EMJ Respiratory最新文献

{"title":"Expert Insights on the Complexities of Respiratory Syncytial Virus Infections in Infants","authors":"Hannah Moir","doi":"10.33590/emjrespir/dnfc1179","DOIUrl":"https://doi.org/10.33590/emjrespir/dnfc1179","url":null,"abstract":"For this article, EMJ conducted an interview with key opinion leader Chryssoula Tzialla, paediatrician and Director of the Paediatrics and Neonatology Unit at Voghera Azienda Socio-Sanitaria Territoriale (ASST), Pavia, Italy. Tzialla specialises in the prevention and treatment of respiratory infections in children, with a particular focus on respiratory syncytial virus (RSV), aiming to improve the lives of children globally. She is a member of the Italian Society of Paediatrics, the Italian Society on Neonatology, and its working group on neonatal infections. During this interview, Tzialla provided her insights into the burden of RSV disease in infants, highlighting the clinical presentations, long-term health consequences, and the importance of implementing preventive measures against RSV infection, including educational campaigns and immunisation programmes.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"100 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140713661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights From the European Respiratory Society Congress 2023: Chronic Obstructive Pulmonary Disease and Severe Asthma","authors":"Eleanor Roberts","doi":"10.33590/emjrespir/10303197","DOIUrl":"https://doi.org/10.33590/emjrespir/10303197","url":null,"abstract":"At the 2023 European Respiratory Society (ERS) International Congress, a significant part of the scientific discussion revolved around asthma and chronic obstructive pulmonary disease (COPD), with multiple abstracts and sessions dedicated to advances in targeted treatments, prevention, and care plans for these patient groups. Clinical remission was one of the key topics in the severe asthma (SA) sessions, with a focus on its definition, patient outcomes, and perceptions. Additionally, biological treatments, their affected pathways, and their role in helping patients achieve remission were central to these discussions. For COPD, much of the scientific dialogue centred around the updated Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, which classify patients according to the number of exacerbations, dyspnoea, and functional assessment, and suggest personalised treatment. Such treatments were the focus of numerous talks and posters, as evidence is mounting on the use of single inhaler triple therapy in patients with COPD and ≥2 moderate exacerbations or ≥1 leading to hospitalisation, with a positive impact on symptoms and quality of life (QoL). Exacerbation prevention was also a notable topic, as patients with COPD and asthma are more susceptible to infections, often leading to exacerbations, and are at higher risk of complications, hospitalisations, and death. Vaccination against vaccine-preventable diseases was recommended as a key cornerstone in the management of respiratory patients, and the importance of increasing awareness, access, and uptake of these vaccines was stressed.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"26 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139246150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming Care in Asthma and Chronic Obstructive Pulmonary Disease: An Expert View","authors":"Jennifer Taylor","doi":"10.33590/emjrespir/10306343","DOIUrl":"https://doi.org/10.33590/emjrespir/10306343","url":null,"abstract":"Across the globe, millions of people live with chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma. Despite treatment advances, many patients do not always receive a timely diagnosis, impacting optimal care for their condition, which is a situation that must be addressed.\u0000Scientific and medical innovation has brought patients a variety of treatments, such as combination therapies and biologics. In clinical practice, this translates to healthcare professionals being able to offer patients more options to manage their condition, including therapies that treat the underlying biology of the disease.\u0000While there has been progress in the respiratory community in achieving earlier diagnosis and initiating appropriate treatment, there is still more to be done. EMJ interviewed Celeste Porsbjerg, Professor of Severe Asthma in the Department of Respiratory Medicine at Bispebjerg Hospital, Copenhagen, Denmark, where they head the severe asthma clinic, and chair the Respiratory Research Unit; and COPD expert John Hurst, Professor of Respiratory Medicine at University College London (UCL), UK, to hear their perspectives on where the respiratory community is going in terms of aiming for asthma remission and more proactive treatment of COPD, and what the focus should be in the future.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133674867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Under-Recognised Burden and Unmet Needs in Infants and Children with Respiratory Syncytial Virus","authors":"Lindsey Broadbent, H. Moir","doi":"10.33590/10.33590/emjrespir/10308334","DOIUrl":"https://doi.org/10.33590/10.33590/emjrespir/10308334","url":null,"abstract":"For this article, an interview was conducted by EMJ in June 2023 with key opinion leader, Lindsay Broadbent, Lecturer (Assistant Professor) in Virology in the Faculty of Health and Medical Sciences at the University of Surrey, Guildford, UK. Broadbent specialises in respiratory virus–host interactions and subsequent innate immune responses, and the role of respiratory viruses in longer-term lung damage and the development of chronic lung disease.