Expert review of respiratory medicine最新文献_第7页

Targeting respiratory microbiomes in COPD and bronchiectasis. 针对慢性阻塞性肺病和支气管扩张症的呼吸道微生物组。

Expert review of respiratory medicine Pub Date : 2024-03-01 Epub Date: 2024-06-12 DOI: 10.1080/17476348.2024.2355155

Micheál Mac Aogáin, Pei Yee Tiew, Tavleen Kaur Jaggi, Jayanth Kumar Narayana, Shivani Singh, Philip M Hansbro, Leopoldo N Segal, Sanjay H Chotirmall

{"title":"Targeting respiratory microbiomes in COPD and bronchiectasis.","authors":"Micheál Mac Aogáin, Pei Yee Tiew, Tavleen Kaur Jaggi, Jayanth Kumar Narayana, Shivani Singh, Philip M Hansbro, Leopoldo N Segal, Sanjay H Chotirmall","doi":"10.1080/17476348.2024.2355155","DOIUrl":"10.1080/17476348.2024.2355155","url":null,"abstract":"Introduction: This review summarizes our current understanding of the respiratory microbiome in COPD and Bronchiectasis. We explore the interplay between microbial communities, host immune responses, disease pathology, and treatment outcomes.Areas covered: We detail the dynamics of the airway microbiome, its influence on chronic respiratory diseases, and analytical challenges. Relevant articles from PubMed and Medline (January 2010-March 2024) were retrieved and summarized. We examine clinical correlations of the microbiome in COPD and bronchiectasis, assessing how current therapies impact upon it. The potential of emerging immunotherapies, antiinflammatories and antimicrobial strategies is discussed, with focus on the pivotal role of commensal taxa in maintaining respiratory health and the promising avenue of microbiome remodeling for disease management.Expert opinion: Given the heterogeneity in microbiome composition and its pivotal role in disease development and progression, a shift toward microbiome-directed therapeutics is appealing. This transition, from traditional 'pathogencentric' diagnostic and treatment modalities to those acknowledging the microbiome, can be enabled by evolving crossdisciplinary platforms which have the potential to accelerate microbiome-based interventions into routine clinical practice. Bridging the gap between comprehensive microbiome analysis and clinical application, however, remains challenging, necessitating continued innovation in research, diagnostics, trials, and therapeutic development pipelines.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924129","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

Prone positioning in awake patients without ventilatory support does not alter major clinical outcomes in severe COVID-19: results from a retrospective observational cohort study, systematic review and meta-analysis. 在无通气支持的清醒患者中进行俯卧位不会改变重症 COVID-19 的主要临床结果：一项回顾性观察队列研究、系统回顾和荟萃分析的结果。

Expert review of respiratory medicine Pub Date : 2024-03-01 Epub Date: 2024-05-09 DOI: 10.1080/17476348.2024.2350587

Raíssa S Freire, Camila M S S Barros, Jefferson Valente, Cássia da Luz Goulart, Anna G R Santos, Fernando H Fonseca, Sabrina T Saenz, Andiana S Dias, Maria G A Rodrigues, Bernardo Maia Silva, Eduardo Fernandes, Nadia Cubas-Vega, Vanderson Sampaio, Mariana Simão, Djane Baía-da-Silva, Richard Severin, Guilherme Peixoto Tinoco Arêas, Roberta Lins Gonçalves, Renata Gonçalves Mendes, Flor E Martinez-Espinosa, Fernando Val

