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Why and how should children be protected from the deluge of vaping related media and marketing overexposure? 为什么以及如何保护儿童免受大量与吸烟有关的媒体和营销过度曝光的影响?
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2023-12-19 DOI: 10.1183/20734735.0141-2023
David White, Andrew Bush, Alan R Smyth, Jayesh Mahendra Bhatt

E-cigarettes are products delivering nicotine via inhalation and are devised to mimic tobacco smoking. While they were initially introduced as a device putatively to aid with smoking cessation, their use is now far broader than that. Use by children is significantly increasing. There is growing evidence of the potential harms of vaping. E-liquids used for e-cigarettes contain a wide range of harmful substances, and the clinical consequences of this are now being increasingly demonstrated, such as the rise in cases of e-cigarette- or vaping-associated lung injury. In addition, early use may result in long-term nicotine addiction. Vaping companies utilise marketing methods that distinctly target young people, and weak legislation in the UK allows them free rein to expose children to vaping. In this review we demonstrate why children must be protected from vaping. We must have stringent legislation to prevent easy access to e-cigarettes, including banning the convenience and affordability disposable vapes provide, and prevent marketing that does not warn about the potential health effects. The Australia approach of prescription or pharmacy only access for smoking cessation should be considered to limit exposure of children and minimise use by nonsmokers.

电子烟是一种通过吸入提供尼古丁的产品,其设计目的是模仿吸烟。虽然电子烟最初是作为帮助戒烟的设备推出的,但现在其使用范围远不止于此。儿童的使用率正在大幅上升。越来越多的证据表明电子烟具有潜在危害。电子烟使用的电子液体中含有多种有害物质,其临床后果也日益显现,如电子烟或电子烟相关肺损伤病例的增加。此外,早期使用可能会导致尼古丁长期上瘾。电子烟公司利用明显针对年轻人的营销方法,而英国薄弱的立法又允许他们随意让儿童接触电子烟。在这篇评论中,我们说明了为什么必须保护儿童免受吸食电子烟的危害。我们必须制定严格的法律,防止儿童轻易接触到电子烟,包括禁止使用方便、价格低廉的一次性电子烟,防止不警告潜在健康影响的营销方式。应考虑澳大利亚的做法,即戒烟只能凭处方或药房购买,以限制儿童接触电子烟,并尽量减少非吸烟者使用电子烟。
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引用次数: 0
Unveiling the power of neutral and inclusive language in tuberculosis prevention and care. 在结核病预防和护理工作中发挥中性和包容性语言的力量。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2024-02-13 DOI: 10.1183/20734735.0157-2023
Pedro Barbosa, Mariana Vieira, João Pedro Ramos, Raquel Duarte

Language plays a crucial role in shaping discourses and responses related to disease, particularly tuberculosis (TB). Stigmatising language and attitudes surrounding TB can lead to discrimination and marginalisation of affected individuals, creating barriers to seeking proper diagnosis and treatment. The terminology used to describe TB-affected individuals can be disempowering and criminalising, reinforcing an "othering" of those affected. To combat this, engaging with TB-affected communities is essential to co-construct a neutral and inclusive vocabulary that respects the dignity of individuals and fosters empathy and support. Thus, an inclusive language approach empowers affected individuals as active participants in their health management, encouraging open communication and the development of support networks. By adopting a neutral and inclusive language system, healthcare providers and communities can work together to remove unnoticed hurdles and align with the World Health Organization's TB care and prevention goals.

