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Asian 
Pacific 
Society of 
Respirology

Selection of publications
with specific educational value

Asthma & Allergy

Bronchiectasis


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    Etiology of bronchiectasis in adults: a systematic literature review Gao et al. (resp. 12832/ RES-15-983.R2)
    onlinelibrary.wiley.com/doi/10.1111/resp.12832/full (Jun 2016)

    Comment by Dr Mark Lavercombe:
    This systematic review identifies regional variations in the underlying aetiologies for non-CF bronchiectasis, which is important to consider when evaluating the applicability of the bronchiectasis literature. It also provides an evidence base for the clinical workup of these patients leading to a change in management.

COPD


  • The respiratory telerehabilitation (TeleR) trial team from Sydney, Australia
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    Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: The randomized controlled TeleR Study Ling Ling Y Tsai, Renae J McNamara, Chloe Moddel, Jennifer A Alison, David K McKenzie & Zoe J McKeough 10.1111/resp.12966 (May 2017)

    Despite the clear health benefits in COPD patients, participation in pulmonary rehabilitation is variable with potential barriers including reduced mobility, lack of transport or travel costs. This randomised controlled trial evaluates home-based telerehabilitation compared with usual care and finds improved endurance exercise capacity and self-efficacy in the treatment group. Telerehabilitation might be an alternative option for pulmonary rehabilitation in those unable to attend centralised programmes. Table 3 presents outcomes for special consideration.

  • Pulmonary Rehabilitation Guidelines for Australia and New Zealand Jennifer A Alison, Zoe J McKeough, Kylie Johnston, Renae J McNamara, Lissa M Spencer, Sue C Jenkins, Catherine J Hill, Vanessa M McDonald, Peter Frith, Paul Cafarella, Michelle Brooke, Helen L Cameron-Tucker, Sarah Candy, Nola Cecins, Andrew S L Chan, Marita T Dale, Leona M Dowman, Catherine Granger, Simon Halloran, Peter Jung, Annemarie L Lee, Regina Leung, Tamara Matulick, Christian Osadnik, Mary Roberts, James Walsh, Sally Wootton, Anne E Holland, on behalf of the Lung Foundation Australia and the Thoracic Society of Australia and New Zealand 10.1111/resp.13025 (Apr 2017)

    The aim of these Guidelines is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts.

    These first-ever pulmonary rehabilitation Guidelines for Australia and New Zealand were launched (24-28 March 2017) at the TSANZSRS Annual Scientific Meeting in Canberra, Australia (24-28 March 2017), and were drawn up following a systematic review of over 275 clinical trials.

    The Guidelines recommend that all COPD patients should be offered pulmonary rehabilitation regardless of their disease severity.

    See the full Editorial for these important Guidelines at onlinelibrary.wiley.com/doi/10.1111/resp.13039/full

  • Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease 2017 Report Claus F Vogelmeier, Gerard J Criner, Fernando J Martinez, Antonio Anzueto, Peter J Barnes, Jean Bourbeau, Bartolome R Celli, Rongchang Chen, Marc Decramer, Leonardo M Fabbri, Peter Frith, David M G Halpin, M Victorina López Varela, Masaharu Nishimura, Nicolas Roche, Roberto Rodriguez-Roisin, Don D Sin, Dave Singh, Robert Stockley, Jørgen Vestbo, Jadwiga A Wedzicha and Alvar Agusti 10.1111/resp.13012 (Apr 2017)

    This Executive Summary focuses primarily on the revised and novel parts of the document, including:

    1. the assessment of COPD has been refined to separate the spirometric assessment from symptom evaluation. ABCD groups are now proposed to be derived exclusively from patient symptoms and their history of exacerbations;
    2. for each of the groups A to D, escalation strategies for pharmacological treatments are proposed;
    3. the concept of de-escalation of therapy is introduced in the treatment assessment scheme;
    4. nonpharmacologic therapies are comprehensively presented;
    5. the importance of comorbid conditions in managing COPD is reviewed.

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    Role of BMI, airflow obstruction, St George's Respiratory Questionnaire and age index in prognostication of Asian COPD. Chan et al. (resp12877/RES-16-062.R2)
    onlinelibrary.wiley.com/doi/10.1111/resp.12877/full (Jan 2017)

    Comment by Dr Mark Lavercombe:
    This study identifies important risk factors for mortality in Asian patients with COPD, and develops a prognosis model that is easy to use. Further validation studies will be required to assess its utility.

