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Table of Contents for
Volume 22 Issue 2
February 2017

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211Precision medicine in COPD: Are we making it too difficult?
Pim A de Jong & Firdaus Mohamed Hoesein
213Pulmonary embolism requiring intensive care: Do we now have a better idea of how to triage?
Kevin C Proud
215Acute exacerbations of interstitial lung disease: Don't just do something, stand there!
Robert J Lentz & Fabien Maldonado
Respiratory Sleep Disorders
217Sleep apnoea in heart failure: To treat or not to treat?
Matthew T Naughton & Kirk Kee
230Anaesthetic management of sleep-disordered breathing in adults
David R Hillman & Frances Chung
240Microbiomes in respiratory health and disease: An Asia-Pacific perspective
Sanjay H Chotirmall, Shaan L Gellatly, Kurtis F Budden, Micheál Mac Aogain, Shakti D Shukla, David L A Wood, Philip Hugenholtz, Kevin Pethe & Philip M Hansbro
251Evaluating the Clinical COPD Questionnaire: A systematic review
Zijing Zhou, Aiyuan Zhou, Yiyang Zhao & Ping Chen
263How is physical activity measured in lung cancer? A systematic review of outcome measures and their psychometric properties
Lara Edbrooke, Linda Denehy, Selina M Parry, Ronan Astin, Sandy Jack & Catherine L Granger
Asthma and Allergy
278Physical activity and lung function decline in adults with asthma: The HUNT Study
Ben M Brumpton, Arnulf Langhammer, Anne H Henriksen, Carlos A Camargo Jr, Yue Chen, Pål R Romundstad & Xiao-Mei Mai

This is one of the first studies to investigate the association between physical activity and lung function decline in adults with asthma. There were small differences in the rates of lung function decline between physically inactive and active participants which tended to favour the active participants.

284Higher prevalence of wheezing and lower FEV1 and FVC percent predicted in adults with sickle cell anaemia: A cross-sectional study
Baba M Musa, Najibah A Galadanci, Mark Rodeghier & Michael R Debaun

This study demonstrates that adults with sickle cell anaemia have higher prevalence of wheezing and lower FEV1% and FVC% predicted than adults without sickle anaemia.

Editor's choice
Infant lung function predicts asthma persistence and remission in young adults
Louisa Owens, Ingrid A Laing, Guicheng Zhang & Peter N Le Souëf

Asthma associates with a persistent reduction in lung function from childhood into adulthood and infant lung function is predictive of childhood asthma. We have shown that reduced lung function in infancy is also predictive of asthma in young adults and can help differentiate those whose symptoms will resolve before adulthood.

295Clinical characteristics of eosinophilic asthma exacerbations
Asger Bjerregaard, Ingrid A Laing, Vibeke Backer, Markus Fally, Siew-Kim Khoo, Glenys Chidlow, Chisha Sikazwe, David W Smith, Peter Le Souëf & Celeste Porsbjerg

Patients with airway eosinophilia during an exacerbation of asthma had lower forced expiratory volume in 1 s (FEV1) and were more likely to require supplemental oxygen during admission than those without eosinophilia. This suggests that eosinophilic asthma exacerbations are more severe than non-eosinophilic exacerbations.

301Contractile capability of the diaphragm assessed by ultrasonography predicts nocturnal oxygen saturation in COPD
Kazuki Okura, Atsuyoshi Kawagoshi, Masahiro Iwakura, Keiyu Sugawara, Hitomi Takahashi, Takeshi Kashiwagura, Mitsunobu Homma, Masahiro Satake & Takanobu Shioya

This study investigated the relationship between the contractile capability of the diaphragm assessed by ultrasonography and the nocturnal percutaneous arterial oxygen saturation (NSpO2) in COPD. The results suggested the existence of a close relationship between NSpO2 and diaphragm contractile capability in COPD patients with mild or no daytime hypoxaemia.

