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Clinics in Chest Medicine

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https://www.readbyqxmd.com/read/28477646/pulmonary-disease-in-non-pulmonary-malignancy
#1
EDITORIAL
Guang-Shing Cheng, Jennifer D Possick
No abstract text is available yet for this article.
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477645/palliative-and-end-of-life-care-for-patients-with-malignancy
#2
REVIEW
Kathleen M Akgün
Patients with cancer continue to have unmet palliative care needs. Concurrent palliative care is tailored to the needs of patients as well as their families to relieve suffering. Specialty palliative care referral is associated with improved symptom management, improved end-of-life quality, and higher family-rated satisfaction. Optimal timing for palliative care referral has not been determined. Barriers to palliative care referral include workforce limitations, provider attitudes and perceptions, and potential ethnic and racial disparities in access to palliative care...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477644/acute-respiratory-failure-in-patients-with-hematologic-malignancies
#3
REVIEW
Anne-Sophie Moreau, Olivier Peyrony, Virginie Lemiale, Lara Zafrani, Elie Azoulay
Acute respiratory failure occurs in up to 50% of patients treated for hematologic malignancies and is associated with a high case fatality rate. Because of residual organ dysfunction and time spent receiving respiratory care, underlying disease control is affected. Early admission to an intensive care unit for acute respiratory failure has proven benefit because it is the best place for rapid implementation of noninvasive diagnostic and therapeutic strategies. This article reviews the clinical approach and diagnostic strategies for acute respiratory failure in patients with hematologic malignancies...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477643/critical-care-prognosis-and-outcomes-in-patients-with-cancer
#4
REVIEW
Ayman O Soubani
Advances in cancer treatment and patient survival are associated with increasing number of these patients requiring intensive care. Over the last 2 decades, there has been a steady improvement in the outcomes of critically ill patients with cancer. This review provides data on the use of the intensive care unit (ICU) and short and long-term outcomes of critically ill patients with cancer, the ICU system practices that influence patients outcomes, and the role of the different clinical variables in predicting the prognosis of these patients...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477642/diagnostic-evaluation-of-pulmonary-abnormalities-in-patients-with-hematologic-malignancies-and-hematopoietic-cell-transplantation
#5
REVIEW
Bianca Harris, Alexander I Geyer
Pulmonary complications (PC) of hematologic malignancies and their treatments are common causes of morbidity and mortality. Early diagnosis is challenging due to host risk factors, clinical instability, and provider preference. Delayed diagnosis impairs targeted treatment and may contribute to poor outcomes. An integrated understanding of clinical risk and radiographic patterns informs a timely approach to diagnosis and treatment. There is little prospective evidence guiding optimal modality and timing of minimally invasive lung sampling; however, a low threshold for diagnostic bronchoscopy during the first 24 to 72 hours after presentation should be a guiding principle in high-risk patients...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477641/pulmonary-function-and-pretransplant-evaluation-of-the-hematopoietic-cell-transplant-candidate
#6
REVIEW
Guang-Shing Cheng
Pretransplant pulmonary function tests provide baseline data by which to reference subsequent respiratory impairment, as well as important prognostic information, for the hematopoietic cell transplant (HCT) recipient. Abnormalities in forced expiratory volume in 1 second and diffusing capacity of carbon monoxide are associated with early respiratory failure and increased all-cause mortality after allogeneic HCT. These parameters have been incorporated into risk assessment calculators that may aid in clinical decision making...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477640/viral-pneumonia-in-patients-with-hematopoietic-cell-transplantation-and-hematologic-malignancies
#7
REVIEW
Margaret L Green
