Search results for " Pulmonary and Respiratory Medicine"

showing 10 items of 70 documents

Oxidative Stress and Respiratory System: Pharmacological and Clinical Reappraisal of N-Acetylcysteine

2014

Abstract The large surface area for gas exchange makes the respiratory system particularly susceptible to oxidative stress-mediated injury. Both endogenous and exogenous pro-oxidants (e.g. cigarette smoke) trigger activation of leukocytes and host defenses. These mechanisms interact in a ìmultilevel cycleî responsible for the control of the oxidant/antioxidant homeostasis. Several studies have demonstrated the presence of increased oxidative stress and decreased antioxidants (e.g. reduced glutathione [GSH]) in subjects with chronic obstructive pulmonary disease (COPD), but the contribution of oxidative stress to the pathophysiology of COPD is generally only minimally discussed. The aim of t…

Pulmonary and Respiratory MedicineChronic ObstructiveAntioxidantantioxidantNeutrophilsmedicine.medical_treatmentAntioxidant; Copd exacerbation; Lung function; Small airways; Acetylcysteine; Antioxidants; Bronchitis Chronic; Disease Progression; Expectorants; Forced Expiratory Volume; Hospitalization; Humans; Macrophages; Neutrophils; Pulmonary Disease Chronic Obstructive; Reactive Oxygen Species; Respiratory Physiological Phenomena; Oxidative Stress; Pulmonary and Respiratory MedicineAntioxidant; Copd exacerbation; Lung function; Small airways; Acetylcysteine; Antioxidants; Bronchitis Chronic; Disease Progression; Expectorants; Forced Expiratory Volume; Hospitalization; Humans; Macrophages; Neutrophils; Pulmonary Disease Chronic Obstructive; Reactive Oxygen Species; Respiratory Physiological Phenomena; Oxidative StressOxidative phosphorylationReviewSettore MED/10 - Malattie Dell'Apparato Respiratoriomedicine.disease_causeAntioxidantsAcetylcysteinePulmonary Diseasechemistry.chemical_compoundPulmonary Disease Chronic ObstructiveCOPD exacerbationForced Expiratory VolumemedicineHumansRespiratory systemChronicBronchitisExpectorantschemistry.chemical_classificationCOPDReactive oxygen speciessmall airwaysbusiness.industryMacrophageslung functionGlutathionemedicine.diseaseAcetylcysteineBronchitis ChronicHospitalizationOxidative StresschemistryImmunologyDisease ProgressionRespiratory Physiological PhenomenabusinessReactive Oxygen SpeciesOxidative stressmedicine.drug
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Chronic obstructive lung disease “expert system”: Validation of a predictive tool for assisting diagnosis

2018

Purpose: The purposes of this study were development and validation of an expert system (ES) aimed at supporting the diagnosis of chronic obstructive lung disease (COLD). Methods: A questionnaire and a WebFlex code were developed and validated in silico. An expert panel pilot validation on 60 cases and a clinical validation on 241 cases were performed. Results: The developed questionnaire and code validated in silico resulted in a suitable tool to support the medical diagnosis. The clinical validation of the ES was performed in an academic setting that included six different reference centers for respiratory diseases. The results of the ES expressed as a score associated with the risk of su…

Pulmonary and Respiratory MedicineChronic ObstructivePilot ProjectsExpert SystemsSettore MED/10 - Malattie Dell'Apparato RespiratorioPulmonary DiseasePulmonary Disease Chronic ObstructiveSoftware DesignSurveys and QuestionnairesChronic obstructive lung diseaseDiagnosisSurveys and QuestionnaireHumansAge FactorPilot ProjectExpert SystemChronic obstructive lung diseasesAgedHealth PolicyEnvironmental and Occupational HealthPublic Health Environmental and Occupational HealthMethodologyAge FactorsChronic obstructive lung diseases Diagnosis Expert systems Pulmonary and Respiratory Medicine Health Policy Public Health Environmental and Occupational HealthMiddle AgedAsthmaCoughSpirometrySample SizeChronic DiseasePublic HealthChronic obstructive lung diseases; Diagnosis; Expert systems; Age Factors; Aged; Asthma; Chronic Disease; Cough; Humans; Middle Aged; Pilot Projects; Pulmonary Disease Chronic Obstructive; Sample Size; Spirometry; Expert Systems; Software Design; Surveys and QuestionnairesDiagnosiHuman
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Randomized Controlled Trials and real life studies. Approaches and methodologies: a clinical point of view.

