Göğüs Hastalıkları

In this edition of Thorax, the new British Thoracic Society (BTS) guideline for diagnosing and monitoring paediatric sleep disordered breathing (SDB)1 is published. The primary aim of the guideline is to promote clinical networking and to equip paediatricians in secondary

Bronchiectasis, a previously neglected disease, is becoming more commonly diagnosed despite varying presentation and overlapping symptoms with other respiratory infections. World Bronchiectasis Day on July 1, 2023, aimed to raise disease awareness through discussions between patients, advocacy groups, and key

Amendments to author list: P78 – Impact of COVID19 pandemic on Thoracoscopy services – change in practice to day-case procedure M Aboushehata, M Shakoor, A Mohammed, S Iftikhar, Q Abdullah, E Hussain, S Leyakathali Khan, M Haris. North Midland University Hospital,

In May, 2021, The Lancet Respiratory Medicine published a Series of papers about the pathophysiology of acute COVID-19. More than 1 year into the pandemic, high-quality evidence from randomised controlled trials (RCTs) was shaping the management and outcomes of acute

The evidence for pulmonary rehabilitation (PR) as a non-pharmacological management strategy for people with idiopathic pulmonary fibrosis (IPF) is consistent and continues to accrue. Meta-analysis has demonstrated that it effectively improves exercise capacity, dyspnoea and health-related quality of life,1 and

Patients need accurate, evidence-based information to understand a diagnosis, learn about treatment options, and make autonomous and informed decisions about their health care. Doctors are still the preferred and trusted source of medical information for most people, but the internet,

The Global Burden of Disease Study has estimated that over 500 million subjects, around 7% of the global population, are affected by chronic respiratory diseases, with substantial individual and societal costs concerning morbidity, disability and mortality.1 Identifying and mitigating potentially

In April, tobacco control advocates and experts gathered at the 2023 European Conference on Tobacco or Health (ECToH) with the theme of how to achieve a tobacco-free generation by 2040. Given one in two people who smoke will die of

Accelerated lung function decline is relatively common from the late 20s and indicates chronic lung disease in many communities, including those living with HIV.1 2 The factors influencing and mechanisms of lung function decline in people living with HIV (PLWH)

Critical care specialists work in several hospital departments, from the emergency department to paediatric and adult intensive care units (ICUs), and in all of these settings, workplace violence (WPV) is experienced by team members. Acts or threats of violence, harassment,

The UK National Screening Committee recently approved a national programme for lung cancer screening (LCS) by low-dose CT (LDCT).1 Measures that will reduce burden on downstream clinical care in the National Health Service (NHS) are therefore greatly welcomed. This need

World TB Day on March 24, 2023, marks another year of both progress and setbacks for tuberculosis research and control efforts. The COVID-19 pandemic continues to impact tuberculosis case detection, treatment, and prevention, which has led to millions of missed

The British Thoracic Society Winter Meeting at the QEII Centre in London provided the first opportunity for the respiratory community to meet and disseminate research findings face to face since the start of the COVID-19 pandemic. World-leading researchers from the

Climate change is the biggest threat to global public health in the 21st century. From the increase in death and illness due to severe weather to worsening air quality, changing patterns of infection, and disruption to food supplies, the health

Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change The 2022 report of the Intergovernmental Panel on Climate Change paints a dark picture of the future of life

Background Research on cigarettes and adult asthma offers mixed findings, perhaps due to overlap with chronic obstructive pulmonary disease (COPD) and inadequate adjustment for other smoke exposures. Associations between other tobacco products, including e-cigarettes, and asthma are also understudied. Research

As The Lancet marks its 200th anniversary in 2023, it plans to shine a light on critical issues affecting health globally through a programme of activities across five Spotlights, including Child and Adolescent Health and Research for Health. The research

Introduction Patients with chronic obstructive pulmonary disease (COPD) are often hospitalised due to severe acute exacerbation (AE) or community-acquired pneumonia (CAP). Previous studies revealed the association of cough reflex sensitivity with the pathophysiology of COPD and pneumonia. We hypothesised that

Introduction Positive expiratory pressure (PEP) is an airway clearance technique involving a series of exhalation manoeuvres against a positive pressure that seeks to promote sputum clearance. It is often prescribed for people with chronic obstructive pulmonary disease (COPD) who experience

Objectives To explore physiotherapists’ opinions of physiotherapy assessment of Breathing Pattern Disorder (BPD). Methods Qualitative study using focus groups (FGs) with reflexive thematic analysis and survey methods. The survey was distributed via social media and email to UK specialist physiotherapy

As we approach January 2023, it seems apt to reflect on past learnings and plans for new beginnings. January is thought to derive from the Roman deity Janus, who represents both endings, transitions, and beginnings as well as doorways, thresholds,

