Don't forget healthcare workers are required to have other mandatory immunisations, so why isn't the influenza vaccination included?
Authors: Seale H PMID: 30106607 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - August 16, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Cardiac sarcoidosis - an expert review for the chest physician.
Authors: Ho JS, Chilvers ER, Thillai M Abstract INTRODUCTION: Sarcoidosis is a multisystem granulomatous disease predominantly affecting the lungs, with increased risk of cardiovascular disease, pulmonary hypertension and cardiac sarcoidosis (CS), the latter due to direct granuloma infiltration. Sarcoidosis is often managed by chest physicians who need to understand the diagnostic pathways and initial management plans for patients with cardiac involvement. Areas covered: The most serious consequence of CS is sudden cardiac death due to ventricular tachyarrhythmias or complete atrioventricular block. Additional comp...
Source: Expert Review of Respiratory Medicine - August 14, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The challenge of avoiding intubation in immunocompromised patients with acute respiratory failure.
Authors: de Jong A, Calvet L, Lemiale V, Demoule A, Mokart D, Darmon M, Jaber S, Azoulay E Abstract INTRODUCTION: A growing number of immunocompromised (IC) patients with acute hypoxemic respiratory failure (ARF) is admitted to the intensive care unit (ICU) worldwide. Initial management of these patients aims primarily to avoid invasive mechanical ventilation (IMV), while adequately managing hypoxemia. Areas covered: This review provides an overview of the current knowledge of the ways to prevent intubation in IC patients with ARF, including discussion about optimal timing of ICU admission, available respiratory su...
Source: Expert Review of Respiratory Medicine - August 14, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Understanding the implications of the biobehavioral basis of nicotine addiction and its impact on the efficacy of treatment.
This article reviews the biobehavioral basis of nicotine addiction, its implications for smoking cessation treatments, the various neurotransmitter systems involved in nicotine addictive effects, and their potential therapeutic value. Included are discussions around the role of genetic factors in predicting response to pharmacotherapy and what we know about appropriate application of pharmacotherapy and behavioral interventions for tobacco use disorder. The evidence for harm reduction measures in individuals who are not willing or able to quit smoking are also reviewed. Expert commentary: Many neurotransmitter system targe...
Source: Expert Review of Respiratory Medicine - August 11, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Treatment of advanced non-small cell lung cancer in the elderly.
Authors: Sacco PC, Maione P, Palazzolo G, Gridelli C Abstract INTRODUCTION: Lung cancer is predominantly a disease that affects the elderly; about 30-40% of lung cancers are diagnosed in patients aged 70 or more. The increasing number of elderly patients over the next decades is generating a new social and health problem; despite that, these patients are under-represented in clinical trials and under-treated in clinical practice. Areas covered: The main difficulty in treating elderly patients is to maximize the therapy benefits while minimizing the treatment risk. Elderly patients show a vulnerable clinical profile...
Source: Expert Review of Respiratory Medicine - August 11, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The concepts of asthma endotypes and phenotypes to guide current and novel treatment strategies.
This article reviews the definition of asthma phenotypes and possible endotypes, advances in allergy-immunology field and contemporary personalized therapy options for asthma. Expert commentary: Better understanding of the complex immune network of allergic inflammation and key players of immunity is continuously being provided for clarification of asthma sub-types. Successful therapy of asthma requires better definition of underlying pathogenesis, which sequentially could end up with 'custom-tailored' individualized, evidence-based and more precise therapy options; a new era termed as 'precision medicine'. Endotype, pheno...
Source: Expert Review of Respiratory Medicine - August 9, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Tezacaftor for the treatment of cystic fibrosis.
Authors: Sala M, Jain M Abstract INTRODUCTION: Cystic fibrosis (CF) is the most common, life-limiting autosomal recessive disease in Caucasians, and is caused by defects in production of the CFTR ion channel. Until recently, there were no available treatments targeting the disease-causing defects in CFTR but newly developed CFTR modulators are changing the course of disease in CF. The newest modulator, tezacaftor, is a CFTR corrector that was recently approved by the FDA to be used in combination with the first approved CFTR potentiator, ivacaftor. Areas Covered: A detailed review of the clinical trials and publish...
