scholarly journals From Mouse to Man and Back: Closing the Correlation Gap between Imaging and Histopathology for Lung Diseases

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 636 ◽  
Author(s):  
Birger Tielemans ◽  
Kaat Dekoster ◽  
Stijn E. Verleden ◽  
Stefan Sawall ◽  
Bartosz Leszczyński ◽  
...  
Keyword(s):  
Lung Disease ◽  
Disease Progression ◽  
Lung Diseases ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Space Technology ◽  
Study Results ◽  
Life Threatening ◽  
End Stage

Lung diseases such as fibrosis, asthma, cystic fibrosis, infection and cancer are life-threatening conditions that slowly deteriorate quality of life and for which our diagnostic power is high, but our knowledge on etiology and/or effective treatment options still contains important gaps. In the context of day-to-day practice, clinical and preclinical studies, clinicians and basic researchers team up and continuously strive to increase insights into lung disease progression, diagnostic and treatment options. To unravel disease processes and to test novel therapeutic approaches, investigators typically rely on end-stage procedures such as serum analysis, cyto-/chemokine profiles and selective tissue histology from animal models. These techniques are useful but provide only a snapshot of disease processes that are essentially dynamic in time and space. Technology allowing evaluation of live animals repeatedly is indispensable to gain a better insight into the dynamics of lung disease progression and treatment effects. Computed tomography (CT) is a clinical diagnostic imaging technique that can have enormous benefits in a research context too. Yet, the implementation of imaging techniques in laboratories lags behind. In this review we want to showcase the integrated approaches and novel developments in imaging, lung functional testing and pathological techniques that are used to assess, diagnose, quantify and treat lung disease and that may be employed in research on patients and animals. Imaging approaches result in often novel anatomical and functional biomarkers, resulting in many advantages, such as better insight in disease progression and a reduction in the numbers of animals necessary. We here showcase integrated assessment of lung disease with imaging and histopathological technologies, applied to the example of lung fibrosis. Better integration of clinical and preclinical imaging technologies with pathology will ultimately result in improved clinical translation of (therapy) study results.

scholarly journals Exosomal miRNAs in Lung Diseases: From Biologic Function to Therapeutic Targets

2019 ◽  
Vol 8 (9) ◽  
pp. 1345 ◽  
Author(s):  
Julien Guiot ◽  
Ingrid Struman ◽  
Edouard Louis ◽  
Renaud Louis ◽  
Michel Malaise ◽  
...  
Keyword(s):  
Lung Disease ◽  
Disease Progression ◽  
Lung Diseases ◽  
Potential Role ◽  
Protective Effects ◽  
Diagnostic Biomarkers ◽  
Exosomal Mirnas ◽  
Stress Signals ◽  
Therapeutic Tools

Increasing evidence suggests the potential role of extracellular vesicles (EVs) in many lung diseases. According to their subcellular origin, secretion mechanism, and size, EVs are currently classified into three subpopulations: exosomes, microvesicles, and apoptotic bodies. Exosomes are released in most biofluids, including airway fluids, and play a key role in intercellular communication via the delivery of their cargo (e.g., microRNAs (miRNAs)) to target cell. In a physiological context, lung exosomes present protective effects against stress signals which allow them to participate in the maintenance of lung homeostasis. The presence of air pollution alters the composition of lung exosomes (dysregulation of exosomal miRNAs) and their homeostatic property. Indeed, besides their potential as diagnostic biomarkers for lung diseases, lung exosomes are functional units capable of dysregulating numerous pathophysiological processes (including inflammation or fibrosis), resulting in the promotion of lung disease progression. Here, we review recent studies on the known and potential role of lung exosomes/exosomal miRNAs, in the maintaining of lung homeostasis on one hand, and in promoting lung disease progression on the other. We will also discuss using exosomes as prognostic/diagnostic biomarkers as well as therapeutic tools for lung diseases.

scholarly journals Hereditary angioedema: an update on causes, manifestations and treatment

2019 ◽  
Vol 80 (7) ◽  
pp. 391-398 ◽  
Author(s):  
Hilary J Longhurst ◽  
Konrad Bork
Keyword(s):  
Quality Of Life ◽  
Hereditary Angioedema ◽  
Genetic Disorder ◽  
Treatment Options ◽  
Correct Diagnosis ◽  
Self Administration ◽  
Diagnosis And Management ◽  
Life Threatening ◽  
Short And Long Term

Hereditary angioedema is a rare genetic disorder caused by deficiency of C1 esterase inhibitor (C1-INH) and characterized by recurrent episodes of severe swelling that affect the limbs, face, intestinal tract and airway. Since laryngeal oedema can be life-threatening as a result of asphyxiation, correct diagnosis and management of hereditary angioedema is vital. Hereditary angioedema attacks are mediated by bradykinin, the production of which is regulated by C1-INH. Hereditary angioedema therapy relies on treatment of acute attacks, and short- and long-term prophylaxis. Acute treatment options include C1-INH concentrate, icatibant and ecallantide. Self-administration of treatment is recommended and is associated with increased quality of life of patients with hereditary angioedema. Advances in diagnosis and management have improved the outcomes and quality of life of patients with hereditary angioedema.

