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Expert Review of Respiratory Medicine

Luke S Howard
Acute pulmonary embolism (PE) is a relatively common cardiopulmonary emergency that is a major cause of hospitalization and morbidity and is the primary cause of mortality associated with venous thromboembolism (VTE). During the last decade, one of the biggest changes in the management of PE has been the approval of four non-vitamin K antagonist oral anticoagulants (NOACs; apixaban, dabigatran, edoxaban and rivaroxaban) for the treatment of PE and deep vein thrombosis and secondary prevention of VTE. Areas covered: This article reviews the evolving management of PE in the NOAC era and addresses three fundamental questions: who should receive NOACs over conventional heparin/vitamin K antagonist regimens for the treatment of acute PE; whether patients should be treated as inpatients or outpatients; and how long patients should be treated to reduce the risk of recurrence? Expert commentary: The management of PE is changing...
March 15, 2018: Expert Review of Respiratory Medicine
Jean-François Etter
No abstract text is available yet for this article.
March 15, 2018: Expert Review of Respiratory Medicine
(no author information available yet)
No abstract text is available yet for this article.
March 14, 2018: Expert Review of Respiratory Medicine
Sophia Chen, Travis C Geraci, Robert James Cerfolio
Robotic lobectomy is an increasingly common surgical approach for anatomic lung resection. Over the last decade, robotic lobectomy has shown to be safe, with oncologic efficacy similar to lobectomy via thoracotomy or video-assisted thoracoscopic surgery (VATS). Comparative analysis between these modalities is an active area of investigation. While initially expensive, the costs of a robotic platform decrease as the number of operations performed increases, length of stay is shortened, and postoperative morbidity is reduced...
March 5, 2018: Expert Review of Respiratory Medicine
Melissa A Maloney, Sheila S Kun, Thomas G Keens, Iris A Perez
Congenital central hypoventilation syndrome (CCHS) is a rare disorder defined by a failure in autonomic control of breathing secondary to mutations of the PHOX2B gene. Affected individuals demonstrate absent or diminished physiologic response to hypercapnia and hypoxia that is most severe during sleep as well as multi-system dysregulation of autonomic functions. Areas covered: In this review, we will discuss how evaluation of the disease-defining PHOX2B gene aids diagnosis and helps prognosticate disease severity, review disease physiology, describe clinical presentation and various aspects of autonomic nervous system dysregulation, review ventilatory strategies, and highlight current challenges in the care of these complex patients...
February 28, 2018: Expert Review of Respiratory Medicine
Natalya Azadeh, Teng Moua, Misbah Baqir, Jay H Ryu
Interstitial lung diseases (ILD) include a broad range of diffuse parenchymal lung disorders of known and unknown etiologies. Patients with ILD can experience acute exacerbations (AE) which are associated with extremely high morbidity and mortality. Little is known about the etiology of AEs, and whether inciting triggers (such as infection) result in an aberrant inflammatory response in a predisposed host. Areas covered: The majority of data regarding AE-ILD comes from the interstitial pulmonary fibrosis (IPF) population and is extrapolated to other forms of ILD...
February 27, 2018: Expert Review of Respiratory Medicine
Neil C Thomson
Bronchial thermoplasty is a licensed non-pharmacological treatment for severe asthma. Area covered: This article considers evidence for the efficacy and safety of bronchial thermoplasty from clinical trials and observational studies in clinical practice. Its place in the management of severe asthma, predictors of response and mechanisms of action are reviewed. Expert commentary: Bronchial thermoplasty improves quality of life and reduces exacerbations in moderate to severe asthma. Morbidity from asthma is increased during treatment...
February 23, 2018: Expert Review of Respiratory Medicine
Manuel Mirón Rubio, Rocío Ceballos Fernández, Inmaculada Parras Pastor, Amaya Palomo Iloro, Borja Manuel Fernández Félix, Jenifer Medina Miralles, Esther Zamudio López, Javier González Pastor, Caridad Amador Lorente, Nazaret Mena Hortelano, Alejandro Domínguez Sánchez, Soledad Alonso-Viteri
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major consumer of healthcare resources, with most costs related to disease exacerbations. Telemonitoring of patients with COPD may help to reduce the number of exacerbations and/or the related costs. On the other hand, home hospitalization is a cost-saving alternative to inpatient hospitalization associated with increased comfort for patients. The results are reported regarding using telemonitoring and home hospitalization for the management of patients with COPD...
February 21, 2018: Expert Review of Respiratory Medicine
Kate Sutherland, Fernanda R Almeida, Philip de Chazal, Peter A Cistulli
Obstructive sleep apnoea (OSA) is common disorder, under-diagnosed, and can be difficult to treat adequately across the lifespan. OSA is a heterogeneous disorder with different risk factors, clinical presentations, pathophysiology and morbidity. Prediction has an important role in OSA recognition and management, embodied in screening methods to circumvent the need for diagnosis by overnight sleep studies and prediction of treatment efficacy and adherence. Other opportunities exist in predicting susceptibility to comorbidity and health outcomes...
