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 about late toxicities associated with CYC has led to novel treatment approaches. Currently, short-course (3 to 6 months) induction treatment with CYC plus CS, followed by maintenance therapy with less toxic agents (eg, methotrexate, azathioprine, mycophenolate mofetil) is recommended. Further, methotrexate combined with CS may be adequate for limited, non-life-threatening AAV. Recent studies suggest that rituximab may be useful for induction therapy or for CYC-refractory AAV. This article reviews the key agents used to treat AAV, with a focus on pharmacology, toxicities, and monitoring.
journal_name
Semin Respir Crit Care Medjournal_title
Seminars in respiratory and critical care medicineauthors
Wang T,Weigt SS,Belperio JA,Lynch JP 3rddoi
10.1055/s-0031-1279831subject
Has Abstractpub_date
2011-06-01 00:00:00pages
346-70issue
3eissn
1069-3424issn
1098-9048journal_volume
32pub_type
杂志文章,评审abstract::The evolution of scientific investigation in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) is replete with examples of effective bench-to-bedside transitions, pioneering research methodology, and international collaboration. This article highlights for clinicians a selection of challenges and ...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0033-1351120
更新日期:2013-08-01 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
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journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2005-916158
更新日期:2005-08-01 00:00:00
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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
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journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2001-18802
更新日期:2001-12-01 00:00:00
abstract::Asthma is a heterogeneous disorder with a complex etiology. Prevalence rates for asthma have been increasing in many countries over the past few decades. While it is unclear why this increase is occurring, the variation reported in asthma prevalence and severity associated with ethnicity offers some insight into the d...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1618568
更新日期:2018-02-01 00:00:00
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journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1546752
更新日期:2015-04-01 00:00:00
abstract::Non-small cell lung cancer (NSCLC) is primarily a disease of the elderly. Although NSCLC is the leading cause of cancer death in the United States and the overall prognosis of this disease is poor, treatment improves survival compared with best supportive care, independent of the stage of disease. Elderly patients hav...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2005-871987
更新日期:2005-06-01 00:00:00
abstract::The human Herpesviridae family consists of eight members: cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus 1 and 2 (HSV-1, -2), varicella-zoster virus (VZV), and human herpesvirus 6, 7, and 8 (HHV-6, -7, -8). Lifelong latency may develop in the host with reactivation during periods of relative imm...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0031-1283285
更新日期:2011-08-01 00:00:00
abstract::Nonneoplastic pulmonary lymphoid disorders consist of a complex spectrum of diseases for pathologists and pulmonologists alike. Advances in our understanding of these disorders in recent years have led to revisions in the classification scheme. This review summarizes the clinicoradiological and pathological features o...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1325156
更新日期:2012-10-01 00:00:00
abstract::Despite recent advances in understanding, the management of acute respiratory distress syndrome (ARDS) remains a challenging clinical problem. Optimization of gas exchange and preventing the iatrogenic propagation of lung injury are cornerstones of its clinical management. A number of novel approaches and adjuncts to ...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2001-15785
更新日期:2001-06-01 00:00:00
abstract::Accurate diagnosis of deep vein thrombosis is important because untreated deep vein thrombosis can cause death or permanent impairment and because effective treatments are available. The approach to the diagnosis of deep vein thrombosis varies because of differences in local resources and expertise. Duplex ultrasonogr...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2000-13187
更新日期:2000-01-01 00:00:00
abstract::Patients admitted to the neuroscience intensive care unit (NICU) may have respiratory compromise from either central or peripheral neurological pathology, and may hence require intubation and mechanical ventilation for very diverse reasons. Liberation from invasive ventilation, that is, extubation, at the earliest pos...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1608773
更新日期:2017-12-01 00:00:00
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journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1564875
更新日期:2015-12-01 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::The genus Scedosporium comprises a group of filamentous fungi found ubiquitously in the environment. The two major human pathogens within this genus are S. apiospermum-the asexual state of Pseudallescheria boydii-and S. prolificans. Both histologically resemble Aspergillus species, with hyphae that are septated and br...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-824901
更新日期:2004-04-01 00:00:00
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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::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::This review summarizes the effects of beta2-agonists on asthma severity. There has been a controversy as to whether the regularly scheduled use of beta2-adrenergic agonists increases the risk of adverse outcomes in asthma. A number of epidemiological and clinical studies have found an association between the regularly...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2002-34332
更新日期:2002-08-01 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::In patients with acute intracerebral hemorrhage (ICH), one of the major concerns is ongoing bleeding or ICH expansion. Anticoagulated patients are at higher risk of ongoing expansion and worse outcome. It may be that rapid anticoagulation reversal can reduce the risk of expansion and improve clinical outcome. For thos...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1607993
更新日期:2017-12-01 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::Usual interstitial pneumonia (UIP) is a distinct histological lesion observed in idiopathic pulmonary fibrosis (IPF) but can be found in other etiologies. The diagnosis of UIP can be established by surgical lung biopsy or by high-resolution thin-section computed tomographic (CT) scans (provided the radiographic featur...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2006-957335
更新日期:2006-12-01 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::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::Vasculitides are a heterogeneous group of disorders in which inflammation of blood vessel walls is present at least some time during the course of the disease. Vasculitides can affect any caliber or type of vessel in many anatomic sites; however, the disease can alter more than just vasculature. Given the diversity of...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1669412
更新日期:2018-08-01 00:00:00
abstract::Over the past 3 decades, antimicrobial resistance among Streptococcus pneumoniae, the most common cause of community-acquired pneumonia (CAP), has escalated dramatically worldwide. In the late 1970s, strains of pneumococci displaying resistance to penicillin were described in South Africa and Spain. By the early 1990s...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0029-1202939
更新日期:2009-04-01 00:00:00
abstract::Lung-protective ventilator strategies are considered standard practice in the care of patients with the acute respiratory distress syndrome (ARDS). To minimize ventilator-induced lung injury, attention is directed at avoidance of alveolar overdistention and cyclical opening and closing. The lowest possible plateau pre...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1382154
更新日期:2014-08-01 00:00:00
abstract::Advances have been made in minimally invasive diagnostic procedures in sarcoidosis, including bronchoalveolar lavage (BAL), endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA), and positron emission tomography (PET). Several independent groups found almost identical predictive values of t...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0030-1262207
更新日期:2010-08-01 00:00:00
abstract::Intensive care unit (ICU) acquired pneumonia is one of the most common and morbid health care-associated infections. Despite decades of work developing and testing prevention strategies, ICU-acquired pneumonia remains stubbornly pervasive. Pneumonia prevention studies are difficult to interpret because all are at risk...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1695783
更新日期:2019-08-01 00:00:00