Expert review of respiratory medicine最新文献_第9页

Extracorporeal membrane oxygenation for cardiac arrest: what, when, why, and how. 体外膜氧合治疗心脏骤停:什么，何时，为什么，以及如何。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2023-11-29 DOI: 10.1080/17476348.2023.2288160

Matthew Brandorff, Clark G Owyang, Joseph E Tonna

{"title":"Extracorporeal membrane oxygenation for cardiac arrest: what, when, why, and how.","authors":"Matthew Brandorff, Clark G Owyang, Joseph E Tonna","doi":"10.1080/17476348.2023.2288160","DOIUrl":"10.1080/17476348.2023.2288160","url":null,"abstract":"Introduction: Extracorporeal membrane oxygenation (ECMO) facilitated resuscitation was first described in the 1960s, but only recently garnered increased attention with large observational studies and randomized trials evaluating its use.Areas covered: In this comprehensive review of extracorporeal cardiopulmonary resuscitation (ECPR), we report the history of resuscitative ECMO, terminology, circuit configuration and cannulation considerations, complications, selection criteria, implementation and management, and important considerations for the provider. We review the relevant guidelines, different approaches to cannulation, postresuscitation management, and expected outcomes, including neurologic, cardiac, and hospital survival. Finally, we advocate for the participation in national/international Registries in order to facilitate continuous quality improvement and support scientific discovery in this evolving area.Expert opinion: ECPR is the most disruptive technology in cardiac arrest resuscitation since high-quality CPR itself. ECPR has demonstrated that it can provide up to 30% increased odds of survival for refractory cardiac arrest, in tightly restricted systems and for select patients. It is also clear, though, from recent trials that ECPR will not confer this high survival when implemented in less tightly protocoled settings and within lower volume environments. Over the next 10 years, ECPR research will explore the optimal initiation thresholds, best practices for implementation, and postresuscitation care.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1125-1139"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10922429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bayesian or frequentist: there is no question when comparing single-inhaler triple therapies via network meta-analysis. Focus on fluticasone furoate/umeclidinium/vilanterol fixed-dose combination in chronic obstructive pulmonary disease. 贝叶斯主义还是频数主义：通过网络荟萃分析比较单吸入器三联疗法是毫无疑问的。聚焦慢性阻塞性肺病中的糠酸氟替卡松/优甲乐/维兰特罗固定剂量组合。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2024-02-16 DOI: 10.1080/17476348.2024.2316167

Luigino Calzetta, Paola Rogliani

{"title":"Bayesian or frequentist: there is no question when comparing single-inhaler triple therapies via network meta-analysis. Focus on fluticasone furoate/umeclidinium/vilanterol fixed-dose combination in chronic obstructive pulmonary disease.","authors":"Luigino Calzetta, Paola Rogliani","doi":"10.1080/17476348.2024.2316167","DOIUrl":"10.1080/17476348.2024.2316167","url":null,"abstract":"Objectives: Single-inhaler triple therapies (SITTs) have never been directly compared in randomized controlled trials (RCTs) in chronic obstructive pulmonary disease (COPD). Cochrane recommends the Bayesian approach for indirect comparisons but a frequentist network meta-analysis (NMA) reported superiority of fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) over other SITT. We assessed the most appropriate inference method for NMA characterized by between-study heterogeneity on SITT in COPD.Methods: Bayesian and frequentist NMA were performed on RCTs investigating the effect of SITT on exacerbations and trough forced expiratory volume in the 1st second (FEV1) in COPD.Results: The included RCTs (ETHOS, FULFIL, IMPACT, KRONOS 200812) reported significant between-study heterogeneity (I2 > 99%, p < 0.001). The Bayesian random-effect NMA provided unbiased evidence that FF/UMEC/VI was not superior to other SITT on exacerbations and trough FEV1. The frequentist fixed-effect NMA indicated that FF/UMEC/VI was significantly (p < 0.05) more effective than other SITT, although results were affected by dispersion, asymmetry, and significant risk of bias. Frequentist random-effect NMA provided effect estimates rather similar but not equal to those of Bayesian approach.Conclusion: Indirect comparison should be performed via Bayesian approach instead of frequentist inference with a fixed-effect model. Claiming the superiority of a specific medication over other therapies should be confirmed by findings originating from well-designed RCTs.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1273-1283"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693720","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 ageing of Cystic Fibrosis patients with new modulators: current gaps and challenges. 囊性纤维化患者的老龄化与新调节剂：当前的差距与挑战。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2024-02-12 DOI: 10.1080/17476348.2024.2311109

