Outcomes from a national screening program for Ukrainian refugees at risk of drug resistant tuberculosis in Wales
High rates of drug-resistant tuberculosis in Ukraine suggest screening is necessary to mitigate public health hazards for host populations. A pathway was implemented in Wales and data prospectively collected Between 8 April and 21 December 2022. Of 5425 Ukrainian arrivals, notifications were received by TB teams on 2395 (44%) of whom 1955 (82%) were screened. The refugees were young (median age 30, IQR 14–41), and predominantly female (66.1%). Interferon- gamma release assay (IGRA) tests were positive in 112 (6.5%). One Case of active tuberculosis was identified (0.05%). Our data supports European guidelines that rou...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Barry, S. M., Davies, G., Barry, T. D., Evans, J., Backx, M., Brouns, M., Mughal, A., Kelly, S., Collier, G., Ambalavanan, S., Davies, C., Sharp, H., Lloyd, P., Hester, Y., Murray, N., Goddard, K., Johnstone, L., Parry, J., Davies, O., Williams, R., Ahern Tags: Open access, Thorax Short report Source Type: research
Impact of the SARS-CoV-2 pandemic on lung cancer survival in England: an analysis of the rapid cancer registration dataset
Early changes in lung cancer care can affect survival. Given the decrease in diagnosis during lockdowns, we calculated their impact on survival using National Lung Cancer Audit data. Percentage survival and HRs for death were compared between 2019 and lockdown periods of 2020. Decreased survival was observed from the first national lockdown onwards and within 90 days of diagnosis. HRs were highest for people diagnosed at the end of 2020 at 1.26 (95% CI 1.20 to 1.32) for death within 90 days and 1.51 (95% CI 1.42 to 1.60) for death between 91 and 270 days. Further work is needed on measures to mitigate this impact. (Source: Thorax)
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Morgan, H., Gysling, S., Navani, N., Baldwin, D., Hubbard, R., ODowd, E. Tags: Thorax, COVID-19 Brief communication Source Type: research
COVID-19-associated pulmonary aspergillosis in mechanically ventilated patients: a prospective, multicentre UK study
We describe the incidence, risk factors and mortality associated with COVID-19-associated pulmonary aspergillosis (CAPA) in a prospective, multicentre UK cohort.
Methods
From March 2020 to March 2021, 266 mechanically ventilated adults with COVID-19 were enrolled across 5 UK hospital intensive care units (ICUs). CAPA was defined using European Confederation for Medical Mycology and the International Society for Human and Animal Mycology criteria and fungal diagnostics performed on respiratory and serum samples.
Results
Twenty-nine of 266 patients (10.9%) had probable CAPA, 14 (5.2%) possible CAPA and none proven CAPA. Pr...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Hurt, W., Youngs, J., Ball, J., Edgeworth, J., Hopkins, P., Jenkins, D. R., Leaver, S., Mazzella, A., Molloy, S. F., Schelenz, S., Wise, M. P., White, P. L., Yusuff, H., Wyncoll, D., Bicanic, T. Tags: Open access, Thorax, COVID-19 Respiratory infection Source Type: research
Infections in autoimmune pulmonary alveolar proteinosis: a large retrospective cohort
Background
Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease, predisposing to an increased risk of infection. A complete picture of these infections is lacking.
Research question
Describe the characteristics and clinical outcomes of patients diagnosed with aPAP, and to identify risk factors associated with opportunistic infections.
