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Lauzacco, Italy

Ambrosino N.,U.O. Pneumologia e Terapia Intensiva Respiratoria | Ambrosino N.,Volterra | Confalonieri M.,Science Pneumologia | Crescimanno G.,Cervello | And 2 more authors.
Respiratory Medicine | Year: 2013

Respiratory failure is an unavoidable event in the natural history of some neuromuscular diseases, while appearing very infrequently in others. In some cases, such as Pompe disease, respiratory failure progresses more rapidly than motor impairment, sometimes being the onset event. Home mechanical ventilation improves survival and quality of life of these patients, with a reduction in healthcare costs. Therefore, pulmonologists must improve their skills in order to play a more relevant role in the care of these patients. The aim of this statement is to provide pulmonologists with some simple information in order for them to fulfil their role of primary caregiver, enabling appropriate and rapid diagnosis and treatment. © 2013. Source

Bisconti M.,Pneumologia | Barbaro M.P.F.,University of Foggia | Serafni A.,Science Pneumologia | Martucci P.,U.O.C. Endoscopia Bronchiale | And 2 more authors.
Rassegna di Patologia dell'Apparato Respiratorio | Year: 2015

The main substances responsible for the diseases of the human respiratory system are marijuana, cocaine, ecstasy and some improperly used medicinal products. Drug epidemic begun in the '50s favoured by the wrong feeling that inhaled drugs were less harmful than injected ones. However they lead as well to sometimes lethal pathologic processes. While D.I.R.D. - Drug Induced Respiratory Diseases - have been thoroughly investigated in Northern Europe and USA they are barely known in Italy. Drug-related respiratory diseases include: asthma, pulmonary oedema, eosinophilic lung disease, COPD, BOOP, pneumothorax, Crack lung syndrome, empyema, granulomatosis, interstitial pulmonary fibrosis, Churg-Strauss Syndrome, ABPA, invasive aspergillosis, RADS, CAP, endocarditis, atelectasis, emphysema, pulmonary arterial hypertension, infections, bronchiectasis, haemoptysis and others. Source

Baraniuk J.N.,Georgetown University | Casado B.,Georgetown University | Pannell L.K.,University of South Alabama | McGarvey P.B.,Georgetown University | And 3 more authors.
International Journal of COPD | Year: 2015

Rationale: Subtypes of cigarette smoke-induced disease affect different lung structures and may have distinct pathophysiological mechanisms. Objective: To determine if proteomic classification of the cellular and vascular origins of sputum proteins can characterize these mechanisms and phenotypes. Subjects and methods: Individual sputum specimens from lifelong nonsmokers (n=7) and smokers with normal lung function (n=13), mucous hypersecretion with normal lung function (n=11), obstructed airflow without emphysema (n=15), and obstruction plus emphysema (n=10) were assessed with mass spectrometry. Data reduction, logarithmic transformation of spectral counts, and Cytoscape network-interaction analysis were performed. The original 203 proteins were reduced to the most informative 50. Sources were secretory dimeric IgA, submucosal gland serous and mucous cells, goblet and other epithelial cells, and vascular permeability. Results: Epithelial proteins discriminated nonsmokers from smokers. Mucin 5AC was elevated in healthy smokers and chronic bronchitis, suggesting a continuum with the severity of hypersecretion determined by mechanisms of goblet-cell hyperplasia. Obstructed airflow was correlated with glandular proteins and lower levels of Ig joining chain compared to other groups. Emphysema subjects’ sputum was unique, with high plasma proteins and components of neutrophil extracellular traps, such as histones and defensins. In contrast, defensins were correlated with epithelial proteins in all other groups. Protein-network interactions were unique to each group. Conclusion: The proteomes were interpreted as complex “biosignatures” that suggest distinct pathophysiological mechanisms for mucin 5AC hypersecretion, airflow obstruction, and inflammatory emphysema phenotypes. Proteomic phenotyping may improve genotyping studies by selecting more homogeneous study groups. Each phenotype may require its own mechanistically based diagnostic, risk-assessment, drug- and other treatment algorithms. © 2015 Baraniuk et al. Source

Vezzani G.,Science Pneumologia | Menzella F.,Science Pneumologia | Saetti R.,R.O.S.A. | Zucchi L.,Science Pneumologia
Rassegna di Patologia dell'Apparato Respiratorio | Year: 2011

There are a number of causes which can lead to the onset of inspiratory stridor and dysphagia and it is sometimes difficult to achieve diagnosis and correct therapeutic approach. We describe the case of a 72-year old man, caucasian, with subglottic concentric tracheal stenosis associated with bilateral vocal chord hypomobility and chronic tracheal and pulmonary aspiration of food material as a result of a stroke and gastrooesophageal reflux. The patient was initially subjected to intensive medical treatment which however did not prevent progressive worsening of the anatomic condition and the symptoms. We arrived at the diagnosis after conducting a number of tests. A diode laser-assisted right posterior ventriculocordectomy was then carried out which made it possible to improve the clinical condition. Source

Baldi S.,Science Pneumologia | Coni F.,Science Pneumologia | Ruffini E.,Cattedra di Chirurgia Toracica | Oliaro A.,Cattedra di Chirurgia Toracica
Rassegna di Patologia dell'Apparato Respiratorio | Year: 2011

Bronchial fistula represents a complication after pulmonary resection, frequently leading to pleural empyema. Their closure is therefore indispensable for the patient recovering, and the bronchoscopist often plays a central role in this treatment. We report 2 cases of patients undergoing pneumonectomy complicated by bronchial stump fistula, very different from each other, who have been dealt with a new device called amplatzer, used by cardiologists to close the inter-septal defects. To our knowledge only 3 cases have been reported in literature. If the first case, characterized by a longstanding fistula, was successful, not so for the second one, which was characterized by recent onset fistula after pneumonectomy in a patient undergoing lung re-transplantation. Source

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