Pulmonary and critical care medicine最新文献_第2页

A mini review of inhaled beta 2 agonists in acute decompensated heart failure requiring respiratory support. 吸入式β2受体激动剂在需要呼吸支持的急性失代偿性心力衰竭中的应用小结。

Pulmonary and critical care medicine Pub Date : 2019-12-01 Epub Date: 2019-06-24 DOI: 10.15761/pccm.1000161

Nicholas Germano, Douglas Summerfield, Bruce Johnson

{"title":"A mini review of inhaled beta 2 agonists in acute decompensated heart failure requiring respiratory support.","authors":"Nicholas Germano, Douglas Summerfield, Bruce Johnson","doi":"10.15761/pccm.1000161","DOIUrl":"10.15761/pccm.1000161","url":null,"abstract":"Acute decompensated heart failure (HF) results in over one million hospital admissions per year, many requiring invasive or noninvasive mechanical ventilation for respiratory/cardiovascular support. Inhaled beta-2 adrenergic receptor agonists have been shown to be effective at clearance of extravascular lung water in HF patients. However, studies done in the late 1990s and early 2000s, prior to standardization and wide adoption of guideline directed medical therapy for HF, suggested that inhaled beta-2 agonist use increased admissions for HF exacerbations as well as in-hospital mortality. One study even attempted to utilize intravenous Beta-2 agonists in Acute Respiratory Distress Syndrome patients, however the study was stopped prematurely due to an 11% increased mortality in the treatment group. More recently however, studies examining patients who have concurrent diagnoses of chronic obstructive pulmonary disease (COPD) and HF showed that beta-2 agonist therapy resulted in similar or better outcomes compared to controls. Likewise, in-vitro studies, animal models, and studies utilizing chronic heart failure patients treated with nebulized beta-2 agonists with no concurrent respiratory diagnosis had a therapeutic effect of treatment over controls. These studies have the advantage of being performed with the standardization of guideline directed HF medical therapy. In conclusion, while we continue to recommend the use of Beta-2 agonist therapy in patients with concurrent COPD and HF requiring respiratory support, further studies, preferably single or double blinded prospective trials, will need to be performed to determine whether Beta-2 agonist therapy offers morbidity and mortality benefits in patients with strictly acute decompensated heart failure requiring respiratory support.","PeriodicalId":91958,"journal":{"name":"Pulmonary and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39336458","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}

引用次数: 0

Lean muscle mass and bone mineral content are predictors of lung function in ex-smokers with or without COPD 瘦肌肉量和骨矿物质含量是有或没有COPD的戒烟者肺功能的预测因子

Pulmonary and critical care medicine Pub Date : 2019-01-01 DOI: 10.15761/pccm.1000159

Joanne M Smart, Vanessa M McDonald, Peter G Gibson, Peter Ab Wark, Lisa G Wood

引用次数: 0

Efficacy of oral montelukast in comparison of inhaled steroids for mild persistent asthma among children aged 1-5 years: A randomized clinical trial in Sri-Lanka 口服孟鲁司特与吸入类固醇治疗1-5岁儿童轻度持续性哮喘的疗效比较:斯里兰卡的一项随机临床试验

Pulmonary and critical care medicine Pub Date : 2019-01-01 DOI: 10.15761/pccm.1000160

Jayawardena Pp, G. J, Imalke Kacp

{"title":"Efficacy of oral montelukast in comparison of inhaled steroids for mild persistent asthma among children aged 1-5 years: A randomized clinical trial in Sri-Lanka","authors":"Jayawardena Pp, G. J, Imalke Kacp","doi":"10.15761/pccm.1000160","DOIUrl":"https://doi.org/10.15761/pccm.1000160","url":null,"abstract":"Background: In Sri Lanka, the incidence of asthma has been reported as 2.6% in children. Increased cost and poor adherence of Inhaled Corticosteroids (ICSs) put forward the advancement of leukotriene antagonists like montelukast. However, the efficacy of montelukast has not been studied fully in children of Sri Lanka. The aim of this study is to compare the efficacy of montelukast and ICS in children aged 1 to 5 years with mild persistent asthma. Methods: This randomized clinical trial was conducted from December 2011 May 2013. Children age 1-5 years having cough and wheeze were included. The endpoint of the study was to determine the effectiveness of montelukast in the improvement of asthma symptoms measured by asthma score in comparison to ICS. Participants were divided into 2 groups where group 1 was designated for ICS and group 2 for montelukast. Data was recorded daily in the symptom diary, while coded and analyzed on SPSS. This trial is registered with Sri Lanka Clinical Trial Registry under number: SLCTR/2011/006. Results: The study population of 81 children of which 64.2% were male, mean age was 40.12 ± 13.50 months and weight of 17.70 ± 21.65 Kg. Significant improvement in the mean asthma score was observed in both groups. As compared to ICS, nasal congestion was significantly reduced in montelukast group with mean score of 281.71 ± 27.05 (p = 0.034) and improvement in physical activities were equally achieved. Conclusion: Montelukast is equally effective as inhaled corticosteroids in prevention of mild persistent asthma among 1-5 years and additional significant benefit in controlling rhinitis. *Correspondence to: Jayawardena PP, Department of Pediatrics, Faculty of Medicine, University of Ruhuna, Karapitiya, Galle, Sri Lanka, Tel: +94 777901662; Fax: +94 91 2222314; E-mail: pushpikaja@yahoo.com.au","PeriodicalId":91958,"journal":{"name":"Pulmonary and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67503263","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}

