EMJ Respiratory最新文献_第6页

Back to Basics in Asthma and COPD: Optimising the Patient Journey 回到哮喘和慢性阻塞性肺病的基础:优化患者旅程

EMJ Respiratory Pub Date : 2018-11-01 DOI: 10.33590/emjrespir/10310580

Alexander Kroll

{"title":"Back to Basics in Asthma and COPD: Optimising the Patient Journey","authors":"Alexander Kroll","doi":"10.33590/emjrespir/10310580","DOIUrl":"https://doi.org/10.33590/emjrespir/10310580","url":null,"abstract":"The objective of this symposium was to build on the guiding principles of asthma and chronic obstructive pulmonary disease (COPD) and to address some of the most frequently encountered challenges in the management of chronic airway disease, using a mix of scientific information and guidance based on clinical practice. Prof Mäkelä opened the symposium by reviewing key achievements from the Finnish asthma, COPD, and allergy programmes. He also highlighted how these co-ordinated educational programmes were responsible for driving an improvement in Finnish public health and reducing the socioeconomic burden of disease. Prof Chrystyn then addressed some of the common misconceptions associated with high-resistance dry powder inhalers; he explained how the properties of these devices make them suitable for use by a broader range of patients than perceived by many clinicians. Next, Prof Lavorini addressed the real-world use of inhalers by highlighting how specific errors in recent real-life studies are associated with a loss of disease control and how the Easyhaler® (Orion Corporation, Espoo, Finland) meets many of the needs of doctors and patients. Finally, Prof Canonica focussed on precision and personalised medicine in chronic airway disease, with an emphasis on how clinicians can optimise patient adherence and, consequently, treatment in daily practice.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126371782","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}

引用次数: 0

Anti-Programmed Death Receptor 1 Signalling Immunotherapy as a Part of Curative Intent Strategies for Stages I-III Non-Small Cell Lung Cancer 抗程序性死亡受体1信号免疫治疗作为I-III期非小细胞肺癌治疗意向策略的一部分

EMJ Respiratory Pub Date : 2018-11-01 DOI: 10.33590/emjrespir/10311519

I. Moya Horno, S. Viteri, Pablo Rubinstein, J. Maestre, A. Alvarado, Inessa Koptseva, S. Simonetti, Natalia Lugo, J. L. Cisneros, R. Rosell

{"title":"Anti-Programmed Death Receptor 1 Signalling Immunotherapy as a Part of Curative Intent Strategies for Stages I-III Non-Small Cell Lung Cancer","authors":"I. Moya Horno, S. Viteri, Pablo Rubinstein, J. Maestre, A. Alvarado, Inessa Koptseva, S. Simonetti, Natalia Lugo, J. L. Cisneros, R. Rosell","doi":"10.33590/emjrespir/10311519","DOIUrl":"https://doi.org/10.33590/emjrespir/10311519","url":null,"abstract":"Surgery provides the best chance of a cure for patients with early stage non-small cell lung cancer (NSCLC) and plays an important role in the multimodal treatment for locally advanced disease. However, many patients still relapse despite intended curative surgery, and no major advances in systemic therapy for resectable NSCLC have been achieved in the last decades. The incorporation of immunotherapy for the treatment of metastatic Stage IV NSCLC and the recent data on the efficacy of cancer consolidation with the anti-programmed death-ligand 1 (PD-L1) antibody durvalumab after concurrent chemoradiation for unresectable Stage III NSCLC open new opportunities for the use of immune checkpoint inhibitors in earlier stages of the disease. Multiple ongoing clinical trials are exploring the safety and efficacy of immunotherapy in Stage I–III resectable NSCLC, either as a postoperative (adjuvant) strategy or before surgical resection (neoadjuvant). The neoadjuvant setting is particularly interesting, as it represents an ideal chance to develop translational research.\u0000\u0000Herein, the authors summarise the main ongoing research and available data on the use of anti-PD1/PD-L1 antibodies for Stage I–III NSCLC.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"18 777 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123805102","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}

引用次数: 1

Asthma in Childhood: Current Perspectives on Diagnosis and Treatment 儿童哮喘:当前诊断和治疗的观点

