Rationale: Post-thoracentesis chest radiography (CXR) is often used to evaluate the degree of residual fluid after thoracentesis. Whether post-drainage ultrasound examination is comparable to CXR in the evaluation of pleural space evacuation is unknown.

Objectives: This Phase 2 study evaluated αvβ6 receptor occupancy in the lung as assessed by changes from baseline in αvβ6 PET tracer uptake, after single-dose administration of bexotegrast to participants with IPF.

Climate Change, Respiratory Health Effects, and Inequities

The management of Mycobacterium avium complex pulmonary disease (MAC-PD) is challenging because of limited efficacy and frequent adverse events associated with standard treatments. The 2020 guidelines from the American Thoracic Society, European Respiratory Society, European Society of Clinical Microbiology and Infectious Diseases, and Infectious Diseases Society of America provide recommendations, but real-world adherence is often hindered by these issues, leading many patients to be unable to complete standard therapy. This review proposes a comprehensive management algorithm for MAC-PD, emphasizing multidisciplinary approaches and integrating nonantimicrobial management before, during, and after drug treatment to enhance patient outcomes. When a patient presents with chronic respiratory symptoms suggestive of nontuberculous mycobacteria, clinicians should follow a guideline-based approach to diagnosis, as diagnostic delays are common because of nonspecific symptoms. Proper evaluation should determine the disease phenotype (existence of cavitary lesions), as it influences treatment choices. Airway clearance, nutritional support, and management of underlying conditions are essential nonantimicrobial components. Regular outpatient monitoring helps detect disease progression and optimize treatment. Treatment strategies vary based on disease severity. For noncavitary nodular bronchiectatic disease, a thrice-weekly regimen is preferred because of better tolerability. Severe cases or those with cavitary forms may require daily treatment with additional aminoglycosides. Amikacin liposome inhalation suspension is recommended for patients not responding to standard regimens after 6 months. Recent research addresses drug intolerance, suggesting alternatives such as a two-drug regimen without rifamycin in certain cases. Consultation with nontuberculous mycobacteria specialists is advised for complex cases, particularly those with macrolide resistance or requiring surgical intervention. The algorithm emphasizes shared decision making, patient education, and family support to improve adherence and outcomes.

Dr. Gregory Tino chats with Dr. Gerard Criner on his article,

Dr. Gregory Tino chats with Dr. Mohamed Zghouzi and Dr. Vikas Aggarwal on their article, "Sex, Racial, and Geographic Disparities in Pulmonary Embolism–related Mortality Nationwide."