Airwaves Highlights from this issue Thorax: first published as 10.1136/thoraxjnl-2021-217537 on 10 June 2021. Downloaded from
doi:10.1136/thoraxjnl-2021-217537 The Triumvirate
Many of the Thorax readership will have DAMMIT JANET study. The investigators found that respi- been in short trousers when the Rocky There are a number of decisions we regret ratory muscle weakness was observed in Horror Picture Show first hit the screens in life, like agreeing to write Airwaves to 37% patients at ICU discharge and but this in 1975. Although panned by the critics a Rocky Horror theme, however the deci- was not associated with 5 year mortality. on its release, the film has gathered a cult sional regret felt by Brad and Dammit However, those survivors with respiratory following—with cinema goers dressing as Janet having approached the castle was muscle weakness demonstrated worse phys- characters from the film and extensive audi- now doubt considerably worse. It will ical function and morbidity. We should not ence participation. The film is still shown come as no surprise to readers of Thorax judge a book by its cover with regard ICU in cinemas, making it the longest-running that decisional regret can be measured. In outcomes as respiratory muscle weakness at theatrical release in film history (though no this issue of Thorax the Decisional Regret ICU discharge was only associated with 5 match for Thorax which is 75 this year). Scale and the Feelings About genomiC year morbidity but not mortality. We will This month we bring you a “Rocky Horror Testing Results Questionnaire were used to need to ask Dr Frank-N-Furter about the Airwaves”. As you read it, feel free to dress assess the impact of screening and genetic ‘secret of life itself’. in character… testing on undiagnosed first-degree rela- tives of patients with pulmonary fibrosis IN JUST SEVEN DAYS, I CAN MAKE YOU (see page 621). Findings were generally MAN “I’VE BEEN MAKING A MAN…” supportive with most patients reporting It is fairly obvious that Dr Frank-N-Furter The preposterous plot of the Rocky Horror no, or mild decisional regret even in the worked as part of a multidisciplinary team Show involves Dr Frank-N-Furter who presence of short telomeres. However, the with the support of physiotherapists and has been creating “Rocky” (a muscular finding of some impaired lung function or occupational therapist. Indeed, with clear creature) in his lab. The muscle bulk of ILAs did increase decisional regret slightly. goal setting over week, the MDT were current and former smokers is the subject Therefore, counselling before screening is focused on making ‘a strong man’ by doing of a paper by Mason and colleagues in this likely to be beneficial but with regards to ‘press ups and chin ups’ ‘to build up his month’s journal (see page 554). The authors screening itself, please don’t tell them to shoulders, his chest, arms, and legs’. Dr measured pectoralis muscle bulk (on CT) in can it, Janet. Frank-N- Furter did not register his trial and almost 6000 current and former smokers he does not provide the details on whether and found that acute exacerbations of THE SWORD OF DAMOCLES this was supervised or unsupervised exer- COPD are associated with accelerated skel- “The Sword of Damocles is hanging over cise. Taylor and colleagues (see page 591) etal muscle loss. Pulmonary rehabilitation http://thorax.bmj.com/ my head, And I've got the feeling some- focused on the efficacy of unsupervised appears to protect individuals from excess one’s gonna be cutting the thread”, may exercise in adults with COPD. This system- muscle decline. There is no rehabilitation be feeling that is familiar to many people atic review and meta-analysis reports the option for Rocky at the end of the movie. with pulmonary fibrosis. So, what should clinical benefits of unsupervised exercise He climbs to the top of the RKO tower and be done about it Dionysius? In this issue interventions on health-related quality of plunges to his death! of Thorax, Tikellis and colleagues (see page life in patients with COPD and suggests 575) describe their results of a priority high-quality randomised trials are needed. setting exercise for patients with pulmo- We can only hope that Dr Frank-N- Furter TIME WARP nary fibrosis. 196 patients gave 560 ques- registers his trials going forward or he will on September 27, 2021 by guest. Protected copyright. The most infectiously danceable number tions and 14 research themes. The number struggle to get his work published. form the Rocky Horror Show is of course one research priority was to reverse estab- “the Time Warp”. (“It’s just a jump to the lished fibrosis followed by improving lung “WHY DON’T YOU COME UP TO THE left, And then a step to the right…”) Shift function and alleviating symptoms. Hope- workers might well feel they have entered LAB AND SEE WHAT’S ON THE SLAB?” fully, with the research priorities identified a time warp when they wake in a groggy We are not told whether Frank-N-Furter researchers can swap the scarring in the haze and prepare for a night’s work. In this used silver nitrate in the lab when creating lung with the hair that holds the Sword of issue of Thorax, Blaikley and colleagues (see “Rocky”. However, the hazards of silver Damocles and make everybody breathe a page 601) show that shift work is not only nitrate in the airway are shown here and little easier. associated with respiratory disease, diabetes on page 632 of this month’s Thorax. and cancer but also with COVID-19. Occu- pational data from half a million people in DON’T JUDGE A BOOK BY ITS COVER the UK Biobank were linked to COVID-19 When Brad and Janet first met Dr Frank-N- PCR results from secondary care. Using Furter at the Annual Transylvanian Conven- multivariate logistic regression, the authors tion he requested they ‘don’t judge a book show that night shift work is associated with by its cover’ explaining ‘he had the secret a 2–3 fold increase in the risk of COVID-19 to life itself’. Survival and survivorship is infection. When the authors compared shift key to those patients who have experienced workers and non-shift workers, who shared critical illness and Van Aerde and colleagues the same type of job, shift workers had a (see page 561) investigated the 5 year higher rate of COVID-19. Let’s not do the outcome of ICU survivors. This was the © Author(s) (or their employer(s)) 2021. No commercial time warp again… secondary analysis of the EPaNIC cohort re-use. See rights and permissions. Published by BMJ.
Thorax June 2021 Vol 76 No 6 529