Multidisciplinary Respiratory Medicine最新文献

{"title":"Multidisciplinary treatment of thoracic fistulous empyema caused by pulmonary infection: a retrospective study","authors":"Yasoo Sugiura, Hiroyuki Fujimoto, Toshinori Hashizume","doi":"10.4081/mrm.2023.926","DOIUrl":"https://doi.org/10.4081/mrm.2023.926","url":null,"abstract":"Background: In cases of thoracic empyema, the presence of a fistula is known to be difficult to treat and associated with a poor prognosis. Few reports have described the management of fistulous empyema caused by lung parenchymal infection. The aim of this study was to describe the outcomes of multidisciplinary management of fistulous empyema caused by pneumonia or lung abscess due to common bacteria and mycobacteria.Methods: Among 108 cases of empyema surgically treated at Kanagawa Hospital over a 10-year period, 14 patients with fistulous empyema due to common bacteria (CBFE) or fistulous empyema due to mycobacteria (MFE) were analyzed. Fistulous empyema due to pneumonectomy was excluded.Results: Eight of the 9 patients with CBFE and 4 of the 5 patients with MFE were male. Patients with CBFE were more likely to be >65 years of age (p=0.052) and to have a poor performance status (p=0.078). The time from onset to first surgical treatment was significantly longer in MFE (median, 5 months; p=0.004). Five patients with CBFE and two patients with MFE underwent open window thoracostomy, while three patients with CBFE and four patients with MFE underwent endobronchial occlusion. Six patients (66%) with CBFE and 3 patients (60%) with MFE achieved fistula closure. Of the patients who underwent EBO, fistula closure was achieved in 3 (100%) of the patients with CBFE and in 2 (50%) of the patients with MFE. Fistula closure was not achieved in any case with non-tuberculous mycobacteria.Conclusions: Fistulous empyema caused by common bacteria or Mycobacterium tuberculosis could be cured by surgical treatment and endobronchial intervention with adequate antimicrobial therapy, but fistulous empyema caused by non-tuberculous mycobacteria proved to be intractable. The challenge in the treatment of fistulous empyema due to non-tuberculous mycobacteria is the achievement of bacterial negativity.","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"42 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135853688","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":"Experimental studies and mathematical modeling of the viscoelastic rheology of tracheobronchial mucus from respiratory healthy patients.","authors":"Sandra Melina Tauwald,&nbsp;Johanna Michel,&nbsp;Marie Brandt,&nbsp;Veronika Vielsmeier,&nbsp;Christian Stemmer,&nbsp;Lars Krenkel","doi":"10.4081/mrm.2023.923","DOIUrl":"https://doi.org/10.4081/mrm.2023.923","url":null,"abstract":"<p><strong>Background: </strong>Tracheobronchial mucus plays a crucial role in pulmonary function by providing protection against inhaled pathogens. Due to its composition of water, mucins, and other biomolecules, it has a complex viscoelastic rheological behavior. This interplay of both viscous and elastic properties has not been fully described yet. In this study, we characterize the rheology of human mucus using oscillatory and transient tests. Based on the transient tests, we describe the material behavior of mucus under stress and strain loading by mathematical models.</p><p><strong>Methods: </strong>Mucus samples were collected from clinically used endotracheal tubes. For rheological characterization, oscillatory amplitude-sweep and frequency-sweep tests, and transient creep-recovery and stress-relaxation tests were performed. The results of the transient test were approximated using the Burgers model, the Weibull distribution, and the six-element Maxwell model. The three-dimensional microstructure of the tracheobronchial mucus was visualized using scanning electron microscope imaging.</p><p><strong>Results: </strong>Amplitude-sweep tests showed storage moduli ranging from 0.1 Pa to 10,000 Pa and a median critical strain of 4%. In frequency-sweep tests, storage and loss moduli increased with frequency, with the median of the storage modulus ranging from 10 Pa to 30 Pa, and the median of the loss modulus from 5 Pa to 14 Pa. The Burgers model approximates the viscoelastic behavior of tracheobronchial mucus during a constant load of stress appropriately (R² of 0.99), and the Weibull distribution is suitable to predict the recovery of the sample after the removal of this stress (R² of 0.99). The approximation of the stress-relaxation test data by a six-element Maxwell model shows a larger fit error (R² of 0.91).</p><p><strong>Conclusions: </strong>This study provides a detailed description of all process steps of characterizing the rheology of tracheobronchial mucus, including sample collection, microstructure visualization, and rheological investigation. Based on this characterization, we provide mathematical models of the rheological behavior of tracheobronchial mucus. These can now be used to simulate mucus flow in the respiratory system through numerical approaches.