Pub Date : 2024-05-01Epub Date: 2024-02-15DOI: 10.1097/MCP.0000000000001057
Patrick A Donohue, David A Kaminsky
Purpose of review: Oscillometry is a noninvasive pulmonary function test that has gained significant interest in the evaluation of lung disease. Currently, oscillometry is primarily a research tool, but there is a growing body of evidence supporting its clinical use. This review describes the recent work evaluating the role of oscillometry in the diagnosis and treatment of asthma.
Recent findings: A large body of observational data supports the ability of oscillometry to distinguish healthy individuals from those with respiratory symptoms or lung disease. Oscillometry may not be as useful as an isolated diagnostic test in asthma, but the combination with other pulmonary function tests may improve its diagnostic ability. Oscillometry can detect peripheral airways dysfunction in asthma, which is associated with symptoms and the risk for exacerbations. To help guide future research, minimal clinically important differences for specific oscillometry variables have been developed. Oscillometry may be useful in monitoring the response to biological therapy and has potential for personalizing treatment for individual patients. Oscillometry also has potential in uncovering unique aspects of the pathophysiology of asthma in obesity.
Summary: Oscillometry is a promising tool in the diagnosis and management of asthma. More research is needed to support its routine clinical use.
{"title":"The role of oscillometry in asthma.","authors":"Patrick A Donohue, David A Kaminsky","doi":"10.1097/MCP.0000000000001057","DOIUrl":"10.1097/MCP.0000000000001057","url":null,"abstract":"<p><strong>Purpose of review: </strong>Oscillometry is a noninvasive pulmonary function test that has gained significant interest in the evaluation of lung disease. Currently, oscillometry is primarily a research tool, but there is a growing body of evidence supporting its clinical use. This review describes the recent work evaluating the role of oscillometry in the diagnosis and treatment of asthma.</p><p><strong>Recent findings: </strong>A large body of observational data supports the ability of oscillometry to distinguish healthy individuals from those with respiratory symptoms or lung disease. Oscillometry may not be as useful as an isolated diagnostic test in asthma, but the combination with other pulmonary function tests may improve its diagnostic ability. Oscillometry can detect peripheral airways dysfunction in asthma, which is associated with symptoms and the risk for exacerbations. To help guide future research, minimal clinically important differences for specific oscillometry variables have been developed. Oscillometry may be useful in monitoring the response to biological therapy and has potential for personalizing treatment for individual patients. Oscillometry also has potential in uncovering unique aspects of the pathophysiology of asthma in obesity.</p><p><strong>Summary: </strong>Oscillometry is a promising tool in the diagnosis and management of asthma. More research is needed to support its routine clinical use.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-02-06DOI: 10.1097/MCP.0000000000001052
Ken Ka Pang Chan, Yun Chor Gary Lee
Purpose of review: Tuberculous pleuritis (TBP) is one of the most common types of extrapulmonary tuberculosis. We highlight the latest epidemiology of TBP, the heterogeneity of its presentation and the performance of different diagnostic strategies.
Recent findings: There are differential trends in the incidences of TBP worldwide. Its incidence increased in China but decreased in the United States in the past decade. The presentation of TBP is heterogeneous regarding clinical symptoms, radiological findings and pleural fluid analysis results. Conventional microbiological tests have low sensitivities to diagnose TBP. Recent research focused on various diagnostic tools with better yield. The sensitivity of nucleic acid amplification tests (NAAT) in pleural fluid, including the latest generation of PCR and sequencing-based techniques for detecting tuberculosis, remains suboptimal. Various pleural fluid biomarkers have been explored, but there is a lack of consensus on their clinical utility and cutoff levels.
Summary: The heterogeneity of clinical presentation poses obstacles to diagnosing TBP. Further development of diagnostic tools, including more robust NAAT and biomarkers with additional validation, is needed before incorporation into routine clinical practice.
