Radiomics analysis to predict pulmonary nodule malignancy using machine learning approaches
Conclusions
We developed highly accurate ML models based on radiomic and epidemiological features from four international lung cancer screening studies that may be suitable for assessing indeterminate screen-detected pulmonary nodules for risk of malignancy. (Source: Thorax)
Source: Thorax - March 15, 2024 Category: Respiratory Medicine Authors: Warkentin, M. T., Al-Sawaihey, H., Lam, S., Liu, G., Diergaarde, B., Yuan, J.-M., Wilson, D. O., Atkar-Khattra, S., Grant, B., Brhane, Y., Khodayari-Moez, E., Murison, K. R., Tammemagi, M. C., Campbell, K. R., Hung, R. J. Tags: Thorax Lung cancer Source Type: research
Survival analysis from the INCREASE study in PH-ILD: evaluating the impact of treatment crossover on overall mortality
Conclusion
Two independent modelling techniques that have been employed in the oncology literature both suggest a long-term survival benefit associated with inhaled treprostinil treatment in patients with PH-ILD. (Source: Thorax)
Source: Thorax - March 15, 2024 Category: Respiratory Medicine Authors: Nathan, S. D., Johri, S., Joly, J. M., King, C. S., Raina, A., McEvoy, C. A., Lee, D., Shen, E., Smith, P., Deng, C., Waxman, A. B. Tags: Open access, Thorax Interstitial lung disease Source Type: research
Post-pandemic tuberculosis incidence: potential success of active case finding?
Until 2020, tuberculosis (TB) was annually the number one infectious killer disease globally. When the COVID-19 pandemic started in 2020, TB took the number two seat in this said ranking, but a very close second.1 TB epidemiologists around the world became very concerned about what might happen with global TB burden in the wake of the pandemic, fearing that lockdowns of health systems and stay-at-home orders would increase TB transmission, decrease access to treatment and screening, and ultimately lead to a surge in incidence and mortality. Recent work by Kendall et al2 published in Thorax set out to answer two questions: ...
Source: Thorax - March 15, 2024 Category: Respiratory Medicine Authors: Stein, C. M. Tags: Thorax Editorial Source Type: research
Blood eosinophils take centre stage in predicting the response to sublingual immunotherapy (SLIT): a familiar twist
Sublingual immunotherapy (SLIT) represents a safer, more comfortable and more convenient allergen immunotherapy than its subcutaneous counterpart. There is an increasing body of evidence showing that SLIT for house dust mites (HDM), grass, ragweed and/or tree pollen improves allergic symptoms and asthma control.1 It is unclear whether SLIT consistently reduces the occurrence of asthma attacks.1–3 Published in 2016, the MITRA trial was arguably the most robust randomised controlled trial assessing the effect of SLIT (specifically HDM-SLIT) on the prevention of asthma attacks in mild-to-moderate allergic asthma.2 Brief...
Source: Thorax - March 15, 2024 Category: Respiratory Medicine Authors: Celis-Preciado, C. A., Lachapelle, P., Couillard, S. Tags: Thorax Editorial Source Type: research
Use of inhaled treprostinil in patients with interstitial lung disease and pulmonary hypertension: to boldly go where no other pulmonary vasodilator has gone before?
Pulmonary hypertension (PH) is a feared complication in patients with any chronic lung disease,1 but those with lung fibrosis have an especially poor mortality and the morbidity burden is very high.2 3 Up to very recently, there has been an almost nihilistic attitude towards these patients, since the lack of treatment options restricted the indication of a definitive diagnosis through right heart catheterisation (RHC) to lung transplant evaluation and enrolment in a clinical trial.4 Although with sound rationale, randomised placebo-controlled trials (RCT) with pulmonary vasodilators, have been negative or at worse detrimen...
Source: Thorax - March 15, 2024 Category: Respiratory Medicine Authors: Piccari, L., Wort, S. J. Tags: Thorax Editorial Source Type: research
Decoding pulmonary nodules: can machine learning enhance malignancy risk stratification?
Randomised controlled trials, with the National Lung Screening Trial and Dutch-Belgian NELSON trial being the two largest, have demonstrated that lung cancer screening of high-risk individuals using low-dose CT reduces lung cancer mortality compared with no screening or screening with chest X-ray. Fuelled by the positive results of these landmark trials, low-dose CT-based lung cancer screening of high-risk individuals is being implemented at national or regional scale in an increasing number of countries worldwide. A comprehensive overview of the current status of implementation of lung cancer screening worldwide can be ob...
Source: Thorax - March 15, 2024 Category: Respiratory Medicine Authors: Jacobs, C. Tags: Thorax Editorial Source Type: research
Type-2 inflammation: a key treatable trait associated with lung function decline in chronic airways disease
The chronic airways diseases, asthma and Chronic Obstructive Pulmonary Disease (COPD), are highly prevalent conditions causing significant morbidity and mortality worldwide. Both are acknowledged to be heterogeneous with respect to clinical presentation, prognosis and driving mechanisms.1 Type-2 airway inflammation is arguably the most important and treatable underlying mechanism to identify,1 as it can be successfully targeted by inhaled and systemic corticosteroids,2 3 or by biological therapies (anti-IL5/IL5R, anti-IL4/IL4R/IL13 and anti-TSLP) in patients with refractory disease.4 Type-2 airway inflammation is not only ...
Source: Thorax - March 15, 2024 Category: Respiratory Medicine Authors: Petousi, N., Pavord, I. D., Kent, B. D. Tags: Thorax Editorial Source Type: research
Role of blood flow restriction strength training in chronic obstructive pulmonary disease
Blood flow restriction (BFR) training is a method partially restricting arterial inflow and fully restricting venous outflow in working musculature during exercise.1 The method uses a pneumatic tourniquet system and involves applying an external pressure, typically using a tourniquet cuff, to the most proximal region of the upper and/or lower limbs. When the cuff is inflated, there is gradual mechanical compression of the vasculature underneath the cuff, resulting in partial restriction of arterial blood flow to structures distal to the cuff, while more profoundly affecting venous outflow from under the cuff. The reduction...
