Percutaneous Ablation of Intrathoracic Malignancy
AbstractPurpose of ReviewLung cancer remains the number one cancer killer in both women and men. The primary treatment of choice for local, early-stage disease is surgical resection; however, up to 25% of patients are medically inoperable or refuse surgery. Most patients who are inoperable or refuse surgery are referred for stereotactic body radiotherapy (SBRT) or percutaneous ablative therapies.Recent FindingsPercutaneous techniques include radiofrequency ablation, microwave ablation, cryoablation, or irreversible electroporation. These modalities can be used with an intent to cure, as well as palliative intent in various...
Source: Current Respiratory Care Reports - October 21, 2020 Category: Respiratory Medicine Source Type: research
High-Resolution Computed Tomography Evaluation of Interstitial Lung Disease for the Pulmonologist
AbstractPurpose of ReviewInterstitial lung disease encompasses variety of entities that have diverse clinical manifestations, prognosis, and treatment options. It is imperative to identify the specific disease early as delays in diagnosis can lead to irreversible damage. Studies demonstrate that treatment with certain medications and avoidance of exposures that potentiate injury can reduce disease progression.Recent FindingsThe use of high-resolution computed tomography has become essential for the evaluation of interstitial lung disease. Being able to accurately identify the characteristic patterns of abnormalities can le...
Source: Current Respiratory Care Reports - October 20, 2020 Category: Respiratory Medicine Source Type: research
Intrathoracic Manifestations of Sarcoidosis: an Imaging Review Highlighting Atypical Features
AbstractPurpose of ReviewThe purpose of this article is to present a more recent radiological review to pulmonologists, radiologists and other clinicians of: typical and atypical manifestations of intrathoracic sarcoidosis, and highlighting its mimic-drug induced sarcoid like reaction.Recent FindingsThere is an association between immunotherapy and the development of sarcoid-like reactions. Clinicians and radiologists should be aware of this entity.SummarySarcoidosis is a multisystem inflammatory disease, of unknown etiology that is characterized by non caseating granulomas. It most commonly involves the lungs and lymph no...
Source: Current Respiratory Care Reports - August 10, 2020 Category: Respiratory Medicine Source Type: research
Imaging in Occupational and Environmental Lung Disease
AbstractPurpose of ReviewThis review article aims to highlight the common and uncommon imaging features of work-related and environmental lung disease to help the clinicians suspect diagnosis in patients with occult or known exposures to inhalational potent substances.Recent FindingsOccupational and environmental lung disease are the most frequent work-related illness in the USA with a recent resurgence mainly due to inadequate exposure control, prolonged working hours, developing industries, and new antigens. Failure to accurately diagnose and promptly manage these lung disorders can lead to long-term and irreversible hea...
Source: Current Respiratory Care Reports - July 26, 2020 Category: Respiratory Medicine Source Type: research
Current Applications for Nuclear Medicine Imaging in Pulmonary Disease
This article reviews current applications for nuclear medicine and molecular imaging and selected future applications for radiopharmaceuticals and targeted molecular imaging techniques. (Source: Current Respiratory Care Reports)
Source: Current Respiratory Care Reports - July 21, 2020 Category: Respiratory Medicine Source Type: research
Management of Insomnia in Chronic Lung Diseases
AbstractPurpose of ReviewReview the treatment of insomnia in those with chronic lung diseases.Recent FindingsCognitive behavioral therapy for insomnia and positive airway pressure, the latter for those with sleep disordered breathing, are effective and safe alternatives to hypnotic therapy. Some new hypnotics improve sleep via mechanisms that theoretically render them safe to use in those afflicted with both insomnia and chronic lung disease.SummaryTreatment for insomnia may include cognitive behavioral therapy, positive airway pressure, and pharmacotherapy. Computerized cognitive behavioral therapy is a safe and effective...
Source: Current Respiratory Care Reports - July 12, 2020 Category: Respiratory Medicine Source Type: research
Cannabinoids and Sleep: Helpful or Harmful?
AbstractPurpose of ReviewLegalization and popular use of cannabis products have historically outpaced scientific literature. There is interest in the effects of cannabis and cannabinoids on human sleep and sleep disorders. This review summarizes research evaluating the relationship between cannabinoids and sleep published after 2016 and references background studies for clarification where no recent publications were available.Recent FindingsSpecific to sleep disorders, the most impactful research is arguably in the treatment of sleep disordered breathing though case reports are emerging to address several other conditions...
Source: Current Respiratory Care Reports - July 12, 2020 Category: Respiratory Medicine Source Type: research
Sleep, Obstructive Sleep Apnea, and Chronic Alveolar Hypoventilation in Cystic Fibrosis: Role of Noninvasive Ventilation During Sleep
We describe sleep disturbances in patients with cystic fibrosis emphasizing treatment of abnormal breathing during sleep with noninvasive ventilation.Recent FindingsAdvances in treatment have transformed cystic fibrosis from a pediatric disorder to an adult condition. The increase in cystic fibrosis life expectancy renders these patients at high risk for nocturnal and diurnal respiratory failure. Hypoventilation during sleep precedes diurnal hypoventilation in cystic fibrosis. In advanced cases, noninvasive ventilation improves awake ABGs, respiratory muscle strength, dyspnea, subjective sleep quality, and level of daily a...
