BMJ Open Respiratory Research最新文献

{"title":"Lung function may recover after coal mine fire smoke exposure: a longitudinal cohort study.","authors":"Nicolette R Holt, Catherine L Smith, Caroline X Gao, Brigitte Borg, Tyler Lane, David Brown, Jillian Ikin, Annie Makar, Thomas McCrabb, Mikayla Thomas, Kris Nilsen, Bruce R Thompson, Michael J Abramson","doi":"10.1136/bmjresp-2024-002539","DOIUrl":"10.1136/bmjresp-2024-002539","url":null,"abstract":"<p><strong>Background and objective: </strong>The 2014 Hazelwood coal mine fire exposed residents in nearby Morwell to high concentrations of particulate matter <2.5 µm (PM_2.5) for approximately 6 weeks. This analysis aimed to evaluate the long-term impact on respiratory health.</p><p><strong>Methods: </strong>Adults from Morwell and the unexposed town of Sale completed validated respiratory questionnaires and performed spirometry, gas transfer and oscillometry 3.5-4 years (round 1) and 7.3-7.8 years (round 2) after the fire. Individual PM_2.5 exposure levels were estimated using chemical transport models mapped onto participant-reported time-location data. Mixed-effects regression models were fitted to analyse associations between PM_2.5 exposure and outcomes, controlling for key confounders.</p><p><strong>Results: </strong>From 519 (346 exposed) round 1 participants, 329 (217 exposed) participated in round 2. Spirometry and gas transfer in round 2 were mostly lower compared with round 1, excepting forced vital capacity (FVC) (increased) and forced expiratory volume in 1 second (minimal change). The effect of mine fire-related PM_2.5 exposure changed from a negative effect in round 1 to no effect in round 2 for both pre-bronchodilator (p=0.005) and post-bronchodilator FVC (p=0.032). PM_2.5 was not associated with gas transfer in either round. For post-bronchodilator reactance and area under the curve, a negative impact of PM_2.5 in round 1 showed signs of recovery in round 2 (both p<0.001).</p><p><strong>Conclusion: </strong>In this novel study evaluating long-term respiratory outcomes after medium-duration high concentration PM_2.5 exposure, the attenuated associations between exposure and respiratory function may indicate some recovery in lung function. With increased frequency and severity of landscape fires observed globally, these results inform public health policies and planning.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852630","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":"Use of metered dose inhalers for bronchodilator responsiveness testing: laboratory practices in Australia and opportunities for carbon footprint reduction.","authors":"Michael J Loftus, Jayne Roberts, Nicholas Romeo, Pam Matsas, Karin Leder, Brigitte Borg, Belinda R Miller","doi":"10.1136/bmjresp-2024-002478","DOIUrl":"10.1136/bmjresp-2024-002478","url":null,"abstract":"<p><strong>Background: </strong>Metered dose inhalers (MDIs) are important devices for delivering inhaled medications; however, they have an outsized carbon footprint due to their propellant gas. Many short-acting beta-agonist inhalers contain HFA-134a which has a global warming potential >1000 fold higher than carbon dioxide. We aimed to determine the practices around MDI use and disposal within Australia's major lung function testing laboratories and identify the actions that most influence the carbon footprint of bronchodilator responsiveness (BDR) testing.</p><p><strong>Methods: </strong>Australia's 45 accredited lung function laboratories were invited to participate in an online survey asking about their volume of BDR testing, as well as practices around MDI use such as the number of actuations per BDR test, reuse of MDIs between patients and disposal method. We calculated MDI-associated carbon dioxide equivalent (CO2e) emissions by combining previously published estimates.</p><p><strong>Results: </strong>39 laboratories completed the survey. Most laboratories used 4 actuations of salbutamol per BDR test for both adults (27/34, 79.4%) and children (17/20, 85%), but this ranged from 2 to 12. Only three (7.7%) laboratories did not routinely reuse MDIs between patients; however, they all sent their used MDIs for high-temperature incineration. Based on different combinations of observed MDI practices in Australia, we identified a potential sixfold difference in CO2e per 100 BDR tests, from as low as 23.3 kg CO2e up to 166 kg CO2e.</p><p><strong>Conclusions: </strong>We identified three key practices to reduce the carbon footprint of BDR testing: disposing of MDIs via high-temperature incineration, reducing the number of actuations per BDR test and reusing MDIs between patients.