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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 18.

Update on Interstitial Pneumonia
This article reviews the causal agents that have been associated with the development of interstitial pneumonia in horses. Pathophysiology, clinical diagnosis, and treatment options are discussed. (Source: Veterinary Clinics of North America: Equine Practice)
Source: Veterinary Clinics of North America: Equine Practice - March 12, 2015 Category: Veterinary Research Authors: Pamela A. Wilkins, Kara M. Lascola Source Type: research

Updates on Respiratory Medicine and Surgery
It has been our privilege to serve as Guest Editors for this issue of Veterinary Clinics of North America: Equine Practice. The last issue that focused specifically on the respiratory system was the April 2003 issue edited by Eric Parente. While various conditions and treatments have been covered individually in issues since then, we hope this issue presents a comprehensive update on the medical and surgical conditions of the equine respiratory tract. (Source: Veterinary Clinics of North America: Equine Practice)
Source: Veterinary Clinics of North America: Equine Practice - March 12, 2015 Category: Veterinary Research Authors: Sarah M. Reuss, A. Berkley Chesen Tags: Preface Source Type: research

Thoracic Trauma in Horses
This article reviews the various types of thoracic injury and their management. (Source: Veterinary Clinics of North America: Equine Practice)
Source: Veterinary Clinics of North America: Equine Practice - March 12, 2015 Category: Veterinary Research Authors: Kim A. Sprayberry, Elizabeth J. Barrett Source Type: research

Investigation of the Occurrence of Porcine Reproductive and Respiratory Virus in Swine Herds Participating in an Area Regional Control and Elimination Project in Ontario, Canada
Summary The main goal of this study was to investigate the occurrence of porcine reproductive and respiratory syndrome virus (PRRSV)‐specific genotypes in swine sites in Ontario (Canada) using molecular, spatial and network data from a porcine reproductive and respiratory syndrome (PRRS) regional control project. For each site, location, animal movement service provider (truck companies), PRRSV status and sequencing data of the open reading frame 5 (ORF5) were obtained. Three‐kilometre buffers were created to evaluate neighbourhood characteristics for each site. Social network analysis was conducted on swine sites and ...
Source: Transboundary and Emerging Diseases - March 12, 2015 Category: Veterinary Research Authors: A. G. Arruda, R. Friendship, J. Carpenter, K. Hand, D. Ojkic, Z. Poljak Tags: Original Article Source Type: research

Intravenous immunoglobulin replacement therapy to prevent pulmonary infection in a patient with Good's syndrome
We describe a 67-year-old woman who presented with respiratory symptoms caused by concomitant disseminated cytomegalovirus infection and Pneumocystis jiroveci pneumonia 38 months after thymectomy for a thymoma. Immunologic analysis revealed hypogammaglobulinemia with absent B-cell population as demonstrated by flow cytometry, consistent with Good's syndrome. Following treatment with sulfamethoxazole/trimethoprim and ganciclovir, the patient improved with resolution of her respiratory symptoms. However, the patient subsequently experienced additional infections, necessitating additional subsequent hospital admissions. Durin...
Source: Journal of Microbiology, Immunology and Infection - March 12, 2015 Category: Microbiology Source Type: research

Human metapneumovirus infection activates the TSLP pathway which drives excessive pulmonary inflammation and viral replication in mice
This article is protected by copyright. All rights reserved (Source: European Journal of Immunology)
Source: European Journal of Immunology - March 12, 2015 Category: Allergy & Immunology Authors: Margarita K. Lay, Pablo F. Céspedes, Christian E. Palavecino, Miguel A. León, Rodrigo A. Díaz, Francisco J. Salazar, Gonzalo P. Méndez, Susan M. Bueno, Alexis M. Kalergis Tags: Regular Article Source Type: research

Paediatric ventilation treatment of acute lung injury in Nordic intensive care units
ConclusionVentilation treatment strategies for paediatric ARDS in the Nordic countries are relatively uniform and largely in accordance with international practice. The use of steroids and surfactant is more frequent than shown in other studies. (Source: Acta Anaesthesiologica Scandinavica)
Source: Acta Anaesthesiologica Scandinavica - March 12, 2015 Category: Anesthesiology Authors: L. L. JENSEN, A. BARATT‐DUE, P. N. ENGLUND, J. A. HARJU, T. S. SIGURÐSSON, J.‐P. LIBERG Tags: Original Article Source Type: research

