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Table of Contents for
Volume 22 Issue 3
April 2017

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409The cost of asthma control
Sanjay H Chotirmall
416New biomarkers in community-acquired pneumonia: Another step in improving outcome prediction
Paola Faverio & Oriol Sibila
418Beyond the thermistor: Novel technology for the ambulatory diagnosis of obstructive sleep apnoea
Emma L Gray & David J Barnes
Respiratory Sleep Disorders
420OSA and cardiometabolic risk: What's the bottom line?
Camilla M Hoyos, Luciano F Drager & Sanjay R Patel
Seeking Innovative Solutions for Severe Asthma
430Can biomarkers help us hit targets in difficult-to-treat asthma?
Michael Fricker, Liam G Heaney & John W Upham
443Radial endobronchial ultrasound for the diagnosis of peripheral pulmonary lesions: A systematic review and meta-analysis
Muhammad S Ali, William Trick, Benjamin I Mba, Divyanshu Mohananey, Jaskaran Sethi & Ali I Musani
Asthma and Allergy
Editor's choice
Association between asthma control and asthma cost: Results from a longitudinal study in a primary care setting
Hai V Nguyen, Nivedita V Nadkarni, Usha Sankari, Shweta Mital, Weng K Lye & Ngiap C Tan

Few studies assessed the relationship between asthma control and asthma costs and most of them relied on cross-sectional data. Using longitudinal administrative data, we showed that asthma control was associated with higher asthma drug costs but significantly lower total asthma costs. These cost savings were signifi cantly greater for obese patients.

460Impact of childhood asthma on growth trajectories in early adolescence: Findings from the Childhood Asthma Prevention Study (CAPS)
Maria Movin, Frances L Garden, Jennifer L P Protudjer, Vilhelmina Ullemar, Frida Svensdotter, David Andersson, Andreas Kruse, Chris T Cowell, Brett G Toelle, Guy B Marks, Catarina Almqvist and for the Childhood Asthma Prevention Team

The association between childhood asthma and heterogeneous sex-specific classes of growth trajectories during adolescence was investigated. No differences were found for boys with versus without asthma. However, girls with asthma had a higher probability of belonging to a class with later growth than those without asthma.

466Combined use of fractional exhaled nitric oxide and bronchodilator response in predicting future loss of asthma control among children with atopic asthma
Je-Kyung Kim, Jae-Yub Jung, Heon Kim, Sang-Yong Eom & Youn-Soo Hahn

High bronchodilator response (BDR) as well as high fractional exhaled nitric oxide (FeNO) are associated with increased risk of asthma control losses among children with atopic asthma. Combined use of BDR and FeNO measurements could improve the prediction capacity for upcoming asthma control losses.

473Activin A and follistatin in patients with asthma. Does severity make the difference?
Anastasia Papaporfyriou, Petros Bakakos, Konstantinos Kostikas, Georgios Papatheodorou, Georgios Hillas, Rodoula Trigidou, Patroklos Katafigiotis, Nikolaos G Koulouris, Spyros A Papiris & Stelios Loukides

Activin A is implicated in the eosinophilic inflammation and airway remodelling in asthmatic patients and is affected by the underlying severity, representing a potential novel therapeutic target for severe refractory asthma.

Interstitial Lung Disease
480Fat-free mass index predicts survival in patients with idiopathic pulmonary fibrosis
Osamu Nishiyama, Ryo Yamazaki, Hiroyuki Sano, Takashi Iwanaga, Yuji Higashimoto, Hiroaki Kume & Yuji Tohda

We measured the body composition of patients with idiopathic pulmonary fibrosis (IPF) using a bioelectrical impedance analyser. The relationship between these anthropometric indices and survival was then examined. The results showed that fat-free mass index, but not BMI, was a significant independent predictor of survival in patients with IPF.

486Validation of the prognostic value of MMP-7 in idiopathic pulmonary fibrosis
Argyris Tzouvelekis, Jose D Herazo-Maya, Martin Slade, Jen-hwa Chu, Giuseppe Deiuliis, Changwan Ryu, Qin Li, Koji Sakamoto, Gabriel Ibarra, Hongyi Pan, Mridu Gulati, Danielle Antin-Ozerkis, Erica L Herzog & Naftali Kaminski

The generalizability of the prognostic value of matrix metalloproteinase-7 (MMP-7) in idiopathic pulmonary fibrosis (IPF) has been questioned. We reproduced prognostic accuracy of a previously published threshold of MMP-7 in an independent cohort of patients with IPF based on similarities in collection matrices. MMP-7 predictive value is robust when heparin plasma is used as collection matrix.

494Unclassifiable interstitial lung diseases: Clinical characteristics and survival
Charlotte Hyldgaard, Elisabeth Bendstrup, Athol U Wells & Ole Hilberg

Unclassifiable interstitial lung disease (ILD) is a common and challenging problem. This study describes the clinical characteristics of a cohort of patients with unclassifiable ILD after diagnostic re-evaluation. We applied the ILD-gender physiology (GAP) model and the recently introduced disease behaviour classification (DBC) and found that both models provide valuable prognostic information.

501A simple dyspnoea scale as part of the assessment to predict outcome across chronic interstitial lung disease
Hadeel Khadawardi & Marco Mura

The Medical Research Council dyspnoea score (MRCDS) is a simple clinical tool to measure the impact of exertional dyspnoea on daily activities. We demonstrated that the MRCDS and its longitudinal changes can predict clinical progression and mortality with good accuracy in patients with chronic interstitial lung disease.

