Pub Date : 2024-03-21DOI: 10.1183/23120541.00765-2023
K. Quadflieg, Rachael Higgins, Eva Arents, H. Demeyer, M. Criel, M. Daenen, David Ruttens, M. Thomeer, Dieter Stevens, Andrew Maiorana, M. Spruit, V. Cavalheri, Chris Burtin
{"title":"Prognostic value of the 1-minute sit-to-stand test to predict postoperative complications in patients with lung cancer elected for lung resection","authors":"K. Quadflieg, Rachael Higgins, Eva Arents, H. Demeyer, M. Criel, M. Daenen, David Ruttens, M. Thomeer, Dieter Stevens, Andrew Maiorana, M. Spruit, V. Cavalheri, Chris Burtin","doi":"10.1183/23120541.00765-2023","DOIUrl":"https://doi.org/10.1183/23120541.00765-2023","url":null,"abstract":"","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140221438","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}
Pub Date : 2024-03-21DOI: 10.1183/23120541.00874-2023
Charles C Reilly, I. Higginson, T. Chalder
Understanding the complexity and multidimensional nature of chronic breathlessness is key to its successful management. The aim of this study was to explore illness perceptions, cognitive and behavioural responses to chronic breathlessness in individuals living with advanced respiratory disease.A cross-sectional secondary analysis of data from a feasibility randomised control trial of SELF-BREATHE for individuals living with chronic breathlessness due to advanced disease. All participants completed the following questionnaires: Numerical rating scale (NRS) breathlessness severity, NRS distress due to breathlessness, NRS self-efficacy for managing breathlessness, Dyspnoea 12, chronic respiratory disease questionnaire (CRQ), brief illness perception questionnaire (brief IPQ) and the cognitive and behavioural response questionnaire short version (CBRQ-S). The associations between the brief IPQ, CBRQ-S, NRS breathlessness severity, distress and self-efficacy, D-12 and CRQ were examined using Spearman's rho correlation coefficients. A Spearman's rho of≥0.50 was pre-defined as the threshold to denote important associations between variables. A p value <0.008 was considered statistically significant, to account for the number of comparisons performed.Illness perception items: consequences, identity, concern, and emotional response were associated with increased breathlessness severity, increased distress, reduced breathlessness self-management ability and lower health related quality of life. Symptom focusing and embarrassment avoidance were identified as important cognitive responses to chronic breathlessness.Interventions that directly target illness perceptions, cognitive and behavioural responses to chronic breathlessness may improve symptom burden, self-efficacy, and health-related quality of life.
{"title":"Illness perceptions, cognitive and behavioural responses to chronic breathlessness in individuals living with advanced respiratory disease: an observational study","authors":"Charles C Reilly, I. Higginson, T. Chalder","doi":"10.1183/23120541.00874-2023","DOIUrl":"https://doi.org/10.1183/23120541.00874-2023","url":null,"abstract":"Understanding the complexity and multidimensional nature of chronic breathlessness is key to its successful management. The aim of this study was to explore illness perceptions, cognitive and behavioural responses to chronic breathlessness in individuals living with advanced respiratory disease.A cross-sectional secondary analysis of data from a feasibility randomised control trial of SELF-BREATHE for individuals living with chronic breathlessness due to advanced disease. All participants completed the following questionnaires: Numerical rating scale (NRS) breathlessness severity, NRS distress due to breathlessness, NRS self-efficacy for managing breathlessness, Dyspnoea 12, chronic respiratory disease questionnaire (CRQ), brief illness perception questionnaire (brief IPQ) and the cognitive and behavioural response questionnaire short version (CBRQ-S). The associations between the brief IPQ, CBRQ-S, NRS breathlessness severity, distress and self-efficacy, D-12 and CRQ were examined using Spearman's rho correlation coefficients. A Spearman's rho of≥0.50 was pre-defined as the threshold to denote important associations between variables. A p value <0.008 was considered statistically significant, to account for the number of comparisons performed.Illness perception items: consequences, identity, concern, and emotional response were associated with increased breathlessness severity, increased distress, reduced breathlessness self-management ability and lower health related quality of life. Symptom focusing and embarrassment avoidance were identified as important cognitive responses to chronic breathlessness.Interventions that directly target illness perceptions, cognitive and behavioural responses to chronic breathlessness may improve symptom burden, self-efficacy, and health-related quality of life.","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140220975","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}
Pub Date : 2024-03-21DOI: 10.1183/23120541.00582-2023
M. Olsson, Anders J Björkelund, Jacob Sandberg, Anders Blomberg, Mats Börjesson, David C Currow, Andrei Malinovschi, Magnus Sköld, Per Wollmer, Kjell Torén, C. Östgren, Gunnar Engström, Magnus Ekström