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852657","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":"Clinical outcomes and severity of laboratory-confirmed RSV compared with influenza, parainfluenza and human metapneumovirus in Australian children attending secondary care.","authors":"Mohinder Sarna, Huong Le, Belaynew Wasie Taye, Kathryn Glass, Avram Levy, Peter Richmond, Hannah C Moore","doi":"10.1136/bmjresp-2024-002613","DOIUrl":"10.1136/bmjresp-2024-002613","url":null,"abstract":"<p><strong>Introduction: </strong>Acute lower respiratory infections (ALRIs) are a major contributor to the global infectious disease burden and a common cause of hospitalisation for children under 2 years. We compared clinical severity in children hospitalised with respiratory syncytial virus (RSV), parainfluenza virus (PIV), human metapneumovirus (hMPV) and influenza virus (IFV).</p><p><strong>Methods: </strong>We used a probabilistically linked population cohort born in Western Australia between 2010 and 2020 and hospitalised before the age of 2 years. Outcomes compared included length of hospital stay (LOS), admission to intensive care unit (ICU), need for respiratory support (RS), complex hospital course (RS, death, ICU admission or LOS >75th percentile), 7-day and 30-day mortality, hospital-in-the-home care, 30-day all-cause and ALRI-specific readmissions and emergency department presentations 14 days prior to hospitalisation. Logistic regression was used for binary outcomes, and negative binomial regression was used for discrete count variables. Incidence rates, time to RS and time to readmissions were calculated using survival analysis techniques.</p><p><strong>Results: </strong>The final cohort included 210 997 hospitalised children under 24 months of age for a total of 315 769 admissions. Infants hospitalised before 6 months had the highest rates for all virus-specific hospitalisations, particularly RSV hospitalisations (50.4 per 1000 child-years (95% CI 48.7 to 52.1)). Infants <6 months had higher odds of an ICU admission (adjusted OR (aOR) 2.39, 95% CI 1.36 to 4.19) and RS (aOR 4.68, 95% CI 2.95 to 7.44) and a complex hospital course (aOR 2.69, 95% CI 2.13 to 3.42) with RSV and four times higher hazards of requiring RS earlier (adjusted HR (aHR) 4.06, 95% CI 2.59 to 6.36). An ALRI-coded 30-day readmission was recorded in 10%-24% of virus-specific hospitalisations.</p><p><strong>Discussion: </strong>Young infants have a more severe and complex hospital course with RSV hospitalisation compared with hospitalisation with other respiratory viruses and should be prioritised for prevention measures such as the single-dose monoclonal antibody, nirsevimab.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852626","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":"What is the true target population for biologics in real-life COPD or asthma-COPD overlap patients?","authors":"Maéva Zysman, Fanchon Herman, Léo Grassion, Camille Taillé, Jesus Gonzalez-Bermejo, Marina Guecamburu, Nicolas Roche, Arthur Pavot, Pierre-Olivier Girodet, Arnaud Bourdin, Nicolas Molinari, Patrick Berger","doi":"10.1136/bmjresp-2024-002702","DOIUrl":"10.1136/bmjresp-2024-002702","url":null,"abstract":"<p><strong>Introduction: </strong>Biologics provide significant benefits in asthma, reducing exacerbations and symptoms. Some biologics have shown promising results in small subgroups of patients with chronic obstructive pulmonary disease (COPD) and frequent exacerbations. Nevertheless, real-life data on the size of the COPD target population remain scarce.</p><p><strong>Methods: </strong>We analysed the characteristics of COPD and coexisting asthma and COPD patients included in the prospective multicentre, French COhort of BRonchial obstruction and Asthma, between 2008 and 2023 and evaluated the number of patients who could correspond to the inclusion criteria of randomised controlled trials evaluating various biologics targeting interleukin 33 (IL-33) (-receptor), IL-5 (-receptor), IL-4Rα or TSLP, in routine clinical practice.</p><p><strong>Results: </strong>Among 434 COPD patients, only 21.7% met inclusion criteria for at least one biologic. Among patients with asthma, 54 (3.5%) had coexisting features of COPD in terms of age, smoking status and airflow obstruction and met inclusion criteria for at least one biologic. Notably, these patients were predominantly female, with worse lung function. Globally, the target chronic airway diseases population of the eagerly awaited biologics remains limited to a small part (ie, 1.3%-8%, depending on the biologic).</p><p><strong>Conclusion: </strong>In a real-life COPD and asthma population (including asthmatic patients with features of COPD), the proportion of patients satisfying selection criteria applied in randomised controlled trials assessing the efficacy of biologics remains limited to less than 10% of the whole population.