-
All roads lead to COPD... or not? Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-28 Agusti, A., Faner, R.
Extract Traditionally, COPD has been understood to be a self-inflicted disease caused by tobacco smoking, occurring in old, "susceptible" males and characterised by an accelerated decline of lung function with age [1, 2]. Yet, our understanding of the pathogenesis of COPD has changed very significantly over the past few years [3–6] and, as a result, it is now defined as a heterogeneous condition that
-
Reply: Transitioning endothelial cells contribute to pulmonary fibrosis Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-28 Wu, X., Boström, K. I., Yao, Y.
Extract We sincerely appreciate the correspondence from S.S. Sohal, whose recent discoveries in human pulmonary fibrosis [1, 2] are complementary to our report on an abnormal endothelial differentiation trajectory contributing myofibroblasts to pulmonary fibrosis in matrix Gla protein (MGP)-deficient mice [3]. S.S. Sohal and his collaborators have provided strong evidence for an essential role of endothelial
-
Oxidation alters IL-33 function: new insights in the biology of different forms of IL-33 and their relevance for COPD Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-28 Pieter S. Hiemstra, Irene H. Heijink
Extract In recent decades, the perception of the epithelium lining the airways has drastically changed from that of a physical barrier that mediates mucociliary transport to a multifunctional tissue that is actively involved in initiating and regulating tissue inflammation and remodelling [1, 2]. The airway epithelium produces a range of mediators, including chemokines, cytokines, growth factors and
-
Endothelial to mesenchymal transition: a novel pathological feature of pulmonary fibrosis Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-28 Sukhwinder Singh Sohal
Extract I read with great interest the recent original research article by Wu et al. [1] published in the prestigious European Respiratory Journal (ERJ), which reported on endothelial cell-like myofibroblasts and their role in pulmonary fibrosis using mouse models. I highly commend this work and the focus on endothelial cells in this decidedly fibrotic condition. To further enhance discussion, and
-
From pre-COPD to COPD: a Simple, Low cost and easy to IMplement (SLIM) risk calculator Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-28 Miguel J. Divo, Congjian Liu, Francesca Polverino, Peter J. Castaldi, Bartolome R. Celli, Yohannes Tesfaigzi
Extract COPD is defined as a heterogeneous lung condition characterised by chronic respiratory symptoms (dyspnoea, cough, expectoration and/or exacerbations) due to abnormalities of the airways (bronchitis, bronchiolitis) and/or alveoli (emphysema) that cause persistent, often progressive, airflow obstruction [1]. COPD has a long latency period and once the diagnosis is established, modifying disease
-
Regular, low-dose, sustained-release morphine for persisting breathlessness in interstitial lung disease: a randomised, double-blind, placebo-controlled, crossover trial Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-28 Diana H. Ferreira, Magnus Ekström, Sabrina Bajwah, Belinda Fazekas, David C. Currow
Extract People with interstitial lung disease (ILD) often have persistent breathlessness that worsens over months or years, despite optimal disease modifying therapies and non-pharmacological interventions [1]. Regular, low-dose, systemic morphine is recommended as treatment for persistent breathlessness [2, 3], but the majority of participants in studies of this therapy have COPD as the most prevalent
-
Oxidised IL-33 drives COPD epithelial pathogenesis via ST2-independent RAGE/EGFR signalling complex Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-28 Strickson, S., Houslay, K. F., Negri, V. A., Ohne, Y., Ottosson, T., Dodd, R. B., Huntington, C. C., Baker, T., Li, J., Stephenson, K. E., O'Connor, A. J., Sagawe, J. S., Killick, H., Moore, T., Rees, D. G., Koch, S., Sanden, C., Wang, Y., Gubbins, E., Ghaedi, M., Kolbeck, R., Saumyaa, S., Erjefält, J. S., Sims, G. P., Humbles, A. A., Scott, I. C., Romero Ros, X., Cohen, E. S.