Source: Thorax - March 15, 2024 Category: Respiratory Medicine Authors: Vogiatzis, I. Tags: Thorax Editorial Source Type: research
Effects of non-invasive ventilation on sleep in chronic hypercapnic respiratory failure
Chronic respiratory disease can exacerbate the normal physiological changes in ventilation observed in healthy individuals during sleep, leading to sleep-disordered breathing, nocturnal hypoventilation, sleep disruption and chronic respiratory failure. Therefore, patients with obesity, slowly and rapidly progressive neuromuscular disease and chronic obstructive airways disease report poor sleep quality. Non-invasive ventilation (NIV) is a complex intervention used to treat sleep-disordered breathing and nocturnal hypoventilation with overnight physiological studies demonstrating improvement in sleep-disordered breathing an...
Source: Thorax - February 15, 2024 Category: Respiratory Medicine Authors: Shah, N. M., Steier, J., Hart, N., Kaltsakas, G. Tags: Editor's choice, Thorax State of the art review Source Type: research
Dry cough with abnormal airway connection
A 69-year-old man of Indian origin presented to the chest clinic with an excessive dry cough for 3 months. He did not report any weight loss, haemoptysis or fever. He had no history of recurrent cough, asthma, tuberculosis (TB) or close TB contact. He denied any nasal symptoms or significant reflux-related symptoms. He was known to have diabetes, hypertension and dyslipidaemia. Systemic examination was unremarkable. Chest X-ray was normal (figure 1A). A diagnosis of reactive airway disease was made, and inhaled corticosteroids were initiated. On follow-up after 3 weeks, his cough was no better. He denied having any fever a...
Source: Thorax - February 15, 2024 Category: Respiratory Medicine Authors: Singhania, S. V. K., Raut, A. Tags: Images in Thorax, Thorax Source Type: research
Phenotypic and genetically predicted leucocyte telomere length and lung cancer risk in the prospective UK Biobank
We investigated phenotypic leucocyte telomere length (LTL), genetically predicted LTL (gTL), and lung cancer risk among 371 890 participants, including 2829 incident cases, from the UK Biobank. Using multivariable Cox regression, we found dose-response relationships between longer phenotypic LTL (p-trendcontinuous=2.6x10-5), longer gTL predicted using a polygenic score with 130 genetic instruments (p-trendcontinuous=4.2x10-10), and overall lung cancer risk, particularly for adenocarcinoma. The associations were prominent among never smokers. Mendelian Randomization analyses supported causal associations between longer telo...
Source: Thorax - February 15, 2024 Category: Respiratory Medicine Authors: Wong, J. Y., Blechter, B., Hubbard, A. K., Machiela, M. J., Shi, J., Gadalla, S. M., Hu, W., Rahman, M. L., Rothman, N., Lan, Q. Tags: Open access, Thorax Short report Source Type: research
Immediate smoking cessation support during lung cancer screening: long-term outcomes from two randomised controlled trials
Conclusion
Providing immediate smoking cessation support alongside TLHC increases long term, biochemically confirmed smoking abstinence.
Trial registration number
ISRCTN12455871. (Source: Thorax)
Source: Thorax - February 15, 2024 Category: Respiratory Medicine Authors: Williams, P. J., Philip, K. E. J., Buttery, S. C., Perkins, A., Chan, L., Bartlett, E. C., Devaraj, A., Kemp, S. V., Addis, J., Derbyshire, J., Chen, M., Polkey, M. I., Laverty, A. A., Hopkinson, N. S. Tags: Thorax Smoking Source Type: research
Combination pharmacological therapy targeting multiple mechanisms of sleep apnoea: a randomised controlled cross-over trial
Conclusions
While AtoOxy halved AHI, and acetazolamide lowered AHI by a third, the combination of these leading experimental interventions provided no greater efficacy than AtoOxy alone. Failure of acetazolamide to further increase efficacy suggests overlapping physiological mechanisms.
Trial registration number
NCT03892772. (Source: Thorax)
Source: Thorax - February 15, 2024 Category: Respiratory Medicine Authors: Sands, S. A., Collet, J., Gell, L. K., Calianese, N., Hess, L. B., Vena, D., Azarbarzin, A., Bertisch, S. M., Landry, S., Thomson, L., Joosten, S. A., Hamilton, G. S., Edwards, B. A. Tags: Thorax Sleep Source Type: research
Predictive value of lung function measures for cardiovascular risk: a large prospective cohort study
Conclusion
Clinicians could consider spirometry indicators in CVD risk assessment. Cost-effectiveness studies and clinical trials are needed to put new CVD risk assessment into practice. (Source: Thorax)
Source: Thorax - February 15, 2024 Category: Respiratory Medicine Authors: Zhou, L., Yang, H., Zhang, Y., Wang, Y., Zhou, X., Liu, T., Yang, Q., Wang, Y. Tags: Thorax Respiratory epidemiology Source Type: research
Retrospective analysis of referrals for hypoxic challenge testing in children born preterm
Conclusions
This study found that the current criteria for referral for preflight testing may incorrectly identify those most at risk and highlights the need for further investigation to ensure those most at risk are being assessed prior to air travel. (Source: Thorax)
Source: Thorax - February 15, 2024 Category: Respiratory Medicine Authors: Howells, A., Riley, M., Samuels, M., Aurora, P. Tags: Thorax Paediatric lung disease Source Type: research
