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Emphysema

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1. Endobronchial valves for patients with advanced heterogeneous emphysema

Endobronchial valves for patients with advanced heterogeneous emphysema Health Policy Advisory Committee on Technology Technology Brief Update Endobronchial valves for patients with advanced heterogeneous emphysema March 2017 © State of Queensland (Queensland Department of Health) 2017 This work is licensed under a Creative Commons Attribution Non-Commercial No Derivatives 3.0 Australia licence. In essence, you are free to copy and communicate the work in its current form for non-commercial (...) HealthPACT through funding. This brief was prepared by Deanne Forel from Research & Evaluation, incorporating ASERNIP-S. Endobronchial valves for treatment of emphysema: Update March 2017 i 2017 Summary of findings In 2015, a Technology Brief was completed to investigate the use of endobronchial valves for the treatment of advanced heterogeneous emphysema. In light of developing evidence on the subject, the Brief recommended that this technology be monitored for further evidence in 24 months. Updated

2018 COAG Health Council - Horizon Scanning Technology Briefs

2. [Procedure for lung volume reduction in severe lung emphysema]

[Procedure for lung volume reduction in severe lung emphysema] Verfahren zur lungenvolumenreduktion beim schweren lungenemphysem: abschlussbericht; auftrag N14-04 [Procedure for lung volume reduction in severe lung emphysema] Verfahren zur lungenvolumenreduktion beim schweren lungenemphysem: abschlussbericht; auftrag N14-04 [Procedure for lung volume reduction in severe lung emphysema] Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record (...) of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Verfahren zur lungenvolumenreduktion beim schweren lungenemphysem: abschlussbericht; auftrag N14-04. [Procedure for lung volume reduction in severe lung emphysema] Cologne: Institut fuer Qualitaet und Wirtschaftlichkeit im Gesundheitswesen (IQWiG). IQWiG-Berichte 487. 2017 Final

2017 Health Technology Assessment (HTA) Database.

3. Lung volume reduction surgery for diffuse emphysema. (PubMed)

Lung volume reduction surgery for diffuse emphysema. Lung volume reduction surgery (LVRS) performed to treat patients with severe diffuse emphysema was reintroduced in the nineties. Lung volume reduction surgery aims to resect damaged emphysematous lung tissue, thereby increasing elastic properties of the lung. This treatment is hypothesised to improve long-term daily functioning and quality of life, although it may be costly and may be associated with risks of morbidity and mortality. Ten (...) years have passed since the last version of this review was prepared, prompting us to perform an update.The objective of this review was to gather all available evidence from randomised controlled trials comparing the effectiveness of lung volume reduction surgery (LVRS) versus non-surgical standard therapy in improving health outcomes for patients with severe diffuse emphysema. Secondary objectives included determining which subgroup of patients benefit from LVRS and for which patients LVRS

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2016 Cochrane

4. Salvianolic acid B as an anti-emphysema agent II: In vivo reversal activities in two rat models of emphysema. (PubMed)

Salvianolic acid B as an anti-emphysema agent II: In vivo reversal activities in two rat models of emphysema. Emphysema progressively destroys alveolar structures, leading to disability and death, yet remains irreversible and incurable to date. Impaired vascular endothelial growth factor (VEGF) signaling is an emerging pathogenic mechanism, thereby proposing a hypothesis that VEGF stimulation/elevation enables recovery from alveolar structural destruction and loss of emphysema. Our previous (...) in vitro study identified that salvianolic acid B (Sal-B), a polyphenol of traditional Chinese herbal danshen, stimulated lung cell proliferation and migration, and protected against induced lung cell death, by virtue of signal transducer and activator of transcription 3 (STAT3) activation and VEGF stimulation/elevation. Thus, this study examined Sal-B for in vivo therapeutic reversal of established emphysema in two rat models. Emphysema was induced with porcine pancreatic elastase (PPE) and cigarette

2018 Pulmonary Pharmacology & Therapeutics

5. Endobronchial valve insertion to reduce lung volume in emphysema

Endobronchial valve insertion to reduce lung volume in emphysema Endobronchial valv Endobronchial valve insertion to reduce lung e insertion to reduce lung v volume in emph olume in emphysema ysema Interventional procedures guidance Published: 20 December 2017 nice.org.uk/guidance/ipg600 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals (...) -and- conditions#notice-of-rights). Page 1 of 101 1 Recommendations Recommendations 1.1 Current evidence on the safety and efficacy of endobronchial valve insertion to reduce lung volume in emphysema is adequate in quantity and quality to support the use of this procedure provided that standard arrangements are in place for clinical governance, consent and audit. 1.2 Patient selection should be done by a multidisciplinary team experienced in managing emphysema, which should typically include a chest physician