Surgical excision remains the best curative-intent option for lung cancer. Despite advances in surgical techniques, including minimally invasive access and parenchymal-sparing resections, a third of patients still suffer complications after surgery.1–3 Postoperative pulmonary complications (PPCs) represent a significant proportion of

Major advances in the diagnosis, management, and treatment of cystic fibrosis over the past 30 years have meant that the life expectancy for someone born today is around 50 years compared with 30 years in 1990, and a recent study

Over the last decade, immune checkpoints inhibitors (ICIs) have changed the landscape of treatment for patients with advanced non-small-cell lung cancer (NSCLC) in the absence of actionable molecular biomarkers. Although the current evidence from phase III randomised clinical trials (RCTs)

On Sept 18, 2022, US President Joe Biden declared the pandemic over in the USA. The remarks, in a television interview, come after the US Department of Health and Human Services (HHS) announced that it could stop purchasing and providing

Bronchiolitis is the most common lower respiratory tract infection in young children, and it is associated with significant morbidity and high rate of hospitalisation.1 In addition, epidemiological data show that bronchiolitis during early life may be associated with long-term respiratory

On Aug 26, 2022, the European Society of Cardiology and the European Respiratory Society published new guidelines for the diagnosis and treatment of pulmonary hypertension. Numerous factors are associated with the development of pulmonary hypertension, which has an estimated prevalence

The development of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA) leads to significant morbidity and mortality.1 ILD impacts approximately 10% of patients with RA and even higher percentages have subclinical ILD.2 3 Despite the clinical impact of

On June 23, 2022, the US Food and Drug Administration (FDA) denied Juul Labs marketing approval for all JUUL products that are marketed in the USA. JUUL is an electronic nicotine-delivery system (ENDS) that has higher nicotine content than many

Changing the guard We would like to lead the vote of thanks to the outgoing Triumvirate (Alan, Gisli and Nick) and the departing associate editors. Their tenure has above all else epitomised Thorax’s core values of ORIGINALITY, RIGOUR & EXCELLENCE.

The winter months normally bring a higher number of respiratory viruses as people spend more time indoors together and the cold, dry air allows viruses to survive, and infect people, more easily. The last two winters, however, have been very

Hull JH, Burns P, Carre J, et al. BTS clinical statement for the assessment and management of respiratory problems in athletic individuals. Thorax 2022;77:540–551. doi: 10.1136/thoraxjnl-2021-217904 The affiliation for author JC is incorrect and should have been listed as SportPark,

The devastating effects of tobacco on the health of users are well known, as are the associated economic costs, including lost productivity due to smoking-related illness, which equate to approximately US$1·4 trillion per year. However, the environmental impact of the

At the end of June, the Triumvirate comes to the end of a 7 year stint as editors in chief of Thorax. We will hand over to a new Triumvirate of Cecilia O’Kane, Mark Griffiths and Jenni Quint. As we

World TB Day on March 24, 2022, provided an opportunity to raise awareness of the devastating health, social, and economic impacts of tuberculosis—the world’s second leading infectious killer after COVID-19—and to consider what is needed to strengthen care and control

There are just a few heroes and many villains on the UK and international scene at present. With a nod to wider geopolitical events (and many works of fiction), this month’s Airwaves presents you with the heroes and villains of

April 7, 2022, marked World Health Day with the theme of “Our planet, our health”, which highlighted the estimated 13 million deaths around the world each year due to environmental causes. This is a timely reminder of the need to

We take our theme for this edition of Airwaves from the Thorax cover picture: ‘playing with fire’. The cover picture is from this month’s case based discussion, ‘Lung on fire: a very severe case of fire-eater’s lung.’ Don’t try this

Lung cancer is one of the most common cancers worldwide, with 2·21 million new cases in 2020, and remains the number one cause of cancer-related deaths globally. It has a 5-year survival rate of only 15%; outcomes are much improved

In this edition of “Airwaves” we celebrate some of the unusual news items and colourful characters which have made the news in recent months. We also ponder the meaning (if any) of the current UK Government slogan “levelling up”. In

Governments of high-income countries with high SARS-CoV-2 vaccination rates have been encouraged by evidence of decreasing COVID-19-associated morbidity and mortality, and can begin to think about the change from pandemic to endemic and the prevention of future pandemics. Meanwhile, some

Nelson MT, Wolter DJ, Eng A, et al. Maintenance tobramycin primarily affects untargeted bacteria in the CF sputum microbiome. Thorax 2020;75:780–790. The NCBI Bioproject identifier was listed incorrectly and has been updated correctly to PRJNA530252.

