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Current Opinion in Pulmonary Medicine

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https://www.readbyqxmd.com/read/28858970/lung-transplantation-in-cystic-fibrosis-patients-with-difficult-to-treat-lung-infections
#1
Lieven Dupont
PURPOSE OF REVIEW: In cystic fibrosis (CF) patients with end-stage pulmonary disease, lung transplantation (LTx) remains a life-extending therapy with good outcome in most patients. Despite early concern about chronic pretransplantation infections in the context of posttransplantation immunosuppression, typical CF-associated organisms such as Pseudomonas aeruginosa turned out to be quite well manageable and associated with favorable outcomes in transplanted CF patients, even in patients with highly resistant strains...
August 30, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28858969/obstructive-sleep-apnoea-of-mild-severity-should-it-be-treated
#2
Walter T McNicholas
PURPOSE OF REVIEW: To provide guidance in the management of mild obstructive sleep apnoea syndrome (OSAS) in the context of a very high prevalence, poor correlation with symptom profile, and lack of evidence that mild OSAS significantly contributes to comorbidity or early mortality. RECENT FINDINGS: Mild obstructive sleep apnoea defined by hourly frequency of apnoeas or hypopnoeas (AHI) between 5 and 15 affects up to 35% of the general adult population but is much less prevalent when associated daytime symptoms are included...
August 30, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28837442/diagnosis-follow-up-and-treatment-of-cystic-fibrosis-related-liver-disease
#3
Ivo P van de Peppel, Anna Bertolini, Johan W Jonker, Frank A J A Bodewes, Henkjan J Verkade
PURPOSE OF REVIEW: To provide an insight and overview of the challenges in the diagnosis, follow-up and treatment of cystic fibrosis-related liver disease (CFLD). RECENT FINDINGS: The variable pathophysiology of CFLD complicates its diagnosis and treatment. A 'gold standard' for CFLD diagnosis is lacking. Over the past years, new techniques to diagnose features of CFLD, such as transient elastography, have been investigated. Although most of these tests confirm cystic fibrosis-related liver involvement (CFLI), they are, however, not suitable to distinguish various phenotypical presentations or predict progression to clinically relevant cirrhosis or portal hypertension...
August 23, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28820755/sleep-complications-following-traumatic-brain-injury
#4
Natalie A Grima, Jennie L Ponsford, Matthew P Pase
PURPOSE OF REVIEW: Recent research has provided extensive characterization as to the frequency and nature of sleep disturbances following traumatic brain injury (TBI). This review summarizes the current state of knowledge and proposes future directions for research. RECENT FINDINGS: Complaints of sleep disturbance are common following TBI, and objective assessments of sleep largely corroborate these complaints. Sleep is often disturbed in the acute phase postinjury and can persist for decades, with the prevalence of sleep disorders higher in patients with TBI as compared with the general population...
August 17, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28820754/sleep-apps-what-role-do-they-play-in-clinical-medicine
#5
Christopher P Lorenz, Adrian J Williams
PURPOSE OF REVIEW: Today's smartphones boast more computing power than the Apollo Guidance Computer. Given the ubiquity and popularity of smartphones, are we already carrying around miniaturized sleep labs in our pockets? RECENT FINDINGS: There is still a lack of validation studies for consumer sleep technologies in general and apps for monitoring sleep in particular. To overcome this gap, multidisciplinary teams are needed that focus on feasibility work at the intersection of software engineering, data science and clinical sleep medicine...
August 17, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28806187/pain-is-an-underestimated-symptom-in-cystic-fibrosis
#6
Alexandra Masson, Maya Kirszembaum, Isabelle Sermet-Gaudelus
PURPOSE OF REVIEW: Life expectancy is increasing in cystic fibrosis and new aspects of the disease have to be taken into account in cystic fibrosis care. RECENT FINDINGS: Pain is encountered among 70% of adult and pediatric patients with cystic fibrosis. This symptom is underestimated by the multidisciplinary team. It has been reported as impacting quality of life and adherence to treatments. The location of pain is inconstant among the different studies but the major symptoms are headaches, gastrointestinal, and chest pain...