307Patient versus proxy-reported problematic activities of daily life in patients with COPD
Nienke Nakken, Daisy J A Janssen, Esther H A van den Bogaart, Monique van Vliet, Geeuwke J de Vries, Gerben P Bootsma, Michiel H M Gronenschild, Jeannet M L Delbressine, Jean W M Muris, Emiel F M Wouters & Martijn A Spruit

Patient proxy agreement for 194 COPD patients' problematic activities of daily living (ADLs) was investigated using the Canadian Occupational Performance Measure. Proxies were often unable to identify the patients' most important problematic ADLs, and perception differences did exist in most pairs regarding the patients' performance and satisfaction of problematic ADLs.

315Reduced DNA methylation of sphingosine-1 phosphate receptor 5 in alveolar macrophages in COPD: A potential link to failed efferocytosis
Jameel Barnawi, Hubertus Jersmann, Rainer Haberberger, Sandra Hodge & Robyn Meech

We describe for the first time the potential linkage of dysregulated sphingosine-1 phosphate receptor 5 (S1PR5) methylation and expression, to the reduced alveolar macrophage efferocytic function in COPD and its potential to contribute to tissue damage and chronic airways inflammation.

322Can computed tomography and carbon monoxide transfer coefficient diagnose an asthma-like phenotype in COPD?
Feisal A Al-Kassimi, Esam H Alhamad, Mohammed S Al-Hajjaj, Emad Raddaoui, Abdulaziz H Alzeer, Ahmad A Alboukai, Ali M Somily, Joseph G Cal, Abdalla F Ibrahim & Shaffi A Shaik

We aimed to compare the emphysematous and the non-emphysematous phenotypes of COPD, and to test the hypothesis that the latter has similarities with asthma. We found that the non-emphysematous phenotype displayed the following features of asthma: clinical picture, higher serum IgE, bronchial histology and response to inhaled corticosteroid.

Critical Care
Editor's choice
Characteristics, incidence and outcome of patients admitted to intensive care because of pulmonary embolism
Dario Winterton, Michael Bailey, David Pilcher, Giovanni Landoni & Rinaldo Bellomo

Little is known about pulmonary embolism severe enough to require intensive care unit admission and/or mechanical ventilation. For the first time, using a bi-national multicentre database, we assess the epidemiology of this condition, provide a description of this population and describe changes in outcome over time.

338Prevalence 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

In this pilot study, we assessed diaphragmatic dysfunction (DD) by ultrasonography in severe acute exacerbations of COPD (AECOPD) patients admitted in intensive care unit for severe hypercapnic respiratory failure. We found that severe DD is reported in almost one-quarter of AECOPD patients. This factor may cause non-invasive mechanical ventilation failure, and impact short-term mortality.

Environmental and Occupational Lung Disease
345Lung function in patients with lung injury due to household chemical inhalation: Post hoc analysis of a prospective nationwide cohort
Won-Young Kim, Soonyoung Park, Hwa Jung Kim, Eun Jin Chae, Kyung-Hyun Do, Jin Won Huh, Chae-Man Lim, Younsuck Koh & Sang-Bum Hong

Inhalation of home humidifier disinfectants can cause severe lung injury and patients with poor post-exposure lung function and/or high levels of exposure exhibit persistent lung dysfunction. A more aggressive therapeutic approach such as lung transplantation may be required for these irreversibly injured patients.

Interstitial Lung Disease
352Bronchoscopy assessment of acute respiratory failure in interstitial lung disease
Antonella Arcadu & Teng Moua

Bronchoscopy is currently recommended to exclude infection in interstitial lung disease (ILD)-associated acute exacerbation. Our study suggests that diagnostic yield is low, often does not alter the outcome of already empirically provided therapy and may be associated with notable procedure-related risk in non-intubated patients. A reassessment of its application in this setting is warranted.

360Characteristics of sarcoidosis in Maori and Pacific Islanders
Margaret L Wilsher, Lisa M Young, Raewyn Hopkins & Megan Cornere

This is the first study of clinical features of sarcoidosis in people of Polynesian ancestry; Maori and Pacific Islanders. This ethnic group presents with less pulmonary and more extra-pulmonary disease, but requirement for treatment is the same.

