Expert review of respiratory medicine最新文献_第2页

Antibiotics at life's end: key role in treating end-of-life pneumonia? 生命终结时的抗生素：治疗临终肺炎的关键作用？

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-19 DOI: 10.1080/17476348.2025.2479613

Thibaut Fraisse, Alain Putot, Emmanuel Forestier, Gaëtan Gavazzi, Petra Vayne-Bossert, Claire Roubaud-Baudron, Virginie Prendki

{"title":"Antibiotics at life's end: key role in treating end-of-life pneumonia?","authors":"Thibaut Fraisse, Alain Putot, Emmanuel Forestier, Gaëtan Gavazzi, Petra Vayne-Bossert, Claire Roubaud-Baudron, Virginie Prendki","doi":"10.1080/17476348.2025.2479613","DOIUrl":"10.1080/17476348.2025.2479613","url":null,"abstract":"Introduction: Pneumonia is a common occurrence at the end of life (EOL). However, clear definitions and consensual guidelines for managing this condition are lacking. Diagnosing EOL pneumonia and deciding whether to treat it with antibiotics can be challenging.Area covered: This special report provides a narrative review of epidemiological data, diagnostic tools for EOL pneumonia, guidance on antibiotic use, and ethical considerations in this context. Literature from 2000 to 2024 was analyzed using PubMed and Cochrane databases.Expert opinion: At the EOL, respiratory symptoms must be managed to improve patients' quality of life. Bacterial pneumonia can be difficult to diagnose, and the benefits of antibiotics on respiratory symptoms remain uncertain. At an individual level, adverse events may impact EOL quality, while at a population level, overprescribing antibiotics contributes to antimicrobial resistance. A multidisciplinary approach is therefore essential. Treatment goals should be established with the patient or their healthcare representative. If antibiotics are prescribed, they should be initiated for a limited duration with daily reassessments. If the set goals are not achieved or if adverse events occur, antibiotics should be discontinued. Palliative care measures should also be introduced as early as possible.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"279-286"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627243","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

Viral community-acquired pneumonia: what's new since COVID-19 emerged?

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-19 DOI: 10.1080/17476348.2025.2479611

Catia Cilloniz, Alejandro J Videla, Laura Pulido, Mary Joy Uy-King

{"title":"Viral community-acquired pneumonia: what's new since COVID-19 emerged?","authors":"Catia Cilloniz, Alejandro J Videla, Laura Pulido, Mary Joy Uy-King","doi":"10.1080/17476348.2025.2479611","DOIUrl":"10.1080/17476348.2025.2479611","url":null,"abstract":"Introduction: All over the world, viral pneumonia has a significant impact on morbidity and mortality, especially among vulnerable populations. The most common respiratory viruses causing pneumonia include influenza virus, respiratory syncytial virus, adenoviruses and rhinovirus. The COVID-19 pandemic has changed the landscape of viral pneumonia and has reshaped our understanding of the role of viruses in this disease. We are now more aware of the importance of early diagnosis, the impact of co-infections, the effects of viral variants, and the long-term consequences of post-viral pneumonia.Areas covered: We discuss the latest scientific evidence regarding epidemiology, diagnosis, treatment, and prevention of viral pneumonia. This review summarizes findings from a PubMed search on respiratory viruses in community-acquired pneumonia.Expert opinion: Our experience during the COVID-19 pandemic has changed our perspective on respiratory viruses and their role in viral pneumonia. Diagnostic advances have been made, co-infections have received greater recognition, immune responses to viral infections are better understood, and approaches to treating viral pneumonia have expanded. Despite this progress, however, research on the impact of respiratory viruses on pneumonia must continue to pursue the development of new antivirals and vaccines, and investigate the long-term sequelae, especially in cases of severe viral pneumonia.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"347-362"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618094","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

The prognostic role of lung ultrasound in hospitalised patients with COVID-19. Correlation with chest CT findings and clinical markers of severity.