Anesthesia crisis in laparoscopic surgery: Bilateral spontaneous pneumothorax. Diagnosis and management, case report
Conclusion Spontaneous pneumothorax has been recognized as a potential crisis in laparoscopic procedures. There are multiple cases of this intraoperative complication reported in the literature since 1939. It is worth highlighting that to this date, and despite the advances in surgical techniques, monitoring and anesthetic agents, few elements may be manipulated and only an insightful anesthesiologist may prevent the condition from evolving into major hemodynamic and respiratory morbidity and even death. Few factors such as establishment of pneumoperitoneum and pressure, length of the procedure and type of surgery have bee...
Source: Colombian Journal of Anesthesiology - March 12, 2015 Category: Anesthesiology Source Type: research

ATP‐induced cellular stress and mitochondrial toxicity in cells expressing purinergic P2X7 receptor
This study aimed to establish a link between gradual P2X7 activation and pharmacological endpoints including oxidative stress, hydrogen peroxide generation, and cytotoxicity. Mechanisms of cellular stress and cytotoxicity were studied in P2X7‐transfected HEK293 cells. We performed real‐time monitoring of metabolic and respiratory activity of cells expressing the P2X7‐receptor protein using a cytosensor system. Agonistic effects were monitored using exogenously applied ATP or the stable analogue BzATP. Oxidative stress induced by ATP or BzATP in target cells was monitored by hydrogen peroxide release in human mononucl...
Source: Pharmacology Research and Perspectives - March 12, 2015 Category: Drugs & Pharmacology Authors: Swen Seeland, Hélène Kettiger, Mark Murphy, Alexander Treiber, Jasmin Giller, Andrea Kiss, Romain Sube, Stephan Krähenbühl, Mathias Hafner, Jörg Huwyler Tags: Original Article Source Type: research

Response to ‘The role of macroaggregated albumin lung perfusion scan in hepatopulmonary syndrome: are we ready to draw conclusions?’ ‐ LIVint‐15‐00158
This article is protected by copyright. All rights reserved. (Source: Liver International)
Source: Liver International - March 12, 2015 Category: Gastroenterology Authors: Sarah Raevens, Christophe Van Steenkiste, Isabelle Colle Tags: Letter to the Editor Source Type: research

Older Adults' Use of Care Strategies in Response to General and Upper Respiratory Symptoms
This study examined the use of complementary and medical treatments, both individually and in combination, to address common general and upper respiratory symptoms. Data for the analysis were collected from a series of 18 daily diary questionnaires administered to community-living older African American and white adults living in rural counties in North Carolina. Participants reported symptoms experienced on each diary day and the treatment strategies they used each day in response to the particular symptom(s). Older adults used diverse categories of strategies to treat symptoms; treatment strategies were used inconsistent...
Source: Journal of Applied Gerontology - March 12, 2015 Category: Geriatrics Authors: Sandberg, J. C., Grzywacz, J. G., Suerken, C. K., Altizer, K. P., Quandt, S. A., Nguyen, H. T., Bell, R. A., Lang, W., Arcury, T. A. Tags: Original Articles (E-Only) Source Type: research

Clinical disease due to enterovirus D68 in adult hematologic malignancy patients and hematopoietic cell transplant recipients
The United States Centers for Disease Control and Prevention reported over 1000 cases of severe respiratory disease in pediatric patients associated with enterovirus D68 (EV-D68) in the fall of 2014. We sought to identify and define the clinical burden of disease due to EV-D68 in adult patients with hematologic malignancy or undergoing hematopoietic cell transplant (HCT). Real-time reverse-transcriptase polymerase chain reaction (PCR) for EV-D68 was performed on all respiratory samples positive for human rhinovirus (HRV) or negative for all respiratory viruses by a laboratory-developed respiratory viral PCR panel from Augu...
Source: Blood - March 12, 2015 Category: Hematology Authors: Waghmare, A., Pergam, S. A., Jerome, K. R., Englund, J. A., Boeckh, M., Kuypers, J. Tags: Transplantation, Free Research Articles, Myeloid Neoplasia, Lymphoid Neoplasia, Clinical Trials and Observations Source Type: research

