Expert review of respiratory medicine最新文献

Home-based pulmonary rehabilitation and health coaching in fibrotic interstitial lung disease: a perspective on current evidence and future directions. 纤维化间质性肺疾病的家庭肺康复和健康指导：当前证据和未来方向的观点

Expert review of respiratory medicine Pub Date : 2025-07-24 DOI: 10.1080/17476348.2025.2539540

Teng Moua, Roberto Benzo

{"title":"Home-based pulmonary rehabilitation and health coaching in fibrotic interstitial lung disease: a perspective on current evidence and future directions.","authors":"Teng Moua, Roberto Benzo","doi":"10.1080/17476348.2025.2539540","DOIUrl":"https://doi.org/10.1080/17476348.2025.2539540","url":null,"abstract":"Introduction: The fibrotic interstitial lung diseases ;(f-ILD) are often progressive and debilitating lung diseases with significant symptom burden and impaired quality of life. Pulmonary rehabilitation (PR) has demonstrated improvements in dyspnea, physical function, and respiratory-related quality of life (RR-QoL) in patients with -f-ILD but had limited uptake and completion in real-world settings.Areas covered: A literature review was completed on the impact and limitations of traditional PR in f-ILD, with additional perspective on the use of home-based approaches and implementation of health coaching. Barriers to traditional center-based PR programs include patient and systems-based factors such as unawareness of benefit, emotional or psychological distress, and limited access. Home-based PR may address these limitations by removing travel barriers, increasing access with remote supervision and monitoring, and promoting social support by connecting care with familiar settings. Studies involving home-based PR in ILD have shown promise with improving functional and quality of life outcomes and high compliance rates. Health coaching is a collaborative paradigm for fostering behavior change and has demonstrated positive impact in the management of chronic diseases.Expert opinion: A combination of health coaching with home-based PR may address ongoing challenges of PR uptake and compliance as well as expand PR as a holistic and comprehensive intervention.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700745","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

Clinical perspective on non-sleepy obstructive sleep apnea; to treat or not to treat? 非困倦性阻塞性睡眠呼吸暂停的临床观察治疗还是不治疗？

Expert review of respiratory medicine Pub Date : 2025-07-24 DOI: 10.1080/17476348.2025.2539542

Steven Luu, Budhima Nanayakkara, Brendon J Yee

{"title":"Clinical perspective on non-sleepy obstructive sleep apnea; to treat or not to treat?","authors":"Steven Luu, Budhima Nanayakkara, Brendon J Yee","doi":"10.1080/17476348.2025.2539542","DOIUrl":"https://doi.org/10.1080/17476348.2025.2539542","url":null,"abstract":"Introduction: Excessive daytime sleepiness has traditionally been regarded as the hallmark symptom of obstructive sleep apnea (OSA), yet nearly half of individuals with OSA do not report significant sleepiness. While treatments are well established for sleepy patients, their role in non-sleepy individuals remains relatively underexplored.Areas covered: This review discusses the limitations of current tools used to measure sleepiness, evaluates the evidence for various treatment options for OSA in non-sleepy populations, and outlines key considerations for shared decision-making. We examine noninvasive therapies including positive airway pressure (PAP), oral appliance therapy, and weight loss interventions only.Expert opinion: Randomized controlled trials have not demonstrated cardiometabolic benefits of PAP therapy in non-sleepy individuals with OSA, though these studies are limited by poor PAP adherence and imprecise tools for identifying high-risk patients. As such, a pragmatic trial of PAP may be a reasonable strategy in non-sleepy people with moderate-to-severe OSA, cardiovascular comorbidities, or other OSA-related complications; provided patients are counseled about the challenges of adherence and the uncertain benefits in this population. Looking ahead, management of non-sleepy OSA will likely be guided by individualized, risk-based approaches incorporating physiological endotyping, objective biomarkers of cardiovascular risk, and patient preferences.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700744","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

An updated guide for clinicians: extracorporeal membrane oxygenation for pediatric patients with refractory acute respiratory failure. 临床医生更新指南：难治性急性呼吸衰竭患儿体外膜氧合。

Expert review of respiratory medicine Pub Date : 2025-07-24 DOI: 10.1080/17476348.2025.2536887

Makenzie Hamilton, Marybeth Burriss-West, Desiree Bonadonna, Caroline P Ozment, Kyle J Rehder

