BMJ Open Respiratory Research最新文献

{"title":"Role of IPF genetic risk loci in post-COVID-19 lung abnormalities: a cohort study.","authors":"Daniel-Costin Marinescu, Alyson W Wong, Aditi Shah, Cameron J Hague, Darra Murphy, Julia Yang, James Johnston, Janice Leung, Christopher Carlsten, Christopher J Ryerson","doi":"10.1136/bmjresp-2024-002725","DOIUrl":"10.1136/bmjresp-2024-002725","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent lung abnormalities following COVID-19 infection are common. Similar parenchymal changes are observed in idiopathic pulmonary fibrosis (IPF). We investigated whether common genetic risk factors in IPF are associated with developing lung parenchymal abnormalities following severe COVID-19 disease.</p><p><strong>Methods: </strong>Consecutive adults hospitalised for laboratory-confirmed COVID-19 infection were prospectively recruited from March to May 2020. Three single-nucleotide polymorphisms (SNPs) conferring risk for IPF were genotyped (<i>MUC5B</i> rs35705950<i>, ATP11A</i> rs1278769 and <i>DPP9</i> rs12610495). High-resolution CT and pulmonary function tests were performed at 3 months postdischarge from hospital. Ground glass opacities and reticulation on imaging were visually quantified by two expert thoracic radiologists. Linear regression was used to evaluate the association between risk alleles at each of the three SNPs and (a) lung parenchymal abnormalities as well as (b) pulmonary function, adjusted for age, sex, smoking history and days spent on supplemental oxygen during acute illness.</p><p><strong>Results: </strong>71 patients were included. Mean age was 63±16 years, 62% were male, 31% were ever-smokers and median hospital length of stay was 9±11 days, with 23% requiring mechanical ventilation. The <i>MUC5B</i> risk allele was associated with a significant decrease in ground glass (β=-0.8, 95% CI -1.5 to -0.1, p=0.02) at 3 months, and this finding was paralleled by a concurrent but non-significant trend towards increased diffusion capacity for carbon monoxide (DLCO) (β=8.8, 95% CI -1.2 to 18.8, p=0.08) compared with patients without this risk allele. None of the risk alleles were significantly associated with reticulation at 3 months.</p><p><strong>Conclusion: </strong>In an adjusted analysis controlling for severity of infection, <i>MUC5B</i> was associated with reduced ground glass and a trend towards concordant higher DLCO at 3 months after severe COVID-19 illness. This hypothesis-generating result suggests a possible protective effect of <i>MUC5B</i> in postinfectious lung abnormalities as compared with fibrosis in IPF, highlighting a plausible trade-off between its role in immune defence and epithelial cell function.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protease-activated receptor 1 in the pathogenesis of cystic fibrosis.","authors":"Sohinee Sarkar, Jia-Xi Han, Kristy Azzopardi, Poshmaal Dhar, Muhammad A Saeed, Sophie Day, Sarath Ranganathan, Philip Sutton","doi":"10.1136/bmjresp-2024-002960","DOIUrl":"https://doi.org/10.1136/bmjresp-2024-002960","url":null,"abstract":"<p><strong>Background: </strong>The most common cause of death in those with cystic fibrosis (CF) is respiratory failure due to bronchiectasis resulting from repeated cycles of respiratory infection and inflammation. Protease-activated receptor 1 (PAR1) is a cell surface receptor activated by serine proteases including neutrophil elastase, which is recognised as a potent modulator of inflammation. While PAR1 is known to play an important role in regulating inflammation, nothing is known about any potential role of this receptor in CF pathogenesis.</p><p><strong>Methods: </strong>PAR1 (<i>PAR1^-/-</i> ) and intestinal-corrected CFTR (<i>Cftr^-/-</i> ) deficient mice were crossed to generate double knock-out (DKO) mutants lacking both PAR1 and CFTR, as well as matching sibling single mutant and wildtype (WT) littermate controls. Mice were weighed weekly to 15 weeks of age; then, the lungs and intestines were examined.