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BMJ Open Respiratory Research

Adama Sana, Serge M A Somda, Nicolas Meda, Catherine Bouland
Introduction: Chronic obstructive pulmonary disease (COPD) is a major and growing cause of morbidity and mortality worldwide. The global prevalence of COPD is growing faster in women than in men. Women are often exposed to indoor pollutants produced by biomass fuels burning during household activities. Methods: We conducted a meta-analysis to establish the association between COPD and exposure to biomass smoke in women.Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched MEDLINE and Scopus databases in 31December 2016, with the terms: "wood", "charcoal", "biomass", "solid fuels", "organic fuel", "biofuel", "female", "women", "COPD", "chronic bronchitis", "emphysema", "chronic obstructive pulmonary disease"...
2018: BMJ Open Respiratory Research
Jeong Su Lee, Heidi Lempp, Vivek Srivastava, Elizabeth Barley
Introduction: Fifteen million people are affected by one or more long-term conditions in England. The cost of caring for this patient group increases every year. Several studies have been conducted to find out why people with those conditions choose to access Accident and Emergency (A&E) frequently. To our knowledge, there is no study that compares the three groups (patients, family members and hospital clinicians), and this approach may enhance understanding of A&E admissions in England...
2018: BMJ Open Respiratory Research
Lucy J Griffiths, Ronan A Lyons, Amrita Bandyopadhyay, Karen S Tingay, Suzanne Walton, Mario Cortina-Borja, Ashley Akbari, Helen Bedford, Carol Dezateux
Introduction: Electronic health records (EHRs) are increasingly used to estimate the prevalence of childhood asthma. The relation of these estimates to those obtained from parent-reported wheezing suggestive of asthma is unclear. We hypothesised that parent-reported wheezing would be more prevalent than general practitioner (GP)-recorded asthma diagnoses in preschool-aged children. Methods: 1529 of 1840 (83%) Millennium Cohort Study children registered with GPs in the Welsh Secure Anonymised Information Linkage databank were linked...
2018: BMJ Open Respiratory Research
Charles S Haworth, John Banks, Toby Capstick, Andrew J Fisher, Thomas Gorsuch, Ian F Laurenson, Andrew Leitch, Michael R Loebinger, Heather J Milburn, Mark Nightingale, Peter Ormerod, Delane Shingadia, David Smith, Nuala Whitehead, Robert Wilson, R Andres Floto
The full guideline for the management of non-tuberculous mycobacterial pulmonary disease is published in Thorax . The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline.
2017: BMJ Open Respiratory Research
Karin Klooster, Dirk-Jan Slebos, Zaid Zoumot, Claire Davey, Pallav L Shah, Nicholas S Hopkinson
Introduction: Endobronchial valve placement has potential as a treatment for patients with chronic obstructive pulmonary disease (COPD). However, a robust evidence base will be needed to convince commissioners of healthcare that it is a high-value treatment. We sought to develop the evidence base by performing an individual patient-level analysis of randomised controlled trials in people with heterogeneous emphysema and an absence of collateral ventilation. Methods: A literature search (PROSPERO register CRD42016048127) identified two trials meeting these criteria, the BelieVeR-HIFi and STELVIO studies...
2017: BMJ Open Respiratory Research
Sian Lax, Julie Rayes, David R Thickett, Steve P Watson
Introduction: Acute respiratory distress syndrome (ARDS) is a devastating pulmonary condition in the critically ill patient. A therapeutic intervention is yet to be found that can prevent progression to ARDS. We recently demonstrated that the interaction between podoplanin expressed on inflammatory alveolar macrophages (iAMs) and its endogenous ligand, platelet C-type lectin-like 2 (CLEC-2), protects against exaggerated lung inflammation during a mouse model of ARDS. In this study, we aim to investigate the therapeutic use of a crosslinking/activating anti-podoplanin antibody (α-PDPN, clone 8...
2017: BMJ Open Respiratory Research
Sanghun Choi, Babak Haghighi, Jiwoong Choi, Eric A Hoffman, Alejandro P Comellas, John D Newell, Sally E Wenzel, Mario Castro, Sean B Fain, Nizar N Jarjour, Mark L Schiebler, R Graham Barr, MeiLan K Han, Eugene R Bleecker, Christopher B Cooper, David Couper, Nadia Hansel, Richard E Kanner, Ella A Kazeroni, Eric A C Kleerup, Fernando J Martinez, Wanda K O'Neal, Prescott G Woodruff, Ching-Long Lin
Introduction: Quantitative CT (QCT) imaging-based metrics have quantified disease alterations in asthma and chronic obstructive pulmonary disease (COPD), respectively. We seek to characterise the similarity and disparity between these groups using QCT-derived airway and parenchymal metrics. Methods: Asthma and COPD subjects (former-smoker status) were selected with a criterion of post-bronchodilator FEV 1 <80%. Healthy non-smokers were included as a control group...
