Current Opinion in Pulmonary Medicine最新文献_第5页

Respiratory hazards of climate change, environmental exposures and diverse topics on COPD. 气候变化的呼吸危害，环境暴露和COPD的不同主题。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-01-30 DOI: 10.1097/MCP.0000000000001149

Manish Joshi, Basil Varkey

引用次数: 0

Pulmonary embolism work-up in chronic obstructive pulmonary disease exacerbations: what is the best strategy for clinicians? 慢性阻塞性肺病加重期的肺栓塞检查：临床医生的最佳策略是什么？

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-23 DOI: 10.1097/MCP.0000000000001130

David Jiménez, Laurent Bertoletti, Behnood Bikdeli

{"title":"Pulmonary embolism work-up in chronic obstructive pulmonary disease exacerbations: what is the best strategy for clinicians?","authors":"David Jiménez, Laurent Bertoletti, Behnood Bikdeli","doi":"10.1097/MCP.0000000000001130","DOIUrl":"10.1097/MCP.0000000000001130","url":null,"abstract":"Purpose of review: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are important events in the natural course of COPD, as they increase morbidity and mortality. Acute pulmonary embolism may mimic the symptoms of COPD exacerbations. However, the exact prevalence of pulmonary embolism in unexplained exacerbations of COPD is unclear based on the current data. This review provides a practical approach to patients with COPD complaining of worsening respiratory symptoms.Recent findings: A randomized clinical trial has shown that a routine pulmonary embolism diagnostic work-up does not improve care of patients with acute exacerbations of COPD. However, review of the recent literature suggests that a nonnegligible proportion of otherwise unexplained exacerbations of COPD may be caused by pulmonary embolism. To date, nevertheless, there are limited studies developing and validating clinical models that might aid in the identification of patients requiring additional tests for the diagnosis of pulmonary embolism.Summary: Until new evidence becomes available, we believe that a routine diagnostic strategy for pulmonary embolism is not appropriate for patients with acute exacerbations of COPD. Recommendations for routine pulmonary embolism diagnostic work-up necessitate further development of prognostic models and conduct of clinical trials that assess important health outcomes.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"175-181"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521301","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

Bronchodilator responsiveness in chronic obstructive pulmonary disease: prevalence, significance, and clinical implications. 慢性阻塞性肺病的支气管扩张剂反应性：发病率、意义和临床影响。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-11-27 DOI: 10.1097/MCP.0000000000001143

Ashutosh N Aggarwal, Ritesh Agarwal

{"title":"Bronchodilator responsiveness in chronic obstructive pulmonary disease: prevalence, significance, and clinical implications.","authors":"Ashutosh N Aggarwal, Ritesh Agarwal","doi":"10.1097/MCP.0000000000001143","DOIUrl":"10.1097/MCP.0000000000001143","url":null,"abstract":"Purpose of review: Bronchodilator responsiveness (BDR) is often considered a key feature distinguishing asthma from chronic obstructive pulmonary disease (COPD). However, recent evidence suggests that BDR alone may not be a reliable discriminator between these conditions. There is still no consensus on BDR definitions and testing protocols. Additionally, it remains unclear whether BDR is linked to a specific COPD phenotype or influences treatment responses. Our review of recent literature attempts to clarify some of these issues.Recent findings: A significant proportion of COPD patients demonstrate BDR, but the variability in testing procedures and definitions makes it challenging to draw any definite conclusion. There is no evident association between BDR and specific COPD characteristics. A few studies suggest that BDR may be associated with marginally better treatment response and disease outcomes in COPD. The impact of recent changes in BDR definitions on clinical practice remains to be fully understood.Summary: There is still no clear, clinically relevant threshold to define BDR. BDR is an unreliable discriminator to differentiate asthma from COPD and is not consistently linked to any specific COPD phenotype, treatment response, or disease outcomes. Further research is needed to refine the definitions and implications of BDR in COPD.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"126-134"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726759","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

The impact of climate change on respiratory health: current understanding and knowledge gaps. 气候变化对呼吸系统健康的影响：目前的认识和知识差距。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-12-02 DOI: 10.1097/MCP.0000000000001145

