Prospective study of e-cigarette use and respiratory symptoms in adolescents and young adults
Conclusions
E-cigarette use in young adults was associated with respiratory symptoms, independent of combustible cannabis and cigarette exposures. (Source: Thorax)
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Tackett, A. P., Urman, R., Barrington-Trimis, J., Liu, F., Hong, H., Pentz, M. A., Islam, T. S., Eckel, S. P., Rebuli, M., Leventhal, A., Samet, J. M., Berhane, K., McConnell, R. Tags: Press releases, Thorax Smoking Source Type: research
Spirometric patterns in young and middle-aged adults: a 20-year European study
Conclusion
Spirometric patterns with onset in young and mid-adult life were associated with distinct characteristics and risk factors. (Source: Thorax)
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Carsin, A.-E., Garcia-Aymerich, J., Accordini, S., Dharmage, S., Leynaert, B., de las Heras, M., Casas, L., Caviezel, S., Demoly, P., Forsberg, B., Gislason, T., Corsico, A. G., Janson, C., Jogi, R., Martinez-Moratalla, J., Nowak, D., Gomez, L. P., Pin, I Tags: Thorax Respiratory epidemiology Source Type: research
Symptom-related screening programme for early detection of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: the SYSPPE study
Conclusions
The implementation of this simple strategy based on symptom evaluation by phone diagnosed more than doubled the number of CTEPH cases. Dedicated follow-up algorithms for PE survivors help diagnosing CTEPH earlier.
Trial registration number
NCT03953560. (Source: Thorax)
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Marin-Romero, S., Ballaz-Quincoces, A., Gomez-Cuervo, C., Marchena-Yglesias, P. J., Lopez-Miguel, P., Francisco-Albesa, I., Pedrajas-Navas, J. M., Lumbierres, M., Aibar-Arregui, M. A., Bosco Lopez-Saez, J., Perez-Pinar, M., Baeza-Martinez, C., Riera-Mestr Tags: Open access, Thorax Pulmonary vasculature Source Type: research
Causal role of lipid metabolism in pulmonary alveolar proteinosis: an observational and mendelian randomisation study
This study aimed to explore the role of lipid traits in PAP and evaluate the potential of lipid-lowering drug targets in PAP.
Methods
Clinical outcomes, lipid profiles and lung function tests were analysed in a clinical cohort of diagnosed PAP patients and propensity score-matched healthy controls. Genome-wide association study data on PAP, lipid metabolism, blood cells and variants of genes encoding potential lipid-lowering drug targets were obtained for Mendelian randomisation (MR) and mediation analyses.
Findings
Observational results showed that higher levels of total cholesterol (TC), triglycerides and low-density l...
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Huang, J., Lin, Z., Lin, J., Xie, S., Xia, S., Chen, G., Zheng, Z., Xu, Z., Liu, F., Wu, H., Li, S. Tags: Thorax Interstitial lung disease Source Type: research
Identification of molecular subphenotypes in two cohorts of paediatric ARDS
Background
Two subphenotypes of acute respiratory distress syndrome (ARDS), hypoinflammatory and hyperinflammatory, have been reported in adults and in a single paediatric cohort. The relevance of these subphenotypes in paediatrics requires further investigation. We aimed to identify subphenotypes in two large observational cohorts of paediatric ARDS and assess their congruence with prior descriptions.
Methods
We performed latent class analysis (LCA) separately on two cohorts using biomarkers as inputs. Subphenotypes were compared on clinical characteristics and outcomes. Finally, we assessed overlap with adult cohorts us...
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Yehya, N., Zinter, M. S., Thompson, J. M., Lim, M. J., Hanudel, M. R., Alkhouli, M. F., Wong, H., Alder, M. N., McKeone, D. J., Halstead, E. S., Sinha, P., Sapru, A. Tags: Open access, Thorax, COVID-19 Critical care Source Type: research
Non-COVID-19 intensive care admissions during the pandemic: a multinational registry-based study
Background
The COVID-19 pandemic resulted in a large number of critical care admissions. While national reports have described the outcomes of patients with COVID-19, there is limited international data of the pandemic impact on non-COVID-19 patients requiring intensive care treatment.
Methods
We conducted an international, retrospective cohort study using 2019 and 2020 data from 11 national clinical quality registries covering 15 countries. Non-COVID-19 admissions in 2020 were compared with all admissions in 2019, prepandemic. The primary outcome was intensive care unit (ICU) mortality. Secondary outcomes included in-hos...
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: McLarty, J., Litton, E., Beane, A., Aryal, D., Bailey, M., Bendel, S., Burghi, G., Christensen, S., Christiansen, C. F., Dongelmans, D. A., Fernandez, A. L., Ghose, A., Hall, R., Haniffa, R., Hashmi, M., Hashimoto, S., Ichihara, N., Kumar Tirupakuzhi Vija Tags: Thorax, COVID-19 Critical care Source Type: research
Influence of age on clinical characteristics, pharmacological management and exacerbations in children with asthma
Conclusion
Children’s baseline characteristics and exacerbation rates varied according to their age group. Clinical guidelines should consider age at time of diagnosis more discretely than the broad range, 5–16 years, as this appears to impact on asthma severity and management. (Source: Thorax)
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Khalaf, Z., Bush, A., Saglani, S., Bloom, C. I. Tags: Thorax Asthma Source Type: research
E-cigarette use in young adults and adolescents: not so safe?
