Risk and impact of #pulmonary complications in survivors of childhood #cancer: A report from the Childhood Cancer Survivor Study
http://onlinelibrary.wiley.com/doi/10.1002/cncr.30200/full
CONCLUSIONS
Pulmonary complications are substantial among adult survivors of childhood cancer and can affect daily activities.
http://onlinelibrary.wiley.com/doi/10.1002/cncr.30200/full
CONCLUSIONS
Pulmonary complications are substantial among adult survivors of childhood cancer and can affect daily activities.
Safety and efficacy of bridging to lung transplantation with antifibrotic drugs in idiopathic #pulmonary #fibrosis: a case series
http://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-016-0308-z
Antifibrotic drugs can probably be safely administered in IPF patients, possibly attenuating disease progression over time, while awaiting LTx.
http://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-016-0308-z
Antifibrotic drugs can probably be safely administered in IPF patients, possibly attenuating disease progression over time, while awaiting LTx.
BMC Pulmonary Medicine
Safety and efficacy of bridging to lung transplantation with antifibrotic drugs in idiopathic pulmonary fibrosis: a case series
Following recent approval of pirfenidone and nintedanib for idiopathic pulmonary fibrosis (IPF), questions arise about the use of these antifibrotics in patients awaiting lung transplantation (LTx). Safety and efficacy of antifibrotic drugs in IPF patients…
Guidelines for Management of Incidental #Pulmonary #Nodules Detected on CT Images: From the Fleischner Society 2017
http://pubs.rsna.org/doi/10.1148/radiol.2017161659
The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences. The guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience.
http://pubs.rsna.org/doi/10.1148/radiol.2017161659
The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect current thinking on nodule management. The revised guidelines incorporate several substantive changes that reflect current thinking on the management of small nodules. The minimum threshold size for routine follow-up has been increased, and recommended follow-up intervals are now given as a range rather than as a precise time period to give radiologists, clinicians, and patients greater discretion to accommodate individual risk factors and preferences. The guidelines for solid and subsolid nodules have been combined in one simplified table, and specific recommendations have been included for multiple nodules. These guidelines represent the consensus of the Fleischner Society, and as such, they incorporate the opinions of a multidisciplinary international group of thoracic radiologists, pulmonologists, surgeons, pathologists, and other specialists. Changes from the previous guidelines issued by the Fleischner Society are based on new data and accumulated experience.
Radiology
Guidelines for Management of Incidental Pulmonary Nodules Detected on CT Images: From the Fleischner Society…
The Fleischner Society Guidelines for management of solid nodules were published in 2005, and separate guidelines for subsolid nodules were issued in 2013. Since then, new information has become available; therefore, the guidelines have been revised to reflect…
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#Marijuana Use, Respiratory Symptoms, and #Pulmonary Function: A Systematic Review and Meta-analysis
http://annals.org/aim/article-abstract/2686986/marijuana-use-respiratory-symptoms-pulmonary-function-systematic-review-meta-analysis
Twenty-two studies were included. A pooled analysis of 2 prospective studies showed that marijuana use was associated with an increased risk for cough (risk ratio RR, 2.04 95% CI, 1.02 to 4.06) and sputum production (RR, 3.84 CI, 1.62 to 9.07). Pooled analysis of cross-sectional studies (1 low and 3 moderate risk of bias) showed that marijuana use was associated with cough (RR, 4.37 CI, 1.71 to 11.19), sputum production (RR, 3.40 CI, 1.99 to 5.79), wheezing (RR, 2.83 CI, 1.89 to 4.23), and dyspnea (RR, 1.56 CI, 1.33 to 1.83). Data on pulmonary function and obstructive lung disease were insufficient
Low-strength evidence suggests that smoking marijuana is associated with cough, sputum production, and wheezing. Evidence on the association between marijuana use and obstructive lung disease and pulmonary function is insufficient
#Marijuana Use, Respiratory Symptoms, and #Pulmonary Function: A Systematic Review and Meta-analysis
http://annals.org/aim/article-abstract/2686986/marijuana-use-respiratory-symptoms-pulmonary-function-systematic-review-meta-analysis
