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Surgical Therapy for Stage I Lung Cancer-Lobar Versus Sublobar Resection. I期肺癌的手术治疗——大叶与叶下切除术。
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-07-30 DOI: 10.1055/a-2649-9277
Sarah Rudasill, Farhood Farjah
{"title":"Surgical Therapy for Stage I Lung Cancer-Lobar Versus Sublobar Resection.","authors":"Sarah Rudasill, Farhood Farjah","doi":"10.1055/a-2649-9277","DOIUrl":"10.1055/a-2649-9277","url":null,"abstract":"<p><p>Lung cancer is a leading cause of cancer-related mortality, but advances in screening and early detection have improved opportunities for curative treatment. Therapeutic intent surgical resection remains a cornerstone for managing clinical stage IA disease. However, the optimal extent of surgical resection in this population has been a subject of ongoing debate. This review, guided by an introductory case-based vignette, provides a primer on the technical aspects of resection, pretreatment patient-level factors underlying decision-making, and other determinants of outcomes that may influence decisions to pursue lobar versus sublobar resection. We then offer a critique of the evidence base, focusing on the results of four randomized controlled trials: the Lung Cancer Study Group, DRKS00004897, JCOG0802/WJOG4607L, and CALGB140503. Following an interpretation of the available evidence, the review highlights contemporary practice patterns and the challenges of preference-based decisions. Finally, evidence gaps are highlighted as opportunities for future study to improve patient outcomes and experiences.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584730","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
Perioperative and Peripartum Management of Patients with Neuromuscular Disease. 神经肌肉疾病患者围手术期和围生期的处理。
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-06-01 Epub Date: 2025-06-26 DOI: 10.1055/a-2568-4804
Julie Williamson, Tom Edd, Geovanny Perez, Karin Provost
{"title":"Perioperative and Peripartum Management of Patients with Neuromuscular Disease.","authors":"Julie Williamson, Tom Edd, Geovanny Perez, Karin Provost","doi":"10.1055/a-2568-4804","DOIUrl":"10.1055/a-2568-4804","url":null,"abstract":"<p><p>Patients with neuromuscular disease are living longer with advancements in respiratory assistive devices for airway clearance and ventilatory support. This technology has been successfully applied to the perioperative and peripartum periods, making these previously prohibitively high-risk procedures now a risk-controlled intervention. This review will cover preoperative planning and assessment, key intraoperative management interventions, postoperative management, and peripartum management for patients with neuromuscular disorders.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"264-280"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508272","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
Evaluation of Neuromuscular Disease in Adults Presenting with Dyspnea. 以呼吸困难为表现的成人神经肌肉疾病的评价。
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-06-01 Epub Date: 2025-03-31 DOI: 10.1055/a-2535-0859
Daniel Scullin, Joseph Barney
{"title":"Evaluation of Neuromuscular Disease in Adults Presenting with Dyspnea.","authors":"Daniel Scullin, Joseph Barney","doi":"10.1055/a-2535-0859","DOIUrl":"10.1055/a-2535-0859","url":null,"abstract":"<p><p>Neuromuscular disorders in adults can present with a wide array of clinical features and vary from acute life-threatening complications such as respiratory failure to slow progressive weakness and comorbidity. Common to most of these disorders are symptoms of weakness and dyspnea. Many patients with occult neuromuscular disorders will be evaluated for underlying cardiac and pulmonary disease by primary care and subspecialty providers and can experience delays in diagnosis due to challenges in attaining early neurological testing and recognizing vague symptoms as potentially arising from the neuromuscular apparatus. Additionally, many adults who develop neuromuscular disorders have concomitant cardiac or pulmonary disease and the presence of dyspnea or limitations in mobility are often attributed to these without pursuing further workup. We outline a review of neuromuscular diseases in adults and an approach to evaluation.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"259-263"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754016","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
Management of Dyspnea in Patients with Neuromuscular Disorders. 神经肌肉疾病患者呼吸困难的处理。
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-06-01 Epub Date: 2025-08-14 DOI: 10.1055/a-2657-9524
Daniel Scullin, Joseph Barney
