Respirology (Carlton, Vic.)最新文献

{"title":"Point of emission air filtration enhances protection of healthcare workers against skin contamination with virus aerosol.","authors":"Shane A Landry, Dinesh Subedi, Martin I MacDonald, Samantha Dix, Donna M Kutey, Jeremy J Barr, Darren Mansfield, Garun S Hamilton, Bradley A Edwards, Simon A Joosten","doi":"10.1111/resp.14227","DOIUrl":"https://doi.org/10.1111/resp.14227","url":null,"abstract":"See related Editorial","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"465-468"},"PeriodicalIF":6.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/f0/RESP-27-465.PMC9115427.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39916581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 infection and the broader impacts of the pandemic on healthcare workers.","authors":"Natasha Smallwood,&nbsp;Warren Harrex,&nbsp;Megan Rees,&nbsp;Karen Willis,&nbsp;Catherine M Bennett","doi":"10.1111/resp.14208","DOIUrl":"https://doi.org/10.1111/resp.14208","url":null,"abstract":"<p><p>The severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease or COVID-19 pandemic is associated with more than 230 million cases and has challenged healthcare systems globally. Many healthcare workers (HCWs) have acquired the infection, often through their workplace, with a significant number dying. The epidemiology of COVID-19 infection in HCWs continues to be explored, with manifold exposure risks identified, leading to COVID-19 being recognised as an occupational disease for HCWs. The physical illness due to COVID-19 in HCWs is similar to the general population, with some HCWs experiencing a long-term illness, which may impact their ability to return to work. HCWs have also been affected by the immense workplace and psychosocial disruption caused by the pandemic. The impacts on the psychological well-being of HCWs globally have been profound, with high prevalence estimates for mental health symptoms, including emotional exhaustion. Globally, governments, healthcare organisations and employers have key responsibilities, including: to be better prepared for crises with comprehensive disaster response management plans, and to protect and preserve the health workforce from the physical and psychological impacts of the pandemic. While prioritising HCWs in vaccine rollouts globally has been critical, managing exposures and outbreaks occurring in healthcare settings remains challenging and continues to lead to substantial disruption to the health workforce. Safeguarding healthcare workforces during crises is critical as we move forward on the new path of 'COVID normal'.</p>","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"411-426"},"PeriodicalIF":6.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39924965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting the human βc receptor inhibits inflammatory myeloid cells and lung injury caused by acute cigarette smoke exposure","authors":"Nok Him Fung, Hao Wang, R. Vlahos, Nick Wilson, A. Lopez, C. Owczarek, S. Bozinovski","doi":"10.1111/resp.14297","DOIUrl":"https://doi.org/10.1111/resp.14297","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is a devastating disease commonly caused by cigarette smoke (CS) exposure that drives tissue injury by persistently recruiting myeloid cells into the lungs. A significant portion of COPD patients also present with overlapping asthma pathology including eosinophilic inflammation. The βc cytokine family includes granulocyte monocyte‐colony‐stimulating factor, IL‐5 and IL‐3 that signal through their common receptor subunit βc to promote the expansion and survival of multiple myeloid cells including monocytes/macrophages, neutrophils and eosinophils.","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127547397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sub‐stratification of type‐2 high airway disease for therapeutic decision‐making: A ‘bomb’ (blood eosinophils) meets ‘magnet’ (FeNO) framework","authors":"S. Couillard, I. Pavord, L. Heaney, N. Petousi, T. Hinks","doi":"10.1111/resp.14294","DOIUrl":"https://doi.org/10.1111/resp.14294","url":null,"abstract":"Biologic therapies targeting components of the type-2 inflammatory response seen in many patients with obstructive airways disease have had a dramatic impact in the clinic. In the severe asthma clinic, extraordinary outcomes are being achieved and the days when the severe asthma clinicians’ job was mainly about overseeing an orderly decline (much of it due to oral corticosteroid-related morbidity) have been confined to the history books. In 2023, it is projected that sales will top $10 billion, accounting for over 30% of total worldwide asthma drug sales. The success of biologics was not predicted by all and there was a view that targeting treatment to a biomarkerdefined subgroup of patients would result in a severely restricted market. In fact, we have seen the opposite. The ability to target treatment to a population who are most likely to benefit has incentivized clinicians to look for these patients, has increased the likelihood of a good response to treatment and has