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Table of Contents for
Volume 21 Issue 8
November 2016

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1338Message from the outgoing Editor-in-Chief
Peter Eastwood
1340Similarities and differences between East and West in COPD
Masaharu Nishimura
1342Nintedanib for idiopathic pulmonary fibrosis: An Asian perspective
Daniel C Chambers
1344Coagulation at the crossroads of the communicable/non-communicable disease dyad: The case of pneumonia
Francesca Santilli, Andrea Boccatonda and Giovanni Davì
Unravelling the Many Faces of COPD to Optimize Its Care and Outcomes
1347Airway remodelling in COPD: It's not asthma!
Robyn L Jones, Peter B Noble, John G Elliot and Alan L James
Idiopathic Interstitial Pneumonia
1357Symptom-based management of the idiopathic interstitial pneumonia
Brian T Garibaldi and Sonye K Danoff
1366Mesenchymal stem cells in the treatment of chronic lung disease
Sophie Wecht and Mauricio Rojas
1376Aetiology of bronchiectasis in adults: A systematic literature review
Yong-hua Gao, Wei-jie Guan, Shao-xia Liu, Lei Wang, Juan-juan Cui, Rong-chang Chen and Guo-jun Zhang
Asthma and Allergy
1384Comorbidities in difficult asthma are independent risk factors for frequent exacerbations, poor control and diminished quality of life
Tunn Ren Tay, Naghmeh Radhakrishna, Fiona Hore-Lacy, Catherine Smith, Ryan Hoy, Eli Dabscheck and Mark Hew

This study examined comorbidities in a consecutive cohort of difficult asthma patients. Increasing BMI, chronic rhinosinusitis, dysfunctional breathing and vocal cord dysfunction were independent risk factors for a broad spectrum of asthma outcomes. Identification and treatment of these comorbidities are essential in management of patients with difficult asthma.

Editor's choice
Environmental influence on the prevalence and pattern of airway dysfunction in elite athletes
Irisz Karolina Levai, James H Hull, Mike Loosemore, Jon Greenwell, Greg Whyte and John W Dickinson

This is the first study to screen the entire elite Great British (GB) Swimming and Boxing teams using a eucapnic voluntary hyperpnoea (EVH) challenge. The findings support the notion that athletes who train and compete in provocative environments at sustained high ventilation have an increased susceptibility to airway dysfunction.

1397TIOtropium Safety and Performance In Respimat® (TIOSPIRTM): Analysis of Asian cohort of COPD patients
Nanshan Zhong, Hwa S Moon, Kwan H Lee, Aziah A Mahayiddin, Watchara Boonsawat, Marie G D Isidro, ChunXue Bai, Achim Mueller, Norbert Metzdorf and Antonio Anzueto

Asian cohort analysis in TIOtropium Safety and Performance In Respimat In Respimat® (TIOSPIRTM) COPD trial demonstrates that, analogous to the global analysis, tiotropium Respimat 5 µg and HandiHaler 18 µg have similar safety and exacerbation efficacy. However, patients in Asia had fewer, but more severe, exacerbations than patients from the rest of the world.

Critical Care
1404Role of the PKCα-c-Src tyrosine kinase pathway in the mediation of p120-catenin degradation in ventilator-induced lung injury
Tao Zhao, Hongwei Zhao, Gang Li, Shengfa Zheng, Mengjie Liu, Changping Gu and Yuelan Wang

This study demonstrates the importance of protein kinase Cα (PKCα) and c-Src kinase in ventilator-induced lung injury (VILI). These proteins may be novel therapeutic targets.

1411Clinical features, aetiology and outcome of bacteraemic pneumonia in neutropenic cancer patients
Carlota Gudiol, Cristina Royo-Cebrecos, Júlia Laporte, Carmen Ardanuy, Carolina Garcia-Vidal, Maite Antonio, Montserrat Arnan and Jordi Carratalà

Bacterial pneumonia is a frequent complication in cancer patients. However, recent information regarding this often life-threatening complication is scarce. The aim of this study is to review the clinical features, aetiologies and outcomes of bacteraemic pneumonia in neutropenic cancer patients in the current era of widespread antibacterial resistance.

