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RESPIRATORY DISEASES (103 journals)                     

Showing 1 - 104 of 104 Journals sorted alphabetically
Advances in Respiratory Medicine     Open Access   (Followers: 7)
Advances in Thoracic Diseases     Open Access  
American Journal of Respiratory and Critical Care Medicine     Full-text available via subscription   (Followers: 257)
American Journal of Respiratory Cell and Molecular Biology     Full-text available via subscription   (Followers: 20)
American Review of Respiratory Disease     Full-text available via subscription   (Followers: 4)
Angiologia e Cirurgia Vascular     Open Access   (Followers: 1)
Annals of the American Thoracic Society     Full-text available via subscription   (Followers: 17)
Annals of Thoracic Medicine     Open Access   (Followers: 6)
Archives of Pulmonology and Respiratory Care     Open Access   (Followers: 1)
Archivos de Bronconeumología     Full-text available via subscription  
Archivos de Bronconeumología (English Edition)     Full-text available via subscription   (Followers: 1)
Asthma Research and Practice     Open Access   (Followers: 1)
BMC Pulmonary Medicine     Open Access   (Followers: 5)
BMJ Open Respiratory Research     Open Access   (Followers: 6)
Breathe     Open Access   (Followers: 4)
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal   (Followers: 1)
Canadian Respiratory Journal     Open Access   (Followers: 3)
Case Reports in Pulmonology     Open Access   (Followers: 3)
Chest     Full-text available via subscription   (Followers: 102)
Chest Disease Reports     Open Access   (Followers: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 9)
Clinical Lung Cancer     Hybrid Journal   (Followers: 6)
Clinical Medicine Insights : Circulatory, Respiratory and Pulmonary Medicine     Open Access   (Followers: 3)
Clinical Pulmonary Medicine     Hybrid Journal   (Followers: 2)
COPD Research and Practice     Open Access   (Followers: 1)
COPD: Journal of Chronic Obstructive Pulmonary Disease     Hybrid Journal   (Followers: 15)
Current Opinion in Pulmonary Medicine     Hybrid Journal   (Followers: 10)
Current Pulmonology Reports     Hybrid Journal  
Current Research in Tuberculosis     Open Access   (Followers: 3)
Current Respiratory Care Reports     Hybrid Journal   (Followers: 1)
Current Respiratory Medicine Reviews     Hybrid Journal   (Followers: 5)
Der Pneumologe     Hybrid Journal   (Followers: 1)
Egyptian Journal of Chest Diseases and Tuberculosis     Open Access   (Followers: 3)
ERJ Open Research     Open Access   (Followers: 3)
Eurasian Journal of Pulmonology     Open Access  
European Clinical Respiratory Journal     Open Access   (Followers: 3)
European Respiratory Journal     Full-text available via subscription   (Followers: 39)
European Respiratory Review     Open Access   (Followers: 7)
Experimental Lung Research     Hybrid Journal  
Expert Review of Respiratory Medicine     Hybrid Journal   (Followers: 5)
Heart & Lung: The Journal of Acute and Critical Care     Hybrid Journal   (Followers: 13)
Heart, Lung and Circulation     Full-text available via subscription   (Followers: 9)
Indian Journal of Respiratory Care     Open Access   (Followers: 3)
Indian Journal of Tuberculosis     Full-text available via subscription  
Influenza and Other Respiratory Viruses     Open Access   (Followers: 3)
International Journal of Chronic Obstructive Pulmonary Disease     Open Access   (Followers: 3)
Journal of Association of Chest Physicians     Open Access   (Followers: 2)
Journal of Asthma     Hybrid Journal   (Followers: 4)
Journal of Asthma Allergy Educators     Hybrid Journal   (Followers: 4)
Journal of Bronchology & Interventional Pulmonology     Hybrid Journal   (Followers: 4)
Journal of Clinical Tuberculosis and Other Mycobacterial Diseases     Open Access  
Journal of Heart and Lung Transplantation     Hybrid Journal   (Followers: 12)
Journal of Respiratory Medicine     Open Access   (Followers: 4)
Journal of Respiratory Research     Open Access   (Followers: 1)
Journal of Tuberculosis Research     Open Access   (Followers: 1)
Jurnal Respirasi     Open Access  
Karger Kompass Pneumologie     Full-text available via subscription   (Followers: 1)
Kindheit und Entwicklung     Hybrid Journal  
Lung     Hybrid Journal   (Followers: 2)
Lung Cancer     Hybrid Journal   (Followers: 16)
Lung Cancer International     Open Access   (Followers: 2)
Lung Cancer: Targets and Therapy     Open Access   (Followers: 3)
Lung India     Open Access   (Followers: 1)
Multidisciplinary Respiratory Medicine     Open Access   (Followers: 4)
npj Primary Care Respiratory Medicine     Open Access   (Followers: 2)
Open Journal of Respiratory Diseases     Open Access   (Followers: 1)
Open Respiratory Medicine Journal     Open Access   (Followers: 1)
Paediatric Respiratory Reviews     Hybrid Journal   (Followers: 11)
Pediatric Quality & Safety     Open Access  
Pediatric Respirology and Critical Care Medicine     Open Access   (Followers: 1)
Pulmonary Circulation     Open Access   (Followers: 4)
Pulmonary Medicine     Open Access   (Followers: 2)
Pulmonary Pharmacology & Therapeutics     Hybrid Journal   (Followers: 2)
Pulmonary Therapy     Open Access   (Followers: 1)
Pulmonology and Respiratory Research     Open Access   (Followers: 1)
Respiratory Care     Full-text available via subscription   (Followers: 10)
Respiratory Investigation     Full-text available via subscription  
Respiratory Medicine     Hybrid Journal   (Followers: 18)
Respiratory Medicine : X     Open Access  
Respiratory Medicine Case Reports     Open Access  
Respiratory Medicine CME     Hybrid Journal  
Respiratory Medicine Extra     Full-text available via subscription   (Followers: 1)
Respiratory Physiology & Neurobiology     Hybrid Journal   (Followers: 4)
Respiratory Research     Open Access   (Followers: 1)
Respirology     Hybrid Journal   (Followers: 5)
Respirology Case Reports     Open Access  
Revista Americana de Medicina Respiratoria     Open Access  
Revista Chilena de Enfermedades Respiratorias     Open Access  
Revista Inspirar     Open Access  
Revista ORL     Open Access  
Revista Portuguesa de Pneumologia     Open Access  
Sarcoidosis Vasculitis and Diffuse Lung Disese     Full-text available via subscription   (Followers: 3)
Seminars in Respiratory and Critical Care Medicine     Hybrid Journal   (Followers: 14)
Sleep Medicine Reviews     Hybrid Journal   (Followers: 17)
The Clinical Respiratory Journal     Hybrid Journal   (Followers: 3)
The International Journal of Tuberculosis and Lung Disease     Full-text available via subscription   (Followers: 8)
The Lancet Respiratory Medicine     Full-text available via subscription   (Followers: 35)
Therapeutic Advances in Chronic Disease     Open Access   (Followers: 7)
Therapeutic Advances in Respiratory Disease     Open Access   (Followers: 1)
Thorax     Hybrid Journal   (Followers: 38)
Translational Respiratory Medicine     Open Access   (Followers: 1)
Tuberculosis     Hybrid Journal   (Followers: 12)
Tuberculosis Research and Treatment     Open Access   (Followers: 3)
Пульмонология     Full-text available via subscription  


Similar Journals
Journal Cover
European Respiratory Journal
Journal Prestige (SJR): 3.788
Citation Impact (citeScore): 5
Number of Followers: 39  
  Full-text available via subscription Subscription journal
ISSN (Print) 0903-1936 - ISSN (Online) 1399-3003
Published by European Respiratory Society Homepage  [4 journals]
  • Antibiotic efficacy varies based on the infection model and treatment
           regimen for Pseudomonas aeruginosa
    • Authors: Cigana, C; Ranucci, S, Rossi, A, De Fino, I, Melessike, M, Bragonzi, A.
      Pages: 1802456 - 1802456
      Abstract: Antibiotic discovery and preclinical testing are needed to combat the Pseudomonas aeruginosa health threat. Most frequently, antibiotic efficacy is tested in models of acute respiratory infection, with chronic pneumonia remaining largely unexplored. This approach generates serious concerns about the evaluation of treatment for chronically infected patients, and highlights the need for animal models that mimic the course of human disease.In this study, the efficacy of the marketed antibacterial drugs tobramycin (TOB) and colistin (COL) was tested in murine models of acute and chronic P. aeruginosa pulmonary infection. Different administration routes (intranasal, aerosol or subcutaneous) and treatment schedules (soon or 7 days post-infection) were tested.In the acute infection model, aerosol and subcutaneous administration of TOB reduced the bacterial burden and inflammatory response, while intranasal treatment showed modest efficacy. COL reduced the bacterial burden less effectively but dampened inflammation. Mice treated soon after chronic infection for 7 days with daily aerosol or subcutaneous administration of TOB showed higher and more rapid body weight recovery and reduced bacterial burden and inflammation than vehicle-treated mice. COL-treated mice showed no improvement in body weight or change in inflammation. Modest bacterial burden reduction was recorded only with aerosol COL administration. When treatment for chronic infection was commenced 7 days after infection, both TOB and COL failed to reduce P. aeruginosa burden and inflammation, or aid in recovery of body weight.Our findings suggest that the animal model and treatment regimen should be carefully chosen based on the type of infection to assess antibiotic efficacy.
