Respiratory medicine
-
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.
-
Respiratory medicine · Apr 2016
ReviewThe three tiers of screening for sarcoidosis organ involvement.
Sarcoidosis may involve any organ in the body. Organ involvement with sarcoidosis may go undetected. This manuscript addresses a suggested approach to screening for sarcoidosis organ involvement. ⋯ The third tier of screening is complex and involves the performance of multiple tests/algorithms or examinations by subspecialists to search for specific organ involvement. The third tier of screening is used to evaluate eye sarcoidosis, vitamin D dysregulation associated with sarcoidosis, and cardiac sarcoidosis. It is hoped that this approach to screening for sarcoidosis organ involvement will be a springboard for rigorous examination of this process that is likely to benefit sarcoidosis patients.
-
Respiratory medicine · Dec 2015
ReviewPreoperative exercise therapy in lung surgery patients: A systematic review.
The impact of postoperative complications after lung surgery for cancer is substantial, with the increasing age of patients and the presence of comorbidities. This systematic review summarises the effects of Preoperative Exercise Therapy (PET) in patients scheduled for lung surgery on aerobic capacity, physical fitness, postoperative complications, length of hospital stay, quality of life and recovery. ⋯ PET may have beneficial effects on various physical fitness variables and postoperative complications in patients with lung cancer scheduled for surgery. Future research must focus on developing patient tailored exercise programs and investigate the influence of co-existing comorbidities on the outcome measures. Definitions of PET, including timing, (acceptable) duration, intensity and exercise training methods should be determined and compared.
-
Respiratory medicine · Dec 2015
ReviewPreoperative exercise therapy in lung surgery patients: A systematic review.
The impact of postoperative complications after lung surgery for cancer is substantial, with the increasing age of patients and the presence of comorbidities. This systematic review summarises the effects of Preoperative Exercise Therapy (PET) in patients scheduled for lung surgery on aerobic capacity, physical fitness, postoperative complications, length of hospital stay, quality of life and recovery. ⋯ PET may have beneficial effects on various physical fitness variables and postoperative complications in patients with lung cancer scheduled for surgery. Future research must focus on developing patient tailored exercise programs and investigate the influence of co-existing comorbidities on the outcome measures. Definitions of PET, including timing, (acceptable) duration, intensity and exercise training methods should be determined and compared.
-
Respiratory medicine · Jan 2015
ReviewPredicting risk of drug-resistant organisms in pneumonia: moving beyond the HCAP model.
Clinical management of community-acquired pneumonia (CAP) is increasingly complicated by antibiotic resistance. CAP due to pathogens resistant to guideline-recommended drugs (CAP-DRP) has increased. 2005 ATS/IDSA guidelines introduced a new category, healthcare-associated pneumonia (HCAP), and recommend extended-spectrum antibiotic treatment for patients meeting HCAP criteria. However, the predictive value of the HCAP model is limited and data suggest that outcomes are not improved using HCAP guideline-concordant therapy. Better methods to predict risk of CAP-DRP are needed. ⋯ Additional development and validation of prediction scores based upon more refined risk factors for CAP-DRP is needed. Once an accurate, adequately validated prediction score is available, an interventional trial will be needed to determine clinical impact.