Pulmonology

Promoting Prevention and Targeting Remission of Asthma: A EUFOREA Consensus Statement on Raising the Bar in Asthma Care

Asthma is a common, multifaceted respiratory disease with a major impact on quality of life. Despite increased insights into mechanisms underlying various asthma phenotypes and endotypes and the availability of targeted biologic treatment options, the disease remains uncontrolled in many patients with risk of exacerbations, requiring systemic corticosteroids, and with progressive disease. A personalised management approach to patients with uncontrolled severe asthma is advocated. This asthma expert panel was convened to discuss strategies to optimise asthma care and to prevent systemic corticosteroid overuse and disease progression. Current concepts and recommendations are summarised, and a rationale is provided to implement personalised asthma management at earlier stages of the disease. The ultimate goal is to move away from the current one-size-fits-most concept and shift toward a phenotype- and endotypetargeted approach aimed at curbing the disease course by improving outcomes. A consensus view on asthma care is provided that advocates a holistic approach and highlights some unmet needs to be addressed in future clinical trials and population studies. This is a shortened version of the article.

Modern Medicine – Issue 4, 2025

Common Cold

Among human diseases, the common cold stands apart. Not only is it one of the most common human diseases, but because there are so many respiratory viruses that cause colds, it is also one of the most complex. This review discusses the respiratory viruses and notes that all these viruses may cause the illness complex recognised as the common cold. The common cold is discussed as part of the “iceberg concept” of disease which ranges from asymptomatic infection to severe illness and death.

Modern Medicine – Issue 3, 2025

Interstitial Lung Disease: From Initial Investigations to Treatments, Shared Care and Beyond

Interstitial lung disease (ILD) is characterised by progressive scarring of the lungs, leading to respiratory failure and a high symptom burden. High resolution CT of the chest with prone views is the investigation of choice when assessing for ILD. A low threshold should be applied for investigating patients presenting with persistent cough or dyspnoea with risk factors for ILD including connective tissue disease, occupational exposure, certain drug therapies and a family history. Antifibrotic therapy (nintedanib) for any patients with ILD who exhibit progressive fibrosing features offers an opportunity for improved patient outcomes with early disease identification and access to respiratory services. Blood monitoring is required lifelong for patients taking antifibrotics or steroid-sparing ILD treatments.

Modern Medicine – Issue 1, 2025

RSV: Understanding the Silent Threat and the Power of Prevention

Respiratory syncytial virus (RSV) is a major yet often overlooked cause of respiratory illness worldwide, especially dangerous to infants, young children and other vulnerable populations. RSV remains a significant contributor to seasonal respiratory infections and severe complications, particularly among high-risk groups. Despite the seemingly mild symptoms, RSV can lead to severe illness and even hospitalisation. The emergence of RSV vaccines promises a substantial advancement in preventive healthcare, highlighting the essential role of vaccination and other preventive measures in reducing RSV’s health impact.

Modern Medicine – Issue 6 2024.

Asthma-COPD Overlap Implications for Patient Management

Asthma-COPD overlap (ACO) is characterised by persistent airflow limitation with features typically associated with both asthma and chronic obstructive pulmonary disease (COPD). Clinical features and underlying inflammatory and physiological mechanisms of asthma and COPD are highly variable and affect the utility of the ACO umbrella in clinical practice. This heterogeneity limits both high-quality research on the subject and treatment recommendations specific to ACO. An approach to treating chronic airways disease that targets identifiable clinical traits rather than the disease label is increasingly recommended.

Modern Medicine – Issue 4 2024

Soothing Cough Relief

Cough due to upper respiratory tract infections (URTI) or cough without a preceding infection is one of the most frequent complaints encountered by family physicians and paediatric providers. Cough, more than other symptoms, is extremely disruptive. In the absence of effective antiviral treatment for URTI, many parents try to find products that will relieve a cough until the illness resolves.1 Medicinal plants have been used for centuries, including for the treatment of coughs.

Modern Medicine – Issue 3 2024

Community-acquired Pneumonia:GP Care after the Pandemic

Community-acquired pneumonia is common and most patients can be managed in the community. Amoxicillin remains the empirical antibiotic of choice to treat patients with community-acquired pneumonia. Pulse oximetry is noninvasive and readily available and should be used in initial patient assessment to help determine disease severity. An episode of pneumonia presents an opportunity to modify the patient’s risk factors, including smoking, high alcohol intake and poor dental hygiene. If a chest x-ray shows abnormalities, it should be repeated at six weeks to confirm resolution.

Modern Medicine – Issue 3 2024

The GINA 2023 Report: What’s new in asthma management?

The Global Initiative for Asthma (GINA) publishes a global strategy for asthma prevention and management that is updated every year based on a review of new evidence. Key changes in the GINA 2023 strategy report, published in May 2023, include treatment strategies for adults and adolescents to reduce the risk of severe exacerbations and minimise adverse effects, the writing of an asthma action plan for patients on different treatment regimens, and how to reduce the environmental impact of asthma and its treatment.

Modern Medicine – Issue 2 2024

Mucus Hypersecretion Opens the Door to Worsening COPD

Patients with chronic obstructive pulmonary disease (COPD) exhibit airway mucus hypersecretion, including sputum production, increased luminal mucus, goblet cell hyperplasia and submucosal gland hypertrophy. These processes have been shown to contribute significantly to morbidity and mortality in patients with COPD, especially in older patients and those who are prone to respiratory tract infection. N-acetylcysteine is a classic antioxidant that can reduce mucus viscosity and promote mucus discharge.

Modern Medicine – Issue 2 2023

Stem the Tide of Mucus Hypersecretion

Airway mucus hypersecretion is an important pathophysiological and clinical manifestation of chronic obstructive pulmonary disease (COPD), bronchiectasis, pulmonary cystic fibrosis and other chronic airway inflammatory diseases. N-acetylcysteine (NAC) is a sulfhydryl-containing compound, with mucolytic properties, that has been used for decades as a mucolytic agent in several lung disorders.

Modern Medicine – Issue 1 2023