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Current Opinion in Pulmonary Medicine

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https://www.readbyqxmd.com/read/29697418/recent-progress-in-systemic-treatment-for-lung-cancer
#1
Jeffrey W Clark, Dan L Longo
PURPOSE OF REVIEW: We intend to highlight progress made in 2017 to lung cancer molecular nosology and application of new knowledge to treatment. RECENT FINDINGS: Studies have shown that agents targeting specific molecular defects in lung cancers such as epidermal growth factor receptor(egfr) mutations, alk or ros1 gene rearrangements, are more effective than conventional combination chemotherapy as primary treatment for various lung cancer subgroups. Identification of mechanisms of drug resistance has guided development of improved agents and effective salvage regimens...
April 24, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29677028/treatment-of-tobacco-dependence-current-state-of-the-art
#2
Hasmeena Kathuria, Frank T Leone, Enid R Neptune
PURPOSE OF REVIEW: The Centers for Medicare and Medicaid Services' requirement to integrate tobacco treatment with lung cancer screening (LCS) has served as a catalyst for motivating pulmonary medicine clinicians to improve upon their ability to effectively treat tobacco dependence. To do so, clinicians need to be well versed in the behavioral and pharmacologic tools that promote smoking cessation. RECENT FINDINGS: The current review outlines current strategies for treating tobacco dependence, focusing on the important interplay between counseling and pharmacotherapy...
April 18, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29634577/evaluation-of-ground-glass-nodules
#3
Varvara Mironova, Justin D Blasberg
PURPOSE OF REVIEW: Ground glass nodules (GGNs) represent an indolent subset of lung nodules including preinvasive nonsmall-cell lung cancer associated with a favorable prognosis and low risk for progression. Increased performance of screening cat-scan (CT) for high-risk patients has identified an increasing number of GGNs. The management of these nodules is founded mostly on single institution data and currently no universally accepted recommendations help guide clinicians managing these patients...
April 9, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29629920/pleural-effusions-in-hematologic-malignancies-and-their-management-with-indwelling-pleural-catheters
#4
Erik Vakil, Carlos A Jimenez, Saadia A Faiz
PURPOSE OF REVIEW: Pleural effusions in patients with hematologic malignancy may represent malignant pleural effusion (MPE) or occur secondary to infection, treatment effects, and other common causes. The impact of MPE on prognosis in this cohort remains unclear. Indwelling pleural catheters (IPCs) are routinely placed for palliation of recurrent symptomatic MPEs, but perceived concerns over infection and bleeding may limit their use in patients with hematologic malignancies. However, recent evidence suggests IPCs are both well tolerated and effective in this cohort...
April 6, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29553974/breathing-abnormalities-during-sleep-in-kleine-levin-syndrome-fact-or-coincidence
#5
Natan Gadoth
PURPOSE OF REVIEW: To highlight and critically discuss the possibility that breathing abnormalities during hypersomnolent episodes are an additional clinical feature of Kleine-Levin Syndrome (KLS). RECENT FINDINGS: A computerized literature search of breathing abnormalities in patients with KLS disclosed two old and a single recent publication describing a total of six patients with sleep apnea during hypersomnolent episodes. SUMMARY: Owing to scarce reports on complete polysomnography during and in-between hypersomnic episodes of KLS, the possibility that breathing abnormalities are an additional clinical feature of this unique episodic sleep syndrome should be further studied...
March 16, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29553973/updates-in-the-diagnosis-and-treatment-of-malignant-pleural-mesothelioma
#6
Daniel Katzman, Daniel H Sterman
PURPOSE OF REVIEW: This review article describes current diagnostic and treatment modalities for malignant pleural mesothelioma (MPM). RECENT FINDINGS: Few randomized trials in MPM have demonstrated improved survival with current therapies. A randomized trial of first-line chemotherapy with and without bevacizumab in unresectable MPM is the only randomized trial of a new treatment regimen to demonstrate a survival benefit since cisplatin with pemetrexed became the standard of care for unresectable MPM in 2003...
March 16, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29538080/emerging-concepts-in-pleural-infection
#7
Ka Pang Chan, Deirdre B Fitzgerald, Y C Gary Lee
PURPOSE OF REVIEW: Pleural infection remains an important pulmonary disease, causing significant morbidity and mortality. There is a resurgence of disease burden despite introduction of antibiotics and pneumococcal vaccines. A revisit of the pathogenesis and update on intervention may improve the care of pleural infection. RECENT FINDINGS: Recent studies have uncovered the prognostic implication of the presence of a pleural effusion in patients with pneumonia. Identifying where the bacteria lives may have diagnostic and therapeutic implications...
