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

Sertraline Hydrochloride Treatment for Patients with Stable Chronic Obstructive Pulmonary Disease Complicated with Depression: A Randomized Controlled Trial
ConclusionsAntidepressant treatment can improve the quality of life and exercise capacity of patients with depression, and it can also improve depression scores, but not lung function. (Source: The Clinical Respiratory Journal)
Source: The Clinical Respiratory Journal - October 13, 2014 Category: Respiratory Medicine Authors: Yuanqiang He, Yulong Zheng, Chuanqin Xu, Haichen Yang, Ziyu Wang, LiYang Zhou, Yufeng Wan, Donghui Zheng, Jing Zhu Tags: Original Article Source Type: research

Association between genetic polymorphisms in XPD and XRCC1 genes and risks of non‐small‐cell lung cancer in East Chinese Han population
ConclusionsThe results suggested that genetic polymorphisms in XPD‐751, XRCC1‐194, and XRCC1‐399 were related to the risk of non‐small cell lung cancer, among which XPD‐751SNP was responsible for adenocarcinoma, while XRCC1‐194SNP was closely linked to squamous carcinoma. Smoking and XRCC1‐194SNP were risk factors of non‐small cell lung cancer. (Source: The Clinical Respiratory Journal)
Source: The Clinical Respiratory Journal - October 13, 2014 Category: Respiratory Medicine Authors: Yong Du, Yanchao He, Zhoufang Mei, Ling Qian, Jindong Shi, Zhijun Jie Tags: Original Article Source Type: research

Delays for diagnosis and treatment of lung cancers: a systematic review
Abstract The impact of diagnosis and treatment delays for non‐small cell lung cancer (NSCLC) management is poorly understood, even if the literature on the subject is currently increasing in importance. We have few indicators which can serve as reference for quality assurance actions. Several studies analyzed these delays mostly in a monocentric setting. There is an important variability in the definition of these delays, in the collection methods, and in the results obtained. However, it seems distinctly clear that long delays are frequently observed in less symptomatic patients and, therefore, are accompanied by better...
Source: The Clinical Respiratory Journal - October 13, 2014 Category: Respiratory Medicine Authors: Vinas F, Ben Hassine I, Jabot L, Monnet I, Chouaid C Tags: Review Article Source Type: research

Adherence to the Global Initiative for Chronic Obstructive Lung Disease guidelines for management of COPD: A hospital‐ base study
ConclusionThe level of adherence to GOLD guidelines for the management of COPD exacerbation was suboptimal at our teaching hospital. Further improvements in adherence to these guidelines are needed. (Source: The Clinical Respiratory Journal)
Source: The Clinical Respiratory Journal - October 13, 2014 Category: Respiratory Medicine Authors: Seyed Masoom Masoompour, Abbas Mohamadi, Hamideh Mahdaviazad Tags: Original Article Source Type: research

Fiducial marker placement via conventional or electromagnetic navigation bronchoscopy (ENB): An interdisciplinary approach to the curative management of lung cancer
ConclusionFiducial marker placement may be an interesting bronchoscopic technique in the interdisciplinary therapeutic approach to inoperable early stage lung cancer. In the described cases therapy planning was successful and no procedure‐related complications were observed. (Source: The Clinical Respiratory Journal)
Source: The Clinical Respiratory Journal - October 13, 2014 Category: Respiratory Medicine Authors: Lars Hagmeyer, Christina Priegnitz, Martin Kocher, Burkhart Schilcher, Wilfried Budach, Marcel Treml, Sven Stieglitz, Winfried Randerath Tags: Original Article Source Type: research

Mitochondrial dysfunction in rat steatotic liver is due to a defect in Complex‐I making them more susceptible to prolonged cold ischemia
Conclusion: Steatotic livers exhibited an apparent mitochondrial dysfunction through an alteration in C‐I activity, making them more susceptible to prolonged cold ischemia. The clinical‐based IPC protocol used here restored MF in mild hepatic steatosis by attenuating C‐I mediated leak following prolonged cold ischemia but not in livers with moderate or severe steatosis. Liver Transpl , 2014. © 2014 AASLD. (Source: Liver Transplantation)
Source: Liver Transplantation - October 13, 2014 Category: Transplant Surgery Authors: Michael J.J. Chu, Anthony J.R. Hickey, Yannan Jiang, Amorita Petzer, Adam S.J.R. Bartlett, Anthony R.J. Phillips Tags: Original Article Source Type: research