Breathlessness is a troublesome and prevalent symptom in the population, but knowledge of related factors is scarce. The aim of this study was to identify the factors most strongly associated with breathlessness in the general population and to describe the shapes of the associations between the main factors and breathlessness.a cross-sectional analysis of the multicentre population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) of adults aged 50 to 64 years. Breathlessness was defined as a modified Medical Research Council (mMRC) breathlessness rating ≥2. The machine-learning algorithm extreme gradient boosting (XGBoost) was used to classify participants as either breathless or nonbreathless using 449 factors, including physiological measurements, blood samples, computer tomography cardiac and lung measurements, lifestyle, health conditions, and socioeconomics. The strength of the associations between the factors and breathlessness were measured by SHapley Additive exPlanations (SHAP), with higher scores reflecting stronger associations.A total of 28 730 participants (52% women) were included in the study. The strongest associated factors for breathlessness were (in order of magnitude): body mass index (BMI; [SHAP score]0.39), forced expiratory volume in 1 s (FEV1; 0.32), physical activity measured by accelerometery (0.27), sleep apnoea (0.22), diffusing lung capacity for carbon monoxide (0.21), self-reported physical activity (0.17), chest pain when hurrying (0.17), high-sensitivity C-reactive protein (hs-CRP) (0.17), recent weight change (0.14), and cough (0.13).This large population-based study of men and women aged 50–64 years identified the main factors related to breathlessness that may be prevented or amenable to public health interventions.
{"title":"Factors most strongly associated with breathlessness in a population aged 50–64 years","authors":"M. Olsson, Anders J Björkelund, Jacob Sandberg, Anders Blomberg, Mats Börjesson, David C Currow, Andrei Malinovschi, Magnus Sköld, Per Wollmer, Kjell Torén, C. Östgren, Gunnar Engström, Magnus Ekström","doi":"10.1183/23120541.00582-2023","DOIUrl":"https://doi.org/10.1183/23120541.00582-2023","url":null,"abstract":"Breathlessness is a troublesome and prevalent symptom in the population, but knowledge of related factors is scarce. The aim of this study was to identify the factors most strongly associated with breathlessness in the general population and to describe the shapes of the associations between the main factors and breathlessness.a cross-sectional analysis of the multicentre population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) of adults aged 50 to 64 years. Breathlessness was defined as a modified Medical Research Council (mMRC) breathlessness rating ≥2. The machine-learning algorithm extreme gradient boosting (XGBoost) was used to classify participants as either breathless or nonbreathless using 449 factors, including physiological measurements, blood samples, computer tomography cardiac and lung measurements, lifestyle, health conditions, and socioeconomics. The strength of the associations between the factors and breathlessness were measured by SHapley Additive exPlanations (SHAP), with higher scores reflecting stronger associations.A total of 28 730 participants (52% women) were included in the study. The strongest associated factors for breathlessness were (in order of magnitude): body mass index (BMI; [SHAP score]0.39), forced expiratory volume in 1 s (FEV1; 0.32), physical activity measured by accelerometery (0.27), sleep apnoea (0.22), diffusing lung capacity for carbon monoxide (0.21), self-reported physical activity (0.17), chest pain when hurrying (0.17), high-sensitivity C-reactive protein (hs-CRP) (0.17), recent weight change (0.14), and cough (0.13).This large population-based study of men and women aged 50–64 years identified the main factors related to breathlessness that may be prevented or amenable to public health interventions.","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":"108 s418","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140223623","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}
Pub Date : 2024-03-21DOI: 10.1183/23120541.00968-2023
K. Makimoto, James Hogg, Jean Bourbeau, Wan C. Tan, Miranda Kirby
Recent advancements in texture-based CT radiomics have demonstrated its potential for classifying chronic obstructive pulmonary disease (COPD).Participants from Canadian Cohort Obstructive Lung Disease (CanCOLD) were investigated. A total of 108 features were included: 8 qCT, 95 texture-based radiomics, and 5 demographics. Machine learning models included demographics along with texture-based radiomics, and/or qCT. Combinations of 5 feature-selection and 5 classification methods were evaluated; a training dataset was used for feature-selection and to train the models, and a testing dataset was used for model evaluation. Models for classifying COPD status and severity were evaluated using the area under the receiver operating characteristic curve (AUC) with DeLong's test for comparison. SHAP analysis was used to investigate the features selected.A total of 1204 participants were evaluated (n=602 no COPD; n=602 COPD). There were no differences between the groups for sex (p=.77) or BMI (p=.21). For classifying COPD status, the combination of demographics, texture-based radiomics and qCT obtained higher performance (AUC=0.87) compared to demographics and texture-based radiomics (AUC=0.81; p<.05) or qCT (AUC=0.84; p<.05). Similarly, for classifying COPD severity, the combination of demographics, texture-based radiomics and qCT obtained higher performance (AUC=0.81) compared to demographics and texture-based radiomics (AUC=0.72; p<.05) or qCT (AUC=0.79; p=<.05). Texture-based radiomics and qCT features were among the top 5 features selected (15th-percentile-of-the-CT-density-histogram, CT total-airway-count, pack-years, CT grey-level-co-occurrence-matrix zone-distance-entropy, CT low-attenuation-clusters) for classifying COPD status.Texture-based radiomics and conventional qCT features in combination improve machine learning models for COPD classification of status and severity.