</p><p><strong>Results: </strong><i>Cftr</i>-deficient mice gained body weight at a significantly slower rate than WT controls and presented with no lung inflammation, but had increased weights of their ilea and proximal colons. DKO mice (lacking both CFTR and PAR1) gained body weight at a similar rate to <i>Cftr^-/-</i> mice but only gained weight in their proximal colons. Weight gain in the ilea of <i>Cftr^-/-</i> but not DKO mice was associated with increased ileal levels in the pro-inflammatory cytokine interleukin (IL)-6.</p><p><strong>Conclusions: </strong>This study provides the first evidence of PAR1 contributing to the pathological effects of <i>Cftr</i> deficiency in the intestine and suggests a possible effect of PAR1 on the regulation of IL-6 in CF pathogenesis.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home high-flow therapy during recovery from severe chronic obstructive pulmonary disease (COPD) exacerbation: a mixed-methods feasibility randomised control trial.","authors":"Rebecca F D'Cruz, Anne Rossel, Georgios Kaltsakas, Eui-Sik Suh, Abdel Douiri, Louise Rose, Patrick B Murphy, Nicholas Hart","doi":"10.1136/bmjresp-2024-002698","DOIUrl":"10.1136/bmjresp-2024-002698","url":null,"abstract":"<p><strong>Introduction: </strong>Patients recovering from severe acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have a 30-day readmission rate of 20%. This study evaluated the feasibility of conducting a randomised controlled trial to evaluate clinical, patient-reported and physiological effects of home high-flow therapy (HFT) in addition to usual medical therapy, in eucapnic patients recovering from AECOPD to support the design of a phase 3 trial.</p><p><strong>Methods: </strong>A mixed-methods feasibility randomised controlled trial (quantitative primacy, concurrently embedded qualitative evaluation) (ISRCTN15949009) recruiting consecutive non-obese patients hospitalised with AECOPD not requiring acute non-invasive ventilation. Participants were randomised to receive usual care or usual care and home HFT (37°C, 30 L/min) with weekly home-based follow-up for 4 weeks to collect data on: device usage, breathlessness (modified Borg scale, visual analogue scale, Multidimensional Dyspnoea Profile), health-related quality of life (COPD Assessment Test (CAT), Clinical COPD Questionnaire), pulse oximetry, spirometry and inspiratory capacity, parasternal electromyography and actigraphy. Semistructured interviews were conducted in week 4. Trial progression criteria were: ≥40% of eligible patients randomised, ≤20% attrition, ≥70% complete data, and no device-related serious adverse events (SAE).</p><p><strong>Results: </strong>18 of 45 eligible patients were randomised (age 69±5 years, 44% female, body mass index 23±5 kg/m², forced expiratory volume in 1 second 32±12%). One withdrew following non-respiratory hospitalisation. Complete outcome measures were collected in >90% of home assessments. There were no device-related SAE. Daily HFT usage was 2.7±2.2 hours in week 1, falling to 2.3±1.4 hours by week 4. Temperature and flow settings were modified for comfort in 6 cases. Higher HFT usage was associated with lower symptom burden (CAT p=0.01). Interviews highlighted ease of device use, reduced salbutamol usage, and improved sputum production and clearance.</p><p><strong>Conclusions: </strong>The data from this feasibility study support the progression to a phase 3 randomised clinical trial investigating the effect of home (HFT) on admission-free survival in COPD patients recovering from a severe exacerbation.</p><p><strong>Trial registration number: </strong>The study received ethical approval (REC19/LO/0194) and was prospectively registered (ISRCTN15949009).</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11784159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between chronic respiratory diseases and frailty in Chinese elderly: a population-based longitudinal study.","authors":"Dan Guo, Ke Huang, Xiaolong Guan, Ruoxi Ding, Dawei Zhu, Yanan Zhao, Ting Yang, Ping He","doi":"10.1136/bmjresp-2023-002171","DOIUrl":"10.1136/bmjresp-2023-002171","url":null,"abstract":"<p><strong>Background: </strong>Chronic respiratory diseases (CRDs) have been shown to be associated with frailty, but these findings have not yet reached a consensus. The aim of this study was to investigate the association between CRDs and frailty in the elderly using a nationally representative data from China.