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Erratum: "Treatment-shortening regimens for tuberculosis: updates and future priorities". F. Saluzzo, V.A. Adepoju, R. Duarte, C. Lange and P.P.J. Phillips on behalf of the UNITE4TB Consortium12. Breathe 2023; 19: 230028. 勘误:"结核病缩短疗程疗法:最新情况和未来优先事项"。F. Saluzzo、V.A. Adepoju、R. Duarte、C. Lange 和 P.P.J. Phillips 代表 UNITE4TB 联合会12。呼吸 2023;19:230028。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.5028-2023

[This corrects the article DOI: 10.1183/20734735.0028-2023.].

[This corrects the article DOI: 10.1183/20734735.0028-2023.].
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引用次数: 0
Unravelling the diagnostic pathology and molecular biomarkers in lung cancer. 揭示肺癌的病理诊断和分子生物标记物。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0192-2023
Andriani Charpidou, Georgia Hardavella, Efimia Boutsikou, Emmanouil Panagiotou, Gökçen Ömeroğlu Simsek, Koen Verbeke, Daniela Xhemalaj, Joanna Domagała-Kulawik

The progress in lung cancer treatment is closely interlinked with the progress in diagnostic methods. There are four steps before commencing lung cancer treatment: estimation of the patient's performance status, assessment of disease stage (tumour, node, metastasis), recognition of histological subtype, and detection of biomarkers. The resection rate in lung cancer is <30% and >70% of patients need systemic therapy, which is individually adjusted. Accurate histological diagnosis is very important and it is the basis of further molecular diagnosis. In many cases only small biopsy samples are available and the rules for their assessment are defined in this review. The use of immunochemistry with at least thyroid transcription factor 1 (TTF1) and p40 is decisive in distinction between lung adenocarcinoma and squamous cell carcinoma. Molecular diagnosis and detection of known driver mutations is necessary for introducing targeted therapy and use of multiplex gene panel assays using next-generation sequencing is recommended. Immunotherapy with checkpoint inhibitors is the second promising method of systemic therapy with best results in tumours with high programmed death-ligand 1 (PD-L1) expression on cancer cells. Finally, the determination of a full tumour pattern will be possible using artificial intelligence in the near future.

肺癌治疗的进步与诊断方法的进步密切相关。开始肺癌治疗前有四个步骤:估计患者的表现状态、评估疾病分期(肿瘤、结节、转移)、识别组织学亚型和检测生物标志物。肺癌的切除率为 70%,患者需要接受系统治疗,治疗方案会根据个体情况进行调整。准确的组织学诊断非常重要,是进一步分子诊断的基础。在许多情况下,只能获得少量活检样本,本综述将对活检样本的评估规则进行定义。至少使用甲状腺转录因子 1(TTF1)和 p40 的免疫化学方法对区分肺腺癌和鳞状细胞癌具有决定性意义。分子诊断和已知驱动基因突变的检测是引入靶向治疗的必要条件,建议使用下一代测序技术进行多重基因面板检测。使用检查点抑制剂进行免疫治疗是第二种有前景的全身治疗方法,对于癌细胞中程序性死亡配体1(PD-L1)高表达的肿瘤效果最佳。最后,在不久的将来,利用人工智能确定完整的肿瘤模式将成为可能。
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引用次数: 0
A 46-year-old woman presenting with anterior mediastinal mass and superior vena cava obstruction syndrome. 一名 46 岁女性,出现前纵隔肿块和上腔静脉阻塞综合征。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0038-2024
Soumi Chakraborty, Suranjan Mukherjee, Arighna Mukherjee, Mithun Chaudhuri

Mucormycosis can rarely lead to an anterior mediastinal mass and a high index of suspicion is necessary so that intervention can be carried out at an early stage. https://bit.ly/4aUuqvc.

粘孢子菌病很少会导致前纵隔肿块,因此有必要高度怀疑,以便及早进行干预。https://bit.ly/4aUuqvc。
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引用次数: 0
Contemporary management of mesothelioma. 间皮瘤的当代管理。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0175-2023
Mark D J Neilly, Jennifer Pearson, Akari Win Thu, Carolyn MacRae, Kevin G Blyth

Pleural mesothelioma (PM) is an aggressive asbestos-associated thoracic malignancy with a median survival of 12-18 months. Due to continued asbestos use in many nations, global incidence is rising. Causes due to non-occupational, environmental exposure are also rising in many countries despite utilisation bans. For many years, platinum--pemetrexed chemotherapy was the solitary licensed therapy, but first-line combination immune checkpoint blockade has recently demonstrated improved outcomes, with both regimes tested in predominantly late-stage cohorts. In the second-line setting, single-agent nivolumab has been shown to extend survival and is now available for routine use in some regions, while second-line chemotherapy has no proven role and opportunities for clinical trials should be maximised in relapsed disease. Surgery for "technically resectable" disease has been offered for decades in many expert centres, but the recent results from the phase III MARS2 trial have challenged this approach. There remains no robustly proven standard of care for early-stage PM. The clinical trial landscape for PM is complex and increasingly diverse, making further development of specialist PM multidisciplinary teams an important priority in all countries. The observation of improving outcomes in centres that have adopted this service model emphasises the importance of high-quality diagnostics and equitable access to therapies and trials. Novel therapies targeting a range of aberrations are being evaluated; however, a better understanding of the molecular drivers and their associated vulnerabilities is required to identify and prioritise treatment targets.

