Respiratory medicine
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Respiratory medicine · Jul 2016
ReviewThe prevalence of small airways disease in adult asthma: A systematic literature review.
Small airways dysfunction and inflammation contribute significantly to the clinical impact of asthma, yet conventional methods of assessing airways function in the clinic cannot reliably evaluate its presence. However, most recently, promising methods of assessment are being utilised. ⋯ Small airways disease is highly prevalent in asthma, even in patients with milder disease. Given the clinical impact of small airways disease, its presence should not be underestimated or overlooked as part of the daily management of patients with asthma.
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Respiratory medicine · Jul 2016
Convex probe EBUS for centrally located parenchymal lesions without a bronchus sign.
Convex probe endobronchial ultrasound (CP-EBUS) has proven safe and accurate for identifying malignancy and granulomatous disease affecting the mediastinum and hilum. For the diagnosis of parenchymal lung lesions, conventional techniques such as transbronchial biopsy, brush and lavage are useful, particularly when an airway leads directly to the lesion. For centrally located intraparenchymal lesions, CP-EBUS has been shown to be efficacious. ⋯ CP-EBUS is useful for diagnosing parenchymal lung abnormalities without a bronchus sign, extending its scope beyond mediastinal and hilar lymph nodes. It is imperative that physicians performing EBUS maintain this tool as a complement to conventional bronchoscopic techniques.
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Respiratory medicine · Jul 2016
Observational StudyTrends in hospital admissions for obstructive lung disease from 2000 to 2010 in Portugal.
The burden of hospitalisations for obstructive lung diseases (OLD) has not been sufficiently studied. We aimed to characterise the hospitalisations for OLD from 2000 to 2010 in all Portuguese public hospitals. We analysed hospital discharges with a diagnosis of OLD regarding the patients' gender, age, residence and comorbidities. ⋯ When both pneumonia and COPD were diagnosed there was an increasing trend to classify pneumonia as the principal diagnosis (64.4%-72.9%), a sign that may lead to underestimation of COPD hospitalisations. In summary, a considerable decrease in in-hospital COPD mortality was observed while hospital admissions and the length of stay did not change substantially. These results suggest that better healthcare or other factors may be counteracting the expected increase of the burden of COPD.
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Respiratory medicine · Jun 2016
High prevalence of obstructive lung disease in non-smoking farmers: The Irish farmers lung health study.
Mortality rates within the Irish farming community are increasing, whilst that of the general population falls. The aim of this cross-sectional study was to determine the prevalence of respiratory disease amongst Irish farmers. ⋯ The majority of Irish farmers are never smokers. They have a high prevalence of respiratory symptoms. 13% of never smokers have airflow obstruction (FEV1/FVC < 0.70). The presence of airflow obstruction is significantly associated with self-reported allergy history and prior airway disease. Further studies are needed to identify the workplace factors accounting for these findings.
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Respiratory medicine · Jun 2016
Randomized Controlled Trial Multicenter StudyLong-term safety of glycopyrrolate: A randomized study in patients with moderate-to-severe COPD (GEM3).
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the United States. Long-acting muscarinic antagonists (LAMAs) are a class of medications used as maintenance therapy for COPD. The GEM3 (Glycopyrrolate Effect on syMptoms and lung function) study assessed the long-term safety and efficacy of a LAMA, glycopyrrolate (GLY) 15.6 μg twice daily (b.i.d.), compared with an approved long-acting β2-agonist (LABA), indacaterol (IND) 75 μg once daily (q.d.) in patients with stable, symptomatic COPD with moderate-to-severe airflow limitation. ⋯ NCT01697696.