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Topic Review
Vectors in Gene Therapy for Pulmonary Diseases
Over the past decades, a better understanding of the genetic and molecular alterations underlying several respiratory diseases has encouraged the development of new therapeutic strategies. Gene therapy offers new therapeutic alternatives for inherited and acquired diseases by delivering exogenous genetic materials into cells or tissues to restore physiological protein expression and/or activity.
  • 4.3K
  • 16 Mar 2022
Topic Review
Contraindications to Initiation of ECMO
Extracorporeal membrane oxygenation (ECMO) is increasingly used for acute respiratory failure with few absolute but many relative contraindications. The contraindications to the initiation of ECMO therapy are not uniformly agreed upon, and each center, as well as each provider involved in the indication for the initiation of ECMO, weights them differently. Whereas absolute contraindications immediately discourage ECMO therapy, relative contraindications should trigger a very thorough consideration of this option. Although relative contraindications should not per se exclude patients from a life-saving procedure such as ECMO, their concurrence may lead to the decision to forgo this procedure. When relative contraindications add up, they might accumulate to a point where they (should) be considered absolute contraindications.
  • 3.3K
  • 16 Sep 2021
Topic Review
Dental Plaque
Dental plaque is a community of microorganisms found on the surface of teeth or other hard surfaces like dentures and embedded in a matrix of polymers of both host and bacterial origin.
  • 2.7K
  • 23 Sep 2021
Topic Review
In Vitro Lung Models
In vitro lung models are used to faithfully model basic human pathology and the complexity and diversity of human respiratory tissues and to study emerging viral respiratory pathogens and diseases. These models include conventional cell lines, primary human airway epithelial cell (hAEC) cultures, lung organoids, lung-on-a-chip technology, ex vivo lung perfusion (EVLP) models and human lung tissue explants.
  • 2.0K
  • 23 Jun 2021
Topic Review Peer Reviewed
Limbic Encephalitis Associated with COVID-19
Limbic encephalitis (LE) is an inflammatory disease of the brain, in which lesion is anatomically limited in structures of the limbic system. In some cases, LE can start with symptoms of limbic dysfunction with further involvement of other regions of the brain. Classic LE syndrome includes such symptoms as the development of personality disorders, depression, sleep disorders, epileptic seizures, hallucinations and cognitive disorders (short-term and long-term memory impairment). The information of clinical examination, electroencephalogram (EEG), magnetic resonance imaging (MRI) and cerebrospinal fluid studies (CSF) suggest the diagnosis of LE in most patients with Coronavirus Disease 2019 (COVID-19).
  • 1.5K
  • 13 Apr 2022
Topic Review Video Peer Reviewed
Sheet Barrier and Intubating Stylet
Coronavirus disease 2019 (COVID-19), a respiratory syndrome caused by SARS-CoV-2, can be transmitted through respiratory droplets and aerosols of droplet nuclei. Aerosol-generating medical procedures (AGMP) are needed to take care of critically ill patients but place health care providers at risk of infection. With limited supplies of personal protective equipment (PPE), barrier systems were developed to help protect health care providers during tracheal intubation. The video intubating stylet shows promise to become the preferred intubation device in conjunction with plastic sheet barriers during the COVID-19 pandemic.
  • 1.5K
  • 13 Apr 2022
Topic Review Peer Reviewed
Physical Properties of Helium and Application in Respiratory Care
Helium is a low-density, inert, monoatomic gas that is widely used in medical applications. In respiratory care, Helium is mainly used as an adjunct therapy for patients with severe upper airway obstruction and asthma. To better understand the action mechanism of helium, the physical properties of several therapeutic gas mixtures with helium are calculated using kinetic theory. Flow in a simplified lung airways model is also shown to support the discussion of helium’s respiratory benefits, including reduced work of breathing.
  • 1.4K
  • 02 Nov 2023
Topic Review
The Importance of Capsules in Dry Powder Inhalers
Capsule-based dry powder inhalers (cDPI) use a hard capsule that contains a powder formulation which consists of a mixture of a micronized drug and a carrier usually the lactose, known for its good lung tolerance. The capsule is either inserted into the device during manufacturer or by the patient prior to use. After perforating, opening or cut the capsule in the device, patients take a deep and rapid breath to inhale the powder, using air as the vector of drug displacement. The system is simple, relatively cheap and characterized by a lower carbon footprint than that of pressurized metered dose inhalers. 
