Contemporary issues in the implementation of lung cancer screening
Lung cancer screening with low-dose computed tomography can reduce death from lung cancer by 20–24% in high-risk smokers. National lung cancer screening programmes have been implemented in the USA and Korea and are being implemented in Europe, Canada and other countries. Lung cancer screening is a process, not a test. It requires an organised programmatic approach to replicate the lung cancer mortality reduction and safety of pivotal clinical trials. Cost-effectiveness of a screening programme is strongly influenced by screening sensitivity and specificity, age to stop screening, integration of smoking cessation inte...
Source: European Respiratory Review - July 20, 2021 Category: Respiratory Medicine Authors: Lam, S., Tammemagi, M. Tags: Lung cancer Thoracic oncology Source Type: research
Impact of ageing and pregnancy on the minute ventilation/carbon dioxide production response to exercise
Ventilatory efficiency can be evaluated using the relationship between minute ventilation (V'E) and the rate of CO2 production (V'CO2). In accordance with the modified alveolar ventilation equation, this relationship is determined by changes in dead space volume (VD) and/or the arterial CO2 tension (PaCO2) equilibrium point. In this review, we summarise the physiological factors that may account for normative ageing and pregnancy induced increases in V'E/V'CO2 during exercise. Evidence suggests that age-related increases in VD and pregnancy-related decreases in the PaCO2 equilibrium point are mechanistically linked to the ...
Source: European Respiratory Review - July 20, 2021 Category: Respiratory Medicine Authors: Schaeffer, M. R., Guenette, J. A., Jensen, D. Tags: Mechanisms of lung disease Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research
Ventilatory efficiency in pulmonary vascular diseases
Cardiopulmonary exercise testing (CPET) is a frequently used tool in the differential diagnosis of dyspnoea. Ventilatory inefficiency, defined as high minute ventilation (V'E) relative to carbon dioxide output (V'CO2), is a hallmark characteristic of pulmonary vascular diseases, which contributes to exercise intolerance and disability in these patients. The mechanisms of ventilatory inefficiency are multiple and include high physiologic dead space, abnormal chemosensitivity and an altered carbon dioxide (CO2) set-point. A normal V'E/V'CO2 makes a pulmonary vascular disease such as pulmonary arterial hypertension (PAH) or c...
Source: European Respiratory Review - July 20, 2021 Category: Respiratory Medicine Authors: Weatherald, J., Philipenko, B., Montani, D., Laveneziana, P. Tags: Mechanisms of lung disease, Pulmonary vascular disease Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research
Ventilatory efficiency in athletes, asthma and obesity
During submaximal exercise, minute ventilation (V'E) increases in proportion to metabolic rate (i.e. carbon dioxide production (V'CO2)) to maintain arterial blood gas homeostasis. The ratio V'E/V'CO2, commonly termed ventilatory efficiency, is a useful tool to evaluate exercise responses in healthy individuals and patients with chronic disease. Emerging research has shown abnormal ventilatory responses to exercise (either elevated or blunted V'E/V'CO2) in some chronic respiratory and cardiovascular conditions. This review will briefly provide an overview of the physiology of ventilatory efficiency, before describing the ve...
Source: European Respiratory Review - July 20, 2021 Category: Respiratory Medicine Authors: Collins, S. E., Phillips, D. B., Brotto, A. R., Rampuri, Z. H., Stickland, M. K. Tags: Mechanisms of lung disease Ventilatory efficiency and its clinical prognostic value in cardiorespiratory disorders Source Type: research
Cough symptom severity in patients with refractory or unexplained chronic cough: a systematic survey and conceptual framework
Conclusions
Our systematic survey and conceptual framework identified items and domains of cough severity in patients with refractory or unexplained chronic cough. The results support item generation and content validity for a PROM assessing cough severity. (Source: European Respiratory Review)
Source: European Respiratory Review - July 13, 2021 Category: Respiratory Medicine Authors: Kum, E., Guyatt, G. H., Devji, T., Wang, Y., Bakaa, L., Lan, L., Liu, E., Mastrolonardo, A., Couban, R., O'Byrne, P. M., Satia, I. Tags: Respiratory clinical practice Review Source Type: research
