Thorax Podcast

Prophylactic use of azithromycin is common in the management of COPD patients with frequent acute exacerbations. But its application is conservative due to concerns around adverse events, interactions with other drugs, and bacterial resistance. Given these concerns, it is important to identify patients who are likely to be responders or non-responders. According to the NICE guidance in the UK, you should consider azithromycin if the patient: Doesn't smoke. Has already accounted for non-drug treatments, inhaled therapies and vaccines. And has one or more of the following kinds of exacerbations: Frequent exacerbations, more than four times a year, with high sputum production Prolonged exacerbations with high sputum production. Exacerbations causing hospitalisation. In this episode, Thorax social media editor Dr. Kate Diomede speaks to Prof. Wim Janssens¹, author of a study proposing five parameters to predict the individual treatment effect of azithromycin. These parameters were developed using a machine learning model trained using the MACRO and COLUMBUS datasets. This led to the creation of an online calculator, serving as an aid in decision making.   Read the paper: Identifying azithromycin responders with an individual treatment effect model in COPD   1. Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), KU Leuven, Leuven, Belgium   Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Another journal club episode featuring guest-host Dr. Kristina Montemayor of the PulmPEEPs, in conversation with Thorax education editor Dr. Christopher Turnbull, and Dr. Natalie McCleod, author of a recent journal club article focussing on the theme of ventilation and sleep. They discuss the four papers selected by Natalie, covering topics including CPAP therapy's benefit on blood pressure, and Hypoglossal nerve stimulation for obstructive sleep apnoea. Links: Journal club Effect of CPAP therapy on blood pressure in patients with obstructive sleep apnoea: a worldwide individual patient data meta-analysis Hypoglossal nerve stimulation for obstructive sleep apnea in adults: An updated systematic review and meta-analysis Noninvasive Ventilation for Preoxygenation during Emergency Intubation Nasal high flow or noninvasive ventilation? navigating hypercapnic COPD exacerbation treatment: A randomized noninferiority clinical trial For more from the PulmPEEPs, visit their podcast's website. You can find them Twitter (@PulmPEEPs) and Instagram (pulmpeeps), and hear past episodes on Apple Podcasts and Spotify. To submit a journal club article of your own, you can contact Chris directly - christopher.turnbull@ouh.nhs.uk Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

There are many factors which might contribute to asthma patients not adhering to their medication, such as access to services, or convenience of use. One well-known and important barrier in the United States is simply cost. Thorax social media editor Dr. Kate Diomede speaks to Dr. Chun-Tse Hung¹, Dr. Steven Erickson²,  and Prof. Chung-Hsuen Wu¹, the authors of a recent study on the subject.   Read the paper: Cost-related non-adherence to medications among adults with asthma in the USA, 2011–2022    1. School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan 2. Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA

With no identified cause or cure, sarcoidosis is a challenging disease that has a heterogeneous presentation and an unpredictable clinical course. A recent paper in Thorax examined the outcomes for patients grouped by pulmonary function phenotypes, race and sex. First author for the study, Dr. Michelle Sharp¹, joins social media editor Dr. Kate Diomede to talk through the findings. Read the paper: Pulmonary sarcoidosis: differences in lung function change over time 1. Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

The PulmPEEPs are back with another journal club episode. Dr. Kristina Montemayor and Dr. David Furfaro are joined by Thorax education editor Dr. Christopher Turnbull, and journal club author Dr. Ewan Mackay. They discuss a handful of selected papers focussing on COPD, covering the global impact of different household fuels on lung disease, early signs of CT changes in smokers before the detection of COPD, and a trial of treprostinil for the treatment of COPD related pulmonary hypertension. Links: Journal club Estimated health effects from domestic use of gaseous fuels for cooking and heating in high-income, middle-income, and low-income countries: a systematic review and meta-analyses BEACON: A Missing Piece of the Puzzle for Chronic Obstructive Pulmonary Disease A New Global Definition of Acute Respiratory Distress Syndrome Inhaled treprostinil in pulmonary hypertension associated with COPD: PERFECT study results For more from the PulmPEEPs, visit their podcast's website. You can find them Twitter (@PulmPEEPs) and Instagram (pulmpeeps), and hear past episodes on Apple Podcasts and Spotify. To submit a journal club article of your own, you can contact Chris directly - christopher.turnbull@ouh.nhs.uk Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Lung conditions remain one of the biggest causes of death and cost the economy billions annually. Despite this they receive only 2.5% of total public research investment in the UK. The Asthma + Lung UK charity brought together a number of experts and stakeholders in an effort to improve the working approach to this problem. This group published a letter in Thorax recently with a number of recommendations. One of the authors, Dr. Samantha Walker¹, joins the podcast. Links: Fixing lung health in the UK: accelerating respiratory research and innovation Asthma + Lung UK 1. Research and Innovation, Asthma + Lung UK, London, UK Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

