Abstract:
:Lung cancer is the number one cause of death from cancer in the United States. Currently, there is no official recommendation to screen for lung cancer even in high-risk populations. Accordingly, we wait for patients to present with symptoms. Only 15-20% of patients are stage I lung cancer at diagnosis. Past screening trials with chest roentgenogram and sputum cytology did not show a reduction of lung cancer mortality in the screened population. Since the completion of those trials in the early 1980s we have learned that the chest X ray is not sensitive at detecting lesions <2 cm in size, and patients with chronic obstructive pulmonary disease (COPD) have a 4- to 6-fold increased risk of lung cancer independent of their smoking history. Recent trials with spiral computed tomography (CT) scan screening have detected 80-85% of lung cancers while they are stage I. The problems related to spiral CT screening are the cost and the frequent detection of benign lesions. Algorithms are being developed to try and prevent unnecessary biopsies and/or surgery. Sputum cytology is currently the only clinically approved sputum test for detecting lung cancer. However, in patients with moderate dysplasia of cytology, the LIFE autofluorescence bronchoscopy system may yield an increased sensitivity of detecting precancerous or cancerous lesions. More studies are needed before the LIFE system can be adopted as a standard clinical tool. Currently, investigators are evaluating the sputum for early lung cancer detection markers. The marker that is the most developed is the monoclonal antibody to the heterogeneous nuclear ribonucleoprotein A2/B1 on the sputum epithelial cell surface. Encouraging preliminary results have been reported and trials are ongoing. The future looks bright for the field of lung cancer screening.
journal_name
Semin Respir Crit Care Medjournal_title
Seminars in respiratory and critical care medicineauthors
Jett JRdoi
10.1055/s-2000-9402keywords:
subject
Has Abstractpub_date
2000-01-01 00:00:00pages
385-92issue
5eissn
1069-3424issn
1098-9048journal_volume
21pub_type
杂志文章abstract::Ultrasonography of the thorax has become a more recognized tool in pulmonary medicine, thanks to continuing clinical research that has proven its many valuable roles in the day-to-day management of pulmonary and pleural diseases. Ultrasound examination is a cost-effective imaging modality that permits the pulmonologis...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1395794
更新日期:2014-12-01 00:00:00
abstract::Pulmonary immunity to fungal pathogens requires both innate and adaptive immune responses. Alveolar macrophages, dendritic cells, and neutrophils are the phagocytic cells of the lung innate system. These cells produce early inflammatory mediators (i.e., reactive oxygen species, cytokines, and chemokines) in response t...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-822306
更新日期:2004-02-01 00:00:00
abstract::Cryptococcosis is an invasive fungal infection (IFI), caused predominantly by Cryptococcus neoformans or Cryptococcus gattii, that affects both immunocompromised (IC) and non-IC patients. Although the most serious disease manifestation is meningoencephalitis, cryptococcal pneumonia is underdiagnosed and may disseminat...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1295720
更新日期:2011-12-01 00:00:00
abstract::Non-small cell lung cancer (NSCLC) is the most common subtype of lung cancer and the leading cause of cancer-related death. Although durable local control rates are high after surgical resection or definitive radiotherapy for early-stage disease, a substantial proportion of these patients eventually experience regiona...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0039-3399578
更新日期:2020-06-01 00:00:00
abstract::Daily oral care with chlorhexidine for mechanically ventilated patients is ubiquitous in contemporary intensive care practice. The practice is predicated upon meta-analyses suggesting that adding chlorhexidine to daily oral care regimens can reduce ventilator-associated pneumonia (VAP) rates by up to 40%. Close analys...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1602584
更新日期:2017-06-01 00:00:00
abstract::With the improving survival of cystic fibrosis (CF) patients and the advent of highly effective cystic fibrosis transmembrane conductance regulator therapy, the clinical spectrum of this complex multisystem disease continues to evolve. One of the most important clinical events for patients with CF in the course of thi...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1697975
更新日期:2019-12-01 00:00:00
abstract::Computed tomography (CT) is the core imaging modality for the evaluation of thoracic disorders. With the recently developed dual-energy CT (DECT) technique, the clinical utility of CT in the management of pulmonary diseases can be expanded. The most actively investigated principle of dual energy is material decomposit...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1363452
