The European respiratory journal. Supplement最新文献_第6页

Correlates of tuberculosis risk: predictive biomarkers for progression to active tuberculosis 结核病风险相关因素:进展为活动性结核病的预测性生物标志物

The European respiratory journal. Supplement Pub Date : 2016-11-11 DOI: 10.1183/13993003.01012-2016

E. Petruccioli, T. Scriba, L. Petrone, M. Hatherill, D. Cirillo, S. Joosten, T. Ottenhoff, C. Denkinger, D. Goletti

{"title":"Correlates of tuberculosis risk: predictive biomarkers for progression to active tuberculosis","authors":"E. Petruccioli, T. Scriba, L. Petrone, M. Hatherill, D. Cirillo, S. Joosten, T. Ottenhoff, C. Denkinger, D. Goletti","doi":"10.1183/13993003.01012-2016","DOIUrl":"https://doi.org/10.1183/13993003.01012-2016","url":null,"abstract":"New approaches to control the spread of tuberculosis (TB) are needed, including tools to predict development of active TB from latent TB infection (LTBI). Recent studies have described potential correlates of risk, in order to inform the development of prognostic tests for TB disease progression. These efforts have included unbiased approaches employing “omics” technologies, as well as more directed, hypothesis-driven approaches assessing a small set or even individual selected markers as candidate correlates of TB risk. Unbiased high-throughput screening of blood RNAseq profiles identified signatures of active TB risk in individuals with LTBI, ≥1 year before diagnosis. A recent infant vaccination study identified enhanced expression of T-cell activation markers as a correlate of risk prior to developing TB; conversely, high levels of Ag85A antibodies and high frequencies of interferon (IFN)-γ specific T-cells were associated with reduced risk of disease. Others have described CD27−IFN-γ+CD4+ T-cells as possibly predictive markers of TB disease. T-cell responses to TB latency antigens, including heparin-binding haemagglutinin and DosR-regulon-encoded antigens have also been correlated with protection. Further studies are needed to determine whether correlates of risk can be used to prevent active TB through targeted prophylactic treatment, or to allow targeted enrolment into efficacy trials of new TB vaccines and therapeutic drugs. Promising biomarkers may allow accurate prediction of progression from infection to active TB disease http://ow.ly/OzCL304ezfk","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"66 1","pages":"1751 - 1763"},"PeriodicalIF":0.0,"publicationDate":"2016-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81360183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 165

Tuberculosis prevention must integrate technological and basic care innovation 结核病预防必须结合技术创新和基本护理创新

The European respiratory journal. Supplement Pub Date : 2016-11-01 DOI: 10.1183/13993003.01449-2016

P. Mason, T. Oni, Maarten M J W van Herpen, A. Coussens

引用次数: 5

Urokinase plasminogen activator receptor polymorphisms and airway remodelling in asthma. 尿激酶纤溶酶原激活物受体多态性与哮喘气道重塑。

The European respiratory journal. Supplement Pub Date : 2016-05-01 Epub Date: 2016-02-11 DOI: 10.1183/13993003.01571-2015

Despo Ierodiakonou, Michael A Portelli, Dirkje S Postma, Gerard H Koppelman, Jorrit Gerritsen, Nick H T Ten Hacken, Wim Timens, H Marike Boezen, Judith M Vonk, Ian Sayers

引用次数: 0

First experience of effectiveness and safety of bedaquiline for 18 months within an optimised regimen for XDR-TB 在针对广泛耐药结核病的优化方案中首次体验贝达喹啉18个月的有效性和安全性

The European respiratory journal. Supplement Pub Date : 2016-02-25 DOI: 10.1183/13993003.01980-2015

J. Lewis, J. Lewis, P. Hine, Jennyer Walker, S. Khoo, M. Taegtmeyer, S. Squire, D. Sloan

引用次数: 31

PICADAR: a diagnostic predictive tool for primary ciliary dyskinesia PICADAR:原发性纤毛运动障碍的诊断预测工具

The European respiratory journal. Supplement Pub Date : 2016-02-25 DOI: 10.1183/13993003.01551-2015