语言在形成与疾病,尤其是结核病(TB)有关的论述和应对措施方面发挥着至关重要的作用。围绕肺结核的污名化语言和态度会导致对患者的歧视和边缘化,为寻求适当的诊断和治疗制造障碍。用于描述受结核病影响的个人的术语可能会削弱他们的能力并使他们成为罪犯,从而强化了对受影响者的 "另类化"。为了解决这一问题,必须与受结核病影响的社区合作,共同构建一个尊重个人尊严、促进共鸣和支持的中立、包容的词汇。因此,包容性语言方法赋予受影响的个人权力,使其成为健康管理的积极参与者,鼓励开放式交流和发展支持网络。通过采用中性和包容性的语言系统,医疗服务提供者和社区可以共同努力,消除未被注意到的障碍,并与世界卫生组织的结核病护理和预防目标保持一致。
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引用次数: 0
Thoracic ultrasound for pneumothorax and infectious effusion: from equine beginnings to clinical cornerstone. 胸腔超声波治疗气胸和感染性渗出物:从马开始到临床基石。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2023-12-19 DOI: 10.1183/20734735.0153-2023
Casper Falster, Elise Noël-Savina, Thomas Gille, Pia Pietersen

Routine clinical application of thoracic ultrasound has greatly enhanced the process of diagnosing and treating patients with pneumothorax and infectious effusion by minimising radiation exposure and facilitating prompt diagnosis https://bit.ly/3FO6jBg.

胸腔超声的常规临床应用极大地改进了气胸和感染性渗出患者的诊断和治疗过程,最大限度地减少了辐射暴露,并有助于及时诊断 https://bit.ly/3FO6jBg。
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引用次数: 0
A young boy with diabetic ketoacidosis and non-resolving pneumonia. 一名患有糖尿病酮症酸中毒和难治性肺炎的小男孩。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2023-12-19 DOI: 10.1183/20734735.0161-2023
Rakesh Kodati, Narendra Kumar Narahari, Anuradha Tadepalli, Nishika Madireddy, Bhaskar Kakarla, Paramjyothi Gongati

Classic radiological signs of invasive fungal disease, especially pulmonary mucormycosis in a predisposed individual should alert the physician to initiate empiric anti-fungal therapy. https://bit.ly/40gt4Hm.

侵袭性真菌病的典型放射学症状,尤其是易感人群的肺粘孢子菌病,应提醒医生启动经验性抗真菌治疗。https://bit.ly/40gt4Hm。
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引用次数: 0
Diagnosing and managing pleural disease. 诊断和处理胸膜疾病。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2023-12-19 DOI: 10.1183/20734735.0230-2023
Brian D Kent

This issue of Breathe focuses on the management of pleural disease https://bit.ly/4a7dh1S.

本期《呼吸》聚焦胸膜疾病的治疗 https://bit.ly/4a7dh1S。
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引用次数: 0
Chronic cough: is the end nigh? 慢性咳嗽:末日即将来临?
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2024-02-13 DOI: 10.1183/20734735.0165-2023
Barnaby Hirons, Richard Turner, Peter S P Cho, Surinder S Birring

Chronic cough (lasting more than 8 weeks) is a common condition with substantial psychosocial impact. Despite huge efforts following robust guidelines, chronic cough in many patients remains refractory or unexplained (RU-CC). Recent insights support a significant role for cough hypersensitivity in RU-CC, including neuropathophysiological evidence from inhalational cough challenge testing, functional magnetic resonance imaging, and airway nerve biopsy. Along with improved approaches to measuring cough, this knowledge has developed in tandem with repurposing neuromodulator medications, including gabapentin, and evidence for non-pharmacological treatments. Most significantly, there is now a pipeline for novel classes of drugs specifically for chronic cough. The P2X3 receptor antagonist gefapixant is the first such drug to be approved in Europe. However, challenges persist. The field of chronic cough needs more robust epidemiological data, enhanced diagnostic tools, further well-designed clinical trials accounting for the effects of placebo, and treatments with minimal side-effects. Addressing these challenges are novel chronic cough registries, improved International Classification of Diseases (10th revision) coding, genetic testing options and further mechanistic studies. This Viewpoint article discusses these facets and considers how, whilst the end of chronic cough may not be imminent for all patients, the evolving landscape looks increasingly optimistic.

