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Publicaciones del Canal
[News] European Respiratory Society International Congress 2026
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00314-0/fulltext?rss=yes
More than half of patients with chronic obstructive pulmonary disease (COPD) have exacerbations despite receiving standard-of-care (SOC) inhaled maintenance therapy. Biologics currently approved for inadequately controlled COPD are limited to use only in patients with raised blood eosinophil counts, leaving an unmet need in the wider COPD population. Frank C Sciurba (University of Pittsburgh, Pittsburgh, PA, USA) presented findings from two identical phase 3 trials (OBERON and TITANIA) of tozorakimab, a monoclonal antibody interleukin (IL)-33 inhibitor, versus placebo as add-on therapy to SOC for former or current smokers with COPD and a history of exacerbations in the previous year.
| 2 | [Comment] Survival is not the end(point): the second phase of ECPR care
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00280-8/fulltext?rss=yes
A 54-year-old male has a cardiac arrest, witnessed by his coworkers who immediately perform cardiopulmonary resuscitation (CPR). Repeated defibrillations and high-quality resuscitation illicit no response, making survival increasingly unlikely. Nowadays, extracorporeal CPR (ECPR) can change that trajectory: circulation is restored, the patient survives and eventually returns home to his family with a favourable neurological outcome.1,2 This patient represents one of approximately 3000 annual ECPR cases in the Extracorporeal Life Support Organization live registry. | 140 |
| 3 | [Correspondence] Identifying the residual unmet need in severe asthma
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00255-9/fulltext?rss=yes
The biologic treatments approved for the management of severe asthma have transformed the outlook for patients over the past decade. Each novel therapy has offered the opportunity for oral steroid-free asthma control and, for many patients, the possibility of clinical remission. Although anti-IgE proved effective for some patients, the development of targeted therapies against eosinophils soon appeared to be the paradigm shift. These anti-IL5 (mepolizumab) and anti-IL5R (benralizumab) biologics were soon followed by equally effective approaches targeting other components of T2 inflammation, namely those mediated via the IL-4 receptor (targeted by dupilumab) and those downstream of the epithelial alarmin TSLP (inhibited by tezepelumab). | 126 |
| 4 | [Articles] Symptom burden to characterise, predict, and prevent asthma attacks: a patient-level meta-analysis of randomised trials and translational prospective studies
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00150-5/fulltext?rss=yes
In a large, individual patient-level meta-analysis of randomised controlled trials and translational prospective observational cohort studies, we observed little alignment of symptom burden with other clinical, physiological, or biological features of asthma and modest prognostic value for severe attacks. Conversely, type 2 biomarkers more reliably identified patients at high risk and those likely to respond to treatment. Symptoms might require contextual interpretation to guide anti-inflammatory escalation in asthma. | 111 |
| 5 | [Spotlight] Edinburgh Festival Fringe: “Cancer isn't pretty—and neither is opera”
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00261-4/fulltext?rss=yes
Cancer is often about numbers: the ups and downs of protein, hormone, or other tumour markers; the number of weeks of chemotherapy or radiotherapy that a patient must face; the number of months or years given as an estimated length of survival during a prognosis. Yet cancer is also about emotions: anger, fear, grief, and even hope. Katy Lees, a professional soprano, brought those emotions to life beautifully during Breathe: Five Arias That Saved My Life, her autobiographical one-woman debut show at the Edinburgh Festival Fringe, the world's biggest arts festival, which is taking place in Edinburgh, UK, on Aug 7–31. | 121 |
| 6 | [Spotlight] A Pox on Fools: The Grifters and Cynics Who Want Us To Reject Vaccines
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00260-2/fulltext?rss=yes
Midway through A Pox on Fools, Thomas Levenson concedes that “one of the biggest problems in writing this book is that the Trump administration-led war on vaccines is moving so quickly that each catastrophic statement or decision is so soon overtaken by something worse.” He makes a good point. In August, 2026, in an interview with CNN, the US Secretary of the Department of Health and Human Services (HHS) Robert F Kennedy Jr repeatedly suggested that there could be a link between vaccination and autism. | 112 |
| 7 |  🚀 UpdatesInMedicine.com is now live!