Evidence-based guideline summary: Diagnosis and treatment of limb-girdle and distal dystrophies: Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Issues Review Panel of the American Association of Neuromuscular & Electrodiagnostic Medicine
Objective: To review the current evidence and make practice recommendations regarding the diagnosis and treatment of limb-girdle muscular dystrophies (LGMDs). Methods: Systematic review and practice recommendation development using the American Academy of Neurology guideline development process. Results: Most LGMDs are rare, with estimated prevalences ranging from 0.07 per 100,000 to 0.43 per 100,000. The frequency of some muscular dystrophies varies based on the ethnic background of the population studied. Some LGMD subtypes have distinguishing features, including pattern of muscle involvement, cardiac abnormalities, ex...
Source: Neurology - October 13, 2014 Category: Neurology Authors: Narayanaswami, P., Weiss, M., Selcen, D., David, W., Raynor, E., Carter, G., Wicklund, M., Barohn, R. J., Ensrud, E., Griggs, R. C., Gronseth, G., Amato, A. A. Tags: All Neuromuscular Disease, Developmental disorders, All Rehabilitation, All Genetics SPECIAL ARTICLE Source Type: research

Highlights from this issue
A spring in your lung Bronchoscopic lung volume reduction is very much a hot topic. Hitherto coils have been positioned for contraceptive purposes somewhat distal to the lungs; so are the Gynaecologists making a Putin-like bid for our territory? This month we publish 12-month outcomes after bronchoscopic insertion of a nitinol coil device in patients with emphysema (Hot topic; see page 980). Coils have potential advantages over other techniques as their spring like effect might address loss of elasticity (is there a whole body coil for your editors?) and dynamic airway collapse; they are applicable in the 60% of patients w...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Bush, A., Pavord, I. Tags: Airwaves Source Type: research

Emphysema: time to say farewell to therapeutic nihilism
It is an interesting time for the management of emphysema. In this condition, destruction of lung parenchyma associated with reduced elastic recoil and dynamic airways closure produce gas trapping and increased operating lung volumes, leading to breathlessness and exercise limitation. It has historically been defined as an irreversible process, which has led to a degree of therapeutic nihilism. One manifestation of this has been the curious neglect of lung volume reduction surgery (LVRS). Clinical guidelines,1 reflecting trial evidence,2 recommend consideration of LVRS in selected patients with upper lobe predominant emphy...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Zoumot, Z., Jordan, S., Hopkinson, N. S. Tags: Open access Editorial Source Type: research

The child is father of the man: the importance of early life influences on lung development
There is a great deal of interest in the early life determinants of lung function as possible determinants of obstructive airways disease through the rest of the life course. Failure to attain maximal lung function in early adult life either alone or coupled with accelerated decline during adulthood could contribute to the substantial burden of morbidity and mortality associated with obstructive airway disease and COPD in later life.1 Longitudinal studies of lung function in unselected populations have suggested that decrements of FEV1 established in the first few years after birth track to adulthood,2 thus pointing to ear...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Henderson, A. J. Tags: Editorial Source Type: research

Antioxidants and respiratory disease: the uric acid paradox
For humble individuals like myself, there is one poor comfort, which is this, viz. that gout, unlike any other disease, kills more rich men than poor, more wise men than simple. Thomas Sydenham. In clinical practice, high blood concentrations of uric acid (UA) are generally thought to be a bad thing—primarily because of the risk of gout, but also because individuals with high UA concentrations are at increased risk of cardiovascular disease, metabolic syndrome and hypertension1; these associations may reflect the fact that, under certain circumstances, UA can be pro-oxidant.2 Perhaps less appreciated are the potentia...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Shaheen, S. O. Tags: Editorial Source Type: research

