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Use of biologics for the treatment of moderate-to-severe asthma: the age of personalized medicine
Purpose of review There are multiple FDA-approved biologics to treat poorly controlled moderate-to-severe asthma. Given the heterogeneity of asthma and the lack of head-to-head data between biologics, selecting the best biologic for a patient can be difficult. This review summarizes the key literature to date, in hopes of facilitating an evidence-based approach to selecting the most appropriate biologic for patients with asthma. Recent findings In addition to unique mechanisms of action, there is increasing literature on predictors of response to each biologic, such as sensitizations to aeroallergens, peripheral...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: ASTHMA: Edited by Jonathan A. Bernstein Source Type: research

Paediatric asthma - all that wheezes is not necessarily asthma - current diagnostic and management strategies
Purpose of review Asthma is a frequently encountered chronic medical condition encountered in paediatrics, affecting 7% of children under the age of 18 in the United States. Although asthma is one of the more common conditions that is associated with wheezing, there is a broad differential diagnosis to consider. The purpose of this review is to describe other causes of wheezing outside of asthma in a paediatric population and discuss diagnostic and management strategies to consider when evaluating a child or adolescent with wheezing. Recent findings The characteristics of the wheezing along with other associated...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: ASTHMA: Edited by Jonathan A. Bernstein Source Type: research

Asthma diagnosis using patient-reported outcome measures and objective diagnostic tests: now and into the future
Purpose of review The global prevalence of asthma continues to increase; however, asthma remains under-diagnosed and under-treated. This results in a significant burden on the healthcare system and preventable patient morbidity and mortality. Over-diagnosis of asthma based on clinical history alone also complicates patient management. This heightens the importance of a prompt and accurate asthma diagnosis. Therefore, a review of the literature was performed regarding both objective diagnostic testing for asthma and using patient-reported outcome measures. Recent findings The cornerstone of asthma diagnosis remai...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: ASTHMA: Edited by Jonathan A. Bernstein Source Type: research

SMART - is it practical in the United States?
Purpose of review The 2020 focused updates to the asthma management guidelines by the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group advocate for inhaled corticosteroid (ICS)-formoterol combinations as single maintenance and reliever therapy (SMART) for patients with persistent asthma. We review the rationale, the evidence supporting SMART use in asthma, and barriers limiting its wide adoption in the United States. Recent findings A growing body of evidence supports the use of SMART over the conventional use of controller medicaments with an as-needed short-act...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: ASTHMA: Edited by Jonathan A. Bernstein Source Type: research

Asthma guidelines: comparison of the National Heart, Lung, and Blood Institute Expert Panel Report 4 with Global Initiative for Asthma 2021
Purpose of review Asthma continues to be a prevalent respiratory disease that affects lives within the United States and worldwide. Clinical asthma guidelines based on scientific evidence on testing and therapeutic interventions are needed to control this disease better. To meet this need, the NAEPP (National Asthma Education and Prevention Program) and GINA (Global Initiative for Asthma) were formed to assist with best practice diagnosis and treatments for asthma. This paper reviews the subtle differences and similarities between the most recent recommendations put forth by NAEPP 2020 and GINA 2021, mainly examining t...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: ASTHMA: Edited by Jonathan A. Bernstein Source Type: research

Editorial: Advancements in asthma diagnosis and management: what's new?
No abstract available (Source: Current Opinion in Pulmonary Medicine)
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: ASTHMA: Edited by Jonathan A. Bernstein Source Type: research

Advancing bacteriophages as a treatment of antibiotic-resistant bacterial pulmonary infections
Purpose of review The current article summarizes the recent advances in the use of bacteriophages to treat pulmonary infections, particularly those caused by Gram-negative drug-resistant bacteria, including Pseudomonas aeruginosa, Acinetobacter baumannii, Klebsiella pneumoniae and Burkholderia species. It provides an updated overview of the current available evidence, with a summary of published clinical cases, case series and clinical trials currently underway. Recent finding Personalized treatment with bacteriophages is still in its infancy in Europe and the USA, despite extensive experience in Eastern countries. ...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research

Disease-specific gaps within fungal respiratory tract infections: clinical features, diagnosis, and management in critically ill patients
Purpose of review We aim to examine the most recent findings in the area of invasive pulmonary fungal infections to determine the appropriate/and or lack of prevention measures and treatment of upper fungal respiratory tract infections in the critically ill. Recent findings This will be addressed by focusing on the pathogens and prognosis over different bedridden periods in ICU patients, the occurrence of invasive fungal respiratory superinfections in patients with severe coronavirus disease 2019 which has been recently noted following the SARS-CoV-2 pandemic. Relevant reports referenced within include randomize...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research

