Pulmonary Therapy最新文献

{"title":"Asthma Exacerbations and Glucagon-Like Peptide-1 Receptor Agonists: a Review of the Current Evidence.","authors":"Alan G Kaplan,&nbsp;James W Kim","doi":"10.1007/s41030-022-00203-x","DOIUrl":"https://doi.org/10.1007/s41030-022-00203-x","url":null,"abstract":"<p><p>Asthma is a chronic inflammatory disease involving multiple mediators and cytokines. While our current treatments have shown significant therapeutic benefits, there still appear to be some patients who, despite aggressive therapy, good adherence, and inhaler technique, continue to have exacerbations. Exacerbations lead to loss of lung function, exposure to systemic corticosteroids, effects on quality of life, and even mortality. There is a large number of glucagon-like peptide-1 (GLP-1) receptors in the lung even compared with other organs, and studies have shown evidence of reduced exacerbations in asthmatics treated with GLP-1 receptor agonists (GLP-1 RA). While weight loss may affect lung mechanics, evidence of inflammatory changes has been revealed that could explain this relationship. This article will review the data behind these conjectures and outline potential clinical utility and the need for future studies to truly understand the role of GLP-1 receptors in the lung.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 4","pages":"343-358"},"PeriodicalIF":3.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/d5/41030_2022_Article_203.PMC9727043.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10373160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship Between Start of Feeding and Functional Outcome in Aspiration Pneumonia: A Retrospective Cohort Study.","authors":"Takako Nagai,&nbsp;Hiroshi Uei,&nbsp;Kazuyoshi Nakanishi","doi":"10.1007/s41030-022-00200-0","DOIUrl":"https://doi.org/10.1007/s41030-022-00200-0","url":null,"abstract":"<p><strong>Introduction: </strong>Aspiration pneumonia is the predominant form of pneumonia in the elderly. Low oral intake levels and malnutrition have been reported to be associated with increased mortality and loss of function in aspiration pneumonia. However, the relationship between start of feeding and readmission, which is associated with malnutrition and low oral intake levels, has not been reported. The purpose of this study was to clarify the relationship between start of feeding and functional prognosis in aspiration pneumonia.</p><p><strong>Methods: </strong>Patients' basic information, comorbidities, severity of pneumonia, swallowing function, time from admission to the start of feeding, geriatric nutritional risk index (GNRI), readmission, and Barthel index (BI) were evaluated in 160 patients. The patients were divided into two groups-a readmission group and a non-readmission group-and statistical verification was performed.</p><p><strong>Results: </strong>The readmission group was 62 cases (38.8%). Univariate analysis showed that the time from admission to the start of feeding was significantly longer in the readmission group (p < 0.001). Age was significantly higher and nutrition parameters were lower in the readmission group (p = 0.001, 0.006). Furthermore, according to logistic regression analysis, readmission was associated with age (odds ratio, 1.063; p =  0.007; 95% confidence interval (CI) 1.017-1.111) and time from admission to the start of feeding (odds ratio 1.080; p < 0.001; 95% CI 1.025-1.137).</p><p><strong>Conclusion: </strong>The time from admission to the start of feeding was significantly longer in the readmitted patients. A comprehensive intervention with multidisciplinary collaboration should be performed from the early stage of hospitalization.</p><p><strong>Trial registration: </strong>This study is registered in the UMIN-Clinical Trials Registry (UMIN-CTR). UMIN-CTR meets the criteria of the International Committee of Medical Journal Editors (ICMJE). (Registration number: 000047141).</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 4","pages":"359-368"},"PeriodicalIF":3.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2d/2f/41030_2022_Article_200.PMC9727170.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10367503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rate of Lung Function Decline in People with Cystic Fibrosis Having a Residual Function Gene Mutation.","authors":"Gregory S Sawicki,&nbsp;Michael W Konstan,&nbsp;Edward F McKone,&nbsp;Richard B Moss,&nbsp;Barry Lubarsky,&nbsp;Ellison Suthoff,&nbsp;Stefanie J Millar,&nbsp;David J Pasta,&nbsp;Nicole Mayer-Hamblett,&nbsp;Christopher H Goss,&nbsp;Wayne J Morgan,&nbsp;Margaret E Duncan,&nbsp;Yoojung Yang","doi":"10.1007/s41030-022-00202-y","DOIUrl":"https://doi.org/10.1007/s41030-022-00202-y","url":null,"abstract":"<p><strong>Introduction: </strong>Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. Approximately 5% of people with CF have residual function (RF) CFTR mutations that result in partially retained CFTR activity. Published literature on disease trajectory among those with RF mutations is limited. In this retrospective study, we characterized lung function decline across different age groups in CFTR modulator-untreated people with CF heterozygous for F508del and an RF mutation (F/RF).