New issue of Current Respiratory Medicine Reviews (Volume 12 - Number 4) is online

Dear Friends was published new issue of Current Respiratory Medicine Reviews (Volume 12 - Number 4)! 

Table of Contents  (For viewing abstracts please visit this link)

Meet Our Editorial Board Member Pp. 247-247
Peter J. Barnes
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Editorial
Editorial: Obstructive Sleep Apnea (OSA) in the Elderly: Does OSA Decrease Mortality in These Patients When They Have Pneumonia? Pp. 248-249
Salim Surani, Daryelle S. Varon and Joseph Varon
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Review Article
Recognition of the Deteriorating Patient: The Ongoing Evolution of Early Warning Score Systems and their Impact on Patients with Respiratory Disease Pp. 250-260
Sarah Forster, John Blakey and Dominick Shaw
[Abstract] [Purchase Article]

Review Article
Effectiveness of Long-Term Macrolide Therapy in Cryptogenic Organising Pneumonia Pp. 261-270
Tommaso D'Elia
[Abstract] [Purchase Article]

Review Article
Epidemiology and Pathology of Malignant Mesothelioma Pp. 271-276
Jack A. Kastelik, Mahmoud Loubani, Michael Greenstone, Simon Hart and Anne Campbell
[Abstract] [Purchase Article]

Review Article
Pulmonary Disease in Beta-Thalassemia Pp. 277-285
Demetrios S. Theodoropoulos and Maria S. Theodoropoulou
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Review Article
Surgical Options for Management of Malignant Pleural Mesothelioma in the Current Era Pp. 286-293
Mahmoud Loubani, Syed S. Qadri, Azar Hussain, Mubarak A. Chaudhry and Jack A. Kastelik
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Review Article
Rheumatoid Nodules and Lung Pp. 294-298
Ciro Manzo
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Research Article
Assessment of Mortality Risk in Elderly Persons with Obstructive Sleep Apnea Diagnosed with Pneumonia Pp. 299-305
Charlisa D. Gibson, Eric Yudelevich, Raymond A. Jean, Pius Ochieng and Raymonde E. Jean
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Acknowledgement
ACKNOWLEDGEMENTS TO REVIEWERS Pp. 306-306
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Procalcitonin could safely halve antibiotic administration in COPD exacerbations (Free full text from European Respiratory Review 2017)

Our latest meta-analysis is now available online!!
Current evidence suggests that serum procalcitonin could safely halve antibiotic administration in COPD exacerbations!

Challenges in the differentiation of the aetiology of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to significant overuse of antibiotics. Serum procalcitonin, released in response to bacterial infections, but not viral infections, could possibly identify AECOPD requiring antibiotics. In this meta-analysis we assessed the clinical effectiveness of procalcitonin-based protocols to initiate or discontinue antibiotics in patients presenting with AECOPD.

Based on a prospectively registered protocol, we reviewed the literature and selected randomised or quasi-randomised trials comparing procalcitonin-based protocols to initiate or discontinue antibiotics versus standard care in AECOPD. We followed Cochrane and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidance to assess risk of bias, quality of evidence and to perform meta-analyses.

We included eight trials evaluating 1062 patients with AECOPD. Procalcitonin-based protocols decreased antibiotic prescription (relative risk (RR) 0.56, 95% CI 0.43–0.73) and total antibiotic exposure (mean difference (MD) −3.83, 95% CI (−4.32–−3.35)), without affecting clinical outcomes such as rate of treatment failure (RR 0.81, 0.62–1.06), length of hospitalisation (MD −0.76, −1.95–0.43), exacerbation recurrence rate (RR 0.96, 0.69–1.35) or mortality (RR 0.99, 0.58–1.69). However, the quality of the available evidence is low to moderate, because of methodological limitations and small overall study population.

Procalcitonin-based protocols appear to be clinically effective; however, confirmatory trials with rigorous methodology are required.

Free full text:

http://ow.ly/c693304JkYB 

Free full text on Researchgate:

https://www.researchgate.net/publication/313160789_Procalcitonin_to_guide_antibiotic_administration_in_COPD_exacerbations_a_meta-analysis 

 

Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report published in Blue Journal

This Executive Summary of the Global Strategy for the Diagnosis, Management, and Prevention of COPD (GOLD) 2017 Report focuses primarily on the revised and novel parts of the document. 

The most significant changes include: 

i) the assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations; 

ii) for each of the groups A to D, escalation strategies for pharmacological treatments are proposed; 

iii) the concept of de-escalation of therapy is introduced in the treatment assessment scheme; 

iv) nonpharmacologic therapies are comprehensively presented and; 

v) the importance of comorbid conditions in managing COPD is reviewed. 