\u0000\u0000In this interview, Broadbent discussed the global burden of respiratory syncytial virus (RSV), a virus spread by micro-droplets. Broadbent highlighted RSV as a major cause of hospitalisations, particularly in children under the age of 1 year, which can impose a significant burden on health, particularly in infants, and healthcare systems globally. Broadbent provided insights into the leading risk factors of RSV, and emphasised the need for preventative measures to mitigate severe infections. Additionally, Broadbent highlighted the importance of improving the diagnosis and treatment options to address the unmet medical needs related with RSV. They called for increased awareness of RSV, and understanding of why certain infants are more susceptible to severe disease.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125876830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proactive Risk Management: A Novel Approach to Embedding Oral Corticosteroid Stewardship into Asthma Care","authors":"D. Price, A. Bourdin","doi":"10.33590/emjrespir/10088956","DOIUrl":"https://doi.org/10.33590/emjrespir/10088956","url":null,"abstract":"The continued inclusion of oral corticosteroids (OCS) in treatment guidelines, as well as the accessibility, familiarity, and relatively low cost of this therapeutic option compared with newer alternatives, has contributed to an ongoing overreliance on OCS treatments in severe asthma. This overuse continues despite accumulating evidence to demonstrate the detrimental long-term effects associated with even a short-term, low-dose course of OCS in this patient population.\u0000\u0000OCS Stewardship is a collaborative, systematic effort designed to protect patients with asthma from inappropriate OCS use through a series of patient- and physician-focused initiatives. Ultimately, OCS Stewardship aims to reduce OCS-related morbidity, lower the risk of OCS-related adverse events (AE), increase health-related quality of life, and reduce healthcare resource utilisation.\u0000\u0000This article summarises data that were exhibited as part of the European Respiratory Society (ERS) International Congress held in Barcelona, Spain, describing a novel proactive risk-management approach to embedding OCS Stewardship into asthma care. The objectives of this meeting were to highlight the latest data demonstrating the need for OCS Stewardship in asthma; discuss approaches to assessing OCS exposure and OCS-related toxicities, and the rationale for systematic assessment of OCS toxicity in individual patients; and to consider practical tools to evaluate future risk of asthma exacerbations and OCS-related adverse effects. Also described in this article are three posters, which were presented during the same meeting, and provide further data to support OCS-sparing activities in severe asthma by AstraZeneca.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127559268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Frontiers in Chronic Obstructive Pulmonary Disease: Where Are We Heading?","authors":"A. Agustí, S. Christenson, M. Han, D. Singh","doi":"10.33590/emjrespir/10038710","DOIUrl":"https://doi.org/10.33590/emjrespir/10038710","url":null,"abstract":"This symposium took place during the 2022 meeting of the European Respiratory Society (ERS). Focusing on new frontiers in chronic obstructive pulmonary disease (COPD), the speakers discussed the current understanding of the heterogeneity of COPD, the spectrum of inflammatory pathways in COPD pathophysiology, and the evolving clinical landscape in COPD. Alvar Agustí, Professor of Medicine at the University of Barcelona, Spain, introduced the concept of a gene, environment, and time (GETomic) perspective of COPD, ending with the trajectome, or range of lung function trajectories, through the lifespan. Stephanie Christenson, Assistant Professor of Pulmonology at the University of California, San Francisco, USA, followed by exploring the role of inflammation in COPD, highlighting that it is a heterogeneous disease with broad inflammatory pathways. This includes types 1, 17, and 2 inflammation; a wide range of immune effector cells beyond eosinophils; and key cytokines such as IL-33, IL-4, IL-13, and IL-5, which mediate the pathophysiology of COPD in response to cigarette smoke and other environmental insults. The need for continued investigation of molecular phenotypes was expanded on further by MeiLan Han, Professor of Medicine at the University of Michigan, Ann Arbor, USA, who explored the knowns and unknowns in the standard-of-care management of patients with COPD, highlighting the evolving understanding and identification of disease endotypes and phenotypes; poor understanding of COPD disease progression; the importance of smoking status in response to currently available treatments; and significant unmet need for additional treatment, even among patients on triple therapy. Dave Singh, Professor of Respiratory Pharmacology at the University of Manchester, UK, then discussed active areas of investigation in the development of additional treatments for patients with COPD.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114472493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Transbronchial Lung Cryobiopsy Versus Forceps Biopsy in the Diagnosis of Fibrotic Lung Disease: Biopsies and Beyond","authors":"Umang Shah","doi":"10.33590/emjrespir/10006376","DOIUrl":"https://doi.org/10.33590/emjrespir/10006376","url":null,"abstract":"Histology is a key element for the multidisciplinary diagnosis of fibrotic diffuse parenchymal lung diseases (f-DPLD) when the clinical–radiological setting of f-DPLD with high-resolution CT features diagnostic of usual interstitial pneumonia (UIP) are not present.