Podcasts about Pneumonitis

Episode 359: Lung Cancer Screening, Early Detection, and Disparities “I was actually speaking to a primary care audience back a few weeks ago, and we were talking about lung cancer screening. And they said, ‘Our patients, they don't want to do it.' And I said, ‘Do you remind them that lung cancer is curable?' Because everybody thinks it is a death sentence. But when you're talking about screening a patient, I think it's really important to say, ‘Listen, if we find this early, stage I or stage II, our chances of curing this and it never coming back again is upwards of 60% to 70%,'” ONS member Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about lung cancer screening. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 18, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to lung cancer screening. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion Episode 247: Tobacco Treatment for Patients With Cancer ONS Voice articles: Lung Cancer Screening and Early Detection Drastically Improves Survival Rates Pack-Year History Is a Biased and Inadequate Criterion for Lung Cancer Screening Eligibility, Researchers Say CMS Expands Eligibility Criteria for Lung Cancer Screening With Low-Dose Computed Tomography Non-Small Cell Lung Cancer Prevention, Screening, Diagnosis, Treatment, Side Effects, and Survivorship Clinical Journal of Oncology Nursing articles: Nurse-Led Tobacco Cessation for Veterans Using Motivational Interviewing in a Lung Cancer Screening Program Identifying Primary Care Patients at High Risk for Lung Cancer: A Quality Improvement Study Oncology Nursing Forum article: Patient–Provider Discussion About Lung Cancer Screening Is Related to Smoking Quit Attempts in Smokers ONS Tobacco, E-Cigarettes, and Vaping Learning Library American Cancer Society Lung Cancer Screening Guidelines American Lung Association lung cancer resources To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Unfortunately, the current state of lung cancer screening is pretty low. Our rate of uptake in eligible patients is somewhere between 6% and 20%. And that falls much further below what we see for screening, such as breast cancer screening, prostate cancer screening, and colorectal cancer screening. So certainly, we can do better.” TS 1:32 “If you quit more than 15 or 20 years, your risk of developing lung cancer at that point is significantly lower. And so that's why once patients have quit more than 15 years, they're actually not eligible for screening anymore—because their risk of developing lung cancer is dramatically reduced. And that takes into account when you are a primary care provider, pulmonary, whatever field you work in, and you are running a screening clinic each year that you screen the patient, you have to remind yourself when they quit smoking, because once they reach that 15 years, then they're no longer eligible for screening.” TS 5:17 “One of the strategies that they've used to get the word out is, I watch a lot of baseball. I love the Philadelphia Phillies, watch Phillies games. And so at least once a year, maybe even twice a year, they will take an inning of the baseball broadcast on TV and on the radio separately, and they will bring on either an oncologist or pulmonologist from one of the local cancer centers in our area, and the whole inning—between batters of course—they will talk about lung cancer screening and why it's beneficial.” TS 13:16 “Medicare always has its idiosyncrasies. So Medicare—I went over the rules with you, so the age, the smoking. They follow all of it, except they have a slight difference in age. They cover it for age 50 to 77, as opposed to 80.” TS 16:52 “I think just the other thing that people don't think about is that to go get a medical test done, no matter what test it is, typically people have to take time off of work. And it can be really hard to do that when you are relying on your job, maybe you don't have vacation time, maybe you have children at home that you need to get home to. When people are weighing the risk/benefit and thinking, ‘Well, I'd love to get screened for lung cancer, but I just can't find time to fit it into my schedule, and my job won't let me take off.' These are all things that we don't always think about if you have the luxury of just taking the day off.” TS 20:01

Welcome to our second episode of the Early Clinical Learners Series - a series dedicated towards fostering clinical reasoning skills and strategies in early clinical learners! In this episode, hosts Caroline Wang, Dr. Kevin Grudzinski, and Samantha Shih guide M1 students Kenny Pham and Naomi Bennett through a classic Alert and Oriented case discussing a farmer's cough. Next, our hosts share clinical pearls and strategies regarding pulmonary diagnostic workups and pulmonary function tests. Hosts: Caroline Wang, Dr. Kevin Grudzinski, Samantha ShihGuests: Kenny Pham, Naomi BennettProduced By: Caroline WangAlert & Oriented is a medical student-run clinical reasoning podcast dedicated to providing a unique platform for early learners to practice their skills as a team in real time. Through our podcast, we strive to foster a learning environment where medical students can engage with one another, share knowledge, and gain valuable experience in clinical reasoning. We aim to provide a comprehensive and supportive platform for early learners to develop their clinical reasoning skills, build confidence in their craft, and become the best clinicians they can be.Follow the team on Twitter:A&OA fantastic resource, by learners, for learners in Internal Medicine, Family Medicine, Pediatrics, Primary Care, Emergency Medicine, and Hospital Medicine.

This recording features audio versions of February 2025 Journal of Vascular and Interventional Radiology (JVIR) abstracts:Radiation Pneumonitis after Yttrium-90 Radioembolization: A Systematic Review ReadComparison of Covered Stent versus Bare-Metal Stent Implantation in Aortoiliac Occlusive Disease: A Systematic Review and Meta-Analysis ReadThirty-Day Healthcare Encounters after Elective Uterine Artery Embolization for Fibroids with and without Superior Hypogastric Nerve Block ReadIncluding the Hollow Viscera (Stomach or Bowel) within the Ice Ball during Cryoablation: A Review of Adverse Events ReadOutcomes of Transarterial Embolization in Patients with Isolated Pelvic Fractures: A Japanese Nationwide Study Focused on Shock Status and Age ReadTransarterial Embolization Using an Inorganic Phosphate Binder Modulates Immunity- and Angiogenesis-Related Factors in a Rat Model of Liver Cancer ReadMicroembolization Effects of Imipenem/Cilastatin In Vivo Depicted by Monochromatic Synchrotron X-Ray Microangiography ReadJVIR and SIR thank all those who helped record this episode. To sign up to help with future episodes, please contact our outreach coordinator at millennie.chen.jvir@gmail.com.  Host:Manbir Singh Sandhu, University of California Riverside School of MedicineAudio editor:Sonya Choe, University of California Riverside School of MedicineOutreach coordinator:Millennie Chen, University of California Riverside School of MedicineAbstract readers:Daniel Roh, Loma Linda University School of MedicineDave Enriquez, University of California Riverside School of MedicineGavin Shu, University of California San Francisco School of MedicineRyan Nolan, University of Nevada Reno School of MedicineMark Oliinik, Loma Linda University School of MedicineManbir Singh Sandhu, University of California Riverside School of MedicineGrace Kloss, University of California San Francisco School of MedicineSIR thanks BD for its generous support of the Kinked Wire.Contact us with your ideas and questions, or read more about about interventional radiology in IR Quarterly magazine or SIR's Patient Center.(c) Society of Interventional Radiology.Support the show