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.02456-2018
      Issue No: Vol. 55, No. 3 (2020)
  • The NLRP3 inflammasome pathway is activated in sarcoidosis and involved in
           granuloma formation
    • Authors: Huppertz, C; Jäger, B, Wieczorek, G, Engelhard, P, Oliver, S. J, Bauernfeind, F.-G, Littlewood-Evans, A, Welte, T, Hornung, V, Prasse, A.
      Pages: 1900119 - 1900119
      Abstract: Sarcoidosis is a disease characterised by granuloma formation. There is an unmet need for new treatment strategies beyond corticosteroids. The NLRP3 inflammasome pathway is expressed in innate immune cells and senses danger signals to elicit inflammatory interleukin (IL)-1β; it has recently become a druggable target. This prompted us to test the role of the NLRP3 inflammasome and IL-1β pathway in granuloma formation and sarcoidosis.19 sarcoid patients and 19 healthy volunteers were recruited into this pilot study. NLRP3 inflammasome activity was measured in bronchoalveolar lavage (BAL) cells and lung and skin biopsies using immunohistochemistry, Western blot, reverse-transcriptase PCR and ELISA. For in vivo experiments we used the trehalose 6,6'-dimycolate-granuloma mouse model and evaluated lung granuloma burden in miR-223 knockout and NLRP3 knockout mice, as well as the treatment effects of MCC950 and anti-IL-1β antibody therapy.We found strong upregulation of the NLRP3 inflammasome pathway, evidenced by expression of activated NLRP3 inflammasome components, including cleaved caspase-1 and IL-1β in lung granuloma, and increased IL-1β release of BAL cells from sarcoid patients compared to healthy volunteers (p=0.006). mRNA levels of miR-223, a micro-RNA downregulating NLRP3, were decreased and NLRP3 mRNA correspondingly increased in alveolar macrophages from sarcoid patients (p
      Keywords: Interstitial and orphan lung disease, Mechanisms of lung disease
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.00119-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Connexin-43 is a promising target for pulmonary hypertension due to
           hypoxaemic lung disease
    • Authors: Bouvard, C; Genet, N, Phan, C, Rode, B, Thuillet, R, Tu, L, Robillard, P, Campagnac, M, Soleti, R, Dumas De La Roque, E, Delcambre, F, Cronier, L, Parpaite, T, Maurat, E, Berger, P, Savineau, J.-P, Marthan, R, Guignabert, C, Freund-Michel, V, Guibert, C.
      Pages: 1900169 - 1900169
      Abstract: The mechanisms underlying pulmonary hypertension (PH) are complex and multifactorial, and involve different cell types that are interconnected through gap junctional channels. Although connexin (Cx)-43 is the most abundant gap junction protein in the heart and lungs, and critically governs intercellular signalling communication, its contribution to PH remains unknown. The focus of the present study is thus to evaluate Cx43 as a potential new target in PH.Expressions of Cx37, Cx40 and Cx43 were studied in lung specimens from patients with idiopathic pulmonary arterial hypertension (IPAH) or PH associated with chronic hypoxaemic lung diseases (chronic hypoxia-induced pulmonary hypertension (CH-PH)). Heterozygous Cx43 knockdown CD1 (Cx43+/–) and wild-type littermate (Cx43+/+) mice at 12 weeks of age were randomly divided into two groups, one of which was maintained in room air and the other exposed to hypoxia (10% oxygen) for 3 weeks. We evaluated pulmonary haemodynamics, remodelling processes in cardiac tissues and pulmonary arteries (PAs), lung inflammation and PA vasoreactivity.Cx43 levels were increased in PAs from CH-PH patients and decreased in PAs from IPAH patients; however, no difference in Cx37 or Cx40 levels was noted. Upon hypoxia treatment, the Cx43+/– mice were partially protected against CH-PH when compared to Cx43+/+ mice, with reduced pulmonary arterial muscularisation and inflammatory infiltration. Interestingly, the adaptive changes in cardiac remodelling in Cx43+/– mice were not affected. PA contraction due to endothelin-1 (ET-1) was increased in Cx43+/– mice under normoxic and hypoxic conditions.Taken together, these results indicate that targeting Cx43 may have beneficial therapeutic effects in PH without affecting compensatory cardiac hypertrophy.
      Keywords: Mechanisms of lung disease, Pulmonary vascular disease
      PubDate: 2020-03-12T01:05:22-07:00
      DOI: 10.1183/13993003.00169-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Association of asthma and smoking with lung function impairment in
           adolescence and early adulthood: the Isle of Wight Birth Cohort Study
    • Authors: Arshad, S. H; Hodgekiss, C, Holloway, J. W, Kurukulaaratchy, R, Karmaus, W, Zhang, H, Roberts, G.
      Pages: 1900477 - 1900477
      Abstract: We investigated associations of asthma and smoking with lung function and airway reversibility from childhood to early adulthood.The population-based Isle of Wight Birth Cohort (n=1456) was assessed at birth, and at 1, 2, 4, 10, 18 and 26 years. Asthma was defined as physician diagnosis plus current wheeze and/or treatment. Spirometry was conducted at 10 (n=981), 18 (n=839) and 26 years (n=547). Individuals were subdivided into nonsmokers without asthma, nonsmokers with asthma, smokers without asthma and smokers with asthma, based on asthma and smoking status at 26 years. Their lung function trajectories from 10 to 26 years were examined using longitudinal models.Nonsmokers with asthma had smaller forced expiratory volume in 1 s (FEV1), FEF25–75% (forced expiratory flow at 25–75% of forced vital capacity (FVC)) and FEV1/FVC ratio compared to nonsmokers without asthma at age 10 and 18 years, with differences reduced after bronchodilator (pre-bronchodilator FEV1 at 26 years 3.75 L versus 4.02 L, p
      Keywords: COPD and smoking, Lung structure and function
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.00477-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Donor surfactant protein A2 polymorphism and lung transplant survival
    • Authors: D'Ovidio, F; Floros, J, Aramini, B, Lederer, D, DiAngelo, S. L, Arcasoy, S, Sonett, J. R, Robbins, H, Shah, L, Costa, J, Urso, A.
      Pages: 1900618 - 1900618
      Abstract: PurposeGene polymorphisms of surfactant proteins, key players in lung innate immunity, have been associated with various lung diseases. The aim of this study was to investigate the potential association between variations within the surfactant protein (SP)-A gene of the donor lung allograft and recipient post-transplant outcome.MethodsLung-transplant patients (n=192) were prospectively followed-up with pulmonary function tests, bronchoscopies with bronchoalveolar lavage and biopsies. Donor lungs were assayed for SP-A1 (6An) and SP-A2 (1An) gene polymorphism using the pyrosequencing method. Unadjusted and adjusted stratified Cox survival models are reported.ResultsSP-A1 and SP-A2 genotype frequency and lung transplant recipient and donor characteristics as well as cause of death are noted. Recipients were grouped per donor SP-A2 variants. Individuals that received lungs from donors with the SP-A2 1A0 (n=102) versus 1A1 variant (n=68) or SP-A2 genotype 1A01A0 (n=54) versus 1A0A1 (n=38) had greater survival at 1 year (log-rank p
      Keywords: Interstitial and orphan lung disease
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.00618-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Screening and treatment of tuberculosis among pregnant women in Stockholm,
           Sweden, 2016-2017
    • Authors: Fröberg, G; Jansson, L, Nyberg, K, Obasi, B, Westling, K, Berggren, I, Bruchfeld, J.
      Pages: 1900851 - 1900851
      Abstract: Swedish National tuberculosis (TB) guidelines recommend screening of active and latent TB (LTBI) among pregnant women (PW) from high-endemic countries or with previous exposure to possibly improve early detection and treatment.We evaluated cascade of care of a newly introduced TB screening programme of pregnant women in Stockholm county in 2016–2017. The algorithm included clinical data and Quantiferon (QFT) at the Maternal Health Care clinics and referral for specialist care upon positive test or TB symptoms.About 29 000 HIV-negative pregnant women were registered yearly, of whom 11% originated from high-endemic countries. In 2016, 72% of these were screened with QFT, of which 22% were QFT positive and 85% were referred for specialist care. In 2017, corresponding figures were 64%, 19% and 96%, respectively. The LTBI treatment rate among all QFT-positive pregnant women increased from 24% to 37% over time. Treatment completion with mainly rifampicin post-partum was 94%. Of the 69 registered HIV-positive pregnant women, 78% originated from high-endemic countries. Of these, 72% where screened with QFT and 15% were positive, but none was treated for LTBI. 9 HIV-negative active pulmonary TB cases were detected (incidence: 215/100 000). None had been screened for TB prior to pregnancy and only one had sought care due to symptoms.Systematic TB screening of pregnant women in Stockholm was feasible with a high yield of unknown LTBI and mostly asymptomatic active TB. Optimised routines improved referrals to specialist care. Treatment completion of LTBI was very high. Our findings justify TB screening of this risk group for early detection and treatment.
