-
Mashup Score: 24Environmental pollutants exposure-derived extracellular vesicles: crucial players in respiratory disorders - 21 hour(s) ago
Background Individual exposure to environmental pollutants, as one of the most influential drivers of respiratory disorders, has received considerable attention due to its preventability and controllability. Considering that the extracellular vesicle (EV) was an emerging intercellular communication medium, recent studies have highlighted the crucial role of environmental pollutants derived EVs (EPE-EVs) in respiratory disorders. Methods PubMed and Web of Science were searched from January 2018 to December 2023 for publications with key words of environmental pollutants, respiratory disorders and EVs. Results Environmental pollutants could disrupt airway intercellular communication by indirectly stimulating airway barrier cells to secrete endogenous EVs, or directly transmitting exogenous EVs, mainly by biological pollutants. Mechanistically, EPE-EVs transferred specific contents to modulate biological functions of recipient cells, to induce respiratory inflammation and impair tissue an
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 47Development of respiratory care guidelines for Duchenne muscular dystrophy in the UK: key recommendations for clinical practice - 1 day(s) ago
Significant inconsistencies in respiratory care provision for Duchenne muscular dystrophy (DMD) are reported across different specialist neuromuscular centres in the UK. The absence of robust clinical evidence and expert consensus is a barrier to the implementation of care recommendations in public healthcare systems as is the need to increase awareness of key aspects of care for those living with DMD. Here, we provide evidenced-based and/or consensus-based best practice for the respiratory care of children and adults living with DMD in the UK, both as part of routine care and in an emergency. Methodology Initiated by an expert working group of UK-based respiratory physicians (including British Thoracic Society (BTS) representatives), neuromuscular clinicians, physiotherapist and patient representatives, draft guidelines were created based on published evidence, current practice and expert opinion. After wider consultation with UK respiratory teams and neuromuscular services, consensus
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 3Serum cytokine biosignatures for identification of tuberculosis among HIV-positive inpatients - 2 day(s) ago
Background Serum cytokines correlate with tuberculosis (TB) progression and are predictors of TB recurrence in people living with HIV. We investigated whether serum cytokine biosignatures could diagnose TB among HIV-positive inpatients. Methods We recruited HIV-positive inpatients with symptoms of TB and measured serum levels of inflammation biomarkers including IL-2, IL-4, IL-6, IL-10, tumour necrosis factor-alpha (TNF-α) and interferon-gamma (IFN-γ). We then built and tested our TB prediction model. Results 236 HIV-positive inpatients were enrolled in the first cohort and all the inflammation biomarkers were significantly higher in participants with microbiologically confirmed TB than those without TB. A binary support vector machine (SVM) model was built, incorporating the data of four biomarkers (IL-6, IL-10, TNF-α and IFN-γ). Efficacy of the SVM model was assessed in training (n=189) and validation (n=47) sets with area under the curve (AUC) of 0.92 (95% CI 0.88 to 0.96) and 0.85
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 16Improved pulmonary function and exercise tolerance despite persistent pulmonary fibrosis over 1 year after severe COVID-19 infection - 2 day(s) ago
We conducted a prospective single-centre cohort study of 104 multi-ethnic severe COVID-19 survivors from the first wave of the pandemic 15 months after hospitalisation. Of those who were assessed at 4 and 15 months, improvement of ground glass opacities correlated with worsened fibrotic reticulations. Despite a high prevalence of fibrotic patterns (64%), pulmonary function, grip strength, 6 min walk distance and frailty normalised. Overall, dyspnoea, cough and exhaustion did not improve and were not correlated with pulmonary function or radiographic fibrosis at 15 months, suggesting non-respiratory aetiologies. Monitoring persistent, and often subclinical, fibrotic interstitial abnormalities will be needed to determine their potential for future progression.
