Current opinion in pulmonary medicine
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Malignant central airway obstruction heavily impacts patients' quality of life and its management continues to be a challenge. The current article will review the use of airway stents in this population. ⋯ Airway stents are of great help in palliating symptoms of malignant central airway obstruction. Unfortunately, there have been no recent striking advances in stent technology and the ideal stent has yet to be designed.
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The aim is to review briefly the problems related to treatment of drug-susceptible and drug-resistant tuberculosis (TB), describe recent advances in the development of new drugs and new regimens, and discuss implications for control programmes. ⋯ Currently, nine compounds at least have advanced to clinical development, including four existing drugs redeveloped for TB indication and five new chemical entities. Present clinical trials are testing new combinations of drugs for a shortened treatment of drug-susceptible TB (<6 months duration) or the safety and efficacy of new drugs in addition to an optimized background therapy for the treatment of multidrug-resistant TB. There are at least 34 compounds or projects in the discovery and preclinical stages, including eight compounds in preclinical development. This increasing development of single compounds underscores the needs for a novel approach to test for optimal drug combinations that would be proposed for treatment of TB in all its forms, and the necessary collaboration of pharmaceutical companies, academia, research institutions, donors, and regulatory authorities.
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Pneumonia is a leading cause of morbidity and death in HIV-infected children. The aim of this study was to review recent advances in the epidemiology, cause, management and prevention of pneumonia in HIV-infected children. ⋯ Greater access to preventive and treatment strategies, especially PCP prophylaxis, pneumococcal immunization and HAART, are urgently needed in areas of high childhood HIV prevalence.
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In the last decade, descriptions of outbreaks of extensively drug-resistant strains of tuberculosis (TB) have increased concern about the nosocomial transmission of TB - a potentially life-threatening occupational respiratory infection. In addition, outbreaks of avian influenza caused by an H5N1 virus, severe acute respiratory syndrome caused by a coronavirus A and the recent pandemic caused by an H1N1 influenza virus have heightened concern about occupational infectious illnesses among workers in healthcare and agriculture. ⋯ Administrative, personal and engineering measures to control respiratory infection are effective and should be implemented in healthcare facilities. The use of N95 personal respirators by healthcare workers who are caring for pulmonary TB and viral respiratory infections patients is strongly recommended. Vaccination against influenza (including H1N1) is effective and strongly recommended for healthcare workers. Ultraviolet germicidal irradiation is underused at present, despite good evidence of safety and efficacy in elimination of airborne respiratory infectious agents including TB.