Current opinion in pulmonary medicine
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Despite decades of scientific attention, chronic obstructive pulmonary disease (COPD) remains a major cause of both morbidity and mortality worldwide with strikingly few effective drug classes available. This may be in part because COPD is actually a syndrome composed of distinct diseases with varying pathophysiology (endotypes), and therapies have not been designed to target the causal pathological processes specific to an endotype. ⋯ Further work characterizing COPD endotypes, including this neutrophilic endotype, will be important as we strive to understand the mechanistic roots of this disease in the hope of creating more effective therapies.
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Several lung volume reduction (LVR) techniques have been increasingly evaluated in patients with advanced pulmonary emphysema, especially in the last decade. Radiologist plays a pivotal role in the characterization of parenchymal damage and, thus, assessment of eligibility criteria. This review aims to discuss the most common LVR techniques, namely LVR surgery, endobronchial valves, and coils LVR, with emphasis on the role of computed tomography (CT). ⋯ CT characterization of heterogeneous parenchymal abnormalities provides criteria for selection of the preferable treatment in each patient and improves outcome of LVR as reflected by better quality of life, higher exercise tolerance, and lower mortality.
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Silicosis because of denim sandblasting emerged as a new cause of silicosis in Turkey in the mid-2000s, and the following years have brought new cases constituting an epidemic with fatal outcomes. Because silicosis is a preventable disease, all efforts should be focused on preventing exposure to crystalline silica and thus development of the disease. ⋯ Clinicians should be aware of potential occupational diseases, such as silicosis because of denim sandblasting, in unrecognized areas. To achieve success in the prevention of silicosis, occupational hygiene measures for crystalline silica should be supported by campaigns to not use sandblasted jeans worldwide.