Manish Joshi, Anita Joshi, Thaddeus Bartter

{"title":"The impact of climate change on respiratory health: current understanding and knowledge gaps.","authors":"Manish Joshi, Anita Joshi, Thaddeus Bartter","doi":"10.1097/MCP.0000000000001145","DOIUrl":"10.1097/MCP.0000000000001145","url":null,"abstract":"Purpose of review: To present an overview of the impact of climate change upon human respiratory health.Recent findings: Climate change is directly impacting air quality. Particulate matter clearly increases mortality rates. Ozone, a longstanding suspect in climate-related injury, turns out not to have the major impact that had been projected at current levels of exposure. The key factors in global warming have been clearly identified, but while these factors collectively cause deleterious changes, a close look at the literature shows that it is unclear to what extent each factor individually is a driver of a specific process. This article summarizes some of those studies.Summary: A better understanding of which components of climate change most impact human health is needed in order to re-define environmental standards. PM 2.5 needs to be broken down by chemical composition to study the differential impacts of different sources of PM 2.5 . The detection and study of climate-related changes in respiratory infectious diseases is in a state of relative infancy.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"79-88"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767437","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

Abnormal spirometry in individuals with a smoking history and no known obstructive lung disease: current understanding and clinical implications. 有吸烟史但未发现阻塞性肺病的人肺活量异常：目前的认识和临床意义。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-11-21 DOI: 10.1097/MCP.0000000000001140

Kevin Tong, Matthew Moll, Emily S Wan

{"title":"Abnormal spirometry in individuals with a smoking history and no known obstructive lung disease: current understanding and clinical implications.","authors":"Kevin Tong, Matthew Moll, Emily S Wan","doi":"10.1097/MCP.0000000000001140","DOIUrl":"10.1097/MCP.0000000000001140","url":null,"abstract":"Purpose of review: Recent recognition of the importance of abnormal spirometry without obstruction has generated interest in its epidemiology, risk factors, longitudinal outcomes, and clinical implications.Recent findings: Preserved ratio impaired spirometry (PRISm), defined as an forced expiratory volume in 1 s (FEV 1 )/ forced vital capacity (FVC) ≥0.7 with an FEV 1 <80% predicted, has a high prevalence globally (2.4-16.7%) and is more common in individuals with metabolic comorbidities, smoking history, female sex, and higher BMI. PRISm is associated with increased respiratory symptoms and poor clinical outcomes such as increased all-cause mortality and cardiovascular events compared to normal spirometry. Longitudinal studies show substantial subsets of individuals with PRISm will transition to other spirometric categories, including progression to obstruction. Individuals with PRISm are heterogeneous; recent investigations have focused on subtyping PRISm based on spirometric features or pathobiologically-based phenotypes.Summary: PRISm is a common spirometric abnormality which is robustly associated with negative outcomes. However, current knowledge gaps with respect to heterogeneity, specific etiologies, and longitudinal progression preclude the development of universal evidence-based diagnostic and management strategies. At present, clinicians are advised to focus on risk factor modification (e.g., diabetes, obesity) and the identification of actionable traits (e.g. emphysema, interstitial lung abnormalities) among patients with PRISm.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"117-125"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681014","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

The bronchiectasis microbiome: current understanding and treatment implications. 支气管扩张症微生物组：目前的认识和治疗意义。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-11-02 DOI: 10.1097/MCP.0000000000001131

Jayanth Kumar Narayana, Micheál Mac Aogáin, Philip M Hansbro, Sanjay H Chotirmall