Objectives Lung cancer screening programmes offer an opportunity to address tobacco dependence in current smokers. The effectiveness of different approaches to smoking cessation in this context has not yet been established. We investigated if immediate smoking cessation support, including pharmacotherapy,

Bronchopulmonary dysplasia (BPD; also known as chronic lung disease of prematurity) is the most common complication of extremely preterm birth. Neonatal respiratory support and a range of antenatal and postnatal factors can contribute to lung injury and impaired lung growth

Objectives Malignant mesothelioma is an aggressive malignancy of mesothelial surfaces, most commonly those of the pleura. The aim of this study was to understand, using a national questionnaire, the gendered care experiences of patients with malignant pleural mesothelioma (MPM). Patients

Background An understanding of differences in clinical phenotypes and outcomes COVID-19 compared with other respiratory viral infections is important to optimise the management of patients and plan healthcare. Herein we sought to investigate such differences in patients positive for SARS-CoV-2

Introduction The impact of acute COVID-19 on people with asthma appears complex, being moderated by multiple interacting disease-specific, demographic and environmental factors. Research regarding longer-term effects in this group is limited. We aimed to assess impacts of COVID-19 and predictors

In the Northern hemisphere, February is one of the colder, darker months of the year (though thankfully shorter). Here we put a positive spin on the last month of meteorological winter and celebrate some Thorax highlights. Super bowl spirometry To

“It is so important to have patients involved in medical research, peer review, and guidelines because research is really about the patient…and what is important to them”, says Eileen Rubin, President of the ARDS Foundation, and an author of a

‘If everyone in the music business were brutally honest about what their intentions were then you could sort things out, but it’s all smoke and mirrors.’ So said Noel Gallagher of Oasis. In this month’s Airwaves, we discuss music, smoke

For more than a year and half, the COVID-19 pandemic has led to an overwhelming caseload in intensive care units (ICUs) and respiratory wards, leading to fatigue and stress among respiratory and critical care staff. In addition to managing personal

Bumper Christmas Special This will be the Last Christmas that this particular Trimuvirate contributes Airwaves. So to save you from tears, we will give you something special. The shops have Christmas items on display and the old familiar hits of

To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT) has been described after vaccination with the adenoviral vector vaccines ChAdOx1 nCoV-19 (Oxford–AstraZeneca) and Ad26.COV2.S (Johnson & Johnson–Janssen). VITT is caused by platelet-activating anti–platelet factor 4 (PF4)…

On Sept 21, 2021, WHO published their new Air Quality Guidelines—a welcome update on the previous report from 2005—where they recommend new air quality levels for the six main pollutants (CO, lead, NO2, O3, PM, and SO2). Meeting these new

As of June 6, 2021, approximately 175 million severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and 3.8 million deaths from coronavirus disease 2019 (Covid-19) have been reported worldwide. Programs providing unprecedented rapid clinical development of vaccines have been…

Figure 1.

To the Editor: Ivermectin is approved by the Food and Drug Administration as an oral treatment for intestinal strongyloidiasis and onchocerciasis and as a topical treatment for pediculosis and rosacea. It is also used as a treatment for parasites in

Aspergillus conidia (spores) are ubiquitous in the environment and thus unavoidable. In soil and on other vegetative or moist material, aspergillus species exist as saprobes, digesting dead or dying organic material. This highly competitive environment requires aspergillus species to survive

“Remember, remember the 5th of November: gunpowder, treason and plot!” As this issue of Thorax drops on your doormat, UK readers are preparing for Guy Fawkes night, when we remember a foiled attempt to blow up parliament and we burn

In Israel, a nationwide campaign to administer the BNT162b2 messenger RNA (mRNA) vaccine (Pfizer–BioNTech) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) started on December 20, 2020. By May 5, 2021, a total of 58.2% of the Israeli population had

To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a rare but potentially fatal complication of vector-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. The clinical picture and the…

On July 23, 2021, in response to data showing an increase in out-of-season respiratory infections among young children, Public Health England issued a warning in which it encouraged caregivers to look out for symptoms of severe respiratory syncytial virus (RSV)

Malignant mesothelioma is an aggressive tumor arising from the serosal outer linings of the lungs (pleurae), heart, abdomen, and testes. Treatment trials have focused on malignant pleural mesothelioma, which accounts for 90% of cases, is often diagnosed at an advanced

As we write this edition of Airwaves, many countries throughout the world are struggling to contain the delta variant of COVID-19. The switch to naming new variants of the coronavirus after Greek letters, rather than the geographical area where the

To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT), a serious adverse event after vaccination with ChAdOx1 nCoV-19 (AstraZeneca) or Ad26.COV2.S (Johnson & Johnson–Janssen), is caused by platelet factor 4 (PF4)–dependent, platelet-activating antibodies. High-dose immune…

The mother clutches her daughter as the nebulized albuterol permeates the young girl’s airways. My eyes dart between the monitor and the child’s small, dark-skinned chest as it heaves up and down at an alarming rate. I smile reassuringly, but

To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT) has been described after vaccination with the adenoviral vector vaccines ChAdOx1 nCoV-19 (Oxford–AstraZeneca) and Ad26.COV2.S (Johnson & Johnson–Janssen). VITT is caused by platelet-activating anti–platelet factor 4 (PF4)…