“CDK4/6 inhibition is considered to be a milestone in the realm of targeted breast cancer therapy. The combination of CDK4/6 inhibitors with the endocrine therapy has really emerged as the foremost therapeutic modality for patients diagnosed with hormone receptor–positive, HER2-negative, advanced breast cancer,” ONS member Teresa Knoop, MSN, RN, AOCN®-emeritus, independent nurse consultant in Nashville, TN, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during the latest episode in our series about anticancer drug classes. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 18, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to CDK inhibitors. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast™ episodes: Pharmacology 101 series Episode 329: Pharmacology 101: BRAF Inhibitors Episode 313: Cancer Symptom Management Basics: Other Pulmonary Complications Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion Episode 80: Patients Need Checkpoint Inhibitor Education Episode 5: New Guidelines for Managing Immunotherapy-Related Adverse Events ONS Voice articles: Combination CDK4/6 and Fulvestrant Has Survival Benefits in Late-Stage Breast Cancer FDA Approves Inavolisib With Palbociclib and Fulvestrant for Endocrine-Resistant, PIK3CA-Variant, HR-Positive, HER2-Negative, Advanced Breast Cancer FDA Approves Ribociclib With an Aromatase Inhibitor and Ribociclib and Letrozole Co-Pack for Early High-Risk Breast Cancer FDA Expands Early Breast Cancer Indication for Abemaciclib With Endocrine Therapy FDA Warns of Rare Lung Inflammation With Certain CDK4/6 Inhibitors Manage Immunotherapy-Related Diarrhea and Colitis Oncology Drug Reference Sheet: Ribociclib The Case of the CTCAE Assessment for CDK4/6 Adverse Events ONS book: Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition) Clinical Journal of Oncology Nursing article: Targeted Therapies: Treatment Options for Patients With Metastatic Breast Cancer ONS Symptom Intervention: Prevention of Infection: General  ONS Breast Cancer Learning Library ONS CDK4/6 Administration Checklist ONS Oral Anticancer Medication Toolkit  Breastcancer.org Susan G. Komen: CDK4/6 Inhibitors Ibrance® (palbociclib) patient site Kisqali® (ribociclib) patient site Verzenio® (abemaciclib) patient site To discuss the information in this episode with other oncology nurses, visit the ONS Communities.  To find resources for creating an Oncology Nursing Podcast club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Common toxicity among this class of agents are things like nausea/vomiting, diarrhea, fatigue. All three are associated with low white blood cell counts, which we know as neutropenia, which can cause an increased risk of infection.” TS 10:46 “All three of these CDK4/6 inhibitors are pills taken by mouth, and in most cases they're all given along with endocrine therapy treatments. So, patients will be taking more than one drug. Teach patients how they will take their medication. And the frequency among the three drugs may vary.” TS 13:33 “Patients and caregivers need to know the time of day to take the pills, whether they need to be taken with or without food, or what to do if they miss a dose. We need to help them with a system for organizing the medications. They may find it helpful to use a pill organizer or set reminders on their smartphone, their smartwatch, their computer.” TS 14:29  “Pharmacy and nursing, in my experience, collaborate greatly by determining those drug–drug and drug–food interactions. It is so crucial in determining those interactions and educating our patients because we have to remind patients at each appointment and review these drugs and foods and other things they may be taking, at each appointment. And that often can be done by either pharmacists or nurses or both in collaboration.” TS 23:29 “This class of drug is generally well-tolerated, and I do want nurses to know that that we can help patients with these side effects. And they are generally well-tolerated with appropriate management.” TS 30:55 

rWotD Episode 2598: Hypersensitivity pneumonitis Welcome to random Wiki of the Day where we read the summary of a random Wikipedia page every day.The random article for Friday, 14 June 2024 is Hypersensitivity pneumonitis.Hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis (EAA) is a syndrome caused by the repetitive inhalation of antigens from the environment in susceptible or sensitized people. Common antigens include molds, bacteria, bird droppings, bird feathers, agricultural dusts, bioaerosols and chemicals from paints or plastics. People affected by this type of lung inflammation (pneumonitis) are commonly exposed to the antigens by their occupations, hobbies, the environment and animals. The inhaled antigens produce a hypersensitivity immune reaction causing inflammation of the airspaces (alveoli) and small airways (bronchioles) within the lung. Hypersensitivity pneumonitis may eventually lead to interstitial lung disease.This recording reflects the Wikipedia text as of 01:06 UTC on Friday, 14 June 2024.For the full current version of the article, see Hypersensitivity pneumonitis on Wikipedia.This podcast uses content from Wikipedia under the Creative Commons Attribution-ShareAlike License.Visit our archives at wikioftheday.com and subscribe to stay updated on new episodes.Follow us on Mastodon at @wikioftheday@masto.ai.Also check out Curmudgeon's Corner, a current events podcast.Until next time, I'm Matthew Standard.

