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Table of Contents for
Volume 22 Issue 6
August 2017

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1045EBUS-TBNA risks and repairs
Christina Bellinger & Travis Dotson
1047The silent zone of the lung in asthma under scrutiny again
Norbert Berend
1049NHF and hypercapnia: How brief can you look?
Jens Bräunlich & Hubert Wirtz
1051Tolerability of treatment with pirfenidone or nintedanib for pulmonary fibrosis in the real world
Takashi Ogura & Hideya Kitamura
1053Lower limb muscle function and exercise performance in lung cancer
Matthew Maddocks & Catherine Granger
1055Pleural infection: To drain or not to drain?
Deirdre B Fitzgerald & Y C Gary Lee
1057Different location, same results?
Kyle R Brownback
1059Will the safe-breakers of sleep apnoea find the right combination?
Ronald R Grunstein
Respiratory Infections in the Asia-Pacific region
1061Respiratory infections in the Asia-Pacific region
Grant Waterer
Respiratory Infections in the Asia-Pacific Region
1062The past decade in bench research into pulmonary infectious diseases: What do clinicians need to know?
Simon Finch, Holly R Keir, Alison J Dicker & James D Chalmers
Respiratory Sleep Disorders
1073The overlaps of asthma or COPD with OSA: A focused review
Robert L Owens, Madalina M Macrea & Mihaela Teodorescu
1084Mucoactive agents for chronic, non-cystic fibrosis lung disease: A systematic review and meta-analysis
Benjamin J Tarrant, Caitlin Le Maitre, Lorena Romero, Ranjana Steward, Brenda M Button, Bruce R Thompson & Anne E Holland
1093Endobronchial ultrasound-guided transbronchial needle aspiration: Safe as it sounds
Preyas J Vaidya, Mohammed Munavvar, Joerg D Leuppi, Atul C Mehta & Prashant N Chhajed
Asthma and Allergy
Editor's choice
Is bronchial thermoplasty cost-effective as treatment for problematic asthma patients? Singapore's perspective on a global model
Hai V Nguyen, Saideep Bose, Shweta Mital, Anthony Chau Ang Yii, Shin Yuh Ang, Sean Shao Wei Lam, Devanand Anantham, Eric Finkelstein & Mariko Siyue Koh

Bronchial thermoplasty (BT) combined with optimized asthma therapy (OAT) was not found cost-effective compared with OAT alone in Singapore. It is most likely to be cost-effective in a setting where the cost of BT procedure is low and costs of hospitalization and emergency department visits are high.

1110Determinants of peripheral airway function in adults with and without asthma
Paul D Robinson, Gregory G King, Malcolm R Sears, Chuen Y Hong & Robert J Hancox

Peripheral airway function was impaired in adults with asthma and particularly those with childhood-onset persistent asthma in a population-based cohort of young adults. Higher BMIs were also associated with impaired peripheral airway function. Tobacco and cannabis had different effects on central and peripheral airways.

1118Effect of smoking on resting-state functional connectivity in smokers: An fMRI study
Shuang Zhou, Dan Xiao, Peng Peng, Shuang-Kun Wang, Zhao Liu, Hai-Yan Qin, Sheng-Shu Li & Chen Wang

In this study, 37 male smokers and 37 age-matched male non-smokers completed resting-state functional MRI (fMRI) scans. These findings provide new insights into the neural mechanisms of tobacco dependence.

1125Profiling cellular and inflammatory changes in the airway wall of mild to moderate COPD
Mathew S Eapen, Kielan McAlinden, Daniel Tan, Steven Weston, Chris Ward, Hans K Muller, Eugene H Walters & Sukhwinder S Sohal

The study is the first to describe hypocellularity in the airway wall tissue of mild-moderate COPD subjects and a corresponding reduction in key innate inflammatory cell populations. Our current observation contests the currently held simplistic description of airway wall inflammation in smokers/COPD, and has implications for current therapeutics.