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852589","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":"Sequential exploratory mixed-method research of an eHealth intervention on blood pressure, sleep quality and physical activity in obstructive sleep apnoea: rationale and methodology of the Moore4Medical trial protocol.","authors":"Fran Valenzuela-Pascual, Francisco Jose Verdejo-Amengual, Oriol Martinez-Navarro, Joan Blanco-Blanco, Rabie Adel El Arab, Esther Rubinat-Arnaldo, Maria Masbernat-Almenara, Francesc Rubí-Carnacea, Blanca Manuel Martí, Ferran Barbé, Manuel Sanchez-de-la-Torre","doi":"10.1136/bmjresp-2023-001889","DOIUrl":"10.1136/bmjresp-2023-001889","url":null,"abstract":"<p><strong>Introduction: </strong>The management of a chronic and frequent pathology, such as obstructive sleep apnoea (OSA), requires personalised programmes that implement new technology-based tools to improve the comprehensive treatment of the patient to reduce the morbidity associated with this disease. This study will evaluate the effectiveness of an eHealth tool in managing the pathophysiological consequences of OSA and how they impact the quality of life after 3 months of intervention among adults.</p><p><strong>Methods and analysis: </strong>This is a mixed-method sequential exploratory study protocol. Participants will be≥18 years with a new diagnosis of moderate OSA and diagnosed with hypertension. The qualitative phase will consist of personal semistructured interviews. The quantitative phase will be a triple-blind randomised controlled trial. The experimental group (n=135) will receive an eHealth intervention using an electronic wrist device and a mobile application that will offer specific healthcare recommendations, physical activity indications and hygienic and dietary advice. These recommendations will be based on the information obtained in the qualitative phase. Those in the control group (n=135) will receive the usual educational materials from the sleep unit. The primary outcome will be blood pressure changes at 3 months. Secondary outcomes are subjective sleep quality, sleep apnoea-related parameters, daytime sleepiness, physical activity, empowerment and motivation for change, quality of life, anthropometry, cost-benefit and adherence.</p><p><strong>Ethics and dissemination: </strong>Ethical approval for the study has been obtained from the Hospital Universitari Arnau de Vilanova (CEIC-2511). Results will be published in a peer-reviewed journal.</p><p><strong>Trial registration number: </strong>ClinicalTrials.gov Identifier: NCT05380726.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852653","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":"Bile acids in the lower airways is associated with airway microbiota changes in chronic obstructive pulmonary disease: an observational study.","authors":"Jose A Caparros-Martin, Montserrat Saladié, S Patricia Agudelo-Romero, Kristy S Nichol, F Jerry Reen, Yuben P Moodley, Siobhain Mulrennan, Stephen Stick, Peter A B Wark, Fergal O'Gara","doi":"10.1136/bmjresp-2024-002552","DOIUrl":"10.1136/bmjresp-2024-002552","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a complex disorder with a high degree of interindividual variability. Gastrointestinal dysfunction is common in patients with COPD and has been proposed to influence the clinical progression of the disease. Using the presence of bile acid(s) (BA) in bronchoalveolar lavage (BAL) fluid as a marker of gastric aspiration, we evaluated the relationships between BAs, clinical outcomes and bacterial lung colonisation.</p><p><strong>Methods: </strong>We used BAL specimens from a cohort of patients with COPD and healthy controls. BAs were profiled and quantified in BAL supernatants using mass spectrometry. Microbial DNA was extracted from BAL pellets and quantified using quantitative PCR. We profiled the BAL microbiota using an amplicon sequencing approach targeting the V3-V4 region of the 16S rRNA gene.</p><p><strong>Results: </strong>Detection of BAs in BAL was more likely at the earliest clinical stages of COPD and was independent of the degree of airway obstruction. BAL specimens with BAs demonstrated higher bacterial biomass and lower diversity. Likewise, the odds of recovering bacterial cultures from BAL were higher if BAs were also detected. Detection of BAs in BAL was not associated with either inflammatory markers or clinical outcomes. We also observed different bacterial community types in BAL, which were associated with different clinical groups, levels of inflammatory markers and the degree of airway obstruction.</p><p><strong>Conclusion: </strong>Detection of BAs in BAL was associated with alterations in the airway bacterial communities. Further studies are needed to evaluate whether BAs in BAL can be used to stratify patients and predict disease progression trajectories.