Welcome back to the next instalment of respiratory GURU, this time we delve into two RCTs investigating rescue therapy for patients with CTD ILD. The EVER ILD study looks at MMF vs MMF plus rituximab, and the RECITAL study looks at rituximab vs cyclophosphamide. 2 very useful studies and I was thrilled to be joined by two national experts in the field, Dr Anjali Crawshaw and Dr Emma Derrett-Smith. Hopefully, this will make you feel more well-prepared for ILD MDTs, and give you a real insight...

A vibrant discussion with our two regional leads for occupational lung disease and a specialised solicitor dealing with OLD claims into how to drill down into the details of an occupational lung disease, how to refer, how to write your clinical letters and how to direct patients towards compensation if it's right for them.  Support the show

A perfect introduction to series 2, a COPD podcast with Professor Turner and Dr LJ Smith where we jump into MART for COPD,  the new P2X3 receptor agonist Filapixant, antihyperglycaemic drugs preventing COPD exacerbations and much more. Happy listening! Studies discussed: Association of the Use of Novel Antihyperglycemic Drugs With Prevention of COPD Exacerbations Among Patients With Type 2 Diabetes  BMJ. 2022 Nov 1;379:e071380. doi: 10.1136/bmj-2022-071380. PMID:...

This fascinating episode delivers pragmatic advice and recommendations for how to identify and manage patients with inducible laryngeal obstruction (ILO)-the new phrase for vocal cord dysfunction, GORD and breathing pattern disorders-the new phrase for dysfunctional breathing. This will make so much difference to how you do your consults with your breathless patients who have one of these disorders, how to reassure them, treat them and not feel a deep heart sink when you read your last letter...

Next instalment of the aspergillosis podcast, where we move on to talk about chronic pulmonary aspergillosis and invasive aspergillosis. Hope you've had time to digest part 1, part 2 is filled with useful content about diagnostics again, including the utility or lack of as it might be of galactomannans and Beta D Glucans in aspergillosis. Thank you again to Dr Chris Kosmidis. 

An interview with Dr Chris Kosmidis, Clinical Senior Lecturer at Wythenshawe Hospital and Aspergillosis centre about aspergillosis. Divided into two parts, the first part of our discussion covers ABPA for the generalist, and is a goldmine of information for diagnosing, treating and monitoring response in these patients. I now feel comfortable interpreting the serology, prescribing antifungals where appropriate and how to look out for a relapse which is a long way from where I...

This month's episode dives into progressive fibrosing ILD, previously a disadvantaged set of patients who have a progressive ILD but as they weren't specifically UIP they were not entitled to antifibrotic treatment. So thank goodness for the INBUILD trial back in 2020 and it's extension and NICE technological appraisal for injecting pragmastism not only in to the types of patients now referrable for antifibrotics, but also the referral criteria. This has moved away from FVC and towards...

Finally it's here, the pleural podcast! Ever wondered why you can't get a straight answer about suction, talc and fibrinolytics? That's because the evidence until recently has been poor and we're still using guidelines written 12 years ago. But with the assistance of two excellent pleural specialists we pull apart the latest studies to discuss all your usual pleural conundrums to help you manage 90% of pleural disease within your local hospital, minimise the time spent in a hospital bed and...

This month's episode is all about COPD, and I am joined by the brilliantly intelligent Professor Alice Turner. Her knowledge of the research in this field is remarkably in-depth, yet she is generous with her experience and answers the questions you want to ask but may not feel comfortable exposing the chasms in your knowledge like I did! 40 minute podcast, strap in for a detailed, transformative and revelatory podcast with an international COPD leader. Studies discussed include: Prevalence...

A vibrant discussion with Dr Sarb Clare MBE and author of Ultrasound for the Generalist about point of care lung USS and how we can use lung USS to achieve rapid diagnoses, without needing to wheel down to imaging. No more distinctly average portable CXRs, USS offer us the ability to do bedside serial imaging on our unwell respiratory patients and to see with our own eyes what is going on inside when we don't quite believe the CXR or our vocal resonance examination. Resources discussed...

A great discussion of the recent MDR TB Clinical Advice Service Annual Report, and a complex MDR TB case as a great demonstration of the intricacies of it's management. Dr Guy Hagan is our local TB lead and an encyclopaedia of TB treatments, and we talk about a tricky pericardial TB patient and his clinical journey. I learnt so much about the group A, B and C selection of medications for MDR TB, how to use the clinical advice service and look out for the rare side effects.  Discussed link...

Discussion with Professor Adel Mansur who is the lead for the Birmingham Regional Asthma Service about the 4 main current biologics in the asthma NICE guidelines together with discussion of three more novel agents in development that have recently been published. A must listen for anyone reviewing asthma patients, Adel gives a great summary of the underlying mechanisms for these agents, their current use in clinical practice and importantly...how to pronounce them! Papers reviewed are as...

This Christmas present is a summary of the recently updated guidelines for Sarcoidosis and asthma. 20 minute summary of the guidelines to listen to whilst munching on a mince pie and a glass of something festive. You're welcome. Sarcoidosis guidelines https://erj.ersjournals.com/content/58/6/2004079.long  GINA asthma guidelines https://ginasthma.org/gina-reports/

November's summary of clinical respiratory updates; 30 min podcast to listen to on the way to work or any kind of multitasking so you can keep up to date without even trying. This month's papers and guidelines are: Single-case metanalysis of fat embolism syndrome https://pubmed.ncbi.nlm.nih.gov/34743891 Clinical and pathophysiological characteristics of valproate-induced pleural effusion https://pubmed.ncbi.nlm.nih.gov/34259092 Randomised trial of the P2X 3 receptor antagonist sivopixant...

October's summary of clinically relevant respiratory publications released in the past month. 10 studies, and 2 interviews, your CPD for keeping up to date in just 52 minutes. List of studies discussed below 1. Evaluation of multi-component interventions for prevention of nosocomial pneumonia in older adults: a randomized, controlled trial. Eur Geriatr Med. 2021 PMID34081314 2. Management and Treatment of Patients With Obstructive Sleep Apnea Using an Intelligent Monitoring System Based...