scholarly journals Ongoing clinical trials and treatment options for patients with systemic sclerosis–associated interstitial lung disease

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 567-579 ◽  
Author(s):  
Dinesh Khanna ◽  
Donald P Tashkin ◽  
Christopher P Denton ◽  
Martin W Lubell ◽  
Cristina Vazquez-Mateo ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Multiple Organ ◽  
Organ Systems ◽  
The Uk ◽  
Disease Modifying Treatment ◽  
Substantial Morbidity

Abstract SSc is a rare CTD that affects multiple organ systems, resulting in substantial morbidity and mortality. Evidence of interstitial lung disease (ILD) is seen in ∼80% of patients with SSc. Currently there is no approved disease-modifying treatment for ILD and few effective treatment options are available. CYC is included in treatment guidelines, but it has limited efficacy and is associated with toxicity. MMF is becoming the most commonly used medication in clinical practice in North America and the UK, but its use is not universal. Newer agents targeting the pathogenic mechanisms underlying SSc-ILD, including fibrotic and inflammatory pathways, lymphocytes, cell–cell and cell–extracellular membrane interactions, hold promise for better treatment outcomes, including improved lung function, patient-related outcomes and quality of life. Here we review ongoing trials of established and novel agents that are currently recruiting patients with SSc-ILD.

scholarly journals Stoma Complications

Acta Medica ◽  
2019 ◽  
Vol 50 (2) ◽  
pp. 47-52
Author(s):  
Timuçin Erol
Keyword(s):  
Treatment Options ◽  
Early Postoperative Period ◽  
Stoma Creation ◽  
Quick Recovery ◽  
Stoma Complications ◽  
Post Operative Period ◽  
Life Threatening ◽  
The Ideal

An improper stoma creation can cause many complications, varying from minor to life-threatening ones. Conversely, a good functioning stoma, at the ideal site improves patient’s quality of life. Most of the stoma complications occur in the early postoperative period and all clinicians must be familiar to these complications. All measures before and during operation must be taken to avoid these complications. Careful follow up after post operative period can help early diagnosis, proper treatment quick recovery of the patient. This review focus on common complications and treatment options of stoma creation.  

scholarly journals Intradialytic Complication and Associated Factors among Patients Undergoing Hemodialysis

2021 ◽  
Vol 8 (3) ◽  
pp. 378-385
Author(s):  
Yeni Kartika Sari ◽  
Ning Arti Wulandari ◽  
Sandi Alfa Wiga Arsa ◽  
Iwit Rata Ari Dewi
Keyword(s):  
Correlation Coefficient ◽  
Linear Regression Analysis ◽  
Rank Correlation ◽  
Multiple Linear Regression Analysis ◽  
Management Options ◽  
Life Threatening ◽  
Stage Renal Disease ◽  
End Stage ◽  
Spearman Rank Correlation Test

Hemodialysis is one of the vital management options for end-stage renal disease (ERDS) patients. Adequate hemodialysis can make a good quality of patient life. Hemodialysis patient commonly has experienced intradialytic complications, and it can be life-threatening. ESRD patients who are not compliant with fluid and dietary restrictions raised Intradialytic weight gain (IDWG), and blood pressure leads to intradialytic complications. This study aimed to determine factors associated with intradialytic complications among undergoing hemodialytic patients in Blitar. The data analysis used Multiple linear regression analysis to ascertain the possible factors that influence intradialytic complications. The sample was 55 hemodialysis patients with intradialytic complications. Based on this study, the Spearman Rank correlation test results, the factor that correlated with intradialytic complications was patient compliance with a Sig (2-tailed) value of 0.016 with a correlation coefficient value of -0.26. The correlation coefficient in the results above was negative, namely -0.263 so that the correlation between the two variables was not unidirectional. The higher compliance showed, the lower the intradialytic complications. The odds ratio (OR) value between adherence and the occurrence of intradialytic complications was 3,229. That value meant that patients with kidney failure who do not comply with the diet will have a 3-fold risk of intradialytic complications compared to patients with renal failure who comply. This result emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.