August 12, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28796008/methicillin-resistant-staphylococcus-aureus-in-cystic-fibrosis-how-should-it-be-managed
#7
Marianne S Muhlebach
PURPOSE OF REVIEW: Methicillin-resistant Staphylococcus aureus (MRSA) remains prevalent in people with cystic fibrosis (CF). As chronic infection with worse pulmonary outcomes develops frequently, the organism is concerning to CF providers and patients. This review describes current epidemiology, our understanding of risk factors for MRSA infection, and relevant aspects of treatment with review of new and ongoing trials. RECENT FINDINGS: Prevalence ranges from a low of 3 to 4% in some European countries to a high of approximately 26% in the United States...
August 8, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28787382/impact-of-home-mechanical-ventilation-on-sleep-quality
#8
Sarah B Schwarz, Friederike S Magnet, Wolfram Windisch
PURPOSE OF REVIEW: The number of patients receiving home mechanical ventilation (HMV) has dramatically increased in recent years. Although physiological parameters, health-related quality of life and long-term outcomes frequently serve as primary outcomes, only a few studies have primarily addressed sleep quality in patients undergoing HMV. Therefore, this review article summarizes the current knowledge on sleep quality in patients receiving HMV. RECENT FINDINGS: HMV can be performed noninvasively via face masks or invasively via tracheal cannulas...
August 5, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28787381/effects-of-new-and-emerging-therapies-on-gastrointestinal-outcomes-in-cystic-fibrosis
#9
Roderick H J Houwen, Wendy L van der Woerd, Mordechai Slae, Michael Wilschanski
PURPOSE OF REVIEW: Several new therapeutic modalities have recently become available to be used in patients with cystic fibrosis such as potentiators, modulators, and probiotics. Although the effects on pulmonary function have been well documented, gastrointestinal outcomes have been addressed only rarely. RECENT FINDINGS: Both the potentiator (ivacaftor) and the potentiator/modulator combination (ivacaftor/lumacaftor) that are currently on the market have a positive effect on BMI...
August 5, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28786883/the-relationship-between-pulmonary-hypertension-and-obstructive-sleep-apnea
#10
Hang S Wong, Adrian J Williams, YingJuan Mok
PURPOSE OF REVIEW: Although obstructive sleep apnea (OSA)-associated pulmonary hypertension is not uncommon and carries a worse prognosis if left untreated, it is less well recognized by clinicians. This review provides information on prevalence, pathophysiology, clinical presentation, treatment, and prognosis of pulmonary hypertension in OSA. RECENT FINDINGS: The prevalence of pulmonary hypertension in OSA ranges from 17 to 53%. The underlying pathophysiology is complex and yet to be fully understood...
August 3, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28786882/how-can-the-cystic-fibrosis-respiratory-microbiome-influence-our-clinical-decision-making
#11
Geraint B Rogers, Kenneth D Bruce, Lucas R Hoffman
PURPOSE OF REVIEW: Almost 15 years have now passed since bacterial community profiling techniques were first used to analyse respiratory samples from people with cystic fibrosis. Since then, many different analytical approaches have been used to try to better understand the contribution of the cystic fibrosis lung microbiota to disease, with varying degrees of success. We examine the extent to which cystic fibrosis respiratory microbiome research has been successful in informing clinical decision-making, and highlight areas that we believe have the potential to yield important insight...
August 3, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28708817/innovating-cystic-fibrosis-clinical-trial-designs-in-an-era-of-successful-standard-of-care-therapies
#12
Donald R VanDevanter, Nicole Mayer-Hamblett
PURPOSE OF REVIEW: Evolving cystic fibrosis 'standards of care' have influenced recent cystic fibrosis clinical trial designs for new therapies; care additions/improvements will require innovative trial designs to maximize feasibility and efficacy detection. RECENT FINDINGS: Three cystic fibrosis therapeutic areas (pulmonary exacerbations, Pseudomonas aeruginosa airway infections, and reduced cystic fibrosis transmembrane conductance regulator [CFTR] protein function) differ with respect to the duration for which recognized 'standards of care' have been available...
July 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28771452/sarcoidosis-update-approaching-the-disease-from-multiple-directions
#13
Robert P Baughman, Marcel Veltkamp
No abstract text is available yet for this article.
