Alternatives to Surgery for Early-Stage Non –Small Cell Lung Cancer
Thermal ablation involves the application of heat or cold energy to the lung under image guidance to eradicate tumors. It is indicated for treatment of early-stage non –small cell lung cancer in nonsurgical patients. Ablation technologies have advanced, such that nearly all small tumors can now be treated safely and effectively. Ablation does not cause a lasting decline in pulmonary function tests and may therefore be used to treat multiple synchronous and metac hronous lung tumors, a chief advantage over other treatments. Large series with intermediate- and long-term data have been reported showing favorable overall...
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Authors: Matthew T. Quirk, Shimwoo Lee, Nikitha Murali, Scott Genshaft, Fereidoun Abtin, Robert Suh Source Type: research

Advances in Treatment of Locally Advanced or Metastatic Non –Small Cell Lung Cancer
The treatment of metastatic non –small cell lung cancer (NSCLC) is constantly evolving. Although the advent of immunotherapy has played an important role in the treatment of patients with NSCLC, the identification of driver mutations and the subsequent specific treatment of these targets often lead to durable responses while mai ntaining quality of life. This review delves into targeted therapies available for epidermal growth factor receptor, anaplastic lymphoma kinase, ROS1, neurotrophic tropomyosin receptor kinase, and BRAF- mutated NSCLC patients, as well as other mutations with promising novel drugs under clinic...
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Authors: Nicholas P. Giustini, Ah-Reum Jeong, James Buturla, Lyudmila Bazhenova Source Type: research

Management of Oligometastatic Disease in Advanced Non –Small Cell Lung Cancer
Non –small cell lung cancer with very limited extent of metastatic spread commonly is termed, oligometastatic disease (OMD), and typically described as no more than 3 to 5 lesions. Definitive local therapy potentially leads to significant improvement in progression-free survival and overall survival. OMD may occur de novo prior to initiation of systemic therapy or as an induced state after initiation of systemic therapy. Although prospective data are limited to small trials, they have consistently supported local therapy as an appropriate consideration if not a clear standard of care for well-se lected patients. Seve...
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Authors: Howard West Source Type: research

Lung Cancer Staging
Anatomic staging is a critical step in evaluation of patients with lung cancer. Accurate identification of stage based on features of primary tumor (T), regional nodes (N), and metastatic disease (M) is fundamental to determining appropriate care. In this article, the TNM components of the anatomic staging system and a framework for description of lung cancer with multiple pulmonary sites of involvement are discussed. TNM combinations are grouped according to prognosis, with patient-level, tumor-level, and environment-level factors also influencing survival outcomes. Although the staging system does not include molecular a...
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Authors: Lynn T. Tanoue Source Type: research

Advances in the Treatment of Stage III Non –Small Cell Lung Cancer
This article reviews the indications for tr aditional therapies in stage III NSCLC and highlights ongoing advances that have led to the incorporation of novel therapeutic agents. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Authors: Nathaniel J. Myall, Millie Das Source Type: research

Pulmonary Complications of Immunotherapy
Immune checkpoint inhibitor (ICI) therapy represents a paradigm shift in the treatment of patients with locally advanced and metastatic lung cancer. Although immunotherapy generally has a more favorable safety profile when compared with chemotherapy, immune-related adverse events represent important, but incompletely understood, treatment-limiting complications associated with significant morbidity and mortality risk. Current guidelines for diagnosis and management are derived from consensus experience, highlighting that further prospective investigation in this area is needed. As ICI-related pneumonitis is a clinically an...
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Authors: Brett C. Bade, Jennifer D. Possick Source Type: research

Passion, Perseverance, and Quantum Leaps: Lung Cancer in the Twenty-First Century
At the turn of the twentieth century, lung cancer was a rare disease accounting for only 1% of all cancers and was found primarily at autopsy. By the 1940s, lung cancer rates had significantly increased. It was the second most common cause of cancer death after gastric cancer, and surgery was the only available treatment. Although a connection between smoking and lung cancer had been recognized by the German physician Fritz Lickint1 in 1929, it was not until the early 1950s, following the publication of 2 landmark studies from the United Kingdom and the United States, that cigarette smoking was identified as an important f...
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Authors: M. Patricia Rivera, Richard A. Matthay Tags: Preface Source Type: research