Extract The airway epithelium plays a central role in the initiation and development of chronic airway diseases [1]. It is the first line of defence against the external environment; therefore, numerous inflammatory and tissue remodelling pathways exist to protect against damage caused by constant exposure to inhaled stimuli (e.g. allergens, cigarette smoke or pathogens) [1, 2]. Dysregulation of these
-
Responding to the tuberculosis risk of forced mass migration from Ukraine: a complex challenge with no single solution Thorax (IF 10.0) Pub Date : 2023-09-27 Pranabashis Haldar, Lauren Ahyow, Martin Dedicoat
Infectious diseases have played a major role in shaping our history—none more so than tuberculosis (TB), which accompanied the first humans out of Africa, and continues to cause the untimely death of more than 1.5 million people each year.1 The COVID-19 pandemic has provided a much-needed wake-up call to the global threat posed by infectious disease at a time of rising population density and mobility
-
Infections in autoimmune pulmonary alveolar proteinosis: a large retrospective cohort Thorax (IF 10.0) Pub Date : 2023-09-27 Axelle Mabo, Raphael Borie, Lidwine Wemeau-Stervinou, Yurdagül Uzunhan, Emmanuel Gomez, Gregoire Prevot, Martine Reynaud-Gaubert, Julie Traclet, Emmanuel Bergot, Jacques Cadranel, Sylvain Marchand-Adam, Anne Bergeron, Elodie Blanchard, Benjamin Bondue, Philippe Bonniaud, Arnaud Bourdin, Pierre Regis Burgel, Sandrine Hirschi, Charles Hugo Marquette, Sébastien Quétant, Hilario Nunes, Cécile Chenivesse
Background Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease, predisposing to an increased risk of infection. A complete picture of these infections is lacking. Research question Describe the characteristics and clinical outcomes of patients diagnosed with aPAP, and to identify risk factors associated with opportunistic infections. Methods We conducted a retrospective cohort including
-
Core outcome set for pulmonary rehabilitation of patients with COPD: results of a modified Delphi survey Thorax (IF 10.0) Pub Date : 2023-09-27 Sara Souto-Miranda, Isabel Saraiva, Martijn A Spruit, Alda Marques
Introduction There is high heterogeneity of outcomes and measures reported in pulmonary rehabilitation (PR) trials of people with chronic obstructive pulmonary disease (COPD). This hinders study comparability and benchmarking of PR. We have developed a core outcome set (COS) to overcome these challenges. Methods This study was informed by a systematic review and two qualitative studies and had patient
-
Opportunistic infections in autoimmune pulmonary alveolar proteinosis: opportunity to better understand the role of GM-CSF in the innate immune response Thorax (IF 10.0) Pub Date : 2023-09-27 Marissa O'Callaghan, Maitreyi Penugonda, Cormac McCarthy
Autoimmune pulmonary alveolar proteinosis (aPAP) is an ultra-rare lung disease characterised by myeloid cell dysfunction, abnormal pulmonary surfactant accumulation resulting in progressive dyspnoea of insidious onset and respiratory failure, innate immune deficiency and secondary infection.1 2 Autoantibodies that bind GM-CSF (granulocyte/macrophage colony-stimulating factor) drive the pathogenesis
-
Spirometric patterns in young and middle-aged adults: a 20-year European study Thorax (IF 10.0) Pub Date : 2023-09-27 Anne-Elie Carsin, Judith Garcia-Aymerich, Simone Accordini, Shyamali Dharmage, Bénédicte Leynaert, Marti de las Heras, Lidia Casas, Seraina Caviezel, Pascal Demoly, Bertil Forsberg, Thorarinn Gislason, Angelo Guido Corsico, Christer Janson, Rain Jogi, Jesús Martínez-Moratalla, Dennis Nowak, Leopoldo Palacios Gómez, Isabelle Pin, Nicole Probst-Hensch, Chantal Raherison-Semjen, Giulia Squillacioti, Cecilie
Background Understanding the natural history of abnormal spirometric patterns at different stages of life is critical to identify and optimise preventive strategies. We aimed to describe characteristics and risk factors of restrictive and obstructive spirometric patterns occurring before 40 years (young onset) and between 40 and 61 years (mid-adult onset). Methods We used data from the population-based
-
Using Trajectories of Bedside Vital Signs to Identify COVID-19 Subphenotypes Chest (IF 9.6) Pub Date : 2023-09-23 Sivasubramanium V. Bhavani, Chad Robichaux, Philip A. Verhoef, Matthew M. Churpek, Craig M. Coopersmith
Background Trajectories of bedside vital signs have been used to identify sepsis subphenotypes with distinct outcomes and treatment responses. The objective of this study is to validate the vitals trajectory model in a multicenter cohort of hospitalized COVID-19 patients and to evaluate the clinical characteristics and outcomes of the resulting subphenotypes. Research Question Can the trajectory of
