Sunday, July 31, 2016

New Respiratory App - #GOLDCOPD app

In partnership with the Global Initiative for Chronic Obstructive Lung Disease - GOLD, Doctot has produced the official ‪#‎GOLDCOPD‬ App.
This much-celebrated App uniquely provides the GOLD strategy for treating Chronic Obstructive Pulmonary Disease (COPD) in a user-friendly and easily navigable format with interactive tables and charts. Doctot #GOLDCOPD (which can be downloaded at: also contains the GOLD sanctioned Combined Assessment of COPD scale.

Follow Global Initiative for Chronic Obstructive Lung Disease - GOLD on facebook:

Friday, July 29, 2016

24th Congress of the Romanian Society of Pneumology, Poiana Brasov, October 5th-8th 2016: “Exacerbation – quo vadis?”

Dear Respiratory Friends we are happy to invite you to the 24th Congress of the Romanian Society of Pneumology, at Poiana Brasov!
Dear Colleagues,
Dear Collaborators,
I have the pleasure of announcing the 24th Congress of the Romanian Society of Pneumology which will take place in Poiana Brasov between October 5th-8th 2016. This is the natural continuance of the high scientific events that you have all been accustomed already in the previous years; therefore it stays in the responsibility of the organizers to ensure the continuity of values and the promotion of medical novelty.

Pneumology has met a wide development in the last 25 years in Romania. The Romanian pneumologists form an exceptional medical community both from the professional Association’s point of view: the Romanian Society of Pneumology being one of the most active and prolific ones of its kind in the country, and from the point of view of the medical activity: diagnostic and modern treatment according to the international standards becoming already a constant concern of each Romanian pneumologist.
What novelties brings this event of Romanian pneumologists? We propose two directions. The congress will represent a bridge between generations. First, we will encourage involving the young pneumologists, because creating the new generations of specialists in respiratory diseases is essential for the progress of the Romanian field of pneumology. Next to the young ones we want for the senior pneumologists to be present, being invitated throught the financial involvement of the Romanian Society of Pneumology as a humble acknowledgement – of the track records of the forthcoming, development and promotion of the Romanian pneumology as it is presented in today’s medical world.
The second direction goes to the theme of the Congres “ Exacerbation – quo vadis?”, this question refferring to the exacerbation of a series of pulmonary diseases starting with Chronic Obstructive Pulmonary Disease or asthma to infectious diseases with pulmonary interference or idiopatic interstitial fibrosis.
This direction is addressed to specialists in multiple areas of expertise – for as the modern and actual approach of exacerbations in pulmonary pathology is required to be an interdisciplinary one! The treatment of the respiratory diseases becomes more and more personalized and involves a rising number or medical specialties. So far, a specialist was treating A DISEASE. We must learn to treat together, doctors of different specialties, ONE PATIENT in a particular situation with a certain pathological identity. Quo vadis? – the path is being built now. I invite you to define it and to make it together.
I am looking forward to seeing you in Poiana Brasov!
ruxandra Ulmeanu 
Ruxandra Ulmeanu
President of the Congress
Elected President of the Romanian Society of Pneumology (2016-2018)

Thursday, July 21, 2016

Clinical Practice Guidelines 2016: The Diagnosis and Management of Alpha-1 Antitrypsin Deficiency in the Adult (free full text)

Dear Respiratory friends we are happy to present you Clinical Practice Guidelines 2016: The Diagnosis and Management of Alpha-1 Antitrypsin Deficiency in the Adult published today in Journal of the COPD Foundation!

Summary of Recommendations

Testing for Alpha-1 Antitrypsin Deficiency (AATD):

· All individuals with COPD regardless of age or ethnicity should be tested for AATD.

· All individuals with unexplained chronic liver disease should be tested for AATD.

· All individuals with necrotizing panniculitis, granulomatosis with polyangiitis, or unexplained bronchiectasis should be tested for AATD.

· Parents, siblings, and children, as well as extended family of individuals identified with an abnormal gene for AAT, should be provided genetic counseling and offered testing for AATD (see guideline document for special considerations about testing minors).

· For family testing after a proband is identified, AAT level testing alone is not recommended because it does not fully characterize disease risk from AATD.

· For diagnostic testing of symptomatic individuals, we recommend genotyping for at least the S and Z alleles. Advanced or confirmatory testing should include Pi-typing, AAT level testing, and/or expanded genotyping.

Pulmonary function testing in those with AATD:

· Initial evaluation with complete lung function testing is recommended.

· Annual follow-up of adults with at least a spirometry test is recommended.

Computed Tomography (CT) scan of the chest in the evaluation in those with AATD:

· In newly diagnosed patients who are symptomatic and/or have abnormal pulmonary function testing, a baseline CT scan of the chest is recommended.

· Serial chest CT scanning to monitor progression of disease is not recommended.

Monitoring for liver disease in those with AATD:

· Monitoring for liver disease at annual intervals (or more frequently as indicated by clinical circumstances), with physical examination including focused exam for signs of liver disease, liver ultrasound, and laboratory monitoring of AST, ALT, GGT, albumin, bilirubin, INR, and platelets is recommended.

Management of lung disease in those with AATD:

· Every effort should be made to prevent exposure to tobacco smoke and facilitate cessation in those who are smoking.

· Lung volume reduction surgery is not recommended for individuals with COPD related to AATD.

Intravenous augmentation therapy in those with AATD is recommended for:

· Individuals with an FEV1 less than or equal to 65% predicted.

o    For those with lung disease related to AATD and an FEV1 greater than 65%, we recommend discussion with each individual regarding the potential benefits of reducing lung function decline with consideration of the cost of therapy and lack of evidence for such benefit.

·         Individuals with necrotizing panniculitis.

Intravenous augmentation therapy is not recommended for:

· Individuals with the MZ genotype of AATD.

· Individuals with lung disease due to AATD who continue to smoke.

· Individuals with AATD and emphysema or bronchiectasis who do not have airflow obstruction.

· The treatment of liver disease due to AATD.

· Individuals who have undergone liver transplantation.

Additional recommendations regarding dosing of intravenous augmentation therapy:

· Weekly doses higher than the current FDA-approved dose are not recommended.

· Monitoring of trough AAT blood levels to evaluate the adequacy of AAT augmentation dosing is not recommended.

Friday, July 8, 2016

Pneumonology Quiz – Case 3 (article from Archives of Hellenic Medicine)

A 67-year-old male patient, lifelong smoker, with a background of asthma since childhood and recurrent ethmoid polyps attended for a routine clinical review. He was only prescribed a salbutamol inhaler, to be used when required. He reported intermittent episodes of shortness of breath with wheezing at night and a progressive deterioration of his symptoms over the previous two years. He was also complaining of cough productive of yellow phlegm, almost every morning. On examination, he was tachypneic at rest, with an oxygen saturation of 92% on room air. He was severely hyperinflated and a bit wheezy on auscultation.
Read full text:

Sunday, July 3, 2016

Pocket Guide to COPD Diagnosis, Management, and Prevention – 2016 (Link for free download)

Pocket Guide has been developed from the Global Strategy for the Diagnosis, Management, and Prevention of COPD (2016 Update). Technical discussions of COPD and COPD management, evidence levels, and specific citations from the scientific literature are included in that source document.