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Topic Review
Congenital Lung Malformations
Congenital lung malformations arise during development and include numerous anatomical anomalies of the lung and respiratory tree. They are usually detected prenatally by ultrasonography and comprise congenital pulmonary airway malformation (CPAM), bronchopulmonary sequestration (BPS), bronchogenic cysts (BC), and more rarely bronchial atresia, congenital lobar emphysema (CLE), and congenital tracheal obstruction. This entry focuses on the molecular and genetic determinants of the most frequent anomalies: CPAM, BPS, and BC. Congenital diaphragmatic hernia (CDH) is not usually included in this group; however, since the lung is also highly affected in this condition, we have also incorporated evidence related to lung hypoplasia.
  • 1.0K
  • 30 Nov 2021
Topic Review
Management of Obstructive Sleep Apnea in Adults
Obstructive sleep apnea (OSA) is a common disease that is often under-diagnosed and under-treated in all ages. The conventional diagnostic and therapeutic approaches for adults with OSA are usually based on clinical assessments, followed by polysomnography (PSG) or respiratory polygraphy (RPG) in a sleep lab or at home (HSAT: home sleep apnea testing), and treatment decisions. With this approach, it could be unadvisable for physicians to decide the treatment approach for OSA without evaluating AHI.
  • 1.0K
  • 21 Dec 2022
Topic Review
The Mechanisms Underlying Vertical Artifacts in Lung Ultrasound
The recent advances in lung ultrasound for the diagnosis of cardiogenic pulmonary edema are outstanding; however, the mechanism of vertical artifacts known as B-lines used for the diagnosis has not yet been fully elucidated. The theory of “acoustic trap” is useful when considering the generation of vertical artifacts. Basic research in several studies supports the theory. Published studies with pilot experiments indicate that clarification of the relationship between the length and intensity of vertical artifacts and physical or acoustic composition of sources may be useful for differentiating cardiogenic pulmonary edema from lung diseases. There is no international consensus with regard to the optimal settings of ultrasound machines even though their contribution to the configuration of vertical artifacts is evident. In the clinical setting, the configuration is detrimentally affected by the use of spatial compound imaging, the placement of the focal point at a deep level, and the use of multiple focus. Simple educational materials using a glass microscope slide also show the non-negligible impact of the ultrasound machine settings on the morphology of vertical artifacts.
  • 987
  • 29 Apr 2022
Topic Review
Vitamin K in Chronic Obstructive Pulmonary Disease
Although defined by the presence of airflow obstruction and respiratory symptoms, patients with chronic obstructive pulmonary disease (COPD) are characterized by multimorbidity. Numerous co-occurring conditions and systemic manifestations contribute to the clinical presentation and progression of COPD. Vitamin A and vitamin D have been related to COPD pathogenesis. Another fat-soluble vitamin, vitamin K, has been put forward to exert protective roles in COPD. Vitamin K is an unequivocal cofactor for the carboxylation of coagulation factors, but also for extra-hepatic proteins including the soft tissue calcification inhibitor matrix Gla-protein and the bone protein osteocalcin.
  • 977
  • 10 May 2023
Topic Review
Cell-Based Therapies to Promote Lung Regeneration in IPF
The lung epithelium is constantly exposed to harmful agents present in the air that we breathe making it highly susceptible to damage. However, in instances of injury to the lung, it exhibits a remarkable capacity to regenerate injured tissue thanks to the presence of distinct stem and progenitor cell populations along the airway and alveolar epithelium. Mechanisms of repair are affected in chronic lung diseases such as idiopathic pulmonary fibrosis (IPF), a progressive life-threatening disorder characterized by the loss of alveolar structures, wherein excessive deposition of extracellular matrix components cause the distortion of tissue architecture that limits lung function and impairs tissue repair. cell therapy has been investigated for the treatment of IPF, including the use of a variety of cell types such as lung epithelial cells, specifically AT2 cells, induced pluripotent stem cells (iPSCs), and mesenchymal stem cells (MSCs) isolated from bone marrow stroma and those from adipose tissue or from other tissues.
  • 965
  • 06 Sep 2022
Topic Review
Genetic Basis of Idiopathic Pulmonary Fibrosis
Idiopathic pulmonary fibrosis (IPF) is a rare, chronic, fibrosing and progressive disease limited to the lung with a largely unknown etiology and a poor prognosis. IPF is associated with a characteristically defined radiological and/or histological usual interstitial pneumonia (UIP) pattern.
