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BMJ Open Respiratory Research

N R Qureshi, R C Rintoul, K A Miles, S George, S Harris, J Madden, K Cozens, L A Little, K Eichhorst, J Jones, P Moate, C McClement, L Pike, D Sinclair, W L Wong, J Shekhdar, R Eaton, A Shah, L Brindle, C Peebles, A Banerjee, S Dizdarevic, S Han, F W Poon, A M Groves, L Kurban, A J Frew, M E Callister, P Crosbie, F V Gleeson, K Karunasaagarar, O Kankam, F J Gilbert
INTRODUCTION: Solitary pulmonary nodules (SPNs) are common on CT. The most cost-effective investigation algorithm is still to be determined. Dynamic contrast-enhanced CT (DCE-CT) is an established diagnostic test not widely available in the UK currently. METHODS AND ANALYSIS: The SPUtNIk study will assess the diagnostic accuracy, clinical utility and cost-effectiveness of DCE-CT, alongside the current CT and 18-flurodeoxyglucose-positron emission tomography) ((18)FDG-PET)-CT nodule characterisation strategies in the National Health Service (NHS)...
2016: BMJ Open Respiratory Research
Paola J Marino, Ailish Hannigan, Sean Haywood, Jade M Cole, Nicki Palmer, Charlotte Emanuel, Tracey Kinsella, Michael A O Lewis, Matt P Wise, David W Williams
INTRODUCTION: During critical illness, dental plaque may serve as a reservoir of respiratory pathogens. This study compared the effectiveness of toothbrushing with a small-headed toothbrush or a foam-headed swab in mechanically ventilated patients. METHODS: This was a randomised, assessor-blinded, split-mouth trial, performed at a single critical care unit. Adult, orally intubated patients with >20 teeth, where >24 hours of mechanical ventilation was expected were included...
2016: BMJ Open Respiratory Research
Jonathan R Weir-McCall, Anu Kamalasanan, Deidre B Cassidy, Allan D Struthers, Brian J Lipworth, J Graeme Houston
INTRODUCTION: To compare the reproducibility of pulmonary pulse wave velocity (PWV) techniques, and the effects of age and exercise on these. METHODS: 10 young healthy volunteers (YHV) and 20 older healthy volunteers (OHV) with no cardiac or lung condition were recruited. High temporal resolution phase contrast sequences were performed through the main pulmonary arteries (MPAs), right pulmonary arteries (RPAs) and left pulmonary arteries (LPAs), while high spatial resolution sequences were obtained through the MPA...
2016: BMJ Open Respiratory Research
James L Kreindler, Michael L Watkins, Sally Lettis, Ruth Tal-Singer, Nicholas Locantore
INTRODUCTION: Sputum and blood eosinophil counts have attracted attention as potential biomarkers in chronic obstructive pulmonary disease (COPD). One question regarding the use of blood eosinophils as a biomarker in COPD is whether their levels are affected by the use of inhaled corticosteroids (ICS), which are commonly prescribed for COPD. METHODS: We performed a retrospective analysis of peripheral blood leucocytes from a previously completed clinical trial that examined effects of ICS in steroid-naïve patients with COPD...
2016: BMJ Open Respiratory Research
Katrine B Buggeskov, Martin M Sundskard, Thomas Jonassen, Lars W Andersen, Niels H Secher, Hanne B Ravn, Daniel A Steinbrüchel, Janus C Jakobsen, Jørn Wetterslev
INTRODUCTION: Absence of pulmonary perfusion during cardiopulmonary bypass (CPB) may be associated with reduced postoperative oxygenation. Effects of active pulmonary artery perfusion were explored in patients with chronic obstructive pulmonary disease (COPD) undergoing cardiac surgery. METHODS: 90 patients were randomised to receive pulmonary artery perfusion during CPB with either oxygenated blood (n=30) or histidine-tryptophan-ketoglutarate (HTK) solution (n=29) compared with no pulmonary perfusion (n=31)...
2016: BMJ Open Respiratory Research
Mariel G Slater, Ian D Pavord, Dominick E Shaw
Many people with asthma do not achieve disease control, despite bronchodilators and inhaled corticosteroid therapy. People with uncontrolled asthma are at higher risk of an asthma attack and death, with mortality rates estimated at 1000 deaths/year in England and Wales. The recent National Review of Asthma Deaths (NRAD) report, 'Why asthma still kills', recommended that patients at step 4 or 5 of the British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN) guidance must be referred to a specialist asthma service...