2017: BMJ Open Respiratory Research
Juan Carlos Aviles-Solis, Sophie Vanbelle, Peder A Halvorsen, Nick Francis, Jochen W L Cals, Elena A Andreeva, Alda Marques, Päivi Piirilä, Hans Pasterkamp, Hasse Melbye
Introduction: Lung auscultation is helpful in the diagnosis of lung and heart diseases; however, the diagnostic value of lung sounds may be questioned due to interobserver variation. This situation may also impair clinical research in this area to generate evidence-based knowledge about the role that chest auscultation has in a modern clinical setting. The recording and visual display of lung sounds is a method that is both repeatable and feasible to use in large samples, and the aim of this study was to evaluate interobserver agreement using this method...
2017: BMJ Open Respiratory Research
David W Shimabukuro, Christopher W Barton, Mitchell D Feldman, Samson J Mataraso, Ritankar Das
Introduction: Several methods have been developed to electronically monitor patients for severe sepsis, but few provide predictive capabilities to enable early intervention; furthermore, no severe sepsis prediction systems have been previously validated in a randomised study. We tested the use of a machine learning-based severe sepsis prediction system for reductions in average length of stay and in-hospital mortality rate. Methods: We conducted a randomised controlled clinical trial at two medical-surgical intensive care units at the University of California, San Francisco Medical Center, evaluating the primary outcome of average length of stay, and secondary outcome of in-hospital mortality rate from December 2016 to February 2017...
2017: BMJ Open Respiratory Research
Spyridon Fortis, Michael Eberlein, Dimitris Georgopoulos, Alejandro P Comellas
Introduction: We compared the predictive value of prebronchodilator and postbronchodilator spirometry for chronic obstructive pulmonary disease (COPD) features and outcomes. Methods: We analysed COPDGene data of 10 192 subjects with smoking history. We created regressions models with the following dependent variables: clinical, functional and radiographic features, and the following independent variables: prebronchodilator airflow obstruction (PREO) and postbronchodilator airflow obstruction (POSTO), prebronchodilator and postbronchodilator FEV 1 % predicted...
2017: BMJ Open Respiratory Research
Phillip A Howells, Kerrie A Aldridge, Dhruv Parekh, Daniel Park, Olga Tucker, Rachel C A Dancer, Fang Gao, Gavin D Perkins, David R Thickett
Introduction: The Beta Agonist Lung Injury Trial-Prevention (BALTI-P) translational substudy and Vitamin D to Prevent Acute Lung Injury Following Oesophagectomy (VINDALOO) trials recruited patients undergoing oesophagectomy, 4 years apart. The acute respiratory distress syndrome (ARDS) rates were lower in the VINDALOO trial. We sought to identify changes between these two trials and identify risk factors for ARDS in oesophagectomy. Methods: There were data available from 61 patients in the BALTI-P substudy and 68 from VINDALOO...
2017: BMJ Open Respiratory Research
Aihem Johar, Chris D Turnbull, John R Stradling
Introduction: When obstructive sleep apnoea (OSA) does not occur throughout sleep, there must be factors influencing its presence or absence. These are most likely to be sleep stage, posture and presleep alcohol, among others. We hypothesised that as OSA severity increases, the likelihood of postural OSA (POSA) would also decrease. Methods: Laboratory sleep studies of 39 patients with OSA were manually reviewed to calculate supine and non-supine oxygen desaturation indices (ODI)...
2017: BMJ Open Respiratory Research
Matthew J Pavitt, Joanne Nevett, Laura L Swanton, Matthew D Hind, Michael I Polkey, Malcolm Green, Nicholas S Hopkinson
Introduction: Complete foreign body airway obstruction is a life-threatening emergency, but there are limited data on its epidemiology. Methods: We conducted a retrospective analysis of data collected routinely from London Ambulance Service calls coded as being for choking was undertaken for the calendar year of 2016. Results: There were 1916 choking episodes of significant severity to call for emergency assessment in London during 2016, 0...
2017: BMJ Open Respiratory Research
Ioannis Psallidas, Hania E G Piotrowska, Ahmed Yousuf, Nikolaos I Kanellakis, Gayathri Kagithala, Seid Mohammed, Lei Clifton, John P Corcoran, Nicky Russell, Melissa Dobson, Robert F Miller, Najib M Rahman
Introduction: Malignant pleural effusion (MPE) is common and currently in UK there are an estimated 50 000 new cases of MPE per year. Talc pleurodesis remains one of the most popular methods for fluid control. The value of thoracic ultrasound (TUS) imaging, before and after pleurodesis, in improving the quality and efficacy of care for patients with MPE remains unknown. Additionally, biomarkers of successful pleurodesis including measurement of pleural fluid proteins have not been validated in prospective studies...