EMJ Respiratory Pub Date : 2018-11-01 DOI: 10.33590/emjrespir/10313228

S. Uwaezuoke, A. Ayuk, J. Eze, S. K. Owusu

{"title":"Asthma in Childhood: Current Perspectives on Diagnosis and Treatment","authors":"S. Uwaezuoke, A. Ayuk, J. Eze, S. K. Owusu","doi":"10.33590/emjrespir/10313228","DOIUrl":"https://doi.org/10.33590/emjrespir/10313228","url":null,"abstract":"This narrative review aims to appraise the current perspectives on the diagnosis and treatment of asthma in childhood, with a focus on diagnostic steps, disease phenotypes and endotypes, and novel biologic therapies. Asthma in children and adults is now regarded as a complex cluster of disease phenotypes linked to specific endotypes. Unravelling asthma heterogeneity is key to understanding the pathogenic mechanisms of the disease and developing novel treatment strategies that are tailored according to these phenotypes and endotypes. This will make for a more precise diagnosis and more personalised treatments. There is currently no gold-standard method for making the diagnosis of asthma due to the non-specific nature of asthma symptoms; respiratory symptoms and airflow limitation need to be carefully evaluated to establish a causal relationship with the disease. Although corticosteroids and bronchodilators still constitute the recommended step-wise pharmacological based therapy in both childhood and adult asthma, novel biologic therapies targeting type 2 immunity have been proven effective in severe childhood and adult asthma and will likely lead to improved disease outcomes.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123547991","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}

引用次数: 0

Discovering Asthma Paradigms in an Evolving Landscape: Expert Perspectives 发现哮喘范式在一个不断发展的景观:专家的观点

EMJ Respiratory Pub Date : 2018-11-01 DOI: 10.33590/emjrespir/10311221

Paul Scutt

{"title":"Discovering Asthma Paradigms in an Evolving Landscape: Expert Perspectives","authors":"Paul Scutt","doi":"10.33590/emjrespir/10311221","DOIUrl":"https://doi.org/10.33590/emjrespir/10311221","url":null,"abstract":"This symposium took place during the 2018 European Respiratory Society (ERS) International Congress in Paris, France and focussed on the disease burden associated with uncontrolled persistent asthma, particularly that driven by Type 2 inflammation; the impact of Type 2 cytokines on the pathophysiology of asthma and other Type 2 inflammatory diseases; current approaches to the assessment and management of uncontrolled persistent asthma; and future aspirations for treatment. Dr Kraft discussed the epidemiology, disease burden, and unmet medical needs of patients with uncontrolled persistent asthma. These patients have an increased risk of exacerbations, morbidity, mortality, and disease progression. Many patients have evidence of Type 2 inflammation, which constitutes a heavy disease burden and is further impacted by Type 2 inflammatory comorbidities. Prof Busse considered how Type 2 inflammation drives the key pathophysiologic characteristics of asthma. Persistent Type 2 inflammation and airway remodelling contribute to a self-perpetuating vicious cycle of exacerbations and progressive loss of lung function, and, therefore, impact disease progression. Targeting specific Type 2 inflammatory pathway cytokines reduces the pathophysiological impact of asthma and other Type 2 inflammatory comorbidities. Prof Pavord examined the current thinking around the management of uncontrolled persistent asthma driven by Type 2 inflammation. Despite recent advances in patient management, unmet needs remain. Of note, biologics have limitations and some patients are ineligible for currently vailable treatments.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122513665","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}

引用次数: 0

Alternative Exercise and Breathing Interventions in Chronic Obstructive Pulmonary Disease: A Critical Review 慢性阻塞性肺疾病的替代运动和呼吸干预:综述

