Abstract:
:Pulmonary arterial hypertension (PAH) is defined as a mean pulmonary artery pressure greater then 25 mm Hg at rest and greater then 30 mm Hg with exercise in association with normal left heart filling pressures. However, many patients with PAH have much higher pulmonary artery pressures, which, untreated, can rapidly result in marked disability, right heart failure, and death. A myriad of recent therapeutic advances have revolutionized the treatment of PAH, significantly impacting both symptoms and survival. This article briefly discusses some of the medication classes currently approved to treat patients with PAH and reviews novel therapies in the context of recent clinical trials. Also examined here are the rationale and data available for the role of combination therapy in the treatment of PAH. The article closes with speculation on new directions in the therapeutic management of this life-threatening disease.
journal_name
Semin Respir Crit Care Medjournal_title
Seminars in respiratory and critical care medicineauthors
Bull TMdoi
10.1055/s-2005-916158keywords:
subject
Has Abstractpub_date
2005-08-01 00:00:00pages
429-36issue
4eissn
1069-3424issn
1098-9048journal_volume
26pub_type
杂志文章,评审abstract::In the past decade, much information has been gained on the diagnostic and therapeutic strategies in patients suspected of having hospital-acquired pneumonia. The key to an effective therapeutic approach is the diagnostic strategy used, and timely administration of appropriate antibiotic therapy. Many patients, but no...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2002-35717
更新日期:2002-10-01 00:00:00
abstract::Bleeding from gastroesophageal varices is a frequent complication of cirrhosis. Mortality from a variceal bleeding episode has decreased in the last 2 decades from 40% to 15 to 20% due to the implementation of effective treatments and improvement in the general medical care. Initial treatment should include adequate f...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1301734
更新日期:2012-02-01 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::When Dr. Joseph Lynch, editor of Seminars in Respiratory and Critical Care Medicine, invited us to organize and edit this topic we-and our contributors-were initially baffled about how we could marry outcomes, ethics, and economics. His perspective as an elder-statesman, who has observed the evolution of critical care...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 社论
doi:10.1055/s-0032-1322413
更新日期:2012-08-01 00:00:00
abstract::Identifying genetic determinants of pulmonary fibrosis is at an early stage of evolution. It is now well recognized that "pulmonary fibrosis" covers a broad range of lung diseases including most topically the idiopathic interstitial pneumonias that have been classified recently. Additionally, it is recognized that the...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2003-39019
更新日期:2003-04-01 00:00:00
abstract::The diaphragm is the most important muscle of ventilation. Its contraction is key to the development of intrathoracic pressures. Diseases that affect diaphragmatic function result in decreased pressure-generating capacity by the respiratory muscles. If the involvement is severe or if there is underlying respiratory pa...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2002-33036
更新日期:2002-06-01 00:00:00
abstract::Although the lung is frequently involved by disseminated lymphoma, isolated pulmonary lymphoma is rare, accounting for less than 1% of all extranodal localized disease. Three broad categories of lymphoma of the lung require recognition: in rare instances, large B cell type lymphoma can present primarily in the lung; a...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2005-922032
更新日期:2005-10-01 00:00:00
abstract::Shock is a broad category of injury to the human body caused by a variety of insults. Fluid resuscitation is the cornerstone of initial therapy for nearly all forms of shock. This article reviews the basic physiology determining body fluid composition, the goals of fluid resuscitation in shock, the types of fluids ava...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-860982
更新日期:2004-12-01 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::Pneumocystis jiroveci remains an important fungal pathogen in a broad range of immunocompromised hosts. The natural reservoir of infection remains unknown. Pneumocystis jiroveci Pneumonia (PJP) develops via airborne transmission or reactivation of inadequately treated infection. Nosocomial clusters of infection have b...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0039-3399559
更新日期:2020-02-01 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::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...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2000-9402
更新日期:2000-01-01 00:00:00
abstract::Acute exacerbations of chronic bronchitis (AECBs) are one of the major causes of morbidity and mortality in the United States, resulting in significant cost to the health care system. Epidemiological information on chronic bronchitis is abundant and has been collected in most industrialized countries. The epidemiology...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2000-9845
更新日期:2000-01-01 00:00:00
abstract::Lung transplant has become an established therapy in the treatment of end-stage lung disease. Many of the advances in the modern immunosuppression regimen have provided more quality and quantity of life to transplant patients. Immunosuppression agents target various aspects of the immune system to maximize graft toler...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0030-1249112
