Abstract:
INTRODUCTION:Optimal management of malignant pleural effusion (MPE) is important in the care of patients with advanced cancer. Surgical (especially video-assisted thoracoscopic surgery (VATS)) and non-surgical strategies are available. Clinicians should be aware of the evidence supporting the use of different modalities to guide treatment choice. Areas covered: This review covers published evidence of the advantages and disadvantages of VATS and non-surgical alternatives for MPE management. Expert commentary: Randomized clinical trials (RCTs) are needed to define the roles and benefits of VATS as existing literature is often flawed by selection bias. Three RCTs have failed to show benefits of VATS talc poudrage over bedside talc pleurodesis. VATS-pleurectomy offered no survival advantage in a RCT of mesothelioma patients. Modification of VATS techniques has reduced the invasiveness and associated risks. Future trials should compare VATS with contemporary, non-surgical approaches (especially combined Indwelling Pleural Catheter (IPC) and chemical pleurodesis therapy). Individualized management for different subgroups of MPE patients should be a long-term research goal. Studies are needed on better patient selection, and adjunct non-invasive, supportive (e.g. nutrition and exercise) therapies.
journal_name
Expert Rev Respir Medjournal_title
Expert review of respiratory medicineauthors
Fitzgerald DB,Koegelenberg CFN,Yasufuku K,Lee YCGdoi
10.1080/17476348.2018.1398085subject
Has Abstractpub_date
2018-01-01 00:00:00pages
15-26issue
1eissn
1747-6348issn
1747-6356journal_volume
12pub_type
杂志文章,评审abstract::The hallmarks of allergic bronchial asthma arise from chronic airway inflammation. Thus, elucidating the mechanisms regulating the maintenance of this chronic inflammatory response is key to understanding asthma pathogenesis. To date, it is not clear whether a predominance of proinflammatory factors or a reduced capac...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2015.1109452
更新日期:2015-01-01 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::Allergic airway disease is a major global health burden, and novel treatment options are urgently needed. Numerous epidemiological and experimental studies suggest that certain helminths and bacteria protect against respiratory allergies. These microorganisms are strong regulators of the immune system, and various pot...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2014.949244
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Paediatric severe therapy resistant asthma (STRA) affects a very small proportion of all children with asthma, but results in significant morbidity, has a high risk of mortality and utilises approximately half of all healthcare resources for childhood asthma. children with STRA need add-on 'beyond guidelin...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2017.1368391
更新日期:2017-11-01 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:INTRODUCTION:Non-small cell lung cancer patients harboring uncommon epidermal growth factor receptor (EGFR) mutations together account for approximately 10% of all EGFR mutations. The most common of which being G719X, S768I, L861Q, and exon 20 insertions. The clinical significance, particularly their response to EGFR t...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2017.1267569
更新日期:2017-01-01 00:00:00
abstract::Sarcoidosis is a multisystem disease for which diagnosis relies on the integration of clinical, radiologic, laboratory, and pathologic information. Assessment of clinical features is an important part of the disease evaluation. Computer Tomography provides information not available on routine chest roentgenogram which...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2016.1164602
更新日期:2016-01-01 00:00:00
abstract::Chronic respiratory disease is an increasingly prevalent cause of life-limiting illness. Care for patients with terminal respiratory diseases has historically focused on disease-modifying therapies, many of which have little impact on life expectancy. This exclusive focus can detract from attention to patient-physicia...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1586/ers.09.47
更新日期:2009-12-01 00:00:00
abstract::Background: Few studies have provided real-world evidence of mepolizumab efficacy and safety. We aimed to evaluate mepolizumab for severe eosinophilic asthma in daily clinical practice.Research design and methods: Patients included in the RINOVA (Interdisciplinary Network for the management of severe asthma in Veneto ...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2019.1676734
更新日期:2019-12-01 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::Introduction: Lung transplantation is an effective treatment for certain types of end-stage lung disease. Frailty is a complex clinical syndrome associated with decreased physiological reserve and an increased risk for suboptimal health outcomes.Area covered: This article reviews the current literature on frailty in l...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2020.1702527
更新日期:2020-02-01 00:00:00
abstract::Caveolin-1 (Cav-1) is the major protein present in invaginations of the plasma membrane of cells known as caveolae. Cav-1 is expressed in numerous resident and inflammatory cells implicated in the pathogenesis of asthma and chronic inflammatory respiratory diseases including chronic obstructive pulmonary disease. A re...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1586/17476348.2014.905915
更新日期:2014-06-01 00:00:00
abstract::Lung transplantation has evolved over the past two decades as a well-recognized therapy for patients with end-stage lung diseases. However, lung transplantation has been limited, in part, due to the scarcity of donor lung organs. Previously, donor lung organs were allocated based on a potential recipient's waiting lis...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1586/17476348.2.4.473
更新日期:2008-08-01 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::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::Introduction. Optimizing nutrition remains the cornerstone of therapy for patients with cystic fibrosis (CF) since it is associated with better pulmonary function and survival. However, a significant proportion of patients still fail to achieve normal growth and nutritional status. Areas covered. This review describes...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2019.1614917
更新日期:2019-06-01 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: 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:OBJECTIVES:Anemia is often seen in chronic obstructive pulmonary disease (COPD) patients. However, the implications of anemia on the outcomes of patients with COPD is not clearly known. Therefore, we conducted a systematic review and meta-analysis to evaluate the effects of anemia on the morbidity and mortality of pati...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2020.1816468
更新日期:2020-12-01 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::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:INTRODUCTION:LTOT is a well-established treatment option for hypoxemic patients. Scientific evidence for its benefits of LTOT dates back to the 1980s, when two randomized controlled trials showed prolonged survival in COPD-patients undergoing LTOT for at least 15 hours/day. In contrast, the potential benefits of LTOT i...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2017.1325323
更新日期:2017-06-01 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::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:Cystic fibrosis (CF) outcomes and survival have improved over the last century primarily due to advancements in antibiotics, nutritional, and pulmonary therapies. Reviewed here are the significant unmet needs that exist for individuals with CF. Areas covered: With the recent development of medications that...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2018.1483723
更新日期:2018-07-01 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:INTRODUCTION:Idiopathic pulmonary fibrosis (IPF) is a chronic, debilitating, fibrotic lung disease leading to respiratory failure, and ultimately to death. It is characterized by marked heterogeneity regarding its clinical course. Despite significant progress in the understanding of its pathogenesis, the course of the ...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2019.1553620
更新日期:2019-01-01 00:00:00
abstract:INTRODUCTION:Lung Clearance Index, measured using the multiple breath washout (MBW) technique, may be a useful test in infants with Cystic Fibrosis (CF). However, the requirement for specialised equipment and a number of important technical and methodological considerations relevant to testing in infants have complicat...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章,评审
doi:10.1080/17476348.2017.1269604
更新日期:2017-01-01 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::Objectives: Pleurodesis is an important management option to palliate breathlessness in patients with malignant pleural effusion (MPE). This systematic review aimed to examine available literature for studies investigating factors that predict pleurodesis outcome.Methods: The healthcare databases advanced search (HDAS...
journal_title:Expert review of respiratory medicine
pub_type: 杂志文章
doi:10.1080/17476348.2020.1746647
更新日期:2020-06-01 00:00:00