Seminars in respiratory and critical care medicine最新文献_第3页

Respiratory Syncytial Virus Prevention in the Adult Population: State of the Art. 成人呼吸道合胞病毒预防：最新进展

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2025-02-01 Epub Date: 2025-06-06 DOI: 10.1055/a-2586-3974

Tommaso Bigoni, Franco Alfano, Francesca Aloe, Federico Baraldi, Francesco Paolo Caggiano, Olga Dell'Adami de Tarczal, Alberto Papi

{"title":"Respiratory Syncytial Virus Prevention in the Adult Population: State of the Art.","authors":"Tommaso Bigoni, Franco Alfano, Francesca Aloe, Federico Baraldi, Francesco Paolo Caggiano, Olga Dell'Adami de Tarczal, Alberto Papi","doi":"10.1055/a-2586-3974","DOIUrl":"https://doi.org/10.1055/a-2586-3974","url":null,"abstract":"Respiratory syncytial virus (RSV) is a common respiratory virus associated with acute respiratory infections (ARIs) in infants and older adults. RSV-related ARIs significantly affect the relevant clinical outcomes, including hospitalization and mortality, in older adults. Elderly individuals and those with chronic diseases are at a higher risk of infections with severe morbidity because of clinical frailty and deficiencies in immune responses. Prevention of respiratory viral infections in the adult population can be achieved through hygiene measures and active immunization. Several vaccination strategies have been developed, including nucleic acid, subunit, chimeric, live-attenuated, particle-based, and recombinant vaccines, with varying results. Subunit vaccines involving the RSV-fusion protein F in its prefusional (pre-F) conformation, with or without adjuvants, have demonstrated significant protection in older adults, reducing the rate of total and severe RSV-related lower tract respiratory diseases (LRTDs). Similarly, an mRNA vaccine encoding for the stabilized pre-F conformation showed a significantly reduced RSV-associated LRTDs in older adults. This evidence led to recent approval of two subunit vaccines (Arexvy and Abrysvo) and one nucleic acid-based vaccine (mResvia) by regulatory authorities. Currently, several vaccines are recommended for adults, resulting in crowded schedules. Therefore, covaccination is a potential strategy for improving vaccine adherence. The coadministration of approved RSV vaccines with seasonal influenza vaccines has been proven to be non-inferior to the immune response from sequential administration. Other vaccines coadministered against different pathogens are currently under investigation.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":"46 1","pages":"41-52"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249472","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

Next-Generation Pneumococcal Vaccines for Children and Adults. 下一代儿童和成人肺炎球菌疫苗。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2025-02-01 Epub Date: 2025-04-16 DOI: 10.1055/a-2588-6965

Rosario Menéndez, María Garces-Sanchez

引用次数: 0

Early Experience on Universal Prophylaxis in Infants against Respiratory Syncytial Virus: Facts and Expectations. 婴儿 RSV 普遍预防的早期经验：事实与期望。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2025-02-01 Epub Date: 2025-02-03 DOI: 10.1055/a-2531-0968

Antoni Soriano-Arandes, Anna Creus-Costa, Aida Perramon-Malavez, Cristina Andrés, Jorgina Vila, Anna Gatell, Maria Piñana, Pepe Serrano, Alejandra González-Sánchez, Ramon Capdevila, Clara Prats, Pere Soler-Palacin, Andrés Antón

{"title":"Early Experience on Universal Prophylaxis in Infants against Respiratory Syncytial Virus: Facts and Expectations.","authors":"Antoni Soriano-Arandes, Anna Creus-Costa, Aida Perramon-Malavez, Cristina Andrés, Jorgina Vila, Anna Gatell, Maria Piñana, Pepe Serrano, Alejandra González-Sánchez, Ramon Capdevila, Clara Prats, Pere Soler-Palacin, Andrés Antón","doi":"10.1055/a-2531-0968","DOIUrl":"10.1055/a-2531-0968","url":null,"abstract":"During the 2023/24 season, nirsevimab significantly reduced the risk of bronchiolitis and confirmed respiratory syncytial virus (RSV) infections in primary care, hospital, and pediatric intensive care unit admissions among infants aged 0 to 11 months, even in a season with a high community RSV burden, particularly for older infants. These findings are very useful for public health authorities to continue to implement immunization campaigns against RSV in the coming seasons. Moreover, universal immunization against RSV represents a transformative step toward reducing the burden of RSV in infants. With promising evidence from recently published studies, the expectations for a reduction of RSV-associated hospitalizations, alongside the improvement of public health outcomes and equitable access to these measures, are high. However, achieving these goals will require addressing challenges related to vaccine uptake, funding, and RSV surveillance to prompt detect resistances due to mutations of the virus. These interventions need to be integrated into public health strategies because they hold the potential to make a significant impact on infant's health worldwide.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"31-40"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122675","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

Pertussis Vaccination: The Challenges Ahead. 百日咳疫苗：未来的挑战。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2025-02-01 Epub Date: 2025-06-06 DOI: 10.1055/a-2592-0735

