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[PMID]:28328824
[Au] Autor:Wang J; Cui Z; Liu S; Gao X; Gao P; Shi Y; Guo S; Li P
[Ad] Endereço:aSouthern Medical University, Guangzhou, Guangdong bDepartment of Critical Care Medicine cDepartment of Respiratory and Critical Care Medicine, Harrison International Peace Hospital, Hengshui, Hebei dDepartment of Respiratory and Critical Care Medicine, Nanjing General Hospital of Nanjing Military Command, Nanjing, Jiangsu, China.
[Ti] Título:Early use of noninvasive techniques for clearing respiratory secretions during noninvasive positive-pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease and hypercapnic encephalopathy: A prospective cohort study.
[So] Source:Medicine (Baltimore);96(12):e6371, 2017 Mar.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China.A total of 74 patients received NPPV and 90 patients received CMV. Inclusion criteria included the following: physician-diagnosed AECOPD, spontaneous airway clearance of excessive secretions, arterial blood gas analysis requiring intensive care, moderate-to-severe dyspnea, and a Kelly-Matthay scale score of 3 to 5. Exclusion criteria included the following: preexisting psychiatric/neurological disorders unrelated to HE, upper gastrointestinal bleeding, upper airway obstruction, acute coronary syndromes, preadmission tracheostomy or endotracheal intubation, and urgent endotracheal intubation for cardiovascular, psychomotor agitation, or severe hemodynamic conditions.Intensive care unit participants were managed by NPPV. Participants received standard treatment consisting of controlled oxygen therapy during NPPV-free periods; antibiotics, intravenous doxofylline, corticosteroids (e.g., salbutamol and ambroxol), and subcutaneous low-molecular-weight heparin; and therapy for comorbidities if necessary. Nasogastric tubes were inserted only in participants who developed gastric distension. No pharmacological sedation was administered.The primary and secondary outcome measures included comparative complication rates, durations of ventilation and hospitalization, number of invasive devices/patient, and in-hospital and 1-year mortality rates.Arterial blood gases and sensorium levels improved significantly within 2 hours in the NPPV group with lower hospital mortality, fewer complications and invasive devices/patient, and superior weaning off mechanical ventilation. Mechanical ventilation duration, hospital stay, or 1-year mortality was similar between groups.NPPV combined with a noninvasive strategy to clear secretions during the first 2 hours may offer advantages over CMV in treating AECOPD patients complicated by HE.
[Mh] Termos MeSH primário: Encefalopatias/terapia
Hipercapnia/terapia
Respiração com Pressão Positiva/métodos
Doença Pulmonar Obstrutiva Crônica/terapia
Sistema Respiratório/secreção
[Mh] Termos MeSH secundário: Idoso
Albuterol/administração & dosagem
Ambroxol/administração & dosagem
Encefalopatias/complicações
Encefalopatias/mortalidade
Desenho de Equipamento
Estudos de Viabilidade
Feminino
Seres Humanos
Hipercapnia/complicações
Hipercapnia/mortalidade
Unidades de Terapia Intensiva
Estimativa de Kaplan-Meier
Tempo de Internação
Masculino
Posicionamento do Paciente
Respiração com Pressão Positiva/instrumentação
Estudos Prospectivos
Doença Pulmonar Obstrutiva Crônica/complicações
Doença Pulmonar Obstrutiva Crônica/mortalidade
Fármacos do Sistema Respiratório/administração & dosagem
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Respiratory System Agents); 200168S0CL (Ambroxol); QF8SVZ843E (Albuterol)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170412
[Lr] Data última revisão:
170412
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170323
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006371


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[PMID]:28130789
[Au] Autor:Flint R; Halbmeijer N; Meesters N; van Rosmalen J; Reiss I; van Dijk M; Simons S
[Ad] Endereço:Division of Neonatology, Department of Paediatrics, Erasmus University Medical Centre - Sophia Children's Hospital, Rotterdam, The Netherlands.
[Ti] Título:Retrospective study shows that doxapram therapy avoided the need for endotracheal intubation in most premature neonates.