2018 National Institute for Health and Clinical Excellence - Interventional Procedures

6. VIDAvision for lung volume analysis in emphysema

VIDAvision for lung volume analysis in emphysema VID VIDA Avision for lung v vision for lung volume analysis in olume analysis in emph emphysema ysema Medtech innovation briefing Published: 5 June 2018 nice.org.uk/guidance/mib148 pathways Summary Summary The technology technology described is VIDAvision. It is used for lung volume analysis in people with advanced emphysema who are being considered for lung reduction procedures. The inno innovativ vative aspects e aspects are that it uses (...) fissure integrity values to assess people with severe emphysema for endobronchial lung volume reduction surgery. The intended place in ther place in therap apy y would be in addition to current lung function and standard CT scans or as an alternative to bronchoscopy in people with severe emphysema. The main points from the e main points from the evidence vidence summarised in this briefing are from 3 studies done in Germany, Brazil and an international multicentre study including 323 adults

2018 National Institute for Health and Clinical Excellence - Advice

7. A randomised controlled study of Bronchoscopic Lung Volume Reduction with endobronchial valves for patients with Heterogeneous emphysema and Intact interlobar Fissures: the BeLieVeR-HIFi study

A randomised controlled study of Bronchoscopic Lung Volume Reduction with endobronchial valves for patients with Heterogeneous emphysema and Intact interlobar Fissures: the BeLieVeR-HIFi study A randomised controlled study of Bronchoscopic Lung Volume Reduction with endobronchial valves for patients with Heterogeneous emphysema and Intact interlobar Fissures: the BeLieVeR-HIFi study the BeLieVeR-HIFi study Journals Library An error occurred retrieving content to display, please try again

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2015 NIHR HTA programme

8. Differing Expression of Cytokines and Tumor Markers in Combined Pulmonary Fibrosis and Emphysema compared to Emphysema and Pulmonary Fibrosis. (PubMed)

Differing Expression of Cytokines and Tumor Markers in Combined Pulmonary Fibrosis and Emphysema compared to Emphysema and Pulmonary Fibrosis. This study aimed to explore the different pathogeneses of combined pulmonary fibrosis and emphysema (CPFE) from emphysema and pulmonary fibrosis. The levels of transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), Krebs Von Den Lungen-6 (KL-6), matrix metalloproteinase-9 (MMP-9), tissue inhibitors of metalloproteinases-1 (...) (TIMP-1), cytokeratin 19 fragment (CYFRA21-1), squamous cell carcinoma antigen (SCC), and the telomerase activity in peripheral blood were measured in 38 CPFE patients, 50 pulmonary emphysema patients, and 34 idiopathic pulmonary fibrosis (IPF) patients. The results demonstrated that the levels of VEGF and TGF-β1 in IPF patients were significantly higher than those in emphysema patients (p < 0.05), and no significant differences were detected between CPFE patients and other two groups (p > 0.05

2017 COPD

9. ADRB2 gene polymorphism and emphysema heterogeneity can modulate bronchodilator response in patients with emphysema. (PubMed)

ADRB2 gene polymorphism and emphysema heterogeneity can modulate bronchodilator response in patients with emphysema. Genetic variation in the β2-adrenergic receptor (ADRB2) gene has been thought to have an important role in the differential response to β2-agonist therapy for asthma. However, previous studies have shown little evidence for an association between these ADRB2 variants and the bronchial dilator response (BDR) in chronic obstructive pulmonary disease (COPD) patients (...) . This discrepancy could be explained by differences in the distribution and heterogeneity of pulmonary emphysema in COPD patients, since emphysema distribution and heterogeneity are thought to have a role in pulmonary function in COPD patients. We hypothesized that differences in emphysema distribution and heterogeneity may have masked significant alterations of the bronchodilator response among ADRB2 genotypes in COPD patients in previous studies.The BDR (induced by 20 μg of procaterol) was measured in 211

2017 Pulmonary Pharmacology & Therapeutics

10. Different histological subtypes of peripheral lung cancer based on emphysema distribution in patients with both airflow limitation and CT-determined emphysema. (PubMed)