EMJ Respiratory Pub Date : 2018-11-01 DOI: 10.33590/emjrespir/10312774

Renae J McNamara, L. Spencer, Marita T Dale, Regina W M Leung, Z. McKeough

{"title":"Alternative Exercise and Breathing Interventions in Chronic Obstructive Pulmonary Disease: A Critical Review","authors":"Renae J McNamara, L. Spencer, Marita T Dale, Regina W M Leung, Z. McKeough","doi":"10.33590/emjrespir/10312774","DOIUrl":"https://doi.org/10.33590/emjrespir/10312774","url":null,"abstract":"Interventions such as exercise training and breathing strategies are components of pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD); however, the conventional mode of gym-based exercise training may not be optimal for all individuals with COPD, and adaptive breathing strategies may be beneficial in reducing dyspnoea, but the current evidence is limited. Uptake and completion rates of pulmonary rehabilitation are suboptimal, so alternative interventions need to be considered. This review examines the current scientific evidence on alternative exercise and breathing interventions from systematic reviews, experimental and observational studies, clinical trial registries, and grey literature. Alternative interventions are assessed for the effect on exercise capacity and quality of life with the aim of guiding the development of strategies to increase training uptake and completion. Systematic reviews of tai chi, yoga, minimal or no equipment exercise, water-based exercise, inspiratory muscle training, and singing demonstrated positive effects on exercise capacity and/or quality of life compared to no training, with some interventions demonstrating comparable outcomes to conventional training. Some positive outcomes have been demonstrated for whole-body vibration, single-limb partitioning, and Nordic and downhill walking; however, further research is required to compare these interventions to conventional training. The most recent interventions examined include exer-gaming, virtual reality, dancing, and laughing; controlled studies are still required to determine the effect on patient outcomes. Although further research is needed to compare alternative exercise and breathing interventions with conventional exercise training, results to date are promising, suggesting that people with COPD will have more options that may help to improve training uptake and adherence.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126940360","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}

引用次数: 9

Infecciones En Las vías Respiratorias Superiores En Niños Y Adultos: Carga Y Gestión 儿童和成人上呼吸道感染:负担和管理

EMJ Respiratory Pub Date : 2017-12-22 DOI: 10.33590/emjrespir/10310086

Eweng Legg

引用次数: 0

Abordando La Amenaza Mundial De La Resistencia Antimicrobiana 应对抗菌素耐药性的全球威胁

EMJ Respiratory Pub Date : 2017-12-22 DOI: 10.33590/emjrespir/10313862

Eweng Legg

引用次数: 0

Exacerbación Del Asma Con Sibilancias Y Desencadenada Por Infección: ¿Es Posible La Prevención a Una Edad Temprana? 哮喘加重与喘息和感染引发:是否有可能在早期预防?

EMJ Respiratory Pub Date : 2017-12-22 DOI: 10.33590/emjrespir/10313892

Eweng Legg

{"title":"Exacerbación Del Asma Con Sibilancias Y Desencadenada Por Infección: ¿Es Posible La Prevención a Una Edad Temprana?","authors":"Eweng Legg","doi":"10.33590/emjrespir/10313892","DOIUrl":"https://doi.org/10.33590/emjrespir/10313892","url":null,"abstract":"El tercer Encuentro Latinoamericano de Infecciones Respiratorias Recurrentes (ELAIR) tuvo lugar en Ciudad de México, México, los días 11 y 12 de mayo de 2017. ELAIR reunió a expertos de toda Latinoamérica y otros países, continuando con un extraordinario ejercicio didáctico en cuanto a los vanguardistas avances de la medicina respiratoria. En los últimos 15 años se ha realizado un progreso espectacular gracias a la aparición de nuevos tratamientos disponibles para gestionar y evitar infecciones en las vías respiratorias. Queda por ver cómo podría afectar todo esto a las afecciones relacionadas de las sibilancias y el asma en los sujetos predispuestos e hipersensibles. No obstante, los primeros datos sugieren que las tasas más bajas de infección en las vías respiratorias podrían reducir el desarrollo de las afecciones antes mencionadas, estrechamente relacionadas con las infecciones víricas. Es probable que los inmunorreguladores que preparan el sistema inmunológico para combatir la infección y que además reducen la inflamación jueguen un papel fundamental en la prevención secundaria (e incluso potencialmente primaria) de las enfermedades atópicas.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"263 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116486190","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}

引用次数: 0

Immunomodulación: Conceptos Básicos Y Aplicaciones Clínicas 免疫调节:基本概念和临床应用

EMJ Respiratory Pub Date : 2017-12-22 DOI: 10.33590/emjrespir/10311693

Eweng Legg

引用次数: 0

Facing the Worldwide Threat of Antimicrobial Resistance 面对抗菌素耐药性的全球威胁

EMJ Respiratory Pub Date : 2017-12-11 DOI: 10.33590/emjrespir/10311209

E. Legg

引用次数: 0