Last year the British Thoracic Society published the results of their 2024 survey of trainees. Since then, a number of commentary pieces have been published in Thorax, and two authors join the podcast this episode. Dr. Abigail MacKintosh¹ a respiratory medicine trainee, and Dr. Daniel Smith², consultant and chair of the BTS workforce committee, join host Dr. Kate Diomede to discuss some of the issues identified and some potential solutions.

Links:

British Thoracic Society trainee survey 2024: what are the trainees saying and how will this impact the future workforce?

Commentary on the 2024 British Thoracic Society Specialty Trainee Survey report

The British Thoracic Society Trainee Survey Report 2024

(1) Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK

(2) Sherwood Forest Hospitals NHS Foundation Trust, Nottinghamshire, 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.

This journal club episode is guest-hosted by Dr. David Furfaro and Dr. Kristina Montemayor of the PulmPEEPs, in conversation with Thorax education editor Dr. Christopher Turnbull, and Dr. George Doumat, author of a recent journal club article focussing on the theme of bronchiectasis. These papers highlight the exciting progress that is being seen in the treatment of this condition, and the challenges that remain ahead.

Links:

• Journal club
• Phase 3 Trial of the DPP-1 Inhibitor Brensocatib in Bronchiectasis
• Cathepsin C (dipeptidyl peptidase 1) inhibition in adults with bronchiectasis: AIRLEAF, a phase II randomised, double-blind, placebo-controlled, dose-finding study
• Five-Year Outcomes among U.S. Bronchiectasis and NTM Research Registry Patients
• Anxiety, depression, physical disease parameters and health-related quality of life in the BronchUK national bronchiectasis cohort

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.

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.