Bronchiectasis Epidemiology and Risk Factors
AbstractPurpose of ReviewThe purpose of this review article was to understand the global trends in bronchiectasis, understand the risk factors and appreciate the role of comorbidities in bronchiectasis.Recent FindingsThe burden of bronchiectasis has been increasing globally over the last decade. Data from national registries suggest geographical variations in aetiology and prevalence, which has further led to the creation of national guidelines for the management of bronchiectasis. Comorbidities play an important role in the prognosis, with some playing a direct role in disease development and progression. Systemic and air...
Source: Current Respiratory Care Reports - July 6, 2023 Category: Respiratory Medicine Source Type: research
Checkpoint Inhibitor-Induced Pneumonitis: Incidence and Management
AbstractPurpose of ReviewDespite immune checkpoint inhibitors ’ (ICIs) many notable benefits, they carry the risk of immune-related adverse events (irAEs). Checkpoint inhibitor pneumonitis (CIP) is an irAE with significant morbidity and mortality. Early recognition and understanding of treatments are essential for those who prescribe ICIs or manage patients on therapy.Recent FindingsEarly detection of pneumonitis may be aided by increased serum CRP and IL-6 levels. Additionally, immunosuppressive treatment for patients failing steroids demonstrates that infliximab and tocilizumab provide some benefit, but outcomes remain...
Source: Current Respiratory Care Reports - July 5, 2023 Category: Respiratory Medicine Source Type: research
Allergic Bronchopulmonary Aspergillosis: Pathogenesis, Diagnosis, and Management
AbstractPurpose of ReviewThis review highlights the role of eosinophilic mucus plugs in the bronchi and IgE immune responses in the pathogenesis, diagnosis, and management of allergic bronchopulmonary aspergillosis (ABPA).Recent FindingsIn addition to type I hypersensitivity to fungi, extracellular trap cell death of eosinophils is closely associated with disease mechanisms. In addition, biologics targeting either the IgE- or eosinophil-mediated pathways may be effective in the treatment of ABPA. Therefore, new diagnostic criteria focusing on both pathways have been validated as being more useful than the existing criteria...
Source: Current Respiratory Care Reports - June 25, 2023 Category: Respiratory Medicine Source Type: research
Idiopathic Pulmonary Fibrosis: 8 Years On After Nintedanib and Pirfenidone Approval —What Is on the Horizon?
AbstractPurpose of ReviewThe approval of nintedanib and pirfenidone has changed the treatment landscape of idiopathic pulmonary fibrosis (IPF); however, both drugs only slow disease progression and are burdened by tolerability issues. We summarize the most advanced developmental drugs in IPF, but also mention selected compounds in earlier phases.Recent FindingsSeveral compounds are currently being tested in IPF; the number of trials has increased exponentially in the last 3 years. Four compounds have reached phase 3: BI101550, an oral PDE4B preferential inhibitor; Pamrevlumab, an anticonnective tissue growth factor intra...
Source: Current Respiratory Care Reports - June 20, 2023 Category: Respiratory Medicine Source Type: research
Cryobiopsy in Interstitial Lung Disease: Is It Prime Time?
AbstractPurpose of ReviewTransbronchial cryobiopsy (TBCB) may be used as an alternative to surgical lung biopsy (SLB) for the histopathologic evaluation of interstitial lung disease (ILD) at experienced centers. The purpose of this review is to discuss recent guidelines and evidence for the use of TBCB in the diagnosis of ILD including technique, review of efficacy, safety, and future perspectives.Recent FindingsTBCB delivers reasonable diagnostic efficacy and offers meaningful contributions to multidisciplinary discussion (MDD) by increasing diagnostic confidence, providing prognostic information, and influencing manageme...
Source: Current Respiratory Care Reports - June 1, 2023 Category: Respiratory Medicine Source Type: research
Correction to: Palliative Care and End-of-Life Decisions in Interstitial Lung Disease
(Source: Current Respiratory Care Reports)
Source: Current Respiratory Care Reports - May 31, 2023 Category: Respiratory Medicine Source Type: research
Pulmonary Hypertension in Interstitial Lung Disease: Management Options to Move Beyond Supportive Care
AbstractPurpose of ReviewThis review delineates current diagnostic and management strategies for pulmonary hypertension due to interstitial lung disease (PH-ILD).Recent FindingsThe INCREASE trial, a phase III multicenter, randomized, placebo-controlled trial demonstrated both improved 6-min walk distance and decreased disease progression with inhaled treprostinil. This pivotal trial led to inhaled treprostinil becoming the first FDA approved medication for treatment of PH-ILD. The availability of this treatment has generated subsequent recommendations for the screening for PH in patients with ILD. As a result, it is becomi...
Source: Current Respiratory Care Reports - May 22, 2023 Category: Respiratory Medicine Source Type: research
Interstitial Pneumonia with Autoimmune Features: 8 Years after Nomenclature and Classification —Where are We Not and Where Are We Headed?
