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1. Inhaled colistimethate sodium in patients with bronchiectasis and Pseudomonas aeruginosa infection: results of PROMIS-I and PROMIS-II, two randomised, double-blind, placebo-controlled phase 3 trials assessing safety and efficacy over 12 months.

Author

Haworth, Charles S, Shteinberg, Michal, Winthrop, Kevin, Barker, Alan, Blasi, Francesco, Dimakou, Katerina, Morgan, Lucy C, O'Donnell, Anne E, Ringshausen, Felix C, Sibila, Oriol, Thomson, Rachel M, Carroll, Kevin J, Pontenani, Federica, Castellani, Paola, and Chalmers, James D

Subjects
PSEUDOMONAS aeruginosa infections, CLINICAL trials, END of treatment, TELEPHONE calls, LUNG infections
Abstract

Chronic lung infection with Pseudomonas aeruginosa is associated with increased exacerbations and mortality in people with bronchiectasis. The PROMIS-I and PROMIS-II trials investigated the efficacy and safety of 12-months of inhaled colistimethate sodium delivered via the I-neb. Two randomised, double-blind, placebo-controlled trials of twice per day colistimethate sodium versus placebo were conducted in patients with bronchiectasis with P aeruginosa and a history of at least two exacerbations requiring oral antibiotics or one requiring intravenous antibiotics in the previous year in hospitals in Argentina, Australia, Belgium, Canada, France, Germany, Greece, Israel, Italy, Netherlands, New Zealand, Poland, Portugal, Spain, Switzerland, the UK, and the USA. Randomisation was conducted through an interactive web response system and stratified by site and long term use of macrolides. Masking was achieved by providing colistimethate sodium and placebo in identical vials. After random assignment, study visits were scheduled for 1, 3, 6, 9, and 12 months (the end of the treatment period); and telephone calls were scheduled for 7 days after random assignment and 2 weeks after the end of treatment. The primary endpoint was the mean annual exacerbation rate. These trials are registered with EudraCT: number 2015–002743–33 (for PROMIS-I) and 2016–004558–13 (for PROMIS-II), and are now completed. 377 patients were randomly assigned in PROMIS-I (177 to colistimethate sodium and 200 to placebo; in the modified intention-to-treat population, 176 were in the colistimethate sodium group and 197 were in the placebo group) between June 6, 2017, and April 8, 2020. The annual exacerbation rate was 0·58 in the colistimethate sodium group versus 0·95 in the placebo group (rate ratio 0·61; 95% CI 0·46–0·82; p=0·0010). 287 patients were randomly assigned in PROMIS-II (152 were assigned to colistimethate sodium and 135 were assigned to placebo, in the modified intention-to-treat population), between Feb 12, 2018, and Oct 22, 2021. PROMIS-II was then prematurely terminated due to the effect of the COVID-19 pandemic. No significant difference was observed in the annual exacerbation rate between the colistimethate sodium and placebo groups (0·89 vs 0·89; rate ratio 1·00; 95% CI 0·75–1·35; p=0·98). No major safety issues were identified. The overall frequency of adverse events was 142 (81%) patients in the colistimethate sodium group versus 159 (81%) patients in the placebo group in PROMIS-I, and 123 (81%) patients versus 104 (77%) patients in PROMIS-II. There were no deaths related to study treatment. The data from PROMIS-I suggest a clinically important benefit of colistimethate sodium delivered via the I-neb adaptive aerosol delivery system in patients with bronchiectasis and P aeruginosa infection. These results were not replicated in PROMIS-II, which was affected by the COVID-19 pandemic and prematurely terminated. Zambon. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Inhaled colistimethate sodium in patients with bronchiectasis and Pseudomonas aeruginosainfection: results of PROMIS-I and PROMIS-II, two randomised, double-blind, placebo-controlled phase 3 trials assessing safety and efficacy over 12 months

Author

Haworth, Charles S, Shteinberg, Michal, Winthrop, Kevin, Barker, Alan, Blasi, Francesco, Dimakou, Katerina, Morgan, Lucy C, O'Donnell, Anne E, Ringshausen, Felix C, Sibila, Oriol, Thomson, Rachel M, Carroll, Kevin J, Pontenani, Federica, Castellani, Paola, and Chalmers, James D

Abstract

Chronic lung infection with Pseudomonas aeruginosais associated with increased exacerbations and mortality in people with bronchiectasis. The PROMIS-I and PROMIS-II trials investigated the efficacy and safety of 12-months of inhaled colistimethate sodium delivered via the I-neb.

Published
2024
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3. Survival Outcomes in US Medicare Patients with Non-Cystic Fibrosis Bronchiectasis by Rate of Baseline Exacerbations

Author

Feliciano, Joseph, Lewing, Benjamin, Mohanty, Maitreyee, Lauterio, Melanie, Fucile, Sebastian, Tkacz, Joseph, and Barker, Alan F.

Abstract

Introduction: There are limited real-world data on outcomes in patients with non-cystic fibrosis bronchiectasis (NCFBE). This study assessed clinical characteristics and survival in patients with NCFBE by baseline exacerbation rate. Methods: Patients with bronchiectasis (≥ 1 inpatient or ≥ 2 outpatient claims with a bronchiectasis diagnosis code, or one outpatient claim with bronchiectasis code and a chest computed tomography scan) were from the 100% Medicare Fee-for-Service database (Jan 2014–Dec 2020). Patients had continuous enrollment ≥ 12 months pre-index (baseline) and post-index (follow-up), with index a random bronchiectasis claim preceded by ≥ 12 months bronchiectasis history. Patients with cystic fibrosis were excluded. Patients were stratified by exacerbations during baseline (0, 1, or ≥ 2). Follow-up exacerbation rate and all-cause mortality were assessed. Controls were identified using a multistep direct matching approach. Time to death from index was estimated by Kaplan–Meier analyses. Results: Exacerbation analysis included 92,529 patients with NCFBE and 92,529 matched controls. Exacerbations were common (43% had ≥ 1 exacerbation), with patients with more baseline exacerbations more likely to have ≥ 2 exacerbations during follow-up (11.4%, 24.2%, and 46.8% of patients with 0, 1, and ≥ 2 baseline exacerbations, respectively). Survival analysis included 110,298 patients with NCFBE and 110,298 controls. Time to death was shorter in patients with more baseline exacerbations (P< 0.0001). Five-year survival was 55.3%, 62.6%, and 65.4% for patients with ≥ 2, 1, and 0 baseline exacerbations, respectively, compared with 64.1% for controls. Conclusions: In these patients with NCFBE, exacerbations were common. History of exacerbations was associated with future exacerbations and increased all-cause mortality.

Published
2024
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4. Criteria and definitions for the radiological and clinical diagnosis of bronchiectasis in adults for use in clinical trials: international consensus recommendations.