</p><p><strong>Methods: </strong>Rate of decline in percent predicted forced expiratory volume in 1 s (ppFEV₁) was analyzed using data from the US CF Foundation Patient Registry (2006-2014) in F/RF (all), F/RF (excluding R117H), and F508del homozygous (F/F) cohorts. Annual rates of ppFEV₁ decline were estimated over 2-year periods based on calendar year. Subgroup analyses by age [6-12 (children), 13-17 (adolescents), 18-24 (young adults), and ≥ 25 years (adults)] were performed.</p><p><strong>Results: </strong>The estimated annualized rate of ppFEV₁ decline was - 0.70 percentage points per year (95% CI -1.09, -0.30) in the F/RF (all) cohort (N = 1242) versus -1.91 percentage points per year (95% CI -2.01, -1.80) in the F/F cohort (N = 11,916) [difference, 1.29 percentage points per year (95% CI 0.88, 1.70); P < 0.001]. In the F/RF (all) cohort, all age groups demonstrated lung function decline ranging from -0.30 to -1.38. In the F/RF (excluding R117H) cohort, the rate of decline was -1.05 percentage points per year (95% CI -1.51, -0.60) [difference versus F/F cohort, 0.95 percentage points per year (95% CI 0.48, 1.41; P < 0.001); not statistically significant in children and young adults].</p><p><strong>Conclusion: </strong>Progressive lung function decline was observed in people with F/RF genotypes across all assessed age groups, reinforcing the importance of early intervention and clinical monitoring to preserve lung function in all people with CF.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 4","pages":"385-395"},"PeriodicalIF":3.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a1/f1/41030_2022_Article_202.PMC9727051.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9276818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Hydrothorax: A Narrative Review.","authors":"Benjamin Pippard,&nbsp;Malvika Bhatnagar,&nbsp;Lisa McNeill,&nbsp;Mhairi Donnelly,&nbsp;Katie Frew,&nbsp;Avinash Aujayeb","doi":"10.1007/s41030-022-00195-8","DOIUrl":"https://doi.org/10.1007/s41030-022-00195-8","url":null,"abstract":"<p><p>Hepatic hydrothorax (HH) represents a distinct clinical entity within the broader classification of pleural effusion that is associated with significant morbidity and mortality. The median survival of patients with cirrhosis who develop HH is 8-12 months. The diagnosis is typically made in the context of advanced liver disease and ascites, in the absence of underlying cardio-pulmonary pathology. A multi-disciplinary approach to management, involving respiratory physicians, hepatologists, and palliative care specialists is crucial to ensuring optimal patient-centered care. However, the majority of accepted therapeutic options are based on expert opinion rather than large, adequately powered randomized controlled trials. In this narrative review, we discuss the epidemiology, pathophysiology, clinical characteristics, and management of HH, highlighting the use of salt restriction and diuretic therapy, porto-systemic shunts, and liver transplantation. We include specific sections focusing on the role of pleural interventions and palliative care, respectively.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 3","pages":"241-254"},"PeriodicalIF":3.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/5b/41030_2022_Article_195.PMC9458779.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10390825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and Clinical Demographics of New Users to Single-Inhaler Triple Therapy in Patients with Chronic Obstructive Pulmonary Disease.","authors":"Benjamin Wu, David Mannino, George Mu, Marjorie Stiegler, Michael Bogart","doi":"10.1007/s41030-022-00189-6","DOIUrl":"10.1007/s41030-022-00189-6","url":null,"abstract":"<p><strong>Introduction: </strong>Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) triple therapy was approved by the United States Food and Drug Administration in 2017 as a maintenance therapy for chronic obstructive pulmonary disease (COPD). Patient characteristics and treatment patterns prior to initiating FF/UMEC/VI are currently unknown. This study assessed patient characteristics, exacerbation, and medication history in patients with COPD before the initiation of FF/UMEC/VI or multiple-inhaler triple therapy (MITT).