- Genetic profile and patient-reported outcomes in chronic obstructive pulmonary disease: A systematic review. [Journal Article]
- PlosPLoS One 2018; 13(6):e0198920
- CONCLUSIONS: Although a limited number of PRO's have been related to genetic variations, findings suggest that there is a significant association between specific gene variants and the number/severity of exacerbations, depressive symptoms and HRQOL. Further research is needed to confirm these findings and assess the genetic influence on other dimensions of patients' lives, since it may enhance our understanding and management of COPD.
- Efficacy and Safety of Gabapentin in the Treatment of Chronic Cough: A Systematic Review. [Review]
- TRTuberc Respir Dis (Seoul) 2018 Jun 19
- CONCLUSIONS: Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed.
- [Pott's Disease in Upper Thoracic Vertebrae in a Two-Year-Old Boy: Case Report]. [Case Reports]
- RPRev Peru Med Exp Salud Publica 2018 Jan-Mar; 35(1):150-154
- Pott's disease is a health problem in developing countries and its diagnosis in children is a challenge. Here we present the case of a two-year-old boy with Pott's disease involving T1 to T3 thoracic...
Pott's disease is a health problem in developing countries and its diagnosis in children is a challenge. Here we present the case of a two-year-old boy with Pott's disease involving T1 to T3 thoracic vertebrae. The clinical presentation was characterized by difficulty walking, fever, cough, and dyspnea. At physical examination, kyphosis and bony prominence were observed in the cervicodorsal area. A positive tuberculin test was obtained, and Mycobacterium tuberculosis was isolated via culture of the gastric aspiration sample. The spine MRI showed a chronic abscess, destruction of two vertebrae, and bone marrow compression. The patient experienced some improvement with anti-TB therapy. Here, we emphasize the importance of giving consideration to the clinical suspicion for the early detection of this condition, as well as a quick TB-treatment start so as to avoid the disability and mortality associated to this disease.
- Managing patients with chronic cough: challenges and solutions. [Journal Article]
- TCTher Clin Risk Manag 2018; 14:1041-1051
- Chronic cough is a common complaint and a frequent cause of medical consultation. Its management can be difficult. We present here an overview of the current guidelines for the management of chronic ...
Chronic cough is a common complaint and a frequent cause of medical consultation. Its management can be difficult. We present here an overview of the current guidelines for the management of chronic cough. Different steps are detailed, including the initial research of an obvious etiology and alert signs that should lead to further investigation of underlying condition. The diagnosis of the most frequent causes: asthma, non-asthmatic eosinophilic bronchitis, gastroesophageal reflux disease and upper airway cough syndrome should be considered, assessed and treated accordingly. Recent advances have been made in the comprehension of refractory chronic cough pathophysiology as well as its pharmacologic and non-pharmacologic treatment, especially speech pathology therapy.
- The heterogeneity of chronic cough: a case for endotypes of cough hypersensitivity. [Review]
- LRLancet Respir Med 2018 Jun 15
- Cough is a troublesome and difficult-to-treat symptom that accompanies a diverse range of pulmonary and extrapulmonary conditions. Although considerable advances have been made over recent years in b...
Cough is a troublesome and difficult-to-treat symptom that accompanies a diverse range of pulmonary and extrapulmonary conditions. Although considerable advances have been made over recent years in basic cough biology, this has not translated into improved clinical management. A major challenge has been in understanding the heterogeneity underlying the development and persistence of chronic cough in different patients. We present evidence that such heterogeneity begins with the multiple peripheral and central neural pathways capable of eliciting cough and associated respiratory behaviours, and extends to incorporate the diversity of diseases that underlie cough and the clinical phenotypic and pathological endotypic presentations that can vary substantially between individual patients with cough. A better understanding of how these sources of heterogeneity are expressed across individual patients with chronic cough is needed to better predict the efficacy of clinical management strategies and of specifically targeted therapies, which will facilitate the development of more personalised clinical approaches to treat patients with chronic cough.
- Comparison of Fractional Exhaled Nitric Oxide in Elderly Patients with Asthma-chronic Obstructive Pulmonary Disease Overlap and Other Airway Inflammatory Diseases. [Journal Article]
- IJIran J Allergy Asthma Immunol 2018; 17(3):232-239
- The exact role of fractional exhaled nitric oxide (FeNO) in older patients with chronic inflammatory diseases including asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) remains uncle...
The exact role of fractional exhaled nitric oxide (FeNO) in older patients with chronic inflammatory diseases including asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) remains unclear. This study aimed to investigate the differences in FeNO levels of elderly patients with ACO, asthma, COPD, and chronic cough. We conducted a retrospective study analysing the data of stable outpatients from Pulmonary Department of the Second Clinical College, Jinan University. All participants (Age≥55 years) were divided into the ACO group (n=19), asthma group (n=16), COPD group (n=25), and chronic cough group (n=22). The clinical data such as peripheral eosinophil counts, serum high sensitivity C-reactive protein (hs-CRP), FeNO, and spirometry was collected, and the correlations between FeNO levels and systemic markers or spirometric indices were analyzed. Patients with ACO and asthma had significantly elevated FeNO levels (37.7±16.5, and 36.3±17.7 ppb) compared with COPD, and chronic cough patients (21.9±10.3, and 16.1±8.8 ppb). The FeNO levels were negatively associated with forced expiratory volume in 1 second (FEV1, p=0.003), FEV1% predicted (p=0.012), and FEV1/forced vital capacity (FVC, p=0.002) in all groups. However, there were no significant correlation between FeNO levels and FVC, peripheral eosinophil counts, or serum hs-CRP (p>0.05). Elderly patients with ACO have higher levels of FeNO, when compared with patients with COPD or chronic cough. These findings suggest that FeNO measurement may provide an important implication for the etiological diagnosis of ACO in the elderly patients.
