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European Clinical Respiratory Journal

Caroline Hedsund, Kasper Linde Ankjærgaard, Daniel Bech Rasmussen, Signe Høyer Schwaner, Helle Frost Andreassen, Ejvind Frausing Hansen, Jon Torgny Wilcke
Introduction : Hospital mortality among chronic obstructive pulmonary disease (COPD) patients receiving NIV for acute respiratory failure has shown to be significantly higher in clinical settings than in the randomized trials (RCTs) which clinical guidelines are based on. This may be due to the quality of care of NIV or patient selection. In daily clinical practice, we include patients with terminal pulmonary disease with a do-not-intubate (DNI) or a do-not-resuscitate (DNR) order with a high mortality risk compared to highly selected patients in RCTs...
2019: European Clinical Respiratory Journal
Andreas Heddini, Josefin Sundh, Magnus Ekström, Christer Janson
Most of the information about the benefits, safety aspects, and cost effectiveness of pharmacological treatment in the respiratory field has been obtained from traditional efficacy studies, such as randomised controlled trials (RCT). The highly controlled environment of an RCT does not always reflect everyday practice. The collection, analysis, and application of effectiveness data to generate Real World Evidence (RWE) through pragmatic trials or observational studies therefore has the potential to improve decision making by regulators, payers, and clinicians...
2019: European Clinical Respiratory Journal
Inge Raadal Skov, Elisabeth Bendstrup, Jesper Rømhild Davidsen
This case report demonstrates 44-year old man, presenting with recurring clinical pneumonias during a period of over 1 year. The patient was clinically affected with, i.a., weight loss, finger clubbing and severely reduced diffusion capacity. Repetitive chest x-rays showed bilateral and consolidating infiltrates, and a high-resolution computed tomography of the thorax (HRCT) exposed ground glass opacities superimposed on a reticular pattern as the so-called 'crazy paving' pattern. A bronchoscopic alveolar lavage revealed alveolar proteinaceous material compatible with the diagnosis pulmonary alveolar proteinosis (PAP)...
2019: European Clinical Respiratory Journal
Laurent Plantier, Christophe Delclaux
Background : The characteristics of cardiopulmonary exercise testing (CPET)-derived parameters for the differential diagnosis of exertional dyspnea are not well known. Objectives: We hypothesized that increased physiological dead space ventilation (VD/Vt) is a marker for mild pulmonary or cardiovascular disease in patients with exertional dyspnea. Design: We used receiver operating characteristic analysis to determine the performance of individual CPET parameters for identifying subjects with either mild pulmonary or cardiovascular disease, among 77 subjects with mild-to-moderate exertional dyspnea (modified Medical Research Council scale 1-2)...
2018: European Clinical Respiratory Journal
Daniel P Henriksen, Uffe Bodtger, Kirsten Sidenius, Niels Maltbaek, Lars Pedersen, Hanne Madsen, Ehm A Andersson, Ole Norgaard, Louise Klokker Madsen, Bo L Chawes
Background : New, complex, and expensive therapies targeting Interleukin-5 (IL-5) to treat severe eosinophilic asthma are emerging. Objective : To assess efficacy, adverse events, and inter-drug comparison of mepolizumab and reslizumab for treating severe eosinophilic asthma. Design : A systematic review and meta-analysis on randomized, placebo-controlled, clinical trials elucidating two critical (exacerbation rate and oral corticosteroid (OCS) use) and six important clinical outcomes on the efficacy and safety of mepolizumab and reslizumab...
2018: European Clinical Respiratory Journal
Elisabeth Bomholt Østergaard, Sajitha Sophia Sritharan, Anne Dal Kristiansen, Pernille Maja Thomsen, Anders Løkke
Background: In Denmark, few people with Chronic Obstructive Pulmonary Disease (COPD) engage in physical activity although it is evident that pulmonary rehabilitation has positive effects on physical activity, dyspnoea, anxiety, fatigue and quality of life. Objective: The purpose of this pilot study was to explore why people with COPD do not engage in physical activity and to explore motivational factors and barriers towards physical activity. Furthermore, to explore the role general practitioners have in this matter...
2018: European Clinical Respiratory Journal
Juho Loponen, Pinja Ilmarinen, Leena E Tuomisto, Onni Niemelä, Minna Tommola, Pentti Nieminen, Lauri Lehtimäki, Hannu Kankaanranta
Background : There is a lack of knowledge on the association between daily physical activity and lung function in patients with asthma. Objective : This study aims to examine the association between daily physical activity and asthma control, lung function, and lung function decline in patients with adult-onset asthma. Design : This study is part of Seinäjoki Adult Asthma Study (SAAS), where 201 patients were followed for 12 years after asthma diagnosis. Daily physical activity was assessed at follow-up by a structured questionnaire and used to classify the population into subgroups of low (≤240 min) or high (>240 min) physical activity...
