During the 2009 H1N1 influenza pandemic, obesity was convincingly identified as a novel, independent risk factor for multiple markers of disease severity. Associations between numerous nosocomial and community-acquired clinical infections have previously been established; yet, little is known about the mechanisms underpinning the increased susceptibility to severe outcomes following pandemic H1N1/09 infection in obesity. Here, we present a brief synthesis of the recent advances in our understanding of the immunomodulatory effects of obesity on outcomes following respiratory viral infection, with a particular focus on pandemic influenza. (Source: Thorax)

Conclusions High-quality data to support the use of HV for ambulatory treatment of pneumothorax is sparse. The use of HV in such circumstances may have benefits for patient comfort, mobility and avoidance of hospital admission, with comparable outcomes to current practice. There is urgent need for a carefully designed RCT to answer his question. (Source: Thorax)

An association has been demonstrated between obstructive sleep apnoea (OSA) and both hypertension and cardiovascular events. Although observational studies suggest that treatment with continuous positive airways pressure (CPAP) can reduce blood pressure and the incidence of fatal and non-fatal cardiovascular events in patients with severe and moderate OSA, short term randomised controlled trials have failed to demonstrate a similar effect in non-sleepy patients. The primary objective of this large, multicentre randomised controlled trial was to investigate the effect of CPAP on the incidence of hypertension and cardiovascular events in non-sleepy patients (Epworth Sleepiness Score of ≤10, range 0–24) with OSA (apnoea-hypopnoea index of 20 h–1 or greater). The secondary ...

In this national database study from the USA, the short-term outcomes following thoracoscopic lobectomy were compared with open thoracotomy lobectomy. From the Nationwide Inpatient Sample database, maintained by the Agency for Healthcare Research and Quality, all adult patients who underwent lobectomy as the principal procedure, by either thoracoscopy or thoracotomy during 2007 and 2008, were included. Patients with prior thoracotomy, or if both thoracoscopic and open lobectomy were listed as the approach, were excluded. All 68 350 patients were included, and 15% underwent a thoracoscopic lobectomy. Propensity score matching was used to reduce confounding by indication, and 10 173 thoracoscopic lobectomy patients were matched to 30 866 patients in the open lobectomy group. T...