Link to full text:

http://www.atsjournals.org/doi/abs/10.1164/rccm.201701-0218PP

Pneumonology Quiz – Case 4 (free article from Archives of Hellenic Medicine)

Dear friends read new Pneumology Quiz from Archives of Hellenic Medicine!

A 34-year-old female patient presented to the emergency department with 6 hours’ history of sudden onset of breathlessness associated with severe pleuritic chest pain, minimal hemoptysis and pyrexia. She denied any other symptoms. She
had only returned from a business meeting in South Africa a week ago and she was quite concerned of the possibility of having contracted a tropical infection, although she had followed vaccination and hygiene advice given by an infectious disease specialist before her departure, four weeks ago. Her past medical history included two episodes of miscarriage. On examination, she was tachycardic (95 bpm) with normal blood pressure (140/75 mmHg), tachypneic (22 bpm) with normal oxygen saturation (95% on room air) and pyrexial (37.4 oC). A detailed clinical examination did not yield positive clinical findings. Full blood count, urea and electrolytes, as well as c-reactive protein (CRP) were all within normal range. Chest X-ray was insignificant.

Full free text:

https://www.researchgate.net/publication/312593052_Pneumonology_Quiz_-_Case_4

Previous cases:

Pneumonology Quiz - Case 1

Pneumonology Quiz - Case 2

Pneumonology Quiz – Case 3

Introducing COPD Research and Practice

Dear friends we are happy to present you new Respiratory Journal: COPD Research and Practice!

COPD Research and Practice publishes basic and clinical research and cutting edge reviews related to chronic obstructive pulmonary disease (COPD). The journal aims to facilitate discussion and dissemination of knowledge to help translate new ideas from bench to bedside by encouraging international and interdisciplinary collaboration.
Editorial from Editor in Chief Professor Mario Cazzola from the University of Rome Tor Vergata, Rome, Italy:

COPD is now the fourth leading cause of death globally, and the World Health Organization (WHO) has predicted that it will become the third most common cause of death in the world by 2030 [1]. In developed countries, current information estimates a prevalence of 8 % to 10 % among adults 40 years of age and older, whereas in developing countries, prevalence varies significantly among countries and is difficult to quote [2].

It is estimated that more than 210 million people have the disease worldwide [3]. Concerning a large number of subjects, COPD generates important health and social costs. However, although COPD is one of the most common chronic diseases and has a high health and social impact, it is still poorly recognized among the general public and also clinicians. Consequently, there is a major and urgent need to better understand this complex disease.

Free full text:

http://copdrp.biomedcentral.com/articles/10.1186/s40749-015-0007-9

2017 Lung Cancer Guidelines: The Eighth Edition Lung Cancer Stage Classification

Stage classification provides a nomenclature about the anatomic extent of a cancer; a consistent language provides the ability to communicate about a specific patient and about cohorts of patients in clinical studies. This paper summarizes the eighth edition of lung cancer stage classification, which is the worldwide standard as of January 1, 2017. 

This revision is based on a large global database, a sophisticated analysis, extensive internal validation as well as multiple assessments confirming generalizability. 

Practicing clinicians must be familiar with the stage classification system when managing contemporary patients with lung cancer.

Fulltext:

http://journal.publications.chestnet.org/article.aspx?articleID=2578191

2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung

This document provides an update to the European Respiratory Society (ERS)/American Thoracic Society (ATS) technical standards for single-breath carbon monoxide uptake in the lung that was last updated in 2005. Although both D_LCO (diffusing capacity) and T_LCO (transfer factor) are valid terms to describe the uptake of carbon monoxide in the lung, the term D_LCO is used in this document. A joint taskforce appointed by the ERS and ATS reviewed the recent literature on the measurement of D_LCO and surveyed the current technical capabilities of instrumentation being manufactured around the world. The recommendations in this document represent the consensus of the taskforce members in regard to the evidence available for various aspects of D_LCO measurement. 

Furthermore, it reflects the expert opinion of the taskforce members on areas in which peer-reviewed evidence was either not available or was incomplete. The major changes in these technical standards relate to D_LCO measurement with systems using rapidly responding gas analysers for carbon monoxide and the tracer gas, which are now the most common type of D_LCO instrumentation being manufactured. Technical improvements and the increased capability afforded by these new systems permit enhanced measurement of D_LCO and the opportunity to include other optional measures of lung function.

Fulltext:

http://erj.ersjournals.com/content/49/1/1600016