Bulletin
No. 120 (July 2019)
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The APSR Bulletin is now ten years old!

A huge thank you to everyone who has contributed articles which have enabled us to distribute 120 issues to date.

The value of the Bulletin shouldn't be underestimated. Reaching over 16,000 respiratory specialists every month, it's a unique medium to disseminate news across the Asia-Pacific region and beyond.

From now, we aim to make the Bulletin even more useful by including more pertinent and important information that will help you in your work and research. But to deliver that, we need more input from YOU!

News, current and emerging issues... anything and everything sent will be considered.

A great opportunity for you to help share important issues, and gain remarkably wide publicity for you and the work you are doing.

Please contact APSRinfo@theapsr.org.

We look forward to hearing from you.

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The APSR Bulletin, conceived by Prof. YoungSoo Shim in 2009 and distributed to members every month since then, is now ten years old!

A huge thank you to everyone who has contributed items filling 1,621 pages to date.

Click any birthday card to read the message:

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10th Birthday Anniversary message
from Dr Wilson Yee

As an APSR en bloc member, the Hong Kong Thoracic Society would like to say congratulations for having a successful membership Bulletin for the past ten years, bringing timely membership and activities news to us.

Wilson Yee
Immediate-Past President of the HKTS

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10th Birthday Anniversary message
from Dr David CL Lam,
Immediate-Past Coordinator of the Bulletin, to whom we are indebted for its growth since the Bulletin's inception

Congratulations to APSR for having the APSR Bulletin, not only for 10 years, but a healthy Bulletin growing beyond 10 years, serving APSR Members non-stop and helping to keep APSR members posted on the latest APSR News and Membership societies' news and events. Our special thanks go to Yasutomi Yamanaka, Suga Konno, Rina Kishigami, Reiko Matsui, Shiho Minagawa and Chieko Omote at the APSR Secretariat for keeping the Bulletin a fresh-looking collation of APSR news all the time.

Best regards,

Dr David CL Lam
Immediate-Past Chair of the APSR Education Committee

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10th Birthday Anniversary message
from Dr Kwun Fong

Happy Anniversary to the APSR Bulletin, turning 10 years old this July celebrating 120 issues that reflects the valuable contribution from many APSR members to keep us up to date with lung news in our region, drawing attention to important regional respiratory news and events.

The Bulletin is emailed to you each month. Who knows how it will be delivered in the future; maybe by an app, podcast or other ways that we can't even imagine. No matter which way, we look forward to the next 10 years of interesting news and events to help us all improve lung health in the AP region and globally. In this endeavour if you haven't done so already, please help by signing and encouraging all your contacts to sign the world Charter for Lung Health; over 5,700 people have signed. www.change.org/p/the-director-general-of-the-world-health-organization-sign-the-charter-for-lung-health

Thank you all

Dr Kwun Fong
President of the APSR

APSR News

Just announced!

The 2018 Journal Citation Report has been released and we're pleased to let you know that Respirology's 2018 Impact Factor has increased to 4.756 (from 4.407 last year).

The journal continues to be placed in the top 20% of Respiratory System journals, with a ranking of 11th out of 63 journals.

We'd like to take this opportunity to thank you for your ongoing support.

Philip Bardin and Paul Reynolds
Editors in Chief, Respirology

Respirology – Alternative Access to Articles

Exclusive feature for members

Now you can read full version of Respirology articles by either logging in using your APSR members-only user-id or your Respirology user-id.

We all have trouble remembering so many different user-ids and passwords. From now, if you forget one, you can use the other.

How it works

When you click a link on the APSR website to a Respirology article, the system will automatically log you into the Wiley Online Library website and display the full version of that article.

The success of that redirection depends on you being registered for viewing APSR members-only webpages on the APSR website. If you are not registered, the system will prompt you to click the REGISTER button at the top of this Bulletin.

Successful redirection also depends on you logging in with a sufficiently strong password. (If you've forgotten your password, click here to reset it.) If your APSR password is not strong enough, you'll be prompted to strengthen it. (Access to the Wiley Online Library requires a password of at least ten mixed characters.)

In some cases, if you registered for APSR members-only access a long time ago, you may be asked to re-register. In this case, simply click the REGISTER button at the top of this Bulletin.

All the above points are to safeguard your privilege to see articles which cannot be seen by non-members

We hope you'll find this feature useful.

Try it now!

We've picked a recent article at random for you to try.

Click this link: 10.1111/resp.13462, then select the option to read the Full article

You'll be able to continue reading full articles for the rest of the time you remain logged in.

Viewing abstracts and Open Access articles will remain freely available to the public. Only you, as a member, have the privilege to get this direct access to the more significant articles.

If you have any questions about this procedure, please contact the APSR Secretariat.

Congress news

2019 Congress banner

Vietnam 2019

Several detailed changes have been made to enhance the workshops and main scientific programme in Hanoi.

All indications are that this will be an outstanding congress!

Submit your abstract(s) online now: www.gakkai-web.net/p/apsr/ab/new2.php for a chance to qualify for a travel award

Abstract submission deadline 15 July 2019.

Tweet your way to FREE registration for the Hanoi Congress

Volunteer to live-tweet and upload to the APSR's social networking site (SNS) accounts during the ERS Congress 2019 in Madrid.

The APSR uses Twitter, Facebook and Instagram, and we are looking for a volunteer (only one!) to kindly contribute to these SNS accounts; in particular, APSR-related activities at the ERS Congress 2019 in Madrid. This is an open invitation for any young APSR member to attending the ERS Congress to apply for this volunteer position.

The volunteer will be offered complimentary registration for the APSR Congress in Hanoi, 2019.

Basic qualifications:

  • Must be APSR member
  • Aged 25-30
  • Excellent SNS skills for Twitter, Facebook and Instagram
  • Good English skills
  • Planning to attend all (or most) of the ERS Congress from 28 September to 2 October

Roles and responsibilities:

  • 20 live-tweets and uploads each day to the APSR's SNS accounts at Twitter, Facebook and Instagram. For example:
    • opening ceremony
    • major sessions
    • APSR young investigator sessions
    • APSR session at the World Village
    • notices from the APSR booth
    • notices from the venue
    • etc.
  • contact the APSR Secretariat staff each day to agree the next day's schedule and receive any special instructions, either at the APSR booth or if that is not possible, by email to Ms Rina Kishigami at the APSR Secretariat rina.kishigami@theapsr.org

To apply for this opportunity please send to Ms Rina Kishigami at the APSR Secretariat rina.kishigami@theapsr.org:

  • a brief (one page) curriculum vitae
  • the dates you plan to attend the congress
  • your Twitter, Facebook and Instagram accounts for the APSR Secretariat to see your past tweets and uploads

Application deadline: 20 August 2019

Feel free to contact the Secretariat APSR@theapsr.org if you have any queries.