Source: Expert Review of Respiratory Medicine - August 6, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The effect of obesity on lung function.
This article reviews the literature addressing the relationship between obesity and lung function, and studies addressing how the mechanical and inflammatory effects of obesity might lead to changes in lung mechanics and pulmonary function in obese adults and children. Expert Commentary: Obesity has significant effects on respiratory function, which contribute significantly to the burden of respiratory disease. These mechanical effects are not readily quantified with conventional pulmonary function testing and measurement of BMI. Changes in mediators produced by adipose tissue likely also contribute to altered lung functio...
Source: Expert Review of Respiratory Medicine - July 31, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Assessing effects of inhaled antibiotics in adults with non-cystic fibrosis bronchiectasis - experiences from recent clinical trials.
The objective of this review is to provide an overview of NCFB and critically evaluate the evidence supporting the outcome measures used in recent clinical trials of inhaled antibiotics. These include quantitative changes in bacterial load, sputum purulence and yield, inflammatory markers, and lung function, as well as clinical changes in exacerbations, exacerbation frequency, hospitalizations, and health-related quality of life. Expert commentary: Recently completed large trials of inhaled antibiotics in NCFB did not consistently meet pre-specified endpoints, suggesting that we have not yet found the best enrollment crite...
Source: Expert Review of Respiratory Medicine - July 22, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The efficacy of inhaled antibiotics in non-cystic fibrosis bronchiectasis.
Authors: Amaro R, Panagiotaraka M, Alcaraz V, Torres A Abstract INTRODUCTION: Non-cystic fibrosis bronchiectasis (NCFB) is considered a chronic heterogenic pulmonary disease, characterized by the permanent and abnormal enlargement and thickening of bronchial walls, impaired mucociliary clearance and suppuration. Inhaled antibiotics have been used for a long time in patients with cystic fibrosis but are seldom used in those with NCFB and few randomized clinical trials are available in this population. Areas covered: This review summarizes current clinical evidence of efficacy, adverse events and future directions of...
Source: Expert Review of Respiratory Medicine - July 18, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Corticosteroids and pneumonia - targeting the ideal candidate.
Authors: Menéndez R, Amara-Elori I, Méndez R PMID: 30016132 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - July 18, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Corrigendum.
Authors: PMID: 29985714 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - July 11, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Diagnosis and management of laryngotracheal stenosis.
Authors: Smith MM, Cotton RT Abstract INTRODUCTION: Laryngotracheal stenosis comprises a broad spectrum of congenital and acquired conditions that commonly cause pediatric airway obstruction. Although the majority of these conditions were historically managed with endoscopic dilations, the introduction of operative procedures such as laryngotracheoplasty, cricotracheal resection, and slide tracheoplasty changed the treatment paradigm. The gradual evolution of endoscopic technology enabled surgeons to perform certain procedures endoscopically that were previously only able to be performed in an open fashion. Areas c...
Source: Expert Review of Respiratory Medicine - July 5, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Multifaceted activity of N-acetyl-l-cysteine in chronic obstructive pulmonary disease.
Authors: Calzetta L, Matera MG, Rogliani P, Cazzola M Abstract INTRODUCTION: N-Acetyl-l-cysteine (NAC), a derivative of the naturally occurring amino acid, l-cysteine, is a mucolytic agent that may also act as an antioxidant by providing cysteine intracellularly for increased production of glutathione. It is also used for the treatment of acetaminophen overdose. Areas covered: The recent international recommendations for the treatment of chronic obstructive pulmonary disease (COPD) report that NAC, because of its mucolytic activity, reduces acute exacerbation of COPD (AECOPD) with a modest improvement in health sta...
Source: Expert Review of Respiratory Medicine - July 5, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Oximetry use in obstructive sleep apnea.