{"title":"An updated guide for clinicians: extracorporeal membrane oxygenation for pediatric patients with refractory acute respiratory failure.","authors":"Makenzie Hamilton, Marybeth Burriss-West, Desiree Bonadonna, Caroline P Ozment, Kyle J Rehder","doi":"10.1080/17476348.2025.2536887","DOIUrl":"10.1080/17476348.2025.2536887","url":null,"abstract":"Introduction: Extracorporeal membrane oxygenation (ECMO) remains a mainstay for refractory respiratory failure in select pediatric patients. Clinical practice surrounding its use continues to evolve, reflecting advances in technology, management strategies, and patient selection. Ongoing research and innovation are actively shaping VV-ECMO's future directions aimed at optimizing outcomes and increasing understanding of best practices.Areas covered: This review summarizes the fundamental concepts of VV-ECMO and highlights established practices and ongoing questions with a focus on indications/contraindications, cannulation, ventilator management, anticoagulation, fluid management, and weaning/decannulation. We also examine recent advancements and emerging technologies that are shaping the evolution of pediatric ECMO therapy. Narrative literature review of the PubMed central database was utilized to help inform this review.Expert opinion: Despite recent progress in pediatric VV-ECMO, substantial gaps remain in understanding optimal practices. And while there are many promising advances, there is a need for high-quality, collaborative research to further define best practices and guide ongoing future improvements for this life-sustaining therapy.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669143","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

Asthma and COPD overlap: a challenging relationship. 哮喘和慢性阻塞性肺病重叠：一个具有挑战性的关系。

Expert review of respiratory medicine Pub Date : 2025-07-22 DOI: 10.1080/17476348.2025.2538276

José Luis Lopez-Campos, Belen Muñoz-Sanchez, Esther Quintana-Gallego

引用次数: 0

Effect of resilience and clinical profile in admitted to lung biopsy patients: a cross-sectional and follow-up study. 住院肺活检患者恢复力和临床特征的影响：一项横断面和随访研究。

Expert review of respiratory medicine Pub Date : 2025-07-22 DOI: 10.1080/17476348.2025.2538277

Alejandro Heredia Ciuró, Ana Belén Gámiz Molina, Julia Raya Benítez, Geraldine Valenza-Peña, María Granados Santiago, Laura López López, Marie Carmen Valenza

{"title":"Effect of resilience and clinical profile in admitted to lung biopsy patients: a cross-sectional and follow-up study.","authors":"Alejandro Heredia Ciuró, Ana Belén Gámiz Molina, Julia Raya Benítez, Geraldine Valenza-Peña, María Granados Santiago, Laura López López, Marie Carmen Valenza","doi":"10.1080/17476348.2025.2538277","DOIUrl":"https://doi.org/10.1080/17476348.2025.2538277","url":null,"abstract":"Background: Early diagnosis of lung cancer is crucial due to often delayed symptoms. While resilience helps patients cope with treatment, its impact on symptom severity and quality of life at diagnosis is not well understood. This study explores how resilience at diagnosis may affect clinical progression in lung cancer patients.Research design and methods: This observational study with a 3-month follow-up included 95 patients admitted for lung biopsy. Participants were classified based on the Brief Resilience Scale (low resilience < 3.00). Main variables included symptom severity, functional status, and health-related quality of life. Patients were assessed at the time of biopsy and again at 3 months.Results: The 34.73% of patients presented low resilience and the 65.26% good resilience. Patients with low resilience presented significantly more respiratory symptoms (p < 0.001), and sleep disturbances (p = 0.05), added to poorer functionality and quality of life (p < 0.001) than those with good resilience. Three months after the biopsy, the good resilience group kept showing lower symptom severity (p < 0.05), better functionality (p < 0.001) and quality of life (p < 0.001) than low resilience patients.Conclusion: Resilience appears to play a protective role in the clinical course of lung cancer and may be a valuable factor to consider in patient management strategies.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692829","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

Economic burdens of pediatric asthma in low and middle-income countries. 低收入和中等收入国家儿童哮喘的经济负担。

Expert review of respiratory medicine Pub Date : 2025-07-22 DOI: 10.1080/17476348.2025.2536886

Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño, Jefferson Antonio Buendia

{"title":"Economic burdens of pediatric asthma in low and middle-income countries.","authors":"Carlos E Rodriguez-Martinez, Monica P Sossa-Briceño, Jefferson Antonio Buendia","doi":"10.1080/17476348.2025.2536886","DOIUrl":"10.1080/17476348.2025.2536886","url":null,"abstract":"Introduction: Childhood asthma is a significant public health challenge in low- and middle-income countries (LMICs), with a high clinical and economic burden due to increased mortality, disability, and healthcare costs. Although numerous studies have been published assessing the economic burden of childhood asthma, most of these studies have focused on the financial burden of asthma in high-income countries.Areas covered: This narrative review aims to identify studies that report the economic burden of childhood asthma in LMICs. We extracted the reported asthma-related costs, the type of institution where the study was conducted, the method of cost calculation, the proportion of direct costs to total costs, the leading direct cost items, and the main cost drivers, if reported, from the identified studies.Expert opinion: This review highlights the high economic cost of childhood asthma in LMICs and provides an opportunity to rethink asthma management. Future strategies should prioritize prevention, ensure universal access to medicines, and incorporate cost assessment. A more proactive and integrated approach, combining a substantial primary care infrastructure, digital health interventions, and financial protection mechanisms, is crucial to reducing the economic burden of asthma and improving health outcomes for children in LMICs.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669144","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

