EMJ Respiratory最新文献_第7页

Immunomodulation: Basic Concepts and Clinical Application 免疫调节:基本概念及临床应用

EMJ Respiratory Pub Date : 2017-12-11 DOI: 10.33590/emjrespir/10310919

E. Legg

引用次数: 0

Wheezing and Infection-Triggered Asthma Exacerbation: Is Prevention in Early Childhood Possible? 喘息和感染引发的哮喘加重:儿童早期预防是可能的吗?

EMJ Respiratory Pub Date : 2017-12-11 DOI: 10.33590/emjrespir/10314544

E. Legg

引用次数: 0

Upper Respiratory Tract Infections in Children and Adults: Burden and Management 儿童和成人上呼吸道感染:负担和管理

EMJ Respiratory Pub Date : 2017-12-11 DOI: 10.33590/emjrespir/10313231

E. Legg

引用次数: 2

Managing Extubation and the Post Extubation Period in the Intensive Care Unit 管理拔管和拔管后期间在重症监护病房

EMJ Respiratory Pub Date : 2017-10-26 DOI: 10.33590/emjrespir/10313378

S. Glover, A. Glossop

{"title":"Managing Extubation and the Post Extubation Period in the Intensive Care Unit","authors":"S. Glover, A. Glossop","doi":"10.33590/emjrespir/10313378","DOIUrl":"https://doi.org/10.33590/emjrespir/10313378","url":null,"abstract":"The process of successfully weaning patients from invasive mechanical ventilation is a great challenge for all healthcare providers working in critical care. Despite several recent advances in the care of intensive care patients, failed extubation remains a significant problem that may result in poor patient outcomes. A lack of consensus in many areas regarding clinical approach to extubation and the peri-extubation period exists, and the numerous strategies described in this review add to the complexity of the decision faced by the clinicians involved.\u0000\u0000The process of weaning and timing of extubation may be improved by implementation of a consistent multidisciplinary approach to weaning, with a number of easily identifiable risk factors available to support clinical decision making. There are also many known risk factors that can be used to predict the likelihood of extubation failure; whilst these factors may not be easily modifiable, they do allow the identification of patients at a high risk of extubation failure who may require more detailed care and planning post extubation. Finally, a number of strategies, including non-invasive ventilation and high flow nasal oxygen therapy, are available to support carefully selected groups in the post extubation period. Evidence is emerging linking these adjuncts to a reduction in the risk of extubation failure. This article will discuss these risk factors and the evidence supporting their use in this challenging patient group.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132486653","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: 2

Nontuberculous Mycobacterial Lung Disease: Current State of Knowledge and Future Directions 非结核性分枝杆菌肺病:目前的知识状况和未来的方向

EMJ Respiratory Pub Date : 2017-10-26 DOI: 10.33590/emjrespir/10310656

Mia Cahill

{"title":"Nontuberculous Mycobacterial Lung Disease: Current State of Knowledge and Future Directions","authors":"Mia Cahill","doi":"10.33590/emjrespir/10310656","DOIUrl":"https://doi.org/10.33590/emjrespir/10310656","url":null,"abstract":"The main objectives of the two symposia were to raise awareness of nontuberculous mycobacterial lung disease (NTM-LD); evaluate the key microbiological and clinical aspects of the disease, including its association with other conditions, such as bronchiectasis and common coinfections; outline the current treatment and management strategies; and review data from clinical trials of new therapies and how these could shape future management strategies. Dr Chalmers, Dr Griffith, and Dr Haworth opened the symposia by introducing NTM-LD and providing a brief overview of the key topics. Dr Ringshausen focussed on the epidemiology, prevalence, and burden of NTM-LD, and briefly discussed pathophysiology. Dr van Ingen outlined the microbiological diagnosis of NTM-LD, in particular the importance of molecular identification and drug susceptibility testing (DST). Dr Aliberti introduced bronchiectasis, outlined the relationship between the two diseases, and discussed the clinical relevance of comorbid disease. Dr Aksamit addressed the assessment and management of co-isolated NTM and other respiratory pathogens. Dr Griffith and Dr Loebinger each summarised the current treatment and management strategies, and reviewed the latest research regarding new therapies and what this could mean for the future. Dr Koh closed the symposium by outlining the latest clinical research on the natural history of NTM-LD from a global perspective.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124329403","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