胸膜间皮瘤(PM)是一种侵袭性石棉相关胸部恶性肿瘤,中位生存期为 12-18 个月。由于许多国家继续使用石棉,全球发病率正在上升。在许多国家,尽管禁止使用石棉,但由于非职业性环境接触导致的发病率也在上升。多年来,铂--培美曲塞化疗一直是唯一获得许可的疗法,但最近一线联合免疫检查点阻断疗法的疗效有所改善,这两种疗法主要在晚期队列中进行了测试。在二线治疗中,单药 nivolumab 已被证明可以延长生存期,目前在一些地区已可常规使用,而二线化疗的作用尚未得到证实,对于复发的疾病,应最大限度地利用临床试验的机会。几十年来,许多专家中心一直为 "技术上可切除 "的疾病提供手术治疗,但最近III期MARS2试验的结果对这种方法提出了挑战。对于早期原发性骨髓瘤,目前仍没有经过充分验证的治疗标准。原发性骨髓瘤的临床试验情况复杂且日益多样化,因此,进一步发展原发性骨髓瘤多学科专科团队是所有国家的当务之急。据观察,采用这种服务模式的中心的治疗效果不断改善,这强调了高质量诊断以及公平获得治疗和试验机会的重要性。目前正在对针对一系列畸变的新型疗法进行评估;然而,需要更好地了解分子驱动因素及其相关的脆弱性,以确定治疗目标并进行优先排序。
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引用次数: 0
Pleural effusion in a patient with previous alcohol excess. 一名酗酒患者的胸腔积液。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2024-07-16 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0036-2024
Richard Eddery, Lucy Searle, Mubashar Iqbal, Victoria Athey

Pleural amylase and/or lipase should be analysed in cases of pleural effusion in patients with pancreatic disease or a history of excess alcohol consumption. https://bit.ly/3Rk5UfO.

对于有胰腺疾病或过量饮酒史的胸腔积液患者,应分析胸膜淀粉酶和/或脂肪酶。https://bit.ly/3Rk5UfO。
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引用次数: 0
Increasing exercise capacity and physical activity in the COPD patient. 增强慢性阻塞性肺病患者的运动能力和体育锻炼。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2024-06-11 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0347-2023
Antarpreet Kaur, Jean Bourbeau, Lisa Brighton, Bartolome Celli, Rebecca Crouch, Heleen Demeyer, Daniel A Gerardi, Hideki Katsura, Paula Meek, Mike Morgan, Mara Paneroni, Sally Singh, Michael K Stickland

Higher levels of exercise capacity and physical activity are desired outcomes in the comprehensive management of the COPD patient. In addition, improvements in exercise capacity and physical activity are instrumental to optimising other important therapeutic goals, such as improved health status, reduced healthcare utilisation and increased survival. Four general approaches towards increasing exercise capacity and physical activity in individuals with COPD will be discussed in this review: 1) pharmacological intervention, especially the administration of long-acting bronchodilators; 2) pulmonary rehabilitation, including exercise training and collaborative self-management; 3) behavioural interventions; and 4) web-based interventions. These are by no means the only approaches, nor are they mutually exclusive: indeed, combining them, as necessary, to meet the needs of the individual respiratory patient may promote optimal outcomes, although further research is necessary in this area.

提高运动能力和体力活动水平是慢性阻塞性肺病患者综合治疗的理想结果。此外,运动能力和体力活动的提高有助于优化其他重要的治疗目标,如改善健康状况、减少医疗使用和提高存活率。本综述将讨论提高慢性阻塞性肺病患者运动能力和体力活动的四种一般方法:1)药物干预,尤其是使用长效支气管扩张剂;2)肺康复,包括运动训练和合作性自我管理;3)行为干预;4)基于网络的干预。这些绝不是唯一的方法,也不是相互排斥的:事实上,根据需要将这些方法结合起来,以满足不同呼吸系统患者的需求,可能会促进最佳治疗效果,尽管在这一领域还需要进一步的研究。
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引用次数: 0
Unravelling the complex interplay of factors behind exercise limitations and physical inactivity in COPD. 揭示慢性阻塞性肺病患者运动受限和缺乏运动背后复杂的相互作用因素。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2024-06-11 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0180-2023
Clarice Y Tang, Bruce Bernstein, Felicity Blackstock, Astrid Blondeel, Andrea Gershon, Elena Gimeno-Santos, Rainer Gloeckl, Alda Marques, Martijn A Spruit, Chris Garvey, Mike Morgan, Linda Nici, Sally J Singh, Thierry Troosters

Exercise limitation and physical inactivity are known treatable traits for people with COPD. Maximising exercise capacity and keeping people physically active improves health status and survival rates among people with COPD. However, managing these two treatable traits can be extremely challenging for clinicians due to the complex intersectionality of factors influencing an individual's capacity, opportunity and motivation to engage in physical activity. This review presents the complex factors influencing exercise capacity ("can do"), levels of physical activity ("do do") and sedentary behaviours amongst people with COPD and provides practical recommendations on how clinicians can address some of these factors in practice. Most importantly, it highlights the importance of referring to pulmonary rehabilitation as a way to improve exercise capacity among people with COPD.

