Publications
121 results found
Beasley V, Joshi P, Singanayagam AS, et al., 2012, Lung microbiology and exacerbations in COPD, International Journal of Chronic Obstructive Pulmonary Disease, Vol: 2012, Pages: 555-569, ISSN: 1176-9106
Chronic obstructive pulmonary disease (COPD) is the most common chronic respiratory condition in adults and is characterized by progressive airflow limitation that is not fully reversible. The main etiological agents linked with COPD are cigarette smoking and biomass exposure but respiratory infection is believed to play a major role in the pathogenesis of both stable COPD and in acute exacerbations. Acute exacerbations are associated with more rapid decline in lung function and impaired quality of life and are the major causes of morbidity and mortality in COPD. Preventing exacerbations is a major therapeutic goal but currently available treatments for exacerbations are not very effective. Historically, bacteria were considered the main infective cause of exacerbations but with the development of new diagnostic techniques, respiratory viruses are also frequently detected in COPD exacerbations. This article aims to provide a state-of-the art review of current knowledge regarding the role of infection in COPD, highlight the areas of ongoing debate and controversy, and outline emerging technologies and therapies that will influence future diagnostic and therapeutic pathways in COPD.
Singanayagam A, Burroughs AK, Kon OM, et al., 2012, Adaptation and Antituberculosis Drug-induced Liver Injury Reply, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 186, Pages: 388-389, ISSN: 1073-449X
Singanayagam A, Joshi PV, Mallia P, et al., 2012, Viruses exacerbating chronic pulmonary disease: the role of immune modulation, BMC Medicine, Vol: 10, ISSN: 1741-7015
Chronic pulmonary diseases are a major cause of morbidity and mortality and their impact is expected to increase in the future. Respiratory viruses are the most common cause of acute respiratory infections and it is increasingly recognized that respiratory viruses are a major cause of acute exacerbations of chronic pulmonary diseases such as asthma, chronic obstructive pulmonary disease and cystic fibrosis. There is now increasing evidence that the host response to virus infection is dysregulated in these diseases and a better understanding of the mechanisms of abnormal immune responses has the potential to lead to the development of new therapies for virus-induced exacerbations. The aim of this article is to review the current knowledge regarding the role of viruses and immune modulation in chronic pulmonary diseases and discuss avenues for future research and therapeutic implications.
Singanayagam A, Sridhar S, Dhariwal J, et al., 2012, A comparison between two strategies for monitoring hepatic function during antituberculous therapy, Am J Respir Crit Care Med, Vol: 185, Pages: 653-659, ISSN: 1535-4970
RATIONALE: The optimum strategy for monitoring liver function during antituberculous therapy is unclear. OBJECTIVES: To assess the value of the American Thoracic Society risk-factor approach for predicting drug-induced liver injury and to compare with a uniform policy of liver function testing in all patients at 2 weeks. METHODS: We conducted an observational study of adult patients undergoing therapy for active tuberculosis at a tertiary center. All patients had alanine transferase measurement at baseline and 2 weeks following commencement of therapy. Sensitivity, specificity, and positive and negative predictive values were used to assess strategies. MEASUREMENTS AND MAIN RESULTS: There were 288 patients included, and 21 (7.3%) developed drug-induced liver injury (57.1% "early" at 2 wk and 42.9% "late," after 2 wk). There were increased rates of individuals with HIV infection in the early drug-induced liver injury group compared with no drug-induced liver injury and late drug-induced liver injury groups (33% vs. 7.1% vs. 0%; P = 0.004). The American Thoracic Society algorithm had a sensitivity and specificity of 66.7 and 65.6%, respectively, for prediction of early and 22.2% and 63.7% for late drug-induced liver injury. The uniform monitoring policy had poor sensitivity but better specificity (22.2 and 82.1%) for prediction of late drug-induced liver injury. CONCLUSIONS: In our urban, ethnically diverse population, a risk-factor approach is neither sensitive nor specific for prediction of drug-induced liver injury. A uniform policy of liver function testing at 2 weeks is useful for prompt identification of a subgroup who develop early drug-induced liver injury and may offer better specificity in ruling out late drug-induced liver injury.
