Current Opinion in Pulmonary Medicine最新文献

A comprehensive review of benign tumors in the lung. 肺部良性肿瘤的综合综述。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-15 DOI: 10.1097/MCP.0000000000001178

Abhishek Sarkar, Shaikh Muhammad Noor Husnain, Kassem Harris

{"title":"A comprehensive review of benign tumors in the lung.","authors":"Abhishek Sarkar, Shaikh Muhammad Noor Husnain, Kassem Harris","doi":"10.1097/MCP.0000000000001178","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001178","url":null,"abstract":"Purpose of review: The purpose of this review is to provide clinicians a comprehensive overview of the epidemiology, clinical symptoms, radiological features, pathological features, and management recommendations for the vast majority of benign lung tumors. Benign lung tumors are very rare with incidence ranging from 1 in 1000 to 1 in 1 million. Despite not being malignant, certain benign tumors carry significant morbidity and mortality along with diagnostic challenges.Recent findings: Advancements in genomic sequencing have led to discovery of mutations in particular benign lung tumors. Improved genotyping have aided the diagnosis of certain tumors and the identification of lung lesions with malignant transformation potential. Genomic understanding has also led to targeted therapy for tumors with significant morbidity.Summary: Despite radiographic and pathologic advances in understanding benign lung tumors, the paucity of cases continues to impact management recommendations and early detection. Global collaborative initiatives in compiling and analyzing cases are essential for stronger evidence based management recommendations.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Considering candidates: modifiable and nonmodifiable risk factors for lung transplantation. 考虑候选者：肺移植可改变和不可改变的危险因素。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-06 DOI: 10.1097/MCP.0000000000001174

Julia A Maheshwari, Lorriana E Leard

引用次数: 0

Artificial intelligence applications for the diagnosis of pulmonary nodules. 人工智能在肺结节诊断中的应用。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-06 DOI: 10.1097/MCP.0000000000001179

David E Ost

{"title":"Artificial intelligence applications for the diagnosis of pulmonary nodules.","authors":"David E Ost","doi":"10.1097/MCP.0000000000001179","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001179","url":null,"abstract":"Purpose of review: This review evaluates the role of artificial intelligence (AI) in diagnosing solitary pulmonary nodules (SPNs), focusing on clinical applications and limitations in pulmonary medicine. It explores AI's utility in imaging and blood/tissue-based diagnostics, emphasizing practical challenges over technical details of deep learning methods.Recent findings: AI enhances computed tomography (CT)-based computer-aided diagnosis (CAD) through steps like nodule detection, false positive reduction, segmentation, and classification, leveraging convolutional neural networks and machine learning. Segmentation achieves Dice similarity coefficients of 0.70-0.92, while malignancy classification yields areas under the curve of 0.86-0.97. AI-driven blood tests, incorporating RNA sequencing and clinical data, report AUCs up to 0.907 for distinguishing benign from malignant nodules. However, most models lack prospective, multiinstitutional validation, risking overfitting and limited generalizability. The \"black box\" nature of AI, coupled with overlapping inputs (e.g., nodule size, smoking history) with physician assessments, complicates integration into clinical workflows and precludes standard Bayesian analysis.Summary: AI shows promise for SPN diagnosis but requires rigorous validation in diverse populations and better clinician training for effective use. Rather than replacing judgment, AI should serve as a second opinion, with its reported performance metrics understood as study-specific, not directly applicable at the bedside due to double-counting issues.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Infections and lung transplantation: key considerations for eligibility, management, and posttransplant care. 感染和肺移植：资格、管理和移植后护理的关键考虑因素。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-02 DOI: 10.1097/MCP.0000000000001177

Jonathan Huang, Rachel Friedman-Moraco, Stephanie Pouch

{"title":"Infections and lung transplantation: key considerations for eligibility, management, and posttransplant care.","authors":"Jonathan Huang, Rachel Friedman-Moraco, Stephanie Pouch","doi":"10.1097/MCP.0000000000001177","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001177","url":null,"abstract":"Purpose of review: Lung transplantation is a critical and evolving therapy for patients with end-stage lung disease. As the need for lung transplantation increases, careful candidate selection is vital to maximizing outcomes and ensuring appropriate organ allocation. A key challenge in lung transplant candidates is the colonization or infection of the lungs by environmental and upper airway pathogens. These lung pathogens, along with other chronic infections, can lead to posttransplant complications with high mortality and an increased risk of graft failure.Recent findings: Major infectious considerations for lung transplantation include colonization or infection by multidrug-resistant bacteria (including Burkholderia cepacia complex), nontuberculous mycobacteria, molds, and chronic viral infections. By recognizing the epidemiology, diagnosis, and management of these infections in the peri-transplant period, transplant providers can better mitigate infectious risks and improve transplant success. Similarly, advancements in diagnostics and therapeutics offer novel approaches to managing previously challenging infections.Summary: As experience grows in treating these difficult infectious syndromes, more candidates are becoming eligible for transplantation. A thorough understanding of infectious considerations in lung transplant candidates is essential for improving candidate selection, reducing posttransplant complications, and expanding transplant eligibility.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial introductions. 编辑介绍。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-27 DOI: 10.1097/MCP.0000000000001164