Twenty-two studies were included. A pooled analysis of 2 prospective studies showed that marijuana use was associated with an increased risk for cough (risk ratio RR, 2.04 95% CI, 1.02 to 4.06) and sputum production (RR, 3.84 CI, 1.62 to 9.07). Pooled analysis of cross-sectional studies (1 low and 3 moderate risk of bias) showed that marijuana use was associated with cough (RR, 4.37 CI, 1.71 to 11.19), sputum production (RR, 3.40 CI, 1.99 to 5.79), wheezing (RR, 2.83 CI, 1.89 to 4.23), and dyspnea (RR, 1.56 CI, 1.33 to 1.83). Data on pulmonary function and obstructive lung disease were insufficient
Low-strength evidence suggests that smoking marijuana is associated with cough, sputum production, and wheezing. Evidence on the association between marijuana use and obstructive lung disease and pulmonary function is insufficient
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#Statins and Multiple Noncardiovascular Outcomes: Umbrella Review of Meta-analyses of Observational Studies and Randomized Controlled Trials
http://annals.org/aim/article-abstract/2706169/statins-multiple-noncardiovascular-outcomes-umbrella-review-meta-analyses-observational-studies
This review explored 278 unique non-CVD outcomes from 112 meta-analyses of observational studies and 144 meta-analyses of RCTs. For observational studies, no convincing (class I) evidence, 2 highly suggestive (class II) associations (decreased cancer mortality in patients with cancer and decreased exacerbation in patients with chronic obstructive #pulmonary disease), 21 suggestive (class III) associations, and 42 weak (class IV) associations were identified. One outcome from the RCTs (decreased all-cause mortality in patients with chronic kidney disease) attained a sufficient amount of evidence with no hints of bias. For adverse events, observational studies showed suggestive evidence that statins increase the risk for diabetes and myopathy. Among the RCTs, no statistically significant effects were found on myopathy, myalgia, or rhabdomyolysis.
The absence of convincing evidence of an association between statins and non-CVD outcomes supports leaving the current recommendations unchanged
#Statins and Multiple Noncardiovascular Outcomes: Umbrella Review of Meta-analyses of Observational Studies and Randomized Controlled Trials
http://annals.org/aim/article-abstract/2706169/statins-multiple-noncardiovascular-outcomes-umbrella-review-meta-analyses-observational-studies
This review explored 278 unique non-CVD outcomes from 112 meta-analyses of observational studies and 144 meta-analyses of RCTs. For observational studies, no convincing (class I) evidence, 2 highly suggestive (class II) associations (decreased cancer mortality in patients with cancer and decreased exacerbation in patients with chronic obstructive #pulmonary disease), 21 suggestive (class III) associations, and 42 weak (class IV) associations were identified. One outcome from the RCTs (decreased all-cause mortality in patients with chronic kidney disease) attained a sufficient amount of evidence with no hints of bias. For adverse events, observational studies showed suggestive evidence that statins increase the risk for diabetes and myopathy. Among the RCTs, no statistically significant effects were found on myopathy, myalgia, or rhabdomyolysis.
The absence of convincing evidence of an association between statins and non-CVD outcomes supports leaving the current recommendations unchanged
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#β-Blocker Therapy and Risk of Chronic Obstructive #Pulmonary Disease – A Danish Nationwide Study of 1·3 Million Individuals
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30004-5/fulltext
Highlights
•
Users of β-blockers had an overall 19·7% lower risk of COPD hospitalization compared to users of any other antihypertensive drug during follow-up.
•
Users of β-blockers had an overall 44% lower risk of death from COPD compared to users of any other antihypertensive drug.
•
Results from this study advocates changes in the present hesitation of treatment with β-blockers in patients at risk of or with concomitant COPD.
#β-Blocker Therapy and Risk of Chronic Obstructive #Pulmonary Disease – A Danish Nationwide Study of 1·3 Million Individuals
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30004-5/fulltext
Highlights
•
Users of β-blockers had an overall 19·7% lower risk of COPD hospitalization compared to users of any other antihypertensive drug during follow-up.
•
Users of β-blockers had an overall 44% lower risk of death from COPD compared to users of any other antihypertensive drug.
•
Results from this study advocates changes in the present hesitation of treatment with β-blockers in patients at risk of or with concomitant COPD.
