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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 7.

The reciprocal interaction between obesity and obstructive sleep apnoea
Summary: Obesity is a significant risk factor in the pathogenesis of obstructive sleep apnoea (OSA) altering airway anatomy and collapsibility, and respiratory control. The association between obesity and OSA has led to an increasing focus on the role of weight loss as a potential treatment for OSA. To date, most discussion of obesity and OSA assumes a one-way cause and effect relationship, with obesity contributing to the pathogenesis of OSA. However, OSA itself may contribute to the development of obesity.OSA has a potential role in the development and reinforcement of obesity via changes to energy expenditure during sle...
Source: Sleep Medicine Reviews - February 12, 2013 Category: Sleep Medicine Authors: Chong Weng Ong, Denise M. O’Driscoll, Helen Truby, Matthew T. Naughton, Garun S. Hamilton Tags: Clinical reviews Source Type: research

Pulmonary function and physical performance outcomes with preoperative physical therapy in upper abdominal surgery: a randomized controlled trial.
Conclusion:Preoperative physical therapy improved pulmonary function and physical performance in the pre- and postoperative periods among patients undergoing upper abdominal surgery. PMID: 23405020 [PubMed - as supplied by publisher]
Source: Clinical Rehabilitation - February 12, 2013 Category: Rehabilitation Authors: Soares SM, Nucci LB, da Silva MM, Campacci TC Tags: Clin Rehabil Source Type: research

Acute and sustained effects of aerosolized vs. bolus surfactant therapy in premature lambs with respiratory distress syndrome.
Conclusion:Aerosolized surfactant produced a similar improvement in gas exchange and lung mechanics to bolus administration, but with less lung injury and fewer cerebral hemodynamic changes.Pediatric Research (2013); doi:10.1038/pr.2013.24. PMID: 23403804 [PubMed - as supplied by publisher]
Source: Pediatric Research - February 12, 2013 Category: Pediatrics Authors: Rey-Santano C, Mielgo VE, Andres L, Ruiz-Del-Yerro E, Valls-I-Soler A, Murgia X Tags: Pediatr Res Source Type: research

Severe Pneumonia Mortality in Elderly Patients Is Associated With Downregulation of Toll-like Receptors 2 and 4 on Monocytes.
CONCLUSIONS:: These findings demonstrate a previously undocumented association between mortality in elderly patients with severe pneumonia and decreased TLR2 and TLR4 expression. Our results highlight that TLRs can be targeted in the development of improved immune modulation therapies for these patients. PMID: 23406892 [PubMed - as supplied by publisher]
Source: The American Journal of the Medical Sciences - February 12, 2013 Category: Journals (General) Authors: Tang L, Li Q, Bai J, Zhang H, Lu Y, Ma S Tags: Am J Med Sci Source Type: research

High-Resolution Computed Tomography Findings for Patients With Drug-Induced Pulmonary Toxicity, With Special Reference to Hypersensitivity Pneumonitis-Like Patterns in Gemcitabine-Induced Cases.
Conclusion. GEM was the leading cause of drug-induced pulmonary toxicity in the patients examined in this study. This toxicity appears as NSIP or an HP-like pattern during HRCT examinations. This HP-like pattern may be useful for diagnosing GEM-induced pulmonary toxicity, as well as demonstrating granuloma or organizing tissue during lung pathology examinations. PMID: 23404815 [PubMed - as supplied by publisher]
Source: The Oncologist - February 12, 2013 Category: Cancer & Oncology Authors: Tamura M, Saraya T, Fujiwara M, Hiraoka S, Yokoyama T, Yano K, Ishii H, Furuse J, Goya T, Takizawa H, Goto H Tags: Oncologist Source Type: research

Single-Dose Safety, Tolerability, and Pharmacokinetics of the Antibiotic GSK1322322, a Novel Peptide Deformylase Inhibitor.
Abstract GSK1322322 is a potent inhibitor of peptide deformylase, an essential bacterial enzyme required for protein maturation. GSK1322322 is active against community-acquired skin and respiratory tract pathogens, including methicillin-resistant Staphylococcus aureus, multidrug-resistant Streptococcus pneumoniae, and atypical pathogens. This phase I, randomized, double-blind, placebo-controlled, 2-part, single-dose, dose-escalation study (first time in humans) evaluated the safety, tolerability, and pharmacokinetics of GSK1322322 (powder-in-bottle formulation) in healthy volunteers. In part A, dose escalation incl...
Source: Antimicrobial Agents and Chemotherapy - February 12, 2013 Category: Microbiology Authors: Naderer OJ, Dumont E, Zhu J, Kurtinecz M, Jones LS Tags: Antimicrob Agents Chemother Source Type: research

