Abstract:
:Mycobacterium avium complex (MAC) is the most commonly isolated nontuberculous mycobacterial respiratory pathogen worldwide. MAC lung disease is manifested either by fibrocavitary radiographic changes similar to pulmonary tuberculosis or by bronchiectasis with nodular and reticulonodular radiographic changes. This latter form of MAC lung disease, termed "nodular bronchiectatic (NB) MAC lung disease" is the most common form of MAC lung disease in the United States. Treatment at the time of diagnosis is always indicated for fibrocavitary MAC lung disease because it is always progressive and associated with increased morbidity and mortality compared with NB MAC lung disease. In contrast, the NB form of MAC lung disease is more indolent and frequently does not require antimycobacterial therapy. For patients with NB MAC lung disease, the priorities are typically to treat the underlying bronchiectasis and determine the course and impact of the MAC infection over time. Guidelines-based MAC therapy with multidrug regimens including macrolides is usually effective, but far from as predictably effective and durable as therapy for tuberculosis. It is imperative that clinicians are familiar with MAC drug resistance mechanisms and the pitfalls of inappropriate dependence on in vitro drug susceptibility testing which can predispose patients to the development of macrolide resistance with its attendant high mortality. It is now more than 20 years since the emergence of macrolides for MAC therapy with no new comparably effective agents introduced in that time, although one new inhaled amikacin therapy under study offers promise.
journal_name
Semin Respir Crit Care Medjournal_title
Seminars in respiratory and critical care medicineauthors
Griffith DEdoi
10.1055/s-0038-1660472subject
Has Abstractpub_date
2018-06-01 00:00:00pages
351-361issue
3eissn
1069-3424issn
1098-9048journal_volume
39pub_type
杂志文章,评审abstract::The purpose of this review is to familiarize a broad range of medical professionals with a relatively new and growing problem of infections caused by mycobacteria other than M. tuberculosis and M. leprae. There are at least 60 mycobacterial species that have been identified as causative agents of diseases in humans. T...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-829501
更新日期:2004-06-01 00:00:00
abstract::Cor pulmonale frequently develops in patients with restrictive lung disease and neuromuscular disorders. Sleep disordered breathing, including nocturnal hypoventilation and obstructive apnea, has been associated with the development of cor pulmonale and may affect morbidity. The mechanisms responsible for sleep disord...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2003-41090
更新日期:2003-06-01 00:00:00
abstract::Assisted mechanical ventilation (MV) may be a favorable alternative to controlled MV at the early phase of acute respiratory distress syndrome (ARDS), since it requires less sedation, no paralysis and is associated with less hemodynamic deterioration, better distal organ perfusion, and lung protection, thus reducing t...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1382153
更新日期:2014-08-01 00:00:00
abstract::Tracheobronchial prostheses, known as airway stents, are used to palliate the effects of large airway obstruction. The most common types of stents in current clinical use are made of silicone or metallic wire. An ideal stent should possess several characteristics: (1) it should be easy to insert and remove, if necessa...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-832710
更新日期:2004-08-01 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::Daily oral care with chlorhexidine for mechanically ventilated patients is ubiquitous in contemporary intensive care practice. The practice is predicated upon meta-analyses suggesting that adding chlorhexidine to daily oral care regimens can reduce ventilator-associated pneumonia (VAP) rates by up to 40%. Close analys...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1602584
更新日期:2017-06-01 00:00:00
abstract::Pneumothorax is a common clinical entity that may present to a wide variety of medical specialties. Primary pneumothorax (in the presence of no known underlying lung disease) and secondary pneumothorax (in known lung disease) are distinct entities with varied etiology, treatment, and prognosis. Diagnosis is usually ba...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2008-1081285
更新日期:2008-08-01 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
abstract::The sleep of intensive care unit (ICU) patients is remarkably disrupted. Several studies, employing both subjective and objective measures of sleep quality, have demonstrated that critically ill patients exhibit severe sleep fragmentation and reduced restorative sleep, particularly a suppression of rapid eye movement ...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2001-13829
更新日期:2001-01-01 00:00:00
abstract::Cystic fibrosis (CF) has been a primary focus for gene therapy of lung diseases because the genetic cause is known and the airway epithelium is accessible for direct deoxyribonucleic acid (DNA) delivery. Soon after the mutated gene was identified in 1989, investigators demonstrated that transfer of a normal copy of th...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-815670
更新日期:2003-12-01 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::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::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::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::Chronic obstructive pulmonary disease (COPD) continues to be an important cause of morbidity, mortality, and health care costs worldwide. Although there exist some heterogeneity between patients, the course of COPD is characterized by recurrent acute exacerbations, which are among the most common causes of medical adm...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0040-1714396
更新日期:2020-12-01 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::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::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::Invasive fungal infections, especially candidemia and systemic candidiasis, have become a major cause of morbidity and mortality in the last few decades. This comes in parallel with the major advances made in intensive care. Patients who are critically ill, in medical or surgical ICUs are especially at risk for CANDID...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0029-1246289
更新日期:2010-02-01 00:00:00
abstract::Aspirin-exacerbated respiratory disease (AERD) is a unique syndrome of airway inflammation that frequently occurs in patients with nasal polyposis, chronic sinusitis, and asthma. These patients tend to have progressive and recalcitrant sinus disease requiring frequent surgical intervention and in many cases systemic c...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-0032-1325618
更新日期:2012-12-01 00:00:00
abstract::Invasive candidiasis (IC) is the most frequent health care associated invasive fungal infection. It is also associated with high morbidity, mortality, and cost. The most frequent etiologic agent is Candida albicans, but non-albicans species are increasing and associated with reduced antifungal susceptibility and outbr...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0040-1701215
更新日期:2020-02-01 00:00:00
abstract::The overarching goals of early sepsis management include early recognition, appropriate antibiotic therapy and source control, maintenance of hemodynamic stability, and supportive care of organ dysfunction. Despite increasing awareness of the global burden of sepsis, and general agreement on the goals of management, t...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1696981
更新日期:2019-10-01 00:00:00
abstract::Pseudomonas aeruginosa is a formidable pathogen in the infection arena. It is able to easily adapt to the environment which it inhabits and can also colonize and invade the human host to cause serious infections. In 2011, it was responsible for 7.1% of all health care-associated infection in the United States. The mor...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1396907
更新日期:2015-02-01 00:00:00
abstract::Critical illness evoked by trauma, extensive surgery, or severe medical illnesses is the ultimate example of acute severe physical stress. The endocrine response in a critically injured and stressed patient is varied and complex. Although the acute and chronic phases of critical illness are characterized by distinct e...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-2006-945533
更新日期:2006-06-01 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::Antimicrobial resistance has generally increased over the past 5 decades, with occasional brief respites following the introduction of new antimicrobial classes. Resistance has been driven by bacterial genetic events, antibiotic pressures, and lapses in hospital hygiene. Recently promoted solutions to the problem of h...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2003-37922
更新日期:2003-02-01 00:00:00
abstract::Increasing donor availability for organ transplantation requires attention to factors that are potentially modifiable. The potential pool of available organs can theoretically be enlarged by considering new sources of organs, including non-beating heart donors, live donor lobar transplants, xenotransplants, and in vit...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2001-18426
更新日期:2001-10-01 00:00:00
abstract::Survivors of critical illness often experience long-lasting impairments in mental, cognitive, and physical functioning. Acute stress reactions and delusional memories appear to play an important role in psychological morbidity following critical illness, and few interventions exist to address these symptoms. This revi...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1570367
更新日期:2016-02-01 00:00:00
abstract::The vasculitides affecting large and medium-sized vessels are heterogeneous. This group includes such disorders as giant cell arteritis, Takayasu's disease, and sarcoidosis. There are several challenges that may arise in the care of patients with these disorders. Diagnosis may be elusive when initially evaluating pati...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1055/s-2004-836148
更新日期:2004-10-01 00:00:00
abstract::This article reviews recent developments in the selection, assessment, and management of the potential lung donor, which aim to increase donor organ use. The scarcity of suitable donor organs continues to limit lung transplantation, but the situation is changing. An expanded donor pool, including the now widespread us...
journal_title:Seminars in respiratory and critical care medicine
pub_type: 杂志文章,评审
doi:10.1055/s-0033-1348464
更新日期:2013-06-01 00:00:00