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 - July 14, 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 - July 5, 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 - July 2, 2018 Category: Respiratory Medicine Source Type: research
NSCLC: State of the Art Diagnosis, Treatment, and Outcomes
AbstractPurpose of ReviewLung cancer is the major cause of cancer mortality in the USA. In this review, we aim to provide a general update on the current status of non-small cell lung cancer (NSCLC) management.Recent FindingsNovel approaches in the diagnosis and treatment of non-small cell lung cancer have been made recently and this was revolutionary in the way lung cancer management has changed even-though the improvement in overall survival remains modest. Furthermore, lung cancer screening using low-dose computed tomography scan has shown benefit in high-risk populations.SummaryThe diagnosis of lung cancer has evolved ...
Source: Current Respiratory Care Reports - June 1, 2018 Category: Respiratory Medicine Source Type: research
Consensus on Molecular Testing in Lung Cancer
AbstractPurpose of ReviewMolecular testing for lung cancer has evolved dramatically over the last decade, driven primarily by the rapid development of targeted therapies. Initial testing was intended to make appropriate therapeutic choices with primary single gene testing and has evolved into larger sensitive and specific panels to evaluate multiple genes.Recent FindingsThe wide array of technologies and an increasing number of targeted therapies have resulted in increasingly complex management algorithms. In this article, we review the current guidelines, briefly discuss individual targets, and introduce some of the compl...
Source: Current Respiratory Care Reports - June 1, 2018 Category: Respiratory Medicine Source Type: research
Making Sense of Immunotherapy in Lung Cancer: What the Pulmonologist Needs to Know?
AbstractPurpose of ReviewThe landscape of lung cancer therapy has completely shifted in the last decade. From the surge of targeted therapy to the resurrection of immunotherapy, the need for adequate lung tissue specimen is critical to evaluate tumor specimens for predictive biomarkers for both types of therapies, hence, the importance of obtaining several samples via endoscopic bronchial ultrasound performed by pulmonologists or thoracic surgeons. Moreover, these novel therapies have also been associated with respiratory side effects which will require prompt evaluation and aggressive management by pulmonologists, oncolog...
Source: Current Respiratory Care Reports - June 1, 2018 Category: Respiratory Medicine Source Type: research
Air Travel-Related Spontaneous Pneumothorax in Diffuse Cystic Lung Diseases
AbstractPurpose of ReviewSpontaneous pneumothorax (SP) is a common manifestation of patients with diffuse cystic lung diseases (DCLDs) such as lymphangioleiomyomatosis (LAM), pulmonary Langerhans cell histiocytosis (PLCH), and Birt-Hogg-Dub é syndrome (BHD). Air travel may pose an additional risk for the development of SP. Here, we summarize the literature pertaining to air travel-related SP in DCLDs in order to assist patients and clinicians in appropriate decision-making with regard to air travel.Recent FindingsSeveral recent studies have estimated that the per-flight risk of SP in patients with DCLDs is approximately 1...
Source: Current Respiratory Care Reports - June 1, 2018 Category: Respiratory Medicine Source Type: research
Consensus on Molecular Testing in Lung Cancer
AbstractPurpose of ReviewMolecular testing for lung cancer has evolved dramatically over the last decade, driven primarily by the rapid development of targeted therapies. Initial testing was intended to make appropriate therapeutic choices with primary single gene testing and has evolved into larger sensitive and specific panels to evaluate multiple genes.Recent FindingsThe wide array of technologies and an increasing number of targeted therapies have resulted in increasingly complex management algorithms. In this article, we review the current guidelines, briefly discuss individual targets, and introduce some of the compl...
Source: Current Respiratory Care Reports - May 19, 2018 Category: Respiratory Medicine Source Type: research
Making Sense of Immunotherapy in Lung Cancer: What the Pulmonologist Needs to Know?