September 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28771451/pitfalls-in-developing-new-compounds-for-idiopathic-pulmonary-fibrosis
#14
Steven D Nathan, Fernando J Martinez
PURPOSE OF REVIEW: The development and availability of nintedanib and pirfenidone has heralded a new era in the management of idiopathic pulmonary fibrosis (IPF). Both agents demonstrate that the disease can be successfully modulated with therapeutic interventions, but neither are a cure and IPF remains a deadly disease. RECENT FINDINGS: There have been many lessons about the natural history of IPF and clinical trial design, not only from the clinical development programs for nintedanib and pirfenidone, but also the numerous negative trials that predated these...
September 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28767520/editorial-introductions
#15
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28661905/genetics-of-pulmonary-hypertension-in-the-clinic
#16
Barbara Girerd, Edmund Lau, David Montani, Marc Humbert
PURPOSE OF REVIEW: Heritable pulmonary arterial hypertension (PAH) is an autosomal dominant disease with incomplete penetrance because of mutations in bone morphogenetic protein receptor-II (BMPR2), activin A receptor type II-like kinase 1, endoglin, caveolin-1, potassium channel subfamily K, member 3, and T-box gene 4 genes. Heritable pulmonary veno-occlusive disease and/or pulmonary capillary hemangiomatosis (PVOD/PCH) is an autosomal recessive disease because of biallelic mutations in the eukaryotic translation initiation factor 2 alpha kinase 4 gene...
September 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28661904/cardiac-sarcoidosis-challenges-in-clinical-practice
#17
Anne L Bakker, Jan C Grutters, Ruth G Keijsers, Martijn C Post
PURPOSE OF REVIEW: To address the current recommendations for screening, diagnosis, and treatment of cardiac sarcoidosis and the difficulties to put these recommendations into clinical practice. RECENT FINDINGS: The incidence of cardiac sarcoidosis appears to be higher than earlier reported, probably because of improved imaging techniques. Late gadolinium enhancement with cardiac MRI (LGE-CMR) and fluorodeoxyglucose positron emission tomography obtained a central role in the diagnostic algorithm and monitoring of disease activity...
September 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28650861/microbiome-in-interstitial-lung-disease-from-pathogenesis-to-treatment-target
#18
Margaret L Salisbury, MeiLan K Han, Robert P Dickson, Philip L Molyneaux
PURPOSE OF REVIEW: This review summarizes current knowledge of the role of the lung microbiome in interstitial lung disease and poses considerations of the microbiome as a therapeutic target. RECENT FINDINGS: Although historically considered sterile, bacterial communities have now been well documented in lungs in health and disease. Studies in idiopathic pulmonary fibrosis (IPF) suggest that increased bacterial burden and/or abundance of potentially pathogenic bacteria may drive disease progression, acute exacerbations, and mortality...
September 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28639957/pulmonary-arterial-hypertension-induced-by-tyrosine-kinase-inhibitors
#19
Jason Weatherald, Marie-Camille Chaumais, David Montani
PURPOSE OF REVIEW: Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of several neoplastic conditions; however, pulmonary arterial hypertension (PAH) has been reported as a complication of TKIs, predominantly with dasatinib. Recent studies have elucidated the potential mechanisms of TKI-induced PAH and have better clarified the long-term outcomes. RECENT FINDINGS: In addition to the known association between dasatinib and PAH, several other TKIs have recently been reported to cause PAH, including ponatinib, bosutinib and lapatinib...
September 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28639956/small-fiber-neuropathy-a-disabling-and-underrecognized-syndrome
#20
Mareye Voortman, Daan Fritz, Oscar J M Vogels, Filip Eftimov, Diederik van de Beek, Matthijs C Brouwer, Marjolein Drent
PURPOSE OF REVIEW: To discuss cause, clinical manifestations, diagnostics, and treatment of small fiber neuropathy (SFN). The diagnosis is difficult and can be easily missed. RECENT FINDINGS: SFN causes high morbidity with disabling symptoms and impact on quality of life. Patients may benefit from being diagnosed with SFN, even if no underlying cause is identified and no specific treatment is yet available. Recently, genetic mutations as a possible cause of SFN were identified...
September 2017: Current Opinion in Pulmonary Medicine
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