[So] Source:Acta Paediatr;106(5):733-739, 2017 May.
[Is] ISSN:1651-2227
[Cp] País de publicação:Norway
[La] Idioma:eng
[Ab] Resumo:AIM: Using doxapram to treat neonates with apnoea of prematurity might avoid the need for endotracheal intubation and invasive ventilation. We studied whether doxapram prevented the need for intubation and identified the predictors of the success. METHODS: This was a retrospective study of preterm infants born from January 2006 to August 2014 who received oral or intravenous doxapram. Success was defined as no need for endotracheal intubation, due to apnoea, during doxapram therapy. Univariable and multivariable logistic regression analyses identified predictors of success during the first 48 hours of doxapram therapy. RESULTS: Data on 203 patients with a median gestational age of 26.1 (interquartile range 25.1-27.4) weeks were analysed. During the first 48 hours of doxapram therapy, 157 (77%) patients did not need endotracheal intubation and 127 (63%) patients were successfully treated over the entire treatment course. The median postnatal age at the start of doxapram therapy was 20 days (interquartile range 12-30). Postnatal age and a lower fraction of inspired oxygen at the start of doxapram therapy were significant predictors of success (odds ratio 0.964, 95% confidence interval 0.938-0.991, p = 0.001). CONCLUSION: Oral and intravenous doxapram effectively treated most cases of apnoea in preterm infants, avoiding the need for intubation.
[Mh] Termos MeSH primário: Apneia/tratamento farmacológico
Doxapram/uso terapêutico
Intubação Intratraqueal/estatística & dados numéricos
Fármacos do Sistema Respiratório/uso terapêutico
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Masculino
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Respiratory System Agents); 94F3830Q73 (Doxapram)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170129
[St] Status:MEDLINE
[do] DOI:10.1111/apa.13761


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[PMID]:28125632
[Au] Autor:Aljebab F; Choonara I; Conroy S
[Ad] Endereço:Division of Medical Sciences & Graduate Entry Medicine, School of Medicine, University of Nottingham, Royal Derby Hospital Centre, Derby, United Kingdom.
[Ti] Título:Systematic Review of the Toxicity of Long-Course Oral Corticosteroids in Children.
[So] Source:PLoS One;12(1):e0170259, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Long courses of oral corticosteroids are commonly used in children in the management of chronic conditions. Various adverse drug reactions (ADRs) are known to occur with their use. This systematic review aimed to identify the most common and serious ADRs and to determine their relative risk levels. METHODS: A literature search of Embase, Medline, International Pharmaceutical Abstracts, CINAHL, Cochrane Library and PubMed was performed with no language restrictions in order to identify studies where oral corticosteroids were administered to patients aged 28 days to 18 years of age for at least 15 days of treatment. Each database was searched from their earliest dates to January 2016. All studies providing clear information on ADRs were included. RESULTS: One hundred and one studies including 33 prospective cohort studies; 21 randomised controlled trials; 21 case series and 26 case reports met the inclusion criteria. These involved 6817 children and reported 4321 ADRs. The three ADRs experienced by the highest number of patients were weight gain, growth retardation and Cushingoid features with respective incidence rates of 21.1%, 18.1% and 19.4% of patients assessed for these ADRs. 21.5% of patients measured showed decreased bone density and 0.8% of patients showed osteoporosis. Biochemical HPA axis suppression was detected in 269 of 487 patients where it was measured. Infection was the most serious ADR, with twenty one deaths. Varicella zoster was the most frequent infection (9 deaths). CONCLUSIONS: Weight gain, growth retardation and Cushingoid features were the most frequent ADRs seen when long-course oral corticosteroids were given to children. Increased susceptibility to infection was the most serious ADR.
