Search results for "Obstructive"
showing 10 items of 609 documents
Bronchial microbiome, PA biofilm-forming capacity and exacerbation in severe COPD patients colonized by P. aeruginosa
2017
Aim: The bronchial microbiome of severe chronic obstructive pulmonary disease patients colonized by Pseudomonas aeruginosa was analyzed using 16S rRNA gene sequencing to identify differences related to biofilm-forming capacity. Patients & methods: Patient sputum samples from 21 patients were studied. Results: Statistically significant differences related to biofilm-forming capacity were only found for genera with relative abundances <1%, and Fusobacterium was over-represented when biofilm-forming capacity was high. Genera with relative abundances >50% which increased from baseline were observed in 10/14 exacerbations, but corresponded to Pseudomonas only in three episodes, while …
Bronchial microbiome of severe COPD patients colonised by Pseudomonas aeruginosa
2014
The bronchial microbiome in severe COPD during stability and exacerbation in patients chronically colonised by Pseudomonas aeruginosa (PA), has not been defined. Our objective was to determine the characteristics of the bronchial microbiome of severe COPD patients colonised and not colonised by P. aeruginosa and its changes during exacerbation. COPD patients with severe disease and frequent exacerbations were categorised according to chronic colonisation by P. aeruginosa. Sputum samples were obtained in stability and exacerbation, cultured, and analysed by 16S rRNA gene amplification and pyrosequencing. Sixteen patients were included, 5 of them showing chronic colonisation by P. aeruginosa.…
Analysis of microbiota in stable patients with chronic obstructive pulmonary disease
2014
To identify the bacterial diversity (microbiota) in expectorated sputum, a pyrosequencing method that investigates complex microbial communities of expectorated sputum was done in 19 stable chronic obstructive pulmonary disease patients (mean (SD) FEV1: 47 (18%) of predicted value). Using conventional culture, 3 phyla and 20 bacterial genera were identified, whereas the pyrosequencing approach detected 9 phyla and 43 genera (p < 0.001). In sputum the prevalent genera with pyrosequencing approach were Streptococcus, Actinomyces, Neisseria, Haemophilus, Rothia, Fusobacterium, Gemella, Granulicatella, Porphyromonas, Prevotella and Veillonella. Enterobacteriaceae, detected frequently in convent…
Change in weight and central obesity by positive airway pressure treatment in obstructive sleep apnea patients: longitudinal data from the ESADA coho…
2018
The effect of positive airway pressure treatment on weight and markers of central obesity in patients with obstructive sleep apnea remains unclear. We studied the change in body weight and anthropometric measures following positive airway pressure treatment in a large clinical cohort. Patients with obstructive sleep apnea with positive airway pressure treatment from the European Sleep Apnea Database registry (n = 1, 415, 77% male, age 54 ± 11 [mean ± SD] years, body mass index 31.7 ± 6.4 kg/m2, apnea–hypopnea index 37 ± 24 n per hr, Epworth Sleepiness Scale 10.2 ± 5.0) were selected. Changes in body mass index and neck/waist/hip circumferences at baseline and at follow-up visit were analyse…
OSA and cancer in Europe: the European Sleep Apnea Database (ESADA) experience
2017
Background: Experimental and clinical studies suggest a relationship between Obstructive Sleep Apnea (OSA) and cancer development or progression Objectives: To explore the association between the severity of OSA and prevalence of cancer among patients reported to the European Sleep Apnea Database (ESADA) after control of several known risk factors for cancer development Methods: A prospective multicentre cohort study of adult patients with OSA (Apnea/Hypopnea Index, AHI≥5). OSA severity was classified according to AHI, Oxygen Desaturation Index (ODI) and % night-time spent with oxygen saturation Results: Of 19,556 participants, 357 (1.8%, 59.4% male) had been diagnosed with malignancy. Pati…
Change in weight and central obesity by positive airway pressure treatment in obstructive sleep apnea patients: Longitudinal data from the European S…
2017
Introduction: The effect of continuous positive airway pressure (CPAP) treatment on body weight and central obesity in obstructive sleep apnea (OSA) patients is still unclear. Objectives: We aimed to study body composition change during CPAP treatment in the European Sleep Apnea Database (ESADA). Methods: OSA patients with a CPAP treatment follow-up time of more than 30 days in the ESADA registry were selected (n=2015). Body mass index (BMI), body weight, waist-, hip- and neck-circumferences were assessed at baseline and follow-up (median [interquartile range], 242 [380] days). Predictors for body composition changes with CPAP were analyzed adjusting for confounders. Results: Overall, there…
Emergence of Aspergillus fumigatus azole resistance in azole-naïve patients with chronic obstructive pulmonary disease and their homes.
2017
Azole-resistant Aspergillus fumigatus (ARAF) has been reported in patients with chronic obstructive pulmonary disease (COPD) but has not been specifically assessed so far. Here, we evaluated ARAF prevalence in azole-naïve COPD patients and their homes, and assessed whether CYP51A mutations were similar in clinical and environmental reservoirs. Sixty respiratory samples from 41 COPD patients with acute exacerbation and environmental samples from 36 of these patient's homes were prospectively collected. A. fumigatus was detected in respiratory samples from 11 of 41 patients (27%) and in 15 of 36 domiciles (42%). Cyp51A sequencing and selection on itraconazole medium of clinical (n = 68) and e…
Inhalation therapy devices for the treatment of obstructive lung diseases: the history of inhalers towards the ideal inhaler.
2020
Inhalation therapy allows conveying drugs directly into the airways. The devices used to administer inhaled drugs play a crucial role in the management of obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). To ensure high bronchial deposition of the drug, a device should deliver a high proportion of fine particles, be easy to use, and provide constant and accurate doses of the active substance. Nowadays, four different types of inhalers are widely used: nebulizers, dry powder inhalers (DPIs), pressurized metered-dose inhalers (pMDIs), and soft mist inhalers (SMIs). Nebulizers can be used by patients unable to use other inhalers. However, they require l…
Consenso Delphi sobre el diagnóstico y manejo de la dislipidemia en pacientes con enfermedad renal crónica: análisis post-hoc del estudio DIANA
2016
Resumen Antecedentes y objetivos: Este estudio post hoc analizó la percepción de la importancia de la enfermedad renal crónica (ERC) en el cribado de la dislipidemia y en la elección del tratamiento con estatinas entre médicos de Atención Primaria (MAP) y otras especialidades mediante cuestionario Delphi. Métodos: El cuestionario incluyó 4 bloques de preguntas alrededor del paciente dislipémico con alteración del metabolismo hidrocarbonado. Aquí se presentan los resultados relacionados con la consideración de la ERC en el cribado y la elección de la estatina. Resultados: De los 497 expertos incluidos, el 58% eran MAP y el 42%, especialistas (35, el 7%, nefrólogos). Hubo consenso en realizar…
An uncommon complication of liver biopsy: obstructive jaundice from blood clots
2005
Introduction: The AA. report on a case of one young woman who developed obstructive jaundice induced by hemo- bilia after percutaneous liver biopsy, successfully treated with endoscopic retrograde cholangiopancreatography (ERCP) Methods: An endoscopic sphincterotomy was performed with extraction of the clots Observations: Four weeks after ERCP the patient was healthy and asymptomatic, valuated as outpatient Conclusions: The role of ERCP in managing biliary sequelae of hemobilia is well established: biliary decompression is required if and intrabiliary lot causes obstructive jaundice and/or biliary colic. ERCP is feasible and leads to relief of symptoms in most cases, without the need of sur…