- Burden of Common Childhood Diseases in Relation to Improved Water, Sanitation, and Hygiene (WASH) among Nigerian Children. [Journal Article]
- IJInt J Environ Res Public Health 2018 Jun 12; 15(6)
- Having access to improved water, sanitation, and hygiene (WASH) facilities constitute a key component of healthy living and quality of life. Prolonged exposure to insanitary living conditions can sig...
Having access to improved water, sanitation, and hygiene (WASH) facilities constitute a key component of healthy living and quality of life. Prolonged exposure to insanitary living conditions can significantly enhance the burden of infectious diseases among children and affect nutritional status and growth. In this study we examined the prevalence of some common infectious diseases/disease symptoms of childhood among under-five children in Nigeria, and the association between the occurrence of these diseases with household’s access to WASH facilities. Types of diseases used as outcome variables included diarrheal, and acute respiratory infections (fever and cough). Access to WASH facilities were defined by WHO classification. The association between diarrhoea, fever and chronic cough with sanitation, and hygiene was analyzed by logistic regression techniques. Results showed that the prevalence of diarrhoea, fever and cough was respectively 10.5% (95% CI = 9.7⁻2.0), 13.4% (95% CI = 11.9⁻14.8), and 10.4% (95% CI = 9.2⁻11.5). In the regression analysis, children in the households that lacked all three types of facilities were found to have respectively 1.32 [AOR = 1.329, 95% CI = 1.046⁻1.947], 1.24 [AOR = 1.242, 95% CI = 1.050⁻1.468] and 1.43 [AOR = 1.432, 95% CI = 1.113⁻2.902] times higher odds of suffering from diarrhea, fever and cough. The study concludes that unimproved WASH conditions is an important contributor to ARIs and diarrheal morbidities among Nigerian children. In light of these findings, it is recommended that programs targeting to reduce childhood morbidity and mortality from common infectious diseases should leverage equitable provision of WASH interventions.
- Black lungs and big nodes: A case of airway anthracosis with bronchial anthracofibrosis. [Journal Article]
- RMRespir Med Case Rep 2018; 25:9-11
- We present a case of a 76 year-old, non-smoking Honduran female who was referred to our clinic for years of persistent dry cough. Cardiac evaluation was unremarkable. She denied symptoms of heartburn...
We present a case of a 76 year-old, non-smoking Honduran female who was referred to our clinic for years of persistent dry cough. Cardiac evaluation was unremarkable. She denied symptoms of heartburn, allergic rhinitis, and there was no personal or family history of asthma. Her physical exam demonstrated wheezing over the right mid-posterior chest. Spirometry was within normal limits. CT-imaging of the chest demonstrated right middle lobe bronchus and lingular segmental bronchus narrowing with bibasilar atelectasis and mild interlobular septal thickening with prominent mediastinal adenopathy. Bronchoscopy showed diffuse airway hyperpigmentation, right middle lobe medial segmental bronchial stenosis and lingular segmental bronchial stenosis. Endobronchial ultrasound demonstrated enlarged mediastinal lymph nodes, and transbronchial needle aspirates revealed necrotic tissue with black anthracotic pigment. Cultures were negative. Post-procedurally, the patient revealed regular use of a wood stove in an enclosed, poorly-ventilated kitchen. Anthracosis is the black discoloration of bronchial mucosa due to deposition of carbon-based particles in the airway, usually related to chronic environmental exposures. It can eventually result in endobronchial and parenchymal fibrosis and is mostly seen in non-smokers. Burning biomass fuel from wood smoke is a risk factor in the developing world. Symptoms include cough, dyspnea, and wheezing. Spirometry will usually demonstrate obstruction. CT-based imaging can show intraluminal narrowing, predominantly affecting the right middle and right upper lobe bronchi, resulting in distal segmental collapse. Extrapulmonary findings are rare, but usually are in the form of calcified mediastinal adenopathy on CT-based imaging, which allows for differentiation from lung cancer. There is no reliable treatment though bronchodilators can achieve clinical benefit.
- The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study. [Journal Article]
- JPJ Prev Med Public Health 2018; 51(3):130-139
- CONCLUSIONS: The results suggest that PM, NO2, and O3 cause respiratory symptoms leading to HR-QoL deterioration. While some adverse effects of air pollution appeared to occur regardless of COPD, others occurred more often and more intensely in COPD patients. The public sector, therefore, needs to consider tailoring air pollution countermeasures to people with different conditions to minimize adverse health effects.
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- Ivacaftor treatment of cystic fibrosis in children aged 12 to <24 months and with a CFTR gating mutation (ARRIVAL): a phase 3 single-arm study. [Journal Article]
- LRLancet Respir Med 2018 Jun 06
- CONCLUSIONS: Ivacaftor was generally safe and well tolerated in children aged 12 to <24 months for up to 24 weeks and was associated with rapid and sustained reductions in sweat chloride concentrations. Improvements in biomarkers of pancreatic function suggest that ivacaftor preserves exocrine pancreatic function if started early. The study is continuing in infants younger than 12 months.