Environmental and Occupational Lung Disease
1419Ultra low dose CT screen-detected non-malignant incidental findings in the Western Australian Asbestos Review Programme
Conor P Murray, Patrick M Wong, Joelin Teh, Nick de Klerk, Tim Rosenow, Helman Alfonso, Alison Reid, Peter Franklin, A W (Bill) Musk and Fraser J H Brims

The utility of low dose CT (LDCT) to screen asbestos-exposed populations is not established. This study describes the incidental radiological findings from LDCT screening an asbestos-exposed cohort. The prevalence of indeterminate nodules compared with other high-risk populations appears low. LDCT appears effective in demonstrating other asbestos-related diseases.

Interstitial Lung Disease
Editor's choice
Subgroup analysis of Asian patients in the INPULSIS® trials of nintedanib in idiopathic pulmonary fibrosis
Hiroyuki Taniguchi, Zuojun Xu, Arata Azuma, Yoshikazu Inoue, Huiping Li, Tsuyoshi Fujimoto, Zelie Bailes, Rozsa Schlenker-Herceg and Dong S Kim

In the two Phase III INPULSIS® trials, nintedanib 150 mg bd slowed disease progression in patients with idiopathic pulmonary fibrosis by reducing the annual rate of decline in forced vital capacity. Pre-specified subgroup analyses of Asian versus White patients demonstrated a consistent treatment effect of nintedanib across these subgroups.

1431Heterogeneity of incidence and outcome of acute exacerbation in idiopathic interstitial pneumonia
Toru Arai, Tomoko Kagawa, Yumiko Sasaki, Reiko Sugawara, Chikatoshi Sugimoto, Kazunobu Tachibana, Masanori Kitaichi, Masanori Akira, Seiji Hayashi and Yoshikazu Inoue

Acute exacerbations of idiopathic interstitial pneumonia occur significantly less frequently in patients with ‘possible usual interstitial pneumonia (UIP)’ and ‘inconsistent with UIP’ HRCT patterns than in idiopathic pulmonary fibrosis (IPF); however, the prognosis of exacerbations in patients with possible UIP HRCT patterns might be worse than that of IPF.

1438Clinical impact of the interstitial lung disease multidisciplinary service
Helen E Jo, Ian N Glaspole, Kovi C Levin, Samuel R McCormack, Annabelle M Mahar, Wendy A Cooper, Rhoda Cameron, Samantha J Ellis, Alice M Cottee, Susanne E Webster, Lauren K Troy, Paul J Torzillo, Peter Corte, Karen M Symons, Nicole Taylor and Tamera J Corte

We demonstrate a significant change in specific interstitial lung disease (ILD) diagnosis in ILD patients assessed at ILD referral centres. This allows specific management to be implemented, which is critically important in patients with idiopathic pulmonary fibrosis (IPF), a disease associated with the poorest prognosis but now with specific therapy available.

Interventional Pulmonology
1445Target-controlled versus fractionated propofol sedation in flexible bronchoscopy: A randomized noninferiority trial
Daniel Franzen, Daniel J Bratton, Christian F Clarenbach, Lutz Freitag and Malcolm Kohler

In this randomized noninferiority trial, we evaluated whether target-controlled infusion (TCI) of propofol is noninferior to fractionated administration in terms of safety in flexible bronchoscopy. TCI of propofol is a favourable and safe sedation technique for flexible bronchoscopy.

1452Airway stenting in the management of iatrogenic tracheal injuries: 10-Year experience
Rachid Tazi-Mezalek, Ali I Musani, Sophie Laroumagne, Philippe J Astoul, Xavier B D'Journo, Pascal A Thomas and Hervé Dutau

We describe the role of airway stenting in the delicate treatment of iatrogenic tracheal injuries. Currently, management is guided by case series using different criteria for selecting either conservative or surgical treatment. This is the largest case series ever compiled on this topic. Airway stenting is proposed as a valid treatment option.