</p><p><strong>Methods: </strong>Data from the China Health and Retirement Longitudinal Study (CHARLS) were analysed, including 3309 frailty-free participants followed for three waves from 2011. Frailty was assessed using the physical frailty phenotype scale, and CRDs were conformed by self-reported physician diagnoses. Cox proportional hazard models were used to examine the association between baseline CRDs and subsequent frailty.</p><p><strong>Results: </strong>Among participants (mean age 67.07 years, 51.53% male), 497 (15.02%) had CRDs. During a mean follow-up of 46 months, 273 (8.25%) participants developed frailty. The incidence rate of frailty was significantly higher in the CRDs group (37.17% per 1000 person-years vs 18.41% per 1000 person-years, p<0.01). Adjusted for covariables, participants with CRDs had a 44% higher risk of developing frailty (HR = 1.44, 95% CI: 1.08 to 1.91). Specifically, asthma only (HR=1.89, 95% CI: 1.07 to 3.33) and asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) (HR=1.79, 95% CI: 1.19 to 2.69) were associated with a higher risk of frailty among the elderly, while COPD only was not (HR=1.11, 95% CI: 0.73 to 1.65).</p><p><strong>Conclusion: </strong>This study shows a significant association between CRDs, particularly asthma only and ACO, and frailty in the elderly. We need to pay attention to the frailty status of CRDs patients and consider routine screening among them in both clinical practice and community settings. Active treatment and control of CRDs are necessary to avoid frailty caused by primary lung disease progression or exacerbation.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"12 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis screening among cough suppressant buyers in pharmacies and drug outlets in Guinea: a cross-sectional study.","authors":"Aboubacar Sidiki Magassouba, Almamy Amara Toure, Boubacar Djelo Diallo, Gnoume Camara, Desire Lucien Dahourou, Aly Badara Nabe, Souleymane Camara, Adama Marie Bangoura, Hugues Asken Traore, Jonathon R Campbell, Vanessa Veronese, Corinne Simone Collette Merle","doi":"10.1136/bmjresp-2024-002334","DOIUrl":"10.1136/bmjresp-2024-002334","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) poses a significant public health challenge in Guinea, with an estimated 22 000 TB cases in 2020; an estimated 6125 (28%) cases went undetected. We evaluated an intensified TB case finding strategy in Guinea which targeted customers who bought cough suppressants from pharmacies or drug outlets.</p><p><strong>Methods: </strong>We involved 25 pharmacies and 25 drug outlets in Matoto, Conakry, Guinea. Pharmacists or outlet owners identified and referred all customers with TB symptoms who were purchasing cough suppressants to healthcare workers for sputum collection either at the pharmacy or drug outlet or at a nearby TB diagnosis and treatment centre (CDT); sputum was subjected to bacteriological testing with acid fast bacilli smear or Xpert MTB/RIF. We assessed factors associated with eventual TB diagnosis using logistic regression and time to TB diagnosis using cox regression and used microcosting to estimate the cost of the intervention in 2020 US$.</p><p><strong>Results: </strong>From November 2019 to June 2020, we screened 916 people referred from pharmacies or drug outlets with TB symptoms, with median age of 31 years (54% male). Overall, 126 (14%) had bacteriologically confirmed TB. Odds of TB diagnosis were significantly lower with increasing age (adjusted OR (aOR) per additional year=0.98; 95% CI 0.97 to 0.99) and higher among males (aOR=1.57; 95% CI 1.04 to 2.39) and those with symptoms. Those identified at drug outlets had significantly faster time to presentation from symptom onset than pharmacies (adjusted HR=1.73; 95% CI 1.50 to 1.99). The total cost of the intervention per person referred was US$32.66 and per person diagnosed and treated for TB disease of US$237.45.</p><p><strong>Conclusion: </strong>Intensified TB case finding through pharmacies and drug outlets is a feasible and effective way to increase TB detection in settings where self-medicating is common, and TB is under-detected.