Expert review of respiratory medicine最新文献_第3页

Strategies for preventing and reducing the impact of acute respiratory failure from pneumonia.

Expert review of respiratory medicine Pub Date : 2025-02-15 DOI: 10.1080/17476348.2025.2464880

Joon Yong Moon, Mohamad El Labban, Ognjen Gajic, Yewande Odeyemi

{"title":"Strategies for preventing and reducing the impact of acute respiratory failure from pneumonia.","authors":"Joon Yong Moon, Mohamad El Labban, Ognjen Gajic, Yewande Odeyemi","doi":"10.1080/17476348.2025.2464880","DOIUrl":"10.1080/17476348.2025.2464880","url":null,"abstract":"Introduction: Pneumonia remains a leading cause of morbidity and mortality, particularly in critically ill patients with acute respiratory failure (ARF). This review discusses prevention strategies for pneumonia-induced ARF, categorized into primary, secondary, and tertiary prevention.Areas covered: A literature search was conducted through PubMed covering the years 2000-2024, using the keywords 'acute respiratory failure,' pneumonia prevention,\" 'risk stratification,' and 'preventive strategies.' Primary prevention focuses on reducing pneumonia risk through vaccination, smoking cessation, and comorbidity management. Secondary prevention involves early detection, risk assessment using clinical tools like the Pneumonia Severity Index (PSI) biomarkers, such as procalcitonin and C-reactive protein, appropriate antibiotic use, and emerging machine learning tools for real-time stratification. Tertiary prevention focuses on optimizing care with noninvasive respiratory support, lung-protective ventilation strategies, and ventilator bundles for intubated patients. Emerging therapies, including targeted use of corticosteroids and other immunomodulatory agents, are also discussed as promising adjuncts to current standards of care.Expert opinion: While these prevention strategies show potential, continued research is necessary to refine these interventions, explore newer therapies and evaluate long-term outcomes. Implementation of these strategies aims to reduce the impact of pneumonia-induced ARF on healthcare systems and improve patient survival and quality of care.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-17"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416626","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

Thoracoabdominal normothermic regional perfusion in organ donation: a comprehensive review of current evidence and best practices.

Expert review of respiratory medicine Pub Date : 2025-02-12 DOI: 10.1080/17476348.2025.2464877

Kentaro Nakata, Matthew G Hartwig

引用次数: 0

Inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review and meta-analysis on mortality protection - making a long story short.

Expert review of respiratory medicine Pub Date : 2025-02-12 DOI: 10.1080/17476348.2025.2465853

Paola Rogliani, Gan Marco Manzetti, Shima Gholamalishahi, Mona Bafadhel, Luigino Calzetta

{"title":"Inhaled corticosteroids in chronic obstructive pulmonary disease: a systematic review and meta-analysis on mortality protection - making a long story short.","authors":"Paola Rogliani, Gan Marco Manzetti, Shima Gholamalishahi, Mona Bafadhel, Luigino Calzetta","doi":"10.1080/17476348.2025.2465853","DOIUrl":"10.1080/17476348.2025.2465853","url":null,"abstract":"Introduction: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality worldwide, primarily due to persistent airflow limitation from tobacco and biomass smoke exposure. While inhaled corticosteroids (ICS) combined with long-acting bronchodilators, namely long-acting β2-adrenoreceptor agonists (LABA) and long-acting muscarinic antagonists (LAMA), are recommended for symptom control and exacerbation reduction, their effect on mortality remains uncertain. Recent randomized controlled trials (RCTs) suggest potential mortality benefits with triple ICS/LABA/LAMA therapy, though findings are not definitive.Methods: We conducted a systematic review and network meta-analysis (NMA) to evaluate the impact of ICS-containing therapies on all-cause mortality in COPD. Searches were performed across ClinicalTrials.gov, Cochrane Library, EMBASE, MEDLINE, and SCOPUS, focusing on RCTs measuring mortality as an efficacy outcome.Results: A total of 42,784 COPD patients from five high-quality studies were included. Pairwise meta-analysis showed a significant reduction in all-cause mortality with ICS-containing therapies (RR 0.80, 95% CI 0.68-0.95), particularly with ICS/LABA and ICS/LABA/LAMA combinations. The NMA ranked ICS/LABA/LAMA as the most effective treatment (SUCRA 0.89).Conclusions: This study provides compelling evidence that ICS-containing therapies, particularly triple therapy, significantly reduce all-cause mortality in COPD patients. Future research should identify patient subgroups most likely to benefit while minimizing adverse effects.Registration: PROSPERO registration ID: CRD42024607568.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384612","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

Burden and regional disparities of chronic obstructive pulmonary disease in India: Insights from the global burden of disease data and projections for future incidence.

