Lung Cancer Screening: Review and 2021 Update
AbstractPurpose of ReviewLung cancer screening with low-dose CT (LDCT) scans has been widely accepted within the last decade. Our knowledge and ability to implement screening has greatly increased because of significant research efforts and guidelines from multiple professional societies. The purpose of this review is to summarize some of the significant findings pertaining to lung cancer screening.Recent FindingsScreening with LDCT decreases lung cancer mortality in multiple studies. Use of validated risk prediction calculators can improve patient selection and screening efficiency. Shared decision making and smoking cess...
Source: Current Respiratory Care Reports - April 2, 2022 Category: Respiratory Medicine Source Type: research
Bronchoscopic Lung Nodule Ablation
AbstractPurpose of ReviewThe number of patients diagnosed with early medically inoperable lung cancer is on the rise. With the recent advances in peripheral bronchoscopy, bronchoscopic ablation has become a desirable alternative to potentially diagnose, stage, and treat these patients in a single procedure. Our goal is to review the most promising techniques and the available data to support them.Recent FindingsPre-clinical studies have shown that techniques such as radiofrequency ablation, photodynamic therapy, microwave ablation, laser, and thermal vapor ablation can be safely delivered bronchoscopically into the periphe...
Source: Current Respiratory Care Reports - March 31, 2022 Category: Respiratory Medicine Source Type: research
Pulmonary Procedures in the COVID-19 Era
AbstractPurpose of ReviewThe purpose of this review is to discuss the impact of the COVID-19 pandemic on pulmonary procedures, including new guidelines, restrictions, techniques, and overall effect on patient care.Recent FindingsSARS-CoV-2 predominately impacts the pulmonary system and can result in a severe lower respiratory tract infection. Early guidelines based largely on data from the SARS epidemic recommended significant restrictions on procedure volume out of concern for healthcare worker safety. Newer data suggests relative safety in performing airway and pleural procedures as long as appropriate precautions are fo...
Source: Current Respiratory Care Reports - March 28, 2022 Category: Respiratory Medicine Source Type: research
Recent Advances in Transbronchial Lung Cryobiopsy
This article will discuss new advances in cryoprobe technology and procedural utilization for the diagnosis of lung cancer and parenchymal lung diseases.Recent FindingsNewly developed smaller cryoprobes can offer similar diagnostic advantages of standard cryoprobes when used as a diagnostic modality in a variety of lung conditions.SummaryBronchoscopic lung cryobiopsy is an innovative diagnostic technique for intraparenchymal lung diseases. Over the past decade, research has been dedicated to evaluating the safety profile of this technique, developing a standard procedural approach, and exploring the utility of this approac...
Source: Current Respiratory Care Reports - March 28, 2022 Category: Respiratory Medicine Source Type: research
An Updated Review of Subglottic Stenosis: Etiology, Evaluation, and Management
AbstractPurpose of ReviewTo assimilate the newly published literature regarding subglottic stenosis (SGS), including basic science and translational research on mechanisms of etiology, clinical diagnostics, and therapeutic treatments.Recent FindingsThe role of inflammation in development of iatrogenic and idiopathic SGS (iSGS) is continuing to be studied. The IL-23/IL-17A inflammatory axis appears to be a potential mechanism for development of iSGS. Additionally, as anticipated in an inflammatory milieu, PD-1/PD-L1 expression is upregulated. If the PD-1/PD-L1 axis is important in SGS pathogenesis, then it may represent a p...
Source: Current Respiratory Care Reports - March 3, 2022 Category: Respiratory Medicine Source Type: research
Asthma-COPD Overlap
AbstractPurpose of ReviewThere is currently no universal definition for asthma-COPD overlap (ACO). However, several statements and guidelines have been developed. We reviewed publications to reflect current consensus on definition, pathobiology, evaluation, and management of patients with ACO with discussion of knowledge gaps.Recent FindingsPatients with ACO demonstrate features of both asthma and COPD. However, there is controversy about whether ACO is recognized as a unique entity. While phenotypes of ACO are present, this is an area under investigation to better elucidate the endotype, or the biologic pathway driving th...
Source: Current Respiratory Care Reports - March 1, 2022 Category: Respiratory Medicine Source Type: research
Donation After Circulatory Death Donors for Lung Transplantation: the US and Worldwide Status
AbstractPurpose of ReviewDue to the persistent sparsity of donor organs, today, organ donation after circulatory death (DCD) has become a promising solution to alleviate the burden of waitlist mortality.Recent FindingsWith survival rates comparable to that of standard donor lungs, DCD utilization is growing worldwide. However, the barriers to DCD lung transplantation adoption should be explored.SummaryThe utilization of DCD lungs is currently a viable option for lung transplantation. In this review, we weigh up the ethical, legal, and clinical barriers facing this alternative, then suggest some solutions for the current se...
Source: Current Respiratory Care Reports - November 16, 2021 Category: Respiratory Medicine Source Type: research
The Assessment and Clinical Utility of the Respiratory Arousal Threshold in Obstructive Sleep-Disordered Breathing
AbstractPurpose of ReviewThe purpose of this review is to examine the pathogenesis of obstructive sleep apnea with emphasis on the respiratory arousal threshold, as its estimation and modification through medical interventions is a purported target to treat obstructive sleep apnea.Recent FindingsLow respiratory arousal threshold endotype OSA can be readily identified by routine PSG, and is common among Caucasians, Australians, patients with BMI < 30 kg/m2, increasing age, those taking antidepressants, and up to 55% of patients with posttraumatic stress disorder. This trait may be predictive of low adherence to po...