A Patient Perspective: Identifying and Understanding the Barriers Associated with the Diagnostic Delay of Lung Cancer 从患者的角度:识别和理解与肺癌诊断延迟相关的障碍

EMJ Respiratory Pub Date : 2017-10-26 DOI: 10.33590/emjrespir/10314298

L. Hill, G. Collier, R. Gemine

{"title":"A Patient Perspective: Identifying and Understanding the Barriers Associated with the Diagnostic Delay of Lung Cancer","authors":"L. Hill, G. Collier, R. Gemine","doi":"10.33590/emjrespir/10314298","DOIUrl":"https://doi.org/10.33590/emjrespir/10314298","url":null,"abstract":"Lung cancer is the most common cancer worldwide and is a fundamental health problem in the UK. Mortality rates are much higher in the UK than other European countries, with overall 5-year survival rates in England and Wales currently as low as 7%. Reducing diagnostic delays may increase the proportion of early stage lung cancer and improve survival, yet the literature surrounding these issues suggests that many people continue to wait a considerable time before presenting symptoms to a clinician. To gain an in-depth understanding into the factors that may influence this delay, this review aims to explore some of the social and psychological barriers that patients face in seeking medical attention for lung cancer symptoms. Likewise, with the majority of lung cancer cases strongly linked to tobacco use, the impact of smoking status and whether it has an effect on an individual’s pathway to diagnosis is imperative to this review. The evidence found suggests that delays in symptom reporting are attributed to low perceptions of risk and a difficulty in recognising lung cancer symptoms early, especially when other comorbidities are present. Additionally, the de-normalisation of smoking appears to have confused understanding regarding risk and reinforced blame and stigma, which ultimately hinders help-seeking behaviours. Future research is thus required to develop strategies and interventions that raise awareness of lung cancer symptoms and empower people to engage in help-seeking behaviours.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133097219","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: 5

‘No Stent Left Behind’: A Review of Stent Removal and Related Complications “不留下支架”:支架移除及相关并发症综述

EMJ Respiratory Pub Date : 2017-10-26 DOI: 10.33590/emjrespir/10314389

A. Innabi, Sarenthia Mcclelland, Tuhina Raman, B. Alzghoul, N. Meena

{"title":"‘No Stent Left Behind’: A Review of Stent Removal and Related Complications","authors":"A. Innabi, Sarenthia Mcclelland, Tuhina Raman, B. Alzghoul, N. Meena","doi":"10.33590/emjrespir/10314389","DOIUrl":"https://doi.org/10.33590/emjrespir/10314389","url":null,"abstract":"Recently, there have been enormous developments in the endoscopic management of central airway obstruction secondary to benign or malignant processes. Airway stents are an essential component of such management. They provide rapid relief to patients with central airway obstruction. However, like any other foreign object introduced into the body, airway stents have their own complications. These can range from benign, such as increased coughing, to fatal, due to massive haemorrhage. Placement of a stent is a temporary bridging therapy to allow the patient to undergo chemotherapy or radiotherapeutic management. Airway stents should not be left in situ for long, as they themselves can become a disease in patients who already have life-limiting diseases. Hence, the motto at our centre is ‘no stent left behind’, with the only caveat being that they are left behind when the removal itself could cause death. In this paper, we will review the recent literature covering the removal of airway stents. We also describe our experience with airway stents removal. We conclude that efforts should be made to remove all airway stents when the primary disease is controlled. No stent left behind!","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"2017 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133430897","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: 3

Allergen Challenge Testing in Atopic Asthma Pharmaceutical Research: Past, Present, and Future Directions 过敏性哮喘药物研究中的过敏原激发试验:过去，现在和未来的方向