2018: European Clinical Respiratory Journal
Per Rönmark, Birgitta Jagorstrand, Guilherme Safioti, Sreedevi Menon, Leif Bjermer
Background: Many patients do not use inhalers correctly. Inhalers associated with good technique have the potential to improve symptom control and are often preferred by patients. Methods: Inhaler-naïve, adult volunteers were randomized to use empty Spiromax®, Easyhaler®, and Turbuhaler® dry powder inhalers (DPIs) in one of six possible sequences in this single-site, single-visit, crossover study conducted in Sweden. Randomization was stratified by age and gender. Participants attempted to use each device intuitively (no instructions) and after reading the instructions for use from the patient information leaflet...
2018: European Clinical Respiratory Journal
Marie Stolbrink, Laura J Bonnett, John D Blakey
Antibiotic prescriptions for lower respiratory tract infections occur commonly in primary care but there is uncertainty about the most effective initial treatment strategy. Both increasing antimicrobial resistance and awareness of preventable harm from medicines make resolving this uncertainty a priority. Pragmatic, real-life epidemiological investigations are needed to inform future interventional studies. In this cross-sectional database study we analysed antibiotic prescriptions for non-pneumonic, lower respiratory tract infections (LRTI) in primary care as captured in the Optimum Care Database from 1984 to 2017...
2018: European Clinical Respiratory Journal
Kristoffer Marsaa, Svend Gundestrup, Jens-Ulrik Jensen, Peter Lange, Anders Løkke, Nassim Bazeghi Roberts, Saher Burhan Shaker, Anita Rath Sørensen, Ingrid Louise Titlestad, Laura Hohwü Thomsen, Ulla Møller Weinreich, Elisabeth Bendstrup, Torgny Wilcke
Background:  Chronic non-malignant lung diseases such as chronic obstructive pulmonary disease (COPD) and interstitial lung diseases (ILD) result in reduced quality of life (QoL), a high symptom burden and reduced survival. Patients with chronic non-malignant lung disease often have limited access to palliative care. The symptom burden and the QoL of these patients resembles patients with cancer and the general palliative approach is similar. However, the disease trajectory is often slow and unpredictable, and the palliative effort must be built on accessibility, continuity and professional competences...
2018: European Clinical Respiratory Journal
Heidi Kjeldgaard Grufstedt, Saher Burhan Shaker, Hanne Konradsen
Idiopathic pulmonary fibrosis (IPF) is a chronic disease with high morbidity and mortality. A reliable and manageable questionnaire that assesses patients' quality of life is needed to help to improve the content of clinical consultations. The chronic obstructive pulmonary disease (COPD) Assessment Test (CAT) is used in clinical practice; therefore, the aim of this study was to investigate correlations among the CAT, St. George's Respiratory Questionnaire (SGRQ) and clinical parameters among patients diagnosed with IPF...
2018: European Clinical Respiratory Journal
Charlotte Sandau, Dorthe Gaby Bove, Kristoffer Marsaa, Camilla Sørli Bekkelund, Matias Greve Lindholm
Context : Patients with chronic obstructive pulmonary disease (COPD) have a high symptom burden and reduced quality of life. There is an increasing attention on palliation for patients with COPD. Recognition of symptoms is a prerequisite for palliation. Objectives : We aim to investigate the extent to which symptoms in patients with COPD are recognized in the documentation of the health professionals, indicated in 'Doctors Symptom Recognition Rate' (DSR), 'Nurses Symptom Recognition Rate' (NSR) or 'Doctors and/or Nurses Symptom Recognition rates '(DNSR) as a team, respectively...
2018: European Clinical Respiratory Journal
Melina Gade Sikjær, Ole Hilberg, Andreas Fløe, Jens Dollerup, Anders Løkke
Background : Although chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity and mortality globally, several studies have shown little awareness of COPD in the general population. The awareness of COPD in the Scandinavian countries is, however, sparsely investigated. Objective : The aim of this study was to explore the awareness in the general Danish population of smoking-related health risks and symptoms related to COPD and attitudinal factors concerning smoking. Design : Adults aged 18 years or older were randomly selected to reflect the background population...
