Challenges facing health care professionals (HCPs) in selecting an inhaled medication delivery system for patients with COPD include (1) numerous maintenance medications and combinations; (2) at least 22 different handheld inhaler devices; (3) management recommendations focusing mainly on classes of medications; (4) lack of knowledge about available medications/combinations, delivery systems, and guidelines/expert recommendations for treating patients with COPD; (5) in some countries, contracts between health insurance and pharmaceutical companies limit which medications or devices are covered. In this article, we address 3 considerations for HCPs related to treating patients with COPD: selecting an inhaled delivery system; assessing whether the inhaled medication device has provided symptomatic benefit; and providing educational materials for patients on how to use their prescribed medication device correctly. Four patient cases are presented to illustrate these clinical aspects. The main patient factors for selecting an inhaled delivery system include cognitive function, manual dexterity, and inhalation ability. Continuity of the type of handheld inhaler can be beneficial if the patient is using it correctly. To assess the efficacy of the inhaled medication-device at follow-up, HCPs can ask the patient, "Does your current treatment help your breathing?" If the response is Yes, it is appropriate to continue the therapy and to also review inhaler technique; if the response is No, then the next step is to assess the patient's inhaler technique as well as adherence. If the patient demonstrates or describes good technique, is adherent, and does not report subjective benefit, it is reasonable to change the medication or the device.

Airway inflammation is a hallmark feature of asthma characterized by elevated eosinophils and/or neutrophils. Eosinophils in sputum can contribute to ventilation defects. The functional consequence of other types of cellularity on ventilation is unknown.

Pulmonary embolism (PE) is one of the leading causes of pregnancy-related deaths in high-income countries. Maternal mortality from PE has been attributed to delayed recognition and investigation. The diagnosis of PE may be challenging, as its early signs and symptoms may overlap with physiological changes of pregnancy. As such, promptly ruling out suspected PE using diagnostic testing is of paramount importance. This narrative review provides a contemporary overview of risk assessment tools, diagnostic modalities, counseling needs, and existing best practice guidance for the diagnosis of PE in pregnancy.

Accurate risk prediction of exacerbations is pivotal in severe asthma management. Multiple risk factors are at play, but the pathway of risk prediction remains unclear.

The low spirometry testing rate for screening of COPD is partly attributed to complex procedures, stringent quality control requirements, and long examination times. Simplifying the spirometry protocol may increase the feasibility of COPD screening in community settings.

Limited real-world data exist on the health impacts of the Philips Respironics recall for positive airway pressure (PAP) devices.

Right heart catheterization is the gold standard for the diagnosis of pulmonary hypertension. There are variations in practice and several pitfalls introducing errors in diagnosis that can significantly affect treatment. Errors in assessing the correct pulmonary artery wedge pressure can significantly affect accurate classification of patients with pulmonary hypertension and lead to potentially deleterious treatment decisions. This review focuses on best practices in right heart catheterization performance, emphasizing practical and pathophysiological principles to obtain the most accurate result, as well as advanced applications in pulmonary hypertension.

Despite the significant health and economic burden associated with OSA among civilians, little is known about this burden among active-duty military personnel.

The high incidence of bronchopulmonary dysplasia (BPD) continues to be a problem among extremely low-gestational-age neonates (ELGANs). Recent improvements in next-generation proteomics have provided opportunities to obtain new perspectives on the early detection of BPD. In this study, our main objectives were to study the proteomes of patients by collecting nasopharyngeal aspirate (NPA) samples and evaluate the differences between ELGANs with and without BPD at 1 week of life.

Preserved ratio impaired spirometry (PRISm) is regarded as a COPD precursor, but whether this varies by smoking status remains unclear.

From screening to treatment, the continuum of lung cancer reflects unequal access and delivery, with more vulnerable patients less able to receive high-quality care. Despite great advances in lung cancer care (eg, screening and nodule programs to identify early-stage disease and immune-mediated and targeted therapies for advanced-stage disease), disparities persist both in the United States and globally. In this narrative review, the spectrum of disparities that influence lung cancer care on a national scale, including race, ethnicity, age, socioeconomic status, geographic location, and insurance access, are explored. The review focuses on how disparities impact screening efforts and lung cancer treatments. Where data are available, trends on a global scale are addressed. Potential solutions are offered to address recognized disparities, primarily by identifying pertinent social determinants of health and launching multipronged interventions to improve the care of all patients with lung cancer.

Limited data exist to inform and appropriately counsel female lung transplant (LuT) recipients regarding pregnancy after transplantation.