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852614","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":"Ultrasound-guided transbronchial cryobiopsy of mediastinal and hilar lesions: a multicenter pragmatic cohort study with real-world evidence.","authors":"Melanie Scarlett Mangold, Daniel P Franzen, Jürgen Hetzel, Tsogyal D Latshang, Maurice Roeder, Silvan M Vesenbeckh, Silvia Ulrich, Thomas Gaisl, Carolin Steinack","doi":"10.1136/bmjresp-2024-002617","DOIUrl":"10.1136/bmjresp-2024-002617","url":null,"abstract":"<p><strong>Background: </strong>Limited data exist on the reliability, efficacy and safety of ultrasound-guided transbronchial cryobiopsy for suspicious mediastinal and hilar lesions. This study shares findings from implementing this method and compares the results with those of the standard endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).</p><p><strong>Methods: </strong>Patients undergoing diagnostic bronchoscopy for mediastinal or hilar lesions in four Swiss centres were included. The study aims to assess the diagnostic yield and safety of EBUS-guided cryobiopsy compared with EBUS-TBNA. Tunnelling to the target lesion was performed using an electric needle knife (70.8%), a 19 G- (12.4%) or a 22 G needle (16.8%). Cryobiopsies were obtained with a freezing time of 4-7 s (18.2% with a 1.7 mm probe) or 6-10 s (81.8% with a 1.1 mm probe).</p><p><strong>Results: </strong>Altogether, 137 patients were enrolled with a median follow-up of 89 days. The overall diagnostic yield was 56.2% for EBUS-TBNA and 91.2% for cryobiopsies (p<0.001). Cryobiopsies increased the diagnostic yield for benign disorders (+28.5%), uncommon tumours (+5.9%) and other metastatic cancer (+0.6%), but not for lung cancer (+0%). For lung cancer (n=27), immunohistochemistry was obtainable in 40.7% of EBUS-TBNA (median of 3 probes [IQR 3 to 3]), significantly lower than cryobiopsy's 88.9% yield (median of 4 probes [IQR 3 to 5]) (p<0.001). Adverse events were found in 23.4% of participants; 10.2% had mild to moderate bleeding, 0.7% had pneumonia, and 0.7% (one) of patients had pneumothorax following pneumomediastinum. No deaths or mediastinum infections were observed.</p><p><strong>Conclusion: </strong>Cryobiopsy of mediastinal and hilar lesions improves the diagnostic yield compared with EBUS-TBNA while maintaining a favourable safety profile.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817237","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 birth weight and chronic obstructive pulmonary disease in the UK Biobank: a prospective cohort study.","authors":"Pengfei Luo, Jialiu He, Xinglin Wan, Mengxia Li, Zheng Zhu, Lulu Chen, Dong Hang, Jian Su, Ran Tao, Jinyi Zhou, Xikang Fan","doi":"10.1136/bmjresp-2024-002366","DOIUrl":"10.1136/bmjresp-2024-002366","url":null,"abstract":"<p><strong>Background: </strong>Birth weight has been reported to be associated with chronic obstructive pulmonary disease (COPD) in adulthood, but the results have not yet been determined. This study aims to analyse the potential association of birth weight with COPD risk in UK Biobank.</p><p><strong>Methods: </strong>We conducted a prospective analysis for participants without baseline COPD in UK Biobank. The HRs and 95% CIs were calculated by multivariable Cox regression models, and dose-response relationship was evaluated by restricted cubic splines. Besides, we also calculated the interactions for covariates and further analysed the joint effects.</p><p><strong>Results: </strong>A total of 251 172 participants with birth weight data were included in this study, and 5602 COPD cases were found during follow-up. According to Cox regression models, participants with the lowest quintile of birth weight (< 2.86 kg) had higher risk for COPD (HR=1.21, 95% CI 1.11 to 1.32). In addition, the dose‒response analysis showed a non-linear relationship between birth weight and COPD risk, which first decreased and then increased, and the interactions for age, passive smoking and maternal smoking were also found by stratified analysis. Furthermore, we also found the joint effects between COPD risk and maternal smoking in the lowest quintile group.</p><p><strong>Conclusions: </strong>This study indicated that lower birth weight may increase the risk of COPD. The non-linear associations between birth weight and COPD risk for prospective cohort; as birth weight increased, the risk showed a trend of decreasing first and then increasing. Moreover, maternal smoking had a joint effect with low birth weight for COPD risk.