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Controversies in the clinical management of chronic pulmonary aspergillosis. 慢性肺曲霉菌病临床治疗中的争议。
IF 2.3
Breathe Pub Date : 2024-10-01 DOI: 10.1183/20734735.0234-2023
Xinxin Hu, Kathryn Hulme, Liana Brien, Sonya Natasha Hutabarat, Zinta Harrington
{"title":"Controversies in the clinical management of chronic pulmonary aspergillosis.","authors":"Xinxin Hu, Kathryn Hulme, Liana Brien, Sonya Natasha Hutabarat, Zinta Harrington","doi":"10.1183/20734735.0234-2023","DOIUrl":"10.1183/20734735.0234-2023","url":null,"abstract":"<p><p>Chronic pulmonary aspergillosis has a range of manifestations from indolent nodules to semi-invasive infection. Patients may be asymptomatic or have chronic symptoms such as cough and weight loss or present with life-threatening haemoptysis. The physician can choose from a range of available therapies including medical therapy with antifungals, minimally invasive therapy with intracavitary antifungal therapy and surgery involving open thoracotomy or video-assisted thoracoscopic surgery. The patients with the most severe forms of pulmonary infection may not be surgical candidates due to their underlying pulmonary condition. The management of haemoptysis can include tranexamic acid, bronchial artery embolisation, antifungals or surgery. There are few controlled studies to inform clinicians managing complex cases, so a multidisciplinary approach may be helpful.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lung imaging methods: indications, strengths and limitations. 肺部成像方法：适应症、优势和局限性。
IF 2.3
Breathe Pub Date : 2024-10-01 DOI: 10.1183/20734735.0127-2023
Dávid László Tárnoki, Kinga Karlinger, Carole A Ridge, Fanni Júlia Kiss, Tamás Györke, Elzbieta Magdalena Grabczak, Ádám Domonkos Tárnoki
{"title":"Lung imaging methods: indications, strengths and limitations.","authors":"Dávid László Tárnoki, Kinga Karlinger, Carole A Ridge, Fanni Júlia Kiss, Tamás Györke, Elzbieta Magdalena Grabczak, Ádám Domonkos Tárnoki","doi":"10.1183/20734735.0127-2023","DOIUrl":"10.1183/20734735.0127-2023","url":null,"abstract":"<p><p>Imaging methods are fundamental tools to detect and diagnose lung diseases, monitor their treatment and detect possible complications. Each modality, starting from classical chest radiographs and computed tomography, as well as the ever more popular and easily available thoracic ultrasound, magnetic resonance imaging and nuclear medicine methods, and new techniques such as photon counting computed tomography, radiomics and application of artificial intelligence, has its strong and weak points, which we should be familiar with to properly choose between the methods and interpret their results. In this review, we present the indications, strengths and main limitations of methods for chest imaging.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary complications of bone marrow transplantation. 骨髓移植的肺部并发症。
IF 2.3
Breathe Pub Date : 2024-10-01 DOI: 10.1183/20734735.0043-2024
Helen O'Brien, John Murray, Nina Orfali, Ruairi J Fahy
{"title":"Pulmonary complications of bone marrow transplantation.","authors":"Helen O'Brien, John Murray, Nina Orfali, Ruairi J Fahy","doi":"10.1183/20734735.0043-2024","DOIUrl":"10.1183/20734735.0043-2024","url":null,"abstract":"<p><p>Bone marrow transplantation, now often known as haematopoietic stem cell transplantation (HSCT), is a complex choreographed procedure used to treat both acquired and inherited disorders of the bone marrow. It has proven invaluable as therapy for haematological and immunological disorders, and more recently in the treatment of metabolic and enzyme disorders. As the number of performed transplants grows annually, and with patients enjoying improved survival, a knowledge of both early and late complications of HSCT is essential for respiratory trainees and physicians in practice. This article highlights the spectrum of respiratory complications, both infectious and non-infectious, the timeline of their likely occurrence, and the approaches used for diagnosis and treatment, keeping in mind that more than one entity may occur simultaneously. As respiratory issues are often a leading cause of short- and long-term morbidity, consideration of a combined haematology/respiratory clinic may prove useful in this patient population.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Large-scale education in respiratory medicine: content versus delivery. 呼吸内科的大规模教育：内容与实施。