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CDC, FDA, States Continue to Investigate Severe #Pulmonary Disease Among People Who Use #Ecigarettes
https://www.cdc.gov/media/releases/2019/s0821-cdc-fda-states-e-cigarettes.html
August 23, 2019: As of 5:00 p.m., August 22, 193 potential cases of severe lung illness associated with e-cigarette product use had been reported by 22 states (CA, CT, IL, IN, IA, MN, MI, NC, NJ, NM, NY, PA, TX, UT, WI, and additional states pending verification). These were reported between June 28th and August 20th of this year.
CDC is providing consultation to state health departments about a cluster of pulmonary illnesses possibly related to e-cigarette product use, or “vaping,” primarily among adolescents and young adults
CDC and states have not identified a cause, but all reported cases have e-cigarette product use or “vaping.”
Available evidence does not suggest that an infectious disease is the principal cause of the illness.
Investigators have not identified any specific product or compound that is linked to all cases...
CDC, FDA, States Continue to Investigate Severe #Pulmonary Disease Among People Who Use #Ecigarettes
https://www.cdc.gov/media/releases/2019/s0821-cdc-fda-states-e-cigarettes.html
August 23, 2019: As of 5:00 p.m., August 22, 193 potential cases of severe lung illness associated with e-cigarette product use had been reported by 22 states (CA, CT, IL, IN, IA, MN, MI, NC, NJ, NM, NY, PA, TX, UT, WI, and additional states pending verification). These were reported between June 28th and August 20th of this year.
CDC is providing consultation to state health departments about a cluster of pulmonary illnesses possibly related to e-cigarette product use, or “vaping,” primarily among adolescents and young adults
CDC and states have not identified a cause, but all reported cases have e-cigarette product use or “vaping.”
Available evidence does not suggest that an infectious disease is the principal cause of the illness.
Investigators have not identified any specific product or compound that is linked to all cases...
Centers for Disease Control and Prevention
Pulmonary Disease Associated with E-cigarettes
Ongoing Investigation of Respiratory Illnesses Reported After Use of E-cigarette Products
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Association of Occupational Exposure to #Disinfectants With Incidence of Chronic Obstructive #Pulmonary Disease Among US Female Nurses
Exposure to disinfectants in health care workers has been associated with respiratory health outcomes, including asthma.
Weekly use of disinfectants to clean surfaces only (16 786 [22.9%] of participants exposed) and to clean medical instruments (13 899 [19.0%] exposed) was associated with COPD incidence, with adjusted hazard ratios of 1.38 (95% CI, 1.13-1.68) for cleaning surfaces only and 1.31 (95% CI, 1.07-1.61) for cleaning medical instruments after adjustment for age, smoking (pack-years), race, ethnicity, and body mass index. High-level exposure, evaluated by the JTEM, to several specific disinfectants (ie, glutaraldehyde, bleach, hydrogen peroxide, alcohol, and quaternary ammonium compounds) was significantly associated with COPD incidence, with adjusted hazard ratios ranging from 1.25 (95% CI, 1.04-1.51) to 1.36 (95% CI, 1.13-1.64). Associations were not modified by smoking or asthma status (P for interaction > .15).
Conclusions and Relevance These longitudinal results suggest that regular use of chemical disinfectants among nurses may be a risk factor for developing COPD. If future studies confirm these results, exposure-reduction strategies that are compatible with infection control in health care settings should be developed
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753247?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=101819
Association of Occupational Exposure to #Disinfectants With Incidence of Chronic Obstructive #Pulmonary Disease Among US Female Nurses
Exposure to disinfectants in health care workers has been associated with respiratory health outcomes, including asthma.
Weekly use of disinfectants to clean surfaces only (16 786 [22.9%] of participants exposed) and to clean medical instruments (13 899 [19.0%] exposed) was associated with COPD incidence, with adjusted hazard ratios of 1.38 (95% CI, 1.13-1.68) for cleaning surfaces only and 1.31 (95% CI, 1.07-1.61) for cleaning medical instruments after adjustment for age, smoking (pack-years), race, ethnicity, and body mass index. High-level exposure, evaluated by the JTEM, to several specific disinfectants (ie, glutaraldehyde, bleach, hydrogen peroxide, alcohol, and quaternary ammonium compounds) was significantly associated with COPD incidence, with adjusted hazard ratios ranging from 1.25 (95% CI, 1.04-1.51) to 1.36 (95% CI, 1.13-1.64). Associations were not modified by smoking or asthma status (P for interaction > .15).
