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Expert Review of Respiratory Medicine

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https://www.readbyqxmd.com/read/28345383/pulmonary-fibrosis-part-i-epidemiology-pathogenesis-and-diagnosis
#1
Keith C Meyer
Many forms of interstitial lung disease (ILD) can progress to extensive fibrosis and respiratory failure. Idiopathic pulmonary fibrosis (IPF), which generally has a poor prognosis, has been thoroughly studied over the past two decades, and many important discoveries have been made that pertain to genetic predisposition, epidemiology, disease pathogenesis, diagnosis, and management. Additionally, non-IPF forms of ILD can have radiologic and histopathologic manifestations that mimic IPF, and making an accurate diagnosis is key to providing personalized medicine to patients with pulmonary fibrosis...
March 26, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28345369/pulmonary-fibrosis-part-ii-state-of-the-art-patient-management
#2
Keith C Meyer
While many pharmacologic therapies for the treatment of idiopathic pulmonary fibrosis (IPF) have been evaluated via randomized, placebo-controlled clinical trials (RCTs) conducted over the past two decades, most therapies have been shown to be ineffective or even potentially harmful. However, a number of recently completed RCTs have shown significant efficacy for pirfenidone and nintedanib for the treatment of IPF. Areas Covered: This manuscript reviews recent advances in the management of IPF and other forms of fibrosing interstitial lung disease (ILD) with an emphasis on IPF...
March 26, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28282995/understanding-copd-overlap-syndromes
#3
Tuang Yeow Poh, Micheál Mac Aogáin, Adrian Kwok Wai Chan, Anthony Chau Ang Yii, Valerie Fei Lee Yong, Pei Yee Tiew, Mariko Siyue Koh, Sanjay Haresh Chotirmall
Chronic obstructive pulmonary disease accounts for a large burden of lung disease. It can 'overlap' with other respiratory diseases including bronchiectasis, fibrosis and obstructive sleep apnea (OSA). While COPD alone confers morbidity and mortality, common features with contrasting clinical outcomes can occur in COPD 'overlap syndromes'. Areas covered: Given the large degree of heterogeneity in COPD, individual variation to treatment is adopted based on its observed phenotype, which in turn overlaps with features of other respiratory disease states such as asthma...
March 24, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28319425/overcoming-challenges-in-the-diagnosis-prevention-and-treatment-of-pediatric-drug-resistant-tuberculosis
#4
Sylvie Jonckheree, Jennifer Furin
Drug-resistant tuberculosis (DR-TB) is a growing global health threat and children are especially vulnerable to becoming infected and sick with DR-TB. There is a growing body of evidence on the optimal diagnosis, treatment and prevention of DR-TB in this vulnerable population. Areas covered: A comprehensive review of the literature on DR-TB in children was done using PubMed and Ovid databases up to December 31, 2016. Topic areas covered included diagnosis of DR-TB, treatment of DR-TB-including novel medications and regimens, prevention of DR-TB, community-based care, and stigma/discrimination...
March 20, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28287009/continuous-positive-airway-pressure-therapy-in-obstuctive-sleep-apnea-benefits-and-alternatives
#5
Michelle T Cao, Joshua M Sternbach, C Guilleminault
Obstructive sleep apnea (OSA) is a highly prevalent condition affecting persons of all age with an increasing public health burden. It is implicated in cardiovascular disease, metabolic syndrome, neurocognitive impairment, reductions in quality of life, and increased motor vehicle accidents. The goals of OSA treatment are to improve sleep and daytime symptoms, and minimize cardiovascular risks.Areas covered: Continuous positive airway pressure (CPAP) is considered the gold standard therapy that delivers pressurized air into the upper airway to relieve obstruction during sleep...
March 17, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28282499/non-opioid-medications-for-the-relief-of-chronic-breathlessness-current-evidence
#6
Carlo Barbetta, David C Currow, Miriam J Johnson
To evaluate systematically randomised clinical trials investigating non-opioid medications for the management and treatment of chronic breathlessness. Areas covered: The evidence for the role of benzodiazepines, anxiolytics, selective serotonin re-uptake inhibitors (SSRIs), tricyclic antidepressants, antihistamines, cannabinoids, nebulized furosemide and herbal-based treatments were critically reviewed. Search of the Clinical Trials Registry (Clinicaltrial.gov) identified ongoing studies expected to generate new data in the near future in several classes of non-opioid medications for their net effect on chronic breathlessness...
March 17, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28299964/biomarkers-to-monitor-exacerbations-in-cystic-fibrosis
#7
Robert D Gray, Damien Downey, Clifford C Taggart
No abstract text is available yet for this article.