{"title":"The bronchiectasis microbiome: current understanding and treatment implications.","authors":"Jayanth Kumar Narayana, Micheál Mac Aogáin, Philip M Hansbro, Sanjay H Chotirmall","doi":"10.1097/MCP.0000000000001131","DOIUrl":"10.1097/MCP.0000000000001131","url":null,"abstract":"Purpose of review: Advances in DNA sequencing and analysis of the respiratory microbiome highlight its close association with bronchiectasis phenotypes, revealing fresh opportunities for diagnosis, stratification, and personalized clinical intervention. An under-recognized condition, bronchiectasis is increasingly the subject of recent large-scale, multicentre, and longitudinal clinical studies including detailed analysis of the microbiome. In this review, we summarize recent progress in our understanding of the bronchiectasis microbiome within the context of its potential use in treatment decisions.Recent findings: Diverse microbiome profiles exist in bronchiectasis, in line with the established disease heterogeneity including treatment response. Classical microbiology has established Pseudomonas aeruginosa and Haemophilus influenza as two microbial markers of disease, while holistic microbiome analysis has uncovered important associations with less common bacterial taxa including commensal an/or pathobiont species, including the emerging role of the fungal mycobiome, virome, and interactome. Integration of airway microbiomes with other high-dimensional biological and clinical datasets holds significant promise to determining treatable traits and mechanisms of disease related to the microbiome.Summary: The bronchiectasis microbiome is an emerging and key area of study with significant implications for understanding bronchiectasis, influencing treatment decisions and ultimately improving patient outcomes.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"135-144"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567770","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

Household air pollution and respiratory health in Africa: persistent risk and unchanged health burdens. 非洲家庭空气污染与呼吸系统健康：持续的风险和不变的健康负担。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-03-01 Epub Date: 2024-10-18 DOI: 10.1097/MCP.0000000000001126

Nkosana Jafta, Busisiwe Shezi, Minenhle Buthelezi, Shamiso Muteti-Fana, Rajen N Naidoo

{"title":"Household air pollution and respiratory health in Africa: persistent risk and unchanged health burdens.","authors":"Nkosana Jafta, Busisiwe Shezi, Minenhle Buthelezi, Shamiso Muteti-Fana, Rajen N Naidoo","doi":"10.1097/MCP.0000000000001126","DOIUrl":"10.1097/MCP.0000000000001126","url":null,"abstract":"Purpose of review: Despite evidence emerging from the Global Burden of Disease studies that biomass use and household air pollution are declining globally, with important positive health impacts for households in low- and middle-income countries, these trends have not been equally documented in African countries. This review describes the state of household air pollution exposure and its relationship with respiratory disease in Africa.Recent findings: African studies on this topic are limited, and generally focus on respiratory infections. Most evidence emerge from models based on the Global Burden of Disease data, and from limited individual epidemiological studies across the continent. More than 80% of the African population is exposed to household air pollution. Women and children continue to bear the substantial burden of exposure. Evidence from limited exposure-response studies strongly points to household air pollution being the major driver of acute and chronic respiratory diseases on the continent.Summary: Respiratory infections, particularly in children, and other chronic respiratory diseases, are strongly attributable to household air pollution. Elimination of such exposures through interventions such as cleaner fuels and preferably, electricity, is critical to improving respiratory health on the continent.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"89-97"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460132","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

Competency-based medical education in interventional pulmonology: current state and future opportunities. 介入性肺病学的能力本位医学教育：现状与未来机遇。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-11-08 DOI: 10.1097/MCP.0000000000001128

Logan J Hostetter, Darlene R Nelson

{"title":"Competency-based medical education in interventional pulmonology: current state and future opportunities.","authors":"Logan J Hostetter, Darlene R Nelson","doi":"10.1097/MCP.0000000000001128","DOIUrl":"10.1097/MCP.0000000000001128","url":null,"abstract":"Purpose of review: This chapter examines the evolution and current status of competency-based medical education (CBME) in interventional pulmonology, focusing on procedural skills assessment and training.Recent findings: Traditionally, interventional pulmonology training has used an apprenticeship model with case logs and director attestation, leading to inconsistent outcomes due to a lack of standardized curricula. CBME, established to address these issues, relies on outcome-based assessments to ensure trainees achieve necessary competencies. The chapter reviews various assessment tools, including global rating scales, checklists, and simulation-based methods, and their effectiveness in skill acquisition and clinical evaluation. It also covers specific procedures such as EBUS-TBNA, electromagnetic navigation bronchoscopy, and rigid bronchoscopy, discussing their assessment tools and learning curves. The chapter emphasizes the need for standardized assessment tools and suggests using entrustable professional activities (EPAs) to improve competency evaluation. Future directions include integrating real-time artificial intelligence feedback, addressing high-risk low-volume procedures, and enhancing workplace-based assessments to improve interventional pulmonology training and patient care quality.Summary: This chapter reviews the transition from traditional apprenticeship models to CBME in interventional pulmonology, highlighting advancements in procedural skills assessment, the effectiveness of various assessment tools, and future directions for improving training and patient care.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"65-71"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602824","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

