Category: U.S. National Library of Medicine (NIH)

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Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma.

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Single-incision video-assisted anatomical segmentectomy with handsewn bronchial closure for endobronchial lipoma.

Ann Transl Med. 2016 Aug;4(15):284

Authors: Galvez C, Sesma J, Bolufer S, Lirio F, Navarro-Martinez J, Galiana M, Baschwitz B, Rivera MJ

Abstract
Endobronchial lipomas are rare benign tumors whose symptoms are usually confused with recurrent infections or even asthma diagnosis, and mostly caused by endobronquial obstructive component which also conditions severity. We report a case of a 60-year-old man with a right-lower lobe upper-segment endobronchial myxoid tumor with uncertain diagnosis. We performed a single incision video-assisted anatomical segmentectomy and wedge bronchoplasty with handsewn closure to achieve complete resection and definitive diagnosis. During the postoperative air leak was not observed and there was no complication, with low pain scores and complete recovery. Final pathological exam showed endobronchial lipoma. Single-incision (SI) anatomical segmentectomies are lung-sparing resections for benign or low-grade malignancies with diagnostic and therapeutic value, and the need for a wedge bronchoplasty is not a necessary indication for conversion to multiport or open thoracotomy.

PMID: 27570778 [PubMed]

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Predictive Properties of the Asthma Control Test and Its Component Questions for Severe Asthma Exacerbations.

Predictive Properties of the Asthma Control Test and Its Component Questions for Severe Asthma Exacerbations.

J Allergy Clin Immunol Pract. 2016 Aug 17;

Authors: Cajigal S, Wells KE, Peterson EL, Ahmedani BK, Yang JJ, Kumar R, Burchard EG, Williams LK

Abstract
BACKGROUND: Current US guidelines recommend the Asthma Control Test (ACT) for assessing disease control and selecting treatment.
OBJECTIVE: The goal of this study was to prospectively assess the ACT and its component questions for their utility in predicting the risk of severe asthma exacerbations.
METHODS: Individuals were participants in the Study of Asthma Phenotypes and Pharmacogenomic Interactions by Race-Ethnicity, and those included in the current analysis had the following characteristics: age 18 years or more, physician-diagnosed asthma, and longitudinal care received at a large health system in southeastern Michigan. Study participants underwent a baseline evaluation, which included answering the ACT. A severe asthma exacerbation was defined as one requiring oral steroids, an emergency department visit, or inpatient admission. Receiver-operator characteristic curves were used to measure and compare the predictive utility of the ACT and its component questions for severe asthma exacerbations.
RESULTS: Of 1180 participants, 354 (30.0%) experienced a severe asthma exacerbation within 6 months of their baseline evaluation. When compared with the individual questions that composed the ACT, the composite score was significantly better at predicting severe exacerbations with 1 exception; the composite ACT score and the question assessing rescue medication use were not significantly different (P = .580). Pharmacy-based records of metered-dose inhaler short-acting beta-agonist use and asthma severity were also not significantly different from the composite ACT score.
CONCLUSIONS: Our study demonstrates that although the ACT is modestly predictive for exacerbations, the composite score may not be superior to assessing rescue medication use alone for predicting the risk of severe asthma exacerbations.

PMID: 27544712 [PubMed – as supplied by publisher]

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Management and referral of patients with severe and poorly controlled asthma in primary care.

Management and referral of patients with severe and poorly controlled asthma in primary care.

