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Targeted therapy in the management of severe asthma patients High T2 High esinophil count and HIGH igE They are responsive to corticosteriods and biological Low T2 Normal esnophil count and normal IgE THEY ARE POOR TO STERIODS AND POOR RESPONSE TO BIOLOGICALS
Multicentre evaluation of multidisciplinary team meeting agreement on diagnosis in diffuse parenchymal lung disease: a case-cohort study Agreement between MDTMs for diagnosis in diffuse lung disease is acceptable and good for a diagnosis of IPF, as validated by the non-significant greater prognostic separation of an IPF diagnosis made by MDTMs than the separation of a diagnosis made by individual clinicians or radiologists. Furthermore, MDTMs made the diagnosis of IPF with higher confidence and more frequently than did clinicians or radiologists. This difference is of particular importance, because accurate and consistent diagnoses of IPF are needed if clinical outcomes are to be optimised. Inter-multidisciplinary team agreement for a diagnosis of hypersensitivity pneumonitis is low, highlighting an urgent need for standardised diagnostic guidelines for this disease.
Why Are Teens so Tired? Sleep Debate Could Change How America Does School Encourage school districts to start the class day no earlier than 8:30 a.m. for middle and high school students in order to accommodate their changing body clocks and improve their chances for quality sleep.
Blood Eosinophils and Response to Maintenance Chronic Obstructive Pulmonary Disease Treatment. Data from the FLAME Trial. indacaterol/glycopyrronium provides superior or similar benefits over salmeterol/fluticasone regardless of blood eosinophil levels in patients with COPD The incidence of pneumonia was higher in patients receiving salmeterol/fluticasone than indacaterol/glycopyrronium in both the <2% and ≥2% subgroups Indacaterol/glycopyrronium was significantly superior to salmeterol/fluticasone for the prevention of exacerbations
What is a chest infection and what causes it? Acute bronchitis This is an infection of the large airways in the lungs (bronchi). Acute bronchitis is common and is often due to a viral infection. Infection with a germ (bacterium) is a less common cause. Pneumonia This is a serious infection of the lung. Treatment with medicines called antibiotics is usually needed. How common are chest infections? Chest infections are very common, especially during the autumn and winter. They often occur after a cold or flu. Anyone can get a chest infection but they are more common in: Young children and the elderly. People who smoke. People with long-term chest problems such as asthma. What are the symptoms of a chest infection? The main symptoms are a chesty cough, breathing difficulties and chest pain. You may also have headaches and have a high temperature (fever). The symptoms of an infection of the large airways (bronchi) in the lungs (acute bronchitis) and a serious lung infection (pneumonia) may be similar; however, pneumonia symptoms are usually more severe
COPD (Chronic obstructive pulmonary diseases or chronic bronchitis) Assessment of the risk of death in this patients depend on their BODE Index B stand for BMI, O- Obstruction depending on FEV1, D - Shortness of breath OR dyspnea using MMRC scale , E - Exercise capacity, measured by 6 minutes walk test 6MWT.This index calculated using a scale of 0 to 3 for each parameter, depending on severity. except BMI scale different < 21 is 0 and more than >21 is 1. BODE score of 7 to 10 falls in the higher chance of mortality. Other factors have also been associated with increased moribidity and mortality in COPD , For example : acute exacerbation of COPD, Hospitalization, cardiac comorbidities Survival benefit are smoking cessation and lung volume reduction surgery in selected patients .Oxygen is beneficial who are hypoxemic on room air. None of the medications consistently demonstrated to prolong life.
COPD patients significant effects on survival have been shown for several interventions , including. high-frequency neuromuscular electrical stimulation should initiated as the main training modality during his Pulmonary rehabilitation programme, weight gain in underweight patients , non-invasive positive pressure ventilation in chronic hypercapnic patients and lung volume reduction surgery or endobronchial valve treatment in patients with upper-lobe predominant emphysema and poor exercise capacity
Diagnostic Yield and Complications of Transbronchial Lung Cryobiopsy for Interstitial Lung Disease. A Systematic Review and Metaanalysis The diagnostic accuracy of transbronchial lung cryobiopsy cannot be determined given the absence of studies directly comparing cryobiopsy diagnoses with diagnoses derived from surgical lung biopsies interpreted within multidisciplinary discussions. The histopathological and multidisciplinary discussion-based diagnostic yield of transbronchial cryobiopsy appears high, but with variable frequencies of complications dominated by pneumothorax and moderate-to-severe hemorrhage.
A definitive diagnosis of pleural TB depends on the isolation of Mycobacterium tuberculosis in the sputum, pleural fluid or pleural biopsy specimens, or the demonstration of caseating granulomas in the parietal pleura. However, lymphocytic exudades with a high ADA content (>35–40 U/L) are generally accepted as tuberculous in the correct clinical context. ● When the cause of a pleural effusion remains obscure after the standard initial workup, which may eventually include pleural biopsy, medical history and all available diagnostic examinations should be revisited. Most of these effusions will resolve spontaneously
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