometry.
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BMC pulmonary medicine · Nov 2019
Acute exacerbations of fibrosing interstitial lung disease associated with connective tissue diseases: a population-based study.
Acute exacerbation (AE) is the major cause of morbidity and mortality in patients with idiopathic pulmonary fibrosis (IPF). AEs also occur in other forms of fibrosing interstitial lung disease (fILD). The clinical features and prognosis of AE patients with connective tissue diseases (CTDs) associated-ILD has not been fully described. ⋯ The clinical characteristics of patients with AE-CTD-ILD differed from those with AE-IPF, while AE incidences were similar between the two groups. Subjects with AE-CTD-fILD tended to have a better prognosis, and WBC count and PO2/FiO2 ratio were the independent survival predictors for these patients.
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BMC pulmonary medicine · Nov 2019
Possible value of antifibrotic drugs in patients with progressive fibrosing non-IPF interstitial lung diseases.
Fibrosing, non-idiopathic pulmonary fibrosis (non-IPF) interstitial lung diseases (fILDs) are a heterogeneous group of diseases characterized by a different amount of inflammation and fibrosis. Therapy is currently based on corticosteroids and/or immunomodulators. However, response to these therapies is highly variable, sometimes without meaningful improvement, especially in more fibrosing forms. Pirfenidone and nintedanib have recently demonstrated to reduce functional decline in patients with IPF. However, their antifibrotic mechanism makes these two drugs an interesting approach for treatment of fibrosing ILDs other than IPF. ⋯ Antifibrotic treatment may be a valuable treatment option in patients with progressive fibrosing non-IPF ILD if currently no other treatment options exist. However, prospective, randomized clinical trials are urgently needed to assess the real impact of antifibrotic therapy in these patients.