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At a crossroads: coronavirus disease 2019 recovery and the risk of pulmonary vascular disease
Purpose of review The coronavirus disease 2019 (COVID-19) pandemic has led to almost 3,000,000 deaths across 139 million people infected worldwide. Involvement of the pulmonary vasculature is considered a major driving force for morbidity and mortality. We set out to summarize current knowledge on the acute manifestations of pulmonary vascular disease (PVD) resulting from COVID-19 and prioritize long-term complications that may result in pulmonary hypertension (PH). Recent findings Acute COVID-19 infection can result in widespread involvement of the pulmonary vasculature, myocardial injury, evidence of persisten...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: DISORDERS OF THE PULMONARY CIRCULATION: Edited by Steven D. Nathan, Christopher King and Oksana A. Shlobin Source Type: research

Postpulmonary embolism syndrome
Purpose of review It is now recognized that more than half of patients with acute pulmonary embolism (APE) will have persistent symptoms beyond 3 months after their initial event. Persistent symptoms are referred to as post-PE syndrome, an umbrella term that covers a spectrum of patient complaints and underlying pathologies. Data published over the last 5 years have added significantly to our understanding of this syndrome and its management. Recent findings Underlying pathologies linked to post-PE syndrome include chronic thromboembolic pulmonary hypertension (CTEPH), chronic thromboembolic disease (CTED), ca...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: DISORDERS OF THE PULMONARY CIRCULATION: Edited by Steven D. Nathan, Christopher King and Oksana A. Shlobin Source Type: research

Metabolics of PH – an update
Purpose of review While there has been a longstanding interest in metabolic disease in pulmonary hypertension, publications in the last several years have translated basic science findings to human disease and even led to recently published studies of metabolic therapy in pulmonary arterial hypertension that are discussed here. Recent findings Progress has been made in four key areas including mechanisms of insulin resistance in pulmonary arterial hypertension, the role of obesity in pulmonary vascular disease, novel clinical trials targeting metabolism in pulmonary hypertension, and the role of metabolism in ch...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: DISORDERS OF THE PULMONARY CIRCULATION: Edited by Steven D. Nathan, Christopher King and Oksana A. Shlobin Source Type: research

The different facets of sickle cell disease-related pulmonary hypertension
Purpose of review Sickle cell disease (SCD), one of the most common genetic diseases in the world, is characterized by repeated episodes of hemolysis and vaso-occlusion. Hemolytic anemia is a risk factor for the development of pulmonary hypertension, and currently SCD-related pulmonary hypertension is classified as World Health Organization group 5 pulmonary hypertension. Patients with SCD-related pulmonary hypertension have unique hemodynamics, multiple comorbidities, and distinct phenotypes that may contribute to the development of pulmonary hypertension. Recent findings SCD-related pulmonary hypertension is d...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: DISORDERS OF THE PULMONARY CIRCULATION: Edited by Steven D. Nathan, Christopher King and Oksana A. Shlobin Source Type: research

Direct oral anticoagulant use in special populations
Purpose of review The pivotal phase III trials demonstrating efficacy and safety of direct oral anticoagulants (DOACs) in the treatment of venous thromboembolism (VTE) or nonvalvular atrial fibrillation (NVAF) excluded patients with important and common comorbidities, including obesity, advanced chronic kidney disease, cirrhosis, cancer and antiphospholipid antibody syndrome. Despite the lack of large prospective randomized control trials in these patient populations, the use of DOACs has led to a wealth of efficacy and safety data within these groups. Recent findings Retrospective studies, meta-analyses, nation...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: DISORDERS OF THE PULMONARY CIRCULATION: Edited by Steven D. Nathan, Christopher King and Oksana A. Shlobin Source Type: research

Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: advances in patient and lesion selection
Purpose of review Balloon pulmonary angioplasty (BPA) has been performed worldwide for patients who are ineligible for pulmonary endarterectomy (PEA). However, the technical details of BPA have not been standardized, and no international consensus regarding patient and lesion selection for BPA has been reached. Evidence for the combination of BPA with PEA or medical therapy is also lacking. This review highlights recent progress in BPA in terms of patient and lesion selection and the current procedural approach for BPA, including combination treatment. Recent findings The indications for BPA have expanded with r...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: DISORDERS OF THE PULMONARY CIRCULATION: Edited by Steven D. Nathan, Christopher King and Oksana A. Shlobin Source Type: research

Shifting gears: the search for group 3 pulmonary hypertension treatment
Purpose of review Treatment options for Group 3 pulmonary hypertension, characterized as secondary to chronic hypoxia or lung disease, remain an elusive holy grail for physicians and patients alike. Despite increasing identification and investigation into this pulmonary vasculopathy group with the second-highest frequency and highest mortality, there are no therapeutic interventions that offer the significant improvements in morbidity and mortality comparable to those benefiting other pulmonary hypertension groups including pulmonary arterial hypertension. This review examines the data on available and emerging Group 3...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: DISORDERS OF THE PULMONARY CIRCULATION: Edited by Steven D. Nathan, Christopher King and Oksana A. Shlobin Source Type: research