IF 2.3
Breathe Pub Date : 2024-10-01 DOI: 10.1183/20734735.0218-2023
Emer Kelly, Richard W Costello
{"title":"Large-scale education in respiratory medicine: content <i>versus</i> delivery.","authors":"Emer Kelly, Richard W Costello","doi":"10.1183/20734735.0218-2023","DOIUrl":"10.1183/20734735.0218-2023","url":null,"abstract":"<p><p>The respiratory literature, both written and in online formats, is growing exponentially. Capturing quality content, to meet the learning needs of those working in all fields of respiratory medicine and delivering it in a palatable, accessible format is challenging but paramount. In this article we discuss ways to determine the information content and review different methods of delivering this content to those who need it.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Spatial lung imaging in clinical and translational settings. 临床和转化环境中的空间肺部成像。
IF 2.3
Breathe Pub Date : 2024-10-01 DOI: 10.1183/20734735.0224-2023
Irma Mahmutovic Persson, Gracijela Bozovic, Gunilla Westergren-Thorsson, Sara Rolandsson Enes
{"title":"Spatial lung imaging in clinical and translational settings.","authors":"Irma Mahmutovic Persson, Gracijela Bozovic, Gunilla Westergren-Thorsson, Sara Rolandsson Enes","doi":"10.1183/20734735.0224-2023","DOIUrl":"10.1183/20734735.0224-2023","url":null,"abstract":"<p><p>For many severe lung diseases, non-invasive biomarkers from imaging could improve early detection of lung injury or disease onset, establish a diagnosis, or help follow-up disease progression and treatment strategies. Imaging of the thorax and lung is challenging due to its size, respiration movement, transferred cardiac pulsation, vast density range and gravitation sensitivity. However, there is extensive ongoing research in this fast-evolving field. Recent improvements in spatial imaging have allowed us to study the three-dimensional structure of the lung, providing both spatial architecture and transcriptomic information at single-cell resolution. This fast progression, however, comes with several challenges, including significant image file storage and network capacity issues, increased costs, data processing and analysis, the role of artificial intelligence and machine learning, and mechanisms to combine several modalities. In this review, we provide an overview of advances and current issues in the field of spatial lung imaging.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Steroids in severe community-acquired pneumonia. 在严重社区获得性肺炎中使用类固醇。
IF 2.3
Breathe Pub Date : 2024-10-01 DOI: 10.1183/20734735.0081-2024
Sachin Ananth, Alexander G Mathioudakis, Jan Hansel
{"title":"Steroids in severe community-acquired pneumonia.","authors":"Sachin Ananth, Alexander G Mathioudakis, Jan Hansel","doi":"10.1183/20734735.0081-2024","DOIUrl":"10.1183/20734735.0081-2024","url":null,"abstract":"<p><p>There is conflicting evidence regarding the use of steroids in severe community-acquired pneumonia (CAP), with previous randomised controlled trials limited by small sample sizes. ESCAPe and CAPE COD are two recently published large trials on steroids in severe CAP. ESCAPe assessed the initiation of methylprednisolone within 72-96 h of hospital admission, while CAPE COD studied the use of hydrocortisone within 24 h of the development of severe CAP. ESCAPe did not show any differences in all-cause 60-day mortality or any of its secondary outcomes. CAPE COD showed that hydrocortisone improved all-cause 28-day mortality and reduced the risk of intubation or vasopressor-dependent shock. Important differences between the trials included the steroid regimens used, timing of steroid administration and baseline characteristics, with more diabetic patients included in ESCAPe. The results of CAPE COD support the initiation of hydrocortisone within 24 h of developing severe CAP, but more research is needed to evaluate long-term outcomes and optimum dosing regimens for steroids in severe CAP.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stage III NSCLC treatment options: too many choices. III 期 NSCLC 治疗方案：选择太多。