-
Making sense of multiorgan MRI imaging for post-acute sequelae of SARS-CoV-2 infection Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-22 Matthew R Baldwin
Abstract not available
-
Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-22
Introduction The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE)
-
Prevalence, Risk factors, Clinical features, and Outcome of Influenza-Associated Pulmonary Aspergillosis (IAPA) in Critically Ill Patients: a systematic review and meta-analysis Chest (IF 9.6) Pub Date : 2023-09-22 Lawrence Y. Lu, Hui Min Lee, Andrew Burke, Gianluigi Li Bassi, Antoni Torres, John F. Fraser, Jonathon P. Fanning
Abstract not available
-
Discrimination predicts suboptimal adherence to continuous positive airway pressure treatment and mediates Black-White differences in use Chest (IF 9.6) Pub Date : 2023-09-22 Douglas M. Wallace, Andrea Barnes Grant, Zuzana Belisova-Gyure, Matthew Ebben, Omonigho M. Bubu, Dayna A. Johnson, Girardin Jean-Louis, Natasha J. Williams
Background Although racial and ethnic differences in continuous positive airway pressure (CPAP) adherence for obstructive sleep apnea (OSA) are widely established, no studies have examined the influence of perceived racial discrimination on CPAP usage, to our knowledge. Research Questions: 1) Do Black adults with OSA report experiencing greater amounts of discrimination than non-Hispanic White adults
-
Increasing respiratory burden of prematurity: can we turn the tide? Thorax (IF 10.0) Pub Date : 2023-09-21 Sanja Zivanovic, Badr Chaban
Despite many improvements in neonatal care, prematurity remains a significant cause of childhood mortality and morbidity, and the second largest cause of death in children worldwide.1 2 Chronic lung disease of prematurity, also known as bronchopulmonary dysplasia (BPD) is the most common respiratory complication, associated with poor long-term health and neurodisability.3 Early lung protective ventilation
-
Novel electromagnetic navigation bronchoscopy system for the diagnosis of peripheral pulmonary nodules: a prospective, multicentre study Thorax (IF 10.0) Pub Date : 2023-09-21 Ying Li, Wei Chen, Fangfang Xie, Rui Huang, Xiang Liu, Yang Xiao, Liming Cao, Yi Hu, Mingyao Ke, Shiman Wu, Jiayuan Sun
Background Traditional electromagnetic navigation bronchoscopy (ENB) is a real-time image-guided system and used with thick bronchoscopes for the diagnosis of peripheral pulmonary nodules (PPNs). A novel ENB that could be used with thin bronchoscopes was developed. This study aimed to evaluate the diagnostic yield and the experience of using this ENB system in a real clinical scenario. Methods This
-
Automatic analysis of bronchus-artery dimensions to diagnose and monitor airways disease in cystic fibrosis Thorax (IF 10.0) Pub Date : 2023-09-21 Qianting Lv, Leticia Gallardo-Estrella, Eleni-Rosalina Andrinopoulou, Yuxin Chen, Jean-Paul Charbonnier, Rikke Mulvad Sandvik, Daan Caudri, Kim Gjerum Nielsen, Marleen de Bruijne, Pierluigi Ciet, Harm Tiddens
Background Cystic fibrosis (CF) lung disease is characterised by progressive airway wall thickening and widening. We aimed to validate an artificial intelligence-based algorithm to assess dimensions of all visible bronchus-artery (BA) pairs on chest CT scans from patients with CF. Methods The algorithm fully automatically segments the bronchial tree; identifies bronchial generations; matches bronchi
-
Accuracy of Cytological vs. Histological Specimens for Assessment of PD-L1 Expression in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis Chest (IF 9.6) Pub Date : 2023-09-20 Pattraporn Tajarernmuang, Felipe Aliaga, Amr J. Alwakeel, Gamuchirai Tavaziva, Kimberly Turner, Dick Menzies, Hangjun Wang, Linda Ofiara, Andrea Benedetti, Anne V. Gonzalez
Background Programmed death-ligand 1 (PD-L1) expression on tumor cells, evaluated by immunohistochemistry, guides the use of immunotherapy in advanced non-small cell lung cancer (NSCLC). Research Question What is the sensitivity and specificity of PD-L1 testing performed in cytological vs. paired histological specimens, in patients with non-small cell lung cancer? Study Design and Methods The MEDLINE
-
Air pollution, climate change, and lung health in Europe Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-20
Abstract not available
-
Reducing the pressure in pulmonary arterial hypertension: sotatercept, haemodynamics and the right ventricle Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-21 Price, L. C., McCabe, C., Weatherald, J.