Advances in Oncology Care

2011 ◽  
Vol 22 (4) ◽  
pp. 323-334
Author(s):  
Kristi Beatty ◽  
Chris Winkelman ◽  
Joseph A. Bokar ◽  
Polly Mazanec
Keyword(s):  
Intensive Care ◽  
Cancer Care ◽  
Treatment Options ◽  
Survival Rates ◽  
Patients With Cancer ◽  
Therapy Targets ◽  
Life Threatening ◽  
Oncology Care ◽  
New Treatment

The start of the 21st century has produced advances in cancer care that have improved both survival rates and quality of life for many persons diagnosed with cancer. Targeted therapy has given new hope for controlling cancer as a chronic illness. Alone, or in combination with traditional therapies such as surgery, radiation, and/or chemotherapy, this new form of therapy targets malignant cells, halting tumor growth and the potential metastatic spread of disease. Toxicities are limited, but some are serious and may require intensive care. It is imperative for the experienced critical care nurse to have an understanding of these new treatment options and those on the horizon, as these therapies are the future of cancer care. Whereas in previous decades, patients with cancer may not have survived an intensive care admission for treatment complications or advanced disease, many patients now are recovering from life-threatening events, continuing treatment for their disease, and going on to live meaningful, good-quality lives.

scholarly journals EXPRESS: Reasons for Refusing Parenteral Therapy: A Qualitative Study of Patients with Pulmonary Arterial Hypertension

2021 ◽  
pp. 204589402110467
Author(s):  
Kellie Morland ◽  
Amresh Raina ◽  
Abigail Nails ◽  
Peter M. Classi ◽  
Martine Etschmaier ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Disease Progression ◽  
Therapy Group ◽  
Treatment Options ◽  
Group A ◽  
Pulmonary Arterial ◽  
Group B

While parenteral prostacyclin (pPCY) therapy, delivered either subcutaneously or intravenously (IV)is recommended for pulmonary arterial hypertension (PAH) patients with severe or rapidly developing disease, some patients refuse this treatment. This study aimed to understand, directly from patients with PAH, why pPCY was refused and, in some cases, later accepted. Interviews were conducted with 25 PAH patients who previously refused pPCY therapy (Group A: Refused/Never Initiated [n=9] and Group B: Refused/Initiated [n=16]). Patients in both groups believed that pPCY could improve their symptoms, slow disease progression, and provide them a greater ability to perform activities. Reasons for refusal included concern over side effects and the perceived limitations of pPCY on daily activities. Group A perceived their decision as a balance between quality of life and prolonging life and most acknowledged they would reconsider pPCY if other treatment options were exhausted. Group B cited they initiated therapy due to a worsening of symptoms, disease progression, to improve quality of life, to be there for their family, or a desire to live. Following initiation, Group B indicated their experience met expectations with reduced symptoms, slowed disease progression, and perception of improved survival; concerns related to pPCY were described as manageable. Given the efficacy of pPCY therapy, clinicians should apply knowledge of these findings in clinical practice. Patients noted improvements to parenteral pump technologies to include smaller size, water resistance, and implantability may increase their acceptance of this modality. Development efforts should focus on technologies that increase the acceptance of pPCY when indicated.

Pelvic Organ Prolapse

2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Healthcare Provider ◽  
Treatment Options ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Life Threatening ◽  
Surgical Options

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall

Pelvic Organ Prolapse

2018 ◽  
Author(s):  
Lennox Hoyte ◽  
Renee Bassaly ◽  
Stuart Hart ◽  
Mona McCullough ◽  
Elisha Jackson
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Healthcare Provider ◽  
Treatment Options ◽  
Pelvic Organ ◽  
Vaginal Wall ◽  
Life Threatening ◽  
Surgical Options

Pelvic organ prolapse (POP) is the descent of one of more aspects of the vagina and/or uterus. Evaluation of POP always begins with a thorough history and physical examination. Management choices include observation, conservative options, and surgical options. Surgical management is divided into two categories, which are restorative and obliterative. It is important to counsel patients that although POP may affect quality of life, it is not life-threatening. This chapter is designed to guide the healthcare provider with a review of epidemiology, anatomy, evaluation, and management of POP. The chapter contains 14 figures that illustrate examples of common examination findings, devices, and treatment options. Also, there are 5 tables that provide concise reference materials to help guide the healthcare provider. This review contains 91 references, 14 figures, and 6 tables. Key Words: constipation, mesh, pain, pelvic floor, pessary, POP-Q, risk factors, surgery, vaginal wall

Death at the Beginning

2015 ◽  
Author(s):  
Renee D. Boss
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Prenatal Diagnosis ◽  
Congenital Anomalies ◽  
Pregnancy Termination ◽  
Treatment Options ◽  
Fetal Surgery ◽  
Technological Advances ◽  
Life Threatening

Medical and technological advances permit the survival of many infants born prematurely or with congenital anomalies. Prenatal diagnosis of a life-threatening fetal condition can give families the time to prepare for a sick infant and to consider treatment options ranging from pregnancy termination to fetal surgery. Despite the successes in perinatal and neonatal care, there remain a group of infants whose neonatal complications result in chronic illness, serious disability, and a foreshortened life span. It remains unclear how clinicians can best guide families who wish to make decisions based on their infant’s predicted quality of life. Multiple legal and policy restrictions attempt to limit the scope of parent–clinician decision making for these infants.

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