Pub Date : 2024-03-01Epub Date: 2024-05-14DOI: 10.1183/20734735.0006-2024
Christoph Lederer, Monika Storman, Adam Domonkos Tarnoki, David Laszlo Tarnoki, George A Margaritopoulos, Helmut Prosch
High-resolution computed tomography (HRCT) plays a pivotal role in the diagnosis and management of interstitial lung diseases (ILDs), particularly given the approval of antifibrotic agents for conditions like idiopathic pulmonary fibrosis and progressive pulmonary fibrosis. Diagnosing fibrotic pulmonary disorders through HRCT involves a detailed and methodical examination. The identification of specific lung tissue changes, including ground-glass opacities and reticulation, along with signs of fibrosis like honeycombing, traction bronchiectasis and lung volume loss, establishes clear HRCT patterns indicative of various ILDs. The reliability of these patterns in predicting pathological conditions depends largely on the clinical context. For instance, when a usual interstitial pneumonia pattern is present, the predictive value of this diagnosis is so high that a lung biopsy is considered to be redundant. This review intends to delineate the HRCT signs of fibrosis, elucidate the specific radiological patterns of fibrotic lung diseases, and identify the clinical circumstances under which these patterns emerge. Additionally, we introduce and discuss novel imaging techniques that hold promise for the diagnosis, screening and early detection of ILDs.
{"title":"Imaging in the diagnosis and management of fibrosing interstitial lung diseases.","authors":"Christoph Lederer, Monika Storman, Adam Domonkos Tarnoki, David Laszlo Tarnoki, George A Margaritopoulos, Helmut Prosch","doi":"10.1183/20734735.0006-2024","DOIUrl":"10.1183/20734735.0006-2024","url":null,"abstract":"<p><p>High-resolution computed tomography (HRCT) plays a pivotal role in the diagnosis and management of interstitial lung diseases (ILDs), particularly given the approval of antifibrotic agents for conditions like idiopathic pulmonary fibrosis and progressive pulmonary fibrosis. Diagnosing fibrotic pulmonary disorders through HRCT involves a detailed and methodical examination. The identification of specific lung tissue changes, including ground-glass opacities and reticulation, along with signs of fibrosis like honeycombing, traction bronchiectasis and lung volume loss, establishes clear HRCT patterns indicative of various ILDs. The reliability of these patterns in predicting pathological conditions depends largely on the clinical context. For instance, when a usual interstitial pneumonia pattern is present, the predictive value of this diagnosis is so high that a lung biopsy is considered to be redundant. This review intends to delineate the HRCT signs of fibrosis, elucidate the specific radiological patterns of fibrotic lung diseases, and identify the clinical circumstances under which these patterns emerge. Additionally, we introduce and discuss novel imaging techniques that hold promise for the diagnosis, screening and early detection of ILDs.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11091715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140920920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-04-09DOI: 10.1183/20734735.0150-2023
Jordache Ellis, Tassos Grammatikopoulos, James Cook, Akash Deep
Respiratory manifestations of chronic liver disease have a profound impact on patient clinical outcomes. Certain conditions within paediatric liver disease have an associated respiratory pathology. This overlap between liver and respiratory manifestations can result in complex challenges when managing patients and requires clinicians to be able to recognise when referral to specialists is required. While liver transplantation is at the centre of treatment, it opens up further potential for respiratory complications. It is established that these complications place patients at risk of longer stays in hospital and reduced survival. Additionally, late post-transplant complications can occur, including post-transplant lymphoproliferative disease and immunosuppression-induced interstitial lung disease. Although rare, it is important for clinicians to recognise these conditions to allow for prompt management. Finally, as liver disease progresses in children, respiratory complications can occur. Hepatopulmonary syndrome can occur in the context of portal hypertension, resulting in increased mortality and poorer quality of life for patients. Another consequence is portopulmonary hypertension, which can be associated with poor survival. Failure to recognise these complications in children may result in poorer outcomes and therefore it is vital that clinicians can establish when referral to a paediatric respiratory medicine specialist is required.
