Pulmonary Manifestations of Connective Tissue Diseases
Semin Respir Crit Care Med DOI: 10.1055/s-0044-1782607Systemic sclerosis is a multisystem connective tissue disease that is associated with substantial morbidity and mortality. Visceral organ involvement is common in patients with systemic sclerosis and occurs independently of skin manifestations. Pulmonary hypertension (PH) is an important and prevalent complication of systemic sclerosis. The clinical classification of PH cohorts conditions with similar pathophysiological mechanisms into one of five groups. While patients with systemic sclerosis can manifest with a spectrum of pulmonary vascular disease, notable clinical ...
Source: Seminars in Respiratory and Critical Care Medicine - March 26, 2024 Category: Respiratory Medicine Authors: Cullivan, Sarah Cronin, Eleanor Gaine, Sean Tags: Review Article Source Type: research

Pulmonary Hypertension in Connective Tissue Diseases Other than Systemic Sclerosis
Semin Respir Crit Care Med DOI: 10.1055/s-0044-1782217Pulmonary hypertension (PH) is a known complication of certain connective tissue diseases (CTDs), with systemic sclerosis (SSc) being the most common in the Western world. However, PH in association with non-SSc CTD such as systemic lupus erythematous, mixed connective tissue disease, and primary Sjögren's syndrome constitutes a distinct subset of patients with inherently different epidemiologic profiles, pathophysiologic mechanisms, clinical features, therapeutic options, and prognostic implications. The purpose of this review is to inform a practical approach for cli...
Source: Seminars in Respiratory and Critical Care Medicine - March 18, 2024 Category: Respiratory Medicine Authors: Budhram, Brandon Weatherald, Jason Humbert, Marc Tags: Review Article Source Type: research

Overview of Rheumatoid Arthritis-Associated Interstitial Lung Disease and Its Treatment
Semin Respir Crit Care Med DOI: 10.1055/s-0044-1782218Interstitial lung disease (ILD) is a common pulmonary complication of rheumatoid arthritis (RA), causing significant morbidity and mortality. Optimal treatment for RA-ILD is not yet well defined. Reliable prognostic indicators are largely byproducts of prior ILD progression, including low or decreasing forced vital capacity and extensive or worsening fibrosis on imaging. In the absence of validated tools to predict treatment response, decisions about whether to initiate or augment treatment are instead based on clinical judgment. In general, treatment should be initiate...
Source: Seminars in Respiratory and Critical Care Medicine - March 14, 2024 Category: Respiratory Medicine Authors: Pugashetti, Janelle Vu Lee, Joyce S. Tags: Review Article Source Type: research

New Guidelines for Severe Community-acquired Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1777797In 2023, the new European guidelines on severe community-acquired pneumonia, providing clinical practice recommendations for the management of this life-threatening infection, characterized by a high burden of mortality, morbidity, and costs for the society. This review article aims to summarize the principal evidence related to eight different questions covered in the guidelines, by also highlighting the future perspectives for research activity. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Ta...
Source: Seminars in Respiratory and Critical Care Medicine - March 1, 2024 Category: Respiratory Medicine Authors: Calabretta, Davide Mart ìn-Loeches, Ignacio Torres, Antoni Tags: Review Article Source Type: research

Long-Term Outcomes in Severe Community-Acquired Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0044-1781426Community-acquired pneumonia (CAP) is globally one of the major causes of hospitalization and mortality. Severe CAP (sCAP) presents great challenges and need a comprehensive understanding of its long-term outcomes. Cardiovascular events and neurological impairment, due to persistent inflammation and hypoxemia, contribute to long-term outcomes in CAP, including mortality. Very few data are available in the specific population of sCAP. Multiple studies have reported variable 1-year mortality rates for patients with CAP up to 40.7%, with a clear influence by age, comorbidi...
Source: Seminars in Respiratory and Critical Care Medicine - February 23, 2024 Category: Respiratory Medicine Authors: Carella, Francesco Aliberti, Stefano Stainer, Anna Voza, Antonio Blasi, Francesco Tags: Review Article Source Type: research

