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Friday 28 Aug 2020
Environmental fungal sensitisation associates with poorer clinical outcomes in COPD.
Fungal sensitisation is prevalent in COPD and associates with frequent exacerbations representing a potential treatable trait. Outdoor and indoor (home) environments represent a key source of fungal allergen exposure, amenable to intervention, in “sensitised” COPD.
Introduction Allergic sensitisation to fungi such as Aspergillus are associated to poor clinical outcomes in asthma, bronchiectasis and cystic fibrosis; however, clinical relevance in COPD remains unclear. Methods Patients with stable COPD (n=446) and nondiseased controls (n=51) were prospectively r...
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Friday 28 Aug 2020
Survival and course of lung function in the presence or absence of antifibrotic treatment in patients with idiopathic pulmonary fibrosis: long-term results of the INSIGHTS-IPF registry.
Survival was significantly higher in IPF patients with antifibrotic therapy, but the course of lung function parameters was similar in patients with and without antifibrotic therapy. This suggests that in clinical practice, premature mortality of IPF patients eventually occurs despite stable measurements for FVC and DLCO.
Objective There is a paucity of observational data on antifibrotic therapy for idiopathic pulmonary fibrosis (IPF). We aimed to assess the course of disease of IPF patients with and without antifibrotic therapy under real-life conditions. Methods We analysed data from a non-interventional, prospecti...
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Friday 28 Aug 2020
Should the number of acute exacerbations in the previous year be used to guide treatments in COPD?
While the underlying AECOPD rate is a stable trait, the frequent exacerbator phenotype based on observed AECOPD patterns is unstable, so much so that its suitability for informing treatment decisions should be questioned. Whether evaluating AECOPD history over longer durations or the use of multivariate prediction models can result in more stable phenotyping needs to be evaluated.
Background In contemporary management of COPD, the frequent exacerbator phenotype based on a 12-month history of acute exacerbations (AECOPD) is a major determinant of therapeutic recommendations. However, there is considerable debate on the stability of this phenotype over time. Methods We used fun...
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Friday 28 Aug 2020
Anticoaguation in COVID-19 patients
Thromboembolic disease is common in coronavirus disease-19 (COVID-19). There is limited evidence on association of in-hospital anticoagulation (AC) wi…
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Friday 28 Aug 2020
Read a case report and review of ARDS due to mercury inhalation in journal CHEST®: https://hubs.ly/H0tXgqD0
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Friday 28 Aug 2020
Read the update on persistent excessive daytime sleepiness in OSA in the August edition of journal CHEST®: https://hubs.ly/H0tJCg40
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Thursday 27 Aug 2020
Exposure to air pollution within EU limits linked to impaired breathing in children and asthma in adults
Babies exposed to levels of air pollution within EU standards develop poorer lung function as children and teenagers, according to research presented at the European Respiratory Society International Congress. The study also suggests that some of the risk from exposure to pollution can be reduced if...
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Thursday 27 Aug 2020
ERS Congress special feature: COVID-19 live programme- Sunday 6 September
The European Respiratory Society (ERS) is pleased to announce a day’s worth of free online sessions dedicated to SARS-CoV-2 and COVID-19 that will take place in addition to the three-day Congress programme.
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Thursday 27 Aug 2020
COPD patients have increased risk of severe pneumonia and poor outcomes when they develop COVID-19. This may be related to poor underlying lung reserves or increased expression of ACE-2 receptor in small airways.
As of 11 July, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic has infected over 12.7 million people around the world and caused more than 560,000 deaths [1]. Given the devastating impact that COVID-19 can...
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Thursday 27 Aug 2020
A Scoping Review of International Barriers to Asthma Medication Adherence Mapped to the Theoretical Domains Framework: International adherence barriers are diverse and may vary with a country’s sociopolitical context.
Internationally, adult asthma medication adherence rates are low. Studies characterizing variations in barriers by country are lacking.
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Thursday 27 Aug 2020
Effect of hypertonic saline on mucociliary clearance and clinical outcomes in chronic bronchitis | European Respiratory Society
Background Mucus dehydration and impaired mucus clearance are common features of cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD). In CF, inhaled hypertonic saline (HS) improves lung function and produces sustained increases in mucociliary clearance (MCC). We hypothesised that a...