  • Insulin resistance is associated with skeletal muscle weakness in COPD. Wells et al.
    onlinelibrary.wiley.com/doi/10.1111/resp.12716/abstract (Dec 2015)
  • "Differences in baseline factors and survival between normocapnia, compensated respiratory acidosis and decompensated respiratory acidosis in COPD exacerbation: A pilot study. Lun et al.
    onlinelibrary.wiley.com/doi/10.1111/resp.12652/abstract (Oct 2015)
  • Efficacy and tolerability of budesonide/formoterol added to tiotropium compared with tiotropium alone in patients with severe or very severe COPD: A randomized, multicentre study in East Asia. Lee et al.
    onlinelibrary.wiley.com/doi/10.1111/resp.12646/abstract (Sep 2015)

Critical Care


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    Characteristics, incidence and outcome of patients admitted to intensive care because of pulmonary embolism Dario Winterton, Michael Bailey, David Pilcher, Giovanni Landoni & Rinaldo Bellomo DOI: 10.1111/resp.12881
    onlinelibrary.wiley.com/doi/10.1111/resp.12881/full (Feb 2017)

    Comment by Dr Mark Lavercombe:
    This important study describes a large cohort of patients admitted with acute pulmonary embolism to Intensive Care Units across Australia and New Zealand. A subpopulation at very high risk of death is identified (those requiring mechanical ventilation). No improvement in mortality rate over time is seen.


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    Prevalence and outcomes of diaphragmatic dysfunction assessed by ultrasound technology during acute exacerbation of COPD: A pilot study Federico Antenora, Riccardo Fantini, Andrea Iattoni, Ivana Castaniere, Antonia Sdanganelli, Francesco Livrieri, Roberto Tonelli, Stefano Zona, Marco Monelli, Enrico M Clini & Alessandro Marchioni DOI: 10.1111/resp.12916
    onlinelibrary.wiley.com/doi/10.1111/resp.12916/full (Feb 2017)

    Comment by Dr Mark Lavercombe:
    The indications for thoracic ultrasonography continue to expand, and this study suggests another indication. Diaphragmatic dysfunction found on ultrasound on admission in patients with acute hypercapnic exacerbations of COPD is identified as a risk factor for failure of NIV, duration of mechanical ventilation and short-term mortality. This non-invasive test might help clinicians identify patients at risk of failing standard care.

Cystic Fibrosis

Environmental and Occupational Lung Disease


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    Ecological study on solid fuel use and pneumonia in young children: A worldwide association. Accinelli et al. (resp. 12865/ RES-16-237.R1)
    onlinelibrary.wiley.com/doi/10.1111/resp.12865/full (Jan 2017)

    Comment by Dr Mark Lavercombe:
    This study demonstrates a potential correlation between childhood pneumonia and exposure to solid fuel burning. Future work might examine whether reduction in indoor biomass pollution will lead to reduction in early childhood pneumonia.


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    Clinical impact of the interstitial lung disease Multidisciplinary service, Jo et al. DOI: 10.1111/resp.12850
    onlinelibrary.wiley.com/doi/10.1111/resp.12850/full (Jul 2016)

    Comment by Dr Mark Lavercombe:
    This study demonstrates that assessment of the diagnosis and management of interstitial lung diseases by an expert multidisciplinary panel can potentially make a major contribution to patient outcomes. A significant proportion of patients is re-classified after MDT discussion, leading to changes in management. Longer term follow-up of patient outcomes might add weight to the use of MDT discussions.

  • Mother's smoking and complex lung function of offspring in middle age: A cohort study from childhood. Perret et al.
    onlinelibrary.wiley.com/doi/10.1111/resp.12750/abstract (Mar 2016)
    (FREE access: Editor's Choice)

Interstitial Lung Disease


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    Frailty is common and strongly associated with dyspnoea severity in fibrotic interstitial lung disease, Kathryn M Milne, Joanne M Kwan, Sabina Guler, Tiffany A Winstone, Angela Le, Nasreen Khalil, Pat G Camp, Pearce G Wilcox & Christopher J Ryerson
    10.1111/resp.12944 (May 2017)

    Prognosis in patients with fibrotic interstitial lung diseases can vary significantly. In this study, the authors demonstrate that Frailty is highly prevalent in a cohort of patients with fibrotic ILD and strongly associated with dyspnoea severity. The authors propose a potential role for frailty assessment in identifying patients at risk of complications from invasive procedures or medical therapies, and/or mortality.


