Abstract:
:Refractory breathlessness is one of the most common and devastating symptoms of advanced cardiorespiratory disease, both malignant and nonmalignant. In spite of increased interest in research in the last 20 years, there have been few significant advances in the palliation of this distressing condition. The most successful palliative regimens for breathlessness always include pharmacological and nonpharmacological interventions used concurrently. When patients are active, nonpharmacological treatments (e.g., exercise) are the most effective. As the patient becomes more breathless, eventually becoming breathless at rest, pharmacological treatments become more important. Opioids have the most extensive evidence base to guide their use. Other pharmacological interventions may act partly by helping breathlessness (by mechanisms still uncertain) or by treating concomitant precipitating and exacerbating conditions, such as depression and anxiety. A specific treatment to palliate breathlessness remains elusive. The neurophysiological substrate of breathlessness perception is still relatively poorly understood and not well reproduced in animal models. Research using functional MRI and other imaging, with more precise clinical trial methods, may help to bring significant advances. In the next 5 years, novel approaches to delivering opioids may be developed, the effective use of inhaled furosemide may be elucidated and the place of antidepressants and anxiolytics will become clearer. A role for cannabinoids may emerge. New drugs may be developed as our understanding of neurophysiology grows.
journal_name
Expert Rev Respir Medjournal_title
Expert review of respiratory medicineauthors
Booth S,Bausewein C,Higginson I,Moosavi SHdoi
10.1586/17476348.3.1.21subject
Has Abstractpub_date
2009-02-01 00:00:00pages
21-36issue
1eissn
1747-6348issn
1747-6356journal_volume
3pub_type
杂志文章abstract:INTRODUCTION:Survival after lung transplantation lags behind outcomes of other solid organ transplants, and complications from lung transplant are the second most common cause of death in cystic fibrosis. Evolving surgical techniques, therapeutics, and perioperative management have improved short-term survival after lu...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2018.1522254
更新日期:2018-11-01 00:00:00
abstract::Smoke inhalation injury continues to increase morbidity and mortality in burn patients in both the third world and industrialized countries. The lack of uniform criteria for the diagnosis and definition of smoke inhalation injury contributes to the fact that, despite extensive research, mortality rates have changed li...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1586/ERS.09.21
更新日期:2009-06-01 00:00:00
abstract::Mometasone furoate and formoterol fumarate dihydrate (MF/F) administered via metered-dose inhaler with a dose counter is a new fixed-dose combination of an inhaled corticosteroid and a long-acting β2-agonist indicated for daily maintenance therapy in patients aged ≥12 years with persistent asthma. Randomized, controll...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/ers.11.71
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:There is an ongoing need for additional interventions in idiopathic pulmonary fibrosis (IPF) as antifibrotic drugs currently available only inhibit and do not stall disease progression. Vitamin K is a co-factor for the activation of coagulation factors. However, it is also required to activate proteins wit...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2018.1424544
更新日期:2018-03-01 00:00:00
abstract:INTRODUCTION:Malignant pleural effusion (MPE) is a feature of metastatic cancer associated with significant morbidity and cost. The typical management of MPE is systemic chemotherapy and mechanical intervention. Vascular endothelial growth factor (VEGF), an inducer of vascular permeability, has been shown to mediate fl...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2018.1417042
更新日期:2018-02-01 00:00:00
abstract::Patients suffering from COPD not controlled by a single bronchodilator should be given two bronchodilators with different mechanisms of action. Addition of a LABA to a LAMA induces a larger bronchodilation than that obtained with the LAMA as monotherapy and also improves many patient-reported outcomes. Since the clini...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1586/17476348.2016.1156538
更新日期:2016-04-01 00:00:00
abstract::Asthma is often associated with various comorbidities. The most frequently reported asthma comorbid conditions include rhinitis, sinusitis, gastroesophageal reflux disease, obstructive sleep apnea, hormonal disorders and psychopathologies. These conditions may, first: share a common pathophysiological mechanism with a...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/ers.11.34
更新日期:2011-06-01 00:00:00
abstract::Introduction: Amongst allergic asthmatics, high allergen exposure increases asthma severity. However, there is no consensus on the role of mite allergen avoidance in the management of asthma, and various guidelines differ in their recommendations. Areas covered: Several systematic reviews/meta-analyses on mite avoidan...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2019.1651647
更新日期:2019-10-01 00:00:00
abstract::Methicillin-resistant Staphylococcus aureus (MRSA) has become one of the leading etiologies of nosocomial pneumonia as a result of an increase in staphylococcal infections caused by methicillin-resistant strains paired with extended ventilatory support of critically, and often, chronically ill patients. The prevalence...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2014.940323
更新日期:2014-10-01 00:00:00
abstract::The Understanding Potential Long-term Improvements in Function with Tiotropium (UPLIFT) trial was a global 4-year randomized placebo-controlled clinical trial that evaluated the long-term impact of tiotropium bromide 18 microg once daily on the accelerated age-related decline in pre- and post-bronchodilator forced exp...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/ers.10.23
更新日期:2010-06-01 00:00:00
abstract::Premature infants are at substantial risk for a spectrum of morbidities that are gestational age dependent. Respiratory syncytial virus (RSV) infection is most common in the first two years of life with the highest burden in children aged <6 months. Preterm infants ≤35 weeks' gestation are handicapped by incomplete im...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2015.1098536
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:The independent and central role of the patient with a complex chronic respiratory disease in targeted, personalized disease management strategies is becoming increasingly important. Patients are the ones living with the disease and are finally responsible for their lives underlining their role as essentia...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2017.1392242
更新日期:2017-12-01 00:00:00
