[⇓][1] 

SERIES “ATS/ERS TASK FORCE: STANDARDISATION OF LUNG FUNCTION TESTING” 

Edited by V. Brusasco, R. Crapo and G. Viegi 

Number 2 in this Series

 [1]: #F13

/pdf/standardisation-of-spirometry-1dkqxgifvl.pdf

Standardisation of spirometry

Global strategy for asthma management and prevention

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(14)61632-3/pdf

Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance

admission. This proportion could already be greater in some parts of the country and may increase if referrals of cases of self-poisoning increase faster than the facilities for their assessment and management. The provision of social work and psychiatric expertise in casualty departments may be one means of preventing unnecessary medical admissions without risk to the patients. Dr Blake's and Dr Bramble's figures do not demonstrate, however, that any advantage would attach to medical teams taking over assessment from psychiatrists except that, by implication, assessments would be completed sooner by staff working on the ward full time. What the figures actually suggest is that if assessment of overdoses were left to house doctors there would be an increase in admissions to psychiatric units (by 19°U), outpatients (by 5O°'), and referrals to social services (by 140o). So for house doctors to assess overdoses would provide no economy for the psychiatric or social services. The study does not tell us what the consequences would have been for the six patients who the psychiatrists would have admitted but to whom the house doctors would have offered outpatient appointments. E J SALTER

Vitamin D deficiency.

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

Thorax had a good 2013. We were all buoyed by a large rise in our impact factor from 6.525 to 8.376, by far the largest rise seen in our specialty area, cementing our position as the second-ranked respiratory journal behind the American Journal of Respiratory and Critical Care Medicine (impact factor 11.041). We suspect this has led to an increase in submission of high-quality manuscripts and are hopeful that gains in impact factor will increase. In part our improved impact factor reflects a reduction in original articles published per edition from 10–12 to 8–10 with the introduction of new content published in the ‘Chest Clinic’ section aimed at the jobbing clinician without a major research interest. However, the tremendous hard work of the associate editors, deputy editors, reviewers and the editorial team and the high-quality manuscripts sent in by you, our readers, have been much more important and hugely appreciated factors.

The acceptance rate for original articles is now 11% and the overall acceptance rate is 23%. Editorial turnaround times continue to improve. The average time to first decision in 2013 was 19 days for all papers and the average time to first decision for reviewed papers was 40 days, a modest improvement from 2012. The instant reject rate has reduced from 43% to 37%. We have seen an increase in time from on-line publication to paper publication …

https://thorax.bmj.com/content/thoraxjnl/69/1/3.full.pdf

Thorax: the prostate years.

SUMMARY Thehaemodynamic effects ofinfusion ofepoprostenol (prostacyclin) and bolus injection oftolazoline were comparedina crossover studyin 11 childrenwith pulmonary hypertension caused bypulmonary vascular disease. The children were studiedduringcardiac catheterisation, while they were anaesthetised, paralysed, andventilated with100% oxygen. The order ofdrugadministration was notrandomised because tolazoline hasa halflife ofhourswhereas epoprostenol hasa halflife ofa fewminutes. Bothdrugscausedpulmonaryand systemic vasodilatation, andthere were no significant differences betweenthetwo. The 95% confidence intervals suggestthat tolazoline didnothaveaclinically important haemodynamicadvantageover epoprostenol. Previous reportssuggestthatserious sideeffects are common when tolazoline isused inrepeated doses; epoprostenol hasonlyafewminorsideeffects that are rapidly reversible when theinfusion isstopped. Epoprostenol ismore expensive thantolazoline butthisstudysuggests thatepoprostenol isa more suitable pulmonary vasodilator ifmore thana single doseisrequired. Tolazoline isana adrenergic antagonist andH, agonist agent that hasbeenwidely usedininfants and children forthepreoperative assessment ofcongenital heart disease,' themanagement ofpostoperative

Comparison ofthehaemodynamic effects of epoprostenol (prostacyclin) andtolazoline

An end to casual sexism.

Introduction and objectives Shortened multiple breath washouts (MBW) are attractive in young children, where a long test time may not be tolerable (Thorax 2013;68:586–7). Lung clearance index (LCI) is usually calculated at 1/40 th of the starting concentration (LCI std ), but in shorter MBWs the LCI is calculated at 1/20 th of the starting concentration (LCI 0.5 ). LCI 0.5 and LCI std are closely correlated but not interchangeable, and so we calculated an extrapolated full LCI (LCI ex ) from LCI 0.5 . Our hypothesis was that extrapolated LCI (LCI ex ) will better reflect LCI std than LCI 0.5 and be more sensitive to intervention. Methods Condition-specific equations for cystic fibrosis (CF), primary ciliary dyskinesia (PCD) and asthma, and an overall equation for all 3 groups, were developed to convert LCI 0.5 to LCI ex from data previously analysed (n = 90, Thorax 2014;69[Suppl 2 ]A166). LCI std , LCI 0.5 and LCI ex were then calculated for new cohorts (n = 70, 20 asthma, 30 CF, 20 PCD), and LCI ex was compared to LCI std . CF patients receiving IV antibiotics (n = 17) and asthma patients receiving triamcinolone (n = 32)) also had LCI std , LCI0.5 and LCI ex calculated and compared. The upper limit of normal for LCI std was calculated from healthy controls. LCI ex was compared to LCI std with a Bland-Altman plot. Results In CF, at higher LCIs, the spread between LCI ex and LCI std grew but there was no bias. For PCD and asthma agreement remained very good. There was no significant difference between LCI std and LCI ex . Results for positive and negative prediction of LCI std for LCI 0.5 and LCI ex are shown in the Table 1. LCI ex and LCI 0.5 were also sensitive to interventions in asthmatic and CF patients, although in general LCI std had better p values. Conclusions LCI ex performed better than LCI 0.5 in predicting results of LCI std . However, LCI ex did not always reflect LCI std , particularly in CF, so the two cannot be used interchangeably in lung disease.

https://thorax.bmj.com/content/thoraxjnl/70/Suppl_3/A115.2.full.pdf

P80 Extrapolating lung clearance index (LCI) from shortened measurements

WS23.4 High Rhinovirus burden in lower airways of children with cystic fibrosis

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