Curr Opin Pulm Med [JOURNAL]
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200 papers
Update in paediatric asthma.
Bush A
Curr Opin Pulm Med · 2025 May · PMID 39973758 · Publisher ↗
PURPOSE OF REVIEW: The field of paediatric asthma is rapidly moving, with the advent of new biologicals for severe asthma and increased understanding of preschool wheeze amongst other developments and insights. RECENT FI...
PURPOSE OF REVIEW: The field of paediatric asthma is rapidly moving, with the advent of new biologicals for severe asthma and increased understanding of preschool wheeze amongst other developments and insights. RECENT FINDINGS: There is increasing evidence of efficacy in children for biologics directed against Type 2 inflammation (especially mepolizumab and dupilumab) as well encouraging evidence that Tezepelumab may be effective against Type 2 low phenotypes. The importance of airway remodelling and infection in the pathophysiology of preschool wheeze is increasingly appreciated. The treatment of preschool wheeze is moving from symptom-based to biomarker driven therapies. Other important areas are prediction of risk of asthma attacks, the SMART regime, the importance of climate change and reducing greenhouse gas emissions from inhalers while ensuring adequate therapy for young children, the association of early adverse environmental factors including childhood poverty and deprivation and the switch to race-neutral lung function equations. SUMMARY: We are increasingly moving towards personalized medicine and the use of biomarkers to guide treatment of wheeze at all ages, but we need to move from counting cells to determining their functional status. Airway wall structural changes rather than inflammation may drive the progression of preschool wheeze to school age asthma.
Pleural infection: controversies on the therapeutic strategies.
Chan KKP, Lau EPM, Lee YCG
Curr Opin Pulm Med · 2025 May · PMID 39960267 · Full text
PURPOSE OF REVIEW: Management of pleural infection remains heterogeneous worldwide. This review highlights current controversies in therapeutic strategies for pleural infection, focusing particularly on recent studies an...
PURPOSE OF REVIEW: Management of pleural infection remains heterogeneous worldwide. This review highlights current controversies in therapeutic strategies for pleural infection, focusing particularly on recent studies and their implications. RECENT FINDINGS: The introduction of intrapleural therapy combining alteplase [a tissue plasminogen activator (tPA)] and deoxyribonuclease (DNase) has revolutionized treatment practices, though the optimal delivery and dosing regimen is an area of active investigation. Variations to simplify administration protocols and/or to lower the required drug doses have been published. Most were exploratory studies, but the variations showed maintained therapeutic efficacy.Whether intrapleural alteplase/DNase or video-assisted thoracoscopic surgery (VATS) is superior is a topic of debate. Retrospective comparative analyses between the two revealed no clear benefits on all-cause mortality from either approach. Pilot randomized trials have been published and further full-scale, head-to-head trials are underway. SUMMARY: Effective management of pleural infection involves adequate pleural drainage and appropriate antibiotic use. This review outlines the current evidence (and its limitations) and highlights knowledge gaps in optimizing the therapeutic strategies.
Novel biomarkers in asthma.
Agrawal N, Kraft M
Curr Opin Pulm Med · 2025 May · PMID 39950260 · Publisher ↗
PURPOSE OF REVIEW: Asthma is a common global respiratory disease characterized by airway inflammation. It is a heterogenous group of disorders with overlapping biological mechanisms. This review will discuss the current...
PURPOSE OF REVIEW: Asthma is a common global respiratory disease characterized by airway inflammation. It is a heterogenous group of disorders with overlapping biological mechanisms. This review will discuss the current state of the use of biomarkers in asthma with an eye to the future. The identification of biomarkers has advanced our understanding of inflammatory pathways in asthma and aided in development of targeted therapies. However, even with similar inflammatory biomarkers, not all patients respond uniformly. Thus, further research into novel biomarkers in asthma is needed. RECENT FINDINGS: Recent literature highlights several key themes in biomarker research for asthma. Biomarkers can be derived from various sources, including sputum, blood, urine, and exhaled breath. Historically, studies have focused on eosinophilic inflammation, yet total blood eosinophil counts do not capture asthma pathology and treatment responses. Recent investigations explore eosinophil activity as well as eosinophil subpopulations based on surface protein expressions. Mast cell involvement, their mediators, and club cell secretory protein are further being examined across different asthma molecular phenotypes. SUMMARY: The complexity of inflammatory pathways in asthma, influenced by various factors, underscores the inadequacy of relying on a single biomarker at one time point. Continued research is essential to identify appropriate biomarkers.