{"title":"Prone positioning in awake patients without ventilatory support does not alter major clinical outcomes in severe COVID-19: results from a retrospective observational cohort study, systematic review and meta-analysis.","authors":"Raíssa S Freire, Camila M S S Barros, Jefferson Valente, Cássia da Luz Goulart, Anna G R Santos, Fernando H Fonseca, Sabrina T Saenz, Andiana S Dias, Maria G A Rodrigues, Bernardo Maia Silva, Eduardo Fernandes, Nadia Cubas-Vega, Vanderson Sampaio, Mariana Simão, Djane Baía-da-Silva, Richard Severin, Guilherme Peixoto Tinoco Arêas, Roberta Lins Gonçalves, Renata Gonçalves Mendes, Flor E Martinez-Espinosa, Fernando Val","doi":"10.1080/17476348.2024.2350587","DOIUrl":"10.1080/17476348.2024.2350587","url":null,"abstract":"Objectives: During the Coronavirus disease (COVID-19) pandemic, clinicians recommended awake-prone positioning (APP) to avoid the worst outcomes. The objectives of this study were to investigate if APP reduces intubation, death rates, and hospital length of stay (HLOS) in acute COVID-19.Methods: We performed a retrospective cohort with non-mechanically ventilated patients hospitalized in a reference center in Manaus, Brazil, 2020. Participants were stratified into APP and awake-not-prone positioning (ANPP) groups. Also, we conducted a systematic review and performed a meta-analysis to understand if this intervention had different outcomes in resource-limited settings (PROSPERO CRD42023422452).Results: A total of 115 participants were allocated into the groups. There was no statistical difference between both groups regarding time to intubation (HR: 0.861; 95CI: 0.474-1.1562; p=0.622) and time to death (HR: 1.666; 95CI: 0.939-2.951; p=0.081). APP was not significantly associated with reduced HLOS. A total of 86 articles were included in the systematic review, of which 76 (88,3%) show similar findings after APP. Also, low/middle, and high-income countries were similar regarding such outcomes.Conclusion: APP in COVID-19 does not present clinical improvement that affects mortality, intubation rate and HLOS. The lack of a prone position protocol, obtained through a controlled study, is necessary. After 3 years, APP benefits are still inconclusive.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140875028","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

Imaging modalities during navigational bronchoscopy. 导航支气管镜检查期间的成像模式。

Expert review of respiratory medicine Pub Date : 2024-03-01 Epub Date: 2024-05-29 DOI: 10.1080/17476348.2024.2359601

Ramsy Abdelghani, Mohamed Omballi, David Abia-Trujillo, Ernesto Casillas, Regina Villalobos, Faraz Badar, Sandeep Bansal, Fayez Kheir

{"title":"Imaging modalities during navigational bronchoscopy.","authors":"Ramsy Abdelghani, Mohamed Omballi, David Abia-Trujillo, Ernesto Casillas, Regina Villalobos, Faraz Badar, Sandeep Bansal, Fayez Kheir","doi":"10.1080/17476348.2024.2359601","DOIUrl":"10.1080/17476348.2024.2359601","url":null,"abstract":"Introduction: Lung nodules are commonly encountered in clinical practice. Technological advances in navigational bronchoscopy and imaging modalities have led to paradigm shift from nodule screening or follow-up to early lung cancer detection. This is due to improved nodule localization and biopsy confirmation with combined modalities of navigational platforms and imaging tools. To conduct this article, relevant literature was reviewed via PubMed from January 2014 until January 2024.Areas covered: This article highlights the literature on different imaging modalities combined with commonly used navigational platforms for diagnosis of peripheral lung nodules. Current limitations and future perspectives of imaging modalities will be discussed.Expert opinion: The development of navigational platforms improved localization of targets. However, published diagnostic yield remains lower compared to percutaneous-guided biopsy. The discordance between the actual location of lung nodule during the procedure and preprocedural CT chest is the main factor impacting accurate biopsies. The utilization of advanced imaging tools with navigation-based bronchoscopy has been shown to assist with localizing targets in real-time and improving biopsy success. However, it is important for interventional bronchoscopists to understand the strengths and limitations of these advanced imaging technologies.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094494","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

Unmet challenges in cystic fibrosis treatment with modulators. 使用调节剂治疗囊性纤维化方面尚未解决的难题。

Expert review of respiratory medicine Pub Date : 2024-03-01 Epub Date: 2024-05-21 DOI: 10.1080/17476348.2024.2357210

Federica Corrao, Mairead Kelly-Aubert, Isabelle Sermet-Gaudelus, Michaela Semeraro