Diphtheria: forgotten, but not gone
Abstract Diphtheria is an acute, highly infectious, vaccine‐preventable and previously endemic disease whose etiologic agent is Corynebacterium diphtheriae. Diphtheria may manifest as an upper respiratory tract infection, a cutaneous infection or as an asymptomatic carrier state. The most common sites of infection are the pharynx and the tonsils, with common clinical manifestations that include sore throat, malaise, cervical lymphadenopathy and low‐grade fever. Absorption and dissemination of C. diphtheriae from the respiratory tract can cause disseminated infection and may lead to cardiac or neurological toxicity. T...
Source: Internal Medicine Journal - February 12, 2013 Category: Internal Medicine Authors: N. R. Adler, A. Mahony, N. D. Friedman Tags: Brief Communication Source Type: research

Unmet needs of people with end‐stage chronic obstructive pulmonary disease: recommendations for change in Australia
ConclusionsA flexible model of care is needed that assists people with COPD to navigate the health system. This should be patient centred and coordinated across primary, acute and community sectors. Neither respiratory nor palliative care services alone can adequately support people with COPD. The integration of a multidisciplinary palliative approach within a chronic disease management strategy will be central for the best care for people living with advanced COPD.
Source: Internal Medicine Journal - February 12, 2013 Category: Internal Medicine Authors: G. B. Crawford, M. A. Brooksbank, M. Brown, T. A. Burgess, M. Young Tags: Original Article Source Type: research

Stenotrophomonas, Mycobacterium, and Streptomyces in home dust and air: Associations with moldiness and other home/family characteristics
Abstract Respiratory illnesses have been linked to children's exposures to water‐damaged homes. Therefore, understanding the microbiome in water‐damaged homes is critical to preventing these illnesses. Few studies have quantified bacterial contamination, especially specific species, in water‐damaged homes. We collected air and dust samples in twenty‐one low‐mold homes and twenty‐one high‐mold homes. The concentrations of three bacteria/genera, Stenotrophomonas maltophilia, Streptomyces sp. and Mycobacterium sp., were measured in air and dust samples using quantitative PCR (QPCR). The concentrations of the bac...
Source: Indoor Air - February 12, 2013 Category: Occupational Health Authors: Eric Kettleson, Sudhir Kumar, Tiina Reponen, Stephen Vesper, Delphine Méheust, Sergey A. Grinshpun, Atin Adhikari Tags: Original Article Source Type: research

Genetic replacement of surfactant protein-C reduces respiratory syncytial virus induced lung injury
Conclusions: Transgenic restoration of SP-C reduced inflammation and improved viral clearance in the lungs of SP-C deficient mice. The loss of SP-C in alveolar type II cells compromises their response to infection. These findings show that the restoration of SP-C in Sftpc -/- mice in response to RSV infection is a useful model to determine parameters for therapeutic intervention.
Source: Respiratory Research - February 12, 2013 Category: Respiratory Medicine Authors: Stephan GlasserAlbert SenftMelissa MaxfieldTeah RuetschillingJohn BaatzKristen PageThomas Korfhagen Source Type: research

Predictive factors for patient outcomes following open bedside tracheotomy
ConclusionsAdmitting diagnosis and serological markers did not predict the rates of decannulation or in‐hospital mortality. However, the presence of cardiac disease and/or oncologic comorbidities played a significant role in predicting hospital mortality or eventual decannulation. Several comorbidity combinations resulted in a greater than 60% likelihood of inpatient mortality. In this population, the overall benefit of an OBT may be debatable. Despite very high overall acuity levels, there were no serious procedural complications, indicating that bedside tracheotomy is safe in ill patients. Level of Evidence2c Laryngoscope, 2013
Source: The Laryngoscope - February 12, 2013 Category: ENT & OMF Authors: Hani M. Rayess, Peter C. Revenaugh, Michael S. Benninger, P. Daniel Knott Tags: Head and Neck Source Type: research

Higher Serum Levels of Interleukin 10 Occur at Onset of Acute Otitis Media Caused by Streptococcus Pneumoniae Compared to Haemophilus Influenzae and Moraxella Catarrhalis
ConclusionOur study indicates that AOM caused by Spn elicits a significantly higher IL‐10 response compared to NTHi and Mcat and may prove to be a biomarker of AOM infections by Spn. Level of Evidence4. Laryngoscope, 2013
Source: The Laryngoscope - February 12, 2013 Category: ENT & OMF Authors: Keyi Liu, Ravinder Kaur, Anthony Almudevar, Michael E. Pichichero Tags: General Otolaryngology Source Type: research

