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Respiratory Medicine

This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 11.

Intraoperative apnea in children after buffered 5% povidone-iodine site sterilization for strabismus surgery.
CONCLUSIONS: Apnea at the time of ocular preparation with buffered 5% povidone-iodine solution is common. The precise mechanism of this response is unknown. PMID: 25040554 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - July 9, 2014 Category: Anesthesiology Authors: Emhardt JD, Haider KM, Plager DA, Grundhoefer DL Tags: Paediatr Anaesth Source Type: research

The Effects of Extrafine Beclometasone/Formoterol (BDP/F) on Lung Function, Dyspnea, Hyperinflation, and Airway Geometry in COPD Patients: Novel Insight Using Functional Respiratory Imaging
Journal of Aerosol Medicine and Pulmonary Drug Delivery , Vol. 0, No. 0. (Source: Journal of Aerosol Medicine and Pulmonary Drug Delivery)
Source: Journal of Aerosol Medicine and Pulmonary Drug Delivery - July 8, 2014 Category: Respiratory Medicine Tags: article Source Type: research

Dose Escalated Liver Stereotactic Body Radiation Therapy at the Mean Respiratory Position
Purpose: The dosimetric impact of dose probability based planning target volume (PTV) margins for liver cancer patients receiving stereotactic body radiation therapy (SBRT) was compared with standard PTV based on the internal target volume (ITV). Plan robustness was evaluated by accumulating the treatment dose to ensure delivery of the intended plan.Methods and Materials: Twenty patients planned on exhale CT for 27 to 50 Gy in 6 fractions using an ITV-based PTV and treated free-breathing were retrospectively evaluated. Isotoxic, dose escalated plans were created on midposition computed tomography (CT), representing the me...
Source: International Journal of Radiation Oncology * Biology * Physics - July 8, 2014 Category: Radiology Authors: Michael Velec, Joanne L. Moseley, Laura A. Dawson, Kristy K. Brock Tags: Physics Contributions Source Type: research

Time-Adjusted Internal Target Volume: A Novel Approach Focusing on Heterogeneity of Tumor Motion Based on 4-Dimensional Computed Tomography Imaging for Radiation Therapy Planning of Lung Cancer
Conclusions: The TTV images reflected nonuniform tumor motion, and they revealed the tumor motion pattern features, suggesting that the TTV concept may facilitate various aspects of radiation therapy planning of lung cancer while incorporating respiratory motion in the future. (Source: International Journal of Radiation Oncology * Biology * Physics)
Source: International Journal of Radiation Oncology * Biology * Physics - July 8, 2014 Category: Radiology Authors: Ikuno Nishibuchi, Tomoki Kimura, Takeo Nakashima, Yusuke Ochi, Ippei Takahashi, Yoshiko Doi, Masahiro Kenjo, Yuko Kaneyasu, Syuichi Ozawa, Yuji Murakami, Koichi Wadasaki, Yasushi Nagata Tags: Physics Contributions Source Type: research

Parameters of lung inflammation in asthmatic as compared to healthy children in a contaminated city
Conclusions: Cys-LTs levels are higher in asthmatic children than in healthy children in a contaminated city and its levels are also associated with passive smoking. (Source: Epidemiologic Perspectives and Innovations)
Source: Epidemiologic Perspectives and Innovations - July 8, 2014 Category: Epidemiology Authors: Benigno Linares SegoviaGabriela Cortés SandovalNorma Amador LiconaJuan Manuel Guízar MendozaEstela Núñez LemusDiana Olivia Rocha AmadorXóchitl Sofía Ramírez GómezRebeca Monroy Torres Source Type: research

The impact of home-based HIV counseling and testing on care-seeking and incidence of common infectious disease syndromes in rural western Kenya
Conclusions: Large scale HBCT enabled a large number of newly diagnosed HIV-infected persons to know their HIV status, leading to a change in care seeking behavior and ultimately a decrease in incidence of common infectious disease syndromes through appropriate treatment and care. (Source: BMC Infectious Diseases)
Source: BMC Infectious Diseases - July 8, 2014 Category: Infectious Diseases Authors: Godfrey BigogoManase AmollohKayla LasersonAllan AudiBarrack AuraWarren DalalMarta AckersDeron BurtonRobert BreimanDaniel Feikin Source Type: research