2017: BMJ Open Respiratory Research
Katie Ward, Prashant Rao, Charles C Reilly, Gerrard Francis Rafferty, Michael I Polkey, Lalit Kalra, John Moxham
Introduction: Each year 7 million people die of stroke worldwide; most deaths are caused by chest infections. Patients with acute stroke have impaired voluntary cough flow, associated with increased risk of chest infections. Reduced functional residual capacity (FRC) could lead to impaired cough flow. We therefore compared FRC in acute hemiparetic stroke patients and controls and explored its relationship with volume inspired before cough and voluntary cough peak flow. Methods: 21 patients within 2 weeks of first-ever middle cerebral artery territory (MCA) infarct (mean (SD) age 68 (11) years, 10 females) and 30 controls (58 (11) years, 15 females) underwent FRC and voluntary cough testing (cough inspired volume and peak flow) while semirecumbent...
2017: BMJ Open Respiratory Research
Avril Zixin Soh, Cynthia Bin Eng Chee, Yee-Tang Wang, Jian-Min Yuan, Woon-Puay Koh
INTRODUCTION: Heavy alcohol consumption increases the risk of active tuberculosis (TB). However, the relation between lower levels of alcohol intake and TB risk remains unclear. We aimed to evaluate the association between alcohol intake and risk of active TB and assess whether the associations were modified by smoking status, which is another risk factor for active TB. METHODS: The Singapore Chinese Health Study is a prospective cohort of 63 257 adults aged 45-74 years recruited from 1993 to 1998...
2017: BMJ Open Respiratory Research
Kavita Pabreja, Peter Gibson, Alyssa J Lochrin, Lisa Wood, Katherine J Baines, Jodie L Simpson
INTRODUCTION: Sputum colour is associated with neutrophilic inflammation in chronic bronchitis and chronic obstructive pulmonary disease (COPD). Neutrophilia and sputum expectoration is notable in asthma, but whether sputum colour is associated with and predicts the presence of neutrophilic inflammation in asthma is unknown. The objective of the study is to assess the ability of sputum colour in distinguishing asthma inflammatory phenotypes. METHODS: Induced sputum samples collected from 271 adults with stable asthma were retrospectively assessed...
2017: BMJ Open Respiratory Research
Joshua Wade, Silvia Mendonca, Sara Booth, Gail Ewing, A Carole Gardener, Morag Farquhar
INTRODUCTION: The Numerical Rating Scale (NRS) is frequently used to assess patient-reported breathlessness in both a research and clinical context. A subgroup of patients report average breathlessness as worse than their worst breathlessness in the last 24 hours (paradoxical average). The Peak/End rule describes how the most extreme and current breathlessness influence reported average. This study seeks to highlight the existence of a subpopulation who give 'paradoxical averages using the NRS, to characterise this group and to investigate the explanatory relevance of the 'Peak/End' rule...
2017: BMJ Open Respiratory Research
Eric Abston, Alejandro Comellas, Robert Michael Reed, Victor Kim, Robert A Wise, Roy Brower, Spyridon Fortis, Reinhard Beichel, Surya Bhatt, Joseph Zabner, John Newell, Eric A Hoffman, Michael Eberlein
INTRODUCTION: The obesity paradox in chronic obstructive pulmonary disease (COPD), whereby patients with higher body mass index (BMI) fare better, is poorly understood. Higher BMIs are associated with lower lung volumes and greater lung elastic recoil, a key determinant of expiratory airflow. The forced expiratory flow (25-75) (FEF25-75)/forced vital capacity (FVC) ratio reflects effort-independent expiratory airflow in the context of lung volume and could be modulated by BMI. METHODS: We analysed data from the COPDGene study, an observational study of 10 192 subjects, with at least a 10 pack-year smoking history...
2017: BMJ Open Respiratory Research
Ruth Barker, Anthony A Laverty, Nicholas S Hopkinson
INTRODUCTION: Oscillatory positive pressure devices (OPEP) can be used as adjuncts to improve sputum clearance in chronic obstructive pulmonary disease (COPD), though the evidence base is incomplete. The attitudes of physiotherapists towards these devices in the care of patients with COPD is unknown. In addition, actual use compared with the prescription of medications has not been studied. METHODS: We analysed English prescribing data, obtained from OpenPrescribing...
2017: BMJ Open Respiratory Research
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