Predictive value of pulse pressure variation for fluid responsiveness in septic patients using lung-protective ventilation strategies
Conclusions Automatized PP accurately predicted fluid responsiveness in septic patients ventilated with low TV.
Source: British Journal of Anaesthesia - February 12, 2013 Category: Anesthesiology Authors: Freitas, F. G. R., Bafi, A. T., Nascente, A. P. M., Assuncao, M., Mazza, B., Azevedo, L. C. P., Machado, F. R. Tags: Critical Care Source Type: research

An attenuated Lassa vaccine in SIV-infected rhesus macaques does not persist or cause arenavirus disease but does elicit Lassa virus-specific immunity. Running title: Lassa vaccine in SIV-positive macaques
Conclusion: SIV-infected and uninfected rhesus macaques responded similarly to ML29 vaccination, and none developed chronic arenavirus infection. Importantly, none of the macaques developed signs, classical or non-classical, of arenavirus disease.
Source: Virology Journal - February 12, 2013 Category: Virology Authors: Juan ZapataBhawna PooniaJoseph BryantHarry DavisEugene AtehLanea GeorgeOswald CrastaYan ZhangTom SlezakCrystal JaingC PauzaMarco GoicocheaDmitry MoshkoffIgor LukashevichMaria Salvato Source Type: research

Heparin‐binding protein (HBP) in critically ill patients with influenza A(H1N1) infection
Abstract Heparin‐binding protein (HBP) is an inducer of vascular endothelial leakage in severe infections. Fluid accumulation into alveoli is a general finding in acute respiratory distress syndrome (ARDS). Severe acute respiratory failure with ARDS is a complication of influenza A(H1N1) infection. Accordingly, we studied the HBP levels in critically ill patients with infection of influenza A(H1N1).Critically ill patients in four intensive care units (ICUs) with polymerase chain reaction (PCR) confirmed infection of influenza A(H1N1) were prospectively evaluated. We collected clinical data and blood samples at ICU admiss...
Source: Clinical Microbiology and Infection - February 12, 2013 Category: Microbiology Authors: K.‐M. Kaukonen, R. Linko, H. Herwald, L. Lindbom, E. Ruokonen, T. Ala‐Kokko, V. Pettilä Tags: Original Article Source Type: research

What Is the Role of Newer Molecular Tests in the Management of CAP?
This article provides an overview of the new rapid molecular tests for the diagnosis of influenza, other respiratory viruses, and bacteria compared with nonmolecular tests and how their use for directed therapy can enhance and improve the management of CAP.
Source: Infectious Diseases Clinics of North America - February 11, 2013 Category: Infectious Diseases Authors: Charlotte A. Gaydos Source Type: research

A self-redressment of neonatal nose-trauma
Abstract: We saw a child after normal delivery with mild hematoma but a substantial deviation of the nose. The child had no respiratory distress nor in rest nor during effort. We decided not to perform a reposition of the nose but watched further development. After a few weeks the nose straightened significantly, and was nearly normal after 3 months. An exam after 1 year did not show any deviation. Recent studies only advise to perform surgical steps, if there is respiratory distress. This well documented case is an impressive example for the ability of the neonatal nose to help itself.
Source: International Journal of Pediatric Otorhinolaryngology - February 11, 2013 Category: ENT & OMF Authors: Thomas Deitmer, Astrid Kiebler Tags: Case reports Source Type: research

Effects of ventilation on hearing loss in preterm neonates: Nasal continuous positive pressure does not increase the risk of hearing loss in ventilated neonates
Abstract: Introduction: There is increased risk of hearing loss in preterm neonates. This risk is further increased by environmental noise exposure especially from life support equipment such as ventilation. Nasal continuous positive airway pressure (NCPAP) used for respiratory support of preterm neonates is known to be associated with prolonged exposure to high levels of noise. However, there is paucity of information on the effect of NCPAP as compared to mechanical ventilation on hearing loss among preterm neonates.Methods: A retrospective chart review was performed on neonates with birth weight (BW)
Source: International Journal of Pediatric Otorhinolaryngology - February 11, 2013 Category: ENT & OMF Authors: Shantanu Rastogi, Michel Mikhael, Panayot Filipov, Deepa Rastogi Tags: Research papers Source Type: research

Systematic review of intralesional Cidofovir dosing regimens in the treatment of recurrent respiratory papillomatosis
Conclusions: Based on this published literature, the precedent for prescribing intralesional cidofovir supports a concentration of 5 to 7.5mg/ml. Volumes up to 5ml per injection are routinely used. Total dose and frequency of cidofovir administration is highly variable. The need for repeat doses of cidofovir should be judged on an individual basis.
Source: International Journal of Pediatric Otorhinolaryngology - February 11, 2013 Category: ENT & OMF Authors: Philip J. Clamp, Michael W. Saunders Tags: Review article Source Type: research