Lung volume reduction coil treatment for patients with severe emphysema: a European multicentre trial
Conclusions LVR coil treatment results in significant clinical improvements in patients with severe emphysema, with a good safety profile and sustained results for up to 1 year. Trial registration number: NCT01328899. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Deslee, G., Klooster, K., Hetzel, M., Stanzel, F., Kessler, R., Marquette, C.-H., Witt, C., Blaas, S., Gesierich, W., Herth, F. J. F., Hetzel, J., van Rikxoort, E. M., Slebos, D.-J. Tags: Hemoptysis, Open access, Pneumonia (infectious disease), TB and other respiratory infections, Pneumonia (respiratory medicine), Cardiothoracic surgery Chronic obstructive pulmonary disease Source Type: research

Comparison of spatially matched airways reveals thinner airway walls in COPD. The Multi-Ethnic Study of Atherosclerosis (MESA) COPD Study and the Subpopulations and Intermediate Outcomes in COPD Study (SPIROMICS)
Conclusions Airway walls are thinner in COPD when comparing spatially matched central airways. Other approaches to airway sampling result in comparisons of more proximal to more distal airways and potentially biased assessment of airway properties in COPD. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Smith, B. M., Hoffman, E. A., Rabinowitz, D., Bleecker, E., Christenson, S., Couper, D., Donohue, K. M., Han, M. K., Hansel, N. N., Kanner, R. E., Kleerup, E., Rennard, S., Barr, R. G. Tags: Health education, Smoking, Tobacco use Chronic obstructive pulmonary disease Source Type: research

Improving antibiotic prescribing in acute respiratory tract infections
This Norwegian cluster randomised controlled trial assessed the effects of multifaceted educational interventions on antibiotic prescribing for acute respiratory tract infections (RTI) in general practice. Authors of the study hoped to reduce prescription rates and use of broad spectrum antibiotics with their intervention. Seventy-nine medical education groups, totalling 382 general practitioners (GPs), were recruited in the study. The intervention consisted of two visits by specially trained GPs; one detailing national guidelines for antibiotic use and recent research on acute RTI, and the second to issue reports on indiv...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Eddie, L. Tags: Miscellanea Source Type: research

Genetic regulation of gene expression in the lung identifies CST3 and CD22 as potential causal genes for airflow obstruction
Conclusions By using integrative genomics and analysing the relationships of COPD phenotypes with SNPs and gene expression in lung tissue, we identified CST3 and CD22 as potential causal genes for airflow obstruction. This study also augmented the understanding of previously described COPD pathways. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Lamontagne, M., Timens, W., Hao, K., Bosse, Y., Laviolette, M., Steiling, K., Campbell, J. D., Couture, C., Conti, M., Sherwood, K., Hogg, J. C., Brandsma, C.-A., van den Berge, M., Sandford, A., Lam, S., Lenburg, M. E., Spira, A., Pare, P. D., Nickle, D. Tags: Clinical genetics, Genetic screening / counselling Chronic obstructive pulmonary disease Source Type: research

SPLUNC1: link between acidity and dehydration of the airway surface liquid in CF
Short palate lung and nasal epithelial clone 1 (SPLUNC1) is the most abundant secreted protein in the airways and helps maintain a normal airway surface liquid (ASL) volume through its regulation of the epithelial Na+ channel (ENaC). In cystic fibrosis (CF), it has been proposed that increased Na+ absorption by ENaC contributes to ASL depletion, despite the presence of SPLUNC1. The study by Garland et al showed the pH of nasal secretions from CF subjects (pH~6.5) was more acidic than non-CF subjects (pH~7.2), consistent with previous studies of CF ASL. Re-creating such conditions in vitro, the investigators found that alka...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Garnett, J. P. Tags: Miscellanea Source Type: research

Cross-sectional associations between air pollution and chronic bronchitis: an ESCAPE meta-analysis across five cohorts
Conclusions Results do not show consistent associations between chronic bronchitis symptoms and current traffic-related air pollution in adult European populations. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Cai, Y., Schikowski, T., Adam, M., Buschka, A., Carsin, A.-E., Jacquemin, B., Marcon, A., Sanchez, M., Vierkotter, A., Al-Kanaani, Z., Beelen, R., Birk, M., Brunekreef, B., Cirach, M., Clavel-Chapelon, F., Declercq, C., de Hoogh, K., de Nazelle, A., Ducre Tags: Epidemiologic studies, TB and other respiratory infections, Bronchitis, Air pollution, Environmental issues, Health education, Smoking, Tobacco use Environmental exposure Source Type: research