引用次数: 0

The role of artificial intelligence in the diagnosis, imaging, and treatment of thoracic empyema. 人工智能在胸脓肿的诊断、成像和治疗中的作用。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2024-12-23 DOI: 10.1097/MCP.0000000000001150

Adam Zumla, Rizwan Ahmed, Kunal Bakhri

{"title":"The role of artificial intelligence in the diagnosis, imaging, and treatment of thoracic empyema.","authors":"Adam Zumla, Rizwan Ahmed, Kunal Bakhri","doi":"10.1097/MCP.0000000000001150","DOIUrl":"10.1097/MCP.0000000000001150","url":null,"abstract":"Purpose of review: The management of thoracic empyema is often complicated by diagnostic delays, recurrence, treatment failures and infections with antibiotic resistant bacteria. The emergence of artificial intelligence (AI) in healthcare, particularly in clinical decision support, imaging, and diagnostic microbiology raises great expectations in addressing these challenges.Recent findings: Machine learning (ML) and AI models have been applied to CT scans and chest X-rays to identify and classify pleural effusions and empyema with greater accuracy. AI-based analyses can identify complex imaging features that are often missed by the human eye, improving diagnostic precision. AI-driven decision-support algorithms could reduce time to diagnosis, improve antibiotic stewardship, and enhance more precise and less invasive surgical therapy, significantly improving clinical outcomes and reducing inpatient hospital stays.Summary: ML and AI can analyse large datasets and recognize complex patterns and thus have the potential to enhance diagnostic accuracy, preop planning for thoracic surgery, and optimize surgical treatment strategies, antibiotic therapy, antibiotic stewardship, monitoring complications, and long-term patient management outcomes.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"237-242"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recent advances in asthma mucus biology and emerging treatment strategies. 哮喘黏液生物学的最新进展及新兴治疗策略。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-06 DOI: 10.1097/MCP.0000000000001167

Sergey Fedosenko, Carmen Venegas Garrido, Parameswaran Nair

{"title":"Recent advances in asthma mucus biology and emerging treatment strategies.","authors":"Sergey Fedosenko, Carmen Venegas Garrido, Parameswaran Nair","doi":"10.1097/MCP.0000000000001167","DOIUrl":"10.1097/MCP.0000000000001167","url":null,"abstract":"Purpose of review: To describe the recent advances in the pathobiology and treatment of mucus hypersecretion in asthma, a critical factor contributing to airway obstruction, inflammation, and impaired lung function.Recent findings: Significant progress has been made in understanding how mucin protein regulation, mucus viscosity, and adhesion are affected by cytokine-driven inflammation, especially interleukin-13, and defects in ion transport mechanisms. Advances in imaging techniques, such as multidetector computed tomography (MDCT) and hyperpolarized gas MRI, allow for a more precise assessment of mucus plugging and associated ventilation defects. Emerging therapies, including biologicals targeting type-2 (T2) inflammation, and novel mucolytics aimed at modifying mucus properties and secretion, offer promising effects in reducing mucus in severe asthmatics.Summary: The growing understanding of mucus biology and the development of advanced imaging and therapeutic strategies could significantly improve the management of mucus-related complications in asthma. By targeting mucus characteristics, these findings support future approaches to reduce airway obstruction, enhance lung function, and improve clinical outcomes in patients with severe asthma. A deeper understanding of the glycobiology of mucus is critical to develop new therapies.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"251-261"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Type 2 inflammation, a common denominator in chronic airway disease? 2型炎症是慢性气道疾病的共同特征？

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-19 DOI: 10.1097/MCP.0000000000001159