EMJ Respiratory Pub Date : 2017-10-26 DOI: 10.33590/emjrespir/10313205

Christianne M Blais, D. Cockcroft, B. Davis

{"title":"Allergen Challenge Testing in Atopic Asthma Pharmaceutical Research: Past, Present, and Future Directions","authors":"Christianne M Blais, D. Cockcroft, B. Davis","doi":"10.33590/emjrespir/10313205","DOIUrl":"https://doi.org/10.33590/emjrespir/10313205","url":null,"abstract":"Over the years, various allergen inhalation challenge models have been developed to study the pathophysiology and pharmacology of allergen-induced asthma. Each allergen challenge method possesses unique benefits and disadvantages. The classic allergen challenge model is useful for assessing the efficacy of new treatments but does not reflect real-world repeated exposure and excludes approximately 50% of allergic asthmatics (i.e. those who do not exhibit a late asthmatic response). The early response model, while also artificial, is less time-consuming and allows for the generation of dose-response data but does not assess the late response or related sequelae. The repeated low-dose allergen model was developed with the purpose of mimicking natural exposure for induction of airway inflammation and airway hyperresponsiveness. However, this method does not consistently produce airway inflammation and is less practical to perform due to the number of study visits required. The segmental allergen model is the only one to allow direct sampling of airway secretions for airway inflammation studies, but it is highly invasive and requires special training and equipment. Attempts have been made to establish a repeated high-dose allergen model for the assessment of drug effects on symptoms and rescue medication use, but participant safety remains a concern and it is also less practical than the classic method. The most difficult allergen model to perform is the natural exposure method, for which standardisation may not be possible given the number of environmental factors that must be controlled or measured. Modifications to these allergen models could improve their clinical relevance and identify their specific, tailored applications in pharmaceutical research of allergic asthma.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129784114","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

Transitioning Clinical Data into Patient Care: Recent Real-Life Experiences with Alpha 1 将临床数据转化为患者护理:最近与Alpha 1的现实生活经验

EMJ Respiratory Pub Date : 2017-10-26 DOI: 10.33590/emjrespir/10310691

J. Fricker

{"title":"Transitioning Clinical Data into Patient Care: Recent Real-Life Experiences with Alpha 1","authors":"J. Fricker","doi":"10.33590/emjrespir/10310691","DOIUrl":"https://doi.org/10.33590/emjrespir/10310691","url":null,"abstract":"The symposium explored the use of state-of-the-art technologies in building the evidence for Alpha 1 Antitrypsin (AAT) efficacy, namely the use of computed tomography (CT) and recent developments in regional lung density analysis, and current challenges and data gaps for the management of AAT deficiency (AATD). The vital importance of registries in building our knowledge and understanding of AATD and its management were also discussed. Dr Stolk opened the symposium with a brief overview of AATD and the results of the RAPID clinical trial programme, which provided evidence for the efficacy of AAT therapy in slowing the rate of lung density loss in AATD. Prof Parr then presented the rationale and methodology for assessing regional lung density changes, as measured by CT, and the potential clinical relevance of regional treatment variability in AATD. Prof Ficker addressed the clinical implications for AATD treatment, in light of data from the RAPID clinical trial programme, and provided an overview of the current challenges for treating patients with AATD, including questions surrounding when to commence AAT therapy and how the potential life-extending effect of AAT therapy can be assessed and quantified. Finally, the importance of registries was discussed; Prof Strange provided an overview of the USA Alpha 1 Foundation registry and presented key published data. In addition, he discussed current and future initiatives. Dr Stolk considered the European Alpha 1 International Registry (AIR) and presented the results of recent projects supported by this registry.","PeriodicalId":300382,"journal":{"name":"EMJ Respiratory","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127113992","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

Thymomas and Thymic Carcinomas: A Review on Pathology, Presentation, Staging, Treatment, and Novel Systemic Therapies 胸腺瘤和胸腺癌:病理、表现、分期、治疗和新型全身治疗的综述

EMJ Respiratory Pub Date : 2017-10-26 DOI: 10.33590/emjrespir/10310358

K. Miyamoto, J. Acoba

引用次数: 8