Respirology : official journal of the Asian Pacific Society of Respirology
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Identifying citation classics in the field is one of the key methodologies used to conduct a systematic evaluation of research performance. The objective of this study was to determine the most frequently cited articles published in journals that are placed under the 'respiratory system' subject category (Institute for Scientific Information (ISI) Journal Citation Reports) and to compare them with the most frequently cited respiratory-related articles published in any journal, regardless of subject category. The authors utilized the ISI Journal Citation Reports: Science Edition 2010 database in April 2012 to determine the most frequently cited articles by respiratory system subject category and by respiratory-related keywords. ⋯ The median numbers of citations for the top 50 cited articles stratified by respiratory system subject category and respiratory-related keywords were 841.5 and 2701, respectively. Half of the top 50 cited articles identified by respiratory-related keywords were published in general medical or basic science journals, whereas only three out of these were published in journals under the respiratory system subject category in ISI Journal Citation Reports. In summary, respiratory-related articles published in general medical or science journals attracted more citations than those published in the specific respiratory journals.
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Lung transplantation has become an accepted therapeutic procedure for the treatment of end-stage pulmonary parenchymal and vascular disease. Despite improved survival rates over the decades, lung transplant recipients have lower survival rates than other solid organ transplant recipients. ⋯ The epidemiology, diagnosis, prophylaxis, treatment and outcomes for the different microbial pathogens will be reviewed. The effects of infection on lung transplant rejection will also be discussed.
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This review details some of the advances that have been made in the recent decade in the diagnosis, treatment and epidemiology of pulmonary fungal infections. These advances have occurred because of increasing knowledge regarding the fungal genome, better understanding of the structures of the fungal cell wall and cell membrane and the use of molecular epidemiological techniques. The clinical implications of these advances are more rapid diagnosis and more effective and less toxic antifungal agents. ⋯ The newest agents, the echinocandins, are especially safe as they interfere with the metabolism of the fungal cell wall, a structure not shared with humans cells. Epidemiological advances include the description of the emergence of Cryptococcus gattii in North America and the increase in pulmonary mucormycosis and pneumonia due to Fusarium and Scedosporium species in transplant recipients and patients with haematological malignancies. The emergence of azole resistance among Aspergillus species is especially worrisome and is likely related to increased azole use for treatment of patients, but also to agricultural use of azoles as fungicides in certain countries.
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Bronchiectasis is a chronic disorder characterized by impaired mucociliary clearance and a relentless cycle of infection, inflammation and bronchial wall injury, which has a debilitating impact on the patient's quality of life and results in increased morbidity and mortality. It is a disease for which there are no currently registered therapeutic products, limited epidemiological data and no validated endpoints that have been accepted by the majority of regulatory authorities. This article reviews the evidence base for the efficacy of inhaled dry powder mannitol in patients with non-cystic fibrosis (CF) bronchiectasis. ⋯ It is designed to hydrate the lungs and restore normal mucociliary clearance mechanisms in the lungs. Based on the available evidence, mannitol inhalation is well tolerated and improves the quality of life of patients with non-CF bronchiectasis. There is a need for well designed and adequately powered multicentre trials to establish the potential usefulness of mannitol as a treatment for non-CF bronchiectasis.
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While the impact of obesity on respiratory function has been extensively studied, and several definitive conclusions have emerged, its impact on exercise performance is complex, with the available data sometimes providing contradictory or inconclusive information. Based on the literature discussed, it appears that resting alterations in lung volumes and gas exchange become attenuated during exercise in the obese, while oxygen cost of breathing and dyspnoea are increased. Respiratory muscle function also seems to be impaired, such that inspiratory muscle strength is reduced and respiratory drive is increased. ⋯ The majority of evidence discussed is based on comparative data from obese versus normal-weight patients, with respiratory disorders currently established as indications for PR. The best evidence currently available regarding the impact of obesity on PR is for patients with chronic obstructive pulmonary disease (COPD); here, it appears that obesity per se has no negative impact on PR. Otherwise, there are no conclusive data on the impact of obesity on PR in respiratory disorders other than COPD, and this remains to be investigated in the future.