L. Behan, B. Dimitrov, C. Kuehni, C. Hogg, M. Carroll, H. Evans, M. Goutaki, A. Harris, S. Packham, W. Walker, J. Lucas

{"title":"PICADAR: a diagnostic predictive tool for primary ciliary dyskinesia","authors":"L. Behan, B. Dimitrov, C. Kuehni, C. Hogg, M. Carroll, H. Evans, M. Goutaki, A. Harris, S. Packham, W. Walker, J. Lucas","doi":"10.1183/13993003.01551-2015","DOIUrl":"https://doi.org/10.1183/13993003.01551-2015","url":null,"abstract":"Symptoms of primary ciliary dyskinesia (PCD) are nonspecific and guidance on whom to refer for testing is limited. Diagnostic tests for PCD are highly specialised, requiring expensive equipment and experienced PCD scientists. This study aims to develop a practical clinical diagnostic tool to identify patients requiring testing. Patients consecutively referred for testing were studied. Information readily obtained from patient history was correlated with diagnostic outcome. Using logistic regression, the predictive performance of the best model was tested by receiver operating characteristic curve analyses. The model was simplified into a practical tool (PICADAR) and externally validated in a second diagnostic centre. Of 641 referrals with a definitive diagnostic outcome, 75 (12%) were positive. PICADAR applies to patients with persistent wet cough and has seven predictive parameters: full-term gestation, neonatal chest symptoms, neonatal intensive care admittance, chronic rhinitis, ear symptoms, situs inversus and congenital cardiac defect. Sensitivity and specificity of the tool were 0.90 and 0.75 for a cut-off score of 5 points. Area under the curve for the internally and externally validated tool was 0.91 and 0.87, respectively. PICADAR represents a simple diagnostic clinical prediction rule with good accuracy and validity, ready for testing in respiratory centres referring to PCD centres. PICADAR is a simple diagnostic prediction tool for PCD with good accuracy and validity that is now ready for testing http://ow.ly/X6y9s","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"18 1","pages":"1103 - 1112"},"PeriodicalIF":0.0,"publicationDate":"2016-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78821677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 170

Fractional exhaled nitric oxide for the management of asthma in adults: a systematic review 分式呼出一氧化氮治疗成人哮喘:系统综述

The European respiratory journal. Supplement Pub Date : 2016-02-04 DOI: 10.1183/13993003.01882-2015

M. Essat, S. Harnan, T. Gomersall, P. Tappenden, Ruth Wong, I. Pavord, R. Lawson, M. Everard

{"title":"Fractional exhaled nitric oxide for the management of asthma in adults: a systematic review","authors":"M. Essat, S. Harnan, T. Gomersall, P. Tappenden, Ruth Wong, I. Pavord, R. Lawson, M. Everard","doi":"10.1183/13993003.01882-2015","DOIUrl":"https://doi.org/10.1183/13993003.01882-2015","url":null,"abstract":"The aim of this review was to evaluate the clinical effectiveness of fractional exhaled nitric oxide (FeNO) measured in a clinical setting for the management of asthma in adults. 13 electronic databases were searched and studies were selected against predefined inclusion criteria. Quality assessment was conducted using QUADAS-2. Class effect meta-analyses were performed. Six studies were included. Despite high levels of heterogeneity in multiple study characteristics, exploratory class effect meta-analyses were conducted. Four studies reported a wider definition of exacerbation rates (major or severe exacerbation) with a pooled rate ratio of 0.80 (95% CI 0.63–1.02). Two studies reported rates of severe exacerbations (requiring oral corticosteroid use) with a pooled rate ratio of 0.89 (95% CI 0.43–1.72). Inhaled corticosteroid use was reported by four studies, with a pooled standardised mean difference of −0.24 (95% CI −0.56–0.07). No statistically significant differences for health-related quality of life or asthma control were found. FeNO guided management showed no statistically significant benefit in terms of severe exacerbations or inhaled corticosteroid use, but showed a statistically significant reduction in exacerbations of any severity. However, further research is warranted to clearly define which management protocols (including cut-off points) offer best efficacy and which patient groups would benefit the most. FeNO testing for adult asthma management may confer clinical benefit, but research is needed to establish its role http://ow.ly/WGWkx","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"25 1","pages":"751 - 768"},"PeriodicalIF":0.0,"publicationDate":"2016-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89506464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 71

Effects of PCV7 and PCV13 on invasive pneumococcal disease and carriage in Stockholm, Sweden 在瑞典斯德哥尔摩，PCV7和PCV13对侵袭性肺炎球菌疾病和携带的影响

The European respiratory journal. Supplement Pub Date : 2016-01-21 DOI: 10.1183/13993003.01451-2015

I. Galanis, A. Lindstrand, J. Darenberg, Sarah Browall, Priyanka Nannapaneni, Karin Sjöström, E. Morfeldt, P. Nauclér, M. Blennow, Å. Örtqvist, B. Henriques-Normark

