European medical journal. Respiratory最新文献

{"title":"Precision Medicine in Airway Diseases: What Can We Offer in the Clinic?","authors":"Abigail Craig","doi":"10.33590/emjrespir/10301711","DOIUrl":"https://doi.org/10.33590/emjrespir/10301711","url":null,"abstract":"AN EXCITING session, delivered at the European Respiratory Society (ERS) International Congress 2023, held in Milan, Italy, saw field experts present recent research surrounding precision medicine in airway diseases. Chaired by Apostolos Bossios, Karolinska University Hospital, Stockholm, Sweden; Emer Kelly, St. Vincent’s University Hospital, Dublin, Ireland; and Omar Usmani, National Heart and Lung Institute (NHLI), Imperial College London, UK, presentations discussed the value of ‘omics’, cellular signatures, novel chronic obstructive pulmonary disease (COPD) classifications, and the identification of treatable traits in improving patient care.","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267751","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":"Resolution of Resorptive and Compressive Atelectasis without Invasive Manoeuvres: A Case Report","authors":"Simone Ielo, Paolo Calò, Alessia Del Pizzo, Riccardo Cucurachi, Giovanni Piraino, Eirini Lemontzi","doi":"10.33590/emjrespir/10309984","DOIUrl":"https://doi.org/10.33590/emjrespir/10309984","url":null,"abstract":"A care challenge that clinicians and other healthcare professionals face very frequently is the complications of bedridden syndrome. Respiratory involvement readily occurs in these patients for whom medical therapy alone is not sufficient. In this clinical case, the authors describe the results of chest physiotherapy in an elderly patient who had developed complete atelectasis of the left lung, attributable to two mechanisms: obstructive, due to mucus plugging, and compressive, due to pleural effusion. The patient was accessed in the authors’ Respiratory Rehabilitation Department, San Raffaele Pisana Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Rome, Italy, with dyspnoea at rest and high O2 requirement (venturi mask fraction of inspired O2: 40%), demonstrated by severe respiratory failure on blood gas analysis (partial pressure of O2/fraction of inspired O2: 155). Physical examination revealed marked reduction of lung sounds, especially on the left side, with diffuse rhonchi. A chest CT scan was performed to demonstrate complete left lung collapse that would have required invasive therapeutic procedures, such as bronchoscopy. However, given the high risk of periprocedural complications and the patient’s refusal, a chest physiotherapy programme was started. The lung was able to re-expand 7 days later, as evidenced by X-ray and improved gas exchange. The manuscript describes the physiotherapeutic techniques used and collects the main scientific evidence on them. The main purpose is to highlight the role of respiratory physiotherapy as an effective, safe, co-adjuvant treatment, and sometimes alternative to invasive manoeuvres in the treatment of frail patients.","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"21 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135273526","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":"Exploring Type 2 Inflammation in Chronic Obstructive Pulmonary Disease","authors":"Deborah Liao","doi":"10.33590/emjrespir/10306588","DOIUrl":"https://doi.org/10.33590/emjrespir/10306588","url":null,"abstract":"This symposium took place during the 2023 meeting of the European Respiratory Society (ERS), with a focus on targeting chronic obstructive pulmonary disease (COPD) with Type 2 inflammation, and the emerging biologic landscape. The speakers discussed the clinical consequences of COPD through an understanding of pathological changes, the spectrum of inflammatory pathways, the role of Type 2 inflammation in the pathophysiology of COPD, and the evolving clinical landscape in COPD. Klaus Rabe, Full Member (Chair), LungenClinic, Grosshansdorf, Germany, utilised hypothetical clinical scenarios to contextualise the clinical presentation of COPD as a consequence of disease pathology, specifically chronic inflammation leading to structural changes of airways and parenchymal destruction resulting in airflow limitation, leading to worsening symptoms, and increasing further exacerbation risk. Stephanie Christenson, Assistant Professor of pulmonology at the University of California, San Francisco, USA, followed with a discussion of the heterogeneity of inflammatory pathways, exploration of distinct inflammatory cells and cytokines, and the evolving state of the knowledge of the diverse inflammatory pathways associated with COPD. COPD inflammation can be differentiated by distinct inflammatory cells and cytokines into Type 1/Type 3 inflammation (i.e., neutrophilic inflammation) and Type 2 inflammation. However, there is potential overlap in the various inflammatory mechanisms driving COPD via the alarmins IL-33 and thymic stromal lymphopoietin. In addition, the key cytokines IL-4, IL-13, and IL-5 mediate the pathophysiology of COPD with Type 2 inflammation. Altogether, the heterogeneous inflammatory pathways contribute to characteristic features of COPD, fibrosis (small airways), wall thickening, airway remodelling, and clinical features, such as shortness of breath at rest. 