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Management of central sleep apnoea: a review of non-hypercapnic causes. 中枢性睡眠呼吸暂停的管理:非高窒息原因综述。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0235-2023
Yizhong Zheng, Jian Eu Tai, Brendon J Yee

Central sleep apnoea (CSA) is characterised by recurrent episodes of airway cessation or reduction in the absence of respiratory effort. Although CSA is less common than obstructive sleep apnoea, it shares similar symptoms. CSA can be secondary to various medical conditions, high altitude and medication exposure. CSA can also emerge during obstructive sleep apnoea therapy. There are a range of treatment options and selecting the right therapy requires an understanding of the pathophysiology of CSA. This review explores the aetiology, pathophysiology and clinical management of non-hypercapnic CSA.

中枢性睡眠呼吸暂停(CSA)的特点是在没有呼吸努力的情况下反复发作气道停止或减弱。虽然中枢性睡眠呼吸暂停比阻塞性睡眠呼吸暂停少见,但症状相似。CSA 可继发于各种疾病、高海拔和药物接触。CSA 也可能在阻塞性睡眠呼吸暂停治疗期间出现。目前有一系列治疗方案,选择正确的治疗方法需要了解 CSA 的病理生理学。本综述探讨了非高海拔 CSA 的病因、病理生理学和临床治疗。
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引用次数: 0
Pro: indwelling pleural catheters cause harm to patients. 赞成:留置胸膜导管会对患者造成伤害。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0034-2024
Beenish Iqbal, Eihab Bedawi, Najib M Rahman

Malignant pleural effusions (MPE) tend to recur and require definitive treatment with either chest drain and talc pleurodesis or indwelling pleural catheters (IPCs), which offer similar symptomatic benefits. In recent years, IPCs have become popular due to the presumed convenience of an outpatient procedure followed by home drainage leading to a misconception of IPCs being an ideal treatment for MPE. However, IPCs predispose the patient to multiple complications and have significant physical and psychological implications that are under-recognised. Patients require additional clinical reviews, hospital admissions and treatment for these complications related to IPCs. Additionally, there is a huge psychological impact of living with a home catheter that is a constant reminder of their cancer and this has been shown to affect quality of life negatively. Hence, IPCs should not be considered the "ideal" treatment for MPE management and clinicians should reflect the equipoise of the evidence for the benefits and accurately reflect the adverse effects of IPCs in their discussions with patients to facilitate informed decision making.

恶性胸腔积液(MPE)容易复发,需要采用胸腔引流和滑石粉胸膜穿刺术或留置胸膜导管(IPC)进行最终治疗,这两种治疗方法具有类似的对症治疗效果。近年来,留置胸膜导管因其门诊手术后在家引流的便利性而广受欢迎,导致人们误认为留置胸膜导管是治疗 MPE 的理想方法。然而,IPC 易使患者出现多种并发症,并对患者的身体和心理造成重大影响,而这些影响却未得到充分认识。患者需要额外的临床复查、住院和治疗这些与 IPC 相关的并发症。此外,家用导尿管时刻提醒患者他们身患癌症,这对患者的心理造成了巨大影响,事实证明这会对生活质量产生负面影响。因此,IPCs 不应被视为治疗 MPE 的 "理想 "疗法,临床医生在与患者讨论时应反映有关 IPCs 优点的证据,并准确反映 IPCs 的不良反应,以便患者在知情的情况下做出决定。
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引用次数: 0
Erratum: "Steroids in severe community-acquired pneumonia". S. Ananth, A.G. Mathioudakis, J. Hansel. Breathe 2024; 20: 240081. 勘误:"社区获得性重症肺炎中的类固醇"。S. Ananth, A.G. Mathioudakis, J. Hansel.呼吸 2024; 20: 240081.
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.5081-2024

[This corrects the article DOI: 10.1183/20734735.0081-2024.].

[This corrects the article DOI: 10.1183/20734735.0081-2024.].
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引用次数: 0
The CheckMate 816 trial: a milestone in neoadjuvant chemoimmunotherapy of nonsmall cell lung cancer. CheckMate 816 试验:非小细胞肺癌新辅助化疗免疫疗法的里程碑。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0044-2024
Marie Mayenga, Ana Rita Pedroso, Marion Ferreira, Thomas Gille, Maria Joana Pereira Catarata, Boris Duchemann

Advancements in immunotherapy in the perioperative setting have revolutionised the treatment of resectable nonsmall cell lung cancer (NSCLC). Here we present the methodology and results of the clinical trial CheckMate 816 demonstrating the benefit of neoadjuvant therapy with nivolumab plus chemotherapy compared with chemotherapy alone. Furthermore, this article discusses the implications for future practice in resectable NSCLC and the need for future research.

