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Bts guidelines

G Watson, N Salter, J Ryan
Revised guidelines for the management of spontaneous pneumothoraces were published by the British Thoracic Society in 2010, however compliance remains poor. A retrospective review was performed on patients diagnosed with a pneumothorax over a 26 month period (January 2012 to March 2014). Of the 57 patients identified, 43 (75%) were diagnosed with spontaneous pneumothorax. 12 patients (21%) had pre-existing lung disease, and 16 patients (28%) admitted to having had a previously documented pneumothorax. 19 patients (33%) were reported as smokers...
2016: Irish Medical Journal
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
Simone Perandini, G A Soardi, A R Larici, A Del Ciello, G Rizzardi, A Solazzo, L Mancino, F Zeraj, M Bernhart, M Signorini, M Motton, S Montemezzi
OBJECTIVES: To achieve multicentre external validation of the Herder and Bayesian Inference Malignancy Calculator (BIMC) models. METHODS: Two hundred and fifty-nine solitary pulmonary nodules (SPNs) collected from four major hospitals which underwent 18-FDG-PET characterization were included in this multicentre retrospective study. The Herder model was tested on all available lesions (group A). A subgroup of 180 SPNs (group B) was used to provide unbiased comparison between the Herder and BIMC models...
September 15, 2016: European Radiology
Sarah B Windle, Kristian B Filion, Joseph G Mancini, Lauren Adye-White, Lawrence Joseph, Genevieve C Gore, Bettina Habib, Roland Grad, Louise Pilote, Mark J Eisenberg
CONTEXT: Treatment guidelines recommend the use of combination therapies for smoking cessation, particularly behavioral therapy (BT) as an adjunct to pharmacotherapy. However, these guidelines rely on previous reviews with important limitations. This study's objective was to evaluate the efficacy of combination therapies compared with monotherapies, using the most rigorous data available. EVIDENCE ACQUISITION: A systematic review and meta-analysis of RCTs of pharmacotherapies, BTs, or both were conducted...
September 8, 2016: American Journal of Preventive Medicine
Kerry Dwan, Stephen J Milan, Lynne Bax, Nicola Walters, Colin Powell
BACKGROUND: Vilanterol (VI) is a long-acting beta2-agonist (LABA) that binds to the beta2-adrenoceptor on the airway smooth muscle, producing bronchodilation. LABA therapy, which is well established in adults as part of the British Thoracic Society (BTS) Guidelines for the Management of Asthma, leads to improvement in symptoms and lung function and reduction in exacerbations. At present, the commonly used LABAs licensed for use in asthma management (formoterol and salmeterol) require twice-daily administration, whereas VI is a once-daily therapy...
September 1, 2016: Cochrane Database of Systematic Reviews
Grace Li, Ofran Almossawi, Hasna Dulfeker, Vicky Jones, Felicity Taylor
AIM: To compare the palatability of oral non-soluble and oral soluble prednisolone tablets in paediatric patients admitted to the general paediatric wards in an acute London Trust. METHOD: As part of ongoing quality improvement initiatives, the Paediatric and Pharmacy departments compared tolerability of soluble versus non-soluble prednisolone in a group of 27 patients. Using a modified 5 point hedonic scale with 'smiley' faces we measured palatability and tolerance (swallowed versus refusal or vomiting) over two three week periods: the first period whilst soluble prednisolone was dispensed (n=17) and the second period after the switch to non-soluble prednisolone had been made (n=10)...
September 2016: Archives of Disease in Childhood
Fang-I Hsieh, Jiann-Shing Jeng, Chang-Ming Chern, Tsong-Hai Lee, Sung-Chun Tang, Li-Kai Tsai, Hsun-Hsiang Liao, Hang Chang, Kenneth A LaBresh, Hung-Jung Lin, Hung-Yi Chiou, Hou-Chang Chiu, Li-Ming Lien
In the management of acute ischemic stroke, guideline adherence is often suboptimal, particularly for intravenous thrombolysis or anticoagulation for atrial fibrillation. We sought to improve stroke care quality via a collaborative model, the Breakthrough Series (BTS)-Stroke activity, in a nationwide, multi-center activity in Taiwan. A BTS Collaborative, a short-term learning system for a large number of multidisciplinary teams from hospitals, was applied to enhance acute ischemic stroke care quality. Twenty-four hospitals participated in and submitted data for this stroke quality improvement campaign in 2010-2011...
