Current opinion in pulmonary medicine
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The recent evidence is reviewed on clinical epidemiology, trends in bacterial resistance, diagnostic tools and therapeutic options in hospital-acquired pneumonia (HAP), with a special focus on ventilator-associated pneumonia (VAP). ⋯ HAP/VAP is a major cause of deaths, morbidity and resources utilization, notably in patients with severe underlying conditions. The development of new diagnostic tools and therapeutic weapons is urgently needed to face the epidemic of multidrug-resistant pathogens.
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This review discusses the current developments in biomarkers for sepsis. ⋯ The potential for novel biomarkers in sepsis will need to be properly realized with considerable funding, academic-industry collaborations, appropriate investigations and validation in heterogenous populations, but these developments do hold the capacity to transform patient care and outcomes.
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This review discusses the recent evidence on epidemiology, diagnosis, and treatment of drug-resistant and multidrug-resistant (MDR) tuberculosis (TB), an area where solutions for better diagnosis and treatment continually develop. ⋯ The innovative diagnostic tools recently validated are changing the traditional paradigms of TB diagnosis, for too long based on sputum smear, culture, and drug susceptibility testing. New anti-TB compounds, which can be combined with several 'old' drugs with new indications, are gradually modifying the chances of cure for MDR-TB cases. Although initial evidence appears promising, the market use of new drugs must be accompanied by a serious public health approach aimed at preventing the development of further drug resistance.
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In the past few years, there have been exciting developments in bronchoscopic efforts at attaining lung volume reduction (LVR), given real and perceived risks of surgical LVR. The purpose of this review is to discuss these techniques, with special emphasis on what we have learnt in the past 1-2 years. ⋯ Though the preliminary results are quite encouraging, further trials need to be done before these procedures can be adopted in daily practice.
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This particular review focusses on the burden of the problem of silicosis and its clinical manifestations reported from India. ⋯ Silicosis is a common occupational disorder seen all over India, particularly in the Central and Western States. It is an important cause of respiratory morbidity. The problem has been highlighted on the national level as a major human-rights concern in India.