Search results for "apparato respiratorio"

Severe asthma at COVID-19 time: what is new on biologic therapies.

2021

Nutritional Status in Aging and Lung Disease

2016

Abstract Lung diseases exert a negative impact on nutritional status, especially among older patients where aging per se is already associated with relevant changes in nutrient intake, metabolism, and body composition. Both respiratory (increased respiratory work, hypoxia, and local oxidative stress and inflammation) and nonrespiratory (sarcopenia, reduced mitochondrial biogenesis and anabolic hormones, balance of orexigenic/anorexigenic neuropeptides, and systemic inflammation and oxidative stress) contribute to the association between lung diseases and malnutrition. For these reasons, nutritional assessments are of paramount importance in older patients with lung diseases. Current evidenc…

The geriatric asthma: pitfalls and challenges

2016

Historically, asthma has been envisioned as a disease of younger ages. This has led to the assumption that respiratory symptoms suggestive of asthma occurring in older ages are to be attributed to conditions other than asthma, mainly COPD. Old observational reports and new epidemiological studies confirm that asthma is as frequent in older as it is in younger populations. Nevertheless, under-recognition, misdiagnosis and under-treatment are still relevant issues. The characterization of asthma in the aged suffers from the fact that there has been very little original research in this field. Indeed, geriatric asthma is often excluded from clinical trials because of age and comorbidities. The…

Blood-pressure variability in patients with obstructive sleep apnea: current perspectives

2018

Obstructive sleep apnea (OSA) is often associated with hypertension and other cardiovascular diseases. Blood pressure (BP) variability is part of the assessment of cardiovascular risk. In OSA, BP variability has been studied mainly as very short-term (beat-by-beat) and short-term (24-hour BP profile) variability. BP measured on consecutive heartbeats has been demonstrated to be highly variable, due to repeated peaks during sleep, so that an accurate assessment of nocturnal BP levels in OSA may require peculiar methodologies. In 24-hour recordings, BP frequently features a "nondipping" profile, ie, <10% fall from day to night, which may increase cardiovascular risk and occurrence of major…

Patógenos atípicos en pacientes hospitalizados con neumonía adquirida en la comunidad: una perspectiva mundial

2018

Abstract Background Empirical antibiotic coverage for atypical pathogens in community-acquired pneumonia (CAP) has long been debated, mainly because of a lack of epidemiological data. We aimed to assess both testing for atypical pathogens and their prevalence in hospitalized patients with CAP worldwide, especially in relation with disease severity. Methods A secondary analysis of the GLIMP database, an international, multicentre, point-prevalence study of adult patients admitted for CAP in 222 hospitals across 6 continents in 2015, was performed. The study evaluated frequency of testing for atypical pathogens, including L. pneumophila, M. pneumoniae, C. pneumoniae, and their prevalence. Ris…

Functional imaging of airway distensibility

2014

The physiological function of the respiratory system is essential in distending airway smooth muscle and maintaining airway patency. Deep inspirations can reverse contracted airways and protect airways from subsequent bronchospastic stimuli. Obstructive lung diseases may lead to impairment of the beneficial effects of lung inflation through either change in the airway wall or lung parenchyma. Conventional pulmonary function measurements are unable to assess airway stiffness, based on changes in airway size with lung inflation (distensibility). However, high-resolution computed tomography (HRCT) is unique in that it can be used to measure airway distensibility in animals and in humans. Funct…

Fluticasone propionate/formoterol: a fixed-combination therapy with flexible dosage.

2014

International guidelines describe asthma control as the main outcome of asthma management. Prevention of symptoms, improved quality of life, and reduction of exacerbations are the main components, consequently decreasing health care costs. However, many of these objectives remain unmet in real life: several surveys show that a large proportion of asthmatic patients are not well controlled despite the efficacy of current available treatment. Several randomized controlled clinical trials indicate that combining inhaled corticosteroids and long-acting β2-agonists, by means of a single inhaler, greatly improves the management of the disease. The results of 9 multicenter phase III clinical studi…

Pharmacological Management of Elderly Patients with Asthma–Chronic Obstructive Pulmonary Disease Overlap Syndrome: Room for Speculation?

2016

Asthma and chronic obstructive pulmonary disease (COPD) are two distinct diseases that share a condition of chronic inflammation of the airways and bronchial obstruction. In clinical settings, it is not rare to come across patients who present with clinical and functional features of both diseases, posing a diagnostic dilemma. The overlap condition has been termed asthma–COPD overlap syndrome (ACOS), and mainly occurs in individuals with long-standing asthma, especially if they are also current or former smokers. Patients with ACOS have poorer health-related quality of life and a higher exacerbation rate than subjects with asthma or COPD alone. Whether ACOS is a distinct nosological entity …

Effectiveness of benralizumab in severe eosinophilic asthma: Distinct sub-phenotypes of response identified by cluster analysis

2022

Background: Benralizumab is effective in severe eosinophilic asthma (SEA), but suboptimal responses are observed in some patients. Although several factors have been associated with benralizumab response, no cluster analysis has yet been undertaken to identify different responsiveness sub-phenotypes. Objective: To identify SEA sub-phenotypes with differential responsiveness to benralizumab. Methods: One hundred and five patients diagnosed with SEA who had completed 6 months of benralizumab treatment were included in a hierarchical cluster analysis based on a set of clinical variables that can be easily collected in routine practice (age, age at disease onset, disease length, allergen sensit…

Comparison between statistical and fuzzy approaches for improving diagnostic decision making in patients with chronic nasal symptoms

2014

This paper compares a fuzzy model, expressed in rule-form, with a well known statistical approach (i.e. logistic regression model) for diagnostic decision making in patients with chronic nasal symptoms. The analyses were carried out using a database obtained from a questionnaire administered to 1359 patients with nasal symptoms containing personal data, clinical data and skin prick test (SPT) results. Both the fuzzy model and the logistic regression model developed were validated using a data set obtained from another medical institution. The accuracy of the two models in identifying patients with positive or negative SPT was similar. This study is a preliminary step to the creation of a so…