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.00851-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Morphomolecular motifs of pulmonary neoangiogenesis in interstitial lung
    • Authors: Ackermann, M; Stark, H, Neubert, L, Schubert, S, Borchert, P, Linz, F, Wagner, W. L, Stiller, W, Wielpütz, M, Hoefer, A, Haverich, A, Mentzer, S. J, Shah, H. R, Welte, T, Kuehnel, M, Jonigk, D.
      Pages: 1900933 - 1900933
      Abstract: The pathogenetic role of angiogenesis in interstitial lung diseases (ILDs) is controversial. This study represents the first investigation of the spatial complexity and molecular motifs of microvascular architecture in important subsets of human ILD. The aim of our study was to identify specific variants of neoangiogenesis in three common pulmonary injury patterns in human ILD.We performed comprehensive and compartment-specific analysis of 24 human lung explants with usual intersitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP) and alveolar fibroelastosis (AFE) using histopathology, microvascular corrosion casting, micro-comupted tomography based volumetry and gene expression analysis using Nanostring as well as immunohistochemistry to assess remodelling-associated angiogenesis.Morphometrical assessment of vessel diameters and intervascular distances showed significant differences in neoangiogenesis in characteristically remodelled areas of UIP, NSIP and AFE lungs. Likewise, gene expression analysis revealed distinct and specific angiogenic profiles in UIP, NSIP and AFE lungs.Whereas UIP lungs showed a higher density of upstream vascularity and lower density in perifocal blood vessels, NSIP and AFE lungs revealed densely packed alveolar septal blood vessels. Vascular remodelling in NSIP and AFE is characterised by a prominent intussusceptive neoangiogenesis, in contrast to UIP, in which sprouting of new vessels into the fibrotic areas is characteristic. The molecular analyses of the gene expression provide a foundation for understanding these fundamental differences between AFE and UIP and give insight into the cellular functions involved.
      Keywords: Interstitial and orphan lung disease, Mechanisms of lung disease
      PubDate: 2020-03-12T01:05:22-07:00
      DOI: 10.1183/13993003.00933-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Mediterranean diet during pregnancy and childhood respiratory and atopic
           outcomes: birth cohort study
    • Authors: Bedard, A; Northstone, K, Henderson, A. J, Shaheen, S. O.
      Pages: 1901215 - 1901215
      Abstract: Evidence for associations between Mediterranean diet during pregnancy and childhood asthma, allergy and related outcomes is conflicting. Few cohorts have followed children to school age, and none have considered lung function.In the Avon Longitudinal Study of Parents and Children, we analysed associations between maternal Mediterranean diet score during pregnancy (estimated by a food frequency questionnaire, using an a priori defined score adapted to pregnant women; score ranging from 0 (low adherence) to 7 (high adherence)) and current doctor-diagnosed asthma, wheeze, eczema, hay fever, atopy and lung function in 8907 children at 7–9 years. Interaction between maternal Mediterranean diet and maternal smoking in pregnancy was investigated.The maternal Mediterranean diet score was not associated with asthma or other allergic outcomes. Weak positive associations were found between maternal Mediterranean diet score and childhood maximal mid-expiratory flow (forced expiratory flow at 25–75% of forced vital capacity (FEF25–75%)) after controlling for confounders. Higher Mediterranean diet scores were associated with increased FEF25–75% z-scores adjusted for age, height and sex (β 0.06, 95% CI 0.01–0.12; p=0.03, comparing a score of 4–7 versus a score of 0–3). Stratifying associations by maternal smoking during pregnancy showed that associations with FEF25–75% were only seen in children of never-/passive-smoking mothers, but no evidence for a statistically significant interaction was found.Results suggest adherence to a Mediterranean diet during pregnancy may be associated with increased small airway function in childhood, but we found no evidence for a reduced risk of asthma or other allergic outcomes.
      Keywords: Paediatric pulmonology
      PubDate: 2020-03-12T01:05:22-07:00
      DOI: 10.1183/13993003.01215-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Culture of pulmonary artery endothelial cells from pulmonary artery
           catheter balloon tips: considerations for use in pulmonary vascular
    • Authors: Ventetuolo, C. E; Aliotta, J. M, Braza, J, Chichger, H, Dooner, M, McGuirl, D, Mullin, C. J, Newton, J, Pereira, M, Princiotto, A, Quesenberry, P. J, Walsh, T, Whittenhall, M, Klinger, J. R, Harrington, E. O.
      Pages: 1901313 - 1901313
      Abstract: Endothelial dysfunction is a hallmark of pulmonary arterial hypertension (PAH) but there are no established methods to study pulmonary artery endothelial cells (PAECs) from living patients. We sought to culture PAECs from pulmonary artery catheter (PAC) balloons used during right-heart catheterisation (RHC) to characterise successful culture attempts and to describe PAEC behaviour.PAECs were grown in primary culture to confluence and endothelial cell phenotype was confirmed. Standard assays for apoptosis, migration and tube formation were performed between passages three to eight. We collected 49 PAC tips from 45 subjects with successful PAEC culture from 19 balloons (39%).There were no differences in subject demographic details or RHC procedural details in successful versus unsuccessful attempts. However, for subjects who met haemodynamic criteria for PAH, there was a higher but nonsignificant (p=0.10) proportion amongst successful attempts (10 out of 19, 53%) versus unsuccessful attempts (nine out of 30, 30%). A successful culture was more likely in subjects with a lower cardiac index (p=0.03) and higher pulmonary vascular resistance (p=0.04). PAECs from a subject with idiopathic PAH were apoptosis resistant compared to commercial PAECs (p=0.04) and had reduced migration compared to PAECs from a subject with portopulmonary hypertension with high cardiac output (p=0.01). PAECs from a subject with HIV-associated PAH formed fewer (p=0.01) and shorter (p=0.02) vessel networks compared to commercial PAECs.Sustained culture and characterisation of PAECs from RHC balloons is feasible, especially in PAH with high haemodynamic burden. This technique may provide insight into endothelial dysfunction during PAH pathogenesis.
      Keywords: Mechanisms of lung disease, Pulmonary vascular disease
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.01313-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Increased ventilation heterogeneity in asthma can be attributed to
           proximal bronchioles
    • Authors: Foy, B; Kay, D, Siddiqui, S, Brightling, C, Paiva, M, Verbanck, S.
      Pages: 1901345 - 1901345
      Abstract: In recent years, tests of ventilation heterogeneity such as the multiple breath washout (MBW) have gained popularity as potentially sensitive measures of disease in the small airways [1]. The premise of a non-invasive test, such as the MBW, is that morphological alterations at differing lung depths can be sampled at the mouth via their effect on ventilation heterogeneity. MBW phase III slope derived indices of ventilation heterogeneity include the conductive slope index (Scond), a purely convection-dependent contribution generated in the conducting zone of the lungs, and the acinar slope index (Sacin), brought about by diffusion–convection mechanisms operating near acinar entrances in the respiratory zone [2, 3].
      PubDate: 2020-03-12T01:05:22-07:00
      DOI: 10.1183/13993003.01345-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Something is changing in adherence to CPAP therapy: real world data after
           1 year of treatment in patients with obstructive sleep apnoea
    • Authors: Morrone, E; Giordano, A, Carli, S, Visca, D, Rossato, F, Godio, M, Paracchini, E, Rossi, S, Balbi, B, Sacco, C, Braghiroli, A.
      Pages: 1901419 - 1901419
      Abstract: Obstructive sleep apnoea syndrome (OSA) is a common sleep disorder, affecting at least 24% of the male and 9% of the female population [1]. Despite progress in alternative treatment options, continuous positive airway pressure (CPAP) therapy is still the first-line treatment in moderate to severe OSA. The effectiveness of CPAP treatment is proportional to the usage: the greater the number of hours of CPAP use per night the greater the improvement in OSA symptoms, daytime sleepiness, quality of life, sleep architecture and blood pressure. Adherence to treatment, however, is the crucial issue: in many case series more than 50% of patients with OSA had interrupted treatment 1 year after the prescription [2].
      Keywords: Sleep medicine
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.01419-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Standardised shorter regimens versus individualised longer regimens for
           rifampin- or multidrug-resistant tuberculosis
    • Authors: Abidi, S; Achar, J, Assao Neino, M. M, Bang, D, Benedetti, A, Brode, S, Campbell, J. R, Casas, E. C, Conradie, F, Dravniece, G, du Cros, P, Falzon, D, Jaramillo, E, Kuaban, C, Lan, Z, Lange, C, Li, P. Z, Makhmudova, M, Maug, A. K. J, Menzies, D, Migliori, G. B, Miller, A, Myrzaliev, B, Ndjeka, N, Noeske, J, Parpieva, N, Piubello, A, Schwoebel, V, Sikhondze, W, Singla, R, Souleymane, M. B, Trebucq, A, Van Deun, A, Viney, K, Weyer, K, Zhang, B. J, Ahmad Khan, F.