Self-sampling for community respiratory illness: a new tool for national virological surveillance
(Source: Eurosurveillance)
Source: Eurosurveillance - March 12, 2015 Category: Infectious Diseases Source Type: research

Conscious Sedation versus General Anesthesia during Endovascular Acute Ischemic Stroke Treatment: A Systematic Review and Meta-Analysis [EVIDENCE-BASED MEDICINE LEVEL 1]
CONCLUSIONS: Patients with acute ischemic stroke undergoing intra-arterial therapy may have worse outcomes with general anesthesia compared with conscious sedation. However, the difference in stroke severity at the onset may confound the comparison in the available studies; thus, a randomized trial is necessary to confirm this association. (Source: American Journal of Neuroradiology)
Source: American Journal of Neuroradiology - March 12, 2015 Category: Radiology Authors: Brinjikji, W., Murad, M. H., Rabinstein, A. A., Cloft, H. J., Lanzino, G., Kallmes, D. F. Tags: EVIDENCE-BASED MEDICINE LEVEL 1 Source Type: research

Highlights from this issue
The fickle fingerprint of fate Sleep deprivation is amongst the many reasons why your editors are glad they are not intensivists, but diagnostic impossibility is another one. The ventilated patient who is deteriorating, who may or may not have a new pulmonary infiltrate, which may or may not be due to pulmonary oedema, atelectasis, haemorrhage, infection or other reasons presents a huge diagnostic challenge—is it ventilator associated pneumonia, and how to confirm it, given any sampling procedure has to traverse a likely heavily infected endotracheal tube and trachea? The penalty of not treating may be death of the p...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Bush, A., Pavord, I. Tags: Airwaves Source Type: research

Wavering in the breeze: is multiple breath washout useful in primary ciliary dyskinesia?
It has long been known that first second forced expired volume (FEV1) is insensitive both to distal airway disease and also structural lung disease as measured by high-resolution CT (HRCT).1 Furthermore, monitoring airway diseases has become harder as successful therapies have limited the rate of deterioration, making change in FEV1 less and less useful in clinical practice and as an endpoint in randomised controlled trials. Accordingly, we have had to deploy novel measures (or in the case of multiple breath washout (MBW), rediscovered old techniques). The use of MBW to calculate lung clearance index (LCI) and calculate ot...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Bush, A., Irving, S. Tags: Editorial Source Type: research

Electronic cigarettes: reasons to be cautious
Tobacco remains the leading cause of preventable mortality, morbidity and of health inequalities in many countries, including the UK. Eighty thousand people die every year in England from smoking.1 Many more suffer terrible disability. Tobacco control remains a public health priority.2 Smoking still kills. In this context anything which could reduce this toll deserves serious consideration, just as any risks of undermining recent tobacco control successes need to be properly understood. It is disappointing then that the debate on electronic cigarettes (also known as electronic nicotine delivery systems (ENDS) or nicotine v...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Furber, A. Tags: Editorial Source Type: research

Electronic cigarettes: pro
Smoking destroys lives, and does so from the point of conception. In 2014 smoking is likely to have caused the death of over 5000 unborn or newly born babies, over 20 000 babies to be born prematurely or with low birth weight, 40 sudden infant deaths and over 165 000 new cases of childhood illness.1 Smoking in England alone will have killed around 80 000 adults,2 caused nearly 500 000 admissions to National Health Service (NHS) hospitals2 and consumed around £5 billion of the NHS budget.3 The total financial cost of smoking to wider society will have been nearly £14 billion,3 £4 billio...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Britton, J. Tags: Editorial Source Type: research

Efficacy and safety of once-daily QVA149 compared with the free combination of once-daily tiotropium plus twice-daily formoterol in patients with moderate-to-severe COPD (QUANTIFY): a randomised, non-inferiority study
Conclusions QVA149 is non-inferior to TIO+FOR in improving HRQoL, with clinically meaningful and significant improvements in breathlessness and lung function in patients with COPD. Trial registration number NCT01120717. (Source: Thorax)
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Buhl, R., Gessner, C., Schuermann, W., Foerster, K., Sieder, C., Hiltl, S., Korn, S. Tags: Open access, Airway biology, Drugs: respiratory system, Lung function Chronic obstructive pulmonary disease Source Type: research

