Chest Medicine (all articles)
The exposome in respiratory diseases: multiple preventable risk factors from early life to adulthood
27 Jun, 2023 | 13:32h | UTC
Commentary on Twitter
The increasing global burden of respiratory diseases over recent decades raises questions about the lifelong impact of environmental factors during industrialisation and urbanisation. There is a clear need for action in primary and secondary prevention. https://t.co/MFzkETBr2X pic.twitter.com/jp9LYSiSAR
— ERS publications (@ERSpublications) June 20, 2023
M-A | Risk factors for non-tuberculous mycobacterial pulmonary disease
27 Jun, 2023 | 13:27h | UTCCommentary: Comorbid respiratory disease key predictor of NTM-PD – MDedge
Cohort Study | Association of preterm birth with increased asthma and COPD risk in adulthood
26 Jun, 2023 | 00:45h | UTCSummary: This population-based register study investigated the correlation between gestational ages (GA) and obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD) in adulthood. The study used registry data from 706,717 individuals born between 1987-1998 in Finland (4.8% preterm), and 1,669,528 individuals born from 1967-1999 in Norway (5.0% preterm). The study observed care episodes of asthma and COPD using nationwide healthcare registers.
The results showed an increased risk of obstructive airway disease in adulthood for those born at <28 or 28–31 completed weeks of gestation. Even after adjustments, the risk remained 2-3 times greater compared to those who were born full term (at 39-41 completed weeks). Additionally, the risk for COPD at age 30–50 was significantly higher for those born at <28 weeks, with an odds ratio (OR) of 7.44. The study also identified that bronchopulmonary dysplasia (BPD) in infancy increased the odds of obstructive airway disease for those born at <28 and 28–31 weeks.
These findings suggest that preterm birth is a notable risk factor for asthma and COPD in adulthood, and this risk was observed across all gestational ages before full term. The study recommends diagnostic vigilance for adults born very preterm presenting with respiratory symptoms. However, the researchers also noted the potential limitations of using registry data, which might include residual confounding from unmeasured confounders and lack of data on certain prenatal or early life factors.
Article: Preterm birth and asthma and COPD in adulthood: a nationwide register study from two Nordic countries – European Respiratory Journal (free for a limited period)
Commentary on Twitter
In this population-based study of 2.4 million people from Finland and Norway, adults born preterm were at higher risk for asthma and COPD at ages 18–50 years. The risks were observed across all gestational ages before full term in a dose-response manner. https://t.co/bGsAOrwAxV pic.twitter.com/WmCoc6cPu2
— ERS publications (@ERSpublications) June 22, 2023
Clinical insights into small cell lung cancer: tumor heterogeneity, diagnosis, therapy, and future directions
26 Jun, 2023 | 00:31h | UTC
Questions in mild asthma | An Official American Thoracic Society research statement
22 Jun, 2023 | 14:56h | UTC
Commentary on Twitter
Questions in Mild Asthma: An Official American Thoracic Society Research Statement
? Open Access
? https://t.co/qqMxWpqafX pic.twitter.com/XHrhpa73XI— ATS Blue Journal (@ATSBlueEditor) June 13, 2023
Review | Antifungal dosing in critically ill patients on extracorporeal membrane oxygenation
21 Jun, 2023 | 13:31h | UTC
RCT | Rituximab and MMF combo improves lung function vs. MMF in interstitial lung disease with NSIP pattern, but may increase infection risk
21 Jun, 2023 | 13:16h | UTCRituximab and mycophenolate mofetil combination in patients with interstitial lung disease (EVER-ILD): a double-blind, randomised, placebo-controlled trial – European Respiratory Journal (link to abstract – $ for full-text)
Commentary on Twitter
ERJ: Rituximab plus MMF is associated with benefits in lung function and progression-free survival compared with MMF plus placebo after 24 weeks of treatment. The safety profile of rituximab plus MMF was similar to that of MMF plus placebo. https://t.co/Mv0IuzLljz pic.twitter.com/1igrt6uDK4
— ERS publications (@ERSpublications) June 11, 2023
Review | Ultrasonographic assessment of diaphragmatic function in the management of patients with acute respiratory failure
21 Jun, 2023 | 13:12h | UTC
Review | Pulmonary rehabilitation and physical interventions
21 Jun, 2023 | 13:11h | UTCPulmonary rehabilitation and physical interventions – European Respiratory Review
Commentary on Twitter
ERR: Pulmonary rehabilitation that includes individualised exercise training is effective in patients with stable COPD and those who have suffered an exacerbation. Remaining challenges are to increase uptake and access to and personalisation of programmes. https://t.co/NSoASus6TW pic.twitter.com/JRl7dCOZrm
— ERS publications (@ERSpublications) June 12, 2023
Guideline | Management of patients with primary spontaneous pneumothorax
20 Jun, 2023 | 12:46h | UTC
Review | Measuring exhaled nitric oxide when diagnosing and managing asthma
20 Jun, 2023 | 12:41h | UTC
SR | Long‐acting muscarinic antagonist (LAMA) plus long‐acting beta‐agonist (LABA) vs. LABA plus inhaled corticosteroid (ICS) for COPD
20 Jun, 2023 | 12:26h | UTC
ESICM guidelines on ARDS: definition, phenotyping and respiratory support strategies