      Pages: 1901467 - 1901467
      Abstract: We sought to compare the effectiveness of two World Health Organization (WHO)-recommended regimens for the treatment of rifampin- or multidrug-resistant (RR/MDR) tuberculosis (TB): a standardised regimen of 9–12 months (the "shorter regimen") and individualised regimens of ≥20 months ("longer regimens").We collected individual patient data from observational studies identified through systematic reviews and a public call for data. We included patients meeting WHO eligibility criteria for the shorter regimen: not previously treated with second-line drugs, and with fluoroquinolone- and second-line injectable agent-susceptible RR/MDR-TB. We used propensity score matched, mixed effects meta-regression to calculate adjusted odds ratios and adjusted risk differences (aRDs) for failure or relapse, death within 12 months of treatment initiation and loss to follow-up.We included 2625 out of 3378 (77.7%) individuals from nine studies of shorter regimens and 2717 out of 13 104 (20.7%) individuals from 53 studies of longer regimens. Treatment success was higher with the shorter regimen than with longer regimens (pooled proportions 80.0% versus 75.3%), due to less loss to follow-up with the former (aRD –0.15, 95% CI –0.17– –0.12). The risk difference for failure or relapse was slightly higher with the shorter regimen overall (aRD 0.02, 95% CI 0–0.05) and greater in magnitude with baseline resistance to pyrazinamide (aRD 0.12, 95% CI 0.07–0.16), prothionamide/ethionamide (aRD 0.07, 95% CI –0.01–0.16) or ethambutol (aRD 0.09, 95% CI 0.04–0.13).In patients meeting WHO criteria for its use, the standardised shorter regimen was associated with substantially less loss to follow-up during treatment compared with individualised longer regimens and with more failure or relapse in the presence of resistance to component medications. Our findings support the need to improve access to reliable drug susceptibility testing.
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.01467-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Targeting treatable traits in severe asthma: a randomised controlled trial
    • Authors: McDonald, V. M; Clark, V. L, Cordova-Rivera, L, Wark, P. A. B, Baines, K. J, Gibson, P. G.
      Pages: 1901509 - 1901509
      Abstract: RationaleTreatable traits have been proposed as a new paradigm for airway disease management.ObjectivesTo characterise treatable traits in a severe asthma population and to determine the efficacy of targeting treatments to these treatable traits in severe asthma.MethodsParticipants (n=140) with severe asthma were recruited to a cross-sectional study and underwent a multidimensional assessment to characterise treatable traits. Eligible participants with severe asthma (n=55) participated in a 16-week parallel-group randomised controlled trial to determine the feasibility and efficacy of management targeted to predefined treatable traits, compared to usual care in a severe asthma clinic. The patient-reported outcome of health-related quality of life was the trial's primary end-point.Main resultsParticipants with severe asthma had a mean±sd of 10.44±3.03 traits per person, comprising 3.01±1.54 pulmonary and 4.85±1.86 extrapulmonary traits and 2.58±1.31 behavioural/risk factors. Individualised treatment that targeted the traits was feasible and led to significantly improved health-related quality of life (0.86 units, p
      Keywords: Asthma and allergy
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.01509-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Exertional dyspnoea-ventilation relationship to discriminate respiratory
           from cardiac impairment
    • Authors: Plachi, F; Balzan, F. M, Fröhlich, L. F, Gass, R, Mendes, N. B, Schroeder, E, Berton, D. C, O'Donnell, D. E, Neder, J. A.
      Pages: 1901518 - 1901518
      Abstract: Activity-related dyspnoea is a key cause of physical impairment in cardiovascular and respiratory diseases [1]. Despite remarkable diagnostic advances in the past decades, discriminating "the heart" versus "the lungs" as a cause of exertional dyspnoea remains a challenge for cardiologists and pulmonologists.
      PubDate: 2020-03-12T01:05:23-07:00
      DOI: 10.1183/13993003.01518-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Effects of suboptimal adherence of CPAP therapy on symptoms of obstructive
           sleep apnoea: a randomised, double-blind, controlled trial
    • Authors: Gaisl, T; Rejmer, P, Thiel, S, Haile, S. R, Osswald, M, Roos, M, Bloch, K. E, Stradling, J. R, Kohler, M.
      Pages: 1901526 - 1901526
      Abstract: IntroductionContinuous positive airway pressure (CPAP) is currently the treatment of choice for sleepiness in patients with obstructive sleep apnoea (OSA); however, adherence is often thought to be suboptimal. We investigated the effects of suboptimal CPAP usage on objective and subjective sleepiness parameters in patients with OSA.Material and methodsIn this 2-week, parallel, double-blind, randomised controlled trial we enrolled moderate-to-severe OSA patients with excessive pre-treatment daytime sleepiness (Epworth sleepiness scale (ESS) score>10 points) who had suboptimal CPAP adherence over ≥12 months (mean nightly usage time 3–4 h). Patients were allocated through minimisation to either subtherapeutic CPAP ("sham CPAP") or continuation of CPAP ("therapeutic CPAP"). A Bayesian analysis with historical priors calculated the posterior probability of superiority.ResultsBetween May, 2016 and November, 2018, 57 patients (aged 60±8 years, 79% male, 93% Caucasian) were allocated in total, and 52 who completed the study (50% in each arm) were included in the final analysis. The unadjusted ESS score increase was 2.4 points (95% CI 0.6–4.2, p=0.01) in the sham-CPAP group when compared to continuing therapeutic CPAP. The probability of superiority of therapeutic CPAP over sham CPAP was 90.4% for ESS, 90.1% for systolic blood pressure and 80.3% for diastolic blood pressure.ConclusionsPatients with moderate-to-severe OSA and daytime sleepiness are still getting a substantial benefit from suboptimal CPAP adherence, albeit not as much as they might get if they adhered more. Whether a similar statement can be made for even lower adherence levels remains to be established in future trials.
      Keywords: Sleep medicine
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.01526-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Gefapixant in two randomised dose-escalation studies in chronic cough
    • Authors: Smith, J. A; Kitt, M. M, Butera, P, Smith, S. A, Li, Y, Xu, Z. J, Holt, K, Sen, S, Sher, M. R, Ford, A. P.
      Pages: 1901615 - 1901615
      Abstract: Background and objectivesGefapixant has previously demonstrated efficacy in the treatment of refractory chronic cough at a high daily dose. The current investigations explore efficacy and tolerability of gefapixant, a P2X3 receptor antagonist, for the treatment of chronic cough using a dose-escalation approach.Materials and methodsTwo randomised, double-blind, placebo-controlled, crossover, dose-escalation studies recruited participants with refractory chronic cough. Patients were assigned to receive ascending doses of gefapixant (study 1: 50–200 mg, study 2: 7.5–50 mg) or placebo for 16 days, then crossed-over after washout. The primary end-point was awake cough frequency assessed using a 24-h ambulatory cough monitor at baseline and on day 4 of each dose. Patient-reported outcomes included a cough severity visual analogue scale and the cough severity diary.ResultsIn clinical studies, gefapixant doses ≥30 mg produced maximal improvements in cough frequency compared with placebo (p
      Keywords: Pulmonary pharmacology and therapeutics, Respiratory clinical practice
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.01615-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Clinical utility of fractional exhaled nitric oxide in severe asthma
    • Authors: Menzies-Gow, A; Mansur, A. H, Brightling, C. E.
      Pages: 1901633 - 1901633
      Abstract: Asthma is a chronic inflammatory disease of the airways, affecting over 350 million people worldwide and placing a significant burden on healthcare providers and wider society. Approximately 5–10% of asthma patients are diagnosed with severe asthma and typically are associated with increased risk of hospitalisation from exacerbations, increased morbidity, mortality and higher asthma-associated healthcare costs. Nitric oxide (NO) is an important regulator of immune responses and is a product of inflammation in the airways that is over-produced in asthma. Fractional exhaled NO (FeNO) is predominantly used as a predictor of response to inhaled corticosteroids (ICSs), to monitor adherence and as a diagnostic tool in ICS-naïve patients. In the UK, the National Institute for Health and Care Excellence (NICE) guidelines recommend the use of FeNO for the initial diagnosis of patients with suspected asthma. In the USA, American Thoracic Society (ATS) guidelines recommend FeNO as part of the initial diagnosis of asthma and for monitoring of airway inflammation. FeNO has also been shown to be a predictive factor for asthma exacerbations, with higher levels being associated with a greater number of exacerbations. In addition, higher levels of FeNO have been shown to be associated with a decline in lung function. FeNO testing is a cost-effective procedure and has been shown to improve patient management when combined with standard assessment methods. Recent evidence suggests that FeNO may also be useful as a surrogate biomarker for the assessment and management of severe asthma and to predict responsiveness to some biological therapies.
