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Legionnaires Disease: Causes, Symptoms and Treatment

Legionnaire's disease is a form of severe pneumonia involving inflammation usually caused by a resulting infection. The disease is caused by a bacterium known as, 'legionalla.' People cannot catch Legionnaire's disease from person-to-person contact. Instead, the majority of people get the disease from inhaling the bacteria. Older adults, people with weakened immune systems, as well as smokers, are all especially susceptible to Legionnaire's disease. (Source: Disabled World)

Global Health: Guarding Against Disease Among Pilgrims to Mecca

Saudi and European scientists outline steps that will be taken to prevent outbreaks of MERS and other illnesses when the hajj starts in October. (Source: NYT)

Pulmonary drug delivery by powder aerosols.

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The efficacy of pharmaceutical aerosols relates to its deposition in the clinically relevant regions of the lungs, which can be assessed by in vivo lung deposition studies. Dry powder formulations are popular as devices are portable and aerosolisation does not require a propellant.

Over the years, key advancements in dry powder formulation, device design and our understanding on the mechanics of inhaled pharmaceutical aerosol have opened up new opportunities in treatment of diseases through pulmonary drug delivery.

This review covers these advancements and future directions for inhaled dry powder aerosols.

Respiratory viruses in exacerbations of non-cystic fibrosis bronchiectasis in children.

Respiratory viral infections precipitate exacerbations of chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease though similar data in non-cystic fibrosis (CF) bronchiectasis are missing. Our study aimed to determine the point prevalence of viruses associated with exacerbations and evaluate clinical and investigational differences between virus-positive and -negative exacerbations in children with bronchiectasis.

METHODS: A cohort of 69 children (median age 7 years) with non-CF bronchiectasis was prospectively followed for 900 child-months. PCR for 16 respiratory viruses was performed on nasopharyngeal aspirates collected during 77 paediatric pulmonologist-defined exacerbations. Clinical data, systemic (C reactive protein (CRP), IL-6, procalcitonin, amyloid-A, fibrinogen) and lung function parameters were also collected.

FINDINGS: Respiratory viruses were detected during 37 (48%) exacerbations: human rhinovirus (HRV) in 20; an enterovirus or bocavirus in four each; adenoviruses, metapneumovirus, influenza A virus, respiratory syncytial virus, parainfluenza virus 3 or 4 in two each; coronavirus or parainfluenza virus 1 and 2 in one each. Viral codetections occurred in 6 (8%) exacerbations. HRV-As (n=9) were more likely to be present than HRV-Cs (n=2). Children with virus-positive exacerbations were more likely to require hospitalisation (59% vs 32.5% (p=0.02)) and have fever (OR 3.1, 95% CI 1.2 to 11.1), hypoxia (OR 25.5, 95% CI 2.0 to 322.6), chest signs (OR 3.3, 95% CI 1.1 to 10.2) and raised CRP (OR 4.7, 95% CI 1.7 to 13.1) when compared with virus-negative exacerbations.

INTERPRETATION: Respiratory viruses are commonly detected during pulmonary exacerbations of children with bronchiectasis. HRV-As were the most frequently detected viruses with viral codetection being rare. Time-sequenced cohort studies are needed to determine the role of viral-bacterial interactions in exacerbations of bronchiectasis.

The Six-Minute-Walk Test in assessing respiratory function after tumor surgery of the lung: a cohort study.

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The Six-Minute-Walk Test (6-MWT) is an established and well-validated diagnostic procedure in cardiovascular and pulmonary diseases. The significance of the 6-MWT in the assessment of the respiratory function in tumor patients after lung surgery is yet unclear.

METHODS: The retrospective study included 227 patients following oncological rehabilitation after lobectomy, pneumonectomy or wedge- and segmental resection due to a malignant tumor disease. Spirometry and 6-MWT were performed at the beginning (T1) and at the end (T2) of oncological rehabilitation and correlated with each other. A subgroup analysis on clinically relevant parameters was conducted as well.

RESULTS: A significant improvement of the walking distance measured in 6-MWT as well as of forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were detected within the scope of spirometry (all three P<0.01). This effect was demonstrable in all subgroups, except for patients who underwent pneumonectomy. However, a low correlation of the parameters walking distance and FEV1 was observed at both measurement points T1 (rho value =0.21) and T2 (rho value =0.25).

CONCLUSIONS: Measuring the walking distance in the 6-MWT could be a suitable parameter to assess respiratory function.

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