The growing use of artificial stone has seen the emergence of an aggressive, progressive respiratory disease, which is causing silicosis in young people. Dr. Johanna Feary¹ ² joins Thorax's Dr. Kate Diomede in the studio, to discuss. They talk through some the UK's earliest cases, the background to this phenomenon, international response, and the broader history of silicosis as a disease. Links: Artificial stone silicosis: a UK case series Relationship between cumulative silica exposure and silicosis: a systematic review and dose-response meta-analysis  1. National Heart and Lung Institute, Imperial College, London, UK 2. Department of Occupational Lung Disease, Royal Brompton Hospital, London, UK Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

A special journal club episode featuring guest-hosts Dr. Kristina Montemayor and Dr. David Furfaro of the PulmPEEPs. They're joined in conversation with Thorax education editor Dr. Christopher Turnbull, and Dr. Imran Howell, author of a recent journal club article in Thorax. Focussing on the theme of airway disease, they discuss the four papers in Imran's roundup, covering topics from nutritional impact on tuberculosis rates to infant vaccination against RSV. Links: Journal club Blood eosinophil-guided oral prednisolone for COPD exacerbations in primary care in the UK (STARR2): a non-inferiority, multicentre, double-blind, placebo-controlled, randomised controlled trial Nutritional supplementation to prevent tuberculosis incidence in household contacts of patients with pulmonary tuberculosis in India (RATIONS): a field-based, open-label, cluster-randomised, controlled trial The airway microbiome mediates the interaction between environmental exposure and respiratory health in humans Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study For more from the PulmPEEPs, visit their podcast's website. You can find them Twitter (@PulmPEEPs) and Instagram (pulmpeeps), and hear past episodes on Apple Podcasts and Spotify. To submit a journal club article of your own, you can contact Chris directly - christopher.turnbull@ouh.nhs.uk Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

A new clinical statement from the British Thoracic Society was recently published in Thorax. It describes a building-block approach for how to manage patients with tobacco dependency in a hospital setting. Thorax podcast host Dr. Kate Diomede speaks with two of the authors, Prof. Sanjay Agrawal (1) and Dr. Matthew Evison (2).  Read the statement: Medical management of inpatients with tobacco dependency Further reading: NCSCT online training NCSCT briefings and practice guidance (1) Department of Respiratory Medicine, Glenfield Hospital, Institute for Lung Health, Leicester, UK (2) Manchester University NHS Foundation Trust, Manchester, UK Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

What are the effects of high levels of social media consumption amongst young people? New research published in Thorax quantifies the impact that exposure to marketing on online platforms is having, showing a greater likelihood of smoking or vaping with greater time spent on these platforms. Thorax associate editor Prof. Nick Hopkinson (1) joins Dr. Kate Diomede to discuss the paper's findings. Read the paper: Association of time spent on social media with youth cigarette smoking and e-cigarette use in the UK: a national longitudinal study  (1) Prof. of Respiratory Medicine, Imperial College London, Respiratory Consultant, Royal Brompton Hospital, Associate Editor of Thorax, Chair of ASH (Action on Smoking in Health) UK Charity https://twitter.com/COPDdoc Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Asthma prevalence is increasing around the world, and is theorised to be due to a number of environmental factors. One such factor is a sensitivity to house dust mite (HDM) allergens, which is common in asthma patients. Dr. Klaus Bønnelykke (1) joins the podcast to speak with Dr. Kate Diomede about this topic, following the publication of the paper, "Genetic and T2 biomarkers linked to the efficacy of HDM sublingual immunotherapy in asthma". (1) Copenhagen Prospective Studies on Asthma in Childhood, Copenhagen University Hospital, Copenhagen, Denmark Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Socioeconomic deprivation is a driving factor in lung cancer rates. With the roll out of a national lung cancer screening programme in the UK, it's important that the right invitation strategies are used for reaching community members who may be at risk. This episode, Dr. Patrick Goodley (@patrick_goodley) joins host Dr. Kate Diomede to discuss the recent paper, "Invitation strategies and participation in a community-based lung cancer screening programme located in areas of high socioeconomic deprivation." Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