{"title":"Enhancing COPD Classification Using Combined Quantitative CT and Texture-Based Radiomics: A CanCOLD Cohort Study","authors":"K. Makimoto, James Hogg, Jean Bourbeau, Wan C. Tan, Miranda Kirby","doi":"10.1183/23120541.00968-2023","DOIUrl":"https://doi.org/10.1183/23120541.00968-2023","url":null,"abstract":"Recent advancements in texture-based CT radiomics have demonstrated its potential for classifying chronic obstructive pulmonary disease (COPD).Participants from Canadian Cohort Obstructive Lung Disease (CanCOLD) were investigated. A total of 108 features were included: 8 qCT, 95 texture-based radiomics, and 5 demographics. Machine learning models included demographics along with texture-based radiomics, and/or qCT. Combinations of 5 feature-selection and 5 classification methods were evaluated; a training dataset was used for feature-selection and to train the models, and a testing dataset was used for model evaluation. Models for classifying COPD status and severity were evaluated using the area under the receiver operating characteristic curve (AUC) with DeLong's test for comparison. SHAP analysis was used to investigate the features selected.A total of 1204 participants were evaluated (n=602 no COPD; n=602 COPD). There were no differences between the groups for sex (p=.77) or BMI (p=.21). For classifying COPD status, the combination of demographics, texture-based radiomics and qCT obtained higher performance (AUC=0.87) compared to demographics and texture-based radiomics (AUC=0.81; p<.05) or qCT (AUC=0.84; p<.05). Similarly, for classifying COPD severity, the combination of demographics, texture-based radiomics and qCT obtained higher performance (AUC=0.81) compared to demographics and texture-based radiomics (AUC=0.72; p<.05) or qCT (AUC=0.79; p=<.05). Texture-based radiomics and qCT features were among the top 5 features selected (15th-percentile-of-the-CT-density-histogram, CT total-airway-count, pack-years, CT grey-level-co-occurrence-matrix zone-distance-entropy, CT low-attenuation-clusters) for classifying COPD status.Texture-based radiomics and conventional qCT features in combination improve machine learning models for COPD classification of status and severity.","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":" 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140222334","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}
Pub Date : 2024-03-14DOI: 10.1183/23120541.00911-2023
Ping Wang, Kozo Morimoto, Naoki Hasegawa, M. Hassan, A. Chatterjee
Nontuberculous mycobacterial pulmonary disease (NTM-PD) prevalence in Japan is among the highest worldwide. Chronic obstructive pulmonary disease (COPD) and bronchiectasis are common comorbidities among patients with NTM-PD, and it is challenging to treat NTM-PD in patients with these conditions. There are limited data on the incremental burden that NTM-PD adds to underlying COPD or bronchiectasis in Japan. Therefore, the objective of this study was to assess the incremental burden associated with NTM-PD in patients with pre-existing COPD and/or bronchiectasis.This nested case-control study was based on JMDC, Inc. (JMDC) claims data (2015–2020). Patients with COPD and/or bronchiectasis with NTM-PD (cases) were age and sex matched 1:3 to patients with COPD and/or bronchiectasis without NTM-PD (controls), resulting in 3 mutually exclusive patient groups (COPD, bronchiectasis, or both, with/without NTM-PD). Incremental burden of NTM-PD was assessed within each group by comparing hospitalisations during the 1-year period after NTM-PD diagnosis (index) between cases and controls with both univariate analysis and multivariate analysis adjusting for pre-index comorbidities.Univariate analyses in the 3 patient groups consistently demonstrated incremental hospitalisation burden in casesversuscontrols (eg, COPD group: 20% of 492 casesversus13% of 1476 controls had all-cause hospitalisations; 11%versus5% had respiratory-related hospitalisations; and 6%versus2% had COPD-related hospitalisations). Subsequent multivariate analysis further confirmed the findings.The substantial incremental burden of hospitalisation associated with NTM-PD in patients with COPD and/or bronchiectasis highlights the urgent need for appropriate management of NTM-PD in Japan.