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-02-27 DOI: 10.1080/17476348.2025.2471776

Ioannis Tomos, Elvira Markela Antonogiannaki, Konstantina Dimakopoulou, Thomas Raptakis, Vasiliki Apollonatou, Maria Kallieri, Stylianos Argentos, Stefanos Lampadakis, Myrto Blizou, Antonis Krouskos, Anna Karakatsani, Effrosyni Manali, Stylianos Loukides, Spyros Papiris

{"title":"The prognostic role of lung ultrasound in hospitalised patients with COVID-19. Correlation with chest CT findings and clinical markers of severity.","authors":"Ioannis Tomos, Elvira Markela Antonogiannaki, Konstantina Dimakopoulou, Thomas Raptakis, Vasiliki Apollonatou, Maria Kallieri, Stylianos Argentos, Stefanos Lampadakis, Myrto Blizou, Antonis Krouskos, Anna Karakatsani, Effrosyni Manali, Stylianos Loukides, Spyros Papiris","doi":"10.1080/17476348.2025.2471776","DOIUrl":"10.1080/17476348.2025.2471776","url":null,"abstract":"Background: The use of lung ultrasound (LUS) has recently become vital in the diagnosis and prognosis of various respiratory diseases. Its role in COVID-19 requires further investigation.Research design and methods: Twenty-five consecutive, non-ICU hospitalized COVID-19 patients were included. LUS was performed on admission and sequentially every 3 days at 8 points in the chest. Based on the LUS findings a score was designed. Logarithmic regression models and ROC curve analysis were applied.Results: A statistically significant positive correlation was found between LUS score at admission and the severity of SARS-COV-2 infection. Higher LUS score was significantly associated with lower PaO2/FiO2 ratio, use of HFNC, longer hospitalization and greater extent of chest CT infiltrates. A significant association between LUS score and risk of death or intubation or HFNC was found. For one point of increase in the score, risk of death or intubation or HFNC increased 1.93-fold (95% CI 1.02 to 3.65). The predictive role of the score was very satisfactory (area under the ROC curve = 0.87).Conclusions: Lung ultrasound findings were significantly positively associated with clinical and radiological markers of severity of SARS-CoV-2 pneumonia. It therefore constitutes a promising and reliable technique for assessing pneumonia, comparable to chest CT.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"363-370"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506652","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

Treatment of nontuberculous mycobacterial pulmonary disease requires a stepwise and multidisciplinary approach.

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-24 DOI: 10.1080/17476348.2025.2479615

Arthur Lemson, Arjan van Laarhoven, Lisa Kurver, Ralf Stemkens, Rob Aarnoutse, Martin Boeree, Jakko van Ingen, Wouter Hoefsloot

{"title":"Treatment of nontuberculous mycobacterial pulmonary disease requires a stepwise and multidisciplinary approach.","authors":"Arthur Lemson, Arjan van Laarhoven, Lisa Kurver, Ralf Stemkens, Rob Aarnoutse, Martin Boeree, Jakko van Ingen, Wouter Hoefsloot","doi":"10.1080/17476348.2025.2479615","DOIUrl":"10.1080/17476348.2025.2479615","url":null,"abstract":"Introduction: Nontuberculous mycobacterial pulmonary disease (NTM-PD) occurs in people with inborn or acquired susceptibility factors. Current treatment guideline recommendations include a watchful waiting strategy, antimycobacterial and surgical treatment, with a comprehensive assessment of clinical, microbiological, and radiological factors determining which approach is most suitable.Areas covered: Treatment outcomes in NTM-PD are unsatisfactory with culture conversion rates varying from 30 to 80% and recurrence rates up to 50%. Possible explanations include our insufficient knowledge and management of host susceptibility factors, poor guideline adherence by physicians, frequent adverse drug reactions demanding premature discontinuation, inadequate drug exposures due to both drug-drug interactions and inter-patient variability in pharmacokinetics, and a lack of pharmacokinetics/pharmacodynamics targets.Expert opinion: We describe a stepwise approach to NTM-PD treatment, complementing existing guidelines, including recommendations for a multidisciplinary assessment, classification of disease severity, personalized supportive care, antimycobacterial treatment, adjuvant surgery, and host-directed therapies. The recommendations are informed by PubMed literature and the authors' clinical expertise. Recognizing that our experience is shaped within a specialized reference clinic, we acknowledge that some of these recommendations may not be applicable in all settings.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"287-299"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672055","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

Current insights into the clinico-pathologic characteristics of lung cancer in women.

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-07 DOI: 10.1080/17476348.2025.2475974

Anna Trojnar, Joanna Domagała-Kulawik

引用次数: 0

Management options for excessive daytime sleepiness in patients with obstructive sleep apnea.

