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Mashup Score: 37Immediate smoking cessation support during lung cancer screening: long-term outcomes from two randomised controlled trials - 2 day(s) ago
Background Immediate smoking cessation interventions delivered alongside targeted lung health checks (TLHCs) to screen for lung cancer increase self-reported abstinence at 3 months. The impact on longer term, objectively confirmed quit rates remains to be established. Methods We followed up participants from two clinical trials in people aged 55–75 years who smoked and took part in a TLHC. These randomised participants in the TLHC by day of attendance to either usual care (UC) (signposting to smoking cessation services) or an offer of immediate smoking cessation support including pharmacotherapy. In the QuLIT1 trial, this was delivered face to face and in QuLIT2, it was delivered remotely. Follow-up was conducted 12 months after the TLHC by telephone interview with subsequent biochemical verification of smoking cessation using exhaled CO. Results 430 people were enrolled initially (115 in QuLIT1 and 315 in QuLIT2), with 4 deaths before 12 months leaving 426 (62.1±5.27 years old and 48%
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 19Medical management of inpatients with tobacco dependency - 2 day(s) ago
### Building block 1: screen for tobacco dependence ### Building block 2: advise on the role of nicotine ### Building block 3: initiate combination nicotine replacement therapy (NRT) as soon as possible ### Building block 4: complete a referral to an on-site tobacco dependency advisor (TDA) ### Building block 5: provide accurate and consistent information on Vaping
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 23
Lung development starts already in utero whereas lung function development can be conceived to begin shortly after birth, marked by the infant’s first cry. This development progresses through adolescence until reaching its peak during early adulthood (typically between 20 and 25 years of age). However, a notable portion of the general population (4%–12%) experiences suboptimal lung development, failing to attain normal peak lung function in early adulthood.1 This phenomenon is linked to an increased prevalence and earlier onset of respiratory, cardiovascular and metabolic disorders, as well as premature mortality. Recent evidence suggests that within the general population, diverse lung function trajectories exist from birth to early adulthood, including high, normal and low trajectories. However, certain subgroups deviate from these trajectories, exhibiting catch-up (where lung function starts from a lower trajectory but progresses to higher ones) or growth failure (where lung functio
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 41Risk of hypersensitivity pneumonitis and other interstitial lung diseases following organic dust exposure - 3 day(s) ago
Background Organic dust is associated with hypersensitivity pneumonitis, and associations with other types of interstitial lung disease (ILD) have been suggested. We examined the association between occupational organic dust exposure and hypersensitivity pneumonitis and other ILDs in a cohort study. Methods The study population included all residents of Denmark born in 1956 or later with at least 1 year of gainful employment since 1976. Incident cases of hypersensitivity pneumonitis and other ILDs were identified in the Danish National Patient Register 1994–2015. Job exposure matrices were used to assign individual annual levels of exposure to organic dust, endotoxin and wood dust from 1976 to 2015. We analysed exposure-response relations by different exposure metrics using a discrete-time hazard model. Results For organic dust, we observed increasing risk with increasing cumulative exposure with incidence rate ratios (IRR) per 10 unit-years of 1.19 (95% CI 1.12 to 1.27) for hypersensi
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 12Invasive versus non-invasive paediatric home mechanical ventilation: review of the international evolution over the past 24 years - 4 day(s) ago
Background Home mechanical ventilation (HMV) is the treatment for chronic hypercapnic alveolar hypoventilation. The proportion and evolution of paediatric invasive (IMV) and non-invasive (NIV) HMV across the world is unknown, as well as the disorders and age of children using HMV. Methods Search of Medline/PubMed for publications of paediatric surveys on HMV from 2000 to 2023. Results Data from 32 international reports, representing 8815 children (59% boys) using HMV, were analysed. A substantial number of children had neuromuscular disorders (NMD; 37%), followed by cardiorespiratory (Cardio-Resp; 16%), central nervous system (CNS; 16%), upper airway (UA; 13%), other disorders (Others; 10%), central hypoventilation (4%), thoracic (3%) and genetic/congenital disorders (Gen/Cong; 1%). Mean age±SD (range) at HMV initiation was 6.7±3.7 (0.5–14.7) years. Age distribution was bimodal, with two peaks around 1–2 and 14–15 years. The number and proportion of children using NIV was significantly
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 10Pulmonary artery-pulmonary artery collaterals in chronic thromboembolic pulmonary hypertension - 4 day(s) ago
