“Citius Pharmaceuticals Expands Scientific Advisory Board with Addition of Dr. John Laffey, Expert in Stem Cell and Gene Therapies for ARDS - PRNewswire” plus 1 more
“Citius Pharmaceuticals Expands Scientific Advisory Board with Addition of Dr. John Laffey, Expert in Stem Cell and Gene Therapies for ARDS - PRNewswire” plus 1 more |
| Posted: 15 Jun 2021 06:20 AM PDT CRANFORD, N.J., June 15, 2021 /PRNewswire/ -- Citius Pharmaceuticals, Inc. ("Citius" or the "Company") (Nasdaq: CTXR), a biopharmaceutical company dedicated to the development and commercialization of first-in-class critical care products with a focus on anti-infective products in adjunct cancer care, unique prescription products and stem cell therapy, today announced that Dr. John Laffey, a leading scholar in Acute Respiratory Distress Syndrome (ARDS) and the use of cutting-edge therapies to treat acute lung disorders, has been appointed to its ARDS Scientific Advisory Board (SAB), effective immediately.  Dr. Laffey joins noted colleagues, Dr. Michael A. Matthay, Dr. Lorraine B. Ware, Dr. Mitchell M. Levy, and Dr. Perenlei Enkhbaatar on the ARDS SAB. Each member of the board is a recognized key opinion leader (KOL) with extensive clinical trial expertise in the treatment of acute lung disorders. "We are delighted to welcome John to our distinguished ARDS Scientific Advisory Board and look forward to leveraging his deep insights and decades of hands-on experience with ARDS to advance our proprietary i-MSC program," stated Myron Holubiak, President and Chief Executive Officer of Citius. "Dr. Laffey is a highly accomplished and recognized expert in acute lung disorders. His cutting-edge research into the use of gene and stem cell-based therapies to treat ARDS will provide Citius with an important perspective as we explore the potential of this exciting new therapeutic area. Development of our i-MSC master cell bank for future trials is underway, and I am confident that John's expertise and guidance will complement our SAB and help direct our clinical efforts," concluded Mr. Holubiak. Dr. John Laffey is Professor of Anesthesia and Intensive Care Medicine at the School of Medicine of the National University of Ireland (NUI Galway), and a Consultant in Anesthesia and Intensive Care Medicine at Galway University Hospitals. He is Director of Clinical Research at Saolta Hospital Group and NUI Galway. Dr. Laffey's primary focus is on the investigation of therapeutic strategies for ARDS. He founded and leads the lung biology group at NUI Galway. His research groups are currently conducting studies into the pathogenesis of ventilation induced lung injury and sepsis induced Acute Lung Injury. The current focus of his research is on the investigation of the therapeutic potential of gene and stem cell-based therapies for acute lung injury. Dr. Laffey is also a principal investigator at the National Centre for Biomedical Engineering Sciences, and a Clinical Trials Investigator at the HRB Clinical Research Facility at NUI Galway. He has acted as principal investigator or co-principal investigator in multiple clinical trials in the fields of anesthesia and critical illness. Additional members of the ARDS Scientific Advisory Board Michael A. Matthay, MD, Professor of Medicine and Anesthesia at the University of California at San Francisco (UCSF), a Senior Associate at the Cardiovascular Research Institute, and Associate Director of the Critical Care Medicine at UCSF. Dr. Matthay's basic research has focused on the pathogenesis and resolution of ARDS, with an emphasis on translational work and patient-based research, including clinical trials. Dr. Matthay's recent research has focused on the biology and potential clinical use of allogeneic bone marrow-derived mesenchymal stromal cells (MSCs) for ARDS. He is currently leading the "Mesenchymal Stromal Cells for Acute Respiratory Distress Syndrome (STAT)," a United States Department of Defense supported study of MSCs for ARDS. Lorraine B. Ware, MD, Professor of Medicine and Ralph and Lulu Owen Endowed Chair, Professor of Pathology, Microbiology and Immunology, Vanderbilt University; Director, Vanderbilt Medical Scholars Program. Dr. Ware's comprehensive bench-to-bedside research program centers on the pathogenesis and treatment of sepsis and acute lung injury with a current focus on mechanisms of lung epithelial and endothelial oxidative injury by cell-free hemoglobin. Dr. Ware is also a lead investigator for the "Mesenchymal Stromal Cells for Acute Respiratory Distress Syndrome (STAT)" study. Mitchell M. Levy, MD, Chief, Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, The Warren Alpert Medical School of Brown University, where he is Professor of Medicine. Dr. Levy also serves as Medical Director of the