March 16, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28274188/extracellular-matrix-remodeling-in-idiopathic-pulmonary-fibrosis-it-is-the-bed-that-counts-and-not-the-sleepers
#8
Ioannis P Tomos, Argyrios Tzouvelekis, Vassilis Aidinis, Effrosyni D Manali, Evangelos Bouros, Demosthenes Bouros, Spyros A Papiris
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive interstitial lung disease characterized by irreversible fibrosis. Current disease pathogenesis assumes an aberrant wound healing process in response to repetitive injurious stimuli leading to apoptosis of epithelial cells, activation of fibroblasts and accumulation of extracellular matrix (ECM). Particularly, lung ECM is a highly dynamic structure that lies at the core of several physiological and developmental pathways. The scope of this review article is to summarize current knowledge on the role of ECM in the pathogenesis of IPF, unravel novel mechanistic data and identify future more effective therapeutic targets...
March 8, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28271728/comparing-approaches-to-the-management-of-malignant-pleural-effusions
#9
José M Porcel, Macy Mei-Sze Lui, Andrew D Lerner, Helen E Davies, David Feller-Kopman, Y C Gary Lee
Management of symptomatic malignant pleural effusions is becoming more complex due to the range of treatment options, which include therapeutic thoracenteses, thoracoscopic talc pleurodesis, bedside pleurodesis with talc or other sclerosing agents via small-bore chest catheters, indwelling pleural catheters, surgery, or a combination of some of these procedures. Areas covered: Recent advances for the expanding range of treatment options in malignant pleural effusions are summarized, according to the best available evidence...
March 8, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28132571/the-diagnosis-and-management-of-respiratory-viral-infections-in-cystic-fibrosis
#10
William Flight, Andrew Jones
Respiratory viruses, such as those that cause influenza and the common cold, are a regular feature of life for the entire human population. Among people with CF, these viruses are associated with prolonged respiratory illness and show a clear association with pulmonary exacerbations which in turn are associated with lung function decline and risk of death. Human rhinovirus is the most commonly encountered respiratory viral pathogen in CF although adenovirus, bocavirus, coronavirus, influenza, parainfluenza, metapneumovirus and respiratory syncytial virus are all also responsible for infections in this population...
February 3, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28128006/non-infectious-pulmonary-disorders-in-hiv
#11
Choua Thao, Andrew F Shorr, Christian Woods
Since the advent of antiretroviral therapy (ART), non-infectious pulmonary disorders have become common comorbidities in the human immunodeficiency virus (HIV) positive population. Clinicians caring for those with HIV disease should be aware of the prevalence of non-infectious pulmonary disorders. A comprehensive understanding is required to diagnosis and manage these syndromes appropriately. Areas covered: This review focuses on the epidemiology, risk factors, pathogenesis, clinical feature and diagnosis, and treatment of HIV-related chronic obstructive pulmonary disease (COPD), lung cancer, pulmonary hypertension...
February 3, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28152323/chemotherapy-and-intercalated-gefitinib-or-erlotinib-in-the-treatment-of-advanced-non-small-cell-lung-cancer
#12
Antonio Rossi, Anna La Salvia, Massimo Di Maio
Preclinical data showed that intercalated administration of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and chemotherapy might be effective in the treatment of advanced non-small-cell lung cancer (NSCLC). This review will summarize and discuss the clinical results available to date from prospective studies investigating this approach. Areas covered: A structured search of bibliographic databases for peer-reviewed literature and of main International meetings was undertaken, for trials testing the intercalated addition of EGFR-TKIs to chemotherapy in advanced NSCLC...
February 2, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28095078/diagnosis-classification-and-therapeutic-interventions-for-sinopulmonary-aspergillosis
#13
Matthew William McCarthy, Daniel Aguilar-Zapata, Vidmantas Petraitis, Thomas J Walsh
Sinopulmonary aspergillosis represents a diverse collection of allergic, invasive, and chronic sinus and respiratory conditions. These diseases can affect patients with and without immune impairment and in some cases may be life-threatening. Areas covered: We review the diagnosis, classification, and therapeutic options available to treat sinopulmonary aspergillosis and look ahead to emerging diagnostic and therapeutic options that may soon play an important role in clinical practice. Expert commentary: Histopathology and tissue culture remain the gold standard for the diagnosis of invasive sinopulmonary aspergillosis, but several new molecular detection methods have recently emerged, including various PCR-based platforms, MALDI-TOF, and lateral flow assays...
