Unclassifiable interstitial lung disease: from phenotyping to possible treatments.

Abstract:

PURPOSE OF REVIEW:Accurate diagnosis of interstitial lung diseases (ILDs) can be challenging, and a substantial percentage of ILD patients remain unclassifiable even after thorough assessment by an experienced multidisciplinary team. In this review, we summarize the recent literature on the definition, prevalence, diagnosis, treatment, and prognosis of unclassifiable ILD, and also discuss important current issues and provide future perspectives on the classification of ILD. RECENT FINDINGS:Approximately 12% of patients with ILD are considered unclassifiable, with large variability across previous studies that is in part secondary to inconsistent definitions of unclassifiable ILD and other ILD subtypes. A recent International Working Group suggested that unclassifiable ILD should be defined by the absence of a leading diagnosis that is considered more likely than not after multidisciplinary discussion of all available information. Clinical features and outcomes of unclassifiable ILD are intermediate between idiopathic pulmonary fibrosis and nonidiopathic pulmonary fibrosis ILD cohorts, and choices for pharmacotherapy should be considered on a case-by-case basis. SUMMARY:Recent studies have provided additional data on the clinical features and prognosis of unclassifiable ILD, but also highlight the many uncertainties that still exist in ILD diagnosis and classification. New tools are needed to more accurately characterize patients with unclassifiable ILD.

journal_name

Curr Opin Pulm Med

authors

Guler SA,Ryerson CJ

doi

10.1097/MCP.0000000000000509

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

461-468

issue

5

eissn

1070-5287

issn

1531-6971

journal_volume

24

pub_type

杂志文章,评审
  • Integrating palliative care: when and how?

    abstract:PURPOSE OF REVIEW:Lung cancer is the leading cause of cancer mortality in men and women. Most patients present with advanced disease and face significant morbidity, with many reporting distressing symptoms throughout the course of their illness. The purpose of this review is to highlight the recent studies that support...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e3283620e76

    authors: Shin J,Temel J

    更新日期:2013-07-01 00:00:00

  • Obesity and asthma: current knowledge and future needs.

    abstract:PURPOSE OF REVIEW:Obesity has significant impact on asthma incidence and manifestations. The purpose of the review is to discuss recent observations regarding the association between obesity and asthma focusing on underlying mechanisms, clinical presentation, response to therapy and effect of weight reduction. RECENT ...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.1097/MCP.0000000000000119

    authors: Sivapalan P,Diamant Z,Ulrik CS

    更新日期:2015-01-01 00:00:00

  • Choosing a nebulizer for cystic fibrosis applications.

    abstract::As the number of inhaled drugs available for cystic fibrosis grows, there is increasing awareness of delivery device issues. Current jet and ultrasonic nebulizers are inefficient at delivering drugs to the lower respiratory tract. There are large differences in output characteristics between nebulizers and high inters...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199711000-00005

    authors: Geller DE

    更新日期:1997-11-01 00:00:00

  • Outpatient talc administration via indwelling pleural catheters for malignant effusions.

    abstract:PURPOSE OF REVIEW:Malignant pleural effusion is a common cause of breathlessness and signifies advanced disease. Common options for definitive pleural intervention include insertion of an indwelling pleural catheter (IPC) or talc pleurodesis. RECENT FINDINGS:Administration of graded talc through an IPC offers an incre...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章

    doi:10.1097/MCP.0000000000000587

    authors: Dipper A,Bhatnagar R,Maskell N

    更新日期:2019-07-01 00:00:00

  • Measurement of quality of life in cystic fibrosis.

    abstract::Considerable progress has been made over the past 2 decades in defining and measuring health-related quality of life (QOL), and there is a growing recognition that these measures provide unique information about the impact of a chronic illness and its treatment. For patients with cystic fibrosis (CF), health-related Q...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199811000-00003

    authors: Quittner AL

    更新日期:1998-11-01 00:00:00

  • Bronchoscopic interventions in the management of chronic obstructive pulmonary disease.

    abstract:PURPOSE OF REVIEW:In the past few years, there have been exciting developments in bronchoscopic efforts at attaining lung volume reduction (LVR), given real and perceived risks of surgical LVR. The purpose of this review is to discuss these techniques, with special emphasis on what we have learnt in the past 1-2 years....