February 17, 2018: Expert Review of Respiratory Medicine
Luigino Calzetta, Maria Gabriella Matera, Paola Rogliani, Mario Cazzola
No abstract text is available yet for this article.
February 16, 2018: Expert Review of Respiratory Medicine
Qian Ye, Amy Liao, Anthony D'Urzo
No abstract text is available yet for this article.
February 9, 2018: Expert Review of Respiratory Medicine
Jiangtao Lin, Xin Zhou, Changzheng Wang, Chuntao Liu, Shaoxi Cai, Mao Huang
The Global Initiative for Asthma (GINA) annual report summarizes the latest evidence for asthma management. GINA recommends stepwise pharmacological treatment, advocating inhaled corticosteroids (ICS) plus rapid, long-acting β2-agonists (LABA) delivered in a single inhaler for maintenance and relief at Steps 3 (moderate persistent asthma requiring 1-2 controllers plus as-needed reliever), 4 (severe persistent asthma requiring ≥2 controllers plus as-needed reliever), and 5 (higher level care and/or add-on treatment)...
February 5, 2018: Expert Review of Respiratory Medicine
Linda Denehy, Catherine L Granger, Doa El-Ansary, Selina M Parry
Cardiorespiratory physiotherapy is an evidence-based practice that has evolved alongside changes in medical and surgical management, analgesia, the ageing society and increasing comorbidities of our patient populations. Continued research provides the profession with the ability to adapt to meet the changing patient and community needs. Areas covered: This review focuses on surgical, respiratory and critical care settings discussing the most significant changes over the past decade with an increased focus on rehabilitation across the care continuum and a shift away from providing predominately airway clearance in established disease populations but also providing this in emerging groups...
January 27, 2018: Expert Review of Respiratory Medicine
Neda Kalhor, Cesar A Moran
Primary mucoepidermoid carcinomas (MEC) of the lung are rare and represent a diagnostic challenge. MEC in the lung is under the umbrella of primary salivary gland type tumors of the lung. Areas Covered: In general, salivary gland type tumors are represented by malignant neoplasms that may range from low to intermediate to high-grade type of malignancy sharing similar histopathological features as those in salivary glands. The focus in this review will be on one tumor in particular - mucoepidermoid carcinoma...
January 17, 2018: Expert Review of Respiratory Medicine
Paul F Pinsky
No abstract text is available yet for this article.
January 17, 2018: Expert Review of Respiratory Medicine
Bart de Brouwer, Ianthe Piscaer, Jan H von der Thusen, Jan C Grutters, Roger Eg Schutgens, Emiel Fm Wouters, Rob Janssen
There is an ongoing need for additional interventions in idiopathic pulmonary fibrosis (IPF) as antifibrotic drugs currently available only inhibit and do not stall disease progression. Vitamin K is a co-factor for the activation of coagulation factors. However, it is also required to activate proteins with functions outside of the coagulation cascade, such as matrix Gla protein (MGP), a defender against soft tissue calcification. Vitamin K antagonists are anticoagulants that are, for unknown reasons, associated with increased mortality in IPF...
January 5, 2018: Expert Review of Respiratory Medicine
Annelies Van Eyck, Stijn L Verhulst
No abstract text is available yet for this article.
January 4, 2018: Expert Review of Respiratory Medicine
Frederik A van Gemert, Bruce J Kirenga, Tewodros Haile Gebremariam, George Nyale, Corina de Jong, Thys van der Molen
In most low and middle-income countries, chronic obstructive pulmonary disease (COPD) is on the rise. Areas covered: Unfortunately, COPD is a neglected disease in these countries. Taking sub-Saharan Africa as an example, in rural areas, COPD is even unknown regarding public awareness and public health planning. Programs for the management of COPD are poorly developed, and the quality of care is often of a low standard. Inhaled medication is often not available or not affordable. Tobacco smoking is the most common encountered risk factor for COPD...
January 3, 2018: Expert Review of Respiratory Medicine
Rogelio Perez-Padilla, Ireri Thirion-Romero, Nicolas Guzman
No abstract text is available yet for this article.
December 26, 2017: Expert Review of Respiratory Medicine
Rachel M Mercer, Maged Hassan, Najib M Rahman
Pleurodesis is used to obliterate the pleural space, most commonly in patients with symptomatic malignant pleural effusions but also in patients with benign effusions or pneumothorax. Areas covered: Traditionally, chemical pleurodesis has been undertaken at thoracoscopy or using instillation of a slurry through a chest drain. The optimum method of achieving pleurodesis, whether surgical or medical, has yet to be proven. Evidence in the different disease areas will be reviewed, along with ongoing trial evidence, which may change practice...
April 2018: Expert Review of Respiratory Medicine
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