{"title":"Tuberculous pleuritis: clinical presentations and diagnostic challenges.","authors":"Ken Ka Pang Chan, Yun Chor Gary Lee","doi":"10.1097/MCP.0000000000001052","DOIUrl":"10.1097/MCP.0000000000001052","url":null,"abstract":"<p><strong>Purpose of review: </strong>Tuberculous pleuritis (TBP) is one of the most common types of extrapulmonary tuberculosis. We highlight the latest epidemiology of TBP, the heterogeneity of its presentation and the performance of different diagnostic strategies.</p><p><strong>Recent findings: </strong>There are differential trends in the incidences of TBP worldwide. Its incidence increased in China but decreased in the United States in the past decade. The presentation of TBP is heterogeneous regarding clinical symptoms, radiological findings and pleural fluid analysis results. Conventional microbiological tests have low sensitivities to diagnose TBP. Recent research focused on various diagnostic tools with better yield. The sensitivity of nucleic acid amplification tests (NAAT) in pleural fluid, including the latest generation of PCR and sequencing-based techniques for detecting tuberculosis, remains suboptimal. Various pleural fluid biomarkers have been explored, but there is a lack of consensus on their clinical utility and cutoff levels.</p><p><strong>Summary: </strong>The heterogeneity of clinical presentation poses obstacles to diagnosing TBP. Further development of diagnostic tools, including more robust NAAT and biomarkers with additional validation, is needed before incorporation into routine clinical practice.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-02-19DOI: 10.1097/MCP.0000000000001058
Søren Sperling, Victor Naestholt Dahl, Andreas Fløe
Purpose of review: Lung abscess is a severe and complex respiratory infection. The purpose of this review is to discuss recent publications on lung abscess, covering topics such as epidemiology, clinical presentation, diagnosis, and treatment and prevention.
Recent findings: Risk factors associated with lung abscess include structural lung disease, poor dental hygiene, and ventilator-associated pneumonia, while concerns are now raised regarding the potential of electronic cigarettes use as a risk factor. The complexity of lung abscess is reflected by the relative high number of case reports describing rare and complex cases. Early transthoracic drainage could improve in-hospital outcomes, while next-generation sequencing could become an important tool in diagnostics and future clinical studies.
Summary: High-quality evidence and guidelines to support treatment of lung abscess are lacking. Despite advancements, we call for prospective studies to evaluate the use of invasive procedures and antibiotic treatment regimens.
{"title":"Lung abscess: an update on the current knowledge and call for future investigations.","authors":"Søren Sperling, Victor Naestholt Dahl, Andreas Fløe","doi":"10.1097/MCP.0000000000001058","DOIUrl":"10.1097/MCP.0000000000001058","url":null,"abstract":"<p><strong>Purpose of review: </strong>Lung abscess is a severe and complex respiratory infection. The purpose of this review is to discuss recent publications on lung abscess, covering topics such as epidemiology, clinical presentation, diagnosis, and treatment and prevention.</p><p><strong>Recent findings: </strong>Risk factors associated with lung abscess include structural lung disease, poor dental hygiene, and ventilator-associated pneumonia, while concerns are now raised regarding the potential of electronic cigarettes use as a risk factor. The complexity of lung abscess is reflected by the relative high number of case reports describing rare and complex cases. Early transthoracic drainage could improve in-hospital outcomes, while next-generation sequencing could become an important tool in diagnostics and future clinical studies.</p><p><strong>Summary: </strong>High-quality evidence and guidelines to support treatment of lung abscess are lacking. Despite advancements, we call for prospective studies to evaluate the use of invasive procedures and antibiotic treatment regimens.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-02-26DOI: 10.1097/MCP.0000000000001061
Pedro A Lamothe, Violeta Capric, F Eun-Hyung Lee
Purpose of review: Asthma exacerbations are associated with substantial symptom burden and healthcare costs. Viral infections are the most common identified cause of asthma exacerbations. The epidemiology of viral respiratory infections has undergone a significant evolution during the COVID-19 pandemic. The relationship between viruses and asthmatic hosts has long been recognized but it is still incompletely understood. The use of newly approved asthma biologics has helped us understand this interaction better.
