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Anitha Vijayasingam, Inmaculada Alcalde, Sachin Shah, Ben Singer, Anthony Bastin, Ian Chikanza, Jeremy Cordingley, Gavin Thomas
No abstract text is available yet for this article.
October 16, 2018: Thorax
Marek Lommatzsch, Maria Klein, Paul Stoll, Johann Christian Virchow
Here, we report that increasing treatment with inhaled corticosteroids (ICS) in patients with not well-controlled asthma from a medium to a high dose results in a profound reduction of blood eosinophils (median fall in blood eosinophil concentrations from 560 to 320 cells/µL). Therefore, 'normal values' of blood eosinophils in patients with asthma need to be considered in view of the individual ICS doses of the patients. In addition, increases in the dose of ICS may result in blood eosinophil concentrations which would formally preclude treatment with biologics targeting the interleukin-5 pathway...
October 12, 2018: Thorax
Nicola Jane Rowbotham, Sherie Smith, Andrew P Prayle, Karen A Robinson, Alan Robert Smyth
INTRODUCTION: Cystic fibrosis (CF) is a multisystem disorder. Treatment is complex and evidence for treatment decisions may be absent. Characterising gaps in the research evidence will highlight treatment uncertainties and help prioritise research questions. We systematically identified the evidence gaps for treatment decisions in CF. METHODS: We searched for systematic reviews and guidelines on treatment interventions in CF. Two researchers identified eligible reviews with arbitration from a third...
October 9, 2018: Thorax
Peter S Cunningham, Robert Maidstone, Hannah J Durrington, Rajamayier V Venkateswaran, Marcelo Cypel, Shaf Keshavjee, Julie E Gibbs, Andrew S Loudon, Chung-Wai Chow, David W Ray, John F Blaikley
The importance of circadian factors in managing patients is poorly understood. We present two retrospective cohort studies showing that lungs reperfused between 4 and 8 AM have a higher incidence (OR 1.12; 95% CI 1.03 to 1.21; p=0.01) of primary graft dysfunction (PGD) in the first 72 hours after transplantation. Cooling of the donor lung, occurring during organ preservation, shifts the donor circadian clock causing desynchrony with the recipient. The clock protein REV-ERBα directly regulates PGD biomarkers explaining this circadian regulation while also allowing them to be manipulated with synthetic REV-ERB ligands...
October 9, 2018: Thorax
Antonios Kourliouros, Rachel Hogg, Jenny Mehew, Mohamed Al-Aloul, Martin Carby, James Laurence Lordan, Richard Damian Thompson, Steven Tsui, Jasvir Parmar
BACKGROUND: The demand for lung transplantation vastly exceeds the availability of donor organs. This translates into long waiting times and high waiting list mortality. We set out to examine factors influencing patient outcomes from the time of listing for lung transplantation in the UK, examining for differences by patient characteristics, lung disease category and transplant centre. METHODS: Data were obtained from the UK Transplant Registry held by NHS Blood and Transplant for adult lung-only registrations between 1January 2004 and 31 March 2014...
October 3, 2018: Thorax
Marie-Hélène Dizier, Patricia Margaritte-Jeannin, Lucile Pain, Chloé Sarnowski, Myriam Brossard, Hamida Mohamdi, Nolwenn Lavielle, Marie-Claude C Babron, Jocelyne Just, Mark Lathrop, Catherine Laprise, Emmanuelle Bouzigon, Florence Demenais, Rachel Nadif
BACKGROUND: A positional cloning study of bronchial hyper-responsiveness (BHR) at the 17p11 locus in the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) families showed significant interaction between early-life environmental tobacco smoke (ETS) exposure and genetic variants located in DNAH9 . This gene encodes the heavy chain subunit of axonemal dynein, which is involved with ATP in the motile cilia function.Our goal was to identify genetic variants at other genes interacting with ETS in BHR by investigating all genes belonging to the ' ATP-binding ' and ' ATPase activity ' pathways which include DNAH9, are targets of cigarette smoke and play a crucial role in the airway inflammation...