Authors: Del Campo F, Crespo A, Cerezo-Hernández A, Gutiérrez-Tobal GC, Hornero R, Álvarez D Abstract INTRODUCTION: Overnight oximetry has been proposed as an accessible, simple, and reliable technique for obstructive sleep apnea syndrome (OSAS) diagnosis. From visual inspection to advanced signal processing, several studies have demonstrated the usefulness of oximetry as a screening tool. However, there is still controversy regarding the general application of oximetry as a single screening methodology for OSAS. Areas covered: Currently, high-resolution portable devices combined with pattern r...
Source: Expert Review of Respiratory Medicine - July 5, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The use of bronchoscopy in critically ill patients: considerations and complications.
Authors: Ergan B, Nava S Abstract INTRODUCTION: Flexible bronchoscopy has been well established for diagnostic and therapeutic purposes in critically ill patients. Areas covered: This review outlines the clinical evidence of the utility and safety of flexible bronchoscopy in the intensive care unit, as well as specific considerations, including practical points and potential complications, in critically ill patients. Expert commentary: Its ease to learn and perform and its capacity for bedside application with relatively few complications make flexible bronchoscopy an indispensable tool in the intensive care unit s...
Source: Expert Review of Respiratory Medicine - July 1, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Durvalumab for the treatment of non-small cell lung cancer.
Authors: Mezquita L, Planchard D Abstract INTRODUCTION: In non-small cell lung cancer (NSCLC), immunotherapy is one of today's most important and ground-breaking systemic treatments, mainly represented by antibodies against cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed death protein 1 or ligand 1 (PD-1/PD-L1). Durvalumab (MEDI4736) is a high-affinity human IgG1 monoclonal antibody that binds to PD-1 and CD80, blocking PD-L1, but not PD-L2. Areas covered: In advanced NSCLC patients, durvalumab has demonstrated activity and acceptable tolerability, particularly with ≥ 25% PD-L1 tumor expressi...
Source: Expert Review of Respiratory Medicine - July 1, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Endoscopic approaches for treating emphysema.
Authors: Kontogianni K, Eberhardt R Abstract INTRODUCTION: Surgical treatment of severe pulmonary emphysema has so far been associated with relatively high perioperative morbidity and mortality. In the past two decades, novel approaches to lung volume reduction and alternative minimally invasive endoscopic techniques have been developed. This review presents the different techniques (blocking and non-blocking) available until present as well as the appropriate patient selection and possible complications. Areas covered: All available randomized controlled trials (RCT) have been evaluated. The only blocking techniqu...
Source: Expert Review of Respiratory Medicine - June 27, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The role of social support in improving chronic obstructive pulmonary disease self-management.
Authors: Lenferink A, van der Palen J, Effing T PMID: 29909705 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - June 20, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Minimally invasive palliative interventions in advanced lung cancer.
Authors: Mallow C, Hayes M, Semaan R, Smith T, Hales R, Brower R, Yarmus L Abstract INTRODUCTION: Lung cancer is the leading cause of cancer related deaths in the United States. Nearly 85% of all lung cancers are diagnosed at a late stage, with an associated five-year survival rate of 4%. Malignant central airway obstruction and malignant pleural effusions occur in upwards of 30% of these patients. Many of these patients are in need of palliative interventions for symptom control and to help improve their quality of life. Areas covered: This review covers the treatment modalities of malignant central airway obstruc...
Source: Expert Review of Respiratory Medicine - June 10, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Emerging problems in the treatment of paediatric community-acquired pneumonia.
Authors: Principi N, Esposito S Abstract INTRODUCTION: Community-acquired pneumonia (CAP) remains one of the most common reasons for paediatric morbidity and accounts for about 16% of all the deaths occurring in children less than 5 years of age. Areas covered: The main aim of this paper is to discuss the emerging problems for CAP treatment in paediatric age. Expert commentary: Official recommendations for therapeutic approaches to paediatric CAP, despite being not very recent, seem still to be the best solution to assure the highest probabilities of cure for children with this disease living in industrialized coun...