An Article published in The Lancet Respiratory Medicine on Aug 16, 2021, makes shocking reading. The paper reports the latest Global Burden of Disease (GBD) incidence and mortality data from 1990 to 2019 for tracheal, bronchus, and lung cancers. There

In some patients, the clinical course of coronavirus disease 2019 (Covid-19) is characterized by an initial period of mild-to-moderate symptoms, followed by progressive respiratory failure leading to cardiovascular or respiratory organ support or death. However, the majority of patients who

To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a rare but potentially fatal complication of vector-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. The clinical picture and the…

Recently, vaccination with adenoviral vector vaccines against coronavirus disease 2019 (Covid-19) has been implicated in a rare prothrombotic disorder that has been termed vaccine-induced immune thrombotic thrombocytopenia (VITT). Most patients in whom VITT has been diagnosed have been between the…

The mother clutches her daughter as the nebulized albuterol permeates the young girl’s airways. My eyes dart between the monitor and the child’s small, dark-skinned chest as it heaves up and down at an alarming rate. I smile reassuringly, but

As we write this edition of Airwaves, the UK has abandoned lockdown and is relying on a high immunisation uptake and a world beating test and trace programme to keep COVID-19 at bay. The immediate effects have been a “pingdemic”

Patients undergoing total knee arthroplasty are at high risk for postoperative venous thromboembolism. Enoxaparin, an inhibitor of factor Xa and thrombin, is often administered postoperatively to reduce this risk. Although reasonably effective, enoxaparin can be associated with bleeding. A search…

Cardiogenic shock is defined as a state of low cardiac output resulting in clinical and biochemical manifestations of end-organ hypoperfusion. Although emergency revascularization has been shown to reduce the risk of death in patients with myocardial infarction complicated by cardiogenic

Figure 1.

Patients who are admitted to the hospital with coronavirus disease 2019 (Covid-19) are at high risk for thrombosis, particularly venous thromboembolism (VTE). In a meta-analysis of 66 studies, the overall prevalence of VTE among patients with Covid-19 was 14.1%, with

The pandemic has laid bare the inequalities that exist in our society, and long-standing social, economic, and racial inequities have led to COVID-19 disproportionately affecting minority racial and ethnic groups. A report published on June 30, 2021—Build Back Fairer in

A 4-year-old girl was brought to the emergency department with a 4-day history of fever, cough, and lethargy. She was up to date with all childhood vaccinations. Three weeks earlier, she had had a presumed viral respiratory tract infection with

To the Editor: In a recent study, Greinacher et al. reported thrombotic complications, mostly cerebral vein thrombosis, associated with thrombocytopenia in 11 patients after they had been vaccinated with ChAdOx1 nCoV-19 (AstraZeneca). Although none of these patients had received heparin,

Patients undergoing total knee arthroplasty are at high risk for postoperative venous thromboembolism. Enoxaparin, an inhibitor of factor Xa and thrombin, is often administered postoperatively to reduce this risk. Although reasonably effective, enoxaparin can be associated with bleeding. A search…

The long hot days and warm nights of summer are hard to beat, although it is likely that the holidays will be spent this year in Old Blighty rather travelling to foreign shores. The Trimuvirate, like others, are going to

To the Editor: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is characterized by thrombosis and thrombocytopenia that occurs 5 to 30 days after ChAdOx1 nCoV-19 vaccination and is associated with heparin-independent platelet factor 4 (PF4) antibodies. Mortality from VITT is approximately…

In April 2020, practitioners first noted a temporal association between infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and multisystem inflammatory syndrome in children (MIS-C) as a rare but serious complication. Since that time, MIS-C has been reported to

Digital health is an area of medicine that has seen huge acceleration and investment globally over the past decade—even more so during the COVID-19 pandemic, when reliance on digital and telehealth has been essential. With this growth in digital health,

Presentation of Case. Dr. David P. Bullis (Behavioral Medicine, Newton–Wellesley Hospital, Newton, MA): A 54-year-old man was evaluated by the neuropsychology service of this hospital because of irritability, confusion, and odd behaviors. The patient had been in his usual state

International guidelines recommend targeted temperature management to prevent hypoxic–ischemic brain damage in patients with coma after cardiac arrest. The evidence to support these recommendations originated in trials involving patients who had been resuscitated from out-of-hospital cardiac arrest…

Since the sudden emergence of multisystem inflammatory disease in children (MIS-C) in April 2020 as a novel and severe presentation of coronavirus disease 2019 (Covid-19), nearly 4000 cases of MIS-C and 35 deaths have been reported in the United States

Thillai M, Atkins CP, Crawshaw A, et al. BTS Clinical Statement on pulmonary sarcoidosis. Thorax 2021;76:4-20. Karen Patterson should have been listed as Karen C Patterson. The original article has been updated to reflect the change.

