Subjects -> MEDICAL SCIENCES (Total: 8359 journals)
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RESPIRATORY DISEASES (102 journals)                     

Showing 1 - 102 of 102 Journals sorted alphabetically
Advances in Respiratory Medicine     Open Access   (Followers: 7)
American Journal of Respiratory and Critical Care Medicine     Full-text available via subscription   (Followers: 253)
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: 16)
Annals of Thoracic Medicine     Open Access   (Followers: 6)
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: 4)
BMJ Open Respiratory Research     Open Access   (Followers: 5)
Breathe     Open Access   (Followers: 4)
Canadian Journal of Respiratory, Critical Care, and Sleep Medicine     Hybrid Journal  
Canadian Respiratory Journal     Open Access   (Followers: 2)
Case Reports in Pulmonology     Open Access   (Followers: 3)
Chest     Full-text available via subscription   (Followers: 100)
Chest Disease Reports     Open Access   (Followers: 2)
Chronic Respiratory Disease     Hybrid Journal   (Followers: 9)
Clinical Lung Cancer     Hybrid Journal   (Followers: 5)
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: 2)
Eurasian Journal of Pulmonology     Open Access  
European Clinical Respiratory Journal     Open Access   (Followers: 3)
European Respiratory Journal     Full-text available via subscription   (Followers: 38)
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: 11)
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: 2)
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: 3)
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: 15)
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: 17)
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: 32)
Therapeutic Advances in Chronic Disease     Open Access   (Followers: 7)
Therapeutic Advances in Respiratory Disease     Open Access   (Followers: 1)
Thorax     Hybrid Journal   (Followers: 37)
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: 38  
  Full-text available via subscription Subscription journal
ISSN (Print) 0903-1936 - ISSN (Online) 1399-3003
Published by European Respiratory Society Homepage  [4 journals]
  • Zoonotic tuberculosis in humans assessed by next-generation sequencing: an
           18-month nationwide study in Lebanon
    • Authors: El Achkar, S; Demanche, C, Osman, M, Rafei, R, Ismail, M. B, Gaudin, C, Duthoy, S, De Matos, F, Yaacoub, H, Pincon, C, Hamze, M, Supply, P.
      Pages: 1900513 - 1900513
      Abstract: The World Health Organization (WHO) and other international organisations, including the Food and Agriculture Organization of the United Nations, the World Organisation for Animal Health and the International Union Against Tuberculosis and Lung Disease recently called for formally assessing and (re)prioritising the burden of zoonotic tuberculosis (TB) in people, due to Mycobacterium bovis [1, 2]. Its global contribution to human TB, otherwise principally caused by Mycobacterium tuberculosis, might be underestimated [2]. Nationally representative prevalence data are virtually non-existent on continents with the highest presumed burdens, i.e. in Africa and Asia [3].
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.00513-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Management of severe asthma: a European Respiratory Society/American
           Thoracic Society guideline
    • Authors: Holguin, F; Cardet, J. C, Chung, K. F, Diver, S, Ferreira, D. S, Fitzpatrick, A, Gaga, M, Kellermeyer, L, Khurana, S, Knight, S, McDonald, V. M, Morgan, R. L, Ortega, V. E, Rigau, D, Subbarao, P, Tonia, T, Adcock, I. M, Bleecker, E. R, Brightling, C, Boulet, L.-P, Cabana, M, Castro, M, Chanez, P, Custovic, A, Djukanovic, R, Frey, U, Frankemölle, B, Gibson, P, Hamerlijnck, D, Jarjour, N, Konno, S, Shen, H, Vitary, C, Bush, A.
      Pages: 1900588 - 1900588
      Abstract: This document provides clinical recommendations for the management of severe asthma. Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the European Respiratory Society/American Thoracic Society Task Force's questions. The evidence was appraised using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and the results were summarised in evidence profiles. The evidence syntheses were discussed and recommendations formulated by a multidisciplinary Task Force of asthma experts, who made specific recommendations on six specific questions. After considering the balance of desirable and undesirable consequences, quality of evidence, feasibility, and acceptability of various interventions, the Task Force made the following recommendations: 1) suggest using anti-interleukin (IL)-5 and anti-IL-5 receptor α for severe uncontrolled adult eosinophilic asthma phenotypes; 2) suggest using a blood eosinophil cut-point ≥150 μL–1 to guide anti-IL-5 initiation in adult patients with severe asthma; 3) suggest considering specific eosinophil (≥260 μL–1) and exhaled nitric oxide fraction (≥19.5 ppb) cut-offs to identify adolescents or adults with the greatest likelihood of response to anti-IgE therapy; 4) suggest using inhaled tiotropium for adolescents and adults with severe uncontrolled asthma despite Global Initiative for Asthma (GINA) step 4–5 or National Asthma Education and Prevention Program (NAEPP) step 5 therapies; 5) suggest a trial of chronic macrolide therapy to reduce asthma exacerbations in persistently symptomatic or uncontrolled patients on GINA step 5 or NAEPP step 5 therapies, irrespective of asthma phenotype; and 6) suggest using anti-IL-4/13 for adult patients with severe eosinophilic asthma and for those with severe corticosteroid-dependent asthma regardless of blood eosinophil levels. These recommendations should be reconsidered as new evidence becomes available.