We are looking forward to working with you!

Save 50% from your registration fee for the Hanoi Congress

The APSR Assemblies are offering a chance for you to save 50% of your Hanoi Congress registration fee.

You must be an existing member of an Assembly, or join one before the Hanoi Congress, and submit one or more of your simple respiratory cases to the APSR Teaching Library. There is no limit to the number of different cases you can submit.

Each case will be peer reviewed and if approved to be a suitable teaching vignette for the education of young doctors, it will be added to the APSR Teaching Library.

The cases should be simple and must not have already been published anywhere. (If you have more complicated original clinical cases, you are encouraged to submit them to Respirology Case Reports.)

You can submit your case for consideration to be included in the Teaching Library via: apsresp.org/education/teaching-library/index.php

Hurry. Only ten of these 50% discount awards are available. The closing date is 15 September 2019 and the APSR Secretariat will contact successful submitters.

Our Members, Our Future

Continuing this series we are delighted to share a tribute to Prof. Norbert Berend, prepared by Prof. Christine Jenkins.

This series complements our APSR Members' Honour Roll, on which as a member, you are welcome to add your appreciation of your mentor(s) at any time.

Tribute to Professor Norbert Berend


Dr Berend

My first acquaintance with Norbert Berend was by his reputation, as an advanced trainee and research fellow in thoracic medicine at Concord Hospital, Sydney. Having completed his physician training and PhD at Concord, he had just departed for Winnipeg, to work with Professor Thurlbeck in the year immediately prior to my commencing as a trainee at Concord, and his reputation was already substantial. He was an industrious, clever and clear-headed registrar, unquestionably headed for greater things, which indeed turned out to the case. Following his two years in Canada he moved to the National Jewish Hospital and Research Centre, Denver, Colorado as Assistant Professor of Medicine, and met many collaborators in his work in the pathophysiology of COPD. Pulmonary physiology has been his great love, and a constant through his research career. He has published over 160 papers on diverse physiologic topics, particularly lung mechanics, neutrophilic airway inflammation, interstitial lung disease, small airways disease, forced oscillometry, ventilation heterogeneity and lung function and obesity.

Norbert has never baulked at challenges in his working life. When he returned to Australia, he was made Senior Lecturer in Medicine at the University of Sydney and Concord Hospital, but he soon moved to Royal North Shore Hospital as Head of the Department of Thoracic Medicine, where he also progressed his research activities as well as training many respiratory and sleep physicians. Ultimately he swapped his clinical role for a major health administration role as Executive Director of the Hospital. Following this, in another crucial career move he took on the role that Ann Woolcock had occupied so remarkably, and became Director of the Institute of Respiratory Medicine, which was subsequently renamed to honour her, as the Woolcock Institute of Medical Research. At the Woolcock, Norbert supported a growing respiratory and sleep facility, many research activities and many people's careers, supervising many PhD students, and strongly supporting early- and mid-career researchers in pulmonary physiology.

Norbert has received many awards and honours that recognise his leadership and research productivity. He has been the recipient of the ERS Award of Merit and Lifetime Honorary Membership, the TSANZ Research and President's Medals, and the APSR President's Medal. He was awarded an Order of Australia in 2003 for his contribution to respiratory science and education.

Norbert has played a key role in the Asian Pacific Society of Respirology. He has had a long-standing commitment to developing respiratory science and expertise in the Asia-Pacific region. In the APSR he has occupied many roles in doing this, following in the steps again of Ann Woolcock, who had a vision of a strong regional advocacy and research body that could contribute to lung health and build scientific and clinical expertise in the region. Apart from being a member of many APSR congress planning committees, his APSR roles include Secretary General 2004–2006, APSR President from 2006–2009 and APSR delegate to the Forum of International Respiratory Societies (FIRS) 2008–2010. Following this he was Chairman of FIRS in 2011.

Norbert has remained a strong advocate for respiratory health in Asia. When he finished in his role as Director of the Woolcock, he moved to The George Institute for Global Health as Head, Respiratory Research. He has worked also as a member of the global leaders' team at GlaxoSmithKline and has relished visiting many of the places and people he has met in Asia over his working life.

Although I have worked with Norbert in most of the locations he has worked, the time at The George Institute has been a period of joint collaboration which has been particularly rewarding. We have worked together over several years on a large study in China and as he said in a recent email, reflecting on our journey through the years in many different roles, "At the end of the day we wound up at the George. What a journey! We have different talents which somehow complemented each other – in retrospect quite successfully and I look forward to future interactions". As do I.


Dr Jenkins

Prepared by Christine Jenkins
Head, Respiratory Group, Executive Director's Office
Professor of Respiratory Medicine, UNSW Sydney
Clinical Professor, Department of Thoracic Medicine, Concord Hospital
Head, Respiratory Discipline, University of Sydney

The George Institute for Global Health
Level 5, 1 King St, Newtown NSW 2042 Australia
Postal Address: PO Box M201, Missenden Rd, NSW 2050 Australia

26 June 2019

Travel Award opportunities

For assistance for Young Investigator to travel to the 2019 Congress in Hanoi, the following awards are available to APSR members who are presenting the best original paper at the Congress, in the following categories.

Each award is based on the quality of your abstract accepted for the Congress, and abstracts must be submitted before 15 July 2019.

New for 2019

APSR / KF-CB Lung Cancer Research Young Investigator Award

This Award is to recognise researchers in the area of lung cancer, one the big 5 lung diseases, and to encourage diversity in scientific excellence. Therefore women are particularly invited to compete for this award.

LMIC

Membership of another society

Membership of an assembly

If your assembly has published a newsletter this year, it will be on your assembly webpage and may contain details of award opportunities. Otherwise, look out for an announcement emailed to you from you assembly leaders.