A longitudinal study of lung function from 1 month to 18 years of age
Conclusions Decrements in lung function in 18-year-olds associated with maternal asthma and early onset atopy may be determined by 1 month of age. Low initial lung function in some individuals can ‘recover’ in some settings. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Turner, S., Fielding, S., Mullane, D., Cox, D. W., Goldblatt, J., Landau, L., le Souef, P. Tags: Epidemiologic studies, Child health, Asthma, Health education, Smoking, Tobacco use, Tobacco use (youth) Paediatric lung disease Source Type: research

Serum uric acid and the risk of respiratory disease: a population-based cohort study
Conclusions Low levels of serum uric acid are associated with higher rates of COPD and lung cancer in current smokers after accounting for conventional risk factors. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Horsfall, L. J., Nazareth, I., Petersen, I. Tags: Lung neoplasms, Epidemiologic studies, Open access, Editor's choice, General practice / family medicine, Lung cancer (oncology), Lung cancer (respiratory medicine), Health education, Smoking, Health effects of tobacco use, Tobacco use Respiratory epidem Source Type: research

Coarse particulate matter associated with increased risk of emergency hospital admissions for pneumonia in Hong Kong
Conclusions Short-term PMc exposure is associated with emergency hospitalisations for pneumonia in Hong Kong. Air quality regulation specifically for PMc might be considered. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Qiu, H., Tian, L. W., Pun, V. C., Ho, K.-f., Wong, T. W., Yu, I. T. S. Tags: Emergency medicine, Epidemiologic studies, Pneumonia (infectious disease), TB and other respiratory infections, Pneumonia (respiratory medicine), Environmental issues Respiratory epidemiology Source Type: research

Myeloid-related protein-8/14 facilitates bacterial growth during pneumococcal pneumonia
Conclusions In sharp contrast to its previously reported host-protective role in several infections, the present results reveal that in a model of CAP, MRP8/14 is misused by S. pneumoniae, facilitating bacterial growth by attenuating zinc toxicity toward the pathogen. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Achouiti, A., Vogl, T., Endeman, H., Mortensen, B. L., Laterre, P.-F., Wittebole, X., van Zoelen, M. A. D., Zhang, Y., Hoogerwerf, J. J., Florquin, S., Schultz, M. J., Grutters, J. C., Biesma, D. H., Roth, J., Skaar, E. P., van 't Veer, C., de Vos, A. F., Tags: Pneumonia (infectious disease), TB and other respiratory infections, Inflammation, Pneumonia (respiratory medicine) Source Type: research

Heterogeneity's ruses: the neglected role of between-individual variability in longitudinal studies of COPD exacerbations
ABSTRACT Studying the causal and temporal association between past and future exacerbations in COPD is an active area of research. Standard survival analysis techniques often used in such studies typically produce results that pertain to the overall population, whereas the greatest interest is in the study of associations within individuals. A factor that can lead to profound discrepancies between population-level and individual-level survival patterns is the between-individual heterogeneity in the rate of exacerbations. We briefly review two studies that, while reporting valid results for the overall population, drew conc...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Sadatsafavi, M., FitzGerald, J. M. Tags: Epidemiologic studies, Open access Research letter Source Type: research

Positional oximetry to screen for pulmonary arteriovenous malformations in HHT
Orthodeoxia has been described in patients with hereditary haemorrhagic telangiectasia (HHT) and pulmonary arteriovenous malformations (PAVM), but its usefulness in screening children for PAVMs is unknown. We show here that while oximetry is overall lower in children with significant PAVMs, supine and upright oximetry is of no additional diagnostic value indicating that positional oximetry is not a useful screening test for PAVMs. (Source: Thorax)
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Carpenter, S., Josepovici, J., Latino, G., Ratjen, F. Tags: Screening (epidemiology), Screening (public health) Research letter Source Type: research