Lung Cancer: Part II
CLINICS IN CHEST MEDICINE (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Authors: M. Patricia Rivera, Richard A. Matthay Source Type: research

Copyright
ELSEVIER (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Source Type: research

Contributors
M. PATRICIA RIVERA, MD (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Source Type: research

Contents
M. Patricia Rivera and Richard Matthay (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Source Type: research

Forthcoming Issues
Chronic Obstructive Pulmonary Disease (COPD) (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - May 11, 2020 Category: Respiratory Medicine Source Type: research

Alternatives to Surgery for Early-Stage Non –small Cell Lung Cancer
This article details the technique of SBRT, the data for its efficacy, as well as the potential toxicities of treatment. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - April 16, 2020 Category: Respiratory Medicine Authors: Brian T. Beaty, Ashley A. Weiner Source Type: research

Palliative Care in Lung Cancer
There is growing evidence that palliative care supports the needs of patients with advanced lung cancer. Early palliative care referral has been shown to improve quality of life, decrease symptom burden, and help patients better understand their illness. However, access to palliative care specialists is limited. All providers caring for patients with lung cancer should be able to manage basic symptoms and engage in routine discussions about goals of care, prognosis, and suffering. By developing primary palliative care skills, more patients, even those with earlier stages of lung cancer, benefit from better symptom manageme...
Source: Clinics in Chest Medicine - April 16, 2020 Category: Respiratory Medicine Authors: Katherine N. Aragon Source Type: research

New Surgical Approaches in the Treatment of Non –small Cell Lung Cancer
Surgery for non –small cell lung cancer has undergone repeated innovations over time. Although medical thoracoscopy has been available for centuries, it was not incorporated into the standard approach until the 1990s, when successful video-assisted thoracoscopic surgery (VATS) techniques were widely reported. Pro gressive efforts to offer minimally invasive approaches while maintaining oncologic surgical quality led to the development of robotic-assisted thoracic surgery and uniportal VATS, which offer improved pain control, shorter hospital stays, and more patients able to receive adjuvant therapy. Innovati ons in i...
Source: Clinics in Chest Medicine - April 16, 2020 Category: Respiratory Medicine Authors: Giye Choe, Rebecca Carr, Daniela Molena Source Type: research

Management of Malignant Pleural Effusions
Malignant pleural effusion frequently complicates both solid and hematologic malignancies and is associated with high morbidity, mortality, and health care costs. Although no pleura-specific therapy is known to impact survival, both pleurodesis and indwelling pleural catheter (IPC) placement can significantly alleviate symptoms and improve quality of life. The optimal choice of therapy in terms of efficacy and particularly cost-effectiveness depends on patient preferences and individual characteristics, including lung expansion and life expectancy. Attempting chemical pleurodesis through an IPC in the outpatient setting ap...
Source: Clinics in Chest Medicine - April 16, 2020 Category: Respiratory Medicine Authors: Majid Shafiq, David Feller-Kopman Source Type: research

Advances in the Treatment of Non –Small Cell Lung Cancer
Clinical development of immune checkpoint blockade has dramatically changed the treatment paradigm and prognosis for patients with non –small cell lung cancer. Immune checkpoint blockade with PD-1 and PD-L1 antibodies generates clinically significant, durable responses in patients with advanced non–small cell lung cancer. These agents are approved for first- and second-line treatment, either as single agents or in combination w ith chemotherapy and angiogenesis inhibitors. Although the toxicity profile of these treatments is favorable, a unique set of immune-mediated adverse events, such as pneumonitis, has bee...
Source: Clinics in Chest Medicine - April 16, 2020 Category: Respiratory Medicine Authors: Shetal A. Patel, Jared Weiss Source Type: research