“Of all the eight different pulmonary toxicities you and I have talked about over these two different podcasts, they're all very different etiologies and treatments. So, we went everywhere from infection and good stewardship with antibiotics to pulmonary GVHD to diffuse alveolar hemorrhage. And I think that's what's the hardest part for us as nurses. It's not just one thing that's causing it, and there's multiple different ways to treat these things,” Beth Sandy, MSN, CRNP, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about pulmonary toxicities in cancer treatment. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by May 24, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to pulmonary complications in people with cancer. Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast episodes: Episode 295: Cancer Symptom Management Basics: Pulmonary Embolism, Pneumonitis, and Pleural Effusion Episode 212: When Cancer Care Gets Complex: Those Other Oncologic Emergencies Episode 206: Graft-Versus-Host Disease: Biomarkers and Beyond Oncologic Emergencies 101 series ONS Voice articles: Pneumonitis With Immunotherapy Treatment The Case of the Post-Transplant Pulmonary Problem How Inhaled Cannabis May Contribute to Pulmonary Toxicity in Patients With Cancer ONS courses: Essentials in Oncologic Emergencies for the Advanced Practice Provider Oncologic Emergencies Treatment and Symptom Management—Oncology RN ONS books: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition) Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition) Clinical Journal of Oncology Nursing article: Influenza Adherence Tool Kit: Implementation and Evaluation Among Allogeneic Hematopoietic Transplantation Recipients Oncology Nursing Forum articles: Community Respiratory Virus Infection in Hematopoietic Stem Cell Transplantation Recipients and Household Member Characteristics Emergence of Stereotactic Body Radiation Therapy Multifactorial Model of Dyspnea in Patients With Cancer ONS Huddle Cards: Hematopoietic Stem Cell Transplantation Proton therapy Radiation Sepsis ONS Guidelines™ and Symptom Interventions: Dyspnea American Cancer Society patient resources: Shortness of Breath Infections in People With Cancer American Lung Association To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “[Intensity-modulated radiation therapy] is a type of radiation that can really take into account certain movements. And this is particularly important with the lungs, because we can't necessarily have patients hold their breath for a long period of time, so the chest rises and falls and the heart beats while you're trying to do radiation to the lungs. So with IMRT, they can simulate that, so that the beam is going to follow that specific movement in that patient. That's really helpful because then, hopefully, we're going to keep that radiation dose mostly on cancer tissue and not on healthy tissue. And thus, that should reduce the amount of radiation that's to the healthy tissue and hopefully reduce pneumonitis.” TS 3:44 “Proton beam radiation is something that we've described in the past as radiation that will typically have an entrance dose but not an exit dose, so minimizing toxicity by hopefully around 50%. … If you're doing proton beam therapy, that radiation is designed to only have an entrance dose from either the back or the front or the side, whichever way they're going, but then hopefully stop on a dime at that tumor so that they're only really getting the entrance dose of that radiation. … So in turn, especially if you're doing that to the lungs, that should minimize dose of radiation to healthy lung tissue.” TS 5:03 “If they're having a fever, low blood count, thick ugly mucus, this often, typically can be infection as well. And then get a chest x-ray because, a lot of times I've been saying for a lot of these things, we need a CT scan to see this. Actually, infection is probably best noted on a chest x-ray because this is something that will consolidate.” TS 18:58 “[Tumors] may be directly invading a vessel. They may directly be invading the bronchus where there's a lot of capillaries or there's a lot of blood vessels that can break and then cause them to cough up blood. You can have tumors or prior treatment that then cause a bronchial fistula that then can cause bleeding. Patients with squamous cell carcinoma of the lung are much more likely to have hemoptysis and pulmonary hemorrhage than patients with adenocarcinoma, though it definitely can happen with adenocarcinoma as well.” TS 22:00 “One of the best treatments for tumor-direct hemorrhage is radiation. This is where radiation can be very helpful for these patients. It's one of the first things that we do. We're going to go in with radiation, shrink that tumor really fast to get it away from those vessels, so patients stop bleeding.” TS 27:17

CME credits: 1.00 Valid until: 15-05-2025 Claim your CME credit at https://reachmd.com/programs/cme/differentiating-and-managing-pneumonitis-in-unresectable-stage-iii-nsclc-case-discussion/24393/ In this video series, learners will explore best practices for the use of immunotherapies in unresectable stage III NSCLC, including staging, determining resectability, applying clinical data, and managing toxicities.

Editor-in-Chief, Robert Amdur, MD, discusses a paper from the March 2024 issue of PRO: “Dose-Volume Predictors of Radiation Pneumonitis After Thoracic Hypofractionated Radiation Therapy” (Volume 14 Issue 2, PMID 37984711). This paper suggests V5, V20, and Mean Lung Dose values to minimize grade ≥2 pneumonitis when treating lung cancer with the moderate hypofractionation programs of 60 or 72 Gy at 4 Gy per treatment. The values they propose are lower than those stated in consensus group guidelines.

Case records of the New Decatur Clinic: Amiodarone-induced interstitial pneumonitis. References: Amiodarone Wikipedia Page Borghi C, Cicero AF, Agnoletti D, Fiorini G. Pathophysiology of cough with angiotensin-converting enzyme inhibitors: How to explain within-class differences? Eur J Intern Med. 2023 Apr;110:10-15. doi: 10.1016/j.ejim.2023.01.005. Epub 2023 Jan 8. PMID: 36628825. Clarke B, Ward DE, Honey M. Pneumonitis with pleural and pericardial effusion and neuropathy during amiodarone therapy. Int J Cardiol. 1985 May;8(1):81-8. doi: 10.1016/0167-5273(85)90266-9. PMID: 3997294. UpToDate Article: Chan, ED, & Talmadge, EK, Jr. Amiodarone pulmonary toxicity.