[Mh] Termos MeSH primário: Corticosteroides/efeitos adversos
Síndrome de Cushing/fisiopatologia
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/classificação
Osteoporose/fisiopatologia
Fármacos do Sistema Respiratório/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Corticosteroides/uso terapêutico
Criança
Pré-Escolar
Doença Crônica/tratamento farmacológico
Síndrome de Cushing/induzido quimicamente
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/fisiopatologia
Feminino
Herpes Zoster/induzido quimicamente
Herpes Zoster/fisiopatologia
Seres Humanos
Lactente
Recém-Nascido
Masculino
Osteoporose/induzido quimicamente
Sistema Hipófise-Suprarrenal/efeitos dos fármacos
Sistema Hipófise-Suprarrenal/fisiopatologia
Fármacos do Sistema Respiratório/uso terapêutico
Ganho de Peso/efeitos dos fármacos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Respiratory System Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170809
[Lr] Data última revisão:
170809
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170127
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0170259


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[PMID]:28114736
[Au] Autor:Ng G; Ohlsson A
[Ad] Endereço:Department of Neonatology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, 5th Floor, Hammersmith House, Du Cane Road, London, UK, W12 0HS.
[Ti] Título:Cromolyn sodium for the prevention of chronic lung disease in preterm infants.
[So] Source:Cochrane Database Syst Rev;1:CD003059, 2017 01 23.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This is an update of a review last published by Cochrane in June 2012 entitled "Cromolyn sodium for the prevention of chronic lung disease in preterm infants", which included two studies. This 2016 update identified no further studies.Chronic lung disease (CLD) frequently occurs in preterm infants and has a multifactorial aetiology including inflammation. Cromolyn sodium is a mast cell stabiliser that inhibits neutrophil activation and neutrophil chemotaxis and therefore may have a role in the prevention of CLD. OBJECTIVES: To determine the effect of prophylactic administration of cromolyn sodium on the incidence of CLD at 28 days or 36 weeks' postmenstrual age (PMA), mortality, or the combined outcome of mortality and CLD at 28 days or 36 weeks' PMA in preterm infants. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2016, Issue 4), MEDLINE via PubMed (1966 to 12 May 2016), Embase (1980 to 12 May 2016), and CINAHL (1982 to 12 May 2016). We searched clinical trials databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: We included randomised or quasi-randomised controlled clinical trials involving preterm infants. Initiation of cromolyn sodium administration was during the first two weeks of life. The intervention had to include administration of cromolyn sodium by nebuliser or metered dose inhaler with or without spacer device versus placebo or no intervention. Eligible studies had to include at least one of the following outcomes: overall mortality, CLD at 28 days, CLD at 36 weeks' PMA, or the combined outcome mortality and CLD at 28 days. DATA COLLECTION AND ANALYSIS: We used the standard method for Cochrane as described in the Cochrane Handbook for Systematic Reviews of Interventions. We reported risk ratio (RR) and risk difference (RD) with 95% confidence intervals (CI) for dichotomous outcomes and mean difference (MD) with 95% CI for continuous data. The meta-analysis used a fixed-effect model. We examined heterogeneity using the I2 statistic. We assessed the quality of evidence for the main comparison at the outcome level using the GRADE approach. MAIN RESULTS: We identified two eligible studies with small numbers of infants enrolled (64 infants). Prophylaxis with cromolyn sodium did not result in a statistically significant effect on the combined outcome of mortality and CLD at 28 days (typical RR 1.05, 95% CI 0.73 to 1.52; typical RD 0.03, 95% CI -0.20 to 0.27; 2 trials, 64 infants; I2 = 0% for both RR and RD); mortality at 28 days (typical RR 1.31, 95% CI 0.52 to 3.29; I2 = 73% typical RD 0.06, 95% CI -0.13 to 0.26; I2 = 87%; 2 trials, 64 infants) (very low quality evidence); CLD at 28 days (typical RR 0.93, 95% CI 0.53 to 1.64; I2 = 40%; typical RD -0.03, 95% CI -0.27 to 0.20; I2 = 38%; 2 trials, 64 infants) or at 36 weeks' PMA (RR 1.25, 95% CI 0.43 to 3.63; RD 0.08, 95% CI -0.29 to 0.44; 1 trial, 26 infants). There was no significant difference in CLD in survivors at 28 days (typical RR 0.97, 95% CI 0.58 to 1.63; typical RD -0.02, 95% CI -0.29 to 0.26; I2 = 0% for both RR and RD; 2 trials, 50 infants) or at 36 weeks' PMA (RR 1.04, 95% CI 0.38 to 2.87; RD 0.02, 95% CI -0.40 to 0.43; 1 trial, 22 infants). Prophylaxis with cromolyn sodium did not show a statistically significant difference in overall neonatal mortality, incidence of air leaks, necrotising enterocolitis, intraventricular haemorrhage, sepsis, and days of mechanical ventilation. There were no adverse effects noted. The quality of evidence according to GRADE was very low for one outcome (mortality to 28 days) and low for all other outcomes. The reasons for downgrading the evidence was due to design (risk of bias in one study), inconsistency between the two studies (high I2 values for mortality at 28 days for both RR and RD), and lack of precision of estimates (small sample sizes). Further research does not seem to be justified. AUTHORS' CONCLUSIONS: There is currently no evidence from randomised trials that cromolyn sodium has a role in the prevention of CLD. Cromolyn sodium cannot be recommended for the prevention of CLD in preterm infants.