Recent findings: We review recent updates on the interaction between asthma and respiratory viruses, and we address how biologics and immunotherapies could affect this relationship by altering the respiratory mucosa cytokine milieu. By exploring the evolving epidemiological landscape of viral infections during the different phases of the COVID-19 pandemic, we emphasize the early post-pandemic stage, where a resurgence of pre-pandemic viruses with atypical seasonality patterns occurred. Finally, we discuss the newly developed RSV and SARS-CoV-2 vaccines and how they reduce respiratory infections.
Summary: Characterizing how respiratory viruses interact with asthmatic hosts will allow us to identify tailored therapies to reduce the burden of asthma exacerbations. New vaccination strategies are likely to shape the future viral asthma exacerbation landscape.
{"title":"Viral infections causing asthma exacerbations in the age of biologics and the COVID-19 pandemic.","authors":"Pedro A Lamothe, Violeta Capric, F Eun-Hyung Lee","doi":"10.1097/MCP.0000000000001061","DOIUrl":"10.1097/MCP.0000000000001061","url":null,"abstract":"<p><strong>Purpose of review: </strong>Asthma exacerbations are associated with substantial symptom burden and healthcare costs. Viral infections are the most common identified cause of asthma exacerbations. The epidemiology of viral respiratory infections has undergone a significant evolution during the COVID-19 pandemic. The relationship between viruses and asthmatic hosts has long been recognized but it is still incompletely understood. The use of newly approved asthma biologics has helped us understand this interaction better.</p><p><strong>Recent findings: </strong>We review recent updates on the interaction between asthma and respiratory viruses, and we address how biologics and immunotherapies could affect this relationship by altering the respiratory mucosa cytokine milieu. By exploring the evolving epidemiological landscape of viral infections during the different phases of the COVID-19 pandemic, we emphasize the early post-pandemic stage, where a resurgence of pre-pandemic viruses with atypical seasonality patterns occurred. Finally, we discuss the newly developed RSV and SARS-CoV-2 vaccines and how they reduce respiratory infections.</p><p><strong>Summary: </strong>Characterizing how respiratory viruses interact with asthmatic hosts will allow us to identify tailored therapies to reduce the burden of asthma exacerbations. New vaccination strategies are likely to shape the future viral asthma exacerbation landscape.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10959678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-03-05DOI: 10.1097/MCP.0000000000001068
Marek Lommatzsch
Purpose of review: To review the current concepts of remission in asthma.
Recent findings: Until 2023, asthma guidelines have been promoting the concept of disease control, recommending the step-wise addition of drugs until the best possible disease control is achieved. With the advent of highly effective, anti-inflammatory disease-modifying antiasthmatic drugs (DMAADs), treatment goals of asthma have changed. Several national guidelines have now announced remission as a general treatment goal in asthma. Currently, all guidelines agree that asthma remission is defined by the presence of at least three characteristics over a period of at least one 1 year: absence of exacerbations, no systemic corticosteroid use for the treatment of asthma and minimal asthma-related symptoms. In the future, a generally accepted, evidence-based and easy-to-use definition of remission will be needed for daily clinical practice. It is clear, however, that precise phenotyping (including measurement of biomarkers) is an essential prerequisite to achieve clinical remission in each individual patient.
Summary: Remission has been included as the treatment goal in asthma in several national guidelines, reflecting the paradigm shift in asthma, from short-term symptom control to long-term symptom prevention. An international consensus on the criteria for asthma remission is expected in the near future.
