Respirology最新文献

{"title":"Chest x-ray has low sensitivity to detect silicosis in artificial stone benchtop industry workers.","authors":"Ryan F Hoy, Catherine Jones, Katrina Newbigin, Michael J Abramson, Hayley Barnes, Christina Dimitriadis, Samantha Ellis, Deborah C Glass, Stella M Gwini, Fiona Hore-Lacy, Javier Jimenez-Martin, Sundeep S Pasricha, Janu Pirakalathanan, Miranda Siemienowicz, Karen Walker-Bone, Malcolm R Sim","doi":"10.1111/resp.14755","DOIUrl":"10.1111/resp.14755","url":null,"abstract":"<p><strong>Background and objective: </strong>Chest x-ray (CXR) remains a core component of health monitoring guidelines for workers at risk of exposure to crystalline silica. There has however been a lack of evidence regarding the sensitivity of CXR to detect silicosis in artificial stone benchtop industry workers.</p><p><strong>Methods: </strong>Paired CXR and high-resolution computed tomography (HRCT) images were acquired from 110 artificial stone benchtop industry workers. Blinded to the clinical diagnosis, each CXR and HRCT was independently read by two thoracic radiologists from a panel of seven, in accordance with International Labour Office (ILO) methodology for CXR and International Classification of HRCT for Occupational and Environmental Respiratory Diseases. Accuracy of screening positive (ILO major category 1, 2 or 3) and negative (ILO major category 0) CXRs were compared with identification of radiological features of silicosis on HRCT.</p><p><strong>Results: </strong>CXR was positive for silicosis in 27/110 (24.5%) workers and HRCT in 40/110 (36.4%). Of the 83 with a negative CXR (ILO category 0), 15 (18.1%) had silicosis on HRCT. All 11 workers with ILO category 2 or 3 CXRs had silicosis on HRCT. In 99 workers ILO category 0 or 1 CXRs, the sensitivity of screening positive CXR compared to silicosis identified by HRCT was 48% (95%CI 29-68) and specificity 97% (90-100).</p><p><strong>Conclusion: </strong>Compared to HRCT, sensitivity of CXR was low but specificity was high. Reliance on CXR for health monitoring would provide false reassurance for many workers, delay management and underestimate the prevalence of silicosis in the artificial stone benchtop industry.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of acute exacerbations of interstitial lung diseases with corticosteroids: Evidence?","authors":"Chi F Hung, Ganesh Raghu","doi":"10.1111/resp.14788","DOIUrl":"10.1111/resp.14788","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing obstructive sleep apnoea by oxygen desaturation metrics: Pre-dawn clearing.","authors":"Octavian C Ioachimescu","doi":"10.1111/resp.14796","DOIUrl":"10.1111/resp.14796","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Steroid therapy in acute exacerbation of fibrotic interstitial lung disease.","authors":"Kavya Koshy, Hayley Barnes, Erica Farrand, Ian Glaspole","doi":"10.1111/resp.14763","DOIUrl":"10.1111/resp.14763","url":null,"abstract":"<p><strong>Background and objective: </strong>Evidence for the benefit of steroid therapy in acute exacerbations (AEs) of idiopathic pulmonary fibrosis (IPF) is limited; however, they remain a cornerstone of management in other fibrotic interstitial lung diseases. This retrospective observational study assesses the effect of steroid treatment on in-hospital mortality in patients with acute exacerbation of fibrotic interstitial lung disease (AE-FILD) including IPF and non-IPF ILDs.</p><p><strong>Methods: </strong>AE-FILD cases over a 10-year period were filtered using a code-based algorithm followed by individual case evaluation. Binary logistic regression analysis was used to assess the relationship between corticosteroid treatment (defined as ≥0.5 mg/kg/day of prednisolone-equivalent for ≥3 days within the first 72 h of admission) and in-hospital mortality or need for lung transplantation. Secondary outcomes included readmission, overall survival, requirement for domiciliary oxygen and rehabilitation.</p><p><strong>Results: </strong>Across two centres a total of 107 AE-FILD subjects were included, of which 46 patients (43%) received acute steroid treatment. The steroid cohort was of younger age with fewer comorbidities but had higher oxygen requirements. Pre-admission FVC and DLCO, distribution of diagnoses and smoking history were similar. The mean steroid treatment dose was 4.59 mg/kg/day. Steroid use appeared to be associated with increased risk of inpatient mortality or transplantation (OR 4.11; 95% CI 1.00-16.83; p = 0.049). In the steroid group, there appeared to be a reduced risk of all-cause mortality in non-IPF patients (HR 0.21; 95% CI 0.04-0.96; p = 0.04) compared to their IPF counterparts. Median survival was reduced in the steroid group (221 vs. 520.5 days) with increased risk of all-cause mortality (HR 3.25; 95% CI 1.56-6.77; p < 0.01).