Extract Pulmonary arterial hypertension (PAH) is a severe progressive disease characterised by obliterative vascular remodelling and increased resistance in small and medium-sized pulmonary arteries (PAs). Contributing factors to PAH pathogenesis include genetic mutations such as those in bone morphogenetic protein receptor type 2 (BMPR2), perivascular inflammation, systemic immune dysregulation, and
-
Treatable traits: a comprehensive precision medicine approach in interstitial lung disease, but why were acute exacerbations not considered? Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-21 Onofre Moran-Mendoza, Maria A. Coppola-Lamas, Elham Alrubai, Carla Paredes
Extract We commend Khor et al. [1] for their important article that proposes a framework for delivering comprehensive care in patients with interstitial lung disease (ILD) based on treatable traits.
-
Effects of sotatercept on haemodynamics and right heart function: analysis of the STELLAR trial Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-21 Souza, R., Badesch, D. B., Ghofrani, H. A., Gibbs, J. S. R., Gomberg-Maitland, M., McLaughlin, V. V., Preston, I. R., Waxman, A. B., Grünig, E., Kopec, G., Meyer, G., Olsson, K. M., Rosenkranz, S., Lin, J., Johnson-Levonas, A. O., de Oliveira Pena, J., Humbert, M., Hoeper, M. M.
Background In the phase 3 STELLAR trial, sotatercept, an investigational first-in-class activin signalling inhibitor, demonstrated beneficial effects on 6-min walk distance and additional efficacy endpoints in pre-treated participants with pulmonary arterial hypertension (PAH). Methods This post hoc analysis evaluated data from right heart catheterisation (RHC) and echocardiography (ECHO) obtained
-
Translated impact on carbon footprint from choice of inhaled therapy: a Danish scenario Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-21 Jørgen Vestbo, Kåre Press-Kristensen
Extract With increasing climate change, all sources of greenhouse gases must be considered. Hydrofluorocarbon (HFC) propellants are used in all pressurised metered dose inhalers (pMDIs) and, although they are not as ozone-depleting as the earlier chlorofluorocarbons (CFCs), they are potent greenhouse gases and there is a general ask for reduction in their use [1]. In this respect, respiratory doctors
-
Derivation of a high-resolution CT-based, semi-automated radiographic score in tuberculosis and its relationship to bacillary load and antitubercular therapy Eur. Respir. J. (IF 24.3) Pub Date : 2023-09-21 Catherine Riou, Elsa du Bruyn, Grace Hyun J. Kim, Irene da Costa, Jihey Lee, Alan Sher, Robert J. Wilkinson, Brian W. Allwood, Jonathan Goldin
Extract Efforts to curb the tuberculosis (TB) pandemic remain hindered by a lack of objective measures to quantify disease severity and track treatment success that are valid in both HIV-1-infected and -uninfected TB patients. Ralph et al. [1] developed a promising radiographic scoring system, with baseline scores being predictive of sputum smear conversion at 2 months, but it is reliant on skilled
-
Effects of Sirolimus on Anti-SARS-CoV2 Vaccination in Patients with LAM Chest (IF 9.6) Pub Date : 2023-09-20 Tat’Yana Worthy, Amanda Jones, Bennett Yang, Hiroko Ishiwata-Endo, Nishant Gupta, Joel Moss
Abstract not available
-
Epidemiology of COVID 19-Associated Mucormycosis in the United States Chest (IF 9.6) Pub Date : 2023-09-19 Aditya Sharma, Aditi Sharma, Ayman O. Soubani
Abstract not available
-
AHL score for predicting mortality risk in patients with pulmonary tuberculosis Chest (IF 9.6) Pub Date : 2023-09-17 Takeshi Osawa, Masato Watanabe, Kozo Morimoto, Takashi Yoshiyama, Shuichi Matsuda, Keiji Fujiwara, Koji Furuuchi, Masafumi Shimoda, Masashi Ito, Tatsuya Kodama, Fumiko Uesugi, Masao Okumura, Yoshiaki Tanaka, Yuka Sasaki, Hideo Ogata, Hajime Goto, Shoji Kudoh, Ken Ohta
Background A clinically applicable mortality-risk prediction system for pulmonary tuberculosis may improve treatment outcomes, but no easy-to-calculate and accurate score has yet been reported. We aimed to construct a simple and objective disease-severity score for patients with pulmonary tuberculosis. Research Question Does a clinical score consisting of simple objective factors predict the mortality
-
Atopic and non-atopic effects of fish oil supplementation during pregnancy Thorax (IF 10.0) Pub Date : 2023-09-18 Hans Bisgaard, Marianne Mikkelsen, Morten Arendt Rasmussen, Astrid Sevelsted, Ann-Marie Malby Schoos, Nicklas Brustad, Anders U Eliasen, Jonathan Thorsen, Bo Chawes, Gözde Gürdeniz, Andreanne Morin, Ken Stark, Jakob Stokholm, Carole Ober, Casper Emil Tingskov Pedersen, Klaus Bønnelykke
