Expert review of respiratory medicine最新文献

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An overview of patient-ventilator asynchrony in children. 儿童患者-呼吸机不同步的概述。
Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-04-10 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":"10.1080/17476348.2025.2487165","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Areas covered: </strong>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.</p><p><strong>Expert opinion: </strong>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.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"435-447"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12109136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756891","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
The risk of stroke-related pneumonia: a systematic review of peripheral immunodepression markers. 卒中相关肺炎的风险:外周免疫抑制标志物的系统回顾
IF 2.7
Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-03-30 DOI: 10.1080/17476348.2025.2481956
Maria Eduarda Lopez de Mello, Scarleth Andreghetto, Maiara de Aguiar da Costa, Victória Linden de Rezende, Cinara Ludvig Gonçalves, Amanda Della Giustina, Fabricia Petronilho
{"title":"The risk of stroke-related pneumonia: a systematic review of peripheral immunodepression markers.","authors":"Maria Eduarda Lopez de Mello, Scarleth Andreghetto, Maiara de Aguiar da Costa, Victória Linden de Rezende, Cinara Ludvig Gonçalves, Amanda Della Giustina, Fabricia Petronilho","doi":"10.1080/17476348.2025.2481956","DOIUrl":"10.1080/17476348.2025.2481956","url":null,"abstract":"<p><strong>Introduction: </strong>Ischemic stroke (IS)-associated pneumonia is a leading cause of mortality after stroke, driven by peripheral immune imbalance. This systematic review evaluates immunosuppression markers associated with pneumonia following IS in clinical studies.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched PubMed/MEDLINE, EMBASE, and LILACS databases until March 2024. Inclusion criteria comprised clinical studies assessing IS-related immunosuppression and pneumonia, excluding in vitro and animal studies. Study quality was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>A total of 32 studies met the inclusion criteria, analyzing 1,833 post-stroke patients. Findings indicate that increased interleukin-6 (IL-6), interleukin-10 (IL-10), and C-reactive protein (CRP) levels, alongside decreased repulsive guidance molecule A (RGM-A), are early indicators of post-stroke pneumonia. Meta-analysis was not conducted due to heterogeneity in study methodologies and populations.</p><p><strong>Conclusions: </strong>Elevated IL-6, IL-10, and CRP levels, along with reduced RGM-A, are associated with post-stroke pneumonia, emphasizing the role of immune dysregulation in its pathophysiology. Despite promising findings, further studies with standardized detection techniques are needed to enhance diagnostic accuracy and improve patient prognosis. The variability in study methodologies presents a limitation to drawing definitive conclusions.<b>Registration:</b> PROSPERO CRD42024543108.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"449-459"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665768","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 update on long-acting muscarinic agents for asthma therapy. 用于哮喘治疗的长效毒蕈碱类药物的最新进展。
Expert review of respiratory medicine Pub Date : 2025-05-01 Epub Date: 2025-03-28 DOI: 10.1080/17476348.2025.2484289
Maria Gabriella Matera, Mario Cazzola, Paola Rogliani, Vincenzo Patella
{"title":"An update on long-acting muscarinic agents for asthma therapy.","authors":"Maria Gabriella Matera, Mario Cazzola, Paola Rogliani, Vincenzo Patella","doi":"10.1080/17476348.2025.2484289","DOIUrl":"10.1080/17476348.2025.2484289","url":null,"abstract":"<p><strong>Introduction: </strong>The manifestations of asthma are influenced by the dysfunction of the autonomic nervous system, which results in elevated vagal tone within the airways. Acetylcholine (ACh) plays a pivotal role in the pathophysiology of asthma through its interaction with muscarinic acetylcholine receptors (mAChRs). Consequently, using mAChR antagonists to counteract the actions of ACh is scientifically sound.</p><p><strong>Areas covered: </strong>This narrative review methodically examines the latest information on the mechanisms and evidence supporting the use of long-acting muscarinic antagonists (LAMAs) in asthma.