Methods
We conducted a retrospective cohort including all patients diagnosed with aPAP between 2008 and 2018 in France and Belgium. Data were collected using a standardised questionnaire including demographics, comorbidities, imaging features, outcomes and microbiological data...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Mabo, A., Borie, R., Wemeau-Stervinou, L., Uzunhan, Y., Gomez, E., Prevot, G., Reynaud-Gaubert, M., Traclet, J., Bergot, E., Cadranel, J., Marchand-Adam, S., Bergeron, A., Blanchard, E., Bondue, B., Bonniaud, P., Bourdin, A., Burgel, P. R., Hirschi, S., M Tags: Thorax Respiratory infection Source Type: research
Invitation strategies and participation in a community-based lung cancer screening programme located in areas of high socioeconomic deprivation
Discussion
Using a population-based invitation strategy, in an area of high socioeconomic deprivation, is effective and may increase screening accessibility. Due to limitations in primary care records, targeted approaches should incorporate historical smoking codes and individuals with absent smoking records. (Source: Thorax)
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Goodley, P., Balata, H., Alonso, A., Brockelsby, C., Conroy, M., Cooper-Moss, N., Craig, C., Evison, M., Hewitt, K., Higgins, C., Johnson, W., Lyons, J., Merchant, Z., Rowlands, A., Sharman, A., Sinnott, N., Sperrin, M., Booton, R., Crosbie, P. A. J. Tags: Open access, Thorax Lung cancer Source Type: research
Association between antidepressants with pneumonia and exacerbation in patients with COPD: a self-controlled case series (SCCS)
Conclusion
Antidepressants were associated with an increased risk of both pneumonia and exacerbation in patients with COPD, with the risks diminished on stopping the treatment. These findings suggest a close monitoring of antidepressant prescription side effects and consideration of non-pharmacological interventions. (Source: Thorax)
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Siraj, R. A., Bolton, C. E., McKeever, T. M. Tags: Editor's choice, Thorax Respiratory epidemiology Source Type: research
Relationship between air quality and asthma-related emergency hospital admissions in Mexico City 2017-2019
Conclusions
Ambient air pollution, within the previous week, was associated with emergency hospital admissions for asthma to public hospitals in adults in Mexico City. The relationship in children was less consistent. Further work is needed to explore why differences between adults and children exist to inform appropriate interventions to benefit public health. (Source: Thorax)
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Hayes, L., Mejia-Arangure, J. M., Errington, A., Bramwell, L., Vega, E., Nunez-Enriquez, J. C., Namdeo, A., Entwistle, J., Miquelajauregui, Y., Jaimes-Palomera, M., Torres, N., Rascon-Pacheco, R. A., Duarte-Rodriguez, D. A., McNally, R. Tags: Open access, Thorax Environmental exposure Source Type: research
Combined effect of ozone and household air pollution on COPD in people aged less than 50 years old
Conclusions
This study concludes that exposure to ambient O3 and household air pollution might be important risk factors for COPD among young adults, and simultaneous exposure to high levels of the two pollutants may intensify their individual effects. (Source: Thorax)
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Xing, Z., Yang, T., Shi, S., Meng, X., Chai, D., Liu, W., Tong, Y., Wang, Y., Ma, Y., Pan, M., Cui, J., Long, H., Sun, T., Chen, R., Guo, Y. Tags: Open access, Thorax Chronic obstructive pulmonary disease Source Type: research
Laryngeal widening and adequate ventilation by expiratory pressure load training improve aerobic capacity in COPD: a randomised controlled trial
Conclusion
These results show that EPT improved aerobic capacity and endurance time with larger laryngeal widening and adequate ventilation despite advanced COPD.