A systematic review of paediatric foreign body ingestion: Presentation, complications, and management
Conclusion: Foreign body ingestion is a common paediatric problem. Batteries and sharp objects should be removed immediately to avoid complications while others can be observed for spontaneous passage. Endoscopy has a high success rate in removing ingested foreign bodies.
Source: International Journal of Pediatric Otorhinolaryngology - February 11, 2013 Category: ENT & OMF Authors: Shruti Jayachandra, Guy D. Eslick Tags: Review article Source Type: research

Acknowledgement of Reviewers 2012
Research journals could not exist without the generous support from scientists willing to be peer reviewers. Respiratory Medicine gratefully acknowledges the time and effort contributed by the following experts, for refereeing the work of their fellow researchers during 2012.
Source: Respiratory Medicine CME - February 11, 2013 Category: Respiratory Medicine Source Type: research

Whole-Heart Coronary MRA with 3D Affine Motion Correction Using 3D Image-Based Navigation.
CONCLUSION: We demonstrate that 3D-NAV and 3D affine correction can be used to acquire Cartesian whole-heart 3D coronary artery images with 100% scan efficiency with similar image quality as with the state-of-the-art gated and corrected method with approximately 50% scan efficiency. Magn Reson Med, 2013. © 2013 Wiley Periodicals, Inc. PMID: 23400902 [PubMed - as supplied by publisher]
Source: Magnetic Resonance in Medicine - February 11, 2013 Category: Radiology Authors: Henningsson M, Prieto C, Chiribiri A, Vaillant G, Razavi R, Botnar RM Tags: Magn Reson Med Source Type: research

Mechanisms Of Acute Exacerbation Of Respiratory Symptoms In Copd
In the coming decades, chronic obstructive pulmonary disease (COPD) is expected to occur with increasing frequency, resulting in enormous health care expenditures and high mortality. Thus, COPD presents a challenge for clinicians and is a leading public health problem worldwide [1]. However, COPD is almost invariably associated with other chronic conditions, and is thus an important component of the epidemy of multimorbidity (due to aging, smoking, indoor and outdoor pollution, alcohol, inactivity, and other risk factors) that affects elderly patients [1].
Source: European Journal of Clinical Investigation - February 11, 2013 Category: Journals (General) Authors: Mihai Roca, Alessia Verduri, Lorenzo Corbetta, Enrico Clini, Leonardo M. Fabbri, Bianca Beghé Tags: Review Source Type: research

Prenatal Diagnosis of a Large Epignathus Teratoma Using Two-Dimensional and Three-Dimensional Ultrasound: Correlation With Pathological Findings.
We report a case of prenatal diagnosis of epignathus teratoma in the 30th week of pregnancy by two-dimensional ultrasonography. We focus on the importance of three-dimensional ultrasonography in rendering mode for demonstrating the spatial relationships of the tumor with the oral cavity and provide correlations between the ultrasound images and the anatomopathological findings. PMID: 23398485 [PubMed - as supplied by publisher]
Source: The Cleft Palate-Craniofacial Journal - February 11, 2013 Category: ENT & OMF Authors: Takagi MM, Bussamra LC, Júnior EA, Drummond CL, Herbst SR, Nardozza LM, Moron AF, Aldrghi JM Tags: Cleft Palate Craniofac J Source Type: research

Guidelines for the Management of Respiratory Complications in Patients With Neuromuscular Disease.
PMID: 23410743 [PubMed - as supplied by publisher]
Source: Archivos de Bronconeumologia - February 11, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Farrero E, Antón A, Egea CJ, Almaraz MJ, Masa JF, Utrabo I, Calle M, Verea H, Servera E, Jara L, Barrot E, Casolivé V Tags: Arch Bronconeumol Source Type: research

Respiratory sinus arrhythmia during sleep in children with upper airway obstruction.
In conclusion, night-time respiratory sinus arrhythmia in children is sleep stage dependent and normal during quiet sleep in children with relatively mild upper airway obstruction. PMID: 23398203 [PubMed - as supplied by publisher]
Source: Journal of Sleep Research - February 11, 2013 Category: Sleep Medicine Authors: Kabir MM, Kohler M, Pamula Y, Martin J, Kennedy D, Abbott D, Baumert M Tags: J Sleep Res Source Type: research