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    Bronchoscopy assessment of acute respiratory failure in interstitial lung disease Antonella Arcadu & Teng Moua DOI: 10.1111/resp.12909
    onlinelibrary.wiley.com/doi/10.1111/resp.12909/full (Feb 2017)

    Comment by Dr Mark Lavercombe:
    This study examines the utility of bronchoscopy in patients admitted with acute exacerbations of interstitial lung disease. Although a relatively low diagnostic yield is identified, significant potential complications are noted and there is no in-hospital mortality benefit seen in those undergoing the procedure.


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    Clinical impact of the interstitial lung disease Multidisciplinary service, Jo et al. DOI: 10.1111/resp.12850
    onlinelibrary.wiley.com/doi/10.1111/resp.12850/full (Jul 2016)

    Comment by Dr Mark Lavercombe:
    This study demonstrates that assessment of the diagnosis and management of interstitial lung diseases by an expert multidisciplinary panel can potentially make a major contribution to patient outcomes. A significant proportion of patients is re-classified after MDT discussion, leading to changes in management. Longer term follow-up of patient outcomes might add weight to the use of MDT discussions.

  • Effect of long-term treatment with corticosteroids on skeletal muscle strength, functional exercise capacity and health status in patients with interstitial lung disease. Hanada et al.
    onlinelibrary.wiley.com/doi/10.1111/resp.12807/abstract (May 2016)
    (FREE access: Editor's Choice; Editorial: onlinelibrary.wiley.com/doi/10.1111/resp.12843/abstract)
  • Interstitial lung disease associated with gemcitabine: A Japanese retrospective cohort study. Hamada et al.
    onlinelibrary.wiley.com/doi/10.1111/resp.12665/abstract (Nov 2015)

Interventional Pulmonology


  • Qualitative endobronchial ultrasound (EBUS) elastography classification of lymph nodes according to the dominant elastographic colour pattern (Figure 1 of 10.1111/resp.12979)
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    Diagnostic value of endobronchial ultrasound elastography for the differentiation of benign and malignant intrathoracic lymph nodes Potjanee Korrungruang and Viboon Boonsarngsuk (resp. 12832/ RES-15-983.R2)
    onlinelibrary.wiley.com/doi/10.1111/resp.12979/full (Jul 2017)

    Comment by Dr Mark Lavercombe:
    The authors of this paper outline the use of EBUS elastography for both qualitative and quantitative assessment of mediastinal lymphadenopathy for the presence of malignancy. Their promising findings suggest the need for further study to better define the elastographic features in both benign and malignant conditions, in order to guide the need for TBNA sampling.


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    Airway stenting in the management of iatrogenic tracheal injuries: 10-Year experience Tazi-Mezalek et al. DOI: 10.1111/resp.12853
    onlinelibrary.wiley.com/doi/10.1111/resp.12853/full (Jul 2016)

    Comment by Dr Mark Lavercombe:
    This paper describes the experience of managing a very rare complication of endotracheal intubation or tracheostomy, including the nature and anatomical distribution of the injuries. Finally, outcomes using different treatment approaches is discussed.

Lung Cancer


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    Malignant pleural fluid from mesothelioma has potent biological activities. Cheah et al. (resp.12874/ RES-16-044.R1)
    onlinelibrary.wiley.com/doi/10.1111/resp.12874/full (Jan 2017)

    Comment by Dr Mark Lavercombe:
    This original article suggests that malignant pleural effusion in mesothelioma might not be purely a consequence of the malignancy, but could contribute to its pathobiology. This suggests the possibility of future therapeutic targets in this disease.

Paediatric Lung Disease


  • (Click image to enlarge)
    Ecological study on solid fuel use and pneumonia in young children: A worldwide association. Accinelli et al. (resp. 12865/ RES-16-237.R1)
    onlinelibrary.wiley.com/doi/10.1111/resp.12865/full (Jan 2017)

    Comment by Dr Mark Lavercombe:
    This study demonstrates a potential correlation between childhood pneumonia and exposure to solid fuel burning. Future work might examine whether reduction in indoor biomass pollution will lead to reduction in early childhood pneumonia.

Pleural Disease


  • (Click image to enlarge)
    Malignant pleural fluid from mesothelioma has potent biological activities. Cheah et al. (resp.12874/ RES-16-044.R1)
    onlinelibrary.wiley.com/doi/10.1111/resp.12874/full (Jan 2017)

    Comment by Dr Mark Lavercombe:
    This original article suggests that malignant pleural effusion in mesothelioma might not be purely a consequence of the malignancy, but could contribute to its pathobiology. This suggests the possibility of future therapeutic targets in this disease.