Coronavirus disease 2019 (Covid-19) has been associated with considerable morbidity and mortality. From the onset of the Covid-19 pandemic to March 2021, more than 126.8 million cases and 2.7 million deaths were documented worldwide. With unprecedented speed, vaccines against severe

Many of the Thorax readership will have been in short trousers when the Rocky Horror Picture Show first hit the screens in 1975. Although panned by the critics on its release, the film has gathered a cult following—with cinema goers

Recently, vaccination with adenoviral vector vaccines against coronavirus disease 2019 (Covid-19) has been implicated in a rare prothrombotic disorder that has been termed vaccine-induced immune thrombotic thrombocytopenia (VITT). Most patients in whom VITT has been diagnosed have been between the…

Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are the most important countermeasure to fight the coronavirus 2019 (Covid-19) pandemic. From December 2020 through March 2021, the European Medicines Agency approved four vaccines on the basis of randomized, blinded,…

Careful descriptions of the clinical features of acute disease in patients infected with the novel coronavirus SARS-CoV-2 had begun to emerge before WHO declared the outbreak of COVID-19 a public health emergency of international concern on Jan 30, 2020. As

To the Editor: Rare thromboembolic events have been observed during the vaccination rollout, which have prompted cautionary pauses in vaccinations by some regulatory authorities, including the South Africa Health Products Regulatory Authority. Here, we report interim safety data from the

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this

To the Editor: Thrombosis and thrombocytopenia have been reported after vaccination with the ChAdOx1 nCoV-19 vaccine (Oxford–AstraZeneca), a recombinant chimpanzee adenoviral vector encoding the spike glycoprotein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To date, such…

Approximately 10% of patients with asthma have severe disease and have symptoms and exacerbations despite treatment with maximal standard-of-care controller therapy. Severe, uncontrolled asthma contributes disproportionately to the overall burden and cost of asthma. Monoclonal antibodies that…

Figure 1.

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this

During the COVID-19 pandemic, evidence suggests that fewer people are stopping smoking and more ex-smokers are relapsing. This finding is especially concerning because smokers are at a higher risk of severe disease and death if they become infected with SARS-CoV-2.

To the Editor: Previous increases in the use of electronic cigarettes (e-cigarettes) by youth were driven by multiple factors, including advertising, the use of appealing flavors, and the introduction of new devices with prefilled pods or cartridges and high nicotine

The coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulated the development of highly effective vaccines that were produced with unprecedented speed with the use of diverse technologies. No major safety warnings, other than

Coronavirus disease 2019 (Covid-19) has been associated with considerable morbidity and mortality. From the onset of the Covid-19 pandemic to March 2021, more than 126.8 million cases and 2.7 million deaths were documented worldwide. With unprecedented speed, vaccines against severe

Ra SH, Lim JS, Kim G, et al. Upper respiratory viral load in asymptomatic individuals and mildly symptomatic patients with SARS-CoV-2 infection. Thorax 2021;76:61–63. The author affiliation of Sang Hyun Ra, Min Jae Kim, Jiwon Jung and Sung-Han Kim should

The coronavirus disease 2019 (Covid-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulated the development of highly effective vaccines that were produced with unprecedented speed with the use of diverse technologies. No major safety warnings, other than

The Covid-19 pandemic has challenged clinicians to find innovative ways to provide essential services while minimizing risks for themselves and their patients. These approaches increasingly leverage remote patient monitoring (RPM), using technology to support treatment for chronic conditions. As…

Patients who are admitted to the intensive care unit (ICU) with acute hypoxemic respiratory failure often receive supplemental oxygen with a high fraction of inspired oxygen (Fio2), which results in a high partial pressure of arterial oxygen (Pao2). In some

In this issue of the Journal, Humbert et al. report on a new approach to the treatment of pulmonary arterial hypertension, particularly the idiopathic and heritable forms of the disease. The treatment, which is given subcutaneously every 3 weeks, is

Pulmonary arterial hypertension is a rare, progressive disorder characterized by pulmonary vascular remodeling, resulting in high pulmonary artery pressure and progressive right ventricular dysfunction. Current treatments, which target the prostacyclin, endothelin-1, or nitric oxide pathways, slow…

In this issue of the Journal, Humbert et al. report on a new approach to the treatment of pulmonary arterial hypertension, particularly the idiopathic and heritable forms of the disease. The treatment, which is given subcutaneously every 3 weeks, is

Pulmonary arterial hypertension is a rare, progressive disorder characterized by pulmonary vascular remodeling, resulting in high pulmonary artery pressure and progressive right ventricular dysfunction. Current treatments, which target the prostacyclin, endothelin-1, or nitric oxide pathways, slow…

In this issue of the Journal, Humbert et al. report on a new approach to the treatment of pulmonary arterial hypertension, particularly the idiopathic and heritable forms of the disease. The treatment, which is given subcutaneously every 3 weeks, is

On March 2, 2021, over a year into the pandemic, Texas Governor Greg Abbott joined 15 other states in the USA and lifted the mask mandate, stating that with vaccines being rolled out and case numbers falling it was time.