  • 1.2K
  • 29 Mar 2022
Topic Review
Sleep Breathing and Sleep-Deprivation Physiology
Sleep-disordered breathing is associated with sleep deprivation. This sleep disruption interferes with the normal restorative functions of NREM and REM sleep, resulting in disruptions of breathing and cardiovascular function, changes in emotional reactivity, and cognitive decline in attention, memory, and decision making. As the human body goes through the different stages of sleep, physiological changes in the breathing mechanism are present. Sleep disorders, such as obstructive sleep apnea-hypopnea syndrome, are often associated with sleep-disordered breathing and sleep deprivation. Hypoxia and hypercapnia coexist with lack of sleep and undermine multiple functions of the body (e.g., cardiovascular system, cognition, immunity). Among the general population, athletes suffer from these consequences more during their performance. This concept supports the beneficial restorative effects of a good sleeping pattern.
  • 1.1K
  • 06 May 2022
Topic Review
Dry Powder Inhaler Products
Dry powder inhalers (DPIs) are drug–device combination products where the complexity of the formulation, its interaction with the device, and input from users play important roles in the drug delivery. As the landscape of DPI products advances with new powder formulations and novel device designs, understanding how these advancements impact performance can aid in developing generics that are therapeutically equivalent to the reference listed drug (RLD) products. 
  • 1.1K
  • 24 Nov 2022
Topic Review
Diagnosing Primary Ciliary Dyskinesia
Primary Ciliary Dyskinesia (PCD) is a rare, under-recognized disease that affects respiratory ciliary function, resulting in chronic oto-sino-pulmonary disease. The PCD clinical phenotype overlaps with other common respiratory conditions and no single diagnostic test detects all forms of PCD. In 2018, PCD experts collaborated with the American Thoracic Society (ATS) to create a clinical diagnostic guideline for patients across North America, specifically considering the local resources and limitations for PCD diagnosis in the United States and Canada. Nasal nitric oxide (nNO) testing is recommended for first-line testing in patients ≥5 years old with a compatible clinical phenotype; however, all low nNO values require confirmation with genetic testing or ciliary electron micrograph (EM) analysis. Furthermore, these guidelines recognize that not all North American patients have access to nNO testing and isolated genetic testing is appropriate in cases with strong clinical PCD phenotypes. For unresolved diagnostic cases, referral to a PCD Foundation accredited center is recommended.
  • 1.1K
  • 26 Jul 2021
Topic Review
HRCT of Drug-Induced ILD
Interstitial Lung Diseases (ILDs) represent a heterogeneous group of pathologies, which may be related to different causes. A low percentage of these lung diseases may be secondary to the administration of drugs or substances. Several different high resolution computed tomography (HRCT) patterns related to pulmonary drug toxicity have been reported in literature, and the most frequent ILDs patterns reported include Nonspecific Interstitial Pneumonia (NSIP), Usual Interstitial Pneumonia (UIP), Hypersensitivity Pneumonitis (HP), Organizing Pneumonia (OP), Acute Respiratory Distress Syndrome (ARDS), and Diffuse Alveolar Damage (DAD). 
  • 1.0K
  • 14 Jul 2021
Topic Review
Management of Obstructive Sleep Apnea with Comorbidities
Obstructive sleep apnea (OSA) is a common disease that is often under-diagnosed and under-treated in all ages. Personalized medicine in OSA should focus on the management of patients’ comorbidities. Comorbidities of OSA are more common in adult or elderly patients than children. These include chronic respiratory diseases, cardiovascular diseases, and endocrinological or neurological disorders. The optimal management of OSA, using a personalized approach, should target comorbidities which may improve patient outcomes.