{"title":"Nontuberculous mycobacterial pulmonary disease added burden to COPD and bronchiectasis in Japan","authors":"Ping Wang, Kozo Morimoto, Naoki Hasegawa, M. Hassan, A. Chatterjee","doi":"10.1183/23120541.00911-2023","DOIUrl":"https://doi.org/10.1183/23120541.00911-2023","url":null,"abstract":"Nontuberculous mycobacterial pulmonary disease (NTM-PD) prevalence in Japan is among the highest worldwide. Chronic obstructive pulmonary disease (COPD) and bronchiectasis are common comorbidities among patients with NTM-PD, and it is challenging to treat NTM-PD in patients with these conditions. There are limited data on the incremental burden that NTM-PD adds to underlying COPD or bronchiectasis in Japan. Therefore, the objective of this study was to assess the incremental burden associated with NTM-PD in patients with pre-existing COPD and/or bronchiectasis.This nested case-control study was based on JMDC, Inc. (JMDC) claims data (2015–2020). Patients with COPD and/or bronchiectasis with NTM-PD (cases) were age and sex matched 1:3 to patients with COPD and/or bronchiectasis without NTM-PD (controls), resulting in 3 mutually exclusive patient groups (COPD, bronchiectasis, or both, with/without NTM-PD). Incremental burden of NTM-PD was assessed within each group by comparing hospitalisations during the 1-year period after NTM-PD diagnosis (index) between cases and controls with both univariate analysis and multivariate analysis adjusting for pre-index comorbidities.Univariate analyses in the 3 patient groups consistently demonstrated incremental hospitalisation burden in casesversuscontrols (eg, COPD group: 20% of 492 casesversus13% of 1476 controls had all-cause hospitalisations; 11%versus5% had respiratory-related hospitalisations; and 6%versus2% had COPD-related hospitalisations). Subsequent multivariate analysis further confirmed the findings.The substantial incremental burden of hospitalisation associated with NTM-PD in patients with COPD and/or bronchiectasis highlights the urgent need for appropriate management of NTM-PD in Japan.","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":"28 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140242631","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}
Pub Date : 2024-03-14DOI: 10.1183/23120541.00081-2024
Fernando Vargas-Ursúa, Cristina Ramos-Hernández, Luis Alberto Pazos-Area, Ignacio Fernández-Granda, Iván Rodríguez-Otero, Eva Gómez-Corredoira, Manuel Pintos-Louro, Alberto Fernández-Villar
Background and objectives: Elastography is a technology that has strongly impacted several medical specialties; however, it is not yet applied as part of standard clinical practice in the field of pulmonology. The objective of this systematic review is to analyse the evidence available to date in relation to pleuropulmonary ultrasound elastography, especially focusing on the three pathologies with the most publications: subpleural consolidations, interstitial lung diseases (ILDs), and pleural effusion. Methods: Originalin vivostudies published up until 12/08/2023 in the Embase, MEDLINE, or Web of Science databases were included. The QUADAS-2 tool was applied to analyse bias. Results:o Included studies: we found 613 records in databases searching. After duplicates removal, we screened 246 records, and finally included 18 papers.o Synthesis of the results: The average cohort sample size was 109 patients. The elastography modes most frequently used were strain (22.2%), transient elastography (TE; 22.2%), point shear-wave elastography (pSWE; 38.9%), and two-dimensional shear-wave elastography (2D-SWE; 22.2%). The possibility of a meta-analysis was ruled out because of the heterogeneity of the studies included. Discussion: The currently available literature indicated that pleuropulmonary ultrasound elastography produced promising and consistent results, although the lack of standardisation in the use of the technique and in the elastography modes employed still impedes its use in daily clinical pneumology practice. The development of a clinical guideline establishing a common nomenclature and standardised techniques for pleuropulmonary elastography will be imperative to generate quality scientific evidence in this field. Other:o Funding: none.o Registration: PROSPERO № CRD42023472828.