Drug-resistant tuberculosis: advances in diagnosis and management
Purpose of review Diagnosis and treatment of drug-resistant tuberculosis (DR-TB) is undergoing substantial changes, owing availability of new diagnostic tools and drugs, coupled with global underdiagnosis and undertreatment. Recent developments are reviewed. Recent findings Molecular diagnostics, for Mycobacterium tuberculosis complex detection and prediction of drug resistance, implemented in the last decade, accelerated TB diagnosis with improved case detection. Nevertheless, access and coverage of drug-resistance testing remain insufficient. Genome sequencing-technologies, based on targeted next-generation se...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research

Respiratory viral infections in the immunocompromised
Purpose of review During much of the COVID-19 pandemic, respiratory viruses other than SARS-CoV-2 did not infect immunocompromised patients. As mitigation strategies lighten, there has been a rapid resurgence of respiratory viruses globally. This review will summarize our current options for the management of the common respiratory viruses in transplant recipients. Recent findings Expansion of the availability and increased utilization of multiplex molecular assays have allowed the recognition of the scope of respiratory virus infections in the transplant populations. New antivirals for influenza, respiratory sy...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research

Influenza: clinical aspects, diagnosis, and treatment
Purpose of review To review the clinico-epidemiological aspects of influenza in the context of the Coronavirus Disease 2019 (COVID-19) pandemic; the recent advances in point-of-care molecular diagnostics and co-detection of influenza and coronaviruses, and the development of new influenza therapeutics. Recent findings Rates of influenza have declined globally since the 2020–2021 season; waning population immunity and uncertainty in vaccine strains could pose a risk in its significant resurgence, especially where pandemic public health interventions start being lifted. As symptoms are similar for influenza and ...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research

COVID-19 and other respiratory tract infections at mass gathering religious and sporting events
Purpose of review Mass gathering (MG) religious events provide ideal conditions for transmission and globalization of respiratory tract infections (RTIs). We review recent literature on COVID-19 and other RTIs at recurring international annual MG religious and sporting events. Recent findings Due to the COVID-19 pandemic organizers of MG religious and sporting events introduced risk-based infection control measures that limited transmission of RTIs. The 2020 and 2021 Hajj were conducted with limited numbers of pilgrims compared to the annual millions of pilgrims. The Tokyo 2020 Olympic and Paralympic Games were ...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research

COVID-19: vaccines, efficacy and effects on variants
Purpose of review We reviewed three leading strategies of vaccine development against coronavirus disease 2019 (COVID- 19): mRNA vaccines, adenoviral vector vaccines and recombinant nanoparticles. We also considered the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants and their impact on the effectiveness of the most widely implemented vaccines. Recent findings General properties, efficacy, safety and global uptake of Pfizer/BioNTech's Comirnaty (BNT162b2), Moderna's Spikevax (mRNA-1273), Oxford/AstraZeneca's ChAdOx1 nCoV-19, J&J/Janssen's Ad26.COV2.S and Novavax's NVX-CoV2373 v...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research

A clinical review of long-COVID with a focus on the respiratory system
Purpose of review Persistence of symptoms after acute coronavirus disease 2019 (COVID-19), often described as long- COVID, is common and debilitating. In this article, we review the epidemiology, clinical features, and research priorities for long-COVID focusing on the respiratory system. Recent findings Breathlessness, cough and chest pain were the most commonly reported respiratory symptoms associated with long-COVID. In hospitalised patients, abnormalities on lung function testing or chest imaging were observed less commonly at 12 months compared to six months since discharge. Clinical assessment of patient...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research

Advances in the epidemiology, clinical features, diagnosis, clinical management and prevention of coronavirus disease 2019
Purpose of review The current article reviews the latest information on the epidemiology, clinical features, diagnostics, clinical management and prevention of coronavirus disease 2019 (COVID-19). Recent findings Atypical pneumonia due to severe acute respiratory syndrome coronavirus-2 emerged in December 2019 in a market in Wuhan, China and rapidly evolved into a pandemic in March 2020. Viral loads of patients with COVID-19 peak in the first week of illness around day 2-4 and hence there is very high-transmission potential causing community outbreaks. Asymptomatic and presymptomatic transmission is a hallmark o...
Source: Current Opinion in Pulmonary Medicine - May 1, 2022 Category: Respiratory Medicine Tags: INFECTIOUS DISEASES: Edited by Alimuddin Zumla and David S. C. Hui Source Type: research