Background We recently conducted a double-blinded randomised controlled trial showing that fish-oil supplementation during pregnancy reduced the risk of persistent wheeze or asthma in the child by 30%. Here, we explore the mechanisms of the intervention. Methods 736 pregnant women were given either placebo or n-3 long-chain polyunsaturated fatty acids (LCPUFAs) in the third trimester in a randomised
-
Oxygen therapy in patients with intermediate-risk acute pulmonary embolism: a randomized trial Chest (IF 9.6) Pub Date : 2023-09-16 Deisy Barrios, Diego Durán, Carmen Rodríguez, Jorge Moisés, Ana Retegui, José Luis Lobo, Raquel López, Leyre Chasco, Luis Jara-Palomares, Alfonso Muriel, Remedios Otero-Candelera, Pedro Ruiz-Artacho, Manuel Monreal, Behnood Bikdeli, David Jiménez
Background The effect of supplemental oxygen therapy in patients with intermediate-risk pulmonary embolism (PE) who do not have hypoxemia at baseline is uncertain. Research Question Does supplemental oxygen improve echocardiographic parameters in non-hypoxemic patients with intermediate-risk PE? Study Design and Methods This pilot trial randomly assigned non-hypoxemic patients with stable PE and echocardiographic
-
COVID-19 boosters versus primary series: update to a living review Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-15 Nana Wu, Keven Joyal-Desmarais, Ariany Marques Vieira, Comfort Sanuade, Mohit Jagwani, Laurence Paquet, Paula A B Ribeiro, Jovana Stojanovic, Doro Yip, Simon L Bacon
Abstract not available
-
Progress and challenges in tuberculosis control in Sudan Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-15 Yassir Adam Shuaib, Nuha Yousif Ibrahim, Rasheeda Hamid Abdalla, Mohamed Abdelsalam Abdalla, Amel Omer Bakhiet, Hamdan Mustafa Hamdan
Abstract not available
-
Is antidepressant use a concern for patients with COPD? Thorax (IF 10.0) Pub Date : 2023-09-15 Gianluca Trifirò, Salvatore Crisafulli
Chronic obstructive pulmonary disease (COPD) affects between 15% and 25% of older people,1 2 who suffer also frequently from mental illnesses.3–5 As such, patients with COPD may require pharmacological treatments to manage psychiatric disorders. Guidelines for the treatment of depression in geriatric population recommend the use antidepressants (combined with interpersonal psychotherapy),6 and specifically
-
Risk Stratification in Pulmonary Arterial Hypertension: Perhaps Simple Is Not Best? Chest (IF 9.6) Pub Date : 2023-09-12 Charles Fauvel, R. James White, Rebecca R. Vanderpool, Roberto Badagliacca, Tobore Tobore, Mohammad Rahman, Carmine Dario Vizza, Shili Lin, Allen D. Everett, Scott H. Visovatti, Raymond L. Benza
Abstract not available
-
Efficacy of a bivalent (D614 + B.1.351) SARS-CoV-2 recombinant protein vaccine with AS03 adjuvant in adults: a phase 3, parallel, randomised, modified double-blind, placebo-controlled trial Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-13 Gustavo H Dayan, Nadine Rouphael, Stephen R Walsh, Aiying Chen, Nicole Grunenberg, Mary Allen, Johannes Antony, Kwaku Poku Asante, Amit Suresh Bhate, Tatiana Beresnev, Matthew I Bonaparte, Médéric Celle, Maria Angeles Ceregido, Lawrence Corey, Dmytro Dobrianskyi, Bo Fu, Marie-Helene Grillet, Maryam Keshtkar-Jahromi, Michal Juraska, Jia Jin Kee, Nianxian Zhang
Background COVID-19 vaccines with alternative strain compositions are needed to provide broad protection against newly emergent SARS-CoV-2 variants of concern. This study aimed to describe the clinical efficacy and safety of a bivalent SARS-CoV-2 recombinant protein vaccine as a two-injection primary series during a period of circulation of the omicron (B.1.1.529) variant. Methods We conducted a phase
-
Broad protection from SARS-CoV-2 variants without antigen matching Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-13 Keith Chappell
Abstract not available
-
Towards an integrated clinical network of care for children with sleep disordered breathing Thorax (IF 10.0) Pub Date : 2023-10-01 Heather E Elphick
In this edition of Thorax , the new British Thoracic Society (BTS) guideline for diagnosing and monitoring paediatric sleep disordered breathing (SDB)1 is published. The primary aim of the guideline is to promote clinical networking and to equip paediatricians in secondary care, with an interest in sleep, with the skills and knowledge to run a local service. The tertiary referral centre would offer
-
Getting the best from pulmonary rehabilitation Thorax (IF 10.0) Pub Date : 2023-10-01 Sara C Buttery
The value of pulmonary rehabilitation (PR) for people with chronic respiratory disease has been firmly established. A large body of evidence supports its efficacy and cost-effectiveness, improving symptoms of breathlessness, exercise capacity and quality of life.1 Although clinical guidelines and quality frameworks support its delivery, access and adherence to PR remains a challenge2 3 (figure 1).