{"title":"Current evidence for lung ultrasound elastography in the field of pneumology: a systematic review","authors":"Fernando Vargas-Ursúa, Cristina Ramos-Hernández, Luis Alberto Pazos-Area, Ignacio Fernández-Granda, Iván Rodríguez-Otero, Eva Gómez-Corredoira, Manuel Pintos-Louro, Alberto Fernández-Villar","doi":"10.1183/23120541.00081-2024","DOIUrl":"https://doi.org/10.1183/23120541.00081-2024","url":null,"abstract":" Background and objectives: Elastography is a technology that has strongly impacted several medical specialties; however, it is not yet applied as part of standard clinical practice in the field of pulmonology. The objective of this systematic review is to analyse the evidence available to date in relation to pleuropulmonary ultrasound elastography, especially focusing on the three pathologies with the most publications: subpleural consolidations, interstitial lung diseases (ILDs), and pleural effusion. Methods: Originalin vivostudies published up until 12/08/2023 in the Embase, MEDLINE, or Web of Science databases were included. The QUADAS-2 tool was applied to analyse bias. Results:o Included studies: we found 613 records in databases searching. After duplicates removal, we screened 246 records, and finally included 18 papers.o Synthesis of the results: The average cohort sample size was 109 patients. The elastography modes most frequently used were strain (22.2%), transient elastography (TE; 22.2%), point shear-wave elastography (pSWE; 38.9%), and two-dimensional shear-wave elastography (2D-SWE; 22.2%). The possibility of a meta-analysis was ruled out because of the heterogeneity of the studies included. Discussion: The currently available literature indicated that pleuropulmonary ultrasound elastography produced promising and consistent results, although the lack of standardisation in the use of the technique and in the elastography modes employed still impedes its use in daily clinical pneumology practice. The development of a clinical guideline establishing a common nomenclature and standardised techniques for pleuropulmonary elastography will be imperative to generate quality scientific evidence in this field. Other:o Funding: none.o Registration: PROSPERO № CRD42023472828.","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":"1 8‐9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140241904","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}
Pub Date : 2024-03-14DOI: 10.1183/23120541.00864-2023
Eleanor C. Majellano, Janelle Yorke, Vanessa L. Clark, Peter G. Gibson, Amber Smith, Leanne J Holmes, V. McDonald
Disabling symptoms of asthma including breathlessness, cough, wheeze and chest tightness largely impact quality of life, however how these symptoms impact people with asthma of different severity levels remains unknown. This study aimed to compare and characterise patient experience of symptoms and their burden, quality of life, and medication preferences of people with severe asthma against those of people with mild/moderate asthma.A multisite qualitative study involving two focus group and semi-structured interviews of adults with severe asthma were undertaken in Australia and UK. Interview were also undertaken in people with mild to moderate asthma. Audio recordings were transcribed and analysed thematically.Participants in both groups had a mean±sdage of 57+12 years. Between groups, 74% of participants were female and 81% lived with family. Themes were identified: 1) what is asthma and most bothersome symptoms: both groups reported breathlessness as the most bothersome symptom; 2) Impacts on life: disease related impact differed as people with severe asthma reported significant burden in their quality of life; 3) personalised and responsive care: severe asthma interviewees preferred injectable biologic therapy as a mode of treatment administration.People with asthma are burdened by breathlessness and cough and other disabling symptoms resulting in impaired quality of life. Understanding the experiences of people with asthma of different severities can improve patient-clinician partnership.