</p><p><strong>Expert opinion: </strong>Adding a LAMA to existing asthma treatments involving an ICS and a LABA, within a single inhaler triple therapy (SITT), improves lung function regulating airflow limitation, reduces exacerbations, and eosinophilic inflammation and offers a more comprehensive approach to managing inflammation and tissue remodeling, which are linked to ACh. Additionally, it disrupts the vicious cycle of ACh release that contributes to neuronal plasticity and dysfunction of small airways. Identifying treatable traits is key to using SITT in a customized way that aligns with patients' needs. The 5T (Triple Therapy Targeting Treatable Traits) approach proposes the utilization of SITT for all asthma cases, not solely severe ones, and involves using LAMAs in ICS/LABA combinations earlier than current guidelines recommend.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"407-421"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694943","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
Interpretation of cardiopulmonary exercise test by GPT - promising tool as a first step to identify normal results. 解释心肺运动试验的GPT -有希望的工具作为第一步,以确定正常的结果。
Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-02 DOI: 10.1080/17476348.2025.2474138
Eyal Kleinhendler, Avital Pinkhasov, Samah Hayek, Avraham Man, Ophir Freund, Tal Moshe Perluk, Evgeni Gershman, Avraham Unterman, Gil Fire, Amir Bar-Shai
{"title":"Interpretation of cardiopulmonary exercise test by GPT - promising tool as a first step to identify normal results.","authors":"Eyal Kleinhendler, Avital Pinkhasov, Samah Hayek, Avraham Man, Ophir Freund, Tal Moshe Perluk, Evgeni Gershman, Avraham Unterman, Gil Fire, Amir Bar-Shai","doi":"10.1080/17476348.2025.2474138","DOIUrl":"10.1080/17476348.2025.2474138","url":null,"abstract":"<p><strong>Background: </strong>Cardiopulmonary exercise testing (CPET) is used in the evaluation of unexplained dyspnea. However, its interpretation requires expertise that is often not available. We aim to evaluate the utility of ChatGPT (GPT) in interpreting CPET results.</p><p><strong>Research design and methods: </strong>This cross-sectional study included 150 patients who underwent CPET. Two expert pulmonologists categorized the results as normal or abnormal (cardiovascular, pulmonary, or other exercise limitations), being the gold standard. GPT versions 3.5 (GPT-3.5) and 4 (GPT-4) analyzed the same data using pre-defined structured inputs.</p><p><strong>Results: </strong>GPT-3.5 correctly interpreted 67% of the cases. It achieved a sensitivity of 75% and specificity of 98% in identifying normal CPET results. GPT-3.5 had varying results for abnormal CPET tests, depending on the limiting etiology. In contrast, GPT-4 demonstrated improvements in interpreting abnormal tests, with sensitivities of 83% and 92% for respiratory and cardiovascular limitations, respectively. Combining the normal CPET interpretations by both AI models resulted in 91% sensitivity and 98% specificity. Low work rate and peak oxygen consumption were independent predictors for inaccurate interpretations.</p><p><strong>Conclusions: </strong>Both GPT-3.5 and GPT-4 succeeded in ruling out abnormal CPET results. This tool could be utilized to differentiate between normal and abnormal results.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"371-378"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517615","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
Demographic and regional trends in asthma mortality in the United States, 1999-2020. 1999-2020年美国哮喘死亡率的人口统计学和区域趋势
Expert review of respiratory medicine Pub Date : 2025-04-01 Epub Date: 2025-03-05 DOI: 10.1080/17476348.2025.2474140
Ahsan Raza Raja, Fareeha Faizan Ghori, Dua Batool Zaide, Ali Bin Sarwar Zubairi
{"title":"Demographic and regional trends in asthma mortality in the United States, 1999-2020.","authors":"Ahsan Raza Raja, Fareeha Faizan Ghori, Dua Batool Zaide, Ali Bin Sarwar Zubairi","doi":"10.1080/17476348.2025.2474140","DOIUrl":"10.1080/17476348.2025.2474140","url":null,"abstract":"<p><strong>Background: </strong>Asthma remains a public health concern in the United States, with mortality disproportionately affecting demographic groups. This study aimed to describe national trends in asthma mortality from 1999 to 2020 and identify demographic and regional disparities.</p><p><strong>Research design and methods: </strong>We retrospectively analyzed mortality data from the CDC WONDER database using International Classification of Diseases, Tenth Revision (ICD-10) codes J45 and J46. Age-adjusted mortality rates (AAMRs) were calculated by sex, race, age group, US Census region, state, and urban-rural classification. Joinpoint regression was employed to detect changes over time.