</p><p><strong>Methods: </strong>This was a retrospective study using the Optum Clinformatics^® Data Mart. Patients who initiated FF/UMEC/VI triple therapy or MITT (consisting of a long-acting muscarinic antagonist [LAMA], long-acting β2-agonist [LABA], and inhaled corticosteroid [ICS]) between October 2017 and September 2018, were enrolled in commercial or Medicare Advantage Prescription Drug plans, were aged > 40 years, and had a COPD diagnosis were eligible. Patient characteristics, comorbidities, COPD medication use, exacerbations, and eosinophil counts were assessed in the 12-month baseline period prior to initiation of FF/UMEC/VI triple therapy or MITT.</p><p><strong>Results: </strong>The study population included 3933 FF/UMEC/VI users and 18,244 MITT users. Mean (standard deviation) patient age was 72.2 (8.6) years in FF/UMEC/VI users and 70.7 (9.7) years in MITT users. Prior to initiating triple therapy, the majority of FF/UMEC/VI (89.1%) and MITT (93.8%) users experienced a moderate or severe exacerbation or used a COPD maintenance therapy during the baseline period. In addition, 41.2% of FF/UMEC/VI users received overlapping ICS/LAMA/LABA, 20.3% received ICS/LABA, and 9.7% received LAMA/LABA.</p><p><strong>Conclusion: </strong>In this population of COPD patients, triple therapy was frequently initiated after previous maintenance medication use or an exacerbation, in line with treatment guideline recommendations.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 1","pages":"195-208"},"PeriodicalIF":2.3,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9098773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47827349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystic Fibrosis and Sleep Circadian Rhythms.","authors":"Mariam Louis,&nbsp;Peter Staiano,&nbsp;Lavender Micalo,&nbsp;Nauman Chaudary","doi":"10.1007/s41030-022-00184-x","DOIUrl":"https://doi.org/10.1007/s41030-022-00184-x","url":null,"abstract":"<p><p>Cystic fibrosis (CF) is due to a mutation in the cystic fibrosis transmembrane conductance regulator gene (CFTR), which leads to unusual water and chloride secretion across epithelial surfaces. The lungs are responsible for most morbidity, though other organs are frequently affected. Sleep abnormalities have long been recognized in CF. Abnormal ventilation and oxygenation, sinus disease, deconditioning due to muscle weakness and recurrent infections, and inflammation have been thought to play a role in sleep disorders in CF. However, there is evidence that CFTR gene dysregulation can affect circadian rhythms in CF. Early recognition and treatment of circadian rhythms may improve outcomes in CF.</p>","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 2","pages":"139-147"},"PeriodicalIF":3.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/54/41030_2022_Article_184.PMC9098776.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39911912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Respiratory Distress Syndrome Associated with Multisystem Inflammatory Syndrome in a Child with Covid-19 and Diabetic Ketoacidosis: A Case Report","authors":"S. Duong-Quy, Duc Huynh-Truong-Anh, Nhung Le-Thi-Hong, Tap Le-Van, Sa Le-Thi-Kim, Tien Nguyen-Quang, Thanh Nguyen-Thi-Kim, Ngan Nguyen-Phuong, Thanh Nguyen-Chi, Tinh Nguyen-Van, Van Duong-Thi-Thanh, Dung Nguyen-Tien, C. Ngo, T. Craig","doi":"10.1007/s41030-022-00192-x","DOIUrl":"https://doi.org/10.1007/s41030-022-00192-x","url":null,"abstract":"","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 1","pages":"333 - 342"},"PeriodicalIF":3.0,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47747567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with Severe Uncontrolled Asthma: Perception of Asthma Control and its Management","authors":"M. George, Camille Graff, A. Bombezin–Domino, E. Pain","doi":"10.1007/s41030-022-00190-z","DOIUrl":"https://doi.org/10.1007/s41030-022-00190-z","url":null,"abstract":"","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 1","pages":"209 - 223"},"PeriodicalIF":3.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42316884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Current and Future Role of Technology in Respiratory Care","authors":"P. Honkoop, O. Usmani, M. Bonini","doi":"10.1007/s41030-022-00191-y","DOIUrl":"https://doi.org/10.1007/s41030-022-00191-y","url":null,"abstract":"","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 1","pages":"167 - 179"},"PeriodicalIF":3.0,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45616503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life and Healthcare Resource Use in a Real-world Patient Population with Idiopathic Pulmonary Fibrosis: The PROOF Registry","authors":"W. Wuyts, C. Dahlqvist, H. Slabbynck, M. Schlesser, N. Gusbin, C. Compère, S. Maddens, S. Rizzo, K. Kirchgaessler, K. Bartley, B. Bondue","doi":"10.1007/s41030-022-00187-8","DOIUrl":"https://doi.org/10.1007/s41030-022-00187-8","url":null,"abstract":"","PeriodicalId":20919,"journal":{"name":"Pulmonary Therapy","volume":"8 1","pages":"181 - 194"},"PeriodicalIF":3.0,"publicationDate":"2022-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47379323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}