Definition, Epidemiology, and Pathogenesis of Severe Community-Acquired Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0044-1779016The clinical presentation of community-acquired pneumonia (CAP) can vary widely among patients. While many individuals with mild symptoms can be managed as outpatients with excellent outcomes, there is a distinct subgroup of patients who present with severe CAP. In these cases, the mortality rate can reach approximately 25% within 30 days and even up to 50% within a year. It is crucial to focus attention on these patients who are at higher risk.Among the various definitions of severe CAP found in the literature, one commonly used criterion is the requirement for admissi...
Source: Seminars in Respiratory and Critical Care Medicine - February 8, 2024 Category: Respiratory Medicine Authors: Cavallazzi, Rodrigo Ramirez, Julio A. Tags: Review Article Source Type: research

Risk of Multidrug-Resistant Pathogens in Severe Community-Acquired Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1778138Severe community-acquired pneumonia (SCAP) is difficult to treat when caused by difficult-to-treat (DTR) pathogens because of limited treatment options and poorer clinical outcomes. Over time, several predictive scoring systems based on risk factors for infection with multidrug resistant pathogens have been developed. We reviewed the available tools for identifying DTR pathogens as the cause of SCAP, both predictive scoring systems and rapid diagnostic methods, to develop management strategies aimed at early identification of DTR pathogens, reducing broad-spectrum antib...
Source: Seminars in Respiratory and Critical Care Medicine - February 1, 2024 Category: Respiratory Medicine Authors: Campa ña-Duel, E. Camprub í-Rimblas, M. Areny-Balaguer ó, A. Quero, Sara Artigas, A. Ceccato, A. Tags: Review Article Source Type: research

Antibiotic Strategies for Severe Community-Acquired Pneumonia
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1778641Despite advancements in health systems and intensive care unit (ICU) care, along with the introduction of novel antibiotics and microbiologic techniques, mortality rates in severe community-acquired pneumonia (sCAP) patients have not shown significant improvement. Delayed admission to the ICU is a major risk factor for higher mortality. Apart from choosing the appropriate site of care, prompt and appropriate antibiotic therapy significantly affects the prognosis of sCAP. Treatment regimens involving ceftaroline or ceftobiprole are currently considered the best options f...
Source: Seminars in Respiratory and Critical Care Medicine - February 1, 2024 Category: Respiratory Medicine Authors: Bassetti, Matteo Giacobbe, Daniele R. Magnasco, Laura Fantin, Alberto Vena, Antonio Castaldo, Nadia Tags: Review Article Source Type: research

Pulmonary Aspergillosis in People with Cystic Fibrosis
Semin Respir Crit Care Med 2024; 45: 128-140 DOI: 10.1055/s-0043-1777267In the last decade, fungal respiratory diseases have been increasingly investigated for their impact on the clinical course of people with cystic fibrosis (CF), with a particular focus on infections caused by Aspergillus spp. The most common organisms from this genus detected from respiratory cultures are Aspergillus fumigatus and Aspergillus terreus, followed by Aspergillus flavus, Aspergillus niger, and Aspergillus nidulans. These species have been identified to be both chronic colonizers and sources of active infection and may negatively impact lung...
Source: Seminars in Respiratory and Critical Care Medicine - January 29, 2024 Category: Respiratory Medicine Authors: Schwarz, C. Eschenhagen, P.N. Mainz, J.G. Schmidergall, T. Schuette, H. Romanowska, E. Tags: Review Article Source Type: research

Radiological Diagnosis of Pulmonary Aspergillosis
Semin Respir Crit Care Med 2024; 45: 050-060 DOI: 10.1055/s-0043-1776998Imaging plays an important role in the various forms of Aspergillus-related pulmonary disease. Depending on the immune status of the patient, three forms are described with distinct imaging characteristics: invasive aspergillosis affecting severely immunocompromised patients, chronic pulmonary aspergillosis affecting less severely immunocompromised patients but suffering from a pre-existing structural lung disease, and allergic bronchopulmonary aspergillosis related to respiratory exposure to Aspergillus species in patients with asthma and cystic fibro...
Source: Seminars in Respiratory and Critical Care Medicine - January 29, 2024 Category: Respiratory Medicine Authors: Laurent, Fran çois Benlala, Ilyes Dournes, Gael Tags: Review Article Source Type: research