</p><p><strong>Conclusion: </strong>In this two-centre retrospective study of 107 patients, AE-FILD demonstrates a high risk of mortality, at a level similar to that seen for AE-IPF, despite steroid treatment. Clinicians should consider other precipitating factors for exacerbations and use steroids judiciously. Further prospective trials are needed to determine the role of corticosteroids in AE-FILD.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstructive sleep apnoea, oxygen desaturation and hypoxic burden: pebble, rock or boulder?","authors":"Octavian C Ioachimescu","doi":"10.1111/resp.14801","DOIUrl":"10.1111/resp.14801","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to 'Home oxygen guidelines: We do not know enough about LTOT'.","authors":"Belinda R Miller, Christine F McDonald, Yet Hong Khor","doi":"10.1111/resp.14809","DOIUrl":"10.1111/resp.14809","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141875847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of radiation exposure during mobile cone-beam CT-guided robotic-assisted bronchoscopy.","authors":"Or Kalchiem-Dekel, Reza Bergemann, Xiaoyue Ma, Paul J Christos, Daniel Miodownik, Yiming Gao, Usman Mahmood, Prasad S Adusumilli, Matthew J Bott, Joseph Dycoco, Daphna Y Gelblum, Robert P Lee, Bernard J Park, Gaetano Rocco, Stephen B Solomon, David R Jones, Mohit Chawla, Bryan C Husta","doi":"10.1111/resp.14765","DOIUrl":"10.1111/resp.14765","url":null,"abstract":"<p><strong>Background and objective: </strong>Robotic-assisted bronchoscopy (RAB) is an emerging modality to sample pulmonary lesions. Cone-beam computed tomography (CBCT) can be incorporated into RAB. We investigated the magnitude and predictors of patient and staff radiation exposure during mobile CBCT-guided shape-sensing RAB.</p><p><strong>Methods: </strong>Patient radiation dose was estimated by cumulative dose area product (cDAP) and cumulative reference air kerma (cRAK). Staff equivalent dose was calculated based on isokerma maps and a phantom simulation. Patient, lesion and procedure-related factors associated with higher radiation doses were identified by logistic regression models.</p><p><strong>Results: </strong>A total of 198 RAB cases were included in the analysis. The median patient cDAP and cRAK were 10.86 Gy cm² (IQR: 4.62-20.84) and 76.20 mGy (IQR: 38.96-148.38), respectively. Among staff members, the bronchoscopist was exposed to the highest median equivalent dose of 1.48 μSv (IQR: 0.85-2.69). Both patient and staff radiation doses increased with the number of CBCT spins and targeted lesions (p < 0.001 for all comparisons). Patient obesity, negative bronchus sign, lesion size <2.0 cm and inadequate sampling by on-site evaluation were associated with a higher patient dose, while patient obesity and inadequate sampling by on-site evaluation were associated with a higher bronchoscopist equivalent dose.</p><p><strong>Conclusion: </strong>The magnitude of patient and staff radiation exposure during CBCT-RAB is aligned with safety thresholds recommended by regulatory authorities. Factors associated with a higher radiation exposure during CBCT-RAB can be identified pre-operatively and solicit procedural optimization by reinforcing radiation protective measures. Future studies are needed to confirm these findings across multiple institutions and practices.</p>","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11329349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asthma-COPD overlap and asthma progressing to COPD: Are we using the right diagnostic approaches and pathways?","authors":"Elvis Malcolm Irusen, Danica Meiring, Coenraad Frederik Nicolaas Koegelenberg","doi":"10.1111/resp.14731","DOIUrl":"10.1111/resp.14731","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of post-operative lung physiology revisited.","authors":"Sylvia Verbanck, Karolien Vekens, Dirk Smets, Shane Hanon, Eef Vanderhelst","doi":"10.1111/resp.14784","DOIUrl":"10.1111/resp.14784","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141559624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clearing the air: Understanding the long-term lung effects of the Hazelwood coal mine fire.","authors":"Paul D Robinson, Dwan Vilcins","doi":"10.1111/resp.14797","DOIUrl":"10.1111/resp.14797","url":null,"abstract":"","PeriodicalId":21129,"journal":{"name":"Respirology","volume":null,"pages":null},"PeriodicalIF":6.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}