Medical ICU at Rhode Island Hospital. He has been an investigator on numerous pharmacologic and biologic trials intended to treat sepsis, cardiovascular and pulmonary pathology. He has expertise in trial design, clinical trial execution and trial management and is one of the three founding members of the Surviving Sepsis Campaign (SSC). Dr. Levy is Past-President of the Society of Critical Care Medicine (2009). Perenlei Enkhbaatar, MD, PhD, FAHA, Charles Robert Allen Professor of Anesthesiology at The University of Texas Medical Branch where he is also Director of the Translational Intensive Care Unit. He is a leading authority on the pathophysiology of acute lung injury and has focused his research on effective therapeutic approaches with special emphasis on tissue regeneration and stem cell biology. Dr. Enkhbaatar has played a leading role in the growing body of knowledge related to basic mechanisms of disease in acute lung injury and acute respiratory distress syndrome. His research advances have been presented at international conferences and in the publication of more than three hundred abstracts, one hundred and fifty-four original manuscripts in leading peer-reviewed journals, and twelve book chapters. In recognition of his contributions to the field of acute lung injury, Dr. Enkhbaatar has been selected to serve on the Editorial Boards of leading journals in the fields of trauma and acute lung injury. About Acute Respiratory Distress Syndrome (ARDS) About Citius Pharmaceuticals, Inc. Safe Harbor Investor Relations for Citius Pharmaceuticals: Ilanit Allen SOURCE Citius Pharmaceuticals, Inc.  Related Links | ||||||||||||
| Clinical analysis of severe radiation pneumonia | IJGM - Dove Medical Press Posted: 15 Jun 2021 04:15 PM PDT IntroductionRadiotherapy is an important treatment method for lung cancer and other thoracic tumors. Radiation pneumonia (RP) is a common complication of this treatment, with an incidence rate of 5–15% in China.1 Patients with mild cases of RP who undergo timely treatment have a good prognosis; however, 5–11.7% of patients who develop RP have severe cases of the disease1–3 (ie, the patients have a high mortality and are prone to developing pulmonary fibrosis,4 which affects radiotherapy implementation and can seriously threaten their safety). Radiotherapy, administered either alone or in combination with chemotherapy, helps control tumor growth and prolong patient survival. However, the use of radiotherapy in the treatment of lung cancer and lung metastases can cause injury to healthy lung tissue while killing the tumor. The majority of RP cases are mild and have a good prognosis. Atsuya Takeda reported a 95% incidence of Grade ≤2 RP, with only a 5% incidence of severe RP.3 However, the mortality of patients with severe RP can reach as high as 50% within two months.4 Hideomi Yamashita reported a 77.8% mortality rate among 9 cases with Grade ≥4 RP (7/9 patients died).5 Other studies on radiotherapy-induced RP have been conducted; however, the relevant medical records mainly focus on patients with mild RP. Only a few studies have been conducted on patients with severe RP. Several well-established pneumonia and sepsis biomarkers, including the monocyte distribution width and the respective presepsin and mid-regional proadrenomedullin levels, have been studied.6–9 There is also a lack of reported studies including a comparison of patients with lung cancer and patients without lung cancer. A total of 34 patients with severe RP admitted to our hospital department between January 2011 and July 2017 were included in the present study. Materials and MethodsGeneral InformationA total of 34 (24 male and 10 female) consecutive patients with severe RP treated in our department between January 2011 and July 2017 were enrolled in the present retrospective study. The patients were aged 43–81, with an average age of 62.9 ± 10.6 years. Of the patients, 22 had lung cancer, 6 had esophageal cancer, 5 had breast cancer, and 1 had colon cancer with lung metastasis. All patients had complete clinical hospitalization data, and the tumor diagnosis was pathologically confirmed in each patient. The patients attended follow-ups after discharge; the follow-up duration was 1–42 months. Inclusion criteria: All patients diagnosed with RP based on the diagnostic criteria of the Expert Consensus on the Diagnosis and Treatment of Radiation Lung Injury.5 Patients diagnosed with Grade ≥3 RP were considered to be severe cases. The patient grading was based on whether or not the patients had Grade ≥3 RP at the time of admission to our department or subsequent progression to Grade ≥3. Exclusion criteria: patients who gave up treatment after diagnosis. Diagnostic CriteriaThe diagnosis of RP was based on the