October 3, 2018: Thorax
Sabariah Noor Harun, Claire E Wainwright, Keith Grimwood, Stefanie Hennig
BACKGROUND: The impact of Aspergillus on lung disease in young children with cystic fibrosis is uncertain. AIMS: To determine if positive respiratory cultures of Aspergillus species are associated with: (1) increased structural lung injury at age 5 years; (2) accelerated lung function decline between ages 5 years and 14 years and (3) to identify explanatory variables. METHODS: A cross-sectional analysis of association between Aspergillus positive bronchoalveolar lavage (BAL) cultures and chest high-resolution CT (HRCT) scan findings at age 5 years in subjects from the Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) study was performed...
October 1, 2018: Thorax
Maja Popovic
No abstract text is available yet for this article.
September 28, 2018: Thorax
Renat Shaykhiev
No abstract text is available yet for this article.
September 28, 2018: Thorax
Philip Ong, Horiana B Grosu, Labib Debiane, Roberto F Casal, George A Eapen, Carlos A Jimenez, Laila Noor, David E Ost
BACKGROUND: While therapeutic bronchoscopy has been used to treat malignant central (CAO) airway obstruction for >25 years, there are no studies quantifying the impact of therapeutic bronchoscopy on long-term quality-adjusted survival. METHODS: We conducted a prospective observational study of consecutive patients undergoing therapeutic bronchoscopy for CAO. Patients had follow-up at 1 week and monthly thereafter until death. Outcomes included technical success (ie, relief of anatomic obstruction), dyspnoea, health-related quality of life (HRQOL) and quality-adjusted survival...
September 25, 2018: Thorax
Makon-Sébastien Njock, Julien Guiot, Monique A Henket, Olivier Nivelles, Marc Thiry, Franck Dequiedt, Jean-Louis Corhay, Renaud E Louis, Ingrid Struman
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease of unknown aetiology which leads rapidly to death. As diagnosis of IPF is complex, we aimed to characterise microRNA (miRNA) content of exosomes from sputum of patients with IPF. Using miRNA quantitative PCR array, we found a substantial dysregulation of sputum exosomal miRNA levels between patients with IPF and healthy subjects and identified a unique signature of three miRNAs. Interestingly, we found a negative correlation between miR-142-3p and diffusing capacity of the lungs for carbon monoxide/alveolar volume...
September 22, 2018: Thorax
Qin Luo, Xingxing Yan, Hongmei Tu, Yibing Yin, Ju Cao
Progranulin (PGRN) exerts multiple functions in various inflammatory diseases. However, the role of PGRN in the pathogenesis of virus infection is unknown. Here, we demonstrated that PGRN production was up-regulated in clinical and experimental influenza, which contributed to the deleterious inflammatory response after influenza virus infection in mice. PGRN-deficient mice were protected from influenza virus-induced lung injury and mortality. Decreased mortality was associated with significantly reduced influx of neutrophils and monocytes/macrophages, release of cytokines and chemokines, and permeability of the alveolar-epithelial barrier without affecting viral clearance...
September 18, 2018: Thorax
Joseph W Duke, Amy M Zidron, Igor M Gladstone, Andrew T Lovering
Adult survivors of very preterm birth (PRET) have significantly lower aerobic exercise capacities than their counterparts born at term (CONT), but the underlying cause is unknown. To test whether expiratory flow limitation (EFL) during exercise negatively affects exercise endurance in PRET, we had PRET and CONT exercise to exhaustion breathing air and again breathing heliox. In PRET, EFL decreased and time-to-exhaustion increased significantly while breathing heliox. Heliox had a minimal effect on EFL and had no effect on time-to-exhaustion in CONT...
September 14, 2018: Thorax
Aaron Conway, Elizabeth Tipton, Wei-Hong Liu, Zachary Conway, Kathleen Soalheira, Joanna Sutherland, James Fingleton
BACKGROUND: Transcutaneous carbon dioxide (TcCO2 ) monitoring is a non-invasive alternative to arterial blood sampling. The aim of this review was to determine the accuracy and precision of TcCO2 measurements. METHODS: Medline and EMBASE (2000-2016) were searched for studies that reported on a measurement of PaCO2 that coincided with a measurement of TcCO2 . Study selection and quality assessment (using the revised Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2)) were performed independently...