Almudena Felipe Montiel, Antonio Álvarez Fernández, Letizia Traversi, Eva Polverino

引用次数: 0

A three-gene random forest model for diagnosing idiopathic pulmonary fibrosis based on circadian rhythm-related genes in lung tissue. 基于肺组织中昼夜节律相关基因诊断特发性肺纤维化的三基因随机森林模型。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2024-01-31 DOI: 10.1080/17476348.2024.2311262

Jie He, Jun Hu, Hairong Liu

{"title":"A three-gene random forest model for diagnosing idiopathic pulmonary fibrosis based on circadian rhythm-related genes in lung tissue.","authors":"Jie He, Jun Hu, Hairong Liu","doi":"10.1080/17476348.2024.2311262","DOIUrl":"10.1080/17476348.2024.2311262","url":null,"abstract":"Background: The disorder of circadian rhythm could be a key factor mediating fibrotic lung disease Therefore, our study aims to determine the diagnostic value of circadian rhythm-related genes (CRRGs) in IPF.Methods: We retrieved the data on CRRGs from previous studies and the GSE150910 dataset. The participants from the GSE150910 dataset were divided into training and internal validation sets. Next, we used several various bioinformatics methods and machine learning algorithms to screen genes. Next, we identified SEMA5A, COL7A1, and TUBB3, which were included in the random forest (RF) diagnostic model. Finally, external validation was conducted on data retrieved from the GSE184316 datasets.Results: The results revealed that the RF diagnostic model could diagnose patients with IPF in the internal validation set with the area under the ROC curve (AUC) value of 0.905 and in the external validation with the AUC value of 0.767. Furthermore, real-time quantitative PCR and western blotting results revealed a significant decrease in SEMA5A (p < 0.05) expression level and an increase in COL7A1 and TUBB3 expression levels in TGF-β1-treated normal human lung fibroblasts.Conclusion: We constructed an RF diagnostic model based on SEMA5A, COL7A1, and TUBB3 expression in lung tissue for diagnosing patients with IPF.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1307-1320"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139577258","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

Demystification of artificial intelligence for respiratory clinicians managing patients with obstructive lung diseases. 为管理阻塞性肺病患者的呼吸科临床医生揭开人工智能的神秘面纱。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2024-01-25 DOI: 10.1080/17476348.2024.2302940

Joana Antão, Jeroen de Mast, Alda Marques, Frits M E Franssen, Martijn A Spruit, Qichen Deng

{"title":"Demystification of artificial intelligence for respiratory clinicians managing patients with obstructive lung diseases.","authors":"Joana Antão, Jeroen de Mast, Alda Marques, Frits M E Franssen, Martijn A Spruit, Qichen Deng","doi":"10.1080/17476348.2024.2302940","DOIUrl":"10.1080/17476348.2024.2302940","url":null,"abstract":"Introduction: Asthma and chronic obstructive pulmonary disease (COPD) are leading causes of morbidity and mortality worldwide. Despite all available diagnostics and treatments, these conditions pose a significant individual, economic and social burden. Artificial intelligence (AI) promises to support clinical decision-making processes by optimizing diagnosis and treatment strategies of these heterogeneous and complex chronic respiratory diseases. Its capabilities extend to predicting exacerbation risk, disease progression and mortality, providing healthcare professionals with valuable insights for more effective care. Nevertheless, the knowledge gap between respiratory clinicians and data scientists remains a major constraint for wide application of AI and may hinder future progress. This narrative review aims to bridge this gap and encourage AI deployment by explaining its methodology and added value in asthma and COPD diagnosis and treatment.Areas covered: This review offers an overview of the fundamental concepts of AI and machine learning, outlines the key steps in building a model, provides examples of their applicability in asthma and COPD care, and discusses barriers to their implementation.Expert opinion: Machine learning can advance our understanding of asthma and COPD, enabling personalized therapy and better outcomes. Further research and validation are needed to ensure the development of clinically meaningful and generalizable models.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1207-1219"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546847","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

Pulmonary embolism: a practical approach to update risk stratification and treatment decisions based on the guidelines. 肺栓塞：根据指南更新风险分层和治疗决策的实用方法。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2023-12-26 DOI: 10.1080/17476348.2023.2298826