Figure 1.

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this

I never got to hear the sound of his voice. Mr. C. was intubated by the time I assumed his care, less than 24 hours after he was admitted to the ICU with rapidly progressive respiratory failure due to Covid-19.

Presentation of Case. Dr. Alexandra T. Lucas (Pediatrics): A 19-year-old man was admitted to the pediatric intensive care unit (PICU) of this hospital because of shock, multiple organ failure, and rash. The patient had been well until 20 hours before

An excellence of Thorax podcasts What is the collective noun for a group of podcasts? A clamour? A babble? A colloquium? The collective noun for a collection of Thorax podcasts however is clear: an ‘excellence’. To listen to these excellent

I never got to hear the sound of his voice. Mr. C. was intubated by the time I assumed his care, less than 24 hours after he was admitted to the ICU with rapidly progressive respiratory failure due to Covid-19.

Presentation of Case. Dr. Alexandra T. Lucas (Pediatrics): A 19-year-old man was admitted to the pediatric intensive care unit (PICU) of this hospital because of shock, multiple organ failure, and rash. The patient had been well until 20 hours before

I never got to hear the sound of his voice. Mr. C. was intubated by the time I assumed his care, less than 24 hours after he was admitted to the ICU with rapidly progressive respiratory failure due to Covid-19.

In May 2020, the first stage of the Adaptive Covid-19 Treatment Trial (ACTT-1), a randomized, double-blind, placebo-controlled trial, showed that remdesivir is an effective treatment for hospitalized adult patients with coronavirus disease 2019 (Covid-19) pneumonia. Despite the benefits of…

On Jan 20, 2021, Joe Biden was inaugurated as the 46th President of the USA. With over 430 000 deaths from COVID-19 (1314 deaths per million of the population), the country has been one of the worst hit globally, and the

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (Covid-19), emerged in China in late 2019 from a zoonotic source. The majority of Covid-19 cases either are asymptomatic or result in only mild disease. However, in

To The Editor: The duration of transmissibility of coronavirus disease 2019 (Covid-19) and the associated level of contagion have been uncertain. We cultured severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in serial respiratory samples obtained from hospitalized patients with Covid-19…

This month’s Airwaves bring you a poetry anthology, including Masefield, Tennyson and Rossetti. We start with John Masefield’s poem “Cargoes” which gives us our theme: the “…mad March days.” Those reading this online can enjoy the poem by clicking here:

Presentation of Case. Dr. Benjamin D. Medoff: A 70-year-old woman was evaluated at the pulmonary clinic of this hospital because of increasing dyspnea on exertion and abnormal findings on chest imaging. In childhood, the patient had eczema, recurrent episodes of

In the United States, race, ancestry, genetics, and medicine are inextricably linked in a complex and fraught history. Medicine is replete with examples of racial injustice inflicted by the use of race and ethnicity as biologic constructs to engender hierarchical

Because of rapidly changing guidelines in response to multiple clinical trials of new therapies, the management of antithrombotic agents for patients after an acute coronary syndrome is becoming increasingly complex. Patients and clinicians must make treatment decisions by weighing the…

In the United States, race, ancestry, genetics, and medicine are inextricably linked in a complex and fraught history. Medicine is replete with examples of racial injustice inflicted by the use of race and ethnicity as biologic constructs to engender hierarchical

The race to develop safe, effective vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has produced impressive results. As of Jan 18, 2021, 64 vaccines were in clinical development according to the WHO COVID-19 candidate vaccine database. Phase 3

Precapillary pulmonary hypertension is defined as an elevation in mean pulmonary arterial pressure and pulmonary vascular resistance. In the World Health Organization (WHO) classification of pulmonary hypertension, precapillary pulmonary hypertension due to lung disease is classified as group 3.…

To The Editor: The duration of transmissibility of coronavirus disease 2019 (Covid-19) and the associated level of contagion have been uncertain. We cultured severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in serial respiratory samples obtained from hospitalized patients with Covid-19…

Presentation of Case. Dr. Sunu S. Thomas: A 26-year-old pregnant woman was transferred to this hospital for evaluation and treatment of cardiogenic shock after a cardiac arrest resulting from ventricular tachycardia. The patient had had two previous uncomplicated pregnancies and

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this

“Altered Images” are the theme for this month’s Airwaves – including the 1980s post-punk band, fronted by Clare Grogan, and much, much more… Altered MRI images in idiopathic pulmonary fibrosis. Patients with idiopathic pulmonary fibrosis (IPF) may develop pulmonary hypertension,

Coronavirus disease 2019 (Covid-19) emerged in China in December 2019 and rapidly led to a public health emergency. In severe and critical cases of Covid-19, which occur in 14% and 5% of patients, respectively, Covid-19–associated pneumonia can lead to acute

Introduction The prognosis of malignant pleural mesothelioma (MPM) is poor, with a median survival of 8–12 months. The ability to predict prognosis in MPM would help clinicians to make informed decisions regarding treatment and identify appropriate research opportunities for patients.