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-20 DOI: 10.1080/17476348.2025.2479614

Maria R Bonsignore, Francesco Fanfulla, Pietro Ingrao, Simone Lombardo, Pasquale Tondo, Vanessa Lo Nano, Carolina Lombardi

{"title":"Management options for excessive daytime sleepiness in patients with obstructive sleep apnea.","authors":"Maria R Bonsignore, Francesco Fanfulla, Pietro Ingrao, Simone Lombardo, Pasquale Tondo, Vanessa Lo Nano, Carolina Lombardi","doi":"10.1080/17476348.2025.2479614","DOIUrl":"10.1080/17476348.2025.2479614","url":null,"abstract":"Introduction: Excessive daytime sleepiness (EDS) is a symptom of obstructive sleep apnea (OSA) associated with the risk of accidents at work or while driving. OSA treatment decreases EDS, but some patients remain sleepy despite optimal control of OSA. Patients who do not tolerate or refuse OSA treatment may be symptomatically treated for EDS. Solriamfetol and pitolisant are wake-promoting agents (WPA) recently approved for use in sleepy OSA patients accepting or refusing OSA treatment.Areas covered: This narrative review provides updated information on: how to assess EDS in OSA patients, epidemiology, and management of residual EDS in treated OSA patients and the results of recent studies using new WPAs in patients accepting or refusing CPAP treatment. Literature was accessed from PubMed between 1 December 2024 and 6 January 2025.Expert opinion: The new WPAs are useful drugs with a favorable safety profile to be included as a possible therapeutic option for sleepy OSA patients. However, it is still uncertain which subgroups of patients should be treated for the symptom of EDS while maintaining a low-risk profile in terms of the consequences of OSA on health. Until such data is available, use of WPA in OSA patients should be managed by Sleep Specialists.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"325-345"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660069","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

Comparison of effectiveness and safety between baricitinib and tocilizumab in severe COVID-19: a retrospective study.

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-04 DOI: 10.1080/17476348.2025.2473486

Ioannis Tomos, Ioannis Grigoropoulos, Chrysavgi Kosti, Serafeim Chrysikos, Antonia Digalaki, Konstantinos Thomas, Georgios Hillas, Pinelopi Kazakou, Anastasia Antoniadou, Dimitra Kavatha, Katerina Dimakou

{"title":"Comparison of effectiveness and safety between baricitinib and tocilizumab in severe COVID-19: a retrospective study.","authors":"Ioannis Tomos, Ioannis Grigoropoulos, Chrysavgi Kosti, Serafeim Chrysikos, Antonia Digalaki, Konstantinos Thomas, Georgios Hillas, Pinelopi Kazakou, Anastasia Antoniadou, Dimitra Kavatha, Katerina Dimakou","doi":"10.1080/17476348.2025.2473486","DOIUrl":"10.1080/17476348.2025.2473486","url":null,"abstract":"Background: Immunomodulators tocilizumab and baricitinib have been used for the treatment of severe COVID-19, however, there are only few published studies comparing their efficacy.Research design and methods: All consecutive non-ICU hospitalized severe COVID-19 patients who received baricitinib or tocilizumab, were included retrospectively. Primary outcomes were mortality or intubation on day 14, time to oxygen therapy weaning and duration of hospitalization. Safety was measured as treatment-related adverse events.Results: 321 hospitalized patients with severe COVID-19 were included (mean age 62.4 years ± 14.7); 241 (75.1%) received baricitinib (mean age 64.2 years ± 15.2) and 80 (24.9%) tocilizumab (mean age 57.3 ± 11.7). Patients who received baricitinib presented significantly lower risk of mortality or intubation on day 14, compared to the tocilizumab group after adjusting for age, sex, vaccination, Charlson comorbidity index, body mass index, remdesivir administration and WHO ordinal scale at enrollment (OR: 0.42, 95% CI: 0.20-0.86). In the augmented inverse-probability weighting regression, the protective role of baricitinib remained statistically significant (OR: 0.76, 95% CI: 0.66-0.88). No difference in secondary bacterial infections was detected, but tocilizumab was associated with significant higher rate of liver injury (Odds Ratio, 95%CI, p < 0.001).Conclusions: Our study suggests survival and safety are significantly better for baricitinib compared to tocilizumab in severe COVID-19. Clinical randomized trials are needed for confirmation.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"389-397"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525573","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

Effects of household cleaning products on the lungs: an update.