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.01633-2019
      Issue No: Vol. 55, No. 3 (2020)
  • A pressure-based single beat method for estimation of right ventricular
           ejection fraction: proof of concept
    • Authors: Heerdt, P. M; Kheyfets, V, Charania, S, Elassal, A, Singh, I.
      Pages: 1901635 - 1901635
      Abstract: The utility of considering right ventricular (RV) contractility and afterload as independent entities and summarising their balance or "coupling" using single beat methods has become widely appreciated [1–3]. Typically expressed as the ratio of end-systolic ventricular elastance (Ees, a load-independent measure of contractility), to arterial elastance (Ea, a lumped parameter measure of afterload) data suggest that when Ees/Ea reaches a critical threshold, the risk of cardiovascular decompensation begins to rise [4].
      PubDate: 2020-03-12T01:05:23-07:00
      DOI: 10.1183/13993003.01635-2019
      Issue No: Vol. 55, No. 3 (2020)
  • The effect of HIV-associated tuberculosis, tuberculosis-IRIS and
           prednisone on lung function
    • Authors: Stek, C; Allwood, B, Du Bruyn, E, Buyze, J, Schutz, C, Thienemann, F, Lombard, A, Wilkinson, R. J, Meintjes, G, Lynen, L.
      Pages: 1901692 - 1901692
      Abstract: Residual pulmonary impairment is common after treatment for tuberculosis (TB). Lung function data in patients with HIV-associated TB are scarce, especially in the context of paradoxical TB-associated immune reconstitution inflammatory syndrome (TB-IRIS) and prophylactic prednisone. We aimed to determine the prevalence of lung function abnormalities in patients with HIV-associated TB and CD4 counts ≤100 cells·μL–1 and assess the effect of prophylactic prednisone and the development of paradoxical TB-IRIS on pulmonary impairment.We performed spirometry, 6-min walk test (6MWT) and chest radiography at baseline (week 0) and at weeks 4, 12 and 28 in participants of the PredART trial, which evaluated a 28-day course of prednisone to prevent TB-IRIS in patients with HIV-associated TB commencing antiretroviral therapy.153 participants underwent spirometry and/or 6MWT at one or more time points. Abnormal spirometry measurements were present in 66% of participants at week 0 and 50% at week 28; low forced vital capacity was the commonest abnormality. Chest radiographs showed little or no abnormalities in the majority of participants. Prednisone use resulted in a 42 m greater 6-min walk distance and a 4.9% higher percentage of predicted forced expiratory volume in 1 s at week 4; these differences were no longer significantly different from week 12 onwards. TB-IRIS did not significantly impair lung function outcome.Residual pulmonary impairment is common in HIV-associated TB. In patients with low CD4 counts, neither prophylactic prednisone as used in our study nor the development of TB-IRIS significantly affected week-28 pulmonary outcome.
      PubDate: 2020-03-12T01:05:23-07:00
      DOI: 10.1183/13993003.01692-2019
      Issue No: Vol. 55, No. 3 (2020)
  • An evaluation of a throat discomfort visual analogue scale in chronic
    • Authors: Hull, J. H; Walsted, E. S, Pavitt, M. J, Tidmarsh, B, Selby, J.
      Pages: 1901722 - 1901722
      Abstract: Chronic cough is a debilitating symptom affecting approximately one in ten of the general population and leading to impaired quality of life and social exclusion [1]. Many individuals with chronic cough localise their symptoms to the throat area and report sensations such as a "persistent tickling", "irritation" or "blockage" in the throat [2]. They also often describe that symptoms are provoked by non-specific environmental triggers, such as exposure to scents or odours. In many patients, there is also an apparent overlap between manifestations of laryngeal dysfunction, such as discomfort on swallowing with or without changes in voice quality. Overall, these phenomena may be attributed to an underlying laryngeal hypersensitivity (LHS) [3] and recognition of this entity in chronic cough may be important to help inform and select the optimum treatment strategy; e.g. preferential specialist speech and language therapy (SLT) intervention [4].
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.01722-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Upregulation of smooth muscle Rho-kinase protein expression in human
    • Authors: Wang, L; Chitano, P, Pare, P. D, Seow, C. Y.
      Pages: 1901785 - 1901785
      Abstract: The lack of bronchodilatory response to deep inspiration in asthmatics is thought to be partially due to reduced airway distensibility [1, 2], possibly caused by an increase in airway smooth muscle (ASM) tone and stiffness [3]. Rho-kinase (ROCK) is known to play a role in regulating ASM tone [4] and ASM cytoskeletal stiffness [5].
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.01785-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Genetic susceptibility to asthma increases the vulnerability to indoor air
    • Authors: Hüls, A; Vanker, A, Gray, D, Koen, N, MacIsaac, J. L, Lin, D. T. S, Ramadori, K. E, Sly, P. D, Stein, D. J, Kobor, M. S, Zar, H. J.
      Pages: 1901831 - 1901831
      Abstract: IntroductionIndoor air pollution and maternal smoking during pregnancy are associated with respiratory symptoms in infants, but little is known about the direct association with lung function or interactions with genetic risk factors. We examined associations of exposure to indoor particulate matter with a 50% cut-off aerodynamic diameter of 10 µm (PM10) and maternal smoking with infant lung function and the role of gene–environment interactions.MethodsData from the Drakenstein Child Health Study, a South African birth cohort, were analysed (n=270). Lung function was measured at 6 weeks and 1 year of age, and lower respiratory tract infection episodes were documented. We measured pre- and postnatal PM10 exposures using devices placed in homes, and prenatal tobacco smoke exposure using maternal urine cotinine levels. Genetic risk scores determined from associations with childhood-onset asthma in the UK Biobank were used to investigate effect modifications.ResultsPre- and postnatal exposure to PM10 as well as maternal smoking during pregnancy were associated with reduced lung function at 6 weeks and 1 year as well as with lower respiratory tract infection in the first year. Due to a significant interaction between the genetic risk score and prenatal exposure to PM10, infants carrying more asthma-related risk alleles were more susceptible to PM10-associated reduced lung function (pinteraction=0.007). This interaction was stronger in infants with Black African ancestry (pinteraction=0.001) and nonexistent in children with mixed ancestry (pinteraction=0.876).ConclusionsPM10 and maternal smoking exposures were associated with reduced lung function, with a higher susceptibility for infants with an adverse genetic predisposition for asthma that also depended on the infant's ancestry.
      Keywords: Epidemiology, occupational and environmental lung disease, Asthma and allergy
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.01831-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Gene-based diagnosis of tuberculosis with a new-generation pathogen
           enrichment technique
    • Authors: Lee, S. W; Kang, Y. A, Jin, C. E, Kim, H. C, Noh, G. S, Lee, H. J, Park, J. H, Koo, Y. S, Shin, Y, Kim, S.-H.
      Pages: 1901885 - 1901885
      Abstract: While the Xpert MTB/RIF assay (Cepheid Sunnyvale, CA, USA) has greater than 95% sensitivity for identifying acid-fast bacilli (AFB) smear-positive tuberculosis (TB) cases, for smear-negative pulmonary tuberculosis (PTB) the sensitivity was as low as 60% [1, 2]. To address the low sensitivity of current TB diagnostics for AFB smear-negative cases, we developed a simple and label-free pathogen enrichment using homobifunctional imidoesters (HIs) using a microfluidic (SLIM) platform followed by conventional Mycobacterium tuberculosis PCR to extract low amounts of pathogens from clinical samples [3]. In this study, we compared the diagnostic performance of the SLIM assay with the Xpert MTB/RIF for PTB diagnosis in a country with an intermediate TB burden and a low human immunodeficiency virus burden. The SLIM assay was performed by using 1 mL and 2 mL aliquots of sputum, respectively.
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.01885-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Increased risk of active tuberculosis during pregnancy and postpartum: a
           register-based cohort study in Sweden
    • Authors: Jonsson, J; Kühlmann-Berenzon, S, Berggren, I, Bruchfeld, J.
      Pages: 1901886 - 1901886
      Abstract: RationaleStudies investigating the risk of active tuberculosis (TB) in association with pregnancy have not been conclusive. We aimed to investigate this risk in a large retrospective register-based cohort study in Sweden.MethodsData from women of 15–49 years of age who had given birth in Sweden between 2005 and 2013 were extracted from the national childbirth register and linked to the national TB register. Cohort time was divided into three exposure periods: during pregnancy, six months (180 days) postpartum and time neither pregnant nor postpartum. We calculated incidence rates (IRs) per 100 000 person-years for each period and incidence rate ratios (IRRs) with IRs neither pregnant nor postpartum as the reference.ResultsThe cohort included 649 342 women, of whom 553 were registered as cases of active TB, 389 when neither pregnant nor postpartum, 85 during pregnancy and 79 when postpartum. Overall IRs were 9, 12 and 17 cases per 100 000 person-years, respectively, giving IRR 1.4, 95% CI 1.1–1.7 (during pregnancy) and IRR 1.9, 95% CI 1.5–2.5 (when postpartum). Stratification by TB incidence in country of origin showed that the increased risk was concentrated amongst women from countries with a TB incidence of 100 or higher, where IRs per 100 000 person-years were 137 (when neither pregnant nor postpartum), 182 (during pregnancy) and 233 (when postpartum).ConclusionWe show a significant increase in risk of active TB during both pregnancy and postpartum in women from high incidence countries and recommend TB screening in pregnant women belonging to this risk group.