慢性咳嗽(持续时间超过 8 周)是一种常见病,对社会心理有很大影响。尽管人们按照严格的指南做出了巨大努力,但许多患者的慢性咳嗽仍然是难治性或原因不明(RU-CC)。最近的研究表明,咳嗽超敏反应在 RU-CC 中起着重要作用,包括吸入性咳嗽挑战测试、功能磁共振成像和气道神经活检所提供的神经病理生理学证据。随着咳嗽测量方法的改进,这些知识也与包括加巴喷丁在内的神经调节药物的再利用以及非药物治疗的证据同步发展。最重要的是,现在已经有了专门治疗慢性咳嗽的新型药物。P2X3 受体拮抗剂 gefapixant 是欧洲批准的第一种此类药物。然而,挑战依然存在。慢性咳嗽领域需要更可靠的流行病学数据、更先进的诊断工具、进一步设计完善的临床试验(考虑安慰剂的影响)以及副作用最小的治疗方法。为应对这些挑战,需要建立新型慢性咳嗽登记处、改进国际疾病分类(第 10 次修订)编码、提供基因检测方案以及开展进一步的机理研究。这篇 "视点 "文章讨论了这些方面的问题,并认为虽然慢性咳嗽的终结对所有患者来说并非迫在眉睫,但不断发展的前景看起来越来越乐观。
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引用次数: 0
Malignant pleural disease. 恶性胸膜疾病。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2024-02-13 DOI: 10.1183/20734735.0145-2023
Laura M Piggott, Conor Hayes, John Greene, Deirdre B Fitzgerald

Malignant pleural disease represents a growing healthcare burden. Malignant pleural effusion affects approximately 1 million people globally per year, causes disabling breathlessness and indicates a shortened life expectancy. Timely diagnosis is imperative to relieve symptoms and optimise quality of life, and should give consideration to individual patient factors. This review aims to provide an overview of epidemiology, pathogenesis and suggested diagnostic pathways in malignant pleural disease, to outline management options for malignant pleural effusion and malignant pleural mesothelioma, highlighting the need for a holistic approach, and to discuss potential challenges including non-expandable lung and septated effusions.

恶性胸膜疾病造成的医疗负担日益加重。全球每年约有 100 万人受到恶性胸腔积液的影响,导致失能性呼吸困难,并预示着预期寿命的缩短。及时诊断是缓解症状、优化生活质量的当务之急,并应考虑患者的个体因素。本综述旨在概述恶性胸膜疾病的流行病学、发病机制和建议的诊断途径,概述恶性胸腔积液和恶性胸膜间皮瘤的治疗方案,强调综合治疗的必要性,并讨论包括肺不张和隔膜积液在内的潜在挑战。
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引用次数: 0
Preview of the Lung Science Conference 2024. 2024 年肺科学大会预览。
IF 2.3 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2024-01-16 DOI: 10.1183/20734735.0226-2023
Sara Cuevas Ocaña, Pauline Bardin, Rui Marçalo, Heleen Demeyer

LSC 2024 offers access to cutting-edge scientific sessions, the opportunity to network with international experts, the possibility to present and discuss the latest findings, and be mentored by ERS leaders. We are looking forward to welcoming you there! https://bit.ly/3Rxr7SH.

LSC 2024 提供了参加前沿科学会议的机会、与国际专家交流的机会、展示和讨论最新研究成果的机会,以及接受 ERS 领导指导的机会。我们期待您的光临!https://bit.ly/3Rxr7SH。
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引用次数: 0
Use of exhaled nitric oxide in the diagnosis and monitoring of childhood asthma: myth or maxim? 在诊断和监测儿童哮喘时使用呼出的一氧化氮:神话还是格言?
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2023-12-19 DOI: 10.1183/20734735.0236-2022
Anna Fraser, Ruaraidh Simpson, Steve Turner