Breaking the Impasse
Small cell lung cancer (SCLC) is an aggressive malignancy and carries a poor prognosis with limited effective treatments in the advanced setting. SCLC is characterized by a high tumor mutation burden and alterations in Notch signaling and DNA damage repair pathways, providing rationale for the use of immunotherapy and targeted therapies. Immunotherapies have led to the most significant advances in treating SCLC in decades, and several promising targeted approaches have emerged from the increased understanding of the biology of SCLC. However, responses to these novel approaches are far from universal, and efforts to refine ...
Source: Clinics in Chest Medicine - April 16, 2020 Category: Respiratory Medicine Authors: Andreas Saltos, Scott Antonia Source Type: research

Lung Cancer 2020
Despite advances in our understanding of risk, development, immunologic control, and treatment options for lung cancer, it remains the leading cause of cancer death. Tobacco smoking remains the predominant risk factor for lung cancer development. Nontobacco risk factors include environmental and occupational exposures, chronic lung disease, lung infections, and lifestyle factors. Because tobacco remains the leading risk factor for lung cancer, disease prevention is focused on smoking avoidance and cessation. Other prevention measures include healthy diet choices and maintaining a physically active lifestyle. Future work sh...
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Authors: Brett C. Bade, Charles S. Dela Cruz Source Type: research

Primary and Secondary Prevention of Lung Cancer
Tobacco dependence is the most consequential target to reduce the burden of lung cancer worldwide. Quitting after a cancer diagnosis can improve cancer prognosis, overall health, and quality of life. Several oncology professional organizations have issued guidelines stressing the importance of tobacco treatment for patients with cancer. Providing tobacco treatment in the context of lung cancer screening is another opportunity to further reduce death from lung cancer. In this review, the authors describe the current state of tobacco dependence treatment focusing on new paradigms and approaches and their particular relevance...
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Authors: Hasmeena Kathuria, Enid Neptune Source Type: research

The Biology of Lung Cancer
Lung cancer is a heterogeneous disease with abundant genomic alterations. Chronic dysregulated airway inflammation facilitates lung tumorigenesis. In contrast, antitumor host immune responses apply continuous selective pressure on the tumor cells during the evolutionary course of the disease. Unprecedented advances in integrative genomic, epigenomic, and cellular profiling of lung cancer and the tumor microenvironment are enhancing the understanding of pulmonary tumorigenesis. This understanding in turn has led to advancements in lung cancer prevention and early detection strategies, and the development of effective target...
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Authors: Ramin Salehi-Rad, Rui Li, Manash K. Paul, Steven M. Dubinett, Bin Liu Source Type: research

Lung Cancer Screening
Robust evidence exists in support of lung cancer (LC) screening with low-dose computed tomography in patients at high risk of developing LC; however, judicious patient selection is necessary to obtain optimal benefit while minimizing harm. Several professional societies have published recommendations regarding patient selection criteria for screening. Multiple risk prediction models that include additional patient-specific risk factors have since been developed to more accurately predict risk of developing LC. Implementation of a new screening program requires thorough multidisciplinary planning and maintenance. Multisocie...
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Authors: Nina A. Thomas, Nichole T. Tanner Source Type: research

Bronchoscopic Diagnostic Procedures Available to the Pulmonologist
In the diagnosis of lung cancer, pulmonologists have several tools at their disposal. From the tried and true convex probe endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration to robotic bronchoscopy for peripheral lesions and new technology to unblind the biopsy tools, this article elucidates and expounds on the tools currently available and being developed for lung cancer diagnosis. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Authors: A. Cole Burks, Jason Akulian Source Type: research

Approach to the Subsolid Nodule
Most focal persistent ground glass nodules (GGNs) do not progress over 10 years. Research suggests that GGNs that do not progress, those that do, and solid lung cancers are fundamentally different diseases, although histologically they seem similar. Surveillance of GGNs to identify those that gradually progress is safe and does not risk losing a window. GGNs with 5  mm solid component or less than 10 mm consolidation (mediastinal and lung windows, respectively, on thin slice CT) are highly curable with resection. The optimal type of resection is unclear; sublobar resection is reasonable but an adequate margin is ...
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Authors: Vincent J. Mase, Frank C. Detterbeck Source Type: research