Trial registration number
UMIN000041250. (Source: Thorax)
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Miki, K., Tsujino, K., Fukui, M., Miki, M., Kitajima, T., Sumitani, H., Hashimoto, K., Yokoyama, M., Hashimoto, H., Nii, T., Matsuki, T., Kida, H., for EPT study group, Sakoda, Maekura, Shiraishi, Hosokawa, Hayama, Honda, Iyama, Yoshikawa, Fujimoto, Katay Tags: Open access, Thorax Chronic obstructive pulmonary disease Source Type: research
Automatic analysis of bronchus-artery dimensions to diagnose and monitor airways disease in cystic fibrosis
Conclusion
The BA analysis can fully automatically analyse a large number of BA pairs on chest CTs to detect and monitor progression of bronchial wall thickening and bronchial widening in patients with CF. (Source: Thorax)
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Lv, Q., Gallardo-Estrella, L., Andrinopoulou, E.-R., Chen, Y., Charbonnier, J.-P., Sandvik, R. M., Caudri, D., Nielsen, K. G., de Bruijne, M., Ciet, P., Tiddens, H. Tags: Open access, Thorax Bronchiectasis Source Type: research
Road map to improve the quality of lung cancer risk data
The success of the United Kingdom Lung Screening (UKLS) trial and subsequent implementation projects in Liverpool, Manchester and London provided the springboard for the NHS Eng. Targeted Lung Health Check (TLHC) programme,1–6 which started in 2019 and has been recently pledged by the Prime Minister (Rishi Sunak)7 to become the National Lung Cancer screening programme in England and also, in time, in the devolved nations. Thus, the UK maybe considered one of the global leaders implementing lung cancer screening. One has to be cognisant of the fact that despite the excellent protocol and quality assurance programme un...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Field, J. K. Tags: Thorax Editorial Source Type: research
COVID-19-associated pulmonary aspergillosis in mechanically ventilated patients: a deadly complication
Despite effectiveness of broad-spectrum antifungal prophylaxis in those at highest risk,1 prevalence of invasive pulmonary aspergillosis continues to increase as it becomes increasingly recognised in non-immunosuppressed individuals, including those in the intensive care unit (ICU) with severe respiratory viral infection such as COVID-19.2–4 COVID-19-associated pulmonary aspergillosis (CAPA) has emerged as an important and deadly complication,5 6 triggered by specific immunological mechanisms including suppression of the type I interferon response,3 as well as depletion of B cells and consequently anti-Aspergillus fu...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Kosmidis, C., Hoenigl, M. Tags: Thorax, COVID-19 Editorial Source Type: research
Opportunistic infections in autoimmune pulmonary alveolar proteinosis: opportunity to better understand the role of GM-CSF in the innate immune response
Autoimmune pulmonary alveolar proteinosis (aPAP) is an ultra-rare lung disease characterised by myeloid cell dysfunction, abnormal pulmonary surfactant accumulation resulting in progressive dyspnoea of insidious onset and respiratory failure, innate immune deficiency and secondary infection.1 2 Autoantibodies that bind GM-CSF (granulocyte/macrophage colony-stimulating factor) drive the pathogenesis, primarily causing alveolar macrophage dysfunction, resulting in an inability to recycle surfactant and cell debris.1 3 Secondary infections are relatively common in aPAP and can include both common and opportunistic pathogens. ...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: O'Callaghan, M., Penugonda, M., McCarthy, C. Tags: Thorax Editorial Source Type: research
Responding to the tuberculosis risk of forced mass migration from Ukraine: a complex challenge with no single solution
Infectious diseases have played a major role in shaping our history—none more so than tuberculosis (TB), which accompanied the first humans out of Africa, and continues to cause the untimely death of more than 1.5 million people each year.1 The COVID-19 pandemic has provided a much-needed wake-up call to the global threat posed by infectious disease at a time of rising population density and mobility. Against this backdrop, the past decade has witnessed large scale population displacement in Europe and the UK caused by conflicts in Syria, Afghanistan and more recently, Ukraine. Since February 2022, over 13 million Uk...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Haldar, P., Ahyow, L., Dedicoat, M. Tags: Thorax, COVID-19 Editorial Source Type: research
Is antidepressant use a concern for patients with COPD?
Chronic obstructive pulmonary disease (COPD) affects between 15% and 25% of older people,1 2 who suffer also frequently from mental illnesses.3–5 As such, patients with COPD may require pharmacological treatments to manage psychiatric disorders. Guidelines for the treatment of depression in geriatric population recommend the use antidepressants (combined with interpersonal psychotherapy),6 and specifically second-generation ones, due to the reduced risk of side effects and the better tolerability in case of overdose. Second-generation antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin ...
Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Trifiro, G., Crisafulli, S. Tags: Thorax Editorial Source Type: research