Conclusions and Relevance These longitudinal results suggest that regular use of chemical disinfectants among nurses may be a risk factor for developing COPD. If future studies confirm these results, exposure-reduction strategies that are compatible with infection control in health care settings should be developed
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753247?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=101819
Jamanetwork
Occupational Exposure to Disinfectants and COPD Among US Female Nurses
This cohort study evaluates data from the Nurses’ Health Study II to investigate the association of occupational exposure to disinfectants and other cleaning products with the incidence of chronic obstructive pulmonary disease (COPD) among female US registered…
Pharmacologic Therapies in Patients With Exacerbation of Chronic #Obstructive #Pulmonary Disease: A Systematic Review With Meta-analysis
https://2medical.news/2020/03/03/pharmacologic-therapies-in-patients-with-exacerbation-of-chronic-obstructive-pulmonary-disease-a-systematic-review-with-meta-analysis/
..Compared with placebo or management without antibiotics, antibiotics given for 3 to 14 days were associated with increased exacerbation resolution at the end of the intervention (odds ratio [OR], 2.03 [95% CI, 1.47 to 2.80]; moderate SOE) and less treatment failure at the end of the intervention (OR, 0.54 [CI, 0.34 to 0.86]; moderate SOE), independent of severity of exacerbations in out- and inpatients. Compared …
https://2medical.news/2020/03/03/pharmacologic-therapies-in-patients-with-exacerbation-of-chronic-obstructive-pulmonary-disease-a-systematic-review-with-meta-analysis/
..Compared with placebo or management without antibiotics, antibiotics given for 3 to 14 days were associated with increased exacerbation resolution at the end of the intervention (odds ratio [OR], 2.03 [95% CI, 1.47 to 2.80]; moderate SOE) and less treatment failure at the end of the intervention (OR, 0.54 [CI, 0.34 to 0.86]; moderate SOE), independent of severity of exacerbations in out- and inpatients. Compared …
Mid-Term Effects of Pulmonary #Rehabilitation on Cognitive Function in People with Severe Chronic Obstructive #Pulmonary Disease
https://2medical.news/2020/05/23/mid-term-effects-of-pulmonary-rehabilitation-on-cognitive-function-in-people-with-severe-chronic-obstructive-pulmonary-disease/
Cognitive dysfunction is a common impairment associated with COPD. However, little is known about 1) its prevalence among those subjects referred for pulmonary rehabilitation (PR), 2) how it may affect the benefit of PR, 3) whether PR improves cognitive function and 4) whether cognitive dysfunction affects the usability of telehealth technology usually used to deliver in-home PR.. ..Mild cognitive dysfunction was found in 41 subjects …
https://2medical.news/2020/05/23/mid-term-effects-of-pulmonary-rehabilitation-on-cognitive-function-in-people-with-severe-chronic-obstructive-pulmonary-disease/
Cognitive dysfunction is a common impairment associated with COPD. However, little is known about 1) its prevalence among those subjects referred for pulmonary rehabilitation (PR), 2) how it may affect the benefit of PR, 3) whether PR improves cognitive function and 4) whether cognitive dysfunction affects the usability of telehealth technology usually used to deliver in-home PR.. ..Mild cognitive dysfunction was found in 41 subjects …
Chronic Obstructive #Pulmonary Disease and Incidence of #Hip Fracture: A Nested Case–Control Study in the EpiChron Cohort
https://2medical.news/2020/11/12/chronic-obstructive-pulmonary-disease-and-incidence-of-hip-fracture-a-nested-case-control-study-in-the-epichron-cohort/
To determine whether chronic obstructive pulmonary disease (COPD) is a risk factor for hip fracture and identify other factors associated with hip fracture. Patients and Methods: Observational nested case–control study was conducted in Aragon, Spain in 2010. We included COPD patients aged > 40 years, in the EpiChron cohort. Each COPD patient was matched for age, sex, and number of comorbidities with a control subject …
https://2medical.news/2020/11/12/chronic-obstructive-pulmonary-disease-and-incidence-of-hip-fracture-a-nested-case-control-study-in-the-epichron-cohort/
To determine whether chronic obstructive pulmonary disease (COPD) is a risk factor for hip fracture and identify other factors associated with hip fracture. Patients and Methods: Observational nested case–control study was conducted in Aragon, Spain in 2010. We included COPD patients aged > 40 years, in the EpiChron cohort. Each COPD patient was matched for age, sex, and number of comorbidities with a control subject …