Expert Consensus on the Diagnosis and Treatment of Radiation Lung Injury diagnostic criteria;5 the RP was then graded in accordance with the Common Terminology Criteria for Adverse Events (CTCAE) 4.0.6 (1) Grade 0: no significant differences in symptoms and signs compared with before treatment; (2) Grade 1: a slight cough and shortness of breath at exertion; (3) Grade 2: persistent cough with the need for narcotic cough suppressant, accompanied by dyspnea at slight exertion (disappears at rest); (4) Grade 3: severe cough unresponsive to narcotic cough suppressants, accompanied by shortness of breath at rest and clinical or radiographical confirmation of acute pneumonia, with the possible need for intermittent oxygen inhalation or corticosteroids; and (5) Grade 4: severe respiratory insufficiency with the need for continuous oxygen inhalation or assisted ventilation. All patient diagnoses were consistent with RP. Patients diagnosed with Grade ≥3 RP were considered to be severe cases.4,7 The patient grading was based on whether or not the patients had Grade ≥3 RP at the time of admission to our department or subsequent progression to Grade ≥3. Evaluation of Therapeutic EffectsThe therapeutic effect on RP was evaluated in accordance with the Criteria For Cure And Improvement Of Clinical Disease Diagnostic Basis (second edition).8 A cured patient was defined as having experienced the disappearance of symptoms and signs, along with the dissipation of chest lesions (chest X-ray). Criteria improvement was defined as reductions in coughing and shortness of breath as well as the gain of basic control over secondary respiratory infections. The patient death criteria were (1) condition deterioration; and (2) death. Clinical Data CollectionGeneral characteristics before and after radiotherapy: (1) whether or not chemotherapy was conducted; (2) whether or not there existed a fundamental disease; and (3) the total radiation dose. General patient characteristics at the severe RP diagnosis time: (1) severe RP onset time; (2) symptoms after radiotherapy and their time of occurrence; (3); the relevant examinations and their results (4) changes in chest imaging as well as ultrasensitive C-reactive protein, blood leukocyte, procalcitonin, and lactate dehydrogenase levels, fungal G test and fungal GM test results, and other infection indicators; (5) sputum and alveolar lavage fluid culture results; and (6) the respective oxygen inhalation and oxygen partial pressure concentrations. Treatment conditions: (1) respiratory support; and (2) antibiotic and methylprednisolone doses. Patient survival follow-up: each patient was followed up with until either October 2017 or the time of death. Statistical MethodsThe Statistical Package for Social Sciences 22.0 was adopted for data analysis, and the dependent sample t-test was used for the measurement data evaluation (expressed as x ± s [mean ± SD]). The countable data were expressed in percentage, and a p value of <0.05 was considered statistically significant. ResultsClinical CharacteristicsAs stated previously, 34 patients were enrolled in the present study, which had an average follow-up duration of 6 months (1–42 months). The patients' general conditions are shown in Table 1. Among the patients, there were 24 males and 10 females. The age ranged between 43 and 81, with an average age of 62.9 ± 10.6. There were 22 cases with lung cancer (5 with adenocarcinoma, 8 with squamous cell carcinoma, 7 with small cell carcinoma, and 2 with adenosquamous carcinoma), 6 cases with esophageal cancer, 5 cases with breast cancer, and 1 case with colon cancer with lung metastasis. Moreover, 3 patients had chronic obstructive pulmonary disease, 1 patient had chronic bronchitis, 2 patients had emphysema and pulmonary bullae, 1 patient had bronchiectasis, 10 patients had cardiovascular disease, and 6 patients had type 2 diabetes mellitus. The total radiation dose was between 37.5 and 66 Gy, and the overall average dose was 53 Gy; the average dose for the dead patients was 52.9 Gy. Here, 2 patients underwent radiotherapy and chemotherapy simultaneously, 22 patients had chemotherapy before radiotherapy, and 10 patients did not have chemotherapy. The chemotherapeutic agents used included pemetrexed, cisplatin, etoposide, cyclophosphamide, docetaxel, paclitaxel, nedaplatin, irinotecan, cetuximab, eflornithine, and epirubicin. There were 20 cases with Grade 3 and 14 cases with Grade 4 according to CTCAE 4.0. Additionally, as the initial symptom, 28 patients had cough and sputum, 2 patients had wheezing, and 2 had fever. Finally, 24 patients had wheezing as the accompanying symptom with the initial symptom, and 8 had fever, 1 had chest pain, 1 had chest tightness, and 2 had wheezing as the only symptom.