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.00588-2019
      Issue No: Vol. 55, No. 1 (2020)
  • A spatially restricted fibrotic niche in pulmonary fibrosis is sustained
           by M-CSF/M-CSFR signalling in monocyte-derived alveolar macrophages
    • Authors: Joshi, N; Watanabe, S, Verma, R, Jablonski, R. P, Chen, C.-I, Cheresh, P, Markov, N. S, Reyfman, P. A, McQuattie-Pimentel, A. C, Sichizya, L, Lu, Z, Piseaux-Aillon, R, Kirchenbuechler, D, Flozak, A. S, Gottardi, C. J, Cuda, C. M, Perlman, H, Jain, M, Kamp, D. W, Budinger, G. R. S, Misharin, A. V.
      Pages: 1900646 - 1900646
      Abstract: Ontologically distinct populations of macrophages differentially contribute to organ fibrosis through unknown mechanisms.We applied lineage tracing, single-cell RNA sequencing and single-molecule fluorescence in situ hybridisation to a spatially restricted model of asbestos-induced pulmonary fibrosis.We demonstrate that tissue-resident alveolar macrophages, tissue-resident peribronchial and perivascular interstitial macrophages, and monocyte-derived alveolar macrophages are present in the fibrotic niche. Deletion of monocyte-derived alveolar macrophages but not tissue-resident alveolar macrophages ameliorated asbestos-induced lung fibrosis. Monocyte-derived alveolar macrophages were specifically localised to fibrotic regions in the proximity of fibroblasts where they expressed molecules known to drive fibroblast proliferation, including platelet-derived growth factor subunit A. Using single-cell RNA sequencing and spatial transcriptomics in both humans and mice, we identified macrophage colony-stimulating factor receptor (M-CSFR) signalling as one of the novel druggable targets controlling self-maintenance and persistence of these pathogenic monocyte-derived alveolar macrophages. Pharmacological blockade of M-CSFR signalling led to the disappearance of monocyte-derived alveolar macrophages and ameliorated fibrosis.Our findings suggest that inhibition of M-CSFR signalling during fibrosis disrupts an essential fibrotic niche that includes monocyte-derived alveolar macrophages and fibroblasts during asbestos-induced fibrosis.
      Keywords: Interstitial and orphan lung disease
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.00646-2019
      Issue No: Vol. 55, No. 1 (2020)
  • European Respiratory Society guideline on long-term management of children
           with bronchopulmonary dysplasia
    • Authors: Duijts, L; van Meel, E. R, Moschino, L, Baraldi, E, Barnhoorn, M, Bramer, W. M, Bolton, C. E, Boyd, J, Buchvald, F, del Cerro, M. J, Colin, A. A, Ersu, R, Greenough, A, Gremmen, C, Halvorsen, T, Kamphuis, J, Kotecha, S, Rooney-Otero, K, Schulzke, S, Wilson, A, Rigau, D, Morgan, R. L, Tonia, T, Roehr, C. C, Pijnenburg, M. W.
      Pages: 1900788 - 1900788
      Abstract: This document provides recommendations for monitoring and treatment of children in whom bronchopulmonary dysplasia (BPD) has been established and who have been discharged from the hospital, or who were>36 weeks of postmenstrual age. The guideline was based on predefined Population, Intervention, Comparison and Outcomes (PICO) questions relevant for clinical care, a systematic review of the literature and assessment of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. After considering the balance of desirable (benefits) and undesirable (burden, adverse effects) consequences of the intervention, the certainty of the evidence, and values, the task force made conditional recommendations for monitoring and treatment of BPD based on very low to low quality of evidence. We suggest monitoring with lung imaging using ionising radiation in a subgroup only, for example severe BPD or recurrent hospitalisations, and monitoring with lung function in all children. We suggest to give individual advice to parents regarding daycare attendance. With regards to treatment, we suggest the use of bronchodilators in a subgroup only, for example asthma-like symptoms, or reversibility in lung function; no treatment with inhaled or systemic corticosteroids; natural weaning of diuretics by the relative decrease in dose with increasing weight gain if diuretics are started in the neonatal period; and treatment with supplemental oxygen with a saturation target range of 90–95%. A multidisciplinary approach for children with established severe BPD after the neonatal period into adulthood is preferable. These recommendations should be considered until new and urgently needed evidence becomes available.
      Keywords: Paediatric pulmonology
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.00788-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Prognostic factors associated with long-term mortality in 1445 patients
           with nontuberculous mycobacterial pulmonary disease: a 15-year follow-up
    • Authors: Jhun, B. W; Moon, S. M, Jeon, K, Kwon, O. J, Yoo, H, Carriere, K. C, Huh, H. J, Lee, N. Y, Shin, S. J, Daley, C. L, Koh, W.-J.