Source: Current Respiratory Care Reports - July 6, 2020 Category: Respiratory Medicine Source Type: research
Current Management Strategies for Primary Spontaneous Pneumothorax
AbstractPurpose of ReviewPrimary spontaneous pneumothorax is a distressing condition which affects young healthy patients. In this review, we highlight recent advances in the management of primary spontaneous pneumothorax and look to the future with the advent of studies that will have global impact in the area.Recent FindingsRecent research has taken a step back from immediate invasive interventions which can confine a patient to a hospital bed, exploring instead alternative approaches such as ambulatory management or observation.SummaryWhen managing primary spontaneous pneumothoraces acutely, rather than opting for aggre...
Source: Current Respiratory Care Reports - June 10, 2020 Category: Respiratory Medicine Source Type: research
Hard Metal Lung Disease: Update in Diagnosis and Management
AbstractPurpose of ReviewHard metal lung disease is a rare entity due to cobalt and tungsten carbide exposure. This review summarizes the literature focusing on pathogenesis, clinical features, diagnosis, and management.Recent FindingsTheories for pathogenesis include immunogenic activation, oxidant injury, and induction of hypoxia-inducible factor in macrophages. Multinucleated giant cells with bizarre cannibalistic features are the most common pathological finding; however, it is not pathognomonic. Corticosteroids remain the mainstay of treatment based on data from small studies.SummaryHard metal lung disease exposure ca...
Source: Current Respiratory Care Reports - May 3, 2020 Category: Respiratory Medicine Source Type: research
The Importance of Genetic Factors in the Management of Spontaneous Pneumothorax
AbstractPurpose of ReviewSpontaneous pneumothoraces can be the presenting phenotype in a variety of different syndromic genetic conditions. Respiratory physicians therefore have the opportunity to diagnose and manage these patients early to prevent serious complications associated with these syndromes.Recent FindingsThe genetic syndromes that present with pneumothoraces can be split broadly between those resulting from defective extracellular matrix formation and those caused by defective tumour-suppressor pathways. When connective tissues are weakened, lifelong surveillance for arterial dilatation can be life-saving as su...
Source: Current Respiratory Care Reports - April 19, 2020 Category: Respiratory Medicine Source Type: research
Human Cytomegalovirus Prophylaxis and Treatment in Lung Transplantation in the Current Era
This article sumarizes recent findings in the pathophysiology of HCMV, especially its effects in lung transplant recipients; the current and new modalities for treatment and prevention of infection; and the latest guidelines for prevention and management of HCMV in lung transplant recipients.Recent FindingsRecent findings include moves towards standardization for monitoring and treating HCMV and approval of a new agent, letermovir, for prevention of HCMV reactivation in hematopoietic cell transplant recipients now in clinical trials for solid organ transplant recipients, and updates on the late stage development of maribav...
Source: Current Respiratory Care Reports - February 21, 2020 Category: Respiratory Medicine Source Type: research
Eosinophilic vs. Neutrophilic Asthma
AbstractPurpose of ReviewUnderstanding the molecular mechanisms and heterogeneity of asthma has allowed the discovery of two distinct endotypes based on the mechanisms driving the underlying airway inflammation: eosinophilic asthma, a subtype of T2-high asthma, and neutrophilic asthma, a subtype of non-T2 asthma or T2-low asthma. In this review, we highlight the current knowledge about the immunopathology of these distinct subtypes and their clinical and therapeutic implications.Recent FindingsThe intricate interplay of immune pathways has been recently evaluated in both eosinophilic and neutrophilic asthma. The delineatio...
Source: Current Respiratory Care Reports - February 12, 2020 Category: Respiratory Medicine Source Type: research
Donor-Derived Disease Transmission in Lung Transplantation
AbstractPurpose of ReviewUnderstanding the risk of donor-derived infection, particularly in the lung transplant population, should reduce discarding organs without risk. Ongoing regulatory efforts and improved clinician awareness can help improve organ supply and post-transplantation outcomes.Recent FindingsInfections can be divided into expected and unexpected. Syndromes that manifest in the early-post-transplant period should raise concern of a donor-derived transmission. Emerging data suggests that donors with certain bacterial infections can be safely used while donors with HCV infection can be a useful source of previ...
Source: Current Respiratory Care Reports - January 29, 2020 Category: Respiratory Medicine Source Type: research
Update on Management of Pleural Disease
AbstractPurpose of reviewThe goal of this paper is to review and summarize the most recent updates in the management of both benign and malignant pleural diseases.Recent findingsMultiple trials evaluating the use of non-surgical techniques for the management of pleural infection have been published in the last 5 years. Additionally, the use of tunneled pleural catheter (TPC) placement in the management of non-infectious recurrent pleural effusions is being increasingly studied. Finally, the separate use of TPC placement or talc pleurodesis as well as a combined rapid pleurodesis protocol involving both talc poudrage and TP...
Source: Current Respiratory Care Reports - December 12, 2019 Category: Respiratory Medicine Source Type: research
