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Saturday 12 Sep 2020
Bronchoscopy units were partly prepared for the #COVID19 pandemic. However, sound evidence to guide units and an international concerted effort are urgently needed to formulate recommendations for future pandemics. buff.ly/2RjMWXh
Background The worldwide impact of the coronavirus disease 2019 (COVID-19) pandemic is unprecedented. Among the aerosol generating procedures, bronchoscopy in particular is an indispensable diagnostic and therapeutic tool that comes with a high risk of infection. Therefore, national societies have i...
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Saturday 12 Sep 2020
Free Access: Low prevalence of bronchial asthma and chronic obstructive lung disease among intensive care unit patients with COVID‐19. Corresponding Author: Sergey Moiseev; Download Article Here: buff.ly/32nm52O
Click on the article title to read more.
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Saturday 12 Sep 2020
What characterizes the interaction between allergen and rhinovirus-induced inflammation over time? A study details the responses of those with allergic asthma to experimental rhinovirus-16 inoculation and evaluates the effects of omalizumab.
Rhinovirus frequently causes asthma exacerbations among children and young adults who are allergic. The interaction between allergen and rhinovirus-induced symptoms and inflammation over time is unclear.
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Saturday 12 Sep 2020
Defining Airflow Obstruction: More Data, Further Clarity
Journals do not normally write editorials about letters. Of course, some letters merit attention being drawn to them. When Watson and Crick wrote a letter to Nature in 1953 proposing a new structure for deoxyribose nucleic acid (1), they changed the world and, ultimately, clinical practice. Their le...
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Saturday 12 Sep 2020
The University of Oxford and AstraZeneca will resume trials of their Covid-19 vaccine candidate after receiving clearance from the UK's Medicines Health Regulatory Authority.
The University of Oxford and AstraZeneca will resume trials of their Covid-19 vaccine candidate after receiving clearance from the UK's Medicines Health Regulatory Authority.
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Saturday 12 Sep 2020
A series on Asthma in the Lancet Worth reading!!!
Despite advances in the diagnosis and management of asthma, this heterogeneous disease still poses an unacceptable health and economic burden globally. The prevalence of asthma is increasing in many regions, and inadequate treatment can lead to substantial disease morbidity and mortality. Steps to e...
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Saturday 12 Sep 2020
Electronic alert may reduce excessive prescribing of short-acting asthma relievers
An automatic electronic computer alert for general practitioners helped identify and reduce excessive prescribing of short-acting beta agonists for patients with asthma.The automatic electronic alert was introduced on general practitioners’ computer systems in 2015. The alert pops up when pati...
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Friday 11 Sep 2020
The chief adviser for the White House vaccine program said Thursday it was “extremely unlikely, but not impossible” that a COVID-19 vaccine could be available by the end of October.
The chief adviser for the White House vaccine program said it was "extremely unlikely" that a COVID-19 vaccine could be available by the end of October.
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Friday 11 Sep 2020
Check out this infographic on the potential role of cytokine storm in the pathogenesis and severity of COVID-19 disease: https://hubs.ly/H0vSJvz0
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Friday 11 Sep 2020
A cure for rhinovirus is not on the near horizon, but we can identify susceptibility factors for related wheeze and potentially modify immune response to RV infection. An editorial comments on 3 promising studies.
Rhinoviruses (RVs) cause respiratory illnesses that are closely linked to asthma in all age groups. RV infections that cause wheezing in infants are strong risk factors for developing asthma, and once asthma is established, RV infections are major contributors to exacerbations of asthma in children....
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Monday 07 Sep 2020
Initial combination therapy of macitentan and tadalafil in pulmonary arterial hypertension.
Overall, in the prospective OPTIMA study, initial double combination therapy with macitentan and tadalafil led to a significant improvement, from baseline to week 16, in cardiopulmonary haemodynamics, functional parameters, NT-proBNP and risk profile in newly diagnosed, treatment-naïve patients with PAH. There were no unexpected safety findings during long-term follow-up.
Initial combination therapy plays a central role in managing pulmonary arterial hypertension (PAH) [1–4]. Patients with low- or intermediate-risk of 1-year mortality at diagnosis should be treated with initial combination therapy with an endothelin receptor antagonist (ERA) and phosphodiesterase t...
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Monday 07 Sep 2020
Sarcoidosis in a time of pandemic.
We are living in a historic event: a novel virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China at the end of 2019 and began its global circulation. By January 24, 2020, at least 830 cases and 26 fatalities were reported across Asia and the USA [1]. 6 months l...