Stradling JR, Craig SE, Kohler M, et al. Markers of inflammation: data from the MOSAIC randomised trial of CPAP for minimally symptomatic OSA. Thorax 2015;70:181–2. The results for tumour necrosis factor (TNF) as shown in Table 1 are incorrect and in fact correspond to the results for CRP. The correct results for TNF are shown below: Table 1Baseline, 6 month, mean change and treatment effect data for all outcomes (excluding patients with CRP values >8 at baseline or follow-up) Standard CareCPAPTreatment effect(95% CI)p-ValueNBaseline6 MonthsMean change(SD)NBaseline6 MonthsMean change(SD)Highly sensitive CRP (mg/L...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Tags: Correction Source Type: research

Surveillance for lower airway pathogens in mechanically ventilated patients by metabolomic analysis of exhaled breath: a case-control study
Conclusions Breath volatile analysis is able to classify breath profiles of patients with and without significant pathogen load in the lower respiratory tract. If validated in independent cohorts, these findings could lead to development of rapid non-invasive point-of-care surveillance systems and diagnostics for lower respiratory tract infection in the intensive care unit. (Source: Thorax)
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Fowler, S. J., Basanta-Sanchez, M., Xu, Y., Goodacre, R., Dark, P. M. Tags: Epidemiologic studies, Pneumonia (infectious disease), TB and other respiratory infections, Pneumonia (respiratory medicine) Critical care Source Type: research

Bronchoscopic transparenchymal nodule access (BTPNA): first in human trial of a novel procedure for sampling solitary pulmonary nodules
Conclusions This first in human study demonstrates that bronchoscopic transparenchymal access of SPNs is feasible. Trial registration number NCT02130115. (Source: Thorax)
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Herth, F. J., Eberhardt, R., Sterman, D., Silvestri, G. A., Hoffmann, H., Shah, P. L. Tags: Lung neoplasms, Editor's choice, Lung cancer (oncology), Screening (oncology), Lung cancer (respiratory medicine), Cardiothoracic surgery, Radiology (diagnostics), Screening (epidemiology), Screening (public health) Source Type: research

Short-term clinical outcome of normotensive patients with acute PE and high plasma lactate
Conclusions Plasma lactate represents a powerful predictor of short-term PE-related complications and may provide guidance for decision-making in PE care. (Source: Thorax)
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Vanni, S., Jimenez, D., Nazerian, P., Morello, F., Parisi, M., Daghini, E., Pratesi, M., Lopez, R., Bedate, P., Lobo, J. L., Jara-Palomares, L., Portillo, A. K., Grifoni, S. Tags: Epidemiologic studies, Mechanical ventilation, Mechanical ventilation Pulmonary vasculature Source Type: research

Lung structure-function correlation in patients with primary ciliary dyskinesia
Conclusions We demonstrated that measuring LCI in patients with PCD is of clinical relevance; it was more frequently abnormal than FEV1, correlated well with CFCT and was more sensitive than FEV1 to detect patients with structural abnormalities. (Source: Thorax)
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Boon, M., Vermeulen, F. L., Gysemans, W., Proesmans, M., Jorissen, M., De Boeck, K. Tags: Cystic fibrosis, Ear, nose and throat/otolaryngology Orphan lung disease Source Type: research

Role of primary care in the follow-up of patients with obstructive sleep apnoea undergoing CPAP treatment: a randomised controlled trial
Conclusions For patients with OSA, treatment provided in a PC setting did not result in worse CPAP compliance compared with a specialist model and was shown to be a cost-effective alternative. Trial registration number Clinical Trials NCT01918449. (Source: Thorax)
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Sanchez-de-la-Torre, M., Nadal, N., Cortijo, A., Masa, J., Duran-Cantolla, J., Valls, J., Serra, S., Sanchez-de-la-Torre, A., Gracia, M., Ferrer, F., Lorente, I., Urgeles, M. C., Alonso, T., Fuentes, A., Armengol, F., Lumbierres, M., Vazquez-Polo, F. J., Tags: Patients, Clinical trials (epidemiology), General practice / family medicine Sleep Source Type: research