Author

Aliberti, Stefano, Goeminne, Pieter C, O'Donnell, Anne E, Aksamit, Timothy R, Al-Jahdali, Hamdan, Barker, Alan F, Blasi, Francesco, Boersma, Wim G, Crichton, Megan L, De Soyza, Anthony, Dimakou, Katerina E, Elborn, Stuart J, Feldman, Charles, Tiddens, Harm, Haworth, Charles S, Hill, Adam T, Loebinger, Michael R, Martinez-Garcia, Miguel Angel, Meerburg, Jennifer J, and Menendez, Rosario

Subjects
BRONCHIECTASIS, CLINICAL trials, COMPUTED tomography, PATIENT selection, SYMPTOMS
Abstract

Bronchiectasis refers to both a clinical disease and a radiological appearance that has multiple causes and can be associated with a range of conditions. Disease heterogeneity and the absence of standardised definitions have hampered clinical trials of treatments for bronchiectasis and are important challenges in clinical practice. In view of the need for new therapies for non-cystic fibrosis bronchiectasis to reduce the disease burden, we established an international taskforce of experts to develop recommendations and definitions for clinically significant bronchiectasis in adults to facilitate the standardisation of terminology for clinical trials. Systematic reviews were used to inform discussions, and Delphi processes were used to achieve expert consensus. We prioritised criteria for the radiological diagnosis of bronchiectasis and suggest recommendations on the use and central reading of chest CT scans to confirm the presence of bronchiectasis for clinical trials. Furthermore, we developed a set of consensus statements concerning the definitions of clinical bronchiectasis and its specific signs and symptoms, as well as definitions for chronic bacterial infection and sustained culture conversion. The diagnosis of clinically significant bronchiectasis requires both clinical and radiological criteria, and these expert recommendations and proposals should help to optimise patient recruitment into clinical trials and allow reliable comparisons of treatment effects among different interventions for bronchiectasis. Our consensus proposals should also provide a framework for future research to further refine definitions and establish definitive guidance on the diagnosis of bronchiectasis. [ABSTRACT FROM AUTHOR]

Published
2022
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5. Effect of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Dysglycemia, Insulin Resistance, and Dyslipidemia: a Temporal Causal Longitudinal Study.

Author

Agbaje, Andrew O., Barker, Alan R., Mitchell, Gary F., and Tuomainen, Tomi-Pekka

Abstract

Background: We investigated the temporal causal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) progression with the risk of dysglycemia, insulin resistance, and dyslipidemia.Methods: We included 3862, 17.7-year-old, participants from the Avon Longitudinal Study of Parents and Children, followed up for 7 years. cfPWV, cIMT, and fasting plasma samples were repeatedly measured. We computed homeostatic model assessment (HOMA) of insulin resistance and percent pancreatic beta-cell function. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models.Results: A higher cfPWV at 17.7 years was associated with higher insulin at age 24.5 years (odds ratio, 1.25 [CI, 1.08-1.44]; P=0.003), which slightly attenuated after covariates adjustment. Higher cIMT at 17.7 years was associated with lower insulin (odds ratio, 0.06 [0.01-0.95]; P=0.046) at 24.5 years, after covariate adjustments. In mixed-effect models, the 7-year progression in cfPWV (predictor) was directly associated with the increase in triglyceride (outcome). cIMT progression was associated with the 7-year increase in LDL (low-density lipoprotein), triglyceride, and glucose. In cross-lagged models, higher cfPWV at 17.7 years was associated with higher insulin (β=0.06, SE, 0.12, P=0.014), HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years. However, insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 17.7 years were not associated with cfPWV at 24.5 years. Higher cIMT at 17.7 years was associated with reduced insulin, HOMA of insulin resistance, and HOMA-percent pancreatic beta-cell function at 24.5 years, but not vice versa. Higher glucose at 17.7 years was associated with higher cfPWV and cIMT at 24.5 years only.Conclusions: Arterial stiffness in adolescence may be a causal risk factor for hyperinsulinemia and insulin resistance in young adulthood. [ABSTRACT FROM AUTHOR]

Published
2022
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6. Effects of Arterial Stiffness and Carotid Intima-Media Thickness Progression on the Risk of Overweight/Obesity and Elevated Blood Pressure/Hypertension: a Cross-Lagged Cohort Study.

Author

Agbaje, Andrew O., Barker, Alan R., and Tuomainen, Tomi-Pekka

Abstract

We examined the temporal longitudinal associations of carotid-femoral pulse wave velocity (cfPWV), a measure of arterial stiffness, and carotid intima-media thickness (cIMT) with the risk of overweight/obesity and elevated blood pressure (BP)/hypertension. We studied 3862 adolescents aged 17.7 years from the Avon Longitudinal Study of Parents and Children, followed-up for 7 years. cfPWV and cIMT were measured by ultrasound. Total and trunk fat mass and lean mass were assessed by dual-energy X-ray absorptiometry. Body mass index and BP were measured. Data were analyzed using logistic regression, linear mixed-effect, and cross-lagged structural equation models, with covariate adjustments. Among 1719 male and 2143 female participants, higher cfPWV at 17.7 years was associated with the risk of elevated systolic BP/hypertension (odds ratio, 1.20 [1.02-1.41]; P=0.026), elevated diastolic BP/hypertension (1.77 [1.32-2.38]; P<0.0001), body mass index-overweight/obesity (1.19 [1.01-1.41]; P=0.041), and trunk fat mass overweight/obesity (1.24 [1.03-1.49]; P=0.023) at 24.5 years. Higher cIMT at 17.7 years had no associations with obesity and elevated BP at follow-up. cfPWV progression was directly associated with 7-year increase in systolic BP (effect estimate 16 mm Hg [9-24]; P<0.0001) and diastolic BP (28 mm Hg [23-34]; P<0.0001). cIMT progression was directly associated with the 7-year increase of all adiposity measures and diastolic BP. In the temporal analysis, baseline cfPWV was directly associated with follow-up systolic and diastolic BP, however, baseline BP was unassociated with follow-up cfPWV. cfPWV but not cIMT was bidirectionally associated with adiposity. Obesity and hypertension prevention from adolescence may require developing novel approaches to mitigate arterial stiffness. [ABSTRACT FROM AUTHOR]

Published
2022
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8. The Association of Long-term Macrolide Therapy and Nontuberculous Mycobacterial Culture Positivity in Patients With Bronchiectasis

Author

Metersky, Mark L., Choate, Radmila, Addrizzo-Harris, Doreen, Aksamit, Timothy R., Barker, Alan, Basavaraj, Ashwin, Choate, Radmila, Daley, Charles L., Anne Daniels, M. Leigh, Eden, Edward, DiMango, Angela, Fennelly, Kevin, Johnson, Margaret M., Knowles, Michael R., Maselli, Diego, McShane, Pamela J., Metersky, Mark L., Naureckas, Edward, Noone, Peadar G., O’Donnell, Anne E., Olivier, Kenneth N., Philley, Julie, Restrepo, Marcos, Salathe, Matthias A., Schmid, Andreas, Thomashow, Byron, Tino, Gregory, and Winthrop, Kevin L.