[Mh] Termos MeSH primário: Cromolina Sódica/uso terapêutico
Doenças do Prematuro/prevenção & controle
Pneumopatias/prevenção & controle
Fármacos do Sistema Respiratório/uso terapêutico
[Mh] Termos MeSH secundário: Doença Crônica
Ensaios Clínicos como Assunto
Seres Humanos
Recém-Nascido
Recém-Nascido Prematuro
Doenças do Prematuro/mortalidade
Pneumopatias/mortalidade
Metanálise como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.; REVIEW
[Nm] Nome de substância:
0 (Respiratory System Agents); Q2WXR1I0PK (Cromolyn Sodium)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170411
[Lr] Data última revisão:
170411
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170124
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD003059.pub3


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[PMID]:27992707
[Au] Autor:Maina M; Akech S; Mwaniki P; Gachau S; Ogero M; Julius T; Ayieko P; Irimu G; English M
[Ad] Endereço:KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
[Ti] Título:Inappropriate prescription of cough remedies among children hospitalised with respiratory illness over the period 2002-2015 in Kenya.
[So] Source:Trop Med Int Health;22(3):363-369, 2017 Mar.
[Is] ISSN:1365-3156
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine trends in prescription of cough medicines over the period 2002-2015 in children aged 1 month to 12 years admitted to Kenyan hospitals with cough, difficulty breathing or diagnosed with a respiratory tract infection. METHODS: We reviewed hospitalisation records of children included in four studies providing cross-sectional prevalence estimates from government hospitals for six time periods between 2002 and 2015. Children with an atopic illness were excluded. Amongst eligible children, we determined the proportion prescribed any adjuvant medication for cough. Active ingredients in these medicines were often multiple and were classified into five categories: antihistamines, antitussives, mucolytics/expectorants, decongestants and bronchodilators. From late 2006, guidelines discouraging cough medicine use have been widely disseminated and in 2009 national directives to decrease cough medicine use were issued. RESULTS: Across the studies, 17 963 children were eligible. Their median age and length of hospital stay were comparable. The proportion of children who received cough medicines shrank across the surveys: approximately 6% [95% CI: 5.4, 6.6] of children had a prescription in 2015 vs. 40% [95% CI: 35.5, 45.6] in 2002. The most common active ingredients were antihistamines and bronchodilators. The relative proportion that included antihistamines has increased over time. CONCLUSIONS: There has been an overall decline in the use of cough medicines among hospitalised children over time. This decline has been associated with educational, policy and mass media interventions.
[Mh] Termos MeSH primário: Tosse/tratamento farmacológico
Dispneia/tratamento farmacológico
Hospitalização
Prescrição Inadequada
Padrões de Prática Médica
Fármacos do Sistema Respiratório/uso terapêutico
Infecções Respiratórias/tratamento farmacológico
[Mh] Termos MeSH secundário: Antitussígenos/uso terapêutico
Broncodilatadores/uso terapêutico
Pré-Escolar
Estudos Transversais
Prescrições de Medicamentos
Expectorantes/uso terapêutico
Antagonistas dos Receptores Histamínicos/uso terapêutico
Seres Humanos
Lactente
Quênia
Descongestionantes Nasais/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antitussive Agents); 0 (Bronchodilator Agents); 0 (Expectorants); 0 (Histamine Antagonists); 0 (Nasal Decongestants); 0 (Respiratory System Agents)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170705
[Lr] Data última revisão:
170705
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161220
[St] Status:MEDLINE
[do] DOI:10.1111/tmi.12831


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[PMID]:27750355
[Au] Autor:Kahl F; Frewer A
[Ad] Endereço:Institut für Geschichte und Ethik der Medizin, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen.