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.01886-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Routine survey of Mycobacterium tuberculosis isolates reveals nosocomial
    • Authors: Genestet, C; Paret, R, Pichat, C, Berland, J.-L, Jacomo, V, Carret, G, Fredenucci, I, Hodille, E, Rasigade, J.-P, Boisset, S, Carricajo, A, Lina, G, Ronnaux-Baron, A.-S, Mornex, J.-F, Grando, J, Senechal, A, Ader, F, Dumitrescu, O, on behalf of the Lyon TB study group
      Pages: 1901888 - 1901888
      Abstract: Control of Mycobacterium tuberculosis transmission in high-income healthcare settings and in low tuberculosis (TB) prevalence countries remains a public health priority given the constant changes in M. tuberculosis epidemiology worldwide. Though Europe is a low prevalence area [1], TB burden among precarious and migrant populations contributes to this evolving landscape, as addressed by the action framework towards TB elimination [2]. At the core of the national healthcare system, tertiary care hospitals manage both patients with greater susceptibility to TB, and patients with complex and/or advanced TB disease. Key measures for TB control rely on enabling linkage of cases and identification of transmission chains, often supported by molecular survey tools [3, 4].
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.01888-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Diabetes is associated with genotypically drug-resistant tuberculosis
    • Authors: Ruesen, C; Chaidir, L, Ugarte-Gil, C, van Ingen, J, Critchley, J. A, Hill, P. C, Ruslami, R, Santoso, P, Huynen, M. A, Dockrell, H. M, Moore, D. A. J, Alisjahbana, B, van Crevel, R.
      Pages: 1901891 - 1901891
      Abstract: Diabetes is associated with failure of tuberculosis (TB) treatment, but it is unclear whether this is related to genotypic drug resistance of the infecting mycobacteria. We used whole genome sequencing (WGS) to examine 1365 known drug resistance mutations in 896 Mycobacterium tuberculosis isolates from TB patients that were screened for diabetes using HbA1c testing as part of the TANDEM project [1]. Ethical approval was received from the London School of Hygiene and Tropical Medicine and institutional review boards in Indonesia and Peru. In Peru we selected all available M. tuberculosis isolates from TANDEM patients (44 with and 445 without diabetes), and in Indonesia we selected all available isolates from diabetic patients (n=115) plus a subset of isolates from non-diabetic patients (n=292) from the same clinics, during the same time period, frequency-matched by age. We used TB Profiler version 0.3.8 [2] to determine M. tuberculosis lineage and drug resistance. A phylogeny was constructed using PhyML version 3.0 [3], and the minimum pairwise distance for isolates was calculated separately for patients with and without diabetes, stratified by country.
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.01891-2019
      Issue No: Vol. 55, No. 3 (2020)
  • WHO 2019 guidelines on drug-resistant tuberculosis treatment: based on
           evidence or expert opinion'
    • Authors: Guglielmetti, L; Huerga, H, Khan, U, Varaine, F.
      Pages: 1901935 - 1901935
      Abstract: Since 2011, the World Health Organization (WHO) has used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system for grading quality of evidence [1, 2] to update guidelines for the management of drug-resistant tuberculosis (DR-TB). This represents an undeniable improvement towards evidence-based recommendations compared to previous guidelines, which were primarily based on expert opinion [3]. However, some aspects of guideline development remain unclear. In our opinion, the WHO 2019 consolidated guidelines on DR-TB treatment [4] have raised some concerns in the way recommendations were drawn from the evidence evaluated to answer specific PICO (Patient, Intervention, Comparator, Outcome) questions.
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.01935-2019
      Issue No: Vol. 55, No. 3 (2020)
  • FEV1 and MRI ventilation defect reversibility in asthma and COPD
    • Authors: Serajeddini, H; Eddy, R. L, Licskai, C, McCormack, D. G, Parraga, G.
      Pages: 1901947 - 1901947
      Abstract: The underlying pathophysiological determinants of asthma and COPD are related in complex ways. Importantly however, post-bronchodilator forced expiratory volume in 1 s (FEV1) reversibility may occur in approximately 50% of COPD patients [1], whilst epidemiological [2] and magnetic resonance imaging (MRI) studies [3] suggest that, in asthma patients, FEV1 reversibility may diminish over time. As compared to patients with asthma or COPD alone, patients with co-existing asthma and COPD report worse clinical outcomes [4] and increased healthcare costs [5] and burden [4, 5].
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.01947-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Transcriptional biomarkers for predicting development of tuberculosis:
           progress and clinical considerations
    • Authors: Esmail, H; Cobelens, F, Goletti, D.
      Pages: 1901957 - 1901957
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.01957-2019
      Issue No: Vol. 55, No. 3 (2020)
  • The safety of isoniazid tuberculosis preventive treatment in pregnant and
           postpartum women: systematic review and meta-analysis
    • Authors: Hamada, Y; Figueroa, C, Martin-Sanchez, M, Falzon, D, Kanchar, A.
      Pages: 1901967 - 1901967
      Abstract: BackgroundThe World Health Organization (WHO) recommends tuberculosis (TB) preventive treatment for high-risk groups. Isoniazid preventive therapy (IPT) has been used globally for this purpose for many years, including in pregnancy. This review assessed current knowledge about the safety of IPT in pregnancy.MethodsWe searched PubMed, Embase, CENTRAL, Global Health Library and HIV and TB-related conference abstracts, until May 15, 2019, for randomised controlled trials (RCTs) and non-randomised studies (NRS) where IPT was administered to pregnant women. Outcomes of interest were: 1) maternal outcomes, including permanent drug discontinuation due to adverse drug reactions, any grade 3 or 4 drug-related toxic effects, death from any cause and hepatotoxicity; and 2) pregnancy outcomes, including in utero fetal death, neonatal death or stillbirth, preterm delivery/prematurity, intrauterine growth restriction, low birth weight and congenital anomalies. Meta-analyses were conducted using a random-effects model.ResultsAfter screening 1342 citations, nine studies (of 34 to 51 942 participants) met inclusion criteria. We found an increased likelihood of hepatotoxicity among pregnant women given IPT (risk ratio 1.64, 95% CI 0.78–3.44) compared with no IPT exposure in one RCT. Four studies reported on pregnancy outcomes comparing IPT exposure to no exposure among pregnant women with HIV. In one RCT, adverse pregnancy outcomes were associated with IPT exposure during pregnancy (odds ratio (OR) 1.51, 95% CI 1.09–2.10), but three NRS showed a protective effect.ConclusionsWe found inconsistent associations between IPT and adverse pregnancy outcomes. Considering the grave consequences of active TB in pregnancy, current evidence does not support systematic deferral of IPT until postpartum. Research on safety is needed.
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.01967-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Treatment with isoniazid or rifampin for latent tuberculosis infection:
           population-based study of hepatotoxicity, completion and costs
    • Authors: Ronald, L. A; FitzGerald, J. M, Bartlett-Esquilant, G, Schwartzman, K, Benedetti, A, Boivin, J.-F, Menzies, D.
      Pages: 1902048 - 1902048
      Abstract: Clinical trials suggest less hepatotoxicity and better adherence with 4 months rifampin (4R) versus 9 months isoniazid (9H) for treating latent tuberculosis infection (LTBI). Our objectives were to compare frequencies of severe hepatic adverse events and treatment completion, and direct health system costs of LTBI regimens 4R and 9H, in the general population of the province of Quebec, Canada, using provincial health administrative data.Our retrospective cohort included all patients starting rifampin or isoniazid regimens between 2003 and 2007. We estimated hepatotoxicity from hospitalisation records, treatment completion from community pharmacy records and direct costs from billing records and fee schedules. We compared rifampin to isoniazid using logistic (hepatotoxicity), log-binomial (completion), and gamma (costs) regression, with adjustment for age, co-morbidities and other confounders.10 559 individuals started LTBI treatment (9684 isoniazid; 875 rifampin). Rifampin patients were older with more baseline co-morbidities. Severe hepatotoxicity risk was higher with isoniazid (n=15) than rifampin (n=1), adjusted OR=2.3 (95% CI: 0.3–16.1); there were two liver transplants and one death with isoniazid and none with rifampin. Overall, patients without co-morbidities had lower hepatotoxicity risk (0.1% versus 1.0%). 4R completion (53.5%) was higher than 9H (36.9%), adjusted RR=1.5 (95% CI: 1.3–1.7). Mean costs per patient were lower for rifampin than isoniazid: adjusted cost ratio=0.7 (95% CI: 0.5–0.9).Risk of severe hepatotoxicity and direct costs were lower, and completion was higher, for 4R than 9H, after adjustment for age and co-morbidities. Severe hepatotoxicity resulted in death or liver transplant in three patients receiving 9H, compared with no patients receiving 4R.