abstract::Chronic airway infection and inflammation are the hallmarks of cystic fibrosis (CF) lung disease. As these events occur early in life, it is critical to develop techniques for the assessment and monitoring of early-CF lung disease in infants and young children. In the last several years, there have been major advances...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1586/17476348.2.3.381
更新日期:2008-06-01 00:00:00
abstract::Chronic obstructive pulmonary disease is an inflammatory disorder characterized by airflow limitation. Its cardinal symptom is dyspnea, which develops gradually with even low levels of exercise. Bronchodilators (BDs) are the most effective drugs for relieving dyspnea. Two main types of BD are currently available, β-mi...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/ers.13.18
更新日期:2013-04-01 00:00:00
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 r...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2018.1495562
更新日期:2018-08-01 00:00:00
abstract::Erdosteine is a multimechanism, mucolytic agent that decreases the sputum viscoelastic properties and bacterial adhesion to the cell membrane, endowed with bronchial anti-inflammatory activity and a scavenging effect on free oxidant radicals. Erdosteine is a prodrug and metabolite I is the active metabolite of erdoste...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1586/17476348.1.3.307
更新日期:2007-12-01 00:00:00
abstract::Innovations in surgery have significantly increased the number of procedures performed every year. While more individuals benefit from better surgical techniques and technology, a larger group of patients previously deemed ineligible for surgery now undergo high-complexity surgical procedures. Despite continuous impro...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2015.996134
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Acute exacerbations of chronic lung disease account for substantial morbidity and health costs. Repeated inflammatory episodes and attendant bronchoconstriction cause structural remodeling of the airway. Remodeling is a multicellular response to mucosal injury that results in epithelial cell-state changes,...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2018.1526677
更新日期:2018-11-01 00:00:00
abstract::Cigarette smoking in asthma is frequently present and is associated with worsening of symptoms, accelerated lung-function decline, a higher frequency of hospital admissions, a higher degree of asthma severity, poorer asthma control and reduced responsiveness to corticosteroids. Furthermore, it is associated with reduc...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/ers.10.85
更新日期:2011-02-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) is a very common disease all around the world and has become an increasing public health concern to the Chinese medical community. In the past decades, telehealthcare technology has become a good way to manage COPD but current evidence makes it hard to determine the effecti...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2013.838019
更新日期:2013-10-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characterized by persistent airflow limitation. It is the third leading cause of death worldwide, and there are currently no curative strategies for this disease. Many factors contribute to COPD susceptibility, progression and exacerbations. These...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2013.842468
更新日期:2013-12-01 00:00:00
abstract::Dendritic cells (DCs) are the most potent antigen-presenting cells in the human lung and are now recognized as crucial initiators of immune responses in general. They are arranged as sentinels in a dense surveillance network inside and below the epithelium of the airways and alveoli, where they are ideally situated to...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1586/17476348.2.2.215
更新日期:2008-04-01 00:00:00
abstract::Introduction: There is an unmet clinical need for improved diagnostic tests for active tuberculosis (TB) to provide high sensitivity for all cases, accelerate time to diagnosis and ensure timely and appropriate treatment. Whilst the measurement of M.tb-specific immune responses is widely used for detecting infection i...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2019.1615888
更新日期:2019-06-01 00:00:00
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...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2018.1457438
更新日期:2018-05-01 00:00:00
abstract::Asthma is perceived as a heterogeneous disease with several clinical phenotypes and triggering factors. In general, cytokines from T-helper 2 cells are believed to be critical contributors of asthma. In recent years, IL-17, another T-helper lymphocyte-associated cytokine, has been put forward as another potentially im...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/ers.12.12
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:Chronic pulmonary aspergillosis (CPA) is a chronic lung infection caused by Aspergillus fumigatus, that complicates structural lung diseases. Of the different types of CPA, chronic cavitary pulmonary aspergillosis (CCPA) is the most common form. The mainstay of treatment of CCPA is oral triazoles. However,...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2020.1750956
更新日期:2020-07-01 00:00:00
abstract::Inhaled antibiotic therapy, targeting Pseudomonas aeruginosa, is a fundamental component of cystic fibrosis (CF) management. Tobramycin inhalation solution (TIS) was approved in the United States (US) in 1998. Subsequent research efforts focused on developing products with a reduced treatment time burden. Aztreonam fo...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2014.896205
更新日期:2014-06-01 00:00:00
abstract::Endobronchial ultrasound (EBUS) is an evolving diagnostic tool in respiratory medicine that allows the bronchoscopist to see beyond the airway. The radial probe EBUS was first introduced to evaluate the central airway structure. With advances in technology, the small radial probes can now visualize and assist transbro...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/ers.10.39
更新日期:2010-08-01 00:00:00
abstract::Introduction: Acute respiratory distress syndrome (ARDS) is a severe form of acute lung injury common in critically ill patients and characterized by significant morbidity and mortality. It frequently manifests long-lasting effects beyond hospitalization, from cognitive impairment to physical weakness.Areas covered: S...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2020.1743182
更新日期:2020-06-01 00:00:00
abstract::Lung transplantation is the only effective treatment for many advanced lung diseases. However, long-term survival after transplantation remains relatively poor, thus limiting the application of lung transplantation to patients with end-stage disease only. Acute and chronic rejection is the main reason for allograft fa...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1586/17476348.1.2.271
更新日期:2007-10-01 00:00:00