  “So much of this is just knowing what is their diagnosis, what medications are they on, what could be the root cause of this—where is their disease to begin with? There's really a lot of differential diagnosis and workup that has to be thought about, you know, when you're dealing with shortness of breath and pulmonary toxicities,” Beth Sandy, MSN, CRNP, OCN®, thoracic medical oncology nurse practitioner at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about just a few of the pulmonary toxicities oncology nurses may encounter in patients receiving pharmaceutical cancer treatments. This episode is part of a series on cancer symptom management basics; the rest are linked below.  You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD), which may be applied to the nursing practice, oncology nursing practice, symptom management, palliative care, supportive care, or treatment.ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by January 19, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: The learner will report an increase in knowledge of pulmonary complications from cancer treatment.   Episode Notes  Complete this evaluation for free NCPD.   Oncology Nursing Podcast Cancer Symptom Management Basics series  ONS Voice articles: Pneumonitis With Immunotherapy Treatment Hematologic Cancers Have Higher Long-Term Risk of Clots and Bleeding  Clinical Journal of Oncology Nursing articles: Durvalumab Immunotherapy: Nursing Management of Immune-Related Adverse Events During the Journey of Patients With Stage III Non-Small Cell Lung Cancer Heart and Lung Complications: Assessment and Prevention of Venous Thromboembolism and Cardiovascular Disease in Patients With Multiple Myeloma Chronic Obstructive Pulmonary Disease: Clinical Implications for Patients With Lung Cancer  Oncology Nursing Forum article: Multifactorial Model of Dyspnea in Patients With Cancer  ONS book: Understanding and Managing Oncologic Emergencies: A Resource for Nurses (third edition)  ONS Symptom Interventions and Guidelines™: Dyspnea  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.    To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From Today's Episode  “Your lungs are what is needed to have the gas exchange within your bloodstream. So, when we inhale, we're inhaling oxygen, and we need that gas exchange to occur in the alveoli, which are the tiny, little bubble-like structures within the periphery of the lungs. And they're communicating with tiny, itty-bitty little blood vessels. And that's where the gas exchange occurs, where you get rid of the carbon dioxide from the blood and you get oxygen to the blood. And what ends up happening is there is, for whatever reason it may be, that gas exchange can't occur, and that can result in so many different forms from different toxicities, whether there's an inflammation causing the alveoli not to work correctly, whether there's an obstruction where there's literally something obstructing the air getting into the lungs, or whether there's compression from an external source like a fusion or something like that that is pressing against the lungs where that gas exchange cannot occur.” TS 2:36  “Pulmonary embolism, I'll tell you, is one of the most common things that we see in cancer. As a matter of fact, often patients are diagnosed with cancer because they present with a pulmonary embolism into the E.R. (emergency room) and there's really not a lot of reasons why healthy-otherwise patients develop a PE [pulmonary embolism]. So, we start looking for cancer. So, just having cancer in general puts you in that hypercoagulable state. . . . And then, being on chemotherapy increases that risk.” TS 6:38  “I think we need to really make sure that they're compliant. We need to make sure they're not having bleeding. Are you having significant bruising anywhere? Are you having unprovoked nosebleeds? And by that, I mean, I always tell people, ‘Were you just sitting watching TV and it started dripping?' versus, ‘Oh, I blew my nose and some blood came out.' Okay, well, that is probably pretty common side effect of this and should stop quickly.” TS 12:06  “The problem is the majority of these patients have metastatic disease or an incurable cancer. So, we prefer not to stop it [PE medication] in those patients because if you think about it, their risk comes from the cancer. And we're not getting rid of that if they have metastatic disease. I think for those patients with metastatic disease, as long as they're tolerating it, they're not having bleeding events, we will typically tend to just keep them on it.” TS 13:09  “The main difference with the targeted therapies is it tends to be worse, and it's not something that you can rechallenge. And I think that's kind of one of the most important things to think about here. In immunotherapy, it's like, okay, it's T-cell mediated; we gave you corticosteroids; it calmed itself down. And a lot of times we can rechallenge, and we don't necessarily see it again. Whereas with targeted therapies, you have to be much more cautious. If you look at the package inserts for the EGFR and ALK inhibitors, most of them are going to tell you this is not something you ever rechallenge. Any kind of symptomatic pneumonitis, you're going to permanently discontinue the drug. Because if you give it again, it's going to recur in a pretty bad way, where corticosteroids may not even be helpful again even if you rechallenge them.” TS 17:52  “What can happen in cancer, typically, thoracic cancers—so lung cancer, mesothelioma for sure, thymic cancers like thymomas and thymic carcinomas—often will have pleural effusion or pleural disease as well. But when cancer cells get into that fluid, there's irritation which causes an increase in the amount of fluid there. And then what happens is when that space, that pleural space, is now enlarged with fluid or engorged with fluid, a few things occur here. Patients are short of breath because it's a pressure gradient there. So, you're trying to inhale against this fluid-filled cavity that's making it hard. So, often patients will describe it as it feels like someone's giving you a really tight hug and they won't stop.” TS 21:59  “There is another procedure called a talc pleurodesis, where you can have a procedure where you inject some powder in there that will kind of dry it up. The downside of that is that it kind of fuses the pleura to the lung, so there can be some complications there, some pain, and decreased lung function just from doing that, but it can be an easy fix that you certainly don't want to have an indwelling catheter there.” TS 25:11  “So, patients need to know, if they are short of breath at all, call us; let us know. The other thing that's important is know with their baseline vital signs are, especially their pulse ox. You know, some people, their pulse oximetry may be in the low 90s or upper 80s at baseline. We need to know that because there's a big difference if a patient has, you know, they're living at 99% versus 91% normally. Because if they come in and they live at 99 and they're 91, that's a huge drop. But if they come in and they were 91 to begin with and they're 90, that's not a big difference. So, we really do need to make sure we know what their baseline is before they're starting any treatments.” TS 29:18  “This is not something that you want to downplay. You can't sit there and say, you know, ‘Oh, they smoke a lot, so it's probably that.' Or, ‘They have this type of cancer, so it's probably that.' I think this is something that you have to take shortness of breath seriously, and you have to work up and understand and know your patient. But for the most part, this is not something you're going to just triage to the next day or to a few days later. You're going to need some kind of urgent intervention or workup to be done pretty quickly.” TS 32:54  “I think the biggest misconception is that they can't be treated even if they're severe. Most of these things can be reversed. Part of it is just diagnosing it at first and then going from there and starting the appropriate treatment strategy.” TS 33:29 

Hypersensitivity pneumonitis (HP) is an interstitial lung disease caused by an allergic reaction to organic environmental antigens, such as mold or bird feathers. Kevin Dsouza, MD, a pulmonologist, discusses the complex diagnosis and management of HP: how specialists distinguish HP from other diseases by analyzing acute symptoms, patient histories, and CT scans; how cases of fibrotic and nonfibrotic HP are treated differently; and how physicians can help patients to identify and prevent exposure to the culprit antigen.

This episode of OncoSnacks kicks off Michael and Josh's sojourn into the wide world of immune-mediated adverse effects. Inevitably, as most blowhards do, they begin with the lungs. Immune-mediated pneumonitis is not as common as endocrine-axis abnormalities, dermatitis or colitis, but it can be insidious and devastating in equal measure. Such is the potential impact that must be considered in any patient who has received immunotherapy and presents with dyspnoea or a dry cough. Listen to learn more, and you will also know what irAEs and Senator Joseph McCarthy have in common.Guidelines for the management of Immune-Mediated Pneumonitis are available at:https://www.frontiersin.org/articles/10.3389/fonc.2020.01785/full#:~:text=will%20be%20discussed.-,Incidence%20and%20Risk%20Factors,due%20to%20pneumonitis%20(6)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7161534/https://www.eviq.org.au/clinical-resources/side-effect-and-toxicity-management/immunological/1993-management-of-immune-related-adverse-eventsFor more episodes, resources and blog posts, visit www.inquisitiveonc.comFind us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of:- Music Unlimited: https://pixabay.com/users/music_unlimited-27600023/- SoulProdMusic: https://pixabay.com/users/soulprodmusic-30064790/Note: This podcast is for educational purposes only. If you are unwell, seek medical advice Hosted on Acast. See acast.com/privacy for more information.

Ang kristiyano nga ba ay ginagawa ang matuwid

Ang kristiyano nga ba ay ginagawa ang matuwid

CME credits: 1.00 Valid until: 20-12-2022 Claim your CME credit at https://reachmd.com/programs/cme/identifying-and-managing-cancer-therapy-induced-interstitial-lung-disease-ild-and-pneumonitis/12929/ Interstitial lung disease (ILD) is a heterogeneous group of diseases that produce inflammation and fibrosis of the parenchyma, affecting the alveolar, interstitial, and vascular spaces. Drug-induced (DI) ILD is associated with a range of novel targeted therapies for the treatment of multiple cancer types, including immune checkpoint inhibitors, CDK 4/6 inhibitors, EGFR tyrosine kinase inhibitors, HER2 targeted therapies, and mechanistic target of rapamycin inhibitors. Although management of low-grade or asymptomatic ILD with corticosteroid treatment and/or treatment interruption may slow or reverse ILD progression, higher-grade/symptomatic ILD requires permanent discontinuation of therapy. Therefore, it is critical that the interprofessional care team is prepared to monitor for and detect anti-cancer therapy–induced ILD. This educational activity will review the latest evidence and strategies for the early detection of medication-induced ILD and pneumonitis and appropriate management strategies to overcome these treatment challenges in patients who receive select anti-cancer therapies. Expert thought leaders will present relevant information about cancer therapy–induced ILD and pneumonitis and how to integrate the latest advances into real-world clinical practice regarding differential diagnosis, hallmark signs/symptoms, recommended management strategies, implications of patient/caregiver education, and the essentials of team-based management to optimize patient outcomes.