For several decades, it has been well known that smoking causes irreversible obstructive lung damage in adults1 and is associated with mild airway obstruction and slowed lung function development in adolescents.2 Despite the more than 1% per year decline in age-standardised tobacco smoke exposure between 2010 and 2019, the Global Burden of Diseases, Injuries and Risk Factors Study reported that tobacco (smoked, secondhand and chewing) was the leading risk factor globally for attributable deaths, accounting for 8.71 million deaths, that is, 15.4% of all deaths in 2019.3 This smoking landscape did not yet consider the e-ciga...
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Nadif, R. Tags: Thorax Editorial Source Type: research
Inflammatory ARDS subphenotypes are generalisable across the age spectrum
Adult patients with acute respiratory distress syndrome (ARDS) are nowadays considered to be a heterogeneous population. Profound differences in systemic inflammation, lung morphology and physiological response have been observed. The use of unsupervised statistical techniques using multiple variables have been used to identify homogeneous subgroups.1 Such subgroups derived from multidimensional data using unbiased algorithms are also called subphenotypes. They can be used to improve trial design and, finally, patient care through prognostic and predictive enrichment.2 In the adult population, two subphenotypes based on bi...
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Wösten-van Asperen, R., Bos, L. D. Tags: Thorax Editorial Source Type: research
Understanding the aetiology of lung function impairment: the crucial role of age of onset
During the last two decades, a paradigm shift in the aetiology of impaired lung function has been unfolding. Here, chronic obstructive pulmonary disease (COPD) is no longer exclusively the result of exposure-related accelerated lung function decline, but may also be a direct consequence of impaired lung growth or early-life lung function deficits. Several epidemiological studies have now demonstrated that reduced peak lung function in early adulthood is indeed associated with COPD later in life, despite normal age-related lung function decline.1 Recently, an additional trajectory of lung function catch-up has been observed...
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Bertels, X., Lahousse, L. Tags: Thorax Editorial Source Type: research
Tobacco use: a smoking gun for IPF?
IPF is increasing in incidence globally.1 Epidemiological studies have identified a number of risk factors for the development of idiopathic pulmonary fibrosis (IPF) including male sex, advancing age, and a history of working in dusty industrial environments or of agricultural exposures.2 3 Smoking has also long been considered a risk factor, but definitive proof has been difficult to come by, as smoking behaviour is also associated with increased risk of other exposures because of sociodemographic factors. Disentangling the relative contributions of each risk factor is therefore tricky. Over recent years, a number of geno...
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Hall, I. Tags: Thorax Editorial Source Type: research
Innocent bystanders: effects of the COVID-19 pandemic on non-COVID-19 critical illness outcomes
The COVID-19 pandemic massively impacted healthcare directly and indirectly causing staggering collateral damage on innocent bystander patients with critical illness and non-COVID-19 community-acquired pneumonia (CAP). We consider in more detail non-COVID-19 CAP because it is one of the most common causes of Intensive Care Unit (ICU) admission and mortality. It is propitious that McLarty et al evaluated effects of the COVID-19 pandemic on critical illness mortality.1 In 1.7 million non-COVID-19 admissions in 15 countries, ICU mortality increased slightly but significantly between 2019 (9.3%) and 2020 (10.4%), especially in...
Source: Thorax - January 18, 2024 Category: Respiratory Medicine Authors: Russell, J. A. Tags: Thorax, COVID-19 Editorial Source Type: research
Journal club
Weaning strategies Weaning from mechanical ventilation (MV) is challenging period in the recovery from respiratory failure and weaning places a significant burden on healthcare resources. To date, standardised protocols on the best timing and specific steps for weaning from MV are lacking. Pham and colleagues conducted a multicentre (481 ICUs) prospective observational cohort study in 50 countries, named "WEAN SAFE" (Lancet Respir Med, 2023;11(5):465–476) to clarify current practises and outcomes of the weaning process in patients requiring invasive MV for at least 2 days. The most striking finding was that only 3817...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Sorano, A. Tags: Thorax Journal club Source Type: research
Silicone depositions: an unusual finding in the explanted and newly transplanted lungs
A woman aged 45 years suffered from progressive unclassifiable interstitial lung disease (ILD) despite treatment with corticosteroids, intravenous cyclophosphamide and rituximab. Chest CT showed extensive bilateral ground glass with associated mosaic attenuation and air trapping on expiration, along with basal predominant fibrosis, volume loss and secondary bronchial dilatation (figure 1A). Examination of bronchoalveolar lavage cytology and transbronchial biopsies showed features consistent with acute neutrophilic inflammation. Thorough medical history and detailed clinical examination revealed no relevant factors other th...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Bos, S., Majo, J., Funston, W., Fisher, A. J., Meachery, G. Tags: Images in Thorax, Thorax Source Type: research
Cardiac MRI in the assessment of chronic thromboembolic pulmonary hypertension and response to treatment
Chronic thromboembolic pulmonary disease (CTEPD) arises in patients with prior pulmonary embolism who do not clear the obstructive material from the pulmonary circulation and may experience persistently raised pulmonary pressures (chronic thromboembolic pulmonary hypertension, CTEPH) and right heart failure. CTEPH affects between 1% and 9% of patients following a single episode of pulmonary embolism.1 The diagnosis of CTEPD requires characteristic radiological appearances, at least 3 months of anticoagulation therapy, and the diagnosis of concomitant pulmonary hypertension requires mean pulmonary artery pressure (mPAP)>...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Bartnik, A., Pepke-Zaba, J., Bunclark, K., Ruggiero, A., Jenkins, D., Taghavi, J., Tsui, S., Screaton, N., DErrico, L., Weir-McCall, J. Tags: Thorax State of the art review Source Type: research