Community acquired pneumonia due to antibiotic resistant- Streptococcus pneumoniae : diagnosis, management and prevention.
Lui GCY, Lai CKC
Curr Opin Pulm Med · 2025 May · PMID 39917810 · Publisher ↗
PURPOSE OF REVIEW: A resurgence of pneumococcal pneumonia has been observed after a marked reduction in the early COVID-19 pandemic. Penicillin-nonsusceptible Streptococcus pneumoniae is regarded as a WHO priority pathog...
PURPOSE OF REVIEW: A resurgence of pneumococcal pneumonia has been observed after a marked reduction in the early COVID-19 pandemic. Penicillin-nonsusceptible Streptococcus pneumoniae is regarded as a WHO priority pathogen. RECENT FINDINGS: Overall antibiotic resistance rates in S. pneumoniae have increased due to increase in antibiotic consumption and changes in serotype distribution, partly driven by the rollout of pneumococcal vaccination. Isolates from pneumococcal pneumonia have higher resistance rates than those from invasive pneumococcal disease. New antibiotics have been approved for treatment of community-acquired pneumonia, and are active against multidrug-resistant S. pneumoniae . Pneumococcal vaccines in both children and adults are effective in reducing the burden of pneumococcal pneumonia in adults, though some circulating vaccine and nonvaccine serotypes are driving antibiotic resistance. SUMMARY: Continual surveillance of serotype and resistance patterns of S. pneumoniae causing pneumonia in adult populations is important after the introduction of new pneumococcal vaccines. Novel pneumococcal vaccine platforms are needed to overcome the threats of serotype replacement and antibiotic resistance.
An updated review of pulmonary radiological features of acute and chronic COVID-19.
Tcheroyan R, Makhoul P, Simpson S
Curr Opin Pulm Med · 2025 May · PMID 39902608 · Publisher ↗
PURPOSE OF REVIEW: Significant progress has been made in our understanding of the acute and chronic clinical and radiological manifestations of coronavirus-19 (COVID-19). This article provides an updated review on pulmon...
PURPOSE OF REVIEW: Significant progress has been made in our understanding of the acute and chronic clinical and radiological manifestations of coronavirus-19 (COVID-19). This article provides an updated review on pulmonary COVID-19, while highlighting the key imaging features that can identify and distinguish acute COVID-19 pneumonia and its chronic sequelae from other diseases. RECENT FINDINGS: Acute COVID-19 pneumonia typically presents with manifestations of organizing pneumonia on computed tomography (CT). In cases of severe disease, patients clinically progress to acute respiratory distress syndrome, which manifests as diffuse alveolar damage on CT. The most common chronic imaging finding is ground-glass opacities, which commonly resolves, as well as subpleural bands and reticulation. Pulmonary fibrosis is an overall rare complication of COVID-19, with characteristic features, including architectural distortion, and traction bronchiectasis. SUMMARY: Chest CT can be a helpful adjunct tool in both diagnosing and managing acute COVID-19 pneumonia and its chronic sequelae. It can identify high-risk cases and guide decision-making, particularly in cases of severe or complicated disease. Follow-up imaging can detect persistent lung abnormalities associated with long COVID and guide appropriate management.
Respiratory hazards of climate change, environmental exposures and diverse topics on COPD.
Joshi M, Varkey B
Curr Opin Pulm Med · 2025 Mar · PMID 39878001 · Publisher ↗
Abstract loading — click title to view on PubMed.