{"title":"Management of Dyspnea in Patients with Neuromuscular Disorders.","authors":"Daniel Scullin, Joseph Barney","doi":"10.1055/a-2657-9524","DOIUrl":"10.1055/a-2657-9524","url":null,"abstract":"<p><p>Neuromuscular diseases encompass a wide array of clinical manifestations, age at presentation, and severity of morbidity and mortality. Central to most patients with these disorders are symptoms of dyspnea and increased work of breathing related to varying degrees of impairment of the neuromuscular apparatus. The degree of dyspnea is often compounded by impaired clearance from the tracheobronchial tree, leading to patients who are weak, dyspneic, and impacted by pulmonary secretions. Approaches to determining contributing causes and management of dyspnea in these patients vary among adult and pediatric patients and are also distinct depending on the natural progression of the specific neuromuscular disorder. We describe an approach to the management of dyspnea in patients with neuromuscular diseases and review the roles of pharmacologic and respiratory support devices in alleviating symptoms and supporting respiration.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"288-294"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856224","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 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-06-01 Epub 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":"10.1055/a-2463-3385","url":null,"abstract":"<p><p>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 <i>SMN2</i> 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.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"250-258"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","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
Clinical Course and Outcomes in Patients with Sjögren's Associated Interstitial Lung Disease. Sjögren相关间质性肺疾病患者的临床过程和预后
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-06-01 Epub Date: 2025-05-30 DOI: 10.1055/a-2578-4335
Prachi Saluja, Joanna L Marco, Nitesh Gautam, Christine L Chhakchhuak, Gregory C Gardner, Nishant Gupta
{"title":"Clinical Course and Outcomes in Patients with Sjögren's Associated Interstitial Lung Disease.","authors":"Prachi Saluja, Joanna L Marco, Nitesh Gautam, Christine L Chhakchhuak, Gregory C Gardner, Nishant Gupta","doi":"10.1055/a-2578-4335","DOIUrl":"10.1055/a-2578-4335","url":null,"abstract":"<p><p>Lung involvement in Sjögren's disease (SjD) is common and significantly impacts patients' quality of life, with the most frequent manifestation being interstitial lung disease (ILD). This study explored the clinical course and prognostic factors in patients with SjD-associated ILD. We conducted a retrospective analysis of patients diagnosed with SjD-ILD across two tertiary care academic referral centers. We assessed key clinical, radiological, and histopathological features of patients with SjD-ILD to investigate the long-term outcomes and determine the factors that can help better prognosticate patients in the clinic. A total of 81 patients with SjD-ILD were included in our analysis. ILD was the presenting manifestation in 21% (<i>n</i> = 17) of the SjD patients. The median survival following diagnosis of SjD-ILD was 11 years. Among ILD subtypes, the UIP pattern was associated with more rapid lung function decline and higher mortality. In contrast, higher baseline forced vital capacity (FVC) and anti-SSA antibody positivity were linked to reduced mortality risk. ILD is a common manifestation that can lead to the diagnosis of SjD. The presence of ILD has an adverse effect on the overall survival of patients with SjD. Baseline lung function and serologies can further assist in prognostication. A critical review of imaging patterns to determine the underlying ILD pattern can aid individualized counseling and therapeutic decision-making in patients with SjD-ILD.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"281-287"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187876","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
Five Questions to Help Prompt End-of-Life Planning in Neuromuscular Disease. 帮助神经肌肉疾病患者制定生命终结计划的五个问题。
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-06-01 Epub Date: 2024-07-19 DOI: 10.1055/s-0044-1787994
Benjamin J Lipanot, Gabriel Bosslet
{"title":"Five Questions to Help Prompt End-of-Life Planning in Neuromuscular Disease.","authors":"Benjamin J Lipanot, Gabriel Bosslet","doi":"10.1055/s-0044-1787994","DOIUrl":"10.1055/s-0044-1787994","url":null,"abstract":"<p><p>Patients with neuromuscular disease are living longer lives but continue to have significant and often unpredictable morbidity and mortality. End-of-life planning for these patients is thus an essential part of their medical care. This planning should include the following topics: health care surrogates, swallowing and nutrition, daytime respiratory support, and all aspects of when end of life is near. <i>Adult-onset</i> and <i>early-onset</i> diseases may require different approaches to these topics. All patients with neuromuscular disease will benefit from these discussions to best reach patient-centered goals. We present health care providers these five questions and explanations as a guide.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"233-239"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727739","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
Management of Chronic Neuromuscular Respiratory Failure in the Intensive Care Unit. 重症监护病房慢性神经肌肉呼吸衰竭的管理。
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-06-01 Epub Date: 2024-10-07 DOI: 10.1055/s-0044-1788551