Rare Lung Disease


  • (Click image to enlarge)
    Clinical impact of the interstitial lung disease Multidisciplinary service, Jo et al. DOI: 10.1111/resp.12850
    onlinelibrary.wiley.com/doi/10.1111/resp.12850/full (Jul 2016)

    Comment by Dr Mark Lavercombe:
    This study demonstrates that assessment of the diagnosis and management of interstitial lung diseases by an expert multidisciplinary panel can potentially make a major contribution to patient outcomes. A significant proportion of patients is re-classified after MDT discussion, leading to changes in management. Longer term follow-up of patient outcomes might add weight to the use of MDT discussions.

Respiratory Infections


  • Crude survival based on cardiac troponin T (cTnT) level on admission. (Figure 1 of 10.1111/resp.12996)
    (Click image to enlarge)
    High-sensitivity cardiac troponin T predicts mortality after hospitalization for community-acquired pneumonia Stefan M T Vestjens, Simone M C Spoorenberg, Ger T Rijkers, Jan C Grutters, Jurrien M ten Berg, Peter G Noordzi, Ewoudt M W van de Garde, Willem Jan W Bos and the Ovidius Study Group. (DOI: 10.1111/resp.12996)
    onlinelibrary.wiley.com/doi/10.1111/resp.12996/full (Jul 2017)

    Comment by Dr Mark Lavercombe:
    This paper demonstrates a significant relationship between levels of cardiac troponin measured at admission in patients with Community-Acquired Pneumonia and both 30-day and long-term mortality. The combination of Pneumonia Severity Index with Troponin level predicted mortality better than either model alone. These findings suggest cardiac evaluation might be worthwhile in patients with CAP and elevated Troponin.


  • (Click image to enlarge)
    Ecological study on solid fuel use and pneumonia in young children: A worldwide association. Accinelli et al. (resp. 12865/ RES-16-237.R1)
    onlinelibrary.wiley.com/doi/10.1111/resp.12865/full (Jan 2017)

    Comment by Dr Mark Lavercombe:
    This study demonstrates a potential correlation between childhood pneumonia and exposure to solid fuel burning. Future work might examine whether reduction in indoor biomass pollution will lead to reduction in early childhood pneumonia.

  • Systematic review and meta-analysis of respiratory viral coinfections in children. Lim et al.
    onlinelibrary.wiley.com/doi/10.1111/resp.12741/abstract (Feb 2016)
  • Randomized controlled trial of the effect of regular paracetamol on influenza infection. Jefferies et al.
    onlinelibrary.wiley.com/doi/10.1111/resp.12685/abstract (Dec 2015)
    (FREE access: Editor's Choice; Editorial: onlinelibrary.wiley.com/doi/10.1111/resp.12726/abstract

Sleep and Ventilation

Stem Cell Treatments for Respiratory Diseases

  • Unproven Stem Cell Treatments for Lung Disease – An Emerging Public Health Problem
    Laertis Ikonomou, Angela Panoskaltsis-Mortari, Darcy E Wagner, Robert J Freishtat, Daniel J Weiss, on behalf of the American Thoracic Society Respiratory Cell and Molecular Biology Assembly Stem Cell Working Group. Reviewer: Marianna Sockrider
    American Journal of Respiratory and Critical Care Medicine (AJRCCM), 195(7), pp. P13–P14 www.atsjournals.org/doi/10.1164/rccm.1957P13 (Apr 2017)

    Comment by Dr Yasuhiro Yamauchi:
    This piece describes the information about unproven stem cell treatments for lung disease. It was prepared by the ATS Stem Cell Working Group. This would be a good resource for patients considering stem cell treatments for respiratory diseases.

  • The Global Emergence of Unregulated Stem Cell Treatments for Respiratory Diseases
    www.atsjournals.org/doi/full/10.1513/AnnalsATS.201604-277ED#.V7ay8vl96Uk (Aug 2016)

Thoracic Surgery / Transplantation


  • (Click image to enlarge)
    Airway stenting in the management of iatrogenic tracheal injuries: 10-Year experience Tazi-Mezalek et al. DOI: 10.1111/resp.12853
    onlinelibrary.wiley.com/doi/10.1111/resp.12853/full (Jul 2016)

    Comment by Dr Mark Lavercombe:
    This paper describes the experience of managing a very rare complication of endotracheal intubation or tracheostomy, including the nature and anatomical distribution of the injuries. Finally, outcomes using different treatment approaches is discussed.