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114941128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Challenges in the Management of Asthma and Chronic Obstructive Pulmonary Disease: Expert Perspectives on Optimising Outcomes Through Guidelines Implementation, Inhaler Selection, and Patient Engagement","authors":"Tuula Vasankari, Federico Lavorini, Christer Janson, L. Lehtimäki, Eric Bateman, Dave Singh, C. Ulrik, Ashley Woodcock, Alvar Agustí","doi":"10.33590/emjrespir/10040731","DOIUrl":"https://doi.org/10.33590/emjrespir/10040731","url":null,"abstract":"Asthma and chronic obstructive pulmonary disease (COPD) affect millions of people throughout Europe, being one of the leading causes of death in the continent. Both conditions also impose considerable morbidity on patients, adversely affecting individuals’ physical and psychological wellbeing, and their capacity to live and work normally. Asthma and COPD also impose a substantial economic burden on healthcare providers and wider society through both direct and indirect costs of care.\u0000\u0000Inhaler-delivered therapy has been central to the successful management of both conditions for several decades. Advances in device technology and understanding of the pathophysiology of both conditions (while theoretically introducing greater flexibility and responsiveness into the repertoire of inhalation therapies) have also added complexity and sometimes confusion into the task of identifying the precise combination of medication and delivery device best suited to the needs of individual patients.\u0000\u0000Recently published multinational consensus reports have set out best-practice frameworks for the management of both asthma and COPD. Presentations at the two symposia summarised in this report examined the implications of these guidelines for the treatment of both conditions. Special focus was on dry power inhalers (DPI) as a means of delivering effective treatment that combines ease of use and widespread acceptance among patients, with the potential to reduce medically-related emissions of greenhouses gases compared with pressurised metered-dose inhalers (pMDI).\u0000\u0000The authors emphasised the importance of patient partnership in determining the care plan, including the choice of both inhaler device and treatment; the benefits of regular monitoring of adherence to the treatment for both patients with asthma and COPD; and the benefits of simplicity, using one type of inhaler where possible to minimise critical errors in inhalation technique.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130639449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home Mechanical Ventilation in Children: Experience of Paediatric Pulmonology Divisions in Istanbul","authors":"M. Yanaz, F. Unal, E. Hepkaya, Sinem Can Oksay, Ebru Köstereli, C. Y. Yeğit, A. Başkan, Z. Onay, A. Gulieva, A. Soyyigit, M. Kalyoncu, H. Kucuk, Y. Ayhan, A. Ergenekon, E. Atag, Selçuk Uzuner, N. Ikizoglu, A. Kılınç, P. Ay, E. E. Eralp, Y. Gokdemir, S. Oktem, E. Çakır, S. Girit, Z. Uyan, H. Çokuğraş, R. Ersu, B. Karadag, F. Karakoc","doi":"10.33590/emjrespir/10144183","DOIUrl":"https://doi.org/10.33590/emjrespir/10144183","url":null,"abstract":"Advances in technology in recent years increased the long-term survival rate of patients with chronic respiratory failure. As a result, the number of patients receiving long-term home mechanical ventilation (LTHV) support is increasing worldwide. The most important step in the management of patients with home mechanical ventilation (HMV) is to ensure adequate oxygenation and ventilation. Successful care at home requires the presence of trained caregivers and accessibility to medical devices and a care team. The aims of this study were, to describe the characteristics of children on LTHV in Istanbul, to compare the patients receiving non-invasive ventilation (NIV) and invasive ventilation, and to evaluate the frequency and risk factors of hospital admission in this population.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114971892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulating the Expression of Multiple Surface Receptors on Epithelial Cells and Promoting Lung Macrophage Anti-viral Functions by OM-85 Inhibits Severe Acute Respiratory Syndrome Coronavirus 2 Infection","authors":"N. Ubags, C. von Garnier","doi":"10.33590/emjrespir/10120899","DOIUrl":"https://doi.org/10.33590/emjrespir/10120899","url":null,"abstract":"The emergence of a new virus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan, China, in December 2019 triggered a global pandemic, forcing much of the world to adopt lockdown strategies and leading to extraordinary threats to the global healthcare system. The clinical manifestations of the disease, referred to as COVID-19, range from mild, self-limiting flu-like respiratory illness to life-threatening multi-organ failure and death. The rapid progress in our understanding of COVID-19 pathogenesis has led the development of effective vaccines, monoclonal antibodies, and anti-viral agents. However, a major cause of concern is the continuous and rapid emergence of new mutations that can progressively decrease sensitivity to the existing anti-COVID-19 tools. Safe, affordable, and widely available treatments are therefore urgently needed to reduce the frequency and/or severity of SARS-CoV-2 infection. OM-85 is a standardised lysate of bacterial strains widely used for the prophylaxis of airway recurrent infections in adults and children with an excellent safety profile. In experimental animal models and in clinical trials this compound was shown to possess anti-viral activities through immunomodulatory responses, but also by inhibiting infection. The positive results reported in models of common respiratory virus infection has recently encouraged researchers from three independent groups to evaluate whether OM-85 could also affect SARS-CoV-2 infection. The results of these studies are summarised in this review.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129122124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}