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817236","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":"Effect of stellate ganglion block on perioperative myocardial injury following thoracoscopic surgery for lung cancer (SGBMI): protocol for a single-centre, randomised controlled trial.","authors":"Wei Wu, Haofei Dai, Meiyun Liu, Yang Liu, Hong Shi","doi":"10.1136/bmjresp-2024-002446","DOIUrl":"10.1136/bmjresp-2024-002446","url":null,"abstract":"<p><strong>Introduction: </strong>Myocardial injury is a common complication of thoracoscopic surgery. The stellate ganglion block is believed to affect myocardial oxygen consumption. The Stellate Ganglion Block and Myocardial Injury (SGBMI) trial aims to test the hypothesis that stellate ganglion block can reduce the incidence of perioperative myocardial injury in patients undergoing thoracoscopic surgery for lung cancer.</p><p><strong>Methods and analysis: </strong>The SGBMI trial is a double-blind, randomised trial comparing the effects of a stellate ganglion block and a sham procedure in patients with cardiovascular risk factors undergoing thoracoscopic surgery. The exclusion criteria include procedure-related contraindications and severe heart failure. The stellate ganglion block or sham procedures will be performed preoperatively. The primary outcome is myocardial injury within 30 days of the follow-up. The main safety outcomes are sepsis, infection and procedure-related complications. We will enrol 248 patients to ensure at least 80% power for the evaluation of the primary outcome. The primary results of the SGBMI trial are expected to be announced by the year 2027.</p><p><strong>Ethics and dissemination: </strong>Ethical approval for the study is obtained from the Ethics Committee of the Shanghai Pulmonary Hospital (approval number: L22-394). Written informed consent will be obtained from all participating patients. The publication of results in a peer-reviewed journal and presentations at conferences are anticipated.</p><p><strong>Trial registration number: </strong>ChiCTR2300071469 (registered on 16 May 2023).</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791068","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":"Why do healthcare workers refuse tuberculosis preventive treatment (TPT)? a qualitative study from Puducherry, South India.","authors":"Sadhana Subramanian, Jilisha Gnanadhas, Sonali Sarkar, Manju Rajaram, Senbagavalli Prakashbabu, Palanivel Chinnakali","doi":"10.1136/bmjresp-2024-002576","DOIUrl":"10.1136/bmjresp-2024-002576","url":null,"abstract":"<p><strong>Background: </strong>The sustainable development goal (SDG) 3.3.2 prompted India to devise the National Strategic Plan 2017-2025, targeting tuberculosis (TB) eradication by 2030. The prevention pillar of this plan emphasises on Tuberculosis Preventive Treatment (TPT) for those with TB infection (TBI). Healthcare workers (HCWs), identified as one of the high-risk groups by the WHO, show a higher refusal rate for TPT. We aimed to explore the reasons for TPT refusal among the HCWs identified with TBI in Puducherry, South India during 2023.</p><p><strong>Methods: </strong>A qualitative descriptive study was conducted among 12 HCWs from a publicly funded tertiary care hospital, each with at least 5 years of experience. Participants were selected by maximum variation sampling, based on the department of work, current TBI status and subject expertise. The in-depth interviews, guided by the health belief model, lasted approximately 45 min each. Two researchers performed manual thematic analysis using the mixed approach for coding. Codes were grouped into categories and themes. Discrepancies were resolved through discussion with a third researcher, reaching a consensus.</p><p><strong>Results: </strong>Three overarching themes emerged: perceived threats, beliefs regarding health interventions and empowering factors. Perceived threat elucidated the lower perceived vulnerability of contracting TB and minimal chance for progression of TBI to TB disease despite having continuous exposure and uncertainties in the workplace. Beliefs about health interventions included perceived obstacles and advantages, such as testing challenges and lack of awareness, as well as the benefits of prophylaxis and infection control measures. Empowering factors centred on prompting action and self-confidence, highlighting strategies to encourage TBI testing through administrative actions and endorsing shorter treatment plans.</p><p><strong>Conclusions: </strong>Addressing the identified knowledge gaps and false perception through targeted interventions, healthcare institutions can improve TPT uptake. Implementing a comprehensive strategy that combines hospital policies to initiate screening and treatment, a supportive environment and shorter TPT regimens is essential to prevent TB among HCWs.</p>","PeriodicalId":9048,"journal":{"name":"BMJ Open Respiratory Research","volume":"11 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791069","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}