Respiratory Updates

The June issue (Vol 11.6) features Updates on lung cancer screening and its management:

  • Effects of volume CT lung cancer screening: mortality results of the NELSON randomized, controlled population-based screening trial.
  • Best practices recommendations for diagnostic immunohistochemistry in lung cancer.
  • Osimertinib in untreated EGFR-mutated advanced non-small-cell lung cancer.
  • Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC.
  • Pembrolizumab plus chemotherapy in metastatic non-small-cell lung cancer.
  • Atezolizumab for first-line treatment of metastatic nonsquamous NSCLC.
  • IMpower130: efficacy and safety from a randomized phase 3 study of carboplatin and nab-paclitaxel with or without atezolizumab in 1L advanced non-squamous NSCLC.
  • Phase 3 study of carboplatin-paclitaxel/nab-paclitaxel with or without pembrolizumab (pembro) for patients (pts) with metastatic squamous (sq) non-small cell lung cancer (NSCLC).
  • Nivolumab plus ipilimumab in lung cancer with a high tumor mutational burden.
  • Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial.

Inside Respirology

Respirology Vol. 24 Issue 7

EDITORIALS
614CRISPR-Cas9 technology: A new direction for personalized medicine in respiratory disease?
Annalicia Vaughan BSc Hons, PhD Ian A Yang MBBS Hons, FRACP, PhD, Grad Dip Clin Epid, FAPSR, FThorSoc
10.1111/resp.13570
616Airways wide shut: A physiological phenotype of asthma?
Claude S Farah FRACP
10.1111/resp.13533
618Hospitalizations for patients with acute respiratory exacerbations: In pursuit of rest or recovery?
Christian R Osadnik PhD, B.Physio(Hons)
10.1111/resp.13555
620Clinical trial design for acute exacerbations in idiopathic pulmonary fibrosis: A thorny path
Elisabetta A Renzoni PhD, Athol U Wells MD
10.1111/resp.13584
622Tuberculous mediastinal lymphadenopathy: Reaching the target
Barbara Kalsdorf MD, Christoph Lange MD
10.1111/resp.13536
624Sleep apnoea and immune regulation: The story is only beginning
David C L Lam MD, PhD, Mary S M Ip MD, FRCP
10.1111/resp.13565
COMMENTARY
626Ambient air pollution in China
Guang-Hui Dong MD, PhD
10.1111/resp.13583
INVITED REVIEW SERIES
Molecular Techniques for Respiratory Diseases
628Applications of CRISPR systems in respiratory health: Entering a new 'red pen' era in genome editing
Colette Moses, Parwinder Kaur
10.1111/resp.13527
ORIGINAL ARTICLES
Asthma and Allergy
638Older age and obesity are associated with increased airway closure in response to methacholine in patients with asthma
David A Kaminsky, David G Chapman, Janet T Holbrook, Robert J Henderson, Elizabeth A Sugar, John Mastronarde, William G Teague, Michael Busk, Kaharu Sumino, Anne E Dixon, Robert A Wise, Charles G Irvin
10.1111/resp.13496

Airway closure during methacholine challenge contributes importantly to airway hyperresponsiveness in asthma and is associated with older age and obesity.

COPD
646Reduced mortality from lower respiratory tract disease in adult diabetic patients treated with metformin
Angelico Mendy, Radha Gopal, John F Alcorn, Erick Forno
10.1111/resp.13486

This population-based prospective cohort demonstrated that metformin use in type 2 diabetes was associated with a significant decrease in the risk of mortality from chronic lower respiratory disease (CLRD) after adjusting for relevant covariates. This reduction was even more pronounced among subjects with CLRD at baseline.

652
Changes in physical activity during hospital admission for chronic respiratory disease
Mark W Orme, Theresa C Harvey-Dunstan, Ismet Boral, Emma J L Chaplin, S Fayyaz Hussain, Mike D L Morgan, Michael C Steiner, Sally J Singh, Neil J Greening
10.1111/resp.13513

Objectively measured inpatient physical activity (PA) was examined for 259 individuals hospitalized due to an acute exacerbation of chronic respiratory disease. PA did not recover as an inpatient, with patients averaging 616 ± 649 steps/day. A single day of PA monitoring provided data representative of the entire inpatient stay.

Interstitial Lung Disease
658Recombinant thrombomodulin for acute exacerbation in idiopathic interstitial pneumonias
Toru Arai, Hiroshi Kida, Yoshitaka Ogata, Satoshi Marumo, Hiroto Matsuoka, Iwao Gohma, Suguru Yamamoto, Masahide Mori, Chikatoshi Sugimoto, Kazunobu Tachibana, Masanori Akira, Ryuya Edahiro, Toshimitsu Hamasaki, Yoshikazu Inoue, on behalf of the Osaka Acute Exacerbation of Interstitial Pneumonia Research Group
10.1111/resp.13514

Our prospective single-arm open-labelled multicentre study aimed to evaluate the efficacy and safety of recombinant human soluble thrombomodulin (rhTM) treatment for acute exacerbation in idiopathic interstitial pneumonias (AE-IIP). rhTM therapy was significantly associated with reduced mortality due to AE-IIP after a propensity score adjustment. Similar frequencies of adverse events with/without rhTM were noted.

Interventional Pulmonology
667
Clinical usefulness of routine AFB culture and MTB PCR of EBUS-TBNA needle rinse fluid
Ryoung-Eun Ko, Byeong-Ho Jeong, Hae Ri Chon, Hee Jae Huh, Joungho Han, Hyun Lee, Kyungjong Lee, Hojoong Kim, O Jung Kwon, Sang-Won Um
10.1111/resp.13488

The routine acid-fast bacilli (AFB) culture of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) needle rinse fluid is useful to increase the diagnostic yield of tuberculous lymphadenitis in an intermediate tuberculosis (TB)-burden country.

