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An Official American Thoracic Society Statement: Work-Exacerbated Asthma.

Conclusions: WEA is a common and underrecognized adverse outcome resulting from conditions at work. Additional research is needed to improve the understanding of the risk factors for, and mechanisms and outcomes of, WEA, and to inform and evaluate preventive interventions.

An Official ATS Clinical Practice Guideline: Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications.

Conclusions: In the setting of chronic inflammatory airway disease including asthma, conventional tests such as FEV(1) reversibility or provocation tests are only indirectly associated with airway inflammation. Fe(NO) offers added advantages for patient care including, but not limited to (1) detecting of eosinophilic airway inflammation, (2) determining the likelihood of corticosteroid responsiveness, (3) monitoring of airway inflammation to determine the potential need for corticosteroid, and (4) unmasking of otherwise unsuspected nonadherence to corticosteroid therapy.

Community-acquired pneumonia in children: what's new?

The community-acquired pneumonia in children guidelines have just been updated with new evidence on incidence, aetiology and management. This guidance should improve patient care. (Source: Thorax)

Diagnosis and definition of severe refractory asthma: an international consensus statement from the Innovative Medicine Initiative (IMI)

Patients with severe refractory asthma pose a major healthcare problem. Over the last decade it has become increasingly clear that, for the development of new targeted therapies, there is an urgent need for further characterisation and classification of these patients. The Unbiased Biomarkers for the Prediction of Respiratory Disease Outcomes (U-BIOPRED) consortium is a pan-European public-private collaboration funded by the European Commission Innovative Medicines Initiative of the European Union. U-BIOPRED aims to subphenotype patients with severe refractory asthma by using an innovative systems biology approach. This paper presents the U-BIOPRED international consensus on the definition and diagnosis of severe asthma, aligning the latest concepts in adults as well as in children. The co...

A potential role for tiotropium bromide as an added therapy for adults with uncontrolled asthma

In this study, the addition of tiotropium bromide to an inhaled glucocorticoid was evaluated as compared with doubling the dose of the inhaled glucocorticoid (primary superiority comparison) or the addition of salmeterol (secondary non-inferiority comparison) in 210 patients with asthma. Tiotropium use showed a superior primary outcome, as compared with doubling of the inhaled glucocorticoid dose, as assessed by measuring the morning peak expiratory flow rate (PEF), with a mean difference of 25.8 l/min, and superiority in most secondary outcomes, including evening PEF, with a difference of 35.3 l/min, the proportion of asthma-control days, the FEV1 before bronchodilation and daily symptom scores. The addition of tiotropium was also non-inferior to the addition of salmeterol for all assesse...

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