Published
2021
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10. MAIL ENTRIES.

Author

Mays, Lyle, Souter, Kelly, McDowell, Mark, Barker, Alan, Armstrong, Darren, and Kroll, Ezio

Abstract

Dear MXA, As a student at the University of North Texas and a big motocross fan, I was shocked to read in the school newspaper that Jody Weisel had received post-graduate degrees from here. So, they shut Husaberg down and kept the better known Husky brand, Husaberg, which only made a 1000 bikes a year, quickly disappeared. Darren Armstrong via motocrossactionmag.com Before you left for Saudi Arabia, you might have heard that KTM, which bought Husaberg in 1998, bought the Husqvarna brand in 2014 and planned to platform share the all-new Husqvarnas with KTM parts. [Extracted from the article]

Published
2023

11. Global Physiology and Pathophysiology of Cough

Author

Lee, Kai K., Davenport, Paul W., Smith, Jaclyn A., Irwin, Richard S., McGarvey, Lorcan, Mazzone, Stuart B., Birring, Surinder S., Abu Dabrh, AbdMoain, Altman, Kenneth W., Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Brightling, Christopher, Chang, Anne B., Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, AdamT., Irwin, Richard S., Iyer, Vivek, Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, AndrewP., Lim, Kaiser, Madison, J. Mark, Malesker, MarkA., McGarvey, Lorcan, Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Oppenheimer, John, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Maeve P., Tarlo, Susan M., and Vertigan, Anne E.

Abstract

The purpose of this state-of-the-art review is to update the American College of Chest Physicians 2006 guideline on global physiology and pathophysiology of cough. A review of the literature was conducted using PubMed and MEDLINE databases from 1951 to 2019 and using prespecified search terms. We describe the basic phenomenology of cough patterns, behaviors, and morphological features. We update the understanding of mechanical and physiological characteristics of cough, adding a contemporary view of the types of cough and their associated behaviors and sensations. New information about acoustic characteristics is presented, and recent insights into cough triggers and the patient cough hypersensitivity phenotype are explored. Lastly, because the clinical assessment of patients largely focuses on the duration rather than morphological features of cough, we review the morphological features of cough that can be measured in the clinic. This is the first of a two-part update to the American College of Chest Physicians 2006 cough guideline; it provides a more global consideration of cough phenomenology, beyond simply the mechanical aspects of a cough. A greater understanding of the typical features of cough, and their variations, may allow a more informed interpretation of cough measurements and the clinical relevance for patients.

Published
2021
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12. Life-Threatening and Non-Life-Threatening Complications Associated With Coughing

Author

Irwin, Richard S., Dudiki, Natasha, French, Cynthia L., Abu Dabrh, Abd Moain, Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Canning, Brendan, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Iyer, Vivek, Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Newcombe, Peter, Oppenheimer, John, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Tarlo, Susan M., and Vertigan, Anne E.

Abstract

This is an update of the section on complications that are associated with coughing in the 2006 CHESTcough guidelines that addresses two aims: (1) to systematically identify and thematically categorize the diverse complications of cough by providing a guide for future studies and (2) to identify gaps in the literature for future research.

Published
2020
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13. Airway Clearance Techniques in Bronchiectasis

Author

Basavaraj, Ashwin, Choate, Radmila, Addrizzo-Harris, Doreen, Aksamit, Timothy R., Barker, Alan, Daley, Charles L., Anne Daniels, M. Leigh, Eden, Edward, DiMango, Angela, Fennelly, Kevin, Griffith, David E., Johnson, Margaret M., Knowles, Michael R., Metersky, Mark L., Noone, Peadar G., O’Donnell, Anne E., Olivier, Kenneth N., Salathe, Matthias A., Schmid, Andreas, Thomashow, Byron, Tino, Gregory, and Winthrop, Kevin L.

Abstract

In patients with bronchiectasis, airway clearance techniques (ACTs) are important management strategies.

Published
2020
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14. Chronic Cough Due to Stable Chronic Bronchitis

Author

Malesker, Mark A., Callahan-Lyon, Priscilla, Madison, J. Mark, Ireland, Belinda, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lilly, Craig, Lim, Kaiser, Lown, Mark, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molassoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Maeve P., Tarlo, Susan M., and Vertigan, Anne E.

Abstract

Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic review on the management of chronic cough due to CB to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.

Published
2020
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15. Managing Chronic Cough Due to Asthma and NAEB in Adults and Adolescents

Author

Côté, Andreanne, Russell, Richard J., Boulet, Louis-Philippe, Gibson, Peter G., Lai, Kefang, Irwin, Richard S., Brightling, Christopher E., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Blackhall, Fiona, Bolser, Donald C., Birring, Surinder S., Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Gibson, Peter, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Lai, Kefang, Lane, Andrew P., Lilly, Craig, Lown, Mark, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Narasimhan, Mangala, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Vertigan, Anne E., and Weinberger, Miles

Abstract

Asthma and non-asthmatic eosinophilic bronchitis (NAEB) are among the commonest causes of chronic cough in adults. We sought to determine the role of non-invasive measurements of airway inflammation, including induced sputum and fractional exhaled nitric oxide, in the evaluation of cough associated with asthma, and what the best treatment is for cough due to asthma or NAEB.

Published
2020
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16. Acute Cough Due to Acute Bronchitis in Immunocompetent Adult Outpatients

Author

Smith, Maeve P., Lown, Mark, Singh, Sonal, Ireland, Belinda, Hill, Adam T., Linder, Jeffrey A., Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Blackhall, Fiona, Birring, Surinder S., Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Lai, Kefang, Kahrilas, Peter J., Lilly, Craig, Lown, Mark, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Vertigan, Anne E., and Weinberger, Miles

Abstract

Evidence for the diagnosis and management of cough due to acute bronchitis in immunocompetent adult outpatients was reviewed as an update to the 2006 “Chronic Cough Due to Acute Bronchitis: American College of Chest Physicians (ACCP) Evidence-Based Clinical Practice Guidelines.”

Published
2020
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18. Effect of maturational timing on bone health in male adolescent athletes engaged in different sports: The PRO-BONE study.