{"title":"Respiratory problems associated with liver disease in children.","authors":"Jordache Ellis, Tassos Grammatikopoulos, James Cook, Akash Deep","doi":"10.1183/20734735.0150-2023","DOIUrl":"https://doi.org/10.1183/20734735.0150-2023","url":null,"abstract":"<p><p>Respiratory manifestations of chronic liver disease have a profound impact on patient clinical outcomes. Certain conditions within paediatric liver disease have an associated respiratory pathology. This overlap between liver and respiratory manifestations can result in complex challenges when managing patients and requires clinicians to be able to recognise when referral to specialists is required. While liver transplantation is at the centre of treatment, it opens up further potential for respiratory complications. It is established that these complications place patients at risk of longer stays in hospital and reduced survival. Additionally, late post-transplant complications can occur, including post-transplant lymphoproliferative disease and immunosuppression-induced interstitial lung disease. Although rare, it is important for clinicians to recognise these conditions to allow for prompt management. Finally, as liver disease progresses in children, respiratory complications can occur. Hepatopulmonary syndrome can occur in the context of portal hypertension, resulting in increased mortality and poorer quality of life for patients. Another consequence is portopulmonary hypertension, which can be associated with poor survival. Failure to recognise these complications in children may result in poorer outcomes and therefore it is vital that clinicians can establish when referral to a paediatric respiratory medicine specialist is required.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-03-12DOI: 10.1183/20734735.0126-2023
Stephanie L Kuek, Colin Pettman, Melanie R Neeland, Joanne Harrison, Sam Mehr, Shivanthan Shanthikumar, Sean Beggs
Primary idiopathic hypereosinophilic syndrome is a rare condition that can cause end-organ damage in multiple systems. The advent of targeted monoclonal antibodies, such as mepolizumab, provides a safe and effective steroid-sparing treatment. https://bit.ly/4bgDP1u.
{"title":"Eosinophilia and wheeze: thinking beyond asthma.","authors":"Stephanie L Kuek, Colin Pettman, Melanie R Neeland, Joanne Harrison, Sam Mehr, Shivanthan Shanthikumar, Sean Beggs","doi":"10.1183/20734735.0126-2023","DOIUrl":"10.1183/20734735.0126-2023","url":null,"abstract":"<p><p><b>Primary idiopathic hypereosinophilic syndrome is a rare condition that can cause end-organ damage in multiple systems. The advent of targeted monoclonal antibodies, such as mepolizumab, provides a safe and effective steroid-sparing treatment.</b> https://bit.ly/4bgDP1u.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10928552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140118835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-12-19DOI: 10.1183/20734735.0178-2023
Irantzu Muerza, Rory Harris
Climate change is a direct threat to the respiratory health of people with difficult-to-control severe asthma and directly affects the daily life of patients. https://bit.ly/49etd24.
{"title":"Patient experience: impact of environmental conditions on severe asthma.","authors":"Irantzu Muerza, Rory Harris","doi":"10.1183/20734735.0178-2023","DOIUrl":"https://doi.org/10.1183/20734735.0178-2023","url":null,"abstract":"<p><p><b>Climate change is a direct threat to the respiratory health of people with difficult-to-control severe asthma and directly affects the daily life of patients.</b> https://bit.ly/49etd24.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The data about the optimal duration of antibiotics and the usefulness of corticosteroids in the management of parapneumonic effusion and pleural infection are scarce. Two randomised controlled trials evaluating short antibiotic courses (ODAPE and SLIM) and another trial assessing the benefit from corticosteroid use (STOPPE) in this setting were recently published. The aim of this journal club is to present these trials and discuss their significance and limitations. ODAPE compared the efficacy and safety of a short (2 weeks) versus an extended (3 weeks) course of amoxicillin-clavulanate in community-acquired complicated parapneumonic effusions, while SLIM compared the efficacy and safety of short (14-21 days) versus longer (28-42 days) antibiotic courses in patients with community- or hospital-acquired pleural infection. STOPPE assessed the benefit from dexamethasone use in patients with community-acquired pneumonia and concomitant pleural effusion. Both ODAPE and SLIM found that shorter antibiotic courses produce less adverse events while being equally efficacious to the longer courses in a subgroup of patients, such as those with pleural infection that is stabilised with only medical treatment and does not require surgery. In contrast, STOPPE found no benefit from the use of dexamethasone in unselected patients with pneumonia and pleural effusion. Due to the significant limitations of these trials, further studies are required to confirm these findings.
