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Respiratory Investigation Nov 2021The prognosis of patients with connective tissue disease (CTD) has improved significantly in recent years, but interstitial lung disease (ILD) associated with connective... (Review)
Review
The prognosis of patients with connective tissue disease (CTD) has improved significantly in recent years, but interstitial lung disease (ILD) associated with connective tissue disease (CTD-ILD) remains a refractory condition, which is a leading cause of mortality. Because it is an important prognostic factor, many observational and interventional studies have been conducted to date. However, CTD is a heterogeneous group of conditions, which makes the clinical course, treatment responses, and prognosis of CTD-ILD extremely diverse. To summarize the current understanding and unsolved questions, the Japanese Respiratory Society and the Japan College of Rheumatology collaborated to publish the world's first guide focusing on CTD-ILD, based on the evidence and expert consensus of pulmonologists and rheumatologists, along with radiologists, pathologists, and dermatologists. The task force members proposed a total of 27 items, including 7 for general topics, 9 for disease-specific topics, 3 for complications, 4 for pharmacologic treatments, and 4 for non-pharmacologic therapies, with teams of 2-4 authors and reviewers for each item to prepare a consensus statement based on a systematic literature review. Subsequently, public opinions were collected from members of both societies, and a critical review was conducted by external reviewers. Finally, the task force finalized the guide upon discussion and consensus generation. This guide is expected to contribute to the standardization of CTD-ILD medical care and is also useful as a tool for promoting future research by clarifying unresolved issues.
Topics: Connective Tissue Diseases; Humans; Japan; Lung Diseases, Interstitial; Prognosis; Pulmonologists
PubMed: 34602377
DOI: 10.1016/j.resinv.2021.04.011 -
The Indian Journal of Tuberculosis Apr 2020Tuberculosis (TB) updates and guidelines have been published rapidly in last few years. The WHO and RNTCP have recommended suggestions that have changed the diagnostics... (Review)
Review
Tuberculosis (TB) updates and guidelines have been published rapidly in last few years. The WHO and RNTCP have recommended suggestions that have changed the diagnostics and therapeutics paradigm in 2019. The rapid nature of these changes need to be appraised at the pulmonologist end. We conducted a google survey to study these gaps and subsequently review TB in 2019 focusing on the gaps in the survey. We narrate a short review covering the important diagnostic and therapeutic aspects in brief. We discuss the results of our google survey to address the knowledge gaps. Diagnosis, principles and rationale of therapy and treatment of drug sensitive and drug resistant tuberculosis including the shorter regimen and regrouping of drugs are important considerations of our review.
Topics: Antitubercular Agents; Ethambutol; Health Policy; Humans; India; Isoniazid; Molecular Diagnostic Techniques; Nucleic Acid Amplification Techniques; Polymerase Chain Reaction; Practice Guidelines as Topic; Pulmonologists; Pyrazinamide; Rifampin; Surveys and Questionnaires; Tuberculosis; Tuberculosis, Multidrug-Resistant; World Health Organization
PubMed: 32553319
DOI: 10.1016/j.ijtb.2019.08.013 -
Clinics in Chest Medicine Dec 2021Medical thoracoscopy is an effective and safe modality to visualize and sample contents of the pleural cavity. It is an outpatient procedure that can be performed while... (Review)
Review
Medical thoracoscopy is an effective and safe modality to visualize and sample contents of the pleural cavity. It is an outpatient procedure that can be performed while the patient is spontaneously breathing, with the use of local anesthesia and intravenous medications for sedation and analgesia. Medical thoracoscopy has indications in the management of a variety of pleural diseases. It is most commonly performed as a diagnostic procedure but has therapeutic applications as well. Although it has its advantages, management strategies of certain pleural diseases should take place within a multidisciplinary environment including general pulmonologists, interventional pulmonologists, and thoracic surgeons.
Topics: Humans; Pleural Diseases; Pleural Effusion; Thoracoscopy
PubMed: 34774180
DOI: 10.1016/j.ccm.2021.08.010 -
Revue Des Maladies Respiratoires Sep 2020
Topics: Diagnostic Techniques, Respiratory System; Dyspnea; Europe; Humans; Practice Patterns, Physicians'; Pulmonary Medicine; Pulmonologists; Respiratory Function Tests; Respiratory Muscles; Sleep Apnea Syndromes
PubMed: 32653337
DOI: 10.1016/j.rmr.2020.06.008