Singanayagam A, Singanayagam A, Elder DHJ, et al., 2012, Is community-acquired pneumonia an independent risk factor for cardiovascular disease?, EUROPEAN RESPIRATORY JOURNAL, Vol: 39, Pages: 187-196, ISSN: 0903-1936
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- Citations: 53
Choudhury G, Mandal P, Singanayagam A, et al., 2011, Seven-day antibiotic courses have similar efficacy to prolonged courses in severe community-acquired pneumoniaua propensity-adjusted analysis, CLINICAL MICROBIOLOGY AND INFECTION, Vol: 17, Pages: 1852-1858, ISSN: 1198-743X
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- Citations: 41
George PM, Mehta M, Dhariwal J, et al., 2011, Post-bronchoscopy sputum: Improving the diagnostic yield in smear negative pulmonary TB., Respir Med. 2011 Nov;105(11):1726-31
Singanayagam A, Singanayagam A, Wood V, et al., 2011, Factors associated with severe illness in pandemic 2009 influenza a (H1N1) infection: Implications for triage in primary and secondary care, JOURNAL OF INFECTION, Vol: 63, Pages: 243-251, ISSN: 0163-4453
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- Citations: 25
Chalmers JD, Taylor JK, Mandal P, et al., 2011, Validation of the Infectious Diseases Society of America/American Thoratic Society Minor Criteria for Intensive Care Unit Admission in Community-Acquired Pneumonia Patients Without Major Criteria or Contraindications to Intensive Care Unit Care, CLINICAL INFECTIOUS DISEASES, Vol: 53, Pages: 503-511, ISSN: 1058-4838
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- Citations: 88
Chalmers JD, Mandal P, Singanayagam A, et al., 2011, Severity assessment tools to guide ICU admission in community-acquired pneumonia: systematic review and meta-analysis, INTENSIVE CARE MEDICINE, Vol: 37, Pages: 1409-1420, ISSN: 0342-4642
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- Citations: 116
Choudhury G, Chalmers JD, Mandal P, et al., 2011, Physician judgement is a crucial adjunct to pneumonia severity scores in low-risk patients, EUROPEAN RESPIRATORY JOURNAL, Vol: 38, Pages: 643-648, ISSN: 0903-1936
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- Citations: 31
Chalmers JD, Taylor JK, Singanayagam A, et al., 2011, Epidemiology, Antibiotic Therapy, and Clinical Outcomes in Health Care-Associated Pneumonia: A UK Cohort Study, CLINICAL INFECTIOUS DISEASES, Vol: 53, Pages: 107-113, ISSN: 1058-4838
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- Citations: 178
Singanayagam A, Chalmers JD, Akram AR, et al., 2011, Impact of inhaled corticosteroid use on outcome in COPD patients admitted with pneumonia, EUROPEAN RESPIRATORY JOURNAL, Vol: 38, Pages: 36-41, ISSN: 0903-1936
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- Citations: 48
Riquelme R, Jimenez P, Videla AJ, et al., 2011, Predicting mortality in hospitalized patients with 2009 H1N1 influenza pneumonia, INTERNATIONAL JOURNAL OF TUBERCULOSIS AND LUNG DISEASE, Vol: 15, Pages: 542-546, ISSN: 1027-3719
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- Citations: 48
Chalmers JD, Singanayagam A, Akram AR, et al., 2011, Safety and efficacy of CURB65-guided antibiotic therapy in community-acquired pneumonia, JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, Vol: 66, Pages: 416-423, ISSN: 0305-7453
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- Citations: 38
Singanayagam A, Scally C, Al-Khairalla MZ, et al., 2011, Are biomarkers additive to pulmonary embolism severity index for severity assessment in normotensive patients with acute pulmonary embolism?, QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, Vol: 104, Pages: 125-131, ISSN: 1460-2725
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- Citations: 24