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 1","pages":"923"},"PeriodicalIF":2.3,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10615166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428943","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":"Re-admission and quality of life among patients with chronic obstructive pulmonary disease after telemedicine video nursing consultation - a randomized study.","authors":"Safaa Saleh, Svein Skeie, Heidi Grundt","doi":"10.4081/mrm.2023.918","DOIUrl":"10.4081/mrm.2023.918","url":null,"abstract":"<p><strong>Background: </strong>Our previous study showed a reduced cumulative length of re-admission stays due to chronic obstructive pulmonary disease (COPD) exacerbations during one year after telemedicine video consultation (TVC). The current study evaluated the effects of TVC on the length of re-admission stays within 12 months follow up post-TVC compared to phone call follow up or COPD usual care in a randomized study. Our secondary aim was to assess the impact of TVC on the frequency of re-admissions within 12 months of follow up. Patient satisfaction, hospital anxiety and depression scale (HADS) and COPD assessment test (CAT) scores were also evaluated.</p><p><strong>Methods: </strong>The study was a prospective randomized study of COPD patients who after hospital discharge for acute COPD exacerbations, were randomized to monitoring by TVC at home compared to phone call follow up for two weeks by a specialist nurse at the hospital or usual COPD care. Prospectively, we compared the cumulative durations and frequencies of hospital re-admissions due to COPD exacerbations within 12 months follow up after TVC, phone call follow up or usual COPD care.</p><p><strong>Results: </strong>Among 173 COPD patients followed for 12 months, 99 were re-admitted. The median cumulative length of readmission stays per patient within 12 months post-TVC did not differ from those followed by phone calls or with usual COPD care. The number of patients re-admitted and the number of re-admissions due to COPD exacerbations were also equal in the three groups. Patient satisfaction was high among those followed by TVC and phone calls, and the HADS and CAT scores favorably declined from baseline to post-intervention in patients followed by TVC and phone calls.</p><p><strong>Conclusions: </strong>The study could not demonstrate a beneficial effect of TVC on the cumulative length of re-admission stays or on the number of re-admissions within 12 months following an acute COPD hospital stay, as compared to those followed by phone calls or with usual COPD care. Patient satisfaction was high among those followed by TVC and phone calls, and the declines in HADS and CAT scores seem to be consequences of increased empowerment and competence for good self-care in COPD patients, remaining through the one-year observation period.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 1","pages":"918"},"PeriodicalIF":2.0,"publicationDate":"2023-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/fe/mrm-18-1-918.PMC10519187.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169079","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":"Physical exercise in asthma adolescents: a concept review.","authors":"Antonio Privitera, Salvatore Privitera","doi":"10.4081/mrm.2023.924","DOIUrl":"10.4081/mrm.2023.924","url":null,"abstract":"<p><p><b>Background:</b> Asthma is a frequent pathological condition during childhood and adolescence. Young asthmatics demonstrate decreased aptitude for physical activity and a limited exercise capacity. Lower hospitalisation rates, reduced school absenteeism, fewer medical examinations, and limited use of bronchodilators have been documented in children and adolescents with bronchial asthma who engage in physical exercise regularly. Structured physical exercise protocols should be encouraged as they can work as a synergistic therapeutic option in addition to regular pharmacologic treatment. This article outlines the most suitable exercise training techniques for young patients with bronchial asthma and their effects on health status.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 1","pages":"924"},"PeriodicalIF":2.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/3c/mrm-18-1-924.PMC10519188.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151945","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":"Effects of EPs 7630 on the duration of inability to work in acute bronchitis - a meta-analysis.","authors":"Heinrich Matthys, Petra Funk, Andrea Zimmermann, Walter Lehmacher","doi":"10.4081/mrm.2023.914","DOIUrl":"10.4081/mrm.2023.914","url":null,"abstract":"<p><strong>Background: </strong>Acute bronchitis (AB) has an enormous economic impact through lost working time. We investigated whether treatment with <i>Pelargonium</i> extract EPs 7630 may reduce the time of inability to work.</p><p><strong>Methods: </strong>A meta-analysis of double-blind, randomized, placebo-controlled trials with adult patients suffering from AB was performed. The average number of days of inability to work and the proportion of patients who were still unable to work after one week's treatment were assessed.