Role of the fission yeast cell integrity MAPK pathway in response to glucose limitation
Conclusions: Unknown upstream elements mediate Pck2-dependent signal transduction of glucose withdrawal to the cell integrity MAPK pathway. This signaling cascade reinforces the adaptive response of fission yeast to such nutritional stress by enhancing the activity of the SAPK pathway.
Source: BMC Microbiology - Latest articles - February 11, 2013 Category: Microbiology Authors: Marisa MadridJesús Fernández-ZapataLaura Sánchez-MirTeresa SotoAlejandro FrancoJero Vicente-SolerMariano GactoJosé Cansado Source Type: research

Lack of nasal carriage of novel coronavirus (HCoV‐EMC) in French Hajj pilgrims returning from the Hajj 2012, despite high rate of respiratory symptoms
Abstract A cohort of 154 French Hajj pilgrims participating in the 2012 Hajj were systematically sampled using nasal swab prior to returning to France and screened for the novel HCoV‐EMC coronavirus by two real‐time RT‐PCR assays. Despite a high rate of respiratory symptoms (83.4%) including 41.0% influenza like illness, no case of HCoV‐EMC infection was detected. Despite the fact that zoonotic transmission was suspected in the first few cases, recent family cluster in KSA hints that the virus might show at least limited spread from person to person, which justifies continuing epidemiological surveillance. © 2013 ...
Source: Clinical Microbiology and Infection - February 11, 2013 Category: Microbiology Authors: Philippe Gautret, Rémi Charrel, Khadidja Belhouchat, Tassadit Drali, Samir Benkouiten, Antoine Nougairede, Christine Zandotti, Ziad A Memish, Malak al Ma, Catherine Gaillard, Philippe Brouqui, Philippe Parola Tags: Research Note Source Type: research

Inactivation of the petE gene encoding plastocyanin causes different photosynthetic responses in cyanobacterium Synechocystis PCC 6803 under light‐dark photoperiod and continuous light conditions
Abstract Plastocyanin, encoded by the petE gene, can transfer electrons to photosystem I (PSI) and cytochrome c oxidase during photosynthetic and respiratory metabolism in cyanobacteria. We constructed a petE mutant of Synechocystis sp. strain PCC 6803 and investigated its phenotypic properties under different light conditions. When cultured under continuous light, inactivation of petE accelerated the plastoquinone pool reoxidation, slowed the reoxidation rate of the primary quinone‐type acceptor, and decreased the connectivity factor between the individual photosystem II (PSII) photosynthetic units. Compared with the wi...
Source: FEMS Microbiology Letters - February 11, 2013 Category: Microbiology Authors: Xiao‐Qin Wang, Hai‐Bo Jiang, Rui Zhang, Bao‐Sheng Qiu Tags: Research Letter Source Type: research

Sputum mediator profiling and relationship to airway wall geometry imaging in severe asthma
Conclusions: We have demonstrated that sputum mediator profiling reveals a number of associations with airway geometry. Whether these findings reflect important biological phenotypes that might inform stratified medicine approaches requires further investigation.
Source: Respiratory Research - February 11, 2013 Category: Respiratory Medicine Authors: Dhananjay DesaiSumit GuptaSalman SiddiquiAmisha SingapuriWilliam MonteiroJames EntwisleSudha VisvanathanHarsukh ParmarRadhika KajekarChristopher Brightling Source Type: research

Preliminary characterizations of a serum biomarker for sarcoidosis by comparative proteomic approach with tandem-mass spectrometry in ethnic Han Chinese patients
Conclusion: This is the first study to investigate serum protein markers in Chinese subjects with sarcoidosis. This study shows that the serum SAA expression profiles were different between the sarcoidosis and non-sarcoidosis groups. SAA may be a potential serum biomarker for ruling-out the diagnosis of sarcoidosis in Chinese subjects.
Source: Respiratory Research - February 11, 2013 Category: Respiratory Medicine Authors: Yuan ZhangXianqiu ChenYang HuShanshan DuLi ShenYifan HeYuxuan ZhangXia ZhangHuiping LiRex Yung Source Type: research

Rapid-growth pneumatocele mimics massive pneumothorax in a HIV-positive patient
We present a rare fast-growing giant pneumatocele in a patient presenting with suspected pneumocystis pneumonia (PCP) infection and bilateral pneumothoraces as a primary manifestation of AIDS (HIV viral loading test: 628 000 copies/ml). Tube thoracostomies were performed and complicated with enduring air leakage and subcutaneous emphysema. Follow-up chest x-rays showed an enlarging radiolucency over the left upper lung field that was interpreted as massive pneumothorax with passive lung atelectasis. Positive ventilation was also applied due to disease progression (The CD4+ T-lymphocyte count was 18/cu mm). Repeated ch...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Hsieh, M.-S., Chen, C.-K., Wong, W.-W., Huang, C.-S. Tags: Images in Thorax, Journalology, Patients, Fungal lung diseases, Lung neoplasms, Drugs: infectious diseases, HIV/AIDS, Pneumonia (infectious disease), TB and other respiratory infections, Lung cancer (oncology), Screening (oncology), Lung cancer (respirato Source Type: research