[Ti] Título:[Medical Treatment of Newly Arrived Refugees in Erlangen: A Study of Drug Prescription Rates Focused on Psychotropic Drugs].
[Ti] Título:Medizinische Versorgung von neu angekommenen Asylsuchenden in Erlangen: Eine Studie zum Medikamenteneinsatz mit besonderem Blick auf Psychopharmaka..
[So] Source:Psychother Psychosom Med Psychol;67(3-04):119-125, 2017 Apr.
[Is] ISSN:1439-1058
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:In 2015 the number of refugees who sought asylum in Germany has increased dramatically. Therefore, the medical care for these refugees faces huge challenges. The treatment of mental illness of refugees is a particular difficult topic. Objective of this study is the acquisition of the outpatient prescriptions of drugs for newly arrived refugees in Erlangen, focused on psychotropic drugs. Evaluation of all outpatient prescribed drugs (n=1 137), which were prescribed between 10/01/2014 and 09/30/2015 for asylum seekers living in the refugee center in Erlangen, a branch of the "Central Admission Institution" ("ZAE") Zirndorf. Funding organization of this treatment is the City of Erlangen. Settlement documents of the City of Erlangen were used for the analysis. The prescribed drugs cover the spectrum of acute primary care. Big parts of the prescription rates are antiinfectives (ATC-Code: J), medication for the respiratory system (ATC: R), as well as non-steroidal anti-inflammatory drug (NSAID's: ibuprofen, paracetamol, metamizole). The prescription of psychotropic drugs is relatively underrepresented.
[Mh] Termos MeSH primário: Transtornos Mentais/tratamento farmacológico
Padrões de Prática Médica/estatística & dados numéricos
Psicotrópicos/uso terapêutico
Refugiados/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Assistência Ambulatorial/estatística & dados numéricos
Anti-Infecciosos/uso terapêutico
Anti-Inflamatórios não Esteroides/uso terapêutico
Criança
Pré-Escolar
Uso de Medicamentos/estatística & dados numéricos
Feminino
Alemanha
Seres Humanos
Lactente
Recém-Nascido
Masculino
Transtornos Mentais/psicologia
Meia-Idade
Refugiados/estatística & dados numéricos
Fármacos do Sistema Respiratório/uso terapêutico
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Psychotropic Drugs); 0 (Respiratory System Agents)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161018
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-116325


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[PMID]:27417306
[Au] Autor:Gupta A; Zheng SL
[Ad] Endereço:Department of Paediatric Respiratory Medicine, King's College Hospital and King's College London, London, UK.
[Ti] Título:Genetic disorders of surfactant protein dysfunction: when to consider and how to investigate.
[So] Source:Arch Dis Child;102(1):84-90, 2017 Jan.
[Is] ISSN:1468-2044
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Genetic mutations affecting proteins required for normal surfactant protein function are a rare cause of respiratory disease. The genes identified that cause respiratory disease are surfactant protein B, surfactant protein C, ATP binding cassette number A3 and thyroid transcription factor-1. Surfactant protein dysfunction syndromes are highly variable in their onset and presentation, and are dependent on the genes involved and environmental factors. This heterogeneous group of conditions can be associated with significant morbidity and mortality. Presentation may be in a full-term neonate with acute and progressive respiratory distress with a high mortality or later in childhood or adulthood with signs and symptoms of interstitial lung disease. Genetic testing for these disorders is now available, providing a non-invasive diagnostic test. Other useful investigations include radiological imaging and lung biopsy. This review will provide an overview of the genetic and clinical features of surfactant protein dysfunction syndromes, and discuss when to suspect this diagnosis, how to investigate it and current treatment options.