AbstractPurpose of ReviewThe landscape of lung cancer therapy has completely shifted in the last decade. From the surge of targeted therapy to the resurrection of immunotherapy, the need for adequate lung tissue specimen is critical to evaluate tumor specimens for predictive biomarkers for both types of therapies, hence, the importance of obtaining several samples via endoscopic bronchial ultrasound performed by pulmonologists or thoracic surgeons. Moreover, these novel therapies have also been associated with respiratory side effects which will require prompt evaluation and aggressive management by pulmonologists, oncolog...
Source: Current Respiratory Care Reports - April 10, 2018 Category: Respiratory Medicine Source Type: research
NSCLC: State of the Art Diagnosis, Treatment, and Outcomes
AbstractPurpose of ReviewLung cancer is the major cause of cancer mortality in the USA. In this review, we aim to provide a general update on the current status of non-small cell lung cancer (NSCLC) management.Recent FindingsNovel approaches in the diagnosis and treatment of non-small cell lung cancer have been made recently and this was revolutionary in the way lung cancer management has changed even-though the improvement in overall survival remains modest. Furthermore, lung cancer screening using low-dose computed tomography scan has shown benefit in high-risk populations.SummaryThe diagnosis of lung cancer has evolved ...
Source: Current Respiratory Care Reports - April 3, 2018 Category: Respiratory Medicine Source Type: research
Air Travel-Related Spontaneous Pneumothorax in Diffuse Cystic Lung Diseases
AbstractPurpose of ReviewSpontaneous pneumothorax (SP) is a common manifestation of patients with diffuse cystic lung diseases (DCLDs) such as lymphangioleiomyomatosis (LAM), pulmonary Langerhans cell histiocytosis (PLCH), and Birt-Hogg-Dub é syndrome (BHD). Air travel may pose an additional risk for the development of SP. Here, we summarize the literature pertaining to air travel-related SP in DCLDs in order to assist patients and clinicians in appropriate decision-making with regard to air travel.Recent FindingsSeveral recent studies have estimated that the per-flight risk of SP in patients with DCLDs is approximately 1...
Source: Current Respiratory Care Reports - April 3, 2018 Category: Respiratory Medicine Source Type: research
Corticosteroids in Lung and Pleural Infections
AbstractPurpose of ReviewDespite modern healthcare practices and antimicrobial agents, community-acquired pneumonia (CAP) and associated parapneumonic effusion (PPE) are still common, associated with significant morbidity and mortality, and responsible for significant healthcare system costs globally. There is a need for adjunctive therapies to improve their clinical outcomes. The use of corticosteroids as an adjunctive therapy to suppress the inflammatory response in CAP has received significant attention.Recent FindingsIn this paper, we review in detail the randomized clinical trials to date on the use of corticosteroids...
Source: Current Respiratory Care Reports - February 3, 2018 Category: Respiratory Medicine Source Type: research
Malignant Pleural Effusion from Lung Cancers with Driver Mutations
AbstractPurpose of ReviewThe presence of driver mutations in lung cancer determines the natural course, options of specific targeted therapies and therefore prognosis and survival. The current review summarizes the knowledge about malignant pleural effusion (MPE) in lung cancer with driver mutations and the limited literature on this topic.Recent FindingsThe availability of targeted therapy highly effective in tumor control and reducing pleural effusion implies that a definitive pleural fluid control measure may not be beneficial at the early stage of the treatment. However, resistance to targeted therapies invariably deve...
Source: Current Respiratory Care Reports - February 1, 2018 Category: Respiratory Medicine Source Type: research
Endobronchial Therapy for Persistent Air Leak
AbstractPurpose of ReviewPersistent air leak (PAL) after intercostal drain insertion delays lung reexpantion, increases complications, and results in longer hospital stays and higher treatment costs. A proportion of patients will have comorbid disease or severe underlying lung disease, precluding surgery. We aimed to review the current available endobronchial treatments for PAL and the evidence for their use.Recent FindingsThe Watanabe spigot had success rates of 57% in early reports. There are numerous case reports and series evaluating endobronchial and intrabronchial valves in the management of PAL. Success rates range ...
Source: Current Respiratory Care Reports - February 1, 2018 Category: Respiratory Medicine Source Type: research