Putative roles of Ca2+‐independent phospholipase A2 in respiratory chain‐associated ROS production in brain mitochondria: influence of docosahexaenoic acid and bromoenol lactone
Abstract Ca2+‐independent phospholipase A2 (iPLA2) is hypothesized to control mitochondrial reactive oxygen species (ROS) generation. Here, we modulated the influence of iPLA2‐induced liberation of non‐esterified free fatty acids on ROS generation associated with the electron transport chain. We demonstrate enzymatic activity of membrane‐associated iPLA2 in native, energized rat brain mitochondria (RBM). Theoretically, enhanced liberation of free fatty acids by iPLA2 modulates mitochondrial ROS generation, either attenuating the reversed electron transport (RET) or deregulating the forward electron transport of ele...
Source: Journal of Neurochemistry - July 8, 2014 Category: Neurology Authors: Caroline Nordmann, Mikhail Strokin, Peter Schönfeld, Georg Reiser Tags: Original Article Source Type: research

Bilateral monosymptomatic optic neuritis following Mycoplasma pneumoniae infection: A case report and literature review
Wei-Yu Chiang, Hsiu-Mei HuangIndian Journal of Ophthalmology 2014 62(6):724-727Herein, we report the clinical findings, treatment choice, and clinical course of a rare case of Mycoplasma pneumoniae (M. pneumoniae) infection with the sole manifestation of optic neuritis (ON). To the best of our knowledge, this is the first case presenting monosymptomatic visual loss without papillitis, neurological symptoms, and abnormal findings on brain imaging. Related articles about ON after M. pneumoniae infection were reviewed to summarize the clinical presentation, possible mechanisms, clinical survey, treatment, and prognosis of thi...
Source: Indian Journal of Ophthalmology - July 8, 2014 Category: Opthalmology Authors: Wei-Yu ChiangHsiu-Mei Huang Source Type: research

Highlights from this issue
Maybe Bill Clinton was right after all? When he said he did not inhale, he may have avoided more trouble than he realised. A unique and aggressive form of interstitial lung disease (ILD) was first described in children; in this issue we publish the results of epidemiological and pathological investigations in adults (see pages 703, 694 with an editorial by Tony Pickering see page 692). All three are our Hot Topic package this month. In children (in whom this ILD was first described) and in adults, shrewd detective work enabled humidifier disinfectant to be pinpointed as the cause, and crucially, the John Snow effect (not t...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Bush, A., Pavord, I. Tags: Airwaves Source Type: research

Exacerbations in non-COPD patients: recognition?
COPD is a progressive lung disease that leads to significant impairment of quality of life and is the third leading cause of death worldwide.1 It is principally caused by tobacco smoking over many years through airway inflammation and oxidative stress to lung tissue. Patients exposed to smoke or occupational dusts are diagnosed with the disease when their post-bronchodilator FEV1/FVC ratio falls to <0.7.2 Disease severity is assessed differently by expressing the measured FEV1 as a percentage of the expected value for normal, healthy people of similar sex, age and height. The threshold value of <0.7 for the FEV1/FVC ...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Donaldson, G. C. Tags: Editorial Source Type: research

Airborne dissemination of transmissible bacterial species in cystic fibrosis
Delivery of multidisciplinary care by experienced teams in specialist units has conferred considerable benefits in care for individuals with cystic fibrosis (CF), with significant improvements in clinical outcome and survival figures. However, one particular concern of congregating patients at specialist CF centres is the potential for cross-infection. Over the past decade, the emergence and spread of clonal (transmissible) Pseudomonas aeruginosa strains among patients with CF has become an international problem.1–3 Case series suggest that initial infection with clonal P. aeruginosa strains may be more difficult to ...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Jones, A. M. Tags: Editorial Source Type: research