Passion, Perseverance, and Quantum Leaps: Lung Cancer in the Twenty-First Century
At the turn of the twentieth century, lung cancer was a rare disease accounting for only 1% of all cancers and found primarily at autopsy. By the 1940s, lung cancer rates had significantly increased. It was the second most common cause of cancer death after gastric cancer, and surgery was the only available treatment. Although a connection between smoking and lung cancer had been recognized by the German physician Fritz Lickint in 1929,1 it was not until the early 1950s, following the publication of 2 landmark studies from the United Kingdom and the United States, that cigarette smoking was identified as an important facto...
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Authors: M. Patricia Rivera, Richard A. Matthay Tags: Preface Source Type: research

Lung Cancer: Part I
CLINICS IN CHEST MEDICINE (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Authors: M. Patricia Rivera, Richard A. Matthay Source Type: research

Copyright
ELSEVIER (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Source Type: research

Contributors
M. PATRICIA RIVERA, MD (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Source Type: research

Contents
M. Patricia Rivera and Richard A. Matthay (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Source Type: research

Forthcoming Issues
Lung Cancer: Part II (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - January 31, 2020 Category: Respiratory Medicine Source Type: research

Biomarkers in Lung Cancer
This article provides an overview of lung cancer biomarker development, focusing on clinical utility and highlighting 2 unmet clinical needs: selection of high-risk patients for lung cancer screening and differentiation of early lung cancer from benign pulmonary nodules. The authors highlight biomarkers under development and those lung cancer screening and nodule management biomarkers post-clinical validation. Finally, trends in lung cancer biomarker development that may improve accuracy and accelerate implementation in practice are discussed. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - January 2, 2020 Category: Respiratory Medicine Authors: Catherine R. Sears, Peter J. Mazzone Source Type: research

Lung Cancer in Women
Lung cancer in women is a modern epidemic and a major health crisis. Cigarette smoking remains the most important risk factor for lung cancer, and unfortunately smoking rates are either stabilized or continue to increase among women. Women may not be more susceptible to the carcinogenic effects of tobacco, but the biology of lung cancer differs between the sexes. This paper summarizes the biological sex differences in lung cancer, including molecular abnormalities, growth factor receptors, hormonal influences, DNA repair capacity, as well as differences in the histology and treatment outcomes of lung cancer in women. (Sour...
Source: Clinics in Chest Medicine - January 2, 2020 Category: Respiratory Medicine Authors: Christina R. MacRosty, M. Patricia Rivera Source Type: research

Lung Cancer Pathology
Lung cancer can be diagnosed based on histologic biopsy or cytologic specimens. The 2015 World Health Organization Classification of Lung Tumors addressed the diagnosis of lung cancer in resection specimens and in small biopsies and cytology specimens. For these small specimens, diagnostic terms and criteria are recommended. Targetable mutations such as EGFR and ALK rearrangements emphasize the importance of managing these small specimens for molecular testing. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - January 2, 2020 Category: Respiratory Medicine Authors: William D. Travis Source Type: research

Therapeutic Bronchoscopic Techniques Available to the Pulmonologist
Therapeutic bronchoscopy for both endobronchial tumors and peripheral lung cancer is rapidly evolving. The expected increase in early stage lung cancer detection and significant improvement in near real-time imaging for diagnostic bronchoscopy has led to the development of bronchoscopy-delivered ablative technologies. Therapies targeting obstructing central airway tumors for palliation and as a method of local disease control, patient selection and patient-centered outcomes have been areas of ongoing research. This review focuses on patient selection when considering therapeutic bronchoscopy and new and developing technolo...
Source: Clinics in Chest Medicine - January 2, 2020 Category: Respiratory Medicine Authors: Matt Aboudara, Otis Rickman, Fabien Maldonado Source Type: research

Epidemiology of Tuberculosis in the United States
Although considerable progress has been made in reducing US tuberculosis incidence, the goal of eliminating the disease from the United States remains elusive. A continued focus on preventing new tuberculosis infections while also identifying and treating persons with existing tuberculosis infection is needed. Continued vigilance to ensure ongoing control of tuberculosis transmission remains key. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Adam J. Langer, Thomas R. Navin, Carla A. Winston, Philip LoBue Source Type: research