resulted in low rates of treatment failure. It has also made the job of jumping regulatory hurdles and making a compelling cost–benefit case for funding of treatment much more straightforward. We now have four monoclonal antibody targeting strategies inhibiting different aspects of the immune response driving asthma attacks (Figure 1). The target population is patients with persistent airway inflammation despite treatment with a reasonable dose of inhaled corticosteroids (ICS). The persistence of type-2 inflammation indicates that the airway mucosal mechanisms driving recruitment of eosinophils towards the airway epithelium are, or have become, corticosteroid-resistant. In this situation, effective treatment exploits other mechanisms to reduce eosinophilic airway inflammation: depletion of circulating eosinophils (oral corticosteroids and biologics targeting the IL-5 pathway: mepolizumab, benralizumab, reslizumab); prevention of eosinophils leaving the vascular compartment (targeting the IL-4 receptor and inhibiting IL-4/IL-13 responses: dupiliumab); or inhibition of the corticosteroid-resistant airway mucosal drivers of type-2 inflammation by other mechanisms (dupilumab again or targeting thymic stromal lymphopoietin [TSLP] with tezepelumab). A sixth biologic (omalizumab) targets the distal effector of the allergic reaction (IgE) with marginal effects on the type-2 immune response. The presence of multiple biologic options and the absence of any direct head-to-head comparisons mean that finding the right biologic for the right patient has become increasingly challenging. In this commentary article, we suggest that one way forward is to sub-stratify type-2 inflammatory airway disease according to the dominant driving mechanism. This concept is based on the demonstration that the two clinically accessible biomarkers of type-2 inflammation, fractional exhaled nitric oxide (FeNO) and the blood eosinophil count, provide independent prognostic (of exacerbations) and predictive (of co","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129463374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep‐disordered breathing was associated with lower health‐related quality of life and cognitive function in a cross‐sectional study of older adults","authors":"S. Ward, E. Storey, D. Gasevic, M. Naughton, G. Hamilton, R. Trevaks, R. Wolfe, F. O'Donoghue, N. Stocks, W. Abhayaratna, S. Fitzgerald, S. Orchard, J. Ryan, J. McNeil, Christopher M. Reid, R. Woods","doi":"10.1111/resp.14279","DOIUrl":"https://doi.org/10.1111/resp.14279","url":null,"abstract":"The clinical significance of sleep‐disordered breathing (SDB) in older age is uncertain. This study determined the prevalence and associations of SDB with mood, daytime sleepiness, quality of life (QOL) and cognition in a relatively healthy older Australian cohort.","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132162717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung cancer screening—Marching along …","authors":"K. Fong, H. Marshall, D. C. Lam","doi":"10.1111/resp.14295","DOIUrl":"https://doi.org/10.1111/resp.14295","url":null,"abstract":"capability through analysis of an entire 3D computed tomography (CT) data set, rather than just a sequence of 2D slices, interrogating the tumour environment, such as blood vessels and other lung structures, and radiomics, the quanti-tative, rather than visual, analysis of nodule features. The data sets required to train these models are very large, requiring many thousands of annotated CT scans. To this end, large data sets are now publicly available. Screening programmes may be well placed to prospectively curate imaging data sets, or at least contribute to international repositories. This is important because lung cancer is a mov-ing target; we have already witnessed the evolution from predominant central squamous cell carcinomas to more peripheral adenocarcinomas in response to changes in ciga-rette manufacture and design over the past half-century. Constant product innovation from tobacco not least of which, the increasing use of electronic cigarettes by younger cohorts of people, will no doubt lead to future chal-lenges for lung cancer.","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129081102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Concise Review 2021: Interstitial lung disease","authors":"C. McCarthy, M. Keane","doi":"10.1111/resp.14278","DOIUrl":"https://doi.org/10.1111/resp.14278","url":null,"abstract":"The last 2 years have presented previously unforeseen challenges in pulmonary medicine. Despite the significant impact of the SARS‐CoV‐2 pandemic on patients, clinicians and communities, advances in the care and understanding of interstitial lung disease (ILD) continued unabated. Recent studies have led to improved guidelines, better understanding of the role for antifibrotics in fibrosing ILDs, prognostic indicators and novel biomarkers. In this concise contemporary review, we summarize many of the important studies published in 2021, highlighting their relevance and impact to the management and knowledge of