Michaela Schedel, Victoria Heimel, Christian Taube

{"title":"Type 2 inflammation, a common denominator in chronic airway disease?","authors":"Michaela Schedel, Victoria Heimel, Christian Taube","doi":"10.1097/MCP.0000000000001159","DOIUrl":"10.1097/MCP.0000000000001159","url":null,"abstract":"Purpose of review: This review addresses the growing understanding that a specific subset of patients with a respiratory disease, including asthma, chronic obstructive pulmonary disease (COPD), or bronchiectasis may have one thing in common: type 2 inflammation. In the era of personalized medicine, we need to refine clinical markers combined with molecular and cellular endotyping to improve patient outcomes.Recent findings: Recent literature reveals that type 2 markers such as blood eosinophils, fractional exhaled nitric oxide (FeNO), and immunglobulin E (IgE), can provide valuable insights into disease progression, exacerbation risk, and treatment response, but their stability remains to be investigated. Treating asthma and COPD patients with biologics to target IL-4/IL-13, IL-5, and alarmins have shown potential, although efficacy varied. In bronchiectasis, a subset of patients with type 2 inflammation may benefit from corticosteroid therapy, despite broader concerns regarding its use.Summary: This underscores the importance of improved disease endotyping to better characterize patients who may benefit from targeted therapies. In clinical practice, personalized treatment based on inflammatory profiles has been shown to improve outcomes in heterogeneous lung diseases. Future research needs to focus on validating reliable biomarkers and optimizing clinical trial designs to advance therapeutic strategies in respiratory diseases.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"302-309"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Optimizing adherence to medication to improve outcomes in asthma. 优化药物依从性以改善哮喘预后。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-03-19 DOI: 10.1097/MCP.0000000000001166

Pamela Rackow, Amelia Drennan, Hilary Pinnock, Alexandra L Dima

{"title":"Optimizing adherence to medication to improve outcomes in asthma.","authors":"Pamela Rackow, Amelia Drennan, Hilary Pinnock, Alexandra L Dima","doi":"10.1097/MCP.0000000000001166","DOIUrl":"10.1097/MCP.0000000000001166","url":null,"abstract":"Purpose of review: Adherence to medication is essential for asthma control and reducing the risk of exacerbations. Research has accumulated in recent years on causes and consequences of adherence and effective interventions. This review highlights current advances in adherence research and their potential for clinical practice.Findings: Optimizing adherence to medication can be achieved through interventions that identify individual barriers and train the care team in offering tailored support. Digital technologies that facilitate remote monitoring, patient-provider communication and care coordination are increasingly being integrated into asthma care.Summary: Adherence determinants reported cover individual, social and health service-related factors. Age and attitudes toward adherence are crucial determinants. Patients' and caregivers' mental health is relevant for adherence and clinical outcomes, highlighting the importance of integrating this aspect into holistic asthma management. Single-site care arrangements are beneficial for adherence. Tailoring adherence interventions to individual needs, using brief questionnaires to assess barriers and recommending evidence-based strategies to address them, have been found useful and feasible across care settings. Digital technologies such as smart inhaler systems and telemedicine-enhanced care have been shown to be effective in randomized controlled trials, yet implementation research highlights challenges to sustaining support on the long-term.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"262-269"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pleural infection: controversies on the therapeutic strategies. 胸膜感染：治疗策略之争。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-05-01 Epub Date: 2025-02-17 DOI: 10.1097/MCP.0000000000001157

Ken K P Chan, Estee P M Lau, Y C Gary Lee

{"title":"Pleural infection: controversies on the therapeutic strategies.","authors":"Ken K P Chan, Estee P M Lau, Y C Gary Lee","doi":"10.1097/MCP.0000000000001157","DOIUrl":"10.1097/MCP.0000000000001157","url":null,"abstract":"Purpose of review: Management of pleural infection remains heterogeneous worldwide. This review highlights current controversies in therapeutic strategies for pleural infection, focusing particularly on recent studies and their implications.Recent findings: The introduction of intrapleural therapy combining alteplase [a tissue plasminogen activator (tPA)] and deoxyribonuclease (DNase) has revolutionized treatment practices, though the optimal delivery and dosing regimen is an area of active investigation. Variations to simplify administration protocols and/or to lower the required drug doses have been published. Most were exploratory studies, but the variations showed maintained therapeutic efficacy.Whether intrapleural alteplase/DNase or video-assisted thoracoscopic surgery (VATS) is superior is a topic of debate. Retrospective comparative analyses between the two revealed no clear benefits on all-cause mortality from either approach. Pilot randomized trials have been published and further full-scale, head-to-head trials are underway.Summary: Effective management of pleural infection involves adequate pleural drainage and appropriate antibiotic use. This review outlines the current evidence (and its limitations) and highlights knowledge gaps in optimizing the therapeutic strategies.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"218-222"},"PeriodicalIF":2.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0