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Monday 07 Sep 2020
With the use of an accurate high throughput assay, researchers from the Weizmann Institute of Science and Magen David Adom Blood Services in Israel showed substantial inter-individual variability and antibody cross-reactivity against seasonal coronaviruses upon SARS-CoV-2 infection, with important i...
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Monday 07 Sep 2020
In a new study published on the preprint server medRxiv, researchers from Laval University and McGill University in Canada reviewed evidence from 18 relevant studies on a possible interaction between influenza vaccines on non-influenza respiratory disease (NIRD).
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Sunday 06 Sep 2020
This meta-analysis pools data from 7 randomized trials to estimate the association between administration of corticosteroids vs usual care or placebo and all-cause mortality at 28 days in patients with severe coronavirus disease 2019 (COVID-19).
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Sunday 06 Sep 2020
CORTICOSTEROIDS FOR COVID-19: WHAT TO DO
(guidance by WHO)
BASIC SUMMARYOF RECOMMENDATIONS:
Recommendation 1: We recommend systemic corticosteroids rather than no corticosteroids for the treatment of patients with severe and critical COVID-19 (strong recommendation).
Recommendation 2: We suggest not to use systemic corticosteroids in the treatment of patients with non-severe COVID-19 (conditional recommendation).
**The evidence: **The panel made its recommendation on the basis of the moderate certainty evidence of a mortality reduction of 8.7% and 6.7% in patients with COVID-19 who are critically or severely ill.
Definitions of COVID-19 severity:
Critical COVID-19: Defined by the criteria for acute respiratory distress syndrome (ARDS), sepsis, septic shock or other conditions that would normally require the provision of life-sustaining therapies, such as mechanical ventilation (invasive or non-invasive) or vasopressor therapy.
Severe COVID-19: Defined by any of:
• oxygen saturation < 90% on room air.
• respiratory rate > 30 breaths per minute in adults and children > 5 years old; ≥ 60 in children less than 2 months; ≥ 50 in children 2–11 months; and ≥ 40 in children 1–5 years old.
• signs of severe respiratory distress (i.e. accessory muscle use, inability to complete full sentences; and in children, very severe chest wall indrawing, grunting, central cyanosis, or presence of any other general danger signs).
Non-severe COVID-19: Defined as absence of any signs of severe or critical COVID-19.
Key practical issues for the use of systemic corticosteroids:
Medication route: systemic corticosteroids may be administered orally or intravenously.
Medication type: dexamethasone or other corticosteroids, such as hydrocortisone or prednisone may be used.
Medication routine: once daily regimens of dexamethasone 6 mg once daily is equivalent to 160 mg of hydrocortisone (e.g. 50 mg every 8 hours or 100 mg every 12 hours), 40 mg of prednisone, 32 mg of methylprednisolone (e.g. 8 mg every 6 hours or 16 mg every 12 hours).
Duration: up to 7–10 days.
Monitoring: monitor glucose levels, regardless of whether patient is known to have diabetes.
Adverse effects, interactions and antidote: the safety profile of systemic corticosteroids is favourable.
Costs and access: systemic corticosteroid therapy is a low-cost intervention that is easy to administer and readily available globally.
Living Guidance
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Saturday 05 Sep 2020
Steroids cut COVID-19 death rates, but not for everyone – here’s who benefits and who doesn’t
Three new studies show corticosteroids can reduce deaths in critically ill COVID-19 patients. But what about other patients?
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Saturday 05 Sep 2020
Eosinophilic Granulomatosis with Polyangiitis (EGPA): Expert Perspectives on Diagnosis and Treatment
Eosinophilic granulomatosis with polyangiitis (EGPA), formerly called Churg-Strauss syndrome, is a rare form of vasculitis that primarily affects the small blood vessels. Individuals diagnosed with EGPA commonly have a history of asthma and/or allergies. Inflammation associated with EGPA can lead to...
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Saturday 05 Sep 2020
Stability of serum precipitins to Aspergillus fumigatus for the diagnosis of allergic bronchopulmonary aspergillosis | Allergy, Asthma & Clinical Immunology | Full Text
Allergic bronchopulmonary aspergillosis (ABPA) reflects hypersensitivity and an exaggerated immune response to Aspergillus fumigatus. ABPA typically occurs in individuals with airway diseases such as asthma or cystic fibrosis and is associated with worse outcomes for individuals with these condition...
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Saturday 05 Sep 2020
Bronchial Rheoplasty for Treatment of Chronic Bronchitis. Twelve-Month Results from a Multicenter Clinical Trial
Rationale: Chronic bronchitis (CB) is characterized by productive cough with excessive mucus production, resulting in quality-of-life impairment and increased exacerbation risk. Bronchial rheoplast...