{"title":"Unmet challenges in cystic fibrosis treatment with modulators.","authors":"Federica Corrao, Mairead Kelly-Aubert, Isabelle Sermet-Gaudelus, Michaela Semeraro","doi":"10.1080/17476348.2024.2357210","DOIUrl":"10.1080/17476348.2024.2357210","url":null,"abstract":"Introduction: 'Highly effective' modulator therapies (HEMTs) have radically changed the Cystic Fibrosis (CF) therapeutic landscape.Areas covered: A comprehensive search strategy was undertaken to assess impact of HEMT in life of pwCF, treatment challenges in specific populations such as very young children, and current knowledge gaps.Expert opinion: HEMTs are prescribed for pwCF with definite genotypes. The heterogeneity of variants complicates treatment possibilities and around 10% of pwCF worldwide remains ineligible. Genotype-specific treatments are prompting theratyping and personalized medicine strategies. Improvement in lung function and quality of life increase survival rates, shifting CF from a pediatric to an adult disease. This implies new studies addressing long-term efficacy, side effects, emergence of adult co-morbidities and possible drug-drug interactions. More sensitive and predictive biomarkers for both efficacy and toxicity are warranted. As HEMTs cross the placenta and are found in breast milk, studies addressing the potential consequences of treatment during pregnancy and breastfeeding are urgently needed. Finally, although the treatment and expected outcomes of CF have improved dramatically in high- and middle-income countries, lack of access in low-income countries to these life-changing medicines highlights inequity of care worldwide.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961260","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

Hypersensitivity pneumonitis: application of a new diagnostic algorithm to a time series of the disease. 超敏性肺炎：将新的诊断算法应用于该疾病的时间序列。

Expert review of respiratory medicine Pub Date : 2024-03-01 Epub Date: 2024-05-30 DOI: 10.1080/17476348.2024.2358939

Ana Casal, Juan Suárez-Antelo, Vanessa Riveiro, Lucía Ferreiro, Carlota Rodríguez-García, Anxo Martínez de Alegría, José Ramón Antúnez, María-Elena Tobes, Borja Otero, Nuria Rodríguez-Núñez, José Manuel Álvarez-Dobaño, Kelly Vargas-Osorio, Francisco Gude, Luis Valdés

{"title":"Hypersensitivity pneumonitis: application of a new diagnostic algorithm to a time series of the disease.","authors":"Ana Casal, Juan Suárez-Antelo, Vanessa Riveiro, Lucía Ferreiro, Carlota Rodríguez-García, Anxo Martínez de Alegría, José Ramón Antúnez, María-Elena Tobes, Borja Otero, Nuria Rodríguez-Núñez, José Manuel Álvarez-Dobaño, Kelly Vargas-Osorio, Francisco Gude, Luis Valdés","doi":"10.1080/17476348.2024.2358939","DOIUrl":"10.1080/17476348.2024.2358939","url":null,"abstract":"Background: The diagnostic criteria for Hypersensitivity pneumonitis (HP) have changed over time. Our aim is to apply a recent diagnostic algorithm to a historical series of patients diagnosed with HP to assess its distribution according to current diagnostic criteria and the diagnostic confidence achieved.Research design and methods: Application to each patient the algorithm criteria. The diagnosis was HP (≥90%), provisional high (70-89%) or low confidence (51-69%) or non-HP (unlikely) (≤50%); or HP, provisional or non-HP, if they had lung biopsy.Results: 129 patients [mean age 64 ± 12 years; 79 (61.2%) women] were included of which 16 (12.4%) were diagnosed on the basis of high clinical suspicion. After applying the algorithm, 106 patients (82.2%) could be evaluated and 83 (78.3%) had a diagnosis of HP or high confidence. Lung biopsy was able to establish a diagnosis of certainty in another 21 patients and a provisional diagnosis in 9 more [total, 113 (87.6%)]. The 16 patients without strict diagnostic criteria for HP had a low confidence diagnosis. A total of 56 lung biopsies (64.4%) could have been avoided according to the new guidelines.Conclusions: The application of this algorithm achieves a high diagnostic yield in HP, significantly reducing the number of lung biopsies required.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077469","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

Filling the gaps in the evaluation and selection of mobile health technologies in respiratory medicine. 填补呼吸内科移动医疗技术评估和选择方面的空白。

Expert review of respiratory medicine Pub Date : 2024-03-01 Epub Date: 2024-06-05 DOI: 10.1080/17476348.2024.2361048