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.02048-2019
      Issue No: Vol. 55, No. 3 (2020)
  • From pests to tests: training rats to diagnose tuberculosis
    • Authors: Fiebig, L; Beyene, N, Burny, R, Fast, C. D, Cox, C, Mgode, G. F.
      Pages: 1902243 - 1902243
      Abstract: 2020 is the year of the rat. The rat is the first of the 12 Chinese zodiac signs, and represents spirit, alertness, flexibility and vitality. In respiratory medicine, we may think of rats as vectors for diseases, such as pulmonary forms of hantavirus disease or leptospirosis, and pneumonic plague. Rodent control is thus part of hygiene guidelines and the International Health Regulations. And yet, the rat's keen sense of smell has led to its incredible career as a living tuberculosis (TB) detector.
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.02243-2019
      Issue No: Vol. 55, No. 3 (2020)
  • WHO guidance on multidrug-resistant tuberculosis treatment: using and
           communicating the evidence
    • Authors: Falzon, D; Schünemann, H. J, Zignol, M, Mirzayev, F, Kasaeva, T.
      Pages: 1902325 - 1902325
      Abstract: From the authors:L. Guglielmetti and co-workers acknowledge that methods used by the World Health Organization (WHO) to develop guidance have improved policies on multidrug-resistant tuberculosis (MDR-TB) in recent years. However, they express some concerns about the interpretation and communication of evidence in the 2019 WHO consolidated guidelines for drug-resistant TB treatment [1].
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.02325-2019
      Issue No: Vol. 55, No. 3 (2020)
  • When it all comes down to pressure: right ventricular ejection fraction at
           cardiac catheterisation
    • Authors: Naeije, R; Richter, M. J, Vanderpool, R, Tello, K.
      Pages: 1902341 - 1902341
      Abstract: In the present issue of the European Respiratory Journal, Heerdt et al. [1] report on the validation of right ventricularejection fraction (RVEF) calculated from a pressure curve at cardiac catheterisation. This is of great interest as right ventricular (RV) function is the main determinant of symptomatology and outcome in pulmonary hypertension [2], and RVEF accordingly adds significantly to risk stratification in these patients [3]. However, ejection fraction (EF) is a ratio of stroke volume (SV) to end-diastolic volume (EDV), with no pressure in the equation. So, how is it possible to calculate a volume ratio from pressure measurements'
      PubDate: 2020-03-12T01:05:23-07:00
      DOI: 10.1183/13993003.02341-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Outcomes consequent to "early" COPD for interventional studies
    • Authors: Rennard; S. I.
      Pages: 1902380 - 1902380
      Abstract: The recent paper by Colak et al. [1] and colleagues adds to the growing body of information relating to early COPD. The study confirms the importance of symptoms among individuals prior to meeting the arbitrary threshold of forced expiratory volume in 1 s (FEV1) to forced vital capacity ratio
      PubDate: 2020-03-12T01:05:23-07:00
      DOI: 10.1183/13993003.02380-2019
      Issue No: Vol. 55, No. 3 (2020)
  • The case for assessing the full value of new tuberculosis vaccines
    • Authors: Gebreselassie, N; Hutubessy, R, Vekemans, J, den Boon, S, Kasaeva, T, Zignol, M.
      Pages: 1902414 - 1902414
      Abstract: Tuberculosis (TB) ranks as the leading cause of death among infectious diseases in human history, claiming over a billion lives in the past two centuries alone [1, 2]. Although a number of important advances have been made to control TB in the past decade, an estimated 10 million people fell ill with TB and 1.5 million died from the disease in 2018 alone [1]. The only licensed TB vaccine, bacille Calmette–Guérin (BCG), provides partial protection against severe forms of TB in infants and young children (averting thousands of paediatric deaths annually), but fails to stop transmission of pulmonary tuberculosis in adults [3, 4].
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.02414-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Maternal nutrition and child respiratory outcomes: paradigms of lung
           health and disease
    • Authors: Hanson, C; Brigham, E.
      Pages: 1902437 - 1902437
      Abstract: Given the large public health burden of obstructive lung diseases, such as asthma and COPD, considerable research has been conducted to identify targeted interventional strategies, with nutrition and dietary intake receiving increasing amounts of attention. Diets rich in antioxidants and omega-3 fatty acids, and low in saturated fats and processed foods (i.e. the Mediterranean diet) have been proposed as "respiratory healthy" diets, possibly attenuating the inflammatory response and potentially protecting against disease incidence, prevalence, and morbidity [1–5].
      Keywords: Paediatric pulmonology
      PubDate: 2020-03-12T01:05:23-07:00
      DOI: 10.1183/13993003.02437-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Demystifying morphomolecular alterations of vasculature in interstitial
           lung diseases
    • Authors: Yanagihara, T; Jones, K. D.
      Pages: 1902446 - 1902446
      Abstract: Interstitial lung diseases (ILDs) encompass a complex group of hundreds of lung disorders that affect lung tissue with variable morphologies and clinical presentations. The most extensively studied type of ILD is idiopathic pulmonary fibrosis (IPF), which is characterised by progressive pulmonary fibrosis, a decline in lung function, and high mortality with a histological pattern of usual interstitial pneumonia (UIP). A proportion of patients with other types of ILD also develop a progressive fibrosing phenotype, including idiopathic nonspecific interstitial pneumonia (NSIP), as well as restrictive allograft syndrome (RAS) and idiopathic pleuroparenchymal fibroelastosis (iPPFE) with a histological pattern of alveolar fibroelastosis (AFE). RAS is a novel form of chronic lung allograft dysfunction first described in 2011 [1].
      PubDate: 2020-03-12T01:05:23-07:00
      DOI: 10.1183/13993003.02446-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Small airways and early origins of COPD: pathobiological and
           epidemiological considerations
    • Authors: Polverino, F; Soriano, J. B.
      Pages: 1902457 - 1902457
      Abstract: Until recently, the conceptual model of the natural history of COPD has been greatly focused on an accelerated decline of lung function, which would occur in adult life in susceptible individuals when chronically exposed to environmental noxious agents, such as cigarette smoke and other inhaled gases. However, 25%–45% of all COPD patients worldwide have never smoked [1]. In addition, pre- and peri-natal factors associated with diverse biological mechanisms can determine low lung function in young adults [2–4]. Among these factors, asthma and active and/or passive smoking act synergistically to affect early lung function deficits in young adulthood [5, 6]. The impact of smoke exposure in susceptible smokers is detectable with exposures to as little as 8–10 pack-years, in their late 30 s to early 40 s [7]. Similarly, early onset asthma is observed in 26% of those diagnosed with COPD at a mean age of 37 years, which represents a 20-fold increased risk of adult airway obstruction compared with those without asthma diagnosis [8]. However, what the combined effects of current active smoking and asthma are in a population of young adults is unknown.
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.02457-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Avoiding immortal time bias in observational studies
    • Authors: Raymakers, A. J. N; Sadatsafavi, M, Sin, D. D, FitzGerald, J. M, Marra, C. A, Lynd, L. D.
      Pages: 1902494 - 1902494
      Abstract: We read with interest the recent study by Suissa et al. [1] published in the European Respiratory Journal. The study used population-based administrative data from the province of Quebec, Canada, to evaluate the association between inhaled corticosteroid (ICS) exposure and lung cancer risk in patients with COPD. The results of the study indicated that ICS use was not associated with lung cancer risk in this patient population.
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.02494-2019
      Issue No: Vol. 55, No. 3 (2020)
  • "Functional ageing in fibrotic interstitial lung disease: the impact of
           frailty on adverse health outcomes." Sabina A. Guler, Joanne M. Kwan,
           Janice M. Leung, Nasreen Khalil, Pearce G. Wilcox and Christopher J.
           Ryerson. Eur Respir J 2020; 55: 1900647.
    • Pages: 1950647 - 1950647
      Abstract: Figures 1 and 2 in this article were published with the incorrect frailty index definitions for "frail" and "non-frail" subjects (in the key to the figures). Frail subjects were incorrectly defined as those with frailty index ≤0.21, and non-frail subjects with frailty index>0.21. The correct definitions of frail and non-frail subjects are those with frailty index>0.21 and ≤0.21, respectively, as presented in the amended figures below.
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.50647-2019
      Issue No: Vol. 55, No. 3 (2020)
  • Treatable traits: a step closer to the "holy grail" of asthma control'
    • Authors: Busse; W. W.
      Pages: 2000002 - 2000002
      Abstract: Gaining optimal disease control remains a major unmet need for many patients with asthma [1]. Although progress in disease control has occurred with modifications to current guidelines and with newly available biologics, this unmet need is particularly problematic in severe asthma [2].
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.00002-2020
      Issue No: Vol. 55, No. 3 (2020)
  • Avoiding ageism and promoting independence from reference equations in
           lung function testing of older adults
    • Authors: Hegendörfer, E; Degryse, J.-M.
