The Management of Subcutaneous Emphysema in Pneumothorax: A Literature Review
AbstractPurpose of ReviewSubcutaneous emphysema is often observed by clinicians in the context of pneumothorax. It is usually clinically insignificant, but in a few cases can progress to threaten the patient ’s vision or airway. A variety of approaches to management of such cases are described in the literature. There no controlled trials and no guidelines on management, other than that the cause should be identified and treated wherever possible. The goal of this article is to review the described ap proaches to subcutaneous emphysema in pneumothorax and provide a reference to the clinician.SummaryTreatment can be direc...
Source: Current Respiratory Care Reports - April 16, 2021 Category: Respiratory Medicine Source Type: research
Effects of High Altitude on Sleep and Respiratory System
AbstractPurpose of ReviewThe purpose of this review is to discuss the pathogenesis, clinical manifestations, and diagnosis treatment of sleep apnea at high altitude as well and acute altitude illnesses.Recent FindingsDifferences in adaptive responses of different native highlander populations are leading to interesting new insights into high-altitude physiology.SummaryPeriodic breathing at altitude is a physiologic response to hypobaric oxygen and patients with obstructive sleep apnea have transition of respiratory events from obstructive to central at altitude. Acetazolamide is first-line therapy for periodic breathing at...
Source: Current Respiratory Care Reports - April 7, 2021 Category: Respiratory Medicine Source Type: research
Lung Cancer in Women: a Review
This article aims to discuss recent changes in lung cancer among women including incidence, mortality, risk factors, diagnosis, staging, treatment, and prognosis.Recent FindingsThe incidence of lung cancer among women is declining overall but at a significantly slower rate compared to men. The implementation of smoking prevention and cessation efforts has decreased the incidence of cigarette smoking of the past 50 years which has revealed other important risk factors for developing lung cancer. Additionally, new algorithms for diagnosis and staging have led to further changes in management strategies for lung cancer.Summar...
Source: Current Respiratory Care Reports - March 22, 2021 Category: Respiratory Medicine Source Type: research
Obstructive Sleep Apnea and Asthma: More Than Chance?
AbstractPurpose of ReviewTo discuss the current evidence regarding the association and mechanistic interaction between asthma and obstructive sleep apnea (OSA).Recent FindingsThe co-existence of OSA is highly prevalent in asthmatics and significantly associated with increased severity, decreased control, more frequent exacerbations, and hospitalizations despite medical management. Pre-existing asthma may also be a risk factor for new onset OSA. Rhinitis, obesity, and gastro-esophageal reflux are risk factors in both conditions. The obese asthmatic with OSA may present a unique phenotype. Positive airway pressure in severe ...
Source: Current Respiratory Care Reports - March 12, 2021 Category: Respiratory Medicine Source Type: research
Upper Airway Stimulation for Treatment of Obstructive Sleep Apnea
AbstractPurpose of ReviewWe proposed to describe hypoglossal nerve stimulation therapy of obstructive sleep apnea emphasizing the evidence for benefit and identifying patient selection factors foretelling of favorable outcomes.Recent FindingsHypoglossal nerve stimulation has proven to have lasting efficacy in the treatment of multiple aspects of obstructive sleep apnea including event frequency, nocturnal hypoxemia, sleepiness, patient quality of life, sleep architecture, and treatment adherence. Obstructive sleep apnea severity, pattern of pharyngeal collapse, weight, age, and previous surgery are cited predictors of hypo...
Source: Current Respiratory Care Reports - March 1, 2021 Category: Respiratory Medicine Source Type: research
Thoracic Endometriosis: a Clinical Review and Update of Current and Evolving Diagnostic and Therapeutic Techniques
AbstractPurpose of ReviewThe goal of this review is to provide a comprehensive understanding of the pathophysiology, clinical presentation, diagnostic workup, and clinical management of thoracic endometriosis (TE), as well as highlight our personal experience with TE workup and management.Recent FindingsTE can present in a wide range of clinical manifestations. Without high clinical suspicion, diagnosis can be delayed. Since no specific laboratory testing is available, diagnosis is often based on careful history taking, imaging, and direct visualization of endometrial lesions through video-assisted thoracoscopic surgery (V...
Source: Current Respiratory Care Reports - February 9, 2021 Category: Respiratory Medicine Source Type: research
Pulmonary Alveolar Proteinosis Secondary to Occupational Exposure
AbstractPurpose of ReviewOccupational exposures are associated with a wide array of respiratory disorders that include asbestosis, coal workers ’ pneumoconiosis and silicosis, asthma, COPD, bronchiolitis, hypersensitivity pneumonitis, pulmonary fibrosis, sarcoidosis, and certain infections. Pulmonary alveolar proteinosis (PAP) is characterized by accumulation of lipoproteinaceous material in the alveoli and alveolar macrophages. Autoimmun ity is the most common etiology for PAP and involves autoantibodies targeting GM-CSF signaling. However, certain occupational and environmental inhalational exposures have been consider...