Asthma is a common condition in children. This review describes the evidence from the literature and international asthma guidelines for using fractional exhaled nitric oxide (FENO) in the diagnosis and monitoring of childhood asthma. The accuracy of FENO measuring devices could be further improved, the difference in FENO results between devices are equivalent to what is considered a clinically important difference. For diagnosing asthma no guideline currently recommends FENO is used as the first test, but many recommend FENO as part of a series of tests. A cut-off of 35 ppb is widely recommended as being supportive of an asthma diagnosis, but evidence from children at risk of asthma suggests that a lower threshold of 25 ppb may be more appropriate. Nine randomised clinical trials including 1885 children have added FENO to usual asthma care and find that exacerbations are reduced when care is guided by FENO (OR for exacerbation compared to usual care 0.77, 95% CI 0.62-0.94). What is not clear is what cut-off(s) of FENO should be used to trigger a change in treatment. After 30 years of intensive research there is not sufficient evidence to recommend FENO for routine diagnosing and monitoring asthma in children.

Educational aims: To give the reader an overview of literature that supports and does not support the role of FENO in diagnosing asthma in children.To give the reader an overview of literature that supports and does not support the role of FENO in monitoring asthma in children.To give the reader an understanding of the role of FENO in international guidelines for diagnosing and monitoring asthma in children.

哮喘是一种常见的儿童疾病。本综述介绍了文献和国际哮喘指南中关于使用分数呼出一氧化氮(FENO)诊断和监测儿童哮喘的证据。FENO 测量设备的准确性有待进一步提高,不同设备之间的 FENO 结果差异相当于临床上的重要差异。在诊断哮喘方面,目前没有任何指南建议将 FENO 作为首次检测,但许多指南建议将 FENO 作为一系列检测的一部分。35 ppb 的临界值被广泛推荐为哮喘诊断的支持性指标,但来自哮喘高危儿童的证据表明,25 ppb 的较低临界值可能更为合适。包括 1885 名儿童在内的九项随机临床试验在常规哮喘护理的基础上增加了 FENO,结果发现,在 FENO 的指导下进行护理可减少病情恶化(与常规护理相比,病情恶化的 OR 值为 0.77,95% CI 为 0.62-0.94)。目前尚不清楚的是,应该使用哪种 FENO 临界值来触发治疗的改变。经过 30 年的深入研究,目前还没有足够的证据建议将 FENO 用于儿童哮喘的常规诊断和监测:向读者概述支持和不支持 FENO 在诊断儿童哮喘中的作用的文献。向读者概述支持和不支持 FENO 在监测儿童哮喘中的作用的文献。
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引用次数: 0
The contemporary management of spontaneous pneumothorax in adults. 成人自发性气胸的现代治疗方法。
IF 2 Q2 RESPIRATORY SYSTEM Pub Date : 2023-12-01 Epub Date: 2024-01-16 DOI: 10.1183/20734735.0135-2023
Matthew Shorthose, Eleanor Barton, Steven Walker

Spontaneous pneumothorax is a common presentation, and there has been a recent surge of research into the condition. With the recent publication of the new British Thoracic Society guidelines and the upcoming European Respiratory Society guidelines, we provide a concise up-to-date summary of clinical learning points. In particular we focus on the role of conservative or ambulatory management, as well as treatment options for persistent air leak and guidance for when to refer to thoracic surgeons for the prevention of the recurrence of pneumothorax.

Educational aims: To give up-to-date guidance on the acute management of spontaneous pneumothorax, including the role of conservative or ambulatory managementTo discuss the different treatment options for persistent air leak.To guide physicians on when to refer patients to thoracic surgeons for the prevention of the recurrence of pneumothorax.

自发性气胸是一种常见病,近年来对这种疾病的研究也在不断深入。最近,英国胸科学会发布了新的指南,欧洲呼吸学会也即将发布指南,因此我们提供了一份简明扼要的最新临床学习要点摘要。我们特别关注保守治疗或非卧床治疗的作用、持续漏气的治疗方案以及何时转诊胸外科医生以预防气胸复发的指导:就自发性气胸的急性处理提供最新指导,包括保守或非卧床处理的作用;讨论持续漏气的不同治疗方案;指导医生何时将患者转诊至胸外科医生以预防气胸复发。
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引用次数: 0
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Breathe
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