Humidifiers: the use of biocides and lung disease
Over the last two decades several publications have reported outbreaks of interstitial lung disease caused by inhalational exposure to a chemical, usually at work, but occasionally in a domestic situation. These outbreaks frequently follow a change in formulation, which may be minor,1 of a chemical already being used in the workplace, or a change in process leading to its aerosolisation. In 2006, paediatricians in South Korea became aware of a severe, rapid-onset interstitial pneumonitis in young children and infants; the disease responded very poorly to treatment, and mortality rates were close to 50%.2 Its seasonal prese...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Pickering, C. A. C. Tags: Editorial Source Type: research

A cluster of lung injury associated with home humidifier use: clinical, radiological and pathological description of a new syndrome
Conclusions This case series report showed that lung injury and respiratory failure can occur as a result of inhaling humidifier disinfectants. This emphasises the need for more stringent safety regulations for potentially toxic inhalants that might be encountered in the home. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Hong, S.-B., Kim, H. J., Huh, J. W., Do, K.-H., Jang, S. J., Song, J. S., Choi, S.-J., Heo, Y., Kim, Y.-B., Lim, C.-M., Chae, E. J., Lee, H., Jung, M., Lee, K., Lee, M.-S., Koh, Y., Korean Unknown Severe Respiratory Failure Collaborative, the Korean Study Tags: Adult respiratory distress syndrome, Epidemiologic studies, Drugs: infectious diseases, Mechanical ventilation, Cardiothoracic surgery, Transplantation Critical care Source Type: research

A cluster of lung injury cases associated with home humidifier use: an epidemiological investigation
Conclusions Epidemiological evidence strongly suggests that the lung injury outbreak was caused by humidifier detergent use at home. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Kim, H. J., Lee, M.-S., Hong, S.-B., Huh, J. W., Do, K.-H., Jang, S. J., Lim, C.-M., Chae, E. J., Lee, H., Jung, M., Park, Y.-J., Park, J.-H., Kwon, G.-Y., Gwack, J., Youn, S.-K., Kwon, J.-W., Yang, B.-G., Jun, B.-Y., Kim, Y., Cheong, H.-K., Chun, B. C., Tags: Epidemiologic studies, Drugs: infectious diseases Respiratory epidemiology Source Type: research

Dupilumab in persistent asthma with elevated eosinophil levels
Monoclonal antibodies are an effective treatment for a number of inflammatory autoimmune conditions, particularly those refractory to first-line medications. In asthma, airway inflammation may be associated with Th2 cell overactivity and raised eosinophils in up to 50% of cases. Th2 activation leads to the release of interleukin (IL)-13 and IL-4, which mediate their effects via receptors containing the IL-4 α subunit. Dupilumab is an IL-4 α subunit inhibitor aiming to block both signalling pathways and reduce airway inflammation. The authors conducted a randomised, double-blind, placebo-controlled study to eval...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Bhadresha, R. Tags: Miscellanea Source Type: research

Exacerbation-like respiratory symptoms in individuals without chronic obstructive pulmonary disease: results from a population-based study
Conclusions Events similar to exacerbations of COPD can occur in individuals without COPD or asthma and are associated with significant health and socioeconomic outcomes. They increase the respiratory burden in the community and may contribute to the false-positive diagnosis of asthma or COPD. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Tan, W. C., Bourbeau, J., Hernandez, P., Chapman, K. R., Cowie, R., FitzGerald, J. M., Marciniuk, D. D., Maltais, F., Buist, A. S., O'Donnell, D. E., Sin, D. D., Aaron, S. D., for the CanCOLD Collaborative Research Group, Samet, Puhan, Hamid, Hogg, Bourbe Tags: Health policy, Epidemiologic studies, Open access, Editor's choice, Asthma, Health service research Respiratory epidemiology Source Type: research