</p><p><strong>Results: </strong>A total of 82,686 asthma-related deaths were identified (37.2% males, 62.8% females). Overall, the AAMR declined from 1.72 in 1999 to 1.14 in 2020. Joinpoint analysis revealed a significant decline from 1999 to 2009, a plateau from 2009 to 2014, a further decline from 2014 to 2018, and a significant increase from 2018 to 2020. Non-Hispanic Black individuals (AAMR 2.73) and older adults (≥65 years) had the highest mortality rates, with females exhibiting higher rates than males (1.30 vs 0.95).</p><p><strong>Conclusions: </strong>Despite declining trends, persistent disparities in asthma mortality underscore the need for targeted interventions, improved healthcare access, and ongoing surveillance.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"399-405"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532268","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. 肺部超声在COVID-19住院患者预后中的作用。与胸部CT表现及严重程度临床指标的相关性。
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":"<p><strong>Background: </strong>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.</p><p><strong>Research design and methods: </strong>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.</p><p><strong>Results: </strong>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 PaO<sub>2</sub>/FiO<sub>2</sub> 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).</p><p><strong>Conclusions: </strong>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.</p>","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
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":"<p><strong>Introduction: </strong>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.</p><p><strong>Area covered: </strong>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.</p><p><strong>Expert opinion: </strong>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.</p>","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? 病毒性社区获得性肺炎:自COVID-19出现以来有什么新进展?
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":"<p><strong>Introduction: </strong>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.</p><p><strong>Areas covered: </strong>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.</p><p><strong>Expert opinion: </strong>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.</p>","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
Treatment of nontuberculous mycobacterial pulmonary disease requires a stepwise and multidisciplinary approach. 非结核性分枝杆菌肺病的治疗需要逐步和多学科的方法。
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":"<p><strong>Introduction: </strong>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.</p><p><strong>Areas covered: </strong>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.</p><p><strong>Expert opinion: </strong>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.</p>","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. 目前对女性肺癌临床病理特征的认识。
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
{"title":"Current insights into the clinico-pathologic characteristics of lung cancer in women.","authors":"Anna Trojnar, Joanna Domagała-Kulawik","doi":"10.1080/17476348.2025.2475974","DOIUrl":"10.1080/17476348.2025.2475974","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer is responsible for premature cancer deaths in women and is the first cause of cancer deaths in women in many countries. The problem of lung cancer in women seems to be underestimated in many aspects, including low participation in clinical trials and screening tests.</p><p><strong>Areas covered: </strong>Current research progress has contributed to a better understanding of the issue and makes it possible to describe the problem in a new light. In our paper, the problem of lung cancer in women was discussed in a broad aspect, taking into account women's health, the harmful effects of smoking and the current diagnostic and treatment process. The results of treatment also differ in relation to sex. All these aspects of the diversity of women's lung cancer were presented on the basis of newest and most comprehensive literature.</p><p><strong>Expert opinion: </strong>Lung cancer in women is and will remain an important health problem worldwide, which is justified by epidemiological data, basic research and treatment results.</p>","PeriodicalId":94007,"journal":{"name":"Expert review of respiratory medicine","volume":" ","pages":"301-312"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560392","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
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