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 7Prognostic factors for survival in unresectable stage III EGFR mutation-positive lung adenocarcinoma: impact of pre-CCRT PET-CT - 3 day(s) ago
Purpose To assess the survival impact of pre-concurrent chemoradiotherapy (CCRT) staging with positron emission tomography-CT (PET-CT) in patients with unresectable epidermal growth factor receptor (EGFR) mutation-positive adenocarcinoma. Methods Patients with unresectable stage IIIA–IIIC EGFR mutation-positive adenocarcinoma undergoing definitive CCRT were divided into two groups: those who received PET-CT staging prior to CCRT and those with other staging methods. Survival outcomes were compared after propensity score matching. Results Analysis of 11 856 patients (5928 in each group) showed that PET-CT staging was associated with improved survival (adjusted HR of all-cause mortality: 0.74, 95% CI 0.71 to 0.79). Other prognostic factors included male sex, age group, clinical stage, adjuvant treatment, smoking status, Charlson Comorbidity Index score and treatment setting. Conclusion Pre-CCRT staging with PET-CT in patients with unresectable EGFR mutation-positive adenocarcinoma of cli
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 5Impact of post-COVID-19 condition on health status and activities of daily living: the PRIME post-COVID study - 3 day(s) ago
Objective To assess health and activities of daily living (ADL) in SARS-CoV-2-positive adults with and without post-COVID-19 condition (PCC) and compare this with negative tested individuals. Furthermore, different PCC case definitions were compared with SARS-CoV-2-negative individuals. Methods All adults tested PCR positive for SARS-CoV-2 at the Public Health Service South Limburg (Netherlands) between June 2020 and November 2021 (n=41 780) and matched PCR negative individuals (2:1, on age, sex, year-quarter test, municipality; n=19 875) were invited by email. Health (five-level EuroQol five-dimension (EQ5D) index and EuroQol visual analogue scale (EQVAS)) and ADL impairment were assessed. PCC classification was done using the WHO case definition and five other common definitions. Results In total, 8409 individuals (6381 SARS-CoV-2 positive; 53±15 years; 57% female; 9 (7–11) months since test) were included. 39.4% of positives had PCC by the WHO case definition (EQVAS: 71±20; EQ5D ind
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 91
Introduction Previous systematic reviews have provided heterogeneous and differing estimates for the efficacy of pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease (COPD). The aim of this review was to examine the efficacy of pulmonary rehabilitation programmes initiated within 3 weeks of hospital discharge following an exacerbation of COPD. Methods An update of a previous Cochrane review was undertaken using the Cochrane Airways Review Group Specialised Register. Searches were conducted from October 2015 to August 2023 for studies that initiated pulmonary rehabilitation within 3 weeks of hospital discharge. Studies assessing the impact of solely inpatient pulmonary rehabilitation were excluded. Forest plots were generated using a generic inverse variance random effects method. Results Seventeen studies were included. Posthospital discharge pulmonary rehabilitation reduced hospital re-admissions (OR 0.48, 95% CI 0.30 to 0.77, I2=67%), improved exe
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 12
Background Poorly controlled asthma is associated with increased morbidity and healthcare resource utilisation (HCRU). Therefore, to quantify the environmental impact of asthma care, this retrospective, cohort, healthCARe-Based envirONmental cost of treatment (CARBON) study estimated greenhouse gas (GHG) emissions in the UK associated with the management of well-controlled versus poorly controlled asthma. Methods Patients with current asthma (aged ≥12 years) registered with the Clinical Practice Research Datalink (2008‒2019) were included. GHG emissions, measured as carbon dioxide equivalent (CO2e), were estimated for asthma-related medication use, HCRU and exacerbations during follow-up of patients with asthma classified at baseline as well-controlled (<3 short-acting β2-agonist (SABA) canisters/year and no exacerbations) or poorly controlled (≥3 SABA canisters/year or ≥1 exacerbation). Excess GHG emissions due to suboptimal asthma control included ≥3 SABA canister prescriptions/year,
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 1Body composition and respiratory outcomes in children: a population-based prospective cohort study - 4 day(s) ago
Background Body composition might influence lung function and asthma in children, but its longitudinal relations are unclear. We aimed to identify critical periods for body composition changes during childhood and adolescence in relation to respiratory outcomes in adolescents. Methods In a population-based prospective cohort study, we measured body mass index, fat mass index (FMI), lean mass index (LMI) and the ratio of android fat mass divided by gynoid fat mass (A/G ratio) by dual-energy X-ray absorptiometry at 6, 10 and 13 years. At 13 years, lung function was measured by spirometry, and current asthma was assessed by questionnaire. Results Most prominently and consistently, higher FMI and A/G ratio at age 13 years were associated with lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) and forced expiratory flow after exhaling 75% of FVC (FEF75) (range Z-score difference −0.13 (95% CI −0.16 to –0.10) to −0.08 (95% CI −0.11 to –0.05) per SD score increase), and
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
-
Mashup Score: 5Unravelling the obesity–asthma connection in childhood and adolescence: does body shape matter? - 4 day(s) ago
Given the concurrent worldwide epidemics of childhood obesity and asthma, it is perhaps not surprising that the two have been inextricably linked in the minds of many. Indeed, there is good evidence to suggest that adiposity in childhood is associated with an increased risk of developing asthma.1 2 Several longitudinal studies conducted in population-based cohorts have demonstrated that childhood obesity precedes incident asthma. One such study, from Taiwan, found that adiposity gain before age 6 years was good at predicting childhood-onset asthma, while adiposity gain during the prepubertal period was best at predicting young adult-onset asthma.3 More recently, however, we have seen rates of new asthma diagnoses in children and adolescents begin to fall in some countries, while childhood obesity continues to increase. This disconnect in asthma and obesity trends signals that there is likely a lot more to the relationship between obesity and asthma than initially meets the eye. There i
Source: thorax.bmj.comCategories: General Medicine News, PulmonologyTweet
State of the art review. Environmental pollutants exposure-derived extracellular vesicles: crucial players in respiratory disorders. https://t.co/9TjcxS3U3P https://t.co/zs0SiAmwaZ