In the United States, race, ancestry, genetics, and medicine are inextricably linked in a complex and fraught history. Medicine is replete with examples of racial injustice inflicted by the use of race and ethnicity as biologic constructs to engender hierarchical

At the time of writing, optimism is in the air as the Pfizer vaccine against SARS-CoV-2 is rolled out in the UK to essential health-care workers and in care homes. For many, this is the first big step along the

Introduction Respiratory tract lining fluid of small airways mainly consists of surfactant that can be investigated by collection of the particles of exhaled aerosol (PExA) method. This offers an exciting prospect to monitor small airway pathology, including subjects with asthma

In the simpler times before Covid-19, I used to play a game with medical students who joined me in the operating room. “There’s a giant flood coming that will devastate the earth and its inhabitants. You’ve got a big boat

Foreword. This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the authors’ clinical recommendations. Stage.

Sarbecoviruses have emerged twice in the 21st century, causing a worldwide epidemic and pandemic. The ongoing pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused unprecedented disruption of human society.…

This month sees the start of a New Year, with 2021 brim full of optimism from the development of a SARS-CoV-2 vaccine and the inauguration of a new US president, with both offering a possibly for the return to some

In May 2020, the first stage of the Adaptive Covid-19 Treatment Trial (ACTT-1), a randomized, double-blind, placebo-controlled trial, showed that remdesivir is an effective treatment for hospitalized adult patients with coronavirus disease 2019 (Covid-19) pneumonia. Despite the benefits of…

Figure 1.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has reminded us of the critical role of an effective host immune response and the devastating effect of immune dysregulation. This year marks 10 years since the first description of a

Figure 1.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has reminded us of the critical role of an effective host immune response and the devastating effect of immune dysregulation. This year marks 10 years since the first description of a

Figure 1.

As we approach the end of 2020, and a year since the outbreak of COVID-19 began, cases are increasing again. We have learnt a lot about SARS-CoV-2 and our ability to test for and manage COVID-19 has improved, but ongoing

Non–cystic fibrosis bronchiectasis (referred to here as bronchiectasis) is a chronic inflammatory disease defined as permanent dilatation of the bronchi. Patients characteristically have a daily cough and sputum production, as well as frequent exacerbations. Exacerbations are independently…

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this

As the festive season approaches, amidst COVID-19 restrictions, we harken back to the glory days of the Christmas single. For decades, the biggest names in popular music (as well as some unlikely contributors) have sought to cheer us up in

Prospective studies may be useful to inform strategies to mitigate the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), particularly in group settings among young adults. U.S. Department of Defense installations have implemented recommended public health interventions.…

The global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has plunged large parts of the world into a protracted medical, social, and economic crisis. Coronavirus disease 2019 (Covid-19), the respiratory illness caused by SARS-CoV-2 infection, has caused over

During the past week, the UK has seen an alarming rise in COVID-19 cases. With a second wave of infections approaching, there is a need to adequately respond with a robust test and trace system. However, neither the testing nor

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this

Over the past two decades, emerging coronaviruses (CoVs) have caused three major outbreaks — severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (Covid-19). Since MERS was reported in Saudi Arabia in 2012, at least

An early addition to the Triumvirate’s record collection was “Elected” the 1972 single by Alice Cooper. The song was released a few months before the US presidential election of that year: a contest between Richard Nixon and George McGovern. Richard

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was discovered in Wuhan, China, in late 2019, and coronavirus disease 2019 (Covid-19), the disease caused by SARS-CoV-2, rapidly evolved into a global pandemic. As of June 15, 2020, there were more than

The world has already observed many devastating effects of human-induced climate change. A vivid manifestation is the several large wildfires that have occurred recently — in some cases, fires of unprecedented scale and duration — including wildfires in Australia in

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. In this

The theme selected for this year’s European Respiratory Society (ERS) International Congress, which drew to a close on Sept 9, 2020, was the early-life origins of respiratory diseases. The programme included a range of presentations and discussions that highlighted the

Presentation of Case. Dr. Matthew B. Roberts: A 66-year-old man who had undergone orthotopic liver transplantation because of end-stage liver disease was admitted to this hospital because of fever and cough during the pandemic of coronavirus disease 2019 (Covid-19), the

Operation Warp Speed (OWS), an effort of the U.S. Department of Health and Human Services and the Department of Defense in partnership with the private sector, is providing financial investment, scientific support, regulatory expertise, and logistic assistance to deliver vaccines,

