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In recent months the Triumvirate have indulged their guilty pleasures of musicals and sitcoms. This month they get serious – the theme is “works of art”.
Tracey Emin’s Bed
“My Bed”, by young British artist Tracey Emin was first exhibited at the Tate Gallery in 1999. The art work consists of an unmade bed and associated bedroom detritus. We don’t know if Tracey Emin suffered from obstructive sleep apnoea while creating this exhibit or indeed whether she has ever used a mandibular advancement device. In this issue of Thorax (Page 667) Pepin and colleagues describe a randomised controlled trial of a custom-made device vs a cheaper model which can be heated and moulded to the patient. The trial recruited just under 200 patients and had a non-inferiority design, with a composite primary outcome of ≥50% reduction in apnoea–hypopnoea index (AHI) or achieving AHI<10 events/hour at 2 months. There was no significant difference in the primary outcome (51% for custom made and 54% for heat moulded). The heat moulded version is cheaper - which should save health services some money. Tracey Emin can afford a custom-made device though – her bed sold for £2.5 million at auction!
Music while you work out
Many runners and gym bunnies listen to music while they work out. The allegretto from Beethoven’s symphony number seven is a personal favourite. However, it has not been established whether acoustic stimulation can affect the perception of exertional dyspnea. Until now that is… In this month’s journal (Page 707), Sharma and colleagues describe a study of 18 healthy volunteers who had a 5 min work out on a treadmill while listening to a positive, negative or neutral set of “standardised affective digitised sounds”. Dyspnoea intensity was significantly lower when listening to “positive” compared with “negative” sounds. We are not told whether symphony number seven was included in the “standardised affective digitised sounds”.
The physical impossibility of death in the mind of someone living
Damien Hirst became famous by displaying animals suspended in formaldehyde. Although Damien Hirst has a long being fascinated by science and medicine, recently suggesting it may be the new religion, although he probably was unaware that his fixatives may have an adverse effect on lung function. In this issue of Thorax (Page 650) Alif and colleagues describe the association between aromatic solvents and metals and lung function decline through analysis of the Tasmanian Health Study. They find that exposure to solvents was associated with a 15 mL/year loss of FEV1 and a 14 mL/year loss of FVC. Interestingly exposure to metals was associated with a lower loss of FEV1 but a higher loss of FVC. It is clear that these studies reveal the physical possibility of loss, which should be high in the minds of all.
The anonymous artist Banksy is the most famous urban artist and often passes comment on major social issues of the time. Although Ozone’s angel is not a comment on the atmosphere, air pollution is undoubtedly one of the major issues affecting us today. In this issue of Thorax (Page 675) Torres et al examined the effect of urban particulate matter on alveolar macrophage and peripheral blood monocyte function following stimulation with M. Tuberculosis and found that it reduced the monocyte/macrophage syntheses of TNFalpha with variable effects on IL1 and interferon gamma. Lets hope calls for clean air are more than banging your head against a brick wall, because the urban atmosphere’s potential to disrupt the immune response to TB is more than existencilism!
Andy Warhol is famous for his portraits of glamorous female celebrities and icons, such as Marilyn Monroe, Judy Garland and Elizabeth Taylor. However, he had another side and “Altered Image” is a series of photographic portraits in which Warhol is heavily made-up wearing an assortment of women’s wigs. This is somewhat different from the change in young asthma patients, reported as the ‘adolescent switch’. Here the change observed is that of a higher prevalence of male childhood asthma, whereas females have a higher prevalence in adolescence and adulthood. Ryan Arathimos and colleagues (Page 633) investigated if sex hormones had a causal role in this gender switch in asthma. Using the Avon Longitudinal Study of Parents and Children, they observed a protective effect of genetically elevated sex hormone binding globulin on asthma and suggest this as a biological explanation of the asthma sex discordance. Much is written about Andy Warhol’s life, but one thing is for sure, he was not asthmatic.
Art and science collision
Art critics use concepts such as space, texture, form, shape, colour, tone, line, movement, unity, harmony, variety, balance, contrast, proportion and pattern to describe works of art. This approach of artistic concepts has been used by Jesus Gonzalez-Bermejo and colleagues of the SomnoNIV group (Page 715) to report a framework for patient-ventilator asynchrony (PVA) during long-term non-invasive ventilation (NIV). The authors have systematically analysed polygraphic recordings and provided a PVA classification, including rate asynchrony and intracycle asynchrony. We now need to use this melding of art and science to assess the clinical impact of asynchrony during home NIV.
In art and folklore, a homunculus is a miniature, distorted representation of a small human being. For an unexpected distortion of the internal organs see the images in Thorax (Page 721).
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