引用次数: 1

Rhinovirus and COPD airway epithelium. 鼻病毒与COPD气道上皮。

Pulmonary and critical care medicine Pub Date : 2017-10-01 Epub Date: 2017-09-07 DOI: 10.15761/PCCM.1000139

Nicole Owuor, Nisha Nalamala, Joao Antonio Gimenes, Uma S Sajjan

{"title":"Rhinovirus and COPD airway epithelium.","authors":"Nicole Owuor, Nisha Nalamala, Joao Antonio Gimenes, Uma S Sajjan","doi":"10.15761/PCCM.1000139","DOIUrl":"https://doi.org/10.15761/PCCM.1000139","url":null,"abstract":"Chronic Obstructive Pulmonary Disease (COPD) is characterized by irreversible airflow limitation. It is a global disease and expected to be the third leading cause of death. Respiratory exacerbations are associated with increased mortality and morbidity in this patient population. Respiratory viruses were isolated from at least 30 to 50% of the infectious respiratory COPD exacerbations with rhinovirus being most commonly isolated pathogen. Although rhinovirus does not cause airway epithelial damage like influenza and other respiratory viruses, it may further impair innate immunity of airway epithelium, which is the first line of defense in the lungs. This may increase susceptibility to secondary bacterial infections leading to progression of lung disease. Currently, there arc no therapies available to treat rhinovirus infection in COPD and therefore understanding the mechanisms underlying RV pathogenesis in COPD is essential to identify molecular target to develop new therapeutic strategies. Quercetin, a plant polyphenol, which modulates innate immunity and effectively blocks viral replication may be useful in treating rhinovirus associated COPD exacerbations.","PeriodicalId":91958,"journal":{"name":"Pulmonary and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36410881","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}

引用次数: 7

Electroporation ablation of bronchial smooth muscle cells: A novel non-thermal asthma therapy. 电穿孔消融支气管平滑肌细胞:一种新的非热哮喘治疗方法。

Pulmonary and critical care medicine Pub Date : 2016-12-01 Epub Date: 2016-11-06 DOI: 10.15761/PCCM.1000120

Jason A Tri, Christopher V DeSimone, Craig Daniels, Roshini S Asirvatham, Susan B Mikell, Dorothy J Ladewig, Kelly Krajnick, Samuel J Asirvatham

{"title":"Electroporation ablation of bronchial smooth muscle cells: A novel non-thermal asthma therapy.","authors":"Jason A Tri, Christopher V DeSimone, Craig Daniels, Roshini S Asirvatham, Susan B Mikell, Dorothy J Ladewig, Kelly Krajnick, Samuel J Asirvatham","doi":"10.15761/PCCM.1000120","DOIUrl":"https://doi.org/10.15761/PCCM.1000120","url":null,"abstract":"Objective: Asthma is a common disease which places significant burden on the US healthcare system and which can be associated with significant patient morbidity and mortality. Current medical therapies are costly and not curative. A new approach for a more permanent asthma treatment is the use of radiofrequency ablation. However, this radiofrequency approach is thermal-based and can result in deleterious effects to the airways, such as stenosis or ulceration. We describe a novel, improved therapeutic approach for smooth muscle ablation using non-thermal DC electroporation ablation.Methods: We developed and tested prototype electroporation ablation devices that access the airways both endoscopically and via a bronchoscope. We tested the feasibility of this approach and demonstrated proof-of-concept in 2 mongrel dogs. In order to assess for smooth muscle function, we performed functional studies pre and post ablation with methacholine challenge to assess for airway reversibility. We also evaluated bronchial lesions via direct vision with bronchoscopy.Results: We developed novel electroporation catheters to delivery energy to the bronchial smooth muscle through an endoscopic approach. We tested these catheters in 2 acute canine studies and successfully demonstrated the ability to destroy smooth muscle tissue via novel prototypes and saline irrigation for widespread non-thermal electroporation ablation. Our functional studies demonstrate the efficacy of this approach.Conclusion: We report a novel method for non-thermal bronchial smooth muscle ablation using novel prototypes and electroporation with normal saline. These early findings require further evaluation in larger, chronic canine studies to assess for use as a potential curative therapy.","PeriodicalId":91958,"journal":{"name":"Pulmonary and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5329751/pdf/nihms837667.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34784786","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}

引用次数: 2