A 66-year-old woman was diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH), with selective angiography revealing direct collaterals between the A9 and A10 pulmonary artery branches (figure 1A, figure 2 and figure 3A; online supplemental Video 1 and online supplemental Video 2). Balloon pulmonary angioplasty (BPA) of A9 revealed pronounced stenosis and lumen irregularities. Peripheral branches of A9, adjacent to A10, demonstrated compromised perfusion, as indicated in figure 1B. The subsequent BPA intervention on the A9 main branch involved a 3 mm balloon inflated to a pressure of 12 mm Hg for a duration of 5 s, repeated twice (figure 1C). Post-intervention angiography painted an optimistic picture: enhanced perfusion of the A9 branch and the …
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 3
Background Observational studies suggest that total testosterone (TT) and sex hormone-binding globulin (SHBG) may have beneficial effects on lung function, but these findings might be spurious due to confounding and reverse causation. We addressed these limitations by using multivariable Mendelian randomisation (MVMR) to investigate the independent causal effects of TT and SHBG on lung function. Methods We first identified genetic instruments by performing genome-wide association analyses of TT and SHBG in the large UK Biobank, separately in males and females. We then assessed the independent effects of TT and SHBG on forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC using one-sample MVMR. We addressed pleiotropy, which could bias MVMR, using several methods that account for it. We performed subgroup MVMR analyses by obesity, physical activity and menopausal status, and assessed associations between TT and SHBG with lung function decline. Finally, we comp
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 16
Introduction Lung graft allocation can be based on a score (Lung Allocation Score) as in the USA or sequential proposals combined with a discrete priority model as in France. We aimed to analyse the impact of allocation policy on the outcome of urgent lung transplantation (LT). Methods US United Network for Organ Sharing (UNOS) and French Cristal databases were retrospectively reviewed to analyse LT performed between 2007 and 2017. We analysed the mortality risk of urgent LT by fitting Cox models and adjusted Restricted Mean Survival Time. We then compared the outcome after urgent LT in the UNOS and Cristal groups using a propensity score matching. Results After exclusion of patients with chronic obstructive pulmonary disease/emphysema and redo LT, 3775 and 12 561 patients underwent urgent LT and non-urgent LT in the USA while 600 and 2071 patients underwent urgent LT and non-urgent LT in France. In univariate analysis, urgent LT was associated with an HR for death of 1.24 (95% CI 1.05
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 11Impact of ambient air pollution on lung function in preterm-born school-aged children - 5 day(s) ago
Rationale Increased outdoor air pollution worsens lung function in children. However, these associations are less well studied in preterm-born individuals. Objectives We assessed associations between ambient air pollutants and spirometry measures in preterm-born children. Methods The Respiratory Health Outcomes in Neonates study recruited preterm-born children aged 7–12 years who were born at ≤34 week’s gestation. We associated four ambient air pollutants (particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), PM10, nitrogen dioxide (NO2) and sulfur dioxide) at time of birth and spirometry assessment and averaged exposure between these two time points with spirometry measures, using linear regression analyses. Gestational age was banded into 23–28, 29–31 and 32–34 week’s. Regression models estimated spirometry values against pollutant levels at birth and at the time of spirometry. Measurements and main results From 565 preterm-born children, 542 (96%) had satisfactory data. Afte
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
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Mashup Score: 38Neutrophil responses to RSV infection show differences between infant and adult neutrophils - 6 day(s) ago
Introduction Respiratory syncytial virus (RSV) causes a severe respiratory condition, bronchiolitis, in infants but not in adults. Bronchiolitis is characterised by neutrophilic infiltration in the airways, but whether neutrophils enhance recovery from infection or contribute to its pathology remains unknown. Methods We used a novel in-vitro model to compare term umbilical cord blood (infant) (n=17 donors) and adult neutrophils (n=15 donors) during migration across RSV-infected differentiated human nasal airway epithelial cells (AECs) in a basolateral to apical direction. Results Greater numbers of infant neutrophils (mean (95% CI)) (336 684 (242 352 to 431 015)) migrated across RSV-infected AECs to the apical compartment (equivalent to the airway lumen) compared with adult neutrophils (56 586 (24 954 to 88 218)) (p<0.0001). Having reached the apical compartment of infected AECs, much greater numbers of infant neutrophils (140 787 (103 117 to 178 456)) became apoptotic compared with ad
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
Providing immediate smoking cessation support alongside lung cancer screening increases long term, biochemically confirmed quits: outcomes from 2 randomised controlled trials (QuLIT-1 & QuLIT-2) https://t.co/WJ4rPcxUW4 @ParrisWilliams1, @keirphilip, @anthonylav, @COPDdoc https://t.co/quPlU5hWYv