Pulmonary Vascular Disease
675Microparticles in systemic sclerosis: Potential pro-inflammatory mediators and pulmonary hypertension biomarkers
Matthew R Lammi, Lesley Ann Saketkoo, Samuel C Okpechi, Mohamed A Ghonim, Dorota Wyczechowska, Natalie Bauer, Kusma Pyakurel, Saito Saito, Bennett P deBoisblanc, A Hamid Boulares
10.1111/resp.13500

CD144+ endothelial microparticles (MP) were significantly higher in systemic sclerosis (SSc) patients with pulmonary hypertension (PH) compared to SSc patients without PH, suggesting that they may be a biomarker of SSc-PH. MP from SSc patients also increased endothelial inflammation in vitro, indicating a possible pathogenic role in this condition.

Sleep and Ventilation
684Age-dependent hypoxia-induced PD-L1 upregulation in patients with obstructive sleep apnoea
Carolina Cubillos-Zapata, Cristina Balbás-Garcìa, Jose Avendaño-Ortiz, Victor Toledano, Marta Torres, Isaac Almendros, Raquel Casitas, Ester Zamarrón. Aldara Garcìa-Sánchez, Jaime Feliu, Luis A Aguirre, Ramón Farre, Eduardo López-Collazo, Francisco Garcìa-Rio
10.1111/resp.13470

Hypoxia-induced upregulation of the programmed cell death-1 receptor and its ligand (PD-L1) may explain associations between sleep apnoea and cancer. This link may be age-dependent but, contrary to expectations, this study shows that PD-L1 upregulation in sleep apnoea occurs mainly in younger patients.

CONTEMPORARY CONCISE REVIEW
693Contemporary Concise Review 2018: Asthma and chronic obstructive pulmonary disease
John W Upham
10.1111/resp.13553
LETTER FROM ASIA-PACIFIC AND BEYOND
700Letter from Greece
Konstantinos Kostikas MD, PhD, FCCP
10.1111/resp.13568
CORRESPONDENCE
702Bronchiolitis obliterans syndrome as manifestation of lung GVHD: Not the only one
Marco Mura MD, PhD Stephen Juvet MD, PhD, FRCPC
10.1111/resp.13567
702Bronchiolitis obliterans syndrome as manifestation of lung GVHD: Not the only one – Reply
David C L Lam MD, PhD, FRCP, FAPSR Wang-Chun Kwok MBBS, MRCP
10.1111/resp.13566

Inside Respirology Case Reports

The following cases have been selected for inclusion in the August 2019 Respirology Case Reports, Volume 07 Issue 6

Case Reports

Pneumothorax in neuromuscular disease associated with lung volume recruitment and mechanical insufflation-exsufflation
Luke Andrew McDonald, David John Berlowitz, Mark Erskine Howard, Linda Rautela, Caroline Chao, Nicole Sheers
DOI: 10.1002/rcr2.447

A 25-year-old male with Duchenne muscular dystrophy and a 73-year-old male with motor neurone disease both presented with chest pain and increasing dyspnoea following routine mechanical insufflation-exsufflation or lung volume recruitment, on a background of long-term non-invasive ventilation. In each case, chest radiograph revealed a pneumothorax which resolved with intercostal catheter insertion and cessation of routine lung volume recruitment. This rare but serious complication highlights the need for careful risk/benefit analysis by clinicians prescribing these therapies.

Pulmonary endometriosis: a rare cause of hydropneumothorax
Husam Alzayer
DOI: 10.1002/rcr2.432

Pulmonary involvement in endometriosis is well described in the literature but asymptomatic significant hydropneumothorax is considered an unusual presentation. We present a rare case of catamenial hydropneumothorax confirmed through a pleural biopsy.

Multiple primary lung adenocarcinomas pre-operatively diagnosed by discordant epidermal growth factor receptor mutations
Yuki Katayama, Sayaka Kawai, Aya Miyagawa-Hayashino, Yoshizumi Takemura
DOI: 10.1002/rcr2.434

We describe a case of simultaneous multiple bilateral lung adenocarcinomas diagnosed by discordant epidermal growth factor receptor mutations in transbronchial lung biopsy specimens that led to a successful radical surgery.

Spontaneous cerebrospinal fluid rhinorrhoea and aspiration pneumonitis following initiation of continuous positive airway pressure treatment for obstructive sleep apnoea
Sanjiwika Lalanjani Wasgewatta, Nathan Manning, Michael Redmond, Diane Howard, Subash Shanthakumar Heraganahally
DOI: 10.1002/rcr2.435

We describe a 53-year-old woman with severe obstructive sleep apnoea (OSA) and intracranial hypertension who developed spontaneous cerebrospinal fluid (CSF) rhinorrhoea and CSF aspiration pneumonitis as a complication following initiation of CPAP therapy for OSA management.

Pulmonary alveolar proteinosis with upper-lobe predominance in a non-smoking female
Hong-Ping Er, Chung-Ta Lee, Tang-Hsiu Huang
DOI: 10.1002/rcr2.445

We describe a rare manifestation of pulmonary alveolar proteinosis (PAP) with an unusual upper-lobe predominance in a 43-year-old non-smoking female patient.

Recurrent lung nodules as a presentation of ventricular septal defect-related endocarditis
Adam Trytell, Jonathan Darby, Matthew Conron, Andrew Newcomb, Andrew Burns
DOI: 10.1002/rcr2.446

This case report describes a patient with a known ventricular septal defect presenting with recurrent fevers associated with migratory lung nodules following a "low-risk" dental procedure without antibiotic prophylaxis. The unusual presentation delayed the diagnosis of the migratory lung lesions as septic pulmonary emboli and consequentially the diagnosis of ventricular septal defect related infective endocarditis. This case questions the role of antibiotic prophylaxis in "high-risk" patients undergoing dental procedures.

Nasal mask average volume-assured pressure support in an infant with congenital central hypoventilation syndrome
Vishal Saddi, Arthur Teng, Ganesh Thambipillay, Hugh Allen, Sonia Pithers, Colin Sullivan
DOI: 10.1002/rcr2.448

We present the case of a 10-month-old female infant with congenital central hypoventilation syndrome who was initiated exclusively on non-invasive ventilation using conventional nasal mask BPAP with average volume assured pressure support (AVAPS) and provide polysomnographic evidence of improved gas exchange on the AVAPS feature.

Clinical Images

Multiple fungus balls in a patient with chronic pulmonary aspergillosis
Keitaro Nakamoto, Yuka Sasaki, Takashi Uchiyama, Ken Ohta
DOI: 10.1002/rcr2.433

We present an atypical but very educational case of a 76 year-old man with interstitial lung disease diagnosed with chronic pulmonary aspergillosis who presented with multiple fungus balls in the right lower lobe.