{"title":"Effects of PCV7 and PCV13 on invasive pneumococcal disease and carriage in Stockholm, Sweden","authors":"I. Galanis, A. Lindstrand, J. Darenberg, Sarah Browall, Priyanka Nannapaneni, Karin Sjöström, E. Morfeldt, P. Nauclér, M. Blennow, Å. Örtqvist, B. Henriques-Normark","doi":"10.1183/13993003.01451-2015","DOIUrl":"https://doi.org/10.1183/13993003.01451-2015","url":null,"abstract":"The effects of pneumococcal conjugated vaccines (PCVs) need to be investigated. In Stockholm County, Sweden, PCV7 was introduced in the childhood immunisation programme in 2007 and changed to PCV13 in 2010. Over 90% of all invasive isolates during 2005–2014 (n=2336) and carriage isolates, 260 before and 647 after vaccine introduction, were characterised by serotyping, molecular typing and antibiotic susceptibility, and serotype diversity was calculated. Clinical information was collected for children and adults with invasive pneumococcal disease (IPD). The IPD incidence decreased post-PCV7, but not post-PCV13, in vaccinated children. Beneficial herd effects were seen in older children and adults, but not in the elderly. The herd protection was more pronounced post-PCV7 than post-PCV13. PCV7 serotypes decreased. IPD caused by PCV13 serotypes 3 and 19A increased post-PCV7. Post-PCV13, serotypes 6A and 19A, but not serotype 3, decreased. The serotype distribution changed in carriage and IPD to nonvaccine types, also in nonvaccinated populations. Expansion of non-PCV13 serotypes was largest following PCV13 introduction. Serotype diversity increased and nonvaccine clones emerged, such as CC433 (serotype 22F) in IPD and CC62 (serotype 11A) in carriage. In young children, meningitis, septicaemia and severe rhinosinusitis, but not bacteraemic pneumonia, decreased. Pneumococcal vaccination leads to expansion of new or minor serotypes/clones, also in nonvaccinated populations. New or minor serotypes/clones expanded, also in nonvaccinated populations, affecting future vaccine strategies http://ow.ly/VA9EO","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"15 1","pages":"1208 - 1218"},"PeriodicalIF":0.0,"publicationDate":"2016-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79874765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 132

A review of national guidelines for management of COPD in Europe 欧洲国家COPD管理指南综述

The European respiratory journal. Supplement Pub Date : 2016-01-21 DOI: 10.1183/13993003.01170-2015

M. Miravitlles, C. Vogelmeier, N. Roche, D. Halpin, J. Cardoso, A. Chuchalin, H. Kankaanranta, T. Sandström, P. Śliwiński, J. Zatloukal, F. Blasi

{"title":"A review of national guidelines for management of COPD in Europe","authors":"M. Miravitlles, C. Vogelmeier, N. Roche, D. Halpin, J. Cardoso, A. Chuchalin, H. Kankaanranta, T. Sandström, P. Śliwiński, J. Zatloukal, F. Blasi","doi":"10.1183/13993003.01170-2015","DOIUrl":"https://doi.org/10.1183/13993003.01170-2015","url":null,"abstract":"The quality of care can be improved by the development and implementation of evidence-based treatment guidelines. Different national guidelines for chronic obstructive pulmonary disease (COPD) exist in Europe and relevant differences may exist among them. This was an evaluation of COPD treatment guidelines published in Europe and Russia in the past 7 years. Each guideline was reviewed in detail and information about the most important aspects of patient diagnosis, risk stratification and pharmacotherapy was extracted following a standardised process. Guidelines were available from the Czech Republic, England and Wales, Finland, France, Germany, Italy, Poland, Portugal, Russia, Spain and Sweden. The treatment goals, criteria for COPD diagnosis, consideration of comorbidities in treatment selection and support for use of long-acting bronchodilators, were similar across treatment guidelines. There were differences in measures used for stratification of disease severity, consideration of patient phenotypes, criteria for the use of inhaled corticosteroids and recommendations for other medications (e.g. theophylline and mucolytics) in addition to bronchodilators. There is generally good agreement on treatment goals, criteria for diagnosis of COPD and use of long-acting bronchodilators as the cornerstone of treatment among guidelines for COPD management in Europe and Russia. However, there are differences in the definitions of patient subgroups and other recommended treatments. There are important differences between European national COPD guidelines http://ow.ly/U2P4y","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"4 1","pages":"625 - 637"},"PeriodicalIF":0.0,"publicationDate":"2016-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76970338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 157

Pirfenidone for idiopathic pulmonary fibrosis: analysis of pooled data from three multinational phase 3 trials 吡非尼酮治疗特发性肺纤维化:来自三个多国iii期试验的汇总数据分析

The European respiratory journal. Supplement Pub Date : 2016-01-01 DOI: 10.1183/13993003.00026-2015

P. Noble, C. Albera, W. Bradford, U. Costabel, R. D. du Bois, E. Fagan, R. Fishman, I. Glaspole, M. Glassberg, L. Lancaster, D. Lederer, J. Leff, S. Nathan, C. Pereira, J. Swigris, D. Valeyre, T. King

