Personalized Variable vs Fixed-Dose Systemic Corticosteroid Therapy in Hospitalized Patients With Acute Exacerbations of COPD
A Prospective, Multicenter, Randomized, Open-Label Clinical Trial. CHEST 2021; 160(5):1660-1669.
INTERPRETATION: Personalized dosing of corticosteroids reduces the risk of failure because more patients were provided with a higher initial dose, especially > 60 mg, whereas 40 mg or less was too low in either group.
Presenta: Dra. Paola Zurita
Estudio:
Tessa M Kole. Predictors and associations of the persistent airflow limitation phenotype in asthma: a post-hoc analysis of the ATLANTIS study. Lancet Respir Med 2023; 11: 55–64. Published Online July 27, 2022. https://doi.org/10.1016/ S2213-2600(22)00185-0
Interpretation: PAL is not only present in severe disease, but also in a considerable proportion of patients with milder disease. In patients with mild asthma, PAL is associated with eosinophilic inflammation and a higher risk of exacerbations. Our findings are important because they suggest that increasing treatment intensity should be considered in patients with milder asthma and PAL.
Presenta el Dr. Miljienko Lolas
Estudio:
Janjua?S. Prophylactic antibiotics for adults with chronic obstructive pulmonary disease: a network meta-analysis. Cochrane Database of Systematic Reviews 2021, Issue 1. Art. No.: CD013198. DOI: 10.1002/14651858.CD013198.pub2
Compared to placebo, prolonged administration of macrolides (ranked first) appeared beneficial in prolonging the time to next exacerbation, improving quality of life, and reducing serious adverse events. No clear benefits were associated with use of quinolones or tetracyclines. In addition, antibiotic resistance was a concern and could not be thoroughly assessed in this review. Given the trade-of between eIectiveness, safety, and risk of antibiotic resistance, prophylactic administration of antibiotics may be best reserved for selected patients, such as those experiencing frequent exacerbations. However, none of the eligible studies excluded patients
Presenta el Dr. Felipe Cayupi
Estudio: Electronic Nicotine-Delivery Systems for Smoking Cessation. N Engl J Med 2024;390:601-10 The addition of e-cigarettes to standard smoking-cessation counseling resulted in greater abstinence from tobacco use among smokers than smoking-cessation counseling alone.
Presenta el Dr. Juan Pablo Cuevas
Estudio Transbronchial needle aspiration combined with cryobiopsy in the diagnosis of mediastinal diseases: a multicentre, open-label, randomised trial. Lancet Respir Med 2023;11: 256–64 The addition of mediastinal cryobiopsy to standard EBUS-TBNA resulted in a significant improvement in diagnostic yield for mediastinal lesions, with a good safety profile. These data suggest that this combined approach is a valid first-line diagnostic tool for mediastinal diseases.
Presenta Dr. Pablo Caballero