AbstractPurpose of ReviewThe term interstitial pneumonia with autoimmune features (IPAF) was proposed by an international task force as a research classification to standardize nomenclature for patients with idiopathic interstitial pneumonia (IIP) and features of connective tissue disease (CTD). This review aims to discuss the advances made in understanding this research classification and the clinical implications of this term.Recent FindingsMultiple cohort studies have described the clinical presentation of patients meeting criteria for IPAF with heterogeneity noted particularly in the morphologic domain as compared to c...
Source: Current Respiratory Care Reports - May 16, 2023 Category: Respiratory Medicine Source Type: research
Diagnostic Approach and Management of Cardiac Sarcoidosis
AbstractPurpose of ReviewSarcoidosis is a systemic inflammatory disorder affecting multiple organ systems, with heterogenous clinical sequelae. Cardiac sarcoidosis (CS) is an underrecognized manifestation with significant clinical implications. Advances in cardiac imaging and new therapeutic options are rapidly changing the clinical approach to CS.Recent FindingsCardiac magnetic resonance imaging (CMR),18Fluorodeoxyglucose positron emission tomography (FDG-PET), and hybrid CMR/FDG-PET imaging have emerged as powerful diagnostic and prognostic tools for CS and provide a means to monitor disease activity. Therapeutic options...
Source: Current Respiratory Care Reports - May 10, 2023 Category: Respiratory Medicine Source Type: research
Current Perspectives in Treatment of Obstructive Sleep Apnea: Positive Airway Pressure
AbstractPurpose of ReviewSleep apnea is prevalent and associated with increased overall and cardiovascular morbidity and mortality. Positive airway pressure has been the mainstay of treatment for decades, however newer treatments are available. We provide an update on the state of positive airway pressure delivery and its effectiveness compared to other sleep apnea treatments.Recent FindingsWell-designed prospective cohort studies of sleep apnea have consistently demonstrated morbidity and mortality benefit with positive airway pressure. Randomized controlled trials have not consistently demonstrated such clear benefit, al...
Source: Current Respiratory Care Reports - May 3, 2023 Category: Respiratory Medicine Source Type: research
Palliative Care and End-of-Life Decisions in Interstitial Lung Disease
AbstractPurpose of ReviewThis review examines recent pulmonary and palliative medicine literature to evaluate the current state of palliative and end-of-life care in interstitial lung diseases (ILDs), addressing unmet needs, challenges, and evidence for best practices.Recent FindingsPatients with ILD and their caregivers do not receive timely and comprehensive supportive and palliative care due to barriers in initiating palliative care on the part of healthcare teams as well as patients and caregivers. Multidisciplinary teams with early integrated palliative care can offer better palliative care for patients with ILD and c...
Source: Current Respiratory Care Reports - April 28, 2023 Category: Respiratory Medicine Source Type: research
Post COVID Interstitial Lung Abnormalities —Incidence and Management
AbstractPurpose of ReviewThis review aims to summarize the available literature to identify the incidence and risk factors for persistent interstitial lung abnormalities (ILAs) following hospitalization for COVID-19. The current and prospective treatment options are reviewed in an effort to help pulmonary practitioners care for this burgeoning patient population.Recent FindingsStatistical modeling suggests that 11.7% of all patients hospitalized with COVID-19 have irreversible fibrotic features on long-term follow-up imaging.SummaryThe available evidence suggests that up to 30% of patients have ILAs following COVID-19 hosp...
Source: Current Respiratory Care Reports - April 11, 2023 Category: Respiratory Medicine Source Type: research
Correction: Interstitial Pneumonia with Autoimmune Features: Implications for Clinical Practice
(Source: Current Respiratory Care Reports)
Source: Current Respiratory Care Reports - April 5, 2023 Category: Respiratory Medicine Source Type: research
Improving Quality of Sleep in Healthy Adults
AbstractPurpose of ReviewThere is unquestionable evidence of the consequences associated with poor quality/insufficient sleep. Furthermore, threats associated with poor quality/insufficient sleep are not only felt on an individual level but have significant societal and economic implications. In consideration of potential strategies and interventions targeting the promotion of sleep health/quality, our focus of this review is threefold, to (1) summarize the current understanding of the widespread implications of insufficient/poor sleep; (2) explore the concept of healthy sleep, its defining features, and associated potenti...
Source: Current Respiratory Care Reports - April 1, 2023 Category: Respiratory Medicine Source Type: research
Interventional Pulmonologist Education and Training
This article summarizes the current interventional pulmonology training paradigm in the USA. Cognitive and procedural training, assessments, and standards are reviewed.Recent FindingsCognitive training includes a didactic curriculum that examines common pathologies and conditions pertinent to the airways, lung parenchyma, and pleural space. Cognitive assessments are performed via a fellowship in-service examination, as well as an accreditation exam administered by the American Association for Bronchology and Interventional Pulmonology (AABIP). Procedural training occurs through synthetic, cadaveric, and animal models, and ...
Source: Current Respiratory Care Reports - March 21, 2023 Category: Respiratory Medicine Source Type: research
