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Grogono" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Joanna C." "apellidos" => "Grogono" ] ] ] 1 => array:2 [ "autoresLista" => "Kyle T.S. Pattinson" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Kyle T.S." "apellidos" => "Pattinson" ] ] ] 2 => array:2 [ "autoresLista" => "Shakeeb H. Moosavi" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Shakeeb H." "apellidos" => "Moosavi" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043719301394?idApp=UINPBA00004E" "url" => "/25310437/0000002500000006/v1_201911020923/S2531043719301394/v1_201911020923/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Strategies to relieve dyspnoea in patients with advanced chronic respiratory diseases. A narrative review. Authors’ reply" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "356" "paginaFinal" => "357" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Nicolino Ambrosino, Claudio Fracchia" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Nicolino" "apellidos" => "Ambrosino" "email" => array:1 [ 0 => "nico.ambrosino@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Claudio" "apellidos" => "Fracchia" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Istituti Clinici Scientifici Maugeri, Istituto di Montescano, Italy" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">“<span class="elsevierStyleItalic">I speak not to disprove what Brutus spoke, But here I am to speak what I do know</span>” .<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p></span></p><p id="par0010" class="elsevierStylePara elsevierViewall">We thank Grogono et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> for their interest in our review on management of dyspnoea in patients with <span class="elsevierStyleBold">advanced</span> respiratory diseases.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">3</span></a> Breathlessness requires much more attention by clinicians and researchers, as a major health problem around the world for millions of people<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">4</span></a> and their letter may contribute to the discussion.</p><p id="par0015" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Inhaled furosemide</span>. Grogono et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> give more details of their study in normal volunteers <a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">5</span></a> as well as of other studies. We fully agree with their conclusion that “<span class="elsevierStyleBold"><span class="elsevierStyleItalic">More</span></span><span class="elsevierStyleItalic">research with inhaled furosemide is justified</span>”. That’s why in our review we concluded that “<span class="elsevierStyleItalic">based on available data, its (nebulised furosemide…) use for the routine management of dyspnoea in</span><span class="elsevierStyleBold"><span class="elsevierStyleItalic">terminal</span></span><span class="elsevierStyleItalic">patients is still either controversial or not indicated</span>.” Indeed we are unaware of any guideline recommending the use of inhaled furosemide in patients with <span class="elsevierStyleBold">advanced</span> respiratory diseases.</p><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Opioids</span>. Practitioners and researchers have paid greater attention to management of pain than dyspnoea, and patients with <span class="elsevierStyleBold">end- stage</span> respiratory diseases are less likely to undergo palliative care than patients with cancer.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">6-8</span></a> The controversy on the use of opioids in respiratory diseases is long standing, and we <span class="elsevierStyleItalic">don’t disprove what anyone spoke, we just speak what we do know</span>. Evidence based international guidelines recommend the use of opioids in <span class="elsevierStyleItalic">appropriate</span> doses, <span class="elsevierStyleItalic">formulations and schedules of administration</span> in patients with <span class="elsevierStyleBold">advanced</span> chronic respiratory diseases,<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">9,10</span></a> but we understand authors’ concern about potential long-term adverse effects, lack of effectiveness or risk of addiction. However, we described evidence based management of patients with <span class="elsevierStyleBold">advanced</span> or <span class="elsevierStyleBold">end-stage</span> respiratory diseases with poor short-term prognosis and life expectancy which would be probably not long enough to develop such potential long-term side effects.