APSR Secretariat news

Out Instagram account has changed.

Please update your bookmarks to www.instagram.com/asianpacificsocietyofrespirol

Regional society news

The spotlight this month is on

MALAYSIA

Each month we share details of activities of a particular country, region or society.

If you would like the spotlight to be on your country, region or society next month, contact the Bulletin Coordinator or APSR Secretariat.

New home

for the Malaysian Thoracic Society

The MTS Secretariat has recently moved into a new office suite at:
Malaysian Thoracic Society
Suite 3B-15-7, Level 15, Block 3B
Plaza Sentral, Jalan Stesen Sentral 5
50470 Kuala Lumpur, Malaysia

The Society was formed in late 1986 and the main objectives of the society are:

  • to advance the knowledge and practice of thoracic (or respiratory) medicine
  • to promote research in the field of respiratory medicine
  • to organise regular scientific meetings
  • to facilitate collaboration work between qualified individuals or societies in respiratory medicine
  • to publish books, magazine, periodicals, leaflets or other literary or scientific works that the society may think desirable for the promotion of its objects, subject to the approval of the relevant authorities

Here are the current Executive Committee members (2017–2019)

President


Assoc Prof Dr Pang Yong Kek
Vice President


Dr Nurhayati Mohd Marzuki
Hon Secretary


Dr Hooi Lai Ngoh
Hon Treasurer


Dr Jessie Anne de Bruyne
Hon Assistant Secretary


Dr Ahmad Izuanuddin Ismail
Hon Assistant Treasurer


Dr Asiah Kassim
Committee Member


Dr Surendran Thavagnanam
Committee Member


Dr Lalitha Pereirasamy
Committee Member


Dr Hilmi Lockman
Committee Member


Dr Dg Zuraini Sahadan
Co-opted Committee Member


Prof Dr Roslina Abdul Manap
(Immediate Past President)
MTS Secretariat office


Ms Nazuha Radzi
Secretary
MTS Secretariat office


Ms Saidatul Nursyida Mat Rahim
Accounts Secretary

Philippines

Congratulations to Dr Malbar G Ferrer in his new role as President of the Philippine College of Chest Physicians (PCCP)

We are looking forward to even greater things from this dynamic Society!

See their latest activities at philchest.org

All Asia-Pacific societies

Plans will be underway by several societies for local events and activities on World Lung Day, 25 September 2019

Don't forget to send photos of your events and activities to the APSR Secretariat APSRinfo@theapsr.org for sharing here in the Bulletin.


Simplified Chinese

English

Japanese

Korean

Traditional Chinese

Vietnamese

Extra-regional societies

Panama

The 12th Congress of the Asociación Latinoamericana del Tórax (ALAT) will take place at the ATLAPA Convention Center in Panama City 3–6 July 2019.

By the kind invitation of Congress Scientific Committee, Dr Kwun Fong (APSR President) and Dr David C L Lam (Immediate Past Chair of the APSR Education Committee) will be the APSR's representative speakers at the Congress.

The symposium APSR–ALAT–WHO essential medicine for respiratory illnesses: unique window of opportunity to address global equity, will be held on 08:00 – 10:00 on 6 July in La Huaca Room of the conference centre:

  • "Access of essential medicines in smoking cessation"
    Dr David C L Lam
  • "Access of essential drugs in COPD: LAMA"
    Dr Rogelio Perez Padilla
  • "Access of essential medicines in lung cancer"
    Dr Kwun Fong
  • "Access of essential medicines in Asthma: LABA / ICS"
    Dr Federico Daniel Colodenco
  • Q&A

The APSR is looking forward to collaborating further with the ALAT in the future.

Health news

Specially prepared for this tenth anniversary of the Bulletin, a report on the fight in Taiwan over the past ten years:

A Decade of Extraordinary Significance in Fighting Against Tuberculosis in Taiwan

Chih-Hsin Lee1,4, Kang-Yun Lee2,4, Meng-Chih Lin3,4
1 Tuberculosis Center, Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
2 Division of Pulmonary Medicine, shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
3 Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
4 Taiwan Society of Pulmonary and Critical Care Medicine, Taiwan

Although the burden of tuberculosis in Taiwan remains substantial, Taiwan has made significant progress in the fight against TB. The incidence of TB in Taiwan decreased from 58 per 100,000 in 2009 to 41 per 100,000 in 2017 (29% reduction) while the numbers of incident multidrug-resistant TB reduced from 175 in 2009 to 103 in 2017 (41% reduction). The proportion of previously treated TB among all notified TB reduced from 9.0% in 2008 to 3.6% (60% reduction) in 2017. These achievements were the results of government commitment in strengthening the National Tuberculosis Program (NTP) and the dedicated collaboration between clinicians, nurses, paramedical staffs, and public health workers. A few important milestones in the NTP are highlighted below.

The directly observed treatment (DOT) program was launched in 2006. Both the anti-TB treatment and the latent TB infection (LTBI) treatment were covered by the DOT program since 2008. The program is highly comprehensive and flexible in the arrangement of time and location for DOT tailoring to patients' preferences. The DOT providers were trained to take care of privacy to avoid unwanted stigmatization. The DOT program establishes linkage between healthcare providers and patients to promote treatment adherence which greatly reduce the risk of recurrent TB and the emergence of drug-resistant strains.

The quality assurance program for mycobacteriology laboratories was initiated in 2009. The TB diagnosis and treatment guidelines recommended universal smear, culture and drug susceptibility testing (DST). Genotypic DST for rifampicin is available in most of the Taiwan Centers of Disease Control (TCDC)-certificated mycobacteriology laboratories. Currently, all TCDC-certificated mycobacteriology laboratories are connected to the National Surveillance Network of Communicable Diseases to ensure timeliness and accuracy of TB notification and treatment monitoring.

Taiwan Multidrug-Resistant TB Consortium (TMTC) was established in May 2007. Comprehensive patient-centered care was provided at no cost to patients and DSTs for second-line anti-TB agents were performed in the Reference Laboratory of Mycobacteriology of TCDC. The treatment regimen was individualized by taking treatment history and results of DST into account. The proportion of treatment success for patients with multidrug-resistant TB increased from 61% before TMTC to 82.4% after the establishment of TMTC. To further improve the treatment quality, active drug-safety monitoring and management program was established in 2017.