{"title":"Pirfenidone for idiopathic pulmonary fibrosis: analysis of pooled data from three multinational phase 3 trials","authors":"P. Noble, C. Albera, W. Bradford, U. Costabel, R. D. du Bois, E. Fagan, R. Fishman, I. Glaspole, M. Glassberg, L. Lancaster, D. Lederer, J. Leff, S. Nathan, C. Pereira, J. Swigris, D. Valeyre, T. King","doi":"10.1183/13993003.00026-2015","DOIUrl":"https://doi.org/10.1183/13993003.00026-2015","url":null,"abstract":"Pirfenidone is an antifibrotic agent that has been evaluated in three multinational phase 3 trials in patients with idiopathic pulmonary fibrosis (IPF). We analysed pooled data from the multinational trials to obtain the most precise estimates of the magnitude of treatment effect on measures of disease progression. All patients randomised to pirfenidone 2403 mg·day−1 or placebo in the CAPACITY or ASCEND studies were included in the analysis. Pooled analyses of outcomes at 1 year were based on the pre-specified end-points and analytic methods described in the ASCEND study protocol. A total of 1247 patients were included in the analysis. At 1 year, pirfenidone reduced the proportion of patients with a ≥10% decline in per cent predicted forced vital capacity or death by 43.8% (95% CI 29.3–55.4%) and increased the proportion of patients with no decline by 59.3% (95% CI 29.0–96.8%). A treatment benefit was also observed for progression-free survival, 6-min walk distance and dyspnoea. Gastrointestinal and skin-related adverse events were more common in the pirfenidone group, but rarely led to discontinuation. Analysis of data from three phase 3 trials demonstrated that treatment with pirfenidone for 1 year resulted in clinically meaningful reductions in disease progression in patients with IPF. Treatment with pirfenidone for 1 year results in clinically meaningful reductions in IPF disease progression http://ow.ly/StvBk","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"30 1","pages":"243 - 253"},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80910533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 352

Accuracy of diagnostic testing in primary ciliary dyskinesia 原发性纤毛运动障碍诊断检测的准确性

The European respiratory journal. Supplement Pub Date : 2015-12-03 DOI: 10.1183/13993003.00749-2015

C. Jackson, L. Behan, Samuel A. Collins, P. Goggin, E. Adam, J. Coles, H. Evans, A. Harris, P. Lackie, S. Packham, A. Page, James Thompson, W. Walker, C. Kuehni, J. Lucas

{"title":"Accuracy of diagnostic testing in primary ciliary dyskinesia","authors":"C. Jackson, L. Behan, Samuel A. Collins, P. Goggin, E. Adam, J. Coles, H. Evans, A. Harris, P. Lackie, S. Packham, A. Page, James Thompson, W. Walker, C. Kuehni, J. Lucas","doi":"10.1183/13993003.00749-2015","DOIUrl":"https://doi.org/10.1183/13993003.00749-2015","url":null,"abstract":"Diagnosis of primary ciliary dyskinesia (PCD) lacks a “gold standard” test and is therefore based on combinations of tests including nasal nitric oxide (nNO), high-speed video microscopy analysis (HSVMA), genotyping and transmission electron microscopy (TEM). There are few published data on the accuracy of this approach. Using prospectively collected data from 654 consecutive patients referred for PCD diagnostics we calculated sensitivity and specificity for individual and combination testing strategies. Not all patients underwent all tests. HSVMA had excellent sensitivity and specificity (100% and 93%, respectively). TEM was 100% specific, but 21% of PCD patients had normal ultrastructure. nNO (30 nL·min−1 cut-off) had good sensitivity and specificity (91% and 96%, respectively). Simultaneous testing using HSVMA and TEM was 100% sensitive and 92% specific. In conclusion, combination testing was found to be a highly accurate approach for diagnosing PCD. HSVMA alone has excellent accuracy, but requires significant expertise, and repeated sampling or cell culture is often needed. TEM alone is specific but misses 21% of cases. nNO (≤30 nL·min−1) contributes well to the diagnostic process. In isolation nNO screening at this cut-off would miss ∼10% of cases, but in combination with HSVMA could reduce unnecessary further testing. Standardisation of testing between centres is a future priority. Combination testing in PCD diagnosis remains the most accurate approach, but standardisation is needed http://ow.ly/TLEDu","PeriodicalId":77419,"journal":{"name":"The European respiratory journal. Supplement","volume":"15 1","pages":"837 - 848"},"PeriodicalIF":0.0,"publicationDate":"2015-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89253795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 83