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Nobody denies that respiratory depression is a predictable adverse effect from a significant opioid <span class="elsevierStyleItalic">overdose</span>, while we need further clinical trials to better individualize treatment. Grogono et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> blame us for ignoring the “<span class="elsevierStyleItalic">opioid crisis</span>” quoting a paper <a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">11</span></a> on “Opioid <span class="elsevierStyleItalic">Overdose”</span> induced by illegal use or pain killers and not including <span class="elsevierStyleItalic">even once</span> the words <span class="elsevierStyleItalic">“</span><span class="elsevierStyleBold"><span class="elsevierStyleItalic">dyspnea</span></span>” or "breathlessness". <span class="elsevierStyleItalic">Overdose</span> in medicine means malpractice and this is not the case of guidelines. Illegal use or painkillers do not refer to the issue of our review,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">3</span></a> As a matter of fact our review<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">3</span></a> underlined the “<span class="elsevierStyleItalic">need to be aware of and treat adverse effects</span>” while suggesting a therapeutical escalation exploiting all available pharmacological and non pharmacological tools described in the review.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Finally nobody portrayed “<span class="elsevierStyleItalic">those who harbour legitimate concerns about opioid safety as human rights violators</span>”, but we do think that avoiding <span class="elsevierStyleItalic">all</span> unpleasant and distressful symptoms, not only pain, in <span class="elsevierStyleBold">terminal</span> conditions <span class="elsevierStyleBold">IS</span> a human right. Whoever has treated or even only seen an <span class="elsevierStyleBold">end-stage</span> dyspnoeic patient with pulmonary fibrosis asking for help, knows what we are talking about.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In conclusion Grogono et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> criticize us for lack of <span class="elsevierStyleItalic">“full, accurate and balanced critical appraisal of the evidence”</span> just because they disagree with some of our evidence based ideas (or what they attribute to us) but we could not agree more with their recommendation. In our (unfortunately….) long life as researchers and clinicians we have always applied that principle, as is the case of this review,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">3</span></a> however in all scientific controversies with our peers we have always tried to rebut (rightly or wrongly) only what they truly meant.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-07-23" "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Shakespeare W. Julius Caesar. Act 3, Scene 2." ] ] ] 1 => array:3 [ "identificador" => "bib0090" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Debating pharmacological options for dyspnoea relief; the need for full, accurate and balanced critical appraisal of the evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.C. Grogono" 1 => "K.T.S. Pattinson" 2 => "S.H. Moosavi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Pulmonology" "fecha" => "2019" "volumen" => "25" "numero" => "6" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0010" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Strategies to relieve dyspnoea in patients with advanced chronic respiratory diseases. A narrative review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Ambrosino" 1 => "C. Fracchia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.pulmoe.2019.04.002" "Revista" => array:7 [ "tituloSerie" => "Pulmonology" "fecha" => "2019" "volumen" => "25" "numero" => "5" "paginaInicial" => "289" "paginaFinal" => "298" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31129045" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0015" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of patients presenting with dyspnea to emergency departments in Europe and the Asia-Pacific region" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Laribi" 1 => "G. Keijzers" 2 => "O. van Meer" 3 => "S. Klim" 4 => "J. Motiejunaite" 5 => "W.S. Kuan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MEJ.0000000000000571" "Revista" => array:7 [ "tituloSerie" => "Eur J Emerg Med" "fecha" => "2019" "volumen" => "26" "numero" => "5" "paginaInicial" => "345" "paginaFinal" => "349" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30169464" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0020" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inhaled furosemide for relief of air hunger versus sense of breathing effort: a randomized controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.C. Grogono" 1 => "C. Butler" 2 => "H. Izadi" 3 => "S.H. Moosavi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12931-018-0886-9" "Revista" => array:5 [ "tituloSerie" => "Respir Res" "fecha" => "2018" "volumen" => "19" "paginaInicial" => "181" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30236110" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0025" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "End-of-life strategies among patients with advanced chronic obstructive pulmonary disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.S. Gershon" 