Different histological subtypes of peripheral lung cancer based on emphysema distribution in patients with both airflow limitation and CT-determined emphysema. The histological subtypes by peripheral tumor location remain uncharacterized in COPD patients with emphysema. We investigated histologic subtypes of peripheral lung cancers based on the context of heterogeneous emphysema distribution in patients with airflow limitation and CT-determined emphysema. A retrospective, cross-sectional study (...) was conducted using data from 754 patients with airflow limitation and newly-diagnosed primary lung cancers from February 2013 to February 2015. Of these, 230 patients had emphysema, as determined by computed tomography software designed to quantify emphysema. Among the 230 patients, the most common subtype in central lesions (n=84) was squamous cell carcinoma (SCC) (n=64/84, 76%). Adenocarcinoma (ADC) was more frequently observed in peripheral lesions (n=146) than central lesions (58/146 [40%] vs. 4/84 [5

2017 Lung Cancer

11. Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection. (PubMed)

Emphysema Distribution and Diffusion Capacity Predict Emphysema Progression in Human Immunodeficiency Virus Infection. Chronic obstructive pulmonary disease (COPD) and emphysema are common amongst patients with human immunodeficiency virus (HIV). We sought to determine the clinical factors that are associated with emphysema progression in HIV.345 HIV-infected patients enrolled in an outpatient HIV metabolic clinic with ≥2 chest computed tomography scans made up the study cohort. Images were (...) qualitatively scored for emphysema based on percentage involvement of the lung. Emphysema progression was defined as any increase in emphysema score over the study period. Univariate analyses of clinical, respiratory, and laboratory data, as well as multivariable logistic regression models, were performed to determine clinical features significantly associated with emphysema progression.17.4% of the cohort were emphysema progressors. Emphysema progression was most strongly associated with having a low

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2016 PLoS ONE

12. Variable Susceptibility to Cigarette Smoke–Induced Emphysema in 34 Inbred Strains of Mice Implicates Abi3bp in Emphysema Susceptibility (PubMed)

Variable Susceptibility to Cigarette Smoke–Induced Emphysema in 34 Inbred Strains of Mice Implicates Abi3bp in Emphysema Susceptibility Chronic obstructive pulmonary disease (COPD) is caused by a complex interaction of environmental exposures, most commonly cigarette smoke, and genetic factors. Chronic cigarette smoke exposure in the mouse is a commonly used animal model of COPD. We aimed to expand our knowledge about the variable susceptibility of inbred strains to this model and test (...) for genetic variants associated with this trait. To that end, we sought to measure differential susceptibility to cigarette smoke-induced emphysema in the mouse, identify genetic loci associated with this quantitative trait, and find homologous human genes associated with COPD. Alveolar chord length (CL) in 34 inbred strains of mice was measured after 6 months of exposure to cigarette smoke. After testing for association, we connected a murine candidate locus to a published meta-analysis of moderate

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2017 American journal of respiratory cell and molecular biology

13. Delayed functional improvement after near-fatal bleeding complication following endobronchial valve therapy for emphysema. (PubMed)

Delayed functional improvement after near-fatal bleeding complication following endobronchial valve therapy for emphysema. Endoscopic treatment of emphysema is supported by different methods, including valves, coils and sealants. The mechanism is mainly related to volume reduction of targeted area. Endobronchial valves (EBV) appear the most studied method. In a multicentre randomised study, placement of unidirectional endobronchial valves resulted in a statistically significant functional

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2018 Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace

14. Predicting all-cause and lung cancer mortality using emphysema score progression rate between baseline and follow-up chest CT images: A comparison of risk model performances. (PubMed)

Predicting all-cause and lung cancer mortality using emphysema score progression rate between baseline and follow-up chest CT images: A comparison of risk model performances. Normalized emphysema score is a protocol-robust CT biomarker of mortality. We aimed to improve mortality prediction by including the emphysema score progression rate-its change over time-into the models.CT scans from 6000 National Lung Screening Trial CT arm participants were included. Of these, 1810 died (445 lung cancer (...) -specific). The remaining 4190 survivors were sampled with replacement up to 24432 to approximate the full cohort. Three overlapping subcohorts were formed which required participants to have images from specific screening rounds. Emphysema scores were obtained after resampling, normalization, and bullae cluster analysis of the original images. Base models contained solely the latest emphysema score. Progression models included emphysema score progression rate. Models were adjusted by including baseline