Coronary artery calcification is increased in patients with COPD and associated with increased morbidity and mortality
Conclusions Patients with COPD have more CAD than controls and this is associated with increased dyspnoea, reduced exercise capacity and increased mortality. These data indicate that the presence of CAD in patients with COPD is associated with poor clinical outcomes. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Williams, M. C., Murchison, J. T., Edwards, L. D., Agusti, A., Bakke, P., Calverley, P. M. A., Celli, B., Coxson, H. O., Crim, C., Lomas, D. A., Miller, B. E., Rennard, S., Silverman, E. K., Tal-Singer, R., Vestbo, J., Wouters, E., Yates, J. C., van Beek, Tags: Epidemiologic studies, Ischaemic heart disease, Health education, Smoking, Tobacco use Chronic obstructive pulmonary disease Source Type: research

Structure-function relationship in COPD revisited: an in vivo microscopy view
Conclusions This is the first FCFM study to describe in vivo microscopic changes in the airways and alveoli of patients with COPD that are related to lung function impairment. These findings open the possibility of assessing the in vivo effects of therapeutic interventions for COPD in future studies. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Cosio, B. G., Shafiek, H., Fiorentino, F., Gomez, C., Lopez, M., Rios, A., Kersul, A., Togores, B., Palmer, J., Sauleda, J., Agusti, A. Tags: Airway biology, Lung function, Cardiothoracic surgery, Radiology (diagnostics), Health education, Smoking, Tobacco use Chronic obstructive pulmonary disease Source Type: research

Determinants and outcomes of physical activity in patients with COPD: a systematic review
Conclusions Physical activity level in COPD is consistently associated with mortality and exacerbations, but there is poor evidence about determinants of physical activity, including the impact of treatment. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Gimeno-Santos, E., Frei, A., Steurer-Stey, C., de Batlle, J., Rabinovich, R. A., Raste, Y., Hopkinson, N. S., Polkey, M. I., van Remoortel, H., Troosters, T., Kulich, K., Karlsson, N., Puhan, M. A., Garcia-Aymerich, J., on behalf of PROactive consortium Tags: Epidemiologic studies, Open access, Inflammation, Internet Chronic obstructive pulmonary disease Source Type: research

Viability of Pseudomonas aeruginosa in cough aerosols generated by persons with cystic fibrosis
Conclusions Viable P aeruginosa in cough aerosols travel further and last longer than recognised previously, providing additional evidence of airborne transmission between patients with CF. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Knibbs, L. D., Johnson, G. R., Kidd, T. J., Cheney, J., Grimwood, K., Kattenbelt, J. A., O'Rourke, P. K., Ramsay, K. A., Sly, P. D., Wainwright, C. E., Wood, M. E., Morawska, L., Bell, S. C. Tags: Open access, Cystic fibrosis Source Type: research

Pulmonary function, CT and echocardiographic abnormalities in sickle cell disease
Conclusions Abnormalities in pulmonary vascular volumes may explain some of the lung function abnormalities and the decline in lung function seen in adults with SCD. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Lunt, A., Desai, S. R., Wells, A. U., Hansell, D. M., Mushemi, S., Melikian, N., Shah, A. M., Thein, S. L., Greenough, A. Tags: Airway biology, Lung function, Radiology (diagnostics) Respiratory physiology Source Type: research

Observational study of the effect of obesity on lung volumes
Conclusions Obese subjects have markedly increased gastric and oesophageal pressures, both when upright and supine, causing dramatically reduced FRC and ERV, which increases work of breathing. (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Steier, J., Lunt, A., Hart, N., Polkey, M. I., Moxham, J. Tags: Epidemiologic studies, Airway biology, Lung function, Health education, Obesity (public health) Respiratory physiology Source Type: research

Use of glucocorticoids and risk of venous thromboembolism
In this Danish population-based case-control study, the association between use of glucocorticoids and risk of venous thromboembolism was studied. The study included 38 765 cases of venous thromboembolism and 387 650 age-matched and sex-matched controls. Conditional logistic regression, adjusted for risk factors for venous thromboembolism, was used to estimate incidence rate ratios (IRR) and 95% CI for glucocorticoid users versus non-users. Diagnoses were retrieved from the Danish national Registry of Patients, and controls were identified from the Danish Civil Registration System. Glucocorticoid use was estimate...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Jonsson, E. W. Tags: Miscellanea Source Type: research

