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BMJ Open Respiratory Research

Anne Caroline Krefis, Jana Fischereit, Peter Hoffmann, Hans Pinnschmidt, Christina Sorbe, Matthias Augustin, Jobst Augustin
Introduction: Associations between air pollutants, meteorological conditions and respiratory diseases have been extensively shown. The aim of this study was to investigate associations between daily meteorological data, data on air pollution and emergency department (ED) visits depending on the day of the week, season and year (study period from 2013 to 2015). Methods: Highly correlated environmental data entered a categorical principal components analysis (CATPCA)...
2018: BMJ Open Respiratory Research
Masatoshi Yamazoe, Hiromi Tomioka
Introduction: In 2016, an international working group proposed a revised definition and new diagnostic criteria for the acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). Based on these criteria, AE-IPF was diagnosed regardless of the presence or absence of a known trigger and categorised as triggered (T-AE) or idiopathic (I-AE) AE-IPF. However, the clinical characteristics of the newly defined AE-IPF and clinical differences between T-AE and I-AE are unresolved. Methods: We retrospectively analysed 64 patients with AE-IPF (I-AE (42), T-AE (22)) admitted to our hospital over a 10- year period...
2018: BMJ Open Respiratory Research
Laila Parvaresh, Shopna K Bag, Jin-Gun Cho, Neil Heron, Hassan Assareh, Sophie Norton, Stephen Corbett, Ben J Marais
Treatment of latent tuberculosis infection (LTBI) is an important component of strategies to achieve global tuberculosis (TB) elimination, but implementation is rarely monitored. This is a retrospective review of TB contact tracing outcomes at one of the busiest TB clinics in Australia, measured against the Centre for Disease Control and Prevention performance indicators. In total, 45 of 53 (85%) pulmonary TB cases had 171 close contacts, of whom 139 (81%) were evaluated with a tuberculin skin test (TST); 58 of 139 (42%) were positive at baseline...
2018: BMJ Open Respiratory Research
Alexander Pate, Michael Barrowman, David Webb, Jeanne M Pimenta, Kourtney J Davis, Rachael Williams, Tjeerd Van Staa, Matthew Sperrin
Introduction: Traditional phase IIIb randomised trials may not reflect routine clinical practice. The Salford Lung Study in chronic obstructive pulmonary disease (SLS COPD) allowed broad inclusion criteria and followed patients in routine practice. We assessed whether SLS COPD approximated the England COPD population and evidence for a Hawthorne effect. Methods: This observational cohort study compared patients with COPD in the usual care arm of SLS COPD (2012-2014) with matched non-trial patients with COPD in England from the Clinical Practice Research Datalink database...
2018: BMJ Open Respiratory Research
Nicholas David Lane, Karen Brewin, Tom Murray Hartley, William Keith Gray, Mark Burgess, John Steer, Stephen C Bourke
Introduction: In exacerbation of chronic obstructive pulmonary disease (ECOPD) requiring hospitalisation greater access to respiratory specialists improves outcome, but is not consistently delivered. The UK National Confidential Enquiry into Patient Outcome and Death 2015 enquiry showed over 25% of patients receiving acute non-invasive ventilation (NIV) for ECOPD died in hospital. On 16 June 2015 the Northumbria Specialist Emergency Care Hospital (NSECH) opened, introducing 24/7 specialty consultant on-call, direct admission from the emergency department to specialty wards and 7-day consultant review...
2018: BMJ Open Respiratory Research
Michela Tinelli, John White, Andrea Manfrin
Introduction: A key priority in asthma management is achieving control. The Asthma Control Test (ACT) is a validated tool showing a numerical indicator which has the potential to provide a target to drive management. A novel pharmacist-led intervention recently evaluated and introduced in the Italian setting with a cluster randomised controlled trial (C-RCT) showed effectiveness and cost-effectiveness. This paper evaluates whether the intervention is successful in securing the minimally important difference (MID) in the ACT score and provides better health outcomes and economic savings...
2018: BMJ Open Respiratory Research
Koichi Nishimura, Saya Nakamura, Masaaki Kusunose, Kazuhito Nakayasu, Ryo Sanda, Yoshinori Hasegawa, Toru Oga
Introduction: The aim of this study was to investigate which patient-reported outcome measure was the best during the recovery phase from severe exacerbation of chronic obstructive pulmonary disease (COPD). Methods: The Exacerbations of Chronic Pulmonary Disease Tool (EXACT), the COPD Assessment Test (CAT), the St George's Respiratory Questionnaire (SGRQ), the Dyspnoea-12 (D-12) and the Hyland Scale (global scale) were recorded every week for the first month and at 2 and 3 months in 33 hospitalised subjects with acute exacerbation of COPD (AECOPD)...
