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Expert Review of Respiratory Medicine

Rosario Menéndez, Isabel Amara-Elori, Raul Méndez
No abstract text is available yet for this article.
July 17, 2018: Expert Review of Respiratory Medicine
Rosanel Amaro, Meropi Panagiotaraka, Victoria Alcaraz, Antoni Torres
Non-cystic fibrosis bronchiectasis (NCFB) is considered a chronic heterogenic pulmonary disease, characterized by the permanent and abnormal enlargement and thickening of bronchial walls, impaired mucociliary clearance and suppuration. Inhaled antibiotics have been used for a long time in patients with cystic fibrosis but are seldom used in those with NCFB and few randomized clinical trials are available in this population. Areas covered: This review summarizes current clinical evidence of efficacy, adverse events and future directions of inhaled antibiotics in NCFB...
July 16, 2018: Expert Review of Respiratory Medicine
(no author information available yet)
No abstract text is available yet for this article.
July 9, 2018: Expert Review of Respiratory Medicine
Laura Mezquita, David Planchard
In non-small cell lung cancer (NSCLC), immunotherapy is one of today's most important and ground-breaking systemic treatments, mainly represented by antibodies against cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death protein 1 or ligand 1 (PD-1/PD-L1). Durvalumab (MEDI4736) is a high-affinity human IgG1 monoclonal antibody that binds to PD-1 and CD80, blocking PD-L1, but not PD-L2. Areas covered: In advanced NSCLC patients, durvalumab has demonstrated activity and acceptable tolerability, particularly with ≥25% PD-L1 tumor expression in the EGFR and ALK wild-type population...
July 9, 2018: Expert Review of Respiratory Medicine
Félix Del Campo, Andrea Crespo, Ana Cerezo-Hernández, Gonzalo C Gutiérrez-Tobal, Roberto Hornero, Daniel Álvarez
Overnight oximetry has been proposed as an accessible, simple, and reliable technique for obstructive sleep apnea syndrome (OSAS) diagnosis. From visual inspection to advanced signal processing, several studies have demonstrated the usefulness of oximetry as a screening tool. However, there is still controversy regarding the general application of oximetry as a single screening methodology for OSAS. Areas covered: Currently, high-resolution portable devices combined with pattern recognition-based applications are able to achieve high performance in the detection of this disease...
July 4, 2018: Expert Review of Respiratory Medicine
Luigino Calzetta, Maria Gabriella Matera, Paola Rogliani, Mario Cazzola
N-Acetyl-l-cysteine (NAC), a derivative of the naturally occurring amino acid, l-cysteine, is a mucolytic agent that may also act as an antioxidant by providing cysteine intracellularly for increased production of glutathione. It is also used for the treatment of acetaminophen overdose. Areas covered: The recent international recommendations for the treatment of chronic obstructive pulmonary disease (COPD) report that NAC, because of its mucolytic activity, reduces acute exacerbation of COPD (AECOPD) with a modest improvement in health status...
July 4, 2018: Expert Review of Respiratory Medicine
Konstantina Kontogianni, Ralf Eberhardt
Surgical treatment of severe pulmonary emphysema has so far been associated with relatively high perioperative morbidity and mortality. In the past two decades, novel approaches to lung volume reduction and alternative minimally invasive endoscopic techniques have been developed. This review presents the different techniques (blocking and nonblocking) available until present as well as the appropriate patient selection and possible complications. Areas covered: All available randomized controlled trials (RCTs) have been evaluated...
July 4, 2018: Expert Review of Respiratory Medicine
Matthew M Smith, Robin T Cotton
Laryngotracheal stenosis comprises a broad spectrum of congenital and acquired conditions that commonly cause pediatric airway obstruction. Although the majority of these conditions were historically managed with endoscopic dilations, the introduction of operative procedures such as laryngotracheoplasty, cricotracheal resection, and slide tracheoplasty changed the treatment paradigm. The gradual evolution of endoscopic technology enabled surgeons to perform certain procedures endoscopically that were previously only able to be performed in an open fashion...
July 3, 2018: Expert Review of Respiratory Medicine
Begum Ergan, Stefano Nava
Flexible bronchoscopy has been well established for diagnostic and therapeutic purposes in critically ill patients. Areas covered: This review outlines the clinical evidence of the utility and safety of flexible bronchoscopy in the intensive care unit, as well as specific considerations, including practical points and potential complications, in critically ill patients. Expert commentary: Its ease to learn and perform and its capacity for bedside application with relatively few complications make flexible bronchoscopy an indispensable tool in the intensive care unit setting...
June 29, 2018: Expert Review of Respiratory Medicine
Anke Lenferink, Job van der Palen, Tanja Effing
No abstract text is available yet for this article.
June 18, 2018: Expert Review of Respiratory Medicine
María Molina-Molina, Myriam Aburto, Orlando Acosta, Julio Ancochea, José Antonio Rodríguez-Portal, Jaume Sauleda, Carlos Lines, Antoni Xaubet
No abstract text is available yet for this article.
