Search results for "228"
showing 10 items of 834 documents
Recurrent On-Duty Sleepiness and Alertness Management Strategies in Long-Haul Airline Pilots
2018
Introduction We examined whether long-haul airline pilots without recurrent on-duty sleepiness obtain more prior sleep and use more effective in-flight alertness management strategies than their colleagues with recurrent on-duty sleepiness. Methods There were 51 pilots who flew at least twice from Helsinki to Asia. Of them, 44 flew at least twice back to Helsinki following 1 local night. On-duty sleepiness was measured by the Karolinska Sleepiness Scale (KSS), alertness management strategies by a diary, and sleep by a diary and activity monitor. Pilots who rated KSS ≥ 7 on each, some, or none of the flights were classified as "regularly", "sometimes", and "never" sleepy, respectively. This …
New developments in optimizing bronchodilator treatment of COPD: a focus on glycopyrrolate/formoterol combination formulated by co-suspension deliver…
2018
COPD causes considerable health and economic burden worldwide, with incidence of the disease expected to continue to rise. Inhaled bronchodilators, such as long-acting muscarinic antagonists (LAMAs) and long-acting β2-agonists (LABAs), are central to the maintenance treatment of patients with COPD. Clinical studies have demonstrated that combined LAMA + LABA therapies improve efficacy while retaining a safety profile similar to LAMA or LABA alone. This has led to the development of several LAMA/LABA fixed-dose combination (FDC) therapies, which provide patients with the convenience of two active compounds in a single inhaler. GFF MDI (Bevespi Aerosphere®) is an FDC of glycopyrrolate/formote…
Asthma-COPD overlap syndrome: recent advances in diagnostic criteria and prognostic significance.
2017
The term asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) has been proposed for individuals with features of both asthma and COPD. Several attempts have been done to define ACOS on the basis of medical history, symptoms, and functional findings. The main diagnostic criteria include airflow obstruction with a strong although incomplete reversibility to bronchodilation tests, a significant exposure to cigarette or biomass smoke, and a history of atopy or asthma. Additional diagnostic elements include eosinophilic airway and systemic inflammation, a good response to corticosteroid treatment, and a high concentration of exhaled nitric oxide. ACOS should be distinguish…
Managing Persistent Hypoxemia: what is new?
2017
Mechanical ventilation is the standard life-support technique for patients with severe acute respiratory failure. However, some patients develop persistent and refractory hypoxemia because their lungs are so severely damaged that they are unable to respond to the application of high inspired oxygen concentration and high levels of positive end-expiratory pressure. In this article, we review current knowledge on managing persistent hypoxemia in patients with injured lungs.
Xerostomia in patients with sleep apnea-hypopnea syndrome : a prospective case-control study
2020
Background To describe the characteristics of xerostomia (dry mouth) in the population with sleep apnea-hypopnea syndrome (SAHS) and contrast its prevalence versus that found in healthy subjects, and to compare the frequency of xerostomia in SAHS patients with and without continuous positive airway pressure (CPAP) treatment. Material and methods A prospective comparative study was made between adults recently diagnosed with SAHS in a public hospital (n=60) and healthy individuals (n=54). The presence of xerostomia was assessed on waking up and during the day, using a frequency scale from 0 ("never") to 3 ("always"). Results The prevalence of xerostomia on waking up in the SAHS group was 45%…
Official Statement of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) on Electronic Cigarettes and IQOS®.
2019
The use of novel tobacco products, particularly the electronic cigarette (EC) and partial tobacco combustion devices (HnB systems: Heat not Burn), has increased exponentially, particularly among adolescents and young people. The health authorities and scientific societies have shown concern about issues surrounding safety and effectiveness (as a method of smoking cessation). A study of the available scientific evidence has concluded that the safety of the vapor or fumes inhaled by the users of these devices cannot be guaranteed. Contradictory results from various clinical trials and meta-analyses also mean that these devices cannot be recommended for their effectiveness in cessation, especi…
Inhaled amikacin versus placebo to prevent ventilator-associated pneumonia: the AMIKINHAL double-blind multicentre randomised controlled trial protoc…
2021
IntroductionPre-emptive inhaled antibiotics may be effective to reduce the occurrence of ventilator-associated pneumonia among critically ill patients. Meta-analysis of small sample size trials showed a favourable signal. Inhaled antibiotics are associated with a reduced emergence of antibiotic resistant bacteria. The aim of this trial is to evaluate the benefit of a 3-day course of inhaled antibiotics among patients undergoing invasive mechanical ventilation for more than 3 days on the occurrence of ventilator-associated pneumonia.Methods and analysisAcademic, investigator-initiated, parallel two group arms, double-blind, multicentre superiority randomised controlled trial. Patients invasi…
Intensity of Respiratory Cortical Arousals Is a Distinct Pathophysiologic Feature and Is Associated with Disease Severity in Obstructive Sleep Apnea …
2021
Background: We investigated whether the number, duration and intensity of respiratory arousals (RA) on C3-electroencephalographic (EEG) recordings correlate with polysomnography (PSG)-related disease severity in obstructive sleep apnea (OSA) patients. We also investigated if every patient might have an individual RA microstructure pattern, independent from OSA-severity. Methods: PSG recordings of 20 OSA patients (9 female
One-Year Evolution of Symptoms and Health Status of the COPD Multi-Dimensional Phenotypes: Results from the Follow-Up of the STORICO Observational St…
2021
Raffaele Antonelli Incalzi,1 Francesco Blasi,2,3 Nicola Scichilone,4 Alessandro Zullo,5 Lucia Simoni,5 Giorgio Walter Canonica6 On Behalf of STORICO study group1Internal Medicine and Geriatrics Department Biomedical Campus University of Rome, Rome, Italy; 2Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; 3Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; 4DIBIMIS, University of Palermo, Palermo, Italy; 5Medineos Observational Research, Modena, Italy; 6Personalized Medicine Asthma & Allergy Clinic, Humanitas University, Humanitas &…
Reduced-Dose Intravenous Thrombolysis for Acute Intermediate–High-risk Pulmonary Embolism: Rationale and Design of the Pulmonary Embolism Internation…
2021
Intermediate-high-risk pulmonary embolism (PE) is characterized by right ventricular (RV) dysfunction and elevated circulating cardiac troponin levels despite apparent hemodynamic stability at presentation. In these patients, full-dose systemic thrombolysis reduced the risk of hemodynamic decompensation or death but increased the risk of life-threatening bleeding. Reduced-dose thrombolysis may be capable of improving safety while maintaining reperfusion efficacy. The Pulmonary Embolism International THrOmbolysis (PEITHO)-3 study (ClinicalTrials.gov Identifier: NCT04430569) is a randomized, placebo-controlled, double-blind, multicenter, multinational trial with long-term follow-up. We will c…