What impact do reproductive events, like menarche, miscarriage or menopause have on female lung health? Prof. Gita Mishra (1) joins Thorax host Dr. Kate Diomede to discuss this question. They consider how recurrent fertility issues can point to an increased risk of chronic obstructive pulmonary disease later in life, and how variance in oestrogen levels throughout the lifespan affect lung development. The conversation is centred around the recently-published study, "Female Reproductive Histories and the Risk of Chronic Obstructive Pulmonary Disease" (https://doi.org/10.1136/thorax-2023-220388). (1) School of Public Health, University of Queensland, Australia Relevant links: A Life Course Approach to Women's Health (2nd ed): https://academic.oup.com/book/46697 Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Lung cancer screening in the UK has only been introduced in recent years, and its processes around smoking cessation guidance may have opportunities for improvement. Visiting the studio today is PhD student Parris Williams (1), to discuss the newly published Thorax research paper, "Immediate smoking cessation support during lung cancer screening: long-term outcomes from two randomised controlled trials" (https://thorax.bmj.com/content/early/2023/10/24/thorax-2023-220367). Along with social media editor Dr. Kate Diomede, Parris discusses what has been learnt from QuLIT (Quit smoking Lung health Intervention Trial) 1 & 2, and how patients might benefit from greater integration of smoking cessation support during targeted lung health checks.   (1) National Heart and Lung Institute, Imperial College London, London, UK Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Head and neck consultant Dr. Tobias Todsen (1) joins the podcast from Copenhagen to speak with social media editor Dr. Kate Diomede. The topic of conversation is the recent paper, "Higher SARS-CoV-2 detection of oropharyngeal compared with nasopharyngeal or saliva specimen for molecular testing: a multicentre randomised comparative accuracy study" (https://thorax.bmj.com/content/78/10/1028). They discuss the sensitivity of different test combinations, cultural inclinations for certain kinds of testing, and the cost implications of each approach.   (1) Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet – Copenhagen University Hospital, Copenhagen, Denmark Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

In a conversation touching on diet, fat distribution, and inflammatory pathways, Dr. Hayley Scott (1) speaks with host Dr. Kate Diomede about the recent paper, “Effect of obesity on airway and systemic inflammation in adults with asthma: a systematic review and meta-analysis". Read the article here: https://thorax.bmj.com/content/78/10/957  (1) School of Biomedical Sciences and Pharmacy, The University of Newcastle, NSW, Australia Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Dr. Wei Shen Lim (1) joins Thorax's podcast host and social media editor Dr. Kate Diomede to talk over the recent research paper, “Readmission following hospital admission for community-acquired pneumonia in England”. Read the article here: https://thorax.bmj.com/content/early/2023/07/28/thorax-2022-219925 (1) Department of Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Dr. Kate Diomede, podcast host and Thorax social media editor, is joined by Dr. Elizabeth Smith (1) to discuss a study on the longterm respiratory outcomes for survivors of very preterm birth, titled "Risk factors for poorer respiratory outcomes in adolescents and young adults born preterm." Read the article here: https://thorax.bmj.com/content/early/2023/05/18/thorax-2022-219634  Find more info on the team's work at: https://walyanrespiratory.telethonkids.org.au/news-and-events/2023/may/WALHIP-young-adult-follow-up-study/   (1) Wal-Yan Respiratory Research Centre, Telethon Kids Institute, Perth, Australia   Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Dr. Kate Diomede, podcast host and Thorax social media editor, is joined by Prof. Najib Rahman (1) and Prof. Nick Maskell (2) to discuss the July 2023 update of the British Thoracic Society's guideline for treatment of pleural disease. This document was last updated in 2010, and now accounts for the high quality data provided by more recent trials, as well as modern practices informed by those. Read the guideline here: https://thorax.bmj.com/content/78/Suppl_3/s1 (1) Oxford Respiratory Trials Unit, Oxford University, UK (2) Academic Respiratory Unit, Bristol University, UK   Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - Thorax.BMJ) and subscribe on your preferred platform, to get the latest episodes directly on your device each month. We would love to hear your thoughts on the podcast, you can leave a review on Apple Podcasts or Spotify.

Dr. Kate Diomede, social media editor at Thorax, is joined by Dr. Sam Janes (1) to discuss the history of lung cancer screening, and its use in early detection. They also examine the process and results of his recent paper, "Growing small solid nodules in lung cancer screening: safety and efficacy of a 200 mm3 minimum size threshold for multidisciplinary team referral". The paper is available online: https://thorax.bmj.com/content/78/2/202 (1) Lungs for Living Research Centre, UCL Respiratory, University College London, UK. Please engage in the conversation through the social media channels (Twitter - @ThoraxBMJ; Facebook - @Thorax.BMJ · Pulmonologist) and subscribe on your preferred platform, to get the latest episodes directly on your device each month.