      Pages: 1900798 - 1900798
      Abstract: Limited data are available regarding the prognostic factors for patients with nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated the prognostic factors associated with long-term mortality in NTM-PD patients after adjusting for individual confounders, including aetiological organism and radiological form.A total of 1445 patients with treatment-naïve NTM-PD who were newly diagnosed between July 1997 and December 2013 were included. The aetiological organisms were as follows: Mycobacterium avium (n=655), M. intracellulare (n=487), M. abscessus (n=129) and M. massiliense (n=174). The factors associated with mortality in NTM-PD patients were analysed using a multivariable Cox model after adjusting for demographic, radiological and aetiological data.The overall 5-, 10- and 15-year cumulative mortality rates for the NTM-PD patients were 12.4%, 24.0% and 36.4%, respectively. On multivariable analysis, the following factors were significantly associated with mortality in NTM-PD patients: old age, male sex, low body mass index, chronic pulmonary aspergillosis, pulmonary or extrapulmonary malignancy, chronic heart or liver disease and erythrocyte sedimentation rate. The aetiological organism was also significantly associated with mortality: M. intracellulare had an adjusted hazard ratio (aHR) of 1.40, 95% CI 1.03–1.91; M. abscessus had an aHR of 2.19, 95% CI 1.36–3.51; and M. massiliense had an aHR of 0.99, 95% CI 0.61–1.64, compared to M. avium. Mortality was also significantly associated with the radiological form of NTM-PD for the cavitary nodular bronchiectatic form (aHR 1.70, 95% CI 1.12–2.59) and the fibrocavitary form (aHR 2.12, 95% CI 1.57–3.08), compared to the non-cavitary nodular bronchiectatic form.Long-term mortality in patients with NTM-PD was significantly associated with the aetiological NTM organism, cavitary disease and certain demographic characteristics.
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.00798-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Systems biology and big data in asthma and allergy: recent discoveries and
           emerging challenges
    • Authors: Tang, H. H. F; Sly, P. D, Holt, P. G, Holt, K. E, Inouye, M.
      Pages: 1900844 - 1900844
      Abstract: Asthma is a common condition caused by immune and respiratory dysfunction, and it is often linked to allergy. A systems perspective may prove helpful in unravelling the complexity of asthma and allergy. Our aim is to give an overview of systems biology approaches used in allergy and asthma research. Specifically, we describe recent "omic"-level findings, and examine how these findings have been systematically integrated to generate further insight.Current research suggests that allergy is driven by genetic and epigenetic factors, in concert with environmental factors such as microbiome and diet, leading to early-life disturbance in immunological development and disruption of balance within key immuno-inflammatory pathways. Variation in inherited susceptibility and exposures causes heterogeneity in manifestations of asthma and other allergic diseases. Machine learning approaches are being used to explore this heterogeneity, and to probe the pathophysiological patterns or "endotypes" that correlate with subphenotypes of asthma and allergy. Mathematical models are being built based on genomic, transcriptomic and proteomic data to predict or discriminate disease phenotypes, and to describe the biomolecular networks behind asthma.The use of systems biology in allergy and asthma research is rapidly growing, and has so far yielded fruitful results. However, the scale and multidisciplinary nature of this research means that it is accompanied by new challenges. Ultimately, it is hoped that systems medicine, with its integration of omics data into clinical practice, can pave the way to more precise, personalised and effective management of asthma.
      PubDate: 2020-01-09T00:05:18-08:00
      DOI: 10.1183/13993003.00844-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Tiotropium add-on therapy reduces seasonal peaks of asthma worsening in
           adults with symptomatic severe asthma
    • Authors: FitzGerald, J. M; Buhl, R, Casale, T. B, Jugovic, B, Zaremba-Pechmann, L, Halpin, D. M. G.
      Pages: 1900964 - 1900964
      Abstract: Despite the use of preferred controller therapies (including inhaled corticosteroids (ICS) with or without additional long-acting β2-agonists (LABAs)), a large proportion of patients with asthma have poor disease control, leaving them at risk of recurring symptoms and episodes of asthma exacerbations and worsening [1, 2]. Such problems can be triggered by many different environmental factors including pollutants, respiratory infections or allergens [3]. They may occur sporadically, but are often determined by the seasons, mirroring seasonal patterns of allergen exposure and prevalence of respiratory viral infection [3, 4].
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.00964-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Peripheral blood leukocyte telomere length is associated with survival of
           sepsis patients
    • Authors: Liu, S; Wang, C, Green, G, Zhuo, H, Liu, K. D, Kangelaris, K. N, Gomez, A, Jauregui, A, Vessel, K, Ke, S, Hendrickson, C, Matthay, M. A, Calfee, C. S, Ware, L. B, Wolters, P. J.
      Pages: 1901044 - 1901044
      Abstract: Shorter peripheral blood leukocyte (PBL) telomere length (TL) has been associated with poor outcomes in various chronic lung diseases. Whether PBL-TL is associated with survival from critical illness was tested in this study.We analysed data from a prospective observational cohort study of 937 critically ill patients at Vanderbilt University Medical Center (VUMC). PBL-TL was measured using quantitative PCR of DNA isolated from PBLs. Findings were validated in an independent cohort of 394 critically ill patients with sepsis admitted to the University of California San Francisco (UCSF).In the VUMC cohort, shorter PBL-TL was associated with worse 90-day survival (adjusted hazard ratio (aHR) 1.3, 95% CI 1.1–1.6 per 1 kb TL decrease; p=0.004); in subgroup analyses, shorter PBL-TL was associated with worse 90-day survival for patients with sepsis (aHR 1.5, 95% CI 1.2–2.0 per 1 kb TL decrease; p=0.001), but not trauma. Although not associated with development of acute respiratory distress syndrome (ARDS), among ARDS subjects, shorter PBL-TL was associated with more severe ARDS (OR 1.7, 95% CI 1.2–2.5 per 1 kb TL decrease; p=0.006). The associations of PBL-TL with survival (adjusted HR 1.6, 95% CI 1.2–2.1 per 1 kb TL decrease; p=0.003) and risk for developing severe ARDS (OR 2.5, 95% CI 1.1–6.3 per 1 kb TL decrease; p=0.044) were validated in the UCSF cohort.Short PBL-TL is strongly associated with worse survival and more severe ARDS in critically ill patients, especially patients with sepsis. These findings suggest that telomere dysfunction may contribute to outcomes from critical illness.