Mustafa H Ghanem, Won Lee, Bethany L Lussier
{"title":"Management of Chronic Neuromuscular Respiratory Failure in the Intensive Care Unit.","authors":"Mustafa H Ghanem, Won Lee, Bethany L Lussier","doi":"10.1055/s-0044-1788551","DOIUrl":"10.1055/s-0044-1788551","url":null,"abstract":"<p><p>In this seminar we describe the critical care management of patients with chronic neuromuscular diseases (cNMD). Determination of the acuity of the critical illness and trajectory of illness in the setting of cNMD is necessary to guide decision making. Systemic complications of critical illness, cardiac support needs, and peri-intubation considerations may be affected by underlying diagnosis. Mechanical ventilatory support, whether noninvasive or invasive, requires redefinition of the goals of ventilation on a patient-by-patient basis. Mode and approach to invasive ventilation and liberation to noninvasive ventilation versus tracheostomy have limited evidence, but potential clinical approaches are reviewed.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"240-249"},"PeriodicalIF":2.7,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142396976","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
Sleep, Circadian Rhythms, and Lung Cancer. 睡眠、昼夜节律和肺癌。
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-04-01 Epub Date: 2025-02-03 DOI: 10.1055/a-2531-1059
Daniel H Cooper, Isaac Almendros, Tetyana Kendzerska
{"title":"Sleep, Circadian Rhythms, and Lung Cancer.","authors":"Daniel H Cooper, Isaac Almendros, Tetyana Kendzerska","doi":"10.1055/a-2531-1059","DOIUrl":"10.1055/a-2531-1059","url":null,"abstract":"<p><p>Lung cancer is the leading cause of cancer-related mortality worldwide, with the prevalence of the disease continually rising. Therefore, identifying disease-modifying risk factors is critical, with increasing recognition of the impact of sleep quality/sleep disorders. This narrative review summarizes the evidence on the role of five domains of sleep on lung cancer incidence and progression: (i) sleep quality/duration, (ii) sleep disordered breathing, (iii) circadian rhythm disturbances, (iv) sleep-related movement disorders, and (v) personal, environmental, and social factors that modulate each of these associations. Epidemiological evidence supports reduced sleep duration, increased sleep duration, poor sleep quality, insomnia, obstructive sleep apnea, evening chronotype, peripheral limb movements in sleep, and less robustly for night shift work and restless leg syndrome to be associated with increased risk of lung cancer development, with potential impacts on cancer survival outcomes. Proposed mechanisms underlying the biological plausibility of these epidemiological associations are also explored, with common theories relating to immune dysregulation, metabolic alterations, reductions in melatonin, sympathetic overactivation, increased reactive oxygen species, production of protumorigenic exosomes, and inflammation. We also summarized potential treatments addressing impaired sleep quality/sleep disorders and their ability to attenuate the risk of lung cancer and improve cancer survival. Although evidence on reversibility is inconsistent, there are trends toward positive outcomes. Future research should focus on clinical trials to confirm cause and effect relationships, large epidemiologic studies for incidence/prognosis, clarification on the relative efficacy of treatment modalities, and more in vivo animal models to establish the molecular mechanisms underlying these relationships.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"189-201"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123111","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 Chronic Obstructive Pulmonary Disease Overlap Syndrome. 阻塞性睡眠呼吸暂停和慢性阻塞性肺疾病重叠综合征。
IF 2.7 3区 医学
Seminars in respiratory and critical care medicine Pub Date : 2025-04-01 Epub Date: 2025-04-22 DOI: 10.1055/a-2531-1166
Marta Marin-Oto, David Sanz-Rubio, José M Marin
{"title":"Obstructive Sleep Apnea and Chronic Obstructive Pulmonary Disease Overlap Syndrome.","authors":"Marta Marin-Oto, David Sanz-Rubio, José M Marin","doi":"10.1055/a-2531-1166","DOIUrl":"10.1055/a-2531-1166","url":null,"abstract":"<p><p>The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) in the same patients is defined as COPD/OSA overlap syndrome (OVL). OSA and sleep complaints are quite common among COPD patients and contribute to an increase in the risk of COPD exacerbation and mortality. Patients with OVL are more likely to develop cardiometabolic disease than patients with OSA or COPD alone. We must consider OSA as a treatable trait since the use of positive pressure ventilation reduces severe exacerbations, all-cause hospitalizations, and mortality in patients with COPD.</p>","PeriodicalId":21727,"journal":{"name":"Seminars in respiratory and critical care medicine","volume":" ","pages":"107-112"},"PeriodicalIF":2.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996583","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
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