Publications
514 results found
Hopkinson NS, 2016, What comes after standardised packaging for tobacco?, British Medical Journal, Vol: 353, ISSN: 0959-8138
Demeyer H, Dueñas-Espín I, De Jongh C, et al., 2016, Can health status questionnaires be used as a measure of physical activity in COPD patients?, European Respiratory Journal, Vol: 47, Pages: 1565-1568, ISSN: 1399-3003
Britton J, Arnott D, McNeill A, et al., 2016, Nicotine without smoke-putting electronic cigarettes in context., British Medical Journal, Vol: 353, Pages: i1745-i1745, ISSN: 1468-5833
Electronic cigarettes have exploded on to global markets over the past decade and in the process have generated some strongly polarised views.1 2 3 Some believe that e-cigarettes are a disruptive technology that could consign tobacco smoking to history; others think that they are a distraction from core public health aims of eradicating all nicotine use and a tobacco industry ploy to perpetuate smoking and undermine international tobacco control treaties. This article summarises the findings of a new report by the Royal College of Physicians (RCP) on the role of e-cigarettes in tobacco harm reduction.4
Patel MS, Donaldson AV, Lewis A, et al., 2016, Klotho and smoking – An interplay influencing the skeletal muscle function deficits that occur in COPD, Respiratory Medicine, Vol: 113, Pages: 50-56, ISSN: 0954-6111
BackgroundKlotho is an ‘anti-ageing’ hormone and transmembrane protein; Klotho deficient mice develop a similar ageing phenotype to smokers including emphysema and muscle wasting. The objective of this study was to evaluate skeletal muscle and circulating Klotho protein in smokers and COPD patients and to relate Klotho levels to relevant skeletal muscle parameters. We sought to validate our findings by undertaking complimentary murine studies.MethodsFat free mass, quadriceps strength and spirometry were measured in 87 participants (61 COPD, 13 ‘healthy smokers’ and 13 never smoking controls) in whom serum and quadriceps Klotho protein levels were also measured. Immunohistochemistry was performed to demonstrate the location of Klotho protein in human skeletal muscle and in mouse skeletal muscle in which regeneration was occurring following injury induced by electroporation. In a separate study, gastrocnemius Klotho protein was measured in mice exposed to 77 weeks of smoke or sham air.ResultsQuadriceps Klotho levels were lower in those currently smoking (p = 0.01), irrespective of spirometry, but were not lower in patients with COPD. A regression analysis identified current smoking status as the only independent variable associated with human quadriceps Klotho levels, an observation supported by the finding that smoke exposed mice had lower gastrocnemius Klotho levels than sham exposed mice (p = 0.005). Quadriceps Klotho levels related to local oxidative stress but were paradoxically higher in patients with established muscle wasting or weakness; the unexpected relationship with low fat free mass was the only independent association. Within locomotor muscle, Klotho localized to the plasma membrane and to centralized nuclei in humans and in mice with induced muscle damage. Serum Klotho had an independent association with quadriceps strength but did not relate to quadriceps Klotho levels or to spirometric parameters.ConclusionsKlotho is expressed
Hopkinson NS, Polkey, Shah PL, et al., 2016, Effective Bronchoscopic Lung Volume Reduction Accelerates Exercise Oxygen Uptake Kinetics in Emphysema, Chest, Vol: 149, Pages: 435-446, ISSN: 1931-3543
The impact of bronchoscopic lung volume reduction (BLVR) on physiologic responses to exercise in patients with advanced emphysema remains incompletely understood. We hypothesized that effective BLVR (e-BLVR), defined as a reduction in residual volume > 350 mL, would improve cardiovascular responses to exercise and accelerate oxygen uptake (View the MathML sourceo2) kinetics.MethodsThirty-one patients (FEV1, 36% ± 9% predicted; residual volume, 219% ± 57% predicted) underwent a constant intensity exercise test at 70% peak work rate to the limit of tolerance before and after treatment bronchoscopy (n = 24) or sham bronchoscopy (n = 7). Physiologic responses in patients who had e-BLVR (n = 16) were compared with control subjects (ineffective BLVR or sham bronchoscopy; n = 15).Resultse-BLVR reduced residual volume (−1.1 ± 0.5 L, P = .001), improved lung diffusing capacity by 12% ± 13% (P = .001), and increased exercise tolerance by 181 ± 214 s (P = .004). View the MathML sourceo2 kinetics were accelerated in the e-BLVR group but remained unchanged in control subjects (Δ mean response time, −20% ± 29% vs 1% ± 25%, P = .04). Acceleration of View the MathML sourceo2 kinetics was associated with reductions in heart rate and oxygen pulse response half-times by 8% (84 ± 14 to 76 ± 15 s, P = .04) and 20% (49 ± 16 to 34 ± 16 s, P = .01), respectively. There were also increases in heart rate and oxygen pulse amplitudes during the cardiodynamic phase post e-BLVR. Faster View the MathML sourceo2 kinetics in the e-BLVR group were significantly correlated with reductions in residual volume (r = 0.66, P = .005) and improvements in inspiratory reserve volume (r = 0.56, P = .024) and exercise tolerance (r = 0.63, P = .008).ConclusionsLung deflation induced by e-BLVR accelerated exercise View the MathML sourceo2 kinetics in patients with emphysema. This beneficial effect appears to be
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