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Interstitial lung disease (ILD) can be considered an umbrella term for a large number of conditions involving inflammation and scarring in the lungs. It can come from a range of causes, including occupational exposures such as asbestosis or silicosis, environmental factors like animal exposure, or idiopathic pulmonary issues. The diagnosis and management of the disease can vary from region to region, and its prevalence is increasing around the world. Social media editor Dr. Kate Diomede is joined by the associate editors Sheetu Singh¹ and Nazia Chaudhuri², who have commissioned a series of articles on ILD in Thorax. Read the articles: State of the art review: Holistic management of symptom burden in ILD Challenging the status quo for clinical trials in fibrotic interstitial lung diseases Treatable traits in interstitial lung disease: towards precision medicine Breaking with Convention: The role of lymphocytes in IPF Epithelial damage and ageing: the perfect storm Global perspective on pulmonary fibrosis: epidemiology, regional variations, gaps in care, and future directions 1. Director ILD & Pulmonary Rehab Clinic, Rajasthan Hospital, Jaipur, India; Thorax associate editor ILD  2. Consultant Respiratory Medicine & Senior Clinical Lecturer, Ulster University, Northern Ireland; Chair of British Thoracic Society ILD Registry; Thorax associate editor ILD 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.

Previous trials on triple therapy inhaler use (ETHOS and IMPACT) were understood to show a reduction in mortality in COPD patients. However, a reanalysis published in Thorax shows that this benefit may have been misattributed. Host Dr. Kate Diomede is joined by the paper's authors, pharmacist Kari Leung¹ and physician Prof. Aroon Hingorani², both members of the ​North Central London Joint Formulary committee. Read the paper: Inhaled corticosteroid withdrawal and mortality rate in trials of triple therapy inhalers for COPD Further reading: Withdrawal of fluticasone propionate from combined salmeterol/fluticasone treatment in patients with COPD causes immediate and sustained disease deterioration: a randomised controlled trial 1. UCL Hospitals NHS Foundation Trust, London, UK 2. University College London, 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.

In this episode, Thorax social media editor Dr. Kate Diomede speaks to Dr. Susan Muiser¹, author of a research paper based on the NOVELTY study that included over 12,000 patients globally with asthma, COPD, or asthma plus COPD. The research sought to find potential biomarkers that could link to exacerbations in these patients, giving consideration to blood eosinophils and fractional exhaled nitric oxide as possible candidates which could give insight into disease progression and treatment response.   Read the paper: Association of blood eosinophils and exhaled nitric oxide with exacerbations in patients with asthma, COPD and asthma+COPD: the NOVELTY study 1. Department of Pulmonology, University Medical Centre Groningen, Groningen, Netherlands   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.

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 - [email protected] 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 - [email protected] 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 - [email protected] 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.

The growing use of artificial stone has seen the emergence of an aggressive, progressive respiratory disease, which is causing silicosis in young people. Dr. Johanna Feary¹ ² joins Thorax's Dr. Kate Diomede in the studio, to discuss. They talk through some the UK's earliest cases, the background to this phenomenon, international response, and the broader history of silicosis as a disease. Links: Artificial stone silicosis: a UK case series Relationship between cumulative silica exposure and silicosis: a systematic review and dose-response meta-analysis  1. National Heart and Lung Institute, Imperial College, London, UK 2. Department of Occupational Lung Disease, Royal Brompton Hospital, 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.

A special journal club episode featuring guest-hosts Dr. Kristina Montemayor and Dr. David Furfaro of the PulmPEEPs. They're joined in conversation with Thorax education editor Dr. Christopher Turnbull, and Dr. Imran Howell, author of a recent journal club article in Thorax. Focussing on the theme of airway disease, they discuss the four papers in Imran's roundup, covering topics from nutritional impact on tuberculosis rates to infant vaccination against RSV. Links: Journal club Blood eosinophil-guided oral prednisolone for COPD exacerbations in primary care in the UK (STARR2): a non-inferiority, multicentre, double-blind, placebo-controlled, randomised controlled trial Nutritional supplementation to prevent tuberculosis incidence in household contacts of patients with pulmonary tuberculosis in India (RATIONS): a field-based, open-label, cluster-randomised, controlled trial The airway microbiome mediates the interaction between environmental exposure and respiratory health in humans Respiratory syncytial virus infection during infancy and asthma during childhood in the USA (INSPIRE): a population-based, prospective birth cohort study 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 - [email protected] 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.

A new clinical statement from the British Thoracic Society was recently published in Thorax. It describes a building-block approach for how to manage patients with tobacco dependency in a hospital setting. Thorax podcast host Dr. Kate Diomede speaks with two of the authors, Prof. Sanjay Agrawal (1) and Dr. Matthew Evison (2).  Read the statement: Medical management of inpatients with tobacco dependency Further reading: NCSCT online training NCSCT briefings and practice guidance (1) Department of Respiratory Medicine, Glenfield Hospital, Institute for Lung Health, Leicester, UK (2) Manchester University NHS Foundation Trust, Manchester, 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.

What are the effects of high levels of social media consumption amongst young people? New research published in Thorax quantifies the impact that exposure to marketing on online platforms is having, showing a greater likelihood of smoking or vaping with greater time spent on these platforms. Thorax associate editor Prof. Nick Hopkinson (1) joins Dr. Kate Diomede to discuss the paper's findings. Read the paper: Association of time spent on social media with youth cigarette smoking and e-cigarette use in the UK: a national longitudinal study  (1) Prof. of Respiratory Medicine, Imperial College London, Respiratory Consultant, Royal Brompton Hospital, Associate Editor of Thorax, Chair of ASH (Action on Smoking in Health) UK Charity https://twitter.com/COPDdoc 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.