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Helena A White, Robert F Miller, Anton L Pozniak, Marc C I Lipman, Iain Stephenson, Martin J Wiselka, Manish Pareek
Latent TB infection (LTBI) screening and treatment in HIV-positive individuals in the UK is advocated by the British HIV Association (BHIVA) and National Institute for Health and Care Excellence (NICE), although each recommends differing strategies. We undertook an evaluation of UK practice, relating the responses to the local HIV/TB disease burden. 162 of 188 (86%) UK geographical areas responded; only 93/162 (57.4%) offer LTBI testing with considerable heterogeneity in practice, and no difference in HIV/TB burden between areas offering testing and those who do not...
October 14, 2016: Thorax
Marco Sperandeo, Gaetano Rea, Maria Arcangela Grimaldi, Francesca Trovato, Lucia M C Dimitri, Vincenzo Carnevale
We investigated if contrast-enhanced ultrasound (CEUS) may differentiate community acquired pneumonia (CAP) from lung cancer (LC). Among 1374 patients admitted in a 5-year period for lung opacities, 728 (329 CAP and 399 LC) were investigated by CEUS, comparing the time of appearance, disappearance, duration and pattern of distribution of contrast enhancement (CE). The patients with CAP and LC did not differ in terms of age, time of CE appearance, disappearance and duration or CE distribution. Our data show that the timing and pattern of CE detected by chest CEUS does not distinguish between CAP and LC and overly optimistic beliefs on this matter should be abandoned...
October 14, 2016: Thorax
Luciano E Busi, Sebastián Restuccia, Ricardo Tourres, Peter D Sly
BACKGROUND: Measuring lung function, including bronchodilator response (BDR), is an integral part of asthma management in older children. While spirometry is possible in preschool-aged children, the question remains whether measuring BDR aids in asthma diagnosis in this age group. METHODS: 431 healthy children and 289 children with asthma, aged 3-5 years, were recruited from kindergartens and the pulmonology clinic in Trelew, Argentina. Spirometry was performed at visit 1 and repeated after 15 min, with children randomised to placebo or salbutamol (400 µg)...
October 14, 2016: Thorax
Michael Kreuter, Francesco Bonella, Toby M Maher, Ulrich Costabel, Paolo Spagnolo, Derek Weycker, Klaus-Uwe Kirchgaessler, Martin Kolb
BACKGROUND: Data are conflicting regarding the possible effects of statins in patients with idiopathic pulmonary fibrosis (IPF). This post hoc analysis assessed the effects of statin therapy on disease-related outcomes in IPF. METHODS: Patients randomised to placebo (n=624) in three controlled trials of pirfenidone in IPF (CAPACITY 004 and 006, ASCEND) were categorised by baseline statin use. Outcomes assessed during the 1-year follow-up included disease progression, mortality, hospitalisation and composite outcomes of death or ≥10% absolute decline in FVC and death or ≥50 m decline in 6-minute walk distance (6MWD)...
October 5, 2016: Thorax
Bidyut K Sarkar, Robert West, Monika Arora, Jasjit S Ahluwalia, K Srinath Reddy, Lion Shahab
BACKGROUND: Tobacco use kills half a million people every month, most in low-middle income countries (LMICs). There is an urgent need to identify potentially low-cost, scalable tobacco cessation interventions for these countries. OBJECTIVE: To evaluate a brief community outreach intervention delivered by health workers to promote tobacco cessation in India. DESIGN: Cluster-randomised controlled trial. SETTING: 32 low-income administrative blocks in Delhi, half government authorised ('resettlement colony') and half unauthorised ('J...
October 5, 2016: Thorax
Sarah A F Chamberlain Mitchell, Rachel Garrod, Lynne Clark, Abdel Douiri, Sean M Parker, Jenny Ellis, Stephen J Fowler, Siobhan Ludlow, James H Hull, Kian Fan Chung, Kai K Lee, H Bellas, Anand Pandyan, Surinder S Birring
BACKGROUND: Physiotherapy, and speech and language therapy are emerging non-pharmacological treatments for refractory chronic cough. We aimed to investigate the efficacy of a physiotherapy, and speech and language therapy intervention (PSALTI) to improve health-related quality of life (HRQoL) and to reduce cough frequency in patients with refractory chronic cough. METHODS: In this multicentre randomised controlled trial, patients with refractory chronic cough were randomised to four weekly 1:1 sessions of either PSALTI consisting of education, laryngeal hygiene and hydration, cough suppression techniques, breathing exercises and psychoeducational counselling or control intervention consisting of healthy lifestyle advice...
September 28, 2016: Thorax
Lynne F Forrest, Sarah Sowden, Greg Rubin, Martin White, Jean Adams
: Cancer diagnosis at an early stage increases the chance of curative treatment and of survival. It has been suggested that delays on the pathway from first symptom to diagnosis and treatment may be socio-economically patterned, and contribute to socio-economic differences in receipt of treatment and in cancer survival. This review aimed to assess the published evidence for socio-economic inequalities in stage at diagnosis of lung cancer, and in the length of time spent on the lung cancer pathway...
September 28, 2016: Thorax
John P Corcoran, John M Wrightson, Alastair J Moore, Fergus V Gleeson, Annemarie Sykes
No abstract text is available yet for this article.
September 28, 2016: Thorax
Peter I Bonta, Harm J Bogaard, Inge van den Berk, Hans W M Niessen, Allard van der Wal, Petr Symersky
No abstract text is available yet for this article.