The role of artificial intelligence in the diagnosis, imaging, and treatment of thoracic empyema.
Zumla A, Ahmed R, Bakhri K
Curr Opin Pulm Med · 2025 May · PMID 39711496 · Publisher ↗
PURPOSE OF REVIEW: The management of thoracic empyema is often complicated by diagnostic delays, recurrence, treatment failures and infections with antibiotic resistant bacteria. The emergence of artificial intelligence...
PURPOSE OF REVIEW: The management of thoracic empyema is often complicated by diagnostic delays, recurrence, treatment failures and infections with antibiotic resistant bacteria. The emergence of artificial intelligence (AI) in healthcare, particularly in clinical decision support, imaging, and diagnostic microbiology raises great expectations in addressing these challenges. RECENT FINDINGS: Machine learning (ML) and AI models have been applied to CT scans and chest X-rays to identify and classify pleural effusions and empyema with greater accuracy. AI-based analyses can identify complex imaging features that are often missed by the human eye, improving diagnostic precision. AI-driven decision-support algorithms could reduce time to diagnosis, improve antibiotic stewardship, and enhance more precise and less invasive surgical therapy, significantly improving clinical outcomes and reducing inpatient hospital stays. SUMMARY: ML and AI can analyse large datasets and recognize complex patterns and thus have the potential to enhance diagnostic accuracy, preop planning for thoracic surgery, and optimize surgical treatment strategies, antibiotic therapy, antibiotic stewardship, monitoring complications, and long-term patient management outcomes.
Respiratory syncytial virus pulmonary infections in adults - disease burden and prevention.
Waterer GW, Metersky M
Curr Opin Pulm Med · 2025 May · PMID 39711487 · Publisher ↗
PURPOSE OF REVIEW: We highlight the evolving understanding of the burden of respiratory syncytial virus (RSV) in older adults and recent data on the three new vaccines. RECENT FINDINGS: As well as a greater recognition o...
PURPOSE OF REVIEW: We highlight the evolving understanding of the burden of respiratory syncytial virus (RSV) in older adults and recent data on the three new vaccines. RECENT FINDINGS: As well as a greater recognition of the amount of RSV infection in adults, and especially over 60 years of age, there has been a significant amount of study detailing the postacute burden including excess cardiovascular disease and loss of physical and cognitive functioning. Three new RSV vaccines now have published data for two seasons, and while direct comparison is not possible due to differences in the timing, methodology and populations studies, all show good efficacy with no serious side effects of concern. SUMMARY: RSV causes a substantial amount of morbidity and mortality in older adults with both acute and longer term impacts. With effective vaccines now available clinicians should be advocating with their patients to prevent RSV infection.
Initiation of home noninvasive ventilation in hypercapnic chronic obstructive pulmonary disease: when, where, and how?
Fortis S, Sarmiento KF
Curr Opin Pulm Med · 2025 Mar · PMID 39699122 · Publisher ↗
PURPOSE OF REVIEW: This review aims to highlight the importance of timely initiation of home noninvasive ventilation (homeNIV) for patients with chronic hypercapnic respiratory failure (CHRF) due to chronic obstructive p...
PURPOSE OF REVIEW: This review aims to highlight the importance of timely initiation of home noninvasive ventilation (homeNIV) for patients with chronic hypercapnic respiratory failure (CHRF) due to chronic obstructive pulmonary disease (COPD). As emerging evidence continues to show substantial benefits in reducing mortality and hospitalizations, it's crucial to identify which patients will benefit most and to provide clear guidance on implementing homeNIV effectively. RECENT FINDINGS: Recent research supports the use of high intensity homeNIV for CHRF secondary to COPD, showing marked reductions in hospitalizations and mortality. However, despite its proven benefits, homeNIV is underutilized, often due to significant barriers related to payor policies and gaps in knowledge by those most likely to be evaluating and managing patients with advanced COPD. The literature also reveals ongoing debate about the optimal timing and setting for starting homeNIV, whether in outpatient clinics or directly after hospital discharge. SUMMARY: The evidence suggests that homeNIV should be more widely used, with a focus on early initiation and careful titration to normalize PaCO 2 over time. By addressing the barriers to its broader use, we can improve outcomes for patients with CHRF due to COPD.
Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights.
James MD, Berton DC, Neder JA
Curr Opin Pulm Med · 2025 Mar · PMID 39639840 · Publisher ↗
PURPOSE OF REVIEW: Exertional dyspnea and exercise intolerance remain key patient-related outcomes in chronic obstructive pulmonary disease (COPD). Improvement in treatment strategies is pendant further understand of the...
PURPOSE OF REVIEW: Exertional dyspnea and exercise intolerance remain key patient-related outcomes in chronic obstructive pulmonary disease (COPD). Improvement in treatment strategies is pendant further understand of their underpinnings across the spectrum of disease severity. RECENT FINDINGS: Emerging literature has been reviewed based on a conceptual framework that relates ventilatory demand to capacity under the modulating influence of sub-cortical and cortical centers (symptom perception and affective interpretation). Evidence supporting these fundamental tenets is critically appraised, focusing on mechanistic and interventional studies that shed novel light on the sources of heightened and/or mechanically constrained ventilation. Mechanistic studies using proxies of the inspiratory neural drive (e.g., diaphragm electromyography) were particularly informative, as well as interventional trials aimed at decreasing afferent stimulation and/or symptom perception via pharmacological (e.g., low-dose opiates in selected patients, high flow oxygen, oral nitrate) and nonpharmacological (e.g., novel exercise training paradigms, inspiratory muscle training, breathing techniques) interventions. SUMMARY: Therapeutic and rehabilitative strategies to lessen dyspnea's devastating impact on quality of life should minimize demand in the setting of reduced capacity and increased sensation awareness in COPD. The most successful attempts so far have amalgamated pharmacological and nonpharmacological approaches tailored to the main underlying mechanisms on an individual basis.
The persistent problem of persistent air-leaks: approach to management.
Mundanchira G, Frye L, Reisenauer J … +1 more , Agrawal A
Curr Opin Pulm Med · 2025 Jan · PMID 39635887 · Publisher ↗
PURPOSE OF REVIEW: Persistent air leaks, defined as an air leak extending beyond 5 days, pose a significant challenge for cardiothoracic surgeons and pulmonologists. Although current guidelines advocate for surgical inte...
PURPOSE OF REVIEW: Persistent air leaks, defined as an air leak extending beyond 5 days, pose a significant challenge for cardiothoracic surgeons and pulmonologists. Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity. RECENT FINDINGS: Although current guidelines advocate for surgical intervention as the primary treatment, many patients may not suitable candidates for immediate return to the operating room. Alternatively, conservative management, which involves watchful waiting for pleural healing, often results in prolonged hospital stays and increased morbidity. For patients who are not surgical candidates, use of autologous blood patch, pleurodesis or endobronchial valves may offer a viable alternative to conservatively manage air leak. SUMMARY: This review evaluates the various noninvasive therapies that have been explored, including sealants, Heimlich valves, chemical and autologous blood patch pleurodesis, and endo and intrabronchial valves. Although these alternatives show promise, further research is needed to compare these treatments before they can be recommended in new guidelines.
The changing landscape of cystic fibrosis and lung transplant.
Lehr CJ, Dasenbrook EC
Curr Opin Pulm Med · 2024 Nov · PMID 39620994 · Publisher ↗
Abstract loading — click title to view on PubMed.
Goals of chronic obstructive pulmonary disease management: a focused review for clinicians.
Raghavan S, Hatipoğlu U, Aboussouan LS
Curr Opin Pulm Med · 2025 Mar · PMID 39620703 · Publisher ↗
PURPOSE OF REVIEW: The diagnosis of chronic obstructive pulmonary disease (COPD) encompasses heterogeneous pathophysiological mechanisms which can shape an individual patient's experience. This paper reviews available th...