Fam Pract. 2016 Aug 20;

Authors: Orozco-Beltrán D, Carratalá-Munuera C, Arriero JM, Campo P, Martínez-Moragón E, Molina J, Quintano-Jiménez JA, Gil-Guillén VF, Working Group for the Consensus Document on the Management of Severe Asthma in Adults in Primary Health Care

Abstract
BACKGROUND: Over 50% of treated patients with asthma in Europe are not well controlled. Their management in primary health care (PHC) differs from that in specialized care, and there is no real coordination between the two.
OBJECTIVES: To identify barriers and solutions to improving the management of patients with severe and poorly controlled asthma and the communication between specialists and PHC, and to reach a consensus on the criteria for referral patients.
METHODS: An observational study using a modified Delphi technique. About 79 physicians from PHC, pneumology and allergy fields from different Spanish regions were invited to participate via an online questionnaire. Consensus was reached on an item when more than two-thirds of the panel members scored within the 3-point category (1-3 or 7-9) containing the median and the interquartile range of answers had to be ?4 points.
RESULTS: Response rate: 52%. After the second round, consensus items were 40 (62.5%): of which 37 in agreement and 3 in disagreement. Around 92.68% of respondents agreed that it would be useful to incorporate questionnaires for asthma control into PHC computer-based searches. About 100% of participants agreed that clear consensus criteria between PHC and specialists must be determined to decide when a patient with asthma is referred from PHC to specialist or vice versa. Ten of the proposed criteria reached consensus agreement.
CONCLUSION: The failure to use guidelines and specific questionnaires for asthma control in PHC is one reason why there is underdiagnosis and poor control of asthma. Some strategies to improve the asthma care management emerged from the survey results.

PMID: 27543792 [PubMed – as supplied by publisher]

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Using Technology to Affect Influenza Vaccine Coverage Among Children With Chronic Respiratory Conditions.

Using Technology to Affect Influenza Vaccine Coverage Among Children With Chronic Respiratory Conditions.

J Pediatr Health Care. 2016 Jul 27;

Authors: Bay SL, Crawford DJ

Abstract
INTRODUCTION: Influenza presents additional burdens for children with chronic respiratory conditions. Influenza vaccinations may reduce complications, yet approximately half of children remain unprotected. Evidence supports integration of text and e-mail into multicomponent strategies to increase influenza vaccination rates among children with chronic respiratory conditions.
METHODS: A single text and e-mail message was sent to those with enabled preferences in the patient portal. A follow-up survey assessed aspects of message receipt. Surveys were completed without collection of demographics.
RESULTS: A total of 3,206 messages were successfully delivered. Surveys were initiated by 107 recipients. Frequency analysis showed that text and e-mail messages were preferred forms of communication. A statistically significant relationship was found between receiving a message and receiving an influenza vaccination (p = .027).
DISCUSSION: Text and e-mail messaging are cost effective and well received, and they can be easily integrated into existing systems. These methods are translatable across populations and can convey various types of messages.

PMID: 27475928 [PubMed – as supplied by publisher]

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Pentoxifylline and its active metabolite lisofylline attenuate transforming growth factor ?1-induced asthmatic bronchial fibroblast-to-myofibroblast transition.

Pentoxifylline and its active metabolite lisofylline attenuate transforming growth factor ?1-induced asthmatic bronchial fibroblast-to-myofibroblast transition.

Acta Biochim Pol. 2016 Jul 30;

Authors: Wójcik-Pszczo?a K, Hi?cza K, Wnuk D, K?dzio?ka D, Koczurkiewicz P, Sanak M, Madeja Z, P?kala E, Michalik M

Abstract
Bronchial asthma is characterized by persistent airway inflammation and airway wall remodeling. Among many different cells and growth factors triggering changes in bronchi structure, transforming growth factor ?1-induced fibroblast to myofibroblast transition is believed to be very important. The aim of this study was to evaluate whether theophylline (used in asthma therapy) and two other methylxanthines (pentoxifylline and its active metabolite lisofylline), may affect transforming growth factor ?1-induced fibroblast to myofibroblast transition in bronchial fibroblasts derived from asthmatic patients. We show here for the first time that selected methylxanthines effectively reduce transforming growth factor ?1-induced myofibroblast formation in asthmatic bronchial fibroblast populations. PTX was found to be the most effective methylxanthine. The number of differentiated myofibroblasts after PTX, LSF and THEO administration was reduced at least twofold. Studies on the use of methylxanthines opens a new perspective in the development of novel strategies in asthma therapy through their two-pronged, anti-inflammatory and anti-fibrotic action. In the future they can be considered as promising anti-fibrotic drugs.