Aspergillus and the Lung
Semin Respir Crit Care Med 2024; 45: 003-020 DOI: 10.1055/s-0043-1777259The filamentous fungus Aspergillus causes a wide spectrum of diseases in the human lung, with Aspergillus fumigatus being the most pathogenic and allergenic subspecies. The broad range of clinical syndromes that can develop from the presence of Aspergillus in the respiratory tract is determined by the interaction between host and pathogen. In this review, an oversight of the different clinical entities of pulmonary aspergillosis is given, categorized by their main pathophysiological mechanisms. The underlying immune processes are discussed, and the mai...
Source: Seminars in Respiratory and Critical Care Medicine - January 29, 2024 Category: Respiratory Medicine Authors: Janssens, Iris Lambrecht, Bart N. Van Braeckel, Eva Tags: Review Article Source Type: research

The Spectrum of Pulmonary Aspergillosis
Semin Respir Crit Care Med 2024; 45: 001-002 DOI: 10.1055/s-0043-1778126 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Respiratory and Critical Care Medicine)
Source: Seminars in Respiratory and Critical Care Medicine - January 29, 2024 Category: Respiratory Medicine Authors: Van Braeckel, Eva Cornely, Oliver A. Tags: Preface Source Type: research

Pathological Diagnosis of Pulmonary Aspergillosis
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1776757Pulmonary aspergillosis constitutes an increasingly prevalent and potentially fatal complex of mycotic diseases, caused by different species of Aspergillus. The broad spectrum of pathological manifestations associated with pulmonary aspergillosis necessitates a differentiation of commensalism from saprophytic colonization, hypersensitivity reactions, and true invasive infections, which highlights the importance of histopathology as a gold standard in a diagnostic setting. For the past decades, changes in terminology and contradicting contributions from different diagnos...
Source: Seminars in Respiratory and Critical Care Medicine - January 24, 2024 Category: Respiratory Medicine Authors: Jensen, Henrik E. Becker, Cecilie B. Tags: Review Article Source Type: research

Severe Community-Acquired Pneumonia in Immunocompromised Patients
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1778137Due to higher survival rates with good quality of life, related to new treatments in the fields of oncology, hematology, and transplantation, the number of immunocompromised patients is increasing. But these patients are at high risk of intensive care unit admission because of numerous complications. Acute respiratory failure due to severe community-acquired pneumonia is one of the leading causes of admission. In this setting, the need for invasive mechanical ventilation is up to 60%, associated with a high hospital mortality rate of around 40 to 50%. A wide range of pa...
Source: Seminars in Respiratory and Critical Care Medicine - January 24, 2024 Category: Respiratory Medicine Authors: Chean, Dara Windsor, Camille Lafarge, Antoine Dupont, Thibault Nakaa, Sabrine Whiting, Livia Joseph, Adrien Lemiale, Virginie Azoulay, Elie Tags: Review Article Source Type: research

Viral Pneumonia: From Influenza to COVID-19
Semin Respir Crit Care Med DOI: 10.1055/s-0043-1777796Respiratory viruses are increasingly recognized as a cause of community-acquired pneumonia (CAP). The implementation of new diagnostic technologies has facilitated their identification, especially in vulnerable population such as immunocompromised and elderly patients and those with severe cases of pneumonia. In terms of severity and outcomes, viral pneumonia caused by influenza viruses appears similar to that caused by non-influenza viruses. Although several respiratory viruses may cause CAP, antiviral therapy is available only in cases of CAP caused by influenza virus...
Source: Seminars in Respiratory and Critical Care Medicine - January 16, 2024 Category: Respiratory Medicine Authors: Cilloniz, Catia Dy-Agra, Guinevere Pagcatipunan, Rodolfo S. Torres, Antoni Tags: Review Article Source Type: research