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Current Opinion in Pulmonary Medicine

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https://www.readbyqxmd.com/read/28463856/multiple-pulmonary-nodules-in-malignancy
#1
Apurwa Karki, Rakesh Shah, Alan Fein
PURPOSE OF REVIEW: Multiple pulmonary nodules are a common finding especially with the implementation of lung cancer screening. Available guidelines address the management of solitary pulmonary nodules. The management of the multiple pulmonary nodules would differ based on the characteristic of the nodules, their distribution, and the history of the patients as well. RECENT FINDINGS: Most of the recent publications on multiple pulmonary nodules consist of individual case reports or case series...
May 1, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28426471/advances-in-the-management-of-malignant-pleural-effusion
#2
Labib G Debiane, David E Ost
PURPOSE OF REVIEW: The current review describes the latest evidence in the management of malignant pleural effusions (MPE). RECENT FINDINGS: Daily drainage of indwelling pleural catheters achieved auto-pleurodesis at a higher rate compared with every-other-day drainage [0.47 vs. 0.24; difference in proportion of 0.23; 95% confidence interval (CI) 0.08-0.38; P = 0.003]. In patients with MPE undergoing talc pleurodesis, a large multicenter randomized clinical trial found that pain control with opiates vs...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28426470/identification-and-management-of-pleural-effusions-of-multiple-aetiologies
#3
Steven Walker, Nick Maskell
PURPOSE OF REVIEW: Historically, pleural effusions have been attributed to a single cause. There is growing recognition that a substantial proportion of pleural effusions may have more than one underlying cause. The purpose of this review is to summarise recent findings regarding the diagnosis and treatment of effusions secondary to more than one aetiology. RECENT FINDINGS: A recent prospective study identified that 30% of pleural effusions had more than one underlying aetiology...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28426469/prophylactic-radiotherapy-for-procedure-tract-metastases-in-mesothelioma-a-review
#4
David T Arnold, Amelia O Clive
PURPOSE OF REVIEW: Malignant pleural mesothelioma is an aggressive malignancy with a very poor prognosis. The majority of patients require pleural procedures for diagnostic or fluid management purposes. Damage to the pleura during these procedures can lead to procedure tract metastases (PTMs), with increasing risk from larger interventions. Prophylactic radiotherapy to these sites is a controversial topic with conflicting results from trial data. In this review, we summarize the recent evidence...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28426468/indwelling-tunneled-pleural-catheters-for-the-management-of-hepatic-hydrothorax
#5
Kevin P Haas, Alexander C Chen
PURPOSE OF REVIEW: Hepatic hydrothorax is a complication of end-stage liver disease that may have significant associated morbidity. Sodium restriction and diuretic therapy are the mainstays of treatment, though up to a quarter of patients will become refractory to this and will require a pleural drainage procedure. Thoracentesis, transjugular intrahepatic portosystemic shunt, and chemical pleurodesis all have variable success rates and associated complications in the management of hepatic hydrothorax...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28403040/playing-the-odds-lung-cancer-surveillance-after-curative-surgery
#6
Ching-Fei Chang, Michael Gould
PURPOSE OF REVIEW: After so-called 'curative' resection, many patients are still at risk for further lung cancer, either as a recurrence or a new metachronous primary. In theory, close follow-up should improve survival by catching relapse early - but in reality, many experts feel that surveillance for recurrence is a waste of time and money. In this article, we explore the reasons behind the controversy, what the current guidelines recommend, and what future solutions are in development that may ultimately resolve this debate...
April 11, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28403039/pneumotoxicity-associated-with-immune-checkpoint-inhibitor-therapies
#7
Vickie R Shannon
PURPOSE OF REVIEW: Immune checkpoint inhibitor therapies represent a new paradigm in cancer therapeutics, in which the targets are not the cancer cells, but the body's own immune system. Harnessing the immune system to better fight cancer has generated a unique spectrum of immune-related adverse events (IrAEs) that effect virtually every major organ system. Although lung involvement is less common than other forms of IrAEs, its consequences are potentially lethal. This review focuses on the evolving spectrum of lung toxicities associated with the two major classes of immune checkpoint inhibitor therapies, cytotoxic T-cell ligand-4, and programed cell death-1 (PDL-1)...
