Current Opinion in Pulmonary Medicine最新文献_第9页

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

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

Ergonomics in bronchoscopy. 支气管镜检查中的人体工学。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI: 10.1097/MCP.0000000000001124

Christopher Di Felice, Jojo Alunilkummannil, Van Holden

{"title":"Ergonomics in bronchoscopy.","authors":"Christopher Di Felice, Jojo Alunilkummannil, Van Holden","doi":"10.1097/MCP.0000000000001124","DOIUrl":"10.1097/MCP.0000000000001124","url":null,"abstract":"Purpose of review: This study examines ergonomic considerations in bronchoscopic procedures, surveying existing research, injury rates, contributing factors, and practical ergonomic controls.Recent findings: The field of ergonomics examines the relationship between workers and their workplace to enhance productivity and minimize injuries. Bronchoscopists may face ergonomic hazards due to extended periods of maintaining fixed positions, repetitive actions, and the design of both tools and procedure spaces. Studies on the ergonomics of bronchoscopy have revealed a wide range of musculoskeletal issues among practitioners. Those new to the field, including trainees and early-career professionals, may be particularly vulnerable to injuries compared to their more experienced counterparts. Implementing a systematic approach, such as that proposed by the National Institute for Occupational Safety and Health, could help reduce physical stress, discomfort, and the likelihood of musculoskeletal disorders for bronchoscopists.Summary: Bronchoscopists increasingly face ergonomic issues in their practice. Despite available measures to address these problems, the field lacks uniform ergonomic guidelines for bronchoscopy. To safeguard bronchoscopists' health and safety from the outset of their careers, more studies and training focused on ergonomics in bronchoscopy are needed.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"72-76"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460131","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 persistent problem of persistent air-leaks: approach to management. 持续空气泄漏的持续问题：管理方法。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-11-07 DOI: 10.1097/MCP.0000000000001134

George Mundanchira, Laura Frye, Janani Reisenauer, Abhinav Agrawal

{"title":"The persistent problem of persistent air-leaks: approach to management.","authors":"George Mundanchira, Laura Frye, Janani Reisenauer, Abhinav Agrawal","doi":"10.1097/MCP.0000000000001134","DOIUrl":"https://doi.org/10.1097/MCP.0000000000001134","url":null,"abstract":"Purpose of review: Persistent air leaks, defined as an air leak extending beyond 5 days, pose a significant challenge for cardiothoracic surgeons and pulmonologists. Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity.Recent findings: Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity. For patients who are not surgical candidates, use of autologous blood patch, pleurodesis or endobronchial valves may offer a viable alternative to conservatively manage air leak.Summary: This review evaluates the various noninvasive therapies that have been explored, including sealants, Heimlich valves, chemical and autologous blood patch pleurodesis, and endo and intrabronchial valves. Although these alternatives show promise, further research is needed to compare these treatments before they can be recommended in new guidelines.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":"31 1","pages":"28-34"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784464","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

Cryoprobe biopsy versus mechanical biopsies in pulmonary diagnostics. 肺部诊断中的冷冻探针活检与机械活检。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI: 10.1097/MCP.0000000000001127

Miki Ueoka, Reza Ronaghi, Samih Khauli, Colleen L Channick

{"title":"Cryoprobe biopsy versus mechanical biopsies in pulmonary diagnostics.","authors":"Miki Ueoka, Reza Ronaghi, Samih Khauli, Colleen L Channick","doi":"10.1097/MCP.0000000000001127","DOIUrl":"10.1097/MCP.0000000000001127","url":null,"abstract":"Purpose of review: Biopsy tools have been essential in improving the diagnostic accuracy of bronchoscopic procedures. Of these tools, cryobiopsy has emerged as a promising technique for diagnosing thoracic diseases. This review summarizes the existing data comparing cryobiopsies to other mechanical biopsy methods for sampling endobronchial, parenchymal, and mediastinal targets.Recent findings: Initially adopted for managing airway stenoses, the use of cryoprobes has expanded to diagnosing endobronchial lesions, parenchymal opacities, and mediastinal lymph node pathologies. Studies have demonstrated that cryobiopsy offers a higher diagnostic yield than forceps biopsy alone. By leveraging the Joule-Thomson effect to freeze and collect larger tissue samples compared to traditional methods, cryobiopsy improves diagnostic accuracy and helps in better characterizing the nature of the lesions. While the risk of complications, such as pneumothorax and hemorrhage are comparable to, or higher than traditional biopsy methods, cryobiopsy's enhanced diagnostic capabilities make it a valuable tool in the assessment of pulmonary disease.Summary: Compared with other mechanical biopsy techniques, cryoprobe biopsies significantly enhance the diagnostic yield for endobronchial lesions, interstitial lung disease, pulmonary nodules, and mediastinal lymph nodes.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"19-27"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460130","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

Rigid versus flexible bronchoscopy in interventional pulmonology: perspective from the master clinicians. 介入性肺病学中刚性支气管镜与柔性支气管镜的对比：临床大师的视角。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-11-02 DOI: 10.1097/MCP.0000000000001136

Carlos Aravena, Atul C Mehta

{"title":"Rigid versus flexible bronchoscopy in interventional pulmonology: perspective from the master clinicians.","authors":"Carlos Aravena, Atul C Mehta","doi":"10.1097/MCP.0000000000001136","DOIUrl":"10.1097/MCP.0000000000001136","url":null,"abstract":"Purpose of review: The review explores the evolving roles and comparative effectiveness of rigid versus flexible bronchoscopy in interventional pulmonology. This topic is particularly timely due to recent technological advancements and the growing body of literature highlighting the strengths and limitations of each technique.Recent findings: Recent literature reveals significant advancements in rigid and flexible bronchoscopy, with studies comparing their efficacy, safety profiles, and clinical outcomes. Key themes include improved diagnostic and therapeutic capabilities, procedural innovations, and patient-centered outcomes.Summary: While rigid and flexible bronchoscopies have distinct advantages, their complementary use can enhance patient care. Future research should focus on developing minimally invasive, high-precision bronchoscopic tools, comparative studies to inform evidence-based practice, exploring hybrid approaches that combine the strengths of both techniques, and enhancing patient-centered outcomes through improved procedural protocols, education, and technologies.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567768","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