For medical professionals:
• Latest clinical guidelines
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From evidence to everyday practice. | 165 |
| 8 | [Spotlight] Medical oxygen supply in Zambia: beyond COVID-19
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00294-8/fulltext?rss=yes
In 2021, as the COVID-19 pandemic overwhelmed health systems worldwide, Zambia designated the Chongwe district hospital as a COVID-19 care centre, receiving critically ill patients from all over the country. | 322 |
| 9 | [Comment] Tuberculosis preventive treatment in high-burden settings: inequality in benefit, evidence, and potential harms
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00278-X/fulltext?rss=yes
The WHO End TB Strategy targets a 90% reduction in global incidence by 2035, with programmatic scale-up of tuberculosis preventive treatment (TPT) in high-burden countries a key priority;1 yet there is scarce evidence to support the effectiveness of this approach for incidence reduction. Guidelines recommend TPT for individuals at high risk of tuberculosis, including recent contacts without clinical evidence of disease and, where possible, with evidence of tuberculosis infection (a positive Mycobacterium tuberculosis immune-sensitisation test), given as 6–9 months of isoniazid or, more recently, 1–4 months of a rifamycin-based regimen. | 496 |
| 10 | [Articles] Duration of effectiveness of tuberculosis preventive treatment across various tuberculosis burden settings: a systematic review and individual-participant meta-analysis
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00219-5/fulltext?rss=yes
Among close contacts with evidence of M tuberculosis infection, we found that the initial protection from TPT eroded relatively quickly in high-burden settings, but was sustained long-term in medium-burden and low-burden settings. In medium-burden and low-burden settings, completing TPT provided greater initial protection, but TPT non-completers had similar long-term tuberculosis risk. | 418 |
| 11 | [Articles] State-level burden of chronic respiratory diseases in the USA, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00218-3/fulltext?rss=yes
State-level policy environments, including fiscal and preventive health measures, might contribute to shaping respiratory health outcomes beyond individual risk factors. Integrating tobacco control measures, equitable vaccination programmes, and targeted health-system investments could help to address the uneven burden of chronic respiratory diseases across US states and the growing mortality gap despite stable prevalence, although further research is needed to clarify which specific policy determinants underlie these associations. | 420 |
| 12 | [Comment] Understanding US state-level heterogeneity in chronic respiratory disease burden
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00226-2/fulltext?rss=yes
Chronic respiratory diseases (CRDs) are a major contributor to global mortality. In 2023, they accounted for an estimated 4·2 million deaths and ranked fourth among the leading causes of death worldwide (fifth in the USA, with 221 000 deaths) according to the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023.1 Mortality alone, however, understates the total health loss attributable to these diseases. Disability-adjusted life-years (DALYs), a composite measure of premature deaths and years lived with disability, more fully captures the totality of disease burden. | 358 |
| 13 | [News] AI data centres could worsen US air pollution
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00293-6/fulltext?rss=yes
Artificial intelligence (AI) firms are exploiting loopholes and lax air pollution enforcement in a race to build new on-site fossil-fuel power plants for data centres across the USA. Concerns over air pollution, water use, secrecy, and noise have fomented a growing backlash against the construction boom just ahead of November's mid-term elections. | 336 |
| 14 | [Comment] When spirometry is normal: can FeNO fill the gap in asthma diagnosis?
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00288-2/fulltext?rss=yes
Asthma is one of the most prevalent chronic respiratory diseases, imposing a considerable individual and societal burden, yet objective diagnosis remains challenging. Diagnosis relies on several complementary tests, many of which are not routinely available in primary care. In their absence, the risk of both under-diagnosis and over-diagnosis is substantial, and treatment is sometimes initiated as a diagnostic trial—an approach rarely considered for other chronic diseases. | 373 |
| 15 | [Articles] Accuracy of type 2 inflammatory biomarkers to diagnose asthma in adults and children: a meta-analysis of 30 studies with prospective validation in an adult primary care cohort
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(26)00228-6/fulltext?rss=yes
In adults and children with suspected asthma, FeNO predicted airway hyper-responsiveness and enabled clinically applicable rule-in and rule-out thresholds. BEC performed poorly alone and added no value to FeNO. Findings and thresholds were replicated in a prospective adult primary care cohort; a similar study in children is ongoing. FeNO-guided diagnostic algorithms using context-specific rule-in and rule-out thresholds, while accounting for recent inhaled corticosteroid exposure, warrant consideration. | 323 |
| 16 | Is acetazolamide a 'REMedy for rapid eye movement-predominant obstructive sleep apnoea?
http://thorax.bmj.com/cgi/content/short/81/10/933?rss=1
Pharmacotherapy for obstructive sleep apnoea (OSA) has entered a new phase in which the focus is shifting from broad, one-size-fits-all approaches to targeted treatments matched to specific physiological endotypes. While continuous positive airway pressure (CPAP) remains the standard of care, many individuals, particularly those with rapid eye movement (REM)-predominant OSA (REM-OSA), struggle with adherence.1 REM sleep is characterised by more frequent and prolonged obstructive events due to dips in ventilatory drive and greater upper-airway vulnerability,2 making this subgroup uniquely challenging to treat. Against this backdrop, interest has grown in the use of medications such as the carbonic anhydrase inhibitor acetazolamide, which modulates ventilatory drive and potentially offers targeted benefit where REM-related pathophysiology dominates. In this issue of Thorax, it is therefore with great interest that we read the recent study by Messineo et al3 which is the first trial to directly test the... | 338 |
| 17 | Increase in second primary lung cancers in a nation-wide cohort study from Sweden
http://thorax.bmj.com/cgi/content/short/81/10/981?rss=1
Background
We describe the occurrence of second primary lung cancers (SPLCs) and their determinant in Sweden.
Methods
Nation-wide cancer registry from years 1961 to 2021 identified a total of 853 SPLCs.