Source: Current Respiratory Care Reports - February 8, 2021 Category: Respiratory Medicine Source Type: research
An Update in Health Disparities in COPD in the USA
AbstractPurpose of ReviewCOPD is a prevalent, highly morbid, but manageable disease. Challenges exist in diagnosis that leads to both missed and inappropriate diagnosis with apparent ethnic, sex, and socioeconomic disparities. Disease management is possible with medications and intensive efforts such as pulmonary rehabilitation, but as these interventions are become increasingly expensive, the divide in socioeconomic outcomes expands.Recent FindingsHealth systems have increasingly focused resources on COPD, but the efforts have not been equally implemented. There is increasing prevalence of COPD in women, patients with low...
Source: Current Respiratory Care Reports - January 23, 2021 Category: Respiratory Medicine Source Type: research
Endobronchial Lung Volume Reduction Therapies
AbstractPurpose of ReviewA variety of endobronchial lung volume reduction therapies have become available since the advent of lung volume reduction surgery. We provide a review of bronchoscopic lung volume reduction (BLVR) therapies for severe emphysema and discuss a practical approach to the use of endobronchial valves.Recent FindingsReversible and irreversible BLVR modalities have been developed over the past decade with the best evidence for endobronchial valves. Studies have identified the importance of determining which patient population would most benefit from BLVR, specifically those with heterogeneous emphysema an...
Source: Current Respiratory Care Reports - January 7, 2021 Category: Respiratory Medicine Source Type: research
Robotic Bronchoscopy for the Diagnosis of Peripheral Lung Nodules: a Review
AbstractPurpose of ReviewConventional bronchoscopy has limitations based on an inability to accurately reach and reliably diagnose peripheral lesions with many studies having a yield of less than 50%. Although newer technology such as virtual bronchoscopy, use of smaller bronchoscopes, peripheral endobronchial ultrasound, and electromagnetic navigation may have some improvements and a better safety profile, oftentimes transthoracic or surgical biopsies are required to establish a diagnosis and rule out malignancy. The purpose of this review is to highlight the potential benefits of robotic bronchoscopy, the latest in techn...
Source: Current Respiratory Care Reports - January 4, 2021 Category: Respiratory Medicine Source Type: research
Pulmonary Imaging Findings of Vasculitis
AbstractPurpose of ReviewThe purpose of this article is to review the various pulmonary imaging findings that may be present in patients with various types of vasculitis. The review will also go over the potential clinical significance of the various findings.Recent FindingsThe majority of pulmonary findings related to vasculitis revolve around granulomatosis with polyangiitis (GPA) and eosinophilic granulomatosis with polyangiitis (EGPA). Additional etiologies are rare and mostly present as diffuse alveolar hemorrhage when small vessels are involved and aneurysms when medium and large vessels are involved.SummaryPulmonary...
Source: Current Respiratory Care Reports - November 27, 2020 Category: Respiratory Medicine Source Type: research
Airway Complications and Endoscopic Management After Lung Transplantation
AbstractPurpose of ReviewAirway complications following lung transplantation are common and difficult to manage. While a bulk of literature exists regarding the prevalence and risk factors associated development of airway complications following lung transplantation, literature guiding specific treatment options is limited.Recent FindingsBalloon dilation alone is able to transiently relieve airway stenosis and improve symptoms though it is frequently insufficient. Treatment with airway stenting in severe disease has resulted in significant clinical improvement and can generally be removed with sustained effects. Translatio...
Source: Current Respiratory Care Reports - November 6, 2020 Category: Respiratory Medicine Source Type: research
Surgical Management of Stage IIIA Non-small Cell Lung Cancer
AbstractPurpose of ReviewThere remains equipoise regarding the optimal treatment approach for patients with stage IIIA non-small cell lung cancer (NSCLC). The purpose of this review is to examine the role of surgery as a modality in the management of stage IIIA NSCLC.Recent FindingsOver the last two decades, several studies including randomized controlled trials have established the importance of multimodality therapies in the management of locally advanced NSCLC.SummarySignificant disparities exist in the reported advantages of surgery between observational and randomized controlled studies of stage IIIA patients. While s...
Source: Current Respiratory Care Reports - October 30, 2020 Category: Respiratory Medicine Source Type: research
Recent Developments in the Management of Malignant Pleural Effusions: a Narrative Review
AbstractPurpose of the ReviewThe goal of this paper is to evaluate the literature published over past 3 years and emphasize the most recent updates in the diagnosis and management of malignant pleural effusions (MPE).Recent FindingsThe management of MPE is focused on palliation of symptoms and should take into account patient preferences and anticipated survival. Chemical pleurodesis and indwelling pleural catheters (IPC) are both definitive options for recurrent symptomatic MPE. IPC placement reduces hospitalization and can result in spontaneous pleurodesis, but these advantages must be weighed against the cost of mater...
Source: Current Respiratory Care Reports - October 26, 2020 Category: Respiratory Medicine Source Type: research
Pulmonary MRI: Applications and Use Cases
AbstractPurpose of ReviewMagnetic resonance imaging (MRI) has robust soft tissue characterization capability which was previously limited to evaluation of the mediastinum, cardiac, and chest wall imaging. MRI has now progressed from an experimental tool to complementary and alternate radiation free imaging modality for optimal identification and comprehensive evaluation of the lung parenchyma including structural, functional, and real-time imaging covering lung nodules/masses, infections, interstitial lung disease, airway diseases, and vascular and pleural abnormalities.Recent FindingsRecent use of fast imaging techniques ...
Source: Current Respiratory Care Reports - October 26, 2020 Category: Respiratory Medicine Source Type: research