The UK prime minister, Boris Johnson, has described the UK approach to local flare-ups of COVID-19 as “whack-a-mole”. The game of “whack-a-mole”, which originated in Japan, involves the player scoring points for hitting electronic moles with a virtual mallet. Each

Approximately 15% of patients undergoing mechanical ventilation receive a tracheostomy as part of their care, but experimental data regarding readiness for decannulation are limited. Evidence of decannulation readiness has been limited to expert opinion, survey studies, single-center experience,…

On rounds in the long-term acute care hospital, I am surprised to see a familiar name on my list — a patient with respiratory failure whom I had initially admitted to our intensive care unit (ICU). In the early days

In the simpler times before Covid-19, I used to play a game with medical students who joined me in the operating room. “There’s a giant flood coming that will devastate the earth and its inhabitants. You’ve got a big boat

Autoimmune pulmonary alveolar proteinosis (aPAP) is a disease characterized by alveolar filling that leads to progressive accumulation of surfactant in alveoli, hypoxemia, and in some patients, the development of serious infections or pulmonary fibrosis. Although PAP can be caused by

Diffuse parenchymal lung diseases encompass a large number of conditions, with a wide range of causes, clinical manifestations, and imaging and pathological features, as well as variable outcomes. Despite the intrinsic heterogeneity of this group of diseases, in most of

Figure 1.

In August, 2019, the first case of EVALI (e-cigarette, or vaping, product use-associated lung injury) was reported to the US Centers for Disease Control and Prevention (CDC). The number of cases peaked in Sept, 2019, and as of Feb 18,

Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics

As a child, you probably played the game “Telephone”: you whispered a message into the ear of the person next to you, who whispered it to the next person, and so forth down the line. When revealed at the end

As we write this month’s Airwaves citizens, scientists and politicians around the world are preparing for a second wave of COVID-19 cases while hoping their fears are groundless. This month’s airwaves takes the “second wave” as its theme and we

Presentation of Case. Dr. Jonathan E. Eisen: A 47-year-old woman presented to this hospital early during the pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), because of cough and shortness of

To the Editor: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preferentially infects cells in the respiratory tract, but its direct affinity for organs other than the lungs remains poorly defined. Here, we present data from an autopsy series of 27

COVID-19 has disproportionately affected people from disadvantaged populations and marginalised communities. People living in social deprivation, Black, Asian, and minority ethnic (BAME) groups, older people, and those with pre-existing health conditions, for example, have increased vulnerability to COVID-19 and its

Presentation of Case. Dr. Daniel A. Zlotoff: A 44-year-old woman was admitted to this hospital because of shortness of breath and chest pain. Eight days before admission — and 3 days after her husband had begun to have fatigue, a

Presentation of Case. Dr. Jonathan E. Eisen: A 47-year-old woman presented to this hospital early during the pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), because of cough and shortness of

Presentation of Case. Dr. Kathy M. Tran: A 76-year-old woman was admitted to this hospital because of confusion and hypoxemia during the pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The

In a platform trial, patients with a single disease are randomly assigned to a group of different therapies on the basis of a decision algorithm to determine whether any therapy has benefit. The principle underpinning such trials allows for the

The current literature on the treatment of coronavirus disease 2019 (Covid-19) is filled with anecdotal reports of therapeutic successes in clinical trials with small numbers of patients and observational cohort studies claiming efficacy with little regard to the effect of

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of coronavirus disease 2019 (Covid-19), emerged in China in late 2019 from a zoonotic source. The majority of Covid-19 cases either are asymptomatic or result in only mild disease. However, in

Acute kidney injury is a common complication in patients admitted to an intensive care unit (ICU) and is associated with a high risk of death or major complications and a high level of resource use. Many patients who are seriously

Presentation of Case. Dr. Daniel A. Zlotoff: A 44-year-old woman was admitted to this hospital because of shortness of breath and chest pain. Eight days before admission — and 3 days after her husband had begun to have fatigue, a

Throughout the COVID-19 pandemic, UK politicians have claimed to “follow the science” – in some cases all the way from Durham to Barnard Castle… In this issue of Thorax the Triumvirate bring you the best science and follow it to

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in humans is associated with a broad spectrum of clinical respiratory syndromes, ranging from mild upper airway symptoms to progressive life-threatening viral pneumonia. Clinically, patients with severe coronavirus disease…

Presentation of Case. Dr. Kathy M. Tran: A 76-year-old woman was admitted to this hospital because of confusion and hypoxemia during the pandemic of coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The

On March 23, 2020, the UK Government enforced a country-wide lockdown in response to the COVID-19 pandemic to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although spread of the virus has been reduced, the lockdown has created

Treatment recommendations for chronic obstructive pulmonary disease (COPD) involve a stepwise approach, in which treatments are added as necessary to control symptoms and reduce or eliminate exacerbations, with an additional goal of reducing mortality from the disease. Triple therapy with