Lung
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Cocaine is the most commonly used illicit drug among patients presenting at hospital emergency departments and the most frequent cause of drug-related deaths reported by medical examiners. Various respiratory problems temporally associated with cocaine use have been reported. ⋯ Although most imaging findings are nonspecific, they may raise suspicion of a cocaine-related etiology when considered together with patients' profiles and medical histories. This literature review describes cocaine-induced diseases with pulmonary involvement, with an emphasis on high-resolution chest computed tomographic findings and patterns.
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Lung cancer is currently one of the most common malignant diseases and is responsible for substantial mortality worldwide. Compared with never smokers, former smokers remain at relatively high risk for lung cancer, accounting for approximately half of all newly diagnosed cases in the US. Screening offers former smokers the best opportunity to reduce their risk of advanced stage lung cancer and there is now evidence that annual screening using low-dose computed tomography (LDCT) is effective in preventing mortality. ⋯ Former smokers may be invited for screening; however, if fewer long-term current smokers and more former smokers with long quit duration elect to attend, this could have very adverse effects on cost and screening test parameters. To illustrate this point, we present three possible screening scenarios with lung cancer prevalence ranging from between 0.62 and 5.0 %. In summary, cost-effectiveness of lung cancer screening may be improved if linked to successful smoking cessation programs and if better approaches are developed to reach very high-risk patients, e.g., long-term current smokers or others based on more accurate risk prediction models.
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Recent advances in our understanding of voltage-gated sodium channels (NaVs) lead to the rational hypothesis that drugs capable of selective blockade of NaV subtypes may be a safe and effective strategy for the treatment of unwanted cough. Among the nine NaV subtypes (NaV1.1-NaV1.9), the afferent nerves involved in initiating cough, in common with nociceptive neurons in the somatosensory system, express mainly NaV1.7, NaV1.8, and NaV1.9. Although knowledge about the effect of selectively blocking these channels on the cough reflex is limited, their biophysical properties indicate that each may contribute to the hypertussive and allotussive state that typifies subacute and chronic nonproductive cough.
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Epigenetics refers to changes in phenotype and gene expression that occur without alterations in DNA sequence. MicroRNAs are relatively recently discovered negative regulators of gene expression and act at the posttranscriptional level. ⋯ By better integrating network biology with evolving technologies in cell culture and in vivo experimentation, we will better understand epigenetic mechanisms of pulmonary hypertension and identify more diagnostic and therapeutic targets in pulmonary hypertension.
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Review Meta Analysis
Safety and efficacy of 12-week or longer indacaterol treatment in moderate-to-severe COPD patients: a systematic review.
This is a meta-analysis of the safety and efficacy of indacaterol in chronic obstructive pulmonary disease (COPD) with treatment duration of ≥12 weeks. ⋯ Indacaterol is effective and well-tolerated as a bronchodilator for the maintenance of moderate to severe COPD.