September 12, 2018: Thorax
Craig L Phillips, Luciano F Drager
No abstract text is available yet for this article.
September 7, 2018: Thorax
Isabelle Vivodtzev, Erwan L'Her, Gabrielle Vottero, Claire Yankoff, Renaud Tamisier, François Maltais, François Lellouche, Jean-Louis Pépin
Automatically titrated O2 flows (FreeO2 ) was compared with constant O2 flow on exercise capacity, O2 saturation and risk of hyperoxia-related hypercapnia in patients with severe COPD with baseline hypercapnia and long-term oxygen therapy (LTOT). Twelve patients were enrolled in a randomised double-blind cross-over study to perform exercise with either FreeO2 or constant flow. Endurance time (primary outcome) and SpO2 were both significantly improved with FreeO2 compared with constant flow (p<0.04), although pCO2 was similar in both conditions...
August 30, 2018: Thorax
Sunayna Best, Amelia Shoemark, Bruna Rubbo, Mitali P Patel, Mahmoud R Fassad, Mellisa Dixon, Andrew V Rogers, Robert A Hirst, Andrew Rutman, Sarah Ollosson, Claire L Jackson, Patricia Goggin, Simon Thomas, Reuben Pengelly, Thomas Cullup, Eleni Pissaridou, Jane Hayward, Alexandros Onoufriadis, Christopher O'Callaghan, Michael R Loebinger, Robert Wilson, Eddie Mk Chung, Priti Kenia, Victoria L Doughty, Julene S Carvalho, Jane S Lucas, Hannah M Mitchison, Claire Hogg
Primary ciliary dyskinesia (PCD) is associated with abnormal organ positioning (situs) and congenital heart disease (CHD). This study investigated genotype-phenotype associations in PCD to facilitate risk predictions for cardiac and laterality defects. This retrospective cohort study of 389 UK patients with PCD found 51% had abnormal situs and 25% had CHD and/or laterality defects other than situs inversus totalis. Patients with biallelic mutations in a subset of nine PCD genes had normal situs. Patients with consanguineous parents had higher odds of situs abnormalities than patients with non-consanguineous parents...
August 30, 2018: Thorax
Andre F S Amaral, Jennifer K Quint
No abstract text is available yet for this article.
August 30, 2018: Thorax
Luke Rowsell, Keith K H Wong, Brendon J Yee, Danny J Eckert, Andrew A Somogyi, James Duffin, Ronald R Grunstein, David Wang
OBJECTIVE: Anaesthesiology guidelines suggest that opioids worsen obstructive sleep apnoea (OSA) despite no randomised controlled trial evidence. We therefore conducted a randomised controlled trial to evaluate the effects of a common clinical dose of morphine on OSA, and to identify clinical phenotype and genotype vulnerability to opioid-respiratory depression. METHODS: Under a double-blind, randomised, crossover design, 60 male patients with OSA attended two visits to the hospital sleep laboratory, at least 1 week apart...
August 30, 2018: Thorax
Sean M Cavany, Emilia Vynnycky, Charlotte S Anderson, Helen Maguire, Frank Sandmann, H Lucy Thomas, Richard G White, Tom Sumner
BACKGROUND: In January 2016, clinical TB guidance in the UK changed to no longer recommend screening contacts of non-pulmonary, non-laryngeal (ETB) index cases. However, no new evidence was cited for this change, and there is evidence that screening these contacts may be worthwhile. The objective of this study was to estimate the cost-effectiveness of screening contacts of adult ETB cases and adult pulmonary or laryngeal TB (PTB) cases in London, UK. METHODS: We carried out a cross-sectional analysis of data collected on TB index cases and contacts in the London TB register and an economic evaluation using a static model describing contact tracing outcomes...
August 18, 2018: Thorax
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