eLetters

219 e-Letters

  • Inhaled corticosteroids and mortality in COPD
    Pierre Ernst

    Dear Editor,

    We read with interest the recent paper by Sin and colleagues (1) which, we believe, raises more questions that it answers.

    A major concern is the fact that ascertainment of mortality was incomplete for a significant proportion of patients (973/5086), corresponding to 19% of the total (not the reported 12%), who did withdraw prematurely from the study. This loss to follow up was more likely...

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  • Inhaled corticosteroids and COPD mortality: are we there yet?
    Robert G Stirling

    Dear Editor,

    Inhaled corticosteroids have for some time been seeking a broader indication in COPD. The recent meta-analysis by Sin et al.[1] suggesting protection against all-cause mortality is therefore of some interest. Although not universally confirmed[2,3], this tantalising concept is being prospectively evaluated in a 3 year study of high dose inhaled corticosteroids (Flixotide 500mcg bid, alone or in combina...

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  • RSV infection in prematurely born infants
    Sanjeev Deshpande

    Dear Editor,

    I read with interest the article by Broughton et al, and wish to offer following comments.

    1. The duration of oxygen therapy (in both Table 1 and the text) ranges from 30 to 107 weeks, thus qualifying every baby in the cohort as having BPD. Even if this was in days, it would make every baby oxygen dependent 28 days after birth, c...

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  • Disease duration: fundamental to the study of airway wall remodelling
    Christopher E Brightling

    Dear Editor,

    We read with interest the study by Park et al(1). We agree that non- asthmatic eosinophilic bronchitis (EB), a condition characterised by eosinophilic inflammation without evidence of variable airflow obstruction is a powerful disease control group to study the mechanisms involved in the development of airway hyperresponsiveness in asthma. Previous comparative studies have demonstrated that asthma and...

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  • Authors' reply to Koh and Kwon
    Robert Wilson

    Dear Editor,

    We would agree with much of the content of the interesting letter from Doctors Koh and Kwon, particularly the details of M.avium complex infection and the use of CT scans in making the diagnosis.[1] We have also had experience of bronchoscopy and biopsy being necessary to make the diagnosis in some cases with suggestive radiology. The one point on which we disagree is the value of routine annual scr...

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  • Consideration of Palivizumab not justified
    Rollo D Clifford

    Dear Editor,

    Broughton and colleagues state that consideration should be given to use of prophylactic palivizumab to infants born at less than 32 weeks in the case of maternal smoking or even if they have siblings. The authors however present no data from their own or other studies to indicate that this would be in any way cost effective or justified. Certainly the word "consider" is fortunate given the stated fu...

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  • Bronchiectasis and nontuberculous mycobacterial pulmonary infection
    Won-Jung Koh

    Dear Editor,

    We read with great interest the paper by Wickremasinghe et al. on the prevalence of nontuberculous mycobacteria (NTM) in patients with bronchiectasis.[1] They showed that the prevalence of NTM was uncommon (only 2%) both in 50 newly referred patients and 50 follow up patients. However, the authors stated in the Discussion that it is now our practice to screen our patients routinely once a year bec...

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  • Predicting in-hospital death related to pulmonary embolism
    Andrew RL Medford

    Dear Editor,

    Ghuysen et al in their recent retrospective study demonstrated the potential value of CTPA RV/LV ratio in predicting in-hospital mortality related to pulmonary embolism.[1] I wondered if they assessed ECG evidence of acute right heart strain and/or serum cardiac biomarkers of injury in the same study and what the relative prognostic value of these indices versus the CTPA RV/LV ratio was, assuming th...

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  • Highlighting the role of lung volume reduction surgery in COPD
    Omer Ashraf

    Dear Editor

    I read with interest this article by Sharafkhaneh et al. wherein the role of lung volume reduction surgery (LVRS) in improving expiratory flow limitation by decreasing thoracic gas compression, is indicated

    Apart from the obvious benefits for emphysema patients shown in this report, it is important to highlight the other significant beneficial roles of LVRS. The procedure is now considered as...

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  • Study design and interpretation
    Imran Aziz

    Dear Editor

    The study by Duffy et al,(1) published in the September issue of Thorax, has a number of errors in the design and interpretation of the results.

    In the study design; 1- By definition COPD is a condition where FEV1 changes very little, so a study of COPD intervention based on change in FEV1 is not correct. 2- The study was in theory powered to show what amounts to about 30% improvement in FEV1...

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