      Keywords: Respiratory infections and tuberculosis, Acute lung injury and critical care
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.01044-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Long-term effect of CFTR modulator therapy on airway nitric oxide
    • Authors: Grasemann, H; Klingel, M, Avolio, J, Prentice, C, Gonska, T, Tullis, E, Ratjen, F.
      Pages: 1901113 - 1901113
      Abstract: The fraction of exhaled nitric oxide (FeNO) is generally lower in individuals with cystic fibrosis (CF), compared to healthy controls. Two recent studies reported that the cystic fibrosis transmembrane conductance regulator (CFTR) potentiator ivacaftor resulted in an increase in FeNO after 4 weeks’ therapy [1, 2], suggesting that changes in FeNO have the potential to serve as biomarker of restored CFTR function.
      PubDate: 2020-01-09T00:05:18-08:00
      DOI: 10.1183/13993003.01113-2019
      Issue No: Vol. 55, No. 1 (2020)
  • ERS guidelines on the diagnosis and treatment of chronic cough in adults
           and children
    • Authors: Morice, A. H; Millqvist, E, Bieksiene, K, Birring, S. S, Dicpinigaitis, P, Domingo Ribas, C, Hilton Boon, M, Kantar, A, Lai, K, McGarvey, L, Rigau, D, Satia, I, Smith, J, Song, W.-J, Tonia, T, van den Berg, J. W. K, van Manen, M. J. G, Zacharasiewicz, A.
      Pages: 1901136 - 1901136
      Abstract: These guidelines incorporate the recent advances in chronic cough pathophysiology, diagnosis and treatment. The concept of cough hypersensitivity has allowed an umbrella term that explains the exquisite sensitivity of patients to external stimuli such a cold air, perfumes, smoke and bleach. Thus, adults with chronic cough now have a firm physical explanation for their symptoms based on vagal afferent hypersensitivity. Different treatable traits exist with cough variant asthma (CVA)/eosinophilic bronchitis responding to anti-inflammatory treatment and non-acid reflux being treated with promotility agents rather the anti-acid drugs. An alternative antitussive strategy is to reduce hypersensitivity by neuromodulation. Low-dose morphine is highly effective in a subset of patients with cough resistant to other treatments. Gabapentin and pregabalin are also advocated, but in clinical experience they are limited by adverse events. Perhaps the most promising future developments in pharmacotherapy are drugs which tackle neuronal hypersensitivity by blocking excitability of afferent nerves by inhibiting targets such as the ATP receptor (P2X3). Finally, cough suppression therapy when performed by competent practitioners can be highly effective. Children are not small adults and a pursuit of an underlying cause for cough is advocated. Thus, in toddlers, inhalation of a foreign body is common. Persistent bacterial bronchitis is a common and previously unrecognised cause of wet cough in children. Antibiotics (drug, dose and duration need to be determined) can be curative. A paediatric-specific algorithm should be used.
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.01136-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Oral steroid-sparing effect of high-dose inhaled corticosteroids in asthma
    • Authors: Maijers, I; Kearns, N, Harper, J, Weatherall, M, Beasley, R.
      Pages: 1901147 - 1901147
      Abstract: BackgroundThe proportion of the efficacy of high-dose inhaled corticosteroids (ICS) in oral corticosteroid-dependent asthma that is due to systemic effects is uncertain. This study aimed to estimate the ICS dose–response relationship for oral corticosteroid-sparing effects in oral corticosteroid-dependent asthma, and to determine the proportion of oral corticosteroid-sparing effects due to their systemic effects, based on the comparative dose–response relationship of ICS versus oral corticosteroids on adrenal suppression.MethodsSystematic review and meta-analysis of randomised controlled trials reporting oral corticosteroid-sparing effects of high-dose ICS in oral corticosteroid-dependent asthma. In addition, reports of oral corticosteroid to ICS dose-equivalence in terms of adrenal suppression were retrieved. The primary outcome was the proportion of the oral corticosteroid-sparing effect of ICS that could be attributed to systemic absorption, per 1000 µg increase of ICS, expressed as a ratio. This ratio estimates the oral corticosteroid sparing effect of ICS due to systemic effects.Results11 studies including 1283 participants reporting oral corticosteroid-sparing effects of ICS were identified. The prednisone dose decrease per 1000 µg increase in ICS varied from 2.1 mg to 4.9 mg, depending on the type of ICS. The ratio of the prednisone-sparing effect due to the systemic effects per 1000 µg of fluticasone propionate was 1.02 (95% CI 0.68–2.08) and for budesonide was 0.93 (95% CI 0.63–1.89).ConclusionIn patients with oral corticosteroid-dependent asthma, the limited available evidence suggests that the majority of the oral corticosteroid-sparing effect of high-dose ICS is likely to be due to systemic effects.