2014

Randomized Controlled Trials (RCTs) are the "gold standard" for evaluating treatment outcomes providing information on treatments "efficacy". They are designed to test a therapeutic hypothesis under optimal setting in the absence of confounding factors. For this reason they have high internal validity. The strict and controlled conditions in which they are conducted, leads to low generalizability because they are performed in conditions very different from real life usual care. Conversely, real life studies inform on the "effectiveness" of a treatment, that is, the measure of the extent to which an intervention does what is intended to do in routine circumstances. At variance to RCTs, real …

Pulmonary and Respiratory MedicineChronic Obstructivemedicine.medical_specialtyAsthma; COPD; Randomized controlled trials; Real life studies; Asthma; Confounding Factors (Epidemiology); Humans; Pulmonary Disease Chronic Obstructive; Randomized Controlled Trials as Topic; Research Design; Pulmonary and Respiratory Medicine; Biochemistry (medical); Pharmacology (medical)Alternative medicineSettore MED/10 - Malattie Dell'Apparato Respiratoriolaw.inventionPulmonary DiseasePulmonary Disease Chronic ObstructiveRandomized controlled triallawIntervention (counseling)medicineCOPDHumansPharmacology (medical)Generalizability theoryMedical physicsInternal validityReal life studiesRandomized Controlled Trials as Topicbusiness.industryBiochemistry (medical)Gold standardConfounding Factors EpidemiologicVariance (accounting)Confounding Factors (Epidemiology)AsthmaReal life studieRandomized controlled trials; Real life studies; Asthma; COPDRandomized controlled trialResearch DesignRandomized controlled trialsPhysical therapybusinessStrengths and weaknesses
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Maternal complications and procedures in pregnancy and at birth and wheezing phenotypes in children

2006

There is increasing interest in the potential influence of fetal and early life conditions on childhood wheezing.To investigate the associations between maternal complications and procedures in pregnancy and at birth and the risk of various wheezing phenotypes in young children.We studied 15,609 children, aged 6-7 yr, enrolled in a population-based study. Standardized questionnaires were completed by the children's mothers.Of the children, 9.5% (1,478) had transient early wheezing, 5.4% (884) had persistent wheezing, and 6.1% (948) had late-onset wheezing. Maternal hypertension or preeclampsia was associated with an increased risk of all three wheezing phenotypes (for transient early wheezi…

Pulmonary and Respiratory MedicinePediatricsmedicine.medical_specialtyPopulationPerinatalCritical Care and Intensive Care Medicineasthma; perinatal; programmingPregnancyRisk FactorsIntensive careAsthma; Perinatal; Programming; Child; Female; Humans; Pregnancy; Respiratory Sounds; Risk Factors; Pregnancy Complications; Medicine (all); Pulmonary and Respiratory Medicine; Critical Care and Intensive Care MedicineMaternal hypertensionMedicineHumansRespiratory Sounds; Pregnancy Complications; Risk Factors; Humans; Child; Female; PregnancyRespiratory soundseducationChildAsthmaRespiratory SoundsPregnancyeducation.field_of_studymedicine.diagnostic_testbusiness.industryRisk FactorMedicine (all)Odds ratiomedicine.diseasePregnancy ComplicationAsthmaPregnancy ComplicationsProgrammingGestationFemaleRespiratory SoundbusinessHuman
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Acute respiratory distress syndrome in traumatic brain injury: how do we manage it?

2017

Abstract: Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice. In this review, we will explore the strategies of the best …

Pulmonary and Respiratory Medicinemedicine.medical_specialtyARDSTraumatic brain injurymedicine.medical_treatmentReview ArticleLung injury03 medical and health sciencesAcute respiratory distress syndrome (ARDS); Extra corporeal membrane oxygenation (ECMO); Positive end expiratory pressure (PEEP); Traumatic brain injury (TBI); Pulmonary and Respiratory Medicine0302 clinical medicineTraumatic brain injury (TBI); acute respiratory distress syndrome (ARDS); extra corporeal membrane oxygenation (ECMO); positive end expiratory pressure (PEEP)medicineExtracorporeal membrane oxygenationTraumatic brain injury (TBI)Intensive care medicinePositive end-expiratory pressureMechanical ventilationpositive end expiratory pressure (PEEP)Lungbusiness.industryextra corporeal membrane oxygenation (ECMO)acute respiratory distress syndrome (ARDS)030208 emergency & critical care medicinemedicine.diseaseProne positionmedicine.anatomical_structurebusiness030217 neurology & neurosurgeryJournal of thoracic disease
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Comparative bench study evaluation of different infant interfaces for non-invasive ventilation