Source: Current Respiratory Care Reports - November 15, 2021 Category: Respiratory Medicine Source Type: research
Current Concepts in Pathogenesis, Diagnosis, and Management of Silicosis and Its Subtypes
AbstractPurpose of ReviewPneumoconiosis due to silicosis is still present due to modern industries such stone carving, garment industry, and road construction. We aim to discuss how to accurately diagnose silicosis, appropriately risk stratify patients with silicosis, and discuss potential new pharmacotherapies that may be of potential use in the future.Recent FindingsAcute silicosis, chronic silicosis, and accelerated silicosis are 3 distinct clinical categories. Acute silicosis is the least common form and occurs with high exposures of silica dust in a short time frame. Patients with prolonged exposures at low concentrat...
Source: Current Respiratory Care Reports - August 2, 2021 Category: Respiratory Medicine Source Type: research
Pleural Manometry —Basics for Clinical Practice
AbstractPurpose of ReviewThe aim of this paper is to present basic data on pleural manometry and to outline the advances in its use as both a research tool enabling a better understanding of pleural pathophysiology and as a clinical tool useful in management strategy planning in patients with pleural diseases. To discuss updates and current trends in the development of pleural manometry, a search of the literature on pleural manometry published in recent years was performed.Recent FindingsThe technique of pleural manometry has significantly evolved over the last 40 years from simple water manometers to electronic or digita...
Source: Current Respiratory Care Reports - July 29, 2021 Category: Respiratory Medicine Source Type: research
Gender Differences in Sleep Disordered Breathing —a Review of Literature
AbstractPurpose of ReviewThe purpose of this review is to examine the gender differences in sleep disordered breathing focusing on biochemical, pathogenesis, clinical manifestation, and uncertainties.Recent FindingsObstructive sleep apnea is the most common form of sleep disordered breathing and a prevalent disease in the general population. Studies on obstructive sleep apnea have included both genders, but women have often been underrepresented. The paucity of recent publications focusing on gender differences in obstructive sleep apnea necessitated that this review explores earlier relevant literature. The data reviewed ...
Source: Current Respiratory Care Reports - July 23, 2021 Category: Respiratory Medicine Source Type: research
A Review of the Evidence for Use of the Home Sleep Apnea Test or Portable Monitoring in the Evaluation of Central Sleep Apnea
AbstractPurpose of ReviewThe purpose of this review is to discuss the current available evidence and potential role of home sleep apnea tests and portable monitoring in the diagnosis and management of central sleep apnea (CSA) in both ambulatory and hospital settings. The ability to diagnose central apnea using a home or portable device may offer considerable advantages at the home environment such as reduced cost, improved access, and more convenience and comfort for the patient.Recent FindingsThere are limited published articles evaluating the utility and accuracy of home testing in CSA patients. In this article, we revi...
Source: Current Respiratory Care Reports - July 7, 2021 Category: Respiratory Medicine Source Type: research
Pregnancy and Lung Transplantation
AbstractPurpose of ReviewIn this article, we review the impact of pregnancy in lung transplant recipients. Specifically, we discuss maternal, fetal, and allograft outcomes. Furthermore, we highlight important considerations for management of pregnancy in these patients.Recent FindingsImproved survival after lung transplantation means more women of childbearing age; many of them with cystic fibrosis may be able to consider pregnancy. Despite the high number of live births, these pregnancies remain at risk for hypertensive disorders, graft rejection, postpartum graft loss, preterm birth, maternal, and neonatal mortality. Fur...
Source: Current Respiratory Care Reports - May 25, 2021 Category: Respiratory Medicine Source Type: research
Lung Denervation for Advanced COPD: Basics and Beyond
AbstractPurpose of ReviewThis review highlights lung denervation procedure as a potential bronchoscopic treatment for patients with advanced chronic obstructive pulmonary disease (COPD).Recent FindingsTo date, clinical studies of bronchoscopic TLD for patients with COPD proved feasibility, demonstrated a good safety profile, established a therapeutic dose of energy, and identified a potential effectiveness outcome. The AIRFLOW-2, multicenter, randomized, sham-controlled, double-blinded trial showed fewer respiratory adverse events, including hospitalization for COPD exacerbation in patients treated with TLD.SummaryTLD of t...
Source: Current Respiratory Care Reports - April 26, 2021 Category: Respiratory Medicine Source Type: research
Pulmonary Hypertension Complicating Pregnancy
This study aims to describe the pathophysiology of pregnancy in pulmonary hypertension (PH) and review recent literature on maternal and fetal outcomes.Recent findingsThere is an increasing number of pregnant women with PH. Maternal mortality in pulmonary arterial hypertension (PAH) ranges from 9 to 25%, most commonly from heart failure and arrythmias. The highest risk of death is peri-partum and post-partum. Fetal/neonatal morbidity and mortality are also substantial. There are high rates of prematurity, intrauterine growth retardation, and preeclampsia. Women should be referred to expert centers for management. Combinati...
Source: Current Respiratory Care Reports - April 21, 2021 Category: Respiratory Medicine Source Type: research