2018: BMJ Open Respiratory Research
Synne Jenum, Selvam Sumithra, Jesuraj Nelson, Ritz Christian, Hesseling Anneke C, Cardenas Vicky, Lau Esther, Doherty T Mark, Grewal Harleen M S, Vaz Mario
Introduction: Accurate tuberculosis (TB) incidence and optimal surveillance strategies are pertinent to TB vaccine trial design. Infants are a targeted population for new TB vaccines, but data from India, with the highest global burden of TB cases, is limited. Methods: In a population-based prospective trial conducted between November 2006 and July 2008, BCG-vaccinated neonates in South India were enrolled and cluster-randomised to active or passive surveillance...
2018: BMJ Open Respiratory Research
Andrew Walden, Nicholas Smallwood, Martin Dachsel, Ashley Miller, Jennifer Stephens, Michael Griksaitis
No abstract text is available yet for this article.
2018: BMJ Open Respiratory Research
Muhammad Saad, Danial H Shaikh, Nikhitha Mantri, Ahmed Alemam, Aiyi Zhang, Muhammad Adrish
Background: Fever is considered as a presenting symptom of pulmonary embolism (PE). We aim to evaluate the association between PE and fever, its clinical characteristics, outcomes and role in prognosis. Methods: A retrospective chart review of patients who were hospitalised with the diagnosis of acute PE was conducted. Patients in whom underlying fever could also be attributable to an underlying infection were also excluded. Results: A total of 241 patients met the study criteria...
2018: BMJ Open Respiratory Research
Lesa Begley, Siddharth Madapoosi, Kristopher Opron, Ogechukwu Ndum, Alan Baptist, Kelly Rysso, John R Erb-Downward, Yvonne Jean Huang
Introduction: Despite strong evidence that maturation patterns of the gut microbiome in early life influence the risk for childhood asthma, very little is known about gut microbiota patterns in adults with established asthma, and of greater interest relationships to phenotypic features that characterise asthma heterogeneity. Methods: Fifty-eight faecal samples from 32 adults with (n=24) and without (n=8) asthma were analysed using 16S ribosomal RNA gene sequencing methods to characterise intestinal bacterial composition...
2018: BMJ Open Respiratory Research
Matthew Kennedy, Mohammadali Y Ramsheh, Caroline M L Williams, Joss Auty, Koirobi Haldar, Mohamad Abdulwhhab, Christopher E Brightling, Michael R Barer
Introduction: The degree to which bacteria in the human respiratory tract are aerosolised by individuals is not established. Building on our experience sampling bacteria exhaled by individuals with pulmonary tuberculosis using face masks, we hypothesised that patients with conditions frequently treated with antimicrobials, such as chronic obstructive pulmonary disease (COPD), might exhale significant numbers of bacteria carrying antimicrobial resistance (AMR) genes and that this may constitute a previously undefined risk for the transmission of AMR...
2018: BMJ Open Respiratory Research
Toby M Maher, Tamera J Corte, Aryeh Fischer, Michael Kreuter, David J Lederer, Maria Molina-Molina, Judit Axmann, Klaus-Uwe Kirchgaessler, Vincent Cottin
Introduction: Despite extensive multidisciplinary team (MDT) assessment, some patients have interstitial lung disease (ILD) that is considered unclassifiable (uILD), for which there are currently no approved treatments. This study will assess the efficacy and safety of the antifibrotic pirfenidone in treating uILD. Methods and analysis: This double-blind, randomised, placebo-controlled phase II trial is enrolling adults with fibrosing ILD, including uILD that fulfils proposed research criteria for interstitial pneumonia with autoimmune features (IPAF), that cannot be classified with moderate or high confidence to any category of ILD following MDT discussion...
2018: BMJ Open Respiratory Research
George Crowley, Sophia Kwon, Syed Hissam Haider, Erin J Caraher, Rachel Lam, David E St-Jules, Mengling Liu, David J Prezant, Anna Nolan
Introduction: Biomarkers of metabolic syndrome expressed soon after World Trade Center (WTC) exposure predict development of WTC Lung Injury (WTC-LI). The metabolome remains an untapped resource with potential to comprehensively characterise many aspects of WTC-LI. This case-control study identified a clinically relevant, robust subset of metabolic contributors of WTC-LI through comprehensive high-dimensional metabolic profiling and integration of machine learning techniques. Methods: Never-smoking, male, WTC-exposed firefighters with normal pre-9/11 lung function were segregated by post-9/11 lung function...