María Barca-Hernando, Luis Jara-Palomares

{"title":"Pulmonary embolism: a practical approach to update risk stratification and treatment decisions based on the guidelines.","authors":"María Barca-Hernando, Luis Jara-Palomares","doi":"10.1080/17476348.2023.2298826","DOIUrl":"10.1080/17476348.2023.2298826","url":null,"abstract":"Introduction: Pulmonary embolism (PE) is a prevalent condition with a substantial morbi-mortality worldwide. Proper risk stratification of PE is essential for identifying the most suitable therapeutic strategy and the optimal care setting for the patient. This process entails evaluating various factors, including symptoms, comorbidities, and right heart dysfunction.Areas covered: This review assesses the tools and methods utilized to identify and stratify individuals based on the probability of developing deterioration or death related to PE. Current guidelines divide PE into three groups: high-risk (previously termed massive) PE, intermediate-risk (sub-massive) PE, and low-risk PE. Various risk scores, such as the simplified pulmonary embolism severity index (sPESI), Bova score, and the FAST score (incorporating Heart-Fatty Acid binding protein [H-ABP], Syncope, Tachycardia), aid in identifying patients at higher risk. Additionally, the Hestia score is instrumental in pinpointing low-risk patients.Expert opinion: Presently, there is a dearth of high-quality frameworks for the optimal management and treatment of PE patients at risk of hemodynamic collapse. A consortium of experts is in the process of formulating a new conceptual model for risk stratification, taking into account a comprehensive array of variables and outcomes to facilitate more individualized management of acute PE.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1151-1158"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833701","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

Mechanisms and management of cough in interstitial lung disease. 间质性肺病咳嗽的机理和治疗。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2023-12-30 DOI: 10.1080/17476348.2023.2299751

Ameer Z Rasheed, Mark L Metersky, Fatima Ghazal

{"title":"Mechanisms and management of cough in interstitial lung disease.","authors":"Ameer Z Rasheed, Mark L Metersky, Fatima Ghazal","doi":"10.1080/17476348.2023.2299751","DOIUrl":"10.1080/17476348.2023.2299751","url":null,"abstract":"Introduction: Many patients with interstitial lung diseases (ILDs), especially fibrotic ILDs, experience chronic cough. It negatively impacts both physical and psychological well-being. Effective treatment options are limited.Areas covered: The pathophysiology of chronic cough in IPF is complex and involves multiple mechanisms, including mechanical distortion of airways, parenchyma, and nerve fibers. The pathophysiology of cough in other fibrosing ILDs is poorly understood and involves various pathways. The purpose of this review is to highlight mechanisms of chronic cough and to present therapeutic evidence for its management in the most commonly occurring diffuse fibrosing lung diseases including idiopathic pulmonary fibrosis (IPF), connective tissue disease-related interstitial lung disease (CTD-ILD), sarcoidosis-related ILD (Sc-ILD), chronic hypersensitivity pneumonitis-related ILD (CHP-ILD), and post-COVID-19-related interstitial lung disease (PC-ILD).Expert opinion: This review guides the management of chronic cough in fibrosing ILDs. In this era of precision medicine, chronic cough management should be individualized in each interstitial lung disease.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1177-1190"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139076419","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 impact of air pollution on asthma: clinical outcomes, current epidemiology, and health disparities. 空气污染对哮喘的影响：临床结果、当前流行病学和健康差异。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2024-01-25 DOI: 10.1080/17476348.2024.2307545

Ryan J Fiter, Lila J Murphy, Michelle N Gong, Krystal L Cleven

{"title":"The impact of air pollution on asthma: clinical outcomes, current epidemiology, and health disparities.","authors":"Ryan J Fiter, Lila J Murphy, Michelle N Gong, Krystal L Cleven","doi":"10.1080/17476348.2024.2307545","DOIUrl":"10.1080/17476348.2024.2307545","url":null,"abstract":"Introduction: Air pollution has been shown to have a significant impact on morbidity and mortality of respiratory illnesses including asthma.Areas covered: Outdoor air pollution consists of a mixture of individual pollutants including vehicle traffic and industrial pollution. Studies have implicated an array of individual components of air pollution, with PM2.5, NO2, SO2, and ozone being the most classically described, and newer literature implicating other pollutants such as black carbon and volatile organic compounds. Epidemiological and cohort studies have described incidence and prevalence of pollution-related asthma and investigated both acute and chronic air pollution exposure as they relate to asthma outcomes. There is an increasing body of literature tying disparities in pollution exposure to clinical outcomes. In this narrative review, we assessed the published research investigating the association of pollution with asthma outcomes, focusing on the adult population and health care disparities.Expert opinion: Pollution has multiple deleterious effects on respiratory health but there is a lack of data on individualized pollution monitoring, making it difficult to establish a temporal relationship between exposure and symptoms, thereby limiting our understanding of safe exposure levels. Future research should focus on more personalized monitoring and treatment plans for mitigating exposure.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1237-1247"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514228","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