Commentary on: Hassan M, et al. The Short versus Long Antibiotic Course for Pleural Infection Management (SLIM) randomised controlled open-label trial. ERJ Open Res 2023; 9: 00635-2022.Porcel JM, et al. Two vs. three weeks of treatment with amoxicillin-clavulanate for stabilized community-acquired complicated parapneumonic effusions. A preliminary non-inferiority, double-blind, randomized, controlled trial. Pleura Peritoneum 2020; 5: 20190027.Fitzgerald DB, et al. Steroid Therapy and Outcome of Parapneumonic Pleural Effusions (STOPPE): a pilot randomized clinical trial. Am J Respir Crit Care Med 2022; 205: 1093-1101.
有关抗生素的最佳疗程以及皮质类固醇在治疗气胸和胸膜感染中的作用的数据很少。最近发表了两项评估短期抗生素疗程的随机对照试验(ODAPE 和 SLIM)和另一项评估在这种情况下使用皮质类固醇的益处的试验(STOPPE)。本期刊俱乐部旨在介绍这些试验,并讨论其意义和局限性。ODAPE比较了社区获得性并发症性肺旁积液患者使用阿莫西林-克拉维酸短程(2周)和长程(3周)治疗的疗效和安全性,而SLIM则比较了社区或医院获得性胸膜感染患者使用抗生素短程(14-21天)和长程(28-42天)治疗的疗效和安全性。STOPPE 评估了社区获得性肺炎合并胸腔积液患者使用地塞米松的益处。ODAPE和SLIM均发现,对于某些亚组患者,如仅接受药物治疗即可稳定病情且无需手术的胸膜感染患者,使用较短疗程的抗生素与使用较长疗程的抗生素相比,不良反应较少,疗效相当。与此相反,STOPPE 发现,在未经筛选的肺炎和胸腔积液患者中使用地塞米松并无益处。由于这些试验存在很大的局限性,还需要进一步的研究来证实这些发现:Hassan M, et al.胸膜感染管理的短抗生素疗程与长抗生素疗程(SLIM)随机对照开放标签试验。ERJ Open Res 2023; 9: 00635-2022.Porcel JM, et al.一项初步的非劣效、双盲、随机对照试验。Pleura Peritoneum 2020; 5: 20190027.Fitzgerald DB, et al. Steroid Therapy and Outcome of Parapneumonic Pleural Effusions (STOPPE): a pilot randomized clinical trial.Am J Respir Crit Care Med 2022; 205:1093-1101.