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32835cfd59

    authors: Taneja A

    更新日期:2013-03-01 00:00:00

  • Serologic evaluation in idiopathic interstitial pneumonias.

    abstract:PURPOSE OF REVIEW:Diagnosis of idiopathic interstitial pneumonias (IIPs) requires the exclusion of, among others, concomitant connective tissue diseases (CTDs), which may present as interstitial lung disease (ILD). This review focuses on the evaluation required to separate these entities through serology, although not ...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e3283560840

    authors: Papiris SA,Kagouridis K,Bouros D

    更新日期:2012-09-01 00:00:00

  • The use of macrolide antibiotics in patients with cystic fibrosis.

    abstract:PURPOSE OF REVIEW:There has been much recent interest in the use of macrolide antibiotics as chronic suppressive therapy in patients with cystic fibrosis. Three recent randomized, placebo-controlled trials have been conducted. RECENT FINDINGS:All three trials used similar regimens of azithromycin, and lung function im...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.mcp.0000142101.53084.f0

    authors: Saiman L

    更新日期:2004-11-01 00:00:00

  • Asthma phenotypes and endotypes.

    abstract:PURPOSE OF REVIEW:It is increasingly clear that asthma is not a single disease, but a disorder with vast heterogeneity in pathogenesis, severity, and treatment response. In this review, we discuss the present understanding of different asthma phenotypes and endotypes, and the prospects of personalized medicine for asth...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32835b10ec

    authors: Lin TY,Poon AH,Hamid Q

    更新日期:2013-01-01 00:00:00

  • Parapneumonic effusions and empyema.

    abstract::Thoracic empyema remains a significant medical problem in 1996. Patients in whom empyema develops suffer significant morbidity, frequently require prolonged hospitalizations, and are at an increased risk of death. In this review of parapneumonic effusions and empyema, four topics are discussed: diagnosis of empyema, t...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:

    authors: Sasse SA

    更新日期:1996-07-01 00:00:00

  • Clinical relevance of distal deep vein thrombosis.

    abstract:PURPOSE OF REVIEW:To discuss pros and cons of anticoagulant treatment in the presence of symptomatic distal deep vein thrombosis. RECENT FINDINGS:Available data are responsible for a lack of consensus regarding treatment of distal deep vein thrombosis. SUMMARY:One standard diagnostic approach of suspected deep vein t...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32830460ea

    authors: Righini M,Bounameaux H

    更新日期:2008-09-01 00:00:00

  • Revisiting matrix metalloproteinase 12: its role in pathophysiology of asthma and related pulmonary diseases.

    abstract:PURPOSE OF REVIEW:Matrix metalloproteinases (MMPs) are a family of over 20 zinc-dependent proteases with different biological and pathological activities, and many have been implicated in several diseases. Although nonselective MMP inhibitors are known to induce serious side-effects, targeting individual MMPs may offer...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000743

    authors: Abd-Elaziz K,Jesenak M,Vasakova M,Diamant Z

    更新日期:2021-01-01 00:00:00

  • Microbes and asthma: the missing cellular and molecular links.

    abstract:PURPOSE OF REVIEW:In this review, we describe the 'state-of-the-art' in our knowledge of asthma and what gaps exist, which can be exploited in the future for effective translation of our knowledge from the bench or population studies to diagnosis and therapy. RECENT FINDINGS:The advent of microbiome research has expan...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e32834dccc0

    authors: Brar T,Nagaraj S,Mohapatra S

    更新日期:2012-01-01 00:00:00

  • New and improved tuberculosis diagnostics: evidence, policy, practice, and impact.