The evolving role of medical thoracoscopy on therapeutic management of pleural disease. 医用胸腔镜在胸膜疾病治疗管理中不断发展的作用。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-10-23 DOI: 10.1097/MCP.0000000000001129

Clare Fong, Y C Gary Lee, Nick Maskell, Pyng Lee

{"title":"The evolving role of medical thoracoscopy on therapeutic management of pleural disease.","authors":"Clare Fong, Y C Gary Lee, Nick Maskell, Pyng Lee","doi":"10.1097/MCP.0000000000001129","DOIUrl":"10.1097/MCP.0000000000001129","url":null,"abstract":"Purpose of review: The use of medical thoracoscopy (MT) has gained widespread acceptance for the diagnosis and management of pleural disease. It is less invasive compared to video-assisted thoracoscopic surgery (VATS), can be performed in the endoscopy suite and in patients who are unfit to undergo general anaesthesia. It is safe, with high diagnostic yield, and enables pulmonologists to intervene therapeutically.Recent findings: There have been several developments in this field, particularly for malignant pleural effusions (MPE). Specifically, we discuss further techniques that can be employed during MT to distinguish between benign and malignant pleural disease. There is also potential for combined thoracoscopic talc poudrage (TTP) and indwelling pleural catheter (IPC) insertion to shorten hospital stay.Summary: Beyond MPE, we discuss the role of MT in patients with pneumothorax and pleural infection. We discuss the advantages and disadvantages of MT over traditional practices in a variety of conditions - diagnosis of exudative pleural effusions, prevention of recurrent MPE and pneumothoraces as well as treatment of pleural infections, so as to better aid physicians in selecting the optimum procedure for patients.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"35-40"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544307","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

Multidisciplinary care in nonmalignant central airway obstruction. 非恶性中央气道阻塞的多学科护理。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-11-05 DOI: 10.1097/MCP.0000000000001133

Septimiu Murgu, Blanca Urrutia-Royo, Prince Ntiamoah, Hervé Dutau

{"title":"Multidisciplinary care in nonmalignant central airway obstruction.","authors":"Septimiu Murgu, Blanca Urrutia-Royo, Prince Ntiamoah, Hervé Dutau","doi":"10.1097/MCP.0000000000001133","DOIUrl":"10.1097/MCP.0000000000001133","url":null,"abstract":"Purpose of review: The management of histologically benign central airway obstruction (CAO) is complex. Published studies have focused on the diagnostic approaches and therapeutic options provided by specific specialties, but there has been no focus on multidisciplinary management of this disease. Our objective is to review the current diagnostic and therapeutic modalities available for managing nonmalignant CAO from a multidisciplinary perspective involving otolaryngology, thoracic surgery and interventional bronchoscopists.Recent findings: For benign airway strictures, management is via medical and endoscopic therapy with surgical resection reserved for complex and recurrent stenoses. There is evidence and growing interest in intralesional corticosteroid injection in treating inflammation and potentially preventing recurrence. Airway specialists from distinct disciplines use different laser types, dilating balloons and anesthesia methods to manage benign CAO. Recent studies have demonstrated substantial improvements in patient breathlessness and quality of life following therapeutic airway interventions, highlighting the evolving landscape in this cross-disciplinary field.Summary: Nonmalignant CAO, arising from various mechanical, inflammatory, and infectious etiologies, poses significant morbidity and mortality risks. Current treatments include endoscopic resection, dilation, stent placement, and surgical resection which are selected based on lesion's complexity, extent, operability and patient's symptoms and goals. A multimodal and multidisciplinary approach to patient care could offer the best outcomes.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"11-18"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575115","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