Journal of pulmonary & respiratory medicine最新文献

{"title":"Chylothorax in a Patient with Pulmonary Aspergillosis and Chronic Renal Disease in Hemodialysis","authors":"Jorge I Miranda, L. Gutierrez, A. Blanco, C. Duran, Sumaya E Moreira Lopez, Alfredo Celedon Lacayo","doi":"10.4172/2161-105x.1000484","DOIUrl":"https://doi.org/10.4172/2161-105x.1000484","url":null,"abstract":"","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70576988","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":"Systematic Review on the Importance of Preventive Measures for Pneumonia Associated with Mechanical Ventilation","authors":"Coelho Jf, Coelho As, Filho Ijz","doi":"10.4172/2161-105x.1000483","DOIUrl":"https://doi.org/10.4172/2161-105x.1000483","url":null,"abstract":"Introduction: Ventilator-associated pneumonia (VAP) occurs in 9.0% to 27.0% of patients on mechanical ventilation (MV) and has a global mortality rate of 13.0%. VAP is the most frequent infection acquired in the intensive care unit (ICU) among patients submitted to this ventilatory support, resulting in mortality rates’ ranging from 20.0% to 70.0%, with the use of antibiotics is presented in the literature as the most effective prophylactic measure. Objective: The primary objective of this study was to review national and international scientific literature on preventive measures and pneumonia associated with mechanical ventilation. The secondary objective was to discuss the efficacy of preventive measures for ventilator-associated pneumonia. Methods: After literary search criteria with the use of Mesh terms: pneumonia, antibiotics, prophylactic antibiotics, mechanical ventilation, patients at risk, major care, contamination and clinical trials and use of the bouleanos “and” between mesh terms and “or” among the historical findings. In the main databases such as Pubmed, Medline, Bireme, EBSCO, Scielo, etc., a total of 56 papers that were submitted to the eligibility analysis were cross-checked and after that 21 studies were selected, following the rules of systematic review-PRISMA. Results: The results suggest that the use of intravenous and technological support that the surgical patient needs on the day of ICU admission is a risk factor for the development of VAP, as well as the prior use of antibiotics. In addition, the results confirm that VAP significantly increases the mechanical ventilation time and the time of ICU injection. Conclusion: EPI is an important cause of increased morbidity and mortality in severe ICU patients. Enteral nutrition was an important risk factor and previous use of antibiotic protection factor for the development of VAP. Studies to determine incidence and risk factors are useful in guiding the implementation of measures to improve diagnostic accuracy and to implement preventive measures. *Corresponding author: Idiberto José Zotarelli Filho, Unipos Post Graduate and Continuing Education, Street Ipiranga, 3460, São José do Rio Preto SP, Brazil, Tel: +55(17) 98166-6537; E-mail: m.zotarelli@gmail.com Received December 20, 2018; Accepted January 20, 2019; Published January 31, 2019 Citation: Coelho JF, Coelho AS, Filho IJZ (2019) Systematic Review on the Importance of Preventive Measures for Pneumonia Associated with Mechanical Ventilation. J Pulm Respir Med 9: 483. doi: 10.4172/2161-105X.1000483 Copyright: © 2019 Coelho JF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-105x.1000483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70576865","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":"Study of Pulmonary Function Test in Type 2 Diabetics and COPD with Diabetes","authors":"Giri Sg, Kapse Vr, B. Sb., Mhaisekar Dg","doi":"10.4172/2161-105x.1000485","DOIUrl":"https://doi.org/10.4172/2161-105x.1000485","url":null,"abstract":"","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-105x.1000485","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70576559","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":"Association of Serum Lipids and Obstructive Lung Disease in Hispanic/Latino Adults of Diverse Backgrounds.","authors":"Majid Afshar,&nbsp;Donghong Wu,&nbsp;Ramon Durazo-Arvizu,&nbsp;Frank G Aguilar,&nbsp;Ravi Kalhan,&nbsp;Sonia M Davis,&nbsp;Robert Kaplan,&nbsp;Oana L Klein,&nbsp;Eliana P Mende,&nbsp;Maria S Pattany,&nbsp;Martha L Daviglus","doi":"10.4172/2161-105X.1000419","DOIUrl":"https://doi.org/10.4172/2161-105X.1000419","url":null,"abstract":"<p><strong>Rationale: </strong>Substantial variation in the prevalences of obstructive lung disease exist between Hispanic/Latino heritage groups. Experimental studies have posited biological mechanisms linking serum lipids and lipid-lowering medications with obstructive lung disease. The aim of this study is to examine the associations of serum lipid levels with the prevalences of asthma and chronic obstructive pulmonary disease in the Hispanic Community Health Study/Study of Latinos and how these associations vary by Hispanic/Latino heritage group.