2016: BMJ Open Respiratory Research
Asma Navasakulpong, Manon Auger, Anne V Gonzalez
BACKGROUND: Studies have reported a high diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of sarcoidosis. We sought to review the yield of EBUS-TBNA for the diagnosis of sarcoidosis at our institution over time, and examine factors that may influence this yield. METHODS: Patients who underwent EBUS-TBNA for suspected sarcoidosis between December 2008 and November 2011 were identified. EBUS was performed without rapid on-site evaluation (ROSE) of samples...
2016: BMJ Open Respiratory Research
Alyn Morice, Peter Kardos
Acute cough caused by viral respiratory tract infections is probably the most common illness to afflict mankind. Despite the widespread but ineffective prescribing of antibiotics, there is no specific therapy. Home remedies and over-the-counter medicines are the mainstay for treatment of this short-lived but debilitating condition where cough is a major troublesome symptom. Across Europe, there are large variations in the recommendations made by healthcare professionals for the treatment of acute cough. This has arisen through custom and practice based on the evidence of historical studies performed to standards well short of what would be considered legitimate today...
2016: BMJ Open Respiratory Research
Emanuel Citgez, Job van der Palen, Kirsten Koehorst-Ter Huurne, Kris Movig, Paul van der Valk, Marjolein Brusse-Keizer
BACKGROUND: Both chronic inflammation and cardiovascular comorbidity play an important role in the morbidity and mortality of patients with chronic obstructive pulmonary disease (COPD). Statins could be a potential adjunct therapy. The additional effects of statins in COPD are, however, still under discussion. The aim of this study is to further investigate the association of statin use with clinical outcomes in a well-described COPD cohort. METHODS: 795 patients of the Cohort of Mortality and Inflammation in COPD (COMIC) study were divided into statin users or not...
2016: BMJ Open Respiratory Research
G C Nicholson, R A Holloway, B R Leaker, I Kilty, M Salganik, L Tan, P J Barnes, L E Donnelly
INTRODUCTION: Janus kinases (JAKs) regulate inflammatory gene expression through phosphorylation of signal transducer and activator of transcription (STAT) proteins. Expression of STAT proteins is increased in chronic obstructive pulmonary disease (COPD), and may be involved in driving chronic inflammation. Oral JAK inhibitors are effective as anti-inflammatory therapy but exhibit dose-limiting adverse effects. Development of inhaled compounds would be enhanced by robust biomarkers that directly reflect the anti-inflammatory and pharmacological activity in the lung...
2016: BMJ Open Respiratory Research
Raj S Dattani, Casey B Swerner, John R Stradling, Ari Rg Manuel
OBJECTIVE: We hypothesised that the airway resistance during tidal breathing would correlate with a particular pattern of increasing obesity, particularly when supine, and would differ between participants with and without ventilatory failure. METHODS: In our cross-sectional cohort study, 72 morbidly obese patients (40 males, 32 females, mean body mass index (BMI) 47.2) had measurements of both airways resistance (by impulse oscillometry (IOS)) and adiposity (by dual-energy X-ray absorptiometry (DXA))...
2016: BMJ Open Respiratory Research
B Ronan O'Driscoll, Nawar Diar Bakerly, Ann-Louise Caress, June Roberts, Miriam Gaston, Mark Newton, Janelle Yorke
BACKGROUND: Patients can be harmed by receiving too little or too much oxygen. There is ongoing disagreement about the use of oxygen in medical emergencies. METHODS: This was a mixed methods study (survey, telephone interviews and focus groups) involving patients, the public and healthcare professionals (HCPs). RESULTS: 62 patients with chronic obstructive pulmonary disease (COPD), 65 members of the public, 68 ambulance crew members, 22 doctors, 22 nurses and 10 hospital managers took part...
2016: BMJ Open Respiratory Research
Hasse Melbye, Luis Garcia-Marcos, Paul Brand, Mark Everard, Kostas Priftis, Hans Pasterkamp
BACKGROUND: The European Respiratory Society (ERS) lung sounds repository contains 20 audiovisual recordings of children and adults. The present study aimed at determining the interobserver variation in the classification of sounds into detailed and broader categories of crackles and wheezes. METHODS: Recordings from 10 children and 10 adults were classified into 10 predefined sounds by 12 observers, 6 paediatricians and 6 doctors for adult patients. Multirater kappa (Fleiss' κ) was calculated for each of the 10 adventitious sounds and for combined categories of sounds...
