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Tuberkuloz Ve Toraks Sep 2019Although parenchymal, pleural and mediastinal lymph node locations of metastatic Lung cancer are frequently seen, they are rarely found endobronchially. Endobronchial... (Review)
Review
Although parenchymal, pleural and mediastinal lymph node locations of metastatic Lung cancer are frequently seen, they are rarely found endobronchially. Endobronchial metastases comprise a portion of central airway obstructions that are diagnosed and treated by interventional pulmonology. Interventional procedures for endobronchial metastases (EBM) can help us reach early diagnosis, or in advanced cases with respiratory symptoms, used palliatively.
Topics: Bronchial Neoplasms; Chest Pain; Cough; Humans; Lung Neoplasms; Lymph Nodes; Mediastinum; Palliative Care
PubMed: 31709954
DOI: 10.5578/tt.68301 -
Treatment of patients with COPD and recurrent exacerbations: the role of infection and inflammation.International Journal of Chronic... 2016Exacerbations of COPD represent an important medical and health care problem. Certain susceptible patients suffer recurrent exacerbations and as a consequence have a... (Review)
Review
Exacerbations of COPD represent an important medical and health care problem. Certain susceptible patients suffer recurrent exacerbations and as a consequence have a poorer prognosis. The effects of bronchial infection, either acute or chronic, and of the inflammation characteristic of the disease itself raise the question of the possible role of antibiotics and anti-inflammatory agents in modulating the course of the disease. However, clinical guidelines base their recommendations on clinical trials that usually exclude more severe patients and patients with more comorbidities, and thus often fail to reflect the reality of clinicians attending more severe patients. In order to discuss aspects of clinical practice of relevance to pulmonologists in the treatment and prevention of recurrent exacerbations in patients with severe COPD, a panel discussion was organized involving expert pulmonologists who devote most of their professional activity to day hospital care. This article summarizes the scientific evidence currently available and the debate generated in relation to the following aspects: bacterial and viral infections, chronic bronchial infection and its treatment with cyclic oral or inhaled antibiotics, inflammatory mechanisms and their treatment, and the role of computerized tomography as a diagnostic tool in patients with severe COPD and frequent exacerbations.
Topics: Bacterial Infections; Clinical Decision-Making; Clinical Trials as Topic; Disease Management; Disease Progression; Humans; Inflammation; Practice Guidelines as Topic; Pulmonary Disease, Chronic Obstructive; Risk Factors; Secondary Prevention; Severity of Illness Index; Symptom Flare Up; Virus Diseases
PubMed: 27042040
DOI: 10.2147/COPD.S98333 -
Journal of Cellular and Molecular... Feb 2021In chronic obstructive pulmonary disease (COPD), the effects of inhaled corticosteroids are predicted by blood eosinophil counts. We previously briefly reported...
In chronic obstructive pulmonary disease (COPD), the effects of inhaled corticosteroids are predicted by blood eosinophil counts. We previously briefly reported increased immunoglobulin (Ig)A and IgM levels in bronchoalveolar lavage (BAL) of COPD patients with higher (eosinophil ) compared to lower (eosinophil ) blood eosinophils (>250/μL versus < 150/μL), suggesting differences in adaptive immune function. An inverse relationship exists between eosinophil counts and airway pathogenic bacteria levels. The mechanistic reasons for these associations between eosinophils, corticosteroids and pathogenic bacteria are unclear. IgA, IgM and IgG levels were assessed in BAL, bronchial biopsies and epithelium collected from eosinophil (n = 20) and eosinophil (n = 21) patients. Bronchial B-cell numbers were measured by immunohistochemistry. B-cell activity was assessed in bronchial samples and following exposure to BAL from eosinophil and eosinophil patients. BAL levels of non-typeable Haemophilus influenza (NTHi)-specific immunoglobulins were quantified. Results showed airway expression of IgA, IgG1 and IgM were lower in eosinophil compared to eosinophil patients, with lower levels of NTHi-specific IgA and IgM. Bronchial B-cell numbers were similar in both groups, but B-cell activity was lower in eosinophil patients. In conclusion, COPD eosinophil patients show differences in adaptive immune function compared to COPD eosinophil patients. These differences may cause different microbiomes in these COPD phenotypes.
