Pulmonary arterio-venous malformation on endobronchial ultrasound bronchoscopy
A-21-year old woman presented with exertional breathlessness, fatigue and episodic mild haemoptysis for the past 7 months. Peripheral arterial oxygen saturation (SpO2) was 87% on room air. Clubbing and central cyanosis were present. There was no improvement in SpO2 and cyanosis with supplemental oxygen therapy. Chest radiograph revealed a heterogeneous opacity in right upper zone (figure 1A). CT pulmonary angiogram revealed diffuse pulmonary A-V malformation (PAVM) involving apical and anterior segments of right upper lobe with multiple pulmonary arterial branches directly communicating with the pulmonary veins (figure 1B)...
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Chauhan, N. K., Rajagopal, R., Shadrach, B. J., Dutt, N. Tags: Images in Thorax, Thorax Source Type: research
Benign but fatal: management of endotracheal Rosai-Dorfman disease with acute onset
Rosai-Dorfman disease (RDD) is a non-malignant condition mainly manifesting as a proliferation of histiocytes in lymph nodes. Endotracheal RDD (ERDD) with an acute onset presentation is extremely rare. There are few case reports of ERDD mainly concerning its pathology, diagnostics and bronchoscopic treatment, without providing sufficient clinical information from a comprehensive perspective. As a novel and challenging technique, tracheal resection and reconstruction (TRR) with spontaneous-ventilation video-assisted thoracoscopic surgery (SV-VATS) has been reported as feasible and safe in highly selected patients, but few c...
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Wang, B., Song, Z.-m., Li, J.-d., Zhao, Y.-l., Sun, P.-l., Tian, J.-k., Yin, J.-z., Zhang, Y. Tags: Thorax Case based discussion Source Type: research
Plasma thymic stromal lymphopoietin (TSLP) in adults with non-severe asthma: the EGEA study
Thymic stromal lymphopoietin (TSLP), a cytokine involved in severe asthma treatment, was never studied in non-severe asthma.
Among 969 adults from a large epidemiological study, cross-sectional analyses showed that plasma TSLP levels were associated with increased age and BMI, male sex, smoking and high TSLP levels (one IQR increase) with current asthma and poor lung function. High TSLP levels were also associated with persistence of asthma attacks (aOR=2.14 (95% CI 1.23 to 3.72)) and dyspnoea (aOR=2.71 (95% CI 1.39 to 5.28)) 10 years later.
Our results suggest that TSLP could be a cytokine of interest in non-severe asthma...
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Ibrahim, B., Achour, D., Zerimech, F., de Nadai, P., Siroux, V., Tsicopoulos, A., Matran, R., Granger, V., Nadif, R. Tags: Thorax Brief communication Source Type: research
Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm3 minimum size threshold for multidisciplinary team referral
The optimal management of small but growing nodules remains unclear. The SUMMIT study nodule management algorithm uses a specific threshold volume of 200 mm3 before referral of growing solid nodules to the multidisciplinary team for further investigation is advised, with growing nodules below this threshold kept under observation within the screening programme. Malignancy risk of growing solid nodules of size >200 mm3 at initial 3-month interval scan was 58.3% at a per-nodule level, compared with 13.3% in growing nodules of size ≤200 mm3 (relative risk 4.4, 95% CI 2.17 to 8.83). The positive predictive value of a com...
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Creamer, A. W., Horst, C., Dickson, J. L., Tisi, S., Hall, H., Verghese, P., Prendecki, R., Bhamani, A., McCabe, J., Gyertson, K., Mullin, A.-M., Teague, J., Farrelly, L., Hackshaw, A., Nair, A., SUMMIT consortium, Devaraj, A., Janes, S. M. Tags: Open access, Thorax Brief communication Source Type: research
Parenchymal lung abnormalities following hospitalisation for COVID-19 and viral pneumonitis: a systematic review and meta-analysis
Discussion
Sequelae consistent with parenchymal lung disease were observed following COVID-19 and other viral pneumonitis. Estimates should be interpreted with caution due to high heterogeneity, differences in study casemix and initial severity.
PROSPERO registration number
CRD42020183139. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Fabbri, L., Moss, S., Khan, F. A., Chi, W., Xia, J., Robinson, K., Smyth, A. R., Jenkins, G., Stewart, I. Tags: Thorax, COVID-19 Interstitial lung disease Source Type: research
Impact of interstitial lung abnormalities on postoperative pulmonary complications and survival of lung cancer
Conclusions
The presence of radiological and pathological features of ILA in patients with lung cancer undergoing curative surgery was associated with frequent complications and decreased survival. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Im, Y., Chung, M. P., Lee, K. S., Han, J., Chung, M. J., Kim, H. K., Cho, J. H., Choi, Y. S., Park, S., Kim, H. J., Kwon, O. J., Park, B., Yoo, H. Tags: Editor's choice, Thorax Interstitial lung disease Source Type: research
Longitudinal lung clearance index and association with structural lung damage in children with cystic fibrosis
Key messages What is the key question? Can longitudinal multiple breath washout examination estimate the extent and the progression rate of CF lung disease measured with chest CT? What is the bottom line? A low lung clearance index during childhood is associated with a lower extent and slower progression rate of structural lung damage compared with a higher lung clearance index. Why read on? To better understand how longitudinal lung clearance index may be used in clinical practice. Introduction Children with cystic fibrosis (CF) now often go through childhood with only subtle upper and lower airway-related symptoms and h...