Nicole Guiso, Carl Heinz Wirsing von Koenig

{"title":"Pertussis Vaccination: The Challenges Ahead.","authors":"Nicole Guiso, Carl Heinz Wirsing von Koenig","doi":"10.1055/a-2592-0735","DOIUrl":"https://doi.org/10.1055/a-2592-0735","url":null,"abstract":"Pertussis, a highly contagious respiratory disease, is preventable with vaccine. Two types of vaccines are used around the world: whole-cell pertussis vaccines (wP), which contain inactivated bacterial suspensions are difficult to produce and induce some side effects, and acellular pertussis vaccines (aP), which contain one to five purified bacterial antigens, chemically or genetically detoxified. Both the vaccines succeeded in massively decreasing child deaths caused by pertussis. However, irrespective of vaccination, the disease is still endemic around the world, and cycles of pertussis are still observed every 3 to 5 years in both wP- or aP-vaccinated regions. The interval between each cycle, and the intensity and incidence of the disease during these cycles vary. The first challenge ahead is to rapidly increase vaccine coverage by vaccinating infants on time, introducing regular vaccine boosters throughout life, and vaccinating pregnant women. The second challenge is to introduce an effective disease surveillance such as a pediatric hospital surveillance, allowing an estimation of the incidence of severe disease in the pediatric population, and/or a sentinel surveillance, allowing to detect changes in the incidence of the disease in the population. All surveillance systems require a functional network of physicians in the country aware of the clinical forms of the disease in children, adolescents, adults, and seniors. Surveillance is required to adapt vaccine strategies according to the vaccine type and to follow the evolution of the agents of the disease. The third challenge is to pursue research to improve these vaccines. However, before changing vaccines once again, an evaluation of the exact consequences of aP or wP vaccines under specific vaccine strategies needs to be carefully carried out.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":"46 1","pages":"14-19"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249471","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

Advances in Disease-Modifying Therapeutics for Chronic Neuromuscular Disorders. 慢性神经肌肉疾病的疾病修饰治疗进展。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-12-21 DOI: 10.1055/a-2463-3385

Long Davalos, Hani Kushlaf

{"title":"Advances in Disease-Modifying Therapeutics for Chronic Neuromuscular Disorders.","authors":"Long Davalos, Hani Kushlaf","doi":"10.1055/a-2463-3385","DOIUrl":"https://doi.org/10.1055/a-2463-3385","url":null,"abstract":"Neuromuscular disorders can cause respiratory impairment by affecting the muscle fibers, neuromuscular junction, or innervation of respiratory muscles, leading to significant morbidity and mortality. Over the past few years, new disease-modifying therapies have been developed and made available for treating different neuromuscular disorders. Some of these therapies have remarkable effectiveness, resulting in the prevention and reduction of respiratory complications. For myasthenia gravis (MG), efgartigimod, ravulizumab, rozanolixizumab, and zilucoplan have been Food and Drug Administration (FDA)-approved for the treatment of acetylcholine receptor (AChR) antibody-positive generalized MG in the past 2 years. Rozanolixiumab is also approved for treating MG caused by muscle-specific tyrosine kinase (MuSK) antibodies. The new MG therapeutics target the complement system or block the neonatal fragment crystallizable (Fc) receptors (FcRn), leading to significant clinical improvement. For spinal muscular atrophy (SMA), nusinersen (intrathecal route) and risdiplam (oral route) modify the splicing of the SMN2 gene, increasing the production of normal survival motor neuron (SMN) protein. Onasemnogene abeparvovec is a gene replacement therapy that encodes a functional SMN protein. All SMA medications, particularly onasemnogene abeparvovec, have led to clinically meaningful improvement. For late-onset Pompe disease (LOPD), avalglucosidase alfa has shown a greater improvement in respiratory function, ambulation, and functional outcomes in comparison to alglucosidase alfa, and cipaglucosidase alfa combined with miglustat has shown improvement in respiratory and motor function in a cohort of enzyme replacement therapy-experienced LOPD patients. Amyotrophic lateral sclerosis (ALS) remains a challenge. The two most recent FDA-approved medications, namely sodium phenylbutyrate and tofersen, may slow down the disease by a few months in a selected population but do not stop the progression of the disease.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872912","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

Is There a Role for Bronchoscopy in Aspiration Pneumonia? 支气管镜对吸入性肺炎有作用吗？

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-12-01 Epub Date: 2024-10-24 DOI: 10.1055/s-0044-1791739