Orthodeoxia and postural orthostatic tachycardia in patients with pulmonary arteriovenous malformations: a prospective 8-year series
Postural changes in 258 patients with pulmonary arteriovenous malformations (PAVMs) reviewed between 2005 and 2013 were evaluated prospectively using validated pulse oximetry methods. Of the 257 completing the test, 75 (29%) demonstrated orthodeoxia with an oxygen saturation fall of at least 2% on standing. None described platypnoea (dyspnoea on standing). The heart rate was consistently higher in the erect posture: 74 (29%) had a postural orthostatic tachycardia of ≥20 min–1, and in 25 (10%) this exceeded 30 min–1. Orthostatic tachycardia was more pronounced in PAVM patients than controls without ...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Santhirapala, V., Chamali, B., McKernan, H., Tighe, H. C., Williams, L. C., Springett, J. T., Bellenberg, H. R., Whitaker, A. J., Shovlin, C. L. Tags: Research letter Source Type: research

Risk factors for sleep-disordered breathing in pregnancy
The stimulating paper of Pien et al1 reported the findings of a prospective cohort study of pregnant women examining risk factors for sleep-disordered breathing (SDB). It was notable that, despite a marked increase in the number of women with obstructive sleep apnoea (OSA) from the first to third trimester (from 10.5% to 26.7%, respectively), there were no significant associations between any SDB variable and development of gestational hypertension or preeclampsia or with preterm delivery, gestational diabetes or low birth weight. The authors acknowledged that, in their study, determination of any associations between OSA ...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Redhead, K., Eastwood, P., Griffin, C. Tags: PostScript Source Type: research

Is the 'spatially matched central airways' relevant to studies of airway dimensions in COPD?
We read with interest the comparison of spatially matched airways which reveals thinner airway walls in COPD than in controls by Smith et al.1 While we find these results interesting, we wonder about the approach taken. First, grouping airway segments from the five prespecified paths in one given generation number (table E1) would dismiss regional differences in airway structure.2 For example, RB1 is very likely different from right lower lobe bronchus (RLL) proximal to RB7 in the 3rd generation while RB1 subsegments are different from RLL distal to RB7 in the 4th generation. The fact that the unadjusted airway wall area (...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Nakano, Y., Tho, N. V., Coxson, H. O. Tags: PostScript Source Type: research

Location, location, location: studying anatomically comparable airways is highly relevant to understanding COPD
We have read with interest Nakano and colleague's thoughtful comments1 on Smith et al2 and are pleased to offer the following observations. We believe that a key strength of our paper is that it defines a rigorous sampling strategy to compare airways from matched hierarchical positions within the tracheobronchial tree with control for the known hierarchical gradient in airway dimensions.3 Nakano et al are correct to point out that hierarchical sampling by generation number results in grouping of airways from multiple anatomic locations (eg, segmental and lobar airways); conversely, hierarchical sampling by anatomic locatio...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Smith, B. M., Hoffman, E. A., Rennard, S., Barr, R. G. Tags: PostScript Source Type: research

Exacerbations in non-COPD patients: truth or myth
We read with great interest the article by Tan et al,1 whereby they have discussed the occurrence of exacerbation-like events in patients without COPD. The basic concept of the study needs debate and clarification. The authors have used the terms ‘non-COPD patients’ and ‘exacerbation like event’ to mention the group of patients who didn't fulfil the spirometric criteria for COPD. Without mentioning its causes, this non-COPD group with chronic respiratory symptoms seems to be a new disease process. Here, it should be clarified that this non-COPD group is not a distinct aetiological entity. Rather, th...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Aggarwal, D., Khurana, A. K. Tags: PostScript Source Type: research

Exacerbations in non-COPD patients: truth or myth--authors' response
Dear Sir, We are grateful to Dr Khurana and Dr Aggarwal for their interest1 in our paper.2 On their first point, we agree that we should be careful about terminology. We evaluated a random sample of individuals representative of the general population rather than patients, so the findings that episodes of respiratory events occurred in these subjects would likely reflect real events in the general population. Furthermore, our study definition for exacerbations was the same standard questionnaire criteria for exacerbations used in clinical trials of selected patients with COPD.3 On the second point on aetiologies for non-CO...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Tan, W. C., Bourbeau, J., Aaron, S., FitzGerald, J. M., Hernandez, P., Cowie, R., Chapman, K. R., Marciniuk, D., Maltais, F., Buist, S., O'Donnell, D., Sin, D. D., for the CanCOLD Collaborative Research Group Tags: PostScript Source Type: research