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.01147-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Characteristics and treatment regimens across ERS SHARP severe asthma
    • Authors: van Bragt, J. J. M. H; Adcock, I. M, Bel, E. H. D, Braunstahl, G.-J, ten Brinke, A, Busby, J, Canonica, G. W, Cao, H, Chung, K. F, Csoma, Z, Dahlen, B, Davin, E, Hansen, S, Heffler, E, Horvath, I, Korn, S, Kots, M, Kuna, P, Kwon, N, Louis, R, Plaza, V, Porsbjerg, C, Ramos-Barbon, D, Richards, L. B, Skrgat, S, Sont, J. K, Vijverberg, S. J. H, Weersink, E. J. M, Yasinska, V, Wagers, S. S, Djukanovic, R, Maitland-van der Zee, A. H, on behalf of the SHARP Clinical Research Collaboration
      Pages: 1901163 - 1901163
      Abstract: Little is known about the characteristics and treatments of patients with severe asthma across Europe, but both are likely to vary. This is the first study in the European Respiratory Society Severe Heterogeneous Asthma Research collaboration, Patient-centred (SHARP) Clinical Research Collaboration and it is designed to explore these variations. Therefore, we aimed to compare characteristics of patients in European severe asthma registries and treatments before starting biologicals.This was a cross-sectional retrospective analysis of aggregated data from 11 national severe asthma registries that joined SHARP with established patient databases.Analysis of data from 3236 patients showed many differences in characteristics and lifestyle factors. Current smokers ranged from 0% (Poland and Sweden) to 9.5% (Belgium), mean body mass index ranged from 26.2 (Italy) to 30.6 kg·m–2 (the UK) and the largest difference in mean pre-bronchodilator forced expiratory volume in 1 s % predicted was 20.9% (the Netherlands versus Hungary). Before starting biologicals patients were treated differently between countries: mean inhaled corticosteroid dose ranged from 700 to 1335 µg·day–1 between those from Slovenia versus Poland when starting anti-interleukin (IL)-5 antibody and from 772 to 1344 µg·day–1 in those starting anti-IgE (Slovenia versus Spain). Maintenance oral corticosteroid use ranged from 21.0% (Belgium) to 63.0% (Sweden) and from 9.1% (Denmark) to 56.1% (the UK) in patients starting anti-IL-5 and anti-IgE, respectively.The severe asthmatic population in Europe is heterogeneous and differs in both clinical characteristics and treatment, often appearing not to comply with the current European Respiratory Society/American Thoracic Society guidelines definition of severe asthma. Treatment regimens before starting biologicals were different from inclusion criteria in clinical trials and varied between countries.
      Keywords: Asthma and allergy
      PubDate: 2020-01-09T00:05:18-08:00
      DOI: 10.1183/13993003.01163-2019
      Issue No: Vol. 55, No. 1 (2020)
  • A regimen containing bedaquiline and delamanid compared to bedaquiline in
           patients with drug-resistant tuberculosis
    • Authors: Olayanju, O; Esmail, A, Limberis, J, Dheda, K.
      Pages: 1901181 - 1901181
      Abstract: There are limited data on combining delamanid and bedaquiline in drug-resistant tuberculosis (DR-TB) regimens. Prospective long-term outcome data, including in HIV-infected persons, are unavailable.We prospectively followed up 122 South African patients (52.5% HIV-infected) with DR-TB and poor prognostic features between 2014 and 2018. We examined outcomes and safety in those who received a bedaquiline-based regimen (n=82) compared to those who received a bedaquiline–delamanid combination regimen (n=40).There was no significant difference in 6-month culture conversion (92.5% versus 81.8%; p=0.26) and 18-month favourable outcome rate (63.4% versus 67.5%; p=0.66) in the bedaquiline versus the bedaquiline–delamanid combination group, despite the latter having more advanced drug resistance (3.7% versus 22.5% resistant to at least five drugs; p=0.001) and higher pre-treatment failure rates (12.2% versus 52.5% with pre-treatment multidrug-resistant TB therapy failure; p
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.01181-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Trajectory and mortality of preserved ratio impaired spirometry: the
           Rotterdam Study
    • Authors: Wijnant, S. R. A; De Roos, E, Kavousi, M, Stricker, B. H, Terzikhan, N, Lahousse, L, Brusselle, G. G.
      Pages: 1901217 - 1901217
      Abstract: Preserved ratio impaired spirometry (PRISm) is a heterogeneous condition but its course and disease progression remain to be elucidated. We aimed to examine its prevalence, trajectories and prognosis in the general population.In the Rotterdam Study (population-based prospective cohort) we examined prevalence, trajectories and prognosis of subjects with normal spirometry (controls; forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.7, FEV1 ≥80%), PRISm (FEV1/FVC ≥0.7, FEV1
      Keywords: Lung structure and function
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.01217-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Preliminary validation of the NTM Module: a patient-reported outcome
           measure for patients with pulmonary nontuberculous mycobacterial disease
    • Authors: Henkle, E; Winthrop, K. L, Ranches, G. P, Plinke, W, Litvin, H. K, Quittner, A. L.
