1,720,984 research outputs found
Idiopathic pulmonary fibrosis management: Caring is sparing
Full text link© Journal of Thoracic Disease. All rights reserved. J Thorac Dis 2020;12(10):5265-5268 | http://dx.doi.org/10.21037/jtd.2020.04.44
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive
and scarring lung disease characterized by irreversible
decline in lung function leading to chronic respiratory
failure (1). About 5 million of people are affected globally (2)
and average life expectancy following diagnosis is about
4 years. Health Related Quality of life (HRQoL) is low
and characterized by symptoms such as shortness of
breath, dry cough and limited exercise tolerance (3,4)
Standardized PaO2/FiO2 ratio in COVID-19: Added value or risky assumption. Author's reply
No full textCombining thalassotherapy and exercise for people with respiratory diseases
No full textThalassotherapy embraces various therapeutic methods, such as climatotherapy, heliotherapy, balneotherapy, psammotherapy and peloid
therapy.Thalassotherapy can also be associated with physical exercise, embracing a broader view of physical fitness. Although the effects of thalassotherapy on the musculoskeletal system are well known, its use for the treatment of respiratory diseases is less established.
Mechanics of healing could be related to an increase in peripheral vasodilation, improving blood supply and transcapillary exchange, and reabsorption of exudates, resulting in reduced bronchial oedema.
Motor and respiratory exercises are a consolidated therapeutic approach for people with
respiratory diseases at different stages of the illness, and there is a large consensus regarding
their efficacy.
There are more opportunitiesn to combine thalassotherapy and physical and respiratory exercise, even for those with respiratory diseases, depending on the disease phase, as these are two symbiotic therapeutic modalities. In fact, the beneficial effects of mobilisation and respiratory exercise in acute respiratory conditions promote and expedite the therapeutic journey of patients, even in critical settings .
Exercise and specialised treatments in thalassotherapy environments could be
considered a viable option to promote new therapeutic pathways for patients with conditions that are not treated in respiratory settings and experience frequent exacerbations, such as those with chronic obstructive pulmonary disease, asthma, bronchiectasis or pulmonary fibrosis. Additional research should be carried out to identify which patients would most benefit from such approaches
COPD Exacerbation: Why It Is Important to Avoid ICU Admission
Full text linkChronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality worldwide. Hospitalization due to acute exacerbations of COPD (AECOPD) is a relevant health problem both for its impact on disease outcomes and on health system resources. Severe AECOPD causing acute respiratory failure (ARF) often requires admission to an intensive care unit (ICU) with endotracheal intubation and invasive mechanical ventilation. AECOPD also acts as comorbidity in critically ill patients; this condition is associated with poorer prognoses. The prevalence reported in the literature on ICU admission rates ranges from 2 to 19% for AECOPD requiring hospitalization, with an in-hospital mortality rate of 20–40% and a re-hospitalization rate for a new severe event being 18% of the AECOPD cases admitted to ICUs. The prevalence of AECOPD in ICUs is not properly known due to an underestimation of COPD diagnoses and COPD misclassifications in administrative data. Non-invasive ventilation in acute and chronic respiratory failure may prevent AECOPD, reducing ICU admissions and disease mortality, especially when associated with a life-threating episode of hypercapnic ARF. In this review, we report on up to date evidence from the literature, showing how improving the knowledge and management of AECOPD is still a current research issue and clinical need
Noninvasive ventilation in unplanned endotracheal extubation: Just a little help from my friend?
No full texteditoria
Colon Sarcoidosis Mimicking Cancer at 18F-FDG PET/CT
No full textThis 68-year-old woman with a 9-year history of skin sarcoidosis presented with abdominal pain, bloating, and diarrhea. Following positive occult fecal blood, a diagnosis of ascending colon sarcoidosis was pathologically confirmed after colonoscopy. FDG PET/CT was performed for sarcoid staging, and the ascending colon demonstrated the only focal site of active sarcoidosis (SUVmax = 10)
“Bevacizumab nel tumore polmonare non a piccole cellule - caso clinico di paziente con metastasi cerebrali”
No full text“Il problema della diagnosi tardiva del tumore polmonare: il limbo delle sindromi paraneoplastiche”,
No full textHigh flow through nasal cannula in exacerbated COPD patients: a systematic review
No full textChronic Obstructive Pulmonary Disease (COPD) history is characterized by episodes of exacerbation of varying severity, featured by acute worsening of respiratory symptoms, commonly precipitated by respiratory tract infection. The recent ERS/ATS clinical practice guidelines strongly recommend the application of non invasive ventilation (NIV) for patients with acute respiratory failure (ARF) leading to acute or acute-on-chronic respiratory acidosis (pH 7.35) and not for those patients with acute exacerbation of COPD (AECOPD) and hypercapnia who are not acidotic. In recent years, High-Flow through Nasal Cannula (HFNC) has been introduced in the clinical practice. We designed the present systematic review of the literature to assess all effects of HFNC use reported in exacerbated COPD patients. In this setting, HFNC is able to keep PaCO2 unmodified, while oxygenation slightly deteriorates as opposed to NIV. Furthermore, the work of breathing is reduced with HFNC by a similar extent to NIV, while it increases by 40–50% during conventional oxygen therapy (COT). HFNC is also reported to be more comfortable than COT and NIV. Despite these results, little and limited evidence for improved clinical outcomes is currently available
Intrinsic Dynamic Positive End-Expiratory Pressure in Stable Patients with Chronic Obstructive Pulmonary Disease
No full textBackground: Assessment of intrinsic dynamic positive end-expiratory pressure (PEEPi,dyn) may be clinically important in stable patients with chronic obstructive pulmonary disease (COPD), but epidemiological data are scant. Objectives: The aim of our study was (i) to assess the PEEPi,dyn in a large population of stable patients with COPD and (ii) to evaluate the correlations with some noninvasive measurements routinely assessed. Method: Retrospective analysis of lung mechanics, dynamic volumes, arterial blood gases, dyspnoea by means of the Medical Research Council (MRC) scale, the COPD Assessment Test score, and maximal inspiratory/expiratory pressures in 87 hypercapnic and 62 normocapnic patients. Results: The mean PEEPi,dyn was significantly higher in hypercapnic than normocapnic patients (2.8 ± 2.2 vs. 1.9 ± 1.6 cm Hsub2/subO, respectively, p = 0.0094). PEEPi,dyn did not differ according to Global Initiative for Chronic Obstructive Lung Disease stage, MRC score, or use or not of long-Term oxygen therapy. There were significant although weak correlations between PEEPi,dyn and airway obstruction, hyperinflation, respiratory muscle function, arterial COsub2/sub tension, and number of exacerbations/year. The transdiaphragmatic pressure was the strongest variable associated to PEEPi,dyn (R = 0.5713, p = 0.001). Conclusion: In stable patients with COPD, PEEPi,dyn is higher in hypercapnic patients and weakly correlated to noninvasive measures of lung and respiratory muscle function
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