2016: BMJ Open Respiratory Research
Clément Medrinal, Guillaume Prieur, David Debeaumont, Aurora Robledo Quesada, Yann Combret, Jean Quieffin, Olivier Contal, Bouchra Lamia
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) has systemic repercussions that can lead to peripheral muscle dysfunction. Muscle atrophy reduces aerobic capacity, greatly limiting activities of daily living and quality of life. Pulmonary rehabilitation is the gold standard treatment for these patients, however, patients may not be able to reach sufficient training intensities for benefits to occur. Technologies such as functional electrical stimulation (FES) are currently being adapted and tested to enhance exercise training...
2016: BMJ Open Respiratory Research
Jayadeep Patra, Yurie Izawa Maher, Sujata Mishra, Mehak Bhatia, Dewan Alam, Doki S Malini, Prakash C Gupta, Prabhat Jha
BACKGROUND: We assessed the relationship of body mass index (BMI), smoking, drinking and solid fuel use (r; SFU), and the individual and combined effects of these factors on wheezing symptoms (WS) and on diagnosed asthma (DA). METHODS: We analysed 175 000 individuals from 51 nationally representative surveys, using self-reports of WS and DA as the measures of asthma. The fixed-effects and random-effects estimates of the pooled ORs between asthma and underweight (BMI <18...
2016: BMJ Open Respiratory Research
Craig Davidson, Steve Banham, Mark Elliott, Daniel Kennedy, Colin Gelder, Alastair Glossop, Colin Church, Ben Creagh-Brown, James Dodd, Tim Felton, Bernard Foëx, Leigh Mansfield, Lynn McDonnell, Robert Parker, Caroline Patterson, Milind Sovani, Lynn Thomas
No abstract text is available yet for this article.
2016: BMJ Open Respiratory Research
Janine Pilcher, Mark Holliday, Stefan Ebmeier, Steve McKinstry, Fatiha Messaoudi, Mark Weatherall, Richard Beasley
BACKGROUND: The SmartTouch Ventolin monitor (Adherium, Auckland, New Zealand) is an electronic monitor for use with a Ventolin metered dose inhaler, which records the date and time of inhaler actuations. This technology has the potential to allow in-depth analysis of patterns of inhaler use in clinical trial settings. The aim of this study was to determine the accuracy of the SmartTouch Ventolin monitor in recording Ventolin actuations. METHODS: 20 SmartTouch Ventolin monitors were attached to Ventolin metered dose inhalers...
2016: BMJ Open Respiratory Research
Niklas Sandler, Jenny Holländer, Disa Långström, Pekka Santtila, Anni Saukkonen, Saku Torvinen
INTRODUCTION: Correct inhaler technique and device preference are positively correlated with improved adherence and clinical outcomes. This study was designed to investigate inhaler technique mastery and device preference for three different dry powder inhalers, Spiromax, Easyhaler and Turbuhaler. METHODS: This was a single site, single visit, crossover study assessing device mastery, handling errors and preference using empty Spiromax, Easyhaler and Turbuhaler devices in healthy adult Finnish volunteers...
2016: BMJ Open Respiratory Research
Peter Brazier, Uwe Schauer, Eckard Hamelmann, Steve Holmes, Clive Pritchard, John O Warner
INTRODUCTION: Chronic asthma is a significant burden for individual sufferers, adversely impacting their quality of working and social life, as well as being a major cost to the National Health Service (NHS). Temperature-controlled laminar airflow (TLA) therapy provides asthma patients at BTS/SIGN step 4/5 an add-on treatment option that is non-invasive and has been shown in clinical studies to improve quality of life for patients with poorly controlled allergic asthma. The objective of this study was to quantify the cost-effectiveness of TLA (Airsonett AB) technology as an add-on to standard asthma management drug therapy in the UK...
2016: BMJ Open Respiratory Research
Stephen Delaney, Mark Biffen, Justine Maltby, John Bell, Sara Asimus, Ajay Aggarwal, Maarten Kraan, David Keeling
BACKGROUND: Many patients with asthma have a T-helper type 2 (Th2) driven inflammation of the lung, whereas toll-like receptor 7 (TLR7) agonists, by inducing type I interferons, inhibit Th2 responses. In man, oral or parenteral TLR7 agonists can induce influenza-like symptoms through systemic induction of type I interferons. Design of a TLR7 agonist that is only active in the lung could reduce the risk of side effects and offer a new means for treating asthma. We developed a TLR7 agonist antedrug, AZD8848, to determine its local and systemic effects in preclinical models and man...
2016: BMJ Open Respiratory Research
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