围手术期免疫疗法的进步彻底改变了可切除非小细胞肺癌(NSCLC)的治疗。本文介绍了临床试验CheckMate 816的方法和结果,该试验表明,与单纯化疗相比,使用nivolumab联合化疗进行新辅助治疗更有疗效。此外,本文还讨论了对可切除NSCLC未来实践的影响以及未来研究的必要性。
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引用次数: 0
Type 2 inflammation in COPD: is it just asthma? 慢性阻塞性肺病的 2 型炎症:仅仅是哮喘吗?
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0229-2023
Augusta Beech, Andrew Higham, Sophie Booth, Vickram Tejwani, Frederik Trinkmann, Dave Singh

COPD is a heterogeneous condition, with tobacco smoking being the main environmental risk factor. The presence of type 2 (T2) inflammation is a well-recognised feature of asthma; however, it is now apparent that a subset of COPD patients also displays evidence of T2 inflammation with respect to elevated eosinophil counts and altered gene and protein expression of several T2 inflammatory mediators. T2 inflammatory mediators represent an attractive therapeutic target in both COPD and asthma; however, the efficacy of pharmaceutical interventions varies between diseases. Furthermore, the nature of some shared clinical features also differs. We provide a narrative review of differences in the nature of T2 inflammation between COPD and asthma, which may partly explain phenotypic differences between diseases. We focus on evidence from studies of pulmonary histopathology, sputum and epithelial gene and protein expression, and response to pharmacological interventions targeted at T2 inflammation.

慢性阻塞性肺病是一种异质性疾病,吸烟是主要的环境风险因素。2型(T2)炎症的存在是哮喘的一个公认特征;然而,现在很明显,一部分慢性阻塞性肺病患者也显示出T2型炎症的证据,如嗜酸性粒细胞计数升高以及几种T2型炎症介质的基因和蛋白表达改变。T2 炎症介质是慢性阻塞性肺病和哮喘的一个有吸引力的治疗目标;然而,不同疾病的药物干预效果各不相同。此外,一些共同临床特征的性质也不尽相同。我们对慢性阻塞性肺病和哮喘之间 T2 炎症性质的差异进行了叙述性综述,这可能是疾病表型差异的部分原因。我们将重点放在肺组织病理学、痰和上皮基因与蛋白表达以及对针对 T2 炎症的药物干预反应的研究证据上。
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引用次数: 0
An elderly woman with acute respiratory failure and diffuse pulmonary changes. 一名老年妇女出现急性呼吸衰竭和弥漫性肺部病变。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0055-2024
Chun Ian Soo, Wai Ling Leong, Nadia Fareeda Muhammad Gowdh, Leng Cheng Sia, Vijayan Munusamy, Chee Kuan Wong, Nazarina Abdul Rahman

Mucoepidermoid carcinoma is a rare primary tumour of the lung. Diagnosis can be made after careful exclusion of other lung neoplasms, especially those with overlapping histological and radiological features. https://bit.ly/4fcISSm.

黏液表皮样癌是一种罕见的肺部原发性肿瘤。在仔细排除其他肺部肿瘤,尤其是那些组织学和放射学特征重叠的肿瘤后,可以做出诊断。https://bit.ly/4fcISSm。
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引用次数: 0
Highlights from the Respiratory Failure and Mechanical Ventilation Conference 2024. 2024 年呼吸衰竭和机械通气会议要点。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0105-2024
Clara Bianquis, Giancarlo De Leo, Giorgio Morana, Marta Duarte-Silva, Santi Nolasco, Rūdolfs Vilde, Athiwat Tripipitsiriwat, Pedro Viegas, Martins Purenkovs, Marieke Duiverman, Christian Karagiannids, Christoph Fisser

The Respiratory Intensive Care Assembly of the European Respiratory Society gathered in Berlin to organise the third Respiratory Failure and Mechanical Ventilation Conference in February 2024. The conference covered key points of acute and chronic respiratory failure in adults. During the 3-day conference ventilatory strategies, patient selection, diagnostic approaches, treatment and health-related quality of life topics were addressed by a panel of international experts. In this article, lectures delivered during the event have been summarised by early career members of the Assembly and take-home messages highlighted.

欧洲呼吸学会呼吸重症监护大会于 2024 年 2 月在柏林召开了第三届呼吸衰竭与机械通气会议。会议涵盖了成人急性和慢性呼吸衰竭的要点。在为期三天的会议中,国际专家小组就通气策略、患者选择、诊断方法、治疗和与健康相关的生活质量等主题进行了讨论。在本文中,大会早期职业成员对会议期间发表的演讲进行了总结,并重点介绍了会议的收获。
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引用次数: 0
Con: indwelling pleural catheters cause harm to patients. 反方:留置胸膜导管会对患者造成伤害。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0111-2024
Katie Adams, Rahul Bhatnagar

Indwelling pleural catheters (IPCs) have rapidly grown in popularity since their introduction for the management of recurrent pleural effusions. In malignant pleural effusions especially, there has been a shift away from measuring pleurodesis success and towards more patient-centred outcomes. Multiple randomised controlled trials have shown that despite lower rates of pleurodesis, symptom control and quality of life outcomes are comparable when compared to alternatives such as talc pleurodesis. IPCs have the added benefit of minimising inpatient hospital stays and reducing the need for recurrent pleural interventions, key priorities for patients with palliative disease. As a result, IPC treatment is associated with excellent patient satisfaction coupled with acceptably low complication rates. Furthermore, in patients with a short life expectancy they confer a cost benefit for the healthcare system. Far from causing harm, IPCs are now recommended as first-line treatment by current clinical guidelines. In malignant pleural disease, guidance advocates IPCs should be offered as a first-line option with the focus on patient priorities and preferences. Ultimately IPCs provide a safe, effective, ambulatory option for managing recurrent pleural effusions.