[Mh] Termos MeSH primário: Doenças Pulmonares Intersticiais/genética
Pulmão/patologia
Mutação/genética
Proteínas Associadas a Surfactantes Pulmonares/genética
[Mh] Termos MeSH secundário: Idade de Início
Biópsia
Broncoscopia/métodos
Criança
Pré-Escolar
Testes Genéticos/métodos
Seres Humanos
Lactente
Recém-Nascido
Doenças Pulmonares Intersticiais/patologia
Doenças Pulmonares Intersticiais/terapia
Transplante de Pulmão
Respiração Artificial
Fármacos do Sistema Respiratório/uso terapêutico
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Pulmonary Surfactant-Associated Proteins); 0 (Respiratory System Agents)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170605
[Lr] Data última revisão:
170605
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160716
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2012-303143


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[PMID]:27920515
[Au] Autor:Beeh KM; Beier J; Candler H; Wittig T
[Ad] Endereço:Insaf Respiratory Research Institute, Wiesbaden, Germany.
[Ti] Título:Effect of ELOM-080 on exacerbations and symptoms in COPD patients with a chronic bronchitis phenotype - a post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial.
[So] Source:Int J Chron Obstruct Pulmon Dis;11:2877-2884, 2016.
[Is] ISSN:1178-2005
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD) long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and chronic bronchitis-dominant COPD. ELOM-080 has demonstrated clinical efficacy in treating symptoms and preventing exacerbations in subjects with chronic bronchitis. However, little is known about the potential effects of ELOM-080 in COPD patients. AIM: To evaluate the effect on exacerbation, cough sputum, and general state of health of long-term treatment with ELOM-080 in COPD patients with an exacerbation history and chronic bronchitis. METHODS: We performed a post-hoc analysis of a randomized, double-blinded, placebo-controlled parallel-group clinical trial of a 6-month treatment with ELOM-080 (3×300 mg) in patients with chronic bronchitis and concomitant COPD. The primary outcome was the proportion of subjects with at least one exacerbation over the 6-month study period. Secondary outcomes included the total number of exacerbations (ie, cumulative occurrence of exacerbations during the study period) and the proportion of acute exacerbations necessitating an antibiotic treatment, monthly evaluations of sputum and cough symptoms, and the general state of health and a safety analysis. RESULTS: Of 260 randomized subjects, 64 patients fulfilled the inclusion criteria for COPD (ELOM-080: 35, placebo: 29). Compared to placebo, ELOM-080 reduced the percentage of subjects with at least one exacerbation (29% versus 55%, =0.031) and a reduction in the overall occurrence of exacerbations (ELOM-080: 10, placebo: 21, =0.012) during the winter season. The percentage of asymptomatic or mildly symptomatic patients (sputum/expectoration and cough) was consistently higher in the ELOM-080 group compared to placebo, with statistical significant differences after 2 and 3 months of treatment (2 months: ELOM-080 25%, placebo 11%, <0.005; 3 months: ELOM-080 26%, placebo 14%, <0.05). Likewise the subjective rating of general health status was better in the ELOM-080 group with statistically significant superiority after 2 and 3 months of treatment (2-month treatment: =0.015; 3-month treatment: =0.024). Tolerability results were comparable between ELOM-080 and placebo. CONCLUSION: ELOM-080 is efficacious in patients with COPD and a chronic bronchitis phenotype. Prophylactic use reduces the rate of exacerbations and improves the key symptoms of sputum and cough with a favorable long-term tolerability profile.