-
Comparing tests in the absence of a reference standard Thorax (IF 10.0) Pub Date : 2023-10-01 Michael A Kohn
The prototypical study of diagnostic test accuracy compares the results of one or more index tests to an independent ‘reference-standard’ determination of true disease status: ‘disease positive’ (D+) or ‘disease negative’ (D−). If the index test is binary—either ‘test positive’ (T+) or ‘test negative’ (T−)—then sensitivity is the proportion of D+ individuals who have T+ on the index test and specificity
-
Can we design better ARDS trials? Thorax (IF 10.0) Pub Date : 2023-10-01 Naomi E Hammond, Simon Finfer
It is not a novel observation that the clinical trial enterprise has largely been unsuccessful in finding new and effective treatments for the acute respiratory distress syndrome (ARDS).1 2 While a significant contributor to the absence of success may be the testing of ineffective treatments, other likely contributors include selecting the wrong population and having unrealistic expectations about
-
Effect of obesity on airway and systemic inflammation in adults with asthma: a systematic review and meta-analysis Thorax (IF 10.0) Pub Date : 2023-10-01 Hayley A Scott, Shawn HM Ng, Rebecca F McLoughlin, Sarah R Valkenborghs, Parameswaran Nair, Alexandra C Brown, Olivia R Carroll, Jay C Horvat, Lisa G Wood
Background Obesity is associated with more severe asthma, however, the mechanisms responsible are poorly understood. Obesity is also associated with low-grade systemic inflammation; it is possible that this inflammation extends to the airways of adults with asthma, contributing to worse asthma outcomes. Accordingly, the aim of this review was to examine whether obesity is associated with increased
-
Changes in exhaled volatile organic compounds following indirect bronchial challenge in suspected asthma Thorax (IF 10.0) Pub Date : 2023-10-01 Adam Peel, Ran Wang, Waqar Ahmed, Iain White, Maxim Wilkinson, Yoon K Loke, Andrew M Wilson, Stephen J Fowler
Background Inhaled mannitol provokes bronchoconstriction via mediators released during osmotic degranulation of inflammatory cells, and, hence represents a useful diagnostic test for asthma and model for acute attacks. We hypothesised that the mannitol challenge would trigger changes in exhaled volatile organic compounds (VOCs), generating both candidate biomarkers and novel insights into their origin
-
Short-term air pollution exposure and exacerbation events in mild to moderate COPD: a case-crossover study within the CanCOLD cohort Thorax (IF 10.0) Pub Date : 2023-10-01 Bryan A Ross, Dany Doiron, Andrea Benedetti, Shawn D Aaron, Kenneth Chapman, Paul Hernandez, François Maltais, Darcy Marciniuk, Denis E O'Donnell, Don D Sin, Brandie L Walker, Wan Tan, Jean Bourbeau
Background Infections are considered as leading causes of acute exacerbations of chronic obstructive pulmonary disease (COPD). Non-infectious risk factors such as short-term air pollution exposure may play a clinically important role. We sought to estimate the relationship between short-term air pollutant exposure and exacerbations in Canadian adults living with mild to moderate COPD. Methods In this
-
Estimating individual treatment effects on COPD exacerbations by causal machine learning on randomised controlled trials Thorax (IF 10.0) Pub Date : 2023-10-01 Kenneth Verstraete, Iwein Gyselinck, Helene Huts, Nilakash Das, Marko Topalovic, Maarten De Vos, Wim Janssens
Rationale Estimating the causal effect of an intervention at individual level, also called individual treatment effect (ITE), may help in identifying response prior to the intervention. Objectives We aimed to develop machine learning (ML) models which estimate ITE of an intervention using data from randomised controlled trials and illustrate this approach with prediction of ITE on annual chronic obstructive
-
Estimating the attributable fraction of mortality from acute respiratory distress syndrome to inform enrichment in future randomised clinical trials Thorax (IF 10.0) Pub Date : 2023-10-01 Rohit Saha, Tài Pham, Pratik Sinha, Manoj V Maddali, Giacomo Bellani, Eddy Fan, Charlotte Summers, Abdel Douiri, Gordon D Rubenfeld, Carolyn S Calfee, John Gerard Laffey, Daniel Francis McAuley, Manu Shankar-Hari
