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Expert Review of Respiratory Medicine

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https://www.readbyqxmd.com/read/28467720/second-line-therapy-of-squamous-non-small-cell-lung-cancer-an-evolving-landscape
#1
Chiara Lazzari, Niki Karachaliou, Vanesa Gregorc, Alessandra Bulotta, Maria Gonzalez-Cao, Alberto Verlicchi, Giuseppe Altavilla, Rafael Rosell, Mariacarmela Santarpia
The treatment of lung cancer has radically changed over the last few years. The discovery of druggable oncogenic alterations and the introduction of immunotherapy have provided lung cancer patients with the possibility of more efficient and less toxic therapeutic alternatives than chemotherapy. In the case of lung squamous cell carcinoma (LSCC), the treatment progress is slower than adenocarcinoma, for which several targeted agents have been already approved. The standard first-line therapy for LSCC, in most sites of the world, is platinum-based chemotherapy...
May 15, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28464704/prospects-for-new-and-emerging-therapeutics-in-severe-asthma-the-role-of-biologics
#2
Seçil Kepil Özdemir, Sevim Bavbek
Asthma is a common and heterogeneous disease. While current conventional therapies are effective in the majority of the patients, a significant subgroup remain uncontrolled despite these treatments. Different biological agents are currently approved or undergoing development for treatment of asthma, including anti-IgE, anti-interleukin (IL)-5, anti-IL-13, anti-IL-4 and anti-thymic stromal lymphopoietin agents. This review will focus on the currently available evidence regarding the new and emerging biological agents in severe asthma...
May 10, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28452241/respiratory-monitoring-in-adult-intensive-care-unit
#3
Pongdhep Theerawit, Yuda Sutherasan, Lorenzo Ball, Paolo Pelosi
The mortality of patients with respiratory failure has steadily decreased with the advancements in protective ventilation and treatment options. Although respiratory monitoring per se has not been proven to affect the mortality of critically ill patients, it plays a crucial role in patients' care, as it helps to titrate the ventilatory support. Several new monitoring techniques have recently been made available at the bedside. The goals of monitoring comprise alerting physicians to detect the change in the patients' conditions, to improve the understanding of pathophysiology to guide the diagnosis and provide cost-effective clinical management...
May 10, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28467730/combination-therapy-for-the-treatment-of-pulmonary-mold-infections
#4
Matthew William McCarthy, Vidmantas Petraitis, Thomas J Walsh
Pulmonary mold infections are caused by ubiquitous organisms found in soil, water, and decaying vegetation, including Aspergillus spp., the Mucormycetes, hyaline molds, and dematiaceous (black) molds. Areas covered: These infections are often a challenge to diagnose and even more difficult to treat. Recently, antifungal combination therapy has emerged as a promising strategy to treat some forms of invasive mycoses, including pulmonary mold infections. Historically, this approach has been limited due to non-uniform interpretation criteria, variations in pharmacodynamic/pharmacokinetic properties of antifungals used in combination, and an inability to predict clinical success based on in vitro data and animal models...
May 9, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28454510/home-oxygen-therapy-evidence-versus-reality
#5
F S Magnet, J H Storre, W Windisch
LTOT is a well-established treatment option for hypoxemic patients. Scientific evidence for its benefits of LTOT dates back to the 1980s, when two randomized controlled trials showed prolonged survival in COPD-patients undergoing LTOT for at least 15 hours/day. In contrast, the potential benefits of LTOT in non-COPD-patients has not been well researched and the recommendations for its application are primarily extrapolated from trials on COPD-patients. Recently, a large trial confirmed that COPD-patients who don't meet classic indication criteria, and have moderate desaturation at rest or during exercise, do not benefit from oxygen therapy...
April 28, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28436715/controlled-invasive-mechanical-ventilation-strategies-in-obese-patients-undergoing-surgery
#6
Lígia de Albuquerque Maia, Pedro Leme Silva, Paolo Pelosi, Patricia Rieken Macedo Rocco
The obesity prevalence is increasing in surgical population. As the number of obese surgical patients increases, so does the demand for mechanical ventilation. Nevertheless, ventilatory strategies in this population are challenging, since obesity results in pathophysiological changes in respiratory function. Areas covered: We reviewed the impact of obesity on respiratory system and the effects of controlled invasive mechanical ventilation strategies in obese patients undergoing surgery. To date, there is no consensus regarding the optimal invasive mechanical ventilation strategy for obese surgical patients, and no evidence that possible intraoperative beneficial effects on oxygenation and mechanics translate into better postoperative pulmonary function or improved outcomes...