PMID: 27474406 [PubMed – as supplied by publisher]

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Polymorphic Variants 279R and 668Q Augment Activity of Matrix Metalloproteinase-9 in Breath Condensates of Children with Asthma.

Polymorphic Variants 279R and 668Q Augment Activity of Matrix Metalloproteinase-9 in Breath Condensates of Children with Asthma.

Arch Immunol Ther Exp (Warsz). 2016 Jul 9;

Authors: Grzela K, Zagórska W, Krejner A, Litwiniuk M, Zawadzka-Krajewska A, Kulus M, Grzela T

Abstract
Matrix metalloproteinase (MMP)-9 is involved in pathophysiology of asthma, mainly asthma-associated airway remodeling. Exhaled breath condensates (EBC) of asthmatics contain increased amounts of MMP-9 with activity higher, than in healthy controls. The increased activity of MMP-9 may originate from its excessive production and activation, but may also result from variations in MMP-9 structure, which are determined by single nucleotide polymorphisms (SNPs). In this pilot study we aimed to assess the possible influence of two functional MMP-9 polymorphisms, Q279R and R668Q, on enzymatic activity of MMP-9, measured in EBC of asthmatic children. The concentration and activity of MMP-9 were analyzed in EBC of 20 children with allergic asthma using specific standard ELISA and novel immunoenzymatic activity assay. The SNPs of MMP-9 were assessed using real-time PCR-based genotyping test. We have found that MMP-9 concentration in breath condensates of children with stable asthma was slightly higher in ELISA, than in the activity assay. Moreover, these results and activity-to-amount ratio have revealed some relationship with a presence of specific 279R and/or 668Q MMP-9 gene variants. Our observation suggests that at least in some patients MMP-9 hyperactivity may result from genetic predisposition, determined by polymorphic variants of MMP-9 gene. Moreover, it supports previous reports postulating significance of MMP-9 in pathogenesis of asthma. However, this issue still requires further studies.

PMID: 27395373 [PubMed – as supplied by publisher]

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Objective measurement of frequency and pattern of nocturnal cough in children with asthma exacerbation.

Objective measurement of frequency and pattern of nocturnal cough in children with asthma exacerbation.

Ann Allergy Asthma Immunol. 2016 Jun 30;

Authors: Hirai K, Enseki M, Tabata H, Nukaga M, Matsuda S, Kato M, Furuya H, Mochizuki H

Abstract
BACKGROUND: Although a number of patients with asthma report experiencing persistent cough during sleep, it has not yet been objectively investigated.
OBJECTIVE: To classify cough severity and evaluate a characteristic pattern of cough frequency in children with asthma using an objective cough monitoring system.
METHODS: An objective cough monitoring system that specialized in children was used to measure cough frequency and nocturnal cough patterns. Coughs were recorded with microphone and accelerometer and analyzed using a customized software program. The number of nocturnal coughs and the pattern of cough frequency in 30-minute intervals were measured along with the severity of each asthma exacerbation, and the results were compared with children without asthma.
RESULTS: The total overnight cough count of 34 children with asthma was higher than that of 15 children without asthma (P < .001). The total overnight cough count in children with severe asthma exacerbation was higher than that in children with moderate asthma exacerbation (P < .05). The cough counts were significantly increased at the time of falling asleep and waking. This pattern was not observed in children without asthma. The total cough counts and cough patterns in children with asthma were not affected by sex, age, cause of asthma exacerbation, or therapy.
CONCLUSION: Our data indicate huge cough counts and characteristic nocturnal cough patterns in children with asthma. Objective and precise cough monitoring is useful for the management of childhood asthma.

PMID: 27372657 [PubMed – as supplied by publisher]

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