PURPOSE OF REVIEW: The diagnosis of chronic obstructive pulmonary disease (COPD) encompasses heterogeneous pathophysiological mechanisms which can shape an individual patient's experience. This paper reviews available therapeutic options for the clinician intending to individualize care toward patient goals. RECENT FINDINGS: The contemporary targeted interventions for COPD include the novel phosphodiesterase inhibitor ensifentrine, the interleukin-4 receptor (IL4R alpha subunit) antibody dupilumab, augmentation therapy for alpha-1 antitrypsin deficiency. Other interventions promoting physical and mental well being include re-envisioned pulmonary rehabilitation, self-management, targeting of comorbidities such as sarcopenia, and virtual health coaching interventions to expand patient access. Opioids did not relieve dyspnea and did not change total step count. SUMMARY: Advances in precision therapy are complemented by the discovery of novel pathophysiology pathways and behavioral and rehabilitation interventions as a holistic view of COPD management emerges. The management of COPD continues to evolve with new tools including precision medicine and individualized care. Comorbidities remain important determinants of health, yet their prevalence and impact are underestimated.
The impact of climate change on respiratory health: current understanding and knowledge gaps.
Joshi M, Joshi A, Bartter T
Curr Opin Pulm Med · 2025 Mar · PMID 39620702 · Publisher ↗
PURPOSE OF REVIEW: To present an overview of the impact of climate change upon human respiratory health. RECENT FINDINGS: Climate change is directly impacting air quality. Particulate matter clearly increases mortality r...
PURPOSE OF REVIEW: To present an overview of the impact of climate change upon human respiratory health. RECENT FINDINGS: Climate change is directly impacting air quality. Particulate matter clearly increases mortality rates. Ozone, a longstanding suspect in climate-related injury, turns out not to have the major impact that had been projected at current levels of exposure. The key factors in global warming have been clearly identified, but while these factors collectively cause deleterious changes, a close look at the literature shows that it is unclear to what extent each factor individually is a driver of a specific process. This article summarizes some of those studies. SUMMARY: A better understanding of which components of climate change most impact human health is needed in order to re-define environmental standards. PM 2.5 needs to be broken down by chemical composition to study the differential impacts of different sources of PM 2.5 . The detection and study of climate-related changes in respiratory infectious diseases is in a state of relative infancy.
Food for thought: optimal diet in patients with asthma and chronic obstructive pulmonary disease.
Vameghestahbanati M, Wang CJ, Sin DD
Curr Opin Pulm Med · 2025 Mar · PMID 39607023 · Publisher ↗
PURPOSE OF REVIEW: Nutritional intake plays a major role in the management of lung health. This review provides the latest perspective on how dietary choices can modulate lung function in patients with chronic obstructiv...
PURPOSE OF REVIEW: Nutritional intake plays a major role in the management of lung health. This review provides the latest perspective on how dietary choices can modulate lung function in patients with chronic obstructive pulmonary disease (COPD) and asthma. RECENT FINDINGS: The pathophysiology of COPD and asthma is driven by oxidative stress and inflammation of the airways, which is exacerbated by modifiable risk factors such as cigarette smoking and diet. Various foods can influence patient symptoms; highly processed foods increase the production of reactive oxygen species that augment airway inflammation, whereas foods rich in antioxidants, fiber and protein combat oxidative stress and muscle wastage. Patients with COPD or asthma are at increased risk of developing metabolic comorbidities, including cachexia and obesity that complicate disease phenotypes, leading to greater symptom severity. While clinical findings suggest a role for antioxidant and macronutrient support of lung function, comprehensive translational and clinical studies are necessary to better understand the mechanisms underlying nutrient interaction and lung structure-function. SUMMARY: Understanding the nutritional requirements that protect lung health and support weight management in COPD and asthma is imperative to providing personalized dietary recommendations and reducing patient morbidity.
Bronchodilator responsiveness in chronic obstructive pulmonary disease: prevalence, significance, and clinical implications.