{"title":"Medical treatment of pleural infection: antibiotic duration and corticosteroid usefulness.","authors":"Vasileios Skouras, Foteini Chatzivasiloglou, Marianthi Iliopoulou, Theofani Rimpa","doi":"10.1183/20734735.0134-2023","DOIUrl":"https://doi.org/10.1183/20734735.0134-2023","url":null,"abstract":"<p><p>The data about the optimal duration of antibiotics and the usefulness of corticosteroids in the management of parapneumonic effusion and pleural infection are scarce. Two randomised controlled trials evaluating short antibiotic courses (ODAPE and SLIM) and another trial assessing the benefit from corticosteroid use (STOPPE) in this setting were recently published. The aim of this journal club is to present these trials and discuss their significance and limitations. ODAPE compared the efficacy and safety of a short (2 weeks) <i>versus</i> an extended (3 weeks) course of amoxicillin-clavulanate in community-acquired complicated parapneumonic effusions, while SLIM compared the efficacy and safety of short (14-21 days) <i>versus</i> longer (28-42 days) antibiotic courses in patients with community- or hospital-acquired pleural infection. STOPPE assessed the benefit from dexamethasone use in patients with community-acquired pneumonia and concomitant pleural effusion. Both ODAPE and SLIM found that shorter antibiotic courses produce less adverse events while being equally efficacious to the longer courses in a subgroup of patients, such as those with pleural infection that is stabilised with only medical treatment and does not require surgery. In contrast, STOPPE found no benefit from the use of dexamethasone in unselected patients with pneumonia and pleural effusion. Due to the significant limitations of these trials, further studies are required to confirm these findings.</p><p><strong>Commentary on: </strong>Hassan M, <i>et al</i>. The Short <i>versus</i> Long Antibiotic Course for Pleural Infection Management (SLIM) randomised controlled open-label trial. <i>ERJ Open Res</i> 2023; 9: 00635-2022.Porcel JM, <i>et al</i>. Two <i>vs</i>. three weeks of treatment with amoxicillin-clavulanate for stabilized community-acquired complicated parapneumonic effusions. A preliminary non-inferiority, double-blind, randomized, controlled trial. <i>Pleura Peritoneum</i> 2020; 5: 20190027.Fitzgerald DB, <i>et al</i>. Steroid Therapy and Outcome of Parapneumonic Pleural Effusions (STOPPE): a pilot randomized clinical trial. <i>Am J Respir Crit Care Med</i> 2022; 205: 1093-1101.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The role of the pharmacist has evolved significantly, not least over the last 20 years. It delivers a skilled profession with a vital role in medicines optimisation and the management of patients with a respiratory or sleep disorder. While pharmacists are capable of acting as independent practitioners delivering direct patient care, this article explores their contribution to multidisciplinary teams within asthma, COPD, cystic fibrosis, tuberculosis, interstitial lung disease and sleep medicine. Having identified patient cohorts needing specialist medicines support, notably those with poor medicines adherence or specific medicines-related needs (for example during adolescence, or women who are pregnant or breastfeeding), these pharmacists work within primary, secondary and specialist tertiary care. The aim of this review is to share and inspire innovative models of working to include more pharmacists in respiratory and sleep medicine.
{"title":"The role of the clinical pharmacist in the respiratory or sleep multidisciplinary team.","authors":"Jessica Clements, Elaine Bowman, Rowan Tolhurst, Maeve Savage, Alicia Piwko, Christabelle Chen, Elaine Lyons, Nixon Leung, Sarah Mulholland, Gráinne d'Ancona","doi":"10.1183/20734735.0123-2023","DOIUrl":"https://doi.org/10.1183/20734735.0123-2023","url":null,"abstract":"<p><p>The role of the pharmacist has evolved significantly, not least over the last 20 years. It delivers a skilled profession with a vital role in medicines optimisation and the management of patients with a respiratory or sleep disorder. While pharmacists are capable of acting as independent practitioners delivering direct patient care, this article explores their contribution to multidisciplinary teams within asthma, COPD, cystic fibrosis, tuberculosis, interstitial lung disease and sleep medicine. Having identified patient cohorts needing specialist medicines support, notably those with poor medicines adherence or specific medicines-related needs (for example during adolescence, or women who are pregnant or breastfeeding), these pharmacists work within primary, secondary and specialist tertiary care. The aim of this review is to share and inspire innovative models of working to include more pharmacists in respiratory and sleep medicine.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-12-19DOI: 10.1183/20734735.0141-2023
David White, Andrew Bush, Alan R Smyth, Jayesh Mahendra Bhatt
E-cigarettes are products delivering nicotine via inhalation and are devised to mimic tobacco smoking. While they were initially introduced as a device putatively to aid with smoking cessation, their use is now far broader than that. Use by children is significantly increasing. There is growing evidence of the potential harms of vaping. E-liquids used for e-cigarettes contain a wide range of harmful substances, and the clinical consequences of this are now being increasingly demonstrated, such as the rise in cases of e-cigarette- or vaping-associated lung injury. In addition, early use may result in long-term nicotine addiction. Vaping companies utilise marketing methods that distinctly target young people, and weak legislation in the UK allows them free rein to expose children to vaping. In this review we demonstrate why children must be protected from vaping. We must have stringent legislation to prevent easy access to e-cigarettes, including banning the convenience and affordability disposable vapes provide, and prevent marketing that does not warn about the potential health effects. The Australia approach of prescription or pharmacy only access for smoking cessation should be considered to limit exposure of children and minimise use by nonsmokers.