      Pages: 1901300 - 1901300
      Abstract: IntroductionNontuberculous mycobacteria (NTM) cause chronic, debilitating pulmonary disease. Patient-reported outcomes provide measures of symptoms, functioning and treatment response. Here we describe the preliminary validation of the recently developed NTM Module.MethodsThe study population included Northwest NTM Biobank patients in whom Mycobacterium avium complex (MAC) was isolated and who had ever met the 2007 American Thoracic Society/Infectious Diseases Society of America pulmonary disease criteria. The NTM Module was administered at enrolment and 12 months; a subset also completed the Quality of Life Questionnaire–Bronchiectasis (QOL-B). The NTM Module generates four domain scores (0–100; higher scores indicate better functioning) reflecting NTM-specific symptoms (NTM Symptoms, Body Image, Digestive Symptoms and Eating Problems). We described patient characteristics and mean scores, and evaluated psychometric properties, including response to treatment at 12 months, for each domain.ResultsOverall, 203 patients with pulmonary MAC disease were included. Average enrolment scores ranged from 76 (NTM Symptoms) to 84 (Eating Problems). Ceiling effects were observed for Body Image (26% of participants) and Eating Problems (52%). Internal consistency (Cronbach's alpha) ranged from 0.67 (Digestive Symptoms) to 0.89 (Eating Problems). The intraclass correlation for test–retest reproducibility (n=27) ranged from 0.72 (Body Image) to 0.94 (Eating Problems). Patients starting treatment (n=35) had statistically significant increases in scores for NTM Symptoms (+5, p=0.04), Digestive Symptoms (+7, p=0.002), Body Image (+7, p=0.03) and QOL-B Respiratory Symptoms (n=25, +10, p=0.006). NTM Symptoms scores increased by 15 points (p=0.002) in the 16 patients with scores ≤80 at enrolment.ConclusionThe NTM Module generally performs well as a valid patient-reported outcome for pulmonary MAC disease and was responsive to MAC treatment.
      Keywords: Respiratory infections and tuberculosis
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.01300-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Bilateral hypoglossal nerve stimulation for treatment of adult obstructive
           sleep apnoea
    • Authors: Eastwood, P. R; Barnes, M, MacKay, S. G, Wheatley, J. R, Hillman, D. R, Nguyen, X.-L, Lewis, R, Campbell, M. C, Petelle, B, Walsh, J. H, Jones, A. C, Palme, C. E, Bizon, A, Meslier, N, Bertolus, C, Maddison, K. J, Laccourreye, L, Raux, G, Denoncin, K, Attali, V, Gagnadoux, F, Launois, S. H.
      Pages: 1901320 - 1901320
      Abstract: Background and aimHypoglossal nerve stimulation (HNS) decreases obstructive sleep apnoea (OSA) severity via genioglossus muscle activation and decreased upper airway collapsibility. This study assessed the safety and effectiveness at 6 months post-implantation of a novel device delivering bilateral HNS via a small implanted electrode activated by a unit worn externally, to treat OSA: the Genio™ system.MethodsThis prospective, open-label, non-randomised, single-arm treatment study was conducted at eight centres in three countries (Australia, France and the UK). Primary outcomes were incidence of device-related serious adverse events and change in the apnoea–hypopnoea index (AHI). The secondary outcome was the change in the 4% oxygen desaturation index (ODI). Additional outcomes included measures of sleepiness, quality of life, snoring and device use. This trial was registered with, number NCT03048604.Results22 out of 27 implanted participants (63% male, aged 55.9±12.0 years, body mass index (BMI) 27.4±3.0 kg·m–2) completed the protocol. At 6 months BMI was unchanged (p=0.85); AHI decreased from 23.7±12.2 to 12.9±10.1 events·h–1, a mean change of 10.8 events·h–1 (p5 h per night. No device-related serious adverse events occurred during the 6-month post-implantation period.ConclusionsBilateral HNS using the Genio™ system reduces OSA severity and improves quality of life without device-related complications. The results are comparable with previously published HNS systems despite minimal implanted components and a simple stimulation algorithm.
      Keywords: Sleep medicine
      PubDate: 2020-01-09T00:05:18-08:00
      DOI: 10.1183/13993003.01320-2019
      Issue No: Vol. 55, No. 1 (2020)
  • ICS-formoterol reliever therapy stepwise treatment algorithm for adult
    • Authors: Beasley, R; Braithwaite, I, Semprini, A, Kearns, C, Weatherall, M, Harrison, T. W, Papi, A, Pavord, I. D.
      Pages: 1901407 - 1901407
      Abstract: A stepwise approach to the pharmacological treatment of asthma is a key feature of current asthma guidelines [1–4]. Through algorithms, treatment intensity is "stepped up" to obtain asthma control and reduce the risk of exacerbations, and "stepped down" after a period of prolonged control and absence of exacerbations. Traditional algorithms advocated short-acting β2-agonist (SABA) reliever therapy for all levels of severity, initially as sole therapy at Step 1, together with maintenance "low dose" inhaled corticosteroids (ICS) at Step 2, with maintenance ICS/long-acting β2-agonist (LABA) at "low", "moderate" or "high" doses at Steps 3 and 4, and finally with "add-on" therapies at Step 5.
      PubDate: 2020-01-09T00:05:18-08:00
      DOI: 10.1183/13993003.01407-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Primary ciliary dyskinesia patients have the same P. aeruginosa clone in
           sinuses and lungs
    • Authors: Arndal, E; Johansen, H. K, Haagensen, J. A. J, Bartell, J. A, Marvig, R. L, Alanin, M, Aanaes, K, Hoiby, N, Nielsen, K. G, Backer, V, von Buchwald, C.
      Pages: 1901472 - 1901472
      Abstract: Similar to patients with cystic fibrosis (CF) and non-CF bronchiectasis, patients with primary ciliary dyskinesia (PCD) are prone to recurrent or chronic lung infections with Pseudomonas aeruginosa. Chronic P. aeruginosa lung infection has a prevalence of up to 39% in patients with PCD [1] and is associated with structural damage, affecting lung function. Treatment of P. aeruginosa infection is challenging because P. aeruginosa adapts to the host environment through genotypic/phenotypic changes, promoting a reduced immune response [2].