Laboratory ExaminationsKlebsiella pneumoniae, Streptococcus pneumoniae, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Acinetobacter baumannii, Enterobacter cloacae, Staphylococcus haemolyticus, Staphylococcus epidermidis, Enterococcus faecium, Candida albicans, Candida glabrata, Candida tropicalis, Candida guilliermondii, and Aspergillus flavus were detected in the patients' sputum. A total of 20 patients underwent bronchoscopy, with little secretion under microscopy. Pseudomonas aeruginosa, Klebsiella pneumoniae, Stenotrophomonas maltophilia, Enterobacter cloacae, Achromobacter xylosoxidans, Candida albicans, Candida glabrata, and Aspergillus versicolor were cultured in the alveolar lavage fluid, in which the neutrophil percentage was between 50% and 95% and the lymphocyte percentage between 5% and 35%. The sputum culture and alveolar lavage fluid culture results are illustrated in Table 2.
Image ExaminationsAll 34 cases had lesions in the radiation field, while 8 also had lesions outside the radiation field. There were 15 cases with ground-glass opacity and 19 cases with consolidation opacity in the images. Four cases had pleural effusion, and one case developed pneumothorax (Figures 1–3).
Treatment and PrognosisOxygen inhalation was conducted in 20 cases, and 10 cases had non-invasive ventilator assistance. Four cases experienced no improvement in symptoms after both treatments and were given tracheal intubation and ventilator-assisted respiration. Steroid therapy was conducted in all patients, with a dose between 40 and 80 mg per day. Methylprednisolone therapy was conducted in all patients as well. Among the patients, 18 cases were cured, 8 cases improved, and 8 cases died, of which 7 had lung cancer and 1 had esophageal cancer. A comparison of the results of the survival group and the death group is demonstrated in Table 3. Eight of 21 culture-negative patients died, while six of 24 culture-negative patients died.
DiscussionOur hospital is a general hospital specializing in oncology. Among others, it has an independent lung cancer department, breast cancer department, lymphoma department, and gastrointestinal tract tumor department. Every year, many patients with tumors need to undergo radiotherapy, resulting in a high number of patients with RP. Patients with mild RP are mostly managed by the radiotherapy department, while patients with severe RP often require ventilator-assisted respiration and visit our department. Generally, RP appears in the radiation field; however, in certain patients, it can also appear outside the radiation field. In the present study, 8/34 patients had an RP appearance both inside and outside the radiation field, which was much higher than the ordinary RP appearance rate. The simultaneous appearance of lesions in the bilateral lungs might also be a cause of severe RP. The present study included a case of radiotherapy-induced RP following the treatment of wandering-form lung cancer. During the methylprednisolone reduction, the patient developed new exudative opacity in the lung. The exudative lesion in the lung was reabsorbed again upon restoration of the original methylprednisolone dose; this has not been previously reported in relevant literature. On the one hand, it is possible that this was correlated with radiation leakage; on the other hand, it might have been due to inflammatory signal diffusion.10 Although RP is an aseptic inflammatory disease, patients with severe RP are prone to lung co-infection. A review of relevant literature failed to find a reports pathogenic RP bacteria. In the present study, sputum and/or alveolar lavage fluid were obtained from all patients for culturing. The results showed 25 microorganism cases as well as 9/21 cases of microorganisms with tracheoscopy among the 34 sputum specimens. However, the tracheoscopy findings show that patient secretion was minimal, and the ultrasensitive C-reactive protein, calcitoninogen, and leukocyte levels were primarily within the normal range. Thus, the presence of infection or colonization was unclear. The main pathogens were Gram-negative bacteria and fungi. In particular, the alveolar lavage fluid results suggested that the pathogens were all Gram-negative bacteria and fungal infections. Moreover, none of the alveolar lavage fluid cultures showed a presence of Gram-positive bacteria, suggesting that Gram-negative and fungi pathogens should be covered in the initial treatment of patients with severe RP. As 24 of the patients were treated with synchronous chemotherapy before and during radiotherapy and 10 were not treated with chemotherapy, it is possible that synchronous chemotherapy aggravates RP occurrence. Arrieta et al11 found that radiotherapy with a simultaneous administration of gemcitabine and carboplatin