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  Citation statistics : Table of Contents
   2016| October-December  | Volume 3 | Issue 4  
    Online since January 17, 2017

 
 
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REVIEW ARTICLES
Non-cystic fibrosis bronchiectasis: The long road to multidrug resistant bacteria
José Miguel Sahuquillo-Arce, Raúl Méndez, Alicia Hernández-Cabezas, Rosario Menéndez
October-December 2016, 3(4):110-117
DOI:10.4103/2225-6482.198491  
Bronchiectasis is a common progressive respiratory disease characterized by exacerbations and recurrent chest infections with high morbidity and reduced quality of life. Cole's vicious cycle model explains the evolution of this disease, in which an initial insult in the bronchi, often on a background of impaired mucociliary clearance or bactericidal activity, results in persistence of microbes in the sinobronchial tree and microbial colonization. Microbial overgrowth then causes infection and chronic inflammation, resulting in tissue damage, and impaired mucociliary motility. Subsequent antimicrobial treatments, microbiota interactions, and hypermutation can favor the development of resistance and the appearance of multidrug-resistant (MDR) bacteria. In this paper, we summarize the current knowledge on how bacteria become MDR in noncystic fibrosis bronchiectasis, and which are the most common bacterial pathogens, excluding Mycobacteria.
  1 3,009 595
Recognition of allergic bronchopulmonary aspergillosis
Xiao-Pei Cao, Min Xie, Xian-Sheng Liu
October-December 2016, 3(4):118-122
DOI:10.4103/2225-6482.198493  
Allergic bronchopulmonary aspergillosis (ABPA) is a complicated inflammatory condition characterized by an allergic response to the fungus Aspergillus colonizing in the bronchus. It occurs most frequently in patients with asthma or cystic fibrosis. Oral corticosteroids are the standard therapy for ABPA. Antifungal drugs can clear the fungi in the airway, reduce the body's antigen load, decrease the body's allergic reaction, and reduce corticosteroid requirement. Total serum IgE should be used as an index for efficacy assessment during treatment and follow-up.
  1 3,328 233
CASE REPORT
Bronchiectasis in rare pulmonary diseases: A case series
Ines Maria Grazia Piroddi, Edmundo Rosales, Catia Cilloniz, Adrian Ceccato, Antonello Nicolini
October-December 2016, 3(4):129-134
DOI:10.4103/2225-6482.198500  
Bronchiectasis, defined as permanent dilatation of the airways, usually causes chronic cough and sputum production with intermittent bacterial exacerbations. Bronchiectasis can have a severe impact on quality of life for many patients due to these symptoms. Establishing the cause of bronchiectasis may be difficult. Even with exhaustive clinical, laboratory, and pathologic testing, up to 50-80% of cases of bronchiectasis may still be idiopathic. Congenital bronchiectasis is much rarer than previously considered. A variety of respiratory and systemic diseases such as autoimmune or rheumatologic diseases may be complicated by pathological bronchial dilatation, and therefore various medical specialists will be dealing with the condition in one-way or another. Some bowel diseases are associated with a variety of systemic manifestations including large and small airway involvement: One of the most commonly associated airway diseases is bronchiectasis. On this regard, we report five patients with bronchiectasis and rare diseases admitted to our hospitals since 2012. Patients were recruited over a period of 36 months after opening a bronchiectasis outpatient clinic.