Results
The incidence of SPLCs increased almost linearly from 1980 onwards, equally for women and men and approximately equally after the four main histological types. SPLC included adenocarcinoma 63.9%, squamous cell carcinoma (SCC) 19.4%, small cell carcinoma 9.6% and large cell carcinoma 9.1%. The female cumulative probability (CumP) of SPLC after first adenocarcinoma in 10 years reached 0.019, after SCC 0.015 and after small and large cell carcinoma 0.008. The respective CumP for men was 0.013, 0.012, 0.002 and 0.005. While adenocarcinoma was often followed by second adenocarcinoma, after first non-adenocarcinoma SPLCs presented in diverse histologies. Relative risk of SPLC compared with first lung cancer was overall 3.59, higher for women (4.16) than for men (2.99) and approximately equally high after adenocarcinoma and SCC. In patients diagnosed before age 55 years, the relative risk was 6.68 for all, but after female adenocarcinoma it was 9.95 compared with 6.77 for males. The highest relative risks, up to 20-fold, were found after early onset female adenocarcinoma diagnosed after defined T stages.
Conclusions
Although SPLCs are still rare, their number is increasing rapidly and the relative risks compared with first lung cancer are substantial, qualifying selected groups of high-risk patients, such as patients with early onset adenocarcinoma for early detection by CT screening when/if such tests become available. | 276 |
| 18 | 2024 BTS/NICE/SIGN asthma guidelines have the potential to improve UK asthma outcomes, but we must act now
http://thorax.bmj.com/cgi/content/short/81/10/949?rss=1
WHAT IS ALREADY KNOWN ON THIS TOPICAsthma is a common lung disease and outcomes in the UK are among the worst in Europe. The overuse of short-acting beta agonist and underuse of anti-inflammatory, inhaled corticosteroid-containing inhalers are associated with risk of exacerbations and death. The new collaborative British Thoracic Society(BTS), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guideline Network (SIGN) Asthma Guideline endorses an anti-inflammatory reliever-based approach to asthma management and has potential to significantly improve asthma outcomes in the UK. WHAT THIS STUDY ADDS We discuss the role of guidelines to support delivery of evidence-based practice and highlight the knowledge-action gap that can prevent implementation of guidelines in practice. Based on the published literature and expert consensus, we describe some of the challenges/barriers that will be faced at both a system and individual level when implementing the BTS, NICE, SIGN... | 213 |
| 19 | Development and validation of the Hypersensitivity Pneumonitis South Asian Questionnaire for Exposure (HP-SAQE): a novel, qualitative and quantitative tool
http://thorax.bmj.com/cgi/content/short/81/10/958?rss=1
Introduction
There is an unmet need for a validated qualitative and quantitative tool to assess environmental exposures in patients with interstitial lung disease (ILD). This study aimed to develop and validate a comprehensive tool to systematically identify exposures in patients with ILD.
Methods
A systematic literature search was completed to identify exposures associated with more than five documented hypersensitivity pneumonitis (HP) cases. These exposures were evaluated through a two-round Delphi survey involving 39 pulmonologists from India, Sri Lanka, Pakistan and Nepal. The questionnaire was prospectively derived at one centre and validated across five centres in India and Sri Lanka. The HP South Asian Questionnaire for Exposure (HP-SAQE) was validated against the gold standard multidisciplinary discussion diagnosis, distinguishing HP from non-HP ILD.
Results
The literature search screened 5170 records and included 407 studies, identifying 24 exposures. A 50-item Delphi survey achieved expert consensus (>70%) on 17 qualitative and 4 quantitative items (six questions) by 39 pulmonologists. HP-SAQE score ranged from 0 to 14. After pilot testing, the questionnaire was translated into Hindi, Tamil and Sinhala. In the derivation cohort (n=40), the HP-SAQE score was significantly higher in patients with HP versus non-HP (mean: 10.2±1.6 vs 6.7±4.2; p=0.001). This finding was validated in a separate cohort (n=163; mean: 9.4±2.2 vs 4.13±4.28; p
Conclusion
The HP-SAQE is the first qualitative and quantitative exposure assessment tool for patients with ILD that has a good diagnostic performance. | 223 |
| 20 | Time to next pleural procedure: should we take it as RED?
http://thorax.bmj.com/cgi/content/short/81/10/941?rss=1
Malignant pleural effusion (MPE) is a common problem in both respiratory and general medical practice, occurring in up to 15% of all patients with malignancy.1 Initial management is principally guided by the degree of symptoms experienced by the patient, especially breathlessness. For large volume symptomatic MPE, options include therapeutic aspiration, inpatient chest drainage with talc pleurodesis or indwelling pleural catheter insertion. The precise strategy employed should be based on individual patient choice, taking into consideration the relative risks and benefits of each modality.2 In practice, this is largely influenced by the ability to intervene safely (ie, whether there is sufficient fluid amenable to drainage) and the presence or absence of non-expandable lung. The size of effusion is readily assessed using bedside thoracic ultrasound; however, non-expandable lung is not always evident from prior imaging. Consequently, a trial of therapeutic aspiration is frequently employed ‘first-line’ to help... | 196 |