Lung Function
364Predictors of long-term compensatory response of pulmonary function following major lung resection for non-small cell lung cancer
Yusuke Takahashi, Noriyuki Matsutani, Shigeki Morita, Hitoshi Dejima, Takashi Nakayama, Hirofumi Uehara & Masafumi Kawamura

Long-term pulmonary function after lobectomy might include compensatory response (CR). In our study, the non-smoker group shows better long-term pulmonary function in case-matched comparison. Higher expression of pro-surfactant protein C (pro-SPC), thyroid transcription factor-1 (TTF-1) and vascular endothelial growth factor receptor 2 (VEGFR2) may contribute to CR. This is the first report showing predictors of long-term pulmonary function.

Pulmonary Vascular Disease
372Long-term outcomes of domiciliary intravenous iloprost in idiopathic and connective tissue disease-associated pulmonary arterial hypertension
Sheila Ramjug, Nehal Hussain, Judith Hurdman, Charlie A Elliot, Ian Sabroe, Iain J Armstrong, Catherine Billings, Neil Hamilton, David G Kiely & Robin Condliffe

From a large single centre, we report on our experience of the efficacy of long-term i.v. iloprost in subjects with idiopathic pulmonary arterial hypertension (iPAH) and connective tissue disease-associated PAH (CTD-PAH). Despite few published studies, reported outcomes have been poor. However, we have found improved survival to that previously reported in iPAH patients treated with domiciliary i.v. iloprost.

Sleep and Ventilation
378Validation of a new domiciliary diagnosis device for automatic diagnosis of patients with clinical suspicion of OSA
Joaquín Durán-Cantolla, Gabriela Zamora Almeida, Odei Vegas Diaz de Guereñu, Luis Saracho Rotaeche, Mohammad Hamdan Alkhraisat, Joaquín Durán Carro, Carlos Egea Santaolalla, Eduardo Anitua & on Behalf of the Spanish Sleep Network

The portable respiratory polygraph tested here is a valid device for the diagnosis of obstructive sleep apnoea (OSA). The automatic analysis is as accurate as manual analysis of the apnoea hypopnoea index (AHI). Reliable and accurate devices for automatic diagnosis of OSA may assist to address the underdiagnosis of OSA in the general population.

386Variability of breathing during wakefulness while using CPAP predicts adherence
Yukio Fujita, Motoo Yamauchi, Hiroki Uyama, Makiko Kumamoto, Noriko Koyama, Masanori Yoshikawa, Kingman P Strohl & Hiroshi Kimura

We investigated the variability of breathing, a marker of respiratory control, as a predictor of continuous positive airway pressure (CPAP) adherence. Our findings indicate that breathing regularity while awake during CPAP acclimatization predicts subsequent adherence to CPAP at 1 month.

Thoracic Surgery / Transplantation
394Histone deacetylase 2 is decreased in peripheral blood pro-inflammatory CD8+ T and NKT-like lymphocytes following lung transplant
Greg Hodge, Sandra Hodge, Chien-Li Holmes-Liew, Paul N Reynolds & Mark Holmes

We investigated expression of histone acetyltransferase and histone deacetylase 2 (HDAC2) in cytotoxic/pro-inflammatory lymphocytes post-lung transplant. HDAC2 was decreased in pro-inflammatory lymphocytes and synergistically increased in the presence of theophylline and prednisolone (with a corresponding decrease in pro-inflammatory cytokines). Treatments that increase HDAC2 may improve graft survival.

401Increased neutrophil expression of pattern recognition receptors during COPD exacerbations
Simon D Pouwels, Wouter H van Geffen, Marnix R Jonker, Huib A M Kerstjens, Martijn C Nawijn & Irene H Heijink
405Thoracic ultrasound recognition of competence: A position paper of the Thoracic Society of Australia and New Zealand
Jonathan P Williamson, Scott H Twaddell, Y C Gary Lee, Matthew Salamonsen, Mark Hew, David Fielding, Phan Nguyen, Daniel Steinfort, Peter Hopkins, Nicola Smith & Christopher Grainge