Epithelial-mesenchymal transition in lung development and disease: does it exist and is it important?
Epithelial–mesenchymal transition (EMT) is a process when epithelial cells gradually transform into mesenchymal-like cells losing their epithelial functionality and characteristics. EMT is thought to be involved in the pathogenesis of numerous lung diseases ranging from developmental disorders, fibrotic tissue remodelling to lung cancer. The most important question—namely what is the importance and contribution of EMT in the pathogenesis of several chronic lung conditions (asthma, COPD, bronchiolitis obliterans syndrome and lung fibrosis)—is currently intensely debated. This review gives a brief insight i...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Bartis, D., Mise, N., Mahida, R. Y., Eickelberg, O., Thickett, D. R. Tags: Lung neoplasms, Bronchiolitis, Clinical genetics, TB and other respiratory infections, Lung cancer (oncology), Asthma, Bronchitis, Lung cancer (respiratory medicine), Interstitial lung disease Review Source Type: research

Pulmonary Langerhans cell histiocytosis (PLCH): a new UK register
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial lung disease of unknown aetiology. We aimed to characterise a UK-wide cohort of patients with PLCH and compare diagnostic and management methods in specialist and non-specialist centres. 106 cases (53 hospitals) identified. Complete data received in 67 cases (53.7% female, age 37.1±14.4 years). 96% current or ex-smokers. Treatment; smoking cessation (79%), corticosteroids (30.6%), cytotoxic therapy (26.9%) and lung transplant (6%). Patients at specialist centres received cytotoxic drugs more often (p=0.0001) and survival appeared higher. This...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Mason, R. H., Foley, N. M., Branley, H. M., Adamali, H. I., Hetzel, M., Maher, T. M., Suntharalingam, J. Tags: Chemotherapy, Interstitial lung disease, Cardiothoracic surgery, Transplantation, Health education, Smoking, Smoking cessation, Tobacco use Research letter Source Type: research

Biomarkers for predicting COPD exacerbations
This study found that simultaneously elevated levels of CRP, fibrinogen and leucocytes positively correlated with an increased risk of frequent exacerbations in stable COPD, which was statistically significant. The relative risk remained consistent when multivariable factors, such as previous exacerbations, symptom burden, disease severity and Body Mass Index were included, indicating that inflammatory biomarkers give additional information when risk-stratifying patients. Although this was a... (Source: Thorax)
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Pais, R. Tags: Miscellanea Source Type: research

Importance of epithelial mesenchymal transition (EMT) in COPD and asthma
We read with interest the recent review article by Bartis et al in Thorax1 and a similar one from some of the same authors in European Respiratory Review,2 addressing the potential importance of epithelial mesenchymal transition (EMT) in lung development and disease. We would like to take issue with the approach used, which is to emphasise ‘molecular patterns’ potentially associated with EMT, rather than starting with any empiric evidence that EMT is present as an active pathological process. EMT has been differentiated into three different types.3 It is a vital process during embryogenesis (type 1 EMT), but ca...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Sohal, S. S., Ward, C., Walters, E. H. Tags: PostScript Source Type: research

Vitamin D and lung function
Afzal et al1 recently reported that low plasma 25-hydroxyvitamin D is associated with a decline in lung function and chronic obstructive pulmonary disease (COPD). While this finding persisted after adjustment for possible confounding variables, and concurs with the findings of others,2 we believe it might still be spurious. First, we suggest the association between plasma vitamin D and lung function is subject to a threshold effect, evident in both the cross-sectional data (figures 1 and 3, reference 1) and prospective data (figure 2 and table 2—see our figure 1 below), and primarily limited to the lowest two quintil...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Young, R. P., Hopkins, R. J. Tags: PostScript Source Type: research