Viral pneumonia is a common complication for patients with hematologic malignancies and after hematopoietic cell transplantation causing significant morbidity, and often mortality. Infections are predominantly caused by herpes viruses, either by reactivation of latent infection, or less commonly primary infection, or community respiratory viruses. High-resolution CT scan is useful for diagnosis but is nonspecific; generally, bronchoalveolar lavage is required. Prevention strategies are not pathogen-specific but include vaccination, chemoprophylaxis, preemptive treatment, and effective infection-prevention strategies during community outbreaks...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477639/fungal-pneumonia-in%C3%A2-patients-with-hematologic-malignancies-and-hematopoietic-cell-transplantation
#8
REVIEW
Steven A Pergam
Invasive fungal infections, which occur primarily as a consequence of prolonged neutropenia and immunosuppression, are a life-threatening complication seen among patients with hematologic malignancies. The routine use of triazole antifungal prophylaxis, enhanced diagnostics, and newer antifungal agents have led to improvements in the care of fungal pneumonias, but invasive fungal infections remain a major cause of morbidity and mortality. This article covers risk factors for major fungal infections, diagnostic approaches, and treatment options for specific fungal pathogens, including Aspergillus and Mucorales species, and discusses current approved strategies for prevention of common and uncommon fungal pneumonias...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477638/bacterial-pneumonia-in-patients-with-cancer-novel-risk-factors-and-management
#9
REVIEW
Justin L Wong, Scott E Evans
Bacterial pneumonias exact unacceptable morbidity on patients with cancer. Although the risk is often most pronounced among patients with treatment-induced cytopenias, the numerous contributors to life-threatening pneumonias in cancer populations range from derangements of lung architecture and swallow function to complex immune defects associated with cytotoxic therapies and graft-versus-host disease. These structural and immunologic abnormalities often make the diagnosis of pneumonia challenging in patients with cancer and impact the composition and duration of therapy...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477637/late-onset-noninfectious-pulmonary-complications-after-allogeneic-hematopoietic-stem-cell-transplantation
#10
REVIEW
Anne Bergeron
Late-onset noninfectious pulmonary complications (LONIPCs), most of which occur between 3 months and 2 years following allogeneic hematopoietic stem cell transplantation (HSCT), have a significant effect on patient outcomes and are highly associated with mortalities and morbidities. LONIPCs can involve all anatomic lung regions: bronchi, parenchyma, vessels, and pleura; this diversity can lead to various clinical entities. Bronchiolitis obliterans syndrome is the most frequent LONIPC. Most LONIPCs are associated with graft-versus-host disease...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477636/early-onset-noninfectious-pulmonary-syndromes-after-hematopoietic-cell-transplantation
#11
REVIEW
Lisa K Vande Vusse, David K Madtes
This article reviews the noninfectious pulmonary syndromes that cause morbidity and mortality early after hematopoietic cell transplantation with an emphasis on risk factors, clinical manifestations, treatment, and outcomes. The first section covers idiopathic pneumonia syndrome and its subtypes: peri-engraftment respiratory distress syndrome, diffuse alveolar hemorrhage, delayed pulmonary toxicity syndrome, and cryptogenic organizing pneumonia. The second section covers pulmonary toxicities of chemotherapies and immunosuppressive agents used in this setting...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477635/pulmonary-toxicities-from-checkpoint-immunotherapy-for-malignancy
#12
REVIEW
Jennifer D Possick
Checkpoint immunotherapy with agents targeting PD-1 and CTLA-4 has transformed the landscape of oncologic therapy. Immune-related adverse events (IRAEs), including significant pulmonary toxicities, have been observed in patients treated with these agents. The incidence, timing, clinical features, and outcomes of pulmonary IRAEs are quite variable, emphasizing the importance for clinical vigilance as these therapies become more ubiquitous in the treatment of a spectrum of malignancies. Outcomes are generally favorable when toxicity is recognized early and treated promptly...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477634/pulmonary-toxicities-from-conventional-chemotherapy
#13
REVIEW
Paul Leger, Andrew H Limper, Fabien Maldonado
Despite significant recent progress in precision medicine and immunotherapy, conventional chemotherapy remains the cornerstone of the treatment of most cancers. Chemotherapy-induced lung toxicity represents a serious diagnostic challenge for health care providers and requires careful consideration because it is a diagnosis of exclusion with significant impact on therapeutic decisions. This review aims to provide clinicians with a valuable guide in assessing their patients with possible chemotherapy-induced lung toxicity...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477633/radiation-pneumonitis