自用于治疗复发性胸腔积液以来,留置胸膜导管(IPC)迅速普及。尤其是在恶性胸腔积液的治疗中,人们已经不再衡量胸腔穿刺的成功率,而是更加关注以患者为中心的治疗效果。多项随机对照试验表明,尽管胸膜腔穿刺术的成功率较低,但与滑石粉胸膜腔穿刺术等替代方法相比,症状控制和生活质量效果相当。IPC的另一个好处是最大限度地缩短住院时间,减少反复胸膜介入治疗的需要,而这正是姑息性疾病患者需要优先考虑的问题。因此,IPC治疗的患者满意度极高,并发症发生率也低得可以接受。此外,对于预期寿命较短的患者,IPC 还能为医疗系统带来成本效益。IPC不但不会造成危害,目前的临床指南还建议将其作为一线治疗手段。对于恶性胸膜疾病,指南提倡将 IPC 作为一线治疗方案,重点关注患者的优先选择和偏好。最终,IPC 为治疗复发性胸腔积液提供了一种安全、有效、非卧床的选择。
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引用次数: 0
Palliative care in lung cancer: tumour- and treatment-related complications in lung cancer and their management. 肺癌姑息治疗:肺癌与肿瘤和治疗相关的并发症及其处理。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0203-2023
Dragana Jovanovic, Vesna Ceriman-Krstic, Pınar Akın Kabalak, Lucia Viola, Konstantinos Papatheodosiou

Palliative care pertains to the holistic multidimensional concept of "patient-centred" care. It is an interprofessional specialty, primarily aiming to improve quality of care for cancer patients and their families, from the time of diagnosis of malignant disease, over the continuum of cancer care, and extending after the patient's death to the period of bereavement to support the patient's family. There are various complex and frequently unmet needs of lung cancer patients and their families/caregivers, not only physical but also psychological, social, spiritual and cultural. Systematic monitoring of patients' symptoms using validated questionnaires and patient-reported outcomes (PROs), on a regular basis, is highly encouraged and recommended in recent guidelines on the role of PRO measures in the continuum of cancer clinical care. It improves patient-physician communication, physician awareness of symptoms, symptom control, patient satisfaction, health-related quality of life and cost-effectiveness. This implies that all treating physicians should improve their skills in communication with lung cancer patients/relatives and become more familiar with this multidimensional assessment, repeatedly screening patients for palliative care needs. Therefore, they should receive education and training to develop palliative care knowledge, skills and attitudes. This review is dedicated to lung cancer palliative care essentials that should be within the competences of treating physicians, i.e. pneumologists/thoracic oncologists.

姑息关怀是 "以病人为中心 "的整体多维关怀理念。它是一门跨专业的专科,主要目的是提高癌症患者及其家属的护理质量,从诊断出恶性疾病开始,贯穿癌症护理的整个过程,并在患者去世后延伸到丧期,为患者家属提供支持。肺癌患者及其家属/照顾者有各种复杂且经常得不到满足的需求,这些需求不仅包括生理需求,还包括心理、社会、精神和文化需求。最近关于 PRO 测量在癌症临床护理中的作用的指南中,大力提倡并建议定期使用有效问卷和患者报告结果(PRO)对患者的症状进行系统监测。它能改善医患沟通、医生对症状的认识、症状控制、患者满意度、与健康相关的生活质量和成本效益。这意味着所有主治医生都应提高与肺癌患者/亲属沟通的技巧,并更加熟悉这种多维评估,反复筛查患者的姑息治疗需求。因此,他们应接受教育和培训,以培养姑息关怀的知识、技能和态度。本综述将专门讨论肺癌姑息关怀的基本要素,这些要素应属于主治医生(即肺科/胸部肿瘤科医生)的能力范围。
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引用次数: 0
Small cell lung cancer and neuroendocrine tumours. 小细胞肺癌和神经内分泌肿瘤。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-11-12 eCollection Date: 2024-10-01 DOI: 10.1183/20734735.0004-2024
Ivelina Pandjarova, Darlene Mercieca, Rolof G P Gijtenbeek, João Oliveira Pereira, Alberto Fantin, Nadia Castaldo, Elli Keramida, Kanwar Pannu, Assia Konsoulova, Avinash Aujayeb

Lung cancer is one of the leading causes of death worldwide. It can broadly be divided into small cell lung cancer (SCLC) and nonsmall cell lung cancer. There have been many advances over the recent years in both fields. The purpose of this review is to provide a concise summary of SCLC for the general respiratory readership.

肺癌是导致全球死亡的主要原因之一。肺癌大致可分为小细胞肺癌(SCLC)和非小细胞肺癌。近年来,这两个领域都取得了许多进展。本综述旨在为广大呼吸科读者提供有关小细胞肺癌的简明摘要。
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引用次数: 0
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Breathe
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