Background Efficiency of randomised clinical trials of acute respiratory distress syndrome (ARDS) depends on the fraction of deaths attributable to ARDS (AFARDS) to which interventions are targeted. Estimates of AFARDS in subpopulations of ARDS could improve design of ARDS trials. Methods We performed a matched case-control study using the Large observational study to UNderstand the Global impact of
-
Acetazolamide for metabolic alkalosis complicating respiratory failure with chronic obstructive pulmonary disease or obesity hypoventilation syndrome: a systematic review Thorax (IF 10.0) Pub Date : 2023-10-01 Timothy John Bemand, Richard Chatoor, Patrizia Natale, Giovanni Strippoli, Anthony Delaney
Background Metabolic alkalosis may lead to respiratory inhibition and increased need for ventilatory support or prolongation of weaning from ventilation for patients with chronic respiratory disease. Acetazolamide can reduce alkalaemia and may reduce respiratory depression. Methods We searched Medline, EMBASE and CENTRAL from inception to March 2022 for randomised controlled trials comparing acetazolamide
-
Emulated trial investigating effects of multiple treatments: estimating combined effects of mucoactive nebulisers in cystic fibrosis using registry data Thorax (IF 10.0) Pub Date : 2023-10-01 Emily Granger, Gwyneth Davies, Ruth H Keogh
Introduction People with cystic fibrosis (CF) are often on multiple long-term treatments, including mucoactive nebulisers. In the UK, the most common mucoactive nebuliser is dornase alfa (DNase). A common therapeutic approach for people already on DNase is to add hypertonic saline (HS). The effects of DNase and HS used alone have been studied in randomised trials, but their effects in combination have
-
Tracheostomy in children is associated with neutrophilic airway inflammation Thorax (IF 10.0) Pub Date : 2023-10-01 Jason Powell, Steven Powell, Michael W Mather, Lauren Beck, Andrew Nelson, Pawel Palmowski, Andrew Porter, Jonathan Coxhead, Ann Hedley, Jonathan Scott, Anthony J Rostron, Thomas P Hellyer, Fatima Zaidi, Tracey Davey, James P Garnett, Rachel Agbeko, Chris Ward, Christopher J Stewart, Clifford C Taggart, Malcolm Brodlie, A John Simpson
Background Tracheostomies in children are associated with significant morbidity, poor quality of life, excess healthcare costs and excess mortality. The underlying mechanisms facilitating adverse respiratory outcomes in tracheostomised children are poorly understood. We aimed to characterise airway host defence in tracheostomised children using serial molecular analyses. Methods Tracheal aspirates
-
Higher SARS-CoV-2 detection of oropharyngeal compared with nasopharyngeal or saliva specimen for molecular testing: a multicentre randomised comparative accuracy study Thorax (IF 10.0) Pub Date : 2023-10-01 Tobias Todsen, Martin G Tolsgaard, Thomas Benfield, Fredrik Folke, Kathrine K Jakobsen, Niels Tobias Gredal, Annette K Ersbøll, Christian von Buchwald, Nikolai Kirkby
Background Testing is critical for detecting SARS-CoV-2 infection, but the best sampling method remains unclear. Objectives To determine whether nasopharyngeal swab (NPS), oropharyngeal swab (OPS) or saliva specimen collection has the highest detection rate for SARS-CoV-2 molecular testing. Methods We conducted a randomised clinical trial at two COVID-19 outpatient test centres where NPS, OPS and saliva
-
Understanding the effectiveness of different exercise training programme designs on V̇O2peak in COPD: a component network meta-analysis Thorax (IF 10.0) Pub Date : 2023-10-01 Thomas JC Ward, Charles D Plumptre, Alessandra V Fraser-Pye, Thomas E Dolmage, Amy V Jones, Ruth Trethewey, Lorna Latimer, Sally J Singh, Martin R Lindley, Michael C Steiner, Rachael A Evans
Pulmonary rehabilitation programmes including aerobic training improve cardiorespiratory fitness in patients with COPD, but the optimal programme design is unclear. We used random effects additive component network meta-analysis to investigate the relative effectiveness of different programme components on fitness measured by V̇O2peak in COPD. The included 59 studies involving 2191 participants demonstrated
-
Pulmonary telerehabilitation vs. conventional pulmonary rehabilitation – a secondary responder analysis Thorax (IF 10.0) Pub Date : 2023-10-01 Henrik Hansen, Andre Torre, Thomas Kallemose, Charlotte Suppli Ulrik, Nina Skavlan Godtfredsen