2018

Abstract Background To compare, in terms of patient-ventilator interaction and performance, a new nasal mask (Respireo, AirLiquide, FR) with the Endotracheal tube (ET) and a commonly used nasal mask (FPM, Fisher and Paykel, NZ) for delivering Pressure Support Ventilation (PSV) in an infant model of Acute Respiratory Failure (ARF). Methods An active test lung (ASL 5000) connected to an infant mannequin through 3 different interfaces (Respireo, ET and FPM), was ventilated with a standard ICU ventilator set in PSV. The test lung was set to simulate a 5.5 kg infant with ARF, breathing at 50 and 60 breaths/min). Non-invasive ventilation (NIV) mode was not used and the leaks were nearly zero. Res…

Pulmonary and Respiratory Medicinemedicine.medical_specialtyAcute respiratory failure; Bench test; Infant mask; Mechanical ventilation; Non invasive ventilation; Patient-ventilator interactionRespiratory ratemedicine.medical_treatmentPressure support ventilationAcute respiratory failureManikinsBench test03 medical and health sciences0302 clinical medicineMechanical ventilationRespiratory Rate030225 pediatricsInternal medicineSettore MED/41 - ANESTESIOLOGIAIntubation IntratrachealTidal VolumeMedicineNon-invasive ventilationHumansTidal volumePatient-ventilator interactionMonitoring PhysiologicWork of BreathingMechanical ventilationlcsh:RC705-779LungNoninvasive Ventilationbusiness.industryMasksInfantNon invasive ventilationlcsh:Diseases of the respiratory systemAcute respiratory failure; Bench test; Infant mask; Mechanical ventilation; Non invasive ventilation; Patient-ventilator interaction; Pulmonary and Respiratory Medicinemedicine.anatomical_structure030228 respiratory systemVolume (thermodynamics)ItalyAcute DiseaseBreathingCardiologyInfant maskbusinessRespiratory InsufficiencyResearch ArticleBMC Pulmonary Medicine
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Which factors affect the choice of the inhaler in chronic obstructive respiratory diseases?

2015

Inhalation is the preferred route of drug administration in chronic respiratory diseases because it optimises delivery of the active compounds to the targeted site and minimises side effects from systemic distribution. The choice of a device should be made after careful evaluation of the patient's clinical condition (degree of airway obstruction, comorbidities), as well as their ability to coordinate the inhalation manoeuvre and to generate sufficient inspiratory flow. These patient factors must be aligned with the specific advantages and limitations of each inhaler when making this important choice. Finally, adherence to treatment is not the responsibility of the patient alone, but should …

Pulmonary and Respiratory Medicinemedicine.medical_specialtyChronic ObstructiveSocio-culturaleSettore MED/10 - Malattie Dell'Apparato RespiratorioAffect (psychology)Anti-asthmatic AgentMedication AdherencePulmonary DiseasePulmonary Disease Chronic ObstructiveSuspensionsAdministration InhalationmedicineCOPDHumansPharmacology (medical)Anti-Asthmatic AgentsMetered Dose InhalersRespiratory systemParticle SizeIntensive care medicineAsthmaAdherence; Asthma; COPD; Inhaler; Administration Inhalation; Anti-Asthmatic Agents; Dry Powder Inhalers; Humans; Medication Adherence; Metered Dose Inhalers; Particle Size; Pulmonary Disease Chronic Obstructive; Solutions; Suspensions; Nebulizers and Vaporizers; Pulmonary and Respiratory Medicine; Pharmacology (medical); Biochemistry (medical); Medicine (all)COPDInhalationbusiness.industryMedicine (all)InhalerNebulizers and VaporizersBiochemistry (medical)Adherence; Asthma; COPD; Inhaler; Administration Inhalation; Anti-Asthmatic Agents; Dry Powder Inhalers; Humans; Medication Adherence; Metered Dose Inhalers; Particle Size; Pulmonary Disease Chronic Obstructive; Solutions; Suspensions; Nebulizers and Vaporizers; Pulmonary and Respiratory Medicine; Biochemistry (medical); Pharmacology (medical)InhalerDry Powder InhalersAirway obstructionmedicine.diseaseAsthmaSolutionsInhalationAdherenceAdministrationAdherence; Asthma; COPD; InhalerbusinessPulmonary pharmacologytherapeutics
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Contemporary spinal cord protection during thoracic and thoracoabdominal aortic surgery and endovascular aortic repair: a position paper of the vascu…

2015

Ischaemic spinal cord injury (SCI) remains the Achilles heel of open and endovascular descending thoracic and thoracoabdominal repair. Neurological outcomes have improved coincidentially with the introduction of neuroprotective measures. However, SCI (paraplegia and paraparesis) remains the most devastating complication. The aim of this position paper is to provide physicians with broad information regarding spinal cord blood supply, to share strategies for shortening intraprocedural spinal cord ischaemia and to increase spinal cord tolerance to transitory ischaemia through detection of ischaemia and augmentation of spinal cord blood perfusion. This study is meant to support physicians cari…