1 => "L.C. Maclagan" 2 => "J. Luo" 3 => "T. To" 4 => "T. Kendzerska" 5 => "M.B. Stanbrook" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.201803-0592OC" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2018" "volumen" => "198" "paginaInicial" => "1389" "paginaFinal" => "1396" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29889548" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0030" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "End-of-life health care utilization between chronic obstructive pulmonary disease and lung cancer patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.C. Kuo" 1 => "J.H. Chen" 2 => "C.H. Lee" 3 => "C.W. Tsai" 4 => "C.C. Lin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jpainsymman.2019.01.011" "Revista" => array:6 [ "tituloSerie" => "J Pain Symptom Manage" "fecha" => "2019" "volumen" => "57" "paginaInicial" => "933" "paginaFinal" => "943" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30708124" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0035" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence and management of chronic breathlessness in COPD in a tertiary care center" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Carette" 1 => "M. Zysman" 2 => "C. Morelot-Panzini" 3 => "J. Perrin" 4 => "E. Gomez" 5 => "A. Guillaumot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12890-019-0851-5" "Revista" => array:5 [ "tituloSerie" => "BMC Pulm Med" "fecha" => "2019" "volumen" => "19" "paginaInicial" => "95" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31096982" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0040" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American College of Chest Physicians consensus statement on the management of dyspnea in patients with advanced lung or heart disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.A. Mahler" 1 => "P.A. Selecky" 2 => "C.G. Harrod" 3 => "J.O. Benditt" 4 => "V. Carrieri-Kohlman" 5 => "J.R. Curtis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.09-1543" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2010" "volumen" => "137" "paginaInicial" => "674" "paginaFinal" => "691" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20202949" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0045" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Managing dyspnea in patients with advanced chronic obstructive pulmonary disease: a Canadian Thoracic Society clinical practice guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.D. Marciniuk" 1 => "D. Goodridge" 2 => "P. Hernandez" 3 => "G. Rocker" 4 => "M. Balter" 5 => "P. Bailey" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2011/745047" "Revista" => array:6 [ "tituloSerie" => "Can Respir J" "fecha" => "2011" "volumen" => "18" "paginaInicial" => "69" "paginaFinal" => "78" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21499589" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0050" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevention of opioid overdose" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.M. Babu" 1 => "J. Brent" 2 => "D.N. Juurlink" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra1807054" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2019" "volumen" => "380" "paginaInicial" => "2246" "paginaFinal" => "2255" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31167053" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/25310437/0000002500000006/v1_201911020923/S2531043719301667/v1_201911020923/en/main.assets" "Apartado" => array:4 [ "identificador" => "72880" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/25310437/0000002500000006/v1_201911020923/S2531043719301667/v1_201911020923/en/main.pdf?idApp=UINPBA00004E&text.app=https://journalpulmonology.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2531043719301667?idApp=UINPBA00004E" ]
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2022 December | 34 | 26 | 60 |
2022 November | 25 | 34 | 59 |
2022 October | 41 | 37 | 78 |
2022 September | 25 | 32 | 57 |
2022 August | 18 | 29 | 47 |
2022 July | 26 | 51 | 77 |
2022 June | 23 | 37 | 60 |
2022 May | 27 | 29 | 56 |
2022 April | 19 | 38 | 57 |
2022 March | 27 | 52 | 79 |
2022 February | 21 | 42 | 63 |
2022 January | 28 | 37 | 65 |
2021 December | 24 | 39 | 63 |
2021 November | 14 | 38 | 52 |
2021 October | 37 | 67 | 104 |
2021 September | 22 | 33 | 55 |
2021 August | 23 | 35 | 58 |
2021 July | 32 | 26 | 58 |
2021 June | 37 | 44 | 81 |
2021 May | 26 | 49 | 75 |
2021 April | 81 | 78 | 159 |
2021 March | 34 | 40 | 74 |
2021 February | 25 | 27 | 52 |
2021 January | 17 | 22 | 39 |
2020 December | 23 | 22 | 45 |
2020 November | 15 | 20 | 35 |
2020 October | 20 | 19 | 39 |
2020 September | 32 | 36 | 68 |
2020 August | 21 | 23 | 44 |
2020 July | 22 | 20 | 42 |
2020 June | 24 | 30 | 54 |
2020 May | 30 | 28 | 58 |
2020 April | 30 | 13 | 43 |
2020 March | 27 | 16 | 43 |
2020 February | 28 | 23 | 51 |
2020 January | 58 | 43 | 101 |
2019 December | 79 | 45 | 124 |
2019 November | 89 | 59 | 148 |
2019 October | 18 | 16 | 34 |