A cavitating pulmonary lesion with eosinophilia
A middle-aged individual of Ethiopian origin attended the emergency department with haemoptysis. The patient had no other significant medical problems and had not travelled for several years. The patient drank moderately and did not smoke but later admitted to chewing khat (a narcotic leaf) frequently over the past 6 months. There were no significant findings on physical examination. Renal and liver function tests and C reactive protein were within normal limits, but a peripheral blood eosinophilia was noted (2.1x109/l). Serological tests for HIV, hepatitis B and C were negative. A poorly defined opacity was seen in t...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: McGregor, A. C., Griffin, N., Breen, R. A., Newsholme, W. Tags: Emergency medicine, Journalology, Hemoptysis, Lung infection, Drugs: infectious diseases, HIV/AIDS, Pneumonia (infectious disease), TB and other respiratory infections, Pneumonia (respiratory medicine), Radiology (diagnostics), Ethics Chest clinic Source Type: research

A case of cough and breathlessness
GE: A 64-year-old man never smoker with a history of dyspnoea and cough was referred for a respiratory opinion. The cough was sporadic but progressive over a 9 month period. It was associated with unpredictable, brief nocturnal paroxysms of breathlessness. There were also coughing bouts associated with phonation and with meals but no sputum production, fever or weight loss. There was no significant past medical history and he was not taking any medication. Physical examination was unremarkable. IM: This gentleman presents with a chronic, non-productive cough and episodic breathlessness. The duration of his symptoms ma...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Esterbrook, G., Molyneux, I., Clark, A. L., Morice, A. H. Tags: Lung neoplasms, Therapeutic trials, Lung cancer (oncology), Screening (oncology), Venous thromboembolism, Airway biology, Asthma, Lung cancer (respiratory medicine), Interstitial lung disease, Lung function, Pulmonary embolism, Radiology (diagnostics), He Source Type: research

How should I interpret an interferon gamma release assay result for tuberculosis infection?
Conclusions and impact Current and planned clinical research will fill the gaps in the evidence-base, narrowing the areas of uncertainty and informing future policy. Translational research into next-generation IGRAs and new T cell-based diagnostic platforms will likely overcome the limitations of current IGRAs in the near future.
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Abubakar, I., Stagg, H. R., Whitworth, H., Lalvani, A. Tags: Epidemiologic studies Chest clinic Source Type: research

Letter in response to: Stark P et al Amoxycillin-clavulanate for chronic wet cough in children: cautious interpretation of study findings warranted
We thank Stark and colleagues1 for comments on our paper and their interest in our recent randomised controlled trial (RCT) of amoxycillin-clavulanate compared with placebo for children with chronic wet cough,2 which as they state are a ‘group of patients that often present paediatricians with a management dilemma’ and which ‘represents a valuable contribution to the literature’. We feel it is important to clarify a few points raised. First, the criteria used for defining chronic cough in children (>3 weeks) was at the time of the study commencement the definition of chronic childhood cough....
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Marchant, J., Petsky, H., Chang, A. B. Tags: PostScript Source Type: research

Amoxycillin-clavulanate for chronic wet cough in children: cautious interpretation of study findings warranted
We read with interest the recent paper by Marchant et al comparing amoxicillin-clavunate to placebo for the treatment of chronic wet cough in children.1 The authors should be commended for attempting a randomised controlled clinical trial in this group of patients that often present paediatricians with a management dilemma. Nevertheless, we have significant concerns regarding several aspects of the study methodology, analysis and interpretation and feel that the authors have overstated their conclusions. We therefore urge caution in interpretation of the study findings. First, the definition of chronic cough used in the st...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Stark, P., Heenan, R., Orsani, F., Jachno, K., Connell, T. G. Tags: PostScript Source Type: research

Authors' response
We have read with great interest the comments by Dr Persson1 on our recent paper in Thorax,2 in which we showed that clinical control of asthma associated significantly with lower numbers of activated eosinophils in the bronchial wall, yet only weakly with sputum eosinophils. As the number of eosinophils in biopsies did not associate with clinical control of asthma, we speculated that activation of eosinophils (measured as eosinophil protein X (EXP)-immunopositive pixels per area) in bronchial biopsies reflects the level of disease control better than the number of eosinophils itself.2 As lysis of activated eosinophils and...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Fattahi, F., Volbeda, F., Broekema, M., Lodewijk, M. E., Hylkema, M. N., Reddel, H. K., Timens, W., Postma, D. S., ten Hacken, N. H. T. Tags: PostScript Source Type: research