Pneumonitis induced by immune checkpoint inhibitors: a systematic review. 免疫检查点抑制剂诱导的肺炎：一项系统综述。

Expert review of respiratory medicine Pub Date : 2025-07-22 DOI: 10.1080/17476348.2025.2538273

Ana Casal, Virginia Leiro, Laura Villar, Manuel Casal-Guisande, Cristina Pou, Mar Mosteiro, Maribel Botana, Tamara Lourido, María Castro, María Torres, Alberto Fernández-Villar

{"title":"Pneumonitis induced by immune checkpoint inhibitors: a systematic review.","authors":"Ana Casal, Virginia Leiro, Laura Villar, Manuel Casal-Guisande, Cristina Pou, Mar Mosteiro, Maribel Botana, Tamara Lourido, María Castro, María Torres, Alberto Fernández-Villar","doi":"10.1080/17476348.2025.2538273","DOIUrl":"https://doi.org/10.1080/17476348.2025.2538273","url":null,"abstract":"Introduction: Pulmonary toxicity induced by immune checkpoint inhibitors (ICIs) has a variable incidence and a high index of suspicion is necessary in order to enable a timely approach. There are few studies on the actual epidemiology and specific outcomes of pulmonary toxicity associated with this treatment. The aim of this study is to assess the frequency, characteristics and outcomes of lung injury induced by ICIs.Methods: We conducted a systematic review applying predefined inclusion and exclusion criteria. A total of 7 studies were included.Results: ICI-induced pneumonitis is a relevant toxicity, with an incidence ranging from 1% to 7%. The risk is higher with anti-PD-1 than with anti-PD-L1 agents, with observed OR of 4.53 for Nivolumab, 3.56 for Pembrolizumab, 2.48 for Atezolizumab and 20.16 for Durvalumab. Pulmonary toxicity is more frequent in gastrointestinal, colorectal, breast, renal cancer and advanced-stage non-small cell lung cancer, particularly when histology is squamous, there is high PD-L1 expression and in patients without prior treatments.Conclusion: This systematic review provides an updated synthesis of the available evidence on ICI-associated pneumonitis, with particular attention to incidence, risk factors and progression. It contributes to outlining the profile of this adverse effect and identifying priority areas for future research.Prospero protocol registration identifier: CRD420251039825.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692830","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

Telerehabilitation in lung transplant recipients and candidates - an exploratory systematic review and meta-analysis. 肺移植受者和候选者的远程康复——一项探索性系统综述和荟萃分析。

Expert review of respiratory medicine Pub Date : 2025-07-20 DOI: 10.1080/17476348.2025.2535760

Ulas Ar, Ebru Calik Kutukcu, Melda Saglam

{"title":"Telerehabilitation in lung transplant recipients and candidates - an exploratory systematic review and meta-analysis.","authors":"Ulas Ar, Ebru Calik Kutukcu, Melda Saglam","doi":"10.1080/17476348.2025.2535760","DOIUrl":"10.1080/17476348.2025.2535760","url":null,"abstract":"Introduction: Lung transplant candidates (LTC) and recipients (LTR) frequently suffer from impaired exercise capacity and reduced quality of life. Telerehabilitation (TR) offers a viable alternative for patients with limited access to center-based rehabilitation.Methods: This systematic review assessed TR's clinical efficacy in LTC and LTR populations. Methods: Eligible trials were identified by searching the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus databases. Continuous data were extracted for relevant outcomes and analyzed using the RevMan software as the pooled mean difference (PMD) and 95%CI in a fixed-effect meta-analysis model.Results: Seven studies (n = 230; mean age = 54.2 years) were included. TR significantly improved 6-minute walk distance in LTR (PMD:65.78 m [5.15-126.42], p = 0.03, I² = 0%).The Duke Activity Status Index scores showed significant improvement in LTC and LTR (PMD:-11.98 [-17.99-5.97], p < 0.0001, I² = 83%).Conclusion: Several telerehabilitation trials have suggested potential benefits in improving exercise capacity, physical fitness, and quality of life in LTC and LTR, both before and after transplantation. However, the overall quality of the evidence remains low. Further research is needed to evaluate the impact of telerehabilitation on clinical outcomes, and feasibility, and cost-effectiveness of these rehabilitation delivery model in this population.Registration: The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO ID: CRD42022378573).","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639063","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