Author

Ubago-Guisado, Esther, Vlachopoulos, Dimitris, Barker, Alan R., Christoffersen, Tore, Metcalf, Brad, and Gracia-Marco, Luis

Abstract

Objectives: To describe differences in bone outcomes according to biological age in male athletes participating in osteogenic (OS) or non-osteogenic (NOS) sports.Design: Longitudinal (12-months).Methods: 104 adolescents (12-14years) were measured at baseline and after 1y: OS group (n=37 football or soccer players) and NOS group (n=39 swimmers, n=28 cyclists). Years from peak height velocity (PHV, -2 to +2) was used as a maturational landmark. Bone mineral content (BMC) was assessed using DXA. Hip structural analysis estimated cross-sectional area (CSA), cross-sectional moment of inertia (CSMI) and section modulus (Z) at the femoral neck (FN). Trabecular bone score (TBS) estimated lumbar spine (LS) texture. Quantitative ultrasound measured bone stiffness. Multilevel regression models adjusted by hours of training were fitted.Results: Compared to NOS, OS had significantly greater total body (less head) BMC from PHV to +2years from PHV (from 9.5% to 11.3%, respectively); LS BMC from -1years from PHV to PHV (from 9.8% to 9.9%); hip BMC (from 11.6% to 22.9%), FN BMC (from 12.0% to 15.9%), TBS (from 4.2% to 4.8%) and stiffness index (from 11.9% to 23.3%) from -1years from PHV to +2years from PHV; and CSA (from 8.4% to 18.8%), Z (from 5.5% to 22.9%) and CSMI (from 10.6% to 23.3%) from -2years from PHV to +2years from PHV. There was a significant trend for the between-group differences to increase with biological age except for LS BMC and TBS.Conclusions: These findings underline the differential bone response to different sports throughout the years surrounding PHV in male adolescent athletes.Clinical Trial Registration: ISRCTN17982776. [ABSTRACT FROM AUTHOR]

Published
2019
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19. Criteria and definitions for the radiological and clinical diagnosis of bronchiectasis in adults for use in clinical trials: international consensus recommendations

Author

Aliberti, Stefano, Goeminne, Pieter C, O'Donnell, Anne E, Aksamit, Timothy R, Al-Jahdali, Hamdan, Barker, Alan F, Blasi, Francesco, Boersma, Wim G, Crichton, Megan L, De Soyza, Anthony, Dimakou, Katerina E, Elborn, Stuart J, Feldman, Charles, Tiddens, Harm, Haworth, Charles S, Hill, Adam T, Loebinger, Michael R, Martinez-Garcia, Miguel Angel, Meerburg, Jennifer J, Menendez, Rosario, Morgan, Lucy C, Murris, Marlene S, Polverino, Eva, Ringshausen, Felix C, Shteinberg, Michal, Sverzellati, Nicola, Tino, Gregory, Torres, Antoni, Vandendriessche, Thomas, Vendrell, Montserrat, Welte, Tobias, Wilson, Robert, Wong, Conroy A, and Chalmers, James D

Abstract

Bronchiectasis refers to both a clinical disease and a radiological appearance that has multiple causes and can be associated with a range of conditions. Disease heterogeneity and the absence of standardised definitions have hampered clinical trials of treatments for bronchiectasis and are important challenges in clinical practice. In view of the need for new therapies for non-cystic fibrosis bronchiectasis to reduce the disease burden, we established an international taskforce of experts to develop recommendations and definitions for clinically significant bronchiectasis in adults to facilitate the standardisation of terminology for clinical trials. Systematic reviews were used to inform discussions, and Delphi processes were used to achieve expert consensus. We prioritised criteria for the radiological diagnosis of bronchiectasis and suggest recommendations on the use and central reading of chest CT scans to confirm the presence of bronchiectasis for clinical trials. Furthermore, we developed a set of consensus statements concerning the definitions of clinical bronchiectasis and its specific signs and symptoms, as well as definitions for chronic bacterial infection and sustained culture conversion. The diagnosis of clinically significant bronchiectasis requires both clinical and radiological criteria, and these expert recommendations and proposals should help to optimise patient recruitment into clinical trials and allow reliable comparisons of treatment effects among different interventions for bronchiectasis. Our consensus proposals should also provide a framework for future research to further refine definitions and establish definitive guidance on the diagnosis of bronchiectasis.

Published
2024
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20. Adapting, restarting, and terminating a randomised control trial for people with cystic fibrosis: Reflections on the impact of the COVID-19 pandemic UPON research in a clinical population

Author

Tomlinson, Owen W., Barker, Alan R., Denford, Sarah, and Williams, Craig A.

Abstract

Habitual physical activity (PA) and exercise form a cornerstone of the management of cystic fibrosis (CF), a genetically inherited pulmonary and digestive condition – whereby telehealth platforms have been proposed as a mechanism to engage remotely people with CF in PA and exercise.

Published
2024
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21. The effect of 12-month participation in osteogenic and non-osteogenic sports on bone development in adolescent male athletes. The PRO-BONE study.

Author

Vlachopoulos, Dimitris, Barker, Alan R., Ubago-Guisado, Esther, Ortega, Francisco B., Krustrup, Peter, Metcalf, Brad, Castro Pinero, Jose, Ruiz, Jonatan R., Knapp, Karen M., Williams, Craig A., Moreno, Luis A., and Gracia-Marco, Luis

Abstract

Objectives Research investigating the longitudinal effects of the most popular sports on bone development in adolescent males is scarce. The aim is to investigate the effect of 12-month participation in osteogenic and non-osteogenic sports on bone development. Design A 12-month study was conducted in adolescent males involved in football, swimming and cycling and compared with an active control group. Methods 116 adolescent males (13.1 ± 0.1 years at baseline): 37 footballers, 37 swimmers, 28 cyclists and 14 active controls were followed for 12 months. Bone mineral content (BMC) was measured by dual-energy X-ray absorptiometry, and bone stiffness was measured by quantitative ultrasound. Bone outcomes at 12 months were adjusted for baseline bone status, age, height, lean mass and moderate to vigorous physical activity. Results Footballers had higher improvement in adjusted BMC at the total body, total hip, shaft, Ward’s triangle, legs and bone stiffness compared to cyclists (6.3–8.0%). Footballers had significantly higher adjusted BMC at total body, shaft and legs compared to swimmers (5.4–5.6%). There was no significant difference between swimmers and cyclists for any bone outcomes. Swimming and cycling participation resulted in non-significant lower bone development at most sites of the skeleton compared to controls (−4.3 to −0.6%). Conclusions Football participation induces significantly greater improvements in BMC and bone stiffness over 12 months compared to cycling and swimming. Clinical trial registration ISRCTN17982776. [ABSTRACT FROM AUTHOR]

Published
2018
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22. Chronic Cough and Gastroesophageal Reflux in Children

Author

Chang, Anne B., Oppenheimer, John J., Kahrilas, Peter J., Kantar, Ahmad, Rubin, Bruce K., Weinberger, Miles, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Bolser, Donald C., Birring, Surinder S., Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Gibson, Peter, Harding, Susan M., Gold, Philip, Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Lai, Kefang, Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Metlay, Joshua P., Molasoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., and Weinberger, Miles

Abstract

Whether gastroesophageal reflux (GER) or GER disease (GERD) causes chronic cough in children is controversial. Using the Population, Intervention, Comparison, Outcome (PICO) format, we undertook four systematic reviews. For children with chronic cough (> 4-weeks duration) and without underlying lung disease: (1) who do not have gastrointestinal GER symptoms, should empirical treatment for GERD be used? (2) with gastrointestinal GER symptoms, does treatment for GERD resolve the cough? (3) with or without gastrointestinal GER symptoms, what GER-based therapies should be used and for how long? (4) if GERD is suspected as the cause, what investigations and diagnostic criteria best determine GERD as the cause of the cough?