{"title":"The illness burden of severe asthma contrasted to people with mild to moderate asthma: A qualitative study","authors":"Eleanor C. Majellano, Janelle Yorke, Vanessa L. Clark, Peter G. Gibson, Amber Smith, Leanne J Holmes, V. McDonald","doi":"10.1183/23120541.00864-2023","DOIUrl":"https://doi.org/10.1183/23120541.00864-2023","url":null,"abstract":"Disabling symptoms of asthma including breathlessness, cough, wheeze and chest tightness largely impact quality of life, however how these symptoms impact people with asthma of different severity levels remains unknown. This study aimed to compare and characterise patient experience of symptoms and their burden, quality of life, and medication preferences of people with severe asthma against those of people with mild/moderate asthma.A multisite qualitative study involving two focus group and semi-structured interviews of adults with severe asthma were undertaken in Australia and UK. Interview were also undertaken in people with mild to moderate asthma. Audio recordings were transcribed and analysed thematically.Participants in both groups had a mean±sdage of 57+12 years. Between groups, 74% of participants were female and 81% lived with family. Themes were identified: 1) what is asthma and most bothersome symptoms: both groups reported breathlessness as the most bothersome symptom; 2) Impacts on life: disease related impact differed as people with severe asthma reported significant burden in their quality of life; 3) personalised and responsive care: severe asthma interviewees preferred injectable biologic therapy as a mode of treatment administration.People with asthma are burdened by breathlessness and cough and other disabling symptoms resulting in impaired quality of life. Understanding the experiences of people with asthma of different severities can improve patient-clinician partnership.","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":"3 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140243201","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}
Pub Date : 2024-03-14DOI: 10.1183/23120541.00741-2023
C. Hinze, R. Ehmann, M. Jandl, K. Milger, Olaf Schmidt, C. Schulz, D. Skowasch, Tobias Welte, Roland Buhl, E. Hamelmann, Marco Idzko, Christian Taube, Stephanie Korn, Hendrik Suhling
{"title":"As-needed low-dose ICS/formoterol therapy in patients with severe asthma included in the German Asthma Net cohort","authors":"C. Hinze, R. Ehmann, M. Jandl, K. Milger, Olaf Schmidt, C. Schulz, D. Skowasch, Tobias Welte, Roland Buhl, E. Hamelmann, Marco Idzko, Christian Taube, Stephanie Korn, Hendrik Suhling","doi":"10.1183/23120541.00741-2023","DOIUrl":"https://doi.org/10.1183/23120541.00741-2023","url":null,"abstract":"","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244607","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}
Pub Date : 2024-03-14DOI: 10.1183/23120541.00021-2024
A. Morice
{"title":"A survey of UK respiratory specialists’ opinion on the management of chronic cough","authors":"A. Morice","doi":"10.1183/23120541.00021-2024","DOIUrl":"https://doi.org/10.1183/23120541.00021-2024","url":null,"abstract":"","PeriodicalId":504874,"journal":{"name":"ERJ Open Research","volume":"40 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244993","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}
Pub Date : 2024-03-14DOI: 10.1183/23120541.00789-2023
C. Barnett, K. Krolikowski, R. Postelnicu, Vikramjit Mukherjee, I. Sulaiman, Matthew Chung, L. Angel, J. Tsay, Benjamin G. Wu, Stephen T. Yeung, Ralf Duerr, Ludovic Desvignes, Kamal Khanna, Yonghua Li, R. Schluger, S. Rafeq, D. Collazo, Y. Kyeremateng, Nancy Amoroso, Deepak Pradhan, Sanchita Das, Laura Evans, T. Uyeki, Elodie Ghedin, Gregg J Silverman, L. Segal, S. Brosnahan
Mounting evidence indicates that an individual's humoral adaptive immune response plays a critical role in the setting of SARS-CoV-2 infection, and that the efficiency of the response correlates with disease severity. The relationship between the adaptive immune dynamics in the lower airways with those in the systemic circulation, and how these relate to an individual's clinical response to SARS-CoV-2 infection, are less understood and are the focus of this study. Here, we investigate the adaptive immune response to SARS-CoV-2 in paired samples from the lower airways and blood from 27 critically ill patients during the first wave of the pandemic (median time from symptom onset to intubation 11 days). Measurements included clinical outcomes (mortality), broncheoalveolar lavage (BAL) and blood specimen antibody levels, and BAL viral load. While there was heterogeneity in the levels of the SARS-CoV-2 specific antibodies, we unexpectedly found that some BAL specimens displayed higher levels than in paired concurrent plasma samples, despite the known dilutional effects common in BAL samples. We found that survivors had higher levels of anti-Spike, anti-Spike-NTD, and anti-Spike-RBD IgG antibodies in their BAL (6684 [258–13 148]versus15 899 [8958–22 629], 5336 [256–10 343]versus13 494 [8028–19 414], and 1620 [199–6637]versus8466 [5144–16 157] median fluorescent intensity units, for deceasedversussurvivors, respectively, p<0.05), while there was no such association with antibody levels in the systemic circulation. Thus, our data highlight the critical role of local adaptive immunity in the airways as a key defense mechanism against primary SARS-CoV-2 infection.
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