CME credits: 1.00 Valid until: 20-12-2022 Claim your CME credit at https://reachmd.com/programs/cme/identifying-and-managing-cancer-therapy-induced-interstitial-lung-disease-ild-and-pneumonitis/12929/ Interstitial lung disease (ILD) is a heterogeneous group of diseases that produce inflammation and fibrosis of the parenchyma, affecting the alveolar, interstitial, and vascular spaces. Drug-induced (DI) ILD is associated with a range of novel targeted therapies for the treatment of multiple cancer types, including immune checkpoint inhibitors, CDK 4/6 inhibitors, EGFR tyrosine kinase inhibitors, HER2 targeted therapies, and mechanistic target of rapamycin inhibitors. Although management of low-grade or asymptomatic ILD with corticosteroid treatment and/or treatment interruption may slow or reverse ILD progression, higher-grade/symptomatic ILD requires permanent discontinuation of therapy. Therefore, it is critical that the interprofessional care team is prepared to monitor for and detect anti-cancer therapy–induced ILD. This educational activity will review the latest evidence and strategies for the early detection of medication-induced ILD and pneumonitis and appropriate management strategies to overcome these treatment challenges in patients who receive select anti-cancer therapies. Expert thought leaders will present relevant information about cancer therapy–induced ILD and pneumonitis and how to integrate the latest advances into real-world clinical practice regarding differential diagnosis, hallmark signs/symptoms, recommended management strategies, implications of patient/caregiver education, and the essentials of team-based management to optimize patient outcomes.

In this podcast episode, Julie Brahmer, MD, MSc, and Jarushka Naidoo, MB BCH BAO, MHS, answer audience questions from a live CCO webinar on evolving immunotherapy strategies for NSCLC, with topics including:Patient and/or disease-related factors considered when choosing first-line immunotherapy-based regimensSecond-line therapeutic options after disease progression on an immunotherapy-based regimenImmunotherapy in patients with advanced NSCLC and brain metastasesDistinguishing between immunotherapy-induced and radiation-induced pneumonitis, with expert perspective on rebiopsyFuture directions in immunotherapy for NSCLC, including the role of the gut microbiome in responsePresenters:Julie Brahmer, MD, MScProfessor of OncologyDirector, Thoracic OncologyCo-Director, Upper Aerodigestive Cancer ProgramBloomberg-Kimmel Institute for Cancer ImmunologySidney Kimmel Comprehensive Cancer CenterJohns Hopkins MedicineBaltimore, MarylandJarushka Naidoo, MB BCH BAO, MHSConsultant Medical OncologistBeaumont Hospital/RCSI University of Health SciencesDublin, IrelandAdjunct Assistant Professor of OncologySidney Kimmel Comprehensive Cancer CenterJohns Hopkins UniversityBaltimore, MarylandContent based on an online CME program supported by educational grants from Bristol-Myers Squibb; Genentech, a member of the Roche Group; Helsinn Healthcare SA; and Merck Sharp & Dohme Corp.Link to full program:https://bit.ly/3CLC0Hd

Pneumonitis is a serious treatment-related side effect of both radiation, immunotherapy and some chemotherapies. This episode of MesoTV includes discussion on diagnosis, treatment and the dilemma facing both patients and doctors while making decisions on how to approach mesothelioma specific therapy during and post treatment for this condition. Dr. Daniel Sterman is a member of the Board of Directors at the Mesothelioma Applied Research Foundation. He is also Director of Pulmonary, Critical Care and Sleep Medicine at NYU Langone Medical Center. More information about MesoTV is available at www.curemeso.org/mesotv. More information about the Mesothelioma Applied Research Foundation can be found at www.curemeso.org.

CHEST August 2021, Volume 160, Issue 2 Evans R. Fernandez Perez, MD, FCCP, joins CHEST Podcast Moderator, Gretchen Winter, MD, to discuss CHEST Guidelines for diagnosing and evaluating hypersensitivity pneumonitis. DOI: https://doi.org/10.1016/j.chest.2021.03.066

Time for a respirology "ask a fellow"! In this episode we go through this niche respiratory diagnosis and cover the new 2020 ATS hypersensitivity pneumonitis guidelines. Written by Dr. Dan Gillet (Respirology Fellow) and Dr. Jennifer D'Cruz (Internal Medicine Resident). Reviewed by Dr. Cory Yamashita (Respirology) 

Expert interventional pulmonologists and medical oncologists discuss the management of malignant pleural effusion, airway obstruction, and immune-related pneumonitis during the COVID-19 pandemic. The panelists review the literature on these topics and share their own personal and institutional experiences. (Originally recorded June 10, 2021) Moderator: Septimiu Murgu, MD, FCCP. Panelists: Mary Jo Fidler, MD; David Feller-Kopman, MD, FCCP; and Eric Edell, MD, FCCP. For more tools to help in the fight against COVID-19, visit CHEST's COVID-19 Resource Center at chestnet.org/COVID19. 

Join our hosts Dr. Afreen Shariff and Dr. Tian Zhang as they discuss with guest expert and Oncologist, Dr. Jarushka Naidoo about the complex and challenging diagnosis of Immune mediated Pneumonitis. Dr. Jarushka Naidoo is currently a thoracic oncologist at Beaumont Hospital, Royal College of Surgeons of Ireland and she is also the national lead for lung cancer for Cancer Trials Ireland, and serves as an adjunct professor at Johns Hopkins University. She also serves on the NCCN guidelines committee for the management of immune-related toxicity, and runs an institutional multidisciplinary team for immune toxicity management.

In this week's episode, we are back with Megan's pick of poison! This is the story of our uptown girl, Brittany Murphy, and the murky details surrounding her untimely passing. This poison doesn't hit you right away, it slowly grows around you, unseen, but everywhere at the same time. Washing your hands won't save you this time...  If you liked this episode please rate, review and subscribe! Follow us on Instagram: @thatshitispoison Email us your homegrown poison stories at thatshitispoison@gmail.com See omnystudio.com/listener for privacy information.

