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Diagnosing Cystic Fibrosis in Adults
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1759881Diagnosing cystic fibrosis (CF) in adulthood is not a rare occurrence for CF centers despite the popular belief that the diagnosis is achieved almost universally in childhood by means of newborn screening or early clinical presentation. The purpose of this review article is to highlight specific considerations of adult diagnosis of CF. Obtaining a diagnosis of CF at any age is exceptionally important to ensure optimal treatment, monitoring, and support. In the new era of more personalized treatment with the advent of transformative therapies targeting the underlying pro...
Source: Seminars in Respiratory and Critical Care Medicine - January 9, 2023 Category: Respiratory Medicine Authors: Barry, Peter J. Simmonds, Nicholas J. Tags: Review Article Source Type: research

Exercise and Airway Clearance Techniques in Cystic Fibrosis
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1758729Exercise and airway clearance techniques (ACTs) have been a cornerstone of treatment for people with cystic fibrosis (pwCF) for many decades. Exercise may confer both respiratory and nonrespiratory benefits for pwCF, with greater exercise capacity associated with improved survival. A wide variety of exercise interventions for pwCF have been investigated. ACTs may assist in reducing respiratory symptoms for pwCF and are currently recommended to be performed daily, with the types of ACTs used varying globally. While recommended components of care, both exercise and ACTs a...
Source: Seminars in Respiratory and Critical Care Medicine - December 19, 2022 Category: Respiratory Medicine Authors: Ward, Nathan Stiller, Kathy Holland, Anne E. Tags: Review Article Source Type: research

CFTR Modulators: Current Status and Evolving Knowledge
This article shortly reviews the past 10 years of development and use of CFTR modulators. Effects of HEMT on extrapulmonary manifestations and on CF demographics are also discussed. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Respiratory and Critical Care Medicine)
Source: Seminars in Respiratory and Critical Care Medicine - December 19, 2022 Category: Respiratory Medicine Authors: Regard, Lucile Martin, Cl émence Da Silva, Jennifer Burgel, Pierre-R égis Tags: Review Article Source Type: research

Impact of Digital Technologies on Clinical Care for Adults with Cystic Fibrosis
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1758730The coronavirus disease 2019 pandemic accelerated the implementation of digital technologies, which have now become embedded as essential tools for the management of chronic disease, including cystic fibrosis (CF). Despite subsequent easing of restrictions and because of improved clinical stability resulting from the introduction of highly effective modulator therapy, digital technologies including video and telephone consultations and remote monitoring are likely to remain integral to the future delivery of CF health care. In this article, we explore some of the key de...
Source: Seminars in Respiratory and Critical Care Medicine - December 19, 2022 Category: Respiratory Medicine Authors: Peckham, Daniel Spoletini, Giulia Tags: Review Article Source Type: research

Antimicrobial Strategies for Cystic Fibrosis
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1758733Lung infection is the leading cause of death in cystic fibrosis (CF), and antimicrobial therapies are the backbone of infection management. While many different strategies may be applied, rigorous microbiological surveillance, intensive eradication therapy, and long-term maintenance therapy based on inhaled antibiotics may be considered the main strategy for infection control in individuals with CF. While most of the existing evidence is based on infection with Pseudomonas aeruginosa, other important pathogens causing lung inflammation and deterioration exist and should...
Source: Seminars in Respiratory and Critical Care Medicine - December 19, 2022 Category: Respiratory Medicine Authors: M øller, Rikke Pressler, Tacjana Qvist, Tavs Tags: Review Article Source Type: research

Beyond the Lungs —Emerging Challenges in Adult Cystic Fibrosis Care
This article provides an up-to-date review of many of the nonrespiratory complications of CF, including mental health issues, nutritional and gastrointestinal problems, fertility issues, diabetes mellitus, bone health and musculoskeletal problems, liver disease, renal problems, and risk of malignancy. It highlights the recent impact of new therapies, including CF transmembrane conductance regulator modulators, on the nonrespiratory complications of CF and provides insights into the potential challenges faced by an aging population of adults with CF and their caregivers, including the potential future risk for cardiovascula...
Source: Seminars in Respiratory and Critical Care Medicine - December 19, 2022 Category: Respiratory Medicine Authors: Mulrennan, Siobhain Sapru, Karuna Tewkesbury, Daniel Jones, Andrew M. Tags: Review Article Source Type: research

Respiratory Viruses and Cystic Fibrosis
This article reviews the epidemiology, diagnosis, and treatment of respiratory virus infection in the context of CF as well as the current understanding of interactions between viruses and other microorganisms in the CF lung. The incidence of respiratory virus infection in CF varies by age with young children typically experiencing more frequent episodes than adolescents and adults. At all ages, respiratory viruses are very common in CF and are associated with pulmonary exacerbations. Respiratory viruses are identified at up to 69% of exacerbations, while viruses are also frequently detected during clinical stability. The ...
Source: Seminars in Respiratory and Critical Care Medicine - December 19, 2022 Category: Respiratory Medicine Authors: Brackenborough, Kate Ellis, Huw Flight, William G. Tags: Review Article Source Type: research