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":93286,"journal":{"name":"European medical journal. Respiratory","volume":"29 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267733","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":"Prioritising Patient Outcomes and Reducing Environmental Burden: How Both Are Achievable in Respiratory Care","authors":"Hannah Moir, Jennifer Taylor","doi":"10.33590/emjrespir/10305679","DOIUrl":"https://doi.org/10.33590/emjrespir/10305679","url":null,"abstract":"Patient outcomes must take precedence when considering environmental legislation related to the availability of inhaler devices, which are essential for the care of patients with respiratory diseases. This article reviews presentations and abstracts from the European Respiratory Society (ERS) International Congress 2023, held in Milan, Italy, in September 2023. The sessions focused on healthcare inequality and patient outcomes, highlighting the need for stakeholders to make patient-centric decisions in order to ensure access to essential inhaled medicines are prioritised. This is especially important during a period when there is an increasing need to reduce the carbon footprint associated with respiratory care. During a satellite symposium, co-chairs John Hurst, Professor of Respiratory Medicine at University College London (UCL), UK, and Helen Reddel, Research Leader at the Woolcock Institute of Medical Research, Sydney, Australia, emphasised the necessity of addressing environmentally sustainable respiratory care while prioritising patient outcomes. Christine Jenkins, Clinical Professor of Respiratory Medicine at the University of New South Wales (UNSW), Sydney, Australia, discussed the association between health inequity and uncontrolled chronic obstructive pulmonary disease (COPD) and asthma, and how that relates to the carbon footprint of treatment. Alberto Papi, Full Professor of Respiratory Medicine at the University of Ferrara, Italy, examined how implementing evidence-based guidelines can improve patient outcomes and reduce the carbon footprint of respiratory care, and the progress being made in the transition to near-zero propellants in pressurised metered-dose inhaler (pMDI) devices. Omar Usmani, Professor of Respiratory Medicine at the National Heart and Lung Institute (NHLI), Imperial College London, UK, stressed that pMDIs contain essential medicines, and inhaler regimens should not be considered readily interchangeable. He urged the respiratory community to ensure that their voice is heard in decisions where it relates to the environment regarding COPD and asthma care. The symposium emphasised the opportunities to reduce the environmental impact of respiratory care whilst prioritising patient outcomes. By supporting the transition to climate-friendly propellants in pMDI devices, and implementing guidelines to improve patient outcomes, the overall carbon footprint of respiratory care can be reduced. However, this must be done without limiting access to essential medicines, or increasing adverse health outcomes. The symposium identified pathways towards achieving patient-centric, sustainable respiratory care by improving outcomes, harnessing innovation, and promoting multi-stakeholder collaboration.","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"8 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135268160","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":"Review of the European Respiratory Society (ERS) International Congress 2023","authors":"None EMJ","doi":"10.33590/emjrespir/10304133","DOIUrl":"https://doi.org/10.33590/emjrespir/10304133","url":null,"abstract":"","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"4 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267554","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":"Deep Learning-Based Quantification of Traction Bronchiectasis Severity For Predicting Outcome in Idiopathic Pulmonary Fibrosis","authors":"F. Felder, Y. Nan, G. Yang, J. Mackintosh, L. Calandriello, N. Goh, P. Hopkins, Y. Moodley, P. Reynolds, T. Corte, V. Navaratnam, S. Walsh","doi":"10.33590/emjrespir/10307156","DOIUrl":"https://doi.org/10.33590/emjrespir/10307156","url":null,"abstract":"","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"6 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267546","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":"Chronic Obstructive Pulmonary Disease: Biofilm Mediated Exacerbation and Innovative Therapeutic Approaches","authors":"Irene Berger, Adina Kagan, Rebecca Bock, Zvi G. Loewy","doi":"10.33590/emjrespir/10305099","DOIUrl":"https://doi.org/10.33590/emjrespir/10305099","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is a leading cause of death. The prevalence of the disease and associated mortality continue to increase. Bacterial and viral infections are responsible for the transition of the disease to more severe stages, resulting in COPD exacerbation. Biofilms, communities of micro-organisms that contribute to COPD exacerbation, pose a formidable challenge for effective pharmacotherapy. This review focuses on the development of biofilms, and approaches to inhibit and eradicate biofilms.","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"47 