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.01472-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Obstructive sleep apnoea severity and liver steatosis measured by magnetic
           resonance imaging
    • Authors: Trzepizur, W; Boursier, J, Berrehare, A, Le Vaillant, M, Andriantsitohaina, R, Ducluzeau, P.-H, Dubois, S, Henni, S, Abraham, P, Cales, P, Aube, C, Paisant, A, Gagnadoux, F, on the behalf of the METABOL group
      Pages: 1901514 - 1901514
      Abstract: Obstructive sleep apnoea (OSA) and non-alcoholic fatty liver disease (NAFLD) are two of many diseases associated with obesity. NAFLD is a common condition ranging in severity from liver steatosis to non-alcoholic steatohepatitis and liver fibrosis, the last step of NAFLD progression. Numerous studies have investigated whether the frequent co-occurrence of OSA and NAFLD simply reflects their link to obesity, or whether there is an independent pathophysiological interconnection between the two diseases (see [1] for comprehensive review). In animal models, intermittent hypoxia mimicking OSA has been shown to cause insulin resistance, dysfunction of key steps in hepatic lipid metabolism, liver steatosis and fibrosis [1].
      PubDate: 2020-01-09T00:05:18-08:00
      DOI: 10.1183/13993003.01514-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Can animal models really teach us anything about pneumonia' Con
    • Authors: Metersky, M; Waterer, G.
      Pages: 1901525 - 1901525
      Abstract: In their 1987 community-acquired pneumonia (CAP) guidelines, the British Thoracic Society recommended amoxicillin with or without erythromycin (or tetracycline) in all admitted patients, with the coverage for Legionella being mandatory in seriously ill patients [1]. They also recommended intravenous flucloxacillin when Staphylococcus aureus was suspected and gentamicin or ceftazidime if a Gram-negative agent was suspected. This guideline, now more than 30 years old, also emphasised the need to identify critically ill patients based on objective physiological criteria so they could receive intensive care support, recommended obtaining culture specimens when possible and stated that antibiotics should be started immediately upon diagnosis. All of these 1987 recommendations were based on clinical studies on the aetiology of pneumonia, analysis of the predictors of outcome from pneumonia from clinical studies and a series of observational studies comparing outcomes of different antibiotic regimens in the prior three decades.
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.01525-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Can animal models really teach us anything about pneumonia' Pro
    • Authors: Orihuela, C. J; Maus, U. A, Brown, J. S.
      Pages: 1901539 - 1901539
      Abstract: Despite highly effective antibiotics and intensive care support, the mortality associated with pneumonia has not substantially decreased since the 1960s [1]. Hence, there remains a major requirement for improved treatment and preventative strategies, which will need new knowledge on the pathogenesis of pneumonia. Animal models have obvious high value when investigating the molecular mechanisms involved in pneumonia pathogenesis, but they are also directly relevant for clinically orientated research into new therapies and vaccines, complications of pneumonia, and identifying high risk groups. In this article we describe how research using animal models will be essential if we are to reduce the immense morbidity and mortality associated with pneumonia.
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.01539-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Current challenges in the management of nonsmall cell lung cancer brain
    • Authors: Hendriks, L. E. L; Cadranel, J, Berghmans, T.
      Pages: 1901686 - 1901686
      Abstract: In May 2019, the third European Respiratory Society research seminar of the Thoracic Oncology Assembly entitled "New biomarkers, molecules and therapeutic sequences for non-small cell lung carcinoma (NSCLC) in the era of precision medicine" was held in Paris, France. The previous two seminars of the Thoracic Oncology Assembly were on targeted therapy (2015) [1] and immune checkpoint inhibitors (ICI, 2017) [2]. During this seminar, breakout sessions on difficult situations were organised. One of the most original and useful was on the current challenges in brain metastases (BM) management, that we propose to share with European Respiratory Journal readers.
      Keywords: Lung cancer
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.01686-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Latent tuberculosis infection among minor asylum seekers in Denmark
    • Authors: Ahmad, B. B; Kristensen, K. L, Glenthoej, J. P, Poulsen, A, Bryld, A.-G, Huber, F. G, Andersen, E. M, Ravn, P.
      Pages: 1901688 - 1901688
      Abstract: We read with interest the study by Wolters et al. [1], reporting the results of radiographic tuberculosis (TB) entry screening of asylum seekers in the Netherlands. We agree with the authors that we lack sufficient studies concerning latent TB infection (LTBI) screening among minor asylum seekers, and we present our study investigating LTBI prevalence and the coverage of follow-up in terms of clinical evaluation and treatment of LTBI among minor asylum seekers arriving in Denmark.
      PubDate: 2020-01-09T00:05:18-08:00
      DOI: 10.1183/13993003.01688-2019
      Issue No: Vol. 55, No. 1 (2020)
  • What kind of emphasis do we need in clinical research to enable
           personalised respiratory medicine'
    • Authors: Gonda; I.
      Pages: 1901866 - 1901866
      Abstract: The manifesto proposed by Roche et al. [1] is a most important plan to revolutionise respiratory clinical research.It also prompts a key question about the balance between the effort spent on randomised clinical trials (RCTs) versus real-life research (RLR), particularly in an era where frequent monitoring of patients capturing their real life, using wearable devices, home diagnostics, smartphones, smart inhalers, collections of contextual information, cloud connectivity and the ability to analyse large complex datasets is becoming increasingly feasible [2].