{"title":"Remission in asthma.","authors":"Marek Lommatzsch","doi":"10.1097/MCP.0000000000001068","DOIUrl":"10.1097/MCP.0000000000001068","url":null,"abstract":"<p><strong>Purpose of review: </strong>To review the current concepts of remission in asthma.</p><p><strong>Recent findings: </strong>Until 2023, asthma guidelines have been promoting the concept of disease control, recommending the step-wise addition of drugs until the best possible disease control is achieved. With the advent of highly effective, anti-inflammatory disease-modifying antiasthmatic drugs (DMAADs), treatment goals of asthma have changed. Several national guidelines have now announced remission as a general treatment goal in asthma. Currently, all guidelines agree that asthma remission is defined by the presence of at least three characteristics over a period of at least one 1 year: absence of exacerbations, no systemic corticosteroid use for the treatment of asthma and minimal asthma-related symptoms. In the future, a generally accepted, evidence-based and easy-to-use definition of remission will be needed for daily clinical practice. It is clear, however, that precise phenotyping (including measurement of biomarkers) is an essential prerequisite to achieve clinical remission in each individual patient.</p><p><strong>Summary: </strong>Remission has been included as the treatment goal in asthma in several national guidelines, reflecting the paradigm shift in asthma, from short-term symptom control to long-term symptom prevention. An international consensus on the criteria for asthma remission is expected in the near future.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-03-13DOI: 10.1097/MCP.0000000000001072
Kelly Colas, Jennifer Namazy
Purpose of review: Asthma remains the most common respiratory disease in pregnancy. Identifying risk factors for asthma exacerbations during pregnancy is critical, as uncontrolled asthma can have detrimental effects for both mother and baby. In this review, we discuss recent literature exploring risk factors, fetal and maternal effects, and treatment options for asthma during pregnancy.
Recent findings: Recent literature suggests that optimizing asthma during pregnancy improves outcomes for both mother and baby, as well as later in childhood. Current research affirms that the benefit of asthma medication use outweighs any potential risks related to the medications themselves. Limited information is available regarding the use of newer therapies such as biologics during pregnancy.
Summary: Identifying risk factors for asthma exacerbations during pregnancy is critical to prevent adverse outcomes for both mother and baby. Recent evidence continues to affirm the safety of asthma medication use; more studies are needed regarding the use of new therapies during pregnancy.
{"title":"Asthma in pregnancy: a review of recent literature.","authors":"Kelly Colas, Jennifer Namazy","doi":"10.1097/MCP.0000000000001072","DOIUrl":"10.1097/MCP.0000000000001072","url":null,"abstract":"<p><strong>Purpose of review: </strong>Asthma remains the most common respiratory disease in pregnancy. Identifying risk factors for asthma exacerbations during pregnancy is critical, as uncontrolled asthma can have detrimental effects for both mother and baby. In this review, we discuss recent literature exploring risk factors, fetal and maternal effects, and treatment options for asthma during pregnancy.</p><p><strong>Recent findings: </strong>Recent literature suggests that optimizing asthma during pregnancy improves outcomes for both mother and baby, as well as later in childhood. Current research affirms that the benefit of asthma medication use outweighs any potential risks related to the medications themselves. Limited information is available regarding the use of newer therapies such as biologics during pregnancy.</p><p><strong>Summary: </strong>Identifying risk factors for asthma exacerbations during pregnancy is critical to prevent adverse outcomes for both mother and baby. Recent evidence continues to affirm the safety of asthma medication use; more studies are needed regarding the use of new therapies during pregnancy.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140109547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-02-28DOI: 10.1097/MCP.0000000000001062
Claudia Blouin, Catherine Lemière
Purpose of review: Occupational asthma (OA) is a complex condition that can be difficult to diagnose. The purpose of this review is to describe some recent findings regarding the epidemiology of OA, the occupational sensitizing agents, the prognosis of OA, and its primary prevention.
Recent findings: The risk of developing OA varies according to the geographic localization of the worker, the type of industry and the type of sensitizing agents. New findings have been reported for several known sensitizing agents, such as isocyanates, seafood & cleaning agents, and their related industries, such as hairdressing salons and schools. Moreover, a few new sensitizing agents, such as cannabis, have been identified in the past few years. The prognosis of OA seems worse than that of nonwork-related asthma. It is mainly determined by the duration and the level of exposure. Primary prevention is crucial to reduce the number of new cases of OA. Complete avoidance of exposure to the causal agent remains the optimal treatment of sensitizer-induced OA.