Topics: Aged; B-Lymphocytes; Biomarkers; Bronchoalveolar Lavage Fluid; Disease Susceptibility; Eosinophils; Female; Gene Expression; Gene Expression Profiling; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Leukocyte Count; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Respiratory Mucosa; Severity of Illness Index
PubMed: 33369092
DOI: 10.1111/jcmm.16206 -
The Korean Journal of Internal Medicine Jul 2015Many patients with asthma or chronic obstructive pulmonary disease (COPD) have overlapping characteristics of both diseases. By spirometric definition, patients with... (Review)
Review
Many patients with asthma or chronic obstructive pulmonary disease (COPD) have overlapping characteristics of both diseases. By spirometric definition, patients with both fixed airflow obstruction (AO) and bronchodilator reversibility or fixed AO and bronchial hyperresponsiveness can be considered to have asthma-COPD overlap syndrome (ACOS). However, patients regarded to have ACOS by spirometric criteria alone are heterogeneous and can be classified by phenotype. Eosinophilic inflammation, a history of allergic disease, and smoke exposure are important components in the classification of ACOS. Each phenotype has a different underlying pathophysiology, set of characteristics, and prognosis. Medical treatment for ACOS should be tailored according to phenotype. A narrower definition of ACOS that includes both spirometric and clinical criteria is needed.
Topics: Anti-Asthmatic Agents; Asthma; Bronchodilator Agents; Humans; Lung; Phenotype; Predictive Value of Tests; Pulmonary Disease, Chronic Obstructive; Risk Factors; Spirometry; Syndrome; Terminology as Topic; Treatment Outcome
PubMed: 26161009
DOI: 10.3904/kjim.2015.30.4.443 -
Journal of the American Veterinary... Jun 2022To assess the prevalence of bronchial wall thickening (BWT) and collapse in brachycephalic dogs with and without brachycephalic obstructive airway syndrome (BOAS) and in...
OBJECTIVE
To assess the prevalence of bronchial wall thickening (BWT) and collapse in brachycephalic dogs with and without brachycephalic obstructive airway syndrome (BOAS) and in nonbrachycephalic dogs.
ANIMALS
85 dogs with no history of lower respiratory tract disease that underwent CT of the thorax.
PROCEDURES
Electronical medical records for March 2011 through August 2019 were reviewed to identify brachycephalic dogs with BOAS (BOAS group) and brachycephalic dogs without BOAS (BDWB group) that did not have any evidence of lower respiratory tract disease and had undergone thoracic CT. A population of nonbrachycephalic dogs of similar weight (control dogs) was also retrospectively recruited.
RESULTS
BWT was identified in 28 of 30 (93.3%; 95% CI, 80.3% to 98.6%) dogs in the BOAS group, 15 of 26 (57.7%; 95% CI, 38.7% to 75.0%) dogs in the BDWB group, and 10 of 28 (35.7%; 95% CI, 20.1% to 54.2%) control dogs. On multivariable analysis, only brachycephalic conformation (P < 0.01) and body weight (P = 0.02) were significantly associated with the presence of BWT. Bronchial collapse was identified in 17 of 30 (56.7%; 95% CI, 39.0% to 73.1%) dogs in the BOAS group, 17 of 26 (65.4%; 95% CI, 46.3% to 81.3%) dogs in the BDWB group, and 3 of 28 (10.7%; 95% CI, 3.1% to 25.9%) control dogs. On multivariable analysis, only brachycephalic conformation was significantly (P < 0.01) associated with the presence of bronchial collapse.
CLINICAL RELEVANCE
A relationship between brachycephalic conformation and body weight with BWT was established, with heavier dogs having thicker bronchial walls. However, further studies are required to investigate the cause. Bronchial collapse was also more common in dogs with brachycephalic conformation, which is in agreement with the previously published literature.
Topics: Dogs; Animals; Retrospective Studies; Prevalence; Dog Diseases; Craniosynostoses; Airway Obstruction; Syndrome; Body Weight
PubMed: 35905164
DOI: 10.2460/javma.21.10.0448 -
Thorax May 2024Airway obstruction is defined by spirometry as a low forced expiratory volume in 1 s (FEV) to forced vital capacity (FVC) ratio. This impaired ratio may originate from a...