Management of those with LTBI to prevent the development of active TB is critical to halt TB transmission. Diagnosis and treatment of LTBI among children and adolescents who had close contact with TB patients was started in 2008. By introducing the interferon-gamma release assays for LTBI detection, the program extended to cover TB contacts of all ages since 2016. In 2017, 81% of individuals with LTBI in the TB contact investigation program received LTBI treatment and the overall completion rate for LTBI treatment was very high.

Air pollution

What's air pollution's connection
with pigeons and cuff links?

How consumers behave when they go shopping for food, is illustrated in this article (see link below) which says "People are so worried about what they eat that they look at all the packs, turn the food upside down and read all the labels. The more informed we are about what we eat, the more interest we take in what we consume. And we consume around 8,000 litres of air every day."

This article looks at some novel ways (including pigeons and cuff links!) to inform the public about air consumption: bbc.com/future/story/20170112-how-the-worlds-biggest-cities-are-fighting-smog

Air pollution may harm cognitive intelligence, study says

It's obvious to everyone that air pollution is bad for respiratory health. The following BBC article, in case you missed seeing it earlier, suggests that it additionally causes lower cognitive abilities, further suggesting that those with less access to education are likely to be more affected because they tend to work in places that expose them to more pollution.

Chronic exposure to air pollution could be linked to cognitive performance, a new study in China suggests. Researchers believe that the negative impact increases with age, and affects men with less education the worst.

Over four years, the maths and verbal skills of some 20,000 people in China were monitored by the US-Chinese study. Researchers believe the results have global relevance, with more than 80% of the world's urban population breathing unsafe levels of air pollution. However, while establishing a link between pollution and lower test scores, the study did not prove cause and effect.

The study – which includes researchers from Beijing's Peking University and Yale University in the US – was based on measurements of sulphur dioxide, nitrogen dioxide and particulates smaller than 10 micrometres in diameter where participants lived. It is not clear how much each of these three pollutants is to blame.

Carbon monoxide, ozone and larger particulates were not included in the study.

Described as an invisible killer, air pollution causes an estimated seven million premature deaths a year worldwide, according to the World Health Organization.

"We provide evidence that the effect of air pollution on verbal tests becomes more pronounced as people age, especially for men and the less educated," the study published on Monday in the Proceedings of the National Academy of Sciences said.

Pollution also increases the risk of degenerative diseases such as Alzheimer's and other forms of dementia, the study suggests.

"Our sample enables us to examine the impact of air pollution as people age. So our results across the life course are quite new," one of the co-authors, Xi Chen of the Yale School of Public Health, told the BBC.

In this study, researchers tested people of both sexes aged 10 and above between 2010 and 2014, with 24 standardised maths questions and 34 word-recognition questions. Previous studies found air pollution had a negative impact on students' cognitive abilities. "This latest study matches with previous research," says Derrick Ho of Hong Kong Polytechnic who has worked on the health effects of extreme weather events like haze. What's new in this paper is the focus on the China scenario and the fact that it's a very detailed study compared to many other ones," he told the BBC. "Also the differentiation between gender and age in this detail is new."

Many pollutants are thought to directly affect brain chemistry in a variety of ways – for instance, particulate matter can carry toxins through small passageways and directly enter the brain. Some pollutants can also have a psychological impact, increasing the risk of depression.

One of the reasons the researchers suggest older men with less education were worst affected by chronic exposure to air pollution is because those subjects often work outdoor manual jobs.

"Our findings about the damaging effect of air pollution on cognition," the study concludes, "particularly on the aging brain, imply that the indirect effect on social welfare could be much larger than previously thought. For older persons (in our study those age 55-65 or 65+) the effects can be very difficult to mitigate given the long term cumulative exposure," Mr Xi says. "This is very worrisome as we all know that people often have to make important financial decisions in old age, such as when we should retire, which health insurance plan is better."

The study suggests that while the research findings are specific to China, it can shed light on other developing countries with severe air pollution. The authors point to the 98% of cities with more than 100,000 people in low- and middle-income countries that fail to meet WHO air quality guidelines.

Extracted from BBC News, 12 June 2019
www.bbc.com/news/health-45326598

See also...

Air pollution statistics from the Asia-Pacific region from the APSR Respiratory Health Map

and

Air pollution: The public health challenge of our time, appearing in the March issue of Respirology, now available online.

Education

Webinar

Telerehabilitation for chronic lung disease – where do we stand?

There is increasing interest in the use of telehealth to improve access and uptake of pulmonary rehabilitation. Clinical trials of telerehabilitation are growing in number, size and quality. However, a wide variety of approaches have been used and there has been limited uptake in clinical practice. This webinar presented current approaches to telerehabilitation in chronic lung disease, considered requirements for implementation in clinical practice, and discussed remaining knowledge gaps in this emerging field.

The above Thoracic Society of Australia and New Zealand (TSANZ) webinar was held on 25 June and produced by Dr Anne Holland, Professor of Physiotherapy at La Trobe University and Alfred Health in Melbourne. Anne's research programme investigates supportive therapies for people with chronic respiratory disease. Her recent clinical trials have tested new models of pulmonary rehabilitation to improve access and uptake, including low cost home-based models and telerehabilitation. Anne has published over 250 peer reviewed journal articles and her publications have been cited over 9,000 times, including in 15 clinical guidelines for chronic lung disease, pulmonary rehabilitation and physiotherapy. Anne is Chair of the Pulmonary Rehabilitation Assembly for the American Thoracic Society.

This and other TSANZ webinars are available for public viewing:

  • The Human Respiratory Virome
  • NIV Therapy – viewed via a community lens
  • Accelerated Silicosis, kitchen benchtops and the emerging epidemic
  • Research Techniques To Study Respiratory Diseases
  • What's in a cough? Implications for the care of people with flu and MROs
  • Primary Ciliary Dyskinesia: Common symptoms from an uncommon condition
  • The Impact of Climate Change on Respiratory Health
  • What we have learned about children who present to hospital with acute wheeze
  • How respiratory specialists can best assist smoking patients to quit
  • Telerehabilitation for chronic lung disease – where do we stand?
    (Note: At the time of preparing this Bulletin for release (28 June) this webinar was not yet available for download)

To access any of the above, click www.thoracic.org.au/events/category/past-tsanz-webinars-on-demand-recordings. Note that for non-TSANZ members, some of the above webinars require payment of a A$10 (plus A$1 GST) pay-as-you-view fee to the TSANZ.