  • 947
  • 16 Jan 2023
Topic Review
Hypercoagulable State in COPD
Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory disease with multisystemic manifestations. Studies either held on stable disease patients or during exacerbations, have demonstrated that COPD is strongly related to venous thromboembolism and cardiovascular events.
  • 940
  • 18 Aug 2021
Topic Review
Chest Imaging in Viral Pneumonia
Viral pneumonia is one the most frequent respiratory diseases among very young people and the elderly, contributing to an increase in the number of hospitalizations and deaths, mainly in subjects over 60 years of age. To assess the presence of pulmonary involvement and extension of disease, diagnostic imaging techniques are traditional chest radiographs (CXR) and computed tomography (CT). CXR may show a negative radiological pattern or otherwise areas of monolateral or bilateral consolidations, in association with nodular opacities, bronchial wall thickening, and small pleural effusions.
  • 937
  • 02 Jul 2021
Topic Review
Biomarkers of Allergic Asthma
Allergic asthma is the most common asthma phenotype and is characterized by IgE sensitization to airborne allergens and subsequent typical asthmatic symptoms after exposure. A form of type 2 (T2) airway inflammation underlies allergic asthma. It usually arises in childhood and is accompanied by multimorbidity presenting with the occurrence of other atopic diseases, such as atopic dermatitis and allergic rhinitis. Biomarkers identifying patients with allergic asthma include total immunoglobulin E (IgE) levels, fractional exhaled nitric oxide (FeNO) and serum eosinophil counts. 
  • 915
  • 28 Jul 2022
Topic Review
Asthma Pathogenesis
Asthma is a widespread chronic disease of the bronchopulmonary system with a heterogeneous course due to the complex etiopathogenesis. Natural-climatic and anthropogenic factors play an important role in the development and progression of this pathology. 
  • 913
  • 28 Jul 2021
Topic Review
Diagnosis and Treatment of Sleep Apnea in Children
Obstructive sleep apnea (OSA) in children is a prevalent, but still, today, underdiagnosed illness, which consists of repetitive episodes of upper airway obstruction during sleep with important repercussions for sleep quality. OSA has relevant consequences in the pediatric population, mainly in the metabolic, cardiovascular (CV), and neurological spheres. However, contrary to adults, advances in diagnostic and therapeutic management have been scarce in the last few years despite the increasing scientific evidence of the deleterious consequences of pediatric OSA. The problem of underdiagnosis and the lack of response to treatment in some groups make an update to the management of OSA in children necessary. Probably, the heterogeneity of OSA is not well represented by the classical clinical presentation and severity parameters (apnea/hypopnea index (AHI)), and new strategies are required. A specific and consensus definition should be established. Additionally, the role of simplified methods in the diagnosis algorithm should be considered. Finally, the search for new biomarkers for risk stratification is needed in this population. In conclusion, new paradigms based on personalized medicine should be implemented in this population. 
  • 901
  • 21 Jun 2023
Topic Review
Diagnosis and Treatment of Obstructive Sleep Apnea Children
Obstructive sleep apnea (OSA) is a common disease that is often under-diagnosed and under-treated in all ages. This is due to differences in morphology, diversity in clinical phenotypes, and differences in diagnosis and treatment of OSA in children and adults, even among individuals of the same age. 
  • 895
  • 21 Dec 2022
Topic Review
Pulmonary Sarcoidosis
Sarcoidosis is a multisystem disorder of unknown origin and poorly understood pathogenesis that predominantly affects lungs and intrathoracic lymph nodes and is characterized by the presence of noncaseating granulomatous inflammation in involved organs. The disease is highly heterogeneous and can mimic a plethora of other disorders, making diagnosis a challenge even for experienced physicians. The evolution and severity of sarcoidosis are highly variable: many patients are asymptomatic and their disease course is generally benign with spontaneous resolution. However, up to one-third of patients develop chronic or progressive disease mainly due to pulmonary or cardiovascular complications that require long-term therapy. The diagnosis of sarcoidosis requires histopathological evidence of noncaseating granulomatous inflammation in one or more organs coupled with compatible clinical and radiological features and the exclusion of other causes of granulomatous inflammation; however, in the presence of typical disease manifestations such as Löfgren’s syndrome, Heerfordt’s syndrome, lupus pernio and asymptomatic bilateral and symmetrical hilar lymphadenopathy, the diagnosis can be established with high level of certainty on clinical grounds alone.
