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

Aerodigestive fistulas in adults: a focus on airway interventions and review of recent literature. 成人气道消化瘘：气道干预的焦点和最近的文献回顾。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-01-01 Epub Date: 2025-11-07 DOI: 10.1097/MCP.0000000000001230

Carrie Kah-Lai Leong, Anne Ann Ling Hsu, Pyng Lee

{"title":"Aerodigestive fistulas in adults: a focus on airway interventions and review of recent literature.","authors":"Carrie Kah-Lai Leong, Anne Ann Ling Hsu, Pyng Lee","doi":"10.1097/MCP.0000000000001230","DOIUrl":"10.1097/MCP.0000000000001230","url":null,"abstract":"Purpose of review: Aerodigestive fistulas (ADFs) cause significant morbidity and mortality, especially in advanced malignancies. This review summarizes current knowledge on etiology, diagnostic, and management strategies.Recent findings: Esophageal carcinoma is the predominant cause of malignant ADFs with their development influenced by tumor location, most often involving the upper and middle thirds of the esophagus, and by prior interventions such as radiotherapy or esophageal stenting.Benign acquired ADFs typically result from iatrogenic injuries including pressure necrosis from cuffed tubes, stent erosion, endoscopy, and surgery. Diagnosis often is delayed by nonspecific symptoms, requiring combined imaging and endoscopic evaluation. Benign ADFs are typically amenable to surgical repair, whereas malignant fistulas usually require individualized palliation, notably airway and esophageal stenting. Dual airway-esophageal stenting has advantages over single stenting for malignant ADFs due to superior quality of life and survival outcomes. Emerging minimally invasive techniques include endoscopic clips, occluder devices, and tissue adhesives.Summary: Optimal management of ADFs requires high clinical vigilance, timely diagnostic evaluation, and individualized multidisciplinary approaches. Further research into emerging therapies and standardized management algorithms is essential for improving patient outcomes and guiding evidence-based clinical practice.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"54-62"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480992","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

Peripheral bronchoscopy: back to basics. 外周支气管镜检查：回归基础。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-01-01 Epub Date: 2025-10-31 DOI: 10.1097/MCP.0000000000001229

Pipetius Quah, Pyng Lee

{"title":"Peripheral bronchoscopy: back to basics.","authors":"Pipetius Quah, Pyng Lee","doi":"10.1097/MCP.0000000000001229","DOIUrl":"10.1097/MCP.0000000000001229","url":null,"abstract":"Purpose of review: Peripheral bronchoscopy is increasingly practiced to gain access to peripheral pulmonary lesions (PPLs). Lung cancer screening with low-dose computed tomography (CT) is fuelling the need for superior navigational tools such as robot-assisted bronchoscopy to target screen-detected pulmonary nodules which may be as small as 6 mm.Recent findings: It is an opportune moment to return to the basics of performing peripheral bronchoscopy through revising airway mapping with CT imaging. Virtual bronchoscopy, electromagnetic navigation bronchoscopy (ENB) and robot-assisted bronchoscopy (RAB) have yet to supplant the accuracy of manual airway mapping achieved simply by CT reading. The technique of airway mapping should be consistently utilised for airway navigation as it is complementary to technologies such as virtual bronchoscopy, ENB or RAB. In this review, we share the technique of performing airway mapping with a case illustration, and our approach to peripheral bronchoscopy.Summary: Airway mapping is a foundational skill that must be preserved, practiced and perfected in our bronchoscopic approach to a PPL. In the absence of advanced navigational tools, peripheral bronchoscopy can be performed in combination with readily available tools to obtain a high diagnostic yield.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"8-16"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145421700","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

History of bronchoscopy: from inception to the modern era of interventional pulmonology. 支气管镜的历史：从开始到介入肺脏学的现代。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-01-01 Epub Date: 2025-10-08 DOI: 10.1097/MCP.0000000000001224

Prince Ntiamoah, Taeko Shirakawa, Atul C Mehta

{"title":"History of bronchoscopy: from inception to the modern era of interventional pulmonology.","authors":"Prince Ntiamoah, Taeko Shirakawa, Atul C Mehta","doi":"10.1097/MCP.0000000000001224","DOIUrl":"10.1097/MCP.0000000000001224","url":null,"abstract":"Purpose of review: This review traces the historical evolution of bronchoscopy, from its origins in the late nineteenth century to its current role as a central tool in interventional pulmonology. It highlights major technological and clinical milestones and considers how early innovations continue to shape modern practices. As bronchoscopy enters the era of robotics and artificial intelligence, this reflection offers a timely perspective on its future trajectory.Recent findings: Advances in both rigid and flexible bronchoscopy have enhanced visualization, navigation, and therapeutic precision. Interventions such as airway stenting, cryotherapy, endobronchial valve placement, and nonthermal ablation are now routine. These developments build on historical foundations and support a more targeted, minimally invasive approach to pulmonary intervention.Summary: The evolution of bronchoscopy reflects a legacy of innovation driven by clinical need and technological advancement. Rigid and flexible techniques remain vital, while recent advances in robotics, artificial intelligence navigation, and image-guided interventions signal a new era. A deep appreciation of its historical development informs current practice and shapes the integration of emerging technologies into the future of interventional pulmonology.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250233","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