A chest physician's guide to mechanisms of sinonasal disease
The upper and lower airways are closely linked from an anatomical, histological and immunological point of view, with inflammation in one part of the airways influencing the other part. Despite the concept of global airway disease, the upper airways tend to be overlooked by respiratory physicians. We provide a clinical overview of the most important and recent insights in rhinitis and rhinosinusitis in relation to lower airway disease. We focus on the various exogenous and endogenous factors that play a role in the development and aggravation of chronic upper airway inflammation. In addition to the classical inhaled allerg...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Hox, V., Maes, T., Huvenne, W., Van Drunen, C., Vanoirbeek, J. A., Joos, G., Bachert, C., Fokkens, W., Ceuppens, J. L., Nemery, B., Hellings, P. W. Tags: TB and other respiratory infections, Inflammation, Ear, nose and throat/otolaryngology, Health education, Smoking, Tobacco use Review Source Type: research

A systematic review of the clinical effectiveness of first-line chemotherapy for adult patients with locally advanced or metastatic non-small cell lung cancer
Our aim was to evaluate the clinical effectiveness of chemotherapy treatments currently licensed in Europe and recommended by the National Institute for Health and Care Excellence (NICE) for the first-line treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC). A systematic search of MEDLINE, EMBASE and the Cochrane Library for randomised controlled trials (RCTs) published from 2001 to 2010 was carried out. Relative treatment effects for overall survival (OS) and progression-free survival (PFS) were estimated using standard meta-analysis and mixed treatment comparison methodology...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Pilkington, G., Boland, A., Brown, T., Oyee, J., Bagust, A., Dickson, R. Tags: Clinical trials (epidemiology), Lung cancer (oncology), Chemotherapy, Lung cancer (respiratory medicine), Internet Review Source Type: research

Year in review 2014. Paediatric and adult clinical studies
Our prizes for best papers in the last year have become as eagerly awaited as the Oscars and are much more glamorous. As before, we have awarded GOLD, SILVER and BRONZE prizes in the following categories: paediatrics, adult clinical, basic science and epidemiology. This is the first of two reviews of manuscripts published in Thorax in 2014 dealing with manuscripts on the clinical aspects of paediatrics and adult respiratory medicine. Decisions are purely those of the editors and deputy editors. Our only restriction has been to not consider manuscripts exclusively from Imperial and Oxford because we have conflicts of intere...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Bush, A., Pavord, I. Tags: Molecular genetics, TB and other respiratory infections, Muscle disease, Neuromuscular disease, Child health, Inflammation, Asthma, Cystic fibrosis, Ear, nose and throat/otolaryngology, Screening (epidemiology), Ethics, Health education, Screening (public Source Type: research

Letter in response to TB during TNF-{alpha} inhibitor therapy, despite screening
We read the case-based discussion published in Thorax by Hofland et al1 with great interest. The case studies reported by the authors raise a very important point about the necessity for continued monitoring of patients on tumour necrosis factor (TNF)-α antagonist therapy, even in the absence of evidence of latent TB infection (LTBI) at the onset of therapy and this is a point that is not discussed in the most recent British Thoracic society (BTS) guidance document on TB and anti-TNF α treatment.2 The two cases described in the article would be classified as ‘low risk’ and thus not offered chemoprop...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Manalan, K., Singanayagam, A., Wickremasinghe, M., Kon, O. M. Tags: PostScript Source Type: research

Inconsistent results or inconsistent methods? A plea for standardisation of biomarker sampling in mesothelioma studies
Reproducibility is a quality that all biomarkers must demonstrate before entering the clinical arena. In October's issue of Thorax, Creaney et al1 reported important diagnostic performance data regarding fibulin-3 in malignant pleural mesothelioma (MPM). Their results (plasma area under the curve (AUC) 0.671, sensitivity 21%) are remarkably discordant with those reported by Pass et al,2 using the same assay in a similarly designed study (plasma AUC 0.974–0.997, sensitivity 97%). Although some discordance is expected, this pattern is common in the MPM biomarker literature. Creaney et al propose logical reasons for the...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Blyth, K. G. Tags: PostScript Source Type: research