</p><p><strong>Results: </strong>Four clinical trials with a total of 1,011 evaluable patients who received the marketed dosage of EPs 7630 (n=505) or placebo (n=506) for seven days were included in the meta-analysis. At baseline, 845/1,011 patients (83.6%) were unable to work. In the four trials, the proportion decreased to between 19 and 14% for EPs 7630 and to between 41 and 55% for placebo (meta-analysis risk ratio and 95% confidence interval: 0.35; 0.26-0.45; p<0.001). For the number of sick days, a weighted mean difference of 1.73 days (1.17-2.29 days; p<0.001) favoring EPs 7630 was observed.</p><p><strong>Conclusions: </strong>For adults suffering from AB, this meta-analysis demonstrates that seven days' treatment with <i>Pelargonium sidoides</i> extract EPs 7630 significantly reduces the average number of sick days and significantly increases the proportion of patients who are able to return to work.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 1","pages":"914"},"PeriodicalIF":2.0,"publicationDate":"2023-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/f8/mrm-18-1-914.PMC10355130.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9848128","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":"Management of interstitial lung disease in patients with autoimmune disease-related interstitial lung disease.","authors":"Kevin G Dsouza, Amanda S Alexander, Jubal R Watts, Tejaswini Kulkarni","doi":"10.4081/mrm.2023.890","DOIUrl":"10.4081/mrm.2023.890","url":null,"abstract":"<p><p>Interstitial lung disease (ILD) is a common manifestation of systemic autoimmune diseases. A proportion of patients with autoimmune disease associated-ILDs develop progressive pulmonary fibrosis. Regular monitoring of patients with pulmonary fibrosis is recommended to enable prompt detection of progression and initiation or escalation of therapy if needed. However, there is no established algorithm for the treatment of autoimmune disease associated-ILDs. In this article, we present three case studies that demonstrate the challenges in the diagnosis and management of patients with autoimmune disease associated-ILDs and the importance of taking a multidisciplinary approach to their care.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 1","pages":"890"},"PeriodicalIF":2.0,"publicationDate":"2023-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/e0/mrm-18-1-890.PMC10184176.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9488795","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":"The OM-85 bacterial lysate: a new tool against SARS-CoV-2?","authors":"Vadim Pivniouk, Donata Vercelli","doi":"10.4081/mrm.2023.906","DOIUrl":"10.4081/mrm.2023.906","url":null,"abstract":"<p><p>The emergence of SARS-CoV-2, a novel coronavirus, caused the global Coronavirus disease of 2019 (COVID-19) pandemic. Because SARS-CoV-2 mutates rapidly, vaccines that induce immune responses against viral components critical for target cell infection strongly mitigate but do not abrogate viral spread, and disease rates remain high worldwide. Complementary treatments are therefore needed to reduce the frequency and/or severity of SARS-CoV-2 infections. OM-85, a standardized lysate of 21 bacterial strains often found in the human airways, has immuno-modulatory properties and is widely used empirically in Europe, South America and Asia for the prophylaxis of recurrent upper airway infections in adults and children, with excellent safety profiles. <i>In vitro</i> studies from our laboratory recently demonstrated that OM-85 inhibits SARS-CoV-2 epithelial cell infection by downregulating SARS-CoV-2 receptor expression, raising the possibility that this bacterial extract might eventually complement the current COVID-19 therapeutic toolkit. Here we discuss how our results and those from other groups are fostering progress in this emerging field of research.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 ","pages":"906"},"PeriodicalIF":2.3,"publicationDate":"2023-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/92/mrm-18-1-906.PMC9926922.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9209270","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":"Germline variant of CTC1 gene in a patient with pulmonary fibrosis and myelodysplastic syndrome.","authors":"Martina Doubková,&nbsp;Zuzana Vrzalová,&nbsp;Marianna Štefániková,&nbsp;Libor Červinek,&nbsp;Kateřina Staňo Kozubík,&nbsp;Ivona Blaháková,&nbsp;Šárka Pospíšilová,&nbsp;Michael Doubek","doi":"10.4081/mrm.2023.909","DOIUrl":"https://doi.org/10.4081/mrm.2023.909","url":null,"abstract":"<p><strong>Introduction: </strong>Telomeropathies are associated with a wide range of diseases and less common combinations of various pulmonary and extrapulmonary disorders.