Aggarwal AN, Agarwal R
Curr Opin Pulm Med · 2025 Mar · PMID 39600297 · Publisher ↗
PURPOSE OF REVIEW: Bronchodilator responsiveness (BDR) is often considered a key feature distinguishing asthma from chronic obstructive pulmonary disease (COPD). However, recent evidence suggests that BDR alone may not b...
PURPOSE OF REVIEW: Bronchodilator responsiveness (BDR) is often considered a key feature distinguishing asthma from chronic obstructive pulmonary disease (COPD). However, recent evidence suggests that BDR alone may not be a reliable discriminator between these conditions. There is still no consensus on BDR definitions and testing protocols. Additionally, it remains unclear whether BDR is linked to a specific COPD phenotype or influences treatment responses. Our review of recent literature attempts to clarify some of these issues. RECENT FINDINGS: A significant proportion of COPD patients demonstrate BDR, but the variability in testing procedures and definitions makes it challenging to draw any definite conclusion. There is no evident association between BDR and specific COPD characteristics. A few studies suggest that BDR may be associated with marginally better treatment response and disease outcomes in COPD. The impact of recent changes in BDR definitions on clinical practice remains to be fully understood. SUMMARY: There is still no clear, clinically relevant threshold to define BDR. BDR is an unreliable discriminator to differentiate asthma from COPD and is not consistently linked to any specific COPD phenotype, treatment response, or disease outcomes. Further research is needed to refine the definitions and implications of BDR in COPD.
Whole lung and sequential bronchoscopic lavage for pulmonary alveolar proteinosis.
Tay CK, Kumar A, Hsu AAL … +1 more , Lee P
Curr Opin Pulm Med · 2025 Jan · PMID 39569652 · Publisher ↗
PURPOSE OF REVIEW: Pulmonary alveolar proteinosis (PAP) is a diffuse lung disease that results from the accumulation of lipoproteinaceous material in the alveoli due to abnormal surfactant homeostasis. Since its introduc...
PURPOSE OF REVIEW: Pulmonary alveolar proteinosis (PAP) is a diffuse lung disease that results from the accumulation of lipoproteinaceous material in the alveoli due to abnormal surfactant homeostasis. Since its introduction in the 1960s, whole lung lavage (WLL) has been the primary treatment for PAP. This review focuses on WLL, including its technique modifications, and sequential bronchoscopic lavage. RECENT FINDINGS: Autoimmune PAP, which accounts for the majority of cases, occurs when antigranulocyte-macrophage colony-stimulating factor (GM-CSF) autoantibodies lead to the deficiency of bioavailable GM-CSF. At present, there are no international guidelines or consensus statements for PAP treatment. Traditionally, therapeutic decisions are made based on the severity and type of PAP. Despite emerging data on GM-CSF-based therapies, WLL remains a central component in the therapeutic strategy for PAP. SUMMARY: Although the technique of WLL has evolved over time, there is still no universally adopted, standardized protocol. However, key periprocedural aspects - such as preprocedural planning, patient evaluation, anesthetic technique, lavage protocol, and postprocedural care - remain essential to ensuring the safety and success of WLL.
Abnormal spirometry in individuals with a smoking history and no known obstructive lung disease: current understanding and clinical implications.
Tong K, Moll M, Wan ES
Curr Opin Pulm Med · 2025 Mar · PMID 39569648 · Publisher ↗
PURPOSE OF REVIEW: Recent recognition of the importance of abnormal spirometry without obstruction has generated interest in its epidemiology, risk factors, longitudinal outcomes, and clinical implications. RECENT FINDIN...