</p><p><strong>Methods: </strong>The Hispanic Community Health Study/Study of Latinos is a population-based probability sample of 16,415 self-identified Hispanic/Latino persons aged 18-74 years recruited between 2008 and 2011 from randomly selected households in four US field centers. The baseline clinical examination included comprehensive biological testing (fasting serum lipid levels), behavioral and socio-demographic assessments, medication inventory including inhalers, and respiratory data including questionnaires for asthma and standardized spirometry with post-bronchodilator measures for identification of obstructive lung disease.</p><p><strong>Measurements and main results: </strong>Hispanic/Latinos with current asthma had lower age- and statin-use-adjusted mean serum total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels than their non-asthmatic counterparts. In analysis adjusted for age plus gender, ethnicity, cigarette smoking, alcohol intake, body mass index, lipid/cholesterol-lowering medications, age at immigration, health insurance status, and use of oral corticosteroids, increasing serum levels of total cholesterol and low-density lipoprotein cholesterol were associated with lower odds of current asthma in the estimated population. Unlike asthma, Hispanic/Latinos with chronic obstructive pulmonary disease had lower mean high-density lipoprotein than their non- chronic obstructive pulmonary disease counterparts. In the fully adjusted analysis no significant associations were found between lipid levels and prevalent chronic obstructive pulmonary disease.</p><p><strong>Conclusions: </strong>We showed a modest inverse relationship between serum lipid levels and current asthma. These results highlight some important differences in Hispanics/Latinos and certain serum lipids may be factors or markers of obstructive lung disease.</p>","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-105X.1000419","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35406095","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":"Differential Effect of LPS on Glucose, Lactate and Inflammatory Markers in the Lungs of Normal and Diabetic Mice.","authors":"Cecilia Nagorny Holmberg,&nbsp;Annika Åstrand,&nbsp;Cecilia Wingren,&nbsp;James P Garnett,&nbsp;Gaëll Mayer,&nbsp;John D Taylor,&nbsp;Emma H Baker,&nbsp;Deborah L Baines","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Elevation of blood glucose results in increased glucose in the fluid that lines the surface of the airways and this is associated with an increased susceptibility to infection with respiratory pathogens. Infection induces an inflammatory response in the lung, but how this is altered by hyperglycemia and how this affects glucose, lactate and cytokine concentrations in the airway surface liquid is not understood. We used Wild Type (WT) and glucokinase heterozygote (GK^+/-) mice to investigate the effect of hyperglycemia, with and without LPS-induced inflammatory responses, on airway glucose, lactate, inflammatory cells and cytokines measured in Bronchoalveolar Lavage Fluid (BALF). We found that glucose and lactate concentrations in BALF were elevated in GK^+/- compared to WT mice and that there was a direct correlation between blood glucose and BALF glucose concentrations. LPS challenge increased BALF inflammatory cell numbers and this correlated with decreased glucose and increased lactate concentrations although the effect was less in GK^+/- compared to WT mice. All cytokines measured (except IL-2) increased in BALF with LPS challenge. However, concentrations of TNFα, INFγ, IL-1β and IL-2 were less in GK^+/- compared to WT mice. This study shows that the normal glucose/lactate environment of the airway surface liquid is altered by hyperglycemia and the inflammatory response. These data indicate that inflammatory cells utilize BALF glucose and that production of lactate and cytokines is compromised in hyperglycemic GK^+/- mice.