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.01866-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Prognostic significance of chronic respiratory symptoms in individuals
           with normal spirometry
    • Authors: Hamad, G; Rigby, A, Morice, A. H.
      Pages: 1902093 - 1902093
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.02093-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Size matters! Peripheral blood leukocyte telomere length and survival
           after critical illness
    • Authors: Mayr, F. B; Yende, S.
      Pages: 1902114 - 1902114
      Abstract: In 2009, Elizabeth Blackburn, Jack Szostak and Carol Greider were awarded the Nobel Prize in Physiology or Medicine for their pioneering work that led to the discovery of telomeres and the enzyme complex telomerase responsible for maintaining its structure [1]. Over the past four decades, the classic view of telomeres protecting the natural ends of linear chromosomes and telomerase as telomere-terminal transferase necessary for the replication of chromosome ends has significantly evolved. Many diverse fields have matured, including the discovery of key molecular components of telomerase, implications for limits to cellular replication, and identification and characterisation of human genetic disorders that result in premature telomere shortening [2].
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.02114-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Integrating high dose inhaled corticosteroids into oral corticosteroids
    • Authors: Bourdin, A; Suehs, C, Charriot, J.
      Pages: 1902193 - 1902193
      Abstract: Uncertainties still surround high dose inhaled corticosteroids (ICS) use in asthma. In hindsight, certain aspects of the ICS development story can help elucidate why. In 1973, Cameron et al. [1] signed a brilliant paper reporting the results of a double blind, randomised controlled trial demonstrating the oral corticosteroid (OCS)-sparing effect of ICS as the primary outcome. A few years later, the assessment of this benefit was mitigated when a complete weaning of OCS remained unachievable [2]. The benefit of ICS was therefore understood to be mostly based on an improved safety profile purportedly due to reduced systemic diffusion. Thus, the understanding of how ICS was of any benefit to asthma patients when compared to OCS was mostly based on a greater safety profile supposedly due to a reduced systemic diffusion. Similarly, topically administered corticosteroids were also developed in the same time period for diseases affecting the skin, the eyes, the nose or the joints. As for ICS, whether or not these formulations reduce corticosteroid-associated adverse events remains largely debated [3].
      Keywords: Asthma and allergy
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.02193-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Patient reported outcomes for non-tuberculous mycobacterial disease
    • Authors: Loebinger, M. R; Birring, S. S.
      Pages: 1902204 - 1902204
      Abstract: The morbidity and mortality from non-tuberculous mycobacterial (NTM) disease is increasing [1]. Treatment of NTM usually requires multidrug regimens and is often associated with poor tolerability, significant side-effects and high failure rates. Not all patients with pulmonary NTM disease need treatment, and deciding who and when to treat can be challenging. The management of NTM is significantly hampered by the lack of reliable and responsive biomarkers to assess disease activity, progression and response to therapy, and at present, clinical decisions are made with a combination of symptom, radiology and microbiological assessments. There is a pressing need for new therapies and approaches for pulmonary NTM disease, and this will require robust clinical endpoints to evaluate them.
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.02204-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Looking at the COPD spectrum through "PRISm"
    • Authors: Adibi, A; Sadatsafavi, M.
      Pages: 1902217 - 1902217
      Abstract: COPD is a major burden globally. According to the Global Burden of Disease study, COPD caused 3.2 million deaths in 2015, accounting for 5% of all deaths worldwide, making it the third leading cause of death in the world [1]. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) defines spirometrically confirmed COPD based on a forced expiratory volume during the first second (FEV1) to a forced vital capacity (FVC) ratio smaller than 0.7 [2]. The severity of airflow obstruction is further defined through GOLD severity grades based on the ratio of FEV1 to its predicted value, with GOLD 1, 2, 3 and 4 defined around cut-off points of 80%, 50%, and 30% [2].
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.02217-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Prognostic significance of chronic respiratory symptoms in individuals
           with normal spirometry
    • Authors: Colak, Y; Afzal, S.
      Pages: 1902226 - 1902226
      PubDate: 2020-01-02T00:05:16-08:00
      DOI: 10.1183/13993003.02226-2019
      Issue No: Vol. 55, No. 1 (2020)
  • Connected real-life research, a pillar of P4 medicine
    • Authors: Roche, N; Anzueto, A, Bosnic Anticevich, S, Kaplan, A, Miravitlles, M, Ryan, D, Soriano, J. B, Usmani, O, Papadopoulos, N, Canonica, G. W.
      Pages: 1902287 - 1902287
      Abstract: We thank I. Gonda for outlining the promises and challenges of real-life research (RLR), following the publication of the Respiratory Effectiveness Group manifesto in the European Respiratory Journal [1]. As outlined in this correspondence, the ultimate goal of RLR is to improve patients' outcomes through more precise decision-making in the current era of personalised medicine. To this aim, RLR provides evidence complementing randomised controlled trials (RCTs), especially exploring benefit–risk–cost ratios in both large and specific subpopulations, while minimising the Hawthorne effect. I. Gonda underlines a particularly important aspect of RLR, i.e. how it can be revolutionised by new technologies. This is especially promising in the respiratory field, where therapy administered with inhalation devices plays a major role, while many chronic conditions are under the influence of environmental conditions that can now be continuously recorded.
      PubDate: 2020-01-16T00:05:19-08:00
      DOI: 10.1183/13993003.02287-2019
      Issue No: Vol. 55, No. 1 (2020)
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Heriot-Watt University
Edinburgh, EH14 4AS, UK
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