Listen as Dr. London Smith (.com) and his producer Cameron discuss Radiation Pneumonitis with special guest Klompy the Elf (Cassie Walker). Not so boring! https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Guest: Cassie Walker. Produced by: Dylan Walker Created by: London Smith

Listen as Dr. London Smith (.com) and his producer Cameron discuss Cryptogenic Organizing Pneumonitis with special guest First Airman Lloyd Kapicky (Ezra Parter of Apocalypse Tips With Lester Pipps). Not so boring! https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark. Guest: Ezra Parter. Produced by: Dylan Walker Created by: London Smith

Listen as Dr. London Smith (.com) and his producer Cameron discuss Hypersensitivity Pneumonitis with special guest Sammy. Not so boring! https://www.patreon.com/join/jockdocpodcast Hosts: London Smith, Cameron Clark Guest: Laura Weeks. Produced by: Dylan Walker Created by: London Smith

In this episode, Edward S. Kim, MD, FACP, and Leora Horn, MD, MSc, FRCPC, answer questions focused on current and evolving biomarkers for immune checkpoint inhibitor–based therapies in advanced non-small-cell lung cancer with topics including:Selecting therapy for advanced NSCLC without actionable mutations and with different levels of PD-L1 expressionChoosing therapy for advanced NSCLC with an actionable mutation on NGS and high PD-L1 expressionLeveraging key data from CheckMate 9LA to identify patients who may benefit from chemotherapy plus nivolumab/ipilimumabSTK11/KEAP1 as potential predictors for a lack of response to immune checkpoint inhibitor–based therapyTreatment for NSCLC after progression on chemotherapy plus an immune checkpoint inhibitorRechallenging after stopping immune checkpoint inhibitor due to immune-related adverse eventsPresenters:Edward S. Kim, MD, FACPChair, Solid Tumor Oncology and Investigational TherapeuticsDonald S. Kim Distinguished Chair for Cancer ResearchLevine Cancer InstituteAtrium HealthCharlotte, North CarolinaLeora Horn, MD, MSc, FRCPCIngram Associate Professor of Cancer ResearchDirector, Thoracic Oncology Research ProgramAssistant Vice Chairman for Faculty DevelopmentVanderbilt Ingram Cancer CenterNashville, TennesseeContent based on an online CME program supported by an educational grant from Lilly.Link to full program, including associated downloadable slidesets: https://bit.ly/3a3e1Xs

Biomarker Assessment and Targeted Treatment of Nonsquamous Non-Small Cell Lung Cancer — A roundtable discussion with clinical investigators Drs Justin F Gainor, Matthew Gubens, Geoffrey R Oxnard and Heather Wakelee and general medical oncologists Drs Isaac Levy and Estelamari Rodriguez regarding biomarker analysis and related treatment decision-making for patients with non-small cell lung cancer. Biomarker testing and therapeutic decision-making for patients with non-small cell lung cancer (NSCLC) (00:00) Case: A woman in her late 80s, a never smoker, is diagnosed with metastatic adenocarcinoma of the lung with an EGFR exon 21 L858R mutation (01:56) Therapeutic approach for patients with NSCLC and EGFR tumor mutations (04:14) Results of the Phase III FLAURA trial evaluating osimertinib versus gefitinib or erlotinib for untreated advanced NSCLC with EGFR tumor mutations (06:08) Pneumonitis and cardiotoxicity associated with osimertinib in patients with NSCLC (09:56) Second-line therapy for patients after disease progression on osimertinib (13:25) Efficacy and tolerability of immune checkpoint inhibitors in patients with NSCLC harboring an actionable genomic alteration (17:08) Resistance mutations in patients who experience disease progression on osimertinib (18:58) Genomic profiling for patients with metastatic nonsquamous NSCLC; optimal testing platforms (24:38) Evaluation of biomarkers in patients with squamous cell carcinoma of the lung (28:54) Targeting KRAS G12C and MET exon 14 splice mutations  (31:39) Case: A woman in her mid-50s who presents with cough, dyspnea and respiratory distress is diagnosed with metastatic adenocarcinoma of the lung with an EGFR exon 21 L858R mutation (36:15) Considerations for switching to an EGFR tyrosine kinase inhibitor (TKI) in a symptomatic patient initially started on chemotherapy prior to the identification of an EGFR tumor mutation (38:18) Role of liquid biopsy in monitoring patients who are receiving EGFR TKI therapy (40:56) Activity of immune checkpoint inhibitors in patients with NSCLC and targetable genomic alterations (44:35) Results of the IMpower150 and IMpower130 trials of atezolizumab with bevacizumab/chemotherapy and atezolizumab with chemotherapy, respectively, as first-line treatment for metastatic nonsquamous NSCLC (47:32) Immune checkpoint inhibitors for patients with advanced lung cancer with oncogenic driver alterations: Results from the IMMUNOTARGET registry (50:37) Toxicities associated with the use of targeted therapy after immunotherapy in patients with NSCLC; risk of pneumonitis with durvalumab and osimertinib (53:33) Increased hepatotoxicity associated with sequential immune checkpoint inhibitor and crizotinib therapy for patients with NSCLC (56:20) Therapeutic approach for patients with locally advanced NSCLC with EGFR tumor mutations who experience disease relapse after treatment with durvalumab (59:10) Cardiac toxicity associated with immune checkpoint inhibitors (1:03:56) Monitoring for and management of the cardiac side effects of immune checkpoint inhibitors (1:06:52) Case: A man in his late 70s with adenocarcinoma of the lung and brain metastases is found through next-generation sequencing to have an EGFR exon 21 L858R mutation, HER2 amplification and high PD-L1 expression (1:09:58) Use of liquid biopsy to detect genomic alterations in patients with NSCLC (1:11:22) FGFR alterations in patients with NSCLC (1:14:42) Targeting HER2 alterations in patients with lung cancer (1:16:27) Efficacy of EGFR TKIs in patients with lung cancer and CNS metastases; sequencing stereotactic radiosurgery and EGFR TKIs (1:18:22) Diagnosis and management of radiation necrosis in patients with lung cancer (1:22:26) Preservation of neurocognitive function during whole-brain radiation therapy with hippocampal sparing for patients with NSCLC and brain metastases (1:25:33) Case: A woman in her early 80s with adenocarcinoma of the lung with an EGFR exon 21 L858R mutation and metastases to the brain receives osimertinib as first-line therapy (1:27:11) Activity of EGFR TKIs in patients with brain metastases; CNS penetration and dosing of osimertinib (1:30:59) Results of the BLOOM study evaluating osimertinib for patients with leptomeningeal metastases from NSCLC with EGFR tumor mutations (1:34:34) Targeting EGFR exon 20 insertions with TAK-788 and poziotinib (1:36:12) Results of the Phase III ALEX study evaluating alectinib and the Phase III ALTA-1L study investigating brigatinib for patients with advanced NSCLC and ALK rearrangements (1:39:36) Sequencing ALK inhibitors for patients with NSCLC with ALK rearrangements (1:42:08) Tolerability of brigatinib, alectinib, ceritinib and lorlatinib in patients with NSCLC with ALK rearrangements (1:45:41) Emerging data with targeted therapies for patients with NSCLC in the (neo)adjuvant setting (1:50:16) Ongoing (neo)adjuvant trials of targeted therapies for patients with locally advanced NSCLC (1:52:38) Perspective on emerging data from studies evaluating adjuvant targeted therapy for advanced NSCLC (1:55:56) Risks associated with neoadjuvant therapy for patients with advanced NSCLC (1:59:02) Case: A woman in her late 50s with metastatic NSCLC with a RET rearrangement receives carboplatin/pemetrexed/bevacizumab followed by selpercatinib upon disease progression (2:01:04) Activity of the selective RET inhibitors selpercatinib and pralsetinib; detection of RET alterations in patients with NSCLC (2:05:48) Duration of response, CNS penetration and tolerability profile of RET inhibitors (2:08:56) Efficacy of pemetrexed-based chemotherapy regimens for patients with NSCLC with RET fusions (2:12:33) Case: A woman in her mid-50s with metastatic NSCLC with a BRAF V600E tumor mutation attains a good response to dabrafenib/trametinib after experiencing disease progression on multiple lines of therapy (2:15:05) Activity and tolerability of BRAF and MEK inhibitors in patients with NSCLC with BRAF tumor mutations (2:17:26) Duration of therapy with BRAF and MEK inhibitors (2:19:47) Biology, detection and management of NSCLC with MET exon 14 mutations (2:22:35) Significance of HER2 mutations in patients with lung cancer (2:26:43) Targeting NTRK gene fusions with larotrectinib and entrectinib (2:29:44) Therapeutic options for patients with NSCLC and ROS1 translocations (2:35:52) CME information and select publications