{"title":"Why and how should children be protected from the deluge of vaping related media and marketing overexposure?","authors":"David White, Andrew Bush, Alan R Smyth, Jayesh Mahendra Bhatt","doi":"10.1183/20734735.0141-2023","DOIUrl":"https://doi.org/10.1183/20734735.0141-2023","url":null,"abstract":"<p><p>E-cigarettes are products delivering nicotine <i>via</i> inhalation and are devised to mimic tobacco smoking. While they were initially introduced as a device putatively to aid with smoking cessation, their use is now far broader than that. Use by children is significantly increasing. There is growing evidence of the potential harms of vaping. E-liquids used for e-cigarettes contain a wide range of harmful substances, and the clinical consequences of this are now being increasingly demonstrated, such as the rise in cases of e-cigarette- or vaping-associated lung injury. In addition, early use may result in long-term nicotine addiction. Vaping companies utilise marketing methods that distinctly target young people, and weak legislation in the UK allows them free rein to expose children to vaping. In this review we demonstrate why children must be protected from vaping. We must have stringent legislation to prevent easy access to e-cigarettes, including banning the convenience and affordability disposable vapes provide, and prevent marketing that does not warn about the potential health effects. The Australia approach of prescription or pharmacy only access for smoking cessation should be considered to limit exposure of children and minimise use by nonsmokers.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138828288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-02-13DOI: 10.1183/20734735.0156-2023
Padraic C Ridge, Daphne Chen-Maxwell, Caroline Brodie, Anne Marie Quinn, John Bruzzi, David Breen
Can you diagnose this case of a 27-year-old female who presented 1-week post-partum with an incidental finding of intrathoracic masses and probable hilar lymphadenopathy? https://bit.ly/3S3ejVK.
{"title":"A pleural based mass in a post-partum woman.","authors":"Padraic C Ridge, Daphne Chen-Maxwell, Caroline Brodie, Anne Marie Quinn, John Bruzzi, David Breen","doi":"10.1183/20734735.0156-2023","DOIUrl":"10.1183/20734735.0156-2023","url":null,"abstract":"<p><p><b>Can you diagnose this case of a 27-year-old female who presented 1-week post-partum with an incidental finding of intrathoracic masses and probable hilar lymphadenopathy?</b> https://bit.ly/3S3ejVK.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10862123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lung cancer is one of the common cancers globally with high mortality and poor prognosis. Most cases of lung cancer are diagnosed at an advanced stage due to limited diagnostic resources. Screening modalities, such as sputum cytology and annual chest radiographs, have not proved sensitive enough to impact mortality. In recent years, annual low-dose computed tomography has emerged as a potential screening tool for early lung cancer detection, but it may not be a feasible option for developing countries. In this context, exhaled breath condensate (EBC) analysis has been evaluated recently as a noninvasive tool for lung cancer diagnosis. The breath biomarkers also have the advantage of differentiating various types and stages of lung cancer. Recent studies have focused more on microRNAs (miRNAs) as they play a key role in tumourigenesis by regulating the cell cycle, metastasis and angiogenesis. In this review, we have consolidated the current published literature suggesting the utility of miRNAs in EBC for the detection of lung cancer.