1133Determinants of annual change in physical activity in COPD
Christian F Clarenbach, Noriane A Sievi, Sarah R Haile, Thomas Brack, Martin H Brutsche, Martin Frey, Sarosh Irani, Jörg D Leuppi, Robert Thurnheer & Malcolm Kohler

COPD patients have a substantial decrease of physical activity (PA) over time mainly determined by the degree of airflow limitation. The rate of decline in PA did not differ between survivors and non-survivors in this cohort.

1140Progranulin protects lung epithelial cells from cigarette smoking-induced apoptosis
Kyoung Young Lee, So-Young Park, Sunjoo Park, Gyong Hwa Hong, Keun-Ai Moon, You-Sun Kim, Yeon-Mok Oh, Hyouk-Soo Kwon, Tae-Bum Kim, Hee-Bom Moon & You Sook Cho

In a previous study, it was shown that progranulin (PGRN) inhibits apoptosis. However, the precise role of PGRN and whether it attenuates apoptosis in alveolar epithelial cells (AECs) has not been clarified. Here, we demonstrate that PGRN protects AECs from apoptosis induced by cigarette smoke.

1149Physiological effects of titrated oxygen via nasal high-flow cannulae in COPD exacerbations: A randomized controlled cross-over trial
Janine Pilcher, Leonie Eastlake, Michael Richards, Sharon Power, Terrianne Cripps, Susan Bibby, Irene Braithwaite, Mark Weatherall & Richard Beasley

In patients with exacerbations of COPD, the short-term use of nasal high-flow cannulae at 35 L/min results in a small reduction in transcutaneous carbon dioxide tension (PtCO2 ) compared with standard nasal prongs.

Critical Care
1156Induced pluripotent stem cells reduce neutrophil chemotaxis via activating GRK2 in endotoxin-induced acute lung injury
Vincent Yi-Fong Su, Shih-Hwa Chiou, Chi-Shiuan Lin, Wei-Chih Chen, Wen-Kuang Yu, Yen-Wen Chen, Cheng-Yu Chen & Kuang-Yao Yang

This study showed that induced pluripotent stem cells downregulate neutrophil chemotaxis in endotoxin-induced acute lung injury, an effect associated with enhancement of G protein-coupled receptor kinase 2 (GRK2) activity and reduction of chemokine (C-X-C motif) receptor 2 (CXCR2) expression.

1165ICU mortality is increased with high admission serum osmolarity in all patients other than those admitted with pulmonary diseases and hypoxia
Shailesh Bihari, Shivesh Prakash, Sandra L Peake, Michael Bailey, David Pilcher & Andrew Bersten

Increased admission serum osmolarity was associated with increased mortality in all patients except in patients with pulmonary diseases and hypoxia where this was not associated with increased odds for intensive care unit (ICU) mortality.

Interstitial Lung Disease
Editor's choice
Pirfenidone and nintedanib for pulmonary fibrosis in clinical practice: Tolerability and adverse drug reactions
Jonathan A Galli, Aloknath Pandya, Michelle Vega-Olivo, Chandra Dass, Huaqing Zhao & Gerard J Criner

In this study, patients with pulmonary fibrosis prescribed nintedanib or pirfenidone in routine clinical practice were found to have similar drug tolerability and adverse drug events to corresponding large clinical trials despite having a greater degree of respiratory impairment, a multitude of medical co-morbidities and older age.

Lung Cancer
1179Lymphatic invasion is a more significant prognostic factor than visceral pleural invasion in non-small cell lung cancer with tumours of 3 cm or less
Youngkyu Moon, Jae Kil Park, Kyo Young Lee & Sook Whan Sung

Visceral pleural invasion is an upstaging factor, but lymphatic invasion has not been adopted as a descriptor in the tumour-node-metastasis (TNM) classification. In our study, lymphatic invasion is a more significant prognostic factor than visceral pleural invasion in non-small cell lung cancer with tumours of 3 sm or less.