Source: Expert Review of Respiratory Medicine - June 10, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Unmet needs in cystic fibrosis: the next steps in improving outcomes.
Authors: West NE, Flume PA Abstract INTRODUCTION: Cystic fibrosis (CF) outcomes and survival have improved over the last century primarily due to advancements in antibiotics, nutritional and pulmonary therapies. Reviewed here are the significant unmet needs that exist for individuals with CF. Areas Covered: With the recent development of medications that address the underlying defect in the CF protein, there is hope that there will be continued improvement in CF outcomes. However, there remains a need to prevent or stop progression of CF related complications, as the CF protein is important to several body systems....
Source: Expert Review of Respiratory Medicine - June 5, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

How close are we to definitively identifying the respiratory health effects of e-cigarettes?
Authors: Ratajczak A, Feleszko W, Smith DM, Goniewicz M Abstract INTRODUCTION: Use of electronic cigarettes (e-cigarettes) is frequently promoted as a less harmful alternative to cigarette smoking. The impact of repeated inhalation of e-cigarette aerosols on respiratory health is not well understood. Areas covered: Using results from laboratory, observational, and clinical studies, we synthesize evidence relevant to potential respiratory health effects that may result from inhalation of e-cigarette aerosols. Expert Commentary: Chemical analyses reveal that e-cigarette aerosols contain numerous respiratory irritants...
Source: Expert Review of Respiratory Medicine - June 5, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Exercise based evaluations and interventions for pulmonary hypertension with connective tissue disorders.
Authors: Babu AS, Morris NR, Arena R, Myers J Abstract INTRODUCTION: Exercise intolerance is a common and often significant limitation in pulmonary arterial hypertension (PAH). This intolerance greatly affects the quality of life and function of the individual with PAH, irrespective of its etiology. In PAH associated with connective tissue disorders (PAH-CTD), exercise intolerance is further amplified by the presence of co-existing musculoskeletal manifestations of CTD. The evaluation of exercise capacity and prescription for exercise training therefore becomes a challenge to the clinician. Areas covered: This revi...
Source: Expert Review of Respiratory Medicine - June 1, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Should tobacco control intervention be implemented into tuberculosis control program?
Authors: Chiang CY, Bam TS PMID: 29799762 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - June 1, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Current and future pharmacotherapy options for non-cystic fibrosis bronchiectasis.
Authors: Athanazio RA, da Costa JC, de la Rosa Carrillo D, Martínez-García MÁ Abstract INTRODUCTION: In recent years, there has been an increasing number of clinical trials investigating the effect of pharmacological treatments on patients with bronchiectasis. Areas covered: This review provides an overview of current drugs used in bronchiectasis patients, as well as those that could make a future contribution to the management of this disease. Expert commentary: Bronchiectasis is a very heterogeneous disease, so it can be studied from a phenotypic standpoint and its pathophysiological mechanis...
Source: Expert Review of Respiratory Medicine - June 1, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Respiratory muscle involvement in sarcoidosis.
Authors: Schreiber T, Windisch W Abstract INTRODUCTION: In sarcoidosis, muscle involvement is common, but mostly asymptomatic. Currently, little is known about respiratory muscle and diaphragm involvement and function in patients with sarcoidosis. Reduced inspiratory muscle strength and/or a reduced diaphragm function may contribute to exertional dyspnea, fatigue and reduced health-related quality of life. Previous studies using volitional and non-volitional tests demonstrated a reduced inspiratory muscle strength in sarcoidosis compared to control subjects, and also showed that respiratory muscle function may even...
Source: Expert Review of Respiratory Medicine - June 1, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Recognizing, quantifying and managing patient-ventilator asynchrony in invasive and noninvasive ventilation.
