Long-term azithromycin confers a net benefit in COPD patients who are former smokers with a recent history of exacerbations, a model-based benefit-harm analysis has shown. The benefit is likely to be larger in those patients who suffer frequent exacerbations, the study found.

The presence of genetic risk factors significantly increases the probability of developing lung cancer in smokers, particularly heavy smokers. However, even with a high genetic risk for lung cancer, individuals who never smoke do not have a significantly increased risk of developing the condition, a prospective cohort study has found. 

Heart failure and current smoking were the strongest risk factors for predicting ten-year mortality in COPD patients, a risk prediction model based on primary care data has found.

Reluctance to seek care is a common response to exacerbations in patients with COPD. Excessive self-reliance, not wanting to bother healthcare professionals and waiting for a tipping point when the exacerbation became more severe were reasons cited by COPD patients for not seeking medical care sooner, in a qualitative study from the USA.

Asthma education reduces the frequency of hospitalisation and visits to emergency departments and clinics in children, a meta-analysis has found. Education involving both children and parents/guardians was more effective than that involving only children.

Impairment of health-related quality of life is a marker for risk of hospitalisation and death in patients with chronic obstructive pulmonary disease (COPD), a study from Spain has found.

Poor growth and nutritional deficits in utero and in childhood are associated with spirometric restriction in adult life, a longitudinal, multicohort population-based study has shown.

Hospitalisation rates for asthma in preschool children have significantly declined since the ban on smoking in vehicles carrying children in Scotland, a study has found.

Use of oral or inhaled corticosteroids appears to be an independent risk factor for osteoporosis and fragility fractures in patients with asthma, a UK population-based study has found.

A nationwide case-control study from Denmark has strengthened the evidence that parental asthma and smoking in pregnancy are risk factors for onset of asthma and persistent wheezing in children. The results also suggest that exposure to ambient small particles < 2.5 µm (PM_2.5) may be a potential risk factor. However, this finding needs to be substantiated in future studies, the authors say.

Asthma that starts in childhood and persists throughout adult life tends to be more severe and is associated with poorer lung function compared with adult-onset asthma, a study from Japan has concluded. The difference in clinical characteristics points to a distinct phenotype.

Adults who put on weight over a 20-year period had a more rapid decline in FVC and FEV₁, a large international population-based study has shown. However, weight loss was found to attenuate the decline.

Overweight teenagers are more likely to consult their GP for asthma, and other respiratory symptoms, than those of normal weight, a study from the Netherlands has found. A total of 617 children, aged 2 to 18 years, were recruited to a prospective cohort study from 71 GP practices across the country. Height and weight were measured at recruitment and other health and social data collated from questionnaires sent to patients/parents. Children with disabilities or conditions affecting their weight were excluded. Details of subsequent consultations were obtained from the medical records.

Analysis of cough sounds captured on a smartphone can potentially be used to help diagnose common respiratory conditions in children, a study from Western Australia has shown. The study authors conclude: ‘We have demonstrated that automated cough analysis delivers good diagnostic accuracy in detecting common childhood respiratory diseases including pneumonia, RAD, croup, bronchiolitis, upper and lower respiratory tract disorders. It can be used as a diagnostic aid for childhood respiratory disorders.’

Abnormal spirometry and FeNO results are common in children with asthma managed in primary care and relate poorly to symptom scores, a UK study has shown.

Middle-aged individuals with a high body mass index (BMI) and those whose BMI had significantly increased since the age of 20 had an increased prevalence of breathlessness, a population-based study has found.

Good cardiorespiratory fitness in midlife may lower the risk of developing and dying from COPD, a prospective cohort study from Denmark has found.

Although an educational intervention increased respiratory consultations in smokers it did not improve detection of lung cancer, in a randomised controlled trial from Australia.

Lower respiratory tract infections (LRTIs), maternal smoking, day care attendance and male gender are important risk factors for wheezing in infants, a panEuropean study has confirmed. Food allergy and infant feeding practices were not associated with wheeze. The prevalence of wheezing varied widely between different European countries.

Longer duration of breastfeeding appears to reduce the risk of recurrent cough in young adults, a study from the United States has found. The researchers used data from the Tucson Children’s Respiratory Study, a large non-selected birth cohort in which infant feeding practices and adult health outcomes were ascertained prospectively.

The number of years that an individual has been smoking is closely linked to the degree of structural lung disease, airflow obstruction and functional outcomes in chronic obstructive pulmonary disease (COPD). It is a better measure than pack-years or the number of cigarettes smoked per day, a large study from the USA has shown.

A temporary four-fold increase in inhaled steroids for deteriorating asthma control reduced the incidence of severe exacerbations, in a UK study.

A breathing retraining exercise programme, incorporating a training DVD and accompanying booklet, achieved similar improvements in quality of life scores as conventional face to face training in patients with asthma, in a UK study.