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-14 DOI: 10.1080/17476348.2025.2478968

Emilie Pacheco Da Silva, Orianne Dumas, Nicole Le Moual

{"title":"Effects of household cleaning products on the lungs: an update.","authors":"Emilie Pacheco Da Silva, Orianne Dumas, Nicole Le Moual","doi":"10.1080/17476348.2025.2478968","DOIUrl":"10.1080/17476348.2025.2478968","url":null,"abstract":"Introduction: Household disinfectants and cleaning products (HDCPs), which involve a complex mixture of chemical ingredients, are commonly used in homes. HDCPs significantly contribute to chemical exposure in the indoor environment by releasing particles and volatile organic compounds while being used, potentially harming the respiratory health of those exposed.Areas covered: We provide an overview of scientific literature, especially from the last five years, regarding the (i) effects of using of HDCPs on adults' respiratory health; (ii) associations between prenatal or childhood exposure to HDCPs and children respiratory health. Finally, we discuss on standard and innovative methods of HDCP exposure assessment.Expert opinion: Recent literature provides further evidence on the harmful role of HDCPs on respiratory health in both adults and children. Exposure to HDCPs is a modifiable asthma risk factor that requires more consideration, in order to reduce asthma-related morbidity, and to improve and maintain an optimal control of the disease. Further research is essential to deepen the current knowledge, particularly by using innovative methods of exposure assessment to HDCPs, which could enhance the exposure characterization in both adults and children, and contribute to identify HDCP's chemical compounds leading to a risk for respiratory health.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"313-324"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627245","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

Elevated serum tumor-associated antigens in patients with interstitial lung disease: a retrospective study on clinical features and prognosis.

Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-06 DOI: 10.1080/17476348.2025.2473480

Yanling Ding, Yahong Chen, Ming Chen, Yi Liu, Nan Li, Yongchang Sun

{"title":"Elevated serum tumor-associated antigens in patients with interstitial lung disease: a retrospective study on clinical features and prognosis.","authors":"Yanling Ding, Yahong Chen, Ming Chen, Yi Liu, Nan Li, Yongchang Sun","doi":"10.1080/17476348.2025.2473480","DOIUrl":"10.1080/17476348.2025.2473480","url":null,"abstract":"Background: Elevated serum tumor-associated antigens (TAAs) were reported to be common in patients with interstitial lung disease (ILD) and correlated with pulmonary involvement or malignancy development. However, there were no adequate longitudinal studies on the association between elevated TAAs and various types of ILDs in Chinese patients.Research design and methods: The treatment-naïve ILD patients were retrospectively enrolled. The clinical, laboratory, imaging characteristics, and prognosis were analyzed and compared among those with normal and different number of elevated TAAs.Results: An increase of at least one TAA was present in 169/308 (54.87%) of our patients. Both baseline alveolar and interstitial scores were much higher, and lung involvement tended to be worse during follow-up in patients with two and three or more elevated TAAs than in normal TAAs. Patients with three or more elevated TAAs had the highest interstitial scores and a higher all-cause mortality during follow-up than those with one elevated TAA or normal TAAs. The occurrence of malignancy was similar in all patients.Conclusion: Elevated TAAs were present in 54.87% of ILD patients and associated with lung interstitial lesions, which might be a marker for lung involvement progression, while not for malignancy development in ILD.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"379-387"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517611","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 overview of patient-ventilator asynchrony in children.

Expert review of respiratory medicine Pub Date : 2025-03-31 DOI: 10.1080/17476348.2025.2487165

Benjamin Yoon, Robert Blokpoel, Chatila Ibn Hadj Hassine, Yukie Ito, Kevin Albert, Melissa Aczon, Martin C J Kneyber, Guillaume Emeriaud, Robinder G Khemani

{"title":"An overview of patient-ventilator asynchrony in children.","authors":"Benjamin Yoon, Robert Blokpoel, Chatila Ibn Hadj Hassine, Yukie Ito, Kevin Albert, Melissa Aczon, Martin C J Kneyber, Guillaume Emeriaud, Robinder G Khemani","doi":"10.1080/17476348.2025.2487165","DOIUrl":"https://doi.org/10.1080/17476348.2025.2487165","url":null,"abstract":"Introduction: Mechanically ventilated children often have patient-ventilator asynchrony (PVA). When a ventilated patient has spontaneous effort, the ventilator attempts to synchronize with the patient, but PVA represents a mismatch between patient respiratory effort and ventilator delivered breaths.Areas covered: This review will focus on subtypes of patient ventilator asynchrony, methods to detect or measure PVA, risk factors for and characteristics of patients with PVA subtypes, potential clinical implications, treatment or prevention strategies, and future areas for research. Throughout this review, we will provide pediatric specific considerations.Expert opinion: PVA in pediatric patients supported by mechanical ventilation occurs frequently and is understudied. Pediatric patients have unique physiologic and pathophysiologic characteristics which affect PVA. While recognition of PVA and its subtypes is important for bedside clinicians, the clinical implications and risks versus benefits of treatment targeted at reducing PVA remain unknown. Future research should focus on harmonizing PVA terminology, refinement of automated detection technologies, determining which forms of PVA are harmful, and development of PVA-specific ventilator interventions.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756891","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