Showing papers in "The Lancet Respiratory Medicine in 2016"

TL;DR: E-cigarette use and cigarette smoking cessation among adult cigarette smokers, irrespective of their motivation for using e-cigarettes, are associated with significantly less quitting among smokers.

TL;DR: In this article, the authors used a modified intention-to-treat analysis using an inferential joint model combining a mixed-effects model for longitudinal outcomes and a survival model to handle non-ignorable missing data.

TL;DR: Global research efforts are needed to establish preventive strategies and treatments for the various types of pulmonary hypertension, where pulmonary hypertension is frequently associated with congenital heart disease and various infectious disorders, including schistosomiasis, HIV, and rheumatic heart disease.

TL;DR: The integrated genomics approach advances understanding of heterogeneity in sepsis by defining subgroups of patients with different immune response states and prognoses, as well as revealing the role of underlying genetic variation.

TL;DR: An analysis of data from two randomised, double-blind, placebo-controlled studies of at least 32 weeks duration has shown a close relationship between baseline blood eosinophil count and clinical efficacy of mepolizumab in patients with severe eOSinophilic asthma and a history of exacerbations.

TL;DR: Lebrikizumab did not consistently show significant reduction in asthma exacerbations in biomarker-high patients, however, it blocked interleukin-13 as evidenced by the effect on interleuko-13-related pharmacodynamic biomarkers and clinically relevant changes could not be ruled out.

TL;DR: In patients having surgery, intraoperative high driving pressure and changes in the level of PEEP that result in an increase of driving pressure are associated with more postoperative pulmonary complications, and a randomised controlled trial comparing ventilation based on driving pressure with usual care is needed to confirm these findings.

TL;DR: Systemic IL-6 inflammation and clinical features of metabolic dysfunction, which occur most commonly in a subset of obese asthma patients but also in a small subset of non-obese patients, are associated with more severe asthma.

TL;DR: The data suggest that counts of 4% or greater or 300 cells per μL or more might identify a deleterious effect of ICS withdrawal, an effect not seen in most patients with eosinophil counts below these thresholds.

TL;DR: An integrated multicohort analysis of samples from publically available datasets to derive a diagnostic gene set in the peripheral blood of patients with active tuberculosis yielded a set of three genes that are robustly diagnostic for active tuberculosis that was validated in multiple independent cohorts and has potential clinical application for diagnosis and monitoring treatment response.

TL;DR: Inter-multidisciplinary team agreement for diagnosis in diffuse lung disease is acceptable and good for a diagnosis of IPF, as validated by the non-significant greater prognostic separation of an IPF diagnosis made by MDTMs than the separation of a diagnoses made by individual clinicians or radiologists.

TL;DR: Standard follow-up and symptomatic treatment have allowed most patients with cystic fibrosis to live to young adulthood but many patients still die prematurely from respiratory insufficiency, so further investigations to improve these therapies are important and might have relevance for other diseases.

TL;DR: The results suggest that limiting the number of direct laryngoscopy attempts and quickly transitioning to an indirect technique when direct laryngeal intubation fails would enhance patient safety.

TL;DR: The microbial ecology of critically ill patients is surveyed, the facts and unanswered questions surrounding gut-derived sepsis are presented, and the radically altered ecosystem of the injured alveolus is explored.

TL;DR: It is shown that WGS has a scalable, rapid turnaround, and is a financially feasible method for full MTBC diagnostics, and Continued improvements to mycobacterial processing, bioinformatics, and analysis will improve the accuracy, speed, and scope of WGS-based diagnosis.

TL;DR: Patients with PAH and BMPR2 mutations present at a younger age with more severe disease, and are at increased risk of death, and death or transplantation, compared with those without BM PR2 mutations.

TL;DR: Ivacaftor at doses of 50 mg and 75 mg seems to be safe in children aged 2-5 years with cystic fibrosis with a gating mutation followed up for 24 weeks, although the frequency of elevated LFTs suggests that monitoring should be frequent in young children, particularly those with a history of elevatedLFTs.

TL;DR: Fevipiprant reduces eosinophilic airway inflammation and is well tolerated in patients with persistent moderate-to-severe asthma and raised sputum eOSinophil counts despite inhaled corticosteroid treatment.

TL;DR: The NoSAS score is a simple, efficient, and easy to implement score enabling identification of individuals at risk of sleep-disordered breathing and can help clinicians to decide which patients to further investigate with a nocturnal recording.

TL;DR: The BACI complements the B SI in the assessment and prediction of mortality and disease outcomes in patients with bronchiectasis and when used in conjunction with the BSI, the combined model was superior to either model alone.

TL;DR: Treatment with this selective CXCR2 antagonist did not reduce the frequency of severe exacerbations in patients with uncontrolled severe asthma, and this findings bring into question the role of CX CR2-mediated neutrophil recruitment in the pathobiology of exacerbation in severe refractory asthma.

TL;DR: In this analysis, combined therapy for PAH was associated with a significant reduction in clinical worsening compared with monotherapy, but this study was limited by the variable definition of clinical worsening among the trials and possible publication bias.

TL;DR: Antacid therapy did not improve outcomes in patients with IPF and might potentially be associated with an increased risk of infection in those with advanced disease.

TL;DR: Non-invasive ventilation might be associated with an increased risk of intubation and mortality and should be used cautiously in immunocompromised patients with acute hypoxaemic respiratory failure.

TL;DR: The incidence and causes of childhood pneumonia in a South African birth cohort is longitudinally investigated to show associations between organisms and pneumonia, and bocavirus, adenovirus, parainfluenza virus, Haemophilus influenzae, and cytomegalovirus were also associated with pneumonia.

TL;DR: The onset of persistent critical illness is measured as the time at which diagnosis and illness severity at intensive care unit (ICU) arrival no longer predict outcome better than do simple pre-ICU patient characteristics, and the timing of this onset at a population level in Australia and New Zealand is measured.

TL;DR: PCV13 appears highly effective against invasive pneumococcal disease among children in the USA in the context of routine and catch-up schedules, although some new vaccine antigens could not be assessed.

TL;DR: Azithromycin reduced the duration of episodes of asthma-like symptoms in young children, suggesting that this drug could have a role in acute management of exacerbations.

TL;DR: Using 2% baseline eosinophil count as a threshold, patients with COPD with lower blood eos inophil counts had more pneumonia events than did those with higher counts, and the magnitude of this increased risk was small.

TL;DR: The management of COPD beyond the respiratory system is discussed and treatment strategies on the basis of the latest research and best practices are proposed.