New Concepts in Tuberculosis Host Defense
Tuberculosis (TB) host defense depends on cellular immunity, including macrophages and adaptively acquired CD4+ and CD8+ T cells. More recently, roles for new immune components, including neutrophils, innate T cells, and B cells, have been defined, and the understanding of the function of macrophages and adaptively acquired T cells has been advanced. Moreover, the understanding of TB immunology elucidates TB infection and disease as a spectrum. Finally, determinates of TB host defense, such as age and comorbidities, affect clinical expression of TB disease. Herein, the authors comprehensively review TB immunology with an e...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: David M. Lewinsohn, Deborah A. Lewinsohn Source Type: research

Tuberculosis and Biologic Therapies
Biologic drugs have revolutionized the treatment of certain hematologic, autoimmune, and malignant diseases, but they may place patients at risk for reactivation or acquisition of tuberculosis. This risk is highest with the tumor necrosis factor-alpha (TNF- α) inhibitors. Amongst this class of drugs, the monoclonal antibodies (infliximab, adalimumab, golimumab) and antibody fragment (certolizumab) carry an increased risk compared to the soluble receptor fusion molecule, etanercept. Treatment of latent TB is critical to decrease the risk of reactivatio n. Data continues to emerge regarding tuberculosis risk associated...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Mark S. Godfrey, Lloyd N. Friedman Source Type: research

How Can the Tuberculosis Laboratory Aid in the Patient-Centered Diagnosis and Management of Tuberculosis?
In 2019, tuberculosis is still a global source of morbidity and mortality. To determine and provide the most effective treatment regimen to patients, the tuberculosis laboratory needs to rapidly but reliably answer 2 main questions: (1) Is Mycobacterium tuberculosis detectable in the patient specimen? and (2) If so, is the strain detected drug susceptible or does it show any form of drug resistance? In cases of drug resistance, health care providers need to have access to minimal inhibitory concentration results and to the type of mutation conferring drug resistance to tailor the most appropriate drug regimen. (Source: Cli...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Akos Somoskovi, Max Salfinger Source Type: research

Tuberculosis Supranational Reference Laboratories
The World Health Organization Supranational TB Reference Laboratory Network (SRLN) has served as the backbone for TB drug-resistance surveillance and diagnosis since 1994 and remains a key WHO programme for antimicrobial resistance (AMR) surveillance at the global level. SRLN is a great technical resource for proficiency testing to ensure accuracy of drug-susceptibility testing, scale-up, capacity development in countries and provides unique support to the reliable detection of drug resistance. Technical assistance from individual SRLs has been supported by a variety of mechanisms but funding for the SRLN has become increa...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Christopher Gilpin, Fuad Mirzayev Source Type: research

Treatment of Drug-Susceptible Tuberculosis
This article focuses on preferred regimens of drug-susceptible tuberculosis under current guidelines by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America and World Health Organization. In addition, topics including patient centered care, poor treatment outcomes, and adverse effects are also discussed. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Beth Shoshana Zha, Payam Nahid Source Type: research

Diagnostic Tests for Latent Tuberculosis Infection
Diagnosing latent tuberculosis (TB) infection (LTBI) is important globally for TB prevention. LTBI diagnosis requires a positive test for infection and negative evaluation for active disease. Current tests measure an immunologic response and include the tuberculin skin test (TST) and interferon-gamma release assays (IGRAs), T-SPOT.TB and QuantiFERON. The IGRAs are preferred in bacille Calmette-Gu érin–vaccinated populations. The TST is still used when cost or logistical advantages over the IGRAs exist. Both TST and IGRAs have low positive predictive values. Tests that differentiate the TB spectrum and better p...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Michelle K. Haas, Robert W. Belknap Source Type: research