  • 1.0K
  • 21 Dec 2022
Topic Review
COPD T-cells and Comorbidity Biomarkers
In smoking-induced chronic obstructive pulmonary disease (COPD), various comorbidities are linked to systemic inflammation and infection-induced exacerbations. The underlying mechanisms are unclear but might provide therapeutic targets. T-cell activity is central in systemic inflammation and for infection-defense mechanisms and might be influenced by comorbidities. Hypothesis: Circulating biomarkers of comorbidities modulate the activity of T-cells of the T-helper type 1 (Th1) and/or T-cytotoxic type 1 (Tc1). T-cells in peripheral blood mononuclear cells (PBMCs) from non-smokers (NS), current smokers without COPD (S), and COPD subjects (total n = 34) were ex vivo activated towards Th1/Tc1 and were then stimulated with biomarkers for metabolic and/or cardiovascular comorbidities (Brain Natriuretic Peptide, BNP; chemokine (C-C motif) ligand 18, CCL18; C-X3-C motif chemokine ligand 1, CX3CL1; interleukin-18, IL-18) or for asthma- and/or cancer-related comorbidities (CCL22; epidermal growth factor, EGF; IL-17; periostin) each at 10 or 50 ng/mL. The Th1/Tc1 activation markers interferon-γ (IFNγ), tumor necrosis factor-α (TNFα), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were analyzed in culture supernatants by Enzyme-Linked Immunosorbent Assay (ELISA). Ex-vivo activation induced IFNγ and TNFα without differences between the groups but GM-CSF more in S vs. NS. At 10 ng/mL, the different biomarkers increased or reduced the T-cell activation markers without a clear trend for one direction in the different categories of comorbidities or for the different T-cell activation markers. At 50 ng/mL, there was a clear shift towards suppressive effects, particularly for the asthma— and cancer-related biomarkers and in cells of S and COPD. Comorbidities might suppress T-cell immunity in COPD. This could explain the association of comorbidities with frequent exacerbations.
  • 1.0K
  • 14 Jul 2021
Topic Review
Mycobacterium Tuberculosis Complex
The Mycobacterium tuberculosis complex (MTBC) is a group of bacteria that cause tuberculosis (TB) in diverse hosts, including captive and free-ranging wildlife species. There is significant research interest in developing immunodiagnostic tests for TB that are both rapid and reliable, to underpin disease surveillance and control.
  • 986
  • 04 Aug 2021
Topic Review
Chronic High Fructose Intake in Beverages and SARS-CoV-2
Fructose intake from SSBs increased during the COVID-19 lockdown. Chronic high intake of fructose activates several damage-associated processes of lung injury, including renin-angiotensin system (RAS) activation, uric acid (UA) levels, aldose reductase (AR) activity, and advanced glycation end products (AGEs) production. These molecular mechanisms are involved in lung injury induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. 
  • 964
  • 12 Jan 2023
Topic Review
Inspiratory Muscle Training in Patients with Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous disease, with pulmonary and extrapulmonary manifestations, which leads to the need to personalize the assessment and treatment of these patients. The latest updates of national and international guidelines for the management of COPD reveal the importance of respiratory rehabilitation (RR) and its role in improving symptoms, quality of life, and psychosocial sphere of patients. Within RR, the inspiratory muscle training (IMT) has received special interest, showing benefits in maximum inspiratory pressure, perception of well-being, and health status in patients with chronic heart disease, respiratory diseases, and dyspnea during exercise. 
  • 951
  • 20 May 2022
Topic Review
Role of Short-Chain Fatty Acids in COPD
Chronic obstructive pulmonary disease (COPD) is a widespread socially significant disease. The development of COPD involves the innate immune system. The regulation of the innate lung immune system is related to the gut microbiota. This connection is due to the production by gut microorganisms of short-chain fatty acids (SCFAs) such as acetate, propionate, and butyrate. Nutritional disturbances and changes in the structure of the intestinal microbiota lead to a decrease in SCFAs production and their effect on pulmonary immunity. The presence of a metabolic and immune axis linking the lungs and gut plays an important role in the pathogenesis of COPD. 
  • 914
  • 27 Jul 2022
Topic Review
Comorbid Insomnia and Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) and insomnia are the two most common sleep disorders among the general population, and they may often coexist in patients with sleep-disordered breathing (SDB). The higher prevalence of insomnia symptoms in patients with OSA (40–60%) compared to that observed in the general population has thus led researchers to identify a new disorder named comorbid insomnia and OSA (COMISA), whose true burden has been so far largely underestimated. The combined treatment of COMISA patients with positive-airway pressure ventilation (PAP) with cognitive behavioral therapy for insomnia (CBTi) has shown a better patient outcome compared to that obtained with a single treatment. Furthermore, recent evidence has shown that an innovative patient-centered approach taking into consideration patient characteristics, treatment preferences and accessibility to treatment is recommended to optimize clinical management of COMISA patients. However, in this complex mosaic, many other sleep disorders may overlap with COMISA, so there is an urgent need for further research to fully understand the impact of these therapies on outcomes for OSA patients with comorbidity. In light of this need, the major sleep disorders comorbid with OSA and the recent advances in the management of these insomniac patients are discussed. 
  • 911
  • 06 Mar 2023
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.
  • 892
  • 21 Dec 2022
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