April 24, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28399721/the-prostacyclin-pathway-in-pulmonary-arterial-hypertension-a-clinical-review
#7
R Del Pozo, I Hernandez Gonzalez, P Escribano-Subias
Prostacyclin is produced in vascular endothelial cells and acts via the IP prostacyclin receptor to cause vasodilation and inhibit smooth muscle cell proliferation and platelet aggregation. Prostacyclin production is reduced in pulmonary arterial hypertension (PAH), and drugs targeting the prostacyclin pathway are one of the pharmacotherapeutic options for PAH. Areas covered: The prostacyclin pathway and drugs that target it are discussed, including synthetic prostacyclin (epoprostenol), prostacyclin analogs (iloprost, treprostinil, beraprost) and selective prostacyclin IP receptor agonists (selexipag)...
April 24, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28299964/biomarkers-to-monitor-exacerbations-in-cystic-fibrosis
#8
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
#9
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/28388307/cytomegalovirus-infection-in-lung-transplant-recipients
#10
Reem S Almaghrabi, Ali S Omrani, Ziad A Memish
Cytomegalovirus (CMV) infection is a major cause of morbidity and mortality in solid organ transplant (SOT) patients. Lung transplant recipients are particularly at risk given the intense immunosuppression required. Areas covered: The Detailed review of the literature related to CMV infection, its direct and indirect effect on lung allograft function, as well as diagnosis, immune monitoring, treatment options and prevention strategies. Expert commentary: In lung transplant recipients, CMV infection is associated with pro-inflammatory and immune inhibitory effects that increase the risk of graft dysfunction and loss...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28388228/clinical-management-of-severe-therapy-resistant-asthma
#11
Kian Fan Chung
Severe therapy-resistant asthma is an area where there has been recent advances in understanding that is percolating into improvements in management. Areas covered: This review covers the recent definition and approach to the diagnosis of severe asthma and its differentiation from difficult-to-treat asthma. The recent advances in phenotyping severe asthma and in ensuing changes in management approaches together with the introduction of new therapies are covered from a review of the recent literature. Expert commentary: After ascertaining the diagnosis of severe asthma, patients need to be treated adequately with existing therapies...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28385046/peripheral-muscle-training-in-patients-with-chronic-obstructive-pulmonary-disease-novel-approaches-and-recent-advances
#12
Gianna W Bisca, Carlos A Camillo, Vinicius Cavalheri, Fabio Pitta, Christian R Osadnik
Pulmonary rehabilitation is one of the most effective non-pharmacological management options for individuals with chronic obstructive pulmonary disease (COPD). Exercise training is the cornerstone of pulmonary rehabilitation, however considerable variability exists regarding the way it is delivered across the world. It is widely accepted that efforts should be made to tailor specific therapeutic approaches to individuals' needs. This applies as much to respiratory medicine as it does to respiratory rehabilitation...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28347199/the-use-of-cellular-and-molecular-biomarkers-to-manage-copd-exacerbations
#13
Terence Ho, Angira Dasgupta, Frederick E Hargreave, Parameswaran Nair
Chronic obstructive pulmonary disease (COPD) exacerbations are a common cause of respiratory morbidity and mortality, and have various etiologies. Multiple cellular and molecular biomarkers have been associated with exacerbations. Quantitative sputum cell counts are able to identify the presence and type of bronchitis, which is an important contributor to exacerbations. Their utility to monitor bronchitis and to help treat exacerbations has been evaluated, yet they are not used in routine clinical practice...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28345383/pulmonary-fibrosis-part-i-epidemiology-pathogenesis-and-diagnosis
#14
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...
May 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28345369/pulmonary-fibrosis-part-ii-state-of-the-art-patient-management
#15
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...
May 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
#16
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 31 December 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...
May 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/28287009/continuous-positive-airway-pressure-therapy-in-obstuctive-sleep-apnea-benefits-and-alternatives
#18
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...
April 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28282995/understanding-copd-overlap-syndromes
#19
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...
April 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28282500/morning-symptoms-in-copd-a-treatable-yet-often-overlooked-factor
#20
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
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