Whole lung lavage: considerations from the anesthesiology perspective. 全肺灌洗：从麻醉学角度考虑问题。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-11-07 DOI: 10.1097/MCP.0000000000001132

Rutuja Sikachi, Megan Anders

{"title":"Whole lung lavage: considerations from the anesthesiology perspective.","authors":"Rutuja Sikachi, Megan Anders","doi":"10.1097/MCP.0000000000001132","DOIUrl":"10.1097/MCP.0000000000001132","url":null,"abstract":"Purpose of review: Whole lung lavage (WLL) remains the standard treatment for pulmonary alveolar proteinosis (PAP). The procedure involves meticulous preparation, including a multidisciplinary team and appropriate facilities, to ensure patient safety and procedural success. Effective anesthesia management is essential to allow for successful completion of the procedure and prevent complications.Recent findings: Effective anesthesia management, including total intravenous anesthesia (TIVA) and careful intraoperative monitoring, is essential to prevent complications such as hypoxemia and fluid overload. Proper airway control with a double-lumen tube, careful positioning, and continuous monitoring during the lavage phase are key to minimizing risks. Challenges such as fluid spillage and ventilation-perfusion mismatch must be managed proactively with techniques such as fiberoptic bronchoscopy and recruitment maneuvers. In cases of severe hypoxemia, advanced options like extra-corporeal membrane oxygenation (ECMO) or sequential lavage may be required.Summary: WLL is a pivotal treatment for PAP, offering significant relief and improvement for many patients despite the challenges in standardizing the procedure due to the rare nature of the condition. Involvement of a multidisciplinary team involving pulmonologist, anesthesiologist, critical care personnel, operating room personnel and in some cases and centers, cardiothoracic surgeon and perfusionist is critical to the success of the procedure.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"53-58"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142602832","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

Whole lung and sequential bronchoscopic lavage for pulmonary alveolar proteinosis. 肺泡蛋白沉积症的全肺灌洗和连续支气管镜灌洗。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-11-21 DOI: 10.1097/MCP.0000000000001138

Chee Kiang Tay, Anupam Kumar, Anne Ann Ling Hsu, Pyng Lee

{"title":"Whole lung and sequential bronchoscopic lavage for pulmonary alveolar proteinosis.","authors":"Chee Kiang Tay, Anupam Kumar, Anne Ann Ling Hsu, Pyng Lee","doi":"10.1097/MCP.0000000000001138","DOIUrl":"10.1097/MCP.0000000000001138","url":null,"abstract":"Purpose of review: Pulmonary alveolar proteinosis (PAP) is a diffuse lung disease that results from the accumulation of lipoproteinaceous material in the alveoli due to abnormal surfactant homeostasis. Since its introduction in the 1960s, whole lung lavage (WLL) has been the primary treatment for PAP. This review focuses on WLL, including its technique modifications, and sequential bronchoscopic lavage.Recent findings: Autoimmune PAP, which accounts for the majority of cases, occurs when antigranulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies lead to the deficiency of bioavailable GM-CSF. At present, there are no international guidelines or consensus statements for PAP treatment. Traditionally, therapeutic decisions are made based on the severity and type of PAP. Despite emerging data on GM-CSF-based therapies, WLL remains a central component in the therapeutic strategy for PAP.Summary: Although the technique of WLL has evolved over time, there is still no universally adopted, standardized protocol. However, key periprocedural aspects - such as preprocedural planning, patient evaluation, anesthetic technique, lavage protocol, and postprocedural care - remain essential to ensuring the safety and success of WLL.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"41-52"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681060","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

Bedside to bench and back again-translational research in interventional pulmonology. 从床边到工作台，再从工作台到床边--介入性肺病学的横向研究。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI: 10.1097/MCP.0000000000001125

Beenish Iqbal, Hee Jae Choi, Nikolaos I Kanellakis, Jason Akulian, Najib M Rahman

{"title":"Bedside to bench and back again-translational research in interventional pulmonology.","authors":"Beenish Iqbal, Hee Jae Choi, Nikolaos I Kanellakis, Jason Akulian, Najib M Rahman","doi":"10.1097/MCP.0000000000001125","DOIUrl":"10.1097/MCP.0000000000001125","url":null,"abstract":"Purpose of review: Translational research in Interventional Pulmonology has made significant advances in recent years, ranging from novel biomarkers and imaging to practice-changing clinical trials in lung cancer and pleural disease. This review article aims to summarize key research studies in the field to understand the latest published evidence and to highlight areas of growing academic interest.Recent findings: In lung cancer, the role of novel imaging and biomarkers and their potential utility in early lung cancer diagnosis will be highlighted. In pleural disease, less invasive/conservative treatment in pneumothorax, early aggressive treatment in pleural infection along with novel biomarkers, and the shift beyond drainage strategies in malignant pleural effusion and mesothelioma will be discussed.Summary: This overview of translational research in the field of interventional pulmonology will ultimately help to highlight the gaps in current evidence to promote research in areas of clinical significance.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"59-64"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142460129","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

Editorial introductions. 编辑介绍。

IF 2.8 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-01-01 Epub Date: 2024-12-05 DOI: 10.1097/MCP.0000000000001137

引用次数: 0