2018: BMJ Open Respiratory Research
(no author information available yet)
[This corrects the article DOI: 10.1136/bmjresp-2018-000309.].
2018: BMJ Open Respiratory Research
Toby M Maher, Susanne Stowasser, Yasuhiko Nishioka, Eric S White, Vincent Cottin, Imre Noth, Moisés Selman, Zuzana Blahova, Daniel Wachtlin, Claudia Diefenbach, R Gisli Jenkins
Introduction: A feature of the pathogenesis of idiopathic pulmonary fibrosis (IPF) is the excess accumulation of extracellular matrix (ECM) in the lungs. Cleavage of the ECM by metalloproteinases (MMPs) generates free-circulating protein fragments known as neoepitopes. The PROFILE study suggested that changes in ECM turnover proteins may be of value as markers of disease progression in patients with IPF. Nintedanib is an approved treatment for IPF that slows disease progression by reducing decline in forced vital capacity (FVC)...
2018: BMJ Open Respiratory Research
Steven D Nathan, Lisa H Lancaster, Carlo Albera, Marilyn K Glassberg, Jeffrey J Swigris, Frank Gilberg, Klaus-Uwe Kirchgaessler, Susan L Limb, Ute Petzinger, Paul W Noble
Introduction: Temporary dose modifications, such as reductions or interruptions, may allow patients to better manage adverse events (AEs) associated with pirfenidone use and continue treatment for idiopathic pulmonary fibrosis (IPF). However, the impact of such dosing adjustments on efficacy and safety is uncertain. Methods: Patients randomised to receive treatment with pirfenidone 2403 mg/day or placebo in the Clinical Studies Assessing Pirfenidone in Idiopathic Pulmonary Fibrosis: Research of Efficacy and Safety Outcomes (CAPACITY (Study 004 (NCT00287716)) and Study 006 (NCT00287729))) and Assessment of Pirfenidone to Confirm Efficacy and Safety in Idiopathic Pulmonary Fibrosis (ASCEND (Study 016 (NCT01366209)) trials were included in the analysis (n=1247)...
2018: BMJ Open Respiratory Research
Benjamin Daniel Fox, Nadav Sheffy, Baruch Vainshelboim, Leonardo Fuks, Mordechai R Kramer
Introduction: Step climbing is a potentially useful modality for testing exercise capacity. However, there are significant variations between test protocols and lack of consistent validation against gold standard cycle ergometry cardiopulmonary exercise testing (CPET). The purpose of the study was to validate a novel technique of exercise testing using a dedicated device. Methods: We built a step oximetry device from an adapted aerobics step and pulse oximeter connected to a computer...
2018: BMJ Open Respiratory Research
Matthew Evison, Kevin G Blyth, Rahul Bhatnagar, John Corcoran, Tarek Saba, Tracy Duncan, Rob Hallifax, Liju Ahmed, Alex West, Justin Charles Thane Pepperell, Mark Roberts, Pasupathy Sivasothy, Ioannis Psallidas, Amelia O Clive, Jennifer Latham, Andrew E Stanton, Nick Maskell, Najib Rahman
Physicians face considerable challenges in ensuring safe and effective care for patients admitted to hospital with pleural disease. While subspecialty development has driven up standards of care, this has been tempered by the resulting loss of procedural experience in general medical teams tasked with managing acute pleural disease. This review aims to define a framework though which a minimum standard of care might be implemented. This review has been written by pleural clinicians from across the UK representing all types of secondary care hospital...
2018: BMJ Open Respiratory Research
Michael Epton, Carol Limber, Carolyn Gullery, Graham McGeoch, Brett Shand, Rose Laing, Simon Brokenshire, Andrew Meads, Rachel Nicholson-Hitt
The devastating 2011 earthquake in Christchurch destroyed or badly damaged healthcare infrastructure, including Christchurch Hospital. This forced change in management of exacerbations of chronic obstructive pulmonary disease (COPD), which until that point had frequently led to admission to hospital and focused attention on providing safe community options for care. This paper describes the process of understanding factors contributing to high admission frequency with exacerbations of COPD and also describes a process of change, predominantly to healthcare delivery systems and philosophies, and the subsequent outcomes...
2018: BMJ Open Respiratory Research
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