</p>","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"2017 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010169/pdf/emss-78014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41157051","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":"C-Reactive Protein in Stable Cystic Fibrosis: An Additional Indicator of Clinical Disease Activity and Risk of Future Pulmonary Exacerbations","authors":"E. Matouk, Dao Nguyen, A. Benedetti, J. Bernier, J. Gruber, J. Landry, S. Rousseau, Heather G. Ahlgren, L. Lands, G. Wojewodka, D. Radzioch","doi":"10.4172/2161-105X.1000375","DOIUrl":"https://doi.org/10.4172/2161-105X.1000375","url":null,"abstract":"Introduction In stable adult cystic fibrosis (CF) patients, we assessed the role of baseline high sensitivity C-reactive protein (hs-CRP) on CF clinical variables and frequency of intravenous (IV) treated pulmonary exacerbations (PExs) 1-year post-baseline. Methods We recruited 51 clinically stable CF patients from our Adult CF Center. We incorporated collected parameters into Matouk CF clinical score and CF questionnaire-revised quality of life score (QOL). We used the clinical minus complications subscores as a clinical disease activity score (CDAS). We dichotomized our patients according to the cohort median baseline hs-CRP of 5.2 mg/L. Results Patients in the high hs-CRP group (≥ 5.2 mg/L) demonstrated worse CDAS (r=0.67, p=0.0001) and QOL scores (r=0.57, p=0.0017) at a given FEV1% predicted. In both hs-CRP groups, prior-year IV-treated PExs and baseline CDASs were significant predictors of future IV-treated PExs. Interestingly, the association between baseline CDAS and future PExs frequency was more robust in the high compared to the low hs-CRP group (r=−0.88, p<0.0001, r=−0.48, p=0.017, respectively) with a steeper regression slope (p=0.001). In addition, a significant interaction was demonstrated between elevated baseline hs-CRP levels and CDASs for the prediction of increased risk of future PExs (p=0.02). This interaction provided an additional indicator of clinical disease activity and added another dimension to the prior year PExs frequency phenotype to identify patients at increased risk for future PExs. Conclusion Stable CF patients with elevated baseline hs-CRP (≥ 5.2 mg/L) demonstrated worse clinical disease activity and QOL scores at a given level of disease severity (FEV1% predicted). Elevated baseline hs-CRP values combined with clinical disease activity scores are associated with increased risk for future IV-treated PExs even in those with mild clinical disease activity scores.","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"6 1","pages":"1000375 - 1000375"},"PeriodicalIF":0.0,"publicationDate":"2016-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-105X.1000375","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70576748","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":"Pleuropulmonary Kaposi Sarcoma in the Setting of Immune Reactivation.","authors":"Karthik Suresh,&nbsp;Roy Semaan,&nbsp;Sixto Arias,&nbsp;Petros Karakousis,&nbsp;Hans Lee","doi":"10.4172/2161-105X.1000352","DOIUrl":"https://doi.org/10.4172/2161-105X.1000352","url":null,"abstract":"<p><p>We present a case of a 26 year with history of HIV/AIDS who presented with a pleural effusion. Serial radiography, pleural fluid analysis as well as clinical symptoms revealed development of Kaposi Sarcoma related immune reconstitution inflammatory syndrome (KS-IRIS) in the setting of initiation of effective anti- retroviral therapy.</p>","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-105X.1000352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34679865","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":"Circulating Aldosterone Levels and Disease Severity in Pulmonary Arterial Hypertension.","authors":"Zeenat Safdar,&nbsp;Aishwarya Thakur,&nbsp;Supriya Singh,&nbsp;Yingqun Ji,&nbsp;Danielle Guffey,&nbsp;Charles G Minard,&nbsp;Mark L Entman","doi":"10.4172/2161-105X.1000295","DOIUrl":"https://doi.org/10.4172/2161-105X.1000295","url":null,"abstract":"<p><strong>Objectives: </strong>It is not known whether aldosterone levels are associated with increased mortality in patients with pulmonary arterial hypertension (PAH). The primary goal of this study was to determine whether circulating aldosterone levels predict severity of PAH in terms of hemodynamic characteristics and mortality.</p><p><strong>Methods: </strong>Patients with stable PAH were enrolled at the Baylor PH program. The plasma levels of aldosterone and BNP were measured. Clinical, hemodynamic, and outcome data was collected by chart review. Mean follow up time from study enrollment was 39 ± 102 months. Cox proportional hazards model was used to assess time to death.