The night a thunderstorm caused an asthma emergency
On 21–22 November 2016 a storm swept across Melbourne during the grass pollen season. Within hours thousands of people had breathing problems. Ambulance services and emergency departments were overwhelmed, and the event is thought to have contributed to nine deaths. Victoria now has a thunderstorm asthma forecast every pollen season.
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Inspector-General for Emergency Management Victoria: Thunderstorm asthma review, Final Report (2017)Inhalers have Victorian ancestors
Inhaled treatment is not a modern invention. A respiratory-history timeline places Nelson's inhaler and nebulisers in the 1860s, well before the pressurised metered-dose inhaler appeared in the 1950s.
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Geddes D. The history of respiratory disease managementSpirometry predates chest X-rays
Hutchinson's spirometer dates to 1842, decades before chest X-rays. Measuring lung volumes came well before clinicians could routinely look inside the chest with radiology.
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Geddes D. The history of respiratory disease managementThe iron lung came before the ICU era
Drinker's iron lung appears in the respiratory timeline in the 1920s. Mechanical breathing support was already developing decades before nasal non-invasive ventilation entered that timeline in the 1980s.
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Geddes D. The history of respiratory disease managementAir can move between neighbouring alveoli
In experimental mouse lung injury, researchers directly visualised pendelluft: neighbouring alveoli ventilating out of synchrony, with gas shifting between them. Local blood oxygenation suffered even without a simple collapse-and-reopening pattern.
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Acute Lung Injury Causes Asynchronous Alveolar Ventilation. PMID 26513710CAP severity changes the question
Severity assessment in adult community-acquired pneumonia is important, but selecting a single best method is not straightforward. For low-severity disease, oral amoxicillin is the empirical mainstay; routine atypical-pathogen cover remains debated.
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Australian Prescriber CAP discussionCPAP joined the respiratory timeline late
CPAP for sleep apnoea appears in the 1980s section of a respiratory-history timeline. By then, clinicians had already used spirometers, chest X-rays and inhaled therapies for generations.
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Geddes D. The history of respiratory disease managementLungs can finish making platelets
Lungs do more than exchange gases. Live imaging in mice showed megakaryocytes releasing platelets in lung vessels; researchers estimated this supplied about half of total platelet production in those mice.
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Lefrançais E et al. Nature 2017;544:105–109The first transplant was not the breakthrough
The first lung transplant and successful lung transplantation belong to different eras. A respiratory-history review places the first operation in the 1960s, but successful transplants in the 1980s.
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Geddes D. The history of respiratory disease managementAn oxygen Nobel awarded a year late
Otto Meyerhof shared the 1922 medicine Nobel for connecting muscle oxygen consumption with lactic-acid metabolism. The award was reserved, so he and co-laureate Archibald Hill actually received it in 1923.
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Nobel Prize: Physiology or Medicine 1922TB was declining before streptomycin
Tuberculosis was already declining in wealthy countries before streptomycin was discovered. The history of TB control is therefore bigger than antibiotics alone, with living conditions and public health also part of the story.
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Geddes D. The history of respiratory disease managementDoctors once collapsed lungs on purpose
Artificial pneumothorax was once a treatment for tuberculosis. Deliberately collapsing a lung belonged to the therapeutic toolkit long before effective anti-tuberculosis antibiotics arrived.
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Geddes D. The history of respiratory disease managementA Nobel Prize for unravelling TB
Robert Koch received the entire 1905 Nobel Prize in Physiology or Medicine for his work on tuberculosis. A disease of the lungs helped shape one of medicine's earliest Nobel awards.
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Nobel Prize: Physiology or Medicine 1905A blood-cell reserve in the lung
In mice, researchers found blood-forming progenitor cells outside lung vessels. Under experimental conditions involving platelet depletion and limited marrow stem cells, these cells could leave the lungs and repopulate bone marrow.
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Lefrançais E et al. Nature 2017;544:105–109You're all caught up
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