Ayfer Koyuncu, Arzu Ari

{"title":"Filling the gaps in the evaluation and selection of mobile health technologies in respiratory medicine.","authors":"Ayfer Koyuncu, Arzu Ari","doi":"10.1080/17476348.2024.2361048","DOIUrl":"10.1080/17476348.2024.2361048","url":null,"abstract":"Introduction: Mobile health (mHealth) technology in respiratory medicine is a fast-growing and promising digital technology that is popular among patients and healthcare providers (HCPs). They provide reminders and step-by-step instructions for the correct inhalation technique, monitor patients' adherence to treatment, and facilitate communication between patients and HCPs.Areas covered: While numerous mHealth apps have been developed over the years, most applications do not have supporting evidence. Selecting the best mHealth app in respiratory medicine is challenging due to limited studies carrying out mHealth app selection. Although mHealth technologies play an important part in the future of respiratory medicine, there is no single guide on the evaluation and selection of mHealth technologies for patients with pulmonary diseases. This paper aims to provide an overview of mHealth technologies, particularly emphasizing digital inhalers and standalone applications used in asthma. Additionally, it offers insights into the evaluation, selection, and pertinent considerations surrounding mHealth applications in respiratory medicine.Expert opinion: Evaluating mHealth apps will take time, resources, and collaboration between stakeholders such as governmental regulatory bodies, subject-matter experts, and industry representatives. Filling the gaps in the evaluation and selection of the mHealth app will improve clinical decision-making, personalized treatments, self-management and disease monitoring in respiratory medicine.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141097032","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

Interstitial lung diseases: never forget to think about it in primary care. 间质性肺病：在初级保健中不要忘记考虑它。

Expert review of respiratory medicine Pub Date : 2024-01-01 Epub Date: 2024-03-19 DOI: 10.1080/17476348.2024.2331763

Guadalupe Bermudo, Miguel Roman-Rodriguez, Maria Molina-Molina

引用次数: 0

Correction. 更正。

Expert review of respiratory medicine Pub Date : 2024-01-01 Epub Date: 2023-12-20 DOI: 10.1080/17476348.2023.2295593

引用次数: 0

Drug-induced interstitial lung disease: a narrative review of a clinical conundrum. 药物诱发的间质性肺病：临床难题的叙述性回顾。

Expert review of respiratory medicine Pub Date : 2024-01-01 Epub Date: 2024-03-19 DOI: 10.1080/17476348.2024.2329612

Megan Harrison, Grace Kavanagh, Tamera J Corte, Lauren K Troy

{"title":"Drug-induced interstitial lung disease: a narrative review of a clinical conundrum.","authors":"Megan Harrison, Grace Kavanagh, Tamera J Corte, Lauren K Troy","doi":"10.1080/17476348.2024.2329612","DOIUrl":"10.1080/17476348.2024.2329612","url":null,"abstract":"Introduction: Drug-induced interstitial lung disease (DI-ILD) is increasing in incidence, due to the use of many new drugs across a broad range of cancers and chronic inflammatory diseases. The presentation and onset of DI-ILD are variable even for the same drug across different individuals. Clinical suspicion is essential for identifying these conditions, with timely drug cessation an important determinant of outcomes.Areas covered: This review provides a comprehensive and up-to-date summary of epidemiology, risk factors, pathogenesis, diagnosis, treatment, and prognosis of DI-ILD. Relevant research articles from PubMed and Medline searches up to September 2023 were screened and summarized. Specific drugs including immune checkpoint inhibitors, CAR-T cell therapy, methotrexate, and amiodarone are discussed in detail. The potential role of pharmacogenomic profiling for lung toxicity risk is considered.Expert opinion: DI-ILD is likely to be an increasingly important contributor to respiratory disability in the community. These conditions can negatively impact quality of life and patient longevity, due to associated respiratory compromise as well as cessation of evidence-based therapy for the underlying disease. This clinical conundrum is relevant to all areas of medicine, necessitating increased understanding and greater vigilance for drug-related lung toxicity.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159771","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

So we now have RSV vaccines. What's our next steps? 现在我们有了 RSV 疫苗。下一步该怎么办？

Expert review of respiratory medicine Pub Date : 2024-01-01 Epub Date: 2024-03-19 DOI: 10.1080/17476348.2024.2331764

Joseph M Blondeau

引用次数: 0