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2019 PLoS ONE

15. Predicting clinical outcome with phenotypic clusters using quantitative CT fibrosis and emphysema features in patients with idiopathic pulmonary fibrosis. (PubMed)

Predicting clinical outcome with phenotypic clusters using quantitative CT fibrosis and emphysema features in patients with idiopathic pulmonary fibrosis. The clinical course of IPF varies. This study sought to identify phenotyping with quantitative computed tomography (CT) fibrosis and emphysema features using a cluster analysis and to assess prognostic impact among identified clusters in patient with idiopathic pulmonary fibrosis (IPF). Furthermore, we evaluated the impact of fibrosis (...) and emphysema on lung function with development of a descriptive formula.This retrospective study included 205 patients with IPF. A texture-based automated system was used to quantify areas of normal, emphysema, ground-glass opacity, reticulation, consolidation, and honeycombing. Emphysema index was obtained by calculating the percentage of low attenuation area lower than -950HU. We used quantitative CT features and clinical features for clusters and assessed the association with prognosis. A formula

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2019 PLoS ONE

16. A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE)

A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (LIBERATE) This is the first multicenter randomized controlled trial to evaluate the effectiveness and safety of Zephyr Endobronchial Valve (EBV) in patients with little to no collateral ventilation out to 12 months.To evaluate the effectiveness and safety of Zephyr EBV in heterogeneous emphysema with little to no collateral ventilation in the treated lobe.Subjects were enrolled with a 2

2018 EvidenceUpdates

17. Patient experience of lung volume reduction procedures for emphysema: a qualitative service improvement project (PubMed)

Patient experience of lung volume reduction procedures for emphysema: a qualitative service improvement project The aim of this service improvement project was to gain understanding of the patient experience of lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement, from referral through to post-discharge care. Focus group interviews were carried out in two tertiary centres in London and Leicester, UK. Sixteen patients who had undergone lung volume reduction surgery (LVRS

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2017 ERJ open research

18. Combined pulmonary fibrosis and emphysema: a systematic review and meta-analysis

Combined pulmonary fibrosis and emphysema: a systematic review and meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email

2019 PROSPERO

19. Severity of pulmonary emphysema and lung cancer: analysis using quantitative lobar emphysema scoring. (PubMed)

Severity of pulmonary emphysema and lung cancer: analysis using quantitative lobar emphysema scoring. The aim of this study was to determine the relationship between lobar severity of emphysema and lung cancer using automated lobe segmentation and emphysema quantification methods.This study included 78 patients (74 males and 4 females; mean age of 72 years) with the following conditions: pathologically proven lung cancer, available chest computed tomographic (CT) scans for lobe segmentation (...) , and quantitative scoring of emphysema. The relationship between emphysema and lung cancer was analyzed using quantitative emphysema scoring of each pulmonary lobe.The most common location of cancer was the left upper lobe (LUL) (n = 28), followed by the right upper lobe (RUL) (n = 27), left lower lobe (LLL) (n = 13), right lower lobe (RLL) (n = 9), and right middle lobe (RML) (n = 1). Emphysema ratio was the highest in LUL, followed by that in RUL, LLL, RML, and RLL. Multivariate logistic regression analysis

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2016 Medicine

20. Surgical Outcomes of Lung Cancer Patients with Combined Pulmonary Fibrosis and Emphysema and Those with Idiopathic Pulmonary Fibrosis without Emphysema (PubMed)

Surgical Outcomes of Lung Cancer Patients with Combined Pulmonary Fibrosis and Emphysema and Those with Idiopathic Pulmonary Fibrosis without Emphysema Combined pulmonary fibrosis and emphysema (CPFE) is a unique disorder. The aim of this study was to compare the surgical outcomes of lung cancer patients with CPFE and those with idiopathic pulmonary fibrosis (IPF) without emphysema.A total of 1548 patients who underwent surgery for primary lung cancer between January 2001 and December 2012 were (...) retrospectively reviewed.Of the 1548 patients, 55 (3.6%) had CPFE on computed tomography (CT), and 45 (2.9%) had IPF without emphysema. The overall and disease-free 5-year survival rates for patients with CPFE were not significantly worse than those for patients with IPF without emphysema (24.9% vs. 36.8%, p = 0.814; 39.8% vs. 39.3%, p = 0.653, respectively). Overall, 21 (38.1%) patients with CPFE and nine patients (20.0%) with IPF without emphysema developed postoperative cardiopulmonary complications

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2016 Annals of Thoracic and Cardiovascular Surgery

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