April 11, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28403038/lung-carcinogenesis-and-fibrosis-taken-together-just-coincidence
#8
Ioanna Giopanou, Kristina A M Arendt, Georgios T Stathopoulos
PURPOSE OF REVIEW: The pathogenesis of lung cancer and pulmonary fibrotic disorders partially overlaps. This review focuses on the common features of the two disease categories, aimed at advancing our translational understanding of their pathobiology and at fostering the development of new therapies. RECENT FINDINGS: Both malignant and collagen-producing lung cells display enhanced cellular proliferation, increased resistance to apoptosis, a propensity for invading and distorting the lung parenchyma, as well as stemness potential...
April 11, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28399010/pleural-effusions-in-acute-idiopathic-pericarditis-and-postcardiac-injury-syndrome
#9
José M Porcel
PURPOSE OF REVIEW: Pleural effusions are frequent in the context of acute idiopathic pericarditis and following pericardiotomy, but they have seldom been characterized. This review summarizes their most relevant clinical features. RECENT FINDINGS: In acute idiopathic pericarditis, pleural effusions tend to be left-sided and, if bilateral, they are usually larger on the left. Less than 5% are unilateral right-sided. About 90% of the effusions occupy less than one-third of the hemithorax, and 99% meet Light's exudative criteria with a predominance of lymphocytes in three fourths of the cases...
April 8, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28399009/primary-effusion-lymphoma-current-concepts-and-management
#10
Nivedita Arora, Arjun Gupta, Navid Sadeghi
PURPOSE OF REVIEW: To summarize the current epidemiology, management, and outcomes of primary effusion lymphoma (PEL) and highlight possible future research efforts. RECENT FINDINGS: Cyclophosphamide, doxorubicin, vincristine, prednisone-based chemotherapy regimens alone or in combination with immunomodulatory agents (e.g., lenalidomide), or proteasome inhibitors (e.g., bortezomib), or targeted therapies, are commonly used to treat PEL. Highly active antiretroviral therapy should be continued or initiated in patients with HIV infection...
April 8, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28399008/use-of-intrapleural-tissue-plasminogen-activator-and-deoxyribonuclease-in-pleural-space-infections-an-update-on-alternative-regimens
#11
Christopher R Gilbert, Jed A Gorden
PURPOSE OF REVIEW: Pleural infection remains a common problem with significant associated morbidity and mortality. The current treatment paradigm for pleural infection appears to be shifting as more recent data have suggested that the use of intrapleural fibrinolytic therapy (IPFT) may be adequate for treatment, potentially avoiding the need for surgical intervention in a significant number of patients. RECENT FINDINGS: The previous Multicenter Intrapleural Sepsis Trial demonstrated improved outcomes when utilizing combined IPFT, however, more recently alterations in this dosing regimen have been explored...