运动受限和缺乏运动是慢性阻塞性肺病患者已知的可治疗特征。最大限度地提高运动能力和保持体力活动可改善慢性阻塞性肺病患者的健康状况和存活率。然而,由于影响个人参与体育锻炼的能力、机会和动机的因素错综复杂,管理这两种可治疗特征对临床医生来说极具挑战性。本综述介绍了影响慢性阻塞性肺病患者运动能力("能做")、体育活动水平("会做")和久坐行为的复杂因素,并就临床医生如何在实践中解决其中一些因素提出了实用建议。最重要的是,它强调了将肺康复作为提高慢性阻塞性肺病患者运动能力的一种方法的重要性。
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引用次数: 0
Prevalence and prognostic importance of exercise limitation and physical inactivity in COPD. 慢性阻塞性肺病患者运动受限和缺乏运动对预后的重要性。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2024-06-11 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0179-2023
Anouk W Vaes, Chris Burtin, Richard Casaburi, Bartolome R Celli, Rachael A Evans, Suzanne C Lareau, Linda Nici, Carolyn L Rochester, Thierry Troosters

Exercise limitation and physical inactivity are separate, but related constructs. Both are commonly present in individuals with COPD, contribute to disease burden over and above the respiratory impairments, and are independently predictive of adverse outcomes. Because of this, clinicians should consider assessing these variables in their patients with COPD. Field tests of exercise performance such as the 6-min walk test and the incremental and endurance shuttle walk tests require limited additional resources, and results correlate with negative outcomes. Laboratory measures of exercise performance using a treadmill or cycle ergometer assess exercise capacity, provide prognostic information and have the advantage of explaining physiological mechanisms (and their interactions) underpinning exercise limitation. Limitations in exercise capacity (i.e. "cannot do") and physical inactivity (i.e. "do not do") are both associated with mortality; exercise limitation appears to be the more important driver of this outcome.

运动受限和缺乏运动是两个不同但相关的概念。这两种情况在慢性阻塞性肺病患者中普遍存在,对疾病负担的影响超过了呼吸障碍,并可独立预测不良后果。因此,临床医生应考虑对慢性阻塞性肺病患者进行这些变量的评估。6分钟步行测试、增量和耐力穿梭步行测试等运动表现的现场测试所需的额外资源有限,且测试结果与不良预后相关。使用跑步机或自行车测力计对运动表现进行实验室测量可评估运动能力,提供预后信息,并能解释运动受限的生理机制(及其相互作用)。运动能力受限(即 "不能做")和缺乏运动(即 "不做")都与死亡率有关;运动受限似乎是导致这一结果的更重要因素。
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引用次数: 0
Use of medical thoracoscopy in managing pleural malignancy. 使用内科胸腔镜治疗胸膜恶性肿瘤。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2024-06-11 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0174-2023
Avinash Aujayeb, Philippe Astoul

Local anaesthetic "medical" thoracoscopy is an important tool for the diagnosis and management of a unilateral pleural effusion. It is performed under conscious sedation and has a high diagnostic yield. Clinical experience has demonstrated that thoracoscopy is a safe procedure. This article is an expert review of various aspects of the procedures from two experienced practitioners and we suggest areas for potential future research.

局部麻醉 "医用 "胸腔镜是诊断和处理单侧胸腔积液的重要工具。它在有意识的镇静状态下进行,诊断率高。临床经验表明,胸腔镜检查是一种安全的手术。本文是两位经验丰富的医生对手术各方面进行的专家点评,并提出了未来可能进行研究的领域。
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引用次数: 0
The importance of addressing physical activity and exercise intolerance in our patients with COPD. 解决慢性阻塞性肺病患者的体育锻炼和运动不耐受问题的重要性。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2024-06-11 eCollection Date: 2024-06-01 DOI: 10.1183/20734735.0272-2023
Roger Goldstein, José R Jardim, Linda Nici, Jonathan Raskin, Martijn A Spruit, Richard ZuWallack

Both increased physical activity and increased exercise capacity are desired outcomes in the treatment of individuals with COPD https://bit.ly/4apLYzm.

增加体力活动和提高运动能力都是治疗慢性阻塞性肺病患者的理想结果 https://bit.ly/4apLYzm。
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引用次数: 0
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Breathe
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