Andrei M Darie, Daiana Stolz

{"title":"Is There a Role for Bronchoscopy in Aspiration Pneumonia?","authors":"Andrei M Darie, Daiana Stolz","doi":"10.1055/s-0044-1791739","DOIUrl":"10.1055/s-0044-1791739","url":null,"abstract":"Aspiration represents the passage of oropharyngeal content to the lower respiratory tract. The interplay between the host and the aspirate proprieties determines the subsequent aspiration syndrome. A low pH, typical of gastric aspirate, favors chemical pneumonitis, whereas an increased bacterial inoculum causes aspiration pneumonia. About a quarter of patients with aspiration pneumonitis will develop a bacterial superinfection during the course of recovery. While antibiotic therapy is indicated for aspiration pneumonia, supportive care remains the cornerstone of treatment in aspiration pneumonitis. However, the overlapping clinical features of these syndromes lead to initiation of antimicrobial therapy in most cases of aspiration. Bronchoscopy can aid in clinical decision-making by direct airway visualization and also by providing access to a series of emerging biomarkers. Invasive microbiological studies increase diagnostic yield and enable a tailored antibiotic treatment. In conjunction with stewardship programs, invasive sampling and novel molecular diagnostics can decrease the amount of inappropriate antibiotic therapy. In the context of foreign body aspiration, bronchoscopy represents both diagnostic and treatment gold standard.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"650-658"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142507456","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

Therapy of Aspiration: Out-of-Hospital and In-Hospital-Acquired. 吸入治疗：院外和院内获得性吸入。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-12-01 Epub Date: 2024-10-25 DOI: 10.1055/s-0044-1791826

Di Pan, Bradley Isaacs, Michael S Niederman

引用次数: 0

Bacteriology of Aspiration Pneumonia: The Lung Microbiome and the Changing Microbial Etiology. 吸入性肺炎的细菌学：肺部微生物组和不断变化的微生物病因学。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-12-01 Epub Date: 2024-11-13 DOI: 10.1055/s-0044-1792111

Francois Fadell, Ranime Saliba, Ali A El-Solh

{"title":"Bacteriology of Aspiration Pneumonia: The Lung Microbiome and the Changing Microbial Etiology.","authors":"Francois Fadell, Ranime Saliba, Ali A El-Solh","doi":"10.1055/s-0044-1792111","DOIUrl":"10.1055/s-0044-1792111","url":null,"abstract":"Aspiration pneumonia refers to the process of alveolar inflammation induced by the inhalation of oropharyngeal secretions into the lower respiratory tract. Predisposing factors comprise swallowing dysfunction, impaired cough reflex, and degenerative neurological diseases. Accumulating evidence projects a fading contribution of anaerobic bacteria in aspiration pneumonia at the expense of Gram-negative bacilli, with Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, becoming the predominant organisms recovered from respiratory specimens. Aspiration of oropharyngeal secretions colonized with respiratory pathogens induces a profound disequilibrium of the lung microbiota resulting in a state of dysbiosis. Understanding this complex temporal variability between microbiome-host associations was only made possible with the introduction of metagenomic sequencing. In this narrative review, we summarize existing knowledge and elaborate on the evolving microbiology of aspiration pneumonia including the link between oral microbiome and pulmonary aspiration. We also highlight the progress and challenges in instituting microbiome-targeted strategies for preventing and treating the sequelae of aspiration pneumonia.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"626-633"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625934","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

Ethical Issues and the Role of Palliative Care for Patients with Aspiration Pneumonia. 吸入性肺炎患者姑息治疗的伦理问题和作用。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-12-01 Epub Date: 2024-11-29 DOI: 10.1055/s-0044-1792110

Amanda Rosen, Bradley Hayward

引用次数: 0

Aspiration after Anesthesia: Chemical versus Bacterial, Differential Diagnosis, Management, and Prevention. 麻醉后误吸：化学与细菌、鉴别诊断、处理和预防。

IF 2.3 3区医学

Seminars in respiratory and critical care medicine Pub Date : 2024-12-01 Epub Date: 2024-11-29 DOI: 10.1055/a-2458-4450

Denise Battaglini, Silvia De Rosa

{"title":"Aspiration after Anesthesia: Chemical versus Bacterial, Differential Diagnosis, Management, and Prevention.","authors":"Denise Battaglini, Silvia De Rosa","doi":"10.1055/a-2458-4450","DOIUrl":"https://doi.org/10.1055/a-2458-4450","url":null,"abstract":"Aspiration following anesthesia is a major patient issue and a difficulty for anesthesiologists. Aspiration syndromes are more common than anticipated, and the condition is frequently undetected. Clinical signs are often dictated by the characteristics of aspiration, such as the infectivity of the material, its volume, and the severity of the underlying clinical condition. Pulmonary aspiration can cause an acute or persistent inflammatory response in the lungs and upper airways that can be complicated by tracheobronchitis, aspiration pneumonia, aspiration pneumonitis, acute respiratory distress syndrome, and subsequent bacterial infection due to particle, acid, and bacteria-related processes. Aspiration during anesthesia, while relatively rare, poses significant risks for patient morbidity and mortality. Chemical and bacterial aspiration provide distinct diagnostic and management issues. Preventive strategies such as a complete preoperative risk assessment, adherence to fasting rules, proper patient positioning, and the use of protective airway devices are critical in reducing aspiration risk. In addition, drugs such as proton pump inhibitors can help lower stomach acidity and volume. Innovations in monitoring techniques, better training, and awareness activities are critical to enhancing aspiration event management. Given the importance of this entity, this narrative review sought to make an updated overview of the management of aspiration after anesthesia: chemical versus bacterial, differential diagnosis, management, and prevention.","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":"45 6","pages":"659-668"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755512","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