Authors' response: Epithelial-mesenchymal Transition (EMT) is a common molecular programme in epithelial cells which can be triggered by injury
We thank Sohal et al1 for commenting on our recent paper.2 The authors argue in their commentary that morphological/histological signs of epithelial-mesenchymal transition (EMT) in patients’ samples, for example, reticular basement membrane fragmentation, are more relevant in detecting EMT than looking for typical EMT-associated molecular patterns in the first place. EMT is defined as the gradual differentiation of epithelial cells into mesenchymal cells involving intermediate phenotypes. Different types of EMT seem to be quite universally present in organ development and repair of epithelial injury. We would like to...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Bartis, D., Thickett, D. R. Tags: PostScript Source Type: research

Authors' response to Young and Hopkins: vitamin D and lung function
We thank Dr RP Young and Ms RJ Hopkins for their interest in our article and their constructive comments.1 We agree with Dr RP Young and Ms RJ Hopkins that our analyses may suggest a threshold effect. However, we believe that more studies are needed before we firmly can assume a threshold effect. It is true that that the association between vitamin D level and FEV1% predicted was mirrored by a corresponding association between vitamin D and FVC% predicted. Therefore in our main analysis, the vitamin D level was not significantly associated with the FEV1/FVC ratio. This general reduction of lung volumes in individuals with ...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Afzal, S., Lange, P., Bojesen, S. E., Freiberg, J. J., Nordestgaard, B. G. Tags: PostScript Source Type: research

Trainee concerns regarding the Specialty Certificate Examination: results of a British Thoracic Society national survey: MRCP (UK) response
We read with interest the results of the British Thoracic Society's national survey related to the specialty certificate examination (SCE) in respiratory medicine.1 We are pleased that trainees felt the SCE to be appropriate in difficulty, content and duration, and that our test centres were fit for purpose. This correlates with the results of the routine surveys we run after each examination, which also ask about quality of examination material and administration. We regularly monitor this important feedback from our candidates and make improvements in response. When trainees take and pass an examination they want to know...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Mucklow, J., Elder, A., Wheaton, L., MacFarlane, J., Hill, A. Tags: PostScript Source Type: research

Rhinovirus-induced interferon production in asthma
After reading the article by Sykes et al,1 we would like to comment on impaired response to rhinovirus in relation to asthma severity. The authors examined rhinovirus-induced interferon (IFN) production in a cohort of asthmatic patients compared with controls. While they previously reported in this population a reduced IFN production in cells from bronchoalveolar lavage,2 they fail to document such an impaired response in bronchial epithelial cells.1 The authors propose to ascribe such discrepancy to asthma severity, since epithelial cells successfully cultured derived from a subset of patients with milder clinical manifes...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Baraldo, S., Saetta, M., Barbato, A., Contoli, M., Papi, A. Tags: PostScript Source Type: research

The 'anatomic shunt test' in clinical practice; contemporary description of test and in-service evaluation
The 100% oxygen shunt test for detecting right-to-left anatomical shunting was originally described 70 years ago. However, its clinical value is not yet established. We conducted an audit in 80 patients undergoing the test between 1996 and 2012 in a tertiary referral centre. A significant difference (p=0.02) existed between the median shunt percentages where anatomical shunting was identified (10.2%) and absent (5.0%). The area under the curve for a ROC plot was 0.70. A shunt percentage of 8.3 had a sensitivity of 80% and specificity of 75% for detection of an anatomic shunt. We conclude the test is satisfactory for t...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Ming, D. K. Y., Patel, M. S., Hopkinson, N. S., Ward, S., Polkey, M. I. Tags: Chest clinic Source Type: research

It's a MALDI but it's a goodie: MALDI-TOF mass spectrometry for microbial identification
The last few years have witnessed a revolution in the diagnostic microbiology laboratory with the emergence of matrix assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF MS) as an indispensible tool in microbial identification. In many laboratories this has superseded biochemical profiling. A mass spectrum is acquired from an unknown micro-organism and this proteomic fingerprint is then compared with a database of reference spectra to ascertain the likely genus and species identity. The reproducibility of this method is facilitated by the analysis of continually produced, highly abundant protei...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Randell, P. Tags: Drugs: infectious diseases Chest clinic Source Type: research