March 13, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29538079/update-on-airway-stents
#8
Bruce F Sabath, David E Ost
PURPOSE OF REVIEW: The current review describes the latest evidence regarding the use of stents for malignant airway obstruction. RECENT FINDINGS: Therapeutic bronchoscopy, including stenting, can restore patency in up to 93% of patients with malignant central airway obstruction. The patients that benefit the most are those with worse baseline dyspnea, higher American Society of Anesthesiology score, poorer functional status, and central obstruction (rather than lobar)...
March 13, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29528854/the-role-of-procalcitonin-in-the-management-of-pleural-infection
#9
Duneesha de Fonseka, Nick A Maskell
PURPOSE OF REVIEW: Pleural infection is a common problem associated with significant morbidity and mortality. Systemic or pleural fluid markers for reliably identifying pleural infection are limited. Procalcitonin (PCT) is known to be elevated in bacterial infection and is currently used for diagnosis and decision-making regarding antibiotic duration in respiratory infections. This review investigates if there is a role for serum and pleural fluid PCT (pf-PCT) in diagnosis and management of pleural infection...
March 9, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29528853/drug-resistance-in-patients-with-tuberculous-pleural-effusions
#10
Vasileios S Skouras, Ioannis Kalomenidis
PURPOSE OF REVIEW: To summarize data regarding categories, detection methods, prevalence and patterns of drug resistance among patients with tuberculous pleural effusion (TPE) and to comment on the management of suspected drug-resistant TPE. RECENT FINDINGS: Pleural and pulmonary tuberculosis (TB) present similar patterns of drug resistance. Approximately 10% and 6-10% of pleural Mycobacterium tuberculosis isolates are resistant to at least one first-line anti-TB drug or at least isoniazid, respectively...
March 9, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29521657/stereotactic-ablative-radiation-therapy-in-lung-cancer-an-emerging-standard
#11
Adam Mutsaers, Hanbo Chen, Alexander V Louie
PURPOSE OF REVIEW: Significant advances have been made in the field of stereotactic ablative radiotherapy (SABR) for the treatment of pulmonary neoplasms in recent years. This review aims to summarize recent salient evidence on SABR for early-stage nonsmall cell lung cancer (ES-NSCLC). RECENT FINDINGS: In medically inoperable patients, SABR remains the standard of care. The optimal SABR dosing regimen is being studied. Comparisons with non-SABR radiotherapy regimens with lower doses per fraction revealed benefit of SABR...
March 7, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29521656/comparison-of-treatment-of-hepatic-hydrothorax-with-catheter-drainage-versus-serial-thoracentesis
#12
Shu-Lan Hsu, Chih-Wei Tseng
PURPOSE OF REVIEW: Hepatic hydrothorax is a nonmalignant pleural effusion associated with portal hypertension that may cause increased morbidity or mortality in cirrhotic patients. For patients who are refractory to salt restriction and diuretics, thoracentesis and catheter drainage are necessary for symptomatic relief. This review aimed to identify the best drainage method in patients with hepatic hydrothorax. RECENT FINDINGS: Chest tube placement is discouraged in cases of hepatic hydrothorax due to high complication and mortality rates...
March 7, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29517587/chest-imaging-for-the-diagnosis-of-complicated-parapneumonic-effusions
#13
José M Porcel
PURPOSE OF REVIEW: To provide an overview of the contribution of thoracic ultrasound (TUS) and computed tomography (CT) in the identification of complicated parapneumonic effusions (CPPE), defined as those which need chest tube drainage for resolution. RECENT FINDINGS: A recent retrospective study found that visualization of complex (nonanechoic) effusions on TUS (likelihood ratio positive = 6.92) outperformed the recognition of loculated/septated effusions on CT (likelihood ratio = 2...
March 6, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29538081/pharmacogenetic-variants-and-vitamin-k-deficiency-a-risk-factor-or-trigger-for-fibrosing-interstitial-pneumonias
#14
Marjolein Drent, Petal Wijnen, Aalt Bast
PURPOSE OF REVIEW: Fibrosing interstitial pneumonias are associated with various stages of fibrosis. The cause of this group of syndromes remains largely unknown. For most of these diseases, a genetic basis, environmental factors and certain triggers have been suggested as possible risk factors. Various studies have found an association between genetic polymorphisms, or the presence of certain variant alleles, and the occurrence and/or progression of interstitial pneumonias of unknown origin...