  • 892
  • 23 Sep 2021
Topic Review
Diet, Gut Microbiota, and Lung
The gut microbiota is often mentioned as a “forgotten organ” or “metabolic organ”, given its profound impact on host physiology, metabolism, immune function and nutrition. A healthy diet is undoubtedly a major contributor for promoting a “good” microbial community that turns out to be crucial for a fine-tuned symbiotic relationship with the host. Meanwhile, diet is a key modifiable factor influencing the gut microbiota in several lung diseases.
  • 880
  • 25 Jun 2021
Topic Review
Oxidative Stress in Chronic Obstructive Pulmonary Disease
Since chronic obstructive pulmonary disease (COPD) is a heterogeneous disease, a specific anti-inflammatory therapy for this disease has not been established yet. Oxidative stress is recognized as a major predisposing factor to COPD related inflammatory responses, resulting in pathological features of small airway fibrosis and emphysema. 
  • 880
  • 06 Feb 2023
Topic Review
Helicobacter pylori and Respiratory Diseases
Helicobacter pylori (H. pylori) is a Gram-negative bacterium involved in the development of gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue. Unexplained iron deficiency anemia, idiopathic thrombocytopenic purpura and vitamin B12 deficiency have also been related to H. pylori infection, whereas for other extra-gastric diseases, the debate is still open. In this entry, we evaluate and discuss the potential involvement of H. pylori infection in the pathogenesis of several respiratory diseases.
  • 869
  • 28 Sep 2021
Topic Review
Connective Tissue Growth Factor in Idiopathic Pulmonary Fibrosis
Connective Tissue Growth Factor, also known as the cellular communication network 2 (CCN2), is a TGF-β-target gene and a member of the CCN family of secreted proteins that regulate matricellular protein. Matricellular proteins are expressed at higher levels during physiological and pathological processes, with distinct functions that bind to multiple receptors, other growth factors, and proteases, modulating their activity and mediating cross-talk between the ECM and cells. Idiopathic Pulmonary Fibrosis is a chronic, devastating, irreversible lung disease, characterized by injury-induced alveolar epithelial cell stress, progressive pathogenic myofibroblast differentiation, and imbalanced macrophage polarization, resulting in ECM deposition. 
  • 863
  • 04 Jul 2022
Topic Review
Melatonin in Disease and Health
Melatonin is a derivative of tryptophan, synthesized mainly in the pineal gland. Its synthesis is characterized by a regular circadian rhythm, with a peak concentration in plasma reached in the night hours. The intensity of melatonin production is related to exposure to light, with an increase of its synthesis in the dark part of the day.
  • 856
  • 25 Aug 2021
Topic Review
Airway Inflammation in Asthma Pathogenesis
Asthma is a heterogeneous disease characterized by chronic airway inflammation. Group 2 innate lymphoid cells (ILC2) play an important role in the pathogenesis of asthma. ILC2s lack antigen-specific receptors and respond to epithelial-derived cytokines, leading to the induction of airway eosinophilic inflammation in an antigen-independent manner. Additionally, ILC2s might be involved in the mechanism of steroid resistance. Numerous studies in both mice and humans have shown that ILC2s induce airway inflammation through inflammatory signals, including cytokines and other mediators derived from immune or non-immune cells.
  • 847
  • 29 Jun 2023
Topic Review
Aspiration Pneumonia and Dysphagia in the Elderly
Pneumonia in the elderly has been increasing on an annual basis. To a greater or lesser extent, aspiration is a major contributor to the development of pneumonia in the elderly. Antimicrobials alone are not sufficient for the treatment of pneumonia, and the condition may become intractable or even recur repeatedly. In addition, some patients with pneumonia may have no problems with eating, while others are unable to receive the necessary nutrition due to severe dysphagia. It has been found that pneumonia decreases both the muscle mass and strength of the swallowing and respiratory muscles, a condition named pneumonia-associated sarcopenia. This contributes to a pathophysiological time-axis of aspiration pneumonia and dysphagia in the elderly, in which silent aspiration leads to the development of pneumonia, and further to dysphagia, malnutrition, and low immunity. 
  • 840
  • 09 Oct 2022
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