Expert review of respiratory medicine Pub Date : 2025-02-12 DOI: 10.1080/17476348.2025.2464882

Vijay Kumar, Mahendra Singh, Mahalaqua Nazli Khatib, Ashok Kumar Balaraman, Rangaswamy Roopashree, Mandeep Kaur, Manish Srivastava, Amit Barwal, G V Siva Prasad, Pranchal Rajput, Rukshar Syed, Gajendra Sharma, Sunil Kumar, Ganesh Bushi, Nagavalli Chilakam, Sakshi Pandey, Manvinder Brar, Rachana Mehta, Sanjit Sah, Muhammed Shabil, Abhay M Gaidhane

{"title":"Burden and regional disparities of chronic obstructive pulmonary disease in India: Insights from the global burden of disease data and projections for future incidence.","authors":"Vijay Kumar, Mahendra Singh, Mahalaqua Nazli Khatib, Ashok Kumar Balaraman, Rangaswamy Roopashree, Mandeep Kaur, Manish Srivastava, Amit Barwal, G V Siva Prasad, Pranchal Rajput, Rukshar Syed, Gajendra Sharma, Sunil Kumar, Ganesh Bushi, Nagavalli Chilakam, Sakshi Pandey, Manvinder Brar, Rachana Mehta, Sanjit Sah, Muhammed Shabil, Abhay M Gaidhane","doi":"10.1080/17476348.2025.2464882","DOIUrl":"10.1080/17476348.2025.2464882","url":null,"abstract":"Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality globally, particularly in low- and middle-income countries like India. This study aims to analyze regional trends and project future burden of COPD in India using data from the Global Burden of Disease (GBD) 1990-2021.Methods: This analysis utilized data from the GBD study to assess age-standardized prevalence (ASPR), incidence (ASIR), disability-adjusted life years (DALYs) (ASDR), and mortality rates (ASMR) for COPD across Indian states. Joinpoint regression was used to analyze temporal trends, while ARIMA models predicted future incidence rates.Results: In 2021, the highest ASIR was observed in Rajasthan at 306.28, and the highest ASMR was observed in Uttarakhand at 227.19. Projections suggest that the ASIR for COPD in India will decrease from 265.16 in 2022 to 258.19 by 2031. The heatmap analysis identified states like Uttarakhand and Rajasthan as having the highest DALYs attributable to COPD risk factors, including air pollution and tobacco use.Conclusion: COPD remains a public health challenge in India, with regional variability. Targeted interventions addressing air pollution, smoking cessation, and improved healthcare access are essential to mitigate the disease's future burden, particularly in high-risk regions.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367094","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

What is personalized lung poromechanical modeling and how can it improve the understanding and management of fibrotic interstitial lung diseases?

Expert review of respiratory medicine Pub Date : 2025-02-10 DOI: 10.1080/17476348.2025.2464886

Pierre-Yves Brillet, Alice Peyraut, Jean-François Bernaudin, Catalin Fetita, Hilario Nunes, Martin Genet

引用次数: 0

Challenges of symptom management in interstitial lung disease: dyspnea, cough, and fatigue. 间质性肺疾病症状管理的挑战：呼吸困难、咳嗽和疲劳。

Expert review of respiratory medicine Pub Date : 2025-02-01 Epub Date: 2025-01-15 DOI: 10.1080/17476348.2025.2453657

Amy Pascoe, Anne E Holland, Natasha Smallwood

{"title":"Challenges of symptom management in interstitial lung disease: dyspnea, cough, and fatigue.","authors":"Amy Pascoe, Anne E Holland, Natasha Smallwood","doi":"10.1080/17476348.2025.2453657","DOIUrl":"10.1080/17476348.2025.2453657","url":null,"abstract":"Introduction: Interstitial lung disease (ILD) is a broad group of conditions characterized by fibrosis of the lung parenchyma. Idiopathic pulmonary fibrosis (IPF) is the most common subvariant. IPF is marked by considerable symptom burden of dyspnea, cough and fatigue that is often refractory to optimal disease-directed treatment.Areas covered: In this narrative review, we searched MEDLINE for articles related to the current evidence regarding management of chronic dyspnea, cough, and fatigue as three of the most prevalent and distressing symptoms associated with IPF and other ILDs. Each symptom shares common features of multi-factorial etiology and a lack of safe and effective pharmacological therapies. Both corticosteroids and opioids have been utilized in this context, yet there is insufficient evidence of therapeutic benefit and considerable risk of harms. Whilst some may benefit from symptom-directed pharmacological management, usage must be carefully monitored. Use of non-pharmacological strategies, such as breathing techniques and speech therapy represent low risk and low-cost option, yet broader validation of these therapies' effectiveness is needed.Expert opinion: Symptom management in IPF and other ILDs requires an iterative and individualized approach. Leveraging the expertise of multidisciplinary teams within an integrated care setting is an important opportunity to maximize health outcomes.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"97-106"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974075","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

Photon-counting CT in lung imaging.

Expert review of respiratory medicine Pub Date : 2025-02-01 Epub Date: 2025-02-03 DOI: 10.1080/17476348.2025.2460601

Ádám Domonkos Tárnoki, Dávid László Tárnoki, Pál Maurovich-Horvat

引用次数: 0

Pulmonary function tests: an integrated approach to interpreting results in the search for treatable traits.

