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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
Fatimata Seydou Sall, Alban De Luca, Lionel Pazart, Aurore Pugin, Gilles Capellier, Abdo Khoury
Introduction: There is a continuous debate concerning the superiority of endotracheal intubation on bag-valve-mask (BVM) ventilation in patients with cardiac arrest. In this manikin-based observational study, we evaluate and compare the performance of manual ventilation through a facemask (BVM) and an endotracheal tube (ETT). Methods: One hundred and forty healthcare providers were instructed to manually ventilate a manikin as they would do for a 75 kg adult patient in respiratory arrest...
2018: BMJ Open Respiratory Research
Jeffrey J Swigris
Patients with idiopathic pulmonary fibrosis (IPF) face a poor prognosis and endure intrusive symptoms that impair quality of life. Many patients with IPF will require supplemental oxygen (O2 ) at some point in the course of their illness, and although it can improve blood oxygen and symptoms, O2 creates physical and emotional challenges for patients and their loved ones. Four events in the course of IPF-the first occurs at the time of diagnosis and the other three are related to O2 -herald periods of transition for patients and their caregivers and mark touchpoints when they need extra care and support from practitioners...
2018: BMJ Open Respiratory Research
Maaike de Vries, Diana A van der Plaat, Judith M Vonk, H Marike Boezen
Introduction: Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease with cigarette smoke as the main risk factor for its development. Since not every smoker develops COPD, other factors likely underlie differences in susceptibility to develop COPD. Here, we tested if DNA methylation may be such a factor by assessing the association between DNA methylation levels and COPD in never and current smokers from the general population. Methods: For the current study, 1561 subjects were non-randomly selected from the LifeLines cohort study...
2018: BMJ Open Respiratory Research
Brooks W Morgan, Matthew R Grigsby, Trishul Siddharthan, Robert Kalyesubula, Robert A Wise, John R Hurst, Bruce Kirenga, William Checkley
Introduction: Chronic obstructive pulmonary disease (COPD) will soon be the third leading global cause of death and is increasing rapidly in low/middle-income countries. There is a need for local validation of the Saint George's Respiratory Questionnaire (SGRQ), which can be used to identify those experiencing lifestyle impairment due to their breathing. Methods: The SGRQ was professionally translated into Luganda and reviewed by our field staff and a local pulmonologist...
2018: BMJ Open Respiratory Research
Alice Malpass, Gene Feder, James W Dodd
Introduction: Dyspnoea has been defined as a 'subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity'. However, the majority of available dyspnoea measures treat it as a single entity and rely on quantitative methodology. We propose that qualitative research can enhance our understanding of dyspnoea, in particular, how perception varies so much among patients with similar disease states. In this paper, we focus on how a specific type of inner attention-mindfulness-may alter perceptions of dyspnoea...
2018: BMJ Open Respiratory Research
Ákos Tényi, Emili Vela, Isaac Cano, Montserrat Cleries, David Monterde, David Gomez-Cabrero, Josep Roca
Introduction: Comorbidities in patients with chronic obstructive pulmonary disease (COPD) generate a major burden on healthcare. Identification of cost-effective strategies aiming at preventing and enhancing management of comorbid conditions in patients with COPD requires deeper knowledge on epidemiological patterns and on shared biological pathways explaining co-occurrence of diseases. Methods: The study assesses the co-occurrence of several chronic conditions in patients with COPD using two different datasets: Catalan Healthcare Surveillance System (CHSS) (ES, 1...
2018: BMJ Open Respiratory Research
Pia Hardelid, Melpo Kapetanstrataki, Lee Norman, Sarah J Fleming, Paula Lister, Ruth Gilbert, Roger C Parslow
Introduction: A universal childhood influenza vaccination programme was introduced in the UK in September 2013. We examine the impact of the gradual introduction of this programme on influenza-related paediatric intensive care unit (PICU) admission rates in England. Methods: We extracted data on all influenza-related admissions to PICUs in England in resident children aged 0-15 years old between October 2003 and March 2017 from the Paediatric Intensive Care Audit Network (PICANet) database...
2018: BMJ Open Respiratory Research
Luke S Howard, Steven Barden, Robin Condliffe, Vincent Connolly, Chris Davies, James Donaldson, Bernard Everett, Catherine Free, Daniel Horner, Laura Hunter, Jasvinder Kaler, Catherine Nelson-Piercy, Emma O'Dowd, Raj Patel, Wendy Preston, Karen Sheares, Campbell Tait
The following is a summary of the recommendations and good practice points for the BTS Guideline for the initial outpatient management of pulmonary embolism. Please refer to the full guideline for full information about each section.
2018: BMJ Open Respiratory Research
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