Treatment of Latent Tuberculosis Infection —An Update
Treatment of latent tuberculosis infection (LTBI) is an important component of TB control and elimination. LTBI treatment regimens include once-weekly isoniazid plus rifapentine for 3 months, daily rifampin for 4 months, daily isoniazid plus rifampin for 3 –4 months, and daily isoniazid for 6–9 months. Isoniazid monotherapy is efficacious in preventing TB disease, but the rifampin- and rifapentine-containing regimens are shorter and have similar efficacy, adequate safety, and higher treatment completion rates. Novel vaccine strategies, host immuni ty-directed therapies and ultrashort antimicrobial regimens for ...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Moises A. Huaman, Timothy R. Sterling Source Type: research

The Future of Vaccines for Tuberculosis
Exciting clinical results from 2 clinical TB vaccine trials were published in 2018. These, plus promising preclinical candidates form a healthy pipeline of potential vaccines against the leading cause of death from a single infectious agent. The only licensed vaccine, the BCG, continues to be an important tool in protecting against severe forms of TB in children, but has not stopped the diseases causing 1.3 million deaths per year. This review provides an overview of the current TB vaccine pipeline, highlighting recent findings, describes work relating to epidemiologic impact of vaccines, and discusses the future of TB vac...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Lisa Stockdale, Helen Fletcher Source Type: research

Preventing Transmission of Mycobacterium Tuberculosis —A Refocused Approach
Traditional tuberculosis (TB) infection control focuses on the known patient with TB, usually on appropriate treatment. A refocused, intensified TB infection control approach is presented. Combined with active case finding and rapid molecular diagnostics, an approach called FAST is described as a convenient way to call attention to the untreated patient. Natural ventilation is the mainstay of air disinfection in much of the world. Germicidal ultraviolet technology is the most sustainable approach to air disinfection under resource-limited conditions. Testing and treatment of latent TB infection works to prevent reactivatio...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Edward A. Nardell Source Type: research

New Drugs for the Treatment of Tuberculosis
Tuberculosis (TB) has now surpassed HIV as the leading infectious cause of death, and treatment success rates are declining. Multidrug-resistant TB, extensively drug-resistant TB, and even totally drug-resistant TB threaten to further destabilize disease control efforts. The second wave in TB drug development, which includes the diarylquinoline, bedaquiline, and the nitroimidazoles delamanid and pretomanid, may offer options for simpler, shorter, and potentially all-oral regimens to treat drug-resistant TB. The “third wave” of TB drug development includes numerous promising compounds, including less toxic versi...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Elisa H. Ignatius, Kelly E. Dooley Source Type: research

Treatment of Drug-Resistant Tuberculosis
This article provides an overview of the latest published strategies for clinical and programmatic management of drug-resistant TB. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Sundari R. Mase, Terence Chorba Source Type: research

Management of Children with Tuberculosis
Children carry a significant tuberculosis disease burden in settings with poor epidemic control and high levels of transmission. Even in high-resource settings, the diagnosis of tuberculosis in children can be challenging, but an accurate diagnosis can be achieved by adopting a systematic approach. This review outlines the general principles of tuberculosis prevention in children, including epidemic control, infection control, contact tracing and preventive therapy, and vaccination; diagnosing pediatric tuberculosis, including specimen collection and microbiological confirmation, highlighting key differences from adults; a...
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Ameneh Khatami, Philip N. Britton, Ben J. Marais Source Type: research

Tuberculosis
Caused by Mycobacterium tuberculosis, tuberculosis (TB) remains a leading cause of infectious disease morbidity and mortality worldwide. In 2017, there were 10 million cases and 1.6 million deaths. The impact of TB is particularly harsh on vulnerable populations, such as children and those with human immunodeficiency virus, and its importance to global health is highlighted by the inclusion of the goal of ending TB in the Sustainable Development Goals, and by the first United Nations high-level meeting on TB that we held in September 2018. (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: David M. Lewinsohn, Charles L. Daley Tags: Preface Source Type: research

Tuberculosis
CLINICS IN CHEST MEDICINE (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Authors: Charles L. Daley, David M. Lewinsohn Source Type: research

Copyright
ELSEVIER (Source: Clinics in Chest Medicine)
Source: Clinics in Chest Medicine - November 13, 2019 Category: Respiratory Medicine Source Type: research