New educational articles

The following article has recently been selected from Respirology for its specific educational value. Previous articles on further topics can be seen at apsresp.org/education/articles/index.html


Fig 2 of 10.1111/resp. 13513
(Click image to enlarge)

Of special interest to those working in:
* Clinical Respiratory Medicine

Changes in physical activity during hospital admission for chronic respiratory disease Mark W Orme, Theresa C Harvey-Dunstan, Ismet Boral, Emma J L Chaplin, S Fayyaz Hussain, Mike D L Morgan, Michael C Steiner, Sally J Singh and Neil J Greening
onlinelibrary.wiley.com/doi/10.1111/resp.13513 (July 2019)

Comment by Dr Mark Lavercombe:
In a large cohort of patients admitted for acute exacerbation of chronic respiratory disease, the authors demonstrate low overall physical activity levels during the inpatient period with no significant improvement over time. This study also demonstrates little day-to-day variance, potentially allowing future study designs to benefit from shorter activity monitoring periods.

APSR Membership

Assembly News

Pulmonary Circulation Assembly Newsletter, June 2019

Dear APSR Pulmonary Circulation Assembly members, colleagues and friends,

Although pulmonary vascular diseases have been mainly treated by cardiologists in APSR countries, more respiratory diseases may accompany pulmonary hypertension (PH) defined as mean pulmonary arterial pressure of >20mmHg according to Nice criteria. We should remember that even mild PH has more than 60% of pulmonary vascular impairment. Biomarkers for early recognition of pulmonary vascular diseases, and novel approaches for treatment of PH due to respiratory diseases are essential for respirologists. Please join our assembly.

Invitation to APSR Assembly Members, and (new members if they join the Assembly before 2019 Hanoi APSR Congress) to apply for the APSR Teaching Library Award

It is a great pleasure for the Pulmonary Circulation Assembly to invite current and new Assembly members to submit applications for this Award.

As you might know, the APSR is developing a Library of respiratory cases and teaching vignettes for compilation into its online Library to be used for education and training of APSR members in the near future.

The Pulmonary Circulation Assembly invites its members (current or those who join before the 2019 Hanoi Congress) to kindly submit cases for this library via: apsresp.org/education/teaching-library/index.php

If your teaching case or vignette is accepted into the Library after Peer Review, you have the chance to be awarded 50% discount to your APSR Hanoi registration fee. There are 10 Awards available to Pulmonary Circulation Assembly members this year.

The closing date is 15 September 2019. The APSR Secretariat will contact successful candidates.

Thank you for your kind consideration and looking forward to seeing you in Hanoi

Sincerely yours,

Pulmonary Circulation Assembly Troika

New assembly members

A warm welcome to the following members who have recently joined APSR assemblies. They will undoubtedly enjoy working with and networking with their assembly colleagues.

Assemblies
Garinda Almaduta
(Indonesia)
Environmental & Occupational Health and Epidemiology
Interstitial Lung Disease
Tri Wahju Astuti
(Indonesia)
Environmental & Occupational Health and Epidemiology
Cell and Molecular Biology
Critical Care Medicine
Guan-Liang Chen
(Taiwan)
Clinical Respiratory Medicine
Lung Cancer
Interstitial Lung Disease
CHI-LI Chung
(Taiwan)
Clinical Respiratory Medicine
Interstitial Lung Disease
Cell and Molecular Biology
Shalin Diwanji
(United Kingdom)
Interstitial Lung Disease
Lung Cancer
Bronchoscopy and Interventional Techniques
Edijono
(Indonesia)
Lung Cancer
Tuberculosis
Clinical Allergy & Immunology
Yunita Eka Wati
(Indonesia)
Clinical Respiratory Medicine
Critical Care Medicine
COPD
Pin-Kuei Fu
(Taiwan)
Asthma
Interstitial Lung Disease
COPD
Kuo-Tung Huang
(Taiwan)
Lung Cancer
Interstitial Lung Disease
Critical Care Medicine
Wan-Chun Huang
(Taiwan)
Asthma
COPD
Tuberculosis
Thahri Iskandar
(Indonesia)
Clinical Respiratory Medicine
Tuberculosis
Critical Care Medicine
Gihani Udeshika Jayaweera
(Sri Lanka)
Environmental & Occupational Health and Epidemiology
Respiratory Structure and Function
Cell and Molecular Biology
Theodora Kerenidi
(United Arab Emirates)
Lung Cancer
COPD
Cell and Molecular Biology
Prawin Kumar
(India)
Paediatric Lung Disease
Asthma
Respiratory Infections (non-tuberculous)
Wang Chun Kwok
(Taiwan)
Clinical Respiratory Medicine
Lung Cancer
COPD
Chih-Hsin Lee
(Taiwan)
Tuberculosis
Clinical Respiratory Medicine
Chien-Chung Lin
(Taiwan)
Lung Cancer
Cell and Molecular Biology
Bronchoscopy and Interventional Techniques
Lei Liu
(China)
COPD
Clinical Respiratory Medicine
Respiratory Infections (non-tuberculous)
Karan Madan
(India)
Bronchoscopy and Interventional Techniques
Environmental & Occupational Health and Epidemiology
Clinical Respiratory Medicine
Dewi Nurul Makhabah
(Indonesia)
Bronchoscopy and Interventional Techniques
COPD
Lung Cancer
Ajoy Samuel Mammen
(India)
Clinical Respiratory Medicine
Critical Care Medicine
Bronchoscopy and Interventional Techniques
Wara Pertiwi
(Indonesia)
Clinical Respiratory Medicine
Critical Care Medicine
Bronchoscopy and Interventional Techniques
Joko Susilo
(Indonesia)
Asthma
Clinical Allergy & Immunology
Critical Care Medicine
Charles Wong
(Hong Kong)
Clinical Respiratory Medicine
Clinical Allergy & Immunology
Bronchoscopy and Interventional Techniques
Szu-Chun Yang
(Taiwan)
Environmental and Occupational Health, and Epidemiology
Lung Cancer
Tuberculosis
Wei Zhang
(China)
Clinical Respiratory Medicine
Respiratory Infections (non-tuberculous)
Lung Cancer

Donations received

The following members have kindly sent his donation towards the Society's goals, as outlined at apsresp.org/members/donors.php.