Sarcoidosis associated pulmonary hypertension: an update
Purpose of review Sarcoidosis associated pulmonary hypertension (SAPH) is a well-recognised complication, associated with a seven-fold increase in mortality. This comprehensive review will summarise these recent developments and proposes the use of a phenotype-based management approach in SAPH. Recent findings Recent registry-based studies have highlighted the adverse outcomes associated with SAPH and shown that reduced 6-min walk distance and diffusion capacity for carbon monoxide are predictive of poor prognosis. There is increasing interest in methods for early detection of SAPH, although whether early diagno...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: DISORDERS OF THE PULMONARY CIRCULATION: Edited by Steven D. Nathan, Christopher King and Oksana A. Shlobin Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Pulmonary Medicine)
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: EDITORIAL INTRODUCTIONS Source Type: research

Pulmonary toxicity associated with occupational and environmental exposure to pesticides and herbicides
Purpose of review Critical review on the notion that exposure to pesticides and herbicides lead to adverse effects in pulmonary health. Recent findings The lung effects of several chemical classes of pesticides and herbicides is biologically plausible. However, the studies that describe the association between exposure and toxic lung effects have numerous limitations. Critical evaluation of the studies that are performed shows that assessment of occupational or environmental exposure to pesticides and herbicides is cumbersome. Moreover, the health effects are not always clearly established due to the use of ques...
Source: Current Opinion in Pulmonary Medicine - June 8, 2021 Category: Respiratory Medicine Tags: PULMONARY TOXICITY OF PESTICIDES AND HERBICIDES: Edited by Aalt Bast Source Type: research

Severe pulmonary toxicity associated with inhalation of pyrethroid-based domestic insecticides (Bop/Sapolio): a case series and literature review
We present three cases of severe pulmonary toxicity after inhalation of pyrethroid-based insecticides demanding hospitalization and oxygen therapy. One of these cases died. Although a causal relationship was hard to establish, these cases all demonstrated an obvious history of (repeated) pyrethroid exposure associated with ILD. Moreover, other causes of ILD as well as infections were excluded. Furthermore, studies in mammals as well as aquatic animals confirm (pulmonary) toxicity of pyrethroids. The occurrence of toxicity is dose-dependent but also associated with individual susceptibility. Therefore, we would like to ackn...
Source: Current Opinion in Pulmonary Medicine - June 8, 2021 Category: Respiratory Medicine Tags: PULMONARY TOXICITY OF PESTICIDES AND HERBICIDES: Edited by Aalt Bast Source Type: research

Labelling and denominating lung toxicity effects of pesticides
Purpose of review With the development and use of pesticide products increasing, information on the safe handling of pesticides becomes increasingly important. In this article, the denomination of lung toxicity on labelling is reviewed. Recent findings The results highlight that whereas hazards, warning statements and instructions for safe use are broadly defined, the different categories of products used as pesticides are associated with different types of clinical manifestations of toxicity. These clinical manifestations are however not directly warned for by means of information provided on the label: more ov...
Source: Current Opinion in Pulmonary Medicine - June 8, 2021 Category: Respiratory Medicine Tags: PULMONARY TOXICITY OF PESTICIDES AND HERBICIDES: Edited by Aalt Bast Source Type: research

Editorial: Pesticides and lung function
No abstract available (Source: Current Opinion in Pulmonary Medicine)
Source: Current Opinion in Pulmonary Medicine - June 8, 2021 Category: Respiratory Medicine Tags: PULMONARY TOXICITY OF PESTICIDES AND HERBICIDES: Edited by Aalt Bast Source Type: research

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia: DIPNECH
Purpose of review Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is a rare premalignant condition. Over the past decade, there has been increased recognition and reporting of DIPNECH in the literature. Currently, our understanding is that DIPNECH has a predilection to nonsmoking females around their sixth decade of life. The patients usually present with chronic cough, dyspnea, and computed tomography (CT) showing multifocal pulmonary nodules with associated mosaic attenuation. The clinic history is largely driven by constrictive obliterative bronchiolitis, which typically has an indolent course...
Source: Current Opinion in Pulmonary Medicine - June 8, 2021 Category: Respiratory Medicine Tags: NEOPLASMS OF THE LUNG: Edited by Alan Fein and David E. Ost Source Type: research

The evolving paradigm of precision medicine in lung cancer
Purpose of review In this review, we report a complete and updated summary of the most recent treatment advances in the fields of oncogene-addicted disease and provide expert perspectives on the evolving paradigm of precision medicine in lung cancer patients. Recent findings The advent of innovative genome sequencing technologies is rapidly increasing the number of targetable molecular alterations in advanced nonsmall cell lung cancer (NSCLC), leading to the introduction of novel selective inhibitors into the clinical arena, showing unprecedent tumor responses against rare and elusive NSCLC targets. The results ...
Source: Current Opinion in Pulmonary Medicine - June 8, 2021 Category: Respiratory Medicine Tags: NEOPLASMS OF THE LUNG: Edited by Alan Fein and David E. Ost Source Type: research