Nonpharmacological Therapies for Interstitial Lung Disease
AbstractPurpose of ReviewInterstitial lung diseases (ILDs) cause unpredictable degrees of fibrosis and inflammation in the lungs leading to functional decline and varying symptom burden for patients. Some patients may live for years and be responsive to therapy, and other disease trajectory may be shorter and similar to patients with lung cancer. This ultimately affects the patient ’s quality of life as well as their caregiver(s).Recent FindingsNonpharmacological therapies play an important role in treatment of interstitial lung disease. These include symptom management, pulmonary rehabilitation, oxygen therapy, and pall...
Source: Current Respiratory Care Reports - October 18, 2018 Category: Respiratory Medicine Source Type: research
Evidence-Based Assessment of Bronchial Thermoplasty in Asthma: Mechanisms and Outcomes
AbstractPurpose of ReviewAsthma is a heterogenous, chronic respiratory disease characterized by airway inflammation, obstruction, and hyperresponsiveness that results in debilitating respiratory symptoms. Despite advances in management strategies, severe asthmatics are often not responsive to the standard management and are disproportionately impacted. Bronchial thermoplasty offers a treatment option for this subgroup of severe asthmatics.Recent FindingsMultiple clinical studies have examined bronchial thermoplasty effectiveness and safety in severe asthma. Recent post-market and translational studies have brought new insi...
Source: Current Respiratory Care Reports - October 17, 2018 Category: Respiratory Medicine Source Type: research
Risk Factors for the Development of Idiopathic Pulmonary Fibrosis: a Review
AbstractPurpose of ReviewIdiopathic pulmonary fibrosis (IPF) is an invariably progressive disease. Current treatment options simply slow disease progression, and better therapeutic options are needed. We aimed to review an emerging literature on risk factors associated with the development of IPF.Recent FindingsThere is increasing data to support the role of intrinsic risk factors (e.g., genetics, aging, sex, lung microbiome), comorbidities (e.g., gastroesophageal reflux, obstructive sleep apnea, diabetes mellitus, herpes virus infection), and extrinsic risk factors (e.g., cigarette smoking, environmental exposures, air po...
Source: Current Respiratory Care Reports - October 16, 2018 Category: Respiratory Medicine Source Type: research
Connective Tissue Related Interstitial Lung Disease
AbstractPurpose of ReviewInterstitial lung disease (ILD) is a common complication of the connective tissue diseases (CTD) and results in significant morbidity and mortality. This review will focus on recent literature pertaining to the epidemiology, clinical presentation, diagnosis, and treatment of CTD-ILD.Recent FindingsSubclinical ILD can be found in the majority of patients with CTD. Clinically significant ILD is most commonly seen in scleroderma followed by polymyositis/dermatomyositis and rheumatoid arthritis, although it can occur in all of the CTDs. Nonspecific interstitial pneumonia is the most common radiographic...
Source: Current Respiratory Care Reports - October 8, 2018 Category: Respiratory Medicine Source Type: research
Chronic Lung Allograft Dysfunction
AbstractPurpose of ReviewSynthesize recent developments in the understanding of chronic lung allograft dysfunction (CLAD) epidemiology, pathophysiology, outcomes, and treatments with a focus on the classification of CLAD into restrictive allograft syndrome (RAS) and from bronchiolitis obliterans syndrome (BOS).Recent FindingsChronic lung allograft dysfunction (CLAD) remains the leading cause of long-term morbidity and mortality in lung transplant recipients. Despite the lack of progress on improving outcomes, significant progress has been made in better characterizing the disease ’s clinical and pathologic diversity. Mos...
Source: Current Respiratory Care Reports - October 2, 2018 Category: Respiratory Medicine Source Type: research
Lung Transplantation in Connective Tissue Disease-Associated Interstitial Lung Disease (CTD-ILD)
AbstractPurpose of ReviewConnective tissue disease-related interstitial lung disease (CTD-ILD) previously was a relative contraindication to lung transplantation primarily due to extra-pulmonary involvement of the disease. Recent published information focusing on the diagnosis and management of the extra-pulmonary complexities associated with CTD-ILD that challenge the success of lung transplantation indicate similar outcomes when compared to idiopathic causes of interstitial lung disease. Recent literature examining appropriate wait-listing criteria, disease management, and outcomes after lung transplantation are discusse...
Source: Current Respiratory Care Reports - September 20, 2018 Category: Respiratory Medicine Source Type: research
Rising to the Challenge of Unmet Need: Expanding the Lung Donor Pool
AbstractPurpose of ReviewThere is a shortage of lungs available to meet the needs of patient who require lung transplantation. Ex vivo lung perfusion (EVLP) has allowed for the assessment and reconditioning of extended criteria and high-risk donor lungs, allowing for an increased volume of lung transplants. Recently, an invested interest in the utilization donation after cardiac death (DCD) donors has surfaced, in which EVLP has played an important role.Recent FindingsClinical studies have shown that EVLP can recondition donor lungs that initially would be unacceptable for transplantation. In a recent study, the interventi...
