Harefuah
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Bronchoscopic techniques for the management of emphysema have evolved from the success of surgical treatment. Lung volume reduction surgery (LVRS) involves the removal of 20% to 30% of each lung and targets the most emphysematous segments. Patients with heterogeneous upper lobe emphysema and a low baseline exercise capacity have been identified as a subgroup within COPD in whom mortality benefits can even be achieved, along with improvements in exercise capacity and quality of life. ⋯ BLVR appears to be safer than LVRS in terms of mortality and morbidity. This safety profile presents an attractive alternative for patients with COPD who are fragile physiologically because of the severity of their lung disease and the presence of co-morbid illnesses. The current report aims to describe the various minimally invasive modalities available for the treatment of emphysema.
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Idiopathic pulmonary fibrosis (IPF) is the most common interstitial lung disease (ILD) characterized by exertional dyspnea, hypoxemia and exercise intolerance. The pathophysiology of IPF usually presents restrictive physiology of lung volume and impaired gas exchange. Most of the research which supports the effectiveness of pulmonary rehabilitation (PR) comes from chronic obstructive pulmonary disease (COPD) patients' studies. ⋯ Nevertheless, PR guidelines for IPF patients have not yet been established. This review presents the current existing data on the effectiveness of PR programs in IPF patients. Large and well controlled trials are needed for the establishment of clinical guidelines of PR in IPF patients.
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Omalizumab is a humanized monoclonal anti-IgE for the treatment of moderate to severe allergic asthma. Although the treatment has been available for several years, there are some concerns about its safety and efficacy. ⋯ Data indicates that the high efficacy of add-on Omalizumab in patients with moderate to severe allergic asthma is accompanied by an acceptable safety profile.