Dr. Jack West recently had the privilege to spend time with Drs. Millie Das and Matthew Gubens for a series of case-based discussions regarding unresectable NSCLC . Dr. Millie Das specializes in the treatment of thoracic malignancies. She sees and treats patients both at the Stanford Cancer Center and at the Palo Alto VA Hospital. She is Chief of Oncology at the Palo Alto VA and also leads the VA thoracic tumor board on a biweekly basis.Dr. Matthew Gubens is a thoracic oncologist who treats patients with lung cancer, mesothelioma and other thoracic malignancies, including thymoma and thymic carcinoma, which are rare tumors of the mediastinum. He is an Assistant Clinical Professor of Medicine at UCSF.Recently the doctors sat down to discuss a series of case-based scenarios. In this video, the doctors discuss the standard treatment of chemotherapy and radiation followed by immunotherapy and the risk of pneumonitis. For more, please visit http://cancerGRACE.org/. To join the conversation, visit https://cancergrace.org/forum.

VAP

Heute geht es um um die Frage “Wie gefährlich oder sicher sind eigentlich e-Zigaretten”, ein sehr aktuelles Thema mit dramatischen Entwicklungen in den letzten Wochen. SONG / INTRO -  Was sind e-ZigarettenEigentlich ein Sammelbegriff, elektronisch, batterie betrieben, erhitzen entweder Flüssigkeiten oder Tabak VerdampferVerdampfen Flüssigkeiten mit Nikotin und anderen Substanzen.  Gelten als „sichere“ und „saubere“ Methode zur Inhalation von Nikotin, da angeblich frei von den krebserregenden Substanzen, die beim Verbrennen von Ta­bak entstehen. ABER! Krebs in Mäusen (Tang 2019)  Weiterhin suchterzeugende Wirkung von Nikotin, fördert die regelmäßige Nut­zung von E-Zigaretten,  Abstinenz vom Rauchen bei 18% versus 10 % bei Standard-Nikotinersatz (Kaugummi, Pflaster) → 82% Rauchen weiterhin, Zigaretten plus eZigaretten TabakerhitzerIQOS = I Quit Ordinary Smoking HEET Sticks statt Zigaretten  Heat-Not-Burn Lifestyle-Produkt, teuer, Flagstores, wie ein Apple-Laden, stylish: Nichts mit Zigaretten zu tun Erhitzer Sieht aus wie ein Schwangerschaftstest oder USB-Stick Verbrennt nicht, sonder erhitzt auf 300°C  20 Zig/HEETS 6€: Zigaretten 3,26€ Steuer;  HEETS nur 0,88€ Steuer, da rechtlich keine Zig, sondern Pfeifentabak in D seit 2017, 100.000 Nutzer, Pro Monat 30 Mio. sticks verkauft, 10 / Tag!! stark steigend in den USA erst 2019 und nur vorläufig zugelassen Schädlich oder nicht? Risiko-LebensV für Raucher teurer Egal ob Zigarette oder eZigarette Man sollte da nicht lügen: Verstößt der Versicherte dagegen, führt dies – bei Vorsatz oder grober Fahrlässigkeit – zu einem Rücktrittsrecht des Versicherers und im Todesfall durch Lungenkrebs keine Zahlung an die Hinterbliebenen, Philip Morris-LebensV Geschäft ein, Rabatte für Zigarette-IQOS-Umsteiger; für e-Zigaretten nur 1/10 Rabatt (2 vs. 25%) https://www.aerzteblatt.de/nachrichten/102752/Philip-Morris-gruendet-Lebensversicherung-mit-Praemienrabatten-fuer-eigene-Produkte  ErhitzerMan atmet keinen Rauch sondern Tabakdampf ein Bundesinstitut für Risikobewertung (BfR):  Weniger Schadstoffe (Formaldehyd, Benzol) als Zigaretten,  Lungenkrebsrisiko nicht verzehnfacht sonder nur 2-3x erhöht Herz-Kreislauf 20x → ? Verdampfer (Vaping) Alle Zigarettenfirmen haben auch in e-Zigaretten/Verdampfer investiert Altria, Tochterfirma von Philip Morris, hat 35% von Juul gekauft Akut, v.a. USA (Centers for Disease Control and Prevention) Bis Ende August 2019 : mindestens 215 akute, schwerwiegende Atemnotanfälle, Sichtbar mit bildgebenden Verfahren (Henry) in 25 Staaten (Layden)(Maddock) mindestens 2 Todesfälle  Bis Ende September, 1 Monat später:  800 Fälle,  46 Staten,  12 Todesfälle Eindeutig eine Epidemie, die eine dringende Reaktion erfordert. Ursachen: Keine aktive Infektion (einschl. lebende bakterielle Kontamination) Akute toxische Lungenverletzung  bis hin zu akutem Lungenversagen ARDS (acute respiratory distress syndrome) z. B. Metalle, Lösungsmitteln, Säuren, Basen, Ozon, Phosgen oder Chlor, bei Bränden oder Unfällen Symptome: geringfügigen Atemwegsbeschwerden bis zu akuten Atemwegs Verletzungen und Schädigungen des Gewebes mit Pneumonitis, Ödem, Atemstillstand und Tod (Matthay) 7 potenziell toxischer Verbindungsgruppen enthalten (Lee; Lee): Nikotin, der eigentliche Grund für die Benutzung von E-Zigaretten, hemmt den mukoziliären Transport, wichtiger Selbstreinigungsmechanismus, nicht über den normalen Nikotinrezeptor, sondern Ionenkanal TRPA1(Chung) Aromastoff Zimtaldehyd bindet ebenfalls an TRPA1 verstärkt die schädliche Wirkung; Blutgefäß Schäden, wieder Zimt und Menthol; Diacetyl und 2,3-Pentandiol, hemmen ebenfalls Zilien. Lösungsmittel (Benzol und Toluol), organische-chemische Verbindungen (Carbonyle)  Partikel  Spuren von Metallen Zwar keine Bakterien und Pilzen, aber Toxine von Bakterien und Pilzen ...