Primary lysis/necrosis of eosinophils and clinical control of asthma
I read with interest the demonstration by Volbeda et al1 that clinical asthma control associates significantly with ‘lower activated eosinophil numbers in the bronchial wall, yet only weakly with sputum eosinophils’. I was particularly intrigued by the online supplemental information1: ‘EPX staining showed widely spread distribution of eosinophilic granules, not necessarily in close proximity to EPX+ cells. Therefore, degranulation of eosinophils was determined by quantification of the EPX immunopositive area by computer-assisted image analysis’. This statement suggests to me that the wall eosinophi...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Persson, C. Tags: PostScript Source Type: research

Author's response: understanding the natural progression in %FEV1 decline in patients with cystic fibrosis: a longitudinal study
We thank Professor Miller for his comments1 regarding our paper,2 in which we outline a novel approach to modelling repeated lung function measures in people with cystic fibrosis (CF) over long follow-up periods. We agree that it would be interesting to apply our methodology using alternative methods of expressing lung function across the age range, and reiterate that our approach can be usefully applied to any clinical outcome measured repeatedly over extended periods. While the merits of different approaches are appreciated, we chose to model forced expiratory volume in 1 s as a percentage of predicted (%FEV1) for a numb...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Taylor-Robinson, D., Whitehead, M., Diderichsen, F., Olesen, H. V., Pressler, T., Smyth, R., Diggle, P. Tags: PostScript Source Type: research

FEV1 decline in cystic fibrosis
I read the paper by Taylor-Robinson et al1 with interest with regard to modelling the decline in forced expiratory volume in 1 second (FEV1) in patients with cystic fibrosis (CF). The authors have made the assumption that expressing spirometry results as a per cent of predicted (PP) is a valid way to use lung function over a wide age range. Young adult patients with cystic fibrosis die with absolute FEV1 values just as low as those found in older patients with chronic obstructive pulmonary disease (COPD), so PP is not likely to be a valid methodology. When young CF patients were transplanted on the basis of an adult-derive...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Miller, M. Tags: PostScript Source Type: research

Follow-up of the Finnish Asthma Programme 2000-2010: reduction of hospital burden needs risk group rethinking
The Finnish Asthma Programme 1994–2004 focused on early intervention and disease control, thereby resulting in a significant reduction of asthma morbidity. During the follow-up period from 2000 to 2010, the number of hospital days continued to fall by 54%. Patients ≥65 years, especially women, accounted for 39% of the hospital days, and they need attention if the hospital burden is to be reduced further.
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Kauppi, P., Linna, M., Martikainen, J., Makela, M. J., Haahtela, T. Tags: PostScript Source Type: research

The yield of different pleural fluid volumes for Mycobacterium tuberculosis culture
We prospectively compared the culture yields of two pleural fluid volumes (5 and 100 ml) inoculated in liquid culture medium in 77 patients of whom 58 (75.3%) were diagnosed with pleural tuberculosis. The overall fluid culture yield was high (60.3% of cases with pleural tuberculosis). The larger volume had a faster time to positivity (329 vs 376 h, p=0.055) but its yield was not significantly higher (53.5% vs 50%; p=0.75). HIV-positive patients were more likely to have positive cultures (78.9% vs 51.5%; p=0.002).
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: von Groote-Bidlingmaier, F., Koegelenberg, C. F., Bolliger, C. T., Chung, P. K., Rautenbach, C., Wasserman, E., Bernasconi, M., Friedrich, S. O., Diacon, A. H. Tags: PostScript Source Type: research

BCG protects against tuberculosis irrespective of HIV status: a matched case-control study in Mwanza, Tanzania
While BCG vaccine protects against severe tuberculosis (TB) in children, its effect against adult TB is questionable. Furthermore, it is not known if HIV co-infection modifies the effect of BCG. Among 352 pairs of Tanzanian TB cases and matched controls, the BCG scar was associated with a reduced risk of TB (OR 0.3, 95% CI 0.2 to 0.7, p=0.005), irrespective of HIV status (interaction, p=0.623). BCG vaccination considerably reduced the risk of TB, both among individuals with and without HIV infection.
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Faurholt-Jepsen, D., Range, N., PrayGod, G., Jeremiah, K., Faurholt-Jepsen, M., Aabye, M. G., Grewal, H. M. S., Changalucha, J., Witte, D. R., Andersen, A. B., Friis, H. Tags: PostScript Source Type: research