  • Kazuhisa Asai (Japan)
  • Chunxue Bai (China)
  • Erlina Burhan (Indonesia)
  • Noriyuki Enomoto (Japan)
  • Tomoyuki Fujisawa (Japan)
  • Akira Fujita (Japan)
  • Masaki Fujita (Japan)
  • Yoshinosuke Fukuchi (Japan)
  • Satoru Fukuyama (Japan)
  • Kazuki Furuhashi (Japan)
  • Naoki Hamada (Japan)
  • Masayuki Hanaoka (Japan)
  • Chu Thi Hanh (Vietnam)
  • Eiji Harada (Japan)
  • Yoshinori Hasegawa (Japan)
  • Tomoaki Hoshino (Japan)
  • Hironao Hozumi (Japan)
  • Naoki Inui (Japan)
  • Shinichiro Iwakami (Japan)
  • Eiji Iwama (Japan)
  • Takashi Iwanaga (Japan)
  • Keiko Kan-o (Japan)
  • Masato Karayama (Japan)
  • Takashi Kijima (Japan)
  • Akira Koarai (Japan)
  • Yohei Korogi (Japan)
  • Kozo Kuribayashi (Japan)
  • Kazuyoshi Kuwano (Japan)
  • Bao Le Khac (Vietnam)
  • Kazuto Matsunaga (Japan)
  • Yasuo Morimoto (Japan)
  • Yasushi Murakami (Japan)
  • Yutaro Nakamura (Japan)
  • Ho Namkoong (USA)
  • Chau Ngo Quy (Vietnam)
  • Hiromasa Ogawa (Japan)
  • Yoshitaka Oku (Japan)
  • Keiichi Ota (Japan)
  • Phuong Phan Thu (Vietnam)
  • Chin Kook Rhee (Republic of Korea)
  • Toshihiro Sakakibara (Japan)
  • Yuichiro Shindo (Japan)
  • Yuanlin Song (China)
  • Takafumi Suda (Japan)
  • Eiichi Suzuki (Japan)
  • Yuzo Suzuki (Japan)
  • Nobuhiro Tanabe (Japan)
  • Akira Umeda (Japan)
  • Giap Vu (Vietnam)
  • Yasuhiro Yamauchi (Japan)
  • Mutsuo Yamaya (Japan)
  • Hideki Yasui (Japan)

The APSR is profoundly grateful for their generosity.

Honorary membership

We are delighted to announce that Honorary membership has been bestowed on Dr Hai Van Nguyen (Canada) and Dr Christian Osadnik (Australia).

New Fellows of the APSR

Congratulations to the following members who have recently become APSR Fellows.

  • Garinda Almaduta FAPSR (Indonesia)
  • Tri Wahju Astuti FAPSR (Indonesia)
  • Shalin Diwanji FAPSR (United Kingdom)
  • Yunita Eka Wati FAPSR (Indonesia)
  • Thahri Iskandar FAPSR (Indonesia)
  • Prawin Kumar FAPSR (India)
  • Ajoy Samuel Mammen FAPSR (India)
  • Wara Pertiwi FAPSR (Indonesia)
  • Joko Susilo FAPSR (Indonesia)

Future Pulmonology Events

Here are the main respiratory events in Asia-Pacific region for the next few months. You can see our full listing on the APSR Calendar.

  • MTS Annual Congress 2019
    18-21 July 2019, Kuala Lumpur, Malaysia
    (Details)
  • VietNam Respiratory Society Annual Congress 2019
    19-20 July 2019, Hanoi, Vietnam
    (Details)
  • Annual Scientific Congress of Ho Chi Minh City Society of Asthma, Allergy & Clinical Immunology
    21 July 2019, Ho Chi Minh City, Vietnam
    (Details)
  • World Lung Cancer Day
    1 August 2019, Worldwide
    (Details)
  • 16th Annual Meeting: Work Conference of the Indonesian Society of Respirology (ISR)
    11-14 September 2019, Surakarta, Indonesia
    (Details)
  • World Lung Day
    25 September 2019, Worldwide
    (Details)
  • WASOG/JSSOG 2019 (Joint Conference of International Conference on Sarcoidosis and Interstitial Lung Diseases 2019; and 39th Annual Meeting of Japan Society of Sarcoidosis and other Granulomatous Disorders)
    9–11 October 2019, Yokohama, Japan
    (Details)
  • Respire 11 annual academic sessions of the Sri Lanka College of Pulmonologists
    29–31 October 2019, Colombo, Sri Lanka
    (Details)
  • Autumn Respiratory Seminar 2019 of the Hong Kong Thoracic Society and CHEST Delegation Hong Kong and Macau Limited
    November (to be confirmed), Hong Kong
    (Details)
  • PULMOCON 2019 (6th International Conference on Lung Health)
    5–8 November, Dhaka, Bangladesh
    (Details)
  • 128th Conference of the Korean Academy of Tuberculosis and Respiratory Diseases (KATRD)
    7–8 November 2019, Seoul, Republic of Korea
    (Details)
  • 24th Congress of the APSR
    14–17 November 2019, Hanoi, Vietnam
    (Details)
  • Asthma & COPD Outpatient Care Unit (ACOCU) Network Day
    17 November 2019
    Ho Chi Minh City, Vietnam
    (Details)
  • World Pneumonia Day
    12 November 2019, Worldwide
    (Details)
  • World COPD Day
    20 November 2019, Worldwide
    (Details)
  • World AIDS Day
    1 December 2019, Worldwide
    (Details)

For more pulmonology events, see apsresp.org/calendar.html
(These events are for information only and APSR endorsement should not be assumed.)

Contact

If you have news or announcements that may be of interest to other APSR members, please send details to Bulletin Coordinator Dr Arata Azuma (a-azuma@nms.ac.jp) or APSR Bulletin (bulletin@apsresp.org).


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