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This study, notwithstanding limitations of its approach, provides the first comprehensive evaluation of adult patients at least 12 months following tPA/DNase treatment for pleural infection. Without a comparison group (e.g. those successfully treated without tPA/DNase or those treated with surgery only), it is difficult to determine if residual symptoms or defects are related to tPA/DNase.5,8 Patient recall biases are inevitable in cross-sectional studies. This cross-sectional multicentre cohort study reports, for the first time, long-term clinical, respiratory and functional outcomes >=12 months following tPA/DNase treatment for pleural infection. Keywords: deoxyribonuclease; intrapleural; pleural effusion; respiratory infection; tissue plasminogen activator EN deoxyribonuclease intrapleural pleural effusion respiratory infection tissue plasminogen activator 388 391 4 03/22/21 20210401 NES 210401 Abbreviations CP loss obliteration of costophrenic angle CXR chest radiograph DNase deoxyribonuclease FEV 1 forced expiratory volume in 1 s FVC forced vital capacity IQR interquartile range mMRC modified Medical Research Council QoL quality of life SF-36v2 36-item short form health survey TLC total lung capacity tPA tissue plasminogen activator Intrapleural tissue plasminogen activator/deoxyribonuclease (tPA/DNase) therapy has been rapidly adopted worldwide for treating pleural infection. [Extracted from the article]

Background and objective: The relationship between vitamin D and respiratory disease was examined by cross-sectional analysis of a large community-based sample. Methods: Serum 25-hydroxyvitamin D (25OHD) and history of respiratory disease, symptoms (recorded by questionnaire) and spirometry were measured in 5011 adults aged 45-69 years. Adjustments were made for age, sex, season and smoking (Model A), plus body mass index (BMI) and physical activity level (Model B), plus history of chronic diseases (Model C). Results: Mean (SD) age was 58 (SD 6) years with 45% males, 10% current smokers and 12% taking vitamin D supplements. The prevalence of 25OHD level <50 nmol/L was 8.0%. In all the three models, 25OHD <50 nmol/L was significantly associated with asthma (Model C: odds ratio (OR): 1.32; 95% CI: 1.00, 1.73), bronchitis (1.54; 1.17, 2.01), wheeze (1.37; 1.10, 1.71) and chest tightness (1.42; 1.10, 1.83). Participants with vitamin D level > 100 nmol/L had higher forced vital capacity (FVC) in all the three models (1.17% higher, compared with the 50-100 nmol/L group in Model C). Conclusion: Low levels of serum 25OHD were independently associated with asthma, bronchitis, wheeze and chest tightness after three levels of adjustment for potential confounders. Higher vitamin D levels were associated with higher levels of lung function. [ABSTRACT FROM AUTHOR]

Haplotypes in the promoter region of the prostanoid DP receptor ( PTGDR) gene have been shown to functionally influence gene transcription and to be associated with asthma in two previous case-control studies in Caucasians. This study tested the association of PTGDR haplotypes with asthma phenotypes in two large Caucasian-Australian populations. These results were incorporated in a meta-analysis with previously published data to determine the overall role for these haplotypes in the risk of asthma. Three PTGDR promoter-region single nucleotide polymorphisms (SNP) were genotyped in 368 individuals from the Western Australian Twin Child Health study and 2988 individuals from the Busselton Health Study. Logistic regression and transition disequilibrium tests were used to assess whether SNP genotypes and three SNP haplotypes were associated with doctor-diagnosed asthma or intermediate quantitative traits. Longitudinal data from the Busselton Health Study were used to examine whether PTGDR influences changes in lung function over time. Meta-analysis incorporated the findings of this study with those of two previous studies in Caucasian populations. Cross-sectional associations between PTGDR haplotypes and asthma phenotypes were non-significant ( P > 0.05) in both populations. Longitudinal analyses of PTGDR and lung function were also non-significant. Meta-analysis, however, suggested that haplotype TCT was significantly associated with decreased risk of asthma (OR = 0.76; P = 0.02) while haplotype CCC was not significantly associated with asthma (OR = 1.30; P = 0.07). These results suggest that despite the non-significant findings in the present study populations, PTGDR promoter haplotypes may account for a small but significant proportion of the risk of asthma in Caucasian populations. Functional haplotypes in the PTGDR gene have been linked to asthma in Caucasians. In this study they were not significantly associated with asthma phenotypes or longitudinal decline in lung function in two Australian populations. A meta-analysis of previous studies in Caucasians demonstrated small but significant effects consistent with functional data. [ABSTRACT FROM AUTHOR]