[Mh] Termos MeSH primário: Bronquite Crônica/tratamento farmacológico
Pulmão/efeitos dos fármacos
Monoterpenos/administração & dosagem
Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico
Fármacos do Sistema Respiratório/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Antibacterianos/administração & dosagem
Bronquite Crônica/complicações
Bronquite Crônica/diagnóstico
Bronquite Crônica/fisiopatologia
Tosse/tratamento farmacológico
Tosse/etiologia
Tosse/fisiopatologia
Progressão da Doença
Método Duplo-Cego
Esquema de Medicação
Combinação de Medicamentos
Feminino
Alemanha
Nível de Saúde
Seres Humanos
Pulmão/fisiopatologia
Masculino
Meia-Idade
Monoterpenos/efeitos adversos
Doença Pulmonar Obstrutiva Crônica/complicações
Doença Pulmonar Obstrutiva Crônica/diagnóstico
Doença Pulmonar Obstrutiva Crônica/fisiopatologia
Fármacos do Sistema Respiratório/efeitos adversos
Estações do Ano
Escarro/efeitos dos fármacos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Drug Combinations); 0 (Monoterpenes); 0 (Respiratory System Agents); 8002-55-9 (myrtol)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161207
[St] Status:MEDLINE


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[PMID]:27876728
[Au] Autor:Esedov EM; Gadzhimirzaev GA; Akhmedova FD; Muradova VR; Gadzhimirzaeva RG; Medzhidova RA; Abasova AS
[Ad] Endereço:Dagestan State Medical Academy, Russian Ministry of Health, Makhachkala, Russia, 367000.
[Ti] Título:[Mucoviscidosis, a challenging medical problem].
[Ti] Título:Mukovistsidoz ­ aktual'naya problema meditsiny..
[So] Source:Vestn Otorinolaringol;81(5):15-18, 2016.
[Is] ISSN:0042-4668
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The authors present the currently available data on mucoviscidosis (cystic fibrosis) based on their original experience and the review of the relevant literature. Special attention is given to the pathogenetic mechanisms underlying the development of this condition, its diagnostics, and methods of treatment as exemplified by the clinical case of cystic fibrosis in an adult patient.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Fibrose Cística
Insuficiência Pancreática Exócrina
Pseudomonas aeruginosa
Fármacos do Sistema Respiratório/uso terapêutico
Infecções Respiratórias
[Mh] Termos MeSH secundário: Adulto
Broncoscopia/métodos
Fibrose Cística/diagnóstico
Fibrose Cística/etiologia
Fibrose Cística/fisiopatologia
Fibrose Cística/terapia
Regulador de Condutância Transmembrana em Fibrose Cística/genética
Gerenciamento Clínico
Insuficiência Pancreática Exócrina/diagnóstico
Insuficiência Pancreática Exócrina/fisiopatologia
Insuficiência Pancreática Exócrina/terapia
Seres Humanos
Masculino
Testes de Sensibilidade Microbiana/métodos
Mutação
Pseudomonas aeruginosa/efeitos dos fármacos
Pseudomonas aeruginosa/isolamento & purificação
Infecções Respiratórias/diagnóstico
Infecções Respiratórias/tratamento farmacológico
Infecções Respiratórias/microbiologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (CFTR protein, human); 0 (Respiratory System Agents); 126880-72-6 (Cystic Fibrosis Transmembrane Conductance Regulator)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170621
[Lr] Data última revisão:
170621
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161124
[St] Status:MEDLINE
[do] DOI:10.17116/otorino201681515-18


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[PMID]:27731786
[Au] Autor:Damonti L; Boggian K
[Ad] Endereço:1 Universitätsklinik für Infektiologie, Inselspital Bern.
[Ti] Título:Aspergillose..
[So] Source:Ther Umsch;73(8):469-474, 2016.
[Is] ISSN:0040-5930
[Cp] País de publicação:Switzerland
[La] Idioma:ger
[Mh] Termos MeSH primário: Antifúngicos/administração & dosagem
Aspergillus/isolamento & purificação
Aspergilose Pulmonar/diagnóstico
Aspergilose Pulmonar/tratamento farmacológico
Fármacos do Sistema Respiratório/administração & dosagem
[Mh] Termos MeSH secundário: Diagnóstico Diferencial
Medicina Baseada em Evidências
Seres Humanos
Aspergilose Pulmonar/microbiologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antifungal Agents); 0 (Respiratory System Agents)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170217
[Lr] Data última revisão:
170217
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161013
[St] Status:MEDLINE



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