1185Lower-limb muscle function is a determinant of exercise tolerance after lung resection surgery in patients with lung cancer
Chris Burtin, Frits M E Franssen, Lowie E G W Vanfleteren, Miriam T J Groenen, Emiel F M Wouters & Martijn A Spruit

We investigated determinants of exercise tolerance in lung cancer patients after resection surgery. This study is the first to identify quadriceps strength and quadriceps endurance capacity as a strong determinant of exercise tolerance in these patients, suggesting the need for routine lower-limb muscle function assessment and targeted interventions.

Lung Function
1190Prevalence of obesity hypoventilation syndrome in ambulatory obese patients attending pathology laboratories
Jean-Christian Borel, Fabrice Guerber, Ingrid Jullian-Desayes, Marie Joyeux-Faure, Nathalie Arnol, Nellie Taleux, Renaud Tamisier & Jean-Louis Pépin

The prevalence of undiagnosed obesity hypoventilation syndrome (OHS) in ambulatory obese patients who have not previously consulted a pulmonologist ranges from 0.5% to 2.3%, much lower than previous estimations based on cohorts of patients with sleep-disordered breathing.

Pleural Disease
1199Computed tomography scoring system for discriminating between parapneumonic effusions eventually drained and those cured only with antibiotics
José M Porcel, Marina Pardina, Carmen Alemán, Esther Pallisa, Richard W Light & Silvia Bielsa

Using a computed tomography (CT) scoring model, the combination of pleural contrast enhancement, pleural microbubbles, increased extrapleural fat attenuation and fluid volume ≥400 mL may aid in identifying parapneumonic effusions potentially benefiting from drainage. Secondarily, the CT grading scale exhibited a moderate ability to predict the need for surgery or infection-related death.

Respiratory Infections
1205Nasopharyngeal viral PCR in immunosuppressed patients and its association with virus detection in bronchoalveolar lavage by PCR
Daniel J Lachant, Daniel P Croft, Heather McGrane Minton, Paritosh Prasad & Robert M Kottmann

There are limited data on nasopharyngeal (NP) testing compared with bronchoscopy in immunosuppressed patients. NP PCR testing has a false negative rate of 8%, positive predictive value of 88% and negative predictive value of 89%.

Sleep and Ventilation
1212Randomized cross-over trial of ventilator modes during non-invasive ventilation titration in amyotrophic lateral sclerosis
Bart Vrijsen, Bertien Buyse, Catharina Belge, Goele Vanpee, Philip Van Damme & Dries Testelmans

This randomized cross-over trial shows that non-invasive ventilation (NIV) with the use of a back-up frequency provides better gas exchange, patient-ventilator synchrony and respiratory events in patients with amyotrophic lateral sclerosis (ALS). Nevertheless, detailed NIV titration seems necessary as some patients show better results in a spontaneous NIV mode.

1219Response to a combination of oxygen and a hypnotic as treatment for obstructive sleep apnoea is predicted by a patient's therapeutic CPAP requirement
Shane A Landry, Simon A Joosten, Scott A Sands, David P White, Atul Malhotra, Andrew Wellman, Garun S Hamilton & Bradley A Edwards

This study compared the utility of different measures of upper airway collapsibility to predict therapeutic response to the combination of oxygen and a hypnotic for the treatment of obstructive sleep apnoea (OSA). Our findings suggest that a patient's continuous positive airway pressure (CPAP) requirement is equally predictive as other validated physiological measurements of upper airway collapsibility.

1225Effects of diabetes mellitus on the clinical presentation and treatment response in tuberculosis
Chi C Leung, Wing W Yew, Thomas Y W Mok, Kam S Lau, Chi F Wong, Chi H Chau, Chi K Chan, Kwok C Chang, Greta Tam & Cheuk M Tam

Diabetes mellitus is associated with more severe disease but not with higher drug resistance rates in tuberculosis. It adversely affects treatment response but does not affect the rate of relapse after completion of 9-month combination regimens with first-line drugs.