Respiratory Infections
1459Serial procalcitonin levels for predicting prognosis in community-acquired pneumonia
Akihiro Ito, Tadashi Ishida, Hiromasa Tachibana, Yuhei Ito and Takuya Takaiwa

The usefulness of serial procalcitonin (PCT) measurements for predicting prognosis and initial treatment failure in community-acquired pneumonia (CAP) patients was shown. Addition of consecutive measurements of PCT starting from admission to measurements of C-reactive protein and assessment of CURB-65 (confusion, urea > 7 mmol/L, respiratory rate ≥ 30 breaths/min, low blood pressure (systolic < 90 mm Hg or diastolic ≤ 60 mm Hg) and age ≥ 65 years) improves the prediction of prognosis and initial treatment failure in CAP patients.

1465Low-grade endotoxemia and clotting activation in the early phase of pneumonia
Roberto Cangemi, Patrizia Della Valle, Camilla Calvieri, Gloria Taliani, Patrizia Ferroni, Marco Falcone, Roberto Carnevale, Simona Bartimoccia, Armando D'Angelo, Francesco Violi and in collaboration with the SIXTUS Study Group

Community-acquired pneumonia (CAP) is associated with an increased risk of arterial and venous thrombosis, but the underlying pathophysiological mechanisms are unclear. This study provides the first evidence that CAP patients disclose an ongoing pro-thrombotic state and suggests a role for endotoxemia in determining enhanced thrombin generation.

1472Age-related risk factors for bacterial aetiology in community-acquired pneumonia
José M Sahuquillo-Arce, Rosario Menéndez, Raúl Méndez, Isabel Amara-Elori, Rafael Zalacain, Alberto Capelastegui, Javier Aspa, Luis Borderías, Juan J Martín-Villasclaras, Salvador Bello, Inmaculada Alfageme, Felipe Rodriguez de Castro, Jordi Rello, Luis Molinos, Juan Ruiz-Manzano and Antoni Torres

We report patterns of rare causative organisms for community-acquired pneumonia related to comorbidities such as liver disease, COPD, neurological illness diabetes, smoking and alcohol abuse in three age groups: young adults (<45 years), adults (45–64 years) and seniors (>65 years).

Sleep and Ventilation
1480Arterial stiffness in obstructive sleep apnoea: Is there a difference between daytime and night-time?
Sevinc Sarinc Ulasli, Muzaffer Sariaydin, Gulay Ozkececi, Ersin Gunay, Bilal Halici and Mehmet Unlu

This study examines arterial stiffness over 24-h periods, comparing daytime and night-time values in obstructive sleep apnoea syndrome (OSAS) and control subjects. It demonstrates that OSAS patients had increased arterial stiffness parameters during the night and higher indices than control subjects.

1486Comparisons of sleep apnoea rate and outcomes among patients with resistant and non-resistant hypertension
Simran K Bhandari, Jiaxiao Shi, Miklos Z Molnar, Scott A Rasgon, Stephen F Derose, Csaba P Kovesdy, David A Calhoun, Kamyar Kalantar-Zadeh, Steven J Jacobsen and John J Sim

The risk for ischaemic heart events and congestive heart failure were increased in a large ethnically diverse hypertension (HTN) population with sleep apnoea (SA) and resistant versus non-resistant HTN. However, there were no differences in risk for stroke and mortality in SA and resistant HTN versus SA and non-resistant HTN.

1493Exercise simultaneously increases nasal patency and bronchial obstruction in asthmatic children
Minna Lukkarinen, Lotta E Haavisto, Heikki Lukkarinen, Jukka I Sipilä, Nikolaos G Papadopoulos and Tuomas Jartti
1496Gastroesophageal reflux and COPD exacerbations: Is cholinergic-mediated oesophago-bronchial reflex a possible link?
Gennaro Liccardi, Antonello Salzillo, Luigino Calzetta, Josuel Ora and Paola Rogliani
1497Gastroesophageal reflux and COPD exacerbations: Is cholinergic-mediated oesophago-bronchial reflex a possible link? - Reply
Luzia Baumeler, Eleni Papakonstaninou and Daiana Stolz