更新日期:2014-02-01 00:00:00
abstract::Patients with severe infections are often treated with multiple courses of antibiotics in the intensive care unit (ICU), making the ICU a true antibiotic hotspot. The increasing incidence of multidrug resistance worldwide emphasizes the need for continued efforts in developing and implementing antibiotic stewardship p...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1693995
更新日期:2019-08-01 00:00:00
abstract::Survivors of critical illness often experience long-lasting impairments in mental, cognitive, and physical functioning. Acute stress reactions and delusional memories appear to play an important role in psychological morbidity following critical illness, and few interventions exist to address these symptoms. This revi...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1570367
更新日期:2016-02-01 00:00:00
abstract::Aspirin-exacerbated respiratory disease (AERD) is a unique syndrome of airway inflammation that frequently occurs in patients with nasal polyposis, chronic sinusitis, and asthma. These patients tend to have progressive and recalcitrant sinus disease requiring frequent surgical intervention and in many cases systemic c...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0032-1325618
更新日期:2012-12-01 00:00:00
abstract::The purpose of this review is to familiarize a broad range of medical professionals with a relatively new and growing problem of infections caused by mycobacteria other than M. tuberculosis and M. leprae. There are at least 60 mycobacterial species that have been identified as causative agents of diseases in humans. T...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-829501
更新日期:2004-06-01 00:00:00
abstract::Pandemics of influenza have been reported since the early sixteenth century. Recent pandemics include the Spanish flu (H1N1) from 1918 to 1920 (resulting in approximately 50 million deaths worldwide); the Asian flu (H2N2) from 1957 to 1958 (resulting in more than 1 million deaths); the Hong Kong flu (H3N2) from 1968 t...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-976488
更新日期:2007-04-01 00:00:00
abstract::Practicing pulmonologists are often faced with the question of whether a lung disease is related to something in the patient's workplace, home, or recreational environment. Recognizing a lung disease as exposure related creates both opportunities and obligations for clinicians. In addition to managing the patient, the...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0028-1101272
更新日期:2008-12-01 00:00:00
abstract::Acinetobacter baumannii is a highly resilient, gram-negative coccobacillus that thrives within the unique and complex ecological setting of an intensive care unit. This evolving pathogen has now surpassed human capacity to create new antimicrobials, and has led physicians into a concerning era for hospital-acquired in...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-996413
更新日期:2007-12-01 00:00:00
abstract::Mycobacterial infections have caused enormous morbidity and mortality in people living with human immunodeficiency virus (HIV) infection. Of these, the most devastating has been tuberculosis (TB), the leading cause of death among HIV-positive persons globally. TB has killed more people living with HIV than any other i...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1572559
更新日期:2016-04-01 00:00:00
abstract::Pulmonary rehabilitation is a standard of care for patients with chronic lung disease. Through appropriate patient selection and assessment, exercise training, educational and psychosocial intervention, nutritional counseling, and breathing retraining, many benefits (e.g., reduction in level of dyspnea, improvement in...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1055/s-0029-1242632
更新日期:2009-12-01 00:00:00
abstract::Pain is experienced by the overwhelming majority of patients during their intensive care unit stay, but it remains an underappreciated problem. To effectively treat pain, it must be detected and quantified using a validated assessment tool. It is acknowledged that optimal pain relief may be difficult to achieve given ...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1342973
更新日期:2013-04-01 00:00:00
abstract::Achieving hemostasis, preventing and treating thrombosis, and laboratory measurement of the hemostatic pathways constitute the core elements of managing the critically ill patient with liver failure. Uncontrolled bleeding in acutely decompensated cirrhosis and acute-on-chronic liver failure is probably the most famili...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1673658
更新日期:2018-10-01 00:00:00