Robotic assisted bronchoscopy for peripheral pulmonary nodules - data review. 机器人辅助支气管镜检查周围性肺结节-资料回顾。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-01-01 Epub Date: 2025-11-06 DOI: 10.1097/MCP.0000000000001233

David Fielding, Thomas R Gildea, Prince Ntiamoah, Tajalli Saghaie

{"title":"Robotic assisted bronchoscopy for peripheral pulmonary nodules - data review.","authors":"David Fielding, Thomas R Gildea, Prince Ntiamoah, Tajalli Saghaie","doi":"10.1097/MCP.0000000000001233","DOIUrl":"10.1097/MCP.0000000000001233","url":null,"abstract":"Purpose of review: Robotic Assisted bronchoscopy has emerged as an important tool in diagnosing small peripheral lung nodules in the era of CT screening. This paper reviews results from recent publications.Recent findings: Three meta -analyses have now been reported. Diagnostic yields reported in studies must be considered in terms of the study prevalence of malignancy, which if high tends to give higher overall diagnostic yield. Diagnostic yields are consistently an improvement on earlier technologies, particularly for lesions <20 mm in size. A range of imaging modalities have emerged as significant ways to improve diagnostic yield in Robotic procedures. These may be \"stand alone\" or integrated into the robotic systems. Robotic procedures may be performed under a single anaesthetic with planned surgical excision, the latter being guided by rapid on-site assessment or frozen section. Learning curve appears to be short and high levels of diagnostic performance with good safety profile have been reported.Summary: Ongoing clinical study with robotic nodule biopsy will continue given the significant advance it has provided to clinicians in the first 5 years of its introduction.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"17-22"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480945","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

Anesthesia strategies to minimize lung atelectasis in peripheral bronchoscopy. 周围支气管镜检查中肺不张最小化的麻醉策略。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2026-01-01 Epub Date: 2025-10-03 DOI: 10.1097/MCP.0000000000001223

Angel Rolando Peralta, Labib G Debiane

{"title":"Anesthesia strategies to minimize lung atelectasis in peripheral bronchoscopy.","authors":"Angel Rolando Peralta, Labib G Debiane","doi":"10.1097/MCP.0000000000001223","DOIUrl":"10.1097/MCP.0000000000001223","url":null,"abstract":"Purpose of review: Peripheral bronchoscopy has become a widely adopted, minimally invasive modality for the diagnosis of peripheral lung lesions. However, its diagnostic yield remains limited in part due to intra-procedural atelectasis - a frequently overlooked phenomenon that obscures lesions and exacerbates computed tomography (CT)-to-body divergence. This review highlights the prevalence and clinical impact of atelectasis during navigational bronchoscopy and presents anesthesia and ventilation strategies to mitigate its occurrence.Recent findings: Emerging data from trials such as I-LOCATE, ventilatory strategy to prevent atelectasis (VESPA), and lung navigation ventilation protocol (LNVP) studies show that atelectasis develops early and frequently during bronchoscopy, particularly in dependent lung zones and patients with high BMI. Strategies to reduce atelectasis include high tidal volumes, optimized positive end-expiratory pressure, reduced FiO 2 , and recruitment maneuvers. Dedicated ventilation protocols like VESPA and LNVP have significantly reduced both incidence and severity of atelectasis, improved lesion visibility, and demonstrated safety. Apneic breath-hold techniques further enhance image quality and lesion targeting.Summary: Atelectasis is a modifiable barrier to diagnostic success in peripheral bronchoscopy. Proactive pre and intra-procedural planning, implementation of structured ventilation protocols, and close collaboration with anesthesia are essential. Future research should focus on protocol standardization, novel imaging synchronization techniques, and validation of atelectasis grading tools.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"32-37"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250249","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

Bronchiectasis evaluation 2025: pediatric and adult perspectives. 支气管扩张评估2025：儿童和成人的观点。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-11-01 Epub Date: 2025-09-05 DOI: 10.1097/MCP.0000000000001217