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How do patients determine when their inhaler is empty? Insights from an analysis of returned inhalers and a patient survey.","authors":"Anna C Murphy, Will Carroll, Marissa Gotsell, Charles Potter, Jennifer K Quint, Rachel Malone","doi":"10.1136/bmjresp-2024-002579","DOIUrl":"10.1136/bmjresp-2024-002579","url":null,"abstract":"<p><strong>Background: </strong>Inhalers are widely used for the management of asthma and chronic obstructive pulmonary disease. However, there is little knowledge about the extent to which an inhaler is used and when it is disposed of, despite the implications for an individual's health (when used beyond the recommended number of doses (overused)), and medicine wastage, healthcare costs and the environment (when discarded with remaining doses (underused)). To explore inhaler use, we assessed the number of doses remaining in pressurised metered-dose inhalers (pMDIs) returned via a Chiesi Inhaler Recycling scheme.</p><p><strong>Methods: </strong>pMDIs were dismantled, and components recycled where possible. Each canister was weighed and the mass of the formulation remaining was calculated. pMDIs were categorised based on number of doses remaining (underused, used, empty (indicating correct use) and overused) and by dose counter presence/absence. A separate online survey was used to obtain patient feedback on inhaler use and disposal behaviours.</p><p><strong>Results: </strong>Overall, 2614 pMDIs were analysed (55.9% maintenance, 44.1% reliever inhalers); 1015 (38.8%) had an integrated dose counter. The proportion of pMDIs returned empty was greater for inhalers with dose counters than for those without (51.3% vs 25.1%; p<0.0001); the proportion of pMDIs returned underused was lower for inhalers with dose counters than for those without (5.2% vs 33.2%; p<0.0001). The proportion of pMDIs returned overused was substantial and similar for devices with and without dose counters (34.0% vs 23.2%; p>0.01). Most respondents (55.2%) using devices without a dose counter reported that they were not confident in identifying when their inhaler was empty. Furthermore, many respondents (20.6%) who used inhalers with a dose counter reported continued use beyond 'zero'.</p><p><strong>Conclusions: </strong>Our study suggests that many inhalers are returned underused or overused, with inadequate knowledge among patients about the number of therapeutic doses remaining in the device and appropriate inhaler disposal. These have concerning implications for patient health and the environment and highlight a need for high-quality education for patients and healthcare professionals.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID among the first three waves of COVID-19 in Japan: a multicentre cohort study.","authors":"Hatsuyo Takaoka, Ichiro Kawada, Gaku Hiruma, Kengo Nagashima, Hideki Terai, Noriyuki Ishida, Ho Namkoong, Takanori Asakura, Katsunori Masaki, Jun Miyata, Shotaro Chubachi, Keiko Ohgino, Kengo Otsuka, Naoki Miyao, Toshio Odani, Mayuko Watase, Rie Baba, Satoshi Okamori, Daisuke Arai, Ichiro Nakachi, Naota Kuwahara, Akiko Fujiwara, Takenori Okada, Takashi Ishiguro, Taisuke Isono, Makoto Ishii, Yasunori Sato, Koichi Fukunaga","doi":"10.1136/bmjresp-2023-002137","DOIUrl":"10.1136/bmjresp-2023-002137","url":null,"abstract":"<p><strong>Objectives: </strong>Severe acute respiratory syndrome coronavirus 2 significantly impacts Japan with a high number of infections and deaths reported. Long coronavirus disease (COVID) characterised by persistent symptoms after COVID-19 has gained recognition but varies across studies. This study aimed to investigate the differences in long COVID among patients hospitalised during Japan's first three waves of the pandemic.</p><p><strong>Design: </strong>Multicentre prospective cohort study.</p><p><strong>Setting: </strong>26 medical facilities across Japan between February 2020 and February 2021.</p><p><strong>Participants: </strong>In total, 1066 hospitalised patients diagnosed with COVID-19 were included with 206, 301 and 559 patients in the first, second and third waves, respectively. Data were collected using electronic data capture and patient-reported outcome forms.