更新日期:2010-04-01 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::Hyperoxia, or excess oxygen supplementation, prevails in the intensive care unit (ICU) without a beneficial effect and, in some instances, may cause harm. Recent interest and surge in clinical studies in mechanically ventilated critically ill patients has brought this to the attention of clinicians and researchers. Hy...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1570359
更新日期:2016-02-01 00:00:00
abstract::The management of patients suspected of having ventilator-associated pneumonia (VAP) requires a strategy for diagnosis and treatment that is designated to: (1) identify patients with true lung bacterial infection; (2) determine the pathogen(s) responsible for pneumonia; (3) permit early selection of appropriate antimi...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2006-933672
更新日期:2006-02-01 00:00:00
abstract::Hematologic factors, in particular platelets and the coagulation system, play an important role in the pathogenesis of organ failure in the intensive care unit. Failure of these hematologic systems is common in intensive care patients and may range from isolated thrombocytopenia or prolonged global clotting tests to c...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1287873
更新日期:2011-10-01 00:00:00
abstract::Cystic fibrosis (CF) is now more common in adults than children in countries with well-developed health care systems. The number of adults continues to increase and will further increase if the new cystic fibrosis transmembrane conductance regulator (CFTR) modulators are disease modifying. Most of the complex morbidit...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0039-3400289
更新日期:2019-12-01 00:00:00
abstract::Selective decontamination of the digestive tract (SDD) is an infection prevention strategy in intensive care unit (ICU) patients by topical administration of antibiotics to the mouth and stomach to eradicate potentially pathogenic bacteria and yeast that may cause infections. It also includes a short course of intrave...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1275536
更新日期:2011-04-01 00:00:00
abstract::Amyloidosis is the term given to abnormal deposition of misfolded precursor proteins at single or multiple sites, leading to organ dysfunction or clinical signs and symptoms. Pulmonary manifestations are nonspecific and may be associated with several amyloid protein subtypes, commonly AL (light chain) and AA (autoimmu...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0040-1708059
更新日期:2020-04-01 00:00:00
abstract::Coccidioidomycosis manifests as a variety of clinical manifestations and ranges in severity from asymptomatic exposure with resultant immunity to reinfection, to fulminant, and life-threatening disseminated disease. Primary coccidioidal pneumonia represents the most common clinical form of infection, and the incidence...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1562900
更新日期:2015-10-01 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::Legionella pneumophila has been found to be a common cause of community-acquired pneumonia in patients who required intensive care unit (ICU) admission. In many studies, the clinical manifestations for Legionnaires' disease were more severe and the mortality was higher when compared with pneumonias of other etiology. ...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2000-9862
更新日期:2000-01-01 00:00:00
abstract::Cystic fibrosis (CF) is a multisystem disease. Some of this is accounted for by CF transmembrane regulator (CFTR) dysfunction in individual organs but in some cases this is compounded by the effects of systemic inflammation. The inflammation is in response to the chronic infection in the airways and is particularly im...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2007-981651
更新日期:2007-06-01 00:00:00
abstract::Current research indicates that the majority of survivors of critical illness develop post-intensive care syndrome (PICS), which includes new or worsening cognitive or psychiatric disorders that persist for months to years after critical illness. These cognitive impairments and psychiatric disorders are profound and l...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1321984
更新日期:2012-08-01 00:00:00
abstract::MYCOBACTERIUM AVIUM complex (MAC) consists of nontuberculous mycobacteria that cause disease in immunocompromised and immunocompetent hosts. The organisms are ubiquitous in the environment, and acquisition occurs through ingestion or inhalation of aerosols from soil, water, or biofilms. Disease may manifest as dissemi...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0028-1085708
更新日期:2008-10-01 00:00:00
abstract::Lung cancer is the leading cause of cancer death in the world. However, there is large geographic variation internationally and within nations. Despite the fact that many causes of lung cancer have been established, cigarette smoking is the principal cause. Accounting for historical prevalence of cigarette smoking is ...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1076742
更新日期:2008-06-01 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::Patients with cystic fibrosis (CF) exhibit significant variability in the course and severity of the disease, and this variability is best interpreted in the context of an interaction between genetic and nongenetic determinants. While a small number of patients with "mild" mutations in the CF transmembrane conductance...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-815660
更新日期:2003-12-01 00:00:00