{"title":"microRNAs in exhaled breath condensate for diagnosis of lung cancer in a resource-limited setting: a concise review.","authors":"Divyanjali Rai, Bijay Pattnaik, Sunil Bangaru, Jaya Tak, Jyoti Kumari, Umashankar Verma, Rohit Vadala, Geetika Yadav, Rupinder Singh Dhaliwal, Sunil Kumar, Rakesh Kumar, Deepali Jain, Kalpana Luthra, Kunzang Chosdol, Jayanth Kumar Palanichamy, Maroof Ahmad Khan, Addagalla Surendranath, Saurabh Mittal, Pawan Tiwari, Vijay Hadda, Karan Madan, Anurag Agrawal, Randeep Guleria, Anant Mohan","doi":"10.1183/20734735.0125-2023","DOIUrl":"10.1183/20734735.0125-2023","url":null,"abstract":"<p><p>Lung cancer is one of the common cancers globally with high mortality and poor prognosis. Most cases of lung cancer are diagnosed at an advanced stage due to limited diagnostic resources. Screening modalities, such as sputum cytology and annual chest radiographs, have not proved sensitive enough to impact mortality. In recent years, annual low-dose computed tomography has emerged as a potential screening tool for early lung cancer detection, but it may not be a feasible option for developing countries. In this context, exhaled breath condensate (EBC) analysis has been evaluated recently as a noninvasive tool for lung cancer diagnosis. The breath biomarkers also have the advantage of differentiating various types and stages of lung cancer. Recent studies have focused more on microRNAs (miRNAs) as they play a key role in tumourigenesis by regulating the cell cycle, metastasis and angiogenesis. In this review, we have consolidated the current published literature suggesting the utility of miRNAs in EBC for the detection of lung cancer.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10862127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2024-02-13DOI: 10.1183/20734735.0157-2023
Pedro Barbosa, Mariana Vieira, João Pedro Ramos, Raquel Duarte
Language plays a crucial role in shaping discourses and responses related to disease, particularly tuberculosis (TB). Stigmatising language and attitudes surrounding TB can lead to discrimination and marginalisation of affected individuals, creating barriers to seeking proper diagnosis and treatment. The terminology used to describe TB-affected individuals can be disempowering and criminalising, reinforcing an "othering" of those affected. To combat this, engaging with TB-affected communities is essential to co-construct a neutral and inclusive vocabulary that respects the dignity of individuals and fosters empathy and support. Thus, an inclusive language approach empowers affected individuals as active participants in their health management, encouraging open communication and the development of support networks. By adopting a neutral and inclusive language system, healthcare providers and communities can work together to remove unnoticed hurdles and align with the World Health Organization's TB care and prevention goals.
{"title":"Unveiling the power of neutral and inclusive language in tuberculosis prevention and care.","authors":"Pedro Barbosa, Mariana Vieira, João Pedro Ramos, Raquel Duarte","doi":"10.1183/20734735.0157-2023","DOIUrl":"10.1183/20734735.0157-2023","url":null,"abstract":"<p><p>Language plays a crucial role in shaping discourses and responses related to disease, particularly tuberculosis (TB). Stigmatising language and attitudes surrounding TB can lead to discrimination and marginalisation of affected individuals, creating barriers to seeking proper diagnosis and treatment. The terminology used to describe TB-affected individuals can be disempowering and criminalising, reinforcing an \"othering\" of those affected. To combat this, engaging with TB-affected communities is essential to co-construct a neutral and inclusive vocabulary that respects the dignity of individuals and fosters empathy and support. Thus, an inclusive language approach empowers affected individuals as active participants in their health management, encouraging open communication and the development of support networks. By adopting a neutral and inclusive language system, healthcare providers and communities can work together to remove unnoticed hurdles and align with the World Health Organization's TB care and prevention goals.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10862121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}