Published
2019
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23. Clinically Diagnosing Pertussis-associated Cough in Adults and Children

Author

Moore, Abigail, Harnden, Anthony, Grant, Cameron C., Patel, Sheena, Irwin, Richard S., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Bolser, Donald C., Birring, Surinder S., Blackwell, Fiona, Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Gibson, Peter, Gold, Philip, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Lown, Mark, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Nguyen, Huong Q., Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Vertigan, Anne E., and Weinberger, Miles

Abstract

The decision to treat a suspected case of pertussis with antibiotics is usually based on a clinical diagnosis rather than waiting for laboratory confirmation. The current guideline focuses on making the clinical diagnosis of pertussis-associated cough in adults and children.

Published
2019
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24. Adult Outpatients With Acute Cough Due to Suspected Pneumonia or Influenza

Author

Hill, Adam T., Gold, Philip M., El Solh, Ali A., Metlay, Joshua P., Ireland, Belinda, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Nguyen, Huong Q., Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Russell, Richard J., Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Smith, Maeve P., Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Wang, Gang, and Weinberger, Miles

Abstract

Patients commonly present to primary care services with upper and lower respiratory tract infections, and guidelines to help physicians investigate and treat acute cough due to suspected pneumonia and influenza are needed.

Published
2019
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26. Treatment of Interstitial Lung Disease Associated Cough

Author

Birring, Surinder S., Kavanagh, Joanne E., Irwin, Richard S., Keogh, Karina A., Lim, Kaiser G., Ryu, Jay H., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Davenport, Paul, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Harding, Susan M., Gold, Philip, Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Narasimhan, Mangala, Nguyen, Huong Q., Newcombe, Peter, Oppenheimer, John, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Wang, Gang, and Weinberger, Miles

Abstract

Chronic cough in interstitial lung disease (ILD) causes significant impairment in quality of life. Effective treatment approaches are needed for cough associated with ILD.

Published
2018
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27. Chronic Cough Related to Acute Viral Bronchiolitis in Children

Author

Chang, Anne B., Oppenheimer, John J., Rubin, Bruce K., Weinberger, Miles, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Metlay, Joshua P., Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Narasimhan, Mangala, Nguyen, Huong Q., Newcombe, Peter, Oppenheimer, John, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Singh, Sonal, Smith, Maeve P., Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Wang, Gang, and Weinberger, Miles

Abstract

Acute bronchiolitis is common in young children, and some children develop chronic cough after their bronchiolitis. We thus undertook systematic reviews based on key questions (KQs) using the PICO (Population, Intervention, Comparison, Outcome) format. The KQs were: Among children with chronic cough (> 4 weeks) after acute viral bronchiolitis, how effective are the following interventions in improving the resolution of cough?: (1) Antibiotics. If so what type and for how long? (2) Asthma medications (inhaled steroids, beta2agonist, montelukast); and (3) Inhaled osmotic agents like hypertonic saline?

Published
2018
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28. Treating Cough Due to Non-CF and CF Bronchiectasis With Nonpharmacological Airway Clearance

Author

Hill, Adam T., Barker, Alan F., Bolser, Donald C., Davenport, Paul, Ireland, Belinda, Chang, Anne B., Mazzone, Stuart B., and McGarvey, Lorcan

Abstract

In bronchiectasis due to cystic fibrosis (CF) and other causes, airway clearance is one of the mainstays of management. We conducted a systematic review on airway clearance by using non-pharmacological methods as recommended by international guidelines to develop recommendations or suggestions to update the 2006 CHEST guideline on cough.

Published
2018
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29. Cough Due to TB and Other Chronic Infections

Author

Field, Stephen K., Escalante, Patricio, Fisher, Dina A., Ireland, Belinda, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Coté, Andréanne, Cowley, Terrie, Davenport, Paul, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasoitis, Alex, Moore, Abigail, Murad, M. Hassan, Narasimhan, Mangala, Nguyen, Huong Q., Newcombe, Peter, Oppenheimer, John, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Singh, Sonal, Smith, Jaclyn, Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Wang, Gang, Weinberger, Miles, and Weir, Kelly

Abstract

Cough is common in pulmonary TB and other chronic respiratory infections. Identifying features that predict whether pulmonary TB is the cause would help target appropriate individuals for rapid and cost-effective screening, potentially limiting disease progression and preventing transmission to others.

Published
2018
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30. Classification of Cough as a Symptom in Adults and Management Algorithms

Author

Irwin, Richard S., French, Cynthia L., Chang, Anne B., Altman, Kenneth W., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, Molassoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Nguyen, Huong Q., Newcombe, Peter, Oppenheimer, John, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Wang, Gang, and Weinberger, Miles

Abstract

We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful?

Published
2018
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31. Pharmacotherapy for Non-Cystic Fibrosis Bronchiectasis

Author

Henkle, Emily, Aksamit, Timothy R., Barker, Alan F., Curtis, Jeffrey R., Daley, Charles L., Anne Daniels, M. Leigh, DiMango, Angela, Eden, Edward, Fennelly, Kevin, Griffith, David E., Johnson, Margaret, Knowles, Michael R., Leitman, Amy, Leitman, Philip, Malanga, Elisha, Metersky, Mark L., Noone, Peadar G., O'Donnell, Anne E., Olivier, Kenneth N., Prieto, Delia, Salathe, Matthias, Thomashow, Byron, Tino, Gregory, Turino, Gerard, Wisclenny, Susan, and Winthrop, Kevin L.

Abstract

Non-cystic fibrosis bronchiectasis (“bronchiectasis”) is a chronic inflammatory lung disease often associated with nontuberculous mycobacteria (NTM) infection. Very little data exist to guide bronchiectasis management decisions. We sought to describe patterns of inhaled corticosteroid (ICS) and antibiotic therapy in the United States.

Published
2017
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32. Pharmacologic and Nonpharmacologic Treatment for Acute Cough Associated With the Common Cold

Author

Malesker, Mark A., Callahan-Lyon, Priscilla, Ireland, Belinda, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Coté, Andréanne, Cowley, Terrie, Davenport, Paul, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Grant, Cameron, Gibson, Peter, Gold, Philip, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molassoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Newcombe, Peter, Nguyen, Huong Q., Oppenheimer, John, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Smith, Jaclyn, Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Wang, Gang, Weinberger, Miles, and Weir, Kelly

Abstract

Acute cough associated with the common cold (CACC) causes significant impairment in quality of life. Effective treatment approaches are needed for CACC. We conducted a systematic review on the management of CACC to update the recommendations and suggestions of the CHEST 2006 guideline on this topic.