    abstract:PURPOSE OF REVIEW:The aim is to summarize the evidence base for tuberculosis (TB) diagnostics, review recent policies on TB diagnostics, and discuss issues such as how evidence is translated into policy, limitations of the existing evidence base, and challenges involved in translating policies into impact. RECENT FIND...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e328338094f

    authors: Pai M,Minion J,Steingart K,Ramsay A

    更新日期:2010-05-01 00:00:00

  • Chronic obstructive pulmonary disease comorbidities.

    abstract:PURPOSE OF REVIEW:Classic descriptions of chronic obstructive pulmonary disease (COPD) centered on its impact on respiratory function. It is currently recognized that comorbidities contribute to the severity of symptoms and COPD progression. Understanding COPD-comorbidities associations could provide innovative treatme...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000241

    authors: Brown JP,Martinez CH

    更新日期:2016-03-01 00:00:00

  • New regimens in the management of posttraumatic respiratory failure.

    abstract::Many individuals are now surviving their injuries to face the consequences of an activated immunoinflammatory system and the complications of supportive therapy. The pulmonary system bears the force of this insult. An understanding of the epidemiology of acute respiratory failure, as well as a greater knowledge of the...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199705000-00008

    authors: O'Keefe GE,Maier RV

    更新日期:1997-05-01 00:00:00

  • Gender and survival in cystic fibrosis.

    abstract:PURPOSE OF REVIEW:Survival for patients with cystic fibrosis (CF) continues to improve. The proportion of CF patients over the age of 18 years is nearly 50%, and care providers will need to better understand this patient population. Despite these improvements, young females continue to have a worse prognosis and lower ...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e328365af49

    authors: McIntyre K

    更新日期:2013-11-01 00:00:00

  • Normal volume and cellular contents of pleural fluid.

    abstract::The pleural space in healthy humans was thought to contain a few milliliters of fluid, based on extrapolation from animal studies. However, because of the obvious technical difficulties in atraumatically retrieving such a small volume of fluid, the exact volume and cellular content of human pleural fluid has not been ...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200107000-00002

    authors: Noppen M

    更新日期:2001-07-01 00:00:00

  • Does pulmonary rehabilitation reduce anxiety and depression in chronic obstructive pulmonary disease?

    abstract:PURPOSE OF REVIEW:Symptoms of anxiety and depression are prevalent in at least 20-40% of patients with moderate-to-severe chronic obstructive pulmonary disease (COPD) and are known to affect prognosis and worsen quality of life. This review examines whether pulmonary rehabilitation can effectively improve psychological...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e3283218318

    authors: Coventry PA

    更新日期:2009-03-01 00:00:00

  • Asthma phenotypes.

    abstract:PURPOSE OF REVIEW:Asthma is a heterogeneous disorder presenting with many phenotypes. Precise phenotypic definition has eluded the medical research community for years, despite recognition of different disease subtypes. Improved phenotypic characterization and knowledge of underlying pathobiology is necessary for linka...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e328011b84b

    authors: Kiley J,Smith R,Noel P

    更新日期:2007-01-01 00:00:00

  • Pleural effusions in systemic amyloidosis.

    abstract:PURPOSE OF REVIEW:Large, recurrent pleural effusions in systemic amyloidoses are rare but clinically challenging events predominantly affecting patients with primary systemic amyloidosis. Examining the mechanisms by which these effusions form and persist offers perspective on the pathophysiology and basis for therapeut...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.mcp.0000162378.35928.37

    authors: Berk JL

    更新日期:2005-07-01 00:00:00

  • The utility of antifungal agents for asthma.

    abstract:PURPOSE OF REVIEW:Recent work demonstrates that patients with refractory asthma are likely to be sensitized to environmental fungi and that specific antifungal treatments may be of benefit to this group. RECENT FINDINGS:The relationships among fungal sensitization, exposure and asthma severity are imperfectly understo...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e328333900a

    authors: Gore RB

    更新日期:2010-01-01 00:00:00

  • Fixed-dose versus adjusted-dose low molecular weight heparin for the initial treatment of patients with deep venous thrombosis.