Authors: Garofalo E, Bruni A, Pelaia C, Liparota L, Lombardo N, Longhini F, Navalesi P Abstract INTRODUCTION: Patient-ventilator asynchrony may occur with modes of partial ventilatory support. Because this problem is associated with worsened outcomes, identifying and managing asynchronies has been recognized as a relevant clinical problem during both invasive and non-invasive (NIV) mechanical ventilation. Areas covered: In this review article, we first describe the different forms of patient-ventilator asynchrony and how they are classified and quantified. Then, we show how these asynchronies can be recognized, con...
Source: Expert Review of Respiratory Medicine - May 28, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Management of pleural infections.
Authors: Ferreiro L, Porcel JM, Bielsa S, Toubes ME, Álvarez-Dobaño JM, Valdés L Abstract INTRODUCTION: The management of infected pleural effusion is complex. Therapeutic resolution requires determining the following: appropriate antibiotic regimen, the need for pleural drainage, the optimal drainage tube size, and the need for intrapleural therapy or surgery. Areas covered: An updating of the latest advances in the management of parapneumonic pleural effusion based on the best evidence available is provided. Expert commentary: The correct management of parapneumonic pleural effusion is based ...
Source: Expert Review of Respiratory Medicine - May 22, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

An overview of glycopyrrolate/eFlow ® CS in COPD.
An overview of glycopyrrolate/eFlow® CS in COPD. Expert Rev Respir Med. 2018 May 18;: Authors: Kerwin E, Ferguson GT Abstract INTRODUCTION: COPD is highly prevalent in the US and globally, requiring new treatment strategies due to the high disease burden and increase in the aging population. Here, we profile the newly FDA-approved LONHALA MAGNAIR (glycopyrrolate [GLY]/eFlow® Closed System [CS]; 25 mcg twice daily), a nebulized long-acting muscarinic antagonist (LAMA) for the long-term maintenance treatment of COPD, including chronic bronchitis and/or emphysema. Areas covered: An overview of COP...
Source: Expert Review of Respiratory Medicine - May 19, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

CFTR dysfunction in cystic fibrosis and chronic obstructive pulmonary disease.
Authors: Fernandez Fernandez E, de Santi C, De Rose V, Greene CM Abstract INTRODUCTION: Obstructive lung diseases such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) are causes of high morbidity and mortality worldwide. CF is a multiorgan genetic disease caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene and is characterized by progressive chronic obstructive lung disease. Most cases of COPD are a result of noxious particles, mainly cigarette smoke but also other environmental pollutants. Areas covered: Although the pathogenesis and pathophysiology o...
Source: Expert Review of Respiratory Medicine - May 12, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Biomarkers for severe allergic asthma in children: could they be useful to guide disease control and use of omalizumab?
Authors: Amat F, Labbé A Abstract INTRODUCTION: Although symptom controls in asthmatic children can be achieved through compliant use of conventional medication, some children have uncontrolled severe persistent asthma, especially if they are allergic. For these children, omalizumab (approved by the EMA and FDA in children aged> 6 years) could be a therapeutic option. However, response to omalizumab varies from one child to another. Predictive biomarkers of omalizumab effectiveness could be useful to monitor response to treatment. Area covered: The authors searched in the PubMed database for publications ...
Source: Expert Review of Respiratory Medicine - May 11, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Current and emerging techniques for the diagnosis of hypersensitivity pneumonitis.
This article will provide a summary of the different classification and diagnostic criteria proposed in acute and chronic forms of HP. In addition, we review current diagnostic procedures including antigen detection, high resolution computed tomography, histopathology and provide an overview of emerging techniques. Expert commentary: Important changes are occurring in the field of HP and knowledge of the disease will likely progress enormously in the coming 5 to 10 years as many techniques continue to be developed, including genomic signature and diagnostic biomarkers. PMID: 29727203 [PubMed - as supplied by publisher]...
Source: Expert Review of Respiratory Medicine - May 8, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Indications and complications of rigid bronchoscopy.