2016: PloS One
Deog Kyeom Kim, Yong Bum Park, Yeon-Mok Oh, Ki-Suck Jung, Ji Hong Yoo, Kwang-Ha Yoo, Kwan Hyung Kim
Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012)...
July 2016: Tuberculosis and Respiratory Diseases
Onur Fevzi Erer, Serhat Erol, Ceyda Anar, Zekiye Aydogdu, Serir Aktogu Ozkan
AIM: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which enables cytological examination of mediastinal lymph node (LN) aspiration samples, is a safe and minimally invasive method for diagnosis and staging of lung cancer and diagnosis of diseases affecting mediastinal LNs. In this study, we investigated the yield of EBUS-TBNA for diagnosis of lymphoma and reviewed the literature since the British Thoracic Society (BTS) guidelines were published. MATERIALS AND METHODS: We retrospectively evaluated our database for patients who underwent EBUS between March 2011 and December 2014...
April 28, 2016: Endoscopic Ultrasound
A Craig Davidson, Stephen Banham, Mark Elliott, Daniel Kennedy, Colin Gelder, Alastair Glossop, Alistair Colin Church, Ben Creagh-Brown, James William Dodd, Tim Felton, Bernard Foëx, Leigh Mansfield, Lynn McDonnell, Robert Parker, Caroline Marie Patterson, Milind Sovani, Lynn Thomas
No abstract text is available yet for this article.
April 2016: Thorax
Derek Manas, Lisa Burnapp, Peter Antony Andrews
The British Transplantation Society Guidelines for Living Donor Liver Transplantation was published in July 2015 and is the first national guideline in the field of living donor liver transplantation. The guideline aims to review the evidence relating to the evaluation process of both recipient and donor candidates; address the moral and ethical issues surrounding the procedure; outline the technical aspects of the procedure, including the middle hepatic vein controversy and the "small for size syndrome"; review donor and recipient outcomes and complications including donor mortality; and examine evidence relating to the advantages and disadvantages of living donor liver transplantation...
June 2016: Transplantation
Richard N J Graham, David R Baldwin, Matthew E J Callister, Fergus V Gleeson
The British Thoracic Society has published new comprehensive guidelines for the management of pulmonary nodules. These guidelines are significantly different from those previously published, as they use two malignancy prediction calculators to better characterize the risk of malignancy. There are recommendations for a higher nodule size threshold for follow-up (≥5 mm or ≥80 mm(3)) and a reduction of the follow-up period to 1 year for solid pulmonary nodules; both of these will reduce the number of follow-up CT scans...
2016: British Journal of Radiology
Jay Suntharalingam, Sabrine Hippolyte, Vikki Knowles, Daryl Freeman, Irem Patel, Maxine Hardinge
The ability to provide oxygen in a patient's home can offer enormous benefits, including improvements in life expectancy when given in the appropriate setting. Confusingly, however, home oxygen is available in many forms, including long-term oxygen therapy (LTOT), ambulatory oxygen therapy (AOT), palliative oxygen therapy (POT) and short-burst oxygen therapy (SBOT)-each with varying degrees of supporting evidence. The British Thoracic Society (BTS) has recently published new guidance on home oxygen therapy, after collating the available evidence...
2016: NPJ Primary Care Respiratory Medicine
Craig Miller, Claire Cushley, Kasey Redler, Claire Mitchell, Elizabeth Aynsley Day, Helen Mansfield, Abigail Nye
Admissions for exacerbations of chronic obstructive pulmonary disease (COPD) present a significant proportion of patients in the acute medical take. The British Thoracic Society (BTS) provides guidelines for time specific interventions, that should be delivered to those with an acute exacerbation of COPD through the admission care bundle. These include correct diagnosis, correct assessment of oxygenation, early administration of treatment, recognition of respiratory failure, and specialist review. Gloucestershire Hospitals NHS Foundation Trust (GHNHSFT) chose improvement in acute COPD care to be a local Commissioning for Quality and Innovation (CQUIN) scheme, which enables commissioners to reward excellence by linking a proportion of English healthcare providers' income to the achievement of local quality improvement goals...