Interventional Pulmonology
508Accuracy and safety of ward based pleural ultrasound in the Australian healthcare system
Gary Hammerschlag, Matthew Denton, Peter Wallbridge, Louis Irving, Mark Hew & Daniel Steinfort

Thoracic physician performed ultrasound has been shown to be safe and effective. We perform a retrospective review of pleural procedures performed at our institution with the aid of thoracic physician operated ultrasound and we show that in the Australian public health system, it remains safe and effective.

513Clinical significance of differentiating post-intubation and post-tracheostomy tracheal stenosis
Beomsu Shin, Kang Kim, Byeong-Ho Jeong, Jung Seop Eom, Won Jun Song, Hyung Koo Kang & Hojoong Kim

Patients with post-tracheostomy tracheal stenosis (PTTS) had more complicated stenosis, poorer general condition and a lower success rate for airway prosthesis removal than those with post-intubation tracheal stenosis (PITS). PITS and PTTS have distinct characteristics and outcomes, and thus should be considered two separate entities.

Lung Cancer
521Lesion heterogeneity and risk of infectious complications following peripheral endobronchial ultrasound
Marc Fortin, Niloofar Taghizadeh, Alex Chee, Christopher A Hergott, Elaine Dumoulin, Alain Tremblay & Paul MacEachern

Low rates of infectious complications have been reported after peripheral endobronchial ultrasound (pEBUS), but studies have mainly focused on small peripheral pulmonary lesions. This study demonstrates a high rate of infectious complications when performing pEBUS-guided biopsies of heterogeneous appearing lesions suggestive of necrosis on computed tomography (CT) scan imaging.

Lung Function
527Angle β of greater than 80° at the start of spirometry may identify high-quality flow volume curves
Ningfang Lian, Li Li, Weiying Ren, Zhilong Jiang & Lei Zhu

Angle β, a simple parameter at the ascending limb of a flow volume curve, is a constant which does not depend on anthropometric or pulmonary function data. In high-quality flow volume curves, the angle is greater than 80°. This angle may be used to identify high-quality flow volume curves at the beginning of test in real time.

533Simvastatin alleviates airway inflammation and remodelling through up-regulation of autophagy in mouse models of asthma
Wen Gu, Rong Cui, Tao Ding, Xiaoming Li, Juan Peng, Weiguo Xu, Fengfeng Han & Xuejun Guo

The study shows that simvastatin contributes to inhibit airway inflammation and airway remodelling likely through activated autophagic process in bronchial smooth muscle cells (BSMCs) in mouse models of asthma.

Respiratory Infections
Editor's choice
YKL-40, CCL18 and SP-D predict mortality in patients hospitalized with community-acquired pneumonia
Simone M C Spoorenberg, Stefan M T Vestjens, Ger T Rijkers, Bob Meek, Coline H M van Moorsel, Jan C Grutters, Willem Jan W Bos & Ovidius Study Group

The prognostic value of YKL-40, chemokine (C-C motif) ligand 18 (CCL18) and surfactant protein-D (SP-D) has been investigated in chronic pulmonary diseases, but their value is largely unknown in acute illness. This study shows that these markers are increased in patients with severe community-acquired pneumonia. YKL-40 predicts both short-term and long-term mortality.

551Clinical relevance of necrotizing change in patients with community-acquired pneumonia
Hyewon Seo, Seung-Ick Cha, Kyung-Min Shin, Jae-Kwang Lim, Seung-Soo Yoo, Jaehee Lee, Shin-Yup Lee, Chang-Ho Kim, Jae-Yong Park & Won-Kee Lee

We investigated the clinical features of community-acquired necrotizing pneumonia. Necrotizing change was noted in approximately 10% of the patients with community-acquired pneumonia (CAP) and was characterized by more severe clinical manifestations and increased need for pleural drainage. Necrotizing change was a predictor of length of hospital stay (LOS) but not of mortality in patients with CAP.

559Potential effect of ezetimibe against Mycobacterium tuberculosis infection in type II diabetes
I-Fang Tsai, Chiu-Ping Kuo, Andrew B Lin, Ming-Nan Chien, Hsin-Tsung Ho, Tsai-Yin Wei, Chien-Liang Wu & Yen-Ta Lu

This study provides evidence that the cholesterol-lowering drug ezetimibe is capable of reducing intracellular mycobacteria growth, and diabetes mellitus (DM) patients receiving ezetimibe therapy have lower prevalence of latent tuberculosis (TB). Our data suggest that ezetimibe treatment not only combats hypercholesterolaemia, but also may have therapeutic potential against TB.

Sleep and Ventilation
567Mandibular position and movements: Suitability for diagnosis of sleep apnoea
Jean-Benoit Martinot, Jean-Christian Borel, Valérie Cuthbert, Hervé Jean-Pierre Guénard, Stéphane Denison, Philip E Silkoff, David Gozal & Jean-Louis Pepin

The study aims to score blindly the mandibular movements (MMs) compared with the respiratory disordered events during an in-laboratory polysomnography in patients with obstructive sleep apnoea. High agreement was found between both scorings. A simple recording of the MMs could be explored for home diagnosis of sleep-disordered breathing.

575Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Lung Disease 2017 Report: GOLD Executive Summary
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 & Alvar Agusti
602Year in review 2016: Respiratory infections, acute respiratory distress syndrome, pleural diseases, lung cancer and interventional pulmonology
Marcos I Restrepo, James D Chalmers, Yuanlin Song, Christopher Mallow, Justin Hewlett, Fabien Maldonado & Lonny Yarmus
612Asthma or asthma-COPD overlap syndrome?
Fa-Ping Wang, Ting Liu, Geng Wang & Hui Mao
612Asthma or asthma-COPD overlap syndrome? – Reply
Tunn R Tay, Naghmeh Radhakrishna & Mark Hew