Community-Acquired Pneumonia: Postpandemic, Not Post-COVID-19
Semin Respir Crit Care Med 2022; 43: 924-935 DOI: 10.1055/s-0042-1755186The coronavirus disease 2019 (COVID-19) pandemic upended our approach to imaging community-acquired pneumonia, and this will alter our diagnostic algorithms for years to come. In light of these changes, it is worthwhile to consider several postpandemic scenarios of community-acquired pneumonia: (1) patient with pneumonia and recent positive COVID-19 testing; (2) patient with air space opacities and history of prior COVID-19 pneumonia (weeks earlier); (3) multifocal pneumonia with negative or unknown COVID-19 status; and (4) lobar or sublobar pneumonia ...
Source: Seminars in Respiratory and Critical Care Medicine - November 28, 2022 Category: Respiratory Medicine Authors: Ketai, Loren Febbo, Jennifer Busby, Hellen K. Sheehan, Elyce B. Tags: Review Article Source Type: research

Imaging in the Intensive Care Unit
This article will provide guidance for interpretation of CXR and thoracic CT images, discuss some of the invasive devices routinely used, and review the radiologic manifestations of common pathologic disease states encountered in ICU patients. In addition, imaging findings and complications of more specific clinical scenarios in which the incidence has increased in the ICU setting, such as patients who are immunocompromised, have interstitial lung disease, or COVID-19, will also be discussed. Communication between the radiologist and intensivist, particularly on complicated cases, is important to help increase diagnostic a...
Source: Seminars in Respiratory and Critical Care Medicine - November 28, 2022 Category: Respiratory Medicine Authors: Toy, Dennis Siegel, Mark D. Rubinowitz, Ami N. Tags: Review Article Source Type: research

Lung Cancer Screening
Semin Respir Crit Care Med 2022; 43: 839-850 DOI: 10.1055/s-0042-1757885Lung cancer is a leading cause of cancer death in the United States and globally with the majority of lung cancer cases attributable to cigarette smoking. Given the high societal and personal cost of a diagnosis of lung cancer including that most cases of lung cancer when diagnosed are found at a late stage, work over the past 40 years has aimed to detect lung cancer earlier when curative treatment is possible. Screening trials using chest radiography and sputum failed to show a reduction in lung cancer mortality however multiple studies using low dose...
Source: Seminars in Respiratory and Critical Care Medicine - November 28, 2022 Category: Respiratory Medicine Authors: Lee, Elizabeth Kazerooni, Ella A. Tags: Review Article Source Type: research

High-Resolution Computed Tomography of Nonfibrotic Interstitial Lung Disease
Semin Respir Crit Care Med 2022; 43: 780-791 DOI: 10.1055/s-0042-1755564Nonfibrotic interstitial lung diseases include a heterogeneous group of conditions that can result in various patterns of lung involvement. When approaching the computed tomographic (CT) scan of a patient with a suspected or known interstitial lung disease, the use of the appropriate radiological terms and a systematic, structured approach to the interpretation of the imaging findings are essential to reach a confident diagnosis or to limit the list of differentials to few possibilities. The large number of conditions that cause nonfibrotic interstitia...
Source: Seminars in Respiratory and Critical Care Medicine - November 28, 2022 Category: Respiratory Medicine Authors: Marrocchio, Cristina Lynch, David A. Tags: Review Article Source Type: research

Chest Imaging
Semin Respir Crit Care Med 2022; 43: 763-763 DOI: 10.1055/s-0042-1757884 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Respiratory and Critical Care Medicine)
Source: Seminars in Respiratory and Critical Care Medicine - November 28, 2022 Category: Respiratory Medicine Authors: Remy-Jardin, Martine Leung, Ann N.C. Lynch, David A. Tags: Preface Source Type: research

Imaging of Drug-Related Pneumonitis in Oncology
This article will describe the computed tomography (CT) pattern-based approach for drug-related pneumonitis that has been utilized to describe the imaging manifestations of pneumonitis from novel cancer therapies. Then, we will discuss pneumonitis from representative agents of precision cancer therapy, including mammalian target of rapamycin inhibitors, epidermal growth factor receptor inhibitors, and ICI, focusing on the incidence, risk factors, and the spectrum of CT patterns. Finally, the article will address emerging challenges in the diagnosis and monitoring of pneumonitis, including pneumonitis from combination ICI a...
Source: Seminars in Respiratory and Critical Care Medicine - October 28, 2022 Category: Respiratory Medicine Authors: Tseng, Shu-Chi Lee, Ho Yun Nishino, Mizuki Tags: Review Article Source Type: research

High-Resolution Computed Tomography of Fibrotic Interstitial Lung Disease
This article will describe the technique used to perform HRCT, the normal and abnormal appearance of the lung on HRCT, and the CT patterns identified in common fibrotic lung diseases. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Respiratory and Critical Care Medicine)
Source: Seminars in Respiratory and Critical Care Medicine - October 28, 2022 Category: Respiratory Medicine Authors: Rodriguez, Karen Ashby, Christian L. Varela, Valeria R. Sharma, Amita Tags: Review Article Source Type: research

Chronic Thromboembolic Pulmonary Disease and Chronic Thromboembolic Pulmonary Hypertension
Semin Respir Crit Care Med DOI: 10.1055/s-0042-1755570Chronic thromboembolic pulmonary hypertension (CTEPH) and chronic thromboembolic pulmonary disease (CTEPD) are two terms characterizing symptomatic patients with chronic thromboembolic occlusions of pulmonary arteries with or without pulmonary hypertension at rest. Their diagnosis follows evolving schemas that integrate technological advances of pivotal imaging modalities among which computed tomography angiography plays a major role. This review article summarizes the current knowledge on the natural history of acute pulmonary embolism and its evolution toward chronic ...
Source: Seminars in Respiratory and Critical Care Medicine - October 28, 2022 Category: Respiratory Medicine Authors: Remy-Jardin, Martine Hutt, Antoine Remy, Jacques Tags: Review Article Source Type: research