Clinical implications of airway hyper-responsiveness in COPD

COPD represents one of the leading causes of mortality in the general population. This study aimed at evaluating the relationship between airway hyperresponsiveness (AHR) and COPD and its relevance for clinical practice. We performed a MEDLINE search that yielded a total of 1919 articles. Eligible studies were defined as articles that addressed specific aspects of AHR in COPD, such as prevalence, pathogenesis, or prognosis. AHR appears to be present in at least one out of two individuals with COPD. The occurrence of AHR in COPD is influenced by multiple mechanisms, among which impairment of factors that oppose airway narrowing plays an important role. The main determinants of AHR are reduct…

Fever and dyspnoea in a tracheostomised patient

A 65-year-old man was referred for evaluation of acute onset of fever, productive cough and dyspnoea. He had previously received a diagnosis of laryngeal carcinoma, which had been treated with laryngectomy and bilateral laterocervical lymphadenectomy, followed by chemotherapy. He underwent plastic surgery of the laryngocutaneous fistula, and a positron emission tomography (PET)- computed tomography (CT) examination performed during follow-up showed 18-FDG (2-fluoro-2-deoxyd- glucose) lung uptake in the apical right portion. He had a smoking history and his regular medications included dexamethasone, metoclopramide, omeprazole, furosemide, cholecalciferol and pregabalin. He had a history of …

The Attenuation of the Bronchodilatory Effect of Deep Inspiration (DI) in COPD Is Related to Reduced Airway Distensibility as Measured by HRCT

Airway wall thickness by HRCT in patients with COPD.

Virtual Multidisciplinary Tumor Boards: A Narrative Review Focused on Lung Cancer

To date, the virtual multidisciplinary tumor boards (vMTBs) are increasingly used to achieve high-quality treatment recommendations across health-care regions, which expands and develops the local MTB team to a regional or national expert network. This review describes the process of lung cancer-specific MTBs and the transition process from face-to-face tumor boards to virtual ones. The review also focuses on the project organization's description, advantages, and disadvantages. Semi-structured interviews identified five major themes for MTBs: current practice, attitudes, enablers, barriers, and benefits for the MTB. MTB teams exhibited positive responses to modeled data feedback. Virtualiz…

The loss of the beneficial effect of deep inspiration (DI) in COPD is associated with severity of disease

Valutazione dell’efficacia e della sicurezza dei sistemi di riduzione endoscopica di volume polmonare nel trattamento dell’enfisema polmonare

Valutazione della riduzione della distensibilità delle vie aeree in relazione alla gravità del quadro di broncopneumopatia cronica ostruttiva mediante Tc ad alta risoluzione.

L’iperreattività bronchiale e la BPCO nel paziente anziano

How Effective and Safe Is Bronchial Thermoplasty in “Real Life” Asthmatics Compared to Those Enrolled in Randomized Clinical Trials?

There is limited information on the efficacy and safety of bronchial thermoplasty (BT) inreal life. We evaluated the outcomes of the randomized clinical trials for BT in severe asthmatics, in whom the exclusion criteria were not strictly controlled. A case series of seven asthmatics (M/F: 4/3; age:54.6±2.9years) is reported. Subjects had a statistically significant improvement in AQLQ (from a mean of3.96±1.1to4.5±1.2and5.5±0.6after 6 and 12 months of treatment;p=0.0007) and in the ACQ score (from2.77±0.8to1.83±1.2and1.5±0.8after 6 and 12 months;p<0.001). In the year after BT, severe exacerbations, salbutamol use, and OCS use were significantly lower compared with the 1-yr pretreatment pe…

Airway distensibility by HRCT decreases with severity of COPD.

Airway Distensibility by HRCT in COPD Patients

The airway response to deep inspirations decreases with COPD severity and is associated with airway distensibility assessed by computed tomography.

In patients with mild chronic obstructive pulmonary disease (COPD), the effect of deep inspirations (DIs) to reverse methacholine-induced bronchoconstriction is largely attenuated. In this study, we tested the hypothesis that the effectiveness of DI is reduced with increasing disease severity and that this is associated with a reduction in the ability of DI to distend the airways. Fifteen subjects [Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I–II: n = 7; GOLD stage III–IV: n = 8] underwent methacholine bronchoprovocation in the absence of DI, followed by DI. The effectiveness of DI was assessed by their ability to improve inspiratory vital capacity and forced expira…

Lung hyperinflation in COPD attenuates airway distension by deep inspiration (DI) measured with HRCT

Virtual Multidisciplinary Tumor Board: A Narrative Review Focused on Lung Cancer

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