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Svedberg, M., Imberg, H., Gustafsson, P. M., Tiddens, H., Davies, G., Lindblad, A. Tags: Open access, Thorax Cystic fibrosis Source Type: research
Thoracic ultrasound influences physiotherapists clinical decision-making in respiratory management of critical care patients: a multicentre cohort study
Conclusion
Thoracic ultrasound has a high impact on the clinical decision-making process by physiotherapists for critical care patients.
Trial registration number
NCT02881814; https://clinicaltrials.gov. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Le Neindre, A., Hansell, L., Wormser, J., Gomes Lopes, A., Diaz Lopez, C., Romanet, C., Choukroun, G., Nguyen, M., Philippart, F., Guinot, P.-G., Buscher, H., Bouhemad, B., Ntoumenopoulos, G. Tags: Thorax Critical care Source Type: research
Evaluation of a health and social care programme to improve outcomes following critical illness: a multicentre study
Conclusions
This multicentre evaluation of a health and social care programme designed for survivors of critical illness appears to show benefit at 12 months following hospital discharge. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Henderson, P., Quasim, T., Shaw, M., MacTavish, P., Devine, H., Daniel, M., Nicolson, F., OBrien, P., Weir, A., Strachan, L., Senior, L., Lucie, P., Bollan, L., Duffty, J., Hogg, L., Ross, C., Sim, M., Sundaram, R., Iwashyna, T. J., McPeake, J. Tags: Open access, Thorax Critical care Source Type: research
Extracellular mitochondria drive CD8 T cell dysfunction in trauma by upregulating CD39
Conclusion
These studies in experimental models and in a cohort of trauma patients reveal important associations between extracellular mitochondria, aberrant purinergic signalling and immune dysfunction. These pathogenic factors with immune exhaustion are linked to SIRS and could be targeted therapeutically. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Tiwari-Heckler, S., Lee, G. R., Harbison, J., Ledderose, C., Csizmadia, E., Melton, D., Zhang, Q., Junger, W., Chen, G., Hauser, C. J., Otterbein, L. E., Longhi, M. S., Robson, S. C. Tags: Thorax Critical care Source Type: research
Nationwide indoor smoking ban and impact on smoking behaviour and lung function: a two-population natural experiment
Conclusions
Nationwide indoor smoking ban is associated with less smoking and improved lung function in the general population. Implementing an indoor smoking ban can improve lung function by influencing smoking behaviour and reducing secondhand smoke. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Strassmann, A., Colak, Y., Serra-Burriel, M., Nordestgaard, B. G., Turk, A., Afzal, S., Puhan, M. A. Tags: Open access, Thorax Chronic obstructive pulmonary disease Source Type: research
Oscillatory positive expiratory pressure therapy in COPD (O-COPD): a randomised controlled trial
Conclusions
Regular use of an Acapella device improves symptoms and quality of life in people with COPD who produce sputum daily or most days.
Trial registration number
ISRCTN44651852. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Alghamdi, S. M., Alsulayyim, A. S., Alasmari, A. M., Philip, K. E. J., Buttery, S. C., Banya, W. A. S., Polkey, M. I., Birring, S. S., Hopkinson, N. S. Tags: Thorax Chronic obstructive pulmonary disease Source Type: research
Long-term effect of asthma on the development of obesity among adults: an international cohort study, ECRHS
Conclusion
This is the first study showing that adult asthmatics have a higher risk of developing obesity than non-asthmatics, particularly those non-atopic, of longer disease duration or on oral corticosteroids. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Moitra, S., Carsin, A.-E., Abramson, M. J., Accordini, S., Amaral, A. F. S., Anto, J., Bono, R., Casas Ruiz, L., Cerveri, I., Chatzi, L., Demoly, P., Dorado-Arenas, S., Forsberg, B., Gilliland, F., Gislason, T., Gullon, J. A., Heinrich, J., Holm, M., Jans Tags: Thorax Asthma Source Type: research
Relationship between asthma and severe COVID-19: a national cohort study
Discussion
People with mild and/or well-controlled asthma are neither at significantly increased risk of hospitalisation with nor more likely to die from COVID-19 than adults without asthma. (Source: Thorax)
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Dolby, T., Nafilyan, V., Morgan, A., Kallis, C., Sheikh, A., Quint, J. K. Tags: Open access, Thorax Asthma Source Type: research
Time to move out of the shadows: ILA in patients with lung cancer
Interstitial lung abnormalities (ILA) are incidentally identified abnormalities on chest computed tomography (CT) consistent with interstitial lung disease (ILD) in an individual without a known or suspected diagnosis. ILA have been associated with many adverse clinical outcomes including significant reductions in lung function,1 exercise capacity2 and survival,3 and in some cases may be a precursor for the most severe forms of ILD—idiopathic pulmonary fibrosis (IPF) and progressive pulmonary fibrosis.4 ILA are becoming increasingly recognised in clinical practice, which motivated publication of a Fleischner Society ...
Source: Thorax - January 12, 2023 Category: Respiratory Medicine Authors: Rose, J. A., Hunninghake, G. M. Tags: Thorax Editorial Source Type: research