This article will review the history, indications, contraindication, technique and complications of rigid bronchoscopy. We will also briefly discuss the methods of anesthesia and ventilation and finally our perspective on the future of rigid bronchoscopy. Expert Commentary: Although the rise of flexible bronchoscopy in the 1960s led to a decline in the use of rigid bronchoscopy, the last two decades have witnessed resurgence in its popularity. We anticipate that it will remain an important tool used by interventional pulmonologists for decades to come. We suggest that interventional pulmonologists must have training and de...
Source: Expert Review of Respiratory Medicine - May 8, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Importance of early diagnosis and treatment in idiopathic pulmonary fibrosis.
Authors: Molina-Molina M, Aburto M, Acosta O, Ancochea J, Rodríguez-Portal JA, Sauleda J, Lines C, Xaubet A PMID: 29718749 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - May 4, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Corrigendum.
Authors: PMID: 29707976 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - May 2, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Is there a link between female asthma and a reduction in fertility?
Authors: Ulrik CS PMID: 29707995 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - May 2, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Is personalized medicine a realistic goal in idiopathic pulmonary fibrosis?
Authors: Thannickal VJ, Antony VB PMID: 29671654 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - April 21, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Inhalation therapy for repairing damaged elastin fibers and decelerating elastinolysis in chronic obstructive pulmonary disease.
Authors: Janssen R, Piscaer I, Wouters EF Abstract INTRODUCTION: Current pharmacologic therapy of chronic obstructive pulmonary disease (COPD) can reduce respiratory symptoms and exacerbation frequency. However, no single COPD intervention except for lung transplantation has proven effective in recovering lung function. Lung elasticity is reduced in COPD lungs, which is for a large part due to chronically enhanced elastin degradation. Elastin calcification and formation of advanced glycation end products (AGEs) may also contribute to this. Areas covered: We propose inhalation therapy to induce repair of damaged pul...
Source: Expert Review of Respiratory Medicine - April 1, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Current and future molecular approaches in the diagnosis of cystic fibrosis.
Authors: Bergougnoux A, Taulan-Cadars M, Claustres M, Raynal C Abstract INTRODUCTION: Cystic Fibrosis is among the first diseases to have general population genetic screening tests and one of the most common indications of prenatal and preimplantation genetic diagnosis for single gene disorders. During the past twenty years, thanks to the evolution of diagnostic techniques, our knowledge of CFTR genetics and pathophysiological mechanisms involved in cystic fibrosis has significantly improved. Areas covered: Sanger sequencing and quantitative methods greatly contributed to the identification of more than 2,000 seque...
Source: Expert Review of Respiratory Medicine - March 29, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

The use of immunotherapy for the treatment of tuberculosis.
Authors: Ramos-Espinosa O, Islas-Weinstein L, Peralta-Álvarez MP, López-Torres MO, Hernández-Pando R PMID: 29575946 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - March 28, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Blood biomarkers in chronic airways diseases and their role in diagnosis and management.
Authors: van Bragt JJMH, Vijverberg SJH, Weersink EJM, Richards LB, Neerincx AH, Sterk PJ, Bel EHD, Maitland-van der Zee AH Abstract INTRODUCTION: The complexity and heterogeneous nature of asthma and chronic obstructive pulmonary disease (COPD) results in difficulties in diagnosing and treating patients. Biomarkers that can identify underlying mechanisms, identify patient phenotypes and to predict treatment response could be of great value for adequate treatment. Areas covered: Biomarkers play an important role for the development of novel targeted therapies in airways disease. Blood biomarkers are relatively non-...
Source: Expert Review of Respiratory Medicine - March 28, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Ventilator-induced lung injury during controlled ventilation in patients with acute respiratory distress syndrome: less is probably better.
Authors: Cruz FF, Ball L, Rocco PRM, Pelosi P Abstract INTRODUCTION: Mechanical ventilation is required to support respiratory function in the acute respiratory distress syndrome (ARDS), but it may promote lung damage, a phenomenon known as ventilator-induced lung injury (VILI). Areas covered: Several mechanisms of VILI have been described, such as: inspiratory and/or expiratory stress inducing overdistension (volutrauma); interfaces between collapsed or edema-filled alveoli with surrounding open alveoli, acting as stress raisers; alveoli that repetitively open and close during tidal breathing (atelectrauma); and p...