</p><p><strong>Case presentation: </strong>In proband with high-risk myelodysplastic syndrome and interstitial pulmonary fibrosis, whole exome sequencing revealed a germline heterozygous variant of <i>CTC1</i> gene (c.1360delG). This \"frameshift\" variant results in a premature stop codon and is classified as likely pathogenic/pathogenic. So far, this gene variant has been described in a heterozygous state in adult patients with hematological diseases such as idiopathic aplastic anemia or paroxysmal nocturnal hemoglobinuria, but also in interstitial pulmonary fibrosis. Described <i>CTC1</i> gene variant affects telomere length and leads to telomeropathies.</p><p><strong>Conclusions: </strong>In our case report, we describe a rare case of coincidence of pulmonary fibrosis and hematological malignancy caused by a germline gene mutation in <i>CTC1</i>. Lung diseases and hematologic malignancies associated with short telomeres do not respond well to standard treatment.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 1","pages":"909"},"PeriodicalIF":2.3,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/ae/mrm-18-1-909.PMC10316942.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804945","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":"Palliative care and end of life management in patients with idiopathic pulmonary fibrosis.","authors":"Assunta Micco,&nbsp;Emanuela Carpentieri,&nbsp;Antonio Di Sorbo,&nbsp;Alfredo Chetta,&nbsp;Mario Del Donno","doi":"10.4081/mrm.2023.896","DOIUrl":"https://doi.org/10.4081/mrm.2023.896","url":null,"abstract":"<p><p>Idiopathic pulmonary fibrosis (IPF) is a chronic disease with an unknown etiology that causes deterioration of the structure of the lung parenchyma, resulting in a severe and progressive decline in respiratory function and early mortality. IPF is essentially an incurable disease, with a mean overall survival of 5 years in approximately 20% of patients without treatment. The combination of a poor prognosis, uncertainty about the disease's progression, and the severity of symptoms has a significant impact on the quality of life of patients and their families. New antifibrotic drugs have been shown to slow disease progression, but their impact on health-related quality of life (HRQoL) has to be proven yet. To date, studies have shown that palliative care can improve symptom management, HRQoL, and end-of-life care (EoL) in patients with IPF, reducing critical events, hospitalization, and health costs. As a result, it is essential for proper health planning and patient management to establish palliative care early and in conjunction with other therapies, beginning with the initial diagnosis of the disease.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 ","pages":"896"},"PeriodicalIF":2.3,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/f5/mrm-18-1-896.PMC9994447.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9108753","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":"Preliminary study of assessing cognitive impairment in older patients with chronic obstructive pulmonary disease by using a cognitive functional assessment tool via a touchscreen personal computer.","authors":"Masahiro Ogawa,&nbsp;Ayame Uchiumi,&nbsp;Susumu Sato,&nbsp;Yoko Hamakawa,&nbsp;Mizuki Kobashi,&nbsp;Tomoki Aoyama,&nbsp;Hitoshi Tanimukai","doi":"10.4081/mrm.2023.892","DOIUrl":"https://doi.org/10.4081/mrm.2023.892","url":null,"abstract":"<p><strong>Background: </strong>Unique cognitive impairments related to chronic obstructive pulmonary diseases (COPD) have been increasingly reported. Considering the dementia risk and medication management, older patients with COPD should be evaluated for cognitive impairment. This study aimed to examine whether specific cognitive impairments related to COPD could be detected by an assessment tool using a touchscreen personal computer (PC) in older patients with COPD.</p><p><strong>Methods: </strong>This study included 28 older male patients with COPD and 30 healthy older male individuals. A touchscreen PC-based cognitive assessment application called CogEvo was used to assess and compare the cognitive function according to five domains: spatial cognition, orientation, working memory, executive function, and attention.</p><p><strong>Results: </strong>Analysis of variance showed an interaction effect on the indices of cognitive function based on five domains between the two groups, indicating differences in the characteristics of cognitive function in such groups. Betweengroup comparisons as a subtest showed that attention, executive function, and working memory were significantly lower in the COPD group than in the healthy group.</p><p><strong>Conclusions: </strong>CogEvo can detect specific cognitive impairments associated with COPD, suggesting that it can be potentially used as a screening tool for cognitive impairment in older patients with COPD.</p>","PeriodicalId":51135,"journal":{"name":"Multidisciplinary Respiratory Medicine","volume":"18 ","pages":"892"},"PeriodicalIF":2.3,"publicationDate":"2023-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/1a/mrm-18-1-892.PMC9926919.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10743317","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}