April 8, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28319473/precision-medicine-in-asthma-the-role-of-bronchial-thermoplasty
#12
Amber J Oberle, Praveen Mathur
PURPOSE OF REVIEW: The inflammatory makeup of severe asthma is heterogeneous. Identification of the predominant cellular endotype via biomarkers can aid in the selection of more advanced therapies. This review is clinically focused on how to use these biomarkers to help select between biologic agents and/or bronchial thermoplasty. RECENT FINDINGS: Several Th2 biomarkers exist for the detection of eosinophilic disease; however, the best biomarker for clinical practice is debatable depending upon local resources...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#13
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28257316/pleural-diseases
#14
Stefano Gasparini, Martina Bonifazi
PURPOSE OF REVIEW: Due to the increasing burden of pleural diseases worldwide, a personalized cost-effective management of these conditions is essential to optimize the healthcare sources. The current review is focused on latest evidence in diagnostic work-up and management of pleural diseases. RECENT FINDINGS: Recent research highlights the increasing role of thoracic ultrasound in both diagnostic and therapeutic interventions and the potential suitability of cytological sampling from pleural effusions for molecular analysis, essential requirement for a satisfactory test in the era of personalized anticancer therapy...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28257315/personalized-medicine-and-chronic-obstructive-pulmonary-disease
#15
E F M Wouters, B B R A F Wouters, I M L Augustin, F M E Franssen
PURPOSE OF REVIEW: The current review summarizes ongoing developments in personalized medicine and precision medicine in chronic obstructive pulmonary disease (COPD). Our current approach is far away of personalized management algorithms as current recommendations for COPD are largely based on a reductionist disease description, operationally defined by results of spirometry. RECENT FINDINGS: Besides precision medicine developments, a personalized medicine approach in COPD is described based on a holistic approach of the patient and considering illness as the consequence of dynamic interactions within and between multiple interacting and self-adjusting systems...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28257314/personalized-medicine-in-influenza-a-bridge-too-far-or-the-near-future
#16
Frank L van de Veerdonk, Mark S Gresnigt, Paul E Verweij, Mihai G Netea
PURPOSE OF REVIEW: Personalized medicine is based on understanding mechanisms of disease and putting this in the context of an individual patient, which eventually helps to guide tailored diagnostic and therapeutic intervention. In this review we focus on one pulmonary infection that has major impact on society, namely influenza, and highlight the way we think personalized medicine could have an impact on the outcome of this pulmonary infection. RECENT FINDINGS: When a patient's defect is known, one could envision that restoring this defect in addition to the standard treatment regimen might result in a better clinical outcome...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28221172/interventional-pulmonology-in-chronic-obstructive-pulmonary-disease
#17
Daniela Gompelmann, Nilab Sarmand, Felix J F Herth
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and emphysema are widespread diseases associated with progressive dyspnea because of airflow limitation and hyperinflation. Fundamental therapeutic strategies consist of pulmonary rehabilitation, pharmacotherapy, long-term oxygen therapy, noninvasive ventilation, and surgical therapeutic approaches. RECENT FINDINGS: In the last 14 years, endoscopic therapeutic modalities emerged as a substantial part of severe COPD and emphysema treatment...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28221171/pathogenesis-of-severe-pneumonia-advances-and-knowledge-gaps
#18
Joseph P Mizgerd
PURPOSE OF REVIEW: Pneumonia is a common disease that becomes severe in a subset of patients, dependent on host biology including mechanisms of immune resistance and tissue resilience. This review emphasizes discoveries in pneumonia biology from 2016, highlighting questions and directions that are especially pressing or newly emerging. RECENT FINDINGS: Novel cell-cell interactions mediating innate immune responses against microbes in the lung have been elucidated, between distinct leukocyte subtypes as well as between leukocytes and the structural cells of the lung...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28212155/molecular-markers-in-lung-cancer-role-of-ebus
#19
Semra Bilaçeroğlu
PURPOSE OF REVIEW: As demonstrated by the recent therapeutic advances in nonsmall cell lung cancer (NSCLC), a personalized approach can considerably reduce its mortality. RECENT FINDINGS: Molecular tests identifying genetic mutations in NSCLC have led to a shift towards more effective and personalized therapies targeted to these alterations. Adequate tissue is required for diagnosing, subcharacterizing, and genotyping NSCLC by morphological, immunohistochemical, and molecular techniques...
May 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28212154/optical-coherence-tomography-and-confocal-laser-endomicroscopy-in-pulmonary-diseases
#20
Lizzy Wijmans, Julia N S d'Hooghe, Peter I Bonta, Jouke T Annema
PURPOSE OF REVIEW: Current imaging techniques (X-ray, computed tomography scan, ultrasound) have limitations in the identification and quantification of pulmonary diseases, in particular, on highly detailed level. The purpose of this review is to provide an overview of the current knowledge of innovative light- and laser-based imaging techniques that might fill this gap. RECENT FINDINGS: Optical coherence tomography (OCT) and confocal laser endomicroscopy (CLE) are high-resolution imaging techniques, which, combined with bronchoscopy, provide 'near histology' detailed imaging of the airway wall, lung parenchyma, mediastinal lymph nodes, and pulmonary vasculature...
May 2017: Current Opinion in Pulmonary Medicine
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