Home-based pulmonary telerehabilitation (PTR) has been proposed to be equivalent to supervised outpatient pulmonary rehabilitation (PR) but available randomised trials have failed to reach the minimal important changes (MIC). The purpose of this study was to analyse the proportion of MIC responders and non-responders on short-term (10 weeks from baseline) and long-term (62 weeks from baseline) in total
-
British Thoracic Society Guideline for diagnosing and monitoring paediatric sleep-disordered breathing Thorax (IF 10.0) Pub Date : 2023-10-01 Hazel J Evans, Neil A Gibson, Joanna Bennett, Samantha YS Chan, Johanna Gavlak, Katharine Harman, Hasnaa Ismail-Koch, Ruth N Kingshott, Ross Langley, Andrew Morley, Kirstie S Opstad, Kylie Russo, Martin P Samuels, Hui Leng Tan, Daniel Tweedie, Michael Yanney, Andrea Whitney
The following is a summary of the British Thoracic Society (BTS) Guideline for diagnosing and monitoring paediatric sleep-disordered breathing (SDB) and includes a summary of the recommendations and good practice points (GPPs). The full guideline is published as a separate Thorax Supplement1 and is available from the BTS website.52 Please refer to the full guideline for full information about each
-
Fibrosing mediastinitis: ‘haemoptysis in the Heartland’ Thorax (IF 10.0) Pub Date : 2023-10-01 Prince Ntiamoah, Jui Rakesh Shah, Subha Ghosh, Atul Mehta
Fibrosing mediastinitis (FM) is an uncommon cause of haemoptysis, characterised by sclerosis of the mediastinum that may occur as an inflammatory sequela of histoplasmosis, lymphoma, sarcoidosis or an idiopathic process. Bleeding is predominantly due to concomitant collateral vessels and engorgement. However, the endobronchial findings obtained via flexible bronchoscopy are not clearly defined in the
-
Journal club Thorax (IF 10.0) Pub Date : 2023-10-01 João Oliveira Rodrigues
There is increasing interest in phenotypes of patients with COPD that may indicate different response to treatments. Patients with COPD and type 2 inflammation have been shown to have a different response to glucocorticoids and so may also respond to other anti-inflammatory medications. The BOREAS trial (NEJM 2023: DOI 10.1056/NEJMoa2303951) was a phase 3, international, multicentre, randomised, double-blind
-
Evaluation of the double-tracer gas single-breath washout test in a pediatric field study Chest (IF 9.6) Pub Date : 2023-09-15 Anne-Christianne Kentgens, Johanna M. Kurz, Rebeca Mozun, Jakob Usemann, Eva S.L. Pedersen, Claudia E. Kuehni, Philipp Latzin, Alexander Moeller, Florian Singer
Background The early-life origins of chronic pulmonary diseases are thought to arise in peripheral small airways. Predictors of ventilation inhomogeneity, a proxy of peripheral airway function, are understudied in schoolchildren. Research Question Is the double-tracer gas single-breath washout (DTG-SBW) measurement feasible in a pediatric field study setting? What are the predictors of the DTG-SBW
-
Effect of once-per-day tacrolimus versus twice-per-day ciclosporin on 3-year incidence of chronic lung allograft dysfunction after lung transplantation in Scandinavia (ScanCLAD): a multicentre randomised controlled trial Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-10 Göran Dellgren, Thomas Kromann Lund, Peter Raivio, Inga Leuckfeld, Johan Svahn, Erik C Holmberg, Peter Skov Olsen, Maija Halme, Arnt Fiane, Sandra Lindstedt, Gerdt C Riise, Jesper Magnusson
Background Evidence is low regarding the choice of calcineurin inhibitor for immunosuppression after lung transplantation. We aimed to compare the use of tacrolimus once per day with ciclosporin twice per day according to the current definition of chronic lung allograft dysfunction (CLAD) after lung transplantation. Methods ScanCLAD is an investigator-initiated, open-label, multicentre, randomised
-
Once-per-day tacrolimus to reduce chronic lung transplant rejection Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-10 Michael P Combs
Abstract not available
-
End-of-life care in cystic fibrosis in the era of new therapies Lancet Respir. Med. (IF 76.2) Pub Date : 2023-09-09 Elisabeth P Dellon, Jessica Goggin
Abstract not available