Chalmers JD, Singanayagam A, Akram AR, et al., 2010, Severity assessment tools for predicting mortality in hospitalised patients with community-acquired pneumonia. Systematic review and meta-analysis, THORAX, Vol: 65, Pages: 878-883, ISSN: 0040-6376
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- Citations: 236
Singanayagam A, Chalmers JD, Hill AT, 2010, Inhaled corticosteroids and risk of pneumonia: evidence for and against the proposed association, QJM-AN INTERNATIONAL JOURNAL OF MEDICINE, Vol: 103, Pages: 379-385, ISSN: 1460-2725
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- Citations: 23
Rahman NM, Singanayagam A, Davies HE, et al., 2010, Diagnostic accuracy, safety and utilisation of respiratory physician-delivered thoracic ultrasound, THORAX, Vol: 65, Pages: 449-453, ISSN: 0040-6376
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- Citations: 51
Singanayagam A, Chalmers JD, 2009, Budesonide and risk of pneumonia, LANCET, Vol: 374, Pages: 2050-2050, ISSN: 0140-6736
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- Citations: 3
Singanayagam A, Chalmers JD, Hill AT, 2009, Admission hypoglycaemia is associated with adverse outcome in community-acquired pneumonia, EUROPEAN RESPIRATORY JOURNAL, Vol: 34, Pages: 932-939, ISSN: 0903-1936
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- Citations: 18
Chalmers JD, Singanayagam A, Murray MP, et al., 2009, Risk factors for complicated parapneumonic effusion and empyema on presentation to hospital with community-acquired pneumonia, THORAX, Vol: 64, Pages: 592-597, ISSN: 0040-6376
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- Citations: 132
Chalmers JD, Singanayagam A, Hill AT, 2009, Management of Infectious Pneumonia: Value of C-reactive Protein Reply, AMERICAN JOURNAL OF MEDICINE, Vol: 122, Pages: E13-E13, ISSN: 0002-9343
Chalmers JD, Singanayagam A, Scally C, et al., 2009, Admission D-dimer Can Identify Low-Risk Patients With Community-Acquired Pneumonia, ANNALS OF EMERGENCY MEDICINE, Vol: 53, Pages: 633-638, ISSN: 0196-0644
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- Citations: 47
Singanayagam A, 2009, Pathogenetic mechanisms involved in viral-induced exacerbations of COPD, Thorax, Vol: 64, ISSN: 0040-6376
Chalmers JD, Singanayagam A, Hill AT, 2008, Predicting the Need for Mechanical Ventilation and/or Inotropic Support for Young Adults Admitted to the Hospital with Community-Acquired Pneumonia, CLINICAL INFECTIOUS DISEASES, Vol: 47, Pages: 1571-1574, ISSN: 1058-4838
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- Citations: 59
Chalmers JD, Singanayagam A, Murray MP, et al., 2008, Prior Statin Use Is Associated with Improved Outcomes in Community-acquired Pneumonia, AMERICAN JOURNAL OF MEDICINE, Vol: 121, Pages: 1002-U78, ISSN: 0002-9343
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- Citations: 131
Chalmers JD, Singanayagam A, Hill AT, 2008, Systolic blood pressure is superior to other haemodynamic predictors of outcome in community acquired pneumonia, THORAX, Vol: 63, Pages: 698-702, ISSN: 0040-6376
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- Citations: 66
Chalmers JD, Singanayagam A, Hill AT, 2008, C-reactive protein is an independent predictor of severity in community-acquired pneumonia, AMERICAN JOURNAL OF MEDICINE, Vol: 121, Pages: 219-225, ISSN: 0002-9343
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- Citations: 245
Ewig S, Schäfer H, Torres A, 2000, Severity assessment in community-acquired pneumonia, EUROPEAN RESPIRATORY JOURNAL, Vol: 16, Pages: 1193-1201, ISSN: 0903-1936
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- Citations: 30
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