Publications
516 results found
Hopkinson NS, Polkey, Shah P, et al., 2016, Endobronchial valves for patients with heterogeneous emphysema and without interlobar collateral ventilation – open label treatment following the BeLieVeR-HIFi study, Thorax, Vol: 72, Pages: 277-279, ISSN: 1468-3296
Outcomes in early trials of bronchoscopic lung volume reduction using endobronchial valves for the treatment of patients with advanced emphysema were inconsistent. However improvements in patient selection with focus on excluding those with interlobar collateral ventilation and homogeneous emphysema resulted in significant benefits in the BeLieVeR-HIFi study compared to sham treated controls. In this manuscript we present data from the control patients in the BeLieVeR-HIFi study who went on to have open label endobronchial valve treatment after completion of the clinical trial (n=12), combined with data from those in the treatment arm who did not have collateral ventilation (n=19). Three months after treatment the forced expiratory volume in the 1st second increased by 27.3(36.4)%, residual volume reduced by 0.49(0.76)L, the 6 minute walk distance increased by 32.6(68.7) m, and the St George Respiratory Questionnaire for COPD score improved by 8.2(20.2) points. These data extend the evidence for endobronchial valve placement in appropriately selected patients with COPD.
Hopkinson NS, Russell A, 2016, Singing for Lung Health – a systematic review of the literature and consensus statement., npj Primary Care Respiratory Medicine, Vol: 26, ISSN: 2055-1010
Abstract:There is growing interest in Singing for Lung Health (SLH), an approach where patients with respiratory disease take part in singing groups, intended to improve their condition. A consensus group was convened in early 2016 to address issues including; the specific features that make SLH distinct from other forms of participation in singing; the existing evidence base via a systematic review; gaps in the evidence base including the need to define value-based outcome measures for sustainable commissioning of SLH; defining the measures needed to evaluate individuals' responses to SLH and the quality of singing programmes; core training, expertise and competencies required by singing group leaders to deliver high quality programmes.A systematic review to establish the extent of the evidence base for Singing for Lung Health was undertaken. Electronic databases including Pubmed, OVID Medline and Embase, Web of Science, Cochrane central register of controlled trials and PEDro were used. Six studies were included in the final review. Quantitative data suggest singing has the potential to improve health related quality of life, particularly related to physical health, and levels of anxiety without causing significant side effects. There is a significant risk of bias in many of the existing studies with small numbers of subjects overall. Little comparison can be made between studies due to their heterogeneity in design. Qualitative data indicate that singing is an enjoyable experience for patients who consistently report that it helps them to cope with their condition better.Larger and longer term trials are needed.
Curtis KJ, Meyrick VM, Mehta B, et al., 2016, Angiotensin-converting enzyme inhibition as an adjunct to pulmonary rehabilitation in COPD, American Journal of Respiratory and Critical Care Medicine, Vol: 194, Pages: 1349-1357, ISSN: 1535-4970
Rationale: Epidemiological studies in older individuals have found an association between use of ACE-inhibition (ACE-I) therapy and preserved locomotor muscle mass, strength and walking speed. ACE-I therapy might therefore have a role in the context of pulmonary rehabilitation. Objectives: We investigated the hypothesis that enalapril, an ACE-inhibitor, would augment the improvement in exercise capacity seen during pulmonary rehabilitation. Methods: We performed a double-blind, placebo-controlled, parallel-group randomised controlled trial. COPD patients, with at least moderate airflow obstruction and taking part in pulmonary rehabilitation, were randomised to either 10 weeks therapy with an ACE-inhibitor (10mg enalapril) or placebo. Measurements: The primary outcome measurement was the change in peak power (assessed using cycle ergometry) from baseline. Main Results: Eighty patients were enrolled, seventy-eight randomised (age 67±8years, FEV1 48±21% predicted), and sixty-five completed the trial (34 placebo, 31 ACE-inhibitor). The ACE-inhibitor treated group demonstrated a significant reduction in systolic blood pressure (Δ-16mmHg, 95% CI -22 to -11) and serum ACE activity (Δ-18IU/L, 95% CI -23 to -12) versus placebo (between group differences p<0.0001). Peak power increased significantly more in the placebo group (placebo Δ+9 Watts, 95% CI 5 to 13 vs. ACE-I Δ+1 Watt, 95% CI -2 to 4, between group difference 8 Watts, 95% CI 3 to 13, p=0.001). There was no significant between group difference in quadriceps strength or health-related quality of life. Conclusion: Use of the ACE-inhibitor enalapril alongside a programme of pulmonary rehabilitation, in patients without an established indication for ACE-inhibition, reduced the peak work rate response to exercise training in COPD patients. Clinical trial registration available at www.controlled-trials.com, ID ISRCTN79038750.
Hopkinson NS, 2016, Endobronchial valves as a treatment for emphysema. Moving out of the shadow of lung volume reduction surgery, American Journal of Respiratory and Critical Care Medicine, Vol: 194, Pages: 1039-1040, ISSN: 1535-4970
Mohan D, Lewis A, Patel MS, et al., 2016, Using laser capture microdissection to study fiber specific signalling in locomotor muscle in COPD: A pilot study, Muscle & Nerve, Vol: 55, Pages: 902-912, ISSN: 1097-4598
INTRODUCTION: Quadriceps dysfunction is important in chronic obstructive pulmonary disease (COPD), with an associated increased proportion of type II fibers. Investigation of protein synthesis and degradation has yielded conflicting results, possibly due to study of whole biopsy samples, whereas signalling may be fiber-specific. Our objective was to develop a method for fiber-specific gene expression analysis. METHODS: 12 COPD and 6 healthy subjects underwent quadriceps biopsy. Cryosections were immunostained for type II fibers, which were separated using laser capture microdissection (LCM). Whole muscle and different fiber populations were subject to quantitative polymerase chain reaction (qPCR). RESULTS: Muscle-RING-finger-protein-1(MURF-1) and Atrogin-1 were lower in type II fibers of COPD versus healthy subjects (P=0.02 and P=0.03, respectively), but differences were not apparent in whole muscle or type I fibers. DISCUSSION: We describe a novel method for studying fiber-specific gene expression in optimum-cutting-temperature (OCT) compound-embedded muscle specimens. LCM offers a more sensitive way to identify molecular changes in COPD muscle. This article is protected by copyright. All rights reserved.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.