increases RP incidence in patients with locally advanced non-small-cell lung cancer. Patients with lowered lung function or emphysema were previously considered to be more likely to develop RP;2 however, recent studies have shown that there is not an increased RP incidence among patients with low lung function. This is possibly due to the lower oxidative stress caused by the poor oxygenation in such patients. Additionally, 32% of patients with interstitial pulmonary disease had Grade ≥3 RP, as opposed to patients with non-interstitial pulmonary disease, of whom only 2% had Grade ≥3 RP. Moreover, with the development of RP, patients with interstitial pulmonary disease had a 21% mortality rate.12 In their study, Wang et al4 reported that 31 patients with non-small-cell lung cancer had a mortality of 50% after two months of severe RP. Moreover, 4 patients with Grade 3 RP as reported by Xu et al13 died on days 2, 28, 48, and 62 after the diagnosis. In our department, the mortality rate was 31% among patients with small-cell lung cancer presenting with severe RP and 57.1% in patients with Grade 4. All 3 patients with lung cancer requiring tracheal intubation died. The patient mortality rate in our department was lower than the mortality rate reported in relevant literature; this is possibly correlated with the widespread use of mechanical ventilation, especially non-invasive ventilation, which may help patients survive respiratory failure and gain time for steroid therapy and anti-infection treatment. The steroid therapy dose and duration are unclear; the usual recommended dose is 40 mg of prednisone daily;14–20 no distinction is made between patients with mild RP and patients with severe RP. In the present study, one patient with lung cancer and severe RP who was administered a daily dose of 40 mg methylprednisolone gradually deteriorated; however, his/her condition improved significantly with the daily administration of 80 mg methylprednisolone. When the dose was reduced to 40 mg/day, his/her condition was aggravated again. Treatment experience is usually gained from treating patients with mild disease cases; however according to our experience, the initial methylprednisolone dose should be 80 mg/day in the presence of severe RP in order to achieve a higher success rate. Generally, cases of RP in China are reported by radiologists; there have been few cases reported by respiratory physicians. Even fewer of these cases have been severe. The mortality rate of the patients with severe RP admitted to our department was lower than the rate reported in relevant literature; this may be correlated with patient ventilator treatment in the respiratory critical care unit. The use of methylprednisolone is an effective in-patient treatment. Based on the results of the present study, aggressive antibiotic therapy and mechanical ventilation in addition to methylprednisolone administration could reduce patient mortality. According to previous related literature and expert consensuses, there is no recommendation for anti-infection treatment for infections accompanying RP. Based on the sputum culture and bronchoscopy results, it is suggested that Gram-negative bacteria and fungi should be covered and if necessary, Gram-positive organisms targeted in the treatment of severe RP. The limitations of the present study: (1) the dependent sample t-test was used for the evaluation of dependent data, while the potential risk factors were investigated through the comparison of the survival patient group and the dead patient group; these results were not compared between patients with lung cancer and patients without lung cancer; and (2) the case number is too limited to show significant findings. Microbiological findings need to be made in future studies in order to gain useful information. In summary, the prognosis of severe RP is not significantly correlated with the administered radiation dose. Patients with lung cancer have a high mortality rate, while patients with other diseases who also present with severe RP have a good prognosis. Delayed diagnosis and a high Acute Physiology and Chronic Health Evaluation score increase patient mortality. Patients with severe RP are prone to co-infection or colonization with Gram-negative bacteria and fungi. A combination of antibiotic therapy, ventilator-assisted respiration, and steroid therapy could improve the prognosis. Due to the currently poor therapeutic effect on severe RP in patients with lung cancer, preventing RP occurrence is particularly important. Patients undergoing radiotherapy should be selected, and in the case of severe RP, promptly transferred to experienced departments for further treatment in order to avoid pneumonia aggravation or even the occurrence of life-threatening conditions. Ethics