#14
REVIEW
Trevor J Bledsoe, Sameer K Nath, Roy H Decker
Radiation-induced lung injury is a well-known complication of thoracic radiation for patients with breast, lung, thymic, and esophageal malignancies, and mediastinal lymphomas. Improvements in radiation technique, as well as the understanding of the pathophysiology of radiation injury, have led to lower rates of pneumonitis and improved symptom control. Here, the authors provide an overview of the pathophysiology, diagnosis, and management of patients with radiation pneumonitis as a complication of treatment of chest malignancies...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477632/pulmonary-manifestations-of-lymphoma-and-leukemia
#15
REVIEW
Lara Bashoura, George A Eapen, Saadia A Faiz
Pulmonary manifestations of lymphoma and leukemia may involve multiple structures within the thoracic cavity. Malignant lymphoma typically originates in lymph nodes, but concomitant or primary presentations with parenchymal, pleural, or tracheobronchial disease may occur. Once infection is excluded, leukemic infiltrates may be related to malignancy, hemorrhage, or secondary pulmonary alveolar proteinosis. Confirmation with cytology or flow cytometry is recommended to diagnose malignant pleural effusions in hematologic malignancies...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28477631/pulmonary-manifestations-of-solid-non-pulmonary-malignancies
#16
REVIEW
Jonathan Puchalski
The lungs are a common site of metastatic disease. Pulmonary metastases develop due to local blood flow and cellular or biochemical properties of tumor cells. Metastases develop from any type of malignancy and may occur via hematogenous, lymphatic, aerogenous, and/or direct spread. Metastatic disease may present with symptoms indistinguishable from primary lung cancer, including dyspnea, hemoptysis, and chest pain. Radiographically, these may present as parenchymal lung disease, mediastinal lymphadenopathy, airway obstruction, or pleural and vascular disease...
June 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159166/respiratory-viral-and-atypical-pneumonias
#17
EDITORIAL
Charles S Dela Cruz, Richard G Wunderink
No abstract text is available yet for this article.
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159165/viral-pneumonia-in-patients-with-hematologic-malignancy-or-hematopoietic-stem-cell-transplantation
#18
REVIEW
Erik Vakil, Scott E Evans
Viral pneumonias in patients with hematologic malignancies and recipients of hematopoietic stem cell transplantation cause significant morbidity and mortality. Advances in diagnostic techniques have enabled rapid identification of respiratory viral pathogens from upper and lower respiratory tract samples. Lymphopenia, myeloablative and T-cell depleting chemotherapy, graft-versus-host disease, and other factors increase the risk of developing life-threatening viral pneumonia. Chest imaging is often nonspecific but may aid in diagnoses...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159164/respiratory-viral-infections-in-chronic-lung-diseases
#19
REVIEW
Clemente J Britto, Virginia Brady, Seiwon Lee, Charles S Dela Cruz
Chronic lung diseases, such as chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis (CF) and interstitial lung diseases (ILD), affect many individuals worldwide. Patients with these chronic lung diseases are susceptible to respiratory lung infections and some of these viral infections can contribute to disease pathogenesis. This review highlights the associations of lung infections and the respective chronic lung diseases and how infection in the different lung diseases affects disease exacerbation and progression...
March 2017: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28159163/epidemic-and-emerging-coronaviruses-severe-acute-respiratory-syndrome-and-middle-east-respiratory-syndrome
#20
REVIEW
David S Hui
Bats are the natural reservoirs of severe acute respiratory syndrome (SARS)-like coronaviruses (CoVs) and likely the reservoir of Middle East respiratory syndrome (MERS)-CoV. The clinical features of SARS-CoV infection and MERS-CoV infection are similar but MERS-CoV infection progresses to respiratory failure more rapidly. Although the estimated pandemic potential of MERS-CoV is lower than that of SARS-CoV, the case fatality rate of MERS is higher. The transmission route and the possibility of other intermediary animal sources remain uncertain among many sporadic primary cases...
March 2017: Clinics in Chest Medicine
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