Published
2017
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33. Cough in Ambulatory Immunocompromised Adults

Author

Rosen, Mark J., Ireland, Belinda, Narasimhan, Mangala, French, Cynthia, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Coté, Andréanne, Cowley, Terrie, Davenport, Paul, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Feinstein, Anthony, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Keogh, Karina A., Lai, Kefang, Lim, Kaiser, Mark Madison, J., Malesker, Mark A., Mazzone, Stuart, Molassoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Nguyen, Huong Q., Newcombe, Peter, Oppenheimer, John J., Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Smith, Jaclyn, Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Wang, Gang, Weinberger, Miles, and Weir, Kelly

Abstract

Cough is a common symptom prompting patients to seek medical care. Like patients in the general population, patients with compromised immune systems also seek care for cough. However, it is unclear whether the causes of cough in immunocompromised patients who are deemed unlikely to have a life-threating condition and a normal or unchanged chest radiograph are similar to those in persons with cough and normal immune systems.

Published
2017
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34. High intensity interval exercise is an effective alternative to moderate intensity exercise for improving glucose tolerance and insulin sensitivity in adolescent boys.

Author

Cockcroft, Emma J., Williams, Craig A., Tomlinson, Owen W., Vlachopoulos, Dimitris, Jackman, Sarah R., Armstrong, Neil, and Barker, Alan R.

Abstract

Objectives: High-intensity interval exercise (HIIE) may offer a time efficient means to improve health outcomes compared to moderate-intensity exercise (MIE). This study examined the acute effect of HIIE compared to a work-matched bout of MIE on glucose tolerance, insulin sensitivity (IS), resting fat oxidation and exercise enjoyment in adolescent boys.Design: Within-measures design with counterbalanced experimental conditions.Methods: Nine boys (14.2 ± 0.4 years) completed three conditions on separate days in a counterbalanced order: (1) HIIE; (2) work matched MIE, both on a cycle ergometer; and (3) rest (CON). An oral glucose tolerance test (OGTT) was performed after exercise or rest and the area under curve (AUC) responses for plasma [glucose] and [insulin] were calculated, and IS estimated (Cederholm index). Energy expenditure and fat oxidation were measured following the OGTT using indirect calorimetry. Exercise enjoyment was assessed using the Physical Activity Enjoyment Scale.Results: The incremental AUC (iAUC) for plasma [glucose] was reduced following both MIE (-23.9%, P = 0.013, effect size [ES] = -0.64) and HIIE (-28.9%, P=0.008, ES = -0.84) compared to CON. The iAUC for plasma [insulin] was lower for HIIE (-24.2%, P = 0.021, ES = -0.71) and MIE (-29.1%, P = 0.012, ES = -0.79) compared to CON. IS increased by 11.2% after HIIE (P = 0.03, ES = 0.76) and 8.4% after MIE (P = 0.10, ES = 0.58). There was a trend for an increase in fat oxidation following HIIE (P = 0.097, ES = 0.70). Both HIIE and MIE were rated as equally enjoyable (P > 0.05, ES < 0.01).Conclusion: A single bout of time efficient HIIE is an effective alternative to MIE for improving glucose tolerance and IS in adolescent boys immediately after exercise. [ABSTRACT FROM AUTHOR]

Published
2015
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35. Etiologies of Chronic Cough in Pediatric Cohorts

Author

Chang, Anne B., Oppenheimer, John J., Weinberger, Miles, Grant, Cameron C., Rubin, Bruce K., Irwin, Richard S., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Brightling, hristopher, Callahan-Lyon, Priscilla, Chang, Anne B., Davenport, Paul, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Harding, Susan M., Gibson, Peter, Gold, Philip, Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kavanagh, Joanne, Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Madison, J. Mark, Malesker, Mark A., Mazzone, Stuart, Molassoitis, Alex, Murad, M. Hassan, Narasimhan, Mangala, Nguyen, Huong Q., Newcombe, Peter, Oppenheimer, John, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Weinberger, Miles, and Weir, Kelly

Abstract

There is no published systematic review on the etiologies of chronic cough or the relationship between OSA and chronic cough in children aged ≤ 14 years. We thus undertook a systematic review based on key questions (KQs) using the Population, Intervention, Comparison, Outcome format. The KQs follow: Among children with chronic (> 4 weeks) cough (KQ 1) are the common etiologies different from those in adults? (KQ 2) Are the common etiologies age or setting dependent, or both? (KQ 3) Is OSA a cause of chronic cough in children?

Published
2017
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36. Adult Patients With Bronchiectasis

Author

Aksamit, Timothy R., O’Donnell, Anne E., Barker, Alan, Olivier, Kenneth N., Winthrop, Kevin L., Daniels, M. Leigh Anne, Johnson, Margaret, Eden, Edward, Griffith, David, Knowles, Michael, Metersky, Mark, Salathe, Matthias, Thomashow, Byron, Tino, Gregory, Turino, Gerard, Carretta, Betsy, and Daley, Charles L.

Abstract

We sought to describe the characteristics of adult patients with bronchiectasis enrolled in the US Bronchiectasis Research Registry (BRR).

Published
2017
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37. Symptomatic Treatment of Cough Among Adult Patients With Lung Cancer

Author

Molassiotis, Alex, Smith, Jaclyn A., Mazzone, Peter, Blackhall, Fiona, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Canning, Brendan J., Chang, Anne B., Cowley, Terrie, Davenport, Paul, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Grant, Cameron, Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Malesker, Mark A., Mazzone, Peter, Mazzone, Stuart, Molassiotis, Alex, Murad, M. Hassan, Newcombe, Peter, Nguyen, Huong Q., Oppenheimer, John, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Smith, Jaclyn, Tarlo, Susan M., Turmel, Julie, Vertigan, Anne E., Weinberger, Miles M., and Weir, Kelly

Abstract

Cough among patients with lung cancer is a common but often undertreated symptom. We used a 2015 Cochrane systematic review, among other sources of evidence, to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.

Published
2017
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38. Cough in the Athlete

Author

Boulet, Louis-Philippe, Turmel, Julie, Irwin, Richard S., Altman, Kenneth W., Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Cowley, Terrie, Davenport, Paul, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Feinstein, Anthony, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Malesker, Mark A., Mazzone, Peter, McGarvey, Lorcan, Murad, M. Hassan, Newcombe, Peter, Nguyen, Huong Q., Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Smith, Jaclyn, Tarlo, Susan M., Vertigan, Anne E., Wang, Gang, Weinberger, Miles, and Weir, Kelly

Abstract

Cough is a common symptom experienced by athletes, particularly after exercise. We performed a systematic review to assess the following in this population: (1) the main causes of acute and recurrent cough, either exercise-induced or not, (2) how cough is assessed, and (3) how cough is treated in this population. From the systematic review, suggestions for management were developed.