</p><p><strong>Primary and secondary outcome measures: </strong>Long COVID was assessed at 3, 6 and 12 months after COVID-19 diagnosis.</p><p><strong>Results: </strong>Significant differences were observed between the waves in various baseline and clinical characteristics such as age, body mass index (BMI), comorbidities, the severity of COVID-19, complications and treatment during hospitalisation. Long COVID, particularly dyspnoea, was most prevalent in the first wave. Multivariate logistic regression analysis confirmed a significant positive association between the first wave and long COVID including dyspnoea after adjusting for age, sex, BMI, smoking status and COVID-19 severity.</p><p><strong>Conclusions: </strong>Patients hospitalised during the first wave had a higher risk of experiencing long COVID, especially dyspnoea, than those hospitalised during the other waves. These findings underscore the need for continued monitoring and managing long COVID in COVID-19 survivors, particularly in those hospitalised during the first wave.</p><p><strong>Trial registration number: </strong>UMIN000042299.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"6-month regimen of isoniazid prevention therapy for tuberculosis among people living with human immunodeficiency virus in minority areas of China: a 3-year prospective cohort study.","authors":"Jing Li, Jinge He, Ting Li, Yunkui Li, Wenfeng Gao, Yin Zhong, Ni Yang, Chuang Chen, Lan Xia, Wen Yang","doi":"10.1136/bmjresp-2024-002801","DOIUrl":"10.1136/bmjresp-2024-002801","url":null,"abstract":"<p><strong>Introduction: </strong>As China is scaling up tuberculosis preventive therapy (TPT) for people living with HIV (PLHIV) in its national programmes, the objective of this study was to evaluate the feasibility and performance of 6-month regimen of isoniazid monotherapy (6H) in terms of preventive therapy acceptance, adherence, effectiveness and outcomes in minority areas with a high burden of tuberculosis (TB) and HIV/AIDS.</p><p><strong>Method: </strong>A prospective observational cohort study was initiated among 461 PLHIV in Butuo County after ruling out active TB (ATB) and followed up for up to 3 years to collect incidence events in real-world settings. TB incidence and protective rates were calculated. The risk factors related to acceptance and adherence were identified using a logistic regression model.</p><p><strong>Results: </strong>Of the 688 PLHIV screened for TB, 115 (16.72 %) had ATB. Among the 461 participants eligible for 6H, 392 (85.03%) initiated 6H, and 277 (70.67%) completed the therapy. In total, 15 were identified as having ATB during follow-up. The incidence of ATB in the complete group was 0.62/100 person years (95% CI 0.20 to 1.45) as compared with the incomplete group 2.96/100 person years (95% CI 1.36 to 5.63) (p=0.005), and the protective rate of 6H was 79.05%. The protection rate between the complete and incomplete and refusal groups was 69.31%. In total, 142 (36.22%) patients experienced adverse drug reactions during isoniazid preventive therapy. The logistic regression model revealed several factors associated with 6H acceptance: first CD4⁺ T lymphocyte count was between 200 and 350 cells/mm³ (adjusted OR (aOR)=0.30, 95% CI 0.10 to 0.92) or>500 cells/mm³ (aOR=0.25, 95% CI 0.08 to 0.77). Factors associated with 6H adherence: 36-45 years old (aOR=2.76, 95% CI 1.49 to 5.10), middle school education (aOR=0.26, 95% CI 0.08 to 0.79) and history of prior TB (aOR=0.09, 95% CI 0.05 to 0.20).</p><p><strong>Conclusion: </strong>6H can reduce the incidence of ATB in minority areas with high burdens of TB and HIV/AIDS. Periodic counselling of patients on adherence and retraining of the TPT staff are essential. Health monitoring and education for specific populations improve TPT acceptance and adherence.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the population to be targeted in a lung cancer screening programme in Denmark.","authors":"María Del Pilar Fernández Montejo, Zaigham Saghir, Uffe Bødtger, Randi Jepsen, Elsebeth Lynge, Søren Lophaven","doi":"10.1136/bmjresp-2024-002499","DOIUrl":"10.1136/bmjresp-2024-002499","url":null,"abstract":"<p><strong>Introduction: </strong>We assessed the impact of recruitment criteria on lung cancer detection in a future Danish screening programme with low-dose CT.