Expert review of respiratory medicine Pub Date : 2025-02-01 Epub Date: 2025-01-25 DOI: 10.1080/17476348.2025.2458607

Agnaldo José Lopes

{"title":"Pulmonary function tests: an integrated approach to interpreting results in the search for treatable traits.","authors":"Agnaldo José Lopes","doi":"10.1080/17476348.2025.2458607","DOIUrl":"10.1080/17476348.2025.2458607","url":null,"abstract":"Introduction: Technological advances have led to the proliferation of lung function assessment techniques beyond spirometry in most countries. At the same time, new knowledge of respiratory physiology has allowed an expansion of lung function parameters, requiring an integrated approach to interpreting results.Areas covered: This review addresses the major pulmonary function tests (PFTs) used in clinical practice, new concepts regarding reference values, and reformulations of terminology for defining standards of lung function impairment. It highlights the complexities and nuances inherent in the interpretation of PFT parameters, particularly in light of recent updates from the European Respiratory Society/American Thoracic Society.Expert opinion: In a new paradigm, PFTs should be used to classify the pathophysiology of treatable traits rather than to diagnose respiratory disease, given the considerable variation in the clinical patterns of PFTs. It is necessary to look not only at lung mechanics but also at lung volume, gas transfer, and small airway involvement to capture as much information as possible. In this context, it is also important to understand that racial/ethnic differences in lung function are not due to biological differences but may reflect socioeconomic status and represent health disparities.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"121-143"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043892","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

Roles of vitamins and nutrition in obstructive sleep apnea.

Expert review of respiratory medicine Pub Date : 2025-02-01 Epub Date: 2025-02-06 DOI: 10.1080/17476348.2025.2462192

Kostas Archontogeorgis, Evangelia Nena, Paschalis Steiropoulos

{"title":"Roles of vitamins and nutrition in obstructive sleep apnea.","authors":"Kostas Archontogeorgis, Evangelia Nena, Paschalis Steiropoulos","doi":"10.1080/17476348.2025.2462192","DOIUrl":"10.1080/17476348.2025.2462192","url":null,"abstract":"Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder, with a prevalence that rises alongside with the increasing prevalence of obesity. OSA is characterized by a low-inflammatory state and is followed by cardiovascular and metabolic sequelae. Continuous positive airway pressure (CPAP) represents the cornerstone of treatment for severe OSA. However, poor compliance with CPAP treatment renders OSA treatment a challenging venture. Weight loss and exercise are recommended as adjunctive treatment options for OSA. Several diets have proven to facilitate weight loss, and to alleviate the inflammatory status in patients with OSA. Moreover, several vitamins exhibit antioxidant properties that beneficially affect OSA pathology and reduce the risk of cardiovascular complications.Area covered: This narrative review aims to summarize the current knowledge regarding the effect of nutrition and vitamin deficiencies on OSA. Included were publications, relevant to the topic, with different types of design (i.e. cross-sectional studies, cohort studies, clinical trials, systematic reviews, meta-analyses, etc.) and indexed in PubMed database until 31 March 2024.Expert opinion: In addition to weight loss, other food components, such as proteins, carbohydrates, anti-inflammatory agents, vitamins A, B, C, D, E, and sodium, may play a beneficial role in the incidence and severity of OSA.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"145-163"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076776","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 usefulness of the forced oscillation technique in the diagnosis of bronchial asthma in seniors.

Expert review of respiratory medicine Pub Date : 2025-02-01 Epub Date: 2025-02-02 DOI: 10.1080/17476348.2025.2461229

Martyna Miodońska, Andrzej Bożek, Ewa Urbaniec, Aleksandra Mitka, Eliza Wasilewska

{"title":"The usefulness of the forced oscillation technique in the diagnosis of bronchial asthma in seniors.","authors":"Martyna Miodońska, Andrzej Bożek, Ewa Urbaniec, Aleksandra Mitka, Eliza Wasilewska","doi":"10.1080/17476348.2025.2461229","DOIUrl":"10.1080/17476348.2025.2461229","url":null,"abstract":"Background: Obstructive pulmonary diseases are common in the elderly but often remain underdiagnosed due to limited spirometry availability or challenges with patient cooperation during testing. This study evaluated the potential of the forced oscillation technique (FOT) as a diagnostic tool for bronchial asthma in individuals over 60 years old.Research design and methods: A total of 189 patients diagnosed with asthma after age 60 and a control group of nonasthmatic seniors were included. Participants underwent spirometry, FOT, and bronchial reversibility testing using both methods. The primary outcomes were correlations between positive results from resting spirometry and FOT in asthmatics and the agreement between reversibility test results across the two methods.Results: FOT parameters (FEV1, V5, R5) effectively distinguished asthmatics from nonasthmatics. Positive reversibility test results were observed in 71 (73.2%) patients using FOT and 68 (70.1%) using spirometry, with both methods aligning in 64 (66%) cases.Conclusion: These results highlight the value of FOT, particularly for bronchial reversibility testing, in improving asthma diagnosis in seniors. FOT offers a practical alternative for patients who face difficulties performing spirometry, addressing a critical need in this population.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"175-182"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082964","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