Published
2017
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39. Chronic Cough Due to Gastroesophageal Reflux in Adults

Author

Kahrilas, Peter J., Altman, Kenneth W., Chang, Anne B., Field, Stephen K., Harding, Susan M., Lane, Andrew P., Lim, Kaiser, McGarvey, Lorcan, Smith, Jaclyn, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Brightling, Christopher, Callahan-Lyon, Priscilla, Canning, Brendan J., Chang, Anne B., Cowley, Terrie, Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Field, Stephen K., Feinstein, Anthony, Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Gould, Michael K., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Murad, M. Hassan, Nguyen, Huong Q., Newcombe, Peter, Oppenheimer, John, Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Smith, Jaclyn, Tarlo, Susan M., Vertigan, Anne E., Wang, Gang, Weinberger, Miles, and Weir, Kelly

Abstract

We updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome.

Published
2016
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40. Accumulating exercise and postprandial health in adolescents.

Author

Bond, Bert, Williams, Craig A., Jackman, Sarah R., Woodward, Adam, Armstrong, Neil, and Barker, Alan R.

Subjects
CARDIOVASCULAR disease treatment, EXERCISE intensity, TRIGLYCERIDES, CALORIC expenditure, EXERCISE physiology, ADOLESCENT health, PHYSICAL activity, HEALTH outcome assessment
Abstract

Purpose To examine the influence of exercise intensity on postprandial health outcomes in adolescents when exercise is accumulated throughout the day. Methods 19 adolescents (9 male, 13.7 ± 0.4 years old) completed three 1-day trials in a randomised order: (1) rest (CON); or four bouts of (2) 2 × 1 min cycling at 90% peak power with 75 s recovery (high-intensity interval exercise; HIIE); or (3) cycling at 90% of the gas exchange threshold (moderate-intensity exercise; MIE), which was work-matched to HIIE. Each bout was separated by 2 hours. Participants consumed a high fat milkshake for breakfast and lunch. Postprandial triacylglycerol (TAG), glucose, systolic blood pressure (SBP) and fat oxidation were assessed throughout the day. Results There was no effect of trial on total area under the curve (TAUC) for TAG ( P = 0.87). TAUC-glucose was lower in HIIE compared to CON ( P = 0.03, ES = 0.42) and MIE ( P = 0.04, ES = 0.41), with no difference between MIE and CON ( P = 0.89, ES = 0.04). Postprandial SBP was lower in HIIE compared to CON ( P = 0.04, ES = 0.50) and MIE ( P = 0.04, ES = 0.40), but not different between MIE and CON ( P = 0.52, ES = 0.11). Resting fat oxidation was increased in HIIE compared to CON ( P = 0.01, ES = 0.74) and MIE ( P = 0.05, ES = 0.51), with no difference between MIE and CON ( P = 0.37, ES = 0.24). Conclusion Neither exercise trial attenuated postprandial lipaemia. However, accumulating brief bouts of HIIE, but not MIE, reduced postprandial plasma glucose and SBP, and increased resting fat oxidation in adolescent boys and girls. The intensity of accumulated exercise may therefore have important implications for health outcomes in youth. [ABSTRACT FROM AUTHOR]

Published
2015
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43. Occupational and Environmental Contributions to Chronic Cough in Adults

Author

Tarlo, Susan M., Altman, Kenneth W., Oppenheimer, John, Lim, Kaiser, Vertigan, Anne, Prezant, David, Irwin, Richard S., Adams, Todd M., Altman, Kenneth W., Azoulay, Elie, Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Chang, Anne B., Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Feinstein, Anthony, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Gould, Michael K., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Keogh, Karina A., Lai, Kefang, Lane, Andrew P., Lim, Kaiser, Malesker, Mark A., Mazzone, Stuart, McGarvey, Lorcan, Molasiotis, Alex, Murad, M. Hassan, Oppenheimer, John, Prezant, David, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Tarlo, Susan M., Vertigan, Anne E., Wang, Gang, Weinberger, Miles, and Weir, Kelly

Abstract

In response to occupational and environmental exposures, cough can be an isolated symptom reflecting exposure to an irritant with little physiological consequence, or it can be a manifestation of more significant disease. This document reviews occupational and environmental contributions to chronic cough in adults, focusing on aspects not previously covered in the 2006 ACCP Cough Guideline or our more recent systematic review, and suggests an approach to investigation of these factors when suspected.

Published
2016
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44. Treatment of Unexplained Chronic Cough

Author

Gibson, Peter, Wang, Gang, McGarvey, Lorcan, Vertigan, Anne E., Altman, Kenneth W., Birring, Surinder S., Adams, Todd M., Altman, Kenneth W., Barker, Alan F., Birring, Surinder S., Blackhall, Fiona, Bolser, Donald C., Boulet, Louis-Philippe, Braman, Sidney S., Brightling, Christopher, Callahan-Lyon, Priscilla, Canning, Brendan J., Chang, Anne B., Coeytaux, Remy, Cowley, Terrie, Davenport, Paul, Diekemper, Rebecca L., Ebihara, Satoru, El Solh, Ali A., Escalante, Patricio, Feinstein, Anthony, Field, Stephen K., Fisher, Dina, French, Cynthia T., Gibson, Peter, Gold, Philip, Gould, Michael K., Grant, Cameron, Harding, Susan M., Harnden, Anthony, Hill, Adam T., Irwin, Richard S., Kahrilas, Peter J., Keogh, Karina A., Lane, Andrew P., Lim, Kaiser, Malesker, Mark A., Mazzone, Peter, Mazzone, Stuart, McCrory, Douglas C., McGarvey, Lorcan, Molasiotis, Alex, Murad, M. Hassan, Newcombe, Peter, Nguyen, Huong Q., Oppenheimer, John, Prezant, David, Pringsheim, Tamara, Restrepo, Marcos I., Rosen, Mark, Rubin, Bruce, Ryu, Jay H., Smith, Jaclyn, Tarlo, Susan M., Vertigan, Anne E., Wang, Gang, Weinberger, Miles, Weir, Kelly, and Wiener, Renda Soylemez

Abstract

Unexplained chronic cough (UCC) causes significant impairments in quality of life. Effective assessment and treatment approaches are needed for UCC.

Published
2016
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45. Aztreonam for inhalation solution in patients with non-cystic fibrosis bronchiectasis (AIR-BX1 and AIR-BX2): two randomised double-blind, placebo-controlled phase 3 trials.