Pulmonary and Respiratory Medicinemedicine.medical_specialtyHeelIntraoperative Neurophysiological MonitoringIschemiaThoracic Surgical ProcedureAorta Thoracic610 Medicine & healthSpinal cord injuryThoracic aorta142-005 142-0052705 Cardiology and Cardiovascular Medicinemedicine.arterymedicineThoracic aortaHumansAorta Abdominal610 Medicine & healthSpinal cord injuryEndovascular ProcedureAortic Aneurysm ThoracicTEVARbusiness.industrySpinal Cord IschemiaEndovascular ProceduresThoracoabdominal aortaGeneral MedicineThoracic Surgical Proceduresmedicine.diseaseSpinal cordSurgery2746 SurgeryEuropemedicine.anatomical_structureSpinal CordCardiothoracic surgery2740 Pulmonary and Respiratory MedicineAnesthesiaPractice Guidelines as TopicSurgeryParaplegiaComplicationbusinessCardiology and Cardiovascular MedicineHuman
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Impact of long-term treatment with inhaled corticosteroids and bronchodilators on lung function in a patient with post-infectious bronchiolitis oblit…

2016

Post-infectious bronchiolitis obliterans (PIBO) is a small airways disease characterized by fixed airflow limitation. Therefore, inhaled bronchodilators and corticosteroids are not recommended as maintenance therapy options. The management of PIBO currently consists only of close monitoring of affected patients, aimed at the prevention and early treatment of pulmonary infections. In recent years, there has been an increase in the incidence of PIBO in the pediatric population. Patients with PIBO are characterized by a progressive decline in lung function, accompanied by a decrease in overall functional capacity. Here, we report the case of a relatively young man diagnosed with PIBO and follo…

Pulmonary and Respiratory Medicinemedicine.medical_specialtyLong term treatmentmedicine.drug_classmedicine.medical_treatmentBronchiolitis obliteransInhaled corticosteroidsAnti-inflammatory agents/ therapeutic useCase ReportMuscarinic antagonists/therapeutic use03 medical and health sciences0302 clinical medicineAnti-inflammatory agents/therapeutic useBronchodilatormedicinePulmonary rehabilitation030212 general & internal medicineBronchiolitis obliterans/therapyLung functionGynecologylcsh:RC705-779Administration inhalationinhalationbusiness.industrylcsh:Diseases of the respiratory systemmedicine.diseaseAdministration inhalation; Adrenergic beta-2 receptor antagonists/therapeutic use; Anti-inflammatory agents/ therapeutic use; Bronchiolitis obliterans/therapy; Infection/complications; Lung diseases/rehabilitation; Muscarinic antagonists/therapeutic use; Pulmonary and Respiratory MedicineLung diseases/rehabilitation030228 respiratory systemPhysical performanceInfection/complicationAnesthesiaInfection/complicationsAdministrationbusinessAdrenergic beta-2 receptor antagonists/therapeutic usePediatric populationJornal Brasileiro de Pneumologia
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A single-institution retrospective analysis of metachronous and synchronous metastatic bronchial neuroendocrine tumors

2018

Background: Broncho-pulmonary neuroendocrine tumors (bpNETs) are rare malignancies and there is no consensus on therapeutical management of metastatic disease and follow-up after radical resection. Methods: Clinical records of patients with a cytological or histological diagnosis of bpNETs and distant metastases (metachronous or synchronous), evaluated at the European Institute of Oncology between 1997 and 2014, were retrospectively analyzed. Data on patient demographics, pathology, imaging exams, surgical and non-surgical treatments were collected. P value descriptive data, uni- and multi-variate survival analysis were generated for all variables. Results: With a median follow-up of 53 [9–…

Pulmonary and Respiratory Medicinemedicine.medical_specialtyMultivariate analysisSettore MED/06 - Oncologia MedicaPopulationDisease030204 cardiovascular system & hematologyNeuroendocrine tumorsCarcinoid tumor; Neoplasm metastasis; Neuroendocrine tumors (NETs); Recurrence; Pulmonary and Respiratory Medicine03 medical and health sciences0302 clinical medicineRecurrencemedicineeducationLymph nodeSurvival analysisNeoplasm metastasieducation.field_of_studyLungbusiness.industryCarcinoid tumormedicine.diseaseClinical trialmedicine.anatomical_structure030220 oncology & carcinogenesisOriginal ArticleNeuroendocrine tumors (NETs)Radiologybusiness
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