abstract::In heart failure (HF), pleural effusion results from increased interstitial fluid in the lung due to elevated pulmonary capillary pressure. Rarely, pleural effusions may occur in association with isolated right HF. HF-associated effusions are typically bilateral, but if unilateral, they are more commonly seen on the r...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1269828
更新日期:2010-12-01 00:00:00
abstract::Treatment strategies for anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are evolving. Cyclophosphamide (CYC) plus corticosteroids (CSs) is the mainstay of therapy for generalized, multisystemic AAV. Historically, the combination of CYC plus CS was used for a minimum of 12 months, but concern a...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1279831
更新日期:2011-06-01 00:00:00
abstract::Although airway inflammation is an intrinsic and key feature of asthma, this response varies in its intensity and translation to clinical characteristics and responsiveness to treatment. The observations that clinical heterogeneity is an important aspect of asthma and a feature that likely dictates and determines resp...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1606218
更新日期:2018-02-01 00:00:00
abstract::Antibiotic resistance has emerged as a key determinant of outcome in patients with serious infections along with the virulence of the underlying pathogen. Within the intensive care unit (ICU) setting, ventilator-associated pneumonia (VAP) is a common nosocomial infection that is frequently caused by multidrug-resistan...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1599224
更新日期:2017-06-01 00:00:00
abstract::In endemic areas, dimorphic fungal infections due to Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides posadasii/immitis account for up to 30% of cases of community-acquired pneumonia. Because respiratory manifestations are often indistinguishable from common bacterial causes of pneumonia, the diagnos...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0040-1702194
更新日期:2020-08-01 00:00:00
abstract::Multiorgan dysfunction syndrome represents a continuum of cumulative organ dysfunction from very mildly altered function to total and, rarely, irreversible organ failure and is the major cause of death in the intensive care unit (ICU). The terms multiple organ failure syndrome (MOFS), multiple organ system failure (MO...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0031-1287862
更新日期:2011-10-01 00:00:00
abstract::Catheters are the leading source of bloodstream infections in critically ill patients. Because the clinical signs of infection are nonspecific, such infections are overly suspected, which results in unnecessary removal of catheters. A conservative approach might be attempted in mild infections, whereas catheters shoul...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1275526
更新日期:2011-04-01 00:00:00
abstract::Over the last decade, improvements in surgical techniques, lung preservation, immunosuppression, and management of ischemia-reperfusion injury and infections have contributed to increase the 1 year patient survival after lung transplantation to 70 to 80%. However, the incidence of acute rejection remains higher than a...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2006-954609
更新日期:2006-10-01 00:00:00
abstract::Venous thromboembolism (VTE) is a frequent complication in surgical patients, with the potential for long-term disability or fatal outcome. The rationale behind routine use of thromboprophylaxis can be summarized in three points: (1) VTE is frequent in certain surgical populations, (2) VTE may be fatal, (3) thrombopro...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1047566
更新日期:2008-02-01 00:00:00
abstract::Healthcare-associated pneumonia (HCAP) represents one of the largest subsets of patients with pneumonia. Based on epidemiological projections for the aging U.S. population, the number of hospitalizations for HCAP is expected to increase exponentially for the next several decades. The unique risk factors for colonizati...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1119812
更新日期:2009-02-01 00:00:00
abstract::This article reviews recent developments in the selection, assessment, and management of the potential lung donor, which aim to increase donor organ use. The scarcity of suitable donor organs continues to limit lung transplantation, but the situation is changing. An expanded donor pool, including the now widespread us...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1348464
更新日期:2013-06-01 00:00:00
abstract::Invasive candidiasis (IC) is the most frequent health care associated invasive fungal infection. It is also associated with high morbidity, mortality, and cost. The most frequent etiologic agent is Candida albicans, but non-albicans species are increasing and associated with reduced antifungal susceptibility and outbr...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0040-1701215
更新日期:2020-02-01 00:00:00