Overcoming challenges to the diagnosis of hypersensitivity pneumonitis

Dr. Fraser, MD, speaks with Jean Baptiste Lascarrou, MD, about the article, Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration: Differentiating Pneumonia from Pneumonitis, published in Critical Care Medicine.

Dr. Fraser, MD, speaks with Jean Baptiste Lascarrou, MD, about the article, Antibiotic Therapy in Comatose Mechanically Ventilated Patients Following Aspiration: Differentiating Pneumonia from Pneumonitis, published in Critical Care Medicine.

Breathing in certain substances often causes hypersensitivity pneumonitis. Learn more about the causes and the two types of hypersensitivity pneumonitis from Dr. Diana Gomez-Manjarres, a UVA specialist in pulmonology. Tagged under: Lung & Respiratory

Dr. West reviews basic principles of treating locally advanced lung cancer, including the need to treat both local disease and possible distant disease, and the need to balance efficacy with toxicity.

Dr. West reviews basic principles of treating locally advanced lung cancer, including the need to treat both local disease and possible distant disease, and the need to balance efficacy with toxicity.

Dr. West reviews basic principles of treating locally advanced lung cancer, including the need to treat both local disease and possible distant disease, and the need to balance efficacy with toxicity.

Pneumonitis (inflammation of the lungs) or infectious pneumonia (e.g., due to bacteria, viral, etc.) can result in significant morbidity in our patients… but, does this correlate to mortality too? Our pneumonia patients may present with mild to life-threatening signs of illness. In this podcast, VetGirl will discuss clinical presentation, physical examination findings, underlying etiologies, and the overall prognosis for aspiration pneumonia. Learn about which appropriate diagnostic tests and treatments are vital in these patients to ensure the best chance of survival.

Pneumonitis (inflammation of the lungs) or infectious pneumonia (e.g., due to bacteria, viral, etc.) can result in significant morbidity in our patients… but, does this correlate to mortality too? Our pneumonia patients may present with mild to life-threatening signs of illness. In this podcast, VetGirl will discuss clinical presentation, physical examination findings, underlying etiologies, and the overall prognosis for aspiration pneumonia. Learn about which appropriate diagnostic tests and treatments are vital in these patients to ensure the best chance of survival.

Hypersensitivity pneumonitis (HP) also called exogenous allergic alveolitis = extrinsic allergic alveolitis in children is an uncommon condition and may not be recognized and treated appropriately. To assess current means of diagnosis and therapy and compare this to recommendations, we used the Surveillance Unit for Rare Paediatric Disorders (ESPED) to identify incident cases of HP in Germany during 2005/6. In addition, cases of HP reported for reference from all over Germany to our center in the consecutive year were included. Twenty-three children with confirmed pediatric HP were identified. All (age 9.4 y (4.4-15.1) presented with dyspnoea at rest or with exercise, mean FVC was 39% of predicted, seven of the 23 children already had a chronic disease state at presentation. IgG against bird was elevated in 20, and against fungi in 15. Bronchoalveolar lavage was done in 18 subjects (41% lymphocytes, CD4/CD8 1.99), and lung biopsy in 6. Except 2, all children were treated with prolonged courses of systemic steroids. Outcome was not favourable in all cases. Late diagnosis in up to a quarter of the children with HP and inappropriate steroid treatment must be overcome to improve management of HP. Inclusion of children with HP into international, web-based registry studies will help to study and follow up such rare lung diseases.

Dr. Gerard Silvestri, pulmonologist from Medical University of South Carolina (MUSC) in Charleston, reviews the subject of pneumonitis (inflamation of the lung tissue) induced by EGFR inhibitors or chest radiation.

Dr. Gerard Silvestri, pulmonologist from Medical University of South Carolina (MUSC) in Charleston, reviews the subject of pneumonitis (inflamation of the lung tissue) induced by EGFR inhibitors or chest radiation.

Dr. Gerard Silvestri, pulmonologist from Medical University of South Carolina (MUSC) in Charleston, reviews the subject of pneumonitis (inflamation of the lung tissue) induced by chemotherapy commonly used for treating lung cancer.

Dr. Gerard Silvestri, pulmonologist from Medical University of South Carolina (MUSC) in Charleston, reviews the subject of pneumonitis (inflamation of the lung tissue) induced by chemotherapy commonly used for treating lung cancer.

2. UCI-Only

Background Herpes simplex virus type-1 (HSV-1) has been described to cause respiratory tract infections in critically ill patients or in individuals that are immunocompromised. It is a continuing matter of debate under which circumstances HSV-1 is a relevant pathogen for pneumonitis. While its role during critical illness has been investigated by prospective interventional studies, comparatively little systematic data is available on the role of HSV-1 for pneumonitis in outpatients with autoimmune disease under a maintenance regimen of immunosuppression. Methods We retrospectively reviewed the charts of ~1400 patients with rheumatoid arthritis, vasculitis, and systemic lupus erythematosus (SLE) that were followed at the outpatient clinic of a German University hospital during the years 2000–2007. Episodes of admission to a ward resulting in the diagnosis of pneumonia/pneumonitis were identified, and the type of pneumonia and clinical features retrospectively studied. Results 63 patients with rheumatoid arthritis, vasculitis, or SLE were admitted to a ward and diagnosed to have pneumonia/pneumonitis. Using bronchoscopy a total of 6 cases of pulmonary infection associated with HSV-1 in the lower respiratory tract were identified. Among those, 2 cases suggested a causative role of HSV-1 as the sole agent causing pneumonitis that proved clinically responsive to antiviral treatment. In the remaining 4 cases HSV-1 appeared as a bystander of bacterial infection. Maintenance therapy with leflunomide, which inhibits HSV-1 assembly in vitro, was associated with a milder course of pneumonitis in one patient. Detection of HSV-1 was associated with stronger immunosuppressive regimens and vasculitic disease. Conclusion The present study analyzed the frequency and hallmarks of cases of HSV-1 associated pneumonitis that occurred in a comparatively large cohort of patients with rheumatologic autoimmune diseases. In an area of controversy, this study provides further evidence that HSV-1 causes isolated pneumonitis in the immunocompromised. The study may provide an estimate on the frequency of relevant HSV-1 infection and bacterial agents in outpatients with autoimmune disease.