Source: Expert Review of Respiratory Medicine - March 28, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Innovations in asthma therapy: is there a role for inhaled statins?
This article will discuss clinical trials of oral statins in asthma, review lab investigations relevant to the systemic versus inhaled administration of statins, address the advantages and disadvantages of inhaled statins, and answer the question: is there a role for delivering inhaled statins for the treatment of asthma? Expert commentary: If ongoing investigations show that oral administration of statins has no clear clinical benefits, then repurposing statins for delivery via inhalation is a logical next step. Inhalation of statins bypasses first-pass metabolism by the liver, and therefore, allows for delivery of signif...
Source: Expert Review of Respiratory Medicine - March 28, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Corrigendum.
Authors: PMID: 29537322 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - March 16, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

E-cigarettes and the obsolescence of combustion.
Authors: Etter JF PMID: 29540079 [PubMed - as supplied by publisher] (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - March 16, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Non-vitamin K antagonist oral anticoagulants for pulmonary embolism: who, where and for how long?
This article reviews the evolving management of PE in the NOAC era and addresses three fundamental questions: who should receive NOACs over conventional heparin/vitamin K antagonist regimens for the treatment of acute PE; whether patients should be treated as inpatients or outpatients; and how long patients should be treated to reduce the risk of recurrence? Expert commentary: The management of PE is changing. NOACs provide new anticoagulant treatment options for patients with PE, based on Phase III clinical study results. The consistent efficacy and safety profile of NOACs across many PE patient subgroups, including the e...
Source: Expert Review of Respiratory Medicine - March 16, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Techniques for lung surgery: a review of robotic lobectomy.
Authors: Chen S, Geraci TC, Cerfolio RJ Abstract INTRODUCTION: Robotic lobectomy is an increasingly common surgical approach for anatomic lung resection. Over the last decade, robotic lobectomy has shown to be safe, with oncologic efficacy similar to lobectomy via thoracotomy or video-assisted thoracoscopic surgery (VATS). Comparative analysis between these modalities is an active area of investigation. While initially expensive, the costs of a robotic platform decrease as the number of operations performed increases, length of stay is shortened, and postoperative morbidity is reduced. Moreover, the added cost has ...
Source: Expert Review of Respiratory Medicine - March 6, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Congenital central hypoventilation syndrome: diagnosis and management.
Authors: Maloney MA, Kun SS, Keens TG, Perez IA Abstract INTRODUCTION: Congenital central hypoventilation syndrome (CCHS) is a rare disorder defined by a failure in autonomic control of breathing secondary to mutations of the PHOX2B gene. Affected individuals demonstrate absent or diminished physiologic response to hypercapnia and hypoxia that is most severe during sleep as well as multi-system dysregulation of autonomic functions. Areas covered: In this review, we will discuss how evaluation of the disease-defining PHOX2B gene aids diagnosis and helps prognosticate disease severity, review disease physiology, desc...
Source: Expert Review of Respiratory Medicine - March 2, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research

Treatment of acute exacerbations of interstitial lung disease.
Authors: Azadeh N, Moua T, Baqir M, Ryu JH Abstract INTRODUCTION: Interstitial lung diseases (ILD) include a broad range of diffuse parenchymal lung disorders of known and unknown etiologies. Patients with ILD can experience acute exacerbations (AE) which are associated with extremely high morbidity and mortality. Little is known about the etiology of AEs, and whether inciting triggers (such as infection) result in an aberrant inflammatory response in a predisposed host. Areas covered: The majority of data regarding AE-ILD comes from the interstitial pulmonary fibrosis (IPF) population and is extrapolated to other ...
Source: Expert Review of Respiratory Medicine - February 28, 2018 Category: Respiratory Medicine Tags: Expert Rev Respir Med Source Type: research