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Fibrosing interstitial lung diseases involve different pathogenic pathways with similar outcomes.

Authors: Vasakova M, Poletti V Abstract Fibrosing interstitial lung diseases (ILDs) are a large group of diseases triggered by external or internal stimuli that can have similar outcomes, i.e. lung fibrosis. Some ILDs are primarily fibro-proliferative disorders in which alveolar loss and epithelial/fibroblastic proliferation and dysplasia lead to lung fibrosis and architectural derangement, while other ILDs are considered inflammatory disorders in which specific underlying conditions (with either an external or an internal origin) can shift the pathogenic process to the fibro-proliferative pathway. The treatment of primarily inflammatory ILDs, regardless of their tendency to switch to lung fibrosis usually consists of anti-inflammatory drugs (e.g. corticosteroids, cytostatic + immu...

Efficacy and safety of surgical lung biopsy for interstitial disease. Experience of 161 consecutive patients from a single institution in Italy.

CONCLUSIONS: Lung biopsy was performed mostly by VATS, with limited morbidity, and was effective in yielding a specific histologic diagnosis in the vast majority of undefined ILD cases. To optimize the outcome of surgical biopsy for specific diagnosis of ILD, this procedure should be performed only exceptionally in patients with critical respiratory illness as postoperative mortality risk in these subjects is exceedingly high. PMID: 26422571 [PubMed - in process] (Source: Sarcoidosis Vasculitis and Diffuse Lung Diseases)

Diagnostic efficacy of ultrasound-guided core-needle biopsy of peripheral lymph nodes in sarcoidosis.

Conclusion

Core-needle biopsy guided by ultrasound has a high efficacy for evidencing granulomas in sarcoidosis patients with PLN involvement either clinically palpable or in the presence of 18FFDG-PET/CT uptake. PMID: 26422562 [PubMed - in process] ()

Chronic obstructive pulmonary disease and periodontitis- unwinding their linking mechanisms

Conclusion The present article briefly reviews the interlinking mechanisms between the two diseases, starting with the role of periodontal pathogens, innate immunity, and, ultimately, imbalances in oxidative stress and the protease-antiprotease system. Although epidemiological evidence provides no clear association between these two diseases, the striking commonalities should not be overlooked. Hence, future research should be targeted to this area in order to obtain constructive information. (Source: Journal of Oral Biosciences)

Trends in use and impact on outcome of empiric antibiotic therapy and non-invasive ventilation in COPD patients with acute exacerbation.

Related Articles

Trends in use and impact on outcome of empiric antibiotic therapy and non-invasive ventilation in COPD patients with acute exacerbation.

Ann Intensive Care. 2015 Dec;5(1):30

Authors: Ouanes I, Ouanes-Besbes L, Ben Abdallah S, Dachraoui F, Abroug F

Abstract
BACKGROUND: Empiric antibiotic therapy is routinely prescribed in patients with acute COPD exacerbations (AECOPD) requiring ventilatory support on the basis of studies including patients conventionally ventilated. Whether this practice remains valid to current management with first-line non-invasive ventilation (NIV) is unclear.
METHODS: In a cohort of ICU patients admitted between 2000 and 2012 for AECOPD, we analyzed the trends in empiric antibiotic therapy and in primary ventilatory support strategy, and their respective impact on patients' outcome.
RESULTS: 440 patients admitted for 552 episodes were included; primary NIV use increased from 29 to 96.7 % (p < 0.001), whereas NIV failure rate decreased significantly (p = 0.004). In parallel, ventilator-associated pneumonia (VAP) rate, VAP density and empiric antibiotic therapy use decreased (p = 0.037, p = 0.002, and p < 0.001, respectively). These figures were associated with a trend toward lower ICU mortality rate (p = 0.058). Logistic regression showed that primary NIV use per se was protective against fatal outcome [odds ratios (OR) = 0.08, 95 %CI 0.03-0.22; p < 0.001], whereas NIV failure, VAP occurrence, and cardiovascular comorbidities were associated with increased ICU mortality [OR = 17.6 (95 %CI 5.29-58.93), 11.5 (95 %CI 5.17-25.45), and 3 (95 %CI 1.37-6.63), respectively]. Empiric antibiotic therapy was associated with decreased VAP rate (log rank; p < 0.001), but had no effect on mortality (log rank; p = 0.793).
CONCLUSIONS: The sustained increase in NIV use allowed a decrease in empiric antibiotic prescriptions in AECOPD requiring ventilatory support. Primary NIV use and its success, but not empiric antibiotic therapy, were associated with a favorable impact on patients' outcome.

PMID: 26429357 [PubMed]

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