Search results for "respiratory tract"

Fractional exhaled nitric oxide is associated with more severe asthma

2018

Fractional exhaled nitric oxide (FeNO) levels are used as a marker of airway inflammation. The aim of the present work was to evaluate a possible relationship between FeNO and parameters of asthma control and severity in different asthma phenotypes. FeNO was evaluated in 200 asthma patients (37% male, mean age ± SD 54±15 years, 19% controlled (GINA), 30% treated with oral corticosteroids (OCS), median FEV1 (interquartile range) 2,05 L (1,49-2,70), 74% pred. (56-90%)), together with other asthma characteristics (lung function, asthma control, allergies, serum IgE, serum ECP, and blood eosinophils). Patients with poorly controlled asthma had significantly higher FeNO values (ACQ-5≥1.5 vs. 70%…

Patients with allergic and eosinophilic asthma in the German severe asthma registry

2015

Targeted treatment strategies for asthma require a precise diagnosis of phenotypes. 308 adult patients (age mean±SD: 50.3±13.5yrs) with severe asthma from the German Severe Asthma Registry (www.german-asthma-net.de) were evaluated based on history of allergy symptoms, results of skin prick tests, total/specific IgE, and blood cell differentials. 121 patients (39%) showed typical signs of allergic asthma including allergic symptoms and a positive skin prick test and/or specific IgE with no elevated blood eosinophils (median total IgE: 222 (range 4-4023) IU/ml, eosinophils: 128 (0-295)/µl, FeNO: 23 (7-300) ppb). 53 (43.8%) of these patients were treated with omalizumab. 50 patients (16%) had …

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…

Noninvasive Continuous Positive Airway Pressure Response in Bronchiectasis Exacerbations: Key Practical Aspects and Topics

2016

Bronchiectasis is a progressive lung disease characterized by gradual airflow obstruction secondary to mucus plugging, excessive airway inflammation, and parenchymal destruction. Continuous positive airway pressure (CPAP) has been shown to promote recruitment of the flooded alveoli, decrease the ventilation-perfusion mismatch, and relieve dyspnea in patients with bronchiectasis exacerbations. It has also been proven to improve respiratory mechanics and reduce the work of breathing. It can be also successfully adopted in promoting mucus clearance and preventing desaturation during chest physiotherapy and exercise. However, validated criteria for starting CPAP treatment in bronchiectasis are …

<p>Bacterial load and inflammatory response in sputum of alpha-1 antitrypsin deficiency patients with COPD</p>

2019

Background Airway inflammation may drive the progression of chronic obstructive pulmonary disease (COPD) associated with alpha-1 antitrypsin deficiency (AATD), but the relationship between airway microbiota and inflammation has not been investigated. Methods We studied 21 non-treated AATD (AATD-noT) patients, 20 AATD-COPD patients under augmentation therapy (AATD-AT), 20 cigarette smoke-associated COPD patients, 20 control healthy smokers (CS) and 21 non-smokers (CON) with normal lung function. We quantified sputum inflammatory cells and inflammatory markers (IL-27, CCL3, CCL5, CXCL8, LTB4, MPO) by ELISA, total bacterial load (16S) and pathogenic bacteria by qRT-PCR. Results AATD-AT patient…

<p>Day and Night Control of COPD and Role of Pharmacotherapy: A Review</p>

2020

The topic of 24-hour management of COPD is related to day-to-night symptoms management, specific follow-up and patients' adherence to therapy. COPD symptoms strongly vary during day and night, being worse in the night and early morning. This variability is not always adequately considered in the trials. Night-time symptoms are predictive of higher mortality and more frequent exacerbations; therefore, they should be a target of therapy. During night-time, in COPD patients the supine position is responsible for a different thoracic physiology; moreover, during some sleep phases the vagal stimulation determines increased bronchial secretions, increased blood flow in the bronchial circulation (…

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…

2017

T1 maps have been shown to yield useful diagnostic information on lung function in patients with chronic obstructive pulmonary disease (COPD) and asthma, both for native T1 and ΔT1, the relative reduction while breathing pure oxygen. As parameter quantification is particularly interesting for longitudinal studies, the purpose of this work was both to examine the reproducibility of lung T1 mapping and to compare T1 found in COPD and asthma patients using IRSnapShotFLASH embedded in a full MRI protocol. 12 asthma and 12 COPD patients (site 1) and further 15 COPD patients (site 2) were examined on two consecutive days. In each patient, T1 maps were acquired in 8 single breath-hold slices, brea…

Relationship between sleep disturbances and peripheral airway abnormalities in COPD patients

2017

Background: Individuals with COPD experience sleep disturbances due to the impact of symptoms on quality of sleep. Aim: To test the hypothesis that, in COPD, sleep disturbances are linked to peripheral airway abnormalities. Methods: An investigational study is being performed at the University of Palermo, Italy. The impact of breathing problems on quality of sleep during the previous week is measured with the COPD and Asthma Sleep Impact Scale (CASIS) questionnaire. Airway resistances by impulse oscillometry (IOS) assesses peripheral airway abnormalities. Lung function evaluation includes static and dynamic lung volume measurements. To rule out the risk of having obstructive sleep apnea, th…

OSACO: an observational study in asthma-COPD overlap syndrome (ACOS)

2017

Background: ACOS describes the co-occurrence of asthma and COPD, although its prevalence and clinical features remain poorly characterized. Aims: To better understand the prevalence and characteristics of ACOS. Methods: An observational study is being performed in subjects with bronchial obstruction at 3 Italian centers. In the first phase, consecutive patients ≥40 years with documented bronchial obstruction are being recruited; eligible patients will enter the second phase, consisting of imaging, functional and clinical evaluation with the MRC dyspnea scale, St. George9s respiratory questionnaire index, Charlson index, and skin prick test. Main inclusion criteria for the evaluation phase a…