Author's response: Inconsistent results or inconsistent methods? A plea for standardisation of biomarker sampling in mesothelioma studies
Dr Blyth raises some important issues regarding the interpretation of malignant pleural mesothelioma (MPM) biomarker studies. First, the effects of confounders, including healing and/or inflammatory factors on biomarker levels; second, the reproducibility of biomarker results between centres. In our independent evaluation of the proposed MPM biomarker fibulin-3, we considered some of the confounders he suggests—for instance, body mass index and renal function—which were not significant determinants of the diagnostic use of fibulin-3; and the neutrophil to lymphocyte ratio, which was reported and adjusted for in...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Creaney, J., Robinson, B. W. S. Tags: PostScript Source Type: research

The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry
This study uses data from the British Thoracic Society Difficult Asthma Registry (n=596) to estimate direct healthcare treatment costs from an National Health Service perspective and examines factors that explain variations in costs. Annual mean treatment costs among severe refractory asthma patients were £2912 (SD £2212) to £4217 (SD £2449). Significant predictors of costs were FEV1% predicted, location of care, maintenance oral corticosteroid treatment and body mass index. Treating individuals with severe refractory asthma presents a substantial cost to the health service. (Source: Thorax)
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: O'Neill, S., Sweeney, J., Patterson, C. C., Menzies-Gow, A., Niven, R., Mansur, A. H., Bucknall, C., Chaudhuri, R., Thomson, N. C., Brightling, C. E., O'Neill, C., Heaney, L. G., on behalf of the British Thoracic Society Difficult Asthma Network Tags: Health policy, Asthma, Health service research Chest clinic Source Type: research

Test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumours
Positron emission tomography-CT (PET-CT) is one of the initial mediastinal staging modality for non-small cell lung cancer; however, the clinical utility in carcinoid tumours is uncertain. We sought to determine the test performance of PET-CT for mediastinal lymph node staging of pulmonary carcinoid tumours. We collated data from seven institutions, performing a retrospective search on pathological databases for a consecutive series of patients who underwent thoracic surgery (with lymph nodal dissection) for carcinoid tumours with preoperative PET-CT staging. PET-CT results were compared with the reference standard of path...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Pattenden, H. A., Leung, M., Beddow, E., Dusmet, M., Nicholson, A. G., Shackcloth, M., Mohamed, S., Darr, A., Naidu, B., Iyer, S., Marchbank, A., Greenwood, A., West, D., Granato, F., Kirk, A., Ariyaratnam, P., Loubani, M., Lim, E., on behalf of the UK Th Tags: Lung cancer (oncology), Lung cancer (respiratory medicine), Radiology (diagnostics) Chest clinic Source Type: research

CT features of pulmonary arterial hypertension and its major subtypes: a systematic CT evaluation of 292 patients from the ASPIRE Registry
We evaluated the prevalence and prognostic value of CT-pulmonary angiographic (CTPA) measures in 292 treatment naive patients with pulmonary arterial hypertension (PAH). Pulmonary artery calcification (13%) and thrombus (10%) were exclusively seen in PAH-congenital heart disease. Oesophageal dilation (46%) was most frequent in PAH-systemic sclerosis. Ground glass opacification (GGO) (41%), pericardial effusion (38%), lymphadenopathy (19%) and pleural effusion (11%) were common. On multivariate analysis, inferior vena caval area, the presence of pleural effusion and septal lines predicted outcome. In PAH, CTPA provides diag...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Rajaram, S., Swift, A. J., Condliffe, R., Johns, C., Elliot, C. A., Hill, C., Davies, C., Hurdman, J., Sabroe, I., Wild, J. M., Kiely, D. G. Tags: Open access, Radiology (diagnostics) Chest clinic Source Type: research