James Tolle, Michael O'Connor

{"title":"Bronchiectasis evaluation 2025: pediatric and adult perspectives.","authors":"James Tolle, Michael O'Connor","doi":"10.1097/MCP.0000000000001217","DOIUrl":"10.1097/MCP.0000000000001217","url":null,"abstract":"Purpose of review: There is a significant overlap between the diagnostic evaluation for adult and pediatric patients with bronchiectasis; however, also important age-specific unique considerations. This review focuses on these specific considerations.Recent findings: Bronchiectasis refers to the radiographic evidence of dilation of distal and proximal bronchi secondary to chronic infection and inflammation. Bronchiectasis can be suspected on plain chest radiograph but is confirmed and detailed through computed tomography (CT) imaging. Several different measures and descriptions of the radiographic findings of bronchiectasis exist, but the most common is a bronchial diameter equal to or greater than an adjacent blood vessel. Consideration for the presence of bronchiectasis begins with recognition of clinical symptoms of suppurative lung disease including persistent sputum producing cough and recurrent respiratory infections. Bronchiectasis etiologies include inherited forms, such as cystic fibrosis and primary ciliary dyskinesia, as well as secondary forms including chronic aspiration as well as certain infections, and immunodeficiency. Up to 40% remain idiopathic even after a comprehensive evaluation.Summary: It is important to start a bronchiectasis evaluation with a broad differential, but secondary testing should focus on etiologies specific to the patient. A thoughtful combination of testing is often required to arrive at an etiology. Patients with bronchiectasis require ongoing monitoring including longitudinal follow-up of respiratory cultures, lung function testing, and repeat CT imaging.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"622-627"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014139","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

Transforming sleep medicine: the evolving role of artificial intelligence. 改变睡眠医学：人工智能的演变作用。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-11-01 Epub Date: 2025-08-22 DOI: 10.1097/MCP.0000000000001210

Prakash Banjade, Munish Sharma, Salim Surani

{"title":"Transforming sleep medicine: the evolving role of artificial intelligence.","authors":"Prakash Banjade, Munish Sharma, Salim Surani","doi":"10.1097/MCP.0000000000001210","DOIUrl":"10.1097/MCP.0000000000001210","url":null,"abstract":"Purpose of review: Artificial intelligence (AI) is in the era of rapid evolution. Like other healthcare fields, AI has significantly impacted sleep medicine. We aim to explain the evolving role of AI in sleep medicine and provide clinicians with key information related to its benefits and limitations.Recent findings: AI technologies, like machine learning and deep learning, improve the detection of sleep disorders, such as obstructive sleep apnea, insomnia, and narcolepsy, through advanced data analysis from tools like polysomnography and consumer sleep devices. AI also enables targeted therapies by endotyping sleep disorders, optimizing patient care, and reducing unnecessary treatments. On the other hand, there are many challenges that need to be addressed before using AI in clinical settings. Ethical issues regarding patient privacy, biases, and transparency regarding data use are some of the key challenges.Summary: AI could transform sleep medicine by enhancing diagnostic accuracy and personalizing treatment plans. Effective collaboration between clinicians and AI experts is necessary to use AI optimally in clinical settings.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"571-576"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945832","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

Understanding idiopathic hypersomnia: diagnosis, pathophysiology, and management. 了解特发性嗜睡症：诊断、病理生理学和治疗。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-11-01 Epub Date: 2025-10-02 DOI: 10.1097/MCP.0000000000001221

Madeeha Shahzadi, Renee Monderer, Michael J Thorpy

{"title":"Understanding idiopathic hypersomnia: diagnosis, pathophysiology, and management.","authors":"Madeeha Shahzadi, Renee Monderer, Michael J Thorpy","doi":"10.1097/MCP.0000000000001221","DOIUrl":"10.1097/MCP.0000000000001221","url":null,"abstract":"Purpose of review: Idiopathic hypersomnia is a chronic and often disabling sleep disorder characterized by excessive daytime sleepiness despite adequate or prolonged nighttime sleep. With recent advances in diagnosis and treatment, this review is timely in addressing evolving approaches to understanding and managing idiopathic hypersomnia, a condition that remains underrecognized and frequently misdiagnosed.Recent findings: Idiopathic hypersomnia is clinically distinct from narcolepsy, lacking REM-related features such as cataplexy and hypnagogic hallucinations. Until recently, treatment options for idiopathic hypersomnia were limited and often off-label. The 2021 FDA approval of low-sodium oxybate (LXB) marked the first medication specifically indicated for idiopathic hypersomnia. Additional agents such as modafinil, pitolisant, and traditional stimulants are used off-label with varying efficacy. Ongoing research is exploring promising treatments, including orexin-2 receptor agonists (e.g. ALKS 2680, ORX-750), serdexmethylphenidate, and flumazenil, which offer new hope for personalized management.Summary: Growing insights into the pathophysiology and clinical features of idiopathic hypersomnia have led to improved diagnostic clarity and therapeutic innovation. These developments carry significant implications for clinical practice, offering hope for better symptom control and quality of life in affected individuals. Ongoing research is crucial for refining treatment strategies and deepening our understanding of this complex condition.","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":" ","pages":"597-604"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130359","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

Obstructive sleep apnea and the gut microbiota - mechanisms and opportunities. 阻塞性睡眠呼吸暂停和肠道微生物群-机制和机会。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1097/MCP.0000000000001211

Joe Alcock

引用次数: 0

Evolving cystic fibrosis care models in the modulator era. 调节剂时代囊性纤维化护理模式的发展。

IF 2.7 3区医学

Current Opinion in Pulmonary Medicine Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1097/MCP.0000000000001215

Isaac Martin, Felix Ratjen, Patrick Flume

引用次数: 0