International journal of clinical practice. Supplement
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Pulmonary hypertension (PH) may complicate the course of many forms of advanced interstitial lung disease (ILD) and has been shown to portend a worse outcome. The aetiology of PH is likely multifactorial with variable contribution of factors amongst the different diseases. The most common such conditions include idiopathic pulmonary fibrosis, sarcoidosis, connective tissue disease-related ILD and pulmonary langerhans cell histiocytosis. Whether the course and impact of PH in these conditions can be modified by therapy requires further study.
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Int J Clin Pract Suppl · Jul 2008
ReviewRight heart function and haemodynamics in pulmonary hypertension.
The primary challenge in the care of the patient with advanced pulmonary arterial hypertension (PAH) is right ventricular dysfunction with concomitant right heart failure. Right heart function is closely tied to survival in this disease, and there is a growing interest in the study of this unique structure. ⋯ Several of the currently available treatments for PAH have been shown to have effects on the RV, not just the pulmonary vasculature, and, in future, therapies aimed at optimizing right ventricular function may allow better outcomes in this challenging disease. New directions in right ventricular assessment including measurement of pulmonary vascular impedance and more widespread availability of CMR may allow greater knowledge about this little studied, yet highly important, right side of the heart.
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Int J Clin Pract Suppl · Sep 2007
ReviewPulmonary hypertension and the serotonin hypothesis: where are we now?
In the 1960s, serotonin (5HT) was associated with pulmonary arterial hypertension (PAH) caused by certain diet pills, but has recently been the subject of renewed interest in the field of PAH. Serotonin can be synthesised in the pulmonary endothelium with the rate-limiting step being the activity of tryptophan hydroxylase1 (Tph1). ⋯ Here we will unravel, discuss and update the 'serotonin hypothesis' of PAH in light of recent advances in the field. In conclusion, the activity of serotonin receptors, the SERT and Tph1 can all be elevated in clinical and experimental PAH and each offers a potentially unique therapeutic target.
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Int J Clin Pract Suppl · Jan 2007
GuidelineBest Practice Guidelines on Publication Ethics: a publisher's perspective.
These Best Practice Guidelines on Publication Ethics describe Blackwell Publishing's position on the major ethical principles of academic publishing and review factors that may foster ethical behavior or create problems. The aims are to encourage discussion, to initiate changes where they are needed, and to provide practical guidance, in the form of Best Practice statements, to inform these changes. Blackwell Publishing recommends that editors adapt and adopt the suggestions outlined to best fit the needs of their own particular publishing environment.
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Int J Clin Pract Suppl · Dec 2005
ReviewDo all dry powder inhalers show the same pharmaceutical performance?
Important measures of pharmaceutical performance of dry powder inhalers include total emitted dose (TED, the quantity of drug emitted from the device when used at a fixed flow rate, typically 60 l/min or the flow rate achieved at a pressure drop of 4 kPa) and fine particle mass (FPM, the quantity of drug with small particles, typically with an aerodynamic diameter of less than 5 microns emitted from the device at a fixed flow rate). There is a wide range of dry powder inhalers available. ⋯ It is not surprising therefore that evidence from in vitro studies shows considerable variation in pharmaceutical performance of dry powder inhalers. Although neither TED nor FPM can accurately predict in vivo performance, it may be expected that highly variable or inhalation flow sensitive in vitro behaviour will be reflected in variable performance when used by patients.