Pulmonary vascular volumes and airways obstruction in SCD patients
Dear Editor We read with interest the recent paper by Chaudry et al1 in which the authors describe an obstructive ventilatory defect in children with sickle cell disease (SCD) which was not linked to bronchial hyper-responsiveness, as assessed by methacholine challenge testing, or to eosinophillic inflammation. Their results further demonstrate that the airflow obstruction seen in children with SCD may not solely be due to asthma. Indeed, in children with SCD, we have shown that pulmonary capillary blood volume is increased compared to matched controls, and is correlated with airflow obstruction as assessed by impulse osci...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Greenough, A., Lunt, A. Tags: PostScript Source Type: research

Letter to the Editor in reply to 'Pulmonary vascular volumes and airways obstruction in SCD patients'
Dear Editor, We thank Professor Greenough and Dr Lunt for their interest1 in our manuscript,2 and for the suggestion that changes in pulmonary vascular volumes may lead to airflow obstruction. In this group of sickle cell diseased (SCD) children and controls, we used carbon monoxide transfer (DLCO) related to pulmonary blood flow (Qpeff) at rest and on exercise as a surrogate for pulmonary capillary blood volume.3 DLCO corrected for haemoglobin and surface area was significantly higher in SCD at rest, but only by about 10%, while Qpeff was 15–20% higher. DLCO:Qpeff, therefore, was significantly lower in SCD at rest a...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Crowley, S., Chaudry, R. A., Rosenthal, M., Bush, A. Tags: PostScript Source Type: research

Cochrane corner: is integrated disease management for patients with COPD effective?
Patients with COPD experience respiratory symptoms, impairments of daily living and recurrent exacerbations. The aim of integrated disease management (IDM) is to establish a programme of different components of care (ie, self-management, exercise, nutrition) in which several healthcare providers (ie, nurses, general practitioners, physiotherapists, pulmonologists) collaborate to provide efficient and good quality of care. The aim of this Cochrane systematic review was to evaluate the effectiveness of IDM on quality of life, exercise tolerance and exacerbation related outcomes. Searches for all available evidence were carri...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Kruis, A. L., Smidt, N., Assendelft, W. J. J., Gussekloo, J., Boland, M. R. S., Rutten-van Molken, M., Chavannes, N. H. Tags: Clinical trials (epidemiology), Open access, General practice / family medicine, Quality improvement Chest clinic Source Type: research

Changes to inhaled corticosteroid dose when initiating combination inhaler therapy in long-acting {beta} agonist-naive patients with asthma: a retrospective database analysis
Retrospective prescribing data were obtained from 46 general practice surgeries in NHS Scotland. Patients with asthma who were naïve to previous long-acting β agonist therapy and initiated combination inhaler therapy in 2008–2009 were classified according to the inhaled corticosteroid (ICS) dose in their combination inhaler compared with the highest dose of ICS they received before initiation. Among the 685 patients (541 (79.0%) who had been prescribed an ICS previously), those originally on low-, medium- or high-dose ICS were changed to high-dose combination therapy in 122/250 (48.8%), 94/151 (62.3%) or 85...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Covvey, J. R., Johnston, B. F., Wood, F., Boyter, A. C. Tags: Asthma, Drugs: respiratory system Chest clinic Source Type: research

Lesson of the month: extrinsic allergic (bronchiolo)alveolitis and metal working fluids
Introduction One of us was asked to consider a diagnosis of occupational asthma for a man who had worked for 20 years as a metal turner in a large, modern factory producing specialised machine parts. He described a 2 year history of severe breathlessness that improved when he was not at work. His spirometry was restrictive with a FEV1 of 1.35 L (40% predicted) and FVC of 1.8 L (45% predicted), a ratio of 75%. Other lung function measurements indicated gas trapping; his TLC was 5.01 L (79% predicted) and RV/TLC 170% predicted. A high resolution CT scan of his lungs revealed a widespread ‘mosai...
Source: Thorax - October 13, 2014 Category: Respiratory Medicine Authors: Cullinan, P., D'Souza, E., Tennant, R., Barber, C. Tags: Open access, Pneumonia (infectious disease), TB and other respiratory infections, Chemotherapy, Asthma, Interstitial lung disease, Pneumonia (respiratory medicine), Radiology (diagnostics), Occupational and environmental medicine Chest clinic Source Type: research