19 Jun, 2023 | 14:18h | UTCSee also: Caring for Patients With Acute Respiratory Distress Syndrome: Summary of the 2023 ESICM Practice Guidelines – JAMA (free for a limited period)
Commentary on Twitter
#ARDS @ESICM guidelines
? definition
? phenotyping
? #HFNO
? CPAP/NIV
? low tidal volume MV
? PEEP & recruitment maneuvers
? prone positioning
? neuromuscular blocking agents
? extracorporeal life support #ECMO #ECLS #ECCO2r#FOAMcc on @yourICM
?️ https://t.co/xGtI2y0vZw pic.twitter.com/H1z7EBxLLo— Intensive Care Medicine (@yourICM) June 16, 2023
Review | The role of diet and nutrition in the management of COPD
19 Jun, 2023 | 13:47h | UTCThe role of diet and nutrition in the management of COPD – European Respiratory Review
M-A | Mechanical ventilation in patients with acute brain injury
16 Jun, 2023 | 14:03h | UTC
ATS Report | Rehabilitation for people with respiratory disease and frailty
16 Jun, 2023 | 13:51h | UTC
Single-center cohort study | Low-risk PE patients with concerning CT findings – increased hospitalization, but no increased risk of mortality
16 Jun, 2023 | 13:49h | UTCCommentary: Acute Low-Risk Pulmonary Embolism and Concerning CT Findings – American College of Cardiology
RCT | Nalbuphine reduces cough in idiopathic pulmonary fibrosis, despite adverse effects
15 Jun, 2023 | 14:55h | UTCNalbuphine Tablets for Cough in Patients with Idiopathic Pulmonary Fibrosis – NEJM Evidence
Review | Basic, translational and clinical aspects of bronchiectasis in adults
14 Jun, 2023 | 14:13h | UTCBasic, translational and clinical aspects of bronchiectasis in adults – European Respiratory Review
Commentary on Twitter
ERR: Bronchiectasis is an underdiagnosed and heterogeneous disorder. Inflammation is a key driver of bronchiectasis and represents a therapeutic target for current and new treatments. https://t.co/mEDcNYvKJq pic.twitter.com/fWay0KgJ67
— ERS publications (@ERSpublications) June 9, 2023
M-A | Oseltamivir fails to lower hospitalization risk in adult and adolescent influenza patients
13 Jun, 2023 | 14:12h | UTC
Commentary on Twitter
In this systematic review and meta-analysis of 15 RCTs, oseltamivir was not associated with reduced risk of first hospitalization compared with placebo or standard of care among influenza-infected adult and adolescent outpatients. https://t.co/UEqsbA2JQZ
— JAMA Internal Medicine (@JAMAInternalMed) June 12, 2023
2ry Analysis of a RCT | Metformin linked to 41% reduction in long COVID incidence in outpatient treatment
12 Jun, 2023 | 13:55h | UTCNews Release: Study shows metformin lowers the risk of getting long COVID – University of Minnesota Medical School
Commentary on Twitter
These data not persuasive. There are 6 different arms. 3 drugs. This is not the primary endpoint. No adjustment for multiple testing.
Even USFDA would not accept these data for regulatory approval, and they are basically working for Pharma at this pthttps://t.co/FZoxo9shtG
— Vinay Prasad MD MPH (@VPrasadMDMPH) June 9, 2023
Review | Acute dyspnea in the emergency department
12 Jun, 2023 | 13:33h | UTCAcute dyspnea in the emergency department: a clinical review – Internal and Emergency Medicine
Cohort Study | Pulmonary hypertension post-VTE linked to a twofold increase in long-term mortality
12 Jun, 2023 | 13:27h | UTC
Review | Hemodynamic and respiratory support in pulmonary embolism
12 Jun, 2023 | 13:22h | UTC
RCT | Noninferiority shown between DOACs and LMWH for recurrent VTE prevention in cancer patients
5 Jun, 2023 | 13:50h | UTCSummary: This unblinded, pragmatic, noninferiority randomized clinical trial aimed to assess the efficacy of direct oral anticoagulants (DOACs) against low-molecular-weight heparin (LMWH) in preventing recurrent venous thromboembolism (VTE) in patients with cancer. The study included 671 patients from 67 oncology centers, with a new clinical or radiological diagnosis of VTE.
Participants were randomly assigned to receive either a DOAC or LMWH for 6 months, and treating physicians selected and prescribed the drugs based on considerations like availability and drug-drug interactions. The primary outcome was the rate of recurrent VTE at 6 months. Findings revealed that the DOAC group had a recurrent VTE rate of 6.1% as compared to 8.8% in the LMWH group, showing noninferiority. Both groups had statistically similar rates of major bleeding and severe adverse events.
This pragmatic study included patients with advanced cancer and brain metastases, impaired performance status, and reduced liver or kidney function, making it more representative of routine oncology practice. Moreover, patient adherence to DOAC treatment was significantly higher than to LMWH. Nevertheless, the study had limitations, including the lack of blinding and underrepresentation of certain racial and ethnic groups.
In conclusion, this trial suggests that DOACs were noninferior to LMWH for preventing recurrent VTE in patients with cancer over a 6-month follow-up period, supporting the use of DOACs in this population for VTE prevention. Further research is needed to confirm these results and investigate long-term outcomes.
Article: Direct Oral Anticoagulants vs Low-Molecular-Weight Heparin and Recurrent VTE in Patients With Cancer: A Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual abstract
Commentary on Twitter
Among adults with cancer and VTE, direct oral anticoagulants were noninferior to low-molecular-weight heparin for preventing recurrent VTE over 6-month follow-up. #ASCO23 https://t.co/DP5RvlSYxe pic.twitter.com/rBJ99plopK
— JAMA (@JAMA_current) June 2, 2023