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Wednesday 26 Aug 2020
Respiratory follow-up of patients with COVID-19 pneumonia
A very useful text for all of us treating COVID-19 patients
The COVID-19 pandemic has led to an unprecedented surge in hospitalised patients with viral pneumonia. The most severely affected patients are older men, individuals of black and Asian minority ethnicity and those with comorbidities. COVID-19 is also associated with an increased risk of hypercoagulability and venous thromboembolism.
The overwhelming majority of patients admitted to hospital have respiratory failure and while most are managed on general wards, a sizeable proportion require intensive care support. The long-term complications of COVID-19 pneumonia are starting to emerge but data from previous coronavirus outbreaks such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) suggest that some patients will experience long-term respiratory complications of the infection.
With the pattern of thoracic imaging abnormalities and growing clinical experience, it is envisaged that interstitial lung disease and pulmonary vascular disease are likely to be the most important respiratory complications. There is a need for a unified pathway for the respiratory follow-up of patients with COVID-19 balancing the delivery of high-quality clinical care with stretched National Health Service (NHS) resources. In this guidance document, we provide a suggested structure for the respiratory follow-up of patients with clinicoradiological confirmation of COVID-19 pneumonia. We define two separate algorithms integrating disease severity, likelihood of long-term respiratory complications and functional capacity on discharge. To mitigate NHS pressures, virtual solutions have been embedded within the pathway as has safety netting of patients whose clinical trajectory deviates from the pathway. For all patients, we suggest a holistic package of care to address breathlessness, anxiety, oxygen requirement, palliative care and rehabilitation.
This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.
The COVID-19 pandemic has led to an unprecedented surge in hospitalised patients with viral pneumonia. The most severely affected patients are older men, individuals of black and Asian minority ethnicity and those with comorbidities. COVID-19 is also associated with an increased risk of hypercoagula...
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Thursday 27 Aug 2020
Efficacy of Selpercatinib in RET Fusion–Positive Non–Small-Cell Lung Cancer
Selpercatinib had durable efficacy, including intracranial activity, with mainly low-grade toxic effects in patients with RET fusion–positive NSCLC who had previously received platinum-based chemotherapy and those who were previously untreated
Original Article from The New England Journal of Medicine — Efficacy of Selpercatinib in RET Fusion–Positive Non–Small-Cell Lung Cancer
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Wednesday 26 Aug 2020
ACIP: Influenza Vaccination Recommendations for 2020-2021
The ACIP has issued new guidelines for the prevention and control of seasonal influenza with vaccines for the 2020–2021 season.
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Wednesday 26 Aug 2020
Proposed guidance on the respiratory follow up of patients with #COVID-19 pneumonia in @ThoraxBMJ.
The COVID-19 pandemic has led to an unprecedented surge in hospitalised patients with viral pneumonia. The most severely affected patients are older men, individuals of black and Asian minority ethnicity and those with comorbidities. COVID-19 is also associated with an increased risk of hypercoagula...
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Wednesday 26 Aug 2020
Ventilator Sharing during an Acute Shortage Caused by the COVID-19 Pandemic
To the Editor:Coronavirus disease (COVID-19) is a rapidly expanding global pandemic. In March 2020, models forecasted imminent exhaustion of regional ventilator supply in New York (1). In response, we developed a novel ventilator sharing strategy to support two patients simultaneously with one venti...
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Wednesday 26 Aug 2020
Among children with persistent asthma and low vitamin D levels, vitamin D3 supplementation, compared with placebo, did not significantly improve the time to a severe asthma exacerbation. buff.ly/3jdjrlW
This randomized trial compares the effects of vitamin D3 vs placebo on time to severe exacerbation in children with asthma and low vitamin D levels.
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Wednesday 26 Aug 2020
Prevalence of SARS-CoV-2 Infection in Children Without Symptoms of Coronavirus Disease 2019 | Infectious Diseases | JAMA Pediatrics | JAMA Network
This cohort study examines the rate of positive test results for severe acute respiratory syndrome coronavirus 2 in children without symptoms who were treated in US hospitals for other conditions.
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Wednesday 26 Aug 2020
August 24, 2020During COVID-19, one question the College has received more than any other is “What are allergists doing with regard to spirometry?” Our recent COVID member survey helps answer that question.Survey demographicsThe College did a follow-up COVID-19 survey of all U.S. College members...
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Wednesday 26 Aug 2020
As the COVID-19 pandemic continues to develop, the global price of ventilators are high and seriously inadequate. Apex Medical Corp., the medical devi...