Summary: Improving our knowledge regarding OA and its causative agents is key to enable an early recognition of this condition and improve its prognosis. Further research is still needed to improve primary prevention.
本综述的目的:职业性哮喘(OA)是一种难以诊断的复杂疾病。本综述旨在介绍有关职业性哮喘的流行病学、职业致敏因素、职业性哮喘的预后及其一级预防的一些最新发现:罹患 OA 的风险因工人的地理位置、行业类型和致敏剂类型而异。一些已知的致敏剂,如异氰酸酯、海鲜和清洁剂,以及与之相关的行业,如美发沙龙和学校,都有新的发现。此外,过去几年还发现了一些新的致敏物质,如大麻。OA 的预后似乎比非工作相关性哮喘更差。这主要取决于接触的时间长短和程度。初级预防对于减少 OA 新发病例至关重要。小结:提高我们对 OA 及其致病因子的认识是早期识别这种疾病并改善其预后的关键。仍需进一步研究,以改善初级预防。
{"title":"Recent developments in occupational asthma.","authors":"Claudia Blouin, Catherine Lemière","doi":"10.1097/MCP.0000000000001062","DOIUrl":"10.1097/MCP.0000000000001062","url":null,"abstract":"<p><strong>Purpose of review: </strong>Occupational asthma (OA) is a complex condition that can be difficult to diagnose. The purpose of this review is to describe some recent findings regarding the epidemiology of OA, the occupational sensitizing agents, the prognosis of OA, and its primary prevention.</p><p><strong>Recent findings: </strong>The risk of developing OA varies according to the geographic localization of the worker, the type of industry and the type of sensitizing agents. New findings have been reported for several known sensitizing agents, such as isocyanates, seafood & cleaning agents, and their related industries, such as hairdressing salons and schools. Moreover, a few new sensitizing agents, such as cannabis, have been identified in the past few years. The prognosis of OA seems worse than that of nonwork-related asthma. It is mainly determined by the duration and the level of exposure. Primary prevention is crucial to reduce the number of new cases of OA. Complete avoidance of exposure to the causal agent remains the optimal treatment of sensitizer-induced OA.</p><p><strong>Summary: </strong>Improving our knowledge regarding OA and its causative agents is key to enable an early recognition of this condition and improve its prognosis. Further research is still needed to improve primary prevention.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-03-15DOI: 10.1097/MCP.0000000000001070
Peter S Nyasulu, Cheick Oumar Doumbia, Veranyuy Ngah, Antieme Combo Georges Togo, Bassirou Diarra, Gershom Chongwe
Purpose of review: This review addresses the escalating global challenge of multidrug-resistant tuberculosis (MDR-TB) in Sub-Saharan Africa, with a focus on its complex comorbidity with HIV/AIDS. Emphasizing the urgency of the issue, the review aims to shed light on the unique healthcare landscape shaped by the convergence of high prevalence rates and intersecting complexities with HIV/AIDS in the region.
Recent findings: A notable increase in MDR-TB cases across Sub-Saharan Africa is attributed to challenges in timely diagnoses, treatment initiation, and patient treatment defaulting. The literature underscores the critical need for proactive measures to address diagnostic and treatment gaps associated with MDR-TB, particularly concerning its comorbidity with HIV/AIDS.
Summary: To effectively manage MDR-TB and its co-morbidity with HIV/AIDS, proactive screening programs are imperative. The review highlights the necessity of active follow-up strategies to ensure treatment adherence and reduce default rates, offering evidence-based insights for improved disease management in the region.