PURPOSE OF REVIEW: Recent recognition of the importance of abnormal spirometry without obstruction has generated interest in its epidemiology, risk factors, longitudinal outcomes, and clinical implications. RECENT FINDINGS: Preserved ratio impaired spirometry (PRISm), defined as an forced expiratory volume in 1 s (FEV 1 )/ forced vital capacity (FVC) ≥0.7 with an FEV 1 <80% predicted, has a high prevalence globally (2.4-16.7%) and is more common in individuals with metabolic comorbidities, smoking history, female sex, and higher BMI. PRISm is associated with increased respiratory symptoms and poor clinical outcomes such as increased all-cause mortality and cardiovascular events compared to normal spirometry. Longitudinal studies show substantial subsets of individuals with PRISm will transition to other spirometric categories, including progression to obstruction. Individuals with PRISm are heterogeneous; recent investigations have focused on subtyping PRISm based on spirometric features or pathobiologically-based phenotypes. SUMMARY: PRISm is a common spirometric abnormality which is robustly associated with negative outcomes. However, current knowledge gaps with respect to heterogeneity, specific etiologies, and longitudinal progression preclude the development of universal evidence-based diagnostic and management strategies. At present, clinicians are advised to focus on risk factor modification (e.g., diabetes, obesity) and the identification of actionable traits (e.g. emphysema, interstitial lung abnormalities) among patients with PRISm.
Impact of occupational exposures in patients with chronic obstructive pulmonary disease: current understanding and knowledge gaps.
Bongers Q, Comellas AP
Curr Opin Pulm Med · 2025 Mar · PMID 39564609 · Full text
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is thought of as a disease caused by tobacco exposure, but numerous occupational exposures have been identified as risk factors for development of disease a...
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is thought of as a disease caused by tobacco exposure, but numerous occupational exposures have been identified as risk factors for development of disease and exacerbations, although these remain underappreciated and underdiagnosed. We highlight evidence of occupational exposures and how they relate to COPD, while also looking at gaps in how the changing workplace might affect the occupational COPD landscape. RECENT FINDINGS: Historical exposures linked to COPD included inorganic dusts like coal and silica and organic dusts like cotton and wood. Other data associated agricultural exposures, cleaning agents, air pollution, and construction work with COPD. As the workplace has evolved to include more work from home and growing industries like ridesharing and delivery, items like radon and indoor and outdoor air quality must be factored into the equation as occupational exposures with the potential to cause COPD and increase its morbidity. Despite this, causal conclusions with many risk factors are challenging due to the complex interaction between patient susceptibilities and environmental factors, both occupation-related and nonoccupation related. SUMMARY: Additional studies are needed, not only to better evaluate occupational exposures and COPD pathogenesis, but also to look at more solution-oriented areas like precision medicine and interventions targeting a healthier workplace.
Competency-based medical education in interventional pulmonology: current state and future opportunities.
Hostetter LJ, Nelson DR
Curr Opin Pulm Med · 2025 Jan · PMID 39513972 · Publisher ↗
PURPOSE OF REVIEW: This chapter examines the evolution and current status of competency-based medical education (CBME) in interventional pulmonology, focusing on procedural skills assessment and training. RECENT FINDINGS...
PURPOSE OF REVIEW: This chapter examines the evolution and current status of competency-based medical education (CBME) in interventional pulmonology, focusing on procedural skills assessment and training. RECENT FINDINGS: Traditionally, interventional pulmonology training has used an apprenticeship model with case logs and director attestation, leading to inconsistent outcomes due to a lack of standardized curricula. CBME, established to address these issues, relies on outcome-based assessments to ensure trainees achieve necessary competencies. The chapter reviews various assessment tools, including global rating scales, checklists, and simulation-based methods, and their effectiveness in skill acquisition and clinical evaluation. It also covers specific procedures such as EBUS-TBNA, electromagnetic navigation bronchoscopy, and rigid bronchoscopy, discussing their assessment tools and learning curves. The chapter emphasizes the need for standardized assessment tools and suggests using entrustable professional activities (EPAs) to improve competency evaluation. Future directions include integrating real-time artificial intelligence feedback, addressing high-risk low-volume procedures, and enhancing workplace-based assessments to improve interventional pulmonology training and patient care quality. SUMMARY: This chapter reviews the transition from traditional apprenticeship models to CBME in interventional pulmonology, highlighting advancements in procedural skills assessment, the effectiveness of various assessment tools, and future directions for improving training and patient care.
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