Source: Current Respiratory Care Reports - September 1, 2018 Category: Respiratory Medicine Source Type: research
Risk of Development of Resistance in Patients with Non-Cystic Fibrosis Bronchiectasis Treated with Inhaled Antibiotics
AbstractPurpose of ReviewBronchiectasis is a debilitating chronic lung disease characterised by recurrent bacterial infection and colonisation with significant associated morbidity and mortality. To date, there are few licenced treatments, and the mainstay of clinical management is prompt antibiotic therapy for exacerbations and regular airway clearance. Inhaled antibiotics are a potential long-term treatment for those with recurrent exacerbations, and represent an obvious advantage over other routes of administration as they achieve high concentrations at the site of infection whilst minimising systemic side effects. The ...
Source: Current Respiratory Care Reports - September 1, 2018 Category: Respiratory Medicine Source Type: research
Treatment of Advanced Non-Small Cell Lung Cancer in the Era of Targeted Therapy
AbstractPurpose of ReviewSince the identification of multiple mutations associated with advanced non-small cell lung cancer (NSCLC), many targeted therapies have been developed for the treatment of this subgroup of lung cancers. These targeted therapies have changed the landscape of lung cancer treatment when compared to standard chemotherapy, with improved survival and quality of life. In this review article, we will review the major mutations associated with advanced NSCLC, namely EGFR, ALK, and ROS1. We will discuss their discovery, their clinical significance, and the diagnostic tests used for their detection. We will ...
Source: Current Respiratory Care Reports - September 1, 2018 Category: Respiratory Medicine Source Type: research
It's What ’s Inside that Counts: Body Composition and Lung Transplantation
AbstractPurpose of ReviewFactors such as weight, body composition, and functional status appear to influence lung transplant outcomes. Body mass index (BMI) is incorporated into the International Society for Heart and Lung Transplantation ’s (ISHLT) recipient selection guidelines. Data suggests BMI does not effectively differentiate patients with high body fat percentage or low lean muscle mass, leading to both over and under estimates of candidates’ risks.Recent FindingsRecent research has focused on alternate measures and estimates of body composition and their associations with important lung transplant outcomes. He...
Source: Current Respiratory Care Reports - September 1, 2018 Category: Respiratory Medicine Source Type: research
Risk of Bacterial Transmission in Bronchiectasis Outpatient Clinics
AbstractPurpose of ReviewThe purpose of this review is to discuss the risk of bacterial cross-infection for bronchiectasis patients in the outpatient setting. Cross-infection has primarily been a matter of concern in cystic fibrosis (CF). There is considerable evidence of transmission of pathogens between CF patients, and this has led to guideline recommendations advocating strict segregation policies. Guidelines in bronchiectasis do not specifically address the issue of cross-infection. If cross-infection is prevalent, it may have significant implications for patients and the practical running of specialist care.Recent Fi...
Source: Current Respiratory Care Reports - September 1, 2018 Category: Respiratory Medicine Source Type: research
Rising to the Challenge of Unmet Need: Expanding the Lung Donor Pool
AbstractPurpose of ReviewThere is a shortage of lungs available to meet the needs of patient who require lung transplantation. Ex vivo lung perfusion (EVLP) has allowed for the assessment and reconditioning of extended criteria and high-risk donor lungs, allowing for an increased volume of lung transplants. Recently, an invested interest in the utilization donation after cardiac death (DCD) donors has surfaced, in which EVLP has played an important role.Recent FindingsClinical studies have shown that EVLP can recondition donor lungs that initially would be unacceptable for transplantation. In a recent study, the interventi...
Source: Current Respiratory Care Reports - August 11, 2018 Category: Respiratory Medicine Source Type: research
Treatment of Advanced Non-Small Cell Lung Cancer in the Era of Targeted Therapy
AbstractPurpose of ReviewSince the identification of multiple mutations associated with advanced non-small cell lung cancer (NSCLC), many targeted therapies have been developed for the treatment of this subgroup of lung cancers. These targeted therapies have changed the landscape of lung cancer treatment when compared to standard chemotherapy, with improved survival and quality of life. In this review article, we will review the major mutations associated with advanced NSCLC, namely EGFR, ALK, and ROS1. We will discuss their discovery, their clinical significance, and the diagnostic tests used for their detection. We will ...
Source: Current Respiratory Care Reports - August 6, 2018 Category: Respiratory Medicine Source Type: research