StatementThis study was conducted with the approval of the Strategic Support Force Medical Center ethics committee and in accordance with the declaration of Helsinki. Written informed consent was obtained from all participants. DisclosureThe authors report no conflicts of interest in this work. References1. Robnett TJ, Machtay M, Vines EF, McKenna MG, Algazy KM, McKenna WG. Factors predicting severe radiation pneumonitis in patients receiving definitive chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys. 2000;48(1):89–94. doi:10.1016/S0360-3016(00)00648-9 2. Shi A, Zhu G, Wu H, Yu R, Li F, Xu B. Analysis of clinical and dosimetric factors associated with severe acute radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with concurrent chemotherapy and intensity-modulated radiotherapy. Radiat Oncol. 2010;5:35. 3. Takeda A, Ohashi T, Kunieda E, et al. Early graphical appearance of radiation pneumonitis correlates with the severity of radiation pneumonitis after stereotactic body radiotherapy (SBRT) in patients with lung tumors. Int J Radiat Oncol Biol Phys. 2010;77(3):685–690. doi:10.1016/j.ijrobp.2009.06.001 4. Wang JY, Chen KY, Wang JT, et al. Outcome and prognostic factors for patients with non-small-cell lung cancer and severe radiation pneumonitis. Int J Radiat Oncol Biol Phys. 2002;54(3):735–741. doi:10.1016/S0360-3016(02)02994-2 5. Wang LH, Fu XL, Chen M, et al. Diagnosis and treatment of radioactive lung injury. Chin J Radiat Oncol. 2015;24:4–9. 6. Ciaccio M, Fugardi G, Titone L, et al. Procalcitonin levels in plasma in oncohaematologic patients with and without bacterial infections. Clin Chim Acta. 2004;340(1–2):149–152. doi:10.1016/j.cccn.2003.10.014 7. Agnello L, Bivona G, Parisi E, et al. Presepsin and midregional proadrenomedullin in pediatric oncologic patients with febrile neutropenia. Lab Med. 2020;51(6):585–591. doi:10.1093/labmed/lmaa011 8. Bellia C, Agnello L, Lo Sasso B, et al. Mid-regional pro-adrenomedullin predicts poor outcome in non-selected patients admitted to an intensive care unit. Clin Chem Lab Med. 2019;57(4):549–555. doi:10.1515/cclm-2018-0645 9. Agnello L, Lo Sasso B, Vidali M, et al. Validation of monocyte distribution width decisional cutoff for sepsis detection in the acute setting. Int J Lab Hematol. 2021. doi:10.1111/ijlh.13496 10. Oh YT. Radiation induced lung damage: mechanisms and clinical implications. J Lung Cancer. 2008;9(7). 11. Arrieta O, Gallardo-Rincón D, Villarreal-Garza C, et al. High frequency of radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with concurrent radiotherapy and gemcitabine after induction with gemcitabine and carboplatin. J Thorac Oncol. 2009;4(7):845–852. doi:10.1097/JTO.0b013e3181a97e17 12. Wang J, Cao J, Yuan S, et al. Poor baseline pulmonary function may not increase the risk of radiation-induced lung toxicity. Int J Radiat Oncol Biol Phys. 2013;85(3):798–804. doi:10.1016/j.ijrobp.2012.06.040 13. Xu HM, Cao JZ, Wang JB, et al. Management and outcome of symptomatic radiation induced lung injury in non-small cell lung cancer. Chin J Radiat Oncol. 2013;22:201–204. 14. Sekine I, Sumi M, Ito Y, et al. Retrospective analysis of steroid therapy for radiation-induced lung injury in lung cancer patients. Radiother Oncol. 2006;80(1):93–97. doi:10.1016/j.radonc.2006.06.007 15. Hanania AN, Mainwaring W, Ghebre YT, Hanania NA, Ludwig M. Radiation-induced lung injury: assessment and management. Chest. 2019;156(1):150–162. doi:10.1016/j.chest.2019.03.033 16. Bledsoe TJ, Nath SK, Decker RH. Radiation pneumonitis. Clin Chest Med. 2017;38(2):201–208. doi:10.1016/j.ccm.2016.12.004 17. Iovine E, Nenna R, Bloise S, et al. Lung ultrasound: its findings and new applications in neonatology and pediatric diseases. Diagnostics (Basel). 2021;11(4):652. doi:10.3390/diagnostics11040652 18. Mummudi N, Jiwnani S, Niyogi D, et al. Salvage radiotherapy for postoperative locoregional failure in esophageal cancer: a systematic review and meta-analysis. Dis Esophagus. 2021;doab020. doi:10.1093/dote/doab020 19. Xue N, Zhou R, Deng M, et al. High serum superoxide dismutase activity improves radiation-related quality of life in patients with esophageal squamous cell carcinoma. Clinics (Sao Paulo). 2021;76:e2226. doi:10.6061/clinics/2021/e2226 20. Tzilas V, Poletti V, Bouros D. Reversed halo sign in radiation induced organizing pneumonia: natural course of the underlying pathophysiology. Pulmonology. 2021. S2531-0437(21)00008-8. doi:10.1016/j.pulmoe.2020.12.015  |
| You are subscribed to email updates from "acute lung injury,acute pulmonary disease,acute respiratory" - Google News. To stop receiving these emails, you may unsubscribe now. | Email delivery powered by Google |
| Google, 1600 Amphitheatre Parkway, Mountain View, CA 94043, United States | |
Comments
Post a Comment