May 7, 2018: Expert Review of Respiratory Medicine
Nicola Principi, Susanna Esposito
Community-acquired pneumonia (CAP) remains one of the most common reasons for paediatric morbidity and accounts for about 16% of all the deaths occurring in children less than 5 years of age. Areas covered: The main aim of this paper is to discuss the emerging problems for CAP treatment in paediatric age. Expert commentary: Official recommendations for therapeutic approaches to paediatric CAP, despite being not very recent, seem still to be the best solution to assure the highest probabilities of cure for children with this disease living in industrialized countries...
July 2018: Expert Review of Respiratory Medicine
Christopher Mallow, Margaret Hayes, Roy Semaan, Thomas Smith, Russell Hales, Roy Brower, Lonny Yarmus
Lung cancer is the leading cause of cancer-related deaths in the United States. Nearly 85% of all lung cancers are diagnosed at a late stage, with an associated five-year survival rate of 4%. Malignant central airway obstruction and malignant pleural effusions occur in upwards of 30% of these patients. Many of these patients are in need of palliative interventions for symptom control and to help improve their quality of life. Areas covered: This review covers the treatment modalities of malignant central airway obstruction and malignant pleural effusion...
July 2018: Expert Review of Respiratory Medicine
Alexsandra Ratajczak, Wojciech Feleszko, Danielle M Smith, Maciej Goniewicz
Use of electronic cigarettes (e-cigarettes) is frequently promoted as a less harmful alternative to cigarette smoking. The impact of repeated inhalation of e-cigarette aerosols on respiratory health is not well understood. Areas covered: Using results from laboratory, observational, and clinical studies, we synthesize evidence relevant to potential respiratory health effects that may result from inhalation of e-cigarette aerosols. Expert commentary: Chemical analyses reveal that e-cigarette aerosols contain numerous respiratory irritants and toxicants...
July 2018: Expert Review of Respiratory Medicine
Natalie E West, Patrick A Flume
Cystic fibrosis (CF) outcomes and survival have improved over the last century primarily due to advancements in antibiotics, nutritional, and pulmonary therapies. Reviewed here are the significant unmet needs that exist for individuals with CF. Areas covered: With the recent development of medications that address the underlying defect in the CF protein, there is hope that there will be continued improvement in CF outcomes. However, there remains a need to prevent or stop progression of CF-related complications, as the CF protein is important to several body systems...
July 2018: Expert Review of Respiratory Medicine
Tina Schreiber, Wolfram Windisch
In sarcoidosis, muscle involvement is common, but mostly asymptomatic. Currently, little is known about respiratory muscle and diaphragm involvement and function in patients with sarcoidosis. Reduced inspiratory muscle strength and/or a reduced diaphragm function may contribute to exertional dyspnea, fatigue and reduced health-related quality of life. Previous studies using volitional and non-volitional tests demonstrated a reduced inspiratory muscle strength in sarcoidosis compared to control subjects, and also showed that respiratory muscle function may even be significantly impaired in a subset of patients...
July 2018: Expert Review of Respiratory Medicine
Rodrigo Athanazio, Joao Cordeiro da Costa, David de la Rosa Carrillo, Miguel Ángel Martínez-García
In recent years, there has been an increasing number of clinical trials investigating the effect of pharmacological treatments on patients with bronchiectasis. Areas covered: This review provides an overview of current drugs used in bronchiectasis patients as well as those that could make a future contribution to the management of this disease. Expert commentary: Bronchiectasis is a very heterogeneous disease, so it can be studied from a phenotypic standpoint and its pathophysiological mechanisms (endotypes) can be defined...
July 2018: Expert Review of Respiratory Medicine
Chen-Yuan Chiang, Tara Singh Bam
No abstract text is available yet for this article.
July 2018: Expert Review of Respiratory Medicine
Abraham Samuel Babu, Norman R Morris, Ross Arena, Jonathan Myers
Exercise intolerance is a common and often significant limitation in pulmonary arterial hypertension (PAH). This intolerance greatly affects the quality of life and function of the individual with PAH, irrespective of its etiology. In PAH associated with connective tissue disorders (PAH-CTD), exercise intolerance is further amplified by the presence of coexisting musculoskeletal manifestations of CTD. The evaluation of exercise capacity and prescription for exercise training therefore becomes a challenge to the clinician...
July 2018: Expert Review of Respiratory Medicine
Eugenio Garofalo, Andrea Bruni, Corrado Pelaia, Luisa Liparota, Nicola Lombardo, Federico Longhini, Paolo Navalesi
Patient-ventilator asynchrony may occur with modes of partial ventilatory support. Because this problem is associated with worsened outcomes, identifying and managing asynchronies has been recognized as a relevant clinical problem during both invasive and noninvasive (NIV) mechanical ventilation. Areas covered: In this review article, we first describe the different forms of patient-ventilator asynchrony and how they are classified and quantified. Then, we show how these asynchronies can be recognized, considering the techniques used to properly detect asynchronies, by either ventilator waveform observation, or through systems based on more complexes mathematical algorithms, by means of adjunctive signals, such as the electrical activity of the diaphragm or esophageal pressure...
July 2018: Expert Review of Respiratory Medicine
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