Interventional bronchoscopy in pediatric pulmonary tuberculosis. 小儿肺结核的介入性支气管镜检查。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2023-12-28 DOI: 10.1080/17476348.2023.2299336

Pierre Goussard, Ernst Eber, Shyam Venkatakrishna, Lisa Frigati, Leonore Greybe, Jacques Janson, Pawel Schubert, Savvas Andronikou

{"title":"Interventional bronchoscopy in pediatric pulmonary tuberculosis.","authors":"Pierre Goussard, Ernst Eber, Shyam Venkatakrishna, Lisa Frigati, Leonore Greybe, Jacques Janson, Pawel Schubert, Savvas Andronikou","doi":"10.1080/17476348.2023.2299336","DOIUrl":"10.1080/17476348.2023.2299336","url":null,"abstract":"Introduction: Lymphobronchial tuberculosis (TB) is common in children with primary TB and enlarged lymph nodes can cause airway compression of the large airways. If not treated correctly, airway compression can result in persistent and permanent parenchymal pathology, as well as irreversible lung destruction. Bronchoscopy was originally used to collect diagnostic samples; however, its role has evolved, and it is now used as an interventional tool in the diagnosis and management of complicated airway disease. Endoscopic treatment guidelines for children with TB are scarce.Areas covered: The role of interventional bronchoscopy in the diagnosis and management of complicated pulmonary TB will be discussed. This review will provide practical insights into how and when to perform interventional procedures in children with complicated TB for both diagnostic and therapeutic purposes. This discussion incorporates current scientific evidence and refers to adult literature, as some of the interventions have only been done in adults but may have a role in children. Limitations and future perspectives will be examined.Expert opinion: Pediatric pulmonary TB lends itself to endoscopic interventions as it is a disease with a good outcome if treated correctly. However, interventions must be limited to safeguard the parenchyma and prevent permanent damage.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1159-1175"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138886817","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

Impact of indoor environment on children's pulmonary health. 室内环境对儿童肺部健康的影响。

Expert review of respiratory medicine Pub Date : 2023-12-01 Epub Date: 2024-01-31 DOI: 10.1080/17476348.2024.2307561

Jared Murphy, Ramiyya Tharumakunarajah, Karl A Holden, Charlotte King, Alice R Lee, Katie Rose, Daniel B Hawcutt, Ian P Sinha

{"title":"Impact of indoor environment on children's pulmonary health.","authors":"Jared Murphy, Ramiyya Tharumakunarajah, Karl A Holden, Charlotte King, Alice R Lee, Katie Rose, Daniel B Hawcutt, Ian P Sinha","doi":"10.1080/17476348.2024.2307561","DOIUrl":"10.1080/17476348.2024.2307561","url":null,"abstract":"Introduction: A child's living environment has a significant impact on their respiratory health, with exposure to poor indoor air quality (IAQ) contributing to potentially lifelong respiratory morbidity. These effects occur throughout childhood, from the antenatal period through to adolescence. Children are particularly susceptible to the effects of environmental insults, and children living in socioeconomic deprivation globally are more likely to breathe air both indoors and outdoors, which poses an acute and long-term risk to their health. Adult respiratory health is, at least in part, determined by exposures and respiratory system development in childhood, starting in utero.Areas covered: This narrative review will discuss, from a global perspective, what contributes to poor IAQ in the child's home and school environment and the impact that indoor air pollution exposure has on respiratory health throughout the different stages of childhood.Expert opinion: All children have the right to a living and educational environment without the threat of pollution affecting their health. Action is needed at multiple levels to address this pressing issue to improve lifelong respiratory health. Such action should incorporate a child's rights-based approach, empowering children, and their families, to have access to clean air to breathe in their living environment.","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"1249-1259"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492968","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