IF 2.3
Breathe Pub Date : 2024-10-01 DOI: 10.1183/20734735.0047-2024
Oke Dimas Asmara, Georgia Hardavella, Sara Ramella, René Horsleben Petersen, Ilona Tietzova, E Christiaan Boerma, Eric Daniel Tenda, Asmaa Bouterfas, Marjolein A Heuvelmans, Wouter H van Geffen
{"title":"Stage III NSCLC treatment options: too many choices.","authors":"Oke Dimas Asmara, Georgia Hardavella, Sara Ramella, René Horsleben Petersen, Ilona Tietzova, E Christiaan Boerma, Eric Daniel Tenda, Asmaa Bouterfas, Marjolein A Heuvelmans, Wouter H van Geffen","doi":"10.1183/20734735.0047-2024","DOIUrl":"10.1183/20734735.0047-2024","url":null,"abstract":"<p><p>Stage III nonsmall cell lung cancer (NSCLC) represents a wide range of tumour (T1 to T4) and nodal (N0 to N3) components, requiring variable management and a multidisciplinary approach. Recent advancements in minimally invasive techniques, molecular biology and novel drug discoveries have accelerated the refinement of stage III NSCLC management. The latest developments in staging include the forthcoming update of the nodal component in the 9th TNM (tumour-node-metastasis) edition, which emphasises the critical role for endobronchial ultrasonography in mediastinal staging. Recent treatment developments include the use of immunotherapy and targeted molecular therapy in both the neoadjuvant and adjuvant setting, either in combination with other modalities or used alone as consolidation. Surgical and radiotherapy advancements have further enhanced patient outcomes. These developments have significantly improved the prognosis for patients with stage III NSCLC. Fast-changing recommendations have also brought about a challenge, with clinicians facing a number of options to choose from. Therefore, a multimodal approach by a multidisciplinary team has become even more crucial in managing stage III NSCLC.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stage IV nonsmall cell lung cancer treatment: oligometastatic disease and disease progression, untangling the knot. IV 期非小细胞肺癌治疗：寡转移疾病与疾病进展，解开心结。
IF 2.3
Breathe Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0039-2024
Tuğbanur Tezvergil, Ismini Kourouni, Adrien E Costantini, Diego Kauffmann-Guerrero, Torsten Gerriet Blum, Thierry Berghmans
{"title":"Stage IV nonsmall cell lung cancer treatment: oligometastatic disease and disease progression, untangling the knot.","authors":"Tuğbanur Tezvergil, Ismini Kourouni, Adrien E Costantini, Diego Kauffmann-Guerrero, Torsten Gerriet Blum, Thierry Berghmans","doi":"10.1183/20734735.0039-2024","DOIUrl":"10.1183/20734735.0039-2024","url":null,"abstract":"<p><p>Stage IV nonsmall cell lung cancer (NSCLC) is a heterogeneous group of patients for whom systemic therapy is decided based on tumour-biological cancer features (histology, PD-L1 expression, genomic alteration, metastatic sites) and patient characteristics (performance status, comorbidities). In most instances, some kind of systemic treatment is proposed, for which immunotherapy-based or targeted therapies are considered the standards of care in 2024. Oligometastatic NSCLC represents a specific concept during the biological spectrum from localised to metastatic disease in which only a limited number of metastatic sites can be documented. Based on this assumption, prospective and a few randomised phase II studies have been performed, which suggested that adding a local ablative treatment to the systemic one can be a new option for selected stage IV NSCLC. The European Organisation for Research and Treatment of Cancer (EORTC) and the European Society for Radiotherapy and Oncology (ESTRO) supported efforts to define oligometastatic NSCLC to unify the semantics within the thoracic oncology community. This article summarises the currently available data and emphasises the questions and perspectives in oligometastatic disease NSCLC in European patient cohorts.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Stage I and II nonsmall cell lung cancer treatment options. I 期和 II 期非小细胞肺癌治疗方案。