September 28, 2016: Thorax
Ranjani Somayaji, John C Lam, Michael G Surette, Barbara Waddell, Harvey R Rabin, Christopher D Sibley, Swathi Purighalla, Michael D Parkins
RATIONALE: Epidemic Pseudomonas aeruginosa (PA) plays an important role in cystic fibrosis (CF) lung disease. A novel strain, the 'Prairie Epidemic Strain' (PES), has been identified in up to 30% of patients in Prairie-based Canadian CF centres. OBJECTIVE: To determine the incidence, prevalence and long-term clinical impact of PES infection. METHODS: A cohort of adults with CF was followed from 1980 to 2014 where bacteria isolated from clinical encounters were prospectively collected...
September 28, 2016: Thorax
B Campbell, C Raherison, C J Lodge, A J Lowe, T Gislason, J Heinrich, J Sunyer, F Gómez Real, D Norbäck, M C Matheson, M Wjst, J Dratva, R de Marco, D Jarvis, V Schlünssen, C Janson, B Leynaert, C Svanes, S C Dharmage
RATIONALE: Evidence has suggested that exposure to environmental or microbial biodiversity in early life may impact subsequent lung function and allergic disease risk. OBJECTIVES: To investigate the influence of childhood living environment and biodiversity indicators on atopy, asthma and lung function in adulthood. METHODS AND MEASUREMENTS: The European Community Respiratory Health Survey II investigated ∼10 201 participants aged 26-54 years from 14 countries, including participants' place of upbringing (farm, rural environment or inner city) before age 5 years...
September 26, 2016: Thorax
Dale T Umetsu
Asthma, an inflammatory disease of the airways, is a common condition, currently affecting about 9% of adults. Obesity is another disease with high prevalence in adults, and asthma that develops in obese individuals appears to be distinct from other forms of asthma, in being particularly severe and difficult to control even with oral corticosteroids. Moreover, recent studies suggest that obesity may have a causal relationship with asthma. In this review, we discuss possible obesity-driven metabolic and immunological pathways that might lead to asthma that is associated with obesity...
September 26, 2016: Thorax
Amit Chopra, Peter Doelken, Marc A Judson, Terrill Huggins
No abstract text is available yet for this article.
September 26, 2016: Thorax
Martin Kolb, Luca Richeldi, Jürgen Behr, Toby M Maher, Wenbo Tang, Susanne Stowasser, Christoph Hallmann, Roland M du Bois
RATIONALE: There is no consensus as to when treatment for idiopathic pulmonary fibrosis (IPF) should be initiated. Some physicians prefer not to treat patients with preserved lung volume. OBJECTIVE: To investigate whether patients with IPF and preserved lung volume receive the same benefit from nintedanib as patients with more impaired lung volume. METHODS: Post hoc subgroup analyses of pooled data from the two replicate phase III INPULSIS trials by baseline FVC % predicted (≤90%, >90%)...
September 26, 2016: Thorax
Anne E Holland, Ajay Mahal, Catherine J Hill, Annemarie L Lee, Angela T Burge, Narelle S Cox, Rosemary Moore, Caroline Nicolson, Paul O'Halloran, Aroub Lahham, Rebecca Gillies, Christine F McDonald
BACKGROUND: Pulmonary rehabilitation is a cornerstone of care for COPD but uptake of traditional centre-based programmes is poor. We assessed whether home-based pulmonary rehabilitation, delivered using minimal resources, had equivalent outcomes to centre-based pulmonary rehabilitation. METHODS: A randomised controlled equivalence trial with 12 months follow-up. Participants with stable COPD were randomly assigned to receive 8 weeks of pulmonary rehabilitation by either the standard outpatient centre-based model, or a new home-based model including one home visit and seven once-weekly telephone calls from a physiotherapist...
September 26, 2016: Thorax
Tom Wilkinson
No abstract text is available yet for this article.
September 26, 2016: Thorax
B Barratt, J K Quint
No abstract text is available yet for this article.
September 22, 2016: Thorax
Zhichen Xing, Junyan Han, Xing Hao, Jinhong Wang, Chunjing Jiang, Yu Hao, Hong Wang, Xueying Wu, Liwei Shen, Xiaojun Dong, Tong Li, Guoli Li, Jianping Zhang, Xiaotong Hou, Hui Zeng
BACKGROUND: As immune regulatory and effector cells, monocytes play an important role in the blood-extracorporeal circuit contact-related acute lung injury in patients undergoing cardiopulmonary bypass (CPB). However, circulating monocytes are phenotypically and functionally heterogeneous, so we characterised how immature monocytes affect acute lung injury induced by CPB. METHODS: The identification and dynamic changes in monocyte subsets were monitored by flow cytometry in patients undergoing CPB and in a rat model of CPB...
September 22, 2016: Thorax
Mark Griffiths, Alastair Proudfoot
No abstract text is available yet for this article.
September 20, 2016: Thorax
Philip Z Svigals, Amit Chopra, James G Ravenel, Paul J Nietert, John T Huggins
We compared the accuracy of pleural ultrasound versus chest CT versus chest radiograph (CXR) to determine radiographic complexity in predicting a complicated parapneumonic effusion (CPPE) defined by pleural fluid analysis. 66 patients with parapneumonic effusions were identified with complete data. Pleural ultrasound had a sensitivity of 69.2% (95% CI 48.2% to 85.7%) and specificity of 90.0% (95% CI 76.3% to 97.2%). Chest CT had a sensitivity of 76.9% (95% CI 56.3% to 91.0%) and specificity of 65.0% (95% CI 48...
September 9, 2016: Thorax
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