    abstract::Patients with acute deep vein thrombosis (DVT) were treated with a body-weight independent dosage of 2 x 8000 aXa IU low-molecular-weight heparin (LMWH) Certoparin. After the subcutaneous administration of 8000 IU Certoparin, pharmacodynamic parameters did not differ between patients and healthy volunteers, and the AU...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200209000-00007

    authors: Harenberg J

    更新日期:2002-09-01 00:00:00

  • Management of chronic obstructive pulmonary disease.

    abstract::Chronic obstructive pulmonary disease is the fourth leading cause of death in the United States, affecting approximately 10% of all adults. Several articles published during the past year contributed significantly to our understanding of the complicated management of this disease. New information concerning bronchodil...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-199603000-00011

    authors: Navin DM,Gross NJ

    更新日期:1996-03-01 00:00:00

  • Sarcoidosis and interstitial pulmonary fibrosis; two distinct disorders or two ends of the same spectrum.

    abstract:PURPOSE OF REVIEW:Pulmonary fibrosis is a reparative response characterized by accumulation of extracellular matrix in the lung parenchyma that may be observed in end-stage sarcoidosis. This article will discuss the recent advancements in the understanding of the pathogenesis of pulmonary fibrosis in sarcoidosis in com...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0b013e3283486d52

    authors: Shigemitsu H,Azuma A

    更新日期:2011-09-01 00:00:00

  • Identification and management of pleural effusions of multiple aetiologies.

    abstract:PURPOSE OF REVIEW:Historically, pleural effusions have been attributed to a single cause. There is growing recognition that a substantial proportion of pleural effusions may have more than one underlying cause. The purpose of this review is to summarise recent findings regarding the diagnosis and treatment of effusions...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/MCP.0000000000000388

    authors: Walker S,Maskell N

    更新日期:2017-07-01 00:00:00

  • Management of respiratory failure in patients with asthma.

    abstract::The goal of management of patients with respiratory failure is to restore them to a state of quiet breathing, without complication. This goal is often achieved by pharmacotherapy alone. Inhaled albuterol sulfate, oxygen, and systemic corticosteroids are mainstays of acute care drug management, whereas other data suppo...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200001000-00014

    authors: Gluckman TJ,Corbridge T

    更新日期:2000-01-01 00:00:00

  • Short- and long-term results after lung volume reduction surgery.

    abstract::Lung volume reduction surgery (LVRS) is a palliative surgical procedure for patients with severe emphysema. Resection of nonfunctional emphysematous lung tissue has been reported to relieve breathlessness and to improve quality of life for many patients by improving lung elastic recoil, respiratory muscle function, an...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/00063198-200003000-00006

    authors: Meyer KC,Cornwell RD,Love RB

    更新日期:2000-03-01 00:00:00

  • Scintigraphic evaluation of lung deposition with a novel inhaler device.

    abstract::A gamma-scintigraphic study was carried out in 13 healthy individuals to compare the lung deposition of budesonide from a novel multidose dry powder inhaler (MDPI; Novolizer) with that from the Pulmicort Turbuhaler, and to assess the degree of flow rate dependence of the Novolizer. Median whole lung depositions for th...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Newman SP,Hirst PH,Pitcairn GR

    更新日期:2001-04-01 00:00:00

  • Uncommon respiratory pathogens.

    abstract:PURPOSE OF REVIEW:In many cases, the specific pathogen responsible for a respiratory infection is not identified and can lead to improper medical treatment, increased duration of illness, and possibly contributes to the development of antibiotic resistance. Molecular-based diagnostic methodologies have significantly im...

    journal_title:Current opinion in pulmonary medicine

    pub_type: 杂志文章,评审

    doi:10.1097/01.mcp.0000219274.65557.dc

    authors: Lednicky JA,Rayner JO

    更新日期:2006-05-01 00:00:00