  - 4,832 293
ORIGINAL ARTICLE
A new wave of influenza A: Description of a cohort of patients in 2013 from a general hospital in Buenos Aires, Argentina
Adrian Ceccato, Alejandra Gonzalez, Elsa Oshiro, Liliana Aguilar, Luciana Ferrando, Maria Sol Sigismondo, Silvina Delarrosa, Jorge Andrada, Graciela Cabral, Marcelo Villaverde
October-December 2016, 3(4):123-128
DOI:10.4103/2225-6482.198497  
Background and Objectives: The first pandemic of the 21 st century was caused in 2009 by influenza A(H1N1). An increase in the number of cases caused by influenza A(H1N1) pdm09 was observed in 2013. The aim was to describe the number of influenza cases observed during 2013 in a general hospital of Argentina. Materials and Methods: A prospective, observational cohort of adult patients with influenza was confirmed by reverse transcription-polymerase chain reaction. Results: We analyzed 428 patients between epidemiological weeks 21 and 31, resulting in 134 (31%) patients who were positive for influenza A. Of these patients, 78% were infected with H1N1 (2009), 17% with H3, and 5% with a subtype that could not be determined. The mean patients' age was 53 ± 18 years. Eighty-three percent of patients had not been vaccinated, and no differences between vaccinated and nonvaccinated patients were observed. Seventy-five percent of patients had underlying conditions. Twenty-eight patients were treated as outpatients, and 86 required admission to the general ward, and 20 to the Intensive Care Unit. A significant difference in patient's age was observed between individuals infected with influenza H1N1 and those infected with other non-H1N1 subtypes. The mortality rate was 11%. In the multivariable analysis, mechanical ventilation (odds ratio: 27.66; 95% confidence interval [CI]: 6.43-119; P < 0.001) and cancer (odds ratio: 6.81; 95% CI: 1.25-37.13; P = 0.02) were predictors of mortality. Conclusions: We report a new wave of influenza A(H1N1). Most patients had underlying conditions, and a significant number of patients had not been vaccinated. Mortality was high; the only predictors of mortality were cancer and the need for mechanical ventilation.
  - 1,984 163
PERSPECTIVE
Phenotyping in bronchiectasis: Are we moving toward a personalized medicine?
Paola Faverio, Stefano Carlo Zucchetti, Edoardo Simonetta, Francesco Amati, Andrea Gramegna, Giovanni Sotgiu, Francesco Blasi, Anthony De Soyza, Stefano Aliberti
October-December 2016, 3(4):96-103
DOI:10.4103/2225-6482.198488  
Bronchiectasis (BE) is a heterogeneous disease. Similarly, to other chronic airway diseases, such as asthma and chronic obstructive pulmonary disease, management of BE patients requires a specific and personalized treatment that depends on many clinical, functional, and microbiological variables. Therefore, developing phenotyping methods that can help clinical and therapeutic choices is of paramount importance. Various methodological approaches have been used to personalize patients' management. In this review, we explore the main tools identified so far to classify and phenotype BE patients, including the approaches based on BE etiologies, disease severity, cluster analysis, and endotyping. We also discuss the strengths and limitations of every approach and highlight the similarities and differences between these studies. Finally, we review the therapeutic implications and clinical management connected with each approach.
  - 2,687 3,692
REVIEW ARTICLES
Nontuberculous mycobacteria and bronchiectasis
Concepción Prados Sánchez, Gabriela González, Sarai Quirós Fernández, María Martínez Redondo, Alberto Mangas Moro
October-December 2016, 3(4):104-109
DOI:10.4103/2225-6482.198489  
Non-tuberculous mycobacteria (NTM) are ubiquitous microorganisms in our environment. Although data are not truthful, we can say that we are experiencing an increase in the incidence-prevalence of infections by these microorganisms, especially in vulnerable population such as those with certain respiratory diseases, such as bronchiectasis (BQ). In all species NTM, the most studied is Mycobacterium avium complex, although the M abscessus is considered the most serious species in cystic fibrosis (CF) and M. xenopi in non-CF BQ. They described five clinical forms, the most frequent nodular/bronchiectasis and severe disseminated. The diagnosis of NTM lung disease in BQ is complicated, and continues to rely on three variables: clinical, radiological and microbiological. Given this difficulty, many suggest an observation period before starting a treatment, not always well tolerated and with side effects. Although morbidity and mortality is not high, they have been described risk factors that make it essential early treatment to avoid further serious complications.
  - 619 30
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