BACKGROUND
Airway obstruction is defined by spirometry as a low forced expiratory volume in 1 s (FEV) to forced vital capacity (FVC) ratio. This impaired ratio may originate from a low FEV (classic) or a normal FEV in combination with a large FVC (dysanaptic). The clinical implications of dysanaptic obstruction during childhood and adolescence in the general population remain unclear.
AIMS
To investigate the association between airway obstruction with a low or normal FEV in childhood and adolescence, and asthma, wheezing and bronchial hyperresponsiveness (BHR).
METHODS
In the BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology; Sweden) and PIAMA (Prevention and Incidence of Asthma and Mite Allergy; the Netherlands) birth cohorts, obstruction (FEV:FVC ratio less than the lower limit of normal, LLN) at ages 8, 12 (PIAMA only) or 16 years was classified as classic (FEV
obstruction. Cross-sectional and longitudinal associations between these two types of obstruction and respiratory health outcomes were estimated by cohort-adjusted logistic regression on pooled data. RESULTS
The prevalence of classic obstruction at ages 8, 12 and 16 in the two cohorts was 1.5%, 1.1% and 1.5%, respectively. Dysanaptic obstruction was slightly more prevalent: 3.9%, 2.5% and 4.6%, respectively. Obstruction, regardless of FEV, was consistently associated with higher odds of asthma (dysanaptic obstruction: OR 2.29, 95% CI 1.40 to 3.74), wheezing, asthma medication use and BHR compared with the normal lung function group. Approximately one-third of the subjects with dysanaptic obstruction in childhood remained dysanaptic during adolescence.
CLINICAL IMPLICATIONS
Children and adolescents with airway obstruction had, regardless of their FEV level, a higher prevalence of asthma and wheezing. Follow-up and treatment at these ages should be guided by the presence of airway obstruction.
Topics: Humans; Child; Forced Expiratory Volume; Adolescent; Male; Female; Asthma; Respiratory Sounds; Airway Obstruction; Vital Capacity; Sweden; Spirometry; Prevalence; Cross-Sectional Studies; Bronchial Hyperreactivity; Netherlands
PubMed: 38514183
DOI: 10.1136/thorax-2023-220952 -
Indian Journal of Anaesthesia Sep 2015Chronic obstructive pulmonary disease (COPD) and bronchial asthma often complicate the surgical patients, leading to post-operative morbidity and mortality. Many authors... (Review)
Review
Chronic obstructive pulmonary disease (COPD) and bronchial asthma often complicate the surgical patients, leading to post-operative morbidity and mortality. Many authors have tried to predict post-operative pulmonary complications but not specifically in COPD. The aim of this review is to provide recent evidence-based guidelines regarding predictors and ventilatory strategies for mechanical ventilation in COPD and bronchial asthma patients. Using Google search for indexing databases, a search for articles published was performed using various combinations of the following search terms: 'Predictors'; 'mechanical ventilation'; COPD'; 'COPD'; 'bronchial asthma'; 'recent strategies'. Additional sources were also identified by exploring the primary reference list.
PubMed: 26556918
DOI: 10.4103/0019-5049.165856 -
Chinese Medical Journal Sep 2017The development of culture-independent techniques for microbiological analysis shows that bronchial tree is not sterile in either healthy or chronic obstructive... (Review)
Review
OBJECTIVE
The development of culture-independent techniques for microbiological analysis shows that bronchial tree is not sterile in either healthy or chronic obstructive pulmonary disease (COPD) individuals. With the advance of sequencing technologies, lung microbiome has become a new frontier for pulmonary disease research, and such advance has led to better understanding of the lung microbiome in COPD. This review aimed to summarize the recent advances in lung microbiome, its relationships with COPD, and the possible mechanisms that microbiome contributed to COPD pathogenesis.
DATA SOURCES
Literature search was conducted using PubMed to collect all available studies concerning lung microbiome in COPD. The search terms were "microbiome" and "chronic obstructive pulmonary disease", or "microbiome" and "lung/pulmonary".