{"title":"Multidrug-resistant tuberculosis: latest opinions on epidemiology, rapid diagnosis and management.","authors":"Peter S Nyasulu, Cheick Oumar Doumbia, Veranyuy Ngah, Antieme Combo Georges Togo, Bassirou Diarra, Gershom Chongwe","doi":"10.1097/MCP.0000000000001070","DOIUrl":"10.1097/MCP.0000000000001070","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review addresses the escalating global challenge of multidrug-resistant tuberculosis (MDR-TB) in Sub-Saharan Africa, with a focus on its complex comorbidity with HIV/AIDS. Emphasizing the urgency of the issue, the review aims to shed light on the unique healthcare landscape shaped by the convergence of high prevalence rates and intersecting complexities with HIV/AIDS in the region.</p><p><strong>Recent findings: </strong>A notable increase in MDR-TB cases across Sub-Saharan Africa is attributed to challenges in timely diagnoses, treatment initiation, and patient treatment defaulting. The literature underscores the critical need for proactive measures to address diagnostic and treatment gaps associated with MDR-TB, particularly concerning its comorbidity with HIV/AIDS.</p><p><strong>Summary: </strong>To effectively manage MDR-TB and its co-morbidity with HIV/AIDS, proactive screening programs are imperative. The review highlights the necessity of active follow-up strategies to ensure treatment adherence and reduce default rates, offering evidence-based insights for improved disease management in the region.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140131002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-03-26DOI: 10.1097/MCP.0000000000001066
Alimuddin Zumla, David S Hui
{"title":"Keeping global focus on the many challenges of respiratory tract infections.","authors":"Alimuddin Zumla, David S Hui","doi":"10.1097/MCP.0000000000001066","DOIUrl":"10.1097/MCP.0000000000001066","url":null,"abstract":"","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140183993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01Epub Date: 2024-02-15DOI: 10.1097/MCP.0000000000001059
Francisco J Machiavello Roman, Lauren Pischel, Marwan M Azar
Purpose of review: This review highlights the epidemiology, pathogenesis and clinical management of pulmonary infections caused by emerging fungal organisms.
Recent findings: Emerging fungal infections have arisen as a result of population and environmental changes. An enlarging pool of immunocompromised hosts on triazole antifungal prophylaxis has led to an increased incidence of non- Aspergillus molds, such as Fusarium , Scedosporium and Lomentospora spp. Advances in diagnostic capabilities led to the identification of the Emergomyces genus and non- dermatitidis Blastomyces species, which have a significant disease burden in Africa and the Middle East. Climate change has contributed to changing the distribution of previously confined endemic mycoses, like coccidioidomycosis and talaromycosis. These emerging organisms pose important diagnostic and therapeutic challenges.
Summary: Newly recognized pathogenic fungi and established endemic mycoses with expanding geographic boundaries have become important agents of pulmonary disease. There is a dearth of clinical evidence on the appropriate management of these infections.
{"title":"Lung infections due to emerging fungal pathogens.","authors":"Francisco J Machiavello Roman, Lauren Pischel, Marwan M Azar","doi":"10.1097/MCP.0000000000001059","DOIUrl":"10.1097/MCP.0000000000001059","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review highlights the epidemiology, pathogenesis and clinical management of pulmonary infections caused by emerging fungal organisms.</p><p><strong>Recent findings: </strong>Emerging fungal infections have arisen as a result of population and environmental changes. An enlarging pool of immunocompromised hosts on triazole antifungal prophylaxis has led to an increased incidence of non- Aspergillus molds, such as Fusarium , Scedosporium and Lomentospora spp. Advances in diagnostic capabilities led to the identification of the Emergomyces genus and non- dermatitidis Blastomyces species, which have a significant disease burden in Africa and the Middle East. Climate change has contributed to changing the distribution of previously confined endemic mycoses, like coccidioidomycosis and talaromycosis. These emerging organisms pose important diagnostic and therapeutic challenges.</p><p><strong>Summary: </strong>Newly recognized pathogenic fungi and established endemic mycoses with expanding geographic boundaries have become important agents of pulmonary disease. There is a dearth of clinical evidence on the appropriate management of these infections.</p>","PeriodicalId":11090,"journal":{"name":"Current Opinion in Pulmonary Medicine","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}