January 27, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28107795/adherence-to-therapies-in-cystic-fibrosis-a-targeted-literature-review
#14
Siva Narayanan, Jochen G Mainz, Smeet Gala, Harold Tabori, Daniel Grossoehme
Cystic fibrosis (CF) is a life-shortening condition with no cure. Available therapies relieving the symptoms of CF are complex and time-consuming. A comprehensive review assessing adherence to different CF therapies, association of adherence with outcomes, and factors influencing adherence could inform optimal patient management strategies. Areas covered: A targeted literature review of studies published from 2010-2016 assessed adherence to CF therapies. Nineteen studies qualified for inclusion. Adherence to CF therapies was sub-optimal, and varied by treatment, mode of treatment administration, age, season, time and method of adherence measurement...
January 20, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28107788/the-indications-and-role-of-paediatric-bronchoscopy-in-a-developing-country-with-high-prevalence-of-pulmonary-tuberculosis-and-hiv
#15
Irwin Webster, Pierre Goussard, Robert Gie, Jacques Janson, Gawie Rossouw
BACKGROUND: Bronchoscopy, an important investigation for the diagnosis and management of respiratory diseases, is widely used in high income countries. There is limited information on value of paediatric bronchoscopy in low and middle income countries (LMIC). AIMS AND OBJECTIVES: Aim was to describe the indications, findings and complications of bronchoscopy in a middle income country with a high prevalence of tuberculosis and HIV. METHODOLOGY: A retrospective analysis of a database over a 3...
January 20, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28076986/utilising-exhaled-nitric-oxide-information-to-enhance-diagnosis-and-therapy-of-respiratory-disease-current-evidence-for-clinical-practice-and-proposals-to-improve-the-methodology
#16
Marieann Högman, Lauri Lehtimäki, Anh Tuan Dinh-Xuan
A non-invasive tool to diagnose respiratory diseases and to follow treatment has long been looked-for. Exhaled nitric oxide (NO) is a promising marker of inflammation in asthma but nearly 25-years of research has shown that it works in only certain endotypes of asthma. The modelling of NO dynamics of the lung can give more information than a single FENO value. Areas covered: The estimation of the NO production in the conducting airways and in the gas exchange area has given new insight of the NO production in diseases beyond asthma...
January 20, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28345480/ultrasound-in-the-management-of-pleural-disease
#17
Rachel M Mercer, Ioannis Psallidas, Najib M Rahman
Pleural disease encompasses a large range of conditions, is a common presentation to the acute medical take and often requires comprehensive investigation and treatment. Ultrasound is well recognised as a useful investigative tool in pleural disease especially in the field of pleural effusion, pleural thickening and interventional procedures. Thoracic ultrasound (TUS) has gained widespread use by physicians as evidence has shown a reduced rate of complications when performing pleural procedures with ultrasound guidance...
April 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28282500/morning-symptoms-in-copd-a-treatable-yet-often-overlooked-factor
#18
Amanda R van Buul, Marise J Kasteleyn, Niels H Chavannes, Christian Taube
Chronic obstructive pulmonary disease (COPD) patients experience the morning as the worst period of the day. Nevertheless, morning symptoms are not mentioned in COPD guidelines. Areas covered: Different topics on morning symptoms are covered in this review to underline their importance: occurrence, tools for assessment and therapies to limit morning symptoms. Expert commentary: Morning symptoms are common and have a negative influence on a patient's life. Pharmacotherapy seems to be effective in decreasing morning symptoms...
April 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28228053/hiv-related-pneumococcal-disease-prevention-in-adults
#19
Charles Feldman, Ronald Anderson, Theresa Rossouw
HIV-infected persons are particularly susceptible to the development of severe pneumococcal disease, even in the setting of combination antiretroviral therapy (cART), due to slow, incomplete recovery of anti-pneumococcal host defenses. This risk is increased by avoidable aspects of lifestyle, particularly smoking, which intensify immunosuppression. Clearly, more effective preventive measures are needed to counter this threat. Areas covered: This is a detailed review of the published literature focusing on currently available strategies for prevention of pneumococcal infection in HIV-infected patients, including cotrimoxazole prophylaxis, cART, pneumococcal vaccination, and smoking cessation strategies...
March 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28228052/inhalation-therapy-in-patients-with-tracheostomy-a-guide-to-clinicians
#20
Arzu Ari, James B Fink
Inhalation therapy has become a popular procedure for the treatment of patients with tracheostomy. However, clinicians are faced with many challenges during inhalation therapy because of the many factors affecting aerosol therapy to this patient population, and the lack of literature providing guidance in this area of research. Areas covered: The purpose of this paper is to describe the factors affecting aerosol drug delivery to patients with tracheostomy and to explain how to optimize inhalation therapy through device selection, interface selection and delivery technique in this patient population...
March 2017: Expert Review of Respiratory Medicine
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