May 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29538078/why-is-the-rate-of-pneumococcal-pneumonia-declining
#15
Carlos M Luna, Laura Pulido, Diego Burgos
PURPOSE OF REVIEW: As Streptococcus pneumoniae was considered the etiological agent of nearly all the cases of pneumonia at the beginning of the 20th century, and today is identified in fewer than 10-15% of cases, we analyze the possible causes of such a decline. RECENT FINDINGS: Extensive use of early empiric antimicrobial therapy, discovery of previously unrecognized pathogens, availability to newer diagnostic methods for the recognition of the pneumonia pathogens (PCR, urinary antigens, monoclonal antibodies etc...
May 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29517586/trade-offs-in-aging-lung-diseases-a-review-on-shared-but-opposite-genetic-risk-variants-in-idiopathic-pulmonary-fibrosis-lung-cancer-and-chronic-obstructive-pulmonary-disease
#16
Coline H M van Moorsel
PURPOSE OF REVIEW: The process of aging involves biological changes that increases susceptibility for disease. In the aging lung disease IPF, GWAS studies identified genes associated with risk for disease. Recently, several of these genes were also found to be involved in risk for COPD or lung cancer. This review describes GWAS-derived risk genes for IPF that overlap with risk genes for lung cancer or COPD. RECENT FINDINGS: Risk genes that overlap between aging lung diseases, include FAM13A, DSP and TERT...
May 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29517585/genetic-causes-and-clinical-management-of-pediatric-interstitial-lung-diseases
#17
Nadia Nathan, Keren Borensztajn, Annick Clement
PURPOSE OF REVIEW: Interstitial lung disease (ILD) in children (chILD) is an umbrella term for a heterogeneous group of rare respiratory disorders that are mostly chronic and associated with high morbidity and mortality. The pathogenesis of the various chILD is complex and implicates genetic contributors. The purpose of this review is to provide updated information on the molecular defects associated with the development of chILD. RECENT FINDINGS: Currently, the main mutations are identified in the surfactant genes SFTPA1, SFTPA2, SFTPB, SFTPC, ABCA3, and NKX2-1...
May 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29517584/disease-modifying-genetic-factors-in-cystic-fibrosis
#18
Fernando A L Marson
PURPOSE OF REVIEW: To compile data from the past 10 years regarding the role of modifying genes in cystic fibrosis (CF). RECENT FINDINGS: CF is a model disease for understanding of the action of modifying genes. Although it is a monogenic (CFTR) autosomal recessive disease, CF presents with wide phenotypic variability. In CF, variability occurs with different intensity among patients by each organ, being organ-specific, resulting from the mutual interaction of environmental and genetic factors, including CFTR mutations and various other genes, most of which are associated with inflammatory processes...
May 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29474209/pulmonary-phenotypes-associated-with-genetic-variation-in-telomere-related-genes
#19
Thijs W Hoffman, Coline H M van Moorsel, Raphael Borie, Bruno Crestani
PURPOSE OF REVIEW: Genomic mutations in telomere-related genes have been recognized as a cause of familial forms of idiopathic pulmonary fibrosis (IPF). However, it has become increasingly clear that telomere syndromes and telomere shortening are associated with various types of pulmonary disease. Additionally, it was found that also single nucleotide polymorphisms (SNPs) in telomere-related genes are risk factors for the development of pulmonary disease. This review focuses on recent updates on pulmonary phenotypes associated with genetic variation in telomere-related genes...
May 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29470256/systematic-screening-in-hereditary-hemorrhagic-telangiectasia-a-review
#20
Steven Kroon, Repke J Snijder, Marie E Faughnan, Hans-Jurgen Mager
PURPOSE OF REVIEW: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant inherited disease characterized by telangiectasia and arteriovenous malformations (AVMs). To date, five genetic types of HHT and one combined juvenile polyposis syndrome and HHT are known. Clinical and genetic screening of patients suspected with HHT is recommended to confirm the diagnosis and to prevent complications associated with HHT. The aim of this article is to give an overview of the evidence and to formulate a recommendation for clinicians concerning screening for HHT...
May 2018: Current Opinion in Pulmonary Medicine
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