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267104","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":"The Clinical Presentation of Tuberculosis in English Primary Care","authors":"Farah Kidy, Shamil Haroon","doi":"10.33590/emjrespir/10301471","DOIUrl":"https://doi.org/10.33590/emjrespir/10301471","url":null,"abstract":"Respiratory 3 Mins 24th October Deep Learning-Based Quantification of Traction Bronchiectasis Severity For Predicting Outcome in Idiopathic Pulmonary Fibrosis","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"59 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267734","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":"Breathing New Life Into Acute Respiratory Care: Proactively Improving Long-Term Outcomes","authors":"Rachel Danks","doi":"10.33590/emjrespir/10305242","DOIUrl":"https://doi.org/10.33590/emjrespir/10305242","url":null,"abstract":"Admissions due to asthma contribute substantially to the burden faced by emergency departments (ED) worldwide, with a considerable impact arising from the high number of readmissions among patients with severe asthma. Repeated ED readmittance not only places considerable demand on healthcare resources, but also increases the humanistic burden on patients through reduced lung function, decreased quality of life, and increased exposure to systemic corticosteroids (SCS) and oral corticosteroids (OCS). In addition, patients are subject to the increased morbidity and mortality risk, and quality of life deficit associated with repeated asthma exacerbations. Admission to the ED should be seen as an opportunity to break this readmission cycle and prevent further admissions, while offering patient-centric benefits, such as investigation into the underlying causes of disease, and optimisation of care to prevent further exacerbations. Actions that require no additional resource may be taken directly in the ED, including biomarker tests among routine blood tests, or teaching inhaler technique as part of patient education and safety-netting. In addition, patient discharge may be considered as an opportunity for improving guidance implementation and breaking the cycle of readmission. Unlike emergency cardiac care, where >90% of patients are discharged on secondary prevention drugs and 85% of patients are referred to follow-up rehabilitation, guidelines for care following an ED visit for asthma are not always followed. Furthermore, current tools designed to accelerate specialist referral are not always rigorously implemented following an ED visit, meaning that follow-up may be delayed. Finally, further efforts should be made to identify high-risk patients in the community earlier in the disease pathway, allowing timely intervention before further lung function impairment, or the onset of adverse events due to OCS over-exposure. This article summarises an AstraZeneca-sponsored symposium delivered on 12th September 2023, as part of the European Respiratory Society (ERS) International Congress in Milan, Italy. The faculty, consisting of David Price, Head of the Observational and Pragmatic Research Institute, Singapore; Mona Al-Ahmad, Consultant Allergist and Clinical Immunologist at the Ministry of Health in Kuwait; and Mohit Bhutani, Professor of Medicine at the University of Alberta, Edmonton, Canada, each gave a brief presentation on proactive strategies to improve long-term outcomes in acute respiratory care. During panel discussions following each presentation, Anne Marie Marley, Respiratory Nurse Consultant from Belfast Health and Social Care Trust, UK, provided examples of implementing transition of care by bridging hospital and community care settings.","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"30 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135267945","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":"Shaping the Future in Rare Lung Diseases: From Imaging to Patient Management","authors":"Nicola Humphry","doi":"10.33590/emjrespir/10304494","DOIUrl":"https://doi.org/10.33590/emjrespir/10304494","url":null,"abstract":"This symposium was held during the 2023 European Respiratory Society (ERS) International Congress in Milan, Italy. The main objective was to discuss unmet needs in the diagnosis and management of rare lung diseases, with a particular emphasis on alpha 1 antitrypsin deficiency (AATD) and idiopathic pulmonary fibrosis (IPF). Presentations focused on promising approaches to meet these needs, including the feasibility of genomic diagnosis, the development of improved biomarkers of disease progression, such as quantitative CT and novel blood biomarkers, the use of digital lung auscultation, and increased screening for AATD in vulnerable populations. The overarching message from the symposium was that advancements in technology, multidisciplinary collaboration, and partnerships between academic institutions, patient associations, and industry are crucial to the continued improvement of patient management in rare diseases, and that the education of healthcare professionals is vital to enhance the understanding and awareness of these conditions.","PeriodicalId":93286,"journal":{"name":"European medical journal. Respiratory","volume":"8 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135268156","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}