Search results for "Pulmonary and Respiratory Medicine"

Protocol for the EARCO Registry

2020

Rationale and objectives Alpha-1 antitrypsin deficiency (AATD) is a genetic condition that leads to an increased risk of emphysema and liver disease. Despite extensive investigation, there remain unanswered questions concerning the natural history, pathophysiology, genetics and the prognosis of the lung disease in association with AATD. The European Alpha-1 Clinical Research Collaboration (EARCO) is designed to bring together researchers from European countries and to create a standardised database for the follow-up of patients with AATD. Study design and population The EARCO Registry is a non-interventional, multicentre, pan-European, longitudinal observational cohort study enrolling patie…

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 …

Severe eosinophilic asthma: a roadmap to consensus

2017

Asthma is widely accepted as a complex heterogeneous condition with diverse pathophysiological mechanisms, clinical presentations, comorbidities, physiological characteristics, pathology and outcomes that is typically best managed by a multidisciplinary team [1–4]. Severe asthma is recognised as a major unmet need with a high personal and social impact, as well as a high burden on healthcare resources [4]. As a consequence of advances in the development of precision medicines for patients with severe asthma, the need to identify asthma subtypes by phenotype based on clinical, functional or inflammatory parameters is becoming a mandatory part of management [4–6]. Severe eosinophilic asthma (…

ISHLT consensus document on lung transplantation in patients with connective tissue disease: Part I: Epidemiology, assessment of extrapulmonary condi…

2021

Patients with connective tissue disease (CTD) and advanced lung disease are often considered suboptimal candidates for lung transplantation (LTx) due to their underlying medical complexity and potential surgical risk. There is substantial variability across LTx centers regarding the evaluation and listing of these patients. The International Society for Heart and Lung Transplantation-supported consensus document on lung transplantation in patients with CTD standardization aims to clarify definitions of each disease state included under the term CTD, to describe the extrapulmonary manifestations of each disease requiring consideration before transplantation, and to outline the absolute contr…

Prognostic Value of Troponins in Patients With or Without Coronary Heart Disease: Is it Dependent on Structure and Biology?

2020

Convincing evidence has emerged that cardiac troponins (cTns) T and I are the biochemical gold standard for diagnosing cardiac injury, and may also be used as efficient screening and risk stratification tools, especially when measured with the new high-sensitivity (hs-) immunoassays. In this narrative review, we aim to explore and critically discuss the results of recent epidemiological studies that have attempted to characterise the prognostic value of cTns in patients with or without cardiovascular disease, and then interpret this information according to cTn biology. Overall, all recent studies agree that higher blood levels of cTns reflect the larger risk of cardiovascular events and/or…

A review of venous thromboembolism in COVID‐19: A clinical perspective

2021

Abstract Coronavirus disease‐19 (COVID‐19) started in Wuhan, China in December 2019 and spread to all around the world in a short period of time. Hospitalized patients with COVID‐19 mostly could suffer from an abnormal coagulation activation risk with increased venous thrombosis events and a poor clinical course. The reported incidence rates of thrombotic complications in hospitalized COVID‐19 patients vary between 2.6 and 85% (both in non‐critically ill and critically ill patients). The risk of venous thromboembolism is not known in non‐hospitalized patients with COVID‐19. There are numerous studies and guidelines for administration of thromboprophylaxis for COVID‐19 cases. All hospitalize…

Respuesta a “Fumador, exfumador y COVID-19”

2021

Acute and sustained increase in endothelial biomarkers in COVID-19.

2020

Endothelial injury is related to poor outcomes in respiratory infections yet little is known in relation to COVID-19. Performing a longitudinal analysis (on emergency department admission and post-hospitalisation follow-up), we evaluated endothelial damage via surrogate systemic endothelial biomarkers, that is, proadrenomedullin (proADM) and proendothelin, in patients with COVID-19. Higher proADM and/or proendothelin levels at baseline were associated with the most severe episodes and intensive care unit admission when compared with ward-admitted individuals and outpatients. Elevated levels of proADM or proendothelin at day 1 were associated with in-hospital mortality. High levels maintaine…

Assessment of the worldwide burden of critical illness: The Intensive Care Over Nations (ICON) audit

2014

Item does not contain fulltext BACKGROUND: Global epidemiological data regarding outcomes for patients in intensive care units (ICUs) are scarce, but are important in understanding the worldwide burden of critical illness. We, therefore, did an international audit of ICU patients worldwide and assessed variations between hospitals and countries in terms of ICU mortality. METHODS: 730 participating centres in 84 countries prospectively collected data on all adult (>16 years) patients admitted to their ICU between May 8 and May 18, 2012, except those admitted for fewer than 24 h for routine postoperative monitoring. Participation was voluntary. Data were collected daily for a maximum of 28 da…

The optimal imaging test for diagnosis of acute pulmonary embolism: a second chance for lung scintigraphy?

2020

Ventilation–perfusion scintigraphy may continue to be the first-line diagnostic method for pulmonary embolism in institutions that can ensure its uninterrupted availability and the expertise in its interpretationhttps://bit.ly/2y3Dlhx