      Pages: 2000033 - 2000033
      Abstract: We read with great interest the paper on relative and absolute lung function change in a general population aged 62–102 years in the region of Skåne, Sweden [1], since lung function research in the growing age group of older adults, especially those ≥80 years old, is indeed limited [2, 3].
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.00033-2020
      Issue No: Vol. 55, No. 3 (2020)
  • Outcomes consequent to "early" COPD for interventional studies
    • Authors: Colak, Y; Nordestgaard, B. G, Vestbo, J, Lange, P, Afzal, S.
      Pages: 2000073 - 2000073
      Abstract: We thank S.I. Rennard for the interest in our study. We observed that individuals with chronic respiratory symptoms and normal spirometry had an increased risk of hospitalisations and death due to respiratory disease [1]. S.I. Rennard was particularly interested in estimating the sample size required for an intervention trial in individuals with early COPD based on the outcomes used in our study. Since COPD develops gradually over many years [2], identification of younger adults at high risk of developing COPD could lead to implementation of preventive measures before disease onset and thereby halt progression to improve long-term prognosis [3–5]. However, attempts to alter the natural history of COPD have mainly focused on lung function decline and development of chronic airflow limitation, rather than clinical outcomes such as respiratory hospitalisations or death.
      PubDate: 2020-03-12T01:05:23-07:00
      DOI: 10.1183/13993003.00073-2020
      Issue No: Vol. 55, No. 3 (2020)
  • The CICERO (Collaboration In COPD ExaceRbatiOns) Clinical Research
    • Authors: Janssens, W; Bafadhel, M, Chairs of the CICERO Clinical Research Collaboration
      Pages: 2000079 - 2000079
      Abstract: Marcus Tullius Cicero was a famous Roman (b. 106 BC) with enterprise in politics, philosophy and oration. Cicero was recognised as a forefather of modernising Latin and Latin prose and for providing the building blocks of many European languages. His most famous of works De Officis was the second book to be printed in Europe after the Gutenberg Bible (c1455), establishing his relevance to both the European and global community. One of Cicero's most famous quotes is "Quousque tandem abutere, patientia nostra" said to Lucius Sergius Catilina (b. 108 BC) upon exposure of the plot to overthrow Rome (c. 63 BC). "When, do you mean to stop abusing our patience", the translation of Cicero's most famous quote, is highly relevant when pointing to the necessity and urgency of this new Clinical Research Collaboration (CRC).
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.00079-2020
      Issue No: Vol. 55, No. 3 (2020)
  • Systemic potency of fluticasone in asthma
    • Authors: Lipworth, B; Kuo, C. R, Chan, R.
      Pages: 2000104 - 2000104
      Abstract: We read with interest the data from Maijers et al. [1], suggesting that in a post hoc analysis of trials in oral corticosteroid (OC)-dependent asthma, the majority of the OC-sparing effects of high-dose inhaled corticosteroids are due to their systemic effects. The meta-regression estimates showed a prednisone (Pred) decrease of 4.9 mg per 1.0 mg increase in fluticasone propionate (FP) dose. This was based on the premise from an analysis of two studies where 1.0 mg FP was equivalent to 5.0 mg Pred for cortisol suppression, although this was only calculated in reference to a 10 mg dose of Pred. A ratio of 1.02 was then inferred for the proportion of the OC-sparing effect due to systemic absorption of FP.
      PubDate: 2020-03-05T02:07:04-08:00
      DOI: 10.1183/13993003.00104-2020
      Issue No: Vol. 55, No. 3 (2020)
  • Tips for success in pulmonary hypertension treatment: progress in
           isolating endothelial cells from pulmonary artery catheters
    • Authors: Frump, A. L; Lahm, T.
      Pages: 2000122 - 2000122
      Abstract: Pulmonary arterial hypertension (PAH) is a rare but deadly cardiopulmonary disease, which has an unclear and multifactorial pathobiology [1]. Unfortunately, despite availability of 13 Food and Drug Administration-approved therapeutic interventions, the 5-year survival rate is just 21–64% [2]. An important clinical need exists to better understand the molecular mechanisms that lead to PAH development. In addition, a growing interest exists in the use of personalised medicine approaches for PAH, since such a strategy is meritorious in other proliferative diseases, such as cancer [3, 4].
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.00122-2020
      Issue No: Vol. 55, No. 3 (2020)
  • Avoiding immortal time bias in observational studies
    • Authors: Suissa, S; Ernst, P.
      Pages: 2000138 - 2000138
      Abstract: We thank A.J.N. Raymakers and co-workers for their letter, which clarifies the method of data analysis used in their study of the association between inhaled corticosteroids (ICS) and lung cancer incidence in COPD [1]. Indeed, as shown by the computing code they provide, the data analysis did consider ICS use as a time-dependent exposure, thus avoiding immortal time bias.
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.00138-2020
      Issue No: Vol. 55, No. 3 (2020)
  • Suboptimal CPAP adherence: half a loaf is better than no bread at all
    • Authors: Billings, M. E; Levy, P, Ayas, N.
      Pages: 2000144 - 2000144
      Abstract: Positive airway pressure (PAP) is the most effective therapy for obstructive sleep apnoea (OSA), a condition affecting an estimated 936 million adults worldwide [1]. Adequate PAP adherence has been defined as 4 h of average use in most research studies. Many US insurance carriers and national payers, including the Centers for Medicaid and Medicare Services (CMS), determine coverage of PAP and supplies based on this metric. If Medicare patients do not meet the threshold of 4 h per night for 70% of nights, their PAP may be confiscated in the USA [2]. This policy may have detrimental consequences for Medicare beneficiaries with OSA [3]. In France, however, a 3-h average use is required for PAP coverage, established more than 20 years ago as a legal minimal usage not corresponding to any physiological threshold.
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.00144-2020
      Issue No: Vol. 55, No. 3 (2020)
  • In addition to mTOR and JAK/STAT, NLRP3 inflammasome is another key
           pathway activated in sarcoidosis
    • Authors: Riteau, N; Bernaudin, J.-F.
      Pages: 2000149 - 2000149
      Abstract: Sarcoidosis is a rare "old disease" first described over a century ago, known as a multifaceted systemic multiorgan inflammatory granulomatosis characterised by the presence of non-necrotising epithelioid granulomas [1, 2]. In many ways sarcoidosis remains a mysterious disease with numerous unsolved knowledge gaps. The still unknown aetiology/aetiologies of sarcoidosis is one of these gaps, i.e. the disease develops in genetically predisposed individuals following as-yet-unknown antigen exposure.
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.00149-2020
      Issue No: Vol. 55, No. 3 (2020)
  • Avoiding ageism and promoting independence from reference equations in
           lung function testing of older adults
    • Authors: Luoto, J. A; Pihlsgard, M.
      Pages: 2000172 - 2000172
      Abstract: We thank E. Hegendörfer and J-M. Degryse for their interest and request for clarification regarding the spirometry inclusion criteria of our study as well your suggestions on avenues for future research. As stated in our paper, up to a maximum of eight consecutive breathing manoeuvres were performed with the goal of completing at least three acceptable spirograms [1]. However, there was a minority of subjects who did not manage to perform more than one or two acceptable curves. After closer inspection and communication with the nurses responsible for the spirometries, it became clear that this was mostly an issue for the frail elderly.
      PubDate: 2020-03-26T01:39:01-07:00
      DOI: 10.1183/13993003.00172-2020
      Issue No: Vol. 55, No. 3 (2020)
  • The continued hunt for the elusive standard short regimen for treatment of
           multidrug-resistant tuberculosis
    • Authors: Cegielski, J. P; Nahid, P, Sotgiu, G.
      Pages: 2000224 - 2000224
      Abstract: With three new and three recently repurposed drugs, treatment of multidrug-resistant tuberculosis (MDR-TB) is more hopeful today than at any time since it emerged in the 1980s and 1990s [1–3]. This optimism contrasts starkly with dismal global treatment success rates of 48–56% as reported by the World Health Organization (WHO) in its annual Global Tuberculosis Reports from 2014 to 2019 [4, 5].
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.00224-2020
      Issue No: Vol. 55, No. 3 (2020)
  • More awareness is needed for severe acute respiratory syndrome coronavirus
           2019 transmission through exhaled air during non-invasive respiratory
           support: experience from China
    • Authors: Guan, L; Zhou, L, Zhang, J, Peng, W, Chen, R.
      Pages: 2000352 - 2000352
      Abstract: As of 17 February, 2020, China has 70 635 confirmed cases of coronavirus disease 2019 (COVID-19), including 1772 deaths [1]. Human-to-human spread of the virus via respiratory droplets is currently considered to be the main route of transmission. However, exhaled air dispersion during non-invasive respiratory support may increase the risk of coronavirus transmission, and requires more attention from medical personnel and patients.
      PubDate: 2020-03-20T11:10:03-07:00
      DOI: 10.1183/13993003.00352-2020
      Issue No: Vol. 55, No. 3 (2020)
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Heriot-Watt University
Edinburgh, EH14 4AS, UK
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