2018: European Clinical Respiratory Journal
Nada Townsi, Ingrid A Laing, Graham L Hall, Shannon J Simpson
Children born preterm, less than 37 weeks' gestation, are at increased risk of viral respiratory infections and associated complications both during their initial birth hospitalisation and in their first years following discharge. This increased burden of viral respiratory infections is likely to have long term implications for lung health and function in individuals born preterm, particularly those with bronchopulmonary dysplasia. Several hypotheses have been put forward to explain the association between early life viral respiratory infection and development of suboptimal lung health and function later in life following preterm birth...
2018: European Clinical Respiratory Journal
Ingela Henoch, Claes-Göran Löfdahl, Ann Ekberg-Jansson
Introduction : Chronic obstructive pulmonary disease (COPD) contributes to impaired health-related quality of life (HRQoL). Patient education and smoking cessation programs are recommended to reduce the number of exacerbations and hospitalizations, but the effects of such programs have yet to be explored in larger samples. Objective : The aim was to explore the longitudinal effects of patient education and smoking cessation programs on exacerbations and hospital admissions in patients with COPD. Design : This is a register study where data from the Swedish National Airway Register, including 20,666 patients with COPD, were used...
2018: European Clinical Respiratory Journal
Diana Chabané Schmidt, Charlotte Andersson, Hans Henrik Schultz
The incidence of spontaneous pneumothorax has been estimated to 7.4-18.0/100,000 for men and 1.2-6.0/100,000 for women. The most common symptoms are sudden chest pain and dyspnoea. Due to chest pain many patients have an electrocardiogram (ECG) done in the acute setting. We present a case of unusual findings of electric alternans in the electrocardiogram (ECG) in a patient with a left-sided spontaneous pneumothorax. Reviewing the literature we found five former cases of pneumothoraxes with electric alternans in the ECG, all occurring in relation to left-sided pneumothorax...
2018: European Clinical Respiratory Journal
Lisbet Krogh Traulsen, Anders Halling, Jesper Bælum, Jesper Rømhild Davidsen, Martin Miller, Øyvind Omland, David Sherson, Torben Sigsgaard, Trine Thilsing, Gert Thomsen, Lars Rauff Skadhauge
Objective: The aim of the study was to evaluate determinants for the prognosis of asthma in a population-based cohort of young adults. Design: The study was a nine-year clinical follow up of 239 asthmatic subjects from an enriched population-based sample of 1,191 young adults, aged 20-44 years, who participated in an interviewer-administered questionnaire and clinical examination at baseline in 2003-2006. From the interview, an asthma score was generated as the simple sum of affirmative answers to five main asthma-like symptoms in order to analyse symptoms of asthma as a continuum...
2018: European Clinical Respiratory Journal
Christian Schyllert, Martin Andersson, Linnea Hedman, Magnus Ekström, Helena Backman, Anne Lindberg, Eva Rönmark
Objectives : To evaluate the ability of three different job title classification systems to identify subjects at risk for respiratory symptoms and asthma by also taking the effect of exposure to vapours, gas, dust, and fumes (VGDF) into account. Background : Respiratory symptoms and asthma may be caused by occupational factors. There are different ways to classify occupational exposure. In this study, self-reported occupational exposure to vapours, gas, dust and fumes was used as well as job titles classifed into occupational and socioeconomic Groups according to three different systems...
2018: European Clinical Respiratory Journal
L L Toennesen, E D Soerensen, M Hostrup, C Porsbjerg, J Bangsbo, V Backer
Background: High-intensity interval training is an effective and popular training regime but its feasibility in untrained adults with asthma is insufficiently described. Objective: The randomized controlled trial 'EFFORT Asthma' explored the effects of behavioural interventions including high-intensity interval training on clinical outcomes in nonobese sedentary adults with asthma. In this article we present a sub analysis of data aiming to evaluate if patients' pre-intervention levels of asthma control, FEV1, airway inflammation and airway hyperresponsiveness (AHR) predicted their training response to the high-intensity interval training program, measured as increase in maximal oxygen consumption (VO2 max)...
2018: European Clinical Respiratory Journal
Mika J Mäkelä, Helene Nordahl Christensen, Antti Karlsson, Sarang Rastogi, Kirsi Kettunen
Background : Eosinophilic airway inflammation is common in asthma patients and appears to be associated with severe exacerbations and loss of asthma control. Objective : To describe the resource utilization and clinical characteristics of patients with eosinophilic asthma. Design : Asthma patients ≥18 years with ≥1 blood eosinophil count in secondary care (South West Finland) during 2003‒2013 were included. Clinical characteristics (age, lung function, body mass index, and comorbidities) and asthma-related resource utilization (hospital admissions, outpatient visits, and emergency room [ER] visits) were retrieved...
2018: European Clinical Respiratory Journal
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