ILD.","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127495435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational COPD—The most under‐recognized occupational lung disease?","authors":"N. Murgia, A. Gambelunghe","doi":"10.1111/resp.14272","DOIUrl":"https://doi.org/10.1111/resp.14272","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) is caused by exposure to noxious particles and gases. Smoking is the main risk factor, but other factors are also associated with COPD. Occupational exposure to vapours, gases, dusts and fumes contributes to the development and progression of COPD, accounting for a population attributable fraction of 14%. Workplace pollutants, in particular inorganic dust, can initiate airway damage and inflammation, which are the hallmarks of COPD pathogenesis. Occupational COPD is still underdiagnosed, mainly due to the challenges of assessing the occupational component of the disease in clinical settings, especially if other risk factors are present. There is a need for specific education and training for clinicians, and research with a focus on evaluating the role of occupational exposure in causing COPD. Early diagnosis and identification of occupational causes is very important to prevent further decline in lung function and to reduce the health and socio‐economic burden of COPD. Establishing details of the occupational history by general practitioners or respiratory physicians could help to define the occupational burden of COPD for individual patients, providing the first useful interventions (smoking cessation, best therapeutic management, etc.). Once patients are diagnosed with occupational COPD, there is a wide international variation in access to specialist occupational medicine and public health services, along with limitations in workplace and income support. Therefore, a strong collaboration between primary care physicians, respiratory physicians and occupational medicine specialists is desirable to help manage COPD patients' health and social issues.","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117042923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovations during the Covid‐19 pandemic to maintain delivery of care for vocal cord dysfunction (VCD) in a multidisciplinary team (MDT) clinic","authors":"Joo Koh, Malcolm Baxter, Debra Phyland, L. Ruane, Adriana Avram, Elizabeth Leahy, K. Lau, M. MacDonald, P. Leong, P. Bardin","doi":"10.1111/resp.14276","DOIUrl":"https://doi.org/10.1111/resp.14276","url":null,"abstract":"See related Reply","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131321359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of virtual bronchoscopic navigation with fused fluoroscopy and vessel mapping for access of pulmonary lesions.","authors":"Jiayuan Sun,&nbsp;Gerard J Criner,&nbsp;David Dibardino,&nbsp;Shiyue Li,&nbsp;Daniel Nader,&nbsp;Bing Lam,&nbsp;Lisa Kopas,&nbsp;Momen M Wahidi,&nbsp;Adnan Majid,&nbsp;Robert Marron,&nbsp;Steven Verga,&nbsp;Felix J F Herth","doi":"10.1111/resp.14224","DOIUrl":"https://doi.org/10.1111/resp.14224","url":null,"abstract":"<p><strong>Background and objective: </strong>Virtual bronchoscopic navigation (VBN) with fused fluoroscopy and vessel mapping provides a point of entry (POE) for puncturing airway wall to biopsy lesions. The study was designed to evaluate the safety and efficacy of this technology to diagnose peripheral pulmonary lesions.</p><p><strong>Methods: </strong>It was a prospective, single-arm, multicentre study. Patients underwent lesions biopsy with the Archimedes® VBN System via a POE using one of the two techniques: (1) bronchoscopic transparenchymal nodule access (BTPNA) and (2) guided transbronchial needle aspiration (TBNA). Biopsy yield, sampling yield and diagnostic yield were mainly determined in lesions biopsy attempted.</p><p><strong>Results: </strong>One hundred and thirty patients underwent anaesthesia and constituted the intention-to-treat population. One hundred and four patients with 114 lesions had biopsy attempted. Mean lesion size was 2.4 ± 1.13 cm. Sufficient tissue samples were obtained from 86 lesions with a biopsy yield of 75.4%. Nevertheless, sufficient samples for diagnosis based on histology ± cytology were obtained from 107 lesions with a sampling yield of 93.9%. Follow-up was conducted for more than 1 year, with a diagnostic yield of 75.4% and 72.8%, respectively, on high and low estimate with consideration of three lesions without follow-up. Two (1.9%) pneumothoraxes and one (1.0%) mild bleeding occurred.</p><p><strong>Conclusion: </strong>BTPNA and guided TBNA contribute to safe and effective sampling of peripheral pulmonary lesions. A relatively high biopsy yield was obtained independent of the presence or absence of a bronchus sign (BS), and high sampling yield and diagnostic yield were obtained independent of location, lesion size and presence or absence of a BS.</p>","PeriodicalId":162871,"journal":{"name":"Respirology (Carlton, Vic.)","volume":" ","pages":"357-365"},"PeriodicalIF":6.9,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39959941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}