</p><p><strong>Methods: </strong>We combined data from two Danish population-based health examination surveys with eligibility criteria from seven randomised controlled trials on lung cancer screening. Incident lung cancers were identified by linkage with the National Pathology Data Bank (Patobank). For an average of 4.4 years of follow-up, we calculated sensitivity, specificity, efficient frontier and number needed to screen (NNS) for lung cancer detection.</p><p><strong>Results: </strong>When applying the different eligibility criteria to the 48 171 persons invited to the two surveys, the number of lung cancer cases identified in the target groups varied from 46 to 68. The National Lung Screening Trial (NLST) criteria had the highest sensitivity of 62.6% (95% CI 52.7 to 71.8) and the Dutch-Belgian NEderlands-Leuvens Screening ONderzoek (NELSON) criteria had the highest specificity 81.6% (95% CI 81.0 to 82.1). Sensitivity was higher for men than for women (NLST criteria 71.7% (95% CI 57.7 to 83.2) and 53.7% (95% CI 39.6 to 67.4), respectively). The NLST criteria identified the target population obtaining the lowest NNS with 46.3. The application of the NLST criteria showed that the higher the sensitivity, the lower the number of false-negative cases and, thus, the lower the NNS.</p><p><strong>Conclusions: </strong>This study highlights the impact of the definition of the at-risk population on lung cancer screening efficacy. We found lower sensitivity among women regardless of screening criteria used. This should be carefully addressed in a possible screening programme.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11752008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enlarged airspaces in the distal lung in adolescents born very preterm as measured by aerosol.","authors":"Hugo Öhrneman, Frida Lindström, Cecilia Hagman, Madeleine Petersson Sjögren, Jenny Rissler, Per Wollmer, Ellen Tufvesson, Jakob Löndahl","doi":"10.1136/bmjresp-2024-002666","DOIUrl":"10.1136/bmjresp-2024-002666","url":null,"abstract":"<p><strong>Rationale: </strong>Preterm infants diagnosed with bronchopulmonary dysplasia (BPD) are thought to have fewer and larger alveoli than their term peers, but it is unclear to what degree this persists later in life.</p><p><strong>Objectives: </strong>To investigate to what degree the distal airspaces are enlarged in adolescents born preterm and to evaluate the new Airspace Dimension Assessment (AiDA) method in investigating this group.</p><p><strong>Methods: </strong>We investigated 41 adolescents between 15 and 17 years of age, of whom 25 were born very preterm (a gestational age <31 weeks, with a mean of 26 weeks) and 16 were term-born controls. Of the preterms, 17 were diagnosed with BPD. The AiDA method was used to measure the average distal airspace radius (r_AiDA) in the lungs. In addition, lung function was evaluated by spirometry, impulse oscillometry and diffusing capacity of carbon monoxide (D_LCO).</p><p><strong>Measurements and main results: </strong>We observed a mean r_AiDA of 295±53 µm for the preterm group compared with 231±12 µm for the control group (p<0.0001). The adolescents diagnosed with BPD had a mean r_AiDA of 313±54 µm. There was a strong negative correlation between gestational age and distal airspace radius (p<0.0001). The BPD group had a decreased FEV₁ (forced expiratory volume in 1 s, z-score: -1.28±1.37, p=0.012) and D_LCO (z-score: -0.92±1.01, p=0.013) compared with the controls, but all other lung function variables showed normal values.</p><p><strong>Conclusions: </strong>Our results suggest that the enlarged airspaces seen in preterm infants likely remain in adolescence. Distal airspace radius as measured by AiDA was the lung function variable that showed the most significant difference between preterm and term-born adolescents.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142963818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}