Vitamin D deficiency and severity of non-cystic fibrosis bronchiectasis: a systematic review. 维生素D缺乏与非囊性纤维化支气管扩张的严重程度：一项系统综述。

Expert review of respiratory medicine Pub Date : 2025-07-20 DOI: 10.1080/17476348.2025.2535764

Dafni Moriki, Despoina Koumpagioti, Michalis Kalogiannis, Maria Tsouprou, Konstantinos Douros

{"title":"Vitamin D deficiency and severity of non-cystic fibrosis bronchiectasis: a systematic review.","authors":"Dafni Moriki, Despoina Koumpagioti, Michalis Kalogiannis, Maria Tsouprou, Konstantinos Douros","doi":"10.1080/17476348.2025.2535764","DOIUrl":"10.1080/17476348.2025.2535764","url":null,"abstract":"Introduction: Vitamin D deficiency is common in cystic fibrosis (CF) and may be linked to disease severity. We aimed to investigate the association between vitamin D deficiency and severity in non-CF bronchiectasis.Methods: A systematic search of PubMed and Scopus (up to December 2024) identified relevant studies. After screening 170 articles, seven met the inclusion criteria. Study quality was assessed using NIH tools.Results: Patients with non-CF bronchiectasis had significantly lower serum 25-hydroxyvitamin D (25OHD) levels compared to healthy controls. In one study, median 25OHD was 24.7 nmol/L in patients vs. 45.3 nmol/L in controls. Another reported mean levels of 14.7 ± 9.6 ng/mL vs. 19.8 ± 6.9 ng/mL, respectively. Disease severity was assessed using validated and semi-structured measures, including the bronchiectasis severity index (BSI), number of exacerbations, pulmonary function tests (PFTs), radiological scores (Bhalla, modified Reiff), and health-related quality-of-life (HRQL) tools. Most studies reported worse severity outcomes in vitamin D-deficient patients.Conclusions: Although vitamin D deficiency appears to be associated with more severe non-CF bronchiectasis, heterogeneity between studies limits definitive conclusions. Future studies should incorporate standardized tools such as the eFACED score to better characterize disease severity.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639064","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

Hospital discharge protocol for patients with chronic obstructive pulmonary disease: expert consensus from India. 慢性阻塞性肺疾病患者的出院协议：来自印度的专家共识。

Expert review of respiratory medicine Pub Date : 2025-07-15 DOI: 10.1080/17476348.2025.2527963

Harjit Dumra, Sanjay Mittal, Devasahayam J Christopher, Sushmita Roy Chowdhury, Lancelot Pinto, P Arjun, Arjun Khanna

{"title":"Hospital discharge protocol for patients with chronic obstructive pulmonary disease: expert consensus from India.","authors":"Harjit Dumra, Sanjay Mittal, Devasahayam J Christopher, Sushmita Roy Chowdhury, Lancelot Pinto, P Arjun, Arjun Khanna","doi":"10.1080/17476348.2025.2527963","DOIUrl":"10.1080/17476348.2025.2527963","url":null,"abstract":"Introduction: Chronic obstructive pulmonary disorder (COPD) is a significant health challenge in India, mainly attributed to smoking, air pollution, and biomass fuel exposure. Severe COPD is associated with frequent hospitalization due to recurring exacerbations, leading to increased healthcare utilization and economic burden, and a higher risk of cardiovascular events and mortality. Preventing exacerbations is key to slowing disease progression, as each exacerbation worsens lung function and increases the risk of future exacerbations. Evidence suggests that implementing evidence-based discharge care bundles may reduce hospital readmissions and improve patient outcomes. A virtual advisory board meeting involving 7 leading experts from pulmonary medicine and cardiology specialties was convened in June 2024 to gain insights into the current unmet needs in managing COPD exacerbations, particularly focused on discharge protocols.Areas covered: Targeted, nonsystematic literature searches using MEDLINE databases focused on local or national discharge protocols/guidelines for COPD patients' post-exacerbation, their clinical implementation, and identified challenges and gaps encountered following hospital discharge.Expert opinion: The panel proposed a standardized COPD discharge protocol based on local clinical practices for uniform implementation and uptake across all healthcare settings in India. Experts recommended prioritizing the accessible and affordable interventions including smoking cessation, education of patients and caregivers, medication reconciliation, and referral to home-based pulmonary rehabilitation programs.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562412","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