STUDY SELECTION
The papers in English about lung microbiome or lung microbiome in COPD were selected, and the type of articles was not limited.
RESULTS
The lung is a complex microbial ecosystem; the microbiome in lung is a collection of viable and nonviable microbiota (bacteria, viruses, and fungi) residing in the bronchial tree and parenchymal tissues, which is important for health. The following types of respiratory samples are often used to detect the lung microbiome: sputum, bronchial aspirate, bronchoalveolar lavage, and bronchial mucosa. Disordered bacterial microbiome is participated in pathogenesis of COPD; there are also dynamic changes in microbiota during COPD exacerbations. Lung microbiome may contribute to the pathogenesis of COPD by manipulating inflammatory and/or immune process.
CONCLUSIONS
Normal lung microbiome could be useful for prophylactic or therapeutic management in COPD, and the changes of lung microbiome could also serve as biomarkers for the evaluation of COPD.
Topics: Animals; Biomarkers; Humans; Lung; Microbiota; Pulmonary Disease, Chronic Obstructive
PubMed: 28741603
DOI: 10.4103/0366-6999.211452 -
International Journal of Molecular... Jan 2022Chronic obstructive pulmonary disease (COPD) is a common, socially significant disease characterized by progressive airflow limitation due to chronic inflammation in the... (Review)
Review
Chronic obstructive pulmonary disease (COPD) is a common, socially significant disease characterized by progressive airflow limitation due to chronic inflammation in the bronchi. Although the causes of COPD are considered to be known, the pathogenesis of the disease continues to be a relevant topic of study. Mechanisms of the innate immune system are involved in various links in the pathogenesis of COPD, leading to persistence of chronic inflammation in the bronchi, their bacterial colonization and disruption of lung structure and function. Bronchial epithelial cells, neutrophils, macrophages and other cells are involved in the development and progression of the disease, demonstrating multiple compromised immune mechanisms.
Topics: Bacterial Infections; Bronchi; Disease Progression; Humans; Immunity, Innate; Pulmonary Disease, Chronic Obstructive
PubMed: 35055174
DOI: 10.3390/ijms23020985 -
Allergology International : Official... Jan 2017Computer-aided lung sound analysis (LSA) has been reported to be useful for evaluating airway inflammation and obstruction in asthma patients. We investigated the... (Clinical Trial)
Clinical Trial
BACKGROUND
Computer-aided lung sound analysis (LSA) has been reported to be useful for evaluating airway inflammation and obstruction in asthma patients. We investigated the relation between LSA and impulse oscillometry with the evaluation of peripheral airway obstruction.
METHODS
A total of 49 inhaled corticosteroid-naive bronchial asthma patients underwent LSA, spirometry, impulse oscillometry, and airway hyperresponsiveness testing. The data were analyzed to assess correlations between the expiration: inspiration lung sound power ratio (dB) at low frequencies between 100 and 195 Hz (E/I LF) and various parameters.
RESULTS
E/I LF and X5 were identified as independent factors that affect V˙. E/I LF showed a positive correlation with R5 (r = 0.34, p = 0.017), R20 (r = 0.34, p = 0.018), reactance area (AX, r = 0.40, p = 0.005), and resonant frequency of reactance (Fres, r = 0.32, p = 0.024). A negative correlation was found between E/I LF and X5 (r = -0.47, p = 0.0006). E/I LF showed a negative correlation with FEV/FVC(%), FEV, V˙, and V˙ (r = -0.41, p = 0.003; r = -0.44, p = 0.002; r = -0.49, p = 0.0004; and r = -0.30, p = 0.024, respectively). E/I LF was negatively correlated with log PC (r = -0.30, p = 0.024). Log PC, X5, and past smoking were identified as independent factors that affected E/I LF level.
CONCLUSIONS
E/I LF as with X5 can be an indicator of central and peripheral airway obstruction in bronchial asthma patients.
Topics: Adrenal Cortex Hormones; Adult; Aged; Asthma; Female; Humans; Male; Middle Aged; Oscillometry; Respiratory Sounds; Signal Processing, Computer-Assisted
PubMed: 27516132
DOI: 10.1016/j.alit.2016.06.008