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Emphysema

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1. Bronchoscopic thermal vapour ablation for upper-lobe emphysema

Bronchoscopic thermal vapour ablation for upper-lobe emphysema Bronchoscopic thermal vapour ablation for Bronchoscopic thermal vapour ablation for upper-lobe emph upper-lobe emphysema ysema Interventional procedures guidance Published: 12 June 2019 www.nice.org.uk/guidance/ipg652 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 (...) for upper-lobe emphysema is inadequate in quantity and quality. Therefore the procedure should only be used in the context of research. © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 41.2 Further research should evaluate safety and efficacy in the short and long term and include details of patient selection. NICE may update the guidance on publication of further evidence. 2 2 The condition, current treatments

2019 National Institute for Health and Clinical Excellence - Interventional Procedures

2. Procedure for lung volume reduction in severe lung emphysema

Procedure for lung volume reduction in severe lung emphysema 1 Translation of the key statement of the final report N14-04 Verfahren zur Lungenvolumenreduktion beim schweren Lungenemphysem (Version 1.0; Status: 7 February 2017). Please note: This document was translated by an external translator and is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. Extract IQWiG Reports – Commission No. N14-04 (...) Procedure for lung volume reduction in severe lung emphysema 1 Extract of final report N14-04 Version 1.0 LVR in severe lung emphysema 7 February 2017 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Procedure for lung volume reduction in severe lung emphysema Commissioning agency: Federal Joint Committee Commission awarded on: 18 December 2014 Internal Commission No.: N14-04 Address of publisher

2019 Institute for Quality and Efficiency in Healthcare (IQWiG)

3. 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

4. [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.

5. 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

6. 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

7. 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

8. Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function. (PubMed)

Association Between Long-term Exposure to Ambient Air Pollution and Change in Quantitatively Assessed Emphysema and Lung Function. While air pollutants at historical levels have been associated with cardiovascular and respiratory diseases, it is not known whether exposure to contemporary air pollutant concentrations is associated with progression of emphysema.To assess the longitudinal association of ambient ozone (O3), fine particulate matter (PM2.5), oxides of nitrogen (NOx), and black carbon (...) exposure with change in percent emphysema assessed via computed tomographic (CT) imaging and lung function.This cohort study included participants from the Multi-Ethnic Study of Atherosclerosis (MESA) Air and Lung Studies conducted in 6 metropolitan regions of the United States, which included 6814 adults aged 45 to 84 years recruited between July 2000 and August 2002, and an additional 257 participants recruited from February 2005 to May 2007, with follow-up through November 2018.Residence-specific

2019 JAMA

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

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

Correction: Predicting clinical outcome with phenotypic clusters using quantitative CT fibrosis and emphysema features in patients with idiopathic pulmonary fibrosis. [This corrects the article DOI: 10.1371/journal.pone.0215303.].

2019 PLoS ONE

20. 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

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