Non-coding RNAs and respiratory disease
Recent scientific developments have radically changed the way we look at the vast ‘non-coding’ part of our genome. It is now clear that this genomic ‘dark matter’ is transcribed into myriads of RNA species that act behind the scenes to veto, or boost, the production of proteins in our cells. As a consequence, non-coding RNAs (ncRNAs) represent an additional layer of regulation for fundamental biological processes such as organ development, tissue repair and immunity. It also follows that disturbances in ncRNA networks (among which microRNAs and long ncRNAs are the best studied) can give rise to a wh...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Mestdagh, P., Vandesompele, J., Brusselle, G., Vermaelen, K. Tags: Chest clinic Source Type: research

The centenary (2015) of the transfer factor for carbon monoxide (TLCO): Marie Krogh's legacy
The birth of the single breath (sb) TLCO: the oxygen secretion controversy Whether or not the lungs actively secreted oxygen, particularly under stressful conditions (severe exertion, alveolar hypoxia), was an argument which continued for more than 50 years (1870–1923), and involved some of the most distinguished respiratory physiologists of that era, such as JS Haldane, Christian Bohr and August Krogh. The denouement, as told by Krogh's daughter, Bodil Schmidt-Neilsen,1 began 11 years earlier in 1904 when a Danish medical student, Marie Jørgensen, attended a class taught by August Krogh, an instruct...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Hughes, J. M. B., Borland, C. D. R. Tags: Screening (epidemiology), Screening (public health) Chest clinic Source Type: research

An uncommon complication of staphylococcal pneumonia: pneumopericardium with cardiac tamponade
A 1-year-old girl presented with a 3-day history of fever, cough, and dyspnoea. A chest radiograph demonstrated consolidation in the right upper lobe (figure 1A). Laboratory tests showed leucocytosis and blood culture showed oxacillin-sensitive Staphylococcus aureus. A radiograph performed 12 days later (figure 1B) showed pneumatocoele formation. On the 25th day, the patient's condition worsened abruptly, with hypotension. A chest radiograph (figure 1C, D) showed pneumopericardium. Pericardiocentesis was performed, but the child died 2 days later. Tension pneumopericardium has a very high mortality rate in the ab...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Marchiori, E., Canella, C., Hochhegger, B., Zanetti, G. Tags: Images in Thorax, Journalology, Epidemiologic studies, Drugs: infectious diseases, Pneumonia (infectious disease), TB and other respiratory infections, Pneumonia (respiratory medicine), Cardiothoracic surgery, Radiology (diagnostics), Ethics Chest clini Source Type: research

Max Klein: a great man and a great paediatrician
Max Klein (1941–2015) died suddenly on 27 January 2015 while riding his bicycle in the beautiful surroundings of Stellenbosch near Cape Town. Professor Klein made a large contribution to the development of paediatric critical care and paediatric pulmonology in South Africa and beyond. Max was born in the isolated central Karoo village of Calvinia where the lonely surroundings and stark landscape he experienced in his early years influenced his great strength of character. This may also account in part for his renowned powers of observation and his ability to improvise and solve problems in ingenious ways. At an early...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Zar, H. J., Weinberg, E. G. Tags: Clinical trials (epidemiology), General practice / family medicine, Pneumonia (infectious disease), TB and other respiratory infections, Child health, Adult intensive care, Mechanical ventilation, Mechanical ventilation, Pneumonia (respiratory medicine), Source Type: research

What's hot that the other lot got
Aid to select smoking cessation treatment? Measuring a biomarker of nicotine clearance may improve smoking quit rate success by optimising cessation treatment selection according to this multicentred, double-blinded, randomised control trial (Lancet Respir Med 2015;doi:10.1016/S2213-2600(14)70294-2). Nicotine metabolite ratio was measured in 1246 patients who were randomly assigned to one of three treatments (nicotine patch plus placebo pill, varenicline plus placebo patch or placebo patch and pill). Patients were assessed at the end of 11-week treatment and had follow-up at 6 and 12 months. Normal metabolisers of nic...
Source: Thorax - March 12, 2015 Category: Respiratory Medicine Authors: Lee, C. Tags: Epidemiologic studies, Pneumonia (infectious disease), TB and other respiratory infections, Asthma, Pneumonia (respiratory medicine), Health education, Smoking, Smoking cessation, Tobacco use Chest clinic Source Type: research