2015: BMJ Quality Improvement Reports
Matthew Smith, Natalie Elkheir
Record keeping for patients on non-invasive ventilation (NIV) at St. Georges Hospital is poor. The initial NIV prescription is often not recorded, and changes to the NIV prescription or the rationale for the changes (ABG results) are also poorly documented. This leads to confusion for nurses/doctors as to what the correct settings are, meaning patients could receive ineffective ventilation. The use of NIV is also poorly recorded by nursing staff meaning that doctors are unsure if the prescribed NIV is being achieved...
2014: BMJ Quality Improvement Reports
James Rudge, Sunita Odedra, Danielle Harrison
In the UK, safe use and administration of oxygen therapy was unsatisfactory prior to the implementation of national guidelines in 2008. Each year since then the British Thoracic Society (BTS) has conducted a national audit that has demonstrated a slow but steady improvement in oxygen use across four key standards. Sandwell and West Birmingham NHS Hospitals Trust has participated in this audit process but has failed to show consistent improvements. The aim of this quality improvement project was to produce meaningful and sustained improvements in oxygen use across each of the four standards...
2014: BMJ Quality Improvement Reports
Matthew E J Callister, David R Baldwin
Pulmonary nodules are a common incidental finding on CT and the inexorable rise in the use of CT (10% increase per year in the UK over the last decade) means that the frequency of their detection is likely to increase over coming years. This may be augmented further if CT screening is implemented. Management has previously been influenced by North American guidelines, with the most widely used resource to date being the Fleischner Society guidelines published in 2005. These predominantly focus on the timing of CT scans arranged to survey small pulmonary nodules (≤ 8 mm), and the guideline authors chose not to offer specific recommendations regarding larger nodules...
January 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Charlotte L Earle, Rhys Jefferies
Reversibility testing is used to identify a positive or negative response to bronchodilators. Results from a reversibility test can not only support a diagnosis of asthma but can alter a patient's treatment plan, so its clinical importance should not be understated. With multiple guidelines published classifying a 'positive response' it becomes unclear on how to categorise certain individuals. This study looks into the discrepancies between the guidelines, and introduces a new algorithm to help clinicians. This retrospective pilot study was completed across four hospitals in South Wales...
2015: European Clinical Respiratory Journal
Nick Kennedy, Sisira Jayathissa, Paul Healy
Aims. To study the use of CT pulmonary angiography (CTPA) at Hutt Hospital and investigate the use of pretest probability scoring in the assessment of patients with suspected pulmonary embolism (PE). Methods. We studied patients with suspected PE that underwent CTPA between January and May 2012 and collected data on demographics, use of pretest probability scoring, and use of D Dimer and compared our practice with the British Thoracic Society (BTS) guideline. Results. 105 patients underwent CTPA and 15% of patients had PE...
2015: Advances in Medicine
Lakshminarayanan Nandagopal, Muthu Veeraputhiran, Tania Jain, Ayman O Soubani, Charles A Schiffer
BACKGROUND: Prophylactic platelet (PLT) transfusions are often administered to patients before bronchoscopy or bronchoalveolar lavage (BAL) to prevent bleeding. There is a paucity of data to validate this approach, with a commonly suggested PLT transfusion threshold of fewer than 50 × 10(9) /L, largely based on expert opinion. We conducted a retrospective study on the incidence of bleeding complications in patients with thrombocytopenia undergoing bronchoscopy. STUDY DESIGN AND METHODS: We identified 150 consecutive patients with PLT counts of not more than 100 × 10(9) /L who underwent bronchoscopy and/or BAL from January 2009 to May 2014 at our institution...
February 2016: Transfusion
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