IF 2.3
Breathe Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0219-2023
Georgia Hardavella, Dimitrios E Magouliotis, Roberto Chalela, Adam Januszewski, Fabio Dennstaedt, Paul Martin Putora, Alfred So, Angshu Bhowmik
{"title":"Stage I and II nonsmall cell lung cancer treatment options.","authors":"Georgia Hardavella, Dimitrios E Magouliotis, Roberto Chalela, Adam Januszewski, Fabio Dennstaedt, Paul Martin Putora, Alfred So, Angshu Bhowmik","doi":"10.1183/20734735.0219-2023","DOIUrl":"10.1183/20734735.0219-2023","url":null,"abstract":"<p><p>Chest radiography, computed tomography (CT) and positron emission tomography (PET)-CT are required for staging nonsmall cell lung cancers. Stage I cancers may be up to 4 cm in maximal diameter, with stage IA tumours being up to 3 cm and stage IB up to 4 cm. A lung cancer becomes stage II if the tumour is between 4 and ≤5 cm (stage IIA), or it spreads to ipsilateral peribronchial or hilar lymph nodes (stage IIB). Stage IA tumours should be surgically resected, ideally using minimally invasive methods. Lobectomy is usually performed, although some studies have shown good outcomes for sublobar resections. If surgery is not possible, stereotactic body radiotherapy is a good alternative. This involves delivering a few high-dose radiation treatments at very high precision. For stage IB to IIB disease, combinations of surgery, chemotherapy or immunotherapy and radiotherapy are used. There is evidence that neoadjuvant treatment (immunotherapy with nivolumab and chemotherapy for stage IB and II) optimises outcomes. Adjuvant chemotherapy with a platinum-based doublet (typically cisplatin+vinorelbine) should be offered for resected stage IIB tumours and considered for resected IIA tumours. Adjuvant pembrolizumab is used for stage IB-IIIA following resection and adjuvant platinum-based chemotherapy. Osimertinib may be used for resected stage IB to IIIA cancers which have relevant mutations (epidermal growth factor receptor exon 19 deletions or exon 21 (L858R) substitution). There are no fixed guidelines for follow-up, but most centres recommend 6-monthly CT scanning for the first 2-3 years after definitive treatment, followed by annual scans.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the efficacy and advancements of medical pleurodesis: a comprehensive review of current research. 探索胸膜腔穿刺术的疗效和进展：当前研究的全面回顾。
IF 2.3
Breathe Pub Date : 2024-08-27 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0002-2024
Nadia Castaldo, Alberto Fantin, Michelangelo Palou-Schwartzbaum, Giovanni Viterale, Ernesto Crisafulli, Giulia Sartori, Avinash Aujayeb, Filippo Patrucco, Vincenzo Patruno
{"title":"Exploring the efficacy and advancements of medical pleurodesis: a comprehensive review of current research.","authors":"Nadia Castaldo, Alberto Fantin, Michelangelo Palou-Schwartzbaum, Giovanni Viterale, Ernesto Crisafulli, Giulia Sartori, Avinash Aujayeb, Filippo Patrucco, Vincenzo Patruno","doi":"10.1183/20734735.0002-2024","DOIUrl":"10.1183/20734735.0002-2024","url":null,"abstract":"<p><p>This narrative review aims to provide an overview of medical pleurodesis techniques, and their indications and potential adverse effects. Pleurodesis is a procedure performed with the aim of obliterating the pleural space. It has indications in the management of both malignant and benign pleural effusions and pneumothorax. Various nonsurgical techniques exist to perform pleurodesis. The scope of this work is to review the different nonsurgical techniques and their indications. This narrative review was performed checking scientific databases for medical literature, focusing especially on the data derived from randomised controlled trials. Pleurodesis is an effective method to manage pleural effusions and pneumothorax, and minimally invasive techniques are now frequently used with good results. Further research is needed to assess the efficacy of new treatments and the possibility of using different techniques in association.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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