Author

Barker, Alan F, O'Donnell, Anne E, Flume, Patrick, Thompson, Philip J, Ruzi, Jonathan D, de Gracia, Javier, Boersma, Wim G, De Soyza, Anthony, Shao, Lixin, Zhang, Jenny, Haas, Laura, Lewis, Sandra A, Leitzinger, Sheila, Montgomery, A Bruce, McKevitt, Matthew T, Gossage, David, Quittner, Alexandra L, and O'Riordan, Thomas G

Subjects
AZTREONAM, INHALATION administration, BRONCHIECTASIS, PLACEBOS, ANTIBIOTICS, GRAM-negative bacteria, PATIENTS, THERAPEUTICS
Abstract

Summary Background The clinical benefit of inhaled antibiotics in non-cystic fibrosis bronchiectasis has not been established in randomised controlled trials. We aimed to assess safety and efficacy of aztreonam for inhalation solution (AZLI) in patients with non-cystic fibrosis bronchiectasis and Gram-negative bacterial colonisation. Methods AIR-BX1 and AIR-BX2 were two double-blind, multicentre, randomised, placebo-controlled phase 3 trials, which included patients aged 18 years or older who had bronchiectasis and history of positive sputum or bronchoscopic culture for target Gram-negative organisms. Patients were randomly assigned to receive either AZLI or placebo (1:1). Randomisation was done without stratification and the code was generated by a Gilead designee. In both studies, two 4-week courses of AZLI 75 mg or placebo (three-times daily; eFlow nebulizer) were each followed by a 4-week off-treatment period. Primary endpoint was change from baseline Quality of Life-Bronchiectasis Respiratory Symptoms scores (QOL-B-RSS) at 4 weeks. These trials are registered with ClinicalTrials.gov , numbers are NCT01313624 for AIR-BX1 and NCT01314716 for AIR-BX2. Findings We recruited participants from 47 ambulatory clinics for AIR-BX1 and 65 ambulatory clinics for AIR-BX2; studies were done between April 25, 2011, and July 1, 2013. In AIR-BX1, of the 348 patients screened, 134 were randomly assigned to receive AZLI and 132 to receive placebo. In AIR-BX2, of the 404 patients screened, 136 were randomly assigned to receive AZLI and 138 to receive placebo. The difference between AZLI and placebo for adjusted mean change from baseline QOL-B-RSS was not significant at 4 weeks (0·8 [95% CI −3·1 to 4·7], p=0·68) in AIR-BX1, but was significant (4·6 [1·1 to 8·2], p=0·011) in AIR-BX2. The 4·6 point difference in QOL-B-RSS after 4 weeks in AIR-BX2 was not deemed clinically significant. In both studies, treatment-related adverse events were more common in the AZLI group than in the placebo group, as were discontinuations from adverse events. The most commonly reported treatment-emergent adverse events were dyspnea, cough, and increased sputum. Each was more common for AZLI-treated than for placebo-treated patients, but the incidences were more balanced in AIR-BX2. Interpretation AZLI treatment did not provide significant clinical benefit in non-cystic fibrosis bronchiectasis, as measured by QOL-B-RSS, suggesting a continued need for placebo-controlled studies to establish the clinical benefit of inhaled antibiotics in patients with this disorder. Funding Gilead Sciences. [ABSTRACT FROM AUTHOR]

Published
2014
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46. A protocol to determine valid V˙O2max in young cystic fibrosis patients.

Author

Saynor, Zoe L, Barker, Alan R, Oades, Patrick J, and Williams, Craig A

Abstract

Objectives: Measuring aerobic fitness (V˙O2max) via a maximal cardiopulmonary exercise test is an important clinical tool in cystic fibrosis. This study sought to establish: (1) the validity of traditional criteria to verify maximal efforts during a ramp cardiopulmonary exercise test; and (2) whether V˙O2 measured during an exhaustive cardiopulmonary exercise test represents a valid V˙O2max in paediatric patients, using a subsequent exhaustive supramaximal (Smax) exercise test.Design: Cross-sectional.Methods: Fourteen patients (7-18 years; 10 males) completed an exhaustive ramp test to determine V˙O2max. Following 15-min recovery, Smax (110% ramp peak power output) was performed.Results: Ramp test V˙O2peak was significantly higher than V˙O2 documented at traditional endpoint criteria, including a RER of 1.00 (0.99±0.47 L min(-1) vs. 1.83±0.78 L min(-1), p<0.001) and 1.10 (1.36±0.59 L min(-1) vs. 1.83±0.78 L min(-1), p<0.001), despite 100% of patients satisfying these two criteria. Only 23% and 75% of patients satisfied the 95% age-predicted heart rate (HR) maximum and 180 b min(-1) criteria. Whilst mean ramp and Smax V˙O2peak were not significantly different (1.83±0.78 L min(-1) vs. 1.82±0.67 L min(-1); p=0.88), at the individual level Smax elicited a 'meaningful' (>9%) increase in V˙O2peak (range 9.9-38.3%) compared with V˙O2peak from the ramp test in 3 of 14 cases (21.4%).Conclusions: Traditional criteria significantly underestimate V˙O2max in young cystic fibrosis patients. Conversely, Smax can confirm when 'true' V˙O2max is achieved. The use of Smax following cardiopulmonary exercise test represents an appropriate method to measure V˙O2max in young cystic fibrosis patients. [ABSTRACT FROM AUTHOR]

Published
2013
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47. A protocol to determine valid in young cystic fibrosis patients.

Author

Saynor, Zoe L., Barker, Alan R., Oades, Patrick J., and Williams, Craig A.

Abstract

Objectives: Measuring aerobic fitness ( ) via a maximal cardiopulmonary exercise test is an important clinical tool in cystic fibrosis. This study sought to establish: (1) the validity of traditional criteria to verify maximal efforts during a ramp cardiopulmonary exercise test; and (2) whether measured during an exhaustive cardiopulmonary exercise test represents a valid in paediatric patients, using a subsequent exhaustive supramaximal (Smax) exercise test. Design: Cross-sectional. Methods: Fourteen patients (7–18 years; 10 males) completed an exhaustive ramp test to determine . Following 15-min recovery, Smax (110% ramp peak power output) was performed. Results: Ramp test was significantly higher than documented at traditional endpoint criteria, including a RER of 1.00 (0.99±0.47Lmin−1 vs. 1.83±0.78Lmin−1, p <0.001) and 1.10 (1.36±0.59Lmin−1 vs. 1.83±0.78Lmin−1, p <0.001), despite 100% of patients satisfying these two criteria. Only 23% and 75% of patients satisfied the 95% age-predicted heart rate (HR) maximum and 180bmin−1 criteria. Whilst mean ramp and Smax were not significantly different (1.83±0.78Lmin−1 vs. 1.82±0.67Lmin−1; p =0.88), at the individual level Smax elicited a ‘meaningful’ (>9%) increase in (range 9.9–38.3%) compared with from the ramp test in 3 of 14 cases (21.4%). Conclusions: Traditional criteria significantly underestimate in young cystic fibrosis patients. Conversely, Smax can confirm when ‘true’ is achieved. The use of Smax following cardiopulmonary exercise test represents an appropriate method to measure in young cystic fibrosis patients. [ABSTRACT FROM AUTHOR]

Published
2013
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