</p><p><strong>Results: </strong>There were 125 PAH patients with plasma aldosterone levels. Median aldosterone level was 9.9 pg/ml (25th-75th percentile: 4.1 pg/ml, 27.1 pg/ml) and median brain natriuretic peptide (BNP) level was 67.5 pg/ml (25th-75th percentile: 31 pg/ml, 225 pg/ml). Aldosterone levels were not significantly associated with BNP levels, six-minute walk distance, Borg dyspnea score, right ventricular systolic pressure, cardiac output and cardiac index. However, the association between aldosterone and right atrial pressure was dependent on mineralocorticoid receptor blocker treatment (Coef. =2.88, 95CI: 1.19, 4.56, p=0.001). By log-rank statistic there was no statistical difference between the survival of patients divided by median aldosterone level (p=0.914). However, there was a significant difference in patient survival between the BNP categories (p<0.001) such that those with high BNP level (>180 pg/mL) had a shorter survival time.</p><p><strong>Conclusions: </strong>The aldosterone level was not associated with increased mortality in PAH but was a marker of disease severity.</p>","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"5 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-105X.1000295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34477564","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":"Circulating Aldosterone Levels and Disease Severity in Pulmonary Arterial Hypertension.","authors":"Z. Safdar, Aishwarya Thakur, Supriya Singh, Ying-qun Ji, D. Guffey, C. Minard, M. Entman","doi":"10.1378/CHEST.2280635","DOIUrl":"https://doi.org/10.1378/CHEST.2280635","url":null,"abstract":"OBJECTIVES\u0000It is not known whether aldosterone levels are associated with increased mortality in patients with pulmonary arterial hypertension (PAH). The primary goal of this study was to determine whether circulating aldosterone levels predict severity of PAH in terms of hemodynamic characteristics and mortality.\u0000\u0000\u0000METHODS\u0000Patients with stable PAH were enrolled at the Baylor PH program. The plasma levels of aldosterone and BNP were measured. Clinical, hemodynamic, and outcome data was collected by chart review. Mean follow up time from study enrollment was 39 ± 102 months. Cox proportional hazards model was used to assess time to death.\u0000\u0000\u0000RESULTS\u0000There were 125 PAH patients with plasma aldosterone levels. Median aldosterone level was 9.9 pg/ml (25th-75th percentile: 4.1 pg/ml, 27.1 pg/ml) and median brain natriuretic peptide (BNP) level was 67.5 pg/ml (25th-75th percentile: 31 pg/ml, 225 pg/ml). Aldosterone levels were not significantly associated with BNP levels, six-minute walk distance, Borg dyspnea score, right ventricular systolic pressure, cardiac output and cardiac index. However, the association between aldosterone and right atrial pressure was dependent on mineralocorticoid receptor blocker treatment (Coef. =2.88, 95CI: 1.19, 4.56, p=0.001). By log-rank statistic there was no statistical difference between the survival of patients divided by median aldosterone level (p=0.914). However, there was a significant difference in patient survival between the BNP categories (p<0.001) such that those with high BNP level (>180 pg/mL) had a shorter survival time.\u0000\u0000\u0000CONCLUSIONS\u0000The aldosterone level was not associated with increased mortality in PAH but was a marker of disease severity.","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1378/CHEST.2280635","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66568888","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":"Optimizing an Aversion Feeding Therapy Protocol for a Child with Food Protein-Induced Enterocolitis Syndrome (FPIES).","authors":"R. Mattingly, V. Mukkada, Alan F. Smith, T. Pitts","doi":"10.4172/2161-105X.1000287","DOIUrl":"https://doi.org/10.4172/2161-105X.1000287","url":null,"abstract":"This case study examines the difficulties of treating food aversion in a 9-month old child with a diagnosis of Food Protein-Induced Enterocolitis Syndrome (FPIES). Given the need to first identify a set of \"safe foods\" with which to work, the twin goals of doing food challenges and minimizing aversion are initially not complimentary, and require an approach outside the standard of care. The chosen plan encouraged flexibility and a positive relationship with feeding-related items, while only introducing one food item at a time. Mom and child accomplished goals surrounding food play easily. She has successfully introduced a wide variety of new foods in small quantities and is currently working on reducing dependence on breast milk. Therapists must be prepared to modify currently accepted interventions to accommodate and support the required medical intervention.","PeriodicalId":89994,"journal":{"name":"Journal of pulmonary & respiratory medicine","volume":"5 4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2015-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4172/2161-105X.1000287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70576883","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}