Advances in tuberculosis 2011-2012
Renewed global interest and funding for tuberculosis (TB) has led to increased research and publications, with several recent advances. The increased incidence of drug resistant TB and emergence of multidrug resistant (MDR) and extensively drug resistant (XDR) TB globally has strengthened the need for improved rapid diagnostics and better treatment regimens. The HIV and TB epidemics have further impacted on TB research, necessitating the development of better preventive and treatment strategies. Important recent strides in adult TB include more widespread validation of molecular techniques and advances in therapeutics, inc...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Zar, H. J., Udwadia, Z. F. Tags: Reviews Source Type: research

Review of the British Thoracic Society Winter Meeting 2012, 5 to 7 December, London, UK
This review highlights new developments in scientific and clinical research presented at the British Thoracic Society Winter Scientific Meeting held from 5 to 7 December 2012. Although a wide spectrum of respiratory research was presented at the meeting the content of the review focuses specifically on the key themes of pleural disease, interstitial lung disease and future therapies in respiratory medicine. Advances in clinical and translational respiratory research presented in the major symposia and spoken sessions related to these areas are summarised. Additional sessions covering lifestyle dilemmas in the context of re...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Bayes, H. K., Church, A. C., Fisher, A. J., on behalf of the BTS Science and Research Committee Tags: Reviews Source Type: research

BCG-specific IgG-secreting peripheral plasmablasts as a potential biomarker of active tuberculosis in HIV negative and HIV positive patients
Conclusions These results suggest that BCG-specific IgG-secreting peripheral plasmablasts could be successfully used as a host-specific biomarker to improve diagnosis of active TB, particularly in people who are HIV positive, and facilitate administration of effective treatment to patients. Elevated IgG responses were associated with impaired peripheral T-cell responses, including reduced T-cell numbers and low M tuberculosis-specific IFN production.
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Ashenafi, S., Aderaye, G., Zewdie, M., Raqib, R., Bekele, A., Magalhaes, I., Lema, B., Habtamu, M., Rekha, R. S., Aseffa, G., Maeurer, M., Aseffa, A., Svensson, M., Andersson, J., Brighenti, S. Tags: Open access, Editor's choice, Drugs: infectious diseases, HIV/AIDS Tuberculosis Source Type: research

Lower prevalence of tuberculosis infection in BCG vaccinees: a cross-sectional study in adult prison inmates
Conclusions Our results suggest that BCG vaccine seems to have a protective effect in adults decades after vaccination according to the number of recent infections (QFT-IT ≥0.7 IU/ml). This finding has important implications for national policy of BCG vaccination. Further prospective cohort studies on the protective effect of BCG vaccination against TB infection in adults are warranted.
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Chan, P.-C., Yang, C.-H., Chang, L.-Y., Wang, K.-F., Kuo, Y.-C., Lin, C.-J., Lee, S.-W., Hsueh, P.-R., Fang, C.-T., Huang, L.-M. Tags: Epidemiologic studies, Drugs: infectious diseases, Vaccination / immunisation, Screening (epidemiology), Ethics, Screening (public health) Tuberculosis Source Type: research

New treatments for Tuberculosis
Diacon et al report a promising advance in both the future management of tuberculosis (TB) and the future design of drug trials in this field.1 The authors undertook a prospective, randomised study in uncomplicated, treatment naive patients with smear-positive pulmonary TB in South Africa. The study assessed the early bactericidal activity (EBA) of novel combinations of new and existing drugs, but avoiding rifampicin and isoniazid, over the first 14 days of treatment, using the novel outcome measure of daily fall in colony forming units (CFUs) of Mycobacterium tuberculosis per millilitres of sputum. This approach has ...
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Ricketts, W. M. Tags: Miscellaneous Source Type: research

Chronic respiratory disease, inhaled corticosteroids and risk of non-tuberculous mycobacteriosis
Conclusion Chronic respiratory disease, particularly COPD treated with ICS therapy, is a strong risk factor for NTM pulmonary disease.
Source: Thorax - February 11, 2013 Category: Respiratory Medicine Authors: Andrejak, C., Nielsen, R., Thomsen, V. O., Duhaut, P., Sorensen, H. T., Thomsen, R. W. Tags: Epidemiologic studies, Pneumonia (infectious disease), TB and other respiratory infections, Asthma, Interstitial lung disease, Drugs: respiratory system, Pneumonia (respiratory medicine), Occupational and environmental medicine Tuberculosis Source Type: research