Case-based discussion from the Royal Devon and Exeter NHS Foundation Trust: a painful paradox
We present a case of a granulomatous thoracic spine lesion, leading to atraumatic fracture, arising as a consequence of etanarcept treatment of connective tissue disease with associated interstitial lung disease (ILD). Dr C Sharp (StR) A 50-year-old woman, a retired hairdresser, with rheumatoid arthritis/Jo-1 overlap syndrome, diagnosed 14 years earlier, and with associated but hitherto stable ILD, was referred to the ILD service with progressive dyspnoea and deteriorating lung function. Other relevant medical history included febrile neutrophilic dermatosis. The patient reported smoking 10–20 cigarettes per day...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Sharp, C., Powari, M., Mascarenhas, R., Spiers, A., Froeschle, P. O., Patel, B. D., Silver, D. A., Maher, T. M., Gibbons, M. A. Tags: Pneumonia (infectious disease), TB and other respiratory infections, Histopathology, Inflammation, Airway biology, Interstitial lung disease, Lung function, Pneumonia (respiratory medicine), Pulmonary hypertension, Radiology (diagnostics), Health educatio Source Type: research

Don't let radiation scare trump patient care: 10 ways you can harm your patients by fear of radiation-induced cancer from diagnostic imaging
Radiation For many people, the term radiation is linked to atomic bombs, cancer and death. Even without these associations, ionising radiation in the form of X-rays is frightening. Acute exposure to X-rays cannot be sensed in any way, yet can be lethal within days or weeks if received at a high enough dose. There is clearly good reason to be concerned about unnecessary exposure to X-rays. In diagnostic imaging, balancing this danger is the benefit that can be realised from the use of these X-rays. When a group of leading general internists was asked to rank 30 medical innovations by the most adverse effect on their patient...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Brody, A. S., Guillerman, R. P. Tags: Patients, Epidemiologic studies, Screening (oncology), Radiology (diagnostics) Chest clinic Source Type: research

Extrathoracic proof of intrathoracic trouble
A 67-year-old man was referred to our hospital for bullectomy. Chest CT scan showed exhaustive bilateral bullous emphysema with a giant bulla in the right lung (figure 1). Cardiopulmonary exercise testing revealed a maximum exercise tolerance of 30 Watts and a progressive dynamic hyperinflation with an inspiratory capacity of less than 50 mL during maximal exercise. During thoracotomy, manipulation of the airway made the patient cough and a giant bulla rapidly expanded with extension outside the right hemithorax (figure 2). This bulla was resected successfully and quality of life significantly improved with an increas...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Dickhoff, C., Hartemink, K. J., Slebos, D. J., Symersky, P., Vonk-Noordegraaf, A. Tags: Images in Thorax, Journalology, Airway biology, Lung function, Cardiothoracic surgery, Ethics Chest clinic Source Type: research

What's hot that the other lot got
Which came first, interstitial pneumonia or collagen vascular disease? The group looked at 111 records retrospectively of patients who had been diagnosed with interstitial pneumonia (IPF) from 1990 to 2007 (PLoS ONE 9:e94775). Ten of these patients subsequently were diagnosed with collagen vascular disease (CVD), being rheumatoid arthritis (4), microscopic polyangitis (4), systemic sclerosis (1) and systemic sclerosis and Sjorgeren's syndrome (1). The average time to the diagnosis of CVD was 3.9±2.4 years. None of the patients had any CVD-positive autoantibodies at the time of diagnosis, though half had a posit...
Source: Thorax - July 8, 2014 Category: Respiratory Medicine Authors: Prior, K. Tags: Lung neoplasms, Epidemiologic studies, Neuromuscular disease, Lung cancer (oncology), Screening (oncology), Child health, Infant health, Neonatal health, Asthma, Lung cancer (respiratory medicine), Interstitial lung disease, Ear, nose and throat/otolaryng Source Type: research