Abstract:
:Lung cancer remains the most common fatal malignancy, so even modest therapeutic advances are potentially beneficial to large numbers of patients. For patients with regional nodal metastases identified at thoracotomy, adjuvant chemotherapy may be of benefit and additional clinical trials are in progress. Locally advanced disease is present in over a third of patients at diagnosis. For patients with marginally resectable tumors, the preliminary results of the neoadjuvant chemotherapy trials are encouraging and may result in an improvement in the 15% 5-year survival in this group. For patients with locally advanced and unresectable tumors, several but not all studies suggest that the combination of chemotherapy and radiation produces better results than radiation alone. Additional trials are needed to clarify these results. In addition, better methods are needed to maintain local control of unresected tumors. Hyperfractionated radiation schedules and concurrent administration of radiosensitizing chemotherapy drugs appear to be the most promising leads. Effective systemic treatment for patients with disseminated disease remains elusive. Several new classes of drugs, especially taxol and the topoisomerase I poisons, are being introduced and have rekindled hope for improved treatment of this large group of patients.
journal_name
Clin Chest Medjournal_title
Clinics in chest medicineauthors
Murren JR,Buzaid ACsubject
Has Abstractpub_date
1993-03-01 00:00:00pages
161-71issue
1eissn
0272-5231issn
1557-8216journal_volume
14pub_type
杂志文章,评审abstract::Pleural malignancies are ideal for novel therapeutic approaches because they are invariably fatal. Intrapleural (IP) chemotherapy has only marginal benefit in pleural malignancies, but may prove efficacious with hyperthermic chemotherapy administered in combination with maximal tumor debulking. IP immunotherapies may ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2013.04.007
更新日期:2013-09-01 00:00:00
abstract::The basic science and clinical understanding of infection with Blastomyces dermatitidis has been a field of constant evolution and continued revision of hypotheses. This article highlights some areas in which recent progress has the potential for significant impact on the clinical care of patients. Specifically, this ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2009.02.003
更新日期:2009-06-01 00:00:00
abstract::Sleep-related breathing disorder or sleep-disordered breathing (SDB) encompasses central sleep apnea (CSA), obstructive sleep apnea (OSA), and sleep-related hypoventilation or hypoxemic syndromes. SDB is common in neurologic conditions that affect the central and/or peripheral nervous systems. Patients with neurologic...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2014.06.009
更新日期:2014-09-01 00:00:00
abstract::This review focuses on the top ten causes of ventilator-associated pneumonia (VAP), updating an earlier study. These pathogens have specific risk factors, different patterns of clinical resolution, and a wide range of attributable mortality. The discussion herein analyzes these aspects, placing particular emphasis on ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2004.10.017
更新日期:2005-03-01 00:00:00
abstract::The tuberculosis (TB) epidemic is well controlled in most developed countries and the focus in these areas has shifted to TB eradication. Transmission within nonendemic areas is limited and most cases of TB result from reactivation of distant (latent) infection. With adequate resources, wide-scale use of preventive th...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2009.08.012
更新日期:2009-12-01 00:00:00
abstract::Because the AIDS epidemic continues to grow, there is a sense of urgency to develop new treatment strategies, both for HIV infection and for AIDS-related illnesses. The rapid gathering of basic information related to HIV type 1 biology and opportunistic infections has led to an explosion in physicians' ability to diag...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70338-5
更新日期:1996-12-01 00:00:00
abstract::Patients with MAC-PD and pre-existing lung disease are a distinct group from the more common and recently recognized group of predominantly middle- to older-aged women without pre-existing lung disease. Those with pre-existing disease are expected to have more sputum positivity and slower conversion of sputum with tre...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(02)00022-9
更新日期:2002-09-01 00:00:00
abstract::With the increasing threat of pandemic influenza and catastrophic bioterrorism, it is important for intensive care providers to be prepared to meet the challenge of large-scale airborne epidemics causing mass casualty respiratory failure. The severe acute respiratory syndrome outbreak exposed the vulnerability of heal...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2008.01.001
更新日期:2008-06-01 00:00:00
abstract::Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for whic...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2010.10.007
更新日期:2011-03-01 00:00:00
abstract::In the United States, trauma is the leading cause of death in people under 40 years of age. Chest trauma is a relatively common but potentially lethal injury and requires a high level of suspicion, rapid diagnosis, and appropriate therapy. Methods for the assessment, diagnosis, and treatment of chest trauma are discus...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-03-01 00:00:00
abstract::Many different therapeutic compounds are associated with pulmonary toxicity. Although the mechanism of injury for many of these compounds is poorly defined, several compounds are believed to produce alterations in normal lung biochemistry. These mechanisms of injury in both clinical and experimental models are discuss...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-03-01 00:00:00
abstract::Chronic obstructive pulmonary disease (COPD) has become a major and growing health problem, with a mortality rate that continues to increase. Several factors, have been identified as individual predictors of mortality in COPD. This article reviews individual predictors for mortality. It also discusses the ability of a...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2007.05.002
更新日期:2007-09-01 00:00:00
abstract::With the performance of more endoscopic procedures and newly developed diagnostic and therapeutic modalities, a wealth of information around the actual procedure is created. To date, accepted guidelines for standardized documentation are lacking. The authors present recommendations for minimal guidelines that may help...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70051-4
更新日期:2001-06-01 00:00:00
abstract::Photodynamic therapy is an investigational treatment of various types of carcinoma. It involves a photosensitizing agent which, when exposed to light of the proper wavelength, forms toxic oxygen radicals that result in cell death. This article describes its current use in the management of bronchogenic carcinoma. ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::This article describes the pathophysiology of the respiratory system after upper abdominal surgery, emphasizing the role of respiratory muscle dysfunction. The history of current techniques to measure respiratory muscle function are reviewed. The authors describe the postoperative pattern of breathing, speculate on th...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-06-01 00:00:00
abstract::The treatment of idiopathic pulmonary fibrosis (IPF) remains controversial. The benefits of conventional treatment with corticosteroids plus either azathioprine or cyclophosphamide have not been established in randomized, controlled trials. Other treatment strategies have been suggested as understanding of the pathoge...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2005.08.004
更新日期:2006-03-01 00:00:00
abstract::This review summarizes the current state of knowledge on experimental and clinical biomarkers of autoimmunity and aims to highlight important aspects of the immunologic evaluation of a patient with fibrotic lung disease. ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2019.06.002
更新日期:2019-09-01 00:00:00
abstract::Several medications have been associated with the development of the BOOP lesion. Often, symptoms include nonproductive cough and shortness of breath with bilateral crackles by examination. Occasionally, there is fever and rash, and, rarely, eosinophilia. The chest radiograph usually shows bilateral patchy infiltrates...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/S0272-5231(03)00140-0
更新日期:2004-03-01 00:00:00
abstract::Obstructive sleep-disordered breathing consists of a spectrum ranging from the upper airway resistance syndrome to complete apnea. Although this disorder is relatively common, it is still under-recognized, resulting in a significant increase in morbidity and mortality. In this article, we describe the rationale for tr...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70434-2
更新日期:1998-03-01 00:00:00
abstract::In the last few years, there has been considerable progress in our understanding of the mechanisms of action and resistance to antimycobacterials. To date, there is information about 11 genes involved in resistance in M. tuberculosis. This has prompted the development of novel tests for the rapid identification of res...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70355-5
更新日期:1997-03-01 00:00:00
abstract::Studies suggest clinically manifest cardiac involvement occurs in 5% of patients with pulmonary/systemic sarcoidosis. The principal manifestations of cardiac sarcoidosis (CS) are conduction abnormalities, ventricular arrhythmias, and heart failure. Data indicate that an 20% to 25% of patients with pulmonary/systemic s...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2015.08.008
更新日期:2015-12-01 00:00:00
abstract::Biologic drugs have revolutionized the treatment of certain hematologic, autoimmune, and malignant diseases, but they may place patients at risk for reactivation or acquisition of tuberculosis. This risk is highest with the tumor necrosis factor-alpha (TNF-α) inhibitors. Amongst this class of drugs, the monoclonal ant...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2019.07.003
更新日期:2019-12-01 00:00:00
abstract::Flexible fiberoptic bronchoscopy is the most useful invasive technique for diagnosing lung cancer. This article details the use and efficacy of bronchoscopy with such established techniques as forceps biopsy, brush biopsy, and bronchial washing in the diagnosis and staging of bronchoscopically visible central lung can...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::The authors' data show a higher rate of pleural and meningeal involvement among extrapulmonary TB cases than expected by previous works. Special attention should be given to tuberculous meningitis cases among all extrapulmonary TB cases because of its high mortality rate. The most common extrapulmonary involvement is ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章
doi:10.1016/s0272-5231(02)00002-3
更新日期:2002-06-01 00:00:00
abstract::Pulmonary function testing (PFT) is used extensively by pulmonary specialists to address two common clinical questions: (1) What is the risk of a postoperative pulmonary complication in an individual with lung disease? and (2) Will the patient be able to tolerate lung resection surgery? Today, there are numerous tests...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70061-7
更新日期:2001-12-01 00:00:00
abstract::Polymerase chain reaction-based diagnosis has become the standard for viral pneumonia and other respiratory tract infections. Expansion of respiratory viral panels (RVPs) outside of influenza and, possibly, respiratory syncytial virus has led to the ability to diagnose viral infections for which no approved specific a...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2016.11.003
更新日期:2017-03-01 00:00:00
abstract::The pathogenesis of O2 toxicity involves intracellular production of partially reduced O2 metabolites, which increases with O2 partial pressure. Cytotoxic O2 metabolites impair enzyme function and inhibit DNA, protein, and surfactant lipid biosynthesis. Compounds used clinically that increase O2 metabolism or that are...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::The process of smoking cessation involves progression through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Most patients are not prepared to take action on their smoking, yet most smoking cessation programs are designed for smokers who are so prepared. Small percentages...
journal_title:Clinics in chest medicine
pub_type: 杂志文章
doi:
更新日期:1991-12-01 00:00:00
abstract::For clinicians involved in airway management, a plan of action for dealing with the difficult airway or a failed intubation should be developed well in advance of encountering a patient in whom intubation is not routine. When difficulty is anticipated, the equipment necessary for performing a difficult intubation shou...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::The Early Goal-Directed Therapy versus Standard Care for Sepsis trial by Rivers and colleagues in 2001 suggested that a significant mortality reduction may be realized